BR112019026371B1 - Instrumento cirúrgico com sistema para controlar velocidade de membro de deslocamento - Google Patents
Instrumento cirúrgico com sistema para controlar velocidade de membro de deslocamento Download PDFInfo
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Abstract
a presente invenção refere-se a um instrumento cirúrgico motorizado. o instrumento cirúrgico inclui um membro de deslocamento móvel entre uma primeira posição e uma segunda posição para efetuar um movimento em um atuador de extremidade, um motor acoplado ao membro de deslocamento, sendo que o motor é configurado para acionar o membro de deslocamento entre a primeira posição e a segunda posição, e um circuito de controle acoplado ao motor. o circuito de controle é configurado para receber um sinal indicativo de força proveniente de um sensor, sendo que o sinal é indicativo da força apli-cada por um tubo de fechamento ao atuador de extremidade, determinar uma força de fechamento aplicada pelo tubo de fechamento ao atuador de extremidade; determinar a possibilidade de a força de fechamento estar dentro de um limite de uma força de fechamento esperada, e definir uma velocidade do motor para acionar o motor a uma velocidade que corresponde à força de fechamento em relação à força esperada.
Description
[0001] A presente invenção refere-se a instrumentos cirúrgicos e, em várias circunstâncias, a instrumentos cirúrgicos de grampeamento e corte, e a cartuchos de grampos para os mesmos, que são projetados para grampear e cortar tecidos.
[0002] Em um instrumento cirúrgico motorizado de grampeamento e corte, pode ser útil controlar a velocidade de um membro de corte ou controlar a velocidade de articulação de um atuador de extremidade. A velocidade de um membro de deslocamento pode ser determinada mediante a medição do tempo decorrido em intervalos de posição predeterminados do membro de deslocamento ou a medição da posição do membro de deslocamento em intervalos de tempo predeterminados. O controle pode ser de circuito aberto ou de circuito fechado. Tais medições podem ser úteis para avaliar as condições do tecido, como espessura do tecido, e ajustar a velocidade do elemento de corte durante um curso de disparo para ter em conta as condições do tecido. A espessura do tecido pode ser determinada pela comparação da velocidade esperada do membro de corte com a velocidade real do membro de corte. Em algumas situações, pode ser útil articular o atuador de extremidade em uma velocidade de articulação constante. Em outras situações, pode ser útil acionar o atuador de extremidade em uma velocidade de articulação diferente da velocidade de articulação padrão em uma ou mais regiões dentro de uma faixa de varredura do atuador de extremidade.
[0003] Durante o uso de um instrumento de grampeamento e corte cirúrgico motorizado é possível que a força para fechar o membro de fechamento e a taxa de alteração da força de fechamento experimentada pelo atuador de extremidade possa variar e a velocidade de disparo pode não ser adequada. Portanto, pode ser desejável controlar a velocidade de disparo do membro de corte ou do membro de disparo com base na força de fechamento experimentada pelo atuador de extremidade. Pode também ser desejável medir a carga experimentada pelo membro de fechamento e controlar a velocidade ou a taxa do membro de corte ou do membro de disparo com base na carga decrescente no membro de fechamento.
[0004] Em um aspecto, é fornecido um instrumento cirúrgico. O instrumento cirúrgico compreende: um membro de deslocamento móvel entre uma primeira posição e uma segunda posição para efetuar um movimento em um atuador de extremidade; um motor acoplado ao membro de deslocamento, sendo que o motor é configurado para acionar o membro de deslocamento entre a primeira posição e a segunda posição; e um circuito de controle acoplado ao motor, sendo que o circuito de controle é configurado para: receber um sinal indicativo de força proveniente de um sensor, sendo que o sinal é indicativo da força aplicada por um tubo de fechamento ao atuador de extremidade; determinar uma força de fechamento aplicada pelo tubo de fechamento ao atuador de extremidade; determinar a possibilidade de a força de fechamento estar dentro de um limite de uma força de fechamento es-perada; e definir uma velocidade de motor para acionar o motor a uma velocidade que corresponde à força de fechamento em relação à força esperada.
[0005] Em outro aspecto, o instrumento cirúrgico compreende um sistema de fechamento configurado para aplicar uma força de fechamento a um atuador de extremidade para fazer a transição do atuador de extremidade entre uma posição aberta e uma posição fechada; um membro de deslocamento acoplado ao sistema de fechamento, sendo que o membro de deslocamento é móvel entre uma primeira posição e uma segunda posição para efetuar um movimento no atuador de extremidade; um motor acoplado ao membro de deslocamento, sendo que o motor é configurado para acionar o membro de deslocamento entre a primeira posição e a segunda posição; e um circuito de controle acoplado ao motor, sendo que o circuito de controle é configurado para: determinar a força de fechamento exercida pelo sistema de fechamento; recuperar uma força de fechamento esperada; determinar a possibilidade de a força de fechamento estar dentro de uma tolerância da força de fechamento esperada; e ajustar o motor para acionar o membro de deslocamento a uma velocidade, sendo que a velocidade corresponde à força de fechamento em relação à força de fechamento esperada.
[0006] Em outro aspecto, é fornecido um método de controle de um motor em um instrumento cirúrgico. O instrumento cirúrgico compreende um sistema de fechamento configurado para aplicar uma força de fechamento a um atuador de extremidade para fazer a transição do atuador de extremidade entre uma posição aberta e uma posição fechada, um membro de deslocamento acoplado ao sistema de fechamento, sendo que o membro de deslocamento se move entre uma primeira posição e uma segunda posição para efetuar um movimento no atuador de extremidade, um motor acoplado ao membro de deslocamento, sendo que o motor é configurado para acionar o membro de deslocamento entre a primeira posição e a segunda posição; e um circuito de controle acoplado ao motor, sendo que o método compreende: determinar a força de fechamento exercida pelo sistema de fechamento; recuperar uma força de fechamento esperada; determinar a possibilidade de a força de fechamento estar dentro de uma tolerância da força de fechamento esperada; e definir uma velocidade de motor para acionar o motor, sendo que a velocidade de motor corresponde à força de fechamento em relação à força de fechamento esperada.
[0007] As características inovadoras dos aspectos aqui descritos são apresentadas com particularidade nas concretizações em anexo. Entretanto, esses aspectos, tanto com relação à organização quanto aos métodos de operação, podem ser mais bem compreendidos por referência à descrição a seguir, tomada em conjunto com os desenhos em anexo.
[0008] A Figura 1 é uma vista em perspectiva de um instrumento cirúrgico que tem um conjunto de eixo de acionamento intercambiável operacionalmente acoplado ao mesmo, de acordo com um aspecto desta revelação.
[0009] A Figura 2 ilustra uma vista do conjunto explodida de uma porção do instrumento cirúrgico ultrassônico da Figura 1, de acordo com um aspecto desta revelação.
[0010] A Figura 3 é uma vista do conjunto explodida de porções do conjunto de eixo de acionamento intercambiável, de acordo com um aspeto desta revelação.
[0011] A Figura 4 é uma vista em perspectiva explodida de um atuador de extremidade do instrumento cirúrgico da Figura 1, de acordo com um aspecto desta revelação.
[0012] As Figuras 5A e 5B são um diagrama de blocos de um cir cuito de controle do instrumento cirúrgico de 1 que abrangem duas folhas de desenho, de acordo com um aspecto desta revelação.
[0013] A Figura 6 é um diagrama de bloco do circuito de controle do instrumento cirúrgico da Figura 1 que ilustra interfaces entre o conjunto de cabo, o conjunto de alimentação e o conjunto de cabo e o conjunto de eixo de acionamento intercambiável, de acordo com um aspecto da presente revelação.
[0014] A Figura 7 ilustra um circuito de controle configurado para controlar aspectos do instrumento cirúrgico da Figura 1, de acordo com um aspeto da presente revelação.
[0015] A Figura 8 ilustra um circuito lógico combinacional configu rado para controlar aspectos do instrumento cirúrgico da Figura 1, de acordo com um aspecto da presente revelação.
[0016] A Figura 9 ilustra um circuito lógico sequencial configurado para controlar aspectos do instrumento cirúrgico da Figura 1, de acordo com um aspecto da presente revelação.
[0017] A Figura 10 é um diagrama de um sistema de posiciona mento absoluto do instrumento cirúrgico da Figura 1, sendo que o sistema de posicionamento absoluto compreende uma disposição de circuito de acionamento controlado do motor que compreende uma disposição de sensor, de acordo com um aspecto da presente revelação.
[0018] A Figura 11 é uma vista em perspectiva explodida da dis posição de sensor para um sistema de posicionamento absoluto, que mostra um conjunto de placa de circuito de controle e o alinhamento relativo dos elementos da disposição de sensor, de acordo com um ou mais aspectos da presente revelação.
[0019] A Figura 12 é um diagrama de um sensor de posição que compreende um sistema de posicionamento absoluto magnético giratório, de acordo com um aspecto da presente revelação.
[0020] A Figura 13 é uma vista em corte de um atuador de extre midade do instrumento cirúrgico da Figura 1, que mostra um curso do membro de disparo em relação ao tecido preso dentro do atuador de extremidade, de acordo com um aspecto da presente revelação.
[0021] A Figura 14 ilustra um diagrama de bloco de um instrumen to cirúrgico programado para controlar a translação distal de um membro de deslocamento, de acordo com um aspecto da presente revelação.
[0022] A Figura 15 ilustra um diagrama que plota dois cursos de membro de deslocamento executados, de acordo com um aspecto da presente revelação.
[0023] A Figura 16 ilustra uma vista em seção transversal de um atuador de extremidade de um instrumento cirúrgico de acordo com um ou mais aspectos da presente revelação.
[0024] A Figura 17 é uma vista em corte de uma disposição de sensor de tubo de fechamento e bigorna, sendo que a bigorna está em uma posição aberta de acordo com um aspecto da presente revelação.
[0025] A Figura 17A é uma vista em detalhe de uma extremidade distal de um tubo de fechamento que inclui uma disposição de sensor de acordo com um aspecto da presente revelação.
[0026] A Figura 18 é uma vista em corte de uma disposição de sensor de tubo de fechamento e bigorna, sendo que a bigorna está em uma posição fechada de acordo com um aspecto da presente revelação.
[0027] A Figura 19 é uma vista em corte de uma disposição de sensor de tubo de fechamento e bigorna, sendo que a bigorna está em uma posição aberta de acordo com um aspecto da presente revelação.
[0028] A Figura 20 é uma vista em corte de uma disposição de sensor de tubo de fechamento e bigorna, sendo que a bigorna está em uma posição fechada de acordo com um aspecto da presente revelação.
[0029] A Figura 21 é um diagrama de plotagem da força de tubo de fechamento esperada versus força de tubo de fechamento real, da força do membro de deslocamento e da velocidade de motor ao longo de uma operação de preensão e disparo do instrumento cirúrgico de acordo com um aspecto da presente revelação.
[0030] A Figura 22 é uma vista em detalhe do período de transição do diagrama de plotagem da força de tubo de fechamento ao longo de uma operação de preensão e disparo do instrumento cirúrgico representado na Figura 21 de acordo com um aspecto da presente revelação.
[0031] A Figura 23 é uma vista em detalhe de um intervalo de tempo do período de transição do diagrama de plotagem da força de tubo de fechamento ao longo de uma operação de preensão e disparo do instrumento cirúrgico representado na Figura 21 de acordo com um aspecto da presente revelação.
[0032] A Figura 24 é uma vista em detalhe de um intervalo de tempo do período de transição do diagrama de plotagem da força de tubo de fechamento ao longo de uma operação de preensão e disparo do instrumento cirúrgico na Figura 21 de acordo com um aspecto da presente revelação.
[0033] A Figura 25 é um diagrama de fluxo lógico de um processo que representa um programa de controle ou uma configuração lógica para controlar a velocidade do membro de deslocamento de acordo com a força de tubo de fechamento de acordo com um aspecto da presente revelação.
[0034] O requerente do presente pedido detém os seguintes pedi dos de patente depositados simultaneamente com o mesmo e que estão, cada um, incorporados no presente documento a título de referência em suas respectivas totalidades:
[0035] N° do documento do procurador END8191USNP/170054, intitulado CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT BASED ON ANGLE OF ARTICULATION, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0036] N° do documento do procurador END8192USNP/170055, intitulado SURGICAL INSTRUMENT WITH VARIABLE DURATION TRIGGER ARRANGEMENT, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0037] N° do documento do procurador END8193USNP/170056, intitulado SYSTEMS AND METHODS FOR CONTROLLING DISPLACEMENT MEMBER MOTION OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, pelos inventores Frederick E. de Shelton, IV et al., depositado em 20 de junho de 2017.
[0038] N° do documento do procurador END8194USNP/170057, intitulado SYSTEMS AND METHODS FOR CONTROLLING MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT ACCORDING TO ARTICULATION ANGLE OF END EFFECTOR, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0039] N° do documento do procurador END8195USNP/170058, intitulado SYSTEMS AND METHODS FOR CONTROLLING MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0040] N° do documento do procurador END8196USNP/170059, intitulado SURGICAL INSTRUMENT HAVING CONTROLLABLE AR-TICULATION VELOCITY pelos inventores Frederick ES. Shelton, IV et al., depositado em 20 de junho de 2017.
[0041] N° do documento do procurador END8197USNP/170060, intitulado SYSTEMS AND METHODS FOR CONTROLLING VELOCITY OF A DISPLACEMENT MEMBER OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0042] N° do documento do procurador END8222USNP/170125, intitulado CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT BASED ON ANGLE OF ARTI CULATION, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0043] N° do documento do procurador END8199USNP/170062M, intitulado ECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0044] N° do documento do procurador END8275USNP/170185M, intitulado TECHNIQUES FOR CLOSED LOOP CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, pelos inventores Raymond E. Parfett, depositado em 20 de junho de 2017.
[0045] N° do documento do procurador END8268USNP/170186, intitulado CLOSED LOOP FEEDBACK CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT BASED ON MAGNITUDE OF VELOCITY ERROR MEASUREMENTS, pelos inventores Raymond E. Parfett et al., depositado em 20 de junho de 2017.
[0046] N° do documento do procurador END8276USNP/170187, intitulado CLOSED LOOP FEEDBACK CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT BASED ON MEASURED TIME OVER A SPECIFIED DISPLACEMENT DISTANCE, pelos inventores Jason l. Harris et al., depositado em 20 de junho de 2017.
[0047] N° do documento do procurador END8266USNP/170188, intitulado CLOSED LOOP FEEDBACK CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT BASED ON MEASURED DISPLACEMENT DISTANCE TRAVELED OVER A SPECIFIED TIME INTERVAL, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0048] N° do documento do procurador END8267USNP/170189, intitulado CLOSED LOOP FEEDBACK CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT BASED ON MEASURED TIME OVER A SPECIFIED NUMBER OF SHAFT ROTATION, pelos inventores Frederick e. Shelton, IV et al., depositado em 20 de junho de 2017.
[0049] N° do documento do procurador END8269USNP/170190, intitulado SYSTEMS AND METHODS FOR CONTROLLING DISPLAYING MOTOR VELOCITY FOR A SURGICAL INSTRUMENT, pelos inventores Jason L. Harris et al., depositado em 20 de junho de 2017.
[0050] N° do documento do procurador END8270USNP/170191, intitulado SYSTEMS AND METHODS FOR CONTROLLING MOTOR SPEED ACCORDING TO USER INPUT FOR A SURGICAL INSTRUMENT, pelos inventores Jason L. Harris et al., depositado em 20 de junho de 2017.
[0051] N° do documento do procurador END8271USNP/170192, intitulado CLOSED LOOP FEEDBACK CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT BASED ON SYSTEM CONDITIONS, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0052] N° do documento do procurador END8274USDP/170193D, intitulado GRAPHICAL USER INTERFACE FOR A DISPLAY OR PORTION THEREOF, pelos inventores Jason L. Harris et al., depositado em 20 de junho de 2017.
[0053] N° do documento do procurador END8273USDP/170194D, intitulado GRAPHICAL USER INTERFACE FOR A DISPLAY OR PORTION THEREOF, pelos inventores Jason L. Harris et al., depositado em 20 de junho de 2017.
[0054] N° do documento do procurador END8272USDP/170195D, intitulado GRAPHICAL USER INTERFACE FOR A DISPLAY OR PORTION THEREOF, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0055] Certos aspectos são mostrados e descritos para fornecer um entendimento da estrutura, função, fabricação e uso dos dispositivos e métodos revelados. Os recursos mostrados ou descritos em um exemplo podem ser combinados com os recursos de outros exemplos e as modificações e variações estão dentro do escopo desta revelação.
[0056] Os termos "proximal" e "distal" são com referência a um médico que manipula o cabo do instrumento cirúrgico, sendo que termo "proximal" se refere à porção mais próxima ao médico e o termo "distal" se refere à porção localizada mais distante do médico. Para conveniência, os termos espaciais "vertical", "horizontal", "para acima" e "para baixo" usados com relação aos desenhos não se destinam a ser limitadores e/ou absolutos, porque os instrumentos cirúrgicos podem ser usados em muitas orientações e posições.
[0057] São fornecidos dispositivos e métodos exemplificadores para realização de procedimentos cirúrgicos laparoscópicos e minimamente invasivos. Tais dispositivos e métodos, entretanto, podem ser usados em outros procedimentos e aplicações cirúrgicas incluindo procedimentos cirúrgicos abertos, por exemplo. Os instrumentos cirúrgicos podem ser inseridos através de um orifício natural ou um através de uma incisão ou perfuração formada no tecido. As porções funcionais ou porções do atuador de extremidade dos instrumentos podem ser inseridas diretamente no corpo ou através de um dispositivo de acesso que tem uma canaleta funcional através do qual podem ser avançados o atuador de extremidade e o eixo de acionamento alongado do instrumento cirúrgico.
[0058] As Figuras de 1 a 4 ilustram um instrumento cirúrgico acio nado por motor 10 para corte e fixação que pode ou não ser reutiliza- do. Nos exemplos ilustrados, o instrumento cirúrgico 10 inclui um compartimento 12 que compreende um conjunto de cabo 14 que é configurado para ser pego, manipulado e atuado pelo médico. O compartimento 12 é configurado para fixação operacional a um conjunto de eixo de acionamento intercambiável 200 que tem um atuador de extremidade 300 operacionalmente acoplado a ele que é configurado para executar uma ou mais tarefas ou procedimentos cirúrgicos. De acordo com a presente descrição, várias formas de conjuntos de eixo de acionamento intercambiáveis podem ser eficazmente usadas em conexão com sistemas cirúrgicos roboticamente controlados. O termo "compartimento" pode abranger um compartimento ou porção similar de um sistema robótico que aloja ou de outro modo suporta operacionalmente ao menos um sistema de acionamento configurado para gerar e aplicar ao menos um movimento de controle que possa ser usado para acionar os conjuntos de eixo de acionamento. O termo "estrutura" pode referir-se a uma porção de um instrumento cirúrgico de mão. O termo "estrutura" pode representar também uma porção de um instrumento cirúrgico controlado roboticamente e/ou uma porção do sistema robótico que pode ser usado para controlar operacionalmente o instrumento cirúrgico. Os conjuntos de eixo de acionamento intercambiá- veis aqui revelados podem ser usados com vários sistemas robóticos, instrumentos, componentes e métodos revelados na patente US n° 9.072.535, intitulada SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, a qual está aqui incorporada a título de referência, em sua totalidade.
