BR112020006065A2 - sistemas e métodos para iniciar um modo de desligamento de energia para um instrumento cirúrgico - Google Patents
sistemas e métodos para iniciar um modo de desligamento de energia para um instrumento cirúrgico Download PDFInfo
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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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- 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
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- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
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- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
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Abstract
Vários sistemas e métodos para controlar um instrumento cirúrgico são revelados. Em um aspecto, o instrumento cirúrgico inclui um atuador de extremidade que é pivotante entre uma posição não articulada e uma posição articulada, sendo uma barra de corte móvel entre uma posição não disparada e uma posição disparada. O instrumento cirúrgico é configurado para determinar um estado de disparo de acordo com se a barra de corte está em movimento entre a posição não disparada e a posição disparada, determinar um estado de articulação de acordo com se o membro de deslocamento está em movimento entre a primeira posição e a segunda posição, e depois iniciar um modo de desligamento de energia de acordo com o estado de disparo e o estado de articulação.
Description
Relatório Descritivo da Patente de Invenção para "SISTEMAS E MÉTODOS PARA INICIAR UM MODO DE
[0001] A presente invenção refere-se a instrumentos cirúrgicos e, em várias circunstâncias, a instrumentos cirúrgicos de grampeamento e corte que são projetados para cortar e grampear tecidos.
[0002] Em um instrumento cirúrgico de grampeamento e corte, pode ser útil controlar o monitor e outros componentes do instrumento para fornecer alertas ao médico que utiliza o instrumento, desligar o instrumento e tomar outras ações de acordo com o estado operacional do instrumento cirúrgico. O estado operacional do instrumento cirúrgico (isto é, se o instrumento está cortando, grampeando, prendendo, articulando, ou tomando outras tais ações) pode ser detectado por um ou mais sensores, que podem ser acoplados de maneira comunicável a um circuito de controle configurado para executar vários processos de acordo com os estados do instrumento detectados pelos sensores. Em algumas situações, pode ser útil fornecer alertas para o médico a fim de alertar o médico quanto a erros experimentados pelo instrumento cirúrgico. Em outras situações, pode ser útil desligar o instrumento quando o instrumento tiver completado suas operações de corte e grampeamento cirúrgico. Ainda em outras situações, pode ser útil exibir a posição da faca no decurso de um curso de disparo da mesma a fim de permitir que um médico veja o progresso do corte.
[0003] Em um aspecto, um instrumento cirúrgico compreendendo: um atuador de extremidade articulável entre uma posição não articulada e uma posição articulada; um membro de deslocamento acoplado ao atuador de extremidade, o membro de deslocamento sendo móvel entre uma primeira posição e uma segunda posição para acionar o atuador de extremidade entre a posição não articulada e a posição articulada; uma barra de corte móvel entre uma posição não disparada e uma posição disparada; um sistema de controle configurado para: determinar um estado de disparo de acordo com se a barra de faca está em movimento entre a posição não disparada e a posição disparada; determinar um estado de articulação de acordo com se o membro de deslocamento está em movimento entre a primeira posição e a segunda posição; e iniciar um modo de desligamento de energia de acordo com o estado de disparo e o estado de articulação.
[0004] Em um outro aspecto, um instrumento cirúrgico que compreende: um atuador de extremidade pivotante a partir de uma posição inicial de articulação; um barra de corte móvel a partir de uma posição inicial de corte; e um circuito de controle configurado para: determinar se a barra de faca está em movimento; determinar se o atuador de extremidade está em movimento; e iniciar um modo de desligamento de energia sobre a barra de faca e o atuador de extremidade que não está em movimento.
[0005] Em um outro aspecto, um método para controlar um instrumento cirúrgico que compreende um atuador de extremidade, um membro de deslocamento acoplado ao atuador de extremidade, sendo o membro de deslocamento móvel entre uma primeira posição e uma segunda posição, e uma barra de faca móvel entre uma posição não disparada e uma posição disparada, sendo que o método compreende: determinar um estado de disparo de acordo com se a barra de faca está se movendo entre a posição não disparada e a posição disparada; determinar um estado de articulação de acordo com se o membro de deslocamento se move entre a primeira posição e a segunda posição;
iniciar um modo de desligamento de energia de acordo com o estado de disparo e o estado de articulação.
[0006] As características inovadoras dos aspectos aqui descritos são apresentadas com particularidade nas reivindicações em anexo. Entretanto, esses aspectos, tanto com relação à organização quanto aos métodos de operação, podem ser mais bem compreendidos por referência à descrição a seguir, tomada em conjunto com os desenhos em anexo.
[0007] A Figura 1 é uma vista em perspectiva de um instrumento cirúrgico que tem um conjunto de eixo de acionamento intercambiável operacionalmente acoplado ao mesmo, de acordo com um aspecto desta revelação.
[0008] A Figura 2 ilustra uma vista do conjunto explodida de uma porção do instrumento cirúrgico ultrassônico da Figura 1, de acordo com um aspecto desta revelação.
[0009] A Figura 3 é uma vista do conjunto explodida de porções do conjunto de eixo de acionamento intercambiável, de acordo com um aspeto desta revelação.
[0010] A Figura 4 é uma vista explodida de um atuador de extremidade do instrumento cirúrgico da Figura 1, de acordo com um aspecto desta revelação.
[0011] As Figuras 5A e 5B são um diagrama de blocos de um circuito de controle do instrumento cirúrgico da Figura 1 abrangendo duas folhas de desenho, de acordo com um aspecto desta revelação.
[0012] A Figura 6 é um diagrama de blocos do circuito de controle do instrumento cirúrgico da Figura 1 que ilustra interfaces entre o conjunto de empunhadura, o conjunto de alimentação e o conjunto de empunhadura e o conjunto de eixo de acionamento intercambiável, de acordo com um aspecto da presente revelação.
[0013] A Figura 7 ilustra um circuito de controle configurado para controlar aspectos do instrumento cirúrgico da Figura 1, de acordo com um aspeto da presente revelação.
[0014] A Figura 8 ilustra um circuito lógico combinacional configurado para controlar aspectos do instrumento cirúrgico da Figura 1, de acordo com um aspecto da presente revelação.
[0015] A Figura 9 ilustra um circuito lógico sequencial configurado para controlar aspectos do instrumento cirúrgico da Figura 1, de acordo com um aspecto da presente revelação.
[0016] A Figura 10 é um diagrama de um sistema de posicionamento absoluto do instrumento cirúrgico da Figura 1, no qual o sistema de posicionamento absoluto compreende uma disposição do circuito de acionamento controlado por motor que compreende uma disposição do sensor, de acordo com um aspecto da presente revelação.
[0017] A Figura 11 é uma vista em perspectiva explodida da disposição de sensor para um sistema de posicionamento absoluto, que mostra um conjunto de placa de circuito de controle e o alinhamento relativo dos elementos da disposição de sensor, de acordo com um ou mais aspectos da presente revelação.
[0018] A Figura 12 é um diagrama de um sensor de posição que compreende um sistema de posicionamento absoluto giratório magnético de acordo com um aspecto da presente revelação.
[0019] A Figura 13 é uma vista em corte de um atuador de extremidade do instrumento cirúrgico da Figura 1, mostrando um curso do membro de disparo em relação ao tecido preso dentro do atuador de extremidade de acordo com um aspecto da presente revelação.
[0020] A Figura 14 ilustra um diagrama de bloco de um instrumento cirúrgico programado para controlar a translação distal de um membro de deslocamento, de acordo com um aspecto da presente revelação.
[0021] A Figura 15 ilustra um diagrama que plota dois cursos de membro de deslocamento executados, de acordo com um aspecto da presente revelação.
