BR112018013216B1 - Instrumento cirúrgico com motor separável e circuito de controle de motor - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00039—Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B2017/00075—Motion
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- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00115—Electrical control of surgical instruments with audible or visual output
- A61B2017/00119—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
- A61B2017/00123—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation and automatic shutdown
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- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
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- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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- A61B2017/00734—Aspects not otherwise provided for battery operated
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- A61B2017/2901—Details of shaft
- A61B2017/2902—Details of shaft characterized by features of the actuating rod
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- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
- A61B2090/0808—Indication means for indicating correct assembly of components, e.g. of the surgical apparatus
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
- A61B2090/0809—Indication of cracks or breakages
Abstract
É apresentado um instrumento cirúrgico que inclui um atuador de extremidade, um conjunto de acionamento operacionalmente acoplado ao atuador de extremidade, e um cartucho de motor substituível que inclui uma placa de circuito de controle do motor e um motor. O instrumento cirúrgico inclui adicionalmente uma placa de circuito de controle principal, incluindo um processador e um dispositivo de armazenamento legível por computador que armazena instruções de programa que, quando executadas pelo processador, fazem com que o processador detecte uma falha no cartucho de motor. O instrumento cirúrgico inclui também uma interface incluindo uma porção de interface mecânica configurada para acoplar de modo liberável o motor ao conjunto de acionamento, e uma porção de interface elétrica configurada para acoplar de modo liberável a placa de circuito de controle do motor à placa de circuito de controle principal.
Description
[0001] Este pedido está relacionado aos pedidos de patente US de propriedade comum e depositados simultaneamente sob o n° do documento do procurador END7792USNP/150506 e intitulado "MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE IN POWERED SURGICAL INSTRUMENTS", e sob o n° do documento do procurador END7797USNP/150511 e intitulado "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS", cada um dos quais está aqui incorporado, a título de referência, em sua totalidade.
[0002] A presente invenção se refere a instrumentos cirúrgicos e, em várias disposições, a instrumentos cirúrgicos para grampeamento e corte, e a cartuchos de grampos para uso com os mesmos, que são projetados para grampear e cortar tecido.
[0003] Os recursos dos vários aspectos são apresentados com particularidade nas concretizações em anexo. Entretanto, os vários aspectos no que se refere tanto à organização quanto aos métodos de operação, juntamente com as vantagens dos mesmos, podem ser melhor compreendidos por referência à descrição apresentada a seguir, considerada em conjunto com os desenhos em anexo, da seguinte forma:
[0004] a Figura 1 é uma vista desmontada em perspectiva de um sistema cirúrgico eletromecânico incluindo um instrumento cirúrgico, um adaptador e um atuador de extremidade, de acordo com a presente descrição;
[0005] a Figura 2 é uma vista em perspectiva do instrumento cirúrgico da Figura 1, de acordo com ao menos um aspecto da presente descrição;
[0006] a Figura 3 é uma vista explodida em perspectiva do instrumento cirúrgico da Figura 1, de acordo com ao menos um aspecto da presente descrição;
[0007] a Figura 4 é uma vista em perspectiva de uma bateria do instrumento cirúrgico da Figura 1, de acordo com ao menos um aspecto da presente descrição;
[0008] a Figura 5 é uma vista superior parcialmente desmontada do instrumento cirúrgico da Figura 1, de acordo com ao menos um aspecto da presente descrição;
[0009] a Figura 6 é uma vista frontal em perspectiva do instrumento cirúrgico da Figura 1 com o adaptador separado do mesmo, de acordo com ao menos um aspecto da presente descrição;
[00010] a Figura 7 é uma vista lateral em seção transversal do instrumento cirúrgico da Figura 1, tomada de 7 a 7 da Figura 2, de acordo com ao menos um aspecto da presente descrição;
[00011] a Figura 8 é uma vista superior em seção transversal do instrumento cirúrgico da Figura 1, tomada de 8 a 8 da Figura 2, de acordo com ao menos um aspecto da presente descrição;
[00012] a Figura 9 é uma vista explodida em perspectiva de um atuador de extremidade da Figura 1, de acordo com ao menos um aspecto da presente descrição;
[00013] a Figura 10A é uma vista superior de um membro de travamento, de acordo com ao menos um aspecto da presente descrição;
[00014] a Figura 10B é uma vista em perspectiva do membro de travamento da Figura 10A, de acordo com ao menos um aspecto da presente descrição;
[00015] a Figura 11 é um diagrama esquemático do instrumento cirúrgico da Figura 1, de acordo com ao menos um aspecto da presente descrição;
[00016] a Figura 12 é uma vista em perspectiva, com peças separadas, de um sistema cirúrgico eletromecânico, de acordo com ao menos um aspecto da presente descrição;
[00017] a Figura 13 é uma vista traseira em perspectiva de um conjunto de eixo de acionamento e um instrumento cirúrgico equipado com motor, do sistema cirúrgico eletromecânico da Figura 12, ilustrando uma conexão entre os mesmos, de acordo com ao menos um aspecto da presente descrição;
[00018] a Figura 14 é uma vista em perspectiva, com peças separadas, do conjunto de eixo de acionamento da Figura 13, de acordo com ao menos um aspecto da presente descrição;
[00019] a Figura 15 é uma vista em perspectiva, com peças separadas, de uma caixa de transmissão do conjunto de eixo de acionamento da Figura 13, de acordo com ao menos um aspecto da presente descrição;
[00020] a Figura 16 é uma vista em perspectiva de um primeiro sistema de trem de engrenagem que é apoiado na caixa de transmissão da Figura 15, de acordo com ao menos um aspecto da presente descrição;
[00021] a Figura 17 é uma vista em perspectiva de um segundo sistema de trem de engrenagem que é apoiado na caixa de transmissão da Figura 15, de acordo com ao menos um aspecto da presente descrição;
[00022] a Figura 18 é uma vista em perspectiva de um terceiro eixo de acionamento que é apoiado na caixa de transmissão da Figura 15, de acordo com ao menos um aspecto da presente descrição;
[00023] a Figura 19 é uma vista em perspectiva de um instrumento cirúrgico, de acordo com ao menos um aspecto da presente descrição;
[00024] a Figura 19A é uma vista superior do instrumento cirúrgico da Figura 19, de acordo com ao menos um aspecto da presente descrição;
[00025] a Figura 19B é uma vista explodida parcial do instrumento cirúrgico da Figura 19, de acordo com ao menos um aspecto da presente descrição;
[00026] a Figura 20 é uma vista em perspectiva de um cartucho do motor, de acordo com ao menos um aspecto da presente descrição;
[00027] a Figura 21 é um diagrama de circuito de vários componentes do instrumento cirúrgico da Figura 20, de acordo com ao menos um aspecto da presente descrição;
[00028] a Figura 22 é um diagrama lógico definindo um método para monitoramento da saúde de um cartucho de motor, de acordo com ao menos um aspecto da presente descrição;
[00029] a Figura 23 é um diagrama lógico definindo um que usa um sensor de corrente para monitorar a saúde de um cartucho de motor, de acordo com ao menos um aspecto da presente descrição;
[00030] a Figura 24 é um diagrama lógico definindo um módulo do instrumento cirúrgico da Figura 20, de acordo com ao menos um aspecto da presente descrição; e
[00031] a Figura 25 é um diagrama lógico definindo um módulo do instrumento cirúrgico da Figura 20, de acordo com ao menos um aspecto da presente descrição.
[00032] Antes de explicar com detalhes as várias formas de instrumentos cirúrgicos com motores e circuitos de controle de motor separáveis em detalhes, deve-se observar que as formas ilustrativas não estão limitadas, em termos de aplicação ou uso, aos detalhes de construção e disposição de partes ilustradas nos desenhos e na descrição em anexo. As formas ilustrativas podem ser implementadas ou incorporadas a outras formas, variações e modificações, e podem ser praticadas ou executadas de várias formas. Além disso, exceto onde indicado em contrário, os termos e expressões usados na presente invenção foram escolhidos com o propósito de descrever as formas ilustrativas para a conveniência do leitor e não para o propósito de limitar a mesma.
[00033] Além disso, deve-se entender que um ou mais dentre as formas, as expressões de formas e os exemplos descritos a seguir podem ser combinados com qualquer um ou mais dentre as outras formas, as outras expressões de formas e os outros exemplos descritos a seguir.
[00034] Várias formas são direcionadas a instrumentos cirúrgicos com motores e circuitos de controle de motor separáveis. Em uma forma, instrumentos cirúrgicos com motores e circuitos de controle de motor separáveis podem ser configurados para uso em procedimentos cirúrgicos abertos, mas têm aplicações em outros tipos de cirurgia, como laparoscopia, endoscopia e procedimentos auxiliados por robôs.
[00035] As Figuras 1 a 18 representam vários aspectos de um sistema cirúrgico que é, de modo geral, designado como 10, e está sob a forma de um instrumento eletromecânico portátil equipado com motor, configurado para a fixação seletiva ao mesmo de uma pluralidade de diferentes atuadores de extremidade que são, cada um, configurados para atuação e manipulação pelo instrumento cirúrgico eletromecânico portátil equipado com motor. Os aspectos das Figuras 1 a 18 são revelados na publicação de pedido de patente US n° 2014/0110453, depositada em 23 de outubro de 2012 e intitulada "SURGICAL INSTRUMENT WITH RAPID POST EVENT DETECTION", publicação de pedido de patente US n° 2013/0282052, depositada em 19 de junho de 2013 e intitulada "APPARATUS FOR ENDOSCOPIC PROCEDU- RES", e publicação de pedido de patente US n° 2013/0274722, depositada em 10 de maio de 2013 e intitulada "APPARATUS FOR ENDOSCOPIC PROCEDURES".
[00036] Com referência às Figuras 1 a 3, um instrumento cirúrgico 100 é configurado para conexão seletiva com um adaptador 200 e, por sua vez, o adaptador 200 é configurado para conexão seletiva com um atuador de extremidade ou unidade de carregamento de uso único ou de recarga 300. Conforme ilustrado nas Figuras 1 a 3, o instrumento cirúrgico 100 inclui um compartimento do cabo 102 que tem uma porção inferior do compartimento 104, uma porção intermediária do compartimento 106 que se estende a partir de e/ou é apoiada na porção inferior do compartimento 104 e uma porção superior do compartimento 108 que se estende a partir de e/ou é apoiada na porção intermediária do compartimento 106. A porção intermediária do compartimento 106 e a porção superior do compartimento 108 são separadas em uma meia seção distal 110a que é formada integralmente com, e estendendo-se a partir de, a porção inferior 104, e uma meia seção proximal 110b conectável à meia seção distal 110a por uma pluralidade de prendedores. Quando unidas, as meias seções distal e proximal 110a, 110b definem um compartimento do cabo 102 que tem uma cavidade 102a no seu interior na qual uma placa de circuito 150 e um mecanismo de acionamento 160 estão situados.
[00037] As meias seções distal e proximal 110a e 110b, são divididas ao longo de um plano que atravessa um eixo geométrico longitudinal "X" da porção superior de compartimento 108, conforme visto nas Figuras 2 e 3. O compartimento do cabo 102 inclui uma guarnição 112 que se estende completamente ao redor de uma borda da meia seção distal e/ou da meia seção proximal 110a e 110b e é interposto entre a meia seção distal 110a e a meia seção proximal 110b. A guarnição 112 veda o perímetro da meia seção distal 110a e da meia seção proximal 110b. A guarnição 112 funciona para estabelecer uma vedação hermética entre a meia seção distal 110a e a meia seção proximal 110b, de modo que a placa de circuito 150 e o mecanismo de acionamento 160 sejam protegidos contra procedimentos de esterilização e/ou de limpeza.
[00038] Dessa maneira, a cavidade 102a do compartimento do cabo 102 é vedada ao longo do perímetro da meia seção distal 110a e da meia seção proximal 110b e, ainda assim, é configurada para possibilitar uma montagem mais fácil e mais eficiente da placa de circuito 150 e um mecanismo de acionamento 160 no compartimento do cabo 102.
[00039] A porção intermediária do compartimento 106 do compartimento do cabo 102 fornece um compartimento no qual a placa de circuito 150 está situada. A placa de circuito 150 é configurada para controlar as várias operações do instrumento cirúrgico 100.
[00040] A porção inferior do compartimento 104 do instrumento cirúrgico 100 define uma abertura (não mostrada) formada em uma superfície superior da mesma e que está situada abaixo ou dentro da porção intermediária do compartimento 106. A abertura da porção inferior do compartimento 104 fornece uma passagem através da qual os fios 152 passam para interconectar eletricamente os componentes elétricos (uma bateria 156, conforme ilustrado na Figura 4, uma placa de circuito 154, conforme ilustrado na Figura 3, etc.) situados na porção inferior do compartimento 104 com componentes elétricos (placa de circuito 150, mecanismo de acionamento 160, etc.) situados na porção intermediária do compartimento 106 e/ou na porção superior do compartimento 108.
[00041] O compartimento do cabo 102 inclui uma guarnição 103 disposta dentro da abertura da porção inferior do compartimento 104 (não mostrada) plugando ou vedando, assim, a abertura da porção inferior do compartimento 104 enquanto permite que os fios 152 passem através do mesmo. A guarnição 103 serve para estabelecer uma vedação hermética entre a porção inferior do compartimento 106 e a porção intermediária do compartimento 108 de modo que a placa de circuito 150 e o mecanismo de acionamento 160 sejam protegidos contra procedimentos de esterilização e/ou de limpeza.
[00042] Conforme mostrado, a porção inferior do compartimento 104 do compartimento do cabo 102 fornece um compartimento no qual uma bateria recarregável 156 está situada de modo removível. A bateria 156 é configurada para fornecer energia a qualquer um dos componentes elétricos do instrumento cirúrgico 100. A porção inferior do compartimento 104 define uma cavidade (não mostrada) na qual a bateria 156 é inserida. A porção inferior do compartimento 104 inclui uma porta 105 conectada de maneira articulada à mesma para fechar a cavidade da porção inferior do compartimento 104 e manter a bateria 156 na mesma.
[00043] Com referência às Figuras 3 e 5, a meia seção distal 110a da porção superior do compartimento 108 define um nariz ou porção de conexão 108a. Um cone de nariz 114 é apoiado na porção do nariz 108a da porção superior do compartimento 108. O cone de nariz 114 é fabricado a partir de um material transparente. Um indicador de retroinformação como, por exemplo, um elemento de iluminação 116, está disposto no interior do cone de nariz 114 de modo que o elemento de iluminação 116 seja visível através do mesmo. O elemento de iluminação 116 pode ser uma placa de circuito impresso de diodo emissor de luz (PCB LED). O elemento de iluminação 116 é configurado para iluminar múltiplas cores com um padrão de cores específico sendo associado a um evento isolado exclusivo.