[0059] A Figura 1 é uma vista em perspectiva de um instrumento cirúrgico 10 que tem um conjunto de eixo de acionamento intercambi- ável 200 operacionalmente acoplado ao mesmo, de acordo com um aspeto desta revelação. O compartimento 12 inclui um atuador de extremidade 300 que compreende um dispositivo cirúrgico de corte e fi- xação configurado para suportar operacionalmente um cartucho de grampos cirúrgicos 304 no mesmo. O compartimento 12 pode ser configurado para uso em conexão com os conjuntos de eixo de acionamento intercambiáveis que incluem os atuadores de extremidade que são adaptados para sustentar diferentes tamanhos e tipos de cartuchos de grampos, e que têm diferentes comprimentos, tamanhos e tipos de eixo de acionamento. O compartimento 12 pode ser usado eficazmente com uma variedade de conjuntos de eixo de acionamento intercambiáveis incluindo conjuntos configurados para aplicar outros movimentos e formas de energia como, por exemplo, energia de radio-frequência (RF), energia ultrassônica e/ou movimento a disposições de atuadores de extremidade adaptados para uso em várias aplicações e procedimentos cirúrgicos. Os atuadores de extremidade, os conjuntos de eixo de acionamento, os cabos, os instrumentos cirúrgicos e/ou os sistemas de instrumento cirúrgico podem utilizar qualquer prendedor adequado, ou prendedores, para prender tecido. Por exemplo, um cartucho de prendedores que compreende uma pluralidade de prendedores nele armazenados de modo removível pode ser inserido de maneira removível dentro e/ou fixado ao atuador de extremidade de um conjunto de eixo de acionamento.
[0060] O conjunto de cabo 14 pode compreender um par de seg mentos interconectáveis de compartimento de cabo 16 e 18 interco- nectados por parafusos, elementos de encaixe por pressão, adesivo, etc. Os segmentos de compartimento de cabo 16, 18 cooperam para formar uma porção da empunhadura da pistola 19 que pode ser empunhada e manipulada pelo clínico. O conjunto de cabo 14 suporta operacionalmente uma pluralidade de sistemas de acionamento configurados para gerar e aplicar movimentos de controle às porções correspondentes do conjunto de eixo de acionamento intercambiável que está operacionalmente fixado ao mesmo. Uma tela pode ser fornecida abaixo uma cobertura 45.
[0061] A Figura 2 ilustra uma vista do conjunto explodida de uma porção do instrumento cirúrgico ultrassônico 10 da Figura 1, de acordo com um aspecto desta revelação. O conjunto de cabo 14 pode incluir uma estrutura 20 que suporta operacionalmente uma pluralidade de sistemas de acionamento. A estrutura 20 pode suportar operacionalmente um "primeiro" sistema de acionamento ou sistema de acionamento de fechamento 30, que pode aplicar movimentos de fechamento e abertura ao conjunto de eixo de acionamento intercambiável 200. O sistema de acionamento de fechamento 30 pode incluir um atuador como um gatilho de fechamento 32 suportado de modo pivotante pela estrutura 20. O gatilho de fechamento 32 é acoplado de modo pivotan- te ao conjunto de cabo 14 por um pino de pivô 33 para permitir que o gatilho de fechamento 32 seja manipulado por um médico. Quando o médico segura a porção de empunhadura da pistola 19 do conjunto de cabo 14, o gatilho de fechamento 32 pode pivotar de uma posição inicial ou "não atuada" para uma posição "atuada" e, mais particularmente, para uma posição completamente comprimida ou completamente atuada.
[0062] O conjunto de cabo 14 e a estrutura 20 podem suportar operacionalmente um sistema de acionamento de disparo 80 configurado para aplicar movimentos de disparo às porções correspondentes do conjunto de eixo de acionamento intercambiável fixado ao mesmo. O sistema de acionamento de disparo 80 pode empregar um motor elétrico 82 situado na porção da empunhadura da pistola 19 do conjunto de cabo 14. O motor elétrico 82 pode ser um motor de corrente contínua (CC) com escovas tendo uma rotação máxima de aproximadamente 25.000 rpm, por exemplo. Em outras disposições, o motor pode incluir um motor sem escovas, um motor sem fio, um motor síncrono, um motor de passo ou qualquer outro motor elétrico adequado. O mo tor elétrico 82 pode ser alimentado por uma fonte de alimentação 90 que pode compreender uma fonte de energia removível 92. A fonte de energia removível 92 pode compreender uma porção do compartimento proximal 94 que é configurada para fixação a uma porção do compartimento distal 96. A porção do compartimento proximal 94 e a porção do compartimento distal 96 são configuradas para suportar operacionalmente uma pluralidade de baterias 98. Cada uma das baterias 98 pode compreender, por exemplo, uma bateria de íons de lítio ("LI") ou outra bateria adequada. A porção de compartimento distal 96 está configurada para fixação operacional removível a uma placa de circuito de controle 100 que está operacionalmente acoplada ao motor elétrico 82. Várias baterias 98 conectadas em série podem alimentar o instrumento cirúrgico 10. A fonte de alimentação 90 pode ser substituível e/ou recarregável. Uma tela 43, que está situada abaixo da cobertura 45, está eletricamente acoplada à placa de circuito de controle 100. A cobertura 45 pode ser removida para expor a tela 43.
[0063] O motor elétrico 82 pode incluir um eixo de acionamento giratório (não mostrado), que, de modo operacional, faz interface com um conjunto redutor de engrenagem 84 montado em engate de acoplamento com um conjunto ou cremalheira, de dentes de acionamento 122 em um membro de acionamento longitudinalmente móvel 120. O membro de acionamento longitudinalmente móvel 120 tem uma cre- malheira de dentes de acionamento 122 formada no mesmo para engate de acoplamento com uma engrenagem de acionamento correspondente 86 do conjunto redutor de engrenagem 84.
[0064] Em uso, uma polaridade de tensão fornecida pela fonte de alimentação 90 pode operar o motor elétrico 82 no sentido horário, sendo que a polaridade de tensão aplicada ao motor elétrico pela bateria pode ser revertida de modo a operar o motor elétrico 82 no sentido anti-horário. Quando o motor elétrico 82 é girado em uma direção, o membro de acionamento longitudinalmente móvel 120 será axialmente ativado na direção distal "DD". Quando o motor elétrico 82 é acionado na direção giratória oposta, o membro de acionamento longitudinalmente móvel 120 será axialmente conduzido na direção proximal "DP". O conjunto de cabo 14 pode incluir uma chave que pode ser configurada para reverter a polaridade aplicada ao motor elétrico 82 pela fonte de alimentação 90. O conjunto de cabo 14 pode incluir um sensor configurado para detectar a posição do membro de acionamento longitudinalmente móvel 120 e/ou a direção em que o membro de acionamento longitudinalmente móvel 120 está sendo movido.
[0065] O acionamento do motor elétrico 82 pode ser controlado por um gatilho de disparo 130 que é suportado de modo pivotante sobre o conjunto de cabo 14. O gatilho de disparo 130 pode ser pivotado entre uma posição não atuada e uma posição atuada.
[0066] Retornando para a Figura 1, o conjunto de eixo de aciona mento intercambiável 200 inclui um atuador de extremidade 300 que compreende uma canaleta alongada 302 configurada para suportar operacionalmente no seu interior um cartucho de grampos cirúrgicos 304. O atuador de extremidade 300 pode incluir uma bigorna 306 que é sustentada de modo pivotante em relação à canaleta alongada 302. O conjunto de eixo de acionamento intercambiável 200 pode incluir uma junta de articulação 270. A construção e a operação do atuador de extremidade 300 e da junta articulação 270 são apresentadas na publicação de pedido de patente US n° 2014/0263541, intitulada ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, a qual está aqui incorporada a título de referência em sua totalidade. O conjunto de eixo de acionamento intercambiável 200 pode inclui um compartimento ou bocal proximal 201 compreendido de porções de bocal 202, 203. O conjunto de eixo de acionamento intercambiável 200 pode incluir um tubo de fechamento 260 que se estende ao longo de um eixo geométrico do eixo de acionamento SA que pode ser usado para fechar e/ou abrir a bigorna 306 do atuador de extremidade 300.
[0067] Voltando para a Figura 1, o tubo de fechamento 260 é transladado distalmente (direção "DD") para fechar a bigorna 306, por exemplo, em resposta à atuação do gatilho de fechamento 32 na maneira descrita na referência anteriormente mencionada da publicação de pedido de patente n° 2014/0263541. A bigorna 306 é aberta mediante a translação proximal do tubo de fechamento 260. Na posição aberta da bigorna, o tubo de fechamento 260 do eixo de acionamento é movido para sua posição proximal.
[0068] A Figura 3 é outra vista de conjunto explodida de porções do conjunto de eixo de acionamento intercambiável 200, de acordo com um ou mais aspectos da presente revelação. O conjunto de eixo de acionamento intercambiável 200 pode incluir um membro de disparo 220 sustentado para realizar um deslocamento axial no interior da coluna central 210. O membro de disparo 220 inclui um de eixo de acionamento de disparo intermediário 222 configurado para se conectar a uma porção de corte distal ou barra de corte 280. O membro de disparo 220 pode ser chamado de um "segundo eixo de acionamento" ou um "segundo conjunto de eixo de acionamento". O eixo de acionamento de disparo intermediário 222 pode incluir uma fenda longitudinal 223 em sua extremidade configurada para receber uma aba 284 na extre-midade proximal 282 da barra de corte 280. A fenda longitudinal 223 e a extremidade proximal 282 podem ser configuradas para permitir o movimento relativo entre as mesmas e podem compreender uma junta deslizante 286. A junta deslizante 286 pode permitir que o eixo de acionamento de disparo intermediário 222 do membro de disparo 220 articule o atuador de extremidade 300 em torno da junta de articulação 270 sem mover, ou ao menos sem mover substancialmente, a barra de corte 280. Quando o atuador de extremidade 300 tiver sido adequadamente orientado, o eixo de acionamento de disparo intermediário 222 pode ser avançado distalmente até uma parede lateral proximal da fenda longitudinal 223 entrar em contato com a aba 284 para avançar a barra de corte 280 e disparar um cartucho de grampos posicionado no interior da canaleta 302. O dorso 210 tem uma abertura ou janela alongada 213 em seu interior para facilitar a montagem e a inserção do eixo de acionamento de disparo intermediário 222 no interior do dorso 210. Quando o eixo de acionamento de disparo intermediário 222 tiver sido inserido no mesmo, um segmento superior da estrutura 215 pode ser engatado na estrutura do eixo de acionamento 212 para encerrar em si o eixo de acionamento de disparo intermediário 222 e a barra de corte 280. A operação do membro de disparo 220 pode ser vista na publicação de pedido de patente US n° 2014/0263541. A coluna central 210 pode ser configurada para suportar de maneira deslizante um membro de disparo 220 e o tubo de fechamento 260 que se estende ao redor da coluna central 210. A coluna central 210 pode suportar de maneira deslizante um acionador de articulação 230.
[0069] O conjunto de eixo de acionamento intercambiável 200 po de incluir um conjunto de embreagem 400 configurado para acoplar de modo seletivo e liberável o acionador de articulação 230 ao membro de disparo 220. O conjunto de embreagem 400 inclui um anel ou luva de travamento 402 posicionado em torno do membro de disparo 220, sendo que a luva de travamento 402 pode ser girada entre uma posição engatada, em que a luva de travamento 402 acopla o acionador de articulação 230 ao membro de disparo 220, e uma posição desengatada, em que o acionador de articulação 230 não está acoplado de modo operável ao membro de disparo 220. Quando a luva de trava- mento 402 está na posição engatada, o movimento distal do membro de disparo 220 pode mover o acionador de articulação 230 em sentido distal e, correspondentemente, o movimento proximal do membro de disparo 220 pode mover o acionador de articulação 230 proximalmen- te. Quando a luva de travamento 402 está na posição desengatada, o movimento do membro de disparo 220 não é transmitido para o acio- nador de articulação 230 e, como resultado, o membro de disparo 220 pode mover-se independentemente do acionador de articulação 230. O bocal 201 pode ser empregado para engatar e desengatar operacionalmente o sistema de acionamento de articulação com o sistema de acionamento de disparo nas várias formas descritas na publicação de pedido de patente US n° 2014/0263541.
[0070] O conjunto de eixo de acionamento intercambiável 200 po de compreender um conjunto de anel deslizante 600 que pode ser configurado para conduzir energia elétrica ao atuador de extremidade 300 e/ou a partir dele e/ou comunicar sinais ao atuador de extremidade 300 e/ou a partir dele, por exemplo. O conjunto de anel deslizante 600 pode compreender um flange de conector proximal 604 e um flange de conector distal 601 posicionado no interior de uma fenda definida nas porções de bocal 202, 203. O flange do conector proximal 604 pode compreender uma primeira face e o flange do conector distal 601 pode compreender uma segunda face posicionada adjacente e móvel em relação à primeira face. O flange de conector distal 601 pode girar em relação ao flange de conector proximal 604 ao redor do eixo geométrico do eixo de acionamento SA-SA (Figura 1). O flange de conector proximal 604 pode compreender uma pluralidade de condutores concêntricos ou ao menos substancialmente concêntricos 602, definidos na sua primeira face. Um conector 607 pode ser montado sobre o lado proximal do flange de conector distal 601 e pode ter uma pluralidade de contatos, sendo que cada contato corresponde e está em contato elétrico com um dos condutores 602. Essa disposição permite a rotação relativa entre o flange de conector proximal 604 e o flange de conector distal 601, enquanto o contato elétrico é mantido entre os mesmos. O flange de conector proximal 604 pode incluir um conector elétrico 606 que pode colocar os condutores 602 em comunicação de sinal com uma placa de circuito de eixo de acionamento, por exemplo. Em ao menos um caso, um chicote elétrico que compreende uma pluralidade de condutores pode se estender entre o conector elétrico 606 e a placa de circuito do eixo de acionamento. O conector elétrico 606 pode se estender proximalmente através de uma abertura do conector definida no flange de montagem do chassi. A publicação de pedido de patente US n° 2014/0263551, intitulada "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", está aqui incorporada a título de referência em sua totalidade. A publicação de pedido de patente US n° 2014/0263552, intitulada "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", está aqui incorporada a título de referência em sua totalidade. Detalhes adicionais com relação ao conjunto do anel de deslizamento 600 podem ser encontrados na publicação de pedido de patente US n° 2014/0263541.
[0071] O conjunto de eixo de acionamento intercambiável 200 po de incluir uma porção proximal montada de forma fixável ao conjunto de cabo 14, e uma porção distal que é giratória em torno de um eixo geométrico longitudinal. A porção giratória distal do eixo de acionamento pode ser girada em relação à porção proximal ao redor do conjunto de anel de deslizamento 600. O flange de conector distal 601 do conjunto de anel deslizante 600 pode ser posicionado na porção de eixo de acionamento giratório distal.
[0072] A Figura 4 é uma vista explodida de um aspecto de um atu- ador de extremidade 300 do instrumento cirúrgico 10 da Figura 1, de acordo com um aspecto desta revelação. O atuador de extremidade 300 pode incluir a bigorna 306 e o cartucho de grampos cirúrgicos 304. A bigorna 306 pode ser acoplada a uma canaleta alongada 302. As aberturas 199 podem ser definidas na canaleta alongada 302 para receber pinos 152 que se estendem a partir da bigorna 306 para permitir que a bigorna 306 gire de uma posição aberta para uma posição fechada em relação à canaleta alongada 302 e cartucho de grampos cirúrgicos 304. Uma barra de disparo 172 é configurada para se transladar longitudinalmente para o interior do atuador de extremidade 300. A barra de disparo 172 pode ser construída em uma seção sólida ou pode incluir um material laminado que compreende, por exemplo, uma pilha de placas de aço. A barra de disparo 172 compreende uma haste com perfil em "I" 178 e um gume cortante 182 em uma extremidade distal do mesmo. Uma extremidade da barra de disparo 172 distalmen- te projetada pode ser fixada à haste com perfil em I 178 para auxiliar no espaçamento da bigorna 306 a partir de um cartucho de grampos cirúrgicos 304 posicionado na canaleta alongada 302 quando a bigorna 306 está em posição fechada. A haste com perfil em I 178 pode incluir um gume cortante afiado 182, que pode ser usado para separar o tecido, conforme a haste com perfil em I 178 é avançada distalmente pela barra de disparo 172. Em funcionamento, a haste com perfil em I 178 pode, ou disparar, o cartucho de grampos cirúrgicos 304. O cartucho de grampos cirúrgicos 304 pode incluir um corpo de cartucho moldado 194 que mantém uma pluralidade de grampos 191 que repousam sobre os acionadores de grampo 192 no interior das respectivas cavidades de grampos abertas para cima 195. Um deslizador em cunha 190 é acionado distalmente pela haste com perfil em I 178, deslizando sobre uma bandeja do cartucho 196 do cartucho de grampos cirúrgicos 304. O deslizador em cunha 190 desloca para cima, por came, os acionadores de grampo 192, para expelir os grampos 191 em contato de deformação com a bigorna 306, enquanto a borda de corte 182 da haste com perfil em I 178 corta o tecido apertado.
[0073] A haste com perfil em I 178 pode incluir pinos superiores 180 que engatam a bigorna 306 durante o disparo. A haste com perfil em I 178 pode incluir pinos intermediários 184 e uma base ("bottom foot") 186 para engatar porções do corpo do cartucho 194, da bandeja do cartucho 196 e da canaleta alongada 302. Quando um cartucho de grampos cirúrgicos 304 está posicionado no interior da canaleta alongada 302, uma fenda 193 definida no corpo de cartucho 194 pode ser alinhada com uma fenda longitudinal 197 definida na bandeja do cartucho 196 e uma fenda 189 definida na canaleta alongada 302. Durante o uso, a haste com perfil em I 178 pode deslizar através das fendas longitudinais alinhadas 193, 197 e 189, sendo que, como indicado na Figura 4, a base 186 da haste com perfil em I 178 pode engatar um sulco posicionado ao longo da superfície inferior da canaleta alongada 302 ao longo do comprimento da fenda 189, os pinos médios 184 podem engatar as superfícies de topo da bandeja de cartucho 196 ao longo do comprimento da fenda longitudinal 197, e os pinos superiores 180 podem engatar a bigorna 306. A haste com perfil em I 178 pode espaçar ou limitar o movimento relativo entre a bigorna 306 e o cartucho de grampos cirúrgicos 304, conforme a barra de disparo 172 é avançada distalmente de forma a disparar os grampos do cartucho de grampos cirúrgicos 304 e/ou fazer uma incisão no tecido capturado entre a bigorna 306 e o cartucho de grampos cirúrgicos 304. A barra de disparo 172 e a haste com perfil em I 178 podem ser retraídas pro- ximalmente permitindo que a bigorna 306 seja aberta para liberar as duas porções de tecido grampeadas e cortadas.
[0074] As Figuras 5A e 5B são um diagrama de blocos de um cir cuito de controle 700 do instrumento cirúrgico 10 da Figura 1 que abrange duas folhas de desenho de acordo com um aspecto desta revelação. Com referência principalmente às Figuras 5A e 5B, um conjunto de empunhadura 702 pode incluir um motor 714, que pode ser controlado por um acionador do motor 715 e pode ser empregado pelo sistema de disparo do instrumento cirúrgico 10. Em várias formas, o motor 714 pode ser um motor de acionamento de corrente contínua (CC) com escovas com uma velocidade de rotação máxima de aproximadamente 25.000 RPM. Em outras disposições, o motor 714 pode incluir um motor sem escovas, um motor sem fio, um motor síncrono, um motor de passo ou qualquer outro tipo de motor elétrico adequado. O acionador de motor 715 pode compreender um acionador de ponte H que compreende transístores de efeito de campo (FETs) 719, por exemplo. O motor 714 pode ser alimentado pelo conjunto de alimentação 706 montado de modo liberável ao conjunto de cabo 200 para fornecer energia de controle ao instrumento cirúrgico 10. O conjunto de alimentação 706 pode compreender uma bateria que pode incluir várias células de bateria conectadas em série, as quais podem ser usadas como a fonte de energia para energizar o instrumento cirúrgico 10. Em determinadas circunstâncias, as células de bateria do conjunto de alimentação 706 podem ser substituíveis e/ou recarregáveis. Em ao menos um exemplo, as células de bateria podem ser baterias de íon de lítio que podem ser separavelmente acopláveis ao conjunto de alimentação 706.