[0022] A Figura 16 é uma vista em perspectiva parcial de uma porção de um atuador de extremidade de um instrumento cirúrgico mostrando um conjunto de eixo de acionamento alongado em uma orientação não articulada com porções dele omitidas para maior clareza, de acordo com um aspecto da presente revelação.
[0023] A Figura 17 é outra vista em perspectiva do atuador de extremidade da Figura 16 mostrando o conjunto de eixo de acionamento alongado em uma orientação não articulada, de acordo com um aspecto da presente revelação.
[0024] A Figura 18 é uma vista montada em perspectiva explodida do atuador de extremidade da Figura 16 mostrando o aspecto do conjunto de eixo de acionamento alongado, de acordo com um aspecto da presente revelação.
[0025] A Figura 19 é uma vista de topo do atuador de extremidade da Figura 16 mostrando o conjunto de eixo de acionamento alongado em uma orientação não articulada, de acordo com um aspecto da presente revelação.
[0026] A Figura 20 é outra vista de topo do atuador de extremidade da Figura 16 mostrando o conjunto de eixo de acionamento alongado em uma primeira orientação articulada, de acordo com um aspecto da presente revelação.
[0027] A Figura 21 é outra vista de topo do atuador de extremidade da Figura 16 mostrando o conjunto de eixo de acionamento alongado em uma segunda orientação articulada, de acordo com um aspecto da presente revelação.
[0028] A Figura 22 é uma vista em perspectiva de um sistema cirúrgico que inclui um conjunto de empunhadura acoplado a um conjunto de ferramenta cirúrgica intercambiável que é configurado para ser usado em conjunto com cartuchos de grampos/prendedores cirúrgicos convencionais e cartuchos de radiofrequência (RF) de acordo com um aspecto desta revelação.
[0029] A Figura 23 é uma vista de conjunto em perspectiva explodida do sistema cirúrgico da Figura 22, de acordo com um aspecto desta revelação.
[0030] A Figura 24 é uma vista em seção transversal de topo de uma porção do conjunto de ferramenta cirúrgica intercambiável da Figura 22 com o seu atuador de extremidade em uma posição articulada, de acordo com um aspecto desta revelação.
[0031] A Figura 25 é uma vista em perspectiva de uma disposição de placa de circuito integrado e do gerador de RF mais a configuração, de acordo com um aspecto desta revelação.
[0032] A Figura 26 ilustra um fluxograma lógico de um processo para determinar quando iniciar um desligamento de baixa energia do instrumento cirúrgico de acordo com um aspecto desta revelação.
[0033] A Figura 27 ilustra uma vista frontal de um monitor de exibição ou porção do mesmo mostrando uma imagem que indica que o instrumento cirúrgico está em um modo de desligamento de baixa potência de acordo com um aspecto da presente revelação.
[0034] O requerente do presente pedido detém os seguintes pedidos de patente que foram depositados simultaneamente com o mesmo e que estão, cada um, incorporados no presente documento a título de referência em suas respectivas totalidades:
[0035] N° do documento do procurador END8312USNP/170177, intitulado SYSTEMS AND METHODS FOR PROVIDING ALERTS
ACCORDING TO THE OPERATIONAL STATE OF A SURGICAL INSTRUMENT, pelos inventores Richard L. Leimbach et al., depositado em 29 de setembro de 2017.
[0036] N° do documento do procurador END8313USNP/170178, intitulado SYSTEMS AND METHODS OF DISPLAYING A KNIFE POSITION FOR A SURGICAL INSTRUMENT, pelos inventores Richard L. Leimbach et al., depositado em 29 de setembro de 2017.
[0037] N° do documento do procurador END8315USNP/170180, intitulado SYSTEMS AND METHODS FOR LANGUAGE SELECTION OF A SURGICAL INSTRUMENT, pelos inventores Richard L. Leimbach et al., depositado em 29 de setembro de 2017.
[0038] N° do documento do procurador END8316USDP/170181D, intitulado DISPLAY SCREEN OR PORTION THEREOF WITH ANIMATED GRAPHICAL USER INTERFACE, pelos inventores Tony C. Siebel et al., depositado em 29 de setembro de 2017.
[0039] N° do documento do procurador END8317USDP/170182D, intitulado DISPLAY SCREEN OR PORTION THEREOF WITH ANIMATED GRAPHICAL USER INTERFACE, pelos inventores Tony C. Siebel et al., depositado em 29 de setembro de 2017.
[0040] N° do documento do procurador END8318USDP/170183D, intitulado DISPLAY SCREEN OR PORTION THEREOF WITH ANIMATED GRAPHICAL USER INTERFACE, pelos inventores Tony C. Siebel et al., depositado em 29 de setembro de 2017.
[0041] N° do documento do procurador END8319USDP/170184D, intitulado DISPLAY SCREEN OR PORTION THEREOF WITH ANIMATED GRAPHICAL USER INTERFACE, pelos inventores Tony C. Siebel et al., depositado em 29 de setembro de 2017.
[0042] N° do documento do procurador END8320USNP/ 170176M, intitulado SYSTEMS AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT, pelos inventores Richard L. Leimbach et al., depositado em 29 de setembro de 2017.
[0043] Certos aspectos são mostrados e descritos para fornecer um entendimento da estrutura, função, fabricação e uso dos dispositivos e métodos revelados. Os recursos mostrados ou descritos em um exemplo podem ser combinados com os recursos de outros exemplos e as modificações e variações estão dentro do escopo desta revelação.
[0044] Os termos "proximal" e "distal" são com referência a um médico que manipula o cabo do instrumento cirúrgico, sendo que termo "proximal" se refere à porção mais próxima ao médico e o termo "distal" se refere à porção localizada mais distante do médico. Para conveniência, os termos espaciais "vertical", "horizontal", "para acima" e "para baixo" usados com relação aos desenhos não se destinam a ser limitadores e/ou absolutos, porque os instrumentos cirúrgicos podem ser usados em muitas orientações e posições.
[0045] São fornecidos dispositivos e métodos exemplificadores para realização de procedimentos cirúrgicos laparoscópicos e minimamente invasivos. Tais dispositivos e métodos, entretanto, podem ser usados em outros procedimentos e aplicações cirúrgicas incluindo procedimentos cirúrgicos abertos, por exemplo. Os instrumentos cirúrgicos podem ser inseridos através de um orifício natural ou um através de uma incisão ou perfuração formada no tecido. As porções funcionais ou porções do atuador de extremidade dos instrumentos podem ser inseridas diretamente no corpo ou através de um dispositivo de acesso que tem uma canaleta funcional através do qual podem ser avançados o atuador de extremidade e o eixo de acionamento alongado do instrumento cirúrgico.
[0046] Em alguns aspectos, os instrumentos cirúrgicos podem incluir dispositivos capazes de executar as operações de corte (como, por exemplo, nas Figuras 1 e 22), grampeamento (como, por exemplo, na Figura 1), eletrocirúrgica (como, por exemplo, na Figura 22), e/ou ultrassônica, conforme descrito em mais detalhes abaixo. Mais detalhes sobre os instrumentos cirúrgicos ultrassônicos podem ser encontrados na Patente US N°. 6.283.981, intitulada METHOD OF BALANCING
ASYMMETRIC ULTRASONIC SURGICAL BLADES; no documento de Patente N° US 6.309.400, intitulado CURVED ULTRASONIC WAVEGUIDE HAVING A TRAPEZOIDAL CROSS SECTION; e no documento de Patente N° US 6.436.115, intitulado BALANCED
ULTRASONIC WAVEGUIDE INCLUDING A PLURALITY OF BALANCE ASYMMETRIES, as revelações dos mesmos sendo aqui incorporadas no presente documento a título de referência.
