BR112018016405B1 - Aparelho cirúrgico com mecanismos para compensar a falha no trem de acionamento em instrumentos cirúrgicos equipados com motor - Google Patents
Aparelho cirúrgico com mecanismos para compensar a falha no trem de acionamento em instrumentos cirúrgicos equipados com motor Download PDFInfo
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- 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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- 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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- A61B2017/00115—Electrical control of surgical instruments with audible or visual output
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- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- 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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- 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
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
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- A—HUMAN NECESSITIES
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- 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
- A61B2017/07214—Stapler heads
- A61B2017/07271—Stapler heads characterised by its cartridge
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- 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
- A61B2017/07214—Stapler heads
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
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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
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
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Abstract
Trata-se de um aparelho cirúrgico que inclui um atuador de extremidade configurado para interagir com um tecido e um instrumento cirúrgico. O instrumento cirúrgico inclui pelo menos um mecanismo de acionamento operável para efetuar pelo menos um movimento no atuador de extremidade. O instrumento cirúrgico inclui adicionalmente um ou mais sensores de vibração configurados para registrar vibrações geradas pelo ao menos um mecanismo de acionamento, sendo que o um ou mais sensores de vibração são configurados para gerar um sinal de saída com base nas vibrações detectadas, e sendo que o sinal de saída é empregado para selecionar entre um estado aceitável, um estado marginal e um estado crítico do instrumento cirúrgico.
Description
[001] Este pedido está relacionado ao pedido de patente US de propriedade comum e depositado simultaneamente sob o n° do documento do procurador END7793USNP/150507 e intitulado "MECHANISMS FOR DETECTING DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS", pedido de patente US referido sob o n° do documento do procurador END7795USNP/150509 e intitulado "MECHANISMS FOR DETECTING DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS", pedido de patente US referido sob o n° do documento do procurador END7796USNP/150510 e intitulado "MECHANISMS FOR DETECTING DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS", cada um dos quais está aqui incorporado, a título de referência, em sua totalidade.
[002] O pedido de patente US n° de série 14/984.488 e intitulado "MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE IN POWERED SURGICAL INSTRUMENTS", o pedido de patente US n° de série 14/984.552 e intitulado "SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROL CIRCUITS" e o pedido de patente US n° de série 14/984.525 e intitulado "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS" estão também aqui incorporados, a título de referência, em suas totalidades.
[003] 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.
[004] Os recursos dos vários aspectos são apresentados com particularidade nas concretizações. 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:
[005] 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;
[006] a figura 2 é uma vista em perspectiva do instrumento cirúrgico da figura 1, de acordo com ao menos um aspecto da presente descrição;
[007] 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;
[008] 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;
[009] 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;
[0010] 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;
[0011] 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;
[0012] 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;
[0013] 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;
[0014] a figura 10A é uma vista superior de um membro de travamento, de acordo com ao menos um aspecto da presente descrição;
[0015] 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;
[0016] a figura 11 é um diagrama esquemático do instrumento cirúrgico da figura 1, de acordo com ao menos um aspecto da presente descrição;
[0017] 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;
[0018] 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;
[0019] 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;
[0020] 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;
[0021] 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;
[0022] 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;
[0023] 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;
[0024] a figura 19 é uma vista em perspectiva de um instrumento cirúrgico, de acordo com ao menos um aspecto da presente descrição;
[0025] a figura 20 é um diagrama de circuito de vários componentes do instrumento cirúrgico da figura 19, de acordo com ao menos um aspecto da presente descrição;
[0026] a figura 21 é um diagrama de circuito que inclui um microfone em comunicação com uma pluralidade de filtros acoplados a uma pluralidade de portas lógicas de acordo com pelo menos um aspecto da presente descrição;
[0027] a figura 22 é um gráfico de saída de um microfone em volts versus tempo em segundos, o gráfico representando uma resposta vibratória de um instrumento cirúrgico da figura 19, que funciona adequadamente, registrado pelo microfone durante o funcionamento do instrumento cirúrgico, de acordo com ao menos um aspecto da presente descrição;
[0028] a figura 22A é um sinal filtrado da saída do microfone da figura 22, de acordo com ao menos um aspecto da presente descrição;
[0029] a figura 23 é um gráfico de saída de um microfone em volts versus tempo em segundos, o gráfico representando uma resposta vibratória de um instrumento cirúrgico com defeito da figura 19, registrado pelo microfone durante o funcionamento do instrumento cirúrgico, de acordo com ao menos um aspecto da presente descrição;
[0030] a figura 23A é um sinal filtrado da saída do microfone da figura 23, de acordo com ao menos um aspecto da presente descrição;
[0031] a figura 24 é um diagrama de circuito que inclui um sensor do instrumento cirúrgico da figura 19 acoplado a uma pluralidade de filtros em comunicação com um microcontrolador por meio de um multiplexador e um conversor analógico-digital, de acordo com ao menos um aspecto da presente descrição;
[0032] a figura 24A é um diagrama de circuito que inclui um sensor do instrumento cirúrgico da figura 19 acoplado a uma pluralidade de filtros em comunicação com um microcontrolador por meio de um multiplexador e um conversor analógico-digital, de acordo com ao menos um aspecto da presente descrição;
[0033] as figuras 24B a 24D ilustram características estruturais e operacionais de um filtro de passagem de banda do instrumento cirúrgico da figura 19, de acordo com ao menos um aspecto da presente descrição;
[0034] a figura 25 é um gráfico que representa um sinal filtrado de uma saída de sensor do instrumento cirúrgico da figura 19, de acordo com ao menos um aspecto da presente descrição;
[0035] a figura 26 é um gráfico que representa um sinal processado de uma saída de sensor do instrumento cirúrgico da figura 19, de acordo com ao menos um aspecto da presente descrição;
[0036] a figura 27 é um gráfico que representa a força necessária para disparar (FTF) o instrumento cirúrgico da figura 19 em relação a uma posição de deslocamento de um conjunto de acionamento do instrumento cirúrgico a partir de uma posição inicial, de acordo com ao menos um aspecto da presente descrição;
[0037] a figura 28 é um gráfico que representa a velocidade de um conjunto de acionamento do instrumento cirúrgico da figura 19, durante um curso de disparo, em relação à posição de deslocamento do conjunto de acionamento a partir de uma posição inicial, de acordo com ao menos um aspecto da presente descrição;
[0038] a figura 29 é um gráfico que representa uma modificação de limite aceitável com base na zona de localização do curso durante um curso de disparo do instrumento cirúrgico da figura 19, de acordo com ao menos um aspecto da presente descrição;
[0039] a figura 30 é um gráfico que representa um sinal processado da saída de um sensor do instrumento cirúrgico da figura 19 mostrando um deslocamento na resposta de frequência do sinal processado devido a alterações de carga e velocidade experimentadas por um conjunto de acionamento durante um curso de disparo, de acordo com ao menos um aspecto da presente descrição;
[0040] a figura 31 é um gráfico que representa um sinal processado de vibrações capturadas por um sensor do instrumento cirúrgico da figura 19 durante uma zona de operação, o gráfico ilustrando um limite aceitável, limite marginal e limite crítico para a zona de operação, de acordo com ao menos um aspecto da presente descrição;
[0041] a figura 32 é um diagrama lógico do instrumento cirúrgico da figura 19, de acordo com ao menos um aspecto da presente descrição;
[0042] a figura 33 é um gráfico que representa um sinal processado de vibrações capturadas por um sensor do instrumento cirúrgico da figura 19, de acordo com ao menos um aspecto da presente descrição;
[0043] a figura 34 é um gráfico que representa um sinal processado de vibrações capturadas por um sensor do instrumento cirúrgico da figura 19, de acordo com ao menos um aspecto da presente descrição; e
[0044] a figura 35 é um gráfico que representa um sinal processado de vibrações capturadas por um sensor do instrumento cirúrgico da figura 19, de acordo com ao menos um aspecto da presente descrição.
[0045] Antes de explicar com detalhes as várias formas de mecanismos para compensar as falhas no trem de acionamento em instrumentos cirúrgicos equipados com motor, deve-se notar que as formas ilustrativas não se limitam, em termos de aplicação ou uso, aos detalhes de construção e disposição das peças 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.