[0075] O conjunto de eixo de acionamento 704 pode incluir um controlador do conjunto de eixo de acionamento 722 que pode se comunicar com um controlador de segurança e um controlador de gerenciamento de energia 716 através de uma interface, enquanto o conjunto de eixo de acionamento 704 e o conjunto de alimentação 706 são acoplados ao conjunto de cabo 702. Por exemplo, a interface pode compreender uma primeira porção de interface 725 que pode incluir um ou mais conectores elétricos para engate de acoplamento com conectores elétricos de conjunto de eixo de acionamento correspondentes e uma segunda porção de interface 727 que pode incluir um ou mais conectores para engate de acoplamento com os conectores elé- tricos do conjunto de energia correspondentes para possibilitar a comunicação elétrica entre o controlador do conjunto de eixo de acionamento 722 e o controlador de gerenciamento de energia 716 enquanto o conjunto de eixo de acionamento 704 e o conjunto de alimentação 706 são acoplados ao conjunto de cabo 702. Um ou mais sinais de comunicação podem ser transmitidos através da interface para comunicar um ou mais dos requisitos de energia do conjunto de eixo de acionamento intercambiável fixado 704 ao controlador de gerenciamento de energia 716. Em resposta, o controlador de gerenciamento de energia pode modular a saída de energia da bateria do conjunto de alimentação 706, conforme descrito abaixo com mais detalhes, de acordo com as exigências de energia do conjunto de eixo de acionamento fixado 704. Os conectores podem compreender chaves que podem ser ativadas após o engate por acoplamento mecânico do conjunto de cabo 702 ao conjunto de eixo de acionamento 704 e/ou ao conjunto de energia 706 para permitir a comunicação elétrica entre o controlador de conjunto de eixo acionamento 722 e o controlador de gerenciamento de energia 716.
[0076] A interface pode facilitar a transmissão do um ou mais si nais de comunicação entre o controlador de gerenciamento de energia 716 e o controlador do conjunto de eixo de acionamento 722 mediante o roteamento destes sinais de comunicação através de um controlador principal 717 situado no conjunto de cabo 702, por exemplo. Em outras circunstâncias, a interface pode facilitar uma linha de comunicação direta entre o controlador de gerenciamento de energia 716 e o controlador do conjunto de eixo de acionamento 722 através do conjunto de cabo 702, enquanto o conjunto de eixo de acionamento 704 e o conjunto de alimentação 706 estão acoplados ao conjunto de cabo 702.
[0077] O controlador principal 717 pode ser qualquer processador de núcleo único ou de múltiplos núcleos, como aqueles conhecidos sob o nome comercial de ARM Cortex pela Texas Instruments. Em um aspecto, o controlador principal 717 pode ser um processador Core Cortex-M4F LM4F230H5QR ARM, disponível junto à Texas Instruments, por exemplo, que compreende uma memória integrada de memória flash de ciclo único de 256 KB, ou outra memória não volátil, até 40 MHz, um buffer de busca antecipada para otimizar o desempenho acima de 40 MHz, uma memória de acesso aleatório seriada de ciclo único de 32 KB (SRAM), uma memória só de leitura interna (ROM) carregada com o programa StellarisWare®, memória só de leitura programável e apagável eletricamente (EEPROM) de 2 KB, um ou mais módulos de modulação por largura de pulso (PWM), uma ou mais análogos de entradas de codificador de quadratura (QEI), um ou mais conversores analógico-digitais (ADC) de 12 bits com 12 canais de entrada analógica, detalhes dos quais estão disponíveis para a folha de dados do produto.
[0078] O controlador de segurança pode ser uma plataforma de controlador de segurança que compreende duas famílias baseadas em controladores, como TMS570 e RM4x, conhecidas sob o nome comercial de Hercules ARM Cortex R4, também pela Texas Instruments. O controlador de segurança pode ser configurado especificamente para as aplicações críticas de segurança IEC 61508 e ISO 26262, dentre outras, para fornecer recursos avançados de segurança integrada enquanto fornece desempenho, conectividade e opções de memória escalonáveis.
[0079] O conjunto de alimentação 706 pode incluir um circuito de gerenciamento de energia que pode compreender o controlador de gerenciamento de energia 716, um modulador de energia 738 e um circuito sensor de corrente 736. O circuito de gerenciamento de energia pode ser configurado para modular a energia de saída da bateria com base nas necessidades de energia do conjunto de eixo de acio- namento 704, enquanto o conjunto de eixo de acionamento 704 e o conjunto de alimentação 706 são acoplados ao conjunto de cabo 702. O controlador de gerenciamento de energia 716 pode ser programado para controlar o modulador de energia 738 da saída de energia do conjunto de alimentação 706 e o circuito sensor de corrente 736 pode ser empregado para monitorar a saída de energia do conjunto de alimentação 706 para fornecer realimentação ao controlador de gerenciamento de energia 716 sobre a saída de energia da bateria para que o controlador de gerenciamento de energia 716 possa ajustar a saída de energia do conjunto de alimentação 706 para manter uma saída desejada. O controlador de gerenciamento de energia 716 e/ou o controlador do conjunto de eixo de acionamento 722 podem compreender, cada um, um ou mais processadores e/ou unidades de memória que podem armazenar vários módulos de software.
[0080] O instrumento cirúrgico 10 (Figuras de 1 a 4) pode compre ender um dispositivo de saída 742 que pode incluir dispositivos para fornecer uma realimentação sensorial a um usuário. Esses dispositivos podem compreender, por exemplo, dispositivos de retroinformação visual (por exemplo, um monitor com tela de LCD, indicadores em LED), dispositivos de retroinformação auditiva (por exemplo, um alto-falante, uma campainha) ou dispositivos de retroinformação tátil (por exemplo, atuadores hápticos). Em determinadas circunstâncias, o dispositivo de saída 742 pode compreender uma tela 743 que pode estar incluída no conjunto de cabo 702. O controlador do conjunto de eixo de acionamento 722 e/ou o controlador de gerenciamento de energia 716 podem fornecer retroinformação a um usuário do instrumento cirúrgico 10 através do dispositivo de saída 742. A interface pode ser configurada para conectar o controlador do conjunto de eixo de acionamento 722 e/ou o controlador de gerenciamento de energia 716 ao dispositivo de saída 742. O dispositivo de saída 742 pode, em vez disso, ser integra- do com o conjunto de alimentação 706. Nestas circunstâncias, a comunicação entre o dispositivo de saída 742 e o controlador do conjunto de eixo de acionamento 722 pode ser feita através da interface, enquanto o conjunto de eixo de acionamento 704 é acoplado ao conjunto de cabo 702.
[0081] O circuito de controle 700 compreende segmentos de cir cuito configurados para controlar as operações do instrumento cirúrgico energizado 10. Um segmento de controlador de segurança (segmento 1) compreende um controlador de segurança e o segmento de controlador principal 717 (segmento 2). O controlador de segurança e/ou o controlador principal 717 são configurados para interagir com um ou mais segmentos de circuito adicionais como um segmento de aceleração, um segmento de exibição, um segmento de eixo de acionamento, um segmento de codificador, um segmento de motor, e um segmento de alimentação. Cada um dos segmentos de circuito pode ser acoplado ao controlador de segurança e/ou ao controlador principal 717. O controlador principal 717 é também acoplado a uma memória flash. O controlador principal 717 compreende também uma interface de comunicação serial. O controlador principal 717 compreende uma pluralidade de entradas acopladas, por exemplo, a um ou mais segmentos de circuito, uma bateria, e/ou uma pluralidade de chaves. O circuito segmentado pode ser implementado por qualquer circuito adequado, como, por exemplo, um conjunto de placa de circuito impresso (PCBA) dentro do instrumento cirúrgico energizado 10. Deve- se compreender que o termo processador, conforme usado aqui, inclui qualquer microprocessador, processador, controlador, controladores ou outro dispositivo de computação básico que incorpora as funções de uma unidade de processamento central do computador (CPU) em um circuito integrado ou no máximo alguns circuitos integrados. O controlador principal 717 é um dispositivo programável multiuso que aceita dados digitais como entrada, processa-os de acordo com as instruções armazenadas em sua memória, e fornece resultados como saída. Este é um exemplo de lógica digital sequencial, já que ele tem memória interna. O circuito de controle 700 pode ser configurado para implementar um ou mais dos processos aqui descritos.
[0082] O segmento de aceleração (segmento 3) compreende um acelerômetro. O acelerômetro é configurado para detectar o movimento ou a aceleração do instrumento cirúrgico energizado 10. A entrada a partir do acelerômetro pode ser usada para fazer a transição para e a partir de um modo de suspensão, identificar a orientação do instrumento cirúrgico energizado, e/ou identificar quando o instrumento cirúrgico for deixado cair. Em alguns exemplos, o segmento de aceleração é acoplado ao controlador de segurança e/ou ao controlador principal 717.
[0083] O segmento de tela ou exibição (segmento 4) compreende um conector da tela acoplado ao controlador principal 717. O conector da tela acopla o controlador primário 717 a uma tela através de um ou mais acionadores dos circuitos integrados da tela. Os acionadores dos circuitos integrados da tela podem estar integrados com a tela e/ou podem estar situados separadamente da tela. A tela pode compreender qualquer tela adequada, como, por exemplo, uma tela de diodos emissores de luz orgânicos (OLED), uma tela de cristal líquido (LCD), e/ou qualquer outra tela adequada. Em alguns exemplos, o segmento de tela é acoplado ao controlador de segurança.
[0084] O segmento de eixo de acionamento (segmento 5) compre ende controles para um conjunto de eixo de acionamento intercambiá- vel 200 (Figuras 1 e 3) acoplados ao instrumento cirúrgico 10 (Figuras de 1 a 4) e/ou um ou mais controles para um atuador de extremidade 300 acoplado ao conjunto de eixo de acionamento intercambiável 200. O segmento de eixo de acionamento compreende um conector do eixo de acionamento configurado para acoplar o controlador principal 717 a um PCBA de eixo de acionamento. O PCBA de eixo de acionamento compreende um microprocessador de baixa potência com uma memória de acesso aleatório ferroelétrico (FRAM), uma chave de articulação, uma chave de efeito Hall de liberação de eixo de acionamento, e uma memória EEPROM de PCBA do eixo de acionamento. A memória EEPROM de PCBA do eixo de acionamento compreende um ou mais parâmetros, rotinas, e/ou programas específicos para o conjunto de eixo de acionamento intercambiável 200 e/ou para o PCBA do eixo de acionamento. O PCBA do eixo de acionamento pode ser acoplado ao conjunto do eixo de acionamento intercambiável 200 e/ou pode ser integral com o instrumento cirúrgico 10. Em alguns exemplos, o segmento de eixo de acionamento compreende um segundo EEPROM do eixo de acionamento. O segundo EEPROM do eixo de acionamento compreende uma pluralidade de algoritmos, rotinas, parâmetros, e/ou outros dados que correspondem a um ou mais conjuntos de eixos de acionamento 200 e/ou atuadores de extremidade 300 que podem fazer interface com o instrumento cirúrgico energizado 10.
[0085] O segmento de codificador de posição (segmento 6) com preende um ou mais codificadores magnéticos da posição do ângulo de rotação. Um ou mais codificadores magnéticos da posição do ângulo de rotação são configurados para identificar a posição rotacional do motor 714, um conjunto de eixo de acionamento intercambiável 200 (Figuras 1 e 3) e/ou um atuador de extremidade 300 do instrumento cirúrgico 10 (Figuras de 1 a 4). Em alguns exemplos, os codificadores magnéticos da posição do ângulo de rotação podem ser acoplados ao controlador de segurança e/ou ao controlador principal 717.
[0086] O segmento de circuito do motor (segmento 7) compreende um motor 714 configurado para controlar os movimentos do instrumento cirúrgico energizado 10 (Figuras de 1 a 4). O motor 714 é acoplado ao processador do microcontrolador principal 717 por um acionador de ponte H que compreende um ou mais transístores de efeito de campo de ponte H (FETs) e um controlador de motor. O acionador de ponte H é também acoplado ao controlador de segurança. Um sensor de corrente do motor é acoplado em série com o motor para medir a drenagem de corrente do motor. O sensor de corrente do motor está em comunicação de sinal com o controlador principal 717 e/ou com o processador de segurança. Em alguns exemplos, o motor 714 é acoplado a um filtro de interferência eletromagnética (IEM) do motor.
[0087] O controlador do motor controla um primeiro sinalizador do motor e um segundo sinalizador do motor para indicar o estado e a posição do motor 714 ao controlador principal 717. O controlador principal 717 fornece um sinal alto de modulação por largura de pulso (PWM), um sinal baixo de PWM, um sinal de direção, um sinal de sincronização, e um sinal de reinicialização do motor ao controlador do motor através de um buffer. O segmento de alimentação é configurado para fornecer uma tensão de segmento a cada um dos segmentos de circuito.
[0088] O segmento de energia (segmento 8) compreende uma ba teria acoplada ao controlador de segurança, o controlador principal 717, e segmentos de circuito adicionais. A bateria é acoplada ao circuito segmentado por um conector da bateria e um sensor de corrente. O sensor de corrente é configurado para medir a drenagem de corrente total do circuito segmentado. Em alguns exemplos, um ou mais conversores de tensão são configurados para fornecer valores de tensão predeterminados a um ou mais segmentos de circuito. Por exemplo, em alguns exemplos, o circuito segmentado pode compreender conversores de tensão de 3,3V e/ou conversores de tensão de 5V. Um conversor de amplificação de tensão é configurado para fornecer uma elevação da tensão até uma quantidade predeterminada, como, por exemplo, até 13V. O conversor de amplificação de tensão é configurado para fornecer tensão e/ou corrente adicional durante as operações que exigem muita energia e evitar apagão ou condições de baixo fornecimento de energia.
[0089] Uma pluralidade de chaves é acoplada ao controlador de segurança e/ou ao controlador principal 717. As chaves podem ser configuradas para controlar as operações do instrumento cirúrgico 10 (Figuras de 1 a 4), do circuito segmentado, e/ou indicar um estado do instrumento cirúrgico 10. Uma chave da porta de ejeção e uma chave de efeito Hall para ejeção são configuradas para indicar o estado de uma porta de ejeção. Uma pluralidade de chaves de articulação, como, por exemplo, uma chave do lado esquerdo de articulação para o lado esquerdo, uma chave do lado direito de articulação para o lado esquerdo, uma chave central de articulação para o lado esquerdo, uma chave do lado esquerdo de articulação para o lado direito, uma do lado direito de articulação para o lado direito, e uma chave central de articu-lação para o lado direito são configuradas para controlar a articulação de um conjunto de eixo de acionamento intercambiável 200 (Figuras 1 e 3) e/ou o atuador de extremidade 300 (Figuras 1 e 4). Uma chave reversa do lado esquerdo e uma chave reversa do lado direito são acopladas ao controlador principal 717. As chaves do lado esquerdo que compreendem a chave do lado esquerdo de articulação para o lado esquerdo, a chave do lado direito de articulação para o lado esquerdo, a chave central de articulação para o lado esquerdo e a chave reversa do lado esquerdo são acopladas ao controlador primário 717 por um conector de flexão à esquerda. As chaves do lado direito que compreendem a chave do lado esquerdo de articulação para o lado direito, a chave do lado direito de articulação para o lado direito, a chave central de articulação para o lado direito, e a chave reversa do lado direito são acopladas ao controlador principal 717 por um conec- tor de flexão à direita. Uma chave de disparo, uma chave de liberação de aperto, e uma chave engatada ao eixo de acionamento são acopladas ao controlador principal 717.
[0090] Quaisquer chaves mecânicas, eletromecânicas, ou de es tado sólido adequadas, podem ser empregadas para implementar a pluralidade de chaves, em qualquer combinação. Por exemplo, as chaves podem limitar as chaves operadas pelo movimento de componentes associados ao instrumento cirúrgico 10 (Figuras de 1 a 4) ou à presença de um objeto. Estas chaves podem ser usadas para controlar várias funções associadas ao instrumento cirúrgico 10. Uma chave de limite é um dispositivo eletromecânico que consiste em um atuador ligado mecanicamente a um conjunto de contatos. Quando um objeto entra em contato com o atuador, o dispositivo opera os contatos para fazer ou romper uma conexão elétrica. As chaves de limite são usadas em uma variedade de aplicações e ambientes por causa de sua robus-tez, facilidade de instalação e confiabilidade de funcionamento. Elas podem determinar a presença ou ausência, passagem, posicionamento e final de deslocamento de um objeto. Em outras implementações, as chaves podem ser chaves de estado sólido que funcionam sob a influência de um campo magnético como dispositivos de efeito Hall, dispositivos magnetorresistivos (MR), dispositivos magnetorresistivos gigantes (GMR), magnetômetros, dentre outros. Em outras implementações, as chaves podem ser chaves de estado sólido que operam sob a influência da luz, como sensores ópticos, sensores de infravermelho, sensores ultravioleta, dentre outros. Além disso, as chaves podem ser dispositivos de estado sólido como transístores (por exemplo, FET, FET de junção, FET semicondutor de óxido metálico (MOSFET), bipo- lares, e similares). Outras chaves podem incluir chaves sem fio, chaves ultrassônicas, acelerômetros, sensores de inércia, dentre outros.
[0091] A Figura 6 é outro diagrama de blocos do circuito de contro- le 700 do instrumento cirúrgico da Figura 1 que ilustra as interfaces entre o conjunto de cabo 702 e o conjunto de alimentação 706 e entre o conjunto de cabo 702 e o conjunto de eixo de acionamento inter- cambiável 704, de acordo com um aspecto da presente revelação. O conjunto de cabo 702 pode compreender um controlador principal 717, um conector do conjunto de eixo de acionamento 726 e um conector do conjunto de alimentação 730. O conjunto de alimentação 706 pode incluir um conector do conjunto de alimentação 732, um circuito de gerenciamento de energia 734 que pode compreender o controlador de gerenciamento de energia 716, um modulador de energia 738, e um circuito sensor de corrente 736. Os conectores do conjunto de eixo de acionamento 730, 732 formam uma interface 727. O circuito de gerenciamento de energia 734 pode ser configurado para modular a energia de saída da bateria 707 com base nas necessidades de energia do conjunto de eixo de acionamento intercambiável 704 enquanto o conjunto de eixo de acionamento intercambiável 704 e o conjunto de alimentação 706 são acoplados ao conjunto de cabo 702. O controlador de gerenciamento de energia 716 pode ser programado para controlar o modulador de energia 738 da saída de energia do conjunto de alimentação 706 e o circuito sensor de corrente 736 pode ser empregado para monitorar a saída de energia do conjunto de alimentação 706 para fornecer retroinformação ao controlador de gerenciamento de energia 716 sobre a saída de energia da bateria 707 para que o controlador de gerenciamento de energia 716 possa ajustar a saída de energia do conjunto de alimentação 706 para manter uma saída desejada. O conjunto de eixo de acionamento 704 compreende um processador de eixo de acionamento 719 acoplado a uma memória não volátil 721 e um conector de conjunto de eixo de acionamento 728 para acoplar eletricamente o conjunto de eixo de acionamento 704 ao conjunto de em- punhadura 702. Os conectores do conjunto de eixo de acionamento 726, 728 formam uma interface 725. O controlador principal 717, o processador de eixo de acionamento 719 e/ou o controlador de gerenciamento de energia 716 podem ser configurados para implementar um ou mais dos processos aqui descritos.
