BR112019027040B1 - Instrumento de grampeamento e corte cirúrgico com controle de velocidade de membro de deslocamento - Google Patents
Instrumento de grampeamento e corte cirúrgico com controle de velocidade de membro de deslocamento Download PDFInfo
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Abstract
a presente invenção se refere a um instrumento cirúrgico motorizado. o instrumento cirúrgico inclui um membro de deslocamento, um motor acoplado ao membro de deslocamento, sendo que o motor é operável para transladar o membro de deslocamento, um circuito de controle acoplado ao motor, e um sensor de posição acoplado ao circuito de controle. o circuito de controle é configurado para receber uma saída de posição do sensor de posição indicativa de ao menos uma posição do membro de deslocamento e controlar a velocidade do motor para transladar o membro de deslocamento em uma pluralidade de velocidades correspondentes à posição de saída. cada uma dentre a pluralidade de velocidades é mantida em uma zona predeterminada.
Description
[001] A presente invenção se refere 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.
[002] 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 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 membro 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.
[003] Durante o uso de um instrumento de grampeamento e corte cirúrgico motorizado é possível que a força para disparar experimentada pelo membro de corte ou membro de disparo possa ser substancialmente diferente com base no local do membro de corte ou de disparo durante o curso de disparo. Em geral, a primeira zona é a mais altamente carregada e a última zona é a menos altamente carregada. Portanto, pode ser desejável definir o curso de disparo em zonas distintas com diferentes velocidades de avanço do membro de corte em cada zona com base na força para disparar a carga experimentada pelo sistema de disparo e para variar a velocidade de disparo do membro de corte com base na posição do membro de corte ao longo do curso de disparo. Seria desejável definir a velocidade de disparo na velocidade mais lenta na primeira zona onde o membro de corte ou membro de disparo está sob a carga mais alta e aumentar a velocidade em cada zona subsequente. Pode ser desejável definir a velocidade na primeira zona determinando-se a espessura de tecido ou o vão de tecido através da medição de qualquer combinação de corrente através do motor, tempo para avançar o membro de corte a uma distância predefinida, deslocamento do membro de corte durante um tempo predefinido, ou qualquer representação para a carga sobre o motor.
[004] Em um aspecto, a presente revelação fornece um instrumento cirúrgico. O instrumento cirúrgico compreende um membro de deslocamento; um motor acoplado ao membro de deslocamento, sendo que o motor é operável para transladar o membro de deslocamento; um circuito de controle acoplado ao motor; e um sensor de posição acoplado ao circuito de controle; sendo que o circuito de controle é configurado para: receber uma saída de posição do sensor de posição indicativa de ao menos uma posição do membro de deslocamento; e controlar a velocidade do motor para transladar o membro de deslocamento em uma pluralidade de velocidades correspondentes à saída de posição, sendo que cada uma da pluralidade de velocidades é mantida em uma zona predeterminada.
[005] Em um outro aspecto, o instrumento cirúrgico compreende um membro de deslocamento; um motor acoplado ao membro de deslocamento, sendo que o motor é operável para transladar o membro de deslocamento; um circuito de controle acoplado ao motor; e um sensor de posição acoplado ao circuito de controle; sendo que o circuito de controle é configurado para: receber uma saída de posição do sensor de posição indicativa de ao menos uma posição do membro de deslocamento; e acionar o motor para transladar o membro de deslocamento a uma velocidade do membro de deslocamento correspondente à posição do membro de deslocamento.
[006] Em um outro aspecto, o instrumento cirúrgico compreende um membro de deslocamento; um motor acoplado ao membro de deslocamento, sendo que o motor é operável para transladar o membro de deslocamento; um circuito de controle acoplado ao motor; e um sensor de posição acoplado ao circuito de controle; sendo que o circuito de controle é configurado para: receber uma saída de posição do sensor de posição indicativa de ao menos uma posição do membro de deslocamento ao longo da distância entre a posição proximal e a posição distal; e acionar o motor em uma pluralidade de ciclos de trabalho correspondentes à saída de posição, sendo que cada uma dentre a pluralidade de ciclos de trabalho é mantida em uma zona predeterminada entre a posição proximal e a posição distal.
[007] 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.
[008] 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.
[009] 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 a 5B é um diagrama de blocos de um circuito de controle do instrumento cirúrgico de 1 que abrange 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 configurado 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 posicionamento 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 disposição 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 extremidade 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 instrumento 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 representa dois diagramas ilustrando a força para fechar (do inglês, "force to close", FTC) a bigorna do instrumento cirúrgico da Figura 1 como uma função do deslocamento de curso de fechamento (d) e a Força para disparar (do inglês, "force to fire", FTF) o instrumento cirúrgico da Figura 1 como uma função do tempo de acordo com um aspecto da presente revelação.
[0024] A Figura 17 ilustra um diagrama de fluxo lógico mostrando um exemplo de um processo de um programa de controle ou uma configuração lógica que pode ser executada por um instrumento cirúrgico (por exemplo, um circuito de controle de um instrumento cirúrgico) para implementar um curso de disparo de feixe-i de acordo com um aspecto da presente revelação.
[0025] A Figura 18 é um diagrama ilustrando a velocidade (v) do feixe-I como uma função do deslocamento de curso de disparo (d) de acordo com um aspecto desta revelação.
[0026] A Figura 19A é um diagrama de fluxo lógico representando um programa de controle de disparo ou uma configuração lógica de acordo com um aspecto da presente revelação.
[0027] A Figura 19B é um diagrama de fluxo lógico representando um programa de controle de disparo ou uma configuração lógica de acordo com um aspecto da presente revelação.
[0028] A Figura 20 representa dois diagramas ilustrando a força para disparar (FTF) do instrumento cirúrgico da Figura 1 como uma função do tempo, e o ciclo de trabalho do motor (% de velocidade) de um motor que aciona o feixe-I como uma função do deslocamento de feixe-I (d) de acordo com um aspecto desta revelação.
[0029] A Figura 21 representa dois diagramas ilustrando o ciclo de trabalho do motor (% de velocidade) de um motor que aciona o feixe-I como uma função de deslocamento de feixe-I (d), e Modulação de Largura de Pulso (PWM) como uma função do deslocamento de feixe-I (d) de acordo com um aspecto desta revelação.
[0030] A Figura 22 representa dois diagramas ilustrando a força para fechar a bigorna do instrumento cirúrgico da Figura 1 como uma função do tempo e a força para disparar o instrumento cirúrgico da Figura 1 como uma função do tempo de acordo com um aspecto da presente revelação.
[0031] A Figura 23 ilustra uma bigorna de acordo com um aspecto desta divulgação.
[0032] O requerente do presente pedido detém os seguintes pedidos de patente depositados simultaneamente com o mesmo e que estão, cada um, incorporados no presente documento a título de referência em suas respectivas totalidades:
[0033] 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.
[0034] 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.
[0035] 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. Shelton, IV et al., depositado em 20 de junho de 2017.
[0036] 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.
[0037] 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.
[0038] N° do documento do procurador END8196USNP/170059, intitulado SURGICAL INSTRUMENT HAVING CONTROLLABLE ARTICULATION VELOCITY pelos inventores Frederick ES. Shelton, IV et al., depositado em 20 de junho de 2017.
[0039] N° do documento do procurador END8198USNP/170061, intitulado SYSTEMS AND METHODS FOR CONTROLLING DISPLACEMENT MEMBER VELOCITY FOR A SURGICAL INSTRUMENT, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0040] N° do documento do procurador END8222USNP/170125, 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.
[0041] 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.
[0042] 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.
[0043] 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.
[0044] 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.
[0045] 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.
[0046] 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.
[0047] 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.
[0048] 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.
[0049] N° do documento do procurador END8271USNP/170062M, 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.
[0050] 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.
[0051] 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.
[0052] 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.
[0053] 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.
[0054] 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.
[0055] 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.
[0056] A Figura 1 a 4 ilustra um instrumento cirúrgico acionado por motor 10 para corte e fixação que pode ou não ser reutilizado. 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 ao mesmo 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" também pode representar 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 intercambiáveis 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.
[0057] A Figura 1 é uma vista em perspectiva de um instrumento cirúrgico 10 que tem um conjunto de eixo de acionamento intercambiável 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 fixação 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 radiofrequência (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.
[0058] O conjunto de cabo 14 pode compreender um par de segmentos interconectáveis de compartimento de cabo 16 e 18 interconectados 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 de uma tampa 45.
[0059] 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 pivotante 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.
[0060] 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 motor 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 tampa 45, está eletricamente acoplada à placa de circuito de controle 100. A tampa 45 pode ser removida para expor a tela 43.
[0061] 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 cremalheira 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.
[0062] 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.
[0063] 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 girado entre uma posição não atuada e uma posição atuada.
[0064] Retornando para a Figura 1, o conjunto de eixo de acionamento 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 incluir 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.
[0065] 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.
[0066] A Figura 3 é uma outra vista do 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 extremidade 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.
[0067] O conjunto de eixo de acionamento intercambiável 200 pode 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 travamento 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 de maneira proximal. Quando a luva de travamento 402 está na posição desengatada, o movimento do membro de disparo 220 não é transmitido para o acionador 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.
[0068] O conjunto de eixo de acionamento intercambiável 200 pode 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.
[0069] O conjunto de eixo de acionamento intercambiável 200 pode 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.
[0070] A Figura 4 é uma vista explodida de um aspecto de um atuador 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 distalmente 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.
[0071] 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. Em 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 superiores 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 proximalmente permitindo que a bigorna 306 seja aberta para liberar as duas porções de tecido grampeadas e cortadas.
[0072] As Figuras 5A a 5B são um diagrama de blocos de um circuito de controle 700 do instrumento cirúrgico de 10 da Figura 1 ocupando duas folhas de desenho, de acordo com um aspecto desta revelação. Com referência principalmente às Figuras 5A a 5B, um conjunto de cabo 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.