[0047] 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 incorporada na presente invenção, por meio desta, a título de referência, em sua totalidade.
[0048] A Figura 1 é uma vista em perspectiva de um instrumento cirúrgico 10 que tem um conjunto de eixo de acionamento intercambiável 200 operacionalmente acoplado ao mesmo, de acordo com um aspeto desta revelação. O compartimento 12 inclui um atuador de extremidade 300 que compreende um dispositivo cirúrgico de corte e fixação configurado para suportar operacionalmente um cartucho de grampos cirúrgicos 304 no mesmo. O compartimento 12 pode ser configurado para uso em conexão com os conjuntos de eixo de acionamento intercambiáveis que incluem os atuadores de extremidade que são adaptados para sustentar diferentes tamanhos e tipos de cartuchos de grampos, e que têm diferentes comprimentos, tamanhos e tipos de eixo de acionamento. O compartimento 12 pode ser usado eficazmente com uma variedade de conjuntos de eixo de acionamento intercambiáveis incluindo conjuntos configurados para aplicar outros movimentos e formas de energia como, por exemplo, energia de radiofrequência (RF), energia ultrassônica e/ou movimento a disposições de atuadores de extremidade adaptados para uso em várias aplicações e procedimentos cirúrgicos. Os atuadores de extremidade, os conjuntos de eixo de acionamento, os cabos, os instrumentos cirúrgicos e/ou os sistemas de instrumento cirúrgico podem utilizar qualquer prendedor adequado, ou prendedores, para prender tecido. Por exemplo, um cartucho de prendedores que compreende uma pluralidade de prendedores nele armazenados de modo removível pode ser inserido de maneira removível dentro e/ou fixado ao atuador de extremidade de um conjunto de eixo de acionamento.
[0049] 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. Um monitor pode ser fornecido abaixo de uma cobertura 45.
[0050] A Figura 2 ilustra uma vista do conjunto explodida de uma porção do instrumento cirúrgico ultrassônico 10 da Figura 1, de acordo com um aspecto desta revelação. O conjunto de cabo 14 pode incluir uma estrutura 20 que suporta operacionalmente uma pluralidade de sistemas de acionamento. A estrutura 20 pode suportar operacionalmente um 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.
[0051] O conjunto de cabo 14 e a estrutura 20 podem suportar operacionalmente um sistema de acionamento de disparo 80 configurado para aplicar movimentos de disparo às porções correspondentes do conjunto de eixo de acionamento intercambiável fixado ao mesmo. O sistema de acionamento de disparo 80 pode empregar um motor elétrico 82 situado na porção da empunhadura da pistola 19 do conjunto de cabo 14. O motor elétrico 82 pode ser um motor de corrente contínua (CC) com escovas tendo uma rotação máxima de aproximadamente 25.000 rpm, por exemplo. Em outras disposições, o motor pode incluir um motor sem escovas, um motor sem fio, um motor síncrono, um motor de passo ou qualquer outro motor elétrico adequado. O motor elétrico 82 pode ser alimentado por uma fonte de alimentação 90 que pode compreender uma fonte de energia removível 92. A fonte de energia removível 92 pode compreender uma porção do compartimento proximal 94 que é configurada para fixação a uma porção do compartimento distal 96. A porção do compartimento proximal 94 e a porção do compartimento distal 96 são configuradas para suportar operacionalmente uma pluralidade de baterias 98. Cada uma das baterias 98 pode compreender, por exemplo, uma bateria de íons de lítio ("LI") ou outra bateria adequada. A porção de compartimento distal 96 está configurada para fixação operacional removível a uma placa de circuito de controle 100 que está operacionalmente acoplada ao motor elétrico 82. Várias baterias 98 conectadas em série podem alimentar o instrumento cirúrgico 10. A fonte de alimentação 90 pode ser substituível e/ou recarregável. Um monitor 43, que está situado abaixo da cobertura 45, está eletricamente acoplado à placa de circuito de controle 100. A cobertura 45 pode ser removida para expor o monitor 43.
[0052] 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.
[0053] Em uso, uma polaridade de tensão fornecida pela fonte de alimentação 90 pode operar o motor elétrico 82 no sentido horário, sendo que a polaridade de tensão aplicada ao motor elétrico pela bateria pode ser revertida de modo a operar o motor elétrico 82 no sentido anti- horário. Quando o motor elétrico 82 é girado em uma direção, o membro de acionamento longitudinalmente móvel 120 será axialmente ativado na direção distal "DD". Quando o motor elétrico 82 é acionado na direção giratória oposta, o membro de acionamento longitudinalmente móvel 120 será axialmente conduzido na direção proximal "DP". O conjunto de cabo 14 pode incluir uma chave que pode ser configurada para reverter a polaridade aplicada ao motor elétrico 82 pela fonte de alimentação 90. O conjunto de cabo 14 pode incluir um sensor configurado para detectar a posição do membro de acionamento longitudinalmente móvel 120 e/ou a direção em que o membro de acionamento longitudinalmente móvel 120 está sendo movido.
[0054] O acionamento do motor elétrico 82 pode ser controlado por um gatilho de disparo 130 que é suportado de modo pivotante sobre o conjunto de cabo 14. O gatilho de disparo (130) pode ser pivotado entre uma posição não atuada e uma posição atuada.
[0055] 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 articulada 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 na presente invenção pelo presente documento 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.
[0056] Voltando para a Figura 1, o tubo de fechamento 260 é transladado distalmente (direção "DD") para fechar a bigorna 306, por exemplo, em resposta à atuação do gatilho de fechamento 32 na maneira descrita na referência anteriormente mencionada da publicação de pedido de patente n° 2014/0263541. A bigorna 306 é aberta mediante a translação proximal do tubo de fechamento 260. Na posição aberta da bigorna, o tubo de fechamento 260 do eixo de acionamento é movido para sua posição proximal.
[0057] A Figura 3 é outra vista de conjunto explodida de porções do conjunto de eixo de acionamento intercambiável 200, de acordo com um aspecto desta revelação. O conjunto de eixo de acionamento intercambiável 200 pode incluir um membro de disparo 220 sustentado para realizar um deslocamento axial no interior da coluna central 210. O membro de disparo 220 inclui um de eixo de acionamento de disparo intermediário 222 configurado para se conectar a uma porção de corte distal ou barra de corte 280. O 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 o cartucho de grampos posicionado no interior do canal alongado 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.
[0058] O conjunto de eixo de acionamento intercambiável 200 pode incluir um conjunto de embreagem 400 configurado para acoplar de modo seletivo e liberável o acionador de articulação 230 ao membro de disparo 220. O conjunto de embreagem 400 inclui um anel ou luva de travamento 402 posicionado em torno do membro de disparo 220, sendo que a luva de travamento 402 pode ser girada entre uma posição engatada, em que a luva de travamento 402 acopla o acionador de articulação 230 ao membro de disparo 220, e uma posição desengatada, em que o acionador de articulação 230 não está acoplado de modo operável ao membro de disparo 220. Quando a luva de travamento 402 está na posição engatada, o movimento distal do membro de disparo 220 pode mover o acionador de articulação 230 em sentido distal e, correspondentemente, o movimento proximal do membro de disparo 220 pode mover o acionador de articulação 230 de maneira proximal. Quando a luva de travamento 402 está na posição desengatada, o movimento do membro de disparo 220 não é transmitido para o acionador de articulação 230 e, como resultado, o membro de disparo 220 pode mover-se independentemente do acionador de articulação 230. O bocal 201 pode ser empregado para engatar e desengatar operacionalmente o sistema de acionamento de articulação com o sistema de acionamento de disparo nas várias formas descritas na publicação de pedido de patente US N° 2014/0263541.