[0092] O instrumento cirúrgico 10 (Figuras de 1 a 4) pode compre ender um dispositivo de saída 742 para uma retroinformação sensorial a um usuário. Esses dispositivos podem compreender dispositivos de retroinformação visual (por exemplo, um monitor com tela de LCD, indicadores em LED), dispositivos de retroinformação auditiva (por exemplo, um alto-falante, uma campainha) ou dispositivos de retroin- formação tátil (por exemplo, atuadores hápticos). Em determinadas circunstâncias, o dispositivo de saída 742 pode compreender uma tela 743 que pode estar incluída no conjunto de cabo 702. O controlador do conjunto de eixo de acionamento 722 e/ou o controlador de gerenciamento de energia 716 podem fornecer retroinformação a um usuário do instrumento cirúrgico 10 através do dispositivo de saída 742. A interface 727 pode ser configurada para conectar o controlador do conjunto de eixo de acionamento 722 e/ou o controlador de gerenciamento de energia 716 ao dispositivo de saída 742. O dispositivo de saída 742 pode ser integrado com o conjunto de alimentação 706. A comuni-cação entre o dispositivo de saída 742 e o controlador do conjunto de eixo de acionamento 722 pode ser feita através da interface 725 enquanto o conjunto de eixo de acionamento intercambiável 704 é acoplado ao conjunto de cabo 702. Tendo descrito um circuito de controle 700 (Figuras 5A, 5B e 6) para controlar a operação do instrumento cirúrgico 10 (Figuras de 1 a 4), a revelação se volta agora para várias configurações do instrumento cirúrgico 10 (Figuras de 1 a 4) e ao circuito de controle 700.
[0093] A Figura 7 ilustra um circuito de controle 800 configurado para controlar aspectos do instrumento cirúrgico 10 (Figuras de 1 a 4), de acordo com um aspecto da presente revelação. O circuito de controle 800 pode ser configurado para implementar vários processos aqui descritos. O circuito de controle 800 pode compreender um controlador que compreende um ou mais processadores 802 (por exemplo, microprocessador, microcontrolador) acoplado a ao menos um circuito de memória 804. O circuito de memória 804 armazena instruções executáveis em máquina que, quando executadas pelo processador 802, fazem com que o processador 802 execute instruções de máquina para implementar vários dos processos aqui descritos. O processador 802 pode ser qualquer um dentre vários processadores de núcleo simples ou processadores de múltiplos núcleos conhecidos na técnica. O circuito de memória 804 pode compreender mídia de armazenamento volátil e não volátil. O processador 802 pode incluir uma unidade de processamento de instruções 806 e uma unidade aritmética 808. A unidade de processamento de instruções pode ser configurada para receber instruções a partir do circuito de memória 804.
[0094] A Figura 8 ilustra um circuito lógico combinacional 810 con figurado para controlar aspectos do instrumento cirúrgico 10 (Figuras de 1 a 4), de acordo com um aspecto da presente revelação. O circuito lógico combinacional 810 pode ser configurado para implementar vários processos aqui descritos. O circuito 810 pode compreender uma máquina de estado finito que compreende um circuito lógico combina- cional 812 configurado para receber dados associados ao instrumento cirúrgico 10 em uma entrada 814, processar os dados pela lógica combinacional 812 e fornecer uma saída 816.
[0095] A Figura 9 ilustra um circuito lógico sequencial 820 configu rado para controlar aspectos do instrumento cirúrgico 10 (Figuras de 1 a 4), de acordo com um aspecto da presente revelação. O circuito lógico sequencial 820 ou o circuito lógico combinacional 822 pode ser configurado para implementar o processo aqui descrito. O circuito 820 pode compreender uma máquina de estados finitos. O circuito lógico sequencial 820 pode compreender um circuito lógico combinacional 822, ao menos um circuito de memória 824, um relógio 829 e, por exemplo. O ao menos um circuito de memória 820 pode armazenar um estado da corrente da máquina de estados finitos. Em certos casos, o circuito lógico sequencial 820 pode ser síncrono ou assíncrono. O circuito lógico combinacional 822 é configurado para receber os dados associados ao instrumento cirúrgico 10, uma entrada 826, processar os dados pelo circuito lógico combinacional 822, e fornecer uma saída 828. Em outros aspectos, o circuito pode compreender uma combinação de o processador 802 e a máquina de estados finitos para implementar vários processos da presente invenção. Em outros aspectos, a máquina de estados finitos pode compreender uma combinação do circuito lógico combinacional 810 e o circuito lógico sequencial 820.
[0096] Os aspectos podem ser implementados sob a forma de um artigo de manufatura. O artigo de manufatura pode incluir uma mídia de armazenamento legível por computador disposto de modo a armazenar lógica, instruções e/ou dados para a execução de várias operações de um ou mais aspectos. Por exemplo, o artigo de manufatura pode compreender um disco magnético, um disco óptico, memória flash ou firmware contendo instruções do programa de computador adequadas para execução por um processador de uso geral ou processador específico para a aplicação.
[0097] A Figura 10 é um diagrama de um sistema de posiciona mento absoluto 1100 do instrumento cirúrgico 10 (Figuras de 1 a 4), sendo que o sistema de posicionamento absoluto 1100 compreende uma disposição de circuito de acionamento controlado do motor que compreende uma disposição de sensor 1102, de acordo com um aspecto da presente revelação. O sensor de posição 1102 para um sistema de posicionamento absoluto 1100 fornece um sinal de posição único que corresponde à localização de um membro de deslocamento 1111. De volta às Figuras de 2 a 4, em um aspecto, o membro de deslocamento 1111 representa um membro de acionamento longitudinalmente móvel 120 (Figura 2) que compreende uma cremalheira de dentes de acionamento 122 para engate de acoplamento com uma engrenagem de acionamento correspondente 86 de um conjunto redutor de engrenagem 84. Em outros aspectos, o membro de deslocamento 1111 representa o membro de disparo 220 (Figura 3), que pode ser adaptado e configurado para incluir uma cremalheira de dentes de acionamento. Em ainda outro aspecto, o membro de deslocamento 1111 representa a barra de disparo 172 (Figura 4) ou a haste com perfil em I 178 (Figura. 4), cada uma das quais pode ser adaptada e configurada para incluir uma cremalheira de dentes de acionamento. Consequentemente, como usado na presente invenção, o termo membro de deslocamento é usado genericamente para se referir a qualquer membro móvel do instrumento cirúrgico 10, como o membro de acionamento 120, o membro de disparo 220, a barra de disparo 172, a haste com perfil em I 178, ou qualquer elemento que possa ser deslocado. Em um aspecto, o membro de acionamento longitudinalmente móvel 120 é acoplado ao membro de disparo 220, à barra de disparo 172 e à haste com perfil em I 178. Consequentemente, o sistema de posicionamento absoluto 1100 pode, com efeito, rastrear o deslocamento linear da haste com perfil em I 178 mediante o rastreamento do deslocamento linear do membro de acionamento longitudinalmente móvel 120. Em vários outros aspectos, o membro de deslocamento 1111 pode ser acoplado a qualquer sensor adequado para medir o deslocamento linear. Dessa forma, o membro de acionamento longitudinalmente móvel 120, o membro de disparo 220, a barra de disparo 172, ou a haste com perfil em I 178, ou suas combinações, podem ser acoplados a qualquer sensor de deslocamento linear adequado. Os sensores de deslocamento linear podem incluir sensores de deslocamento de contato ou sem contato. Os sensores de deslocamento linear podem compreender transformadores lineares diferenciais variáveis (LVDT), transdutores diferenciais de relutância variável (DVRT), um potenciô- metro, um sistema de detecção magnético que compreende um magneto móvel e uma série linearmente disposta em sensores de efeito Hall, um sistema de detecção magnético que compreende um magneto fixo e uma série de móveis, dispostos linearmente em sensores de efeito Hall, um sistema de detecção óptico móvel que compreende uma fonte de luz móvel e uma série de fotodiodos ou fotodetectores linearmente dispostos, um sistema de detecção óptico que compreende uma fonte de luz fixa e uma série móvel de fotodiodos ou fotodetec- tores linearmente dispostos, ou qualquer combinação dos mesmos.
[0098] Um motor elétrico 1120 pode incluir um eixo de acionamen to giratório 1116, que faz interface operacional com um conjunto de engrenagem 1114, que está montado em engate de acoplamento com um conjunto, ou cremalheira, de dentes de acionamento no membro de acionamento 1111. Um elemento sensor 1126 pode ser operacionalmente acoplado a um conjunto de engrenagem 1114 de modo que uma única revolução do elemento sensor 1126 corresponda a alguma translação longitudinal linear do membro de deslocamento 1111. Uma disposição de engrenagens e sensores 1118 pode ser conectada ao atuador linear por meio de uma disposição de cremalheira e pinhão, ou de um atuador giratório, por meio de uma roda dentada ou outra conexão. Uma fonte de alimentação 1129 fornece energia para o sistema de posicionamento absoluto 1100 e um indicador de saída 1128 pode mostrar a saída do sistema de posicionamento absoluto 1100. Na Figura 2, o membro de acionamento 1111 representa o membro de acionamento longitudinalmente móvel 120 que compreende uma crema- lheira de dentes de acionamento 122 formada na mesma para engate de acoplamento com uma engrenagem de acionamento correspondente 86 do conjunto redutor de engrenagem 84. O membro de deslocamento 1111 representa o membro de disparo longitudinalmente móvel 220, a barra de disparo 172, a haste com perfil em I 178, ou combinações dos mesmos.
[0099] Uma única revolução do elemento sensor 1126 associada ao sensor de posição 1112 é equivalente a um deslocamento linear longitudinal d1 do membro de deslocamento 1111, sendo que d1 representa a distância linear longitudinal pela qual o membro de deslocamento 1111 se move do ponto "a" ao ponto "b" depois de uma única revolução do elemento sensor 1126 acoplado ao membro de deslocamento 1111. A disposição do sensor 1102 pode ser conectada por meio de uma redução de engrenagem que resulta no sensor de posição 1112 completando uma ou mais revoluções para o curso completo do membro de deslocamento 1111. O sensor de posição 1112 pode completar múltiplas revoluções para o curso completo do membro de deslocamento 1111.
[0100] Uma série de chaves 1122a a 1122n, onde n é um número inteiro maior que um, pode ser empregada sozinha ou em combinação com redução de engrenagem para fornecer um sinal de posição único por mais de uma revolução do sensor de posição 1112. O estado das chaves 1122a a 1122n é alimentado de volta para um controlador 1104 que aplica lógica para determinar um sinal de posição única que corresponde ao deslocamento linear longitudinal dl + d2 + ... dn do membro de acionamento 1111. A saída 1124 do sensor de posição 1112 é fornecida ao controlador 1104. O sensor de posição 1112 da disposição de sensor 1102 pode compreender um sensor magnético, um sensor giratório analógico, como um potenciômetro, uma série de elementos de efeito Hall analógicos, que emitem uma combinação única de posição de sinais ou valores.
[0101] O sistema de posicionamento absoluto 1100 fornece um posicionamento absoluto do membro de deslocamento 1111 com a energização do instrumento sem que seja preciso retrair ou avançar o membro de acionamento 1111 para a posição de reinício (zero ou inicial), como pode ser o caso de codificadores convencionais giratórios que meramente contam o número de passos progressivos ou regressivos que o motor 1120 percorreu para inferir a posição de um atuador dispositivo, barra de acionamento, bisturi, e similares.
[0102] O controlador 1104 pode ser programado para realizar vá rias funções, como o controle preciso da velocidade e da posição dos sistemas de articulação e bisturi. Em um aspecto, o controlador 1104 inclui um processador 1108 e uma memória 1106. O motor elétrico 1120 pode ser um motor de corrente contínua com escovas com uma caixa de câmbio e conexões mecânicas com um sistema de articulação ou bisturi. Em um aspecto, um acionador de motor 1110 pode ser um A3941 disponível junto à Allegro Microsystems, Inc. Outros acio- nadores de motor podem ser prontamente substituídos para uso no sistema de posicionamento absoluto 1100. Uma descrição mais detalhada do sistema de posicionamento absoluto 1100 é descrita no pedido de patente US n° 15/130.590, intitulado SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT, depositado em 15 de abril de 2016, cuja revelação está aqui incorporada a título de referência.
[0103] O controlador 1104 pode ser programado para fornecer controle preciso da velocidade e da posição do membro de deslocamento 1111 e dos sistemas de articulação. O controlador 1104 pode ser configurado para computar uma resposta no software do controlador 1104. A resposta computada é comparada a uma resposta medida do sistema real para se obter uma resposta "observada", que é usada para as decisões reais baseadas na realimentação. A resposta obser- vada é um valor favorável e ajustado, que equilibra a natureza uniforme e contínua da resposta simulada com a resposta medida, o que pode detectar influências externas no sistema.
[0104] O sistema de posicionamento absoluto 1100 pode compre ender e/ou ser programado para implementar um controlador de re- troinformação, como um PID, uma realimentação de estado, e um controlador adaptável. Uma fonte de alimentação 1129 converte o sinal do controlador de realimentação em uma entrada física para o sistema, nesse caso a tensão. Outros exemplos incluem uma modulação por largura de pulso (PWM) de tensão, corrente e força. Outros sensores 1118 podem ser fornecidos para mediar os parâmetros físicos do sistema físico além da posição medida pelo sensor de posição 1112. Em um sistema de processamento de sinal digital, um sistema de posicionamento absoluto 1100 é acoplado a um sistema de captura de dados digitais no qual a saída do sistema de posicionamento absoluto 1100 terá uma resolução e frequência de amostragem finitas. O sistema de posicionamento absoluto 1100 pode compreender um circuito de comparação e combinação para combinar uma resposta computada com uma resposta medida através do uso de algoritmos, como uma média ponderada e um circuito de controle teórico, que acionam a resposta calculada em direção à resposta medida. A resposta computada do sistema físico considera as propriedades como massa, inércia, atrito viscoso, resistência à indutância, etc., para prever pelo conhecimento da entrada quais serão os estados e saídas do sistema físico. O controlador 1104 pode ser um circuito de controle 700 (Figuras 5A e 5B).
[0105] O acionador de motor 1110 pode ser um A3941, disponível junto à Allegro Microsystems, Inc. O acionador 1110 A3941 é um controlador de ponte inteira para uso com transístores de efeito de campo de óxido de metal semicondutor (MOSFET) de potência externa, de canal N, especificamente projetados para cargas indutivas, como mo- tores de corrente contínua com escovas. O acionador 1110 compreende um regulador de bomba de carga único, fornece acionamento de porta completo (>10 V) para baterias com tensão até 7 V e permite que o A3941 opere com um acionamento de porta reduzido, até 5,5 V. Um capacitor de comando de entrada pode ser empregado para fornecer a tensão excedente à fornecida pela bateria necessária para os MOS- FETs de canal N. Uma bomba de carga interna para o acionamento do lado de cima permite a operação em corrente contínua (100% ciclo de trabalho). A ponte inteira pode ser acionada nos modos de queda rápida ou lenta usando diodos ou retificação sincronizada. No modo de queda lenta, a recirculação da corrente pode se dar por meio de FET do lado de cima ou do lado de baixo. Os FET de potência são protegidos do efeito shoot-through por meio de resistores com tempo morto programável. O diagnóstico integrado fornece indicação de subtensão, sobretemperatura e falhas na ponte de energia, podendo ser configurado para proteger os MOSFETs de potência na maioria das condições de curto-circuito. Outros controladores de motor podem ser prontamente substituídos para uso no sistema de posicionamento absoluto 1100.
[0106] Tendo descrito uma arquitetura geral para implementar as pectos de um sistema de posicionamento absoluto 1100 para uma disposição de sensor 1102, a revelação agora se volta para as Figuras 11 e 12 para uma descrição de um aspecto de uma disposição de sensor 1102 para o sistema de posicionamento absoluto 1100. A Figura 11 é uma vista em perspectiva explodida da disposição de sensor 1102 para o sistema de posicionamento absoluto 1100, mostrando um circuito 1205 e o alinhamento relativo dos elementos da disposição de sensor 1102, de acordo com um aspecto. A disposição de sensor 1102 para um sistema de posicionamento absoluto 1100 compreende um sensor de posição 1200, um elemento sensor de magneto 1202, um suporte de magneto 1204, que dá uma volta a cada curso completo do membro de deslocamento 1111, e um conjunto de engrenagens 1206 para fornecer uma redução de engrenagens. Com breve referência à Figura 2, o membro de deslocamento 1111 pode representar o membro de acionamento longitudinalmente móvel 120 que compreende uma cre- malheira de dentes de acionamento 122 para engate de acoplamento com uma engrenagem de acionamento correspondente 86 do conjunto redutor de engrenagem 84. Voltando à Figura 11, um elemento estrutural, como um bráquete 1216, é fornecido para sustentar o conjunto de engrenagens 1206, o suporte de magneto 1204 e o magneto 1202. O sensor de posição 1200 compreende um ou mais elementos magnéticos de detecção, como elementos de efeito Hall, e está posicionado próximo ao magneto 1202. Conforme o magneto 1202 gira, os elementos magnéticos de detecção do sensor de posição 1200 determinam a posição angular absoluta do magneto 1202 durante uma revolução.
[0107] A disposição de sensor 1102 pode compreender qualquer número de elementos de detecção magnética, como, por exemplo, sensores magnéticos classificados de acordo sua capacidade de medir o campo magnético total ou os componentes vetoriais do campo magnético. As técnicas usadas para produzir ambos os tipos de sensores magnéticos abrangem muitos aspectos da física e da eletrônica. As tecnologias usadas para a detecção de campo magnético incluem fluxômetro, fluxo saturado, bombeamento óptico, precessão nuclear, SQUID, efeito Hall, magnetorresistência anisotrópica, magnetorresis- tência gigante, junções túnel magnéticas, magnetoimpedância gigante, compostos magnetostritivos/piezoelétricos, magnetodiodo, transistor magnético, fibra óptica, magneto-óptica e sensores magnéticos baseados em sistemas microeletromecânicos, dentre outros.
[0108] Um conjunto de engrenagens compreende uma primeira engrenagem 1208 e uma segunda engrenagem 1210 em engate de acoplamento para fornecer uma conexão com uma relação de engrenagens de 3:1. Uma terceira engrenagem 1212 gira ao redor de um eixo de acionamento 1214. A terceira engrenagem 1212 está engrenada em acoplamento com o membro de acionamento 1111 (ou 120 conforme mostrado na Figura 2) e gira em uma primeira direção, à medida que o elemento de acionamento 1111 avança em uma direção distal D e gira em uma segunda direção à medida que o membro de acionamento 1111 se retrai em uma direção proximal P. A segunda engrenagem 1210 também gira em torno do eixo de acionamento 1214 e, portanto, a rotação da segunda engrenagem 1210 em torno do eixo de acionamento 1214 corresponde à translação longitudinal do membro de acionamento 1111. Dessa forma, um curso completo do membro de acionamento 1111, seja na direção distal, seja na proximal, D, P, corresponde a três rotações da segunda engrenagem 1210 e a uma única rotação da primeira engrenagem 1208. Como o suporte de magneto 1204 está acoplado à primeira engrenagem 1208, o suporte de magneto 1204 completa uma rotação com cada curso completo do membro de acionamento 1111.
[0109] O sensor de posição 1200 é sustentado por um suporte de sensor de posição 1218, definindo uma abertura 1220 adequada para conter o sensor de posição 1200 em alinhamento preciso com um magneto 1202 girando abaixo no interior do suporte de magneto 1204. O acessório é acoplado ao bráquete 1216 e ao circuito 1205 e permanece estacionário enquanto o magneto 1202 gira com o suporte de magneto 1204. É fornecido um cubo 1222 que se acopla à primeira engrenagem 1208 e ao suporte magnético 1204. A segunda engrenagem 1210 e a terceira engrenagem 1212 acopladas ao eixo 1214 também são mostradas.
