Advanced energy devices are essential to minimally invasive surgery, and robotic surgery is no exception. Reliable haemostasis, efficient tissue division and the ability to dissect while controlling vessels are fundamental to a successful robotic workflow.
The da Vinci platform has offered advanced energy instruments for years. Ultrasonic devices came first, providing effective tissue dissection and cutting. Advanced bipolar technology followed, combining vessel sealing with tissue division in increasingly versatile instruments.
Intuitive’s energy portfolio has evolved from the original Vessel Sealer to the more refined Vessel Sealer Extend and, since 2019, SynchroSeal. The latter combines advanced bipolar energy with grasping, dissection, sealing and division in a wristed instrument. Unlike a conventional vessel sealer that requires a separate mechanical blade, SynchroSeal uses energy to seal and divide tissue in a single instrument.
Medtronic has now brought its well-established LigaSure technology to the Hugo RAS platform with the LigaSure RAS Maryland Jaw. It seals and divides vessels up to 7 mm, using advanced bipolar energy followed by mechanical cutting. Its Maryland geometry also supports grasping and blunt dissection.
The technology itself is familiar. The more interesting question concerns its robotic implementation, because the first-generation LigaSure RAS Maryland is not wristed.
This matters because wristed articulation is one of the defining advantages of robotic instruments. It allows the surgeon to change the angle of approach at the instrument tip, facilitating dissection and manipulation in confined anatomical spaces. Advanced bipolar instruments such as SynchroSeal demonstrate that vessel sealing and wristed articulation can coexist.
Ultrasonic instruments face different engineering constraints because of the design and mechanical transmission requirements of their active blade. But the LigaSure RAS Maryland uses bipolar energy. So why sacrifice distal articulation?
J Granell. Oct 18, 2026
PS. An articulated second-generation LigaSure RAS Maryland may already be in development. Belyaev et al. reported in 2026 that such an instrument was “in the pipeline”, although it was not yet commercially available at the time of publication. If confirmed, this would address one of the main limitations of the current design.
Belyaev O, Salama H, Fahlbusch T, Uhl W. Configurational Setup for Fully Robotic Distal Pancreatectomy with Splenectomy Using Hugo™ RAS and Ligasure™ RAS Maryland: First Case Report (With Video). J Clin Med. 2026 Mar 22;15(6):2423. doi: 10.3390/jcm15062423.