[0073] 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 elétricos 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.
[0074] A interface pode facilitar a transmissão do um ou mais sinais 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 outros 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.
[0075] 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 para digital (ADC) de 12 bits com 12 canais de entrada analógica, detalhes dos quais estão disponíveis para a folha de dados do produto.
[0076] 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.
[0077] 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 acionamento 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.
[0078] O instrumento cirúrgico 10 (Figuras 1 a 4) pode compreender 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 integrado 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.
[0079] O circuito de controle 700 compreende segmentos de circuito 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 também compreende 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.
[0080] 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.
[0081] 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.
[0082] O segmento de eixo de acionamento (segmento 5) compreende controles para um conjunto de eixo de acionamento intercambiável 200 (Figuras 1 e 3) acoplados ao instrumento cirúrgico 10 (Figuras 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.
[0083] O segmento de codificador de posição (segmento 6) compreende 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 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.
[0084] O segmento de circuito do motor (segmento 7) compreende um motor 714 configurado para controlar os movimentos do instrumento cirúrgico energizado 10 (Figuras 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.
[0085] 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.
[0086] O segmento de energia (segmento 8) compreende uma bateria 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 3,3 V e/ou conversores de tensão de 5 V. Um conversor de amplificação de tensão é configurado para fornecer uma elevação da tensão até uma quantidade predeterminada, como, por exemplo, até 13 V. 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.
[0087] 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 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 articulação 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 conector 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.
[0088] Quaisquer chaves mecânicas, eletromecânicas, ou de estado 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 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 robustez, 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), bipolares, e similares). Outras chaves podem incluir chaves sem fio, chaves ultrassônicas, acelerômetros, sensores de inércia, dentre outros.
[0089] A Figura 6 é um outro diagrama de blocos do circuito de controle 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 intercambiável 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 cabo 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.
[0090] O instrumento cirúrgico 10 (Figuras 1 a 4) pode compreender 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 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 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 comunicação 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 a 5B e 6) para controlar a operação do instrumento cirúrgico 10 (Figuras 1 a 4), a revelação se volta agora para várias configurações do instrumento cirúrgico 10 (Figuras 1 a 4) e ao circuito de controle 700.
[0091] A Figura 7 ilustra um circuito de controle 800 configurado para controlar aspectos do instrumento cirúrgico 10 (Figuras 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.
[0092] A Figura 8 ilustra um circuito lógico combinacional 810 configurado para controlar aspectos do instrumento cirúrgico 10 (Figuras 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 combinacional 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.
[0093] A Figura 9 ilustra um circuito lógico sequencial 820 configurado para controlar aspectos do instrumento cirúrgico 10 (Figuras 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.
[0094] 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.
[0095] A Figura 10 é um diagrama de um sistema de posicionamento absoluto 1100 do instrumento cirúrgico 10 (Figuras 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 para as figuras 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 um 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 potenciômetro, 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 fotodetectores linearmente dispostos, ou qualquer combinação dos mesmos.
[0096] Um motor elétrico 1120 pode incluir um eixo de acionamento giratório 1116, que, de modo operacional, faz interface 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 cremalheira 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.
[0097] 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.
[0098] 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.
[0099] 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.
[00100] O controlador 1104 pode ser programado para realizar várias 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 acionadores 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.
[00101] 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 observada 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.
[00102] O sistema de posicionamento absoluto 1100 pode compreender e/ou ser programado para implementar um controlador de retroinformação, 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 a 5B).
[00103] 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 motores 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 MOSFETs 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.
[00104] Tendo descrito uma arquitetura geral para implementar aspectos de um sistema de posicionamento absoluto 1100 para uma disposição de sensor 1102, a revelação agora se volta para as Figuras 11 a 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 acionamento 1111, e um conjunto de engrenagens 1206 para fornecer uma redução de engrenagens. Com referência à Figura 2, o membro de acionamento 1111 pode representar o membro de acionamento longitudinalmente móvel 120 que compreende uma cremalheira de dentes de acionamento 122 para engate de acoplamento com uma engrenagem de acionamento correspondente 86 do conjunto redutor de engrenagem 84. Voltando para a 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.
[00105] 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, magnetorresistência gigante, junções túnel magnéticas, magnetoimpedância gigante, compostos magnetostritivos/piesoelétricos, magnetodiodo, transistor magnético, fibra óptica, magneto-óptica e sensores magnéticos baseados em sistemas microeletromecânicos, dentre outros.
[00106] 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.
[00107] 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 ponto central 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.
[00108] 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 está em 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 AS5055 fornecido em uma pequena embalagem QFN de 16 pinos cuja medida corresponde a 4x4x0,85 mm.
[00109] 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 e 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.
[00110] O sensor de posição AS5055 1200 exige apenas alguns componentes externos para operar quando conectado ao controlador 1104. Seis fios são necessários para uma aplicação simples usando 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 suspende para entrar no 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 pela sinalizador correspondente no registro de estados.
[00111] 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 energização. 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 energização 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%).
[00112] A Figura 13 é uma vista em corte de um atuador de extremidade 2502 do instrumento cirúrgico 10 (Figuras 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 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 distalmente, 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.
[00113] 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 em 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.
[00114] 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 começar 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.
[00115] Como discutido acima e com referência agora às Figuras 10 a 13, o motor elétrico 1122 posicionado no interior do conjunto de cabo do de instrumento cirúrgico 10 (Figuras 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 incidir 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.
[00116] 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.
[00117] A Figura 14 ilustra um diagrama de bloco de um instrumento 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 1 a 13.
[00118] 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 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 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 temporizador/contador 2531 pode ser configurado para medir o tempo decorrido, contar eventos externos, ou medir eventos externos.
[00119] 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.
[00120] O Motor 2504 Pode Receber Energia De Uma Fonte De Energia 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.
[00121] 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 resistivo, 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.
[00122] O um ou mais sensores 2538 podem compreender um medidor 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 bigorna 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.
[00123] 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 acionamento 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 a 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.
[00124] Um sensor de corrente 2536 pode ser usado para medir a corrente consumida pelo motor 2504. A força necessária para avançar a haste com perfil em I 2514 corresponde à corrente drenada pelo motor 2504. A força é convertida em um sinal digital e fornecida ao circuito de controle 2510.
[00125] Usando as propriedades físicas dos instrumentos aqui revelados, agora com referência às Figuras 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 PWM, tensão modulada por frequência, corrente, torque e/ou força, por exemplo.
[00126] 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. Um 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 operação desejada do sistema físico.
[00127] 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 descrição 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.
[00128] 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 distalmente ao longo do eixo geométrico longitudinal do atuador de extremidade 2502 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.
[00129] 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 programas 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.
[00130] Em alguns exemplos, o circuito de controle 2510 pode, inicialmente, 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.
[00131] 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.
[00132] Um primeiro exemplo 2592 mostra uma resposta do instrumento 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.
[00133] 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.
[00134] Com referência à Figura 16, um diagrama 6040 plota um exemplo da força aplicada durante um curso de fechamento para fechar o atuador de extremidade 2502 ao redor do tecido pinçado entre a bigorna 2516 e o cartucho de grampos 2518, a força de fechamento plotada como uma função do deslocamento de curso de fechamento (d). O diagrama 6040 compreende dois eixos geométricos. Um eixo geométrico vertical 6042 indica a força para fechar (FTC) o atuador de extremidade 2502 em newtons (N). Um eixo geométrico horizontal 6044 indica uma distância percorrida por um membro de fechamento como, por exemplo, o tubo de fechamento 260 (Figura 1) para causar o fechamento do atuador de extremidade 2502. Durante o curso de fechamento, o tubo de fechamento 260 é transladado distalmente (direção "DD") para mover a bigorna 2516, por exemplo, em relação ao cartucho de grampos 2518 em resposta à atuação do gatilho de fechamento 32 (Figura 1) na maneira descrita na referência anteriormente mencionada da publicação de pedido de patente US n° 2014/0263541. Em outros casos, o curso de fechamento envolve mover um cartucho de grampos em relação a uma bigorna em resposta à atuação do gatilho de fechamento 32. Em outros casos, o curso de fechamento envolve mover o cartucho de grampos e a bigorna em resposta à atuação do gatilho de fechamento 32.
[00135] O diagrama 6040 indica que a força para fechar (FTC) o atuador de extremidade 2502 aumenta conforme o tubo de fechamento 260 se desloca distalmente. A força para fechar (FTC) atinge uma força máxima (Fmáx) a uma distância (d) percorrida pelo tubo de fechamento 260 de uma posição inicial. Um atuador de extremidade 300, que é similar em muitos aspectos ao atuador de extremidade 2502, comprime o tecido a um limite máximo correspondente à força máxima (Fmáx). A força máxima (Fmáx) depende, ao menos em parte, da espessura do tecido pinçado pelo atuador de extremidade 2502. Em um exemplo, o membro de fechamento é configurado para percorrer a distância (d1) de cerca de 0,210" (5,334 mm de) para alcançar uma força máxima (Fmáx) de cerca de 160 libras força (711,715 newtons).
[00136] A Figura 16 também mostra um diagrama 6046 que plota um exemplo da força aplicada para disparar (FTF) o instrumento cirúrgico 2500. A força para disparar (FTF) pode ser aplicada para avançar o feixe-I 2514 durante um curso de disparo do instrumento cirúrgico 2500. O diagrama 6046 compreende dois eixos geométricos. Um eixo geométrico vertical 6048 indica a força, em newtons (N), aplicada para avançar o feixe-I 2514 durante o curso de disparo. O feixe-I 2514 é configurado para avançar a faca 2509 e motivar os acionadores 2511 para implantar os grampos 2505 durante o curso de disparo. Um eixo geométrico horizontal 6050 indica o tempo em segundos.