[0046] 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.
[0047] Várias formas são direcionadas a mecanismos para compensar falhas no trem de acionamento em instrumentos cirúrgicos equipados com motor. Em uma forma, os mecanismos para compensar as falhas no trem de acionamento de instrumentos cirúrgicos equipados com motor 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.
[0048] 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 descritos 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 PROCEDURES", e publicação de pedido de patente US n° 2013/0274722, depositada em 10 de maio de 2013 e intitulada "APPARATUS FOR ENDOSCOPIC PROCEDURES".
[0049] 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 da 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.
[0050] 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, 110b e sendo 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.
[0051] 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.
[0052] 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.
[0053] 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.
[0054] 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.
[0055] 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.
[0056] 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 feedback, tal 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.
[0057] A porção superior do compartimento 108 do compartimento do cabo 102 fornece um compartimento no qual está situado o mecanismo 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.
[0058] 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.
[0059] 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.
[0060] 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.
[0061] 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.
[0062] 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 sentido, 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.
[0063] 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.
[0064] 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.
[0065] 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.
[0066] 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.
[0067] 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, 126 e um par de dispositivos osciladores 128, 130 dentro de um compartimento 107a. Os botões de controle 124, 126 são acoplados aos eixos de extensão 125, 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.
[0068] O conjunto de controle 107 e seus componentes (por exemplo, os botões de controle 124, 126 e os dispositivos oscilantes 128, 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 componentes 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.
[0069] Os materiais adequados para a formação dos componentes do conjunto de controle 107 incluem, mas não se limitam a poliaminas, 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.
[0070] 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.
[0071] 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.
[0072] 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.
[0073] 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.
[0074] 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.
[0075] 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.
[0076] 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.
[0077] 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.
[0078] 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.
[0079] Mediante a retração da viga de acionamento 364, após ao menos um disparo parcial, o membro de travamento 371 passa sob as projeções 303a, 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 elemento de travamento 371 em alinhamento justaposto com a projeção 303c, desabilitando efetivamente o atuador de extremidade descartável, quando uma tentativa é feita para reativar o aparelho, carregado com o atuador de extremidade existente 300, o elemento de travamento 371 irá encostar na projeção 303c da porção de alojamento 301b e irá inibir o movimento distal do feixe de acionamento 364.
[0080] 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.
[0081] 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, 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.
[0082] 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.
[0083] 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.
[0084] 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.
[0085] A rotação seletiva do (s) um ou mais membro (s) de acionamento ou conector (es) 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.
[0086] 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.
[0087] 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 giratoriamente 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.
[0088] O conjunto de acoplamento de acionamento do eixo de acionamento 514 inclui um primeiro, um segundo e um terceiro elementos 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.
[0089] 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, 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.
[0090] 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.
[0091] 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.
[0092] 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.
[0093] 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.
[0094] 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 engrenagens 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.
[0095] O segundo sistema de trem de engrenagens 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.
[0096] 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.
[0097] 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.
[0098] 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.
[0099] 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.
[00100] 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.
[00101] 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, 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.
[00102] 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 descritos, 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.
[00103] A totalidade das descrições das:
[00104] 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";
[00105] publicação de pedido de patente US n° 2013/0282052, depositada em 19 de junho de 2013 e intitulada "APPARATUS FOR ENDOSCOPIC PROCEDURES"; e
[00106] 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.
[00107] Com referência às figuras 19 a 20, 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 um invólucro do cabo 102 que inclui uma porção inferior do invólucro 104, uma porção intermediária do invólucro 106 e uma porção superior do invólucro 108.
[00108] Como o instrumento cirúrgico 100, o instrumento cirúrgico 10 inclui um mecanismo de acionamento 160 que é configurado para acionar eixos de acionamento e/ou componentes de engrenagem de modo a executar as várias operações do instrumento cirúrgico 10. Em ao menos um caso, o mecanismo de acionamento 160 inclui um trem de acionamento de rotação 12 (vide figura 20) configurado para girar o atuador de extremidade 300 em torno de um eixo geométrico longitudinal "X" (vide figura 2) em relação ao compartimento do cabo 102. O mecanismo de acionamento 160 inclui adicionalmente um trem de acionamento de fechamento 14 (vide figura 20) configurado para mover o conjunto de bigorna 306 em relação ao conjunto de cartucho 308 do atuador de extremidade 300 para capturar tecido entre o mesmo. Além disso, o mecanismo de acionamento 160 inclui um trem de acionamento de disparo 16 (vide figura 20) configurado para disparar um cartucho de grampeamento e corte no interior do conjunto de cartucho 308 do atuador de extremidade 300.
[00109] Conforme descrito acima, referindo-se principalmente às figuras 7, 8 e 20, o mecanismo de acionamento 160 inclui um conjunto de caixa de câmbio com seletor 162 que pode estar situado imediatamente proximal em relação ao adaptador 200. Proximal ao conjunto de caixa de câmbio com seletor 162 está o módulo de seleção de função 163 que inclui o primeiro motor 164 que funciona para mover seletivamente os elementos de engrenagem dentro do conjunto de caixa de câmbio com seletor 162 para posicionar seletivamente um dos trens de acionamento 12, 14 e 16 para engatar no componente de acionamento de entrada 165 do segundo motor 166.
[00110] Com referência à figura 20, os motores 164 e 166 são acoplados aos circuitos de controle de motor 18 e 18', respectivamente, que são configurados para controlar a operação dos motores 164 e 166, incluindo o fluxo de energia elétrica de uma fonte de alimentação 156 para os motores 164 e 166. A fonte de alimentação 156 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 instrumento cirúrgico 10.
[00111] O instrumento cirúrgico 10 inclui adicionalmente 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. Uma fonte de alimentação 156 pode ser configurada para fornecer energia ao controlador 20, por exemplo.
[00112] O processador 36 pode estar em comunicação com o circuito de controle do motor 18. Além disso, a memória 38 pode armazenar instruções de programa que, quando executadas pelo processador 36 em resposta a uma entrada de usuário 34, podem fazer com que o circuito de controle do motor 18 induza o motor 164 a gerar ao menos um movimento giratório para mover seletivamente os elementos de engrenagem dentro do conjunto de caixa de câmbio com seletor 162 para posicionar seletivamente um dos trens de acionamento 12, 14 e 16 para engatar no componente de acionamento de entrada 165 do segundo motor 166. Além disso, o processador 36 pode estar em comunicação com o circuito de controle do motor 18'. A memória 38 pode também armazenar instruções de programa que, quando executadas pelo processador 36 em resposta a uma entrada de usuário 34, podem fazer com que o circuito de controle do motor 18' induza o motor 166 a gerar ao menos um movimento giratório para acionar o trem de acionamento engatado no componente de acionamento de entrada 165 do segundo motor 166, por exemplo.
[00113] 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.
[00114] 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.
[00115] 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.
[00116] Em vários casos, pode ser vantajoso ser capaz de avaliar o estado da funcionalidade de um instrumento cirúrgico para assegurar sua função adequada. É possível, por exemplo, que o mecanismo de acionamento, conforme explicado acima, que é configurado para incluir vários motores, trens de acionamento e/ou componentes de engrenagem para executar as várias operações do instrumento cirúrgico 10, se desgaste ao longo do tempo. Isso pode ocorrer através do uso normal e, em alguns casos, o mecanismo de acionamento pode se desgastar mais rapidamente devido a condições de abuso. Em certos casos, um instrumento cirúrgico 10 pode ser configurado para executar autoavaliações para determinar o estado, por exemplo, a integridade do mecanismo de acionamento e seus vários componentes.
[00117] Por exemplo, a autoavaliação pode ser usada para determinar quando o instrumento cirúrgico 10 é capaz de realizar sua função antes de uma reesterilização ou quando alguns dos componentes devem ser substituídos e/ou reparados. A avaliação do mecanismo de acionamento e seus componentes, incluindo, mas não se limitando ao trem de acionamento de rotação 12, trem de acionamento de fechamento 14 e/ou trem de acionamento de disparo 16, pode ser realizada de diversas maneiras. A magnitude do desvio de um desempenho previsto pode ser usada para determinar a probabilidade de uma falha detectada e a gravidade de tal falha. Várias métricas podem ser usadas, incluindo: análise periódica dos eventos, picos ou quedas repetitivamente previsíveis que excedem um limite esperado, e a largura da falha.