[0059] 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 SA-SA do eixo de acionamento (Figura 1). O flange de conector proximal 604 pode compreender uma pluralidade de condutores concêntricos ou ao menos substancialmente concêntricos 602, definidos na sua primeira face. Um conector 607 pode ser montado sobre o lado proximal do flange de conector distal 601 e pode ter uma pluralidade de contatos, sendo que cada contato corresponde e está em contato elétrico com um dos condutores 602. Essa disposição permite a rotação relativa entre o flange de conector proximal 604 e o flange de conector distal 601, enquanto o contato elétrico é mantido entre os mesmos. O flange de conector proximal 604 pode incluir um conector elétrico 606 que pode colocar os condutores 602 em comunicação de sinal com uma placa de circuito de eixo de acionamento, por exemplo. Em ao menos um caso, um chicote elétrico que compreende uma pluralidade de condutores pode se estender entre o conector elétrico 606 e a placa de circuito do eixo de acionamento. O conector elétrico 606 pode se estender proximalmente através de uma abertura do conector definida no flange de montagem do chassi. Detalhes adicionais com relação ao conjunto do anel de deslizamento 600 podem ser encontrados na publicação de pedido de patente US N° 2014/0263541.
[0060] 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 deslizante 600. O flange de conector distal 601 do conjunto de anel deslizante 600 pode ser posicionado na porção giratória distal do eixo de acionamento.
[0061] A Figura 4 é uma vista explodida de um aspecto de um atuador de extremidade 300 do instrumento cirúrgico 10 da Figura 1, de acordo com um aspecto desta revelação. O atuador de extremidade 300 pode incluir a bigorna 306 e o cartucho de grampos cirúrgicos 304. A bigorna 306 pode ser acoplada a uma canaleta alongada 302. As aberturas 199 podem ser definidas na canaleta alongada 302 para receber pinos 152 que se estendem a partir da bigorna 306 para permitir que a bigorna 306 gire de uma posição aberta para uma posição fechada em relação à canaleta alongada 302 e cartucho de grampos cirúrgicos 304. Uma barra de disparo 172 é configurada para se transladar longitudinalmente para o interior do atuador de extremidade
300. A barra de disparo 172 pode ser construída em uma seção sólida ou pode incluir um material laminado que compreende, por exemplo, uma pilha de placas de aço. A barra de disparo 172 compreende uma haste com perfil em "I" 178 e um gume cortante 182 em uma extremidade distal do mesmo. Uma extremidade da barra de disparo 172 distalmente projetada pode ser fixada à haste com perfil em I 178 para auxiliar no espaçamento da bigorna 306 a partir de um cartucho de grampos cirúrgicos 304 posicionado na canaleta alongada 302 quando a bigorna 306 está em posição fechada. A haste com perfil em I 178 pode incluir um gume cortante afiado 182, que pode ser usado para separar o tecido, conforme a haste com perfil em I 178 é avançada distalmente pela barra de disparo 172. Em funcionamento, a haste com perfil em I 178 pode, ou disparar, o cartucho de grampos cirúrgicos 304. O cartucho de grampos cirúrgicos 304 pode incluir um corpo de cartucho moldado 194 que mantém uma pluralidade de grampos 191 que repousam sobre os acionadores de grampo 192 no interior das respectivas cavidades de grampos abertas para cima 195. Um deslizador em cunha 190 é acionado distalmente pela haste com perfil em I 178, deslizando sobre uma bandeja do cartucho 196 do cartucho de grampos cirúrgicos 304. O deslizador em cunha 190 desloca para cima, por came, os acionadores de grampo 192, para expelir os grampos 191 em contato de deformação com a bigorna 306, enquanto a borda de corte 182 da haste com perfil em I 178 corta o tecido apertado.
[0062] A haste com perfil em I 178 pode incluir pinos superiores 180 que engatam a bigorna 306 durante o disparo. A haste com perfil em I 178 pode incluir pinos intermediários 184 e uma base ("bottom foot") 186 para engatar porções do corpo do cartucho 194, da bandeja do cartucho 196 e da canaleta alongada 302. Quando um cartucho de grampos cirúrgicos 304 está posicionado no interior da canaleta alongada 302, uma fenda 193 definida no corpo do cartucho 194 pode ser alinhada com uma fenda longitudinal 197 definida na bandeja do cartucho 196 e uma fenda 189 definida na canaleta alongada 302. Em uso, a haste com perfil em I 178 pode deslizar através das fendas longitudinais alinhadas 193, 197 e 189, sendo que, como indicado na Figura 4, a base 186 da haste com perfil em I 178 pode engatar um sulco posicionado ao longo da superfície inferior da canaleta alongada 302 ao longo do comprimento da fenda 189, os pinos médios 184 podem engatar as superfícies superiores da bandeja de cartucho 196 ao longo do comprimento da fenda longitudinal 197, e os pinos superiores 180 podem engatar a bigorna 306. A haste com perfil em I 178 pode espaçar ou limitar o movimento relativo entre a bigorna 306 e o cartucho de grampos cirúrgicos 304, conforme a barra de disparo 172 é avançada distalmente de forma a disparar os grampos do cartucho de grampos cirúrgicos 304 e/ou fazer uma incisão no tecido capturado entre a bigorna 306 e o cartucho de grampos cirúrgicos 304. A barra de disparo 172 e a haste com perfil em I 178 podem ser retraídas proximalmente permitindo que a bigorna 306 seja aberta para liberar as duas porções de tecido grampeadas e cortadas.
[0063] As Figuras 5A e 5B são um diagrama de blocos de um circuito de controle 700 do instrumento cirúrgico 10 da Figura 1 que abrange duas folhas de desenho de acordo com um aspecto desta revelação. Com referência principalmente às Figuras 5A e 5B, um conjunto de empunhadura 702 pode incluir um motor 714, que pode ser controlado por um acionador do motor 715 e pode ser empregado pelo sistema de disparo do instrumento cirúrgico 10. Em várias formas, o motor 714 pode ser um motor de acionamento de corrente contínua (CC) com escovas com uma velocidade de rotação máxima de aproximadamente 25.000 RPM. Em outras disposições, o motor 714 pode incluir um motor sem escovas, um motor sem fio, um motor síncrono, um motor de passo ou qualquer outro tipo de motor elétrico adequado. O acionador de motor 715 pode compreender um acionador de ponte H que compreende transístores de efeito de campo (FETs - field-effect transistors) 719, por exemplo. O motor 714 pode ser alimentado pelo conjunto de alimentação 706 montado de modo liberável ao conjunto de empunhadura 14 para fornecer energia de controle ao instrumento cirúrgico 10. O conjunto de alimentação 706 pode compreender uma bateria que pode incluir várias células de bateria conectadas em série, as quais podem ser usadas como a fonte de energia para energizar o instrumento cirúrgico 10. Em determinadas circunstâncias, as células de bateria do conjunto de alimentação 706 podem ser substituíveis e/ou recarregáveis. Em ao menos um exemplo, as células de bateria podem ser baterias de íon de lítio que podem ser separavelmente acopláveis ao conjunto de alimentação 706.
[0064] 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 os conectores elétricos correspondentes do conjunto de eixo de acionamento, e uma segunda porção de interface 727, que pode incluir um ou mais conectores elétricos para engate de acoplamento com os conectores elétricos correspondentes do conjunto de alimentação, 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 empunhadura 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.
[0065] A interface pode facilitar a transmissão do um ou mais sinais de comunicação entre o controlador de gerenciamento de energia 716 e o controlador do conjunto de eixo de acionamento 722 mediante o roteamento destes sinais de comunicação através de um controlador principal 717 situado no conjunto de cabo 702, por exemplo. Em outros casos, 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 empunhadura 702, enquanto o conjunto de eixo de acionamento 704 e o conjunto de alimentação 706 estão acoplados ao conjunto de empunhadura 702.