[0110] A Figura 12 é um diagrama de um sensor de posição 1200 para um sistema de posicionamento absoluto 1100, que compreende um sistema de posicionamento absoluto magnético giratório, de acordo com um aspecto da presente invenção. O sensor de posição 1200 pode ser implementado como um sensor de posição giratório, magnético, de chip único, AS5055EQFT, disponível junto à Austria Microsystems, AG. O sensor de posição 1200 faz interface com o controlador 1104 para fornecer um sistema de posicionamento absoluto 1100. O sensor de posição 1200 é um componente de baixa tensão e baixa potência e inclui quatro elementos de efeito Hall 1228A, 1228B, 1228C, 1228D em uma área 1230 do sensor de posição 1200 que está localizada acima do magneto 1202 (Figuras 15 e 16). Um ADC de alta resolução 1232 e um controlador inteligente de gerenciamento de potência 1238 são também fornecidos no circuito integrado. Um processador CORDIC 1236 (acrônimo de COordinate Rotation DIgital Computer), também conhecido como método dígito por dígito e algoritmo de Volder, é fornecido para implementar um algoritmo simples e eficiente para calcular funções hiperbólicas e trigonométricas que exigem apenas operações de adição, subtração, deslocamento de bits e tabela de pesquisa. A posição angular, bits de alarme e informações de campo magnético são transmitidos através de uma interface de comunicação serial padrão, como uma interface SPI 1234 para o controlador 1104. O sensor de posição 1200 fornece 12 ou 14 bits de resolução. O sensor de posição 1200 pode ser um circuito integrado AS5055 fornecido em uma pequena embalagem QFN de 16 pinos cuja medida corresponde a 4x4x0,85 mm.
[0111] Os elementos de efeito Hall 1228A, 1228B, 1228C, 1228D estão localizados diretamente acima do magneto giratório 1202 (Figura 11). O efeito Hall é um efeito bem conhecido e por conveniência não será descrito em detalhes na presente invenção, no entanto, em geral, o efeito Hall produz uma diferença de tensão (a tensão de Hall) através de um condutor elétrico transversal a uma corrente elétrica no condutor e um campo magnético perpendicular à corrente. O coeficiente de Hall é definido como a razão entre o campo elétrico induzido e o produto da densidade de corrente pelo campo magnético aplicado. É uma característica do material a partir do qual o condutor é feito, pois seu valor depende do tipo, do número e das propriedades dos portadores de carga que constituem a corrente. No sensor de posição AS5055 1200, os elementos de efeito Hall 1228A, 1228B, 1228C, 1228D são capazes de produzir um sinal de tensão indicativo do posicionamento absoluto do magneto 1202 em termos do ângulo em relação a uma única revolução do magneto 1202. Esse valor do ângulo, que é um sinal de posição único, é calculado pelo processador CORDIC 1236, é armazenado integrado no sensor de posição AS5055 1200 em um registro ou memória. O valor do ângulo que é indicativo da posição do magneto 1202 durante uma revolução é fornecido ao controlador 1104 em uma variedade de técnicas, por exemplo, ao energizar ou mediante demanda do controlador 1104.
[0112] O sensor de posição AS5055 1200 precisa de apenas al guns componentes externos para operar quando conectado ao controlador 1104. Seis fios são necessários para uma aplicação simples com uso de uma única fonte de alimentação: dois fios para alimentação e quatro fios 1240 para a interface SPI 1234 com o controlador 1104. Uma sétima conexão pode ser adicionada de forma a enviar um sinal de interrupção ao controlador 1104 informando que um novo ângulo válido pode ser lido. Com a energização, o sensor de posição AS5055 1200 realiza uma sequência completa de energização, incluindo uma medição de ângulo. A conclusão desse ciclo é indicada como uma saída INT 1242, e o valor do ângulo é armazenado em um registro interno. Uma vez configurada essa saída, o sensor de posição AS5055 1200 entra em modo suspenso. O controlador 1104 pode responder à solicitação INT na saída INT 1242 pela leitura do valor do ângulo a partir do sensor de posição AS5055 1200 por intermédio da interface SPI 1234. Uma vez lido o valor do ângulo pelo controlador 1104, a saída INT 1242 é liberada novamente. Enviar um comando "ler ângulo" pela interface SPI 1234 por meio do controlador 1104 ao sensor de posição 1200 também energiza automaticamente o circuito integrado e inicia outra medição de ângulo. Assim que o controlador 1104 concluir a leitura do valor do ângulo, a saída INT 1242 é liberada e um novo resultado é armazenado no registro de ângulos. O término dessa medição de ângulo é indicado novamente pela configuração da saída INT 1242 e pelo sinalizador correspondente no registro de estados.
[0113] Devido ao princípio de medição do sensor de posição AS5055 1200, apenas uma única medição de ângulo é realizada em tempo muito curto (~600 μs) depois de cada sequência de energiza- ção. Assim que a medição de um ângulo é concluída, o sensor de posição AS5055 1200 entra no estado desenergizado. Não há filtro do valor do ângulo por média digital implementado, pois isso exigiria mais de uma medição de ângulo e, consequentemente, um tempo de ener- gização mais longo, o que não é desejado em aplicações de baixa potência. A variação de ângulo pode ser reduzida fazendo-se a média de várias amostras de ângulo no controlador 1104. Por exemplo, uma média de quatro amostras reduz a variação em 6 dB (50%).
[0114] A Figura 13 é uma vista em corte de um atuador de extre midade 2502 do instrumento cirúrgico 10 (Figuras de 1 a 4) que mostra um curso de disparo da haste com perfil em I 2514 em relação ao tecido 2526 preso dentro do atuador de extremidade 2502, de acordo com um aspecto da presente revelação. O atuador de extremidade 2502 é configurado para operar com o instrumento cirúrgico 10 mostrado nas Figuras de 1 a 4. O atuador de extremidade 2502 compreende uma bigorna 2516 e uma canaleta alongada 2503 com um cartucho de grampos 2518 posicionado na canaleta alongada 2503. Uma barra de disparo 2520 é transladável distalmente e proximalmente ao longo de um eixo geométrico longitudinal 2515 do atuador de extremidade 2502. Quando o atuador de extremidade 2502 não é articulado, o atuador de extremidade 2502 está em linha com o eixo de acionamento do instrumento. Uma haste com perfil em I 2514 que compreende um gume cortante 2509 é ilustrada em uma porção distal da barra de disparo 2520. Um deslizador em cunha 2513 está posicionado no cartucho de grampos 2518. Conforme a haste com perfil em I 2514 translada dis- talmente, o gume cortante 2509 entra em contato e pode cortar o tecido 2526 posicionado entre a bigorna 2516 e o cartucho de grampos 2518. Além disso, a haste com perfil em I 2514 entra em contato com o deslizador em cunha 2513 e o empurra distalmente, fazendo com que o deslizador em cunha 2513 entre em contato com os acionadores de grampos 2511. Os acionadores de grampo 2511 podem ser acionados para cima para dentro dos grampos 2505, fazendo com que os grampos 2505 avancem através do tecido e para dentro de bolsos 2507 definidos na bigorna 2516, que formam os grampos 2505.
[0115] Um curso de disparo exemplificador da haste com perfil em I 2514 é ilustrado por um gráfico 2529 alinhado com o atuador de extremidade 2502. O tecido exemplificador 2526 é também mostrado alinhado com o atuador de extremidade 2502. O curso do membro de disparo pode compreender uma posição de início de curso 2527 e uma posição de final de curso 2528. Durante um curso de disparo da haste com perfil em I 2514, a haste com perfil em I 2514 pode ser avançada distalmente da posição de início de curso 2527 até a posição de final de curso 2528. A haste com perfil de I 2514 é mostrada em um local exemplificador de uma posição de início de curso 2527. O gráfico 2529 do curso do membro de disparo da haste com perfil de I 2514 ilustra cinco regiões de curso do membro de disparo 2517, 2519, 2521, 2523 e 2525. Em uma primeira região do curso de disparo 2517, a haste com perfil em I 2514 pode começar a avançar distalmente. Na primeira região do curso de disparo 2517, a haste com perfil em I 2514 pode entrar em contato com o deslizador de cunha 2513 e começar a movê- lo distalmente. Enquanto na primeira região, entretanto, o gume cortante 2509 pode não entrar em contato com o tecido e o deslizador em cunha 2513 pode não entrar em contato com um acionador de grampo 2511. Depois do atrito estático ser superado, a força para acionar a haste com perfil em I 2514 na primeira região 2517 pode ser substancialmente constante.
[0116] Na segunda região de curso do membro de disparo 2519, o gume cortante 2509 pode começar a entrar em contato e cortar o tecido 2526. Além disso, o deslizador em cunha 2513 pode começa a entrar em contato com os acionadores de grampo 2511 para acionar os grampos 2505. A força para acionar a haste com perfil em I 2514 pode começar a aumentar gradualmente. Conforme mostrado, o tecido encontrado inicialmente pode ser comprimido e/ou ser mais fino devido à maneira como a bigorna 2516 gira em relação ao cartucho de grampos 2518. Na terceira região de curso do membro de disparo 2521, o gume cortante 2509 pode estar continuamente em contato e cortar o tecido 2526 e o deslizador em cunha 2513 pode repetidamente entrar em contato com os acionadores de grampos 2511. A força para acionar a haste com perfil em I 2514 pode estacionar na terceira região 2521. Perto da quarta região 2523 do curso de disparo, a força para acionar a haste com perfil em I 2514 pode começar a diminuir. Por exemplo, o tecido na porção do atuador de extremidade 2502 correspondente à quarta região de disparo 2523 pode ser menos comprimido que o tecido mais próximo ao ponto de pivô da bigorna 2516, exigindo menos força para cortar. Além disso, o gume cortante 2509 e o deslizador em cunha 2513 podem atingir a extremidade do tecido 2526 enquanto na região 2523 quarto. Quando a haste com perfil em I 2514 atingir a quinta região 2525, o tecido 2526 pode ser completamente separado. O deslizador em cunha 2513 pode entrar em contato com um ou mais acionadores de grampos 2511 no ou próximo ao final do tecido. A força para avançar a haste com perfil em I 2514 através da quinta região 2525 pode ser reduzida e, em alguns exemplos, pode ser similar à força para acionar a haste com perfil em I 2514 na primeira região 2517. Na conclusão do curso do membro de disparo, a haste com perfil em I 2514 pode alcançar a posição final do curso 2528. O posicionamento das regiões de curso do membro de disparo 2517, 2519, 2521, 2523 e 2525 na Figura 18 é apenas um exemplo. Em alguns exemplos, diferentes regiões podem começar em diferentes posições ao longo do eixo geométrico longitudinal de atuador de extremidade 2515, por exemplo, com base no posicionamento de tecido entre a bigorna 2516 e o cartucho de grampos 2518.
[0117] Como discutido acima e com referência agora às Figuras de 10 a 13, o motor elétrico 1122 posicionado no interior do conjunto de cabo do de instrumento cirúrgico 10 (Figuras de 1 a 4) pode ser usado para avançar e/ou retrair o sistema de disparo do conjunto de eixo de acionamento, incluindo a haste com perfil em I 2514, em relação ao atuador de extremidade 2502 do conjunto de eixo de acionamento de forma a grampear e/ou cortar o tecido capturado no interior do atuador de extremidade 2502. A haste com perfil em I 2514 pode ser avançada ou retraída em uma velocidade desejada, ou dentro de uma faixa de velocidades desejadas. O controlador 1104 pode ser configurado para controlar a velocidade da haste com perfil em I 2514. O controlador 1104 pode ser configurado para prever a velocidade da haste com perfil em I 2514 com base em vários parâmetros da energia fornecida ao motor elétrico 1122, como tensão e/ou corrente, por exemplo, e/ou outros parâmetros operacionais do motor elétrico 1122 ou influências externas. O controlador 1104 pode ser configurado para prever a velocidade da corrente da haste com perfil em I 2514 com base nos valores anteriores da corrente e/ou da tensão fornecidos ao motor elétrico 1122 e/ou nos estados anteriores do sistema, como velocidade, aceleração e/ou posição. O controlador 1104 pode ser configurado para detectar a velocidade da haste com perfil em I 2514 com o uso do sistema de sensor de posicionamento absoluto aqui descrito. O controlador pode ser configurado para comparar a velocidade prevista da haste com perfil em I 2514 e a velocidade detectada da haste com perfil em I 2514 para determinar se a energia do motor elétrico 1122 precisa ser aumentada de forma a aumentar a velocidade da haste com perfil em I 2514 e/ou diminuída de forma a diminuir a velocidade da haste com perfil em I 2514. A patente US n° 8.210.411, intitulada MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, está aqui incorporada, a título de referência em sua totalidade. A patente US n° 7.845.537, intitulada SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES, está aqui incorporada, a título de referência em sua totalidade.
[0118] A força que age sobre a haste com perfil em I 2514 pode ser determinada com o uso de várias técnicas. A força da haste com perfil em I 2514 pode ser determinada por medição da corrente do motor 2504, sendo que a corrente do motor 2504 se baseia na carga experimentada pela haste com perfil em I 2514 à medida que ela avança distalmente. A força da haste com perfil em I 2514 pode ser determinada mediante o posicionamento de um medidor de tensão no membro de acionamento 120 (Figura 2), no membro de disparo 220 (Figura 2), na haste com perfil em I 2514 (haste com perfil em I 178, Figura 20), na barra de disparo 172 (Figura 2), e/ou em uma extremidade proximal do gume cortante 2509. A força da haste com perfil em I 2514 pode ser determinada pelo monitoramento da posição real da haste com perfil em I 2514 que se move em uma velocidade esperada com base na velocidade da corrente ajustada do motor 2504 após um período decorrido predeterminado T1 e por comparação da posição real da haste com perfil em I 2514 em relação à posição esperada da haste com perfil em I 2514 com base na velocidade da corrente ajustada do motor 2504 no final do período T1. Dessa forma, se a posição real da haste com perfil em I 2514 for menor que a posição esperada da haste com perfil em I 2514, a força na haste com perfil em I 2514 é maior que uma força nominal. Por outro lado, se a posição real da haste com perfil em I 2514 for maior que a posição esperada da haste com perfil em I 2514, a força na haste com perfil em I 2514 é menor que a força nominal. A diferença entre as posições real e esperada da haste com perfil em I 2514 é proporcional ao desvio da força na haste com perfil em I 2514 a partir da força nominal. Essas técnicas são descritas no documento do procurador número END8195USNP, o qual está aqui incorporado por referência em sua totalidade.
[0119] A Figura 14 ilustra um diagrama de bloco de um instrumen to cirúrgico 2500 programado para controlar a translação distal de um membro de deslocamento de acordo com um aspecto da presente revelação. Em um aspecto, o instrumento cirúrgico 2500 é programado para controlar a translação distal de um membro de deslocamento 1111 como a haste com perfil em I 2514. O instrumento cirúrgico 2500 compreende um atuador de extremidade 2502 que pode compreender uma bigorna 2516, uma haste com perfil em I 2514 (incluindo um gume cortante afiado 2509), e um cartucho de grampos removível 2518. O atuador de extremidade 2502, a bigorna 2516, a haste com perfil em I 2514 e o cartucho de grampos 2518 podem ser configurados conforme descrito aqui, por exemplo, em relação às Figuras de 1 a 13.
[0120] A posição, o movimento, o deslocamento, e/ou a translação de um membro de deslocamento 1111, como a haste com perfil em I 2514, podem ser medidos pelo sistema de posicionamento absoluto 1100, pela disposição de sensor 1102, e pelo sensor de posição 1200 conforme mostrado nas Figuras de 10 a 12 e representado como o sensor de posição 2534 na Figura 14. Devido à haste com perfil em I 2514 ser acoplada a um membro de acionamento longitudinalmente móvel 120, a posição da haste com perfil em I 2514 pode ser determinada mediante a medição da posição do membro de acionamento longitudinalmente móvel 120 com o uso do sensor de posição 2534. Consequentemente, na descrição a seguir, a posição, o deslocamento e/ou a translação do membro de fechamento 2514 podem ser obtidos pelo sensor de posição 2534, conforme descrito na presente invenção. Um circuito de controle 2510, como o circuito de controle 700 descrito nas Figuras 5A e 5B, pode ser programado para controlar a translação do membro de deslocamento 1111, como a haste com perfil em I 2514, conforme descrito em conexão com as Figuras de 10 a 12. O circuito de controle 2510, em alguns exemplos, pode compreender um ou mais microcontroladores, microprocessadores, ou outros processadores adequados para executar as instruções que fazem com que o processador ou processadores controlem o membro de deslocamento, por exemplo, a haste com perfil em I 2514, da maneira descrita. Em um aspecto, um temporizador/contador 2531 fornece um sinal de saída, como o tempo decorrido ou uma contagem digital, ao circuito de controle 2510 para correlacionar a posição da haste com perfil em I 2514, conforme determinado pelo sensor de posição 2534, com a saída do temporizador/contador 2531 de modo que o circuito de controle 2510 possa determinar a posição da haste com perfil em I 2514 em um momento específico (t) em relação a uma posição inicial. O temporiza- dor/contador 2531 pode ser configurado para medir o tempo decorrido, contar eventos externos, ou medir eventos externos.
[0121] O circuito de controle 2510 pode gerar um sinal de ponto de ajuste do motor 2522. O sinal do ponto de ajuste do motor 2522 pode ser fornecido a um controlador do motor 2508. O controlador do motor 2508 pode compreender um ou mais circuitos configurados para fornecer um sinal de acionamento do motor 2524 ao motor 2504 para acionar o motor 2504, conforme descrito na presente invenção. Em alguns exemplos, o motor 2504 pode ser um motor elétrico de corrente contínua (CC) com escovas, como o motor 82, 714, 1120 mostrado nas Figuras 1, 5B, 10. Por exemplo, a velocidade do motor 2504 pode ser proporcional ao sinal de acionamento do motor 2524. Em alguns exemplos, o motor 2504 pode ser um motor elétrico CC sem escovas e o sinal de acionamento do motor 2524 pode compreender um sinal modulado por largura de pulso (PWM) fornecido a um ou mais enrolamentos do estator do motor 2504. Além disso, em alguns exemplos, o controlador do motor 2508 pode ser omitido, e o circuito de controle 2510 pode gerar o sinal de acionamento do motor 2524 diretamente.
[0122] O motor 2504 pode receber energia de uma fonte de ener gia 2512. A fonte de energia 2512 pode ser ou incluir uma bateria, um super capacitor, ou qualquer outra fonte de energia adequada 2512. O motor 2504 pode ser mecanicamente acoplado à haste com perfil em I 2514 por meio de uma transmissão 2506. A transmissão 2506 pode incluir uma ou mais engrenagens ou outros componentes de ligação para acoplar o motor 2504 à haste com perfil em I 2514. Um sensor de posição 2534 pode detectar uma posição da haste com perfil em I 2514. O sensor de posição 2534 pode ser ou pode incluir qualquer tipo de sensor que seja capaz de gerar dados de posição que indicam uma posição da haste com perfil em I 2514. Em alguns exemplos, o sensor de posição 2534 pode incluir um codificador configurado para fornecer uma série de pulsos ao circuito de controle 2510 conforme a haste com perfil em I 2514 translada distalmente e proximalmente. O circuito de controle 2510 pode rastrear os pulsos para determinar a posição da haste com perfil em I 2514. Outro sensor de posição adequado pode ser usado, incluindo, por exemplo, um sensor de proximidade. Outros tipos de sensores de posição podem fornecer outros sinais que indiquem o movimento da haste com perfil em I 2514. Além disso, em alguns exemplos, o sensor de posição 2534 pode ser omitido. Quando o motor 2504 for um motor de passo, o circuito de controle 2510 pode rastrear a posição da haste com perfil em I 2514 ao agregar o número e a orientação das etapas que o motor 2504 foi instruído a executar. O sensor de posição 2534 pode estar situado no atuador de extremidade 2502 ou em qualquer outra porção do instrumento.
[0123] O circuito de controle 2510 pode estar em comunicação com um ou mais sensores 2538. Os sensores 2538 podem ser posicionados no atuador de extremidade 2502 e adaptados para funcionar com o instrumento cirúrgico 2500 para medir os vários parâmetros derivados como a distância do vão em relação ao tempo, a compressão do tecido em relação ao tempo, e a tensão da bigorna em relação ao tempo. Os sensores 2538 podem compreender, por exemplo, um sensor magnético, um sensor de campo magnético, um medidor de tensão, um sensor de pressão, um sensor de força, um sensor indutivo como, por exemplo, um sensor de correntes parasitas, um sensor re- sistivo, um sensor capacitivo, um sensor óptico, e/ou quaisquer outros sensores adequados para a medição de um ou mais parâmetros do atuador de extremidade 2502. Os sensores 2538 podem incluir um ou mais sensores.