[00137] O feixe-I 2514 é avançado a partir de um tempo inicial (t=0). O avanço do feixe-I 2514 é iniciado quando a força para fechar (FTC) o atuador de extremidade 2502 atinge uma força máxima (Fmáx). Alternativamente, conforme ilustrado na Figura 22, um período de espera pode ser aplicado antes do início do curso de disparo. O período de espera permite a saída de fluido a partir do tecido comprimido que reduz a espessura do tecido comprimido produzindo uma redução na força máxima (Fmáx).
[00138] O diagrama 6046 indica que a força para disparar (FTF) o instrumento cirúrgico 2500 aumenta até uma força máxima (F2) no topo do pico mais alto 6052. A força máxima (F2) está em uma seção inicial do curso de disparo durante o engate do deslizador em cunha 2513. O topo do menor pico 6054 representa uma força máxima (F1) que ocorre na seção final do curso de disparo. A força máxima (F1) é aplicada ao feixe-I 2514 durante o engate do deslizador em cunha 2513 com os acionadores de grampo distais 2511. Além disso, os picos intermediários 6056, que ocorrem em uma seção intermediária do curso de disparo, entre o pico 6052 e o pico 6054, descrevem um coeficiente angular descendente 6053 da força necessária para disparar (FTF) o instrumento cirúrgico 2500 durante a seção intermediária do curso de disparo. O coeficiente angular descendente 6053 começa em um tempo (t1) correspondente à força máxima (F1) no topo do pico mais alto 6052. O coeficiente angular descendente 6053 geralmente resulta de uma redução gradual na carga à medida que o feixe-I 2514 avança o deslizador em cunha 2513 através da porção intermediária do curso de disparo além do tempo (t1).
[00139] A Figura 17 ilustra um diagrama de fluxo lógico mostrando um exemplo de um processo 6030 de um programa de controle ou uma configuração lógica que pode ser executada pelo instrumento cirúrgico 2500 (por exemplo, o circuito de controle 2510) para implementar um curso de feixe-I responsivo às condições do tecido e/ou tipo de cartucho de grampos. O circuito de controle 2510 pode receber 6031 um sinal de disparo. O sinal de disparo pode ser recebido 6031 partir do gatilho 32 (Figura 1) ou outro dispositivo de atuação adequado. Por exemplo, um médico pode colocar o atuador de extremidade 2502, prender o tecido entre a bigorna 2516 e o cartucho de grampos 2518 e então atuar o gatilho 32 para iniciar um curso de feixe-I. O gatilho 32 pode ser configurado para fornecer o sinal de disparo ao circuito de controle 2510 mediante a atuação.
[00140] O circuito de controle 2510, em resposta ao sinal de disparo, pode fornecer 6032 uma configuração inicial do motor. Por exemplo, a configuração inicial pode ser um ponto de ajuste do motor 2522 fornecido ao controlador do motor 2508. O controlador do motor 2508 pode transladar o ponto de ajuste do motor inicial 2522 em um sinal PWM, sinal de tensão, ou outro sinal de acionamento de motor adequado para acionar o motor 2504. Em alguns exemplos, (por exemplo, quando o circuito de controle 2510 gera diretamente o sinal de acionamento do motor 2524), a configuração inicial do motor pode ser um sinal de acionamento do motor 2524 fornecido diretamente ao motor 2504. A configuração inicial do motor pode corresponder a uma velocidade, potência ou outra variável adequada do motor. Em alguns exemplos nos quais o motor 2504 é um motor CC com escovas, a configuração inicial do motor pode ser um sinal que tem uma tensão constante. Em alguns exemplos nos quais o motor é um motor CC sem escovas, a configuração inicial pode ser um sinal ou conjunto de sinais tendo um ciclo de trabalho em fase constante, entre outros.
[00141] O circuito de controle 2510 pode receber dados de movimento do elemento de feixe-I 6036. Os dados de movimento do feixe de membro-E podem compreender informações (por exemplo, do sensor de posição 2534) que descreve a posição e/ou movimento do feixe-I 2514. Apesar de receber os dados de movimento do membro do feixe-I 6036 poder ser uma porção do processo 6030, em alguns exemplos, o circuito de controle 2510 pode receber 6036 os dados de movimento do membro do feixe-I enquanto enquanto o feixe-I 2514 está em movimento. Por exemplo, quando o sensor de posição 2534 é um codificador, o circuito de controle 2510 pode receber sinais de pulso a partir do codificador enquanto o feixe-I 2514 está se movendo com cada sinal de pulso representando um quantum de movimento. Além disso, nos exemplos nos quais o motor 2504 é um motor de passo, o circuito de controle 2510 pode derivar dados de movimento de membro de feixe- I com base no número total de etapas que o circuito de controle 2510 instrui o motor 2504 a executar.
[00142] Os dados de movimento de membro de feixe-I que podem indicar uma distância que o feixe-I 2514 se moveu durante o período de tempo inicial, o que pode refletir as condições do tecido como a espessura e/ou a robustez do tecido presentes entre a bigorna 2516 e o cartucho de grampos 2518 porque diferentes tipos de tecido vão oferecer diferentes níveis de resistência. Por exemplo, tecidos mais espessos ou mais resistentes podem fornecer mais resistência mecânica à faca e aos grampos. Mais resistência mecânica pode fazer com que o motor 2504 funcione mais lentamente enquanto a configuração inicial do motor é mantida substancialmente constante. De modo similar, o tecido mais delgado ou mais fraco pode fornecer menos resistência mecânica para a faca e grampos. Isso pode fazer com que o motor funcione mais rapidamente e atravesse uma distância maior enquanto a configuração inicial do motor é mantida substancialmente constante.
[00143] Após a configuração inicial do motor ser fornecida, o instrumento 2500 pode funcionar em uma configuração de circuito aberto em uma primeira porção de diagnóstico (1a) da zona 1, conforme ilustrado na Figura 18. Por exemplo, o sinal de acionamento do motor 2524 pode ser mantido substancialmente constante. Como resultado, as propriedades reais do motor 2504, como a velocidade do motor, podem se desviar com base em fatores que incluem as condições do tecido (por exemplo, espessura do tecido, robustez do tecido, etc.) por exemplo, quando tecido mais espesso ou mais robusto está presente entre a bigorna 2516 e o cartucho de grampos 2518, o tecido pode fornecer mais resistência mecânica para a faca e/ou grampos, o que pode tender a diminuir a velocidade do feixe-I 2514 à medida que a configuração do motor é mantida substancialmente constante.
[00144] O circuito de controle 2510 pode ser configurado para manter a configuração inicial do motor para uma porção de circuito aberto do curso do membro de disparo. No exemplo da Figura 17, a porção de circuito aberto do curso de feixe-I pode continuar até que o feixe-I 2514 tenha atravessado uma distância inicial. Consequentemente, o circuito de controle 2510 pode ser configurado para manter a configuração inicial do motor até que o feixe-I tenha atravessado a distância inicial. A distância inicial pode ser, por exemplo, uma porção predeterminada da distância total entre a posição de início do curso de disparo e a posição final do curso de disparo (por exemplo, 1/6, 1/4, 1/3, etc.). Em um exemplo, a distância de circuito aberto inicial é uma primeira porção inicial (1a) da zona 1 que se estende por uma distância de cerca de 0,200" (5,08 milímetros) a partir da posição de início de curso 2527 (Figura 13). O circuito de controle 2510 pode determinar 6034 a partir dos dados de movimento do membro do feixe-I recebidos se o feixe-I 2514 atravessou a distância inicial. Se não, o circuito de controle 2510 pode continuar a fornecer 6032 a configuração inicial do motor e receber 6036 dados de movimento adicional do membro de feixe-I.
[00145] Em alguns exemplos, a distância de circuito aberto inicial é uma primeira porção de diagnóstico (1a) da zona 1, abrangendo uma distância selecionada entre cerca de 1 milímetro e cerca de 10 milímetros. Em alguns exemplos, a distância inicial de circuito aberto abrange uma distância selecionada entre cerca de 3 milímetros e cerca de 7 milímetros.
[00146] O processo 6030 pode prosseguir se o circuito de controle 2510 determinar 6034 que o feixe-I atravessou a distância inicial. Em alguns exemplos, o circuito de controle 2510 pode manter um contador ou temporizador 2531 em funcionamento (Figura 14) enquanto a distância inicial é percorrida. Quando o circuito de controle 2510 determina que o feixe-I percorreu a distância inicial, o circuito de controle 2510 pode parar o temporizador 2531. O circuito de controle 2510 pode determinar 6039 uma velocidade de feixe-I ao longo da distância inicial. O circuito de controle 2510 pode encontrar a velocidade do feixe-I tomando a distância inicial dividida pelo tempo necessário para percorrer a distância.
[00147] Alternativamente, em alguns exemplos, a porção de circuito aberto pode ser um período de tempo inicial, o qual pode também ser referido como um período de tempo de circuito aberto. O período de tempo inicial pode ser de qualquer comprimento adequado incluindo, por exemplo, 100 milissegundos. Um sensor de posição como, por exemplo, o sensor de posição 2534 (Figura 14) pode rastrear a posição do feixe-I 2514 durante o período de tempo inicial. O circuito de controle 2510 pode determinar uma velocidade do feixe-I ao longo do período de tempo inicial. O circuito de controle 2510 pode encontrar a velocidade do feixe-I tomando-se a distância percorrida pelo feixe-I 2514 durante o período de tempo inicial dividida pelo período de tempo inicial. A velocidade do feixe-I 2514 na primeira porção de diagnóstico (1a) da zona 1 pode ser indicativa das condições do tecido como a espessura e/ou a robustez do tecido presente entre a bigorna 2516 e o cartucho de grampos 2518.
