公开(公告)号：WO2011156548A3

公开(公告)日：2012-01-26

申请号：PCT/US2011039715

申请日：2011-06-09

Applicant: ETHICON ENDO SURGERY INC ,  BECKMAN ANDREW T ,  WHITE BRADLEY E ,  KIMBALL CORY G ,  CUMMINGS JOHN F ,  MIREL AL ,  SCHALL CHRISTOPHER J ,  ALDRIDGE JEFFREY L ,  DIETZ TIMOTHY G ,  WITT DAVID A ,  MOOTOO MARY E ,  HUANG ZHIFAN F ,  BANKS RAYMOND M ,  WIDENHOUSE TAMARA ,  SHELTON FREDERICK E ,  HARRIS JASON L ,  SWAYZE JEFFREY S ,  STULEN FOSTER B ,  MALAVIYA PRASANNA ,  JOHNSON GREGORY W ,  GUERRA PAUL

Inventor： BECKMAN ANDREW T ,  WHITE BRADLEY E ,  KIMBALL CORY G ,  CUMMINGS JOHN F ,  MIREL AL ,  SCHALL CHRISTOPHER J ,  ALDRIDGE JEFFREY L ,  DIETZ TIMOTHY G ,  WITT DAVID A ,  MOOTOO MARY E ,  HUANG ZHIFAN F ,  BANKS RAYMOND M ,  WIDENHOUSE TAMARA ,  SHELTON FREDERICK E ,  HARRIS JASON L ,  SWAYZE JEFFREY S ,  STULEN FOSTER B ,  MALAVIYA PRASANNA ,  JOHNSON GREGORY W ,  GUERRA PAUL

IPC: A61B18/14

CPC classification number: A61B18/1445 ,  A61B17/32 ,  A61B18/1482 ,  A61B2018/00005 ,  A61B2018/00011 ,  A61B2018/00017 ,  A61B2018/00023 ,  A61B2018/00029 ,  A61B2018/00047 ,  A61B2018/00619 ,  A61B2018/0063 ,  A61B2018/1412 ,  A61B2018/1452 ,  A61B2018/1455 ,  A61B2018/1472 ,  A61B2218/002

Abstract: In various embodiments, a surgical instrument is provided that may comprise an end effector for performing a surgical procedure on tissue, for example. The end effector may comprise at least one energy delivery surface and heat dissipation means for dissipating heat from at least a portion of the end effector. For example, in at least one embodiment, the end effector may comprise a first jaw, a second jaw, and a cutting member. The cutting member may comprise a cutting surface and a body, which may define a cavity and at least one opening communicating with the cavity. A fluid may be moved through the cavity to and/or from the opening(s). Additionally, in at least one embodiment, a surgical instrument's end effector may comprise a first jaw, a second jaw, a cutting member, and at least one heat pipe. Various other heat dissipation means are also disclosed.

Abstract translation: 在各种实施例中，提供了可以包括用于在组织上执行外科手术的端部执行器的外科器械。 末端执行器可以包括至少一个能量输送表面和用于从末端执行器的至少一部分散热的散热装置。 例如，在至少一个实施例中，末端执行器可以包括第一钳口，第二钳口和切割构件。 切割构件可以包括切割表面和主体，其可以限定空腔和与空腔连通的至少一个开口。 流体可以通过空腔移动到和/或从开口移动。 另外，在至少一个实施例中，手术器械的末端执行器可以包括第一钳口，第二钳口，切割构件和至少一个热管。 还公开了各种其它散热装置。

公开(公告)号：WO2011130042A2

公开(公告)日：2011-10-20

申请号：PCT/US2011031147

申请日：2011-04-05

Applicant: ETHICON ENDO SURGERY INC ,  FALLER CRAIG N ,  MILLER MATTHEW C ,  VAKHARIA OMAR J ,  LAIRD ROBERT J ,  MONSON GAVIN M ,  HUNT JOHN V ,  TIMM RICHARD W ,  WITT DAVID A ,  HUANG ZHIFAN F ,  DIETZ TIMOTHY G ,  ALDRIDGE JEFFREY L ,  MOOTOO MARY E ,  BANKS RAYMOND M ,  SHELTON FREDERICK E

Inventor： FALLER CRAIG N ,  MILLER MATTHEW C ,  VAKHARIA OMAR J ,  LAIRD ROBERT J ,  MONSON GAVIN M ,  HUNT JOHN V ,  TIMM RICHARD W ,  WITT DAVID A ,  HUANG ZHIFAN F ,  DIETZ TIMOTHY G ,  ALDRIDGE JEFFREY L ,  MOOTOO MARY E ,  BANKS RAYMOND M ,  SHELTON FREDERICK E