[0124] O um ou mais sensores 2538 podem compreender um me didor de tensão como, por exemplo, um medidor de microtensão, configurado para medir a magnitude da tensão na bigorna 2516 durante uma condição apertada. O medidor de tensão fornece um sinal elétrico cuja amplitude varia com a magnitude da tensão. Os sensores 2538 podem compreender um sensor de pressão configurado para detectar uma pressão gerada pela presença de tecido comprimido entre a bi- gorna 2516 e o cartucho de grampos 2518. Os sensores 2538 podem ser configurados para detectar a impedância de uma seção de tecido situada entre a bigorna 2516 e o cartucho de grampos 2518 que é indicativa da espessura e/ou da completude do tecido situado entre os mesmos.
[0125] Os sensores 2538 podem ser configurados para medir as forças exercidas sobre a bigorna 2516 pelo sistema de acionamento de fechamento 30. Por exemplo, um ou mais sensores 2538 podem estar em um ponto de interação entre o tubo de fechamento 260 (Figura 3) e a bigorna 2516 para detectar as forças de fechamento aplicadas pelo tubo de fechamento 260 à bigorna 2516. As forças exercidas sobre a bigorna 2516 podem ser representativas da compressão do tecido experimentada pela seção do tecido capturada entre a bigorna 2516 e o cartucho de grampos 2518. O um ou mais sensores 2538 podem ser posicionados em vários pontos de interação ao longo do sistema de acionamento de fechamento 30 (Figura 2) para detectar as forças de fechamento aplicadas à bigorna 2516 pelo sistema de acio-namento de fechamento 30. O um ou mais sensores 2538 podem ser amostrados em tempo real durante uma operação de preensão por um processador conforme descrito nas Figuras 5A e 5B. O circuito de controle 2510 recebe medições de amostra em tempo real para fornecer e analisar informações baseadas em tempo e avaliar, em tempo real, as forças de fechamento aplicadas à bigorna 2516.
[0126] Um sensor de corrente 2536 pode ser usado para medir a corrente drenada pelo motor 2504. A força necessária para avançar a haste com perfil em I 2514 corresponde à corrente drenada pelo motor 2504. A força medida é convertida em um sinal digital e fornecida ao circuito de controle 2510.
[0127] Usando as propriedades físicas dos instrumentos aqui reve lados, agora com referência às Figuras de 1 a 14, e com referência à Figura 14, o circuito de controle 2510 pode ser configurado para simular a resposta do sistema real do instrumento no software do controlador. Um membro de deslocamento pode ser atuado para mover uma haste com perfil em I 2514 no atuador de extremidade 2502 em ou próximo a uma velocidade-alvo. O instrumento cirúrgico 2500 pode incluir um controlador de retroinformação, que pode ser um ou qualquer dos controladores de retroinformação, incluindo, mas não se limitando a, um PID, uma retroinformação de estado, LQR, e/ou um controlador adaptável, por exemplo. O instrumento cirúrgico 2500 pode incluir uma fonte de energia para converter o sinal do controlador de retroinformação para uma entrada física como tensão do estojo, tensão modulada por largura de pulso, tensão modulada por frequência, corrente, torque e/ou força, por exemplo.
[0128] O sistema de acionamento real do instrumento cirúrgico 2500 é configurado para acionar o membro de deslocamento, o membro de corte ou a haste com perfil em I 2514, por um motor CC com escovas com caixa de câmbio e ligações mecânicas a um sistema de articulação e/ou bisturi. Outro exemplo é o motor elétrico 2504 que opera o membro de deslocamento e o acionador de articulação, por exemplo, de um conjunto de eixo de acionamento intercambiável. Uma influência externa é uma influência desmedida e imprevisível de coisas como tecido, corpos circundantes, e atrito no sistema físico. Essa influência externa pode ser chamada de arrasto, que age em oposição ao motor elétrico 2504. A influência externa, como o arrasto, pode fazer com que o funcionamento do sistema físico se desvie de uma ope-ração desejada do sistema físico.
[0129] Antes de explicar com detalhes os aspectos do instrumento cirúrgico 2500, deve-se observar que os aspectos exemplificadores não estão limitados, em termos de aplicação ou uso, aos detalhes de construção e disposição das partes ilustradas nos desenhos e na des- crição em anexo. Os aspectos exemplificadores podem ser implementados ou incorporados em outros aspectos, variações e modificações, e podem ser praticados ou executados de várias maneiras. Além disso, exceto onde indicado em contrário, os termos e expressões usados na presente invenção foram escolhidos com o propósito de descrever os aspectos exemplificadores para a conveniência do leitor e não para o propósito de limitar a mesma. Além disso, deve-se entender que um ou mais dentre os aspectos, expressões de aspectos e/ou exemplos descritos a seguir podem ser combinados com qualquer um ou mais dentre os outros aspectos, expressões de aspectos e/ou exemplos descritos a seguir.
[0130] Vários aspectos exemplificadores são direcionados a um instrumento cirúrgico 2500 que compreende um atuador de extremidade 2502 com implementos cirúrgicos de grampeamento e corte acionados por motor. Por exemplo, um motor 2504 pode acionar um membro de deslocamento distalmente e proximalmente ao longo de um eixo geométrico longitudinal do atuador de extremidade 2502. O atuador de extremidade 2502 pode compreender uma bigorna articulável 2516 e, quando configurada para o uso, uma lâmina ultrassônica 2518 posicionada no lado oposto da bigorna 2516. Um médico pode segurar o tecido entre a bigorna 2516 e o cartucho de grampos 2518, conforme descrito na presente invenção. Quando pronto para usar o instrumento 2500, o médico pode fornecer um sinal de disparo, por exemplo, pressionando um gatilho do instrumento 2500. Em resposta ao sinal de disparo, o motor 2504 pode acionar o membro de deslocamento dis- talmente ao longo do eixo geométrico longitudinal do atuador de extremidade 2502 a partir de uma posição proximal de início de curso para uma posição de fim de curso distal da posição de início de curso. À medida que o membro de deslocamento se desloca distalmente, a haste com perfil em I 2514 com um elemento de corte posicionado em uma extremidade distal, pode cortar o tecido entre o cartucho de grampos 2518 e a bigorna 2516.
[0131] Em vários exemplos, o instrumento cirúrgico 2500 pode compreender um circuito de controle 2510 programado para controlar a translação distal do membro de deslocamento, como a haste com perfil em I 2514, por exemplo, com base em uma ou mais condições do tecido. O circuito de controle 2510 pode ser programado para detectar direta ou indiretamente as condições do tecido, como espessura, conforme descrito aqui. O circuito de controle 2510 pode ser programado para selecionar um programa de controle baseado nas condições do tecido. Um programa de controle de disparo pode descrever o movimento distal do membro de deslocamento. Diferentes progra-mas de controle de disparo podem ser selecionados para melhor tratar as diferentes condições do tecido. Por exemplo, quando um tecido mais espesso está presente, o circuito de controle 2510 pode ser programado para transladar o membro de deslocamento a uma velocidade inferior e/ou com potência mais baixa. Quando um tecido mais fino está presente, o circuito de controle 2510 pode ser programado para transladar o membro de deslocamento a uma velocidade mais alta e/ou com maior potência.
[0132] Em um aspecto, o circuito de controle 2510 pode, inicial mente, operar o motor 2504 em uma configuração de circuito aberto para uma primeira porção de circuito aberto de um curso do membro de deslocamento. Com base em uma resposta do instrumento 2500 durante a porção de circuito aberto do curso, o circuito de controle 2510 pode selecionar um programa de controle de disparo. A resposta do instrumento pode incluir uma translação da distância do membro de deslocamento durante a porção de circuito aberto, um tempo decorrido durante a porção de circuito aberto, a energia fornecida ao motor 2504 durante a porção de circuito aberto, uma soma de larguras de pulso de um sinal de acionamento do motor, etc. Após a porção de circuito aberto, o circuito de controle 2510 pode implementar o programa de controle de disparo selecionado para uma segunda porção do curso do membro de deslocamento. Por exemplo, durante a porção de circuito fechado do curso, o circuito de controle 2510 pode modular o motor 2504 com base nos dados de translação que descrevem uma posição do membro de deslocamento em uma maneira de circuito fechado para transladar o membro de deslocamento em uma velocidade constante.
[0133] A Figura 15 ilustra um diagrama 2580 que plota dois cursos exemplificadores do membro de deslocamento executados de acordo com um aspecto da presente revelação. O diagrama 2580 compreende dois eixos geométricos. Um eixo geométrico horizontal 2584 indica o tempo decorrido. Um eixo geométrico vertical 2582 indica a posição da haste com perfil em I 2514 entre uma posição inicial do curso 2586 e uma posição final do curso 2588. No eixo geométrico horizontal 2584, o circuito de controle 2510 pode receber o sinal de disparo e começar a fornecer a configuração inicial do motor em t0. A porção de circuito aberto do curso do membro de deslocamento é um período de tempo inicial que pode decorrer entre t0 e t1.
[0134] Um primeiro exemplo 2592 mostra uma resposta do instru mento cirúrgico 2500 quando um tecido espesso é posicionado entre a bigorna 2516 e o cartucho de grampos 2518. Durante a porção de circuito aberto do curso do membro de deslocamento, por exemplo, o período de tempo inicial entre t0 e t1, a haste com perfil em I 2514 pode se mover da posição inicial do curso 2586 para a posição 2594. O circuito de controle 2510 pode determinar que essa posição 2594 corresponde a um programa de controle de disparo que avança a haste com perfil em I 2514 em uma velocidade selecionada constante (Vlenta), indicada pela inclinação do exemplo 2592 após t1 (por exemplo, na porção do circuito fechado). O circuito de controle 2510 pode acionar a haste com perfil em I 2514 para a velocidade Vlenta mediante o monitoramento da posição da haste com perfil em I 2514 e modulação do ponto de ajuste do motor 2522 e/ou do sinal de acionamento do motor 2524 para manter a Vlenta. Um segundo exemplo 2590 mostra uma resposta do instrumento cirúrgico 2500 quando um tecido fino é posicionado entre a bigorna 2516 e o cartucho de grampos 2518.
[0135] Durante o período de tempo inicial (por exemplo, o período de circuito aberto) entre t0 e t1, a haste com perfil em I 2514 pode se mover da posição inicial do curso 2586 para a posição 2596. O circuito de controle pode determinar que a posição 2596 corresponde a um programa de controle de disparo que avança o membro de deslocamento em uma velocidade selecionada constante (Vrápida). Porque o tecido no exemplo 2590 é mais fino do que o tecido no exemplo 2592, ele pode fornecer menos resistência ao movimento da haste com perfil em I 2514. Como resultado, a haste com perfil em I 2514 pode mover uma porção maior do curso durante o período de tempo inicial. Além disso, em alguns exemplos, um tecido mais fino (por exemplo, uma porção maior do curso do membro deslocamento percorrido durante o período de tempo inicial) pode corresponder a velocidades maiores do membro de deslocamento após o período de tempo inicial.
[0136] A Figura 16 ilustra uma vista em seção transversal de um atuador de extremidade 912 de um instrumento cirúrgico de acordo com um aspecto da presente revelação. O atuador de extremidade 912 é um aspecto do atuador de extremidade 300 (Figuras 1 e 4) que pode ser adaptado para operar com o instrumento cirúrgico 10 (Figura 1) para medir os vários parâmetros derivados, como distância do vão em função do tempo, compressão do tecido em função do tempo e deformação da bigorna em função do tempo. Consequentemente, o atu- ador de extremidade 912 pode incluir um ou mais sensores configura- dos para medir um ou mais parâmetros ou características associadas ao atuador de extremidade 912 e/ou uma seção de tecido capturada pelo atuador de extremidade 912. O atuador de extremidade 912 compreende um primeiro sensor 920 e um segundo sensor 926. Em vários exemplos, o primeiro sensor 920 e/ou o segundo sensor 926 podem compreender, por exemplo, um sensor magnético como, por exemplo, um sensor de campo magnético, um medidor de esforço, um sensor de pressão, um sensor de força, um sensor indutivo como, por exemplo, um sensor de correntes parasitas, um sensor resistivo, um sensor capacitivo, um sensor óptico e/ou quaisquer outros sensores adequados para medição de um ou mais parâmetros do atuador de extremi-dade 912. Embora o atuador de extremidade ilustrado 912 compreenda dois sensores, mais ou menos sensores podem ser empregados.
[0137] O primeiro sensor 920 e/ou o segundo sensor 926 podem compreender, por exemplo, um sensor de campo magnético embutido em uma bigorna 914, e é configurado para detectar um campo magnético gerado por um magneto 924 embutido em um membro de garra 916 e/ou cartucho de grampos 918. A bigorna 914 é giratória de forma articulada entre as posições aberta e fechada. A intensidade do campo magnético detectado pode corresponder, por exemplo, à espessura e/ou à completude de um pedaço de tecido situado entre a bigorna 914 e o membro de garra 916. Em determinados casos, o primeiro sensor 920 e/ou o segundo sensor 926 podem compreender um medidor de esforço como, por exemplo, um medidor de microesforço, con-figurado para medir a magnitude do esforço na bigorna 914 durante uma condição presa. O medidor de tensão fornece um sinal elétrico cuja amplitude varia com a magnitude da tensão.
[0138] Em alguns aspectos, um ou mais sensores do atuador de extremidade 912 como, por exemplo, o primeiro sensor 920 e/ou o segundo sensor 926 podem compreender um sensor de pressão configu- rado para detectar uma pressão gerada pela presença de tecido comprimido entre a bigorna 914 e o membro de garra 916. Em alguns exemplos, um ou mais sensores do atuador de extremidade 912 como, por exemplo, o primeiro sensor 920 e/ou o segundo sensor 926 são configurados para detectar a impedância de uma seção de tecido localizada entre a bigorna 914 e o membro de garra 916. A impedância detectada pode ser indicativa da espessura e/ou da completude do tecido situado entre a bigorna 914 e o membro de garra 916.
[0139] Os sensores do atuador de extremidade 912 como, por exemplo, o primeiro sensor 920, podem ser configurados para medir o vão 922 entre a bigorna 914 e o membro de garra 916. Em certos casos, o vão 922 pode ser representativo da espessura e/ou da com- pressibilidade de uma seção de tecido presa entre a bigorna 914 e o membro de garra 916. O vão 922 pode ser representativo da força aplicada à bigorna 914 para comprimir o tecido. Em um aspecto, o vão 922 entre a bigorna 914 e o membro de garra 916 pode ser medido posicionando-se um sensor de campo magnético sobre a bigorna 914 e posicionando-se um magneto sobre o membro de garra 916, de modo que o vão 922 seja proporcional ao sinal detectado pelo sensor de campo magnético, e o sinal seja proporcional à distância entre o magneto e o sensor de campo magnético. Será reconhecido que a localização do sensor de campo magnético e do magneto pode ser trocada de modo que o sensor de campo magnético seja posicionado sobre o membro de garra 916 e o magneto seja colocado sobre a bigorna 914.
[0140] Os sensores do atuador de extremidade 912 como, por exemplo, o primeiro sensor 920, podem ser configurados para medir uma ou mais forças exercidas sobre a bigorna 914 pelo sistema de acionamento de fechamento 30. Por exemplo, o primeiro sensor 920 pode estar em um ponto de interação entre o tubo de fechamento 260 (Figura 3) e a bigorna 914 para detectar as forças de fechamento apli- cadas pelo tubo de fechamento 260 à bigorna 914. As forças exercidas sobre a bigorna 914 podem ser representativas da compressão do tecido experimentada pela seção de tecido capturado entre a bigorna 914 e o membro de garra 916. Em certos aspectos, o primeiro sensor 920 e/ou outros sensores podem ser posicionados em vários pontos de interação ao longo do sistema de acionamento de fechamento 30 (Figura 2) para detectar as forças de fechamento aplicadas à bigorna 914 pelo sistema de acionamento de fechamento 30. O primeiro sensor 920 e/ou o segundo sensor 926 podem ser amostrados em tempo real durante uma operação de preensão por um processador conforme descrito nas Figuras de 5 a 10, por exemplo, e, mais particularmente, o sistema 970. O processador recebe medições de amostra em tempo real para fornecer e analisar informações baseadas em tempo e avaliar, em tempo real, as forças de fechamento aplicadas à bigorna 914.
[0141] As Figuras de 17 a 20 são vistas em corte de uma bigorna e uma disposição de sensor de tubo de fechamento com a bigorna 914 nas posições aberta e fechada de acordo com um aspecto da presente revelação. Conforme discutido acima, em relação à Figura 16, o instrumento cirúrgico pode incluir um sensor 6600 ou um conjunto de sensor que é configurado para medir uma força exercida sobre a bigorna 914 pelo sistema de fechamento. Em um aspecto, o sistema de fechamento compreende um tubo de fechamento 260. Nesse exemplo, o sensor 6600 pode ser posicionado em um ponto de interação entre a extremidade proximal 6500 da bigorna 914 e a extremidade distal 6502 do tubo de fechamento 260. Quando o tubo de fechamento 260 é transladado distalmente para fechar a bigorna 914, a extremidade distal 6502 do tubo de fechamento 260 entra em contato com a extremidade proximal 6500 da bigorna 914, conforme representado nas Figuras 18 e 20. O sensor 6600 posicionado nesse ponto de interação pode, portanto, medir o grau absoluto ou relativo de força exercida por e entre o tubo de fechamento 260 e a bigorna 914. O sensor 6600 pode incluir medidores de esforço; células de carga hidráulica, pneumática, piezoelétrica e capacitiva; transdutores de força de cristal piezoelétricos; e qualquer outro tipo de dispositivo capaz de detectar pressão ou força exercida entre a bigorna 914 e o tubo de fechamento 260. O sensor 6600 pode ser operacionalmente acoplado a um processador e/ou circuito de controle, conforme descrito nas Figuras de 5 a 10 e 14, por exemplo, de modo que a saída do sensor 6600 seja amostrada ou recebida pelo processador e/ou pelo circuito de controle para utilização através deles. A saída do sensor 6600 pode ser fornecida como um sinal digital.
[0142] O sensor 6600 pode ser posicionado na extremidade distal 6502 do tubo de fechamento 260, conforme representado nas Figuras 17 e 18. O sensor 6600 pode compreender um ou mais medidores de esforço 6504. Os medidores de esforço 6504 podem ser configurados para detectar um esforço mecânico longitudinal ou axial experimentado pelo tubo de fechamento 260 à medida em que ele entra em contato com a bigorna 914. Os medidores de esforço 6504 podem estar dispostos em uma ponte de Wheatstone. Em outro aspecto, o sensor 920 pode ser posicionado na extremidade proximal 6500 da bigorna 914, conforme representado nas Figuras 19 e 20. Nesse aspecto, o sensor 6600 pode, por exemplo, compreender um elemento móvel 6512 que é operacionalmente acoplado a uma célula de carga 6514 que é configurada para detectar um grau de força proveniente do contato com a extremidade distal 6502 do tubo de fechamento 260. Os exemplos supracitados podem ser adicionalmente aplicados de forma intercambiá- vel tanto à extremidade proximal da bigorna 6500 quanto à extremidade distal do tubo de fechamento 6502. Em ainda outros aspectos, o sensor 6600 pode compreender um ou mais dispositivos de detecção de força dispostos tanto extremidade proximal da bigorna 6500 quanto na extremidade distal do tubo de fechamento 6502.