[00118] Em vários casos, uma forma de onda de assinatura de um mecanismo de acionamento com funcionamento adequado ou um ou mais de seus componentes pode ser empregada para avaliar o estado do mecanismo de acionamento ou do um ou mais dos seus componentes. Um ou mais sensores de vibração podem ser dispostos em relação a um mecanismo de acionamento adequado ou um ou mais dos seus componentes para registrar várias vibrações que ocorrem durante o funcionamento do mecanismo de acionamento que funciona adequadamente ou um ou mais dos seus componentes. As vibrações registradas podem ser empregadas para criar a forma de onda de assinatura. As formas de onda futuras podem ser comparadas com a forma de onda de assinatura para avaliar o estado do mecanismo de acionamento e seus componentes.
[00119] Em ao menos um aspecto, os princípios da acústica podem ser empregados para avaliar o estado do mecanismo de acionamento e seus componentes. Para uso na presente invenção, o termo acústica refere-se, em geral, a todas as ondas mecânicas em gases, líquidos e sólidos, incluindo vibração, som, ultrassom (ondas sonoras com frequências superiores ao limite audível superior da audição humana), e infrassom (som de baixa frequência, menor em frequência do que 20 Hz [Hertz] ou ciclos por segundo, portanto, inferior ao limite "normal" da audição humana). Consequentemente, as emissões acústicas do mecanismo de acionamento e seus componentes podem ser detectadas com sensores acústicos incluindo sensores de vibração, som, ultrassom e infrassom. Em um aspecto, a assinatura de frequência vibratória de um mecanismo de acionamento 160 pode ser analisada para determinar o estado de um ou mais dos trens de acionamento 12, 14 e/ou 16. Um ou mais sensores de vibração podem ser acoplados a um ou mais dos trens de acionamento 12, 14 e/ou 16, a fim de registrar a saída acústica dos trens de acionamento quando em uso.
[00120] Novamente com referência à figura 20, o instrumento cirúrgico 10 inclui um módulo de detecção de falha de trem de acionamento 40 configurado para registrar e analisar uma ou mais saídas acústicas de um ou mais dos trens de acionamento 12, 14 e/ou 16. O processador 36 pode estar em comunicação com ou, de outro modo, controlar o módulo 40. Conforme descrito com mais detalhes abaixo, o módulo 40 pode ser incorporado como vários meios, como circuitos, hardware, um produto de programa de computador que compreende uma mídia legível por computador (por exemplo, a memória 38) que armazena instruções de programa legíveis por computador que são executáveis por um dispositivo de processamento (por exemplo, o processador 36), ou alguma combinação dos mesmos. Em alguns casos, o processador 36 pode incluir ou, de outro modo, controlar o módulo 40.
[00121] O módulo 40 pode incluir um ou mais sensores 42 que podem ser empregados pelo módulo 40 para detectar falhas do trem de acionamento do instrumento cirúrgico 10. Em ao menos um caso, conforme ilustrado na figura 21, os sensores 42 podem compreender um ou mais sensores acústicos ou microfones acústicos, por exemplo. Em ao menos um caso, conforme ilustrado na figura 24, os sensores 42 podem compreender um ou mais acelerômetros.
[00122] Vários tipos de filtros e transformadas podem ser usados na saída de um sensor 42 para gerar uma forma de onda que representa o estado operacional de um trem de acionamento, por exemplo, do instrumento cirúrgico 10. Conforme ilustrado na figura 21, uma pluralidade de filtros de passagem de banda pode ser configurada para se comunicar com um sensor 42 para processar uma saída do mesmo. No exemplo mostrado na figura 21, há quatro filtros de passagem de banda, BPF1, BPF2, BPF3 e BPF4, usados para filtrar a saída do sensor 42. Esses filtros são usados para determinar os vários limiares usados para avaliar a integridade de um instrumento cirúrgico 10, incluindo limites aceitáveis, limites marginais e limites críticos, por exemplo. Em um exemplo, uma série de filtros passa-baixa, conforme ilustrado na figura 24, podem ser usados na saída do sensor 42.
[00123] Em um aspecto, conforme ilustrado na figura 21, portas lógicas podem ser empregadas com os filtros para processar a saída dos sensores 42. Alternativamente, um processador como, por exemplo, o processador 36 pode ser empregado com os filtros para processar a saída dos sensores 42, conforme ilustrado nas figuras 24 e 24A. As figuras 24B, 24C e 24D representam uma estrutura exemplificadora e detalhes operacionais de um filtro de passagem de banda usado para filtrar a saída do sensor 42. Em ao menos um caso, um ou mais dos filtros empregados na filtragem da saída do sensor 42 é um amplificador operacional de propósito geral de entrada JFET duplo de baixo ruído.
[00124] Embora várias frequências possam ser usadas, as frequências exemplificadoras dos filtros mostrados na figura 21 são 5 kHz, 1 kHz, 200 Hz e 50 Hz. A saída de cada filtro é mostrada na figura 25, que ilustra a amplitude de tensão na frequência de cada filtro. A amplitude de pico da saída de cada filtro é mostrada na figura 26. Esses valores podem ser usados para determinar a integridade do instrumento cirúrgico 10 por comparação com valores-limite armazenados na memória 38, por exemplo. Conforme ilustrado na figura 24, um multiplexador 44 e um conversor analógico para digital 46 podem ser empregados para comunicar a saída dos filtros ao processador 36.
[00125] Em ao menos um caso, uma saída de um sensor 42 pode ser registrada quando um motor está em funcionamento durante uma função conhecida que tem movimento repetível. Por exemplo, a saída pode ser registrada quando o motor 166 está em funcionamento para retrair ou reinicializar um trem de acionamento como, por exemplo, o trem de acionamento de disparo 16 para uma posição original ou inicial. A saída registrada do sensor 42 pode ser usada para desenvolver uma forma de onda de assinatura desse movimento. Em um exemplo, a saída registrada do sensor 42 é executada através de uma transformada rápida de Fourier para desenvolver a forma de onda de assinatura.
[00126] Além do exposto acima, a amplitude das regiões chave da forma de onda de assinatura resultante pode ser comparada a valores predeterminados armazenados na memória 38, por exemplo. Em ao menos um caso, a memória 38 pode incluir instruções de programa que, quando executadas pelo processador 36, podem fazer com que o processador 36 compare as amplitudes das regiões chave com os valores predeterminados armazenados na memória 38. Quando as amplitudes excedem esses valores armazenados, o processador 36 determina que um ou mais componentes do instrumento cirúrgico 10 não estão mais funcionando adequadamente e/ou que o instrumento cirúrgico 10 atingiu o final de sua vida útil.
[00127] A figura 22 ilustra uma resposta vibratória de um trem de acionamento que está funcionando adequadamente. A saída em volts de um microfone que é posicionada sobre ou em estreita proximidade com o trem de acionamento é registrada ao longo do tempo. A resposta de frequência dessa saída é determinada com o uso de uma transformada rápida de Fourier, conforme mostrado na figura 22A, para desenvolver uma forma de onda de assinatura para um trem de acionamento que funciona adequadamente. A forma de onda de assinatura do trem de acionamento que funciona adequadamente pode ser usada para detectar qualquer falha no mesmo trem de acionamento ou outros similares. Por exemplo, a figura 23 ilustra uma resposta vibratória de um trem de acionamento que não está funcionando adequadamente. A saída do microfone é usada para determinar a resposta de frequência do trem de acionamento avariado, conforme ilustrado na figura 23A. O desvio da resposta de frequência do dispositivo de transmissão avariado a partir da forma de onda de assinatura do dispositivo de transmissão que funciona corretamente indica uma anomalia no trem de acionamento.