[0066] O controlador principal 717 pode ser qualquer processador de núcleo único ou de múltiplos núcleos, como aqueles conhecidos sob o nome comercial de ARM Cortex pela Texas Instruments. Em um aspecto, o controlador principal 717 pode ser um processador Core Cortex-M4F LM4F230H5QR ARM, disponível junto à Texas Instruments, por exemplo, que compreende uma memória integrada de memória flash de ciclo único de 256 KB, ou outra memória não volátil, até 40 MHz, um buffer de busca antecipada para otimizar o desempenho acima de 40 MHz, uma memória de acesso aleatório seriada de ciclo único de 32 KB (SRAM), uma memória só de leitura interna (ROM) carregada com o programa StellarisWare®, memória só de leitura programável e apagável eletricamente (EEPROM) de 2 KB, um ou mais módulos de modulação por largura de pulso (PWM), uma ou mais análogos de entradas de codificador de quadratura (QEI), um ou mais conversores analógico para digital (ADC) de 12 bits com 12 canais de entrada analógica, detalhes dos quais estão disponíveis para a folha de dados do produto.
[0067] 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.
[0068] 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 saída de energia 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 empunhadura 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.
[0069] O instrumento cirúrgico 10 (Figuras 1 a 4) pode compreender um dispositivo de saída 742 que pode incluir dispositivos para fornecer uma realimentação sensorial a um usuário. Esses dispositivos podem compreender, por exemplo, dispositivos de retroinformação visual (por exemplo, um monitor com tela de LCD, indicadores em LED), dispositivos de retroinformação auditiva (por exemplo, um alto-falante, uma campainha) ou dispositivos de retroinformação tátil (por exemplo, atuadores hápticos). Em determinadas circunstâncias, o dispositivo de saída 742 pode compreender um monitor 743 que pode estar incluído no conjunto de empunhadura 702. O controlador do conjunto de eixo de acionamento 722 e/ou o controlador de gerenciamento de energia 716 podem fornecer retroinformação a um usuário do instrumento cirúrgico 10 através do dispositivo de saída 742. A interface pode ser configurada para conectar o controlador do conjunto de eixo de acionamento 722 e/ou o controlador de gerenciamento de energia 716 ao dispositivo de saída 742. O dispositivo de saída 742 pode, em vez disso, ser integrado com o conjunto de alimentação 706. Nestas circunstâncias, a comunicação entre o dispositivo de saída 742 e o controlador do conjunto de eixo de acionamento 722 pode ser feita através da interface, enquanto o conjunto de eixo de acionamento 704 é acoplado ao conjunto de cabo 702.
[0070] 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.
[0071] 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.
[0072] 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.
[0073] 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. A segunda 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.
[0074] 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.
[0075] 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 controlador principal 717 por um acionador de ponte H que compreende um ou mais transístores de efeito de campo de ponte H (FETs) e uma controladora do 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.
[0076] 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.
[0077] 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.
[0078] 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.
[0079] 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.
[0080] 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 empunhadura 702 e o conjunto de alimentação 706 e entre o conjunto de empunhadura 702 e o conjunto de eixo de acionamento intercambiável 704, de acordo com um aspecto da presente revelação. O conjunto de cabo 702 pode compreender um controlador principal 717, um conector do conjunto de eixo de acionamento 726 e um conector do conjunto de alimentação 730. O conjunto de alimentação 706 pode incluir um conector do conjunto de alimentação 732, um circuito de gerenciamento de energia 734 que pode compreender o controlador de gerenciamento de energia 716, um modulador de energia 738, e um circuito sensor de corrente 736. Os conectores do conjunto de alimentação 730, 732 formam uma interface
727. O circuito de gerenciamento de energia 734 pode ser configurado para modular a energia de saída da bateria 707 com base nas necessidades de energia do conjunto de eixo de acionamento intercambiável 704 enquanto o conjunto de eixo de acionamento intercambiável 704 e o conjunto de alimentação 706 são acoplados ao conjunto de cabo 702. O controlador de gerenciamento de energia 716 pode ser programado para controlar o modulador de energia 738 da saída de energia do conjunto de alimentação 706 e o circuito sensor de corrente 736 pode ser empregado para monitorar a saída de energia do conjunto de alimentação 706 para fornecer retroinformação ao controlador de gerenciamento de energia 716 sobre a saída de energia da bateria 707 para que o controlador de gerenciamento de energia 716 possa ajustar a saída de energia do conjunto de alimentação 706 para manter uma saída desejada. O conjunto de eixo de acionamento 704 compreende um controlador do conjunto de eixo de acionamento 722 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 empunhadura 702. Os conectores do conjunto de eixo de acionamento 726, 728 formam uma interface
725. O controlador principal 717, o controlador do conjunto de eixo de acionamento 722 e/ou o controlador de gerenciamento de energia 716 podem ser configurados para implementar um ou mais dos processos aqui descritos.
[0081] O instrumento cirúrgico 10 (Figuras 1 a 4) pode compreender um dispositivo de saída 742 para uma retroinformação sensorial a um usuário. Esses dispositivos podem compreender dispositivos de retroinformação visual (por exemplo, um monitor com tela de LCD, indicadores em LED), dispositivos de retroinformação auditiva (por exemplo, um alto-falante, uma campainha) ou dispositivos de retroinformação tátil (por exemplo, atuadores hápticos). Em determinadas circunstâncias, o dispositivo de saída 742 pode compreender uma tela 743 que pode estar incluída no conjunto de cabo
702. O controlador do conjunto de eixo de acionamento 722 e/ou o controlador de gerenciamento de energia 716 podem fornecer retroinformação a um usuário do instrumento cirúrgico 10 através do dispositivo de saída 742. A interface 727 pode ser configurada para conectar o controlador do conjunto de eixo de acionamento 722 e/ou o controlador de gerenciamento de energia 716 ao dispositivo de saída
742. O dispositivo de saída 742 pode ser integrado com o conjunto de alimentação 706. A comunicação entre o dispositivo de saída 742 e o controlador do conjunto de eixo de acionamento 722 pode ser feita através da interface 725 enquanto o conjunto de eixo de acionamento intercambiável 704 é acoplado ao conjunto de cabo 702. Tendo descrito um circuito de controle 700 (Figuras 5A a 5B e 6) para controlar a operação do instrumento cirúrgico 10 (Figuras 1 a 4), a revelação se volta agora para várias configurações do instrumento cirúrgico 10 (Figuras 1 a 4) e ao circuito de controle 700.
[0082] A Figura 7 ilustra um circuito de controle 800 configurado para controlar aspectos do instrumento cirúrgico 10 (Figuras 1 a 4), de acordo com um aspecto da presente revelação. O circuito de controle 800 pode ser configurado para implementar vários processos aqui descritos. O circuito de controle 800 pode compreender um controlador que compreende um ou mais processadores 802 (por exemplo, microprocessador, microcontrolador) acoplado a ao menos um circuito de memória 804. O circuito de memória 804 armazena instruções executáveis em máquina que, quando executadas pelo processador 802, fazem com que o processador 802 execute instruções de máquina para implementar vários dos processos aqui descritos. O processador 802 pode ser qualquer um dentre inúmeros processadores de núcleo simples ou processadores de múltiplos núcleos (multi-core) 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.