IPC: A61B18/14

CPC classification number: A61B18/1445 ,  A61B18/1447 ,  A61B2018/00083 ,  A61B2018/0063 ,  A61B2018/1412 ,  A61B2018/1455 ,  A61B2018/1467

Abstract: Various embodiments are directed to a surgical instrument comprising, a shaft, and an end effector. The shaft may be coupled to the handle and may extend distally along a longitudinal axis. The end effector may be positioned at a distal end of the shaft and may comprise first and second jaw members and a reciprocating member. The first and second jaw members may define first and second longitudinal slots. One or both of the jaw members may be pivotable relative to the other about a pivot point. The reciprocating member may be translatable distally and proximally parallel to the longitudinal axis and through the first and second longitudinal slots. A distal portion of the reciprocating member may define a blade. The instrument may comprise an overtube translatable distally to exert a force on a portions of the first and second jaw members tending to close the first and second jaw members.

Abstract translation: 各种实施例涉及包括轴和端部执行器的外科器械。 轴可以联接到手柄并且可以沿着纵向轴线向远侧延伸。 末端执行器可以定位在轴的远端，并且可以包括第一和第二钳口构件和往复运动构件。 第一和第二钳口构件可以限定第一和第二纵向槽。 一个或两个钳口构件可相对于另一个枢转点枢转。 往复运动构件可以在远侧和近侧平行于纵向轴线并通过第一和第二纵向狭槽平移。 往复运动构件的远侧部分可以限定一个叶片。 该仪器可以包括可以向远端平移的外套管，以在第一和第二钳口构件的一部分上施加力，倾向于关闭第一和第二钳口构件。

公开(公告)号：WO2014150169A8

公开(公告)日：2015-09-24

申请号：PCT/US2014022462

申请日：2014-03-10

Applicant: ETHICON ENDO SURGERY INC

Inventor： MESSERLY JEFFREY D ,  WITT DAVID A ,  STULEN FOSTER B ,  PAPA CHRISTOPHER A ,  BATTAGLIA VINCENT P JR

IPC: A61B17/32

CPC classification number: A61B17/320092

Abstract: An apparatus for operating on tissue comprises a shaft, an acoustic waveguide, and an end effector. The acoustic waveguide extends along the shaft and is configured to transmit ultrasonic vibration. The end effector comprises an ultrasonic blade and a clamp arm. The ultrasonic blade is in acoustic communication with the acoustic waveguide. The clamp arm is pivotable toward the ultrasonic blade. The end effector defines a first longitudinal region and a second longitudinal region. The end effector is configured to clamp tissue between the clamp arm and the ultrasonic blade in the first longitudinal region. The end effector is configured to sever tissue with the ultrasonic blade in the second longitudinal region.

Abstract translation: 用于在组织上操作的装置包括轴，声波导和端部执行器。 声波导沿着轴延伸并被构造成传递超声波振动。 末端执行器包括超声波刀片和夹紧臂。 超声波刀片与声波导管声学连通。 夹臂可以朝向超声波刀片枢转。 末端执行器限定第一纵向区域和第二纵向区域。 端部执行器构造成在第一纵向区域中夹紧夹持臂和超声波叶片之间的组织。 末端执行器构造成在第二纵向区域中用超声波刀片切断组织。

公开(公告)号：WO2012009431A3

公开(公告)日：2012-07-26

申请号：PCT/US2011043844

申请日：2011-07-13

Applicant: ETHICON ENDO SURGERY INC ,  BECKMAN ANDREW T ,  GUERRA PAUL ,  HARRIS JASON L ,  MALAVIYA PRASANNA ,  STULEN FOSTER B ,  SWAYZE JEFFREY S ,  WHITE BRADLEY E ,  TIMM RICHARD W ,  THOMPSON SUZANNE E ,  HUNT JOHN V ,  MONSON GAVIN M ,  VAKHARIA OMAR J ,  LAIRD ROBERT J ,  HUANG ZHIFAN F ,  WOODRUFF SCOTT A ,  PAYNE GWENDOLYN P ,  KORVICK DONNA L ,  ZINGMAN ARON O ,  MOOTOO MARY E ,  ALDRIDGE JEFFREY L ,  DIETZ TIMOTHY G ,  WITT DAVID A ,  NORVELL DAVID K