[0143] A Figura 21 é um diagrama 6700 de plotagem de força de tubo de fechamento esperada versus força de tubo de fechamento real, da força de membro de deslocamento e da velocidade do motor ao longo de uma operação de preensão e disparo do instrumento cirúrgico. Na descrição a seguir do diagrama 6700, também se faz referência às Figuras de 17 a 20. O diagrama 6700 inclui um primeiro gráfico 6702 de plotagem da força de tubo de fechamento 6710 em relação ao tempo 6708, um segundo gráfico 6704 de plotagem da força de membro de deslocamento 6712 em relação ao tempo 6708 e um terceiro gráfico 6706 de plotagem da velocidade do motor 6714 em relação ao tempo 6708. O tempo de plotagem do eixo geométrico x 6708 para cada um dentre o primeiro gráfico 6702, o segundo gráfico 6704 e o terceiro gráfico 6706 é normalizado e alinhado de modo que corresponda a uma única operação de preensão e disparo executada pelo instrumento cirúrgico. Cada operação de preensão e disparo executada pelo instrumento cirúrgico é delineada em três períodos de tempo entre o tempo inicial 6750 e o tempo final 6752: o período de tempo de fechamento tc, o período de tempo de transição tt e o período de tempo de disparo tf.
[0144] No primeiro gráfico 6702, a força do tubo de fechamento esperada 6716 é plotada através de cada um dentre o período de tempo de fechamento tc, o período de tempo de transição tt t e o período de tempo de disparo tf. A força de tubo de fechamento esperada 6716 é a força que é exercida ou experimentada pelo tubo de fechamento 260 quando o tubo de fechamento 260 mantém o atuador de extremidade fechado. A força de tubo de fechamento esperada 6716 pode ser medida, por exemplo, por um sensor 6600 configurado para detectar uma força em um ponto de interação entre o tubo de fechamento 260 e a bigorna 914, conforme descrito acima. No segundo grá- fico 6704, a força de membro de deslocamento esperada 6720 é plo- tada de modo semelhante através desses sucessivos períodos de tempo. A força de membro de deslocamento esperada 6720 é a força que é exercida ou experimentada pelo membro de deslocamento 1111 (Figura 10) à medida que ele translada distalmente através do atuador de extremidade para cortar e/ou grampear o tecido preso.
[0145] Em vários aspectos, a força de tubo de fechamento espe rada 6716, a força de membro de deslocamento esperada 6720 e a velocidade de motor esperada 6724 foram modeladas ou determinadas experimentalmente para um determinado conjunto de condições, como a espessura de tecido, o tipo de operação realizada (corte, grampeamento ou uma combinação deles) e o tipo de cartucho. A força de tubo de fechamento esperada 6716, a força de membro de deslocamento esperada 6720 e a velocidade de motor esperada 6724 específicas ilustradas nas Figuras 21a 24 são meramente ilustrativas, no entanto. A força de tubo de fechamento esperada 6716, a força de membro de deslocamento esperada 6720 e a velocidade de motor esperada 6720 podem ser armazenadas na memória do instrumento cirúrgico e a cessadas durante a operação dele. A força de tubo de fechamento esperada 6716, a força de membro de deslocamento esperada 6720 e a velocidade do motor esperada 6720 podem ser armazenadas como algoritmos executados pelo processador que executa cálculos de tempo de execução, uma série de valores distintos em uma tabela de consulta, uma fórmula do melhor ajuste de curva linear ou não linear com base nos dados de caracterização ou qualquer outro desses formatos.
[0146] O período de tempo de fechamento tc começa no tempo inicial 6750 quando o operador inicia o uso do instrumento cirúrgico por meio do fechamento da bigorna 914, do membro de garra 916 e/ou do cartucho de grampos 918 (Figura 16) para prender um tecido no atuador de extremidade. O atuador de extremidade é fechado por um sistema de fechamento que recebe uma entrada do operador e exerce uma força de fechamento sobre o atuador de extremidade. Em um aspecto, o sistema de fechamento compreende um tubo de fechamento 260 configurado para exercer uma força de fechamento sobre o atua- dor de extremidade conforme o tubo de fechamento 260 é transladado distalmente. A força de tubo de fechamento esperada 6716 tem um período de elevação inicial 6754 conforme o tubo de fechamento 260 se apoia contra a porção correspondente do atuador de extremidade, fazendo com que o atuador de extremidade se feche e prenda ou engate o tecido. Após a fase de elevação inicial 6754, a força de tubo de fechamento esperada 6716 tem, então, uma fase de declínio 6756 conforme o tecido preso relaxa. Quando o tecido preso relaxa, é necessário que o tubo de fechamento 260 exerça menos força para manter o tecido preso pelo atuador de extremidade. A resposta de relaxamento do tecido preso pode ser devido, por exemplo, à saída de fluido da área presa e/ou uma resposta mecânica do tecido preso. A fase de declínio 6756 da força de tubo de fechamento esperada 6716 se aproxima assintoticamente de um valor de estado estável CTF1 sobre o período de tempo de fechamento tc até que o membro de deslocamento 1111 começa a avançar.
[0147] Quando o membro de deslocamento 1111 começa a avan çar, isto é, é disparado, há um período de tempo de transição tt na força de tubo de fechamento esperada 6716 conforme o atuador de extremidade faz a transição do estado fechado unicamente pelo tubo de fechamento 260 para o estado fechado por uma combinação do tubo de fechamento 260 com a haste com perfil em I 178 (Figura 4). Conforme descrito com mais detalhes acima, à medida que o membro de deslocamento 1111 avança distalmente, as porções da haste com perfil em I 178 engatam o cartucho de grampos 304 e/ou a bigorna 306, fazendo com que a haste com perfil em I 178 mantenha o atuador de extremidade fechado durante a operação de grampeamento e/ou corte. A haste com perfil em I 178 que mantém o atuador de extremidade fechado à medida que ele faz a translação através dela faz com que a força de tubo de fechamento esperada 6716 diminua 6758 de CTF1 para CTF2 visto que é necessário que menos força seja exercida pelo tubo de fechamento 260 para manter o atuador de extremidade na posição presa. Por outro lado, a força de membro de deslocamento esperada 6720 aumenta 6762 através do período de tempo de transição tt. O aumento 6762 da força de membro de deslocamento esperada 6720 é causado pelo aumento da carga experimentada pelo membro de deslocamento 1111 à medida que ele exerce uma força para manter o atuador de extremidade na posição presa e experimenta uma carga ou resistência do tecido que está sendo cortado e/ou grampeado pela haste com perfil em I 178. Conforme descrito em mais detalhes abaixo, a força de tubo de fechamento e a força de membro de deslocamento são, dessa forma, inversamente relacionadas entre si. O disparo do membro de deslocamento 1111 é iniciado por um aumento correspondente 6766 da velocidade de motor esperada 6724.
[0148] Quando o período de tempo de transição tt tiver terminado, a força de tubo de fechamento esperada 6716 diminui gradualmente 6760 durante o período de tempo de disparo t f quando a haste com perfil em I 178 avança através do atuador de extremidade para grampear e/ou cortar o tecido preso. Por outro lado, a força de deslocamento linear esperada 6720 tem uma fase de declínio com formato genericamente senoidal 6764 através do período de tempo de disparo tf. Em um aspecto, cada pico durante a fase de declínio senoidal 6764 corresponde, por exemplo, ao disparo de um grampo no tecido preso pela haste com perfil em I 178. Em cada grampo, a força experimentada ou exercida pelo membro de deslocamento 1111 diminui por um período de tempo, antes de se elevar novamente antes do disparo de um grampo subsequente. Além disso, a força de membro de deslocamento esperada global 6720 diminui gradualmente ao longo da fase de declínio senoidal 6764, visto que a quantidade de força necessária para o avanço da haste com perfil em I 178 através do tecido diminui conforme o tecido é preso e/ou grampeado. A operação de corte e/ou gram- peamento do tecido preso é completada no fim do tempo 6752.
[0149] A força experimentada pelo tubo de fechamento 260 e a força experimentada pelo membro de deslocamento 1111 são inversamente relacionadas entre si durante o período de tempo de transição tt, visto que, quanto maior a força experimentada pelo membro de deslocamento, mais lento será o seu avanço através do tecido preso. Quanto mais lento for avanço do membro de deslocamento 1111, menor será a tomada de controle da haste com perfil em I 178 sobre a manutenção em estado fechado do atuador de extremidade em relação ao tubo de fechamento 260. Quanto menor for o controle da haste com perfil em I 178 em relação ao tubo de fechamento 260, mais força será experimentada pelo tubo de fechamento 260. Portanto, o monitoramento da força de tubo de fechamento real 6718 pode ser usado efi-cazmente como um substituto para monitorar indiretamente a função do membro de deslocamento 1111, que é caracterizada pela força que ele experimenta à medida que avança, isto é, a força de membro de deslocamento real 6722. Em um aspecto, se a força de tubo de fechamento real 6718 for maior que a força de tubo de fechamento es- perada6716, então, a força de membro de deslocamento real 6722 é menor que a força de membro de deslocamento esperada 6720. Quando a força de membro de deslocamento real 6722 é baixa, então, a carga experimentada pelo membro de deslocamento 1111, isto é, o a resistência de tecido experimentada pela haste com perfil em I 178, pode ser correspondentemente menor do que o esperado. Quando a haste com perfil em I 178 encontra baixa resistência do tecido, então, a velocidade do motor pode ser aumentada de modo a avançar a haste com perfil em I 178 mais rapidamente. Pode ser desejável aumentar a velocidade da haste com perfil em I 178 quando são encontradas baixas resistências do tecido a fim de diminuir a quantidade de tempo tomada pela operação de corte e/ou grampeamento pelo instrumento cirúrgico. Consequentemente, se a força de tubo de fechamento real 6718 for menor que a força de tubo de fechamento esperada 6716, então, a força de membro de deslocamento real 6722 é maior que a força de membro de deslocamento esperada 6720. Quando a força de membro de deslocamento real 6722 é alta, então, a carga experimentada pelo membro de deslocamento 1111, isto é, a resistência de tecido experimentada pela haste com perfil em I 178, pode ser correspondentemente maior do que o esperado. Quando a haste com perfil em I 178 encontra alta resistência do tecido, então, a velocidade do motor pode diminuir de modo a avançar a haste com perfil em I 178 mais lentamente. A diminuição da velocidade da haste com perfil em I 178 pode ser desejável quando altas resistências de tecido são encontradas para evitar sobrecarrega do motor e para evitar a malformação dos grampos causada pelos grampos que não são suficientemente acionados através do tecido.
[0150] A Figura 22 é uma vista em detalhe do período de transição tt do primeiro gráfico 6702 ilustrado na Figura 21 de acordo com um aspecto da presente revelação. Em condições ideais, a força de tubo de fechamento se comporta de uma maneira conhecida que é ilustrada em um aspecto pela força de tubo de fechamento esperada 6716; no entanto, quando o instrumento cirúrgico é utilizado na prática, o desempenho real do instrumento cirúrgico irá variar devido a desvios das condições esperadas do tecido, de fatores ambientais e de outras variáveis. Visto que a força do tubo de fechamento real 6718 é detectável e a relação inversa entre a força do tubo de fechamento e a força do membro de deslocamento é conhecida, o instrumento cirúrgico pode, em alguns aspectos, ser configurado para ajustar o motor que aciona o membro de deslocamento 1111 para compensar a carga variável ou inesperada encontrada assim quando desvios na força do tubo de fechamento real 6718 provenientes da força de tubo de fechamento esperada 6716 são detectados. Visto que a força de tubo de fechamento esperada 6716 pode representar o estado operacional preferencial para o instrumento cirúrgico, pode ser desejável, assim, ajustar a força de tubo de fechamento real 6718 para que seja correspondente à força de tubo de fechamento esperada 6716 ao longo de uma operação de preensão e disparo executada pelo instrumento cirúrgico.
[0151] Deve-se observar que as Figuras de 21 a 24 meramente representam exemplos para a força de tubo de fechamento real 6718 e a força de membro de deslocamento real 6722 para ilustrar os princípios de vários aspectos do instrumento cirúrgico. A força de tubo de fechamento real 6718 e a força de membro de deslocamento real 6722 irão variar com cada uso do instrumento cirúrgico de acordo com condições variáveis de tecido, condições ambientais variáveis, os tipos de operações realizadas pelo instrumento cirúrgico, e assim por diante.
[0152] Em um aspecto, o período de tempo de transição tt é dividi do em uma série de intervalos de tempo distintos t0, t1, .. tn. Em cada intervalo de tempo, o circuito de controle faz a amostragem da força de tubo de fechamento real 6718, calcula ou recupera a força de tubo de fechamento esperada 6716 por um intervalo de tempo determinado e, então, compara a força de tubo de fechamento real 6718 à força de tubo de fechamento esperada 6716. Se a força de tubo de fechamento real 6718 estiver dentro de um limite da força de tubo de fechamento esperada 6716, então, nenhuma ação é tomada pelo instrumento cirúrgico. Nenhuma ação foi tomada pelo instrumento cirúrgico porque, conforme discutido acima, se a força de tubo de fechamento real 6718 for igual ou estiver dentro de uma faixa de tolerância da força de tubo de fechamento esperada 6716, então, a força de membro de deslocamento real 6722 está dentro de uma faixa aceitável da força de membro de deslocamento esperada 6720. Por outro lado, se a força de tubo de fechamento real 6718 não estiver dentro de um limite da força de tubo de fechamento esperada 6716, sabe-se, então, que a força de membro de deslocamento real 6722 não está dentro de uma faixa aceitável da força de membro de deslocamento esperada 6720 e o instrumento cirúrgico pode ajustar a velocidade na qual o membro de deslocamento 1111 translada para compensação. O limite pode incluir, por exemplo, uma faixa de porcentagem ou um valor determinado a partir da força de tubo de fechamento esperada 6716.
[0153] Com referência novamente à Figura 21, o terceiro gráfico 6706 mostra vários exemplos do comportamento da velocidade do motor que aciona a haste com perfil em I 178 durante o período de tempo de disparo tf que reflete a relação entre a força de tubo de fechamento real 6718 e a força de membro de deslocamento real 6722. Após a fase de inclinação inicial 6766, à medida que a haste com perfil em I 178 é disparada durante o período de tempo de transição tt, a velocidade de motor corresponderá à possibilidade de a força de tubo de fechamento real 6718 estar acima, dentro ou abaixo de um limite da força de tubo de fechamento esperada 6716. Se a haste com perfil em I 178 encontrar resistência abaixo do esperado, isto é, a força de membro de deslocamento for menor que o esperado e a força de tubo de fechamento for maior que o esperado, então, a velocidade de motor aumentará rapidamente 6772 até uma velocidade máxima V1 para fazer a translação da haste com perfil em I 178 na velocidade mais rápida possível. Se a haste com perfil em I 178 encontrar a resistência esperada, isto é., as forças de membro de deslocamento e de tubo de fe- chamento estiverem dentro das faixas de tolerância aceitáveis, estão, a velocidade de motor aumentará gradativamente 6768 ao longo do curso de disparo da haste com perfil em I 178. Se a haste com perfil em I encontrar resistência maior que o esperado, então, a velocidade de motor cairá 6726 uma ou mais vezes à medida que a resistência maior que o esperado for encontrada pela haste com perfil em I 178 para evitar a sobrecarga do motor. Em alguns aspectos, o instrumento cirúrgico pode ser configurado para não diminuir 6726 a velocidade do motor abaixo de uma velocidade mínima definida V2. A velocidade de motor diminui 6770 até zero mediante o término do curso de disparo da haste com perfil em I 178.
[0154] A Figura 25 é um diagrama de fluxo lógico de um processo 6800 que representa um programa de controle ou uma configuração lógica para controlar a velocidade do membro de deslocamento de acordo com a força de tubo de fechamento de acordo com um aspecto da presente revelação. Na descrição a seguir do processo 6800, também se faz referência às Figuras 14 e de 17 a 20. Consequentemente, o processo 6800 primeiro inicia 6802 um curso de disparo do membro de deslocamento 2520, que faz com que o membro de deslocamento 2520 avance distalmente para o atuador de extremidade 2502. Antes de o curso de disparo ser iniciado 6802, o tecido já foi preso pelo atu- ador de extremidade 2502 devido à ação do tubo de fechamento 260.
[0155] Depois de o curso de disparo ser iniciado 6802, em um as pecto, o circuito de controle 2510 determina 6804 a força de fechamento real CFa aplicada pelo sistema de acionamento de fechamento 30 em um tempo tx. Em alguns aspectos, a força de fechamento real CFa pode ser diretamente detectada por um sensor configurado para detectar uma força ou tensão exercida ou experimentada pelo tubo de fechamento 260 contra a bigorna 834 ou o cartucho de grampos 2518 em um ponto de interação. Em outros aspectos, a força de tubo de fe- chamento real CFa pode ser indiretamente determinada, por exemplo, mediante a detecção de uma força ou tensão exercida ou experimentada por uma ligação mecânica que conecta o gatilho de fechamento 32 e o tubo de fechamento 260 durante a manutenção do atuador de extremidade 2502 em uma posição presa.
[0156] O processo 6800, conforme executado pelo circuito de con trole 2510, determina a seguir 6806 a força de tubo de fechamento esperada CF0 correspondente ao tempo específico t x. Em um aspecto, o circuito de controle 2510 determina 6806 a força de tubo de fechamento esperada CFe recuperando-se o valor da força de tubo de fechamento esperada CFe correspondente ao tempo tx de uma tabela de consulta armazenada, por exemplo, em uma memória do instrumento cirúrgico. Em outros aspectos, o circuito de controle 2510 determina 6806 a força de tubo de fechamento esperada CFe calculando-se o valor da força de tubo de fechamento esperada CFe de acordo com um algoritmo executado pelo circuito de controle 2510.
[0157] O processo 6800, conforme executado pelo circuito de con trole 2510, determina a seguir 6808 a possibilidade de a força de fechamento real CFa está dentro de um limite da força de tubo de fechamento esperada CFe. Em um aspecto, o circuito de controle 2510 determina 6808 a possibilidade de a força de fechamento real CFa estar dentro de um limite da força de tubo de fechamento esperada CFe comparando-se diretamente os dois valores para determinar a possibilidade de que estejam dentro de um limite entre si. Em outro aspecto, o circuito de controle utiliza uma derivada de uma curva de melhor ajuste da força de tubo de fechamento esperada 6716 e da força de tubo de fechamento real 6718 durante um intervalo de tempo de um tempo anterior tx-1 até o tempo atual tx para determinar se a taxa de mudança da força de tubo de fechamento real 6718 está dentro de um limite da força de tubo de fechamento esperada 6716. Em outro aspec- to, conforme ilustrado nas Figuras 23 e 24, o circuito de controle calcula uma primeira diferença δa entre o valor da força de tubo de fechamento real e o valor da força de tubo de fechamento esperada do tempo anterior tx-1 e uma segunda diferença δe entre o valor da força de tubo de fechamento esperada e o valor da força de tubo de fechamento do período de tempo anterior tx-1. O sistema de controle, então, compara as diferenças δa, δe no tempo tx para determinar se a primeira diferença δa está dentro de um limite ± x da segunda diferença δe.
[0158] Por exemplo, a Figura 23 representa um intervalo de tempo em que a força de tubo de fechamento real 6718 excede a força de tubo de fechamento esperada 6716. Conforme ilustrado na Figura 23, no tempo t1, o circuito de controle 2510 determina o valor da força de tubo de fechamento real 6902 e o valor da força de tubo de fechamento esperada 6900 que corresponde ao tempo t1. O circuito de controle 2510 calcula a seguir uma primeira diferença δ1a entre o valor da força de tubo de fechamento real 6902 e o valor da força de tubo de fechamento esperada 6904 do tempo anterior t0 e uma segunda diferença δ1e entre o valor da força de tubo de fechamento esperada 6900 e o valor da força de tubo de fechamento esperada 6904 do tempo anteri-or t0. O circuito de controle, então, compara as diferenças δ1a, δ1e no tempo t1 para determinar se a primeira diferença δ1a está dentro de um limite ± x da segunda diferença δ1e. Visto que a primeira diferença δ1a é maior que a segunda diferença δ1e + x (isto é, o valor de força de tubo de fechamento real 6902 está acima do limite de tolerância do valor de força de tubo de fechamento esperada 6900 no tempo t1), então, a força de membro de deslocamento real 6722 é menor que a força de membro de deslocamento esperada 6720 e o circuito de controle 2510 do instrumento cirúrgico pode compensar aumentando-se a velocidade em que a haste com perfil em I 2514 translada.