[0083] A Figura 8 ilustra um circuito lógico combinacional 810 configurado para controlar aspectos do instrumento cirúrgico 10 (Figuras 1 a 4), de acordo com um aspecto da presente revelação. O circuito lógico combinacional 810 pode ser configurado para implementar vários processos aqui descritos. O circuito 810 pode compreender uma máquina de estado finito que compreende um circuito lógico combinacional 812 configurado para receber dados associados ao instrumento cirúrgico 10 em uma entrada 814, processar os dados pela lógica combinacional 812 e fornecer uma saída 816.
[0084] A Figura 9 ilustra um circuito lógico sequencial 820 configurado para controlar aspectos do instrumento cirúrgico 10 (Figuras 1 a 4), de acordo com um aspecto da presente revelação. O circuito lógico sequencial 820 ou o circuito lógico combinacional 822 pode ser configurado para implementar 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 atual 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 do processador 802 e uma máquina de estados finitos para implementar vários processos na 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.
[0085] Os aspectos podem ser implementados sob a forma de um artigo de fabricação. O artigo de fabricação pode incluir um meio 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 fabricação pode compreender um disco magnético, um disco óptico, uma memória flash ou firmware contendo instruções de programa de computador adequadas para execução por um processador de uso geral ou processador específico para a aplicação.
[0086] A Figura 10 é um diagrama de um sistema de posicionamento absoluto 1100 do instrumento cirúrgico 10 (Figuras 1 a 4), sendo que o sistema de posicionamento absoluto 1100 compreende uma disposição do circuito de acionamento controlado por motor que compreende uma disposição do sensor 1102, de acordo com um aspecto da presente revelação. A disposição do sensor 1102 de um sistema de posicionamento absoluto 1100 fornece um sinal de posição único que corresponde à localização de um membro de deslocamento
1111. De volta brevemente às Figuras 2 a 4, em um aspecto, o membro de deslocamento 1111 representa o 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.
[0087] 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 deslocamento 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 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.
[0088] Uma única revolução do elemento sensor 1126 associada ao sensor de posição 1112 é equivalente a um deslocamento linear longitudinal d1 do membro de deslocamento 1111, sendo que d1 representa a distância linear longitudinal pela qual o membro de deslocamento 1111 se move do ponto "a" ao ponto "b" depois de uma única revolução do elemento sensor 1126 acoplado ao membro de deslocamento 1111. A disposição do sensor 1102 pode ser conectada por meio de uma redução de engrenagem que resulta na conclusão de uma ou mais revoluções por parte do sensor de posição 1112 do curso completo do membro de deslocamento 1111. O sensor de posição 1112 pode concluir múltiplas revoluções do curso completo do membro de deslocamento 1111.
[0089] Uma série de chaves 1122a a 1122n, onde n é um número inteiro maior que um, podem ser usadas sozinhas 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 único que corresponde ao deslocamento linear longitudinal d1 + d2 + … dn do membro de deslocamento 1111. A saída 1124 do sensor de posição 1112 é fornecida ao controlador 1104. O sensor de posição 1112 da disposição do sensor 1102 pode compreender um sensor magnético, um sensor giratório analógico, como um potenciômetro, ou uma matriz de elementos de efeito Hall analógicos, que emitem uma combinação única de posição de sinais ou valores.
[0090] 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.
[0091] O controlador 1104 pode ser programado para realizar várias funções, como o controle preciso da velocidade e da posição dos sistemas de articulação e corte. 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 escovado com uma caixa de câmbio e conexões mecânicas com um sistema de articulação ou corte. 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, cuja revelação está aqui incorporada a título de referência.
[0092] O controlador 1104 pode ser programado para fornecer controle preciso da velocidade e da posição do membro de deslocamento 1111 e dos sistemas de articulação. O controlador 1104 pode ser configurado para computar uma resposta no software do controlador 1104. A resposta computada é comparada a uma resposta medida do sistema real para se obter uma resposta "observada", que é usada para as decisões reais baseadas na realimentação. A resposta observada é um valor favorável e ajustado, que equilibra a natureza uniforme e contínua da resposta simulada com a resposta medida, o que pode detectar influências externas no sistema.
[0093] O sistema de posicionamento absoluto 1100 pode compreender e/ou ser programado para implementar um controlador de retroinformação, como um PID, retroinformação do estado e 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. Outro(s) sensor(es) 1118 pode(m) ser fornecido(s) para medir os parâmetros físicos do sistema físico, além da posição medida pelo sensor de posição 1112. Em alguns aspectos, o(s) outro(s) sensor(es) pode(m) incluir disposições de sensor conforme aquelas descritas na patente US N°
9.345.481 intitulada STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, que está incorporada por referência em sua totalidade neste documento; A publicação de pedido de patente US N° 2014/0263552, intitulada "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", a qual está aqui incorporada a título de referência em sua totalidade; e o pedido de patente US N° 15/628.175, intitulado
TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, o qual está incorporado por referência em sua totalidade neste documento. Em um sistema de processamento de sinal digital, um sistema de posicionamento absoluto 1100 é acoplado a um sistema de captura de dados digitais em que 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 laço 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 quais serão os estados e saídas do sistema físico, sabendo-se a entrada. O controlador 1104 pode ser um circuito de controle 700 (Figuras 5A e 5B).
[0094] O acionador de motor 1110 pode ser um A3941, disponível junto à Allegro Microsystems, Inc. O acionador A3941 1110 é um controlador de ponte inteira para uso com transístores de efeito de campo de semicondutor de óxido metálico (MOSFET) de potência externa de canal N, especificamente projetados para cargas indutivas, como motores CC escovados. O acionador 1110 compreende um regulador único de bomba de carga, que fornece acionamento de porta completo (>10 V) para baterias com tensão até 7 V e possibilita que o A3941 opere com um acionamento de porta reduzido, até 5,5 V. Um capacitor de comando de entrada pode ser usado para fornecer a tensão fornecida pela bateria acima 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 acionadores de motor podem ser prontamente substituídos para uso no sistema de posicionamento absoluto 1100.
[0095] Tendo descrito uma arquitetura geral para implementar aspectos de um sistema de posicionamento absoluto 1100 para uma disposição de sensor 1102, a revelação agora se volta para as Figuras 11 a 12 para uma descrição de um aspecto de uma disposição de sensor 1102 para o sistema de posicionamento absoluto 1100. A Figura 11 é uma vista em perspectiva explodida da disposição de sensor 1102 para o sistema de posicionamento absoluto 1100, mostrando um circuito 1205 e o alinhamento relativo dos elementos da disposição de sensor 1102, de acordo com um aspecto. A disposição de sensor 1102 para um sistema de posicionamento absoluto 1100 compreende um sensor de posição 1200, um elemento sensor de magneto 1202, um suporte de magneto 1204, que dá uma volta a cada curso completo do membro de deslocamento 1111, e um conjunto de engrenagens 1206 para fornecer uma redução de engrenagens. Com referência brevemente à Figura 2, o membro de deslocamento 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. De volta à Figura 11, um elemento estrutural, como um bráquete 1216, é fornecido para sustentar o conjunto de engrenagens 1206, o suporte de magneto 1204 e o magneto 1202. O sensor de posição 1200 compreende um ou mais elementos magnéticos de detecção, como elementos de efeito Hall, e está posicionado próximo ao magneto 1202. Conforme o magneto 1202 gira, os elementos magnéticos de detecção do sensor de posição 1200 determinam a posição angular absoluta do magneto 1202 durante uma revolução.
[0096] A disposição do 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/piezoelétricos, magnetodiodo, transistor magnético, fibra óptica, magneto-óptica e sensores magnéticos baseados em sistemas microeletromecânicos, dentre outros.
[0097] 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.