Inventor： BECKMAN ANDREW T ,  GUERRA PAUL ,  HARRIS JASON L ,  MALAVIYA PRASANNA ,  STULEN FOSTER B ,  SWAYZE JEFFREY S ,  WHITE BRADLEY E ,  TIMM RICHARD W ,  THOMPSON SUZANNE E ,  HUNT JOHN V ,  MONSON GAVIN M ,  VAKHARIA OMAR J ,  LAIRD ROBERT J ,  HUANG ZHIFAN F ,  WOODRUFF SCOTT A ,  PAYNE GWENDOLYN P ,  KORVICK DONNA L ,  ZINGMAN ARON O ,  MOOTOO MARY E ,  ALDRIDGE JEFFREY L ,  DIETZ TIMOTHY G ,  WITT DAVID A ,  NORVELL DAVID K

IPC: A61B17/115 ,  A61B17/00 ,  A61B17/064 ,  A61B17/072 ,  A61B17/11 ,  A61B17/29 ,  A61B18/12 ,  A61B18/14 ,  A61B19/00

CPC classification number: A61B17/07207 ,  A61B17/0644 ,  A61B17/1114 ,  A61B17/115 ,  A61B17/1155 ,  A61B18/1442 ,  A61B18/1445 ,  A61B18/1447 ,  A61B2017/00026 ,  A61B2017/00088 ,  A61B2017/0647 ,  A61B2017/07214 ,  A61B2017/07228 ,  A61B2017/07271 ,  A61B2017/2923 ,  A61B2018/00071 ,  A61B2018/00404 ,  A61B2018/0063 ,  A61B2018/00642 ,  A61B2018/00678 ,  A61B2018/00708 ,  A61B2018/00791 ,  A61B2018/00875 ,  A61B2018/126 ,  A61B2018/145 ,  A61B2018/1455 ,  A61B2090/061

Abstract: An end-effector assembly configured to be attached to a surgical instrument. The end- effector assembly comprises a first portion and a second portion comprising a cavity. At least one of the first portion and the second portion is movable relative to the other jaw. The end- effector assembly comprises a fastening means removably positioned within the cavity and at least one electrode.

Abstract translation: 构造成附接到手术器械的端部执行器组件。 末端执行器组件包括第一部分和包括空腔的第二部分。 第一部分和第二部分中的至少一个相对于另一个颚部是可移动的。 末端执行器组件包括可移除地定位在空腔内的紧固装置和至少一个电极。

公开(公告)号：WO2014150169A2

公开(公告)日：2014-09-25

申请号：PCT/US2014022462

申请日：2014-03-10

Applicant: ETHICON ENDO SURGERY INC

Inventor： MESSERLY JEFFREY D ,  WITT DAVID A ,  STULEN FOSTER B ,  PAPA CHRISTOPHER A ,  BATTAGLIA VINCENT P JR

IPC: A61B17/32

CPC classification number: A61B17/320092

Abstract: An apparatus for operating on tissue comprises a shaft, an acoustic waveguide, and an end effector. The acoustic waveguide extends along the shaft and is configured to transmit ultrasonic vibration. The end effector comprises an ultrasonic blade and a clamp arm. The ultrasonic blade is in acoustic communication with the acoustic waveguide. The clamp arm is pivotable toward the ultrasonic blade. The end effector defines a first longitudinal region and a second longitudinal region. The end effector is configured to clamp tissue between the clamp arm and the ultrasonic blade in the first longitudinal region. The end effector is configured to sever tissue with the ultrasonic blade in the second longitudinal region.

Abstract translation: 用于在组织上操作的设备包括轴，声波导和端部执行器。 声波导沿着轴延伸并且被配置为传输超声波振动。 末端执行器包括超声刀和夹臂。 超声波刀片与声波导声学通信。 夹臂可以朝超声刀转动。 末端执行器限定第一纵向区域和第二纵向区域。 末端执行器构造成在第一纵向区域中将夹持臂与超声刀之间的组织夹紧。 末端执行器构造成用第二纵向区域中的超声刀片切割组织。

公开(公告)号：WO2011156257A3

公开(公告)日：2012-02-02

申请号：PCT/US2011039239

申请日：2011-06-06

Applicant: ETHICON ENDO SURGERY INC ,  DIETZ TIMOTHY G ,  WITT DAVID A ,  ALDRIDGE JEFFREY L ,  HUANG ZHIFAN F ,  MOOTOO MARY E ,  BANKS RAYMOND M ,  STULEN FOSTER B ,  SWAYZE JEFFREY S ,  MALAVIYA PRASANNA ,  JOHNSON GREGORY W ,  HARRIS JASON L ,  GUERRA PAUL ,  NORVELL DAVID K