[00148] Alternativamente, em alguns exemplos, a corrente (I) consumida pelo motor 2504 na porção de circuito aberto pode ser usada para avaliar as condições do tecido como a espessura e/ou a robustez do tecido presentes entre a bigorna 2516 e o cartucho de grampos 2518. Um sensor como, por exemplo, um sensor de corrente pode ser usado para rastrear a corrente (I) consumida pelo motor 2504 na porção de circuito aberto. Um exemplo de um sensor de corrente 2536 é mostrado na Figura 14.
[00149] Retornando agora à Figura 17, o circuito de controle 2510 pode selecionar 6038 um programa ou configuração de controle de disparo, por exemplo, com base na determinação da velocidade de feixe-I e/ou a corrente (I) consumida pelo motor 2504 na porção de circuito aberto na primeira porção de diagnóstico (1a) da zona 1. O circuito de controle 2510 pode executar 6041 o programa de controle de disparo ou a configuração lógica selecionada.
[00150] Em alguns exemplos, o programa de controle de disparo pode determinar um valor alvo para o movimento do feixe-I 2514 durante o restante do curso de feixe-I. A Figura 18 ilustra um diagrama 6100 que plota velocidade versus distância percorrida ao longo de um golpe de disparo por três cursos de feixe-I de exemplo 6106, 6108, 6110, que pode ser implementado pelos programas de controle de disparo selecionados em 6038. O diagrama 6100 inclui dois eixos geométricos. Um eixo geométrico horizontal 6102 representa o deslocamento de curso de disparo em milímetros. Um eixo geométrico vertical 6104 indica a velocidade do feixe-I 2514 em milímetros por segundo. Conforme ilustrado na Figura 18, os exemplos 6106, 6108, 6110 têm inicialmente a mesma velocidade do feixe-I na primeira porção de diagnóstico (1a) da zona 1 da distância do curso de disparo.
[00151] No exemplo 6106 da Figura 18, o programa de controle de disparo é configurado para manter a velocidade do feixe-I 2514 a uma velocidade predeterminada constante, ou substancialmente constante. A velocidade constante pode ser selecionada com base no movimento do feixe-I durante a primeira porção de diagnóstico (1a) da zona 1. Em alguns exemplos, o programa de controle de disparo pode incluir acionar o feixe-I 2514 com uma potência constante. O circuito de controle 2510 pode implementar 6041 o programa de controle de disparo ou configuração lógica previamente selecionada 6038. Por exemplo, o circuito de controle 2510 pode acionar o feixe-I 2514 com velocidade constante, monitorando a posição do feixe-I 2514 indicada pelo sensor de posição 2534 e modulando o ponto de ajuste do motor 2522 e/ou o sinal de acionamento do motor 2524 para manter uma velocidade constante. De modo similar, o circuito de controle 2510 pode acionar o feixe-I 2514 com potência constante, monitorando a tensão e/ou a corrente consumida pelo motor 2504 e modulando o ponto de ajuste do motor 2522 e/ou o sinal de acionamento do motor 2524 para manter um consumo de energia constante.
[00152] Conforme descrito acima em relação ao diagrama 6046 da Figura 16, a força para disparar (FTF) diminui gradualmente à medida que o feixe-I 2514 é avançado durante o curso de disparo. Como tal, a força para disparar (FTF) o feixe-I 2514 geralmente é mais alta no início do curso de disparo do que no meio do curso de disparo, e geralmente mais alta no meio do curso de disparo do que no final do curso de disparo. Ao manter-se uma velocidade reduzida do feixe-I 2514 em porções do curso de disparo onde o feixe-I 2514 experimenta cargas mais altas melhora-se o desempenho do motor 2504 e da fonte de energia 2512. Em primeiro lugar, a corrente total (i) consumida pelo motor 2504 durante o curso de disparo é reduzida, o que prolonga a vida da fonte de energia 2512 (Figura 14). Em segundo lugar, a redução da velocidade do feixe-I 2514 em porções do curso de disparo com as cargas mais altas protege o motor 2504 para que ele não pare. A resistência aumentada pode fazer com que o motor 2504 pare. A parada é uma condição em que o motor para de girar. Esta condição ocorre quando o torque da carga é maior que o torque do eixo de acionamento do motor.
[00153] Para reduzir a carga ou a força para disparar (FTF) aplicada ao feixe-I 2514, programas de controle de disparo alternativos são empregados pelo circuito de controle 2510. Dois dos programas de controle de disparo alternativos são representados nos exemplos 6108, 6110 da Figura 18. A Figura 19B ilustra um diagrama de fluxo lógico mostrando um exemplo de um processo 6131 de um programa de controle ou uma configuração lógica que pode ser selecionada 6038 e executada 6041 pelo instrumento cirúrgico 2500 (por exemplo, o circuito de controle 2510) em 6041 para implementar um curso de feixe-I responsivo às condições do tecido e/ou ao tipo de cartucho de grampos. O processo de disparo 6131 pode incluir acionar o feixe-I 2514 em uma velocidade que aumenta linearmente à medida que o feixe-I 2514 é avançado ao longo do curso de disparo, conforme ilustrado em um exemplo 6108 da Figura 18.
[00154] O circuito de controle 2510 controla 6132 o motor 2504 para alcançar uma velocidade inicial (v1) em uma posição predeterminada em um ponto de partida 6101. O circuito de controle 2510 aciona 6134 o feixe-I 2514 com uma velocidade que aumenta linearmente em uma taxa predeterminada a medida que o feixe-I 2514 é avançado ao longo do curso de disparo mediante a modulação do ponto de ajuste do motor 2522 e/ou do sinal de acionamento do motor 2524 para produzir um aumento linear, ou substancialmente linear, na velocidade do feixe-I 2514 à medida que o feixe-I 2514 é avançado ao longo do curso de disparo. A taxa de velocidade do feixe-I 2514 é mantida 6135 até o final do curso de disparo.
[00155] O circuito de controle 2510 pode monitorar a posição do feixe-I 2514 indicada pelo sensor de posição 2534 e o tempo, conforme indicado pelo temporizador 2531. Os dados do sensor de posição 2534 e do temporizador 2531 podem ser empregados pelo circuito de controle 2510 para amostrar a velocidade do feixe-I 2514 em posições distintas ao longo do curso de disparo. A velocidade amostrada pode ser comparada com os limiares predeterminados para determinar como modular o ponto de ajuste do motor 2522 e/ou o sinal de acionamento de motor 2524 para produzir o aumento linear, ou substancialmente linear, da velocidade do feixe-I 2514 à medida que o feixe-I 2514 é avançado ao longo do curso de disparo. Em alguns exemplos, a velocidade do feixe-I 2520 é amostrada em intervalos de 1 milímetro.
[00156] Em alguns exemplos, o sistema de posicionamento absoluto 1100 (Figuras 10 a 12) pode ser usado para detectar a posição do feixe- I 2514, e a velocidade do feixe-I 2520 é amostrada em intervalos definidos pela(s) revolução(ões) do elemento sensor 1126.
[00157] Em alguns exemplos, o circuito de controle 2510 é configurado para aumentar a velocidade do feixe-I 2514 em uma taxa constante, ou substancialmente constante, à medida que o feixe-I 2514 é avançado através do curso de disparo. A taxa de aumento da velocidade do feixe-I 2514 pode ser selecionada com base no movimento do feixe-I durante a primeira porção (1a) de diagnóstico da zona 1. Em um exemplo, uma tabela de consulta pode ser empregada para determinar a taxa de aumento da velocidade do feixe-I 2514 com base nas medições que representam o movimento do feixe-I durante a primeira porção de diagnóstico (1a) da zona 1.
[00158] Conforme ilustrado na Figura 18, o aumento linear na velocidade do feixe-I 2514 começa em um ponto de partida 6101 que representa uma velocidade inicial (v1) em uma posição predeterminada no início de uma segunda porção (1b) da zona 1. A velocidade inicial v1 também pode ser determinada com base no movimento do feixe-I 2514 durante a primeira porção de diagnóstico (1a) da zona 1. Em um exemplo, uma tabela de consulta pode ser empregada para determinar a velocidade inicial v1 com base nas medições que representam o movimento do feixe-I 2514 durante a primeira porção de diagnóstico (1a) da zona 1. Notavelmente, a velocidade inicial (v1) do exemplo 6108 é significativamente mais baixa que a velocidade constante do exemplo 6110, que produz uma força reduzida para disparar (FTF) no exemplo 6108.
[00159] O circuito de controle 2510 também pode ser configurado para determinar a velocidade inicial v1 e/ou a taxa de aumento da velocidade do feixe-I 2514 com base nas condições do tecido. Conforme descrito acima, as condições do tecido como a espessura e/ou a robustez do tecido presente entre a bigorna 2516 e o cartucho de grampos 2518 podem influenciar o movimento do feixe-I 2514 devido ao fato de que diferentes tipos de tecido vão oferecer diferentes níveis de resistência. Por exemplo, o tecido mais espesso ou robusto pode fornecer mais resistência mecânica para o feixe-I 2520. Mais resistência mecânica pode fazer com que o motor 2504 funcione mais lentamente enquanto a configuração inicial do motor é mantida substancialmente constante. De modo similar, o tecido mais delgado ou mais fraco pode fornecer menos resistência mecânica ao feixe-I 2520. Isso pode fazer com que o motor funcione mais rapidamente e atravesse uma distância maior enquanto a configuração inicial do motor é mantida substancialmente constante.
[00160] No exemplo 6110 da Figura 18, um programa de controle de disparo pode incluir acionar ou manter o feixe-I 2514 em uma pluralidade de velocidades constantes, ou substancialmente constantes, em uma pluralidade de porções ou zonas distintas ou contínuas dentro do curso de disparo para reduzir a carga ou força para disparar (FTF) à medida que o feixe-I 2514 é avançado através do curso de disparo. A distância do curso de disparo é dividida em três zonas: zona 1, zona 2 e zona 3. A carga experimentada pelo feixe-I 2514 na zona 1 é maior que na zona 2, e a carga experimentada pelo feixe-I 2514 na zona 2 é maior que na zona 3. Para reduzir a força para disparar (FTF), conforme ilustrado no exemplo 6110 da Figura 18, o feixe-I 2514 é acionado em três velocidades constantes, ou substancialmente constantes, v1, v2, e v3 na zona 1, zona 2, e zona 3, respectivamente.