[0098] O sensor de posição 1200 é sustentado por um suporte de sensor de posição 1218, definindo uma abertura 1220 adequada para conter o sensor de posição 1200 em alinhamento preciso com um magneto 1202 girando abaixo no interior do suporte de magneto 1204. O acessório é acoplado ao bráquete 1216 e ao circuito 1205 e permanece estacionário enquanto o magneto 1202 gira com o suporte de magneto 1204. É fornecido um cubo 1222 que se acopla à primeira engrenagem 1208 e ao suporte magnético 1204. A segunda engrenagem 1210 e a terceira engrenagem 1212 acopladas ao eixo 1214 também são mostradas.
[0099] A Figura 12 é um diagrama de um sensor de posição 1200 de um sistema de posicionamento absoluto 1100, que compreende um sistema de posicionamento absoluto magnético giratório, de acordo com um aspecto desta revelação. O sensor de posição 1200 pode ser implementado como um sensor de posição giratório, magnético, de circuito integrado único, AS5055EQFT, disponível junto à Austria Microsystems, AG. O sensor de posição 1200 faz interface com o controlador 1104 para fornecer um sistema de posicionamento absoluto
1100. O sensor de posição 1200 é um componente de baixa tensão e baixa potência e inclui quatro elementos de efeito Hall 1228A, 1228B, 1228C, 1228D em uma área 1230 do sensor de posição 1200 que está localizada acima do magneto 1202 (Figuras 15 e 16). Um conversor A- D de alta resolução 1232 e um controlador de gerenciamento de potência inteligente 1238 são apresentados, também, no circuito integrado. Um processador CORDIC (Coordinate Rotation DIgital Computer) 1236, também conhecido como método de 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 consulta. A posição angular, os bits de alarme e as 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.
[0100] 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 aqui em detalhes, no entanto, de modo geral, o efeito Hall produz uma diferença de tensão (a tensão de Hall) através de um condutor elétrico transversal a uma corrente elétrica no condutor e um campo magnético perpendicular à corrente. O coeficiente de Hall é definido como a razão entre o campo elétrico induzido e o produto da densidade de corrente pelo campo magnético aplicado. É uma característica do material a partir do qual o condutor é feito, pois seu valor depende do tipo, do número e das propriedades dos portadores de carga que constituem a corrente. No sensor de posição AS5055
1200, os elementos de efeito Hall 1228A, 1228B, 1228C, 1228D são capazes de produzir um sinal de tensão indicativo do posicionamento absoluto do magneto 1202 em termos do ângulo em relação a uma única revolução do magneto 1202. Esse valor do ângulo, que é um sinal de posição único, é calculado pelo processador CORDIC 1236 e armazenado integrado no sensor de posição AS5055 1200 em um registro ou memória. O valor do ângulo que é indicativo da posição do magneto 1202 durante uma revolução é fornecido ao controlador 1104 em uma variedade de técnicas, por exemplo, mediante a energização ou mediante a demanda do controlador 1104.
[0101] 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 para enviar um sinal de interrupção ao controlador 1104 informando que um novo ângulo válido pode ser lido. Com a energização, o sensor de posição AS5055 1200 realiza uma sequência completa de energização, incluindo uma medição de ângulo. A conclusão desse ciclo é indicada como uma saída INT 1242, e o valor do ângulo é armazenado em um registro interno. Uma vez configurada essa saída, o sensor de posição AS5055 1200 entra no modo suspenso. O controlador 1104 pode responder à solicitação INT na saída INT 1242 mediante leitura do valor do ângulo a partir do sensor de posição AS5055 1200 por intermédio da interface SPI 1234. Depois que o valor do ângulo é lido pelo controlador 1104, a saída INT 1242 é liberada novamente. O envio de 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 tiver concluído a leitura do valor do ângulo, a saída INT 1242 é liberada e um novo resultado é armazenado no registro de ângulos. A conclusão dessa medição de ângulo é indicada novamente pela definição da saída INT 1242 e pela identificação correspondente no registro de estados.
[0102] 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 no circuito integrado, 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 obtendo-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%).
[0103] A Figura 13 é uma vista seccional de um atuador de extremidade 2502 do instrumento cirúrgico 10 (Figuras 1 a 4) que mostra um curso de disparo da viga com perfil em I 2514 em relação ao tecido 2526 preso dentro do atuador de extremidade 2502, de acordo com um aspecto da presente revelação. O atuador de extremidade 2502 é configurado para operar com o instrumento cirúrgico 10 mostrado nas Figuras 1 a 4. O atuador de extremidade 2502 compreende uma bigorna 2516, uma canaleta alongada 2503 com um cartucho de grampos 2518 posicionado na canaleta alongada 2503. Uma barra de disparo 2520 é transladável distal 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 viga 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. À medida que a viga com perfil em i 2514 traslada 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 viga 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 conduzidos 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 formata os grampos 2505.
[0104] Um curso de disparo da viga com perfil em i 2514 exemplificador é ilustrado por um gráfico 2529 alinhado com o atuador de extremidade 2502. O tecido 2526 exemplificador também é mostrado alinhado com o atuador de extremidade 2502. O curso do membro de disparo pode compreender uma posição inicial do curso 2527 e uma posição final do curso 2528. Durante um curso de disparo da viga com perfil em i 2514, a viga com perfil em i 2514 pode ser avançada distalmente a partir da posição inicial do curso 2527 para a posição final do curso 2528. A viga com perfil em i 2514 é mostrada em um local de exemplo de uma posição inicial do curso 2527. O gráfico 2529 de curso do membro de disparo da viga com perfil em i 2514 ilustra cinco regiões de curso do membro de disparo 2517, 2519, 2521, 2523, 2525. Em uma primeira região de curso de disparo 2517, a viga com perfil em i 2514 pode começar a avançar distalmente. Na primeira região de curso de disparo 2517, a viga 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, no entanto, 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 que o atrito estático é soprepujado, a força necessária para acionar a viga com perfil em i 2514 na primeira região 2517 pode ser substancialmente constante.
[0105] Na segunda região do 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 necessária para acionar a viga com perfil em i 2514 pode começar a aumentar gradualmente. Conforme mostrado, o tecido encontrado inicialmente pode ser comprimido e/ou mais delgado devido à maneira como a bigorna 2516 gira em relação ao cartucho de grampos 2518. Na terceira região do curso do membro de disparo 2521, o gume cortante 2509 pode entrar continuamente em contato e cortar o tecido 2526 e o deslizador em cunha 2513 pode entrar repetidamente em contato com os acionadores de grampos 2511. A força necessária para acionar a viga com perfil em i 2514 pode atingir o platô na terceira região 2521. Na quarta região do curso de disparo 2523, a força necessária para acionar a viga 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 alcançar o final do tecido 2526 enquanto na quarta região 2523. Quando a viga com perfil em i 2514 atinge 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 viga 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 viga com perfil em i 2514 na primeira região 2517. Na conclusão do curso do membro de disparo, a viga 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, 2525 na Figura 18 é apenas um exemplo. Em alguns exemplos, as diferentes regiões podem começar em diferentes posições ao longo do eixo geométrico longitudinal do atuador de extremidade 2515, por exemplo, com base no posicionamento de tecido entre a bigorna 2516 e o cartucho de grampos 2518.
[0106] 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 viga com perfil em I 2514. O controlador 1104 pode ser configurado para prever a velocidade da viga 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 atual da viga com perfil em I 2514 com base nos valores anteriores da corrente e/ou tensão fornecida 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 viga 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 viga com perfil em I 2514 e a velocidade detectada da viga com perfil em I 2514 para determinar se a energia para o motor elétrico 1122 deve ser aumentada, de modo a aumentar a velocidade da viga com perfil em I 2514, e/ou diminuída, de modo a diminuir a velocidade da viga com perfil em I 2514. Outras considerações relativas aos instrumentos cirúrgicos 10 acionados por um motor elétrico 1122 podem ser encontradas na patente US N° 8.210.411, intitulada MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, a qual é incorporada na presente invenção por referência, em sua totalidade. Outros detalhes relativos aos instrumentos cirúrgicos 10 incluindo as disposições de sensor podem ser encontradas na patente US N° 7.845.537, intitulada SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES, a qual é incorporada na presente invenção por referência, em sua totalidade.