[00128] Em ao menos um caso, valores armazenados de regiões chave de uma resposta de frequência de um trem de acionamento em funcionamento adequado, conforme mostrado na figura 22A, são comparados aos valores registrados de regiões correspondentes de uma resposta de frequência de um trem de acionamento examinado, conforme mostrado na figura 23A. No caso de os valores armazenados serem excedidos pelos valores registados, pode concluir-se que é detectada uma anomalia no trem de acionamento examinado. Em resposta, várias medidas de segurança e corretivas podem ser tomadas como descrito em mais detalhes no pedido de patente US número de série 14/984.525, intitulado "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS" e depositado em 30 de dezembro de 2015, que está aqui incorporado por referência em sua totalidade.
[00129] Pode haver vários estágios de operação do instrumento cirúrgico 10 à medida que os componentes são movidos para efetuar uma função em um atuador de extremidade do instrumento cirúrgico 10 como, por exemplo, capturar tecido, disparar grampos no tecido capturado e/ou cortar o tecido capturado. As vibrações geradas pelo mecanismo de acionamento 160 do instrumento cirúrgico 10 podem variar dependendo do estágio de operação do instrumento cirúrgico 10. Certas vibrações podem ser associadas de modo exclusivo a certos estágios de operação do instrumento cirúrgico 10. Consequentemente, levar em consideração o estágio ou zona de operação do instrumento cirúrgico 10 permite analisar seletivamente as vibrações que estão associadas àquele estágio ou zona de operação, ignorando outras vibrações que não são relevantes para aquele estágio ou zona de operação. Vários sensores como, por exemplo, sensores de posição podem ser empregados pelo processador 36 para determinar o estágio de operação do instrumento cirúrgico 10.
[00130] Em um exemplo, vários estágios de operação do instrumento 10 são representados no gráfico da figura 27, que ilustra a força necessária para disparar (FTF) o instrumento cirúrgico 10 em relação a uma posição de deslocamento do conjunto de acionamento 360 a partir de uma posição inicial ou original durante uma sequência de disparo ou curso do instrumento cirúrgico 10. Na zona 1, um atuador de extremidade 300 do instrumento cirúrgico 10 foi preso ao tecido, conforme descrito acima, mas não afetou o tecido. Na zona 2, uma carga é aplicada para mover um deslizador de atuação do instrumento cirúrgico 10 para permitir que o atuador de extremidade 300 afete o tecido, por exemplo, corte e grampeamento do tecido. Na zona 3, o tecido foi cortado e grampeado pelo atuador de extremidade 300 do instrumento cirúrgico 10. Dependendo de em qual zona o instrumento cirúrgico 10 está durante a captura e o processamento das vibrações produzidas pelos vários trens de acionamento, as vibrações podem ser comparadas a valores-limite de frequência ou podem ser desprezadas ou não consideradas. Para vibrações capturadas por um sensor 42 no bloco 48 e no bloco 50 da figura 27, certas porções das vibrações capturadas podem ser desprezadas ou não consideradas para fins de determinação da integridade do instrumento cirúrgico 10.
[00131] Em ao menos um caso, quaisquer vibrações capturadas abaixo da linha-limite 52 podem ser desprezadas ou não consideradas. Em ao menos um caso, a razão entre o limiar mínimo 52 e um FTF máximo durante uma sequência de disparo ou curso do instrumento cirúrgico 10 é qualquer valor selecionado dentre uma faixa de cerca de 0,001 a cerca de 0,30, por exemplo. Em ao menos um caso, a razão é qualquer valor selecionado de uma faixa de cerca de 0,01 a cerca de 0,20, por exemplo. Em ao menos um caso, a razão é qualquer valor selecionado de uma faixa de cerca de 0,01 a cerca de 0,10, por exemplo.
[00132] Além disso, quaisquer vibrações capturadas dentro do bloco 48 e do bloco 50 também podem ser desprezadas ou não consideradas enquanto os eventos dentro desses blocos não são um evento catastrófico. No caso de uma falha catastrófica, um mecanismo de acionamento 160 se torna inoperável, e certas etapas de recuperação são executadas para assegurar, entre outras coisas, uma remoção segura do instrumento cirúrgico 10 do tecido sob tratamento. Alternativamente, no caso de uma falha aguda no trem de acionamento, o trem de acionamento pode ainda ser operado para completar uma etapa cirúrgica ou para reinicializar o instrumento cirúrgico 10; entretanto, certas etapas de precaução e/ou de segurança podem ser executadas para evitar ou minimizar danos adicionais ao trem de acionamento e/ou a outros componentes do instrumento cirúrgico 10.
[00133] Novamente com referência à figura 27, em ao menos um caso, as vibrações detectadas no início e/ou no final do curso de disparo do instrumento cirúrgico 10 são desprezadas ou não consideradas para os propósitos de avaliar um estado de dano/função do instrumento cirúrgico 10. Em um exemplo, apenas as vibrações detectadas em um segmento central do curso de disparo do instrumento cirúrgico 10 são consideradas para os propósitos de avaliar um estado de dano/função do instrumento cirúrgico 10. Em ao menos um caso, as vibrações detectadas no início da zona 1 e/ou no final da zona 2 do curso de disparo do instrumento cirúrgico 10, conforme ilustrado na figura 27, são desprezadas ou não consideradas para fins de avaliação de um estado de dano/função do instrumento cirúrgico 10.
[00134] Um aumento limitado do ruído poderia indicar maior desgaste ou uma falha não catastrófica de partes das engrenagens, por exemplo. Um aumento significativo da magnitude do ruído de maneira crônica poderia indicar erosão contínua da transmissão, mas poderia ser usado para predizer a vida útil do instrumento 10 e a degradação de desempenho permitindo a conclusão de certos trabalhos, por exemplo. Um aumento dramático agudo da magnitude ou número de picos poderia indicar uma falha substancial ou catastrófica fazendo com que o instrumento inicie opções de reação mais imediatas e finais, por exemplo.
[00135] A figura 28 ilustra a velocidade do conjunto de acionamento 360 do instrumento cirúrgico 10 em relação a uma posição de deslocamento do conjunto de acionamento 360 a partir de uma posição inicial ou original. O ponto A, mostrado nas figuras 27 e 28, representa um contato inicial com o tecido, aumentando a força para avançar o conjunto de acionamento 360 do instrumento cirúrgico 10, conforme mostrado na figura 27, e diminuindo a velocidade do conjunto de acionamento 360, conforme mostrado na figura 28. O ponto B, também mostrado nas figuras 27 e 28, representa um contato com a porção mais espessa do tecido durante o grampeamento e corte. Consequentemente, o FTF no ponto B está no máximo, conforme mostrado na figura 27, e a velocidade no ponto B está em seu ponto mais baixo, conforme mostrado na figura 28. Um ou mais sensores como, por exemplo, sensores de força, podem ser configurados para medir o FTF conforme o conjunto de acionamento 360 é avançado. Além disso, um ou mais sensores de posição podem ser configurados para detectar a posição do conjunto de acionamento 360 durante uma sequência de disparo do instrumento cirúrgico 10.
[00136] Em ao menos um caso, a memória 38 inclui instruções de programa que, quando executadas pelo processador 36, fazem com que o processador 36 empregue um ou mais sensores 42 posicionados próximos de um ou mais componentes do mecanismo de acionamento 160 do instrumento cirúrgico 10, para capturar ou registrar seletivamente vibrações geradas pelo um ou mais componentes do mecanismo de acionamento 160 durante uma seção predeterminada da sequência de disparo. Em ao menos um caso, os sensores 42 são ativados pelo processador 36 em um ponto de partida da seção predeterminada e desativados em um ponto final da seção predeterminada da sequência ou curso de disparo de modo que os sensores 42 podem apenas capturar ou registrar vibrações geradas durante a seção predeterminada.
[00137] A seção predeterminada pode ter um ponto de partida após a sequência de disparo ser iniciada e um ponto final antes de a sequência de disparo ser concluída. Dito de outra forma, o processador 36 é configurado para fazer com que os sensores 42 apenas registrem vibrações em uma seção central da sequência de disparo. Conforme ilustrado na figura 28, o processador 36 pode ser configurado para fazer com que os sensores 42 comecem a capturar ou registrar vibrações durante um coeficiente angular descendente da velocidade do conjunto de acionamento 360, e parem de registrar vibrações durante um coeficiente angular ascendente da velocidade do conjunto de acionamento 360. Alternativamente, os sensores 42 podem estar ativos durante toda a sequência de disparo do instrumento cirúrgico 10, enquanto o processador 36 ignora ou exclui vibrações registradas fora da seção predeterminada da sequência ou curso de disparo.