[00161] Em alguns exemplos, o número de zonas e as velocidades correspondentes podem ser maiores ou menores que três dependendo do tamanho do cartucho de grampos e/ou das condições do tecido. O posicionamento das zonas de curso de feixe-I na Figura 18 é apenas um exemplo. Em alguns exemplos, diferentes zonas 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.
[00162] A Figura 19A ilustra um diagrama de fluxo lógico mostrando um exemplo de um processo 6111 de um programa de controle ou uma configuração lógica que pode ser selecionada 6038 e executada 6041 pelo instrumento cirúrgico 2500 (por exemplo, o circuito de controle 2510) em 6041 para implementar um curso de feixe-I responsivo para as condições do tecido e/ou tipo de cartucho de grampos. Na zona 1, onde o feixe-I 2514 experimenta a carga mais alta, o feixe-I 2514 é acionado a uma velocidade baixa constante, ou substancialmente constante (v1). O circuito de controle 2510 controla 6114 o motor 2504 para atingir uma velocidade (v1) ao ponto de partida 6101 (Figura 18), o que representa uma posição predeterminada no Início de uma segunda porção (1b) da zona 1. O circuito de controle 2510 mantém 6116 a velocidade do feixe-I 2514 na velocidade (v1) para o restante da zona 1 começando no ponto de partida 6101. Em 6115, se o feixe-I 2514 estiver na zona 1, o circuito de controle 2510 mantém 6116 a velocidade do feixe-I 2514 na velocidade (v1). Se, entretanto, o feixe-I 2514 não estiver mais na zona 1, o circuito de controle 2510 controla 6117 o motor 2504 para alcançar uma velocidade (v2) no ponto de partida 6103 (Figura 18), que representa uma posição predeterminada na zona 2. Notavelmente, a velocidade (v1) é significativamente mais baixa que a velocidade constante do exemplo 6106, o que reduz a força para disparar (FTF) no exemplo 6110 em relação ao exemplo 6106.
[00163] Na zona 2, quando o feixe-I 2514 experimenta uma carga intermediária, o feixe-I 2514 é mantido 6119 em uma velocidade constante, ou substancialmente constante (v2) que é maior que a velocidade (v1) para o restante da zona 2. Se o circuito de controle 2510 determinar 6118 que o feixe-I 2514 está na zona 2, o circuito de controle 2510 mantém 6119 velocidade do feixe-I 2514 na velocidade (v2). Se, entretanto, o feixe-I 2514 não estiver mais na zona 2, o circuito de controle 2510 controla 6120 o motor 2504 para alcançar uma velocidade predeterminada (v3) no ponto de partida 6105 (Figura 18), que representa uma posição predeterminada na zona 3. O circuito de controle 2510 mantém 6121 velocidade (v3) até que o feixe-I 2514 atinja uma extremidade de curso 6122.
[00164] Conforme descrito acima, o circuito de controle 2510 pode acionar o feixe-I 2514 com velocidade constante, monitorando a posição do feixe-I 2514 indicada pelo sensor de posição 2534 e modulando o ponto de ajuste do motor 2522 e/ou o sinal de acionamento do motor 2524 para manter uma velocidade constante.
[00165] O circuito de controle 2510 pode selecionar a velocidade (v1), a velocidade (v2) e/ou a velocidade (v3) com base no movimento do feixe-I 2514 durante a primeira porção de diagnóstico (1a) da zona 1. Em alguns exemplos, o circuito de controle 2510 pode selecionar a velocidade (v1), a velocidade (v2) e/ou a velocidade (v3) com base na velocidade de feixe-I determinada e/ou na corrente (i) consumida pelo motor 2504 na porção de circuito aberto na primeira porção de diagnóstico (1a) da zona 1. Em um exemplo, uma tabela de consulta pode ser empregada para determinar a velocidade (v1), a velocidade (v2) e/ou a velocidade (v3) com base nas medições que representam o movimento do feixe-I 2514 durante a primeira porção de diagnóstico (1a) da zona 1.
[00166] Em um exemplo, o circuito de controle 2510 pode selecionar a velocidade constante, ou substancialmente constante, de uma zona do curso de disparo com base no movimento do feixe-I 2514 em uma ou mais zonas anteriores do curso de disparo. Por exemplo, o circuito de controle 2510 pode selecionar a velocidade da segunda zona ou zona intermediária com base no movimento do feixe-I 2514 em uma primeira zona. Além disso, o circuito de controle 2510 pode selecionar a velocidade de uma terceira zona com base no movimento do feixe-I 2514 em uma primeira zona e/ou uma segunda zona.
[00167] Conforme indicado no exemplo da Figura 18, o circuito de controle 2510 pode ser configurado para manter uma transição linear, ou substancialmente linear da velocidade (v1) para a velocidade (v2) mais alta na porção inicial da zona 2. O circuito de controle 2510 pode aumentar a velocidade do feixe-I 2514 a uma taxa constante para produzir a transição linear, ou substancialmente linear da velocidade (v1) para a velocidade mais alta (v2). Alternativamente, o circuito de controle 2510 pode ser configurado para manter uma transição não linear da velocidade(v1) para a velocidade mais alta (v2) na porção inicial da zona 2.
[00168] Além disso, o circuito de controle 2510 pode ser configurado para manter uma transição linear, ou substancialmente linear da velocidade (v2) para a velocidade mais alta (v3) na porção inicial da zona 3. O circuito de controle 2510 pode aumentar a velocidade do feixe-I 2514 a uma taxa constante para produzir a transição linear, ou substancialmente linear da velocidade (v2) para a velocidade mais alta (v3). Alternativamente, o circuito de controle 2510 pode ser configurado para manter uma transição não linear da velocidade(v2) para a velocidade (v3) mais alta na porção inicial da zona 3.
[00169] Conforme ilustrado no diagrama 6230 Figura 20, a força para disparar (FTF) diminui gradualmente à medida que o feixe-I 2514 é avançado durante o curso de disparo. Desta forma, a força para disparar (FTF) aplicada ao feixe-I 2514 geralmente é mais alta no início do curso de disparo do que no meio do curso de disparo, e geralmente mais alta no meio do curso de disparo do que no final do curso de disparo. O funcionamento do motor 2504 em um ciclo de trabalho reduzido ou baixo em porções do curso de disparo quando o feixe-I 2514 experimenta cargas mais altas melhora o desempenho do motor 2504 e a fonte de energia 2512. Conforme descrito acima, a corrente total (I) consumida pelo motor 2504 durante o curso de disparo é reduzida, o que prolonga a vida da fonte de energia 2512 (Figura 14). Em segundo lugar, o funcionamento do motor 2504 em um ciclo de trabalho reduzido nas porções do curso de disparo com as cargas mais altas protege o motor 2504 para que ele não pare.
[00170] Em alguns exemplos, um programa de controle de disparo pode determinar um valor alvo para o ciclo de trabalho do motor 2504 com base na posição do feixe-I 2514 ao longo do curso de disparo. A Figura 20 ilustra um diagrama 6200 que plota o ciclo de trabalho do motor 2504 versus a distância percorrida ao longo de um curso de disparo para três cursos de disparo de exemplo 6206, 6208, 6210, que pode ser implementado pelos programas de controle de disparo selecionados em 6038. No diagrama 6200, um eixo geométrico horizontal 6202 representa o deslocamento do curso de disparo em milímetros. O eixo geométrico vertical 6204 indica o ciclo de trabalho do motor 2504 expresso como uma porcentagem. Conforme ilustrado na Figura 20, os exemplos 6206, 6208, 6210 inicialmente têm o mesmo ciclo de trabalho em uma primeira porção de diagnóstico (1a) da zona 1 da distância do curso de disparo. A Figura 20 ilustra um diagrama 6230 que inclui os exemplos 6206', 6208', e 6210' correspondentes aos exemplos 6206, 6208, e 6210 do diagrama 6200, respectivamente. No diagrama 6200, um eixo geométrico horizontal 6234 representa o tempo em segundos. O eixo geométrico vertical 6232 indica a força para disparar (FTF) aplicada à medida que o feixe-I 2514 é avançado através do curso de disparo.
[00171] No exemplo 6206 da Figura 20, um programa de controle de disparo é configurado para fazer funcionar o motor 2504 em um ciclo de trabalho constante, ou substancialmente constante, predeterminado. O ciclo de trabalho constante pode ser selecionado com base no movimento do feixe-I durante a primeira porção de diagnóstico (1a) da zona 1. O exemplo 6206' representa a força para disparar (FTF) associada ao funcionamento do motor 2504 durante o curso de disparo em um ciclo de trabalho constante ou substancialmente constante e predeterminado.
[00172] Para reduzir a carga ou a força para disparar (FTF), conforme ilustrado nos perfis de força para disparar (FTF) dos exemplos 6208' e 6210', programas de controle de disparo alternativos são selecionados em 6038 correspondendo aos Exemplos 6208 e 6210 do diagrama 6100. Conforme representado no diagrama 6230, os exemplos 6208' e 6210' têm menores perfis de força para disparar (FTF) do que o exemplo 6206' e menores limiares de força máxima (F1) e (F2) do que o limiar de força máxima (F3) do exemplo 6206'.
[00173] O exemplo 6210' representa o perfil de força para disparar (FTF) associado ao funcionamento do motor 2504 em um circuito fechado. Durante a porção de circuito fechado do curso, o circuito de controle 2510 pode modular o ciclo de trabalho do motor 2504 com base nos dados de translação que descrevem uma posição do feixe-I 2514. Durante o circuito fechado, o circuito de controle 2510 é configurado para aumentar gradualmente o ciclo de trabalho do motor 2504 à medida que o feixe-I 2514 é avançado ao longo do curso de disparo.