[00044] A porção superior do compartimento 108 do compartimento do cabo 102 fornece um compartimento no qual está situado o meca- nismo de acionamento 160. Conforme ilustrado na Figura 5, o mecanismo de acionamento 160 é configurado para acionar eixos de acionamento e/ou componentes de engrenagem de modo a executar as diversas operações do instrumento cirúrgico 100. Em particular, o mecanismo de acionamento 160 é configurado para acionar eixos de acionamento e/ou componentes de engrenagem para mover seletivamente o conjunto de ferramentas 304 do atuador de extremidade 300 (vide Figuras 1 e 9) em relação à porção do corpo proximal 302 do atuador de extremidade 300, para girar o atuador de extremidade 300 em torno de um eixo geométrico longitudinal "X" (veja a Figura 2) em relação ao compartimento do cabo 102, para mover o conjunto da bigorna 306 em relação ao conjunto de cartucho 308 do atuador de extremidade 300 e/ou para disparar um cartucho de grampeamento e corte dentro do conjunto de cartucho 308 do atuador de extremidade 300.
[00045] O mecanismo de acionamento 160 inclui um conjunto de caixa de câmbio com seletor 162 que está situado imediatamente proximal em relação ao adaptador 200. Proximal ao conjunto de caixa de câmbio com seletor 162 está um módulo de seleção de função 163 que tem um primeiro motor 164 que funciona para mover seletivamente os elementos de engrenagem dentro do conjunto de caixa de câmbio com seletor 162 para engate a um componente de acionamento de entrada 165 que tem um segundo motor 166.
[00046] Conforme ilustrado nas Figuras 1 a 4, e conforme mencionado acima, a meia seção distal 110a da porção superior do compartimento 108 define uma porção de conexão 108a configurada para aceitar um conjunto de acoplamento de acionamento correspondente 210 do adaptador 200.
[00047] Conforme ilustrado nas Figuras 6 a 8, a porção de conexão 108a do instrumento cirúrgico 100 tem uma reentrância cilíndrica 108b que recebe um conjunto de acoplamento de acionamento 210 do adaptador 200 quando o adaptador 200 é acoplado ao instrumento cirúrgico 100. A porção de conexão 108a abriga três conectores de acionamento giratórios 118, 120 e 122.
[00048] Quando o adaptador 200 é acoplado ao instrumento cirúrgico 100, cada um dos conectores de acionamento giratórios 118, 120 e 122 do instrumento cirúrgico 100 se acopla a uma luva do conector giratório correspondente 218, 220 e 222 do adaptador 200, conforme mostrado na Figura 6. Nesse sentido, a interface entre o primeiro conector de acionamento 118 e a primeira luva do conector correspondente 218, a interface entre o segundo conector de acionamento 120 e a segunda luva do conector 220 correspondente e a interface entre o terceiro conector de acionamento 122 e a terceira luva do conector 222 correspondente são encaixadas de modo que a rotação de cada um dos conectores de acionamento 118, 120 e 122 do instrumento cirúrgico 100 cause uma rotação correspondente da luva do conector correspondente 218, 220 e 222 do adaptador 200.
[00049] O acoplamento dos conectores de acionamento 118, 120 e 122 do instrumento cirúrgico 100 com as luvas do conector 218, 220 e 222 do adaptador 200 permite que forças rotacionais sejam transmitidas independentemente através de cada uma das três respectivas interfaces de conector. Os conectores de acionamento 118, 120 e 122 do instrumento cirúrgico 100 são configurados para serem girados independentemente pelo mecanismo de acionamento 160. Nesse semtido, o módulo de seleção de função 163 do mecanismo de acionamento 160 seleciona qual ou quais conectores de acionamento 118, 120 ou 122 do instrumento cirúrgico 100 devem ser acionados pelo componente de acionamento de entrada 165 do mecanismo de acionamento 160.
[00050] Como cada um dos conectores de acionamento 118, 120 e 122 do instrumento cirúrgico 100 tem uma interface encaixada, e/ou substancialmente não giratória, nas respectivas luvas do conector 218, 220 e 222 do adaptador 200, quando o adaptador 200 é acoplado ao instrumento cirúrgico 100, as uma ou mais forças rotacionais são seletivamente transferidas do mecanismo de acionamento 160 do instrumento cirúrgico 100 para o adaptador 200.
[00051] A rotação seletiva dos um ou mais conectores de acionamento 118, 120 e/ou 122 do instrumento cirúrgico 100 permite que o instrumento cirúrgico 100 acione seletivamente diferentes funções do atuador de extremidade 300. A rotação seletiva e independente do primeiro conector de acionamento 118 do instrumento cirúrgico 100 corresponde à abertura e ao fechamento seletivos e independentes do conjunto de ferramentas 304 do atuador de extremidade 300 e ao acionamento de um componente de grampeamento/corte do conjunto de ferramentas 304 do atuador de extremidade 300. Além disso, a rotação seletiva e independente do segundo conector de acionamento 120 do instrumento cirúrgico 100 corresponde à articulação seletiva e independente do conjunto de ferramentas 304 do atuador de extremidade 300 transversal ao eixo geométrico longitudinal "X" (veja a Figura 2). Adicionalmente, a rotação seletiva e independente do terceiro conector de acionamento 122 do instrumento cirúrgico 100 corresponde à rotação seletiva e independente do atuador de extremidade 300 em torno do eixo geométrico longitudinal "X" (veja a Figura 2) em relação ao compartimento do cabo 102 do instrumento cirúrgico 100.
[00052] Conforme mencionado acima e conforme ilustrado nas Figuras 5 e 8, o mecanismo de acionamento 160 inclui um conjunto de caixa de câmbio com seletor 162; e um módulo de seleção de função 163, localizado próximo ao conjunto de caixa de câmbio com seletor 162, que funciona para mover seletivamente os elementos de engrenagem dentro do conjunto de caixa de câmbio com seletor 162 para engate no segundo motor 166. Dessa forma, o mecanismo de acionamento 160 aciona seletivamente um dos conectores de acionamento 118, 120 e 122 do instrumento cirúrgico 100 em um dado momento.
[00053] Conforme ilustrado nas Figuras 1 a 3, o compartimento do cabo 102 sustenta um conjunto de controle 107 em uma superfície distal ou ao lateral da porção intermediária do compartimento 108. O conjunto de controle 107 é um subconjunto mecânico completamente funcional que pode ser montado e testado separadamente do restante do instrumento 100 antes do acoplamento ao mesmo.
[00054] O conjunto de controle 107, em cooperação com a porção intermediária do compartimento 108, sustenta um par de botões de controle acionados através dos dedos 124 e 126 e um par de dispositivos osciladores 128 e 130 dentro de um compartimento 107a. Os botões de controle 124 e 126 são acoplados aos eixos de extensão 125 e 127, respectivamente. Em particular, o conjunto de controle 107 define uma abertura superior 124a, para receber de modo deslizante o eixo de acionamento de extensão 125, e uma abertura inferior 126a para receber de modo deslizante o eixo de acionamento de extensão 127.
[00055] O conjunto de controle 107 e seus componentes (por exemplo, os botões de controle 124 e 126 e os dispositivos oscilantes 128 e 130) podem ser feitos de plásticos ou materiais ou revestimentos de baixo atrito, autolubrificantes e escorregadios, que cobrem os componentes móveis para reduzir as forças de atuação e o desgaste dos principais componentes, para a eliminação de atrito, acionamento suave e consistente, melhor confiabilidade do componente e do conjunto e redução nas folgas para um encaixe mais justo e uma sensação tátil consistente. Isso inclui o uso de materiais plásticos nos coxins, moentes oscilantes, coxins de êmbolo, bolsos de mola, anéis de retenção e componentes deslizantes. A moldagem dos componen- tes em plástico também fornece componentes em formato de rede ou formato de malha com todos esses atributos de desempenho. Os componentes plásticos eliminam a corrosão e as reações anódicas de bimetal sob condições eletrolíticas, como autoclavagem, esterilizações a vapor e limpeza. Os encaixes por pressão com plásticos e materiais escorregadios também eliminam folgas, minimizando a tensão ou as penalidades funcionais nos componentes quando comparadas aos componentes similares de metal.
[00056] Os materiais adequados para a formação dos componentes do conjunto de controle 107 incluem, mas não se limitam a, poliami- nas, sulfetos de polifenileno, poliftalamidas, polifenilsulfonas, cetonas de poliéter, politetrafluoroetilenos e combinações dos mesmos. Esses componentes podem ser usados na presença ou ausência de lubrificantes e podem também incluir aditivos para reduzir o desgaste e forças de atrito.
[00057] Pode ser feita referência a um pedido de patente US n° de série 13/331.047, agora patente US n° 8.968.276, estando a totalidade de seu conteúdo aqui incorporada, a título de referência, para uma discussão detalhada sobre a construção e operação do instrumento cirúrgico 100.
[00058] O instrumento cirúrgico 100 inclui um conjunto de disparo configurado para implantar ou ejetar uma pluralidade de grampos no tecido capturado pelo atuador de extremidade 300. O conjunto de disparo compreende um conjunto de acionamento 360, conforme ilustrado na Figura 9. O conjunto de acionamento 360 inclui uma viga de acionamento flexível 364 que tem uma extremidade distal que é presa a um membro de preensão dinâmico 365 e uma seção de engate proximal 368. A seção de engate 368 inclui uma porção com degraus definindo um ombro 370. Uma extremidade proximal da seção de engate 368 inclui dedos diametralmente opostos que se estendem para dentro 372. Os dedos 372 se engatam a um membro de acionamento oco 374 para prender por fixação o membro de acionamento 374 à extremidade proximal da viga 364. O membro de acionamento 374 define um orifício proximal 376a que recebe um membro de conexão do tubo de acionamento 246 (Figura 1) do adaptador 200 quando o atuador de extremidade 300 é fixado ao acoplamento distal 230 do adaptador 200.
[00059] Quando o conjunto de acionamento 360 é avançado distalmente dentro do conjunto de ferramentas 304, uma viga superior 365a do membro de fixação 365 se move dentro de um canal definido entre a placa da bigorna 312 e a tampa da bigorna 310, e uma viga inferior 365b se move sobre a superfície exterior do suporte 316 para fechar o conjunto de ferramentas 304 e disparar grampos a partir do mesmo.
[00060] A porção proximal do corpo 302 do atuador de extremidade 300 inclui uma bainha ou tubo externo 301 que circunda uma porção superior do compartimento 301a e uma porção inferior do compartimento 301b. As porções do compartimento 301a e 301b encerram um elo de articulação 366 que tem uma extremidade proximal em forma de gancho 366a que se estende a partir de uma extremidade proximal do atuador de extremidade 300. A extremidade proximal em forma de gancho 366a do elo de articulação 366 engata um gancho de acoplamento (não mostrado) do adaptador 200 quando o atuador de extremidade 300 é preso ao compartimento distal 232 do adaptador 200. Quando a barra de acionamento 258 do adaptador 200 é avançada ou retraída, conforme descrito acima, o elo de articulação 366 do atuador de extremidade 300 é avançado ou retraído no interior do atuador de extremidade 300 para girar o conjunto de ferramentas 304 em relação a uma extremidade distal da porção proximal do corpo 302.
[00061] Conforme ilustrado na Figura 9, acima, o conjunto de cartucho 308 do conjunto de ferramentas 304 inclui um cartucho de grampos 305 apoiado no suporte 316. O cartucho pode ser permanentemente instalado no atuador de extremidade 300 ou pode ser disposto de modo a ser removido ou substituído. O cartucho de grampos 305 define uma fenda longitudinal central 305a e três fileiras lineares de fendas de retenção de grampo 305b posicionadas em cada lado da fenda longitudinal 305a. Cada uma das fendas de retenção de grampo 305b recebe um único grampo 307 e uma porção de um propulsor de grampos 309. Durante o funcionamento do instrumento 100, o conjunto de acionamento 360 está em contiguidade com um deslizador de atuação e empurra o deslizador de atuação através do cartucho 305. À medida que o deslizador de atuação se move através do cartucho 305, as cunhas de came do deslizador de atuação engatam sequencialmente os empurradores de grampo 309 para mover os empurradores de grampo 309 verticalmente dentro das fendas de retenção de grampo 305b e ejetam sequencialmente os grampos 307 a partir dos mesmos para a formação contra a placa da bigorna 312.
[00062] O elemento de acionamento oco 374 inclui um mecanismo de travamento 373 que impede um disparo dos atuadores de extremidade previamente disparados 300. O mecanismo de travamento 373 inclui um membro de travamento 371 acoplado de modo pivotante dentro de um orifício distal 376b através de um pino 377, de modo que o membro de travamento 371 seja pivotante em torno do pino 377 em relação ao membro de acionamento 374.
[00063] Com referência às Figuras 10A e 10B, o membro de travamento 371 define um canal 379 formado entre os deslizadores alongados 381 e 383. A manta 385 une uma porção das superfícies superiores dos deslizadores 381 e 383. A manta 385 está configurada e dimensionada para encaixar-se no interior do orifício 376b do elemento de acionamento 374. As saliências horizontais 389 e 391 se estendem a partir de deslizadores 381 e 383, respectivamente. Conforme é melhor mostrado na Figura 9, uma mola 393 está disposta no interior do membro de acionamento 374 e engata a saliência horizontal 389 e/ou a saliência horizontal 391 para inclinar o membro de travamento 371 para baixo.
[00064] Em funcionamento, o membro de travamento 371 é inicialmente disposto em sua posição pré-disparo na extremidade proximal das porções de compartimento 301a e 301b com a saliência horizontal 389 e 391 repousando no topo das projeções 303a e 303b formadas nas paredes laterais da porção de compartimento 301b. Nessa posição, o membro de travamento 371 é mantido para cima e para fora do alinhamento com uma projeção 303c formada na superfície de fundo da porção de compartimento 301b, distal da projeção 303a e 303b, e a manta 385 está em justaposição longitudinal com o ombro 370 definido na viga de acionamento 364. Essa configuração permite que a bigorna 306 seja aberta e reposicionada sobre o tecido a ser grampeado até que o cirurgião esteja satisfeito com a posição sem ativar o membro de travamento 371 para desabilitar o atuador de extremidade descartável 300.