[00138] A figura 29 ilustra modificações de limite aceitáveis com base na zona do local do curso. Os perfis de limite para ambas as zonas 1 e zona 2 são mostrados. Os valores-limite para a zona 2 são maiores que a zona 1 devido à carga do tecido no instrumento cirúrgico 10. Conforme a velocidade do instrumento diminui, conforme o instrumento se move da zona 1 para a zona 2, o espectro de potência irá se deslocar para baixo em frequência. Conforme mostrado na figura 30, que representa a amplitude de tensão versus a frequência em várias larguras de banda representadas pelos filtros mostrados na figura 24 para os pontos A e B das figuras 27 e 28, as linhas de frequência associadas ao ponto B para cada largura de banda do filtro são menores que as linhas de frequência associadas ao ponto A devido à carga no instrumento 10 a partir do tecido no ponto B e a alteração de velocidade devido à zona de curso.
[00139] Dessa forma, esses limites podem ser usados para avaliar os danos potenciais ao instrumento cirúrgico 10. Com o uso das vibrações capturadas a partir dos vários trens de acionamento do instrumento cirúrgico 10, as vibrações podem ser processadas usando-se o processador 36 mostrado na figura 21 para determinar quando a frequência das vibrações está acima de certos valores-limite armazenados na memória 38 associados ao processador 36, enquanto leva em consideração a zona de operação do instrumento cirúrgico 10 durante o tempo da captura das vibrações. Quando o instrumento cirúrgico 10 é determinado como defeituoso de alguma forma, o instrumento 10 pode ser reparado ou substituído antes da esterilização ou seu uso subsequente. Várias outras medidas de segurança e/ou correção também podem ser tomadas.
[00140] Em um outro aspecto, a magnitude do ruído produzido pelo instrumento cirúrgico 10 pode ser comparada a harmônicas de sistema predefinidas para avaliar os danos potenciais ao instrumento cirúrgico 10, e a gravidade desse dano. Conforme mostrado na figura 31, a saída do sensor 42 de um ou mais trens de acionamento do instrumento cirúrgico 10 é apresentada como um sinal de tensão para a zona 1, por exemplo. Cada frequência, conforme capturada durante o processamento do sinal através dos filtros, como aqueles mostrados na figura 24, pode ter seu próprio perfil-limite.
[00141] Por exemplo, conforme mostrado na figura 31, cada frequência pode ter seu próprio limite aceitável 54, limite marginal 56 e limite crítico 58 para cada zona de operação do instrumento cirúrgico 10. Com base no exemplo mostrado na figura 31, todas as frequências são aceitáveis e representam um instrumento cirúrgico 10 que funciona adequadamente, exceto pela frequência representada por A'. Em ao menos um caso, isso faz com que um processador, como o processador 36 mostrado na figura 24, conclua que ocorreu uma falha aguda, mas não catastrófica, do trem de acionamento.
[00142] Além do exposto acima, em ao menos um caso, o processador 36 é configurado para concluir que ocorreu uma falha catastrófica do trem de acionamento, quando qualquer uma frequência é igual ou excede o limite crítico 58. Alternativamente, o processador 36 pode ser configurado para concluir que uma falha catastrófica do trem de acionamento ocorreu somente quando uma pluralidade de frequências é igual ou excede o limite crítico 58, por exemplo. Alternativamente, o processador 36 pode ser configurado para concluir que uma falha catastrófica do trem de acionamento ocorreu somente quando todas as frequências, conforme capturadas durante o processamento do sinal através dos filtros, são iguais ou excedem o limite crítico 58, por exemplo.
[00143] Além do exposto acima, em ao menos um caso, o processador 36 é configurado para concluir que uma falha de trem de acionamento aguda ocorreu quando qualquer uma frequência é igual ou excede o limite marginal 56, mas está abaixo do limite crítico 58, conforme ilustrado na figura 31. Alternativamente, o processador 36 pode ser configurado para concluir que uma falha de trem de acionamento aguda ocorreu somente quando uma pluralidade de frequências é igual ou excede o limite marginal 56, mas abaixo do limite crítico 58, por exemplo. Alternativamente, o processador 36 pode ser configurado para concluir que uma falha de trem de acionamento aguda ocorreu somente quando todas as frequências, conforme capturadas durante o processamento do sinal através dos filtros, são iguais ou excedem o limite marginal 56, mas abaixo do limite crítico 58, por exemplo.
[00144] Com referência à figura 32, um diagrama lógico 21 representa possíveis operações que podem ser implementadas pelo instrumento cirúrgico 10 em resposta às falhas detectadas no trem de acionamento. A memória 38 pode incluir instruções de programa que, quando executadas pelo processador 36, podem fazer com que o processador 36 avalie a gravidade de uma falha do trem de acionamento com base na entrada dos sensores 42 e ative as respostas adequadas dependendo da gravidade determinada. A memória 38 pode incluir instruções de programa que, quando executadas pelo processador 36, podem fazer com que o processador 36 responda a uma falha aguda detectada 23 no trem de acionamento mediante a ativação de um modo de segurança 22 de operação, por exemplo. Além disso, a memória 38 pode incluir instruções de programa que, quando executadas pelo processador 36, podem fazer com que o processador 36 responda a uma falha catastrófica no trem de acionamento detectada através da ativação de um modo de recuperação ou resgate 22. Quando não é detectada nenhuma falha no trem de acionamento, o processador 36 pode permitir que o instrumento cirúrgico 10 continue 27 com operações normais até que uma falha no trem de acionamento seja detectada.
[00145] Novamente com referência à figura 32, o modo de segurança 22 pode compreender uma ou mais etapas como, por exemplo, uma etapa de modulação do motor que pode ser empregada pelo processador 36 para limitar a velocidade de um trem de acionamento ativo. Por exemplo, quando o trem de acionamento de disparo 16 estiver sendo acionado ativamente pelo motor 166 durante uma sequência de disparo, uma detecção de uma falha aguda no trem de acionamento pelo módulo 40 pode fazer com que o processador 36 comunique instruções ao circuito de acionamento do motor 18' (figura 20) para fazer com que a saída mecânica do motor 166 seja reduzida. Uma redução na saída mecânica do motor 166 reduz a velocidade do trem de acionamento ativo 16 que garante a conclusão segura da sequência de disparo e/ou reconfiguração do trem de acionamento 16 para uma posição original ou inicial.
[00146] Em um outro aspecto, uma comparação de frequência de uma magnitude de ruído cumulativa em relação a um limiar mínimo e/ou máximo predeterminado é usada para avaliar os danos potenciais ao instrumento cirúrgico 10. Em ao menos um caso, um limiar mínimo define um limite aceitável 54. Uma magnitude de ruído cumulativa que está abaixo do limiar mínimo é interpretada pelo processador 36 como um limite aceitável 54. Além disso, um limiar máximo pode ser empregado para definir um limite crítico 58. Uma magnitude de ruído cumulativa que está acima do limiar mínimo é interpretada pelo processador 36 como um limite crítico 58. Um limite marginal 56 pode ser definido pelos limiares mínimo e máximo. Em um exemplo, uma magnitude de ruído cumulativa que está acima do limiar mínimo, mas abaixo do limiar máximo, é interpretada pelo processador 36 como um limite marginal 56.
[00147] A figura 33 é uma representação de um sinal processado da saída de um sensor 42 que foi filtrado por quatro filtros de passagem de banda, BPF1, BPF2, BPF3 e BPF4. O sinal processado é representado dentro de larguras de banda de frequência a1, a2, a3, e a4 que correspondem às larguras de banda dos quatro filtros de passagem de banda, BPF1, BPF2, BPF3 e BPF4.
[00148] A figura 33 ilustra um gráfico da amplitude de tensão versus frequência do sinal processado. As amplitudes de tensão de peal do sinal processado nas frequências centrais dos filtros de passagem de banda, BPF1, BPF2, BPF3 e BPF4 são representadas por linhas verticais sólidas A, A', A” e A"', respectivamente. Além disso, um valor- limite de linha de base 60 é usado para permitir que uma quantidade previsível de ruído seja desprezada ou não considerada. O ruído adicional pode ser levado em consideração ou desprezado, dependendo de onde ele se enquadra no espectro de frequências.