Inventor： DIETZ TIMOTHY G ,  WITT DAVID A ,  ALDRIDGE JEFFREY L ,  HUANG ZHIFAN F ,  MOOTOO MARY E ,  BANKS RAYMOND M ,  STULEN FOSTER B ,  SWAYZE JEFFREY S ,  MALAVIYA PRASANNA ,  JOHNSON GREGORY W ,  HARRIS JASON L ,  GUERRA PAUL ,  NORVELL DAVID K

IPC: A61B18/14

CPC classification number: A61B18/1445 ,  A61B2018/00065 ,  A61B2018/00083 ,  A61B2018/00642 ,  A61B2018/00702 ,  A61B2018/00755 ,  A61B2018/00791 ,  A61B2018/00982 ,  A61B2018/1455 ,  A61B2090/065 ,  A61B2218/002

Abstract: An electrosurgical surgical instrument that includes an end effector, wherein the end effector can comprise first and second jaws which can be opened and closed in order to capture tissue therebetween. In various embodiments, the first and second jaws can comprise one or more electrodes configured to apply a voltage across the tissue, wherein at least one of the electrodes can comprise i) a conductive material positioned within a non-conductive, or high- resistance, material or ii) a pressure sensitive conductive material, or iii) a plurality of electrodes may each comprise of a positive temperature coefficient material having a different switching temperature or iv) electrodes can be independently and/or sequentially operated. During and/or after energizing the electrodes, a cutting member can be advanced to cut the tissue.

Abstract translation: 一种包括端部执行器的电外科手术器械，其中末端执行器可以包括可以打开和关闭的第一和第二钳口，以便在其间捕获组织。 在各种实施例中，第一和第二钳口可以包括被配置为跨组织施加电压的一个或多个电极，其中至少一个电极可以包括：i）定位在非导电或高电阻内的导电材料， 材料或ii）压敏导电材料，或iii）多个电极可以各自包含具有不同开关温度的正温度系数材料，或iv）电极可以独立地和/或顺序操作。 在电极通电期间和/或之后，切割构件可以前进以切割组织。

公开(公告)号：WO2007143439A2

公开(公告)日：2007-12-13

申请号：PCT/US2007069842

申请日：2007-05-29

Applicant: ETHICON ENDO SURGERY INC ,  FORTSON REGINALD D ,  YOUNG JOSEPH E ,  WITT DAVID A ,  DANNAHER WILLIAM D ,  WEED JOHN A III ,  ADAMS THOMAS A ,  NOSCHANG SARAH A

Inventor： FORTSON REGINALD D ,  YOUNG JOSEPH E ,  WITT DAVID A ,  DANNAHER WILLIAM D ,  WEED JOHN A III ,  ADAMS THOMAS A ,  NOSCHANG SARAH A

IPC: A61B18/18

CPC classification number: A61B17/320068 ,  A61B17/320092 ,  A61B2017/2825 ,  A61B2090/031 ,  A61B2090/033 ,  B25B23/142 ,  G10K11/24

Abstract: An ultrasonic clamp coagulator assembly that is configured to permit selective cutting, coagulation and clamping of tissue during surgical procedures. An elongated portion of the instrument can be configured for endoscopic applications and has an outside diameter of less than 6mm. The construction includes a clamping mechanism, including a clamp arm pivotally mounted at the distal portion of the instrument, which is specifically configured to create a desired level of tissue clamping forces. The clamping mechanism includes a two-piece pad design and pad material that enables the higher tissue clamping forces and a force-limiting mechanism that effectively smoothes out abusive tissue forces.