[00065] Mediante o movimento distal da viga de acionamento 364 pelo tubo de acionamento 246, o membro de travamento 371 se desloca para fora das projeções 303a e 303b e é inclinado para ser engatado na porção de compartimento 301b pela mola 393, distal da projeção 303c. O membro de travamento 371 permanece nessa configuração durante o disparo do aparelho.
[00066] Mediante a retração da viga de acionamento 364, após ao menos um disparo parcial, o membro de travamento 371 passa sob as projeções 303a e 303b e se desloca sobre a projeção 303c da porção de compartimento 301b, até que a porção mais distal do membro de travamento 371 seja proximal à projeção 303c. A mola 393 inclina o membro de travamento 371 em alinhamento justaposto com a projeção 303c, desabilitando efetivamente o atuador de extremidade descartável. Se uma tentativa é feita para reativar o aparelho, carregado com o atuador de extremidade existente 300, o membro de travamento 371 entra em contiguidade com a projeção 303c da porção de compartimento 301b e inibe o movimento distal da trava de acionamento 364.
[00067] Uma outra modalidade do instrumento 100 é mostrada na Figura 11. O instrumento 100 inclui o motor 164. O motor 164 pode ser qualquer motor elétrico configurado para atuar uma ou mais unidades (por exemplo, conectores de acionamento giratórios 118, 120 e 122 da Figura 6). O motor 164 é acoplado à bateria 156, que pode ser uma bateria CC, corrente direta, (por exemplo, uma bateria recarregável à base de chumbo, à base de níquel, à base de íons de lítio, bateria, etc.), um transformador CA/CC ou qualquer outra fonte de alimentação adequada para fornecer energia elétrica ao motor 164.
[00068] A bateria 156 e o motor 164 são acoplados a um circuito acionador de motor 404 disposto na placa de circuito 154 que controla a operação do motor 164 incluindo o fluxo de energia elétrica da bateria 156 para o motor 164. O circuito acionador 404 inclui uma pluralidade de sensores 408a e 408b... 408n configurados para medir os estados operacionais do motor 164 e da bateria 156. Os sensores 408a a 408n podem incluir sensores de tensão, sensores de corrente, sensores de temperatura, sensores de pressão, sensores de telemetria, sensores ópticos e combinações dos mesmos. Os sensores 408a a 408n podem medir tensão, corrente e outras propriedades elétricas da energia elétrica fornecida pela bateria 156. Os sensores 408a a 408n podem também medir a velocidade de rotação como revoluções por minuto (RPM), torque, temperatura, drenagem de corrente e outras propriedades operacionais do motor 164. RPM pode ser determinada mediante a medição da rotação do motor 164. A posição de vários eixos de acionamento (por exemplo, conectores de acionamento giratórios 118, 120 e 122 da Figura 6) pode ser determinada pelo uso de vários sensores lineares dispostos sobre ou próximos aos eixos de acionamento ou extrapolados a partir das medições de RPM. Em aspectos, o torque pode ser calculado com base na drenagem de corrente regulada do motor 164 a uma RPM constante. Em aspectos adicionais, o circuito acionador 404 e/ou o controlador 406 podem medir o tempo e processar os valores descritos acima como uma função do mesmo, incluindo a integração e/ou a diferenciação, por exemplo, para determinar a taxa de alteração dos valores medidos e similares.
[00069] O circuito acionador 404 também é acoplado a um controlador 406, que pode ser qualquer circuito de controle lógico adequado adaptado para executar os cálculos e/ou operar de acordo com um conjunto de instruções. O controlador 406 pode incluir uma unidade de processamento central operacionalmente conectada a uma memória que pode incluir memória do tipo transitório (por exemplo, RAM) e/ou memória do tipo não transitório (por exemplo, mídia flash, mídia de disco, etc.). O controlador 406 inclui uma pluralidade de entradas e saídas para fazer interface com o circuito acionador 404. Em particular, o controlador 406 recebe sinais de sensor medidos a partir do circuito acionador 404 em relação ao estado operacional do motor 164 e à bateria 156 e, por sua vez, emite sinais de controle para o circuito acionador 404 para controlar a operação do motor 164 com base nas leituras de sensor e instruções de algoritmo específicas. O controlador 406 é também configurado para aceitar uma pluralidade de entradas de usuário a partir de uma interface de usuário (por exemplo, chaves, botões, tela sensível ao toque etc., do conjunto de controle 107 acoplado ao controlador 406). Um cartão ou de memória removível ou chip pode ser fornecido ou os dados podem ser baixados sem fio.
[00070] Com referência às Figuras 12 a 18, um sistema cirúrgico 10’ é mostrado. O sistema cirúrgico 10’ é similar, em muitos aspectos, ao instrumento cirúrgico 10. Por exemplo, o sistema cirúrgico 10’ inclui o instrumento cirúrgico 100. A porção superior do compartimento 108 do compartimento do instrumento 102 define um nariz ou porção de conexão 108a configurada para aceitar um conjunto de acoplamento do eixo de acionamento correspondente 514 de um compartimento de transmissão 512 de um conjunto de eixo de acionamento 500 que é similar em muitos aspectos ao conjunto de eixo de acionamento 200.
[00071] O conjunto de eixo de acionamento 500 tem um conjunto transmissor de força para interconectar o ao menos um membro de acionamento do instrumento cirúrgico a ao menos um membro de recepção de rotação do atuador de extremidade. O conjunto de transmissão de força tem uma primeira extremidade que é conectável a ao menos um membro de acionamento giratório e uma segunda extremidade que é conectável a ao menos um membro de recepção de rotação do atuador de extremidade. Quando o conjunto de eixo de acionamento 500 é acoplado ao instrumento cirúrgico 100, cada um dos membros de acionamento giratórios ou conectores 118, 120 e 122 do instrumento cirúrgico 100 se acopla a uma luva do conector giratório correspondente 518, 520 e 522 do conjunto de eixo de acionamento 500 (vide Figuras 13 e 15). Nesse sentido, a interface entre o primeiro membro de acionamento ou conector 118 e a primeira luva de conector 518 correspondente, a interface entre o segundo membro de acionamento ou conector 120 e a segunda luva de conector 520 correspondente e a interface entre o terceiro membro de acionamento ou conector 122 e a terceira luva de conector 522 correspondente são encaixadas de modo que a rotação de cada um dos membros de acionamento ou conectores 118, 120 e 122 do instrumento cirúrgico 100 cause uma rotação correspondente da luva do conector correspondente 518, 520 e 522 do conjunto de eixo de acionamento 500.
[00072] A rotação seletiva dos um ou mais membros de acionamento ou conectores 118, 120 e/ou 122 do instrumento cirúrgico 100 possibilita que o instrumento cirúrgico 100 acione seletivamente diferentes funções de um atuador de extremidade 400.
[00073] Com referência às Figuras 12 e 14, o conjunto de eixo de acionamento 500 inclui um corpo tubular externo alongado, substancialmente rígido 510 que tem uma extremidade proximal 510a e uma extremidade distal 510b e uma caixa de transmissão 212 conectada à extremidade proximal 210a do corpo tubular 510 e é configurado para conexão seletiva ao instrumento cirúrgico 100. Além disso, o conjunto de eixo de acionamento 500 inclui, ainda, um conjunto de pescoço de articulação 530 conectado à extremidade distal 510b da porção de corpo alongado 510.
[00074] A caixa de transmissão 512 é configurada para alojar um par de sistemas de trem engrenagem em seu interior para variar uma velocidade/força de rotação (por exemplo, aumentar ou diminuir) do primeiro, segundo e/ou terceiro membros de acionamento giratórios ou conectores 118, 120 e/ou 122 do instrumento cirúrgico 100, antes da transmissão dessa velocidade/força rotacional para o atuador de extremidade 501. Conforme visto na Figura 15, a caixa de transmissão 512 e o conjunto de acoplamento do eixo de acionamento 514 girato- riamente apoiam um primeiro eixo de acionamento proximal ou de entrada 524a, um segundo eixo de acionamento proximal ou de entrada 526a e um terceiro eixo de acionamento 528.
[00075] O conjunto de acoplamento de acionamento do eixo de acionamento 514 inclui um primeiro, um segundo e um terceiro ele- mentos de inclinação 518a, 520a e 522a dispostos distalmente das respectivas primeira, segunda e terceira luvas do conector 518, 520 e 522. Cada um dos elementos de inclinação 518a, 520a e 522a está disposto em torno do respectivo primeiro eixo de acionamento proximal 524a, do segundo eixo de acionamento proximal 526a e do terceiro eixo de acionamento 228. Os elementos de inclinação 518a, 520a e 522a agem sobre as respectivas luvas do conector 518, 520 e 522 para ajudar a manter as luvas do conector 218, 220 e 222 engatadas à extremidade distal dos respectivos membros de acionamento giratórios ou conectores 118, 120 e 122 do instrumento cirúrgico 100 quando o conjunto de eixo de acionamento 500 está conectado ao instrumento cirúrgico 100.
[00076] O conjunto de eixo de acionamento 500 inclui um primeiro e um segundo sistemas de trem de engrenagem 540, 550, respectivamente, dispostos dentro da caixa de transmissão 512 e do corpo tubular 510 e do conjunto de acoplamento adjacente 514. Conforme mencionado acima, cada sistema de trem de engrenagem 540 e 550 é configurado e adaptado para variar uma velocidade/força de rotação (por exemplo, aumentar ou diminuir) do primeiro e do segundo conectores de acionamento giratórios 118 e 120 do instrumento cirúrgico 100 antes da transmissão dessa velocidade/força rotacional para o atuador de extremidade 501.
[00077] Conforme ilustrado nas Figuras 15 e 16, o primeiro sistema de trem de engrenagem 540 inclui um primeiro eixo de acionamento de entrada 524a e uma primeira roda dentada do eixo de acionamento de entrada 542a encaixada no primeiro eixo de acionamento de entrada 524a. O primeiro sistema de trem de engrenagem 540 inclui também um primeiro eixo de transmissão 544 giratoriamente apoiado na caixa de transmissão 512, uma primeira roda dentada de transmissão de entrada 544a encaixada no primeiro eixo de transmissão 544 e engatada na primeira roda dentada do eixo de acionamento de entrada 542a e uma primeira roda dentada de transmissão de saída 544b encaixada no primeiro eixo de transmissão 544. O primeiro sistema de trem de engrenagem 540 inclui, ainda, um primeiro eixo de acionamento de saída 546a giratoriamente apoiado na caixa de transmissão 512 e no corpo tubular 510, e uma primeira roda dentada do eixo de acionamento de saída 546b encaixada no primeiro eixo de acionamento de saída 546a e engatada na primeira roda dentada de transmissão de saída 544b.
[00078] Em ao menos um exemplo, a primeira roda dentada do eixo de acionamento de entrada 542a inclui 10 dentes; a primeira roda dentada de transmissão de entrada 544a inclui 18 dentes; a primeira roda dentada de transmissão de saída 544b inclui 13 dentes; e a primeira roda dentada do eixo de acionamento de saída 546b inclui 15 dentes. De acordo com a configuração, uma rotação de entrada do primeiro eixo de acionamento de entrada 524a é convertida em uma rotação de saída do primeiro eixo de acionamento de saída 546a em uma razão de 1:2,08.
[00079] Em funcionamento, à medida que a primeira roda dentada do eixo de acionamento de entrada 542a é girada, devido a uma rotação da primeira luva do conector 558 e do primeiro eixo de acionamento de entrada 524a, como resultado da rotação do primeiro respectivo conector de acionamento 118 do instrumento cirúrgico 100, a primeira roda dentada do eixo de acionamento de entrada 542a engata na primeira roda dentada de transmissão de entrada 544a, fazendo girar a primeira roda dentada de transmissão de entrada 544a. À medida que a primeira roda dentada de transmissão de entrada 544a gira, o primeiro eixo de transmissão 544 é girado e, dessa forma, faz girar a primeira roda dentada do eixo de acionamento de saída 546b, que está encaixada no primeiro eixo de transmissão 544. À medida que a primeira roda dentada do eixo de acionamento de saída 546b gira, uma vez que a primeira roda dentada do eixo de acionamento de saída 546b é engatada na mesma, a primeira roda dentada do eixo de acionamento de saída 546b também gira. À medida que a primeira roda dentada do eixo de acionamento de saída 546b gira, uma vez que a primeira roda dentada do eixo de acionamento de saída 546b é encaixada no primeiro eixo de acionamento de saída 546a, o primeiro eixo de acionamento de saída 546a gira.
[00080] O conjunto de eixo de acionamento 500, incluindo o primeiro sistema de engrenagem 540, funciona para transmitir forças operacionais do instrumento cirúrgico 100 para o atuador de extremidade 501 de modo a operar, acionar e/ou disparar o atuador de extremidade 501.
[00081] Conforme ilustrado nas Figuras 15 e 17, o segundo sistema de trem de engrenagem 550 inclui um segundo eixo de acionamento de entrada 526a e uma segunda roda dentada do eixo de acionamento de entrada 552a, encaixada no segundo eixo de acionamento de entrada 526a. O segundo sistema de trem de engrenagem 550 inclui, também, um primeiro eixo de transmissão 554, giratoriamente apoiado na caixa de transmissão 512, uma primeira roda dentada de transmissão de entrada 554a que é encaixada no primeiro de eixo de transmissão 554 e engatada na segunda roda dentada do eixo de acionamento de entrada 552a, e uma primeira roda dentada de transmissão de saída 554b é encaixada no primeiro eixo de transmissão 554.
[00082] O segundo sistema de trem de engrenagem 550 inclui adicionalmente um segundo eixo de transmissão 556 giratoriamente apoiado na caixa de transmissão 512, uma segunda roda dentada de transmissão de entrada 556a encaixada no segundo eixo de transmissão 556 e engatada na primeira roda dentada de transmissão de saída 554b que é encaixada no primeiro eixo de transmissão 554, e uma segunda roda dentada de transmissão de saída 556b encaixada no segundo eixo de transmissão 556.
[00083] O segundo sistema de trem de engrenagem 550 inclui adicionalmente um segundo eixo de acionamento de saída 558a giratoriamente apoiado na caixa de transmissão 512 e no corpo tubular 510, e uma segunda roda dentada do eixo de acionamento de saída 558b encaixada no segundo eixo de acionamento de saída 558a e engatada na segunda roda dentada de transmissão de saída 556b.