[00149] No exemplo ilustrado na figura 33, a amplitude da tensão Z2 é descontada conforme está abaixo do valor-limite de linha de base 60 que representou um nível aceitável de ruído, e Z4 é descontado conforme não se enquadra nas larguras de banda predeterminadas a1, a2, a3, e a4. Conforme Z, Z1 e Z3 se situam acima do valor-limite de linha de base 60 e estão dentro das larguras de banda predeterminadas a1, a2, a3 e a4, essas amplitudes de tensão são consideradas com um, um A, A', A” e A"' na definição da magnitude de ruído cumulativa e, por sua vez, determinando os possíveis danos ao instrumento 10.
[00150] Em ao menos um caso, os valores de amplitude de tensão nas frequências centrais A, A', A” e A"' são somados para gerar a magnitude de ruído cumulativa, conforme representada pela amplitude de tensão, que é então empregada para avaliar se ocorreu uma falha e, caso positivo, a gravidade dessa falha. Em outro caso, os valores de amplitude de tensão nas frequências centrais A, A', A” e A"' e qualquer amplitude de tensão dentro das larguras de banda predeterminadas a1, a2, a3 e a4 são somados para gerar a magnitude de ruído cumulativa, conforme representada pela amplitude de tensão, que é então empregada para avaliar se ocorreu uma falha e, caso positivo, a gravidade dessa falha. Em outro caso, os valores de amplitude de tensão nas frequências centrais A, A', A” e A"' e quaisquer valores de amplitude de tensão maiores que o valor-limite de linha de base 60 e dentro das larguras de banda predeterminadas a1, a2, a3 e a4 são somados para gerar a magnitude de ruído cumulativa, conforme representada pela amplitude de tensão, que é então empregada para avaliar se ocorreu uma falha e, caso positivo, a gravidade dessa falha.
[00151] Em vários casos, uma comparação entre um sinal de ruído atual e um sinal de ruído anteriormente registrado, que pode estar armazenado na memória 38, pode ser empregada pelo processador 36 para determinar um estado de dano/função do instrumento cirúrgico 10. Um sinal de ruído que é registrado pelo sensor 42 durante uma operação normal do instrumento cirúrgico 10 pode ser filtrado e processado pelo processador 36 para gerar um sinal processado normal que é armazenado na memória 38. Qualquer sinal de ruído novo registrado pelo sensor 42 pode ser filtrado e processado da mesma maneira que o sinal de ruído normal para gerar um sinal processado atual que pode ser comparado ao sinal processado normal armazenado na memória 38.
[00152] Um desvio entre a assinatura processada atual e o sinal processado normal além de um limiar predeterminado pode ser interpretado como um dano potencial ao instrumento cirúrgico 10. O sinal processado normal pode ser ajustado na primeira vez em que o instrumento é usado, por exemplo. Alternativamente, um sinal processado atual torna-se o sinal processado normal contra o próximo sinal processado atual.
[00153] A figura 34 é uma representação de dois sinais processados da saída de um sensor 42 que foram filtrados por quatro filtros de passagem de banda, BPF1, BPF2, BPF3 e BPF4. Os sinais processados são representados em larguras de banda de frequência a1, a2, a3, e a4 que correspondem às larguras de banda dos quatro filtros de passagem de banda, BPF1, BPF2, BPF3, e BPF4. A figura 34 ilustra um gráfico da amplitude de tensão versus frequência do sinal processado.
[00154] As amplitudes de tensão dos sinais processados normal e atual são representadas por linhas verticais sólidas. O sinal processado normal está nas linhas sólidas enquanto o sinal processado atual está nas linhas tracejadas representando um sinal processado atual/presente, conforme descrito acima. Há um valor- limite de linha de base 60 que é usado para permitir que uma quantidade previsível de ruído seja desprezada, similar ao limiar de linha de base 60 da figura 33. A diferença entre as duas iterações é calculada e mostrada como δ1, δ2, e δ3 na figura 34. Há vários valores-limite que são comparados aos vários valores de δ para determinar os danos ao instrumento cirúrgico 10, indicando um δ aceitável, um δ marginal ou um δ crítico, que indicaria a necessidade de substituir ou reparar o instrumento 10.
[00155] Em ao menos um caso, uma ou mais amplitudes de tensão são comparadas com as amplitudes de tensão correspondentes em um padrão de ruído previamente registrado para avaliar quaisquer danos ao instrumento cirúrgico 10. A diferença entre uma amplitude de tensão presente e uma amplitude de tensão armazenada anteriormente pode ser comparada com um ou mais limiares predeterminados, que podem ser armazenados na memória 38, para selecionar uma saída de um estado aceitável, marginal ou crítico.
[00156] Em ao menos um caso, as diferenças entre as amplitudes de tensão presentes e as amplitudes de tensão anteriormente armazenadas são somadas e comparadas a um ou mais limiares predeterminados armazenados na memória 38, por exemplo, para selecionar uma saída de um estado aceitável, marginal ou crítico. A magnitude do desvio poderia ser comparada com a faixa para indicar alteração de cisalhamento em um evento local.
[00157] Em vários casos, um ou mais algoritmos, que podem ser armazenados na memória 38, podem ser empregados pelo processador 36 para determinar um estado de dano/função do instrumento cirúrgico 10, com base no sinal processado da saída do sensor 42. Diferentes sinais de ruído que são registrados pelo sensor 42 podem ser interpretados como representando diferentes situações de dano/função do instrumento cirúrgico 10. Durante a operação normal, um sinal de ruído normal ou esperado é registrado pelo sensor 42. Quando um sinal de ruído anormal é registrado pelo sensor 42, ele pode ser adicionalmente avaliado pelo processador 36, com o uso de um ou mais dos algoritmos armazenados na memória 38, para determinar um estado de dano/função do instrumento cirúrgico 10. O sinal anormal pode compreender características exclusivas que podem ser usadas para avaliar a natureza dos danos ao instrumento cirúrgico 10. Por exemplo, as características exclusivas do sinal anormal podem ser indicativas de danos a um componente particular do instrumento cirúrgico 10, que pode ser prontamente substituído.
[00158] Em certos casos, um ou mais algoritmos são configurados para avaliar o desgaste normal de um ou mais componentes do instrumento cirúrgico 10, com base no sinal processado da saída do sensor 42. O desgaste normal pode ser detectado mediante a identificação de um sinal de ruído indicativo de detritos potenciais, por exemplo. Quando os detritos, conforme medidos pelos seus sinais de ruído registrados, atingem ou excedem um limiar predeterminado armazenado na memória 38, por exemplo, o processador 36 pode ser configurado para emitir um alerta de que o instrumento cirúrgico 10 está próximo do final de sua vida útil ou exige manutenção, por exemplo.
[00159] Além disso, um ou mais algoritmos podem ser configurados para determinar danos potenciais a um ou mais mecanismos de engrenagem como, por exemplo, um mecanismo de engrenagem planetária dentro do mecanismo de acionamento 160, com base no sinal processado da saída de um sensor 42. Durante o funcionamento normal, a engrenagem planetária pode produzir um sinal de ruído normal, conforme registrado pelo sensor 42. Quando a engrenagem planetária está danificada devido a um dente quebrado, por exemplo, um sinal de ruído anormal é registrado pelo sensor 42. O sinal anormal pode compreender características exclusivas indicativas de uma engrenagem planetária danificada, por exemplo.
[00160] A figura 35 é uma representação de um sinal processado da saída de um sensor 42 que foi filtrado por quatro filtros de passagem de banda, BPF1, BPF2, BPF3 e BPF4. O sinal processado é representado dentro de larguras de banda de frequência a1, a2, a3, e a4 que correspondem às larguras de banda dos quatro filtros de passagem de banda, BPF1, BPF2, BPF3 e BPF4. Vários algoritmos, conforme descrito acima, podem ser aplicados ao sinal processado da figura 35 para determinar um estado de dano/função do instrumento cirúrgico 10.