[0159] Como outro exemplo, a Figura 24 representa um intervalo de tempo em que a força de tubo de fechamento real 6718 é menor que a força de tubo de fechamento esperada 6716. Conforme ilustrado na Figura 24, no tempo t3 o circuito de controle 2510 determina o valor de força de tubo de fechamento real 6908 e o valor de força de tubo de fechamento esperada 6906 que corresponde ao tempo t3. O circuito de controle 2510 calcula a seguir uma primeira diferença δ3a entre o valor de força de tubo de fechamento real 6908 e o valor de força de tubo de fechamento esperada 6910 do tempo anterior t2 e uma segunda diferença δ3e entre o valor da força de tubo de fechamento esperada 6906 e o valor da força de tubo de fechamento esperada 6910 do tempo anterior t2. O circuito de controle, então, compara as diferenças δ3a, δ3e no tempo t3 para determinar se a primeira diferença δ3a está dentro de um limite ± x da segunda diferença δ3e. Visto que a primeira diferença δ3a é menor que a segunda diferença δ3e - x, a força de membro de deslocamento real 6722 é maior que a força de membro de deslocamento esperada 6720 e o circuito de controle 2510 do instrumento cirúrgico pode compensar diminuindo-se a velocidade em que o membro de deslocamento 1111 translada.
[0160] Se a força de tubo de fechamento real CFa estiver fora da faixa de tolerância da força de tubo de fechamento esperada CFe, o processo 6800 prossegue ao longo da ramificação NÃO e o circuito de controle 2510 ajusta 6810 a velocidade do membro de deslocamento, como, por exemplo, a haste com perfil em I 2514. No exemplo em que o membro de deslocamento é a haste com perfil em I 2514, a velocidade em que a haste com perfil em I 2514 translada é ajustada de acordo com a possibilidade de a força de tubo de fechamento real CFa estar acima ou abaixo da faixa de limite da força de tubo de fechamento esperada CFe. Se a força de tubo de fechamento real CFa estiver acima da faixa de limite da força de tubo de fechamento esperada CFe, conforme ilustrado na Figura 23, o circuito de controle 2510 gera um sinal de ponto de ajuste de motor 2522 que é fornecido ao controlador de motor 2508 para acionar o motor 2504 a uma velocidade que é maior que a velocidade atual em que o motor 2504 é ajustado. Por outro lado, se a força de tubo de fechamento real CFa estiver abaixo da faixa de limite da força de tubo de fechamento esperada CFe, conforme ilustrado na Figura 24, o circuito de controle 2510 gera um sinal de ponto de ajuste de motor 2522 que é fornecido ao controlador de motor 2508 para acionar o motor 2504 a uma velocidade que é menor que a velocidade atual em que o motor 2504 é ajustado. Em um as-pecto, o ajuste aplicado ao motor 2504 pode ser um valor fixo. Em outro aspecto, o ajuste aplicado ao motor 2504 pode ser proporcional ao grau ao qual a força de tubo de fechamento real CFa está acima ou abaixo da faixa de limite da força de tubo de fechamento esperada CFe. Em ainda outro aspecto, o ajuste aplicado ao motor 2504 pode ser calculado pelo circuito de controle 2510 de acordo com uma função linear ou não linear.
[0161] Se a força de tubo de fechamento real CFa estiver dentro da faixa de tolerância da força de tubo de fechamento esperada CFe, o processo 6800 prossegue ao longo da ramificação SIM e o circuito de controle 2510 determina a seguir 4084 a possibilidade de o curso da haste com perfil em I 2514 ser concluído. Alternativamente, após a velocidade da haste com perfil em I 2514 ser ajustada 6810, o circuito de controle 2510 determina a seguir, de modo semelhante, 6812 a possibilidade de o curso da haste com perfil em I 2514 ser concluído. Se o curso de disparo estiver concluído, o processo 6800 prossegue ao longo da ramificação SIM e o processo 6800 é concluído 6814. Se o curso de disparo não estiver concluído, o processo 6800 prossegue ao longo da ramificação NÃO e continua um circuito de determinação 6804 da força de tubo de fechamento real CFa, determinação 6806 da força de tubo de fechamento esperada CFe, determinação 6808 da possibilidade de elas estarem dentro de um limite entre si, e do ajuste 6810 à velocidade da haste com perfil em I 2514 em conformidade para cada intervalo de tempo subsequente tx+1, tx+2, .. tx+n. Em outras palavras, o processo 6800 continua a monitorar o força de tubo de fechamento e a ajustar a velocidade da haste com perfil em I 2514 em conformidade até que a operação de corte e/ou grampeamento seja concluída.
[0162] A função ou o processo 6800 aqui descritos podem ser executados por qualquer um dos circuitos de processamento aqui descritos, como o circuito de controle 700 descrito nas Figuras 5 e 6, os circuitos 800, 810, 820 descritos nas Figuras de 7 a 9, o microcontro- lador 1104 descrito juntamente com as Figuras 10 e 12, e/ou o circuito de controle 2510 descrito na Figura 14.
[0163] Os aspectos do instrumento cirúrgico motorizado podem ser praticados sem os detalhes específicos revelados na presente invenção. Alguns aspectos foram mostrados como diagramas de bloco em vez de detalhes. Partes desta revelação podem ser apresentadas em termos de instruções que operam em dados armazenados em uma memória do computador. Um algoritmo se refere à sequência autocon- sistente de etapas que levam ao resultado desejado, em que uma "etapa" se refere à manipulação de quantidades físicas que podem assumir a forma de sinais elétricos ou magnéticos capazes de serem armazenados, transferidos, combinados, comparados e manipulados de qualquer outra forma. Esses sinais podem ser chamados de bits, valores, elementos, símbolos, caracteres, termos, números. Esses termos e termos semelhantes podem ser associados às grandezas físicas adequadas e são identificações meramente convenientes aplicadas a essas grandezas.
[0164] De modo geral, os aspectos aqui descritos, os quais podem ser implementados, individual e/ou coletivamente, por uma ampla ga ma de hardware, software, firmware, ou qualquer combinação dos mesmos, podem ser vistos como sendo compostos por vários tipos de "circuitos elétricos". Consequentemente, "circuito elétrico" inclui, mas não se limita aos, circuitos elétricos que tenham ao menos um circuito elétrico distinto, circuitos elétricos que tenham ao menos um circuito integrado, circuitos elétricos que tenham ao 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 ou processador para finalidades gerais configurado por um programa de computador que ao 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). Esses aspectos podem ser implementados em forma analógica ou digital, ou combinações dos mesmos.
[0165] A descrição anteriormente mencionada apresentou aspec tos dos dispositivos e/ou processos por meio do uso de diagramas de blocos, fluxogramas, e/ou exemplos, que pode conter uma ou mais funções e/ou operação. Cada função e/ou operação dentro de tais diagramas de blocos, fluxogramas ou exemplos pode ser implementada, individualmente e/ou coletivamente, por uma ampla gama de hardware, software, firmware ou virtualmente qualquer combinação dos mesmos. Em um aspecto, várias porções do assunto aqui descrito podem ser implementadas por meio de circuitos integrados de aplicação específica (ASICs), arranjos de portas programáveis em campo (FPGAs), processadores de sinais digitais (DSPs), dispositivos lógicos programáveis (PLDs), circuitos, registradores e/ou componentes de software, por exemplo, programas, sub-rotinas, lógica e/ou combinações de componentes de hardware e software, portas lógicas, ou outros formatos integrados. Alguns aspectos aqui revelados, no todo ou em parte, podem ser implementados de modo equivalente em circuitos integrados, como um ou mais programas de computador executando em um ou mais computadores (por exemplo, como um ou mais programas operando em um ou mais sistemas de computador), como um ou mais programas operando em um ou mais processadores (por exemplo, como um ou mais programas operando 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 de uma pessoa versada na técnica à luz desta revelação.
[0166] Os mecanismos do assunto revelado podem ser distribuí dos como um produto de programa em uma variedade de formas, e um aspecto ilustrativo do assunto aqui descrito é aplicável independentemente do tipo específico da mídia de transmissão de sinais usado para efetivamente executar a distribuição. Exemplos de uma mídia de transmissão de sinais incluem, mas não se limitam aos seguintes: uma mídia 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.).
[0167] A descrição anteriormente mencionada de um ou mais as pectos 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. Esses aspectos foram escolhidos e descritos com a finalidade de ilustrar os princípios e a aplicação prática para, assim, permitir que a pessoa versada na técnica use os vários aspectos e com várias modificações, conforme sejam convenientes ao uso específico contemplado. Pretende-se que as concretizações apresentadas em anexo definam o escopo global.
[0168] Vários aspectos da matéria descrita no presente documento são definidos nos seguintes exemplos numerados: Exemplo 1. Um instrumento cirúrgico compreende: um membro de deslocamento móvel entre uma primeira posição e uma segunda posição para efetuar um movimento em um atuador de extremidade; um motor acoplado ao membro de deslocamento, sendo que o motor é configurado para acionar o membro de deslocamento entre a primeira posição e a segunda posição; e um circuito de controle acoplado ao motor, sendo que o circuito de controle é configurado para: receber um sinal indicativo de força proveniente de um sensor, sendo que o sinal é indicativo da força aplicada por um tubo de fecha-mento ao atuador de extremidade; determinar uma força de fechamento aplicada pelo tubo de fechamento ao atuador de extremidade; determinar a possibilidade de a força de fechamento estar dentro de um limite de uma força de fechamento esperada; e definir uma velocidade de motor para acionar o motor a uma velocidade que corresponde à força de fechamento em relação à força esperada. Exemplo 2. Instrumento cirúrgico, de acordo com o Exemplo 1, que compreende adicionalmente um sensor acoplado ao circuito de controle, o sendo que sensor é configurado para detectar uma força exercida em um ponto de interação entre o atuador de extremidade e o tubo de fechamento. Exemplo 3. Instrumento cirúrgico, de acordo com o Exemplo 2, sendo que a força de fechamento compreende a força exercida no ponto de interação entre o atuador de extremidade e o tubo de fechamento. Exemplo 4. Instrumento cirúrgico, de acordo com o Exemplo 1 até o Exemplo 3, sendo que o circuito de controle é configurado para recuperar a força de fechamento esperada de uma memória. Exemplo 5. Instrumento cirúrgico, de acordo com o Exemplo 1 até o Exemplo 4, sendo que o circuito de controle é configurado para comparar um valor da força de fechamento a um valor da força de fechamento esperada e para determinar a possibilidade de a força de fechamento estar dentro de um limite da força de fechamento esperada com base nos resultados da comparação. Exemplo 6. Instrumento cirúrgico, de acordo com o Exemplo 1 até o Exemplo 5, sendo que o circuito de controle é configurado para comparar uma primeira diferença entre a força de fechamento e uma força de fechamento esperada anterior e uma segunda diferença entre a força de fechamento esperada e a força de fechamento esperada anterior e para determinar a possibilidade de a força de fechamento estar dentro de um limite da força de fechamento esperada com base nos resultados da comparação. Exemplo 7. Instrumento cirúrgico, de acordo com o Exemplo 1 até o Exemplo 6, que compreende adicionalmente: um atuador de extremidade; e um tubo de fechamento acoplado ao atuador de extremidade, sendo que o tubo de fechamento é configurado para aplicar uma força de fechamento ao atuador de extremidade. Exemplo 8. Instrumento cirúrgico que compreende: um sistema de fechamento configurado para aplicar uma força de fechamento a um atuador de extremidade para fazer a transição do atuador de extremidade entre uma posição aberta e uma posição fechada; um membro de deslocamento acoplado ao sistema de fechamento, sendo que o membro de deslocamento é móvel entre uma primeira posição e uma segunda posição para efetuar um movimento no atuador de extremidade; um motor acoplado ao membro de deslocamento, sendo que o motor é configurado para acionar o membro de deslocamento entre a primeira posição e a segunda posição; e um circuito de controle acoplado ao motor, sendo que o circuito de controle é configurado para: determinar a força de fechamento exercida pelo sistema de fechamento; recuperar uma força de fechamento esperada; determinar a possibilidade de a força de fechamento estar dentro de uma tolerância da força de fechamento esperada; e ajustar o motor para acionar o membro de deslocamento a uma velocidade, sendo que a velocidade corresponde à força de fechamento em relação à força de fechamento esperada. Exemplo 9. Instrumento cirúrgico, de acordo com o Exemplo 8, que compreende adicionalmente um sensor acoplado ao circuito de controle, sendo que o sensor é configurado para detectar a força de fechamento. Exemplo 10. Instrumento cirúrgico, de acordo com o Exemplo 9, sendo que o sensor está disposto em um ponto de interação entre o sistema de fechamento e o atuador de extremidade. Exemplo 11. Instrumento cirúrgico, de acordo com o Exemplo 8 até o Exemplo 10, sendo que o circuito de controle é configurado para recuperar a força de fechamento esperada de uma memória. Exemplo 12. Instrumento cirúrgico, de acordo com o Exemplo 8 até o Exemplo 11, sendo que o circuito de controle é configurado para comparar um valor da força de fechamento a um valor da força de fechamento esperada e para determinar a possibilidade de a força de fechamento estar dentro de um limite de força de fechamento esperada com base na comparação. Exemplo 13. Instrumento cirúrgico, de acordo com o Exemplo 8 até o Exemplo 12, sendo que o circuito de controle é configurado para comparar uma primeira diferença entre a força de fechamento e uma força de fechamento esperada anterior e uma segunda diferença entre a força de fechamento esperada e a força de fechamento esperada anterior e para determinar a possibilidade de a força de fechamento estar dentro de um limite da força de fechamento esperada com base nos resultados da comparação. Exemplo 14. Instrumento cirúrgico, de acordo com o Exemplo 8 até o Exemplo 13, que compreende adicionalmente: um atuador de extremidade; e um tubo de fechamento acoplado ao atuador de extremidade, sendo que o tubo de fechamento é configurado para aplicar uma força de fechamento ao atuador de extremidade. Exemplo 15. Método de controle de um motor em um instrumento cirúrgico, sendo que o instrumento cirúrgico compreende um sistema de fechamento configurado para aplicar uma força de fechamento a um atuador de extremidade para fazer a transição do atuador de extremidade entre uma posição aberta e uma posição fechada, sendo que um membro de deslocamento está acoplado ao sistema de fechamento, o membro de deslocamento é móvel entre uma primeira posição e uma segunda posição para efetuar um movimento no atua- dor de extremidade, um motor é acoplado ao membro de deslocamento, sendo que o motor é configurado para acionar o membro de deslocamento entre a primeira posição e a segunda posição; e um circuito de controle acoplado ao motor, sendo que o método compreende: de-terminar a força de fechamento exercida pelo sistema de fechamento; recuperar uma força de fechamento esperada; determinar a possibilidade de a força de fechamento estar dentro de uma tolerância da força de fechamento esperada; e definir uma velocidade de motor para acionar o motor, sendo que a velocidade de motor corresponde à força de fechamento em relação à força de fechamento esperada. Exemplo 16. Método, de acordo com o Exemplo 15, que compreende adicionalmente a recuperação, por meio do circuito de controle, da força de fechamento esperada da memória. Exemplo 17. Método, de acordo com o Exemplo 15, que compreende adicionalmente a detecção, por meio de um sensor acoplado ao circuito de controle, de uma força exercida pelo sistema de fechamento em um ponto de interação com o atuador de extremidade. Exemplo 18. Método, de acordo com o Exemplo 17, que compreende adicionalmente a determinação, por meio do circuito de controle, da força de fechamento exercida pelo sistema de fechamento. Exemplo 19. Método, de acordo com o Exemplo 15, que compreende adicionalmente a comparação, por meio do circuito de controle, de um valor da força de fechamento a um valor da força de fechamento esperada e a determinação, por meio do circuito de controle, da possibilidade de a força de fechamento estar dentro de um limite da força de fechamento esperada com base nos resultados da comparação. Exemplo 20. Método, de acordo com o Exemplo 15 até o Exemplo 19, que compreende adicionalmente a comparação, por meio do circuito de controle, de uma primeira diferença entre a força de fechamento e uma força de fechamento esperada anterior e uma segunda diferença entre a força de fechamento esperada e a força de fechamento esperada anterior e a determinação, por meio do circuito de controle, da possibilidade de a força de fechamento estar dentro de um limite da força de fechamento esperada com base nos resultados da comparação.
Claims (6)
1. Instrumento cirúrgico (10) compreendendo: um sistema de fechamento configurado para aplicar uma força de fechamento a um efetor de extremidade (300, 912, 2502) para fazer transição do efetor de extremidade (300, 912, 2502) entre uma posição aberta e uma posição fechada; um membro de deslocamento (1111) acoplado ao sistema de fechamento, o membro de deslocamento (1111) móvel entre uma primeira posição e uma segunda posição para efetuar um movimento no efetor de extremidade (300, 912, 2502); um motor (714) acoplado ao membro de deslocamento (1111), o motor (714) configurado para acionar o membro de deslocamento (1111) entre a primeira posição e a segunda posição; um circuito de controle (700, 800, 2510) acoplado ao motor (714), o circuito de controle (700, 800, 2510) configurado para: determinar a força de fechamento exercida pelo sistema de fechamento; em que um sensor (920, 6600) acoplado ao circuito de controle (700, 800, 2510) é configurado para detectar a força de fechamento; recuperar uma força de fechamento esperada; determinar se a força de fechamento está dentro de uma tolerância da força de fechamento esperada; e caracterizado pelo fato de que o circuito de controle (700, 800, 2510) é configurado para ajustar o motor (714) para ajustar a velocidade na qual o membro de deslocamento (1111) é transladado quando a força de fechamento não estiver dentro de uma tolerância da força de fechamento esperada, em que o ajuste aplicado ao motor (714) é proporcional ao grau ao qual a força de fechamento está acima ou abaixo de uma faixa de limite da força de fechamento esperada.
2. Instrumento cirúrgico, de acordo com a reivindicação 1, caracterizado pelo fato de que o circuito de controle (700, 800, 2510) é configurado para recuperar a força de fechamento esperada a partir de uma memória.
3. Instrumento cirúrgico, de acordo com a reivindicação 1 ou 2, caracterizado pelo fato de que o circuito de controle (700, 800, 2510) é configurado para comparar um valor da força de fechamento a um valor da força de fechamento esperada e para determinar se a força de fechamento está dentro um limite da força de fechamento esperada com base na comparação.
4. Instrumento cirúrgico, de acordo com qualquer uma das reivindicações 1 a 3, caracterizado pelo fato de que o circuito de controle (700, 800, 2510) é configurado para comparar uma primeira diferença entre a força de fechamento e uma força de fechamento esperada anterior e uma segunda diferença entre a força de fechamento esperada e a força de fechamento esperada anterior e para determinar se a força de fechamento está dentro de um limite da força de fechamento esperada com base nos resultados da comparação.
5. Instrumento cirúrgico, de acordo com qualquer uma das reivindicações 1 a 4, caracterizado pelo fato de que ainda compreende um atuador de extremidade (300, 912, 2502); e em que o sistema de fechamento compreende um tubo de fechamento (260) acoplado ao atuador de extremidade (300, 912, 2502), o tubo de fechamento configurado para aplicar uma força de fechamento (6716) ao atuador de extremidade (300, 912, 2502).
6. Instrumento cirúrgico, de acordo com a reivindicação 5, caracterizado pelo fato de que o sensor (6600) é posicionado na extremidade distal (6502) do tubo de fechamento (260).
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JP7286556B2 (ja) | 2023-06-05 |
JP2020524044A (ja) | 2020-08-13 |
EP3824820A1 (en) | 2021-05-26 |
CN110769758B (zh) | 2022-10-28 |
CN110769758A (zh) | 2020-02-07 |
EP3417810A1 (en) | 2018-12-26 |
EP3417810B1 (en) | 2021-01-20 |
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