[0107] A força que atua sobre a viga com perfil em i 2514 pode ser determinada com o uso de várias técnicas. A força sobre a viga com perfil em i 2514 pode ser determinada mediante a medição da corrente do motor 2504, em que a corrente do motor 2504 se baseia na carga sobre a viga 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 viga com perfil em i 2514 pode ser determinada pelo monitoramento da posição real da viga com perfil em i 2514 se movendo a uma velocidade esperada com base na velocidade ajustada atual do motor 2504 após um período de tempo predeterminado T 1 decorrido e pela comparação da posição real da viga com perfil em i 2514 em relação à posição esperada da viga com perfil em i 2514 com base na velocidade ajustada atual do motor 2504 no final do período T1. Dessa forma, se a posição real da viga com perfil em i 2514 for menor que a posição esperada da viga com perfil em i 2514, a força na viga com perfil em i 2514 é maior que uma força nominal. Por outro lado, se a posição real da viga com perfil em i 2514 for maior que a posição esperada da viga com perfil em i 2514, a força na viga com perfil em i 2514 é menor que a força nominal. A diferença entre as posições real e esperada da viga com perfil em i 2514 é proporcional ao desvio da força na viga com perfil em i 2514 a partir da força nominal. Estas técnicas são descritas no pedido de patente US N° 15/628.075, intitulado SYSTEMS AND
METHODS FOR CONTROLLING MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, que está incorporado na presente invenção a título de referência, em sua totalidade.
[0108] A Figura 14 ilustra um diagrama de bloco de um instrumento cirúrgico 2500 programado para controlar a translação distal de um membro de deslocamento de acordo com um aspecto da presente revelação. Em um aspecto, o instrumento cirúrgico 2500 é programado para controlar a translação distal de um membro de deslocamento 1111 como a haste com perfil em I 2514. O instrumento cirúrgico 2500 compreende um atuador de extremidade 2502 que pode compreender uma bigorna 2516, uma haste com perfil em I 2514 (incluindo um gume cortante afiado 2509), e um cartucho de grampos removível 2518. O atuador de extremidade 2502, a bigorna 2516, a haste com perfil em I 2514 e o cartucho de grampos 2518 podem ser configurados conforme descrito aqui, por exemplo, em relação às Figuras 1 a 13.
[0109] 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. Como a viga com perfil em I 2514 é acoplada ao membro de acionamento longitudinalmente móvel 120, a posição da viga com perfil em I 2514 pode ser determinada mediante a medição da posição do membro de acionamento longitudinalmente móvel 120 que emprega o sensor de posição 2534. Consequentemente, na descrição a seguir, a posição, o deslocamento e/ou a translação da viga com perfil em I 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 juntamente 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 viga com perfil em I 2514 da maneira descrita. Em um aspecto, um circuito 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 viga com perfil em I 2514 conforme determinado pelo sensor de posição 2534 com a saída do circuito temporizador/contador 2531 para que o circuito de controle 2510 possa determinar a posição da viga 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.
[0110] 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 de corrente contínua (CC) sem escovas, e o sinal de acionamento do motor 2524 pode compreender um sinal de modulação por largura de pulso (PWM) fornecido a um ou mais enrolamentos de 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.
[0111] O motor 2504 pode receber energia de uma fonte de energia
2512. A fonte de energia 2512 pode ser ou pode incluir uma bateria, um supercapacitor ou qualquer outra fonte de energia adequada 2512. O motor 2504 pode ser mecanicamente acoplado à viga 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 viga com perfil em I 2514. Um sensor de posição 2534 pode detectar uma posição da viga 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 viga 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 viga com perfil em I 2514 translada distal e proximalmente. O circuito de controle 2510 pode rastrear os pulsos para determinar a posição da viga 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 viga 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 viga 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.
[0112] 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 distância de vão em relação ao tempo, compressão do tecido em relação ao tempo e deformação da bigorna em relação ao tempo. Os sensores 2538 podem compreender um sensor magnético, um sensor de campo magnético, um medidor de esforço, um sensor de pressão, um sensor de força, um sensor indutivo como, por exemplo, um sensor de correntes parasitas, um sensor resistivo, um sensor capacitivo, um sensor óptico e/ou quaisquer outros sensores adequados para medição de um ou mais parâmetros do atuador de extremidade 2502. Os sensores 2538 podem incluir um ou mais sensores.
[0113] O um ou mais sensores 2538 podem compreender um medidor de esforço, como um medidor de microesforço, configurado para medir a magnitude da tensão na bigorna 2516 durante uma condição presa. 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.
[0114] 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 de 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 e 5B. O circuito de controle 2510 recebe medições de amostra em tempo real para fornecer e analisar informações baseadas em tempo e avaliar, em tempo real, as forças de fechamento aplicadas à bigorna 2516.
[0115] Um sensor de corrente 2536 pode ser empregado para medir a corrente drenada pelo motor 2504. A força necessária para avançar a viga com perfil em I 2514 corresponde à corrente drenada pelo motor
2504. A força é convertida em um sinal digital e fornecida ao circuito de controle 2510.
[0116] Usando as propriedades físicas dos instrumentos aqui revelados, juntamente com as Figuras 1 a 14, e com referência à Figura
14, um circuito de controle 2510 pode ser configurado para simular a resposta do sistema real do instrumento no software do controlador. Um membro de deslocamento pode ser atuado para mover uma viga com perfil em i 2514 no atuador de extremidade 2502 em ou próximo a uma velocidade alvo. O instrumento cirúrgico 2500 pode incluir um controlador de retroinformação, que pode ser um ou qualquer dos controladores de retroinformação, incluindo, mas não se limitando a, um PID, uma retroinformação de estado, LQR, e/ou um controlador adaptável, por exemplo. O instrumento cirúrgico 2500 pode incluir uma fonte de energia para converter o sinal do controlador de retroinformação para uma entrada física como tensão do estojo, tensão PWM, tensão modulada por frequência, corrente, torque e/ou força, por exemplo.
[0117] O sistema de acionamento real do instrumento cirúrgico 2500 é configurado para acionar o membro de deslocamento, o membro de corte ou a viga com perfil em i 2514, por um motor CC escovado com caixa de câmbio e ligações mecânicas a um sistema de articulação e/ou uma faca. 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.
[0118] 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.
[0119] 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 distal 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 a partir de uma posição proximal de início de curso para uma posição de fim de curso distal da posição de início de curso. À medida que o membro de deslocamento se desloca distalmente, a viga 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.
[0120] 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 viga 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 o 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.
[0121] Em alguns exemplos, o circuito de controle 2510 pode, inicialmente, operar o motor 2504 em uma configuração de circuito aberto para uma primeira porção de circuito aberto de um curso do membro de deslocamento. Com base em uma resposta do instrumento 2500 durante a porção de circuito aberto do curso, o circuito de controle 2510 pode selecionar um programa de controle de disparo. A resposta do instrumento pode incluir uma distância de translação 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 de 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.
[0122] A Figura 15 ilustra um diagrama 2580 que plota dois cursos exemplificadores do membro de deslocamento executados de acordo com um aspecto da presente revelação. O diagrama 2580 compreende dois eixos geométricos. Um eixo geométrico horