BR112019027390B1 - Instrumento cirúrgico de grampeamento - Google Patents
Instrumento cirúrgico de grampeamento Download PDFInfo
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- BR112019027390B1 BR112019027390B1 BR112019027390-5A BR112019027390A BR112019027390B1 BR 112019027390 B1 BR112019027390 B1 BR 112019027390B1 BR 112019027390 A BR112019027390 A BR 112019027390A BR 112019027390 B1 BR112019027390 B1 BR 112019027390B1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00115—Electrical control of surgical instruments with audible or visual output
- A61B2017/00119—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00137—Details of operation mode
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00734—Aspects not otherwise provided for battery operated
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Biomedical Technology (AREA)
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- Molecular Biology (AREA)
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Abstract
a presente invenção refere-se a um instrumento cirúrgico motorizado. o instrumento cirúrgico inclui um membro de deslocamento, uma fonte de alimentação, um motor, um circuito de controle e um sensor de posição. o circuito de controle é configurado para iniciar o disparo do membro de deslocamento em uma determinada carga elétrica sobre a fonte de alimentação, sendo que a carga elétrica predeterminada é aplicada ao motor para acionar o membro de deslocamento, monitorar a posição do membro de deslocamento por meio do sensor de posição, continuamente amostrar uma tensão da fonte de alimentação durante um primeiro intervalo de deslocamento do membro de deslocamento, comparar a tensão amostrada a uma tensão limite, e continuar o disparo do deslocamento na primeira velocidade quando a tensão amostrada for maior que ou igual ao limite de tensão ou ajustar a primeira velocidade quando a tensão amostrada for menor que a tensão limite. são também reveladas técnicas para manusear as condições de parada do motor e as transições entre as velocidades.
Description
[001] A presente invenção refere-se a instrumentos cirúrgicos e, em várias circunstâncias, a instrumentos cirúrgicos de grampeamento e corte, e a cartuchos de grampos para os mesmos, que são projetados para grampear e cortar tecidos.
[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 elemento de corte durante um curso de disparo para ter em conta as condições do tecido. A espessura do tecido pode ser determinada pela comparação da velocidade esperada do membro de corte com a velocidade real do membro de corte. Em algumas situações, pode ser útil articular o atuador de extremidade em uma velocidade de articulação constante. Em outras situações, pode ser útil acionar o atuador de extremidade em uma velocidade de articulação diferente da velocidade de articulação padrão em uma ou mais regiões dentro de uma faixa de varredura do atuador de extremidade.
[003] Durante o uso de um instrumento cirúrgico motorizado de grampeamento e corte, é possível que ocorra um superaquecimento da bateria devido às cargas externamente aplicadas que causam uma parada repentina, ou estol, do motor. Portanto, pode ser desejável interrogar a tensão na bateria durante uma porção do curso de disparo, quando o sistema é carregado, para avaliar a capacidade da bateria e ajustar a velocidade de disparo do membro de corte ou do membro de disparo com base nessa realimentação (feedback).
[004] Em um aspecto, a presente descrição fornece um instrument cirúrgico. O instrumento cirúrgico compreende um membro de deslocamento configurado para transladar dentro do instrumento cirúrgico ao longo de uma pluralidade de zonas predefinidas; uma fonte de alimentação; um motor acoplado ao membro de deslocamento para transladar o membro de deslocamento; um circuito de controle acoplado à fonte de alimentação e ao motor; um sensor de posição acoplado ao circuito de controle, sendo o sensor de posição configurado para monitorar a posição do membro de deslocamento; em que o circuito de controle é configurado para: iniciar o disparo do membro de deslocamento em uma carga elétrica predeterminada na fonte de alimentação, em que a carga elétrica predeterminada é aplicada ao motor para atuar o membro de deslocamento; monitorar a posição do membro de deslocamento através do sensor de posição; amostrar continuamente uma tensão da fonte de alimentação durante um primeiro intervalo de deslocamento do membro de deslocamento; comparar a tensão amostrada a uma tensão limite; e continuar o disparo do deslocamento na primeira velocidade quando a tensão amostrada for maior que ou igual à tensão limite; ou ajustar a primeira velocidade quando a tensão amostrada for menor que a tensão limite.
[005] Em um outro aspecto, o instrumento cirúrgico compreende um membro de deslocamento configurado para transladar dentro do instrumento cirúrgico; um motor que compreende um eixo de acionamento, sendo o motor acoplado ao membro de deslocamento para transladar o membro de deslocamento; um circuito de controle acoplado ao motor; em que o circuito de controle é configurado para: iniciar o disparo do membro de deslocamento em uma velocidade de comando ajustada para uma primeira velocidade, em que a velocidade de comando é a velocidade aplicada ao motor; verificar se há uma condição de parada do motor; e continuar o disparo do deslocamento na primeira velocidade quando o motor não estiver parado; ou reduzir a velocidade de comando para uma segunda velocidade, em que a segunda velocidade é mais lenta que a primeira velocidade.
[006] Em um outro aspecto, o instrumento cirúrgico compreende um membro de deslocamento configurado para transladar dentro do instrumento cirúrgico ao longo de uma pluralidade de zonas predefinidas; uma fonte de alimentação; um motor acoplado ao membro de deslocamento para transladar o membro de deslocamento; um circuito de controle acoplado à fonte de alimentação e ao motor; um sensor de posição acoplado ao circuito de controle, sendo o sensor de posição configurado para monitorar a posição do membro de deslocamento; em que o circuito de controle é configurado para: iniciar o disparo do membro de deslocamento em uma velocidade de comando ajustada para uma primeira velocidade, em que a velocidade de comando é a velocidade aplicada ao motor; monitorar a posição do membro de deslocamento em uma zona atual até o membro de deslocamento atingir uma posição-alvo para comparação; quando o membro de deslocamento atingir a posição- alvo, determinar se uma alteração na velocidade de comando foi iniciada em uma zona anterior antes da zona atual; e continuar o disparo do membro de deslocamento na velocidade de comando quando uma alteração na velocidade de comando foi iniciada na zona anterior.
[007] As características inovadoras dos aspectos aqui descritos são apresentadas com particularidade nas concretizações. Entretanto, esses aspectos, tanto com relação à organização quanto aos métodos de operação, podem ser melhor 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 instrument cirúrgico que tem um conjunto de eixo de acionamento intercambiável operacionalmente acoplado ao mesmo, de acordo com um aspecto desta descrição.
[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 descrição.
[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 descrição.
[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 descrição.
[0012] As Figuras 5A a 5B é um diagrama de blocos de um circuito de controle do instrumento cirúrgico da Figura 1 que abrange duas folhas de desenho, de acordo com um aspecto desta descrição.
[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 descrição.
[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 descrição.
[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 descrição.
[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 descrição.
[0017] A Figura 10 é um diagrama de um sistema de posicionamento absoluto do instrumento cirúrgico da Figura 1, em 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 descrição.
[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 descrição.
[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 descrição.
[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 descrição.
[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 descrição.
[0022] A Figura 15 ilustra um diagrama que plota dois cursos de membro de deslocamento executados, de acordo com um aspecto da presente descrição.
[0023] A Figura 16 é um diagrama de fluxo lógico de um processo que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição da bateria, de acordo com um aspecto da presente descrição.
[0024] A Figura 17 é um diagrama de fluxo lógico de um processo que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo, de acordo com um aspecto da presente descrição.
[0025] A Figura 18 é um diagrama de fluxo lógico de um processo que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor enquanto em modo manual, de acordo com um aspecto da presente descrição.
[0026] A Figura 19 é um diagrama de fluxo lógico de um processo que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo e implementar uma pausa forçada no ciclo de disparo, de acordo com um aspecto da presente descrição.
[0027] A Figura 20 é um diagrama de fluxo lógico de um processo que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição parada durante um disparo normal e reduzir a velocidade um nível depois que o ciclo de disparo é reiniciado, de acordo com um aspecto da presente descrição.
[0028] A Figura 21 é um diagrama de fluxo lógico de um processo que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo em modo manual e reduzir a velocidade um nível depois que o ciclo de disparo é reiniciado, de acordo com um aspecto da presente descrição.
[0029] A Figura 22 é um diagrama de fluxo lógico de um processo que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo e interromper o ciclo de disparo até o usuário liberar o gatilho de disparo, de acordo com um aspecto da presente descrição.
[0030] A Figura 23 é um diagrama de fluxo lógico de um processo que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor durante a transição entre velocidades, de acordo com um aspecto da presente descrição.
[0031] 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:
[0032] N° do documento de procuração 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.
[0033] N° do documento de procuração 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.
[0034] N° do documento de procuração END8193USNP/170056, intitulado SYSTEMS AND METHODS FOR CONTROLLING DISPLACEMENT MEMBER MOTION OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, pelos inventores Frederick E. de Shelton, IV et al., depositado em 20 de junho de 2017.
[0035] N° do documento de procuração 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.
[0036] N° do documento de procuração END8195USNP/170058, titled 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.
[0037] N° do documento de procuração END8196USNP/170059, intitulado SURGICAL INSTRUMENT HAVING CONTROLLABLE ARTICULATION VELOCITY pelos inventores Frederick ES. Shelton, IV et al., depositado em 20 de junho de 2017.
[0038] N° do documento de procuração END8197USNP/170060, intitulado SYSTEMS AND METHODS FOR CONTROLLING VELOCITY OF A DISPLACEMENT MEMBER OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, pelos inventores Frederick E. Shelton, IV et al., depositado em 20 de junho de 2017.
[0039] N° do documento de procuração 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 de procuração 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 de procuração 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 de procuração 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 de procuração END8268USNP/170186, intitulado CLOSED LOOP REALIMENTAÇÃO 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 de procuração 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 de procuração 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 de procuração 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 de procuração 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 de procuração 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] O requerente do presente pedido detém os seguintes pedidos de patente de design depositados simultaneamente com o mesmo e que estão, cada um, incorporados no presente documento a título de referência em suas respectivas totalidades:
[0050] N° do documento de procuração 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 de procuração 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 de procuração 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 descrição.
[0054] Os termos "proximal" e "distal" são com referência a um médico que manipula o cabo do instrumento cirúrgico, em 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 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] As Figuras 1 a 4 ilustram 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 instrument cirúrgico 10 que tem um conjunto de eixo de acionamento intercambiável 200 operacionalmente acoplado ao mesmo, de acordo com um aspeto desta descrição. 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.
[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 descrição. 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 alimentação removível 92. A fonte de alimentação 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.
[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, em 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 US 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 descrição. 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, em 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, em 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 descrição. 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 superiors 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, em 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 e 5B mostram um diagrama de blocos de um circuito de controle 700 do instrumento cirúrgico 10 de Figura 1 que abrange duas folhas de desenho, de acordo com um aspecto da presente descrição. Com referência principalmente às Figuras 6A a 6B, 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 transistores 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 alimentação 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 outras circunstâncias, a interface pode facilitar uma linha de comunicação direta entre o controlador de gerenciamento de energia 716 e o controlador do conjunto de eixo de acionamento 722 através do conjunto de cabo 702, enquanto o conjunto de eixo de acionamento 704 e o conjunto de alimentação 706 estão acoplados ao conjunto de cabo 702.
[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), um 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 realimentação visual (por exemplo, um monitor com tela de LCD, indicadores em LED), dispositivos de realimentação auditiva (por exemplo, um alto-falante, uma campainha) ou dispositivos de realimentação 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 realimentação a um usuário do instrumento cirúrgico 2000 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 transistores 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 descrição. 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 realimentação 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 realimentação sensorial a um usuário. Esses dispositivos podem compreender dispositivos de realimentação visual (por exemplo, um monitor com tela de LCD, indicadores em LED), dispositivos de realimentação auditiva (por exemplo, um alto-falante, uma campainha) ou dispositivos de realimentação 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 realimentação 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 descrição 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 descrição. 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 descrição. 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 descrição. O circuito lógico sequencial 820 ou o circuito lógico combinacional 822 pode ser configurado para implementar vários processos aqui descritos. 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, e um relógio 829 , 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), em 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 descrição. 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, em 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 descrição está aqui incorporada a título de referência.
[00101] O controlador 1104 pode ser programado para fornecer controle preciso da velocidade e da posição dos membros 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 realimentação, 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 transistores 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 descrição 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 relative 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 de 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 é armazenado integrado no sensor de posição AS5055 1200 em um registro ou memória. O valor do ângulo que é indicativo da posição do magneto 1202 durante uma revolução é fornecido ao controlador 1104 em uma variedade de técnicas, por exemplo, ao energizar ou mediante demanda do controlador 1104.
[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 o modo suspenso. O controlador 1104 pode responder à solicitação INT na saída INT 1242 pela leitura do valor do ângulo a partir do sensor de posição AS5055 1200 por intermédio da interface SPI 1234. Uma vez lido o valor do ângulo pelo controlador 1104, a saída INT 1242 é liberada novamente. Enviar um comando "ler ângulo" pela interface SPI 1234 por meio do controlador 1104 ao sensor de posição 1200 também energiza automaticamente o circuito integrado e inicia outra medição de ângulo. Assim que o controlador 1104 concluir a leitura do valor do ângulo, a saída INT 1242 é liberada e um novo resultado é armazenado no registro de ângulos. O término dessa medição de ângulo é indicado novamente pela configuração da saída INT 1242 e pelo sinalizador correspondente no registro de estados.
[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 descrição. 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 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 de cunha 2513 e começar a movê- lo distalmente. Enquanto na primeira região, entretanto, o gume cortante 2509 pode não entrar em contato com o tecido e o deslizador em cunha 2513 pode não entrar em contato com um acionador de grampo 2511. Depois do atrito estático ser superado, a força para acionar a haste com perfil em I 2514 na primeira região 2517 pode ser substancialmente constante.
[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 quarta região 2523 . 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, em 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 de procuração 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 descrição. 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 alimentação 2512. A fonte de alimentação 2512 pode ser ou incluir uma bateria, um super capacitor, ou qualquer outra fonte de alimentação 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 processador 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 drenada pelo motor 2504. A força necessária para avançar a haste com perfil em I 2514 corresponde à corrente drenada pelo motor 2504. A força medida é convertida em um sinal digital e fornecida ao circuito de controle 2510.
[00125] Usando as propriedades físicas dos instrumentos aqui revelados, agora com referência às Figuras 1 a 14, e com referência à Figura 14, um controlador 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 realimentação, que pode ser qualquer um dos controladores de realimentação, incluindo, mas não se limitando a, um PID, uma realimentação de estado, LQR, e/ou um controlador adaptável, por exemplo. O instrumento cirúrgico 2500 pode incluir uma fonte de alimentação para converter o sinal do controlador de realimentação 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 um aspecto, 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 descrição. 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 de deslocamento percorrido durante o período de tempo inicial) pode corresponder a velocidades maiores do membro de deslocamento após o período de tempo inicial.
[00134] A descrição se volta agora para um sistema de realimentação de circuito fechado para controlar a velocidade do motor com base em uma variedade de condições. Em um aspecto, um diagrama de fluxo lógico de um processo de um programa de controle ou uma configuração lógica é fornecido para controlar a velocidade do motor com base na condição da bateria. Em um outro aspecto, um diagrama de fluxo lógico de um processo de um programa de controle ou uma configuração lógica é fornecido para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo. Em um outro aspecto, um diagrama de fluxo lógico de um processo de um programa de controle ou uma configuração lógica é fornecido para controlar a velocidade do motor enquanto em modo manual. Em um outro aspecto, um diagrama de fluxo lógico de um processo de um programa de controle ou uma configuração lógica é fornecido para controlar a velocidade do motor com base numa condição parada durante um ciclo normal de disparo e implementar uma pausa forçada no ciclo de disparo. Em um outro aspecto, um diagrama de fluxo lógico de um processo de um programa de controle ou uma configuração lógica é fornecido para controlar a velocidade do motor com base numa condição parada durante uma operação normal de disparo e reduzir a velocidade um nível após o ciclo de disparo ser reiniciado. Em um outro aspecto, um diagrama de fluxo lógico de um processo de um programa de controle ou uma configuração lógica é fornecido para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo em modo manual e reduzir a velocidade um nível após o ciclo de disparo ser reiniciado. Em um outro aspecto, um diagrama de fluxo lógico de um processo que representa um programa de controle ou uma configuração lógica é fornecido para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo e interromper o ciclo de disparo até o usuário liberar o gatilho de disparo. Em um outro aspecto, um diagrama de fluxo lógico de um processo de um programa de controle ou uma configuração lógica é fornecido para controlar a velocidade do motor durante a transição entre as velocidades. Esses aspectos são descritos em maiores detalhes abaixo, com referência às Figuras 16 a 23.
[00135] Uma condição de parada do motor ocorre quando a saída rotacional do motor cai para zero. O torque da parada é o torque que é produzido pelo motor quando a velocidade rotacional de saída é zero. Isso pode também significar a carga de torque que causa a velocidade rotacional de saída do motor se tornar zero, isto é, causar a parada. A parada é uma condição em que o motor para de girar. Esta condição ocorre quando o torque de carga é maior do que o torque de acionamento do motor, isto é, a condição de torque máximo. Nessa condição o motor drena a corrente máxima, mas o eixo de motor não gira. A corrente é chamada a corrente de parada (corrente de estol). Os motores elétricos continuam a fornecer torque quando parados. No entanto, os motores elétricos deixados em uma condição de parada são propensos a superaquecimento e possíveis danos uma vez que o fluxo da corrente que flui é máximo sob essas condições. O torque máximo que um motor elétrico pode produzir a longo prazo quando parado sem causar danos é chamado de o torque de parada contínua máximo.
[00136] Com referência à Figura 14, uma condição de parada do motor pode ser detectada com o uso de uma variedade de técnicas. Em um aspecto, uma parada do motor pode ser detectada pelo monitoramento da fonte de alimentação 2512 para o motor 2504. Se a tensão cair abaixo de um limite predeterminado, ela pode ser uma indicação de uma condição de parada do motor. Em um outro aspecto, uma condição de parada do motor pode ser detectada mediante o monitoramento da corrente que flui pelo motor 2504 através do sensor de corrente 2536. Se a corrente detectada pelo sensor de corrente 2536 aumentar acima de um limite predeterminado para um valor maior que a corrente de parada, pode ocorrer parada ou estol do motor 2504. Em um outro aspecto, o sensor de corrente 2536 pode ser colocado em série com a perna de terra ("ground leg") do motor 2504. Em um outro aspecto, uma condição de parada do motor pode ser detectada pelo monitoramento da corrente aplicada ao motor 2504 em relação ao deslocamento real de um membro de deslocamento, como a haste com perfil em I 2514, monitorado pelo sensor de posição 2534. Se a corrente do motor for maior do que a esperada, próxima ou maior que a corrente de parada, e a velocidade real for menor que a velocidade de comando, pode ocorrer parada ou estol do motor. O motor 2504 pode sofrer danos por superaquecimento se uma condição de parada do motor não for corrigida em tempo hábil.
[00137] Consequentemente, com referência agora à Figura 16, é ilustrado um diagrama de fluxo lógico de um processo 11500 que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição da bateria, de acordo com um aspecto da presente descrição. Com referência também às Figuras 1 a 15 e em particular à Figura 14, em um aspecto, o circuito de controle 2510 é configurado para interrogar a fonte de alimentação 2512 para determinar a tensão sobre a bateria durante uma porção do ciclo de disparo, quando o instrumento cirúrgico 2500 é carregado, para avaliar a capacidade da bateria e ajustar a velocidade de disparo do membro de deslocamento (por exemplo, o membro de acionamento 120, o membro de disparo 220, a barra de disparo 172, a haste com perfil em I 2514, etc.) com base nessa realimentação. Conforme anteriormente discutido, a velocidade de disparo do membro de deslocamento é controlada pelo circuito de controle 2510 com base em várias condições de realimentação. O circuito de controle 2510 determina uma nova velocidade do membro de deslocamento e aplica um ponto de ajuste do motor 2522 ao controle do motor 2508 que, por sua vez, aplica o sinal de acionamento do motor 2524 ao motor 2504. A velocidade ajustada ou de comando do motor 2504 é aplicada a uma transmissão 2506. A velocidade real do membro de deslocamento é determinada com base na realimentação do sensor de posição 2534, da fonte de alimentação 2512, do sensor de corrente 2536, do temporizador/contador 2531, ou dos sensores 2538, sozinhos ou em combinação. Conforme anteriormente discutido, os fatores que podem afetar a velocidade real do membro de deslocamento incluem influências externas como a espessura do tecido, o tecido, o tipo ou as condições do sistema. A determinação da condição da bateria, como uma condição de superaquecimento da bateria, informa o circuito de controle 2510 da velocidade de disparo. Como um exemplo, o circuito de controle 2510 mede a tensão, a resistência interna, e/ou a corrente em/através da bateria durante os primeiros 0,080" a 0,12" (2 mm a 3 mm) e, em um exemplo, 0,09" (2,286 mm) de deslocamento do membro de deslocamento, (por exemplo, quando o sistema é carregado). Se a tensão Vb de uma bateria de 12 V for < 9 V, a resistência interna Rb da bateria está acima de um limiar, ou a corrente Ib está abaixo de um limiar, então é provável que a bateria esteja em um estado superaquecido. O circuito de controle 2510 imediatamente ajusta a velocidade de disparo para a configuração mínima para todo o ciclo de disparo.
[00138] Agora com referência às Figuras 14 e 16, de acordo com o processo 11500, o circuito de controle 2510 inicia 11502 um ciclo de disparo do membro de deslocamento e continuamente amostra 11504 a fonte de alimentação 2512 durante a fase de disparo inicial (por exemplo, durante os primeiros 0,090" de percurso conforme determinado pelo sensor de posição 2534). A tensão amostrada é comparada. 11506 a uma tensão limite. Em um exemplo, para uma fonte de alimentação 12 V 2512, o limiar é ajustado para 9 V. O limiar pode ser ajustado para acomodar os requisitos de tensão do sistema. Se a tensão amostrada for maior que ou igual à tensão limite, o circuito de controle 2510 continua ao longo da ramificação NO e continua 11508 o ciclo de disparo até a tensão amostrada ser menor que a tensão limite, o circuito de controle 2510 continua ao longo da ramificação SIM e o circuito de controle 2510 comunica 11510 a condição de bateria fraca através de um indicador de estado como uma tela 43, 743 (Figuras 2, 5B, 6). O indicador de estado pode ser um LED, uma tela, um sinal sonoro, entre outros. Após comunicar 11510 o estado fraco da bateria, o circuito de controle 2510 determina 11512 se o dispositivo instrumento cirúrgico 2500 está em modo automático. Se o instrumento cirúrgico 2500 estiver em modo automático, o circuito de controle 2510 continua ao longo da ramificação SIM e o circuito de controle 2510 converte 11514 o instrumento cirúrgico 2500 para o modo manual e reduz 11516 a velocidade de comando do motor 2504 para lento. Se o instrumento cirúrgico 2500 não estiver em modo automático, o circuito de controle 2510 continua ao longo da ramificação NÃO e o circuito de controle 2510 reduz 11516 a velocidade de comando do motor 2504 para lento. Em alguns aspectos, uma velocidade de comando lenta pode ser menor que 10 mm/s e em alguns aspectos pode ser menor que 5 mm/s.
[00139] A Figura 17 é um diagrama de fluxo lógico de um processo 11520 que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo de acordo com um aspecto da presente descrição. Em geral, se o motor parar durante um ciclo normal de disparo, o processo 11520 força o motor a operar no modo mais lento durante o restante do ciclo de disparo. Dessa forma, se o motor parar, o curso restante é executado em uma velocidade lenta.
[00140] Com referência agora às Figuras 14 e 17, de acordo com o processo 11520, o circuito de controle 2510 inicia 11522 um ciclo de disparo do membro de deslocamento em uma velocidade de comando média como 12 mm/seg. Durante o ciclo de disparo, o circuito de controle 2510 verifica 11524 se há uma condição de parada do motor e se o circuito de controle determinar 11526 que o motor não está parado, o circuito de controle 2510 continua ao longo da ramificação NÃO e continua 11532 o ciclo de disparo até a parada do motor 2504. No momento em que o circuito de controle 2510 continua ao longo da ramificação SIM, ele reduz 11528 a velocidade de comando para lenta e indica 11530 o estado por meio da luz de alerta ou outro indicador como tela 43, 743 (Figuras 2, 5B, 6). Ao reduzir 11528 a velocidade de comando para lenta, o circuito de controle 2510 continua 11532 o ciclo de disparo e verifica 11524 se há paradas até o motor 2504 parar ou o deslocamento membro atingir o final do curso. Conforme anteriormente discutido, uma velocidade de comando lenta pode ser menor que 10 mm/s e em alguns aspectos pode ser menor que 5 mm/s. Neste exemplo, a velocidade de comando é ajustada para 9 mm/seg.
[00141] A Figura 18 é um diagrama de fluxo de um processo 11540 que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor enquanto no modo manual, de acordo com um aspecto da presente descrição. Em geral, enquanto o instrumento cirúrgico 2500 está no modo manual, o motor está em risco de parar e o circuito de controle exibe um aviso. Se a velocidade de comando do motor não for interrompida ou reduzida pelo usuário, o dispositivo entrará automaticamente em uma velocidade baixa durante o restante do ciclo de disparo. Consequentemente, enquanto o instrumento cirúrgico estiver no modo manual e o risco de parada for detectado pelo circuito de controle, o usuário tem a oportunidade de ajustar manualmente a velocidade de comando para evitar uma parada do motor.
[00142] Agora com referência às Figuras 14 e 18, de acordo com o processo 11540, o circuito de controle 2510 seleciona 11542 o modo manual ao receber uma solicitação do usuário e inicia 11544 um ciclo de disparo do membro de deslocamento. Durante o ciclo de disparo, o circuito de controle 2510 verifica 11546 se há uma parada do motor e se o circuito de controle 2510 não detectar 11548 uma velocidade baixa, o circuito de controle 2510 prossegue ao longo da ramificação NÃO e o circuito de controle 2510 continua 11550 o ciclo de disparo até uma velocidade baixa ser detectada 11548. Quando uma velocidade baixa é detectada 11548, o circuito de controle 2510 continua ao longo da ramificação SIM e o circuito de controle indica 11552 o estado de velocidade baixa por meio da tela 43, 743 (Figuras 2, 5B, 6), luz de alerta, e exibe um temporizador de contagem regressiva para fornecer ao usuário algum tempo para reduzir manualmente a velocidade do motor. Este período de tempo pode ser de alguns segundos e até 10 segundos, por exemplo. Depois que o temporizador de contagem regressiva expira, o circuito de controle 2510 determina 11554 se o usuário selecionou ajustar manualmente a velocidade do motor 2504 ou interromper o motor 2504. Se o usuário tiver selecionado ajustar manualmente a velocidade do motor 2504 ou interromper o motor 2504, o circuito de controle 2510 continua ao longo da ramificação SIM e o circuito de controle 2510 detecta 11548 se há velocidade baixa e o processo 11540 continua até o usuário selecionar não ajustar manualmente a velocidade do motor 2504 ou interromper o motor 2504. Nesse ponto, o circuito de controle 2510 continua ao longo da ramificação NÃO e reduz 11556 a velocidade do motor 2504 para velocidade lenta e continua o ciclo de disparo. O processo continua até o membro de deslocamento atingir o final do curso. Conforme anteriormente discutido, uma velocidade de comando lenta do motor pode ser menor que 10 mm/s. e em alguns aspectos pode ser menor que 5 mm/s. Neste exemplo, a velocidade de comando é reduzida 11556 para 9 mm/s.
[00143] A Figura 19 é um diagrama de fluxo de um processo 11560 que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo e implementar uma pausa forçada no ciclo de disparo de acordo com um aspecto da presente descrição. Em geral, quando o motor para durante um ciclo normal de disparo, o circuito de controle interrompe o motor e força uma pausa no ciclo de disparo. A duração da pausa depende da velocidade de comando do motor no momento da parada. Velocidades mais rápidas do motor podem exigir pausas mais longas, etc. Consequentemente, se o motor parar, o circuito de controle interrompe o motor e força uma pausa antes de permitir que o motor reinicie na mesma velocidade no momento da parada.
[00144] Agora com referência às Figuras 14 e 19, de acordo com o processo 11560, o circuito de controle 2510 inicia 11562 um ciclo de disparo do membro de deslocamento e armazena 11564 a velocidade da corrente do motor (por exemplo, LENTA: 0 < V < 10 mm/s; MÉDIA: 10 mm/s < V <12,5 mm/s; RÁPIDA: 12,5 mm/s < V <15 mm/s) e verifica 11566 se há uma condição de parada do motor. O circuito de controle 2510 então determina 11568 se o motor 2504 parou. Se o motor 2504 parou, o circuito de controle continua ao longo da ramificação NÃO e o circuito de controle 2510 continua 11570 o ciclo de disparo e verifica 11566 se há uma condição de parada do motor até a parada do motor 2504. O circuito de controle 2510 então prossegue ao longo da ramificação SIM e avalia três condições. Uma primeira avaliação determina 11572 se a velocidade do motor 2504 anterior era RÁPIDA e se for, o circuito de controle 2510 ajusta 11574 um atraso maior que ou igual a 2 segundos e menor que ou igual a 5 segundos e continua 11576 o ciclo de disparo na velocidade armazenada. Ao mesmo tempo, o circuito de controle 2510 indica 11578 o estado do instrumento cirúrgico 2500 exibindo ou mostrando uma luz de alerta, entre outras técnicas de realimentação como tela 43, 743 (Figuras 2, 5B, 6). Uma segunda avaliação determina 11580 se a velocidade do motor 2504 anterior era MÉDIA e se for, o circuito de controle 2510 ajusta 11582 um atraso maior que ou igual a 1 e menor que 2 segundos e continua 11584 o ciclo de disparo na velocidade armazenada. Ao mesmo tempo, o circuito de controle 2510 indica 11586 o estado exibindo ou mostrando uma luz de alerta, entre outras técnicas de realimentação como tela 43, 743. Uma terceira avaliação determina 11588 se a velocidade do motor 2504 anterior era LENTA e se for, o circuito de controle 2510 ajusta 11590 um atraso de 0 a 1 segundo e, de preferência, um atraso de 0 a 0,25 s e continua 11592 o ciclo de disparo na velocidade armazenada. Ao mesmo tempo, o circuito de controle 2510 indica 11594 o estado exibindo ou mostrando uma luz de alerta, entre outras técnicas de realimentação como tela 43, 743. O processo 11560 continua até o membro de deslocamento atingir o final do curso.
[00145] A Figura 20 é um diagrama de fluxo lógico de um processo 11600 que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo e reduzir a velocidade um nível após o ciclo de disparo ser reiniciado, de acordo com um aspecto da presente descrição. Em geral, quando o motor para durante um ciclo normal de disparo, a velocidade do motor é reduzida um nível abaixo da velocidade da corrente do motor depois que o ciclo de disparo é reiniciado. Se a velocidade do motor já estiver na velocidade mais lenta, uma pausa forçada de uma duração predeterminada é necessária antes de reiniciar o ciclo de disparo na velocidade mais lenta. Consequentemente, se o motor parar, o circuito de controle diminui a velocidade do motor para um nível abaixo da velocidade armazenada.
[00146] Agora com referência às Figuras 14 e 20, de acordo com o processo 11600, o circuito de controle 2510 inicia 11602 um ciclo de disparo do membro de deslocamento e armazena 11604 a velocidade da corrente do motor (por exemplo, LENTA: V < 10 mm/s; MÉDIA: 10 mm/s < V < 12,5 mm/s; RÁPIDA: V > 12,5 mm/s) e verifica 11606 se há uma condição de parada do motor. O circuito de controle 2510 determina 11608 se o motor 2504 parou. Se o motor 2504 parou, o circuito de controle 2510 continua ao longo da ramificação NÃO e o circuito de controle 2510 continua 11610 o ciclo de disparo e verifica 11606 se há uma condição de parada do motor até a parada do motor 2504. O circuito de controle 2510 então prossegue ao longo da ramificação SIM e avalia três condições. Uma primeira avaliação determina 11612 se a velocidade do motor 2504 anterior era RÁPIDA e se for, o circuito de controle 2510 autoajusta 11614 a velocidade do motor 2504 para MÉDIA e reinicia 11602 o ciclo de disparo na nova velocidade MÉDIA. Ao mesmo tempo, o circuito de controle 2510 indica 11616 o estado do instrumento cirúrgico 2500 exibindo ou mostrando uma luz de alerta, entre outras técnicas de realimentação como a tela 43, 743 (Figuras 2, 5B, 6). Uma segunda avaliação determina 11618 se a velocidade do motor 2504 anterior era MÉDIA e, se for, o circuito de controle 2510 autoajusta 11620 a velocidade do motor 2504 para velocidade LENTA e reinicia 11602 o ciclo de disparo na nova velocidade LENTA. Ao mesmo tempo, o circuito de controle 2510 indica 11622 o estado exibindo ou mostrando uma luz de alerta, entre outras técnicas de realimentação como a tela 43, 743. Uma terceira avaliação determina 11624 se a velocidade do motor 2504 anterior era LENTA e se for, o circuito de controle 2510 força uma pausa 11626 de uma duração predeterminada. Depois de uma pausa predeterminada, o circuito de controle 2510 reinicia 11602 o ciclo de disparo na velocidade LENTA. Ao mesmo tempo, o circuito de controle 2510 indica 11628 o estado exibindo ou mostrando uma luz de alerta, entre outras técnicas de realimentação como a tela 43, 743. O processo 11600 continua até o membro de deslocamento atingir o final do curso.
[00147] A Figura 21 é um diagrama de fluxo de um processo 11630 que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo em modo manual e reduzir a velocidade um nível após o ciclo de disparo ser reiniciado de acordo com um aspecto da presente descrição. Em geral, quando o motor para durante um ciclo normal de disparo enquanto no modo manual, o circuito de controle reduz a velocidade do motor um nível após o ciclo de disparo ser reiniciado. Se já na velocidade mais lenta, o circuito de controle força a pausa de uma duração predeterminada antes de reiniciar o ciclo de disparo na menor velocidade novamente. O usuário pode escolher apenas uma velocidade que é mais lenta que a velocidade na qual a parada ocorreu para o restante do ciclo de disparo. Consequentemente, se o motor parar enquanto no modo manual, o circuito de controle diminui a velocidade do motor um nível e bloqueia as velocidades mais altas anteriores do motor.
[00148] Agora com referência às Figuras 14 e 21, de acordo com o processo 11630, o circuito de controle 2510 inicia 11632 um ciclo de disparo do membro de deslocamento 11634 e armazena a velocidade da corrente do motor (por exemplo, LENTA: V < 10 mm/s; MÉDIA: 10 mm/s < V < 12,5 mm/s; RÁPIDA: V > 12,5 mm/s) e verifica 11636 se há uma condição de parada do motor. O circuito de controle 2510 então determina 11638 se o motor 2504 parou. Se o motor 2504 tiver parado, o circuito de controle 2510 continua ao longo da ramificação NÃO e o circuito de controle 2510 continua 11640 o ciclo de disparo e verifica 11636 se há uma condição de parada do motor até a parada do motor 2504. O circuito de controle 2510 então prossegue ao longo da ramificação SIM e avalia três condições. Uma primeira avaliação determina 11642 se a velocidade do motor 2504 anterior era RÁPIDA e se for, o circuito de controle 2510 reduz 11644 a velocidade para MÉDIA e desativa, inibe, ou bloqueia a velocidade RÁPIDA. O circuito de controle 2510 reinicia 11632 o ciclo de disparo na nova velocidade MÉDIA enquanto bloqueia a RÁPIDA. O circuito de controle 2510 pode indicar o estado do instrumento cirúrgico 2500 exibindo ou mostrando uma luz de alerta, entre outras técnicas de realimentação. Uma segunda avaliação determina 11646 se a velocidade do motor2504 anterior era MÉDIA e se for, o circuito de controle 2510 reduz 11648 a velocidade do motor 2504 para velocidade LENTA e desativa, inibe, ou bloqueia as velocidades MÉDIA e RÁPIDA. O circuito de controle 2510 reinicia 11632 o ciclo de disparo na nova velocidade LENTA enquanto bloqueia as velocidades MÉDIA e RÁPIDA. O circuito de controle 2510 pode indicar o estado exibindo ou mostrando uma luz de alerta, entre outras técnicas de realimentação. Uma terceira avaliação determina 11650 se a velocidade do motor 2504 anterior era LENTA e se for, o circuito de controle 2510 força uma pausa 11652 de uma duração predeterminada. Depois de uma pausa predeterminada, o circuito de controle 2510 reinicia 11632 o ciclo de disparo a uma velocidade que é mais lenta que a velocidade LENTA na qual ocorreu a parada do motor para o restante do ciclo de disparo. Ao mesmo tempo, o circuito de controle 2510 indica 11628 o estado exibindo ou mostrando uma luz de alerta, entre outras técnicas de realimentação. O processo 11600 continua até o membro de deslocamento atingir o final do curso.
[00149] A Figura 22 é um diagrama de fluxo lógico 11660 de um processo que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor com base na condição parada durante um ciclo normal de disparo e interromper o ciclo de disparo até o usuário liberar o gatilho de disparo, de acordo com um aspecto da presente descrição. Em geral, quando o motor para durante um ciclo normal de disparo, o circuito de controle para até o usuário (por exemplo, o cirurgião) liberar o gatilho. Quando o ciclo de disparo é reiniciado, o circuito de controle reinicia na mesma velocidade de comando na qual ocorreu a parada do motor.
[00150] Com referência agora às Figuras 14 e 22, de acordo com o processo 11660, o circuito de controle 2510 inicia 11622 um ciclo de disparo do membro de deslocamento e verifica 11664 se há uma parada do motor. Se o motor não estiver parado 11666, o circuito de controle 2510 continua ao longo da ramificação NÃO e verifica 11664 se há uma parada do motor até o motor 2504 parar. Se houver uma parada do motor, o circuito de controle 2510 prossegue ao longo da ramificação SIM e interrompe 11668 o motor 2504 e o ciclo de disparo. O circuito de controle 2510 indica 11674 o estado e alerta para uma condição de parada do motor em uma tela 43, 743 (Figuras 2, 5B, 6) e instrui o usuário (por exemplo, o cirurgião) para liberar o gatilho. O circuito de controle 2510 então determina 11672 se o gatilho é liberado e continua ao longo da ramificação NÃO até o gatilho ser liberado. O circuito de controle 2510 então prossegue ao longo da ramificação SIM e continua 11670 o ciclo de disparo até o motor 2504 parar ou o membro de deslocamento atingir o final do curso.
[00151] A Figura 23 é um diagrama de fluxo lógico de um processo 11680 que representa um programa de controle ou uma configuração lógica para controlar a velocidade do motor durante a transição entre as velocidades de acordo com um aspecto da presente descrição. Em geral, durante os esquemas de controle baseados em tempo, distância ou velocidade, a transição de uma velocidade para uma outra provavelmente afeta o valor-alvo para a próxima comparação. Para evitar constantes alterações da velocidade desencadeadas principalmente devido às alterações na velocidade de comando, as zonas imediatamente após a última alteração de velocidade são excluídas da consideração. Em um aspecto, a velocidade de retorno é sempre a velocidade mais rápida.
[00152] Agora com referência às Figuras 14 e 23, de acordo com o processo 11680, o circuito de controle 2510 inicia 11682 um ciclo de disparo do membro de deslocamento e monitora 11684 a posição do membro de deslocamento com base no sensor de posição 2534 até o membro de deslocamento atingir um alvo para comparação das alterações na velocidade. Quando o membro de deslocamento atinge uma posição-alvo para comparação, o circuito de controle 2510 determina 11686 se a zona anterior iniciou uma alteração na velocidade. Se a zona anterior iniciou uma alteração na velocidade, o circuito de controle 2510 continua ao longo da ramificação SIM e continua a disparar 11688 na velocidade de comando da corrente e monitora 11684 se o deslocamento membro atingiu um alvo para comparação. O processo continua até o circuito de controle 2510 determinar 11686 que a zona anterior não iniciou uma alteração na velocidade. O circuito de controle 2510 prossegue ao longo da ramificação NÃO e compara 11690 o valor da velocidade esperada do membro de deslocamento com o valor da velocidade real do membro de deslocamento. O circuito de controle 2510 ajusta 11692 a nova velocidade de comando do motor 2504 para a próxima zona com base nos resultados da comparação 11690. Depois de ajustar 11692 a nova velocidade de comando 2504, o circuito de controle determina 11694 se o membro de deslocamento está localizado na zona final. Se o membro de deslocamento não estiver localizado na zona final, o circuito de controle 2510 continua ao longo da ramificação NÃO e continua a disparar na nova velocidade de comando e o processo continua até o membro de deslocamento estar localizado na zona final. Neste ponto, o circuito de controle 2514 continua a disparar 11696 até o membro de deslocamento atingir o final do curso. Caso contrário, o circuito de controle 2510 continua 11688 a disparar o membro de deslocamento na velocidade de comando da corrente.
[00153] As funções ou processos 11500, 11520, 11540, 11560, 11600, 11630, 11660, 11680 aqui descritos podem ser executados por qualquer um dos circuitos de processamento aqui descritos, como o circuito de controle 700 descrito nas Figuras 5 a 6, os circuitos 800, 810, 820 descritas nas Figuras 7 a 9, o microcontrolador 1104 descrito nas Figuras 10 e 12, e/ou o circuito de controle 2510 descrito na Figura 14.
[00154] Os aspectos do instrumento cirúrgico motorizado podem ser praticados sem os detalhes específicos revelados na presente descrição . Alguns aspectos foram mostrados como diagramas de bloco em vez de detalhes. Partes desta descrição podem ser apresentadas em termos de instruções que operam em dados armazenados em uma memória do computador. Um algoritmo se refere à sequência autoconsistente de etapas que levam ao resultado desejado, em que uma "etapa" se refere à manipulação de quantidades físicas que podem assumir a forma de sinais elétricos ou magnéticos capazes de serem armazenados, transferidos, combinados, comparados e manipulados de qualquer outra forma. Esses sinais podem ser chamados de bits, valores, elementos, símbolos, caracteres, termos, números. Esses termos e termos semelhantes podem ser associados às grandezas físicas adequadas e são identificações meramente convenientes aplicadas a essas grandezas.
[00155] De modo geral, os aspectos aqui descritos, os quais podem ser implementados, individual e/ou coletivamente, por uma ampla gama de hardware, software, firmware, ou qualquer combinação dos mesmos, podem ser vistos como sendo compostos por vários tipos de "circuitos elétricos". Consequentemente, "circuito elétrico" inclui, mas não se limita aos, circuitos elétricos que tenham ao menos um circuito elétrico distinto, circuitos elétricos que tenham ao menos um circuito integrado, circuitos elétricos que tenham ao menos um circuito integrado para aplicação específica, circuitos elétricos que formem um dispositivo de computação para finalidades gerais configurado por um programa de computador (por exemplo, um computador ou processador para finalidades gerais configurado por um programa de computador que ao menos parcialmente execute os processos e/ou dispositivos aqui descritos), circuitos elétricos que formem um dispositivo de memória (por exemplo, formas de memória de acesso aleatório), e/ou circuitos elétricos que formem um dispositivo de comunicações (por exemplo, um modem, roteadores ou equipamento óptico-elétrico). Esses aspectos podem ser implementados em forma analógica ou digital, ou combinações dos mesmos.
[00156] A descrição anteriormente mencionada apresentou aspectos dos dispositivos e/ou processos por meio do uso de diagramas de blocos, fluxogramas, e/ou exemplos, que pode conter uma ou mais funções e/ou operação. Cada função e/ou operação dentro de tais diagramas de blocos, fluxogramas ou exemplos pode ser implementada, individualmente e/ou coletivamente, por uma ampla gama de hardware, software, firmware ou virtualmente qualquer combinação dos mesmos. Em um aspecto, várias porções do assunto aqui descrito podem ser implementadas por meio de circuitos integrados de aplicação específica (ASICs), arranjos de portas programáveis em campo (FPGAs), processadores de sinais digitais (DSPs), dispositivos lógicos programáveis (PLDs), circuitos, registradores e/ou componentes de software, por exemplo, programas, sub-rotinas, lógica e/ou combinações de componentes de hardware e software, portas lógicas, ou outros formatos integrados. Alguns aspectos aqui revelados, no todo ou em parte, podem ser implementados de modo equivalente em circuitos integrados, como um ou mais programas de computador executando em um ou mais computadores (por exemplo, como um ou mais programas operando em um ou mais sistemas de computador), como um ou mais programas operando em um ou mais processadores (por exemplo, como um ou mais programas operando em um ou mais microprocessadores), como firmware, ou virtualmente como qualquer combinação dos mesmos, e que projetar o conjunto de circuitos e/ou escrever o código para o software e firmware estaria dentro do âmbito de prática de uma pessoa versada na técnica à luz desta descrição.
[00157] Os mecanismos do assunto revelado podem ser distribuídos como um produto de programa em uma variedade de formas, e um aspecto ilustrativo do assunto aqui descrito é aplicável independentemente do tipo específico da mídia de transmissão de sinais usado para efetivamente executar a distribuição. Exemplos de uma mídia de transmissão de sinais incluem, mas não se limitam aos seguintes: uma mídia do tipo gravável como um disquete, uma unidade de disco rígido, um disco compacto (CD), um disco de vídeo digital (DVD), uma fita digital, uma memória de computador, etc.; e uma mídia do tipo de transmissão, como uma mídia de comunicação digital e/ou analógica (por exemplo, um cabo de fibra óptica, um guia de onda, um enlace de comunicação com fio, um enlace de comunicação sem fio (por exemplo, transmissor, receptor, lógica de transmissão, lógica de recepção, etc.).
[00158] A descrição anteriormente mencionada de um ou mais aspectos foi apresentada para propósitos de ilustração e descrição. Essa descrição não pretende ser exaustiva nem limitar a invenção à forma precisa revelada. Modificações ou variações são possíveis à luz dos ensinamentos acima. Esses aspectos foram escolhidos e descritos com a finalidade de ilustrar os princípios e a aplicação prática para, assim, permitir que a pessoa versada na técnica use os vários aspectos e com várias modificações, conforme sejam convenientes ao uso específico contemplado. Pretende-se que as concretizações apresentadas em anexo definam o escopo global.
[00159] Vários aspectos da matéria descrita no presente documento são definidos nos seguintes exemplos numerados:
[00160] Exemplo 1. Um instrumento cirúrgico que compreende: um membro de deslocamento configurado para transladar dentro do instrumento cirúrgico ao longo de uma pluralidade de zonas predefinidas; uma fonte de alimentação; um motor acoplado ao membro de deslocamento para transladar o membro de deslocamento; um circuito de controle acoplado à fonte de alimentação e ao motor; um sensor de posição acoplado ao circuito de controle, sendo o sensor de posição configurado para monitorar a posição do membro de deslocamento; em que o circuito de controle é configurado para: iniciar o disparo do membro de deslocamento em uma carga elétrica predeterminada na fonte de alimentação, em que a carga elétrica predeterminada é aplicada ao motor para atuar o membro de deslocamento; monitorar a posição do membro de deslocamento através do sensor de posição; amostrar continuamente uma tensão da fonte de alimentação durante um primeiro intervalo de deslocamento do membro de deslocamento; comparar a tensão amostrada a uma tensão limite; e continuar o disparo do deslocamento na primeira velocidade quando a tensão amostrada for maior que ou igual à tensão limite; ou ajustar a primeira velocidade quando a tensão amostrada for menor que a tensão limite.
[00161] Exemplo 2. O instrumento cirúrgico do Exemplo 1 em que, quando a tensão amostrada é menor que a tensão limite, o circuito de controle é configurado ainda para determinar se o instrumento cirúrgico está em modo automático ou em modo manual.
[00162] Exemplo 3. O instrumento cirúrgico do Exemplo 2 em que, quando o instrumento cirúrgico está em modo automático, o circuito de controle é configurado ainda para converter a operação do instrumento cirúrgico para o modo manual.
[00163] Exemplo 4. O instrumento cirúrgico do Exemplo 3 em que o circuito de controle é ainda configurado para reduzir a velocidade de comando para uma segunda velocidade, em que a segunda velocidade é menor que a primeira velocidade.
[00164] Exemplo 5. O instrumento cirúrgico do Exemplo 4 em que a segunda velocidade é maior que zero e menor que 10 mm/seg.
[00165] Exemplo 6. O instrumento cirúrgico do Exemplo 1 ao Exemplo 5 em que o primeiro intervalo se situa entre 2 mm e 3 mm.
[00166] Exemplo 7. O instrumento cirúrgico do Exemplo 1 ao Exemplo 6 em que o circuito de controle é configurado para comunicar o estado da fonte de alimentação quando a tensão amostrada for menor que a tensão limite.
[00167] Exemplo 8. Um instrumento cirúrgico, que compreende: um membro de deslocamento configurado para transladar dentro do instrumento cirúrgico; um motor que compreende um eixo de acionamento, sendo o motor acoplado ao membro de deslocamento para transladar o membro de deslocamento; um circuito de controle acoplado ao motor; em que o circuito de controle é configurado para: iniciar o disparo do membro de deslocamento em uma velocidade de comando ajustada para uma primeira velocidade, em que a velocidade de comando é a velocidade aplicada ao motor; verificar se há uma condição de parada do motor; e continuar o disparo do deslocamento na primeira velocidade quando o motor não estiver parado; ou reduzir a velocidade de comando para uma segunda velocidade, em que a segunda velocidade é mais lenta que a primeira velocidade.
[00168] Exemplo 9. O instrumento cirúrgico do Exemplo 8 em que a primeira velocidade se situa entre 10 mm/seg. e 12 mm/seg. e a segunda velocidade é menor que 9 mm/seg.
[00169] Exemplo 10. O instrumento cirúrgico do Exemplo 8 ao Exemplo 9 em que o circuito de controle é configurado para indicar um alerta de parada do motor.
[00170] Exemplo 11. O instrumento cirúrgico do Exemplo 10 em que o circuito de controle é configurado para: ajustar o instrumento cirúrgico em modo manual com base em uma entrada recebida; detectar uma condição de baixa velocidade do motor; indicar a condição de baixa velocidade do motor durante um período de tempo predeterminado; monitorar um ajuste da velocidade de comando manual ou pausa; e reduzir a velocidade de comando quando o ajuste da velocidade de comando manual ou pausa não for detectado(a).
[00171] Exemplo 12. O instrumento cirúrgico do Exemplo 8 ao Exemplo 11 em que o circuito de controle é configurado para: armazenar uma velocidade de comando da corrente na memória como uma velocidade rápida, uma velocidade média, ou uma velocidade lenta, em que a velocidade rápida é maior que a velocidade média e a velocidade média é maior que a velocidade lenta; e quando uma condição de parada do motor for detectada, o circuito de controle é configurado para: interromper o motor para um primeiro atraso quando a velocidade de comando armazenada for uma velocidade rápida e continuar o disparo do membro de deslocamento na velocidade rápida; interromper o motor para um segundo atraso quando a velocidade de comando armazenada for uma velocidade média e continuar o disparo do membro de deslocamento na velocidade média; ou interromper o motor para um terceiro atraso quando a velocidade de comando armazenada for uma velocidade média e continuar o disparo do membro de deslocamento na velocidade lenta; em que o primeiro atraso é maior que o segundo retardo e o segundo atraso é maior que o terceiro atraso.
[00172] Exemplo 13. O instrumento cirúrgico do Exemplo 12 em que: a velocidade lenta é maior que zero e menor que 10 mm/seg.; a velocidade média é maior que ou igual a 10 mm/seg. e menor que ou igual a 12,5 mm/seg.; e a velocidade rápida é maior que 12,5 mm/seg. e menor que 15 mm/seg.
[00173] Exemplo 14. O instrumento cirúrgico do Exemplo 12 ao Exemplo 13, em que: o primeiro atraso é maior que ou igual a 2 segundos e menor que cinco segundos; o segundo atraso é maior que ou igual a 1 segundo e menos que dois segundos; e o terceiro atraso maior que 0 e menor que 1 segundo.
[00174] Exemplo 15. O instrumento cirúrgico do Exemplo 8 ao Exemplo 14 em que o circuito de controle é configurado para: armazenar uma velocidade de comando da corrente na memória como uma velocidade rápida, uma velocidade média, ou uma velocidade lenta, em que a velocidade rápida é maior que a velocidade média e a velocidade média é maior que a velocidade lenta; e quando uma condição de parada do motor for detectada, o circuito de controle é configurado para: autoajustar a velocidade de comando para uma velocidade média quando a velocidade de comando armazenada for uma velocidade rápida; autoajustar a velocidade de comando para uma velocidade lenta quando a velocidade de comando armazenada for uma velocidade média; e interromper o motor quando a velocidade de commando armazenada for uma velocidade lenta.
[00175] Exemplo 16. O instrumento cirúrgico do Exemplo 8 ao Exemplo 15, em que o circuito de controle é configurado para: interromper o curso de disparo de uma velocidade de comando da corrente na memória como uma velocidade rápida, uma velocidade média, ou uma velocidade lenta, em que a velocidade rápida é maior que a velocidade média e a velocidade média é maior que a velocidade lenta; e quando uma condição de parada do motor for detectada, o circuito de controle é configurado para: reduzir a velocidade de comando para uma velocidade média e inibir a velocidade rápida quando a velocidade de comando armazenada for uma velocidade rápida; reduzir a velocidade de comando para uma velocidade lenta e inibir uma velocidade média e uma velocidade rápida quando a velocidade de comando armazenada for uma velocidade média; e interromper o motor quando a velocidade de comando armazenada for uma velocidade lenta.
[00176] Exemplo 17. O instrumento cirúrgico do Exemplo 8 ao Exemplo 16, em que quando uma condição de parada do motor é detectada, o circuito de controle é configurado para: interromper o motor; indicar um alerta de parada do motor e instruir o usuário para liberar o gatilho; monitorar a liberação do gatilho; e continuar o disparo do membro de deslocamento quando o gatilho for liberado.
[00177] Exemplo 18. Um instrumento cirúrgico que compreende: um membro de deslocamento configurado para transladar dentro do instrumento cirúrgico ao longo de uma pluralidade de zonas predefinidas; uma fonte de alimentação; um motor acoplado ao membro de deslocamento para transladar o membro de deslocamento; um circuito de controle acoplado à fonte de alimentação e ao motor; um sensor de posição acoplado ao circuito de controle, sendo o sensor de posição configurado para monitorar a posição do membro de deslocamento; em que o circuito de controle é configurado para: iniciar o disparo do membro de deslocamento em uma velocidade de comando ajustada para uma primeira velocidade, em que a velocidade de comando é a velocidade aplicada ao motor; monitorar a posição do membro de deslocamento em uma zona atual até o membro de deslocamento atingir uma posição-alvo para comparação; quando o membro de deslocamento atingir a posição- alvo, determinar se uma alteração na velocidade de comando foi iniciada em uma zona anterior antes da zona atual; e continuar o disparo do membro de deslocamento na velocidade de comando quando uma alteração na velocidade de comando foi iniciada na zona anterior.
[00178] Exemplo 19. O instrumento cirúrgico do Exemplo 18 em que, quando uma alteração na velocidade de comando não for iniciada na zona anterior, o circuito de controle é configurado para: comparar uma velocidade esperada do membro de deslocamento para uma velocidade real do membro de deslocamento; e ajustar a velocidade de comando com base nos resultados da comparação.
[00179] Exemplo 20. O instrumento cirúrgico do Exemplo 19 em que o circuito de controle é configurado para: determinar quando o deslocamento está em uma zona final; e continuar o disparo do membro de deslocamento até um fim de curso ser atingido.
[00180] Exemplo 21. O instrumento cirúrgico do Exemplo 19 ao Exemplo 20 em que o circuito de controle é configurado para continuar o disparo do membro de deslocamento na velocidade de comando da corrente quando o membro de deslocamento não estiver na zona final.
Claims (6)
1. Instrumento cirúrgico (2500) de grampeamento, compreendendo: um membro de deslocamento configurado para transladar dentro do instrumento cirúrgico (2500) ao longo de uma pluralidade de zonas predefinidas; uma fonte de alimentação (2512); um motor (2504) acoplado ao membro de deslocamento para transladar o membro de deslocamento; um circuito de controle (2510) acoplado à fonte de alimentação (2512) e ao motor (2504); um sensor de posição (2534), sendo o sensor de posição (2534) configurado para monitorar a posição do membro de deslocamento; em que o circuito de controle (2510) é configurado para: iniciar um disparo do membro de deslocamento em uma carga elétrica pré-determinada sobre a fonte de alimentação (2512), em que a carga elétrica predeterminada é aplicada ao motor (2504) para acionar o membro de deslocamento; caracterizado pelo fato de que o sensor de posição (2534) é acoplado ao circuito de controle (2510) e o circuito de controle (2510) é configurado para: monitorar a posição do membro de deslocamento via o sensor de posição (2534); amostrar continuamente uma tensão da fonte de alimentação (2512) durante um primeiro intervalo de deslocamento do membro de deslocamento conforme determinado pelo sensor de posição (2534); comparar a tensão amostrada a uma tensão limite; e continuar disparando o membro de deslocamento na primeira velocidade quando a tensão amostrada for maior que ou igual à tensão limite; e ajustar a primeira velocidade quando a tensão amostrada for menor que a tensão limite.
2. Instrumento cirúrgico (2500), de acordo com a reivindicação 1, caracterizado pelo fato de que, quando a tensão amostrada é menor que a tensão limite, o circuito de controle (2510) é configurado ainda para determinar se o instrumento cirúrgico (2500) está em modo automático ou em modo manual, e em que, quando o instrumento cirúrgico (2500) está em modo automático, o circuito de controle (2510) é configurado ainda para converter a operação do instrumento cirúrgico (2500) para o modo manual em que a primeira velocidade é manualmente ajustável por um usuário.
3. Instrumento cirúrgico (2500), de acordo com a reivindicação 2, caracterizado pelo fato de que o circuito de controle (2510) é ainda configurado para reduzir a velocidade de comando para uma segunda velocidade, em que a segunda velocidade é menor que a primeira velocidade.
4. Instrumento cirúrgico (2500), de acordo com a reivindicação 3, caracterizado pelo fato de que a segunda velocidade é maior do que zero e menor que 10 mm/seg.
5. Instrumento cirúrgico (2500), de acordo com qualquer uma das reivindicações 1 a 4, caracterizado pelo fato de que o primeiro intervalo de deslocamento do membro de deslocamento se situa entre 2 mm e 3 mm.
6. Instrumento cirúrgico (2500), de acordo com qualquer uma das reivindicações 1 a 5, caracterizado pelo fato de que o circuito de controle (2510) é configurado para comunicar o estado da fonte de alimentação (2512) quando a tensão amostrada for menor que a tensão limite.
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Application Number | Priority Date | Filing Date | Title |
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US15/628,115 US10813639B2 (en) | 2017-06-20 | 2017-06-20 | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions |
US15/628,115 | 2017-06-20 | ||
PCT/IB2018/053582 WO2018234904A1 (en) | 2017-06-20 | 2018-05-21 | CLOSED LOOP FEEDBACK CONTROL OF THE MOTOR SPEED OF A SURGICAL CUTTING AND STAPLING INSTRUMENT BASED ON SYSTEM STATES |
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BR112019027390A2 BR112019027390A2 (pt) | 2020-08-18 |
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BR112019027390-5A BR112019027390B1 (pt) | 2017-06-20 | 2018-05-21 | Instrumento cirúrgico de grampeamento |
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US (1) | US10813639B2 (pt) |
EP (2) | EP3417802B1 (pt) |
JP (1) | JP7184817B2 (pt) |
CN (1) | CN110769759B (pt) |
BR (1) | BR112019027390B1 (pt) |
WO (1) | WO2018234904A1 (pt) |
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2017
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- 2017-12-21 EP EP21152361.8A patent/EP3881774B1/en active Active
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EP3417802B1 (en) | 2021-01-20 |
CN110769759B (zh) | 2022-12-02 |
BR112019027390A2 (pt) | 2020-08-18 |
EP3417802A1 (en) | 2018-12-26 |
JP7184817B2 (ja) | 2022-12-06 |
US10813639B2 (en) | 2020-10-27 |
EP3881774C0 (en) | 2023-11-15 |
EP3881774A1 (en) | 2021-09-22 |
US20180360455A1 (en) | 2018-12-20 |
WO2018234904A1 (en) | 2018-12-27 |
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