[00174] O circuito de controle 2510 pode monitorar a posição do feixe-I 2514 indicada pelo sensor de posição 2534. Os dados provenientes do sensor de posição 2534 podem ser usados pelo circuito de controle 2510 para definir o ciclo de trabalho do motor 2504. Em alguns exemplos, o ciclo de trabalho do motor 2504 é alterado pelo circuito de controle 2510 em intervalos de 1 milímetro. Em um exemplo, o circuito de controle 2510 é configurado para manter um aumento substancialmente linear no ciclo de trabalho do motor 2504 à medida que o feixe-I 2514 é avançado através do curso de disparo.
[00175] Em alguns exemplos, o sistema de posicionamento absoluto 1100 (Figuras 10 a 12) pode ser usado para detectar a posição do feixe- I 2514, e o ciclo de trabalho do motor 2504 pode ser definido com base na posição do feixe-I 2514 conforme avaliado pela(s) revolução(ões) do elemento sensor 1126.
[00176] Em alguns exemplos, o circuito de controle 2510 é configurado para aumentar o ciclo de trabalho do motor 2504 em uma taxa substancialmente constante à medida que o feixe-I 2514 é avançado através do curso de disparo. A taxa de aumento do ciclo de trabalho do motor 2504 pode ser selecionada com base no movimento do feixe-I 2514 durante um tempo de diagnóstico (t1) na primeira porção de diagnóstico (1a) da zona 1. Em um exemplo, uma tabela de consulta pode ser empregada para determinar a taxa de aumento da velocidade do feixe-I 2514 com base nas medições que representam o movimento do feixe-I 2514 durante um tempo de diagnóstico (t1) na primeira porção de diagnóstico (1a) da zona 1.
[00177] Em um exemplo, uma tabela de consulta pode ser empregada para determinar o ciclo de trabalho do motor 2504 com base nas medições que representam o movimento do feixe-I 2514 durante a primeira porção de diagnóstico (1a) da zona 1. O circuito de controle 2510 também pode ser configurado para determinar o ciclo de trabalho do motor 2504 em várias posições do feixe-I 2514 ao longo do curso de disparo com base nas condições de tecido. Conforme descrito acima, as condições do tecido como a espessura e/ou a robustez do tecido presente entre a bigorna 2516 e o cartucho de grampos 2518 podem influenciar o movimento do feixe-I 2514 devido ao fato de que diferentes tipos de tecido vão oferecer diferentes níveis de resistência.
[00178] Um exemplo alternativo 6208' representa o perfil de força para disparar (FTF) reduzido associado ao funcionamento do motor 2504 em uma pluralidade de ciclos de trabalho constantes, ou substancialmente constantes, em uma pluralidade de porções ou zonas distintas ou contínuas dentro do curso de disparo. Conforme descrito acima em relação à Figura 6100, a distância do curso de disparo é dividida em três zonas: zona 1, zona 2 e zona 3. A carga experimentada pelo feixe-I 2514 na zona 1 é maior que na zona 2, e a carga experimentada pelo feixe-I 2514 na zona 2 é maior que na zona 3. Para reduzir a força para disparar (FTF), o motor 2504 é operado em três diferentes ciclos de trabalho definidos em posições predeterminadas nos pontos 6201, 6203, e 6205 da zona 1, zona 2 e zona 3, respectivamente, conforme ilustrado na Figura 20. Em alguns exemplos, o número de zonas e os ciclos de trabalho correspondentes podem ser maiores ou menores que três dependendo do tamanho do cartucho de grampos e/ou das condições do tecido. O posicionamento das zonas de curso do feixe-I na Figura 20 é apenas um exemplo. Em alguns exemplos, diferentes zonas 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.
[00179] Na zona 1, quando o feixe-I 2514 experimenta a carga mais alta, o motor 2504 é operado em um baixo ciclo de trabalho. Conforme indicado no exemplo 6208 da Figura 20, o circuito de controle 2510 é configurado para manter o ciclo de trabalho do motor 2504 em cerca de 45%, por exemplo, para o restante da zona 1 que começa no ponto 6201, que representa uma posição predeterminada no início de uma segunda porção (1b) da zona 1.
[00180] Na zona 2, quando o feixe-I 2514 experimenta uma carga intermediária, o motor 2504 é operado em um ciclo de trabalho intermediário maior que o ciclo de trabalho mantido na zona 1. No início da zona 2, o circuito de controle 2510 é configurado para aumentar o ciclo de trabalho do motor 2504 até um ciclo de trabalho predeterminado, que é mantido a um valor constante, ou substancialmente constante, pelo circuito de controle 2510 para o restante da zona 2. Conforme indicado no exemplo 6208 da Figura 20 o circuito de controle 2510 é configurado para manter o ciclo de trabalho do motor 2504 em cerca de 75%, por exemplo, para o restante da zona 2 que começa no ponto 6203, que representa uma posição predeterminada.
[00181] Na zona 3, quando o feixe-I 2514 experimenta uma carga mais baixa, o motor 2504 é operado em um ciclo de trabalho maior que o ciclo de trabalho mantido na zona 2. No início da zona 3, o circuito de controle 2510 é configurado para aumentar o ciclo de trabalho do motor 2504 até um ciclo de trabalho predeterminado, que é mantido a um valor constante, ou substancialmente constante, pelo circuito de controle 2510 para o restante da zona 3. Conforme indicado no exemplo 6208 da Figura 20 o circuito de controle 2510 é configurado para manter o ciclo de trabalho do motor 2504 em cerca de 100%, por exemplo, para o restante da zona 3 que começa no ponto 6205, que representa uma posição predeterminada.
[00182] O circuito de controle 2510 pode selecionar os ciclos de trabalho para as zonas 1, 2 e 3 com base no movimento do feixe-I 2514 durante a primeira porção de diagnóstico (1a) da zona 1. Em alguns exemplos, o circuito de controle 2510 pode selecionar os ciclos de trabalho para as zonas 1, 2 e 3 com base na velocidade de feixe-I determinada e/ou na corrente (i) consumida pelo motor 2504 na porção de circuito aberto na primeira porção de diagnóstico (1a) da zona 1. Em um exemplo, uma tabela de consulta pode ser empregada para determinar os ciclos de trabalho para as zonas 1, 2 e 3 com base nas medições que representam o movimento do feixe-I 2514 durante a primeira porção de diagnóstico (1a) da zona 1.
[00183] Embora o programa de controle de disparo ou configuração lógica do exemplo 6208 represente três etapas com ciclos de trabalho constantes, ou substancialmente constantes, em 45%, 75% e 100%, outros ciclos de trabalho são contemplados pela presente revelação. Em um exemplo, conforme ilustrado em um diagrama 6300 da Figura 21, um programa de controle de disparo pode incluir o funcionamento do motor 2504 em um ciclo de trabalho de cerca de 33% em uma primeira zona do curso de disparo, um ciclo de trabalho de cerca de 66% em uma segunda zona do curso de disparo, e um ciclo de trabalho de cerca de 100% em uma terceira zona do curso de disparo. Os diferentes ciclos de trabalho podem ser definidos para começar em diferentes posições do feixe-I ao longo do curso de disparo, por exemplo.
[00184] Em um exemplo, o circuito de controle 2510 pode selecionar o ciclo de trabalho constante, ou substancialmente constante, do motor 2504 de uma zona do curso de disparo com base no movimento do ciclo do motor 2504 em uma ou mais zonas anteriores do curso de disparo. Por exemplo, o circuito de controle 2510 pode selecionar o ciclo de trabalho de uma segunda zona ou zona intermediária com base no ciclo de trabalho em uma primeira zona. Além disso, o circuito de controle 2510 pode selecionar o ciclo de trabalho de uma terceira zona com base no ciclo de trabalho em uma primeira zona e/ou uma segunda zona.
[00185] O diagrama 6300 ilustra uma plotagem do ciclo de trabalho do motor 2504 versus a distância percorrida ao longo de um curso de disparo para um exemplo de curso de disparo 6310, que pode ser implementado por um programa de controle de disparo selecionado em 6038. No diagrama 6300, um eixo geométrico horizontal 6302 representa o deslocamento do curso de disparo em milímetros. O eixo geométrico vertical 6304 indica o ciclo de trabalho do motor 2504 expresso como uma porcentagem. Conforme ilustrado na Figura 21, o exemplo 6310 indica o funcionamento do motor 2504 em um ciclo de trabalho de cerca de 33% na zona 1 do curso de disparo, um ciclo de trabalho de cerca de 66% na zona 2 do curso de disparo, e um ciclo de trabalho de cerca de 100% na zona 3 do curso de disparo. Outros valores para os ciclos de trabalho na zona 1, zona 2 e/ou zona 3 são contemplados pela presente revelação.
[00186] Em um exemplo, o motor 2504 pode ser operado, em uma zona inicial do curso de disparo, em um ciclo de trabalho selecionado dentre uma faixa de cerca de 25% a cerca de 50%. Em um exemplo, o motor 2504 pode ser operado, em uma zona intermediária do curso de disparo, em um ciclo de trabalho selecionado dentre uma faixa de cerca de 50% a cerca de 80%. Em um exemplo, o motor 2504 pode ser operado, em uma zona final do curso de disparo, em um ciclo de trabalho selecionado dentre uma faixa de cerca de 75% a cerca de 100%.
[00187] 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. A Figura 21 ilustra adicionalmente um diagrama 6350 que representa um exemplo 6360 indicando sinais modulados de largura de pulso correspondentes aos ciclos de trabalho do motor da zona 1, zona 2 e zona 3 do exemplo 6310. O diagrama 6350 inclui dois eixos geométricos. Um eixo geométrico horizontal 6354 representa o deslocamento de curso de disparo em milímetros. Um eixo geométrico vertical 6352 indica os sinais de modulação de largura de pulso.