[00161] Como a figura 33, a figura 35 ilustra um gráfico de amplitude de tensão versus frequência do sinal processado. As amplitudes de tensão do sinal processado são representadas por linhas verticais sólidas. Em cada uma das larguras de banda a1, a2, a3, e a4, o sinal processado é avaliado dentro de uma faixa esperada definida por um limiar de amplitude e um limiar de sub-banda. Espera- se que as faixas de E1, E2, E3, e E4 correspondam às larguras de banda de a1, a2, a3, e a4, respectivamente.
[00162] No exemplo ilustrado na figura 35, um primeiro evento indicativo de dano potencial à planetária é observado. O primeiro evento observado inclui um sinal processado que compreende duas leituras de amplitude de tensão que são indicativas de possíveis danos à planetária. As duas leituras de amplitude de tensão são uma primeira leitura de amplitude de tensão que excede a faixa esperada E1 na frequência central da largura de banda a1, e uma segunda leitura de amplitude de tensão em uma frequência que esteja situada entre, mas fora das larguras de banda a1 e a2. Um primeiro algoritmo pode ser configurado para reconhecer o evento observado como indicativo de possíveis danos à engrenagem planetária. O processador 36 pode empregar o primeiro algoritmo para concluir que potenciais danos à planetária são detectados.
[00163] Também, no exemplo ilustrado na figura 35, um segundo evento indicativo de um único dano potencial em conexão com uma parte central do instrumento cirúrgico 10 é observado. O segundo evento inclui um sinal processado que compreende uma leitura de amplitude de tensão que se situa abaixo do limiar de amplitude de tensão esperado na frequência central da largura de banda a2. Além disso, o sinal processado compreende as leituras de amplitude de tensão Z1 e Z2 que excedem o valor-limite de linha de base 60 e estão dentro da largura de banda a2, mas estão fora do limiar de sub-banda da faixa esperada E2. Um segundo algoritmo pode ser configurado para reconhecer o segundo evento observado como indicativo de um único dano potencial. O processador 36 pode empregar o segundo algoritmo para concluir que é detectado um dano potencial em conexão com uma parte central do instrumento cirúrgico 10.
[00164] Também, no exemplo ilustrado na figura 35, um terceiro evento indicativo de detritos potenciais indicativos de desgaste associado a um ou mais componentes do instrumento cirúrgico 10 é observado. O terceiro evento inclui um sinal processado que compreende uma leitura de amplitude de tensão que excede o limiar de amplitude de tensão esperado na frequência central da largura de banda a4. Um terceiro algoritmo pode ser configurado para reconhecer o terceiro evento observado como indicativo de detritos potenciais. O processador 36 pode empregar o terceiro algoritmo para avaliar a gravidade dos detritos potenciais com base na diferença entre a amplitude de tensão observada e o valor-limite de amplitude de tensão esperado, por exemplo.
[00165] Embora vários detalhes tenham sido apresentados na descrição acima, será reconhecido que os vários aspectos dos mecanismos de compensação das falhas no trem de acionamento em instrumentos cirúrgicos equipados com 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.
[00166] 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.
[00167] 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 específicas podem ser combinados de qualquer maneira adequada em um ou mais aspectos.
[00168] 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 descritos materiais para certos componentes, outros materiais podem ser usados. Deve-se compreender, portanto, que a descrição precedente e as concretizações se destinam a cobrir todas essas modificações e variações como estando dentro do escopo dos aspectos descritos. As concretizações se destinam a cobrir todas essas modificações e variações.
[00169] Alguns ou todos os aspectos aqui descritos podem, de modo geral, compreender tecnologias com mecanismos para compensar falhas no trem de acionamento em instrumentos cirúrgicos equipados com motor ou, caso contrário, 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.
[00170] A descrição detalhada supracitada apresentou vários aspectos 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, fluxogramas 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 descritos, 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 programas 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.).
[00171] 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, 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 do mesmo, 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.
[00172] 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.
[00173] 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.
[00174] 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.
[00175] 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.
[00176] Em alguns casos, um ou mais componentes podem ser chamados na presente invenção de "configurado para", "configurável para", "operável/operacional para", "adaptado/adaptável para", "capaz de", "conformável/conformado para", 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 o contrário.
[00177] 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 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 (por exemplo, corpos das concretizações) 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 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.
[00178] Além disso, mesmo quando um número específico de uma menção de concretização introduzida for expressamente mencionado, os versados na técnica reconhecerão que a menção deve, tipicamente, ser 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".
[00179] Em relação às concretizações, 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 sequência (s), 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 particípios adjetivos não pretendem de modo geral excluir essas variantes, exceto quando o contexto determinar em contrário.
[00180] Em certos casos, o uso de um sistema ou método pode ocorrer em um território, mesmo quando os componentes 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).
[00181] Uma venda de um sistema ou método pode, da mesma forma, ocorrer em um território, mesmo quando os componentes do sistema e/ou método estão situados e/ou são 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.
[00182] 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 descritos materiais para certos componentes, outros materiais podem ser usados. Deve-se compreender, portanto, que a descrição precedente e as concretizações se destinam a cobrir todas essas modificações e variações como estando dentro do escopo dos aspectos descritos. As concretizações se destinam a cobrir todas essas modificações e variações.
[00183] 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 ensinamentos 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 definam o escopo global.
[00184] Vários aspectos do assunto aqui descrito são definidos nas seguintes cláusulas numeradas:
[00185] 1. Aparelho cirúrgico que compreende um atuador de extremidade configurado para interagir com um tecido; e um instrumento cirúrgico que compreende ao menos um mecanismo de acionamento operável para efetuar ao menos um movimento no atuador de extremidade; e um ou mais sensores de vibração configurados para registrar vibrações geradas pelo ao menos um mecanismo de acionamento, sendo que o um ou mais sensores de vibração são configurados para gerar um sinal de saída com base nas vibrações detectadas, e sendo que o sinal de saída é empregado para selecionar entre um estado aceitável, um estado marginal e um estado crítico do instrumento cirúrgico.
[00186] 2. Aparelho cirúrgico, de acordo com a cláusula 1, que compreende adicionalmente ao menos um filtro de frequência configurado para receber o sinal de saída do um ou mais sensores de vibração, sendo que o ao menos um filtro de frequência é configurado para gerar um sinal filtrado com base no sinal de saída recebido.
[00187] 3. Aparelho cirúrgico, de acordo com qualquer uma das cláusulas 1 a 2, que compreende adicionalmente uma memória que armazena valores-limite predeterminados associados ao estado aceitável, ao estado marginal e ao estado crítico; e um processador em comunicação com o ao menos um filtro de frequência.
[00188] 4. Aparelho cirúrgico, de acordo com qualquer uma das cláusulas 1 a 3, em que a memória inclui instruções de programa que, quando executadas pelo processador, fazem com que o processador gere um sinal processado com base no sinal filtrado.
[00189] 5. Aparelho cirúrgico, de acordo com qualquer uma das cláusulas 1 a 4, em que a memória inclui instruções de programa que, quando executadas pelo processador, fazem com que o processador empregue uma transformada rápida de Fourier para desenvolver o sinal processado.
[00190] 6. Aparelho cirúrgico, de acordo com qualquer uma das cláusulas 1 a 4, em que as instruções de programa, quando executadas pelo processador, fazem com que o processador compare os valores-limite predeterminados com os valores correspondentes do sinal processado.
[00191] 7. Aparelho cirúrgico, de acordo com qualquer uma das cláusulas 1 a 4 ou 6, em que as instruções de programa, quando executadas pelo processador, fazem com que o processador detecte uma falha crítica do instrumento cirúrgico quando os valores-limite predeterminados associados ao estado crítico são iguais ou menores que os valores correspondentes do sinal processado.
[00192] 8. Aparelho cirúrgico, de acordo com qualquer uma das cláusulas 1 a 4, 6 ou 7, em que as instruções de programa, quando executadas pelo processador, fazem com que o processador detecte uma falha aguda do instrumento cirúrgico quando os valores-limite predeterminados associados ao estado crítico são maiores que os valores correspondentes do sinal processado e os valores-limite predeterminados associados ao estado marginal são iguais ou menores que os valores correspondentes do sinal processado.