Abstract translation: 超声波夹具凝固器组件，其构造成允许在外科手术期间选择性地切割，凝结和夹紧组织。 仪器的细长部分可以配置为内窥镜应用，外径小于6mm。 该结构包括夹紧机构，其包括枢转地安装在器械的远端部分处的夹臂，其特别地构造成产生期望水平的组织夹紧力。 夹紧机构包括两件式垫设计和垫材料，其能够实现较高的组织夹紧力，以及有效地平滑出滥用组织力的力限制机构。

公开(公告)号：WO2014149318A3

公开(公告)日：2015-01-08

申请号：PCT/US2014017111

申请日：2014-02-19

Applicant: ETHICON ENDO SURGERY INC

Inventor： WORRELL BARRY C ,  BATROSS JONATHAN T ,  STOKES MICHAEL J ,  WITT DAVID A ,  BOUDREAUX CHAD P ,  NORVELL DAVID K ,  MILLER MATTHEW C ,  DIETZ TIMOTHY G

IPC: A61B18/14 ,  A61B18/00

CPC classification number: A61B18/1445 ,  A61B2018/00345 ,  A61B2018/00589 ,  A61B2018/00601 ,  A61B2018/00607 ,  A61B2018/0063 ,  A61B2018/1455

Abstract: An end effector comprises a first jaw, a second jaw, a firing beam, and a lockout feature. The second jaw pivots relative to the first jaw from an open position to a closed position. The firing beam has a sharp distal end and translates between the first and second jaws. The firing beam translates from a proximal position to a first distal position to pivot the second jaw to the closed position. The end effector applies bipolar RF energy when the firing beam is in the first distal position. The firing beam then translates to a second distal position to sever tissue captured between the first and second jaws. The lockout feature prevents the firing beam from advancing from the first distal position to the second distal position until the lockout feature is actuated.

Abstract translation: 末端执行器包括第一钳口，第二钳口，发射梁和锁定特征。 第二钳口相对于第一钳口从打开位置枢转到关闭位置。 射击梁具有尖锐的远端并且在第一和第二钳口之间平移。 射击射束从近侧位置平移到第一远侧位置，以将第二钳口枢转到关闭位置。 当击发束处于第一远端位置时，末端执行器施加双极RF能量。 射击射束然后平移到第二远侧位置以切断捕获在第一和第二钳口之间的组织。 锁定功能防止起搏梁从第一远端位置前进到第二远端位置，直到锁定特征被致动。

公开(公告)号：WO2013154925A3

公开(公告)日：2014-06-26

申请号：PCT/US2013035370

申请日：2013-04-05

Applicant: ETHICON ENDO SURGERY INC

Inventor： SCHULTE JOHN B ,  PRICE DANIEL W ,  KIRK JEFFERY T ,  VASQUEZ JOSE DOMINGO ,  DIETZ TIMOTHY G ,  SMITH RICHARD C ,  ASHER RYAN M ,  ALDRIDGE JEFFREY L ,  TIMM RICHARD W ,  DAVIS CRAIG T ,  MARCOTTE AMY L ,  WITT DAVID A ,  TELLIO KARALYN R ,  MESSERLY JEFFREY D ,  BERTKE BRIAN D ,  WIENER EITAN T ,  YATES DAVID C ,  GIORDANO JAMES R

IPC: A61B17/32 ,  A61B17/00 ,  A61B18/12 ,  A61F9/007

CPC classification number: A61B17/320068 ,  A61B17/320092 ,  A61B18/1206 ,  A61B2017/00026 ,  A61B2017/0003 ,  A61B2017/00115 ,  A61B2017/00128 ,  A61B2017/00132 ,  A61B2017/00176 ,  A61B2017/00367 ,  F04C2270/041

Abstract: Various forms are directed to a method for operating an ultrasonic surgical instrument. The ultrasonic surgical instrument may be activated by generating a drive signal provided to the ultrasonic drive system to drive the end effector. A plurality of input variables may be applied to a multi-variable model to generate a multi-variable model output, where the multi-variable model output corresponds to an effect of the ultrasonic instrument on tissue. The plurality of input variables may comprise at least one variable describing the drive signal and at least one variable describing a property of the ultrasonic surgical instrument. When the multi-variable model output reaches a threshold value, feedback may be generated indicating a corresponding state of at least one of the ultrasonic surgical instrument and tissue acted upon by the ultrasonic surgical instrument.

Abstract translation: 各种形式涉及用于操作超声外科器械的方法。 可以通过产生提供给超声波驱动系统来驱动末端执行器的驱动信号来激活超声外科器械。 可以将多个输入变量应用于多变量模型以生成多变量模型输出，其中多变量模型输出对应于超声波仪器对组织的影响。 多个输入变量可以包括描述驱动信号的至少一个变量和描述超声外科器械的属性的至少一个变量。 当多变量模型输出达到阈值时，可以产生指示由超声波手术器械作用的超声外科器械和组织中的至少一个的对应状态的反馈。