[00188] Um programa de controle de disparo do exemplo 6310 pode variar a largura de pulso do sinal fornecido ao motor 2504 dependendo da posição do feixe-I 2514 ao longo do curso de disparo. Uma primeira largura de pulso pode ser mantida na zona 1. Uma segunda largura de pulso maior que a primeira largura de pulso pode ser mantida na zona 2. Uma terceira largura de pulso maior que a segunda largura de pulso pode ser mantida na zona 3.
[00189] Em vários exemplos, as zonas 1, 2 e 3 acima descritas do curso de disparo podem ter distâncias iguais, ou substancialmente iguais. Em outras palavras, cada uma das três zonas pode ser cerca de um terço da distância total percorrida pelo feixe-I 2514 durante um curso de disparo. Em outros exemplos, a distância do curso de disparo pode ser dividida em mais ou menos que três zonas que são de distâncias iguais ou diferentes.
[00190] Com referência à Figura 22, um diagrama 6400 plota um exemplo 6408 da força aplicada durante um curso de fechamento para fechar o atuador de extremidade 2502 em relação ao tecido pinçado entre a bigorna 2516 e o cartucho de grampos 2518, a força de fechamento sendo plotada como uma função de tempo. O diagrama 6400 compreende dois eixos geométricos. Um eixo geométrico vertical 6402 indica a força para fechar (FTC) o atuador de extremidade 2502 em newtons (N). Um eixo geométrico horizontal 6404 indica o tempo em segundos. Durante o curso de fechamento, o tubo de fechamento 260 é transladado distalmente (direção "DD") para mover a bigorna 2516, por exemplo, em relação ao cartucho de grampos 2518 em resposta à atuação do gatilho de fechamento 32 (Figura 1) na maneira descrita na referência anteriormente mencionada da publicação de pedido de patente US n° 2014/0263541. Em outros casos, o curso de fechamento envolve mover um cartucho de grampos em relação a uma bigorna em resposta à atuação do gatilho de fechamento 32. Em outros casos, o curso de fechamento envolve mover o cartucho de grampos e a bigorna em resposta à atuação do gatilho de fechamento 32.
[00191] O exemplo 6408 indica que a força para fechar (FTC) o atuador de extremidade 2502 aumenta durante um período de tempo de aperto inicial terminando em um tempo (t0). A força para fechar (FTC) atinge uma força máxima (F3) no tempo (t0). O período de tempo de aperto inicial pode ser de cerca de um segundo, por exemplo. Um período de espera pode ser aplicado antes de iniciar um curso de disparo. O período de espera permite a saída de fluido a partir do tecido comprimido pelo atuador de extremidade 2502, que reduz a espessura do tecido comprimido produzindo um vão menor entre a bigorna 2516 e o cartucho de grampos 2518 e uma força de fechamento reduzida (F1) no final do período de espera. Em alguns exemplos, um período de espera selecionado dentre uma faixa de cerca de 10 segundos a cerca de 20 segundos é tipicamente empregado. No exemplo 6408, um período de tempo de cerca de 15 segundos é empregado. O período de espera é seguido pelo curso de disparo, que dura tipicamente um período de tempo selecionado dentre uma faixa de cerca de 3 segundos, por exemplo, a cerca de 5 segundos, por exemplo. A força para fechar (FTC) diminui à medida que o feixe-I 2514 é avançado em relação ao atuador de extremidade através do curso de disparo.
[00192] A Figura 22 também mostra um diagrama 6450 que plota três exemplos 6456, 6458, 6460 da força aplicada para avançar o feixe-I 2514 durante o curso de disparo do instrumento cirúrgico 2500. O diagrama 6450 compreende dois eixos geométricos. Um eixo geométrico vertical 66452 indica a força, em newtons (N), aplicada para avançar o feixe-I 2514 durante o curso de disparo. O feixe-I 2514 é configurado para avançar a faca 2509 e motivar os acionadores 2511 para implantar os grampos 2505 durante o curso de disparo. Um eixo geométrico horizontal 6050 indica o tempo em segundos.
[00193] O feixe-I 2514 é avançado a partir da posição de início de curso 2527 (Figura 13) em um tempo inicial (t=0) até a posição de fim de curso 2528 (Figura 13). À medida que o feixe-I 2514 é avançado através do curso de disparo, o conjunto de fechamento fornece o controle do cartucho de grampos 2518 e da bigorna 2516 ao conjunto de disparo, o que faz com que a força para disparar (FTF) aumente e a força para fechar (FTC) diminua.
[00194] Em um exemplo alternativo 6406, uma bigorna mais dura 6410 (Figura 23) é empregada. A dureza da bigorna 6410 do exemplo 6406 é maior que a dureza da bigorna do exemplo 6408. A bigorna mais dura 6410 produz forças de fechamento máximas maiores (F4) no tempo (t0) e (F2) no final do período de espera do que as forças de fechamento máximas (F3) e (F1) associadas com a bigorna do exemplo 6408. Devido à maior dureza, a capacidade da bigorna 6410 do exemplo 6406 para defletir ou flexionar na direção oposta ao tecido comprimido é menor que aquela da bigorna do exemplo 6408. Consequentemente, a bigorna 6410 do exemplo 6406 experimenta uma carga maior que a bigorna do exemplo 6408 ao longo do curso de fechamento.
[00195] Os exemplos 6456 e 6458 do diagrama 6450 são força para disparar (FTF) correspondentes aos exemplos 6406 e 6408, respectivamente, do diagrama 6400. A bigorna mais dura 6410 dos exemplos 6406 e 5458, quando encontra um perfil de força para fechar (FTC) maior do que a bigorna dos exemplos 6408 e 6456, experimenta um perfil de força para disparar (FTF) menor. Nos exemplos 6456 e 6458, o perfil de força para disparar (FTF) é reduzido em cerca de 20% devido à maior dureza da bigorna 6410. Várias técnicas podem ser empregadas para aumentar a dureza de uma bigorna, conforme descrito no pedido de patente n° de Série US 15/385.922, intitulado SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES, e depositado em 21 de dezembro de 2019, cuja revelação está aqui incorporada a título de referência.
[00196] A bigorna mais dura 6410 tem um corpo de bigorna alongado 6412 que tem uma porção de corpo superior 6414 que tem uma tampa de bigorna 6416 fixada ao mesmo. No aspecto representado na Figura 22, a tampa de bigorna 6416 tem formato aproximadamente retangular e tem um perímetro externo da tampa 6418. O perímetro 6418 da tampa da bigorna 6416 é configurado para ser inserido através da abertura de formato correspondente formada na porção de corpo superior e recebida em porções salientes internas que se estendem axialmente do corpo de bigorna 6412. O corpo da bigorna 6412 e a tampa da bigorna 6416 podem ser fabricados a partir de metal adequado que é propício à soldagem. Uma primeira solda 6420 pode se estender ao redor de todo o perímetro da tampa 6418 da tampa de bigorna 6416 ou pode estar situada apenas ao longo dos lados longos 6422 da tampa de bigorna 6416 e não da sua extremidade distal 6424 e/ou extremidade proximal 6426. A primeira solda 6418 pode ser contínua ou pode ser descontínua ou intermitente.
[00197] O perfil de força eficiente para disparar (FTF) do exemplo 6458 pode ser adicionalmente aprimorado, conforme indicado no exemplo 6460, mediante o uso de um programa de controle de disparo, que pode ser selecionado em 6038 (Figura 17), em combinação com a bigorna mais dura 6410. Qualquer um dos programas de controle de disparo associado ao anteriormente descrito nos exemplos 6108, 6110, 6208, ou 6210 pode ser usado com a bigorna mais dura 6410 para produzir um perfil de força para disparar mais eficiente. No aspecto do exemplo 6460, a bigorna mais dura 6410 é combinada com um programa de controle de disparo que opera o feixe-I 2514 a uma velocidade mais rápida inicialmente seguida por uma velocidade mais lenta quando o tecido mais espesso é encontrado. A combinação da bigorna mais dura 6410 e do programa de disparo pode produzir um tempo mais curto (t1) para uma força para disparar (FTF) máxima em relação aos tempos correspondentes (t2), (t3) dos exemplos 6456 e 6458. Além disso, a combinação pode produzir um tempo mais curto (t4) até a posição de final de curso 2528 (Figura 13) do curso de disparo em relação aos tempos correspondentes (t5) e (t6) dos exemplos 6456 e 6458. Conforme ilustrado no diagrama 6450, a combinação produz uma redução adicional de 20% na força máxima (FTF) em comparação com a força máxima (FTF) do exemplo 6458. Em alguns exemplos, o programa de controle de disparo selecionado é configurado para reduzir a velocidade do feixe-I 2514 em uma primeira porção do curso de disparo por cerca de um terço em relação à velocidade empregada em conexão com o exemplo 6458.
[00198] As funções ou processos 6030, 6111, 6131 aqui descritos podem ser executados por qualquer um dos circuitos de processamento aqui descritos, como o circuito de controle 700 descrito em relação às Figuras 5 a 6, os circuitos 800, 810, 820 descritos nas Figuras 7 a 9, o microcontrolador 1104 descrito em relação às Figuras 10 e 12, e/ou o circuito de controle 2510 descrito na Figura 14.
[00199] Vários aspectos da matéria descrita no presente documento são definidos nos seguintes exemplos numerados:
[00200] Exemplo 1. Um instrumento cirúrgico que compreende: um membro de deslocamento; um motor acoplado ao membro de deslocamento, sendo que o motor é operável para transladar o membro de deslocamento; um circuito de controle acoplado ao motor; e um sensor de posição acoplado ao circuito de controle; sendo que o circuito de controle é configurado para: receber uma saída de posição do sensor de posição indicativa de ao menos uma posição do membro de deslocamento; e controlar a velocidade do motor para transladar o membro de deslocamento em uma pluralidade de velocidades correspondentes à saída de posição, sendo que cada uma da pluralidade de velocidades é mantida em uma zona predeterminada.