[00084] Em ao menos um exemplo, a segunda roda dentada do eixo de acionamento de entrada 552a inclui 10 dentes; a primeira roda dentada de transmissão de entrada 554a inclui 20 dentes; a primeira roda dentada de transmissão de saída 554b inclui 10 dentes; a segunda roda dentada de transmissão de entrada 556a inclui 20 dentes; a segunda roda dentada de transmissão de saída 556b inclui 10 dentes; e a segunda roda dentada do eixo de acionamento de saída 558b inclui 15 dentes. Conforme configurado, uma rotação de entrada do segundo eixo de acionamento de entrada 526a é convertida em uma rotação de saída do segundo eixo de acionamento de saída 558a em uma razão de 1:6.
[00085] Em funcionamento, à medida que a segunda roda dentada do eixo de acionamento de entrada 552a é girada, devido a uma rotação da segunda luva do conector 560 e do segundo eixo de acionamento de entrada 526a, como resultado da rotação do segundo respectivo conector de acionamento 120 do instrumento cirúrgico 100, a segunda roda dentada do eixo de acionamento de entrada 552a engata na primeira roda dentada de transmissão de entrada 554a fazendo com que a primeira roda dentada de transmissão de entrada 554a gire. À medida que a primeira roda dentada de transmissão de entrada 554a gira, o primeiro eixo de transmissão 554 é girado e, dessa forma, faz girar a primeira roda dentada de transmissão de saída 554b, que é encaixada no primeiro eixo de transmissão 554. À medida que a primeira roda dentada de transmissão de saída 554b gira, uma vez que a segunda roda dentada de transmissão de entrada 556a é engatada na mesma, a segunda roda dentada de transmissão de entrada 556a também é girada. À medida que a segunda roda dentada de transmissão de entrada 556a gira, o segundo eixo de transmissão 256 é girado e, dessa forma, faz girar a segunda roda dentada de transmissão de saída 256b, que está encaixada no segundo eixo de transmissão 556. À medida que a segunda roda dentada de transmissão de saída 556b gira, uma vez que a segunda roda dentada do eixo de acionamento de saída 558b é engatada na mesma, uma segunda roda dentada do eixo de acionamento de saída 558b é girada. À medida que a segunda roda dentada do eixo de acionamento de saída 558b gira, uma vez que a segunda roda dentada do eixo de acionamento de saída 558b é encaixada no segundo eixo de acionamento de saída 558a, o segundo eixo de acionamento de saída 558a é girado.
[00086] O conjunto de eixo de acionamento 500, incluindo o segundo sistema de trem de engrenagem 550, funciona para transmitir forças operacionais do instrumento cirúrgico 100 para o atuador de extremidade 501 de modo a girar o conjunto de eixo de acionamento 500 e/ou o atuador de extremidade 501 em relação ao instrumento cirúrgico 100.
[00087] Conforme ilustrado nas Figuras 15 e 18, a caixa de transmissão 512 e o conjunto de acoplamento do eixo de acionamento 514 giratoriamente apoiam um terceiro eixo de acionamento 528. O terceiro eixo de acionamento 528 inclui uma extremidade proximal 528a configurada para apoiar a terceira luva do conector 522 e uma extremidade distal 528b que se estende para, e operacionalmente conectada a, um conjunto de articulação 570.
[00088] Conforme ilustrado na Figura 14, o corpo tubular externo alongado 510 do conjunto de eixo de acionamento 500 inclui uma primeira meia seção 511a e uma segunda meia seção 511b definindo, ao menos, três canais que se estendem longitudinalmente através do corpo tubular externo 510 quando as meias seções 511a e 511b são encaixadas uma na outra. Os canais são configurados e dimensionados para receber e apoiar, de modo giratório, o primeiro eixo de acionamento de saída 546a, o segundo eixo de acionamento de saída 558a e o terceiro eixo de acionamento 528, à medida que o primeiro eixo de acionamento de saída 546a, o segundo eixo de acionamento de saída 558a e o terceiro eixo de acionamento 528 se estendem a partir da caixa de transmissão 512 para o conjunto de pescoço de articulação 530. Cada um dentre o primeiro eixo de acionamento de saída 546a, o segundo eixo de acionamento de saída 558a e o terceiro eixo de acionamento 528 são alongados e suficientemente rígidos para transmitir forças rotacionais da caixa de transmissão 520 para o conjunto de pescoço de articulação 530.
[00089] Com referência à Figura 14, o conjunto de eixo de acionamento 500 inclui, ainda, um conjunto de pescoço de articulação 530. O conjunto de pescoço de articulação 530 inclui uma carcaça de pescoço proximal 532, uma pluralidade de elos 534 conectados e estendendo- se, em série, a partir da carcaça de pescoço proximal 532; e uma carcaça de pescoço distal 536 conectada, e se estendendo, a partir de um elo mais distal da pluralidade de elos 534. Considera-se que, em qualquer um dos aspectos aqui revelados, o conjunto de eixo de acionamento pode ter um único elo ou elemento de pivô para possibilitar a articulação do atuador de extremidade. Considera-se que, em qualquer um dos aspectos apresentados na presente invenção, a carcaça de pescoço distal pode ser incorporada ao elo mais distal.
[00090] A totalidade das revelações de:
[00091] Publicação de Pedido de Patente US n° 2014/0110453, depositada em 23 de outubro de 2012 e intitulada "SURGICAL INSTRUMENT WITH RAPID POST EVENT DETECTION";
[00092] Publicação de Pedido de Patente US n° 2013/0282052, depositada em 19 de junho de 2013 e intitulada "APPARATUS FOR ENDOSCOPIC PROCEDURES"; e
[00093] Publicação de Pedido de Patente US n° 2013/0274722, depositada em 10 de maio de 2013 e intitulada "APPARATUS FOR ENDOSCOPIC PROCEDURES", estão aqui incorporadas, por referência.
[00094] Com referência às Figuras 19 a 19B, um instrumento cirúrgico 10 é mostrado. O instrumento cirúrgico 10 é similar, em muitos aspectos, ao instrumento cirúrgico 100. Por exemplo, o instrumento cirúrgico 10 é configurado para conexão seletiva com o atuador de extremidade ou a unidade de carregamento de uso único ou recarregável 300 através do adaptador 200. Além disso, o instrumento cirúrgico 10 inclui o compartimento do cabo 102 que inclui uma porção inferior do compartimento 104, uma porção intermediária do compartimento 106 e uma porção superior do compartimento 108. Além disso, o instrumento cirúrgico 10 inclui adicionalmente um cartucho de motor substituível 12, conforme ilustrado na Figura 20. O cartucho de motor 12 é separavelmente acoplável ao instrumento cirúrgico 10. Uma porta de acesso do motor 13 (Figura 19) pode ser aberta para se obter acesso ao cartucho de motor 12. Uma vez aberta a porta de acesso do motor 13, o cartucho de motor 12 pode ser removido e substituído por outro cartucho de motor.
[00095] Conforme descrito com mais detalhes abaixo, o instrumento cirúrgico 10 é configurado para detectar um cartucho de motor danificado 12 e, em certos exemplos, instruir um operador do instrumento cirúrgico 10 a substituir o cartucho de motor danificado 12 por um cartucho de motor não danificado 12. A capacidade de substituir um cartucho de motor 12 é bastante útil pelo menos porque possibilita uma capacidade de reparo aprimorada, uma vez que um cartucho de motor danificado 12 pode ser prontamente substituído por um cartucho de motor não danificado 12. Na ausência da capacidade de substituir um cartucho de motor danificado 12, o instrumento cirúrgico 10 pode ser tornado inoperante mesmo que a maioria dos componentes do instrumento cirúrgico 10 esteja em boas condições de operação. A capacidade de substituir um cartucho de motor 12 também é útil para possibilitar a modularidade em novos designs de produto e simplificar a instalação de atualizações de hardware como parte das melhorias no ciclo de vida. Por exemplo, um cartucho de motor de primeira geração pode ser prontamente substituído por um cartucho de motor de segunda geração atualizado. Os cartuchos de motor também podem ser trocados entre instrumentos cirúrgicos que usam o mesmo tipo de cartucho de motor, por exemplo.
[00096] O cartucho de motor 12 compreende uma carcaça 14 que inclui componentes de alta corrente do instrumento cirúrgico 10 como, por exemplo, pelo menos um motor 16 e pelo menos uma placa de circuito de motor 18. Como os componentes de alta corrente do instrumento cirúrgico 10 são mais suscetíveis a danos que os componentes de baixa corrente, como uma placa de circuito de controle principal 19 e vários sistemas de retroinformação, é desejável poder substituir prontamente os componentes de alta corrente substituindo-se o cartucho de motor 12.
[00097] Conforme ilustrado na Figura 21, o cartucho de motor 12 é acoplado de modo liberável ao instrumento cirúrgico 10. Uma interface 21 entre o cartucho de motor 12 e o instrumento cirúrgico 10 compreende um componente mecânico representado pelos conectores mecânicos 22, 23, 24 e 25, e um componente de transmissão de energia/comunicação representado pelos conectores elétricos 26, 28, 30 e 32. Em ao menos um exemplo, a placa de circuito de controle principal 19 compreende um receptor 53 que pode estar sob a forma de um soquete, conforme ilustrado na Figura 19B. O receptor 53 pode ser configurado para receber os conectores 28 e 32, por exemplo, para acoplar eletricamente a placa de circuito de controle principal 19 às placas de circuito 18 e 18’. Em certos exemplos, a interface 21 pode compreender uma ou mais chaves que podem ser ativadas após o engate de acoplamento do cartucho de motor 12 e do instrumento cirúrgico 10. Vários conectores adequados são descritos na publicação de pedido de patente US n° 2014/0305990, depositada em 16 de abril de 2013 e intitulada "DRIVE SYSTEM DECOUPLING ARRANGE-MENT FOR A SURGICAL INSTRUMENT", que está aqui incorporada a título de referência, em sua totalidade.
[00098] No aspecto ilustrado na Figura 21, o cartucho de motor 12 inclui dois motores 16 e 16’ que são controlados por placas de circuito de controle de motor separadas 18 e 18’. Alternativamente, os motores 16 e 16’ podem ser controlados por uma placa de circuito de controle de motor. Em certos exemplos, dois ou mais cartuchos de motor separados podem ser usados com o instrumento cirúrgico 10, sendo que cada cartucho de motor inclui pelo menos um motor e pelo menos uma placa de circuito de controle de motor para controlar o pelo menos um motor, por exemplo. Por uma questão de brevidade, a discussão a seguir se concentrará no motor 16 e na placa de circuito de controle 18; entretanto, a discussão a seguir também se aplica ao motor 16’ e à placa de circuito de controle 18’.
[00099] O motor 16 pode ser qualquer motor elétrico configurado para atuar uma ou mais unidades (por exemplo, o conector de acionamento giratório 24 da Figura 19B). O motor 16 é alimentado por uma fonte de alimentação 34 no instrumento cirúrgico 10. A energia elétrica é transmitida ao motor 16 por meio da interface 21. A fonte de alimentação 34 pode ser uma bateria de CC (por exemplo, uma bateria recarregável à base de chumbo, à base de níquel, à base de íons de lítio, bateria, etc.), um transformador de CA/CC ou qualquer outra fonte de alimentação adequada para fornecer energia elétrica ao motor 16. Quando o cartucho de motor 12 é acoplado ao instrumento cirúrgico 10, a fonte de alimentação 34 e o motor 16 são acoplados ao circuito de controle do motor 18 que controla a operação do motor 16, incluindo o fluxo de energia elétrica da fonte de alimentação 34 para o motor 16.
[000100] Com referência à Figura 21, a placa de circuito de controle principal 19 inclui um microcontrolador 20 ("controlador"). Em certos exemplos, o controlador 20 pode incluir um microprocessador 36 ("processador") e uma ou mais mídias legíveis por computador ou unidades de memória 38 ("memória"). Em certos exemplos, a memória 38 pode armazenar várias instruções de programa que, quando executadas, podem fazer com que o processador 36 execute uma pluralidade de funções e/ou cálculos aqui descritos. A fonte de alimentação 34 pode ser configurada para fornecer energia ao controlador 20 e/ou outros componentes da placa de circuito de controle principal 19, por exemplo.
[000101] O controlador 20 e/ou outros controladores da presente descrição podem ser implementados usando elementos de hardware integrados e/ou distintos, elementos de software e/ou uma combinação de ambos. Exemplos de elementos de hardware integrados podem incluir processadores, microprocessadores, microcontroladores, circuitos integrados, ASICs, PLDs, DSPs, FPGAs, portas lógicas, registros, dispositivos de semicondutor, circuitos integrados, microcircuitos, chipsets, microcontroladores, SoC e/ou SiP. Exemplos de elementos de hardware distintos podem incluir circuitos e/ou elementos de circuito, como portas lógicas, transistores de efeito de campo, transistores bipolares, resistores, capacitores, indutores e/ou relés. Em certas modalidades, o controlador 20 pode incluir um circuito híbrido que compreende elementos ou componentes de circuitos integrados e isolados em um ou mais substratos, por exemplo.
[000102] Em certos exemplos, o controlador 20 e/ou outros controladores da presente descrição podem ser um LM 4F230H5QR, disponível junto à Texas Instruments, por exemplo. Em certas instâncias, o LM4F230H5QR da Texas Instruments é um núcleo processador ARM Cortex-M4F que compreende uma memória integrada do tipo flash de ciclo único de 256 KB, ou outra memória não volátil, até 40 MHz, um buffer de pré-busca para otimizar o desempenho acima de 40 MHz, uma SRAM de ciclo único de 32 KB, ROM interna carregada com o software StellarisWare®, EEPROM de 2 KB, um ou mais módulos de PWM, um ou mais análogos de QEI, um ou mais ADCs de 12 bits com 12 canais de entrada analógicos, dentre outros recursos que são prontamente disponíveis. Outros microcontroladores podem ser prontamente substituídos para uso com a presente descrição. Consequentemente, a presente descrição não deve ser limitada nesse contexto.
[000103] Em vários exemplos, uma ou mais das várias etapas aqui descritas podem ser executadas por uma máquina de estados finitos que compreende um circuito lógico combinacional ou um circuito lógico sequencial, onde o circuito lógico combinacional ou o circuito lógico sequencial é acoplado, ao menos, a um circuito de memória. O pelo menos um circuito de memória armazena um estado atual da máquina de estados finitos. O circuito lógico combinacional ou sequencial é configurado para fazer com que a máquina de estados finitos execute as etapas. O circuito lógico sequencial pode ser síncrono ou assíncrono. Em outros exemplos, uma ou mais das várias etapas aqui descritas podem ser executadas por um circuito que inclui uma combinação do processador 36 e da máquina de estados finitos, por exemplo.
[000104] Com referência à Figura 22, esta é um diagrama lógico 70 representativo de possíveis operações que podem ser implementadas pelo instrumento cirúrgico 10, por exemplo para monitorar a saúde de um cartucho de motor 12 e responder a uma falha detectada no cartucho de motor. Um sinal de ativação do motor pode ser recebido 72 pelo processador 36, a partir de um atuador 42 do instrumento cirúrgico 10. O atuador 42 pode ser uma chave que é configurada para fechar ou abrir um circuito mediante o acionamento do atuador 42. O fechamento ou a abertura do circuito pode sinalizar ao processador 36 que o atuador 42 foi acionado. Em ao menos um exemplo, o atuador 42 pode estar sob a forma de um gatilho de disparo que pode ser acionado por um operador para ativar uma sequência de disparo do instrumento cirúrgico 10, por exemplo. Em um outro exemplo, o atuador 42 pode estar sob a forma de um gatilho de fechamento que pode ser acionado por um operador para fechar um atuador de extremidade 300 do instrumento cirúrgico 10, por exemplo. Em um outro exemplo, o atuador 42 pode estar sob a forma de um gatilho de rotação que pode ser acionado por um operador para fechar um atuador de extremidade 300 do instrumento cirúrgico 10, por exemplo.
[000105] Ao receber o sinal de ativação, o processador 36 pode sinalizar 74 à placa de circuito de controle do motor 18 para ativar o motor 16. A saúde do cartucho de motor 12 pode ser continuamente monitorada 76 enquanto o atuador 42 é acionado. Sob condições de operação normais, conforme ilustrado na Figura 21, o motor 16 drena corrente da fonte de alimentação 34 e gera um ou mais movimentos giratórios que são transmitidos através da interface 21 para o mecanismo de acionamento 160 em resposta ao acionamento do atuador 42. Se, entretanto, uma falha no cartucho de motor 12 for detectada 78, uma ou mais medidas de segurança e/ou operacionais podem ser ativadas 79, conforme descrito com mais detalhes abaixo. De outro modo, a saúde do cartucho de motor é monitorada continuamente 76 enquanto o atuador 42 é acionado, até que uma falha seja detectada 78.
[000106] Com referência à Figura 23, esta é um diagrama lógico 80 representativo de possíveis operações que podem ser implementadas pelo instrumento cirúrgico 10, por exemplo para monitorar a saúde de um cartucho de motor 12 e responder a uma falha detectada no cartucho de motor. Um sinal de ativação do motor pode ser recebido 82 pelo processador 36, a partir de um atuador 42 do instrumento cirúrgico 10. Ao receber o sinal de ativação, o processador 36 pode sinalizar 84 à placa de circuito de controle do motor 18 para ativar o motor 16. Em 86, a saúde do cartucho de motor 12 pode ser monitorada continuamente, enquanto o atuador 42 é acionado, por meio do monitoramento da drenagem de corrente do cartucho de motor 12. Conforme ilustrado na Figura 21, a drenagem de corrente do cartucho de motor 12 pode ser monitorada por um ou mais sensores de corrente 40. As leituras de corrente detectadas podem ser comunicadas ao processador 36 pelo sensor de corrente 40. Em 88, se a drenagem de corrente do cartucho de motor 12, enquanto o atuador 42 é acionado, fica fora de um valor ou faixa predeterminada, o processador 36 pode concluir que uma falha no cartucho de motor 12 é detectada 88. Se uma falha no cartucho de motor 12 for detectada 88, uma ou mais medidas de segurança e/ou operacionais podem ser ativadas 89, conforme descrito com mais detalhes abaixo. De outro modo, a saúde do cartucho de motor é monitorada continuamente 86 enquanto o atuador 42 é acionado, até que uma falha seja detectada 88.
[000107] O valor, ou a faixa de valores, predeterminado pode ser armazenado na memória 38, por exemplo. No caso de uma faixa predeterminada ser armazenada na memória 38, o processador 36 pode acessar a memória 38 para comparar uma leitura de corrente, ou uma média de uma pluralidade de leituras de corrente, do sensor de corrente 40 para a faixa predeterminada. Se a leitura de corrente for maior que ou igual a um valor máximo da faixa predeterminada, o processador 36 pode concluir que uma falha no cartucho de motor 12 é detectada 88. Além disso, se a leitura de corrente for menor que ou igual a um valor mínimo da faixa predeterminada, o processador 36 pode concluir que uma falha no cartucho de motor 12 é detectada 88.
[000108] De modo semelhante, caso um valor armazenado seja armazenado na memória 38, o processador 36 pode acessar a memória 38 para comparar uma leitura de corrente, ou uma média de uma pluralidade de leituras de corrente, do sensor de corrente 40 para a faixa predeterminada. Se a leitura de corrente for maior que ou igual ao valor predeterminado, por exemplo, ou menor que ou igual ao valor predeterminado, por exemplo, o processador 36 pode concluir que uma falha no cartucho de motor 12 é detectada 88.
[000109] Em ao menos um exemplo, o processador 36 pode concluir que é detectada uma falha no cartucho de motor 12 se a drenagem de corrente do cartucho de motor 12, enquanto o atuador 42 está ativado, for menor que ou igual a 10% do valor predeterminado. Em ao menos um exemplo, o processador 36 pode concluir que é detectada uma falha no cartucho de motor 12 se a drenagem de corrente do cartucho de motor 12, enquanto o atuador 42 está ativado, for menor que ou igual a 20% do valor predeterminado. Em ao menos um exemplo, o processador 36 pode concluir que é detectada uma falha no cartucho de motor 12 se a drenagem de corrente do cartucho de motor 12, enquanto o atuador 42 está ativado, for maior que ou igual a 150% do valor predeterminado. Em ao menos um exemplo, o processador 36 pode concluir que é detectada uma falha no cartucho de motor 12 se a drenagem de corrente do cartucho de motor 12, enquanto o atuador 42 está ativado, for maior que ou igual a 200% do valor predeterminado.
[000110] Conforme indicado acima, o processador 36 pode ser configurado para responder a uma falha detectada do cartucho de motor 12 mediante a ativação (79 e 89) de uma ou mais medidas de segurança e/ou operacionais. Por exemplo, o processador 36 pode usar um ou mais elementos de retroinformação 44 para emitir um alerta a um operador do instrumento cirúrgico 100. Em certas instâncias, os elementos de retroinformação 44 podem compreender um ou mais sistemas de retroinformação visuais, como telas de exibição, luzes de fundo e/ou LEDs, por exemplo. Em certas instâncias, os elementos de retroinformação 44 podem compreender um ou mais sistemas de retroinformação de áudio, como alto-falantes e/ou campainhas, por exemplo. Em certas instâncias, os elementos de retroinformação 44 podem compreender um ou mais sistemas de retroinformação tátil, por exemplo. Em certas instâncias, os elementos de retroinformação 44 podem compreender combinações de sistemas de retroinformação visual, de áudio e/ou tátil, por exemplo.
[000111] Além do exposto acima, o processador 36 pode usar uma tela de retroinformação 46 (Figura 19B) do instrumento cirúrgico 10 para fornecer instruções a um operador de como substituir o cartucho de motor 12, por exemplo. Além disso, o processador 36 pode responder a uma falha detectada no cartucho de motor 12 ao armazenar ou registrar um estado danificado do cartucho de motor 12 na memória 38.
[000112] Em ao menos um exemplo, o processador 36 pode desabilitar o instrumento cirúrgico 10 até que o cartucho de motor danificado 12 seja substituído por um cartucho de motor não danificado. Por exemplo, a memória 38 pode incluir instruções de programa que, quando executadas pelo processador 36 em resposta a uma falha detectada no cartucho de motor 12, podem fazer com que o processador 36 ignore a entrada do atuador 42 até que o cartucho de motor danificado 12 seja substituído. Um elemento de retroinformação de substituição do cartucho de motor 58 pode ser usado para alertar o processador 36 quando o cartucho de motor 12 for substituído, conforme descrito com mais detalhes abaixo.
[000113] Referindo-se principalmente às Figuras 19A e 21, o instrumento cirúrgico 10 pode incluir uma porta de acesso do motor 13. A porta de acesso do motor 13 pode ser travada de modo liberável no compartimento do cabo 102 para controlar o acesso ao cartucho de motor 12. Conforme ilustrado na Figura 19A, a porta de acesso do motor 13 pode incluir um mecanismo de travamento como, por exemplo, um mecanismo de travamento do tipo encaixe por pressão 47 para engate de travamento com o compartimento do cabo 102. Outros mecanismos de travamento para travar a porta de acesso do motor 13 no compartimento do cabo 102 são contemplados na presente descrição. Em uso, o médico pode obter acesso ao cartucho de motor 12 destravando o mecanismo de travamento 47 e abrindo a porta de acesso do motor 13. Em ao menos um exemplo, a porta de acesso do motor 13 pode ser acoplada, de modo separável, ao compartimento do cabo 102 e pode ser destacada do compartimento do cabo 102 para permitir o acesso à porta de acesso do motor 13, por exemplo. Em um outro exemplo, a porta de acesso do motor 13 pode ser acoplada, de modo pivotante, ao compartimento do cabo 102 através de dobradiças (não mostradas) e pode ser girada em relação ao compartimento do cabo 102 para permitir o acesso à porta de acesso do motor 13, por exemplo. Em ainda outro exemplo, a porta de acesso do motor 13 pode ser uma porta deslizante que pode ser móvel de maneira deslizante em relação ao compartimento do cabo 102 para possibilitar o acesso à porta de acesso do motor 13.
[000114] Novamente com referência à Figura 21, em certos exemplos, um elemento de retroinformação da porta do motor 48 pode ser configurado para alertar o processador 36 de que o mecanismo de travamento 47 está destravado. Em ao menos um exemplo, o elemento de retroinformação da porta do motor 48 pode compreender um circuito de chave (não mostrado) acoplado, de modo operável, ao processador 36; o circuito de chave pode ser configurado para ser transicionado para uma configuração aberta, quando o mecanismo de travamento 47 é destravado por um médico, e/ou transicionado para uma configuração fechada, quando o mecanismo de travamento 47 é travado pelo médico, por exemplo. Em ao menos um exemplo, o elemento de retroinformação de porta do motor 48 pode compreender ao menos um sensor (não mostrado) acoplado, de modo operável, ao processador 36; o sensor pode ser configurado para ser reativado quando o mecanismo de travamento 47 é transicionado para as configurações destravada e/ou travada pelo médico, por exemplo. O elemento de retroinformação da porta do motor 48 pode incluir outros meios para detectar o travamento e/ou destravamento do mecanismo de travamento 47 pelo médico.
[000115] Com referência às Figuras 21 e 24, o controlador 20 pode compreender uma ou mais aplicações incorporadas e implementadas, como firmware, software, hardware ou qualquer combinação dos mesmos. Em certas modalidades, o controlador 20 pode compreender vários módulos executáveis, como software, programas, dados, unidades e/ou interfaces de programação de aplicativos (API, de "application program interfaces"), por exemplo. A Figura 24 representa um exemplo de módulo 50 que pode ser armazenado na memória 38, por exemplo. O módulo 50 pode ser executado pelo processador 36, por exemplo, para alertar, guiar e/ou fornecer retroinformação a um usuário do instrumento cirúrgico 10 sobre a substituição de um cartucho de motor 12.
[000116] Conforme ilustrado na Figura 24, o módulo 50 é executado pelo processador 36 para fornecer ao usuário instruções sobre como substituir o cartucho de motor 12, por exemplo. Em vários exemplos, o módulo 50 pode compreender uma ou mais etapas de tomada de decisão como, por exemplo, uma etapa de tomada de decisão 52 relacionada à detecção de um ou mais erros que exigem a substituição do cartucho de motor 12. Em ao menos um exemplo, conforme descrito acima com mais detalhes, o processador 36 é configurado para detectar um erro que exige a substituição do cartucho de motor 12 quando a drenagem de corrente do cartucho de motor 12, enquanto o atuador 42 é acionado, está fora de uma faixa predeterminada, por exemplo.
[000117] Quando o processador 36 detecta um erro na etapa de tomada de decisão 52, o processador 36 pode responder parando e/ou desativando o motor 16, por exemplo. Além disso, em certos exemplos, o processador 36 pode também armazenar na memória 38 um estado danificado do cartucho de motor 12, após detectar o erro do cartucho de motor, conforme ilustrado na Figura 25. Conforme descrito acima, a memória 38 pode ser uma memória não volátil que pode preservar a condição armazenada quando o instrumento cirúrgico 10 é reinicializado pelo usuário, por exemplo. Em vários exemplos, o motor 16 pode ser parado e/ou desativado desconectando-se a bateria 34 do motor 16, por exemplo. Em vários exemplos, a placa de circuito de controle principal 19 pode incluir um circuito de cancelamento de motor que pode ser usado pelo processador 36 para interromper o fornecimento de energia ao cartucho de motor 12, por exemplo. A etapa de parar o motor 16 e/ou interromper o fornecimento de energia ao cartucho de motor 12 pode ser vantajosa para evitar, ou pelo menos reduzir, a possibilidade de danos adicionais ao instrumento cirúrgico 10, por exemplo.
[000118] Além do descrito acima, ainda com referência à Figura 24, o módulo 50 pode incluir uma etapa de tomada de decisão 54 para detectar se a porta de acesso do motor 13 foi removida. Como descrito acima, o processador 36 pode ser acoplado, de modo operacional, ao elemento de retroinformação da porta do motor 48 que pode ser configurado para alertar o processador 36 se a porta de acesso do motor 13 foi ou não removida. Em certos exemplos, o processador 36 pode ser programado para detectar que a porta de acesso do motor 13 foi removida quando o elemento de retroinformação da porta do motor 48 relatar que o mecanismo de travamento 47 está destravado, por exemplo. Em certos exemplos, o processador 36 pode ser programado para detectar que a porta de acesso do motor 13 foi removida quando o elemento de retroinformação da porta do motor 48 relatar que a porta de acesso do motor 13 está aberta, por exemplo. Em certos exemplos, o processador 36 pode ser programado para detectar que a porta de acesso do motor 13 foi removida quando o elemento de retroinformação da porta do motor 48 relatar que o mecanismo de travamento 47 está destravado e que a porta de acesso do motor 13 está aberta, por exemplo.
[000119] Ainda com referência à Figura 24, quando o processador 36 não detecta um erro de cartucho de motor na etapa de tomada de decisão 52 e não detecta que a porta de acesso do motor 13 foi removida na etapa de tomada de decisão 54, o processador 36 pode não interromper a operação normal do instrumento cirúrgico 10 e pode prosseguir com vários algoritmos clínicos. Entretanto, o processador 36 pode continuar a detectar erros que exijam a substituição do cartucho de motor 12.
[000120] Em certos exemplos, quando o processador 36 não detecta um erro de cartucho de motor na etapa de tomada de decisão 52, mas detecta que a porta de acesso do motor 13 foi removida na etapa de tomada de decisão 54, o processador 36 pode responder parando e/ou desativando o motor 16, conforme descrito acima. Além disso, o processador 36 pode, também, fornecer ao usuário instruções para reinstalar a porta de acesso do motor 13. Em certos exemplos, quando o processador 36 detecta que a porta de acesso do motor 13 está reinstalada, embora nenhum erro no cartucho de motor seja detectado, o processador 36 pode ser configurado para reconectar a energia ao motor 16 e permitir que o usuário continue com algoritmos clínicos, conforme ilustrado na Figura 24.
[000121] Além do exposto acima, quando o processador 36 detecta um erro de cartucho de motor e detecta adicionalmente a remoção da porta de acesso do motor 13, o processador 36 pode sinalizar ao usuário para que substitua o cartucho de motor 12 mediante o fornecimento, ao usuário, de uma retroinformação visual, de áudio e/ou tátil, por exemplo. Em certos casos, o processador 36 pode sinalizar ao usuário do instrumento cirúrgico 10 para que substitua o cartucho de motor 12, mediante o piscar de uma luz de fundo da tela de retroinformação 46. Em todo caso, o processador 36 pode fornecer ao usuário instruções para substituir o cartucho de motor 12, conforme ilustrado na Figura 24.
[000122] Novamente com referência à Figura 24, em vários exemplos, as instruções fornecidas pelo processador 36 ao usuário para que remova a porta de acesso do motor 13 e/ou substitua o cartucho de motor 12 podem compreender uma ou mais etapas; as etapas podem ser apresentadas ao usuário em ordem cronológica. As etapas podem compreender ações a ser executadas pelo usuário. Em tais exemplos, o usuário pode proceder com as etapas por meio da execução das ações apresentadas em cada uma das etapas. Em certos exemplos, as ações necessárias em uma ou mais das etapas podem ser apresentadas ao usuário na forma de imagens animadas exibidas na tela de retroinformação 46 (Figura 19B), por exemplo. Em certos exemplos, uma ou mais etapas podem ser apresentadas ao usuário na forma de mensagens que podem incluir palavras, símbolos e/ou imagens.
[000123] Além do descrito acima, ainda com referência à Figura 24, o módulo 50 pode incluir uma etapa de tomada de decisão 56 para detectar se o cartucho de motor 12 foi removido. Em ao menos um exemplo, o usuário do instrumento cirúrgico 10 é solicitado a alertar o processador 36 quando o cartucho de motor 12 tiver sido substituído com o uso de um ou mais dos elementos de retroinformação de usuário 44, por exemplo. Alternativamente, conforme ilustrado na Figura 21, o processador 36 pode ser operacionalmente acoplado a um elemento de retroinformação de substituição do cartucho de motor 58 que pode ser configurado para alertar o processador 36 quando o cartucho de motor 12 é substituído. Em ao menos um exemplo, o elemento de retroinformação de substituição do cartucho de motor 58 inclui um ou mais sensores e/ou chaves que podem ser acionados quando o cartucho de motor 12 for removido e/ou substituído para alertar o processador 36 quando o cartucho de motor 12 foi removido e/ou substituído.
[000124] Em ao menos um exemplo, o elemento de retroinformação de substituição do cartucho de motor 58 inclui um sensor de pressão posicionado na interface 21 entre o instrumento cirúrgico 10 e o cartucho de motor 12. O processador 36 pode ser configurado para usar o sensor de pressão do elemento de retroinformação de substituição do cartucho de motor 58 para detectar quando o cartucho de motor 12 foi removido e/ou substituído. Em ao menos um exemplo, o processador 36 pode ser configurado para usar o sensor de pressão do elemento de retroinformação de substituição do cartucho de motor 58 para detectar uma leitura de pressão com definição de limiar quando o cartucho de motor 12 é instalado com o instrumento cirúrgico 10. A leitura de pressão com definição de limiar pode ser usada para definir um limiar predeterminado que pode ser armazenado na memória 38. Alternativamente, o limiar predeterminado pode ser calculado e armazenado na memória 36 independentemente de quaisquer leituras obtidas pelo sensor de pressão.
[000125] Além do exposto acima, o processador 36 pode ser configurado para concluir que um cartucho de motor 12 instalado foi removido quando uma ou mais leituras de pressão detectadas pelo sensor de pressão do elemento de retroinformação de substituição do cartucho de motor 58 forem menores ou iguais ao limiar predeterminado. O processador 36 pode também ser configurado para concluir que um cartucho de motor de substituição 12 foi instalado quando as leituras de pressão subsequentes detectadas pelo sensor de pressão do elemento de retroinformação de substituição do cartucho de motor 58 se tornam maiores ou iguais ao limiar predeterminado, por exemplo.
[000126] Além do exposto acima, ainda com referência à Figura 24, uma vez que é determinado que o cartucho de motor 12 foi substituído, o processador 36 pode ser configurado para instruir o usuário a reinstalar a porta de acesso do motor 13. Após a subsequente detecção de que a porta de acesso do motor 13 foi instalada, o processador 36 pode ser configurado para permitir a transmissão de energia ao cartucho de motor de substituição 12 instalado. Em certos exemplos, o processador 36 é adicionalmente configurado para usar um ou mais dos elementos de retroinformação de usuário 44 para alertar o uso da instalação bem-sucedida do cartucho de motor de substituição 12 e/ou que o instrumento cirúrgico 10 agora está pronto para continuar com vários algoritmos clínicos.
[000127] Em vários exemplos, a porta de acesso do motor 13 pode ser substituída por um elemento de acesso do motor ou um elemento de fixação do motor configurado para prender o cartucho de motor 12 no compartimento do cabo 102. Alternativamente, a porta de acesso do motor 13 pode ser removida completamente ou ser integrada ao compartimento 14 do cartucho de motor 12, de modo que o cartucho de motor 12 possa ser prontamente removido ou separado do instrumento cirúrgico 10, puxando ou retraindo o cartucho de motor 12 para longe do compartimento do cabo 102, por exemplo. Em ao menos um exemplo, na ausência de uma porta de acesso do motor, uma parede externa 59 (Figura 20) do compartimento 14 do cartucho de motor 12 pode ser configurada para formar uma porção de uma parede externa do compartimento do cabo 102 do instrumento cirúrgico 10 quando o cartucho de motor 12 é instalado com o instrumento cirúrgico 10. Em tais exemplos, a parede externa 59 pode incluir uma porção de fixação (não mostrada) que pode ser agarrada por um usuário do instrumento cirúrgico e puxada para facilitar a separação do cartucho de motor 12 do compartimento do cabo 102, por exemplo.
[000128] A Figura 25 representa um exemplo de módulo 60 que pode ser armazenado na memória 38, por exemplo. O módulo 60 é similar em muitos aspectos ao módulo 50. Por exemplo, o módulo 60 pode também ser executado pelo processador 36, por exemplo, para alertar, guiar e/ou fornecer retroinformação a um usuário do instrumento cirúrgico 10 em relação à substituição de um cartucho de motor 12; entretanto, o módulo 60 é implementado quando o recurso de porta de acesso do motor não é usado.
[000129] Conforme ilustrado na Figura 24, o módulo 50 é executado pelo processador 36 para fornecer ao usuário instruções sobre como substituir o cartucho de motor 12, por exemplo. Em vários exemplos, o módulo 50 pode compreender uma ou mais etapas de tomada de decisão como, por exemplo, uma etapa de tomada de decisão 52 relacionada à detecção de um ou mais erros que exigem a substituição do cartucho de motor 12. Em ao menos um exemplo, conforme descrito acima com mais detalhes, o processador 36 é configurado para detectar um erro que exige a substituição do cartucho de motor 12 quando a drenagem de corrente do cartucho de motor 12, enquanto o atuador 42 é acionado, está fora de uma faixa predeterminada, por exemplo.
[000130] Como o módulo 50, o módulo 60 também inclui uma ou mais etapas de tomada de decisão como, por exemplo, uma etapa de tomada de decisão 52 relacionada com a detecção de um ou mais erros que exigem a substituição do cartucho de motor 12. Quando o processador 36 detecta um erro na etapa de tomada de decisão 52, o processador 36 pode responder parando e/ou desativando o motor 16, por exemplo. Além disso, em certos exemplos, o processador 36 pode também armazenar na memória 38 um estado danificado do cartucho de motor 12, após detectar o erro do cartucho de motor, conforme ilustrado na Figura 25.
[000131] Além do exposto acima, quando o processador 36 detecta um erro de cartucho de motor, o processador 36 pode sinalizar ao usuário para substituir o cartucho de motor 12, fornecendo ao usuário retroinformação visual, de áudio e/ou tátil, por exemplo. Em certos casos, o processador 36 pode sinalizar ao usuário do instrumento cirúrgico 10 para que substitua o cartucho de motor 12, mediante o piscar de uma luz de fundo da tela de retroinformação 46. Em todo caso, o processador 36 pode fornecer ao usuário instruções para substituir o cartucho de motor 12, conforme ilustrado na Figura 25. Além disso, o módulo 60 inclui a etapa de tomada de decisão 56 para detectar se o cartucho de motor 12 foi substituído, conforme descrito acima em mais detalhes. Além disso, uma vez que seja determinado que o cartucho de motor 12 foi substituído, o processador 36 pode ser configurado para permitir a transmissão de energia ao cartucho de motor de substituição 12 instalado. O processador 36 pode ser adicionalmente configurado para usar um ou mais dos elementos de retroinformação ao usuário 44 para alertar o usuário sobre a instalação bem-sucedida do cartucho de motor de substituição 12.
[000132] Embora vários detalhes tenham sido apresentados na descrição acima, será entendido que os vários aspectos dos instrumentos cirúrgicos com motores separáveis e circuitos de controle de motor podem ser praticados sem esses detalhes específicos. Por exemplo, por concisão e clareza, aspectos selecionados foram mostrados em diagramas de blocos em vez de em detalhes. Algumas porções das descrições detalhadas fornecidas na presente invenção podem ser apresentadas em termos de instruções que operam com base em dados armazenados em uma memória de computador. Essas descrições e representações são usadas pelos versados na técnica para descrever e transmitir a substância de seu trabalho a outros versados na técnica. Em geral, um algoritmo refere-se à sequência autoconsistente de etapas que levam ao resultado desejado, em que uma "etapa" refere-se à manipulação de quantidades físicas que podem, embora não necessariamente precisem, assumir a forma de sinais elétricos ou magnéticos que possam ser armazenados, transferidos, combinados, comparados e manipulados de qualquer outra forma. É uso comum chamar esses sinais de bits, valores, elementos, símbolos, caracteres, termos, números ou congêneres. Esses termos e termos semelhantes podem ser associados às grandezas físicas apropriadas e são identificações meramente convenientes aplicadas a essas grandezas.
[000133] Salvo afirmação expressa em contrário, como fica patente com a discussão precedente, é entendido que, ao longo da descrição precedente, as discussões que usam termos como "processamento", ou "computação", ou "cálculo", ou "determinação", ou "exibição", ou similares, referem-se à ação e aos processos de um computador, ou dispositivo de computação eletrônica semelhante, que manipule e transforme os dados representados na forma de grandezas físicas (eletrônicas) nos registros e nas memórias do computador em outros dados representados de modo semelhante sob a forma de grandezas físicas nas memórias ou nos registros do computador, ou em outros dispositivos similares de armazenamento, transmissão ou exibição de informações.
[000134] Vale notar que qualquer referência a "aspecto" ou "um aspecto", significa que um determinado recurso, estrutura ou característica descrito em conexão com o aspecto está incluído em ao menos um aspecto. Dessa forma, ocorrências das frases "em um aspecto" ou "no aspecto" em vários locais ao longo deste relatório descritivo não se referem todas necessariamente ao mesmo aspecto. Além disso, os recursos, estruturas ou características específicos podem ser combinados de qualquer maneira adequada em um ou mais aspectos.
[000135] Embora vários aspectos tenham sido aqui descritos, muitas modificações, variações, substituições, alterações e equivalentes àqueles aspectos podem ser implementadas e ocorrerão aos versados na técnica. Além disso, onde forem revelados materiais para certos componentes, outros materiais podem ser usados. Deve-se compreender, portanto, que a descrição precedente e as concretizações em anexo se destinam a cobrir todas essas modificações e variações como estando dentro do escopo dos aspectos revelados. As concretizações a seguir se destinam a cobrir todas essas modificações e variações.
[000136] Alguns ou todos os aspectos aqui descritos podem compreender genericamente tecnologias de instrumentos cirúrgicos com motores e circuitos de controle de motor separáveis, ou de outro modo de acordo com as tecnologias aqui descritas. Em um sentido geral, os versados na técnica reconhecerão que os vários aspectos aqui descritos, os quais podem ser implementados, individual e/ou coletivamente, por meio de uma ampla gama de hardware, software, firmware, ou qualquer combinação destes, podem ser vistos como sendo compostos por vários tipos de "circuitos elétricos". Consequentemente, como usado na presente invenção, "circuito elétrico" inclui, mas não se limita aos, circuitos elétricos que tenham pelo menos um circuito elétrico discreto, circuitos elétricos que tenham pelo menos um circuito integrado, circuitos elétricos que tenham pelo menos um circuito integrado para aplicação específica, circuitos elétricos que formem um dispositivo de computação para finalidades gerais configurado por um programa de computador (por exemplo, um computador para finalidades gerais configurado por um programa de computador que pelo menos parcialmente execute processos e/ou dispositivos aqui descritos, ou um microprocessador configurado por um programa de computador que pelo menos parcialmente execute os processos e/ou dispositivos aqui descritos), circuitos elétricos que formem um dispositivo de memória (por exemplo, formas de memória de acesso aleatório), e/ou circuitos elétricos que formem um dispositivo de comunicações (por exemplo, um modem, roteadores ou equipamento óptico-elétrico). Os versados na técnica reconhecerão que o assunto aqui descrito pode ser implementado de modo analógico ou digital, ou em alguma combinação destes.
[000137] A descrição detalhada supracitada apresentou vários as- pectos dos dispositivos e/ou processos por meio do uso de diagramas de blocos, fluxogramas e/ou exemplos. Embora esses diagramas de bloco, fluxogramas e/ou exemplos contenham uma ou mais funções e/ou operações, será compreendido pelos versados na técnica que cada função e/ou operação dentro desses diagramas de bloco, fluxo- gramas ou exemplos pode ser implementada, individual e/ou coletivamente, por meio de uma ampla gama de hardware, software, firmware ou praticamente qualquer combinação destes. Em um aspecto, várias porções do assunto descrito na presente invenção podem ser implementadas por meio de circuitos integrados de aplicação específica (ASICs, de "Application Specific Integrated Circuits"), arranjos de portas programáveis em campo (FPGAs, de "Field Programmable Gate Arrays"), processadores de sinal digital (DSPs, de "Digital Signal Processors") ou outros formatos integrados. Os versados na técnica reconhecerão, contudo, que alguns aspectos dos aspectos aqui revelados, no todo ou em parte, podem ser implementados de modo equivalente em circuitos integrados, como um ou mais programas de computador executados em um ou mais computadores (por exemplo, como um ou mais programas executados em um ou mais sistemas de computador), como um ou mais progra-mas executados em um ou mais processadores (por exemplo, como um ou mais programas executados em um ou mais microprocessadores), como firmware, ou virtualmente como qualquer combinação dos mesmos, e que projetar o conjunto de circuitos e/ou escrever o código para o software e firmware estaria dentro do âmbito de prática do versado na técnica, à luz desta descrição. Além disso, os versados na técnica entenderão que os mecanismos do assunto aqui descrito podem ser distribuídos como um produto de programa em uma variedade de formas, e que um aspecto ilustrativo do assunto aqui descrito é aplicável independentemente do tipo específico de meio de transmissão de sinais usado para efetivamente executar a distribuição. Exemplos de um meio de transmissão de sinais incluem, mas não se limitam aos seguintes: um meio do tipo gravável como um disquete, uma unidade de disco rígido, um disco compacto (CD), um disco de vídeo digital (DVD), uma fita digital, uma memória de computador, etc.; e uma mídia do tipo de transmissão, como uma mídia de comunicação digital e/ou analógica (por exemplo, um cabo de fibra óptica, um guia de onda, um enlace de comunicação com fio, um enlace de comunicação sem fio (por exemplo, transmissor, receptor, lógica de transmissão, lógica de recepção, etc.), etc.).
[000138] Todas as supracitadas patentes US, publicações de pedido de patente US, pedidos de patente US, patentes estrangeiras, pedidos de patentes estrangeiros e publicações de não patentes mencionadas neste relatório descritivo e/ou listadas em qualquer Folha de Dados de Pedido (ADS, de "Application Data Sheet"), ou qualquer outro material de descrição estão aqui incorporados, por referência, na medida em que não forem inconsistentes com o conteúdo da presente descrição. Desse modo, e na medida em que for necessário, a descrição como explicitamente aqui apresentada substitui qualquer material conflitante incorporado à presente invenção a título de referência. Qualquer material, ou porção deste, tido como aqui incorporado a título de referência, mas que entre em conflito com as definições, declarações, ou outros materiais de descrição existentes aqui apresentados estará aqui incorporado apenas na medida em que não haja conflito entre o material incorporado e o material de descrição existente.
[000139] Os versados na técnica reconhecerão que os componentes (por exemplo, operações), dispositivos e objetivos descritos na presente invenção, e a discussão que os acompanha, são usados como exemplos tendo em vista a clareza conceitual, e que são contempladas várias modificações de configuração. Consequentemente, como usado na presente invenção, os exemplares específicos apresentados e a discussão que os acompanha pretendem ser representativos de suas classes mais gerais. Em geral, o uso de qualquer exemplar específico pretende ser representativo de sua classe, e a não inclusão de componentes (por exemplo, operações), dispositivos e objetos específicos não deve ser considerada limitadora.
[000140] Com respeito ao uso de substancialmente quaisquer termos plurais e/ou singulares na presente invenção, os versados na técnica podem mudar do plural para o singular e/ou do singular para o plural conforme seja adequado ao contexto e/ou aplicação. As várias permutações singular/plural não são expressamente aqui apresentadas por fins de clareza.
[000141] O assunto descrito na presente invenção ilustra por vezes componentes distintos contidos em outros componentes distintos, ou a eles relacionados. É necessário compreender que essas arquiteturas representadas são meramente exemplificadoras, e que, de fato, podem ser implementadas muitas outras arquiteturas que alcancem a mesma funcionalidade. No sentido conceitual, qualquer disposição de componentes para alcançar a mesma funcionalidade está efetivamente "associada" se a funcionalidade desejada for alcançada. Assim, quaisquer dois componentes mencionados na presente invenção que sejam combinados para alcançar uma funcionalidade específica podem ser vistos como "associados" um ao outro se a funcionalidade desejada é alcançada, independentemente das arquiteturas ou dos componentes intermediários. De modo semelhante, quaisquer desses dois componentes assim associados também podem ser vistos como estando "conectados de modo operável" ou "acoplados de modo operável" um ao outro para alcançar a funcionalidade desejada, e quaisquer desses dois componentes capazes de serem associados dessa forma podem ser vistos como sendo "acopláveis de modo operável" um ao outro para alcançar a funcionalidade desejada. Exemplos específicos de componentes operacionalmente acopláveis incluem, mas não se limitam a, componentes fisicamente encaixáveis e/ou em interação física, e/ou os que podem interagir por conexão sem fio, e/ou que interajam por lógica, e/ou podem interagir por lógica.
[000142] Alguns aspectos podem ser descritos com o uso da expressão "acoplado" e "conectado" juntamente com seus derivados. Deve- se compreender que esses termos não são concebidos para serem sinônimos uns dos outros. Por exemplo, alguns aspectos podem ser descritos com o uso do termo "conectado" para indicar que dois ou mais elementos estão em contato físico direto ou em contato elétrico uns com os outros. Em outro exemplo, alguns aspectos podem ser descritos com o uso do termo "acoplado" para indicar que dois ou mais elementos estão em contato físico direto ou em contato elétrico. O termo "acoplado", entretanto, também pode significar que dois ou mais elementos não estão em contato direto um com o outro, mas ainda assim cooperam ou interagem entre si.
[000143] Em alguns casos, um ou mais componentes podem ser mencionados na presente invenção como "configurado para", "configu- rável para", "operável/operacional para", "adaptado/adaptável", "capaz de", "conformável/conformado a", etc. Os versados na técnica reconhecerão que "configurado para" pode, de modo geral, abranger componentes em estado ativo, e/ou componentes em estado inativo, e/ou componentes em estado de espera, exceto quando o contexto determinar em contrário.
[000144] Embora aspectos específicos do assunto aqui descrito tenham sido mostrados e descritos, ficará evidente aos versados na técnica que, com base nos ensinamentos na presente invenção, podem ser feitas mudanças e modificações sem se afastar do assunto aqui descrito e de seus aspectos mais amplos e, portanto, as concretizações em anexo se destinam a abranger em seu escopo todas essas alterações e modificações, já que estão dentro do verdadeiro espírito e escopo do assunto aqui descrito. Será compreendido pelos versados na técnica que, em geral, os termos usados aqui, e principalmente nas concretizações em anexo (por exemplo, corpos das concretizações em anexo) destinam-se geralmente como termos "abertos" (por exemplo, o termo "incluindo" deve ser interpretado como "incluindo, mas não se limitando a", o termo "tendo" deve ser interpretado como "tendo, ao menos", o termo "inclui" deve ser interpretado como "inclui, mas não se limita a", etc.). Será ainda entendido pelos versados na técnica que, quando um número específico de uma menção de concretização introduzida for pretendido, tal intenção será expressamente mencionada na concretização e, na ausência de tal menção, nenhuma intenção estará presente. Por exemplo, como uma ajuda para a compreensão, as seguintes concretizações em anexo podem conter o uso das frases introdutórias "ao menos um" e "um ou mais" para introduzir menções de concretização. Entretanto, o uso de tais frases não deve ser interpretado como implicando que a introdução de uma menção da concretização pelos artigos indefinidos "um, uns" ou "uma, umas" limita qualquer concretização específica contendo a menção da concretização introduzida a concretizações que contêm apenas uma tal menção, mesmo quando a mesma concretização inclui as frases introdutórias "um ou mais" ou "ao menos um" e artigos indefinidos, como "um, uns" ou "uma, umas" (por exemplo, "um, uns" e/ou "uma, umas" deve tipicamente ser interpretado como significando "ao menos um" ou "um ou mais"); o mesmo vale para o uso de artigos definidos usados para introduzir as menções de concretização.
[000145] Além disso, mesmo se um número específico de uma menção de concretização introduzida for explicitamente mencionado, os versados na técnica reconhecerão que essa menção precisa ser tipicamente interpretada como significando ao menos o número mencionado (por exemplo, a mera menção de "duas menções", sem outros modificadores, tipicamente significa ao menos duas menções, ou duas ou mais menções). Além disso, naqueles casos em que é usada uma convenção análoga a "pelo menos um dentre A, B e C, etc.", em geral essa construção se destina a ter o sentido no qual a convenção seria entendida por (por exemplo, "um sistema que tem ao menos um dentre A, B e C" incluiria, mas não se limitaria a, sistemas que têm A sozinho, B sozinho, C sozinho, A e B juntos, A e C juntos, B e C juntos, e/ou A, B e C juntos, etc.). Naqueles casos em que é usada uma convenção análoga a "pelo menos um dentre A, B ou C, etc.", em geral essa construção se destina a ter o sentido no qual a convenção seria entendida por (por exemplo, "um sistema que tem ao menos um dentre A, B e C" incluiria, mas não se limitaria a, sistemas que têm A sozinho, B sozinho, C sozinho, A e B juntos, A e C juntos, B e C juntos, e/ou A, B e C juntos, etc.). Será adicionalmente entendido pelos versados na técnica que tipicamente uma palavra e/ou uma frase disjuntiva apresentando dois ou mais termos alternativos, quer na descrição, nas concretizações ou nos desenhos, deve ser entendida como contemplando a possibilidade de incluir um dos termos, qualquer um dos termos ou ambos os termos, exceto quando o contexto determinar indicar algo diferente. Por exemplo, a frase "A ou B" será tipicamente entendida como incluindo as possibilidades de "A" ou "B" ou "A e B".
[000146] Com respeito às concretizações em anexo, os versados na técnica entenderão que as operações mencionadas nas mesmas podem, de modo geral, ser executadas em qualquer ordem. Além disso, embora vários fluxos operacionais sejam apresentados em uma ou mais sequências, deve-se compreender que as várias operações podem ser executadas em outras ordens diferentes daquelas que estão ilustradas, ou podem ser executadas simultaneamente. Exemplos dessas ordenações alternativas podem incluir ordenações sobrepostas, intercaladas, interrompidas, reordenadas, incrementais, preparatórias, suplementares, simultâneas, inversas ou outras ordenações variantes, exceto quando o contexto determinar em contrário. Ademais, termos como "responsivo a", "relacionado a" ou outros parti- cípios adjetivos não pretendem de modo geral excluir essas variantes, exceto quando o contexto determinar em contrário.
[000147] Em certos casos, o uso de um sistema ou método pode ocorrer mesmo se os componentes em um território estão localizados fora do território. Por exemplo, em um contexto de computação distribuída, o uso de um sistema de computação distribuída pode ocorrer em uma região ainda que partes do sistema possam ser localizados fora do território (por exemplo, relé, servidor, processador, sinal contendo meio, transmissão de computador, computador, etc., localizado fora do território).
[000148] Uma venda de um sistema ou método pode, da mesma forma, ocorrer em um território mesmo se os componentes do sistema e/ou método estiverem situados e/ou forem usados fora do território. Adicionalmente, a implementação de pelo menos parte de um sistema para executar um método em um território não impede o uso do sistema em um outro território.
[000149] Embora vários aspectos tenham sido aqui descritos, muitas modificações, variações, substituições, alterações e equivalentes àqueles aspectos podem ser implementadas e ocorrerão aos versados na técnica. Além disso, onde forem revelados materiais para certos componentes, outros materiais podem ser usados. Deve-se compreender, portanto, que a descrição precedente e as concretizações em anexo se destinam a cobrir todas essas modificações e variações como estando dentro do escopo dos aspectos revelados. As concretizações a seguir se destinam a cobrir todas essas modificações e variações.
[000150] Em resumo, foram descritos numerosos benefícios que resultam do emprego dos conceitos descritos no presente documento. A descrição anteriormente mencionada de um ou mais aspectos foi apresentada para propósitos de ilustração e descrição. Essa descrição não pretende ser exaustiva nem limitar a invenção à forma precisa revelada. Modificações ou variações são possíveis à luz dos ensina-mentos acima. O um ou mais aspectos foram escolhidos e descritos com a finalidade de ilustrar os princípios e a aplicação prática para, assim, permitir que o versado na técnica use os vários aspectos e com várias modificações, conforme sejam convenientes ao uso específico contemplado. Pretende-se que as concretizações apresentadas em anexo definam o escopo global.