公开(公告)号：WO2012006306A3

公开(公告)日：2012-08-23

申请号：PCT/US2011043008

申请日：2011-07-06

Applicant: ETHICON ENDO SURGERY INC ,  HUANG ZHIFAN F ,  WITT DAVID A ,  BANKS RAYMOND M ,  DIETZ TIMOTHY G ,  MOOTOO MARY E ,  JOHNSON GREGORY W ,  SWAYZE JEFFREY S ,  HARRIS JASON L ,  STULEN FOSTER B ,  MALAVIYA PRASANNA ,  TIMM RICHARD W ,  HUNT JOHN V ,  THOMPSON SUZANNE E ,  MONSON GAVIN M ,  LAIRD ROBERT J ,  VAKHARIA OMAR J ,  SCHALL CHRISTOPHER J ,  KIMBALL CORY G ,  MIREL AL ,  CUMMINGS JOHN F ,  BECKMAN ANDREW T

Inventor： HUANG ZHIFAN F ,  WITT DAVID A ,  BANKS RAYMOND M ,  DIETZ TIMOTHY G ,  MOOTOO MARY E ,  JOHNSON GREGORY W ,  SWAYZE JEFFREY S ,  HARRIS JASON L ,  STULEN FOSTER B ,  MALAVIYA PRASANNA ,  TIMM RICHARD W ,  HUNT JOHN V ,  THOMPSON SUZANNE E ,  MONSON GAVIN M ,  LAIRD ROBERT J ,  VAKHARIA OMAR J ,  SCHALL CHRISTOPHER J ,  KIMBALL CORY G ,  MIREL AL ,  CUMMINGS JOHN F ,  BECKMAN ANDREW T

IPC: A61B18/14

CPC classification number: A61B18/1445 ,  A61B17/32 ,  A61B2017/003 ,  A61B2017/00309 ,  A61B2017/00323 ,  A61B2017/2902 ,  A61B2017/291 ,  A61B2017/2927 ,  A61B2018/00077 ,  A61B2018/00607 ,  A61B2018/0063 ,  A61B2018/1412 ,  A61B2018/1455 ,  A61B2018/1861 ,  A61B2034/305

Abstract: An electrosurgical instrument can comprise a handle, a shaft, and an end effector, wherein the end effector can be rotatably coupled to the shaft by an articulation joint. The instrument can further comprise a drive member and the articulation joint can comprise flexible support members which can be configured to support the drive member. The instrument can further comprise supply wires electrically coupled to electrodes in the end effector and a wire tensioning device configured to prevent the supply wires from accumulating slack within the articulation joint. The drive member can comprise a plurality of flexible layers wherein some of the layers can be comprised of an electrically insulative material and other layers can be comprised of an electrically conductive material which is in electrical communication with a cutting member in the end effector and/or electrodes positioned within the end effector. A surgical instrument can comprise a handle and an end effector, wherein the end effector can comprise first and second jaws which can be opened and closed in order to capture tissue therebetween. The surgical instrument can further comprise a shaft extending between the handle and the effector and means for articulating the end effector relative to the shaft. The articulating means can comprise a portion of the shaft which is rotatable about a first axis in order to articulate the end effector about a second axis. In at least one embodiment, the shaft can comprise a first portion including a cam and a second portion including a cam follower, wherein the rotation of the second portion and the interaction of the cam and cam follower can cause the second portion to pivot relative to the first portion.

Abstract translation: 电外科器械可以包括手柄，轴和端部执行器，其中末端执行器可以通过铰接接头可旋转地联接到轴。 仪器还可以包括驱动构件，并且铰接接头可以包括可配置成支撑驱动构件的柔性支撑构件。 仪器还可以包括电耦合到末端执行器中的电极的电线，以及配置成防止供电线在铰接接头内累积松弛的电线张紧装置。 驱动构件可以包括多个柔性层，其中一些层可以由电绝缘材料构成，并且其它层可以由与末端执行器中的切割构件电连通的导电材料和/或 位于末端执行器内的电极。 手术器械可以包括手柄和末端执行器，其中末端执行器可以包括可以打开和关闭的第一和第二钳口，以便在其间捕获组织。 外科器械还可以包括在手柄和执行器之间延伸的轴和用于相对于轴铰接端部执行器的装置。 所述铰接装置可以包括所述轴的可围绕第一轴线旋转的部分，以便使所述端部执行器围绕第二轴线铰接。 在至少一个实施例中，轴可以包括包括凸轮的第一部分和包括凸轮从动件的第二部分，其中第二部分的旋转和凸轮和凸轮从动件的相互作用可以使第二部分相对于 第一部分。