[00201] Exemplo 2. O instrumento cirúrgico, de acordo com o Exemplo 1, sendo que o circuito de controle é configurado para manter a translação do membro de deslocamento em uma primeira velocidade em uma primeira zona e uma segunda velocidade em uma segunda zona, e sendo que a segunda zona é distal à primeira zona.
[00202] Exemplo 3. O instrumento cirúrgico, de acordo com o Exemplo 2, sendo que a segunda velocidade é maior que a primeira velocidade.
[00203] Exemplo 4. O instrumento cirúrgico, de acordo com o Exemplo 3, sendo que o circuito de controle é configurado para manter a translação do membro de deslocamento em uma terceira velocidade em uma terceira zona, e sendo que a terceira zona é distal à segunda zona.
[00204] Exemplo 5. O instrumento cirúrgico, de acordo com o Exemplo 4, sendo que a terceira velocidade é maior que a segunda velocidade.
[00205] Exemplo 6. O instrumento cirúrgico, de acordo com o Exemplo 2 ao Exemplo 5, que compreende adicionalmente um circuito temporizador acoplado ao circuito de controle, sendo que o circuito temporizador é configurado para medir o tempo decorrido durante a translação do membro de deslocamento para uma posição inicial predeterminada.
[00206] Exemplo 7. O instrumento cirúrgico, de acordo com o Exemplo 6, sendo que o circuito de controle é configurado para determinar a primeira velocidade com base no tempo decorrido durante a translação do membro de deslocamento para a posição inicial predeterminada.
[00207] Exemplo 8. O instrumento cirúrgico dos Exemplos 1 a 7, que compreende adicionalmente um atuador de extremidade que compreende um cartucho de grampos que aloja uma pluralidade de grampos, e sendo que a translação do membro de deslocamento a partir da posição proximal para a posição distal faz com que os grampos sejam implantados a partir do cartucho de grampos.
[00208] Exemplo 9. O instrumento cirúrgico, de acordo com o Exemplo 1 ao Exemplo 8 sendo que o circuito de controle é configurado para determinar a primeira velocidade com base na força ou na corrente experimentada pelo motor.
[00209] Exemplo 10. Um instrumento cirúrgico que compreende: um membro de deslocamento; um motor acoplado ao membro de deslocamento, sendo que o motor é operável para transladar o membro de deslocamento; um circuito de controle acoplado ao motor; e um sensor de posição acoplado ao circuito de controle; sendo que o circuito de controle é configurado para: receber uma saída de posição do sensor de posição indicativa de ao menos uma posição do membro de deslocamento; e acionar o motor para transladar o membro de deslocamento a uma velocidade do membro de deslocamento correspondente à posição do membro de deslocamento.
[00210] Exemplo 11. O instrumento cirúrgico, de acordo com o Exemplo 10, sendo que o circuito de controle é configurado para aumentar a velocidade do membro de deslocamento a uma taxa linear a partir de uma velocidade inicial.
[00211] Exemplo 12. O instrumento cirúrgico, de acordo com o Exemplo 11, que compreende adicionalmente um circuito temporizador acoplado ao circuito de controle, sendo que o circuito temporizador é configurado para medir o tempo decorrido durante a translação do membro de deslocamento para uma posição inicial predeterminada.
[00212] Exemplo 13. O instrumento cirúrgico, de acordo com o Exemplo 12, sendo que o circuito de controle é configurado para determinar a velocidade inicial com base no tempo decorrido durante a translação do membro de deslocamento para a posição inicial predeterminada.
[00213] Exemplo 14. O instrumento cirúrgico, de acordo com o Exemplo 10 ao Exemplo 13, que compreende adicionalmente um atuador de extremidade que compreende um cartucho de grampos que aloja uma pluralidade de grampos, e sendo que a translação do membro de deslocamento a partir da posição proximal para a posição distal faz com que os grampos sejam implantados a partir do cartucho de grampos.
[00214] Exemplo 15. O instrumento cirúrgico, de acordo com o Exemplo 10 ao Exemplo 14 sendo que o circuito de controle é configurado para determinar a primeira velocidade com base na força ou corrente experimentada pelo motor.
[00215] Exemplo 16. Um instrumento cirúrgico que compreende: um membro de deslocamento; um motor acoplado ao membro de deslocamento, sendo que o motor é operável para transladar o membro de deslocamento; um circuito de controle acoplado ao motor; e um sensor de posição acoplado ao circuito de controle; sendo que o circuito de controle é configurado para: receber uma saída de posição do sensor de posição indicativa de ao menos uma posição do membro de deslocamento ao longo da distância entre a posição proximal e a posição distal; e acionar o motor em uma pluralidade de ciclos de trabalho correspondentes à saída de posição, sendo que cada uma dentre a pluralidade de ciclos de trabalho é mantida em uma zona predeterminada entre a posição proximal e a posição distal.
[00216] Exemplo 17. O instrumento cirúrgico, de acordo com a Exemplo 16, sendo que o circuito de controle é configurado para acionar o motor em um primeiro ciclo de trabalho em uma primeira zona e um segundo ciclo de trabalho em uma segunda zona, e sendo que a segunda zona é distal à primeira zona.
[00217] Exemplo 18. O instrumento cirúrgico, de acordo com o Exemplo 17, sendo que o segundo ciclo de trabalho é maior que o primeiro ciclo de trabalho.
[00218] Exemplo 19. O instrumento cirúrgico, de acordo com o Exemplo 18, sendo que o circuito de controle é configurado para acionar o motor em um terceiro ciclo de trabalho em uma terceira zona, e sendo que a terceira zona é distal à segunda zona.
[00219] Exemplo 20. O instrumento cirúrgico, de acordo com o Exemplo 19, sendo que o terceiro ciclo de trabalho é maior que o segundo ciclo de trabalho.
[00220] Exemplo 21. O instrumento cirúrgico, de acordo com o Exemplo 17 ao Exemplo 20, que compreende adicionalmente um circuito temporizador acoplado ao circuito de controle, sendo que o circuito temporizador é configurado para medir o tempo decorrido durante a translação do membro de deslocamento para uma posição inicial predeterminada.
[00221] Exemplo 22. Instrumento cirúrgico, de acordo com o Exemplo 21, sendo que o circuito de controle é configurado para determinar o primeiro ciclo de trabalho com base no tempo decorrido durante a translação do membro de deslocamento para a posição inicial predeterminada.
[00222] Exemplo 23. O instrumento cirúrgico, de acordo com o Exemplo 16 ao Exemplo 22 sendo que o circuito de controle é configurado para determinar a primeira velocidade com base na força ou corrente experimentada pelo motor.
Claims (8)
1. Instrumento cirúrgico de grampeamento e corte (10) compreendendo: um membro de deslocamento (1111, 2514); um motor (2504) acoplado ao membro de deslocamento (1111, 2514), o motor (2504) operável para transladar o membro de deslocamento (1111, 2514); um circuito de controle (2510) acoplado ao motor (2504); e um sensor de posição (2534) acoplado ao circuito de controle (2510); em que o circuito de controle (2510) é configurado para: receber uma saída de posição do sensor de posição (2534) indicativa de pelo menos uma posição do membro de deslocamento (1111, 2514); e controlar velocidade do motor (2504) para transladar o membro de deslocamento (1111, 2514) em uma pluralidade de velocidades correspondendo à saída de posição; caracterizado pelo fato de que o circuito de controle (2510) é configurado para manter a translação do membro de deslocamento (1111, 2514) a uma primeira velocidade em uma primeira zona e uma segunda velocidade em uma segunda zona, e em que a segunda zona é distal à primeira zona.
2. Instrumento cirúrgico (10) de acordo com a reivindicação 1, caracterizado pelo fato de que a segunda velocidade é maior do que à primeira velocidade.
3. Instrumento cirúrgico (10) de acordo com a reivindicação 1 ou 2, caracterizado pelo fato de que o circuito de controle (2510) é configurado para manter a translação do membro de deslocamento (1111, 2514) a uma terceira velocidade em uma terceira zona, e em que a terceira zona é distal à segunda zona.
4. Instrumento cirúrgico (10) de acordo com a reivindicação 3, caracterizado pelo fato de que a terceira velocidade é maior do que a segunda velocidade.
5. Instrumento cirúrgico (10), de acordo com qualquer uma das reivindicações 1 a 4, caracterizado pelo fato de que ainda compreende um circuito temporizador acoplado ao circuito de controle (2534), em que o circuito temporizador é configurado para medir tempo decorrido durante translação do membro de deslocamento (1111, 2514) para uma posição inicial predeterminada.
6. Instrumento cirúrgico (10) de acordo com a reivindicação 5, caracterizado pelo fato de que o circuito de controle (2534) é configurado para determinar a primeira velocidade com base no tempo decorrido durante translação do membro de deslocamento (1111, 2514) para a posição inicial predeterminada.
7. Instrumento cirúrgico (10), de acordo com qualquer uma das reivindicações 1 a 6, caracterizado pelo fato de que ainda compreende um atuador de extremidade (2502) compreendendo um cartucho de grampos (2518) alojando uma pluralidade de grampos, e em que a translação do membro de deslocamento (1111, 2514) da posição proximal para a posição distal leva os grampos a serem implantados a partir do cartucho de grampos (2518).
8. Instrumento cirúrgico (10), de acordo com qualquer uma das reivindicações 1 a 7, caracterizado pelo fato de que o circuito de controle (2510) é configurado para determinar a primeira velocidade com base na força ou corrente experimentada pelo motor (2504).
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CN110785132B (zh) | 2023-05-05 |
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