[000151] Vários aspectos do assunto aqui descrito são definidos nas seguintes cláusulas numeradas: 1. Um instrumento cirúrgico, que compreende: um conjunto de garra, que compreende: um cartucho de grampos que inclui uma pluralidade de grampos; e uma bigorna, sendo que pelo menos um dentre o cartucho de grampos e a bigorna é móvel em relação ao outro dentre o cartucho de grampos e a bigorna, para capturar tecido entre os mesmos; um conjunto de disparo configurado para implantar a pluralidade de grampos no tecido capturado durante uma sequência de disparo; e um cabo, que compreende: um atuador; e uma interface; um cartucho de motor, sendo que a interface é configurada para acoplar de modo liberável o cartucho de motor ao cabo, sendo que o cartucho de motor compreende: um motor elétrico operacionalmente acoplado ao conjunto de disparo, quando o cartucho de motor está acoplado ao cabo; e um circuito de controle do motor, sendo que o circuito de controle do motor é configurado para fazer com que o motor elétrico gere pelo menos um movimento giratório para induzir o conjunto de disparo a implantar a pluralidade de grampos no tecido capturado, em resposta ao acionamento do atuador; e um controlador, que compreende: um processador; e um dispositivo de armazenamento legível por computador que armazena instruções de programa que, quando executadas pelo processador, fazem com que o processador detecte uma falha no cartucho de motor. 2. O instrumento cirúrgico da cláusula 1, sendo que o dispositivo de armazenamento legível por computador é uma memória. 3. O instrumento cirúrgico de qualquer uma das cláusulas 1 a 2, sendo que as instruções de programa, quando executadas, fazem adicionalmente com que o processador armazene na memória um estado danificado do cartucho de motor, após detectar a falha do cartucho de motor. 4. O instrumento cirúrgico de qualquer uma das cláusulas 1 a 3, que compreende adicionalmente pelo menos um elemento de retroinformação ao usuário, sendo que as instruções de programa, quando executadas, fazem adicionalmente com que o processador use o pelo menos um elemento de retroinformação ao usuário para alertar um usuário sobre a falha. 5. O instrumento cirúrgico da cláusula 4, sendo que as instruções de programa, quando executadas, fazem adicionalmente com que o processador use o pelo menos um elemento de retroinfor- mação ao usuário a fim de fornecer ao usuário instruções para substituição do cartucho de motor. 6. O instrumento cirúrgico de qualquer uma das cláusulas 1 a 5, que compreende adicionalmente uma fonte de alimentação, sendo que as instruções de programa, quando executadas, fazem adicionalmente com que o processador interrompa a transmissão de energia da fonte de alimentação para o cartucho de motor, após detectar a falha do cartucho de motor. 7. O instrumento cirúrgico de qualquer uma das cláusulas 1 a 6, que compreende adicionalmente um sensor de corrente, sendo que as instruções de programa, quando executadas, fazem com que o processador use o sensor de corrente na detecção da falha do cartucho de motor. 8. O instrumento cirúrgico de qualquer uma das cláusulas 1 a 7, que compreende adicionalmente um elemento de retroinformação de substituição do cartucho de motor, sendo que as instruções de programa, quando executadas, fazem com que o processador use o elemento de retroinformação de substituição do cartucho de motor para detectar a substituição do cartucho de motor. 9. O instrumento cirúrgico da cláusula 8, sendo que o elemento de retroinformação de substituição do cartucho de motor é um sensor de pressão. 10. Um instrumento cirúrgico, que compreende: um atuador de extremidade; um conjunto de acionamento operacionalmente acoplado ao atuador de extremidade; um cartucho de motor substituível, que compreende: uma placa de circuito de controle do motor; e um motor; uma placa de circuito de controle principal, que compreende: um processador; e um dispositivo de armazenamento legível por computador que armazena instruções de programa que, quando execu-tadas pelo processador, fazem com que o processador detecte uma falha no cartucho de motor; e uma interface, que compreende: uma porção de interface mecânica configurada para acoplar de modo liberável o motor ao conjunto de acionamento; e uma porção de interface elétrica configurada para acoplar de modo liberável a placa de circuito de controle do motor à placa de circuito de controle principal. 11. O instrumento cirúrgico da cláusula 10, sendo que o cartucho de motor substituível compreende adicionalmente um outro motor. 12. O instrumento cirúrgico de qualquer uma das cláusulas 10 e 11, sendo que o dispositivo de armazenamento legível por computador é uma memória. 13. O instrumento cirúrgico da cláusula 12, sendo que as instruções de programa, quando executadas, fazem adicionalmente com que o processador armazene na memória um estado danificado do cartucho de motor, após detectar a falha no cartucho de motor. 14. O instrumento cirúrgico de qualquer uma das cláusulas 10 a 13, que compreende adicionalmente pelo menos um elemento de retroinformação ao usuário, sendo que as instruções de programa, quando executadas, fazem adicionalmente com que o processador use o pelo menos um elemento de retroinformação ao usuário para alertar um usuário sobre a falha. 15. O instrumento cirúrgico da cláusula, sendo que as instruções de programa, quando executadas, fazem adicionalmente com que o processador use o ao menos um elemento de retroinfor- mação ao usuário a fim de fornecer ao usuário instruções para substituição do cartucho de motor. 16. O instrumento cirúrgico de qualquer uma das cláusulas 10 a 15, que compreende adicionalmente uma fonte de alimentação, sendo que as instruções de programa, quando executadas, fazem adicionalmente com que o processador interrompa a transmissão de energia da fonte de alimentação para o cartucho de motor, após detectar a falha do cartucho de motor. 17. O instrumento cirúrgico de qualquer uma das cláusulas 10 a 16, que compreende adicionalmente um sensor de corrente, sendo que as instruções de programa, quando executadas, fazem com que o processador use o sensor de corrente na detecção da falha do cartucho de motor. 18. O instrumento cirúrgico de qualquer uma das cláusulas 10 a 17, que compreende adicionalmente um elemento de retroinfor- mação de substituição do cartucho de motor, sendo que as instruções de programa, quando executadas, fazem com que o processador use o elemento de retroinformação de substituição do cartucho de motor para detectar a substituição do cartucho de motor. 19. O instrumento cirúrgico da cláusula 18, sendo que o elemento de retroinformação de substituição do cartucho de motor é um sensor de pressão. 20. Um instrumento cirúrgico, que compreende: um atuador de extremidade; um conjunto de acionamento operacionalmente acoplado ao atuador de extremidade; elementos de alta corrente substituíveis, que compreendem: um circuito de controle de motor; e um motor; elementos de baixa corrente, que compreendem: ao menos um elemento de retroinformação; um controlador, que compreende: um processador; e um dispositivo de armazenamento legível por computador que armazena instruções de programa que, quando executadas pelo processador, fazem com que o processador detecte uma falha nos elementos de alta corrente; e uma interface, que compreende: uma porção de interface mecânica configurada para acoplar de modo liberável o motor ao conjunto de acionamento; e uma porção de interface elétrica configurada para acoplar de modo liberável o circuito de controle do motor ao controlador.
Claims (18)
1. Instrumento cirúrgico (10, 100), caracterizado pelo fato de que compreende: um conjunto de garra (304), compreendendo: um cartucho de grampos (305) incluindo uma pluralidade de grampos (307); e uma bigorna (306), em que pelo menos um dentre o cartucho de grampos (305) e a bigorna (306) é móvel em relação ao outro dentre o cartucho de grampos (305) e a bigorna (306) para capturar tecido entre os mesmos; um conjunto de disparo (360) configurado para implantar a pluralidade de grampos (307) no tecido capturado durante uma sequência de disparo; um cabo (102), compreendendo: um atuador (42); e uma interface (21); um cartucho de motor (12), em que a interface (21) é configurada para acoplar de modo liberável o cartucho de motor (12) ao cabo (102), e em que o cartucho de motor (12) compreende: um motor elétrico (16) operacionalmente acoplado ao conjunto de disparo (360) quando o cartucho de motor (12) estiver acoplado ao cabo (102); e um circuito de controle de motor (18), em que o circuito de controle de motor (18) é configurado para fazer com que o motor elétrico (16) gere pelo menos um movimento giratório para induzir o conjunto de disparo (360) a implantar a pluralidade de grampos (307) no tecido capturado em resposta a acionamento do atuador (42); um elemento de retroinformação; e um controlador (20), compreendendo: um processador (36); e um dispositivo de armazenamento legível por computador (38) que armazena um método executável pelo processador (36), compreendendo etapas de: detectar um erro exigindo que o cartucho de motor (12) seja substituído; interromper o motor elétrico (16) em resposta ao erro ser detectado; armazenar um estado danificado do cartucho de motor (12); indicar instruções de substituição do cartucho de motor através do elemento de retroinformação; e detectar substituição do cartucho de motor (12) por um cartucho de motor não danificado.
2. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 1, caracterizado pelo fato de que o dispositivo de armazenamento legível por computador (38) é uma memória.
3. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 1, caracterizado pelo fato de que ainda compreende pelo menos um elemento de retroinformação ao usuário, em que o método ainda compreende uma etapa de empregar o pelo menos um elemento de retroinformação ao usuário para alertar um usuário sobre o erro exigindo que o cartucho de motor (12) seja substituído através do elemento de retroinformação.
4. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 3, caracterizado pelo fato de que o método ainda compreende uma etapa de empregar o pelo menos um elemento de retroinformação ao usuário para fornecer as instruções de substituição de cartucho de motor ao usuário para substituição do cartucho de motor (12).
5. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 1, caracterizado pelo fato de que ainda compreende uma fonte de alimentação, em que o método ainda compreende uma etapa de interromper transmissão de energia da fonte de alimentação para o cartucho de motor (12) após detectar o erro exigindo que o cartucho de motor (12) seja substituído.
6. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 1, caracterizado pelo fato de que ainda compreende um sensor de corrente, em que o método ainda compreende uma etapa de empregar o sensor de corrente na detecção do erro exigindo que o cartucho de motor (12) seja substituído.
7. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 1, caracterizado pelo fato de que ainda compreende um elemento de retroinformação de substituição de cartucho de motor (58), em que o método ainda compreende uma etapa de empregar o elemento de retroinformação de substituição de cartucho de motor (58) para detectar substituição do cartucho de motor (12) pelo cartucho de motor não danificado.
8. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 7, caracterizado pelo fato de que o elemento de retroinformação de substituição de cartucho de motor (58) é um sensor de pressão.
9. Instrumento cirúrgico (10, 100), caracterizado pelo fato de que compreende: um atuador de extremidade (304); um conjunto de acionamento (360) operacionalmente acoplado ao atuador de extremidade (304); um elemento de retroinformação; um cartucho de motor (12) substituível, compreendendo: uma placa de circuito de controle de motor (18); e um motor (16); uma porta de acesso de motor removível configurada para permitir que um usuário do instrumento cirúrgico (10, 100) acesse o cartucho de motor (12) quando a porta de acesso de motor for removida do instrumento cirúrgico (10, 100); uma placa de circuito de controle principal (19), compreendendo: um processador (36); e um dispositivo de armazenamento legível por computador (38) que armazena um método executável pelo processador (36), compreendendo uma etapa de detectar um erro exigindo que o cartucho de motor (12) seja substituído; e uma interface (21), compreendendo: uma porção de interface mecânica (22, 23, 24, 25) configurada para acoplar de modo liberável o motor (16) ao conjunto de acionamento (360); e uma porção de interface elétrica (26, 28, 30, 32) configurada para acoplar de modo liberável a placa de circuito de controle de motor (18) à placa de circuito de controle principal (19), em que o método ainda compreende etapas de: interromper o motor elétrico (16) em resposta ao erro ser detectado; armazenar um estado danificado do cartucho de motor (12); fornecer instruções de remoção de porta de acesso de motor através de um elemento de retroinformação; detectar substituição do cartucho de motor (12) por um cartucho de motor não danificado; e detectar refixação da porta de acesso de motor ao instrumento cirúrgico (10, 100).
10. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 9, caracterizado pelo fato de que o cartucho de motor (12) substituível ainda compreende um outro motor.
11. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 9, caracterizado pelo fato de que o dispositivo de armazenamento legível por computador (38) é uma memória.
12. Instrumento cirúrgico (10, 100), de acordo com qualquer reivindicação 9, caracterizado pelo fato de que ainda compreende pelo menos um elemento de retroinformação ao usuário, em que o método ainda compreende uma etapa de empregar o pelo menos um elemento de retroinformação ao usuário para alertar um usuário sobre o erro exigindo que o cartucho de motor (12) seja substituído.
13. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 12, caracterizado pelo fato de que o método ainda compreende uma etapa de empregar o pelo menos um elemento de retroinformação ao usuário para fornecer as instruções de remoção de porta de acesso de motor ao usuário para remover a porta de acesso de motor.
14. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 9, caracterizado pelo fato de que ainda compreende uma fonte de alimentação, em que o método ainda compreende uma etapa de interromper transmissão de energia da fonte de alimentação para o cartucho de motor (12) após detectar o erro exigindo que o cartucho de motor (12) seja substituído.
15. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 9, caracterizado pelo fato de que ainda compreende um sensor de corrente, em que o método ainda compreende uma etapa de empregar o sensor de corrente na detecção do erro exigindo que o cartucho de motor (12) seja substituído.
16. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 9, caracterizado pelo fato de que ainda compreende um elemento de retroinformação de substituição de cartucho de motor (58), em que o método ainda compreende uma etapa de empregar o elemento de retroinformação de substituição de cartucho de motor (58) para detectar substituição do cartucho de motor (12) pelo cartucho de motor não danificado.
17. Instrumento cirúrgico (10, 100), de acordo com a reivindicação 16, caracterizado pelo fato de que o elemento de retroinformação de substituição de cartucho de motor (58) é um sensor de pressão.
18. Instrumento cirúrgico (10, 100), caracterizado pelo fato de que compreende: um atuador de extremidade (304); um conjunto de acionamento (360) operacionalmente acoplado ao atuador de extremidade (304); um elemento de retroinformação; elementos de alta corrente substituíveis, compreendendo: um circuito de controle de motor (18); e um motor (16); elementos de baixa corrente, compreendendo: pelo menos um elemento de retroinformação (44); e um controlador (20), compreendendo: um processador (36); e um dispositivo de armazenamento legível por computador (38) que armazena um método executável pelo processador (36), compreendendo uma etapa de detectar um erro exigindo que os elementos de alta corrente sejam substituídos; e uma interface (21), compreendendo: uma porção de interface mecânica (22, 23, 24, 25) configurada para acoplar de modo liberável o motor (16) ao conjunto de acionamento (360); e uma porção de interface elétrica (26, 28, 30, 32) configurada para acoplar de modo liberável o circuito de controle de motor (18) ao controlador (20), em que método ainda compreende etapas de: interromper o motor elétrico (16) em resposta ao erro ser detectado; armazenar um estado danificado dos elementos de alta corrente; fornecer instruções de substituição para os elementos de alta corrente através do elemento de retroinformação; e detectar substituição dos elementos de alta corrente por elementos de alta corrente não danificados.
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PCT/US2016/066791 WO2017116726A1 (en) | 2015-12-30 | 2016-12-15 | Surgical instruments with separable motors and motor control circuits |
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BR112018013216A2 BR112018013216A2 (pt) | 2018-12-11 |
BR112018013216B1 true BR112018013216B1 (pt) | 2023-05-09 |
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EP (1) | EP3189790A1 (pt) |
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BR (1) | BR112018013216B1 (pt) |
WO (1) | WO2017116726A1 (pt) |
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2015
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EP3189790A1 (en) | 2017-07-12 |
JP2022009499A (ja) | 2022-01-14 |
US11129613B2 (en) | 2021-09-28 |
WO2017116726A1 (en) | 2017-07-06 |
US20210275172A1 (en) | 2021-09-09 |
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Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 15/12/2016, OBSERVADAS AS CONDICOES LEGAIS |