[00193] 9. Aparelho cirúrgico, de acordo com qualquer uma das cláusulas 1 a 3, em que os valores-limite predeterminados são gerados a partir de um sinal de saída de teste dos um ou mais sensores de vibração.
[00194] 10. Aparelho cirúrgico, de acordo com qualquer uma das cláusulas 1 a 3 ou 9, em que o sinal de saída de teste é baseado nas vibrações de teste registradas pelos um ou mais sensores de vibração durante um procedimento de teste do instrumento cirúrgico.
[00195] 11. Aparelho cirúrgico, de acordo com qualquer uma das cláusulas 1 a 3, em que os valores-limite predeterminados são gerados a partir de um sinal processado anteriormente.
[00196] 12. Método para avaliar o desempenho de um instrumento cirúrgico incluindo um ou mais trens de acionamento, sendo que o método compreende detectar, através de um ou mais sensores de vibração, as vibrações geradas durante o funcionamento do um ou mais trens de acionamento do instrumento cirúrgico; gerar um sinal de saída com base nas vibrações detectadas; filtrar o sinal de saída para gerar um sinal filtrado das vibrações detectadas a partir do um ou mais trens de acionamento; processar o sinal filtrado para gerar um sinal processado das vibrações detectadas a partir do um ou mais trens de acionamento; e comparar os valores-limite predeterminados para cada um dentre um estado aceitável, um estado marginal e um estado crítico do instrumento cirúrgico aos valores correspondentes do sinal processado.
[00197] 13. Método, de acordo com a cláusula 12, que compreende adicionalmente detectar uma avaria crítica do instrumento cirúrgico, quando os valores-limite predeterminados associados ao estado crítico são iguais ou menores que os valores correspondentes do sinal processado.
[00198] 14. Método, de acordo com a cláusula 12, que compreende adicionalmente detectar uma falha aguda do instrumento cirúrgico, quando os valores-limite predeterminados associados ao estado crítico são maiores que os valores correspondentes do sinal processado, e os valores-limite predeterminados associados ao estado marginal são iguais ou menores que os valores correspondentes do sinal processado.
[00199] 15. Método, de acordo com qualquer uma das cláusulas 12 a 13, em que os valores-limite predeterminados são gerados a partir de um sinal de saída de teste.
[00200] 16. Método, de acordo com qualquer uma das cláusulas 12 a 13, em que o sinal de saída de teste é baseado em vibrações detectadas pelo um ou mais sensores de vibração durante um procedimento de teste do instrumento cirúrgico.
[00201] 17. Método, de acordo com a cláusula 12, em que os valores-limite predeterminados são gerados a partir de um sinal processado anteriormente.
[00202] 18. Grampeador cirúrgico que compreende um cartucho de grampos que compreende uma pluralidade de grampos passíveis de posicionamento no tecido; pelo menos um mecanismo de acionamento operável para posicionar a pluralidade de grampos no tecido durante uma sequência de disparo do grampeador cirúrgico; e um ou mais sensores de vibração configurados para registrar vibrações geradas pelo ao menos um mecanismo de acionamento, sendo que o um ou mais sensores de vibração são configurados para gerar um sinal de saída com base nas vibrações detectadas, e sendo que o sinal de saída é empregado para selecionar entre um estado aceitável, um estado marginal e um estado crítico do pelo menos um mecanismo de acionamento.
[00203] 19. Grampeador cirúrgico, de acordo com a cláusula 18, que compreende adicionalmente pelo menos um filtro de frequência configurado para receber o sinal de saída do um ou mais sensores de vibração, sendo que o pelo menos um filtro de frequência é configurado para gerar um sinal filtrado com base no sinal de saída recebido.
[00204] 20. Grampeador cirúrgico, de acordo com qualquer uma das cláusulas 18 a 19, que compreende adicionalmente uma memória que armazena valores-limite predeterminados associados ao estado aceitável, ao estado marginal e ao estado crítico; e um processador em comunicação com o ao menos um filtro de frequência.
Claims (8)
1. Aparelho cirúrgico, caracterizado pelo fato de que compreende: um atuador de extremidade (300) configurado para interagir com um tecido; e um instrumento cirúrgico, que compreende: pelo menos um mecanismo de acionamento (160) operável para efetuar pelo menos um movimento no atuador de extremidade (300); e um ou mais sensores de vibração (42) configurados para registrar vibrações geradas pelo ao menos um mecanismo de acionamento (160), sendo que o um ou mais sensores de vibração (42) são configurados para gerar um sinal de saída com base nas vibrações detectadas, e sendo que o sinal de saída é empregado para selecionar entre um estado aceitável, um estado marginal e um estado crítico do instrumento cirúrgico, em que o aparelho cirúrgico ainda compreende adicionalmente pelo menos um filtro de frequência configurado para receber o sinal de saída dos um ou mais sensores de vibração (42), sendo que o pelo menos um filtro de frequência é configurado para gerar um sinal filtrado compreendendo uma amplitude de tensão em uma frequência específica com base no sinal de saída recebido, uma memória (38) que armazena valores-limite predeterminados associados ao estado aceitável, ao estado marginal e ao estado crítico; e um processador (36) em comunicação com o pelo menos um filtro de frequência, sendo que a memória (38) inclui um método que, quando executado pelo processador (36), faz com que o processador (36) gere um sinal processado com base no sinal filtrado, e em que o método, quando executado pelo processador (36), faz com que o processador (36) compare os valores-limite predeterminados com valores correspondentes do sinal processado.
2. Aparelho cirúrgico, de acordo com a reivindicação 1, caracterizado pelo fato de que a memória (38) inclui um método que, quando executado pelo processador (36), faz com que o processador (36) empregue uma transformada rápida de Fourier para desenvolver o sinal processado.
3. Aparelho cirúrgico, de acordo com a reivindicação 1, caracterizado pelo fato de que o método, quando executado pelo processador (36), faz com que o processador (36) detecte uma falha crítica do instrumento cirúrgico quando os valores-limite predeterminados associados ao estado crítico são iguais ou menores que os valores correspondentes do sinal processado.
4. Aparelho cirúrgico, de acordo com a reivindicação 1 ou 3, caracterizado pelo fato de que o método, quando executado pelo processador (36), faz com que o processador (36) detecte uma falha aguda do instrumento cirúrgico quando os valores-limite predeterminados associados ao estado crítico são maiores que os valores correspondentes do sinal processado, e os valores-limite predeterminados associados ao estado marginal são iguais ou menores que os valores correspondentes do sinal processado.
5. Aparelho cirúrgico, de acordo com qualquer uma das reivindicações 1 a 4, caracterizado pelo fato de que os valores-limite predeterminados são gerados a partir de um sinal de saída de teste dos um ou mais sensores de vibração (42).
6. Aparelho cirúrgico, de acordo com a reivindicação 5, caracterizado pelo fato de que o sinal de saída de teste é baseado nas vibrações de teste registradas pelos um ou mais sensores de vibração (42) durante um procedimento de teste do instrumento cirúrgico.
7. Aparelho cirúrgico, de acordo com qualquer uma das reivindicações 1 a 4, caracterizado pelo fato de que os valores-limite predeterminados são gerados a partir de um sinal processado anteriormente.
8. Aparelho cirúrgico, de acordo com qualquer uma das reivindicações 1 a 7, caracterizado pelo fato de que compreende um grampeador cirúrgico, compreendendo: cartucho de grampos que compreende uma pluralidade de grampos passíveis de posicionamento em tecido; em que o pelo menos um mecanismo de acionamento (160) é operável para posicionar a pluralidade de grampos no tecido durante uma sequência de disparo do grampeador cirúrgico.
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PCT/US2017/016907 WO2017139308A1 (en) | 2016-02-12 | 2017-02-08 | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
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2016
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2017
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CN108601595B (zh) | 2021-05-28 |
BR112018016405A2 (pt) | 2018-12-18 |
US11344303B2 (en) | 2022-05-31 |
CN108601595A (zh) | 2018-09-28 |
US11779336B2 (en) | 2023-10-10 |
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JP2019506232A (ja) | 2019-03-07 |
US20220225986A1 (en) | 2022-07-21 |
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EP3205284B1 (en) | 2020-03-25 |
EP3205284A1 (en) | 2017-08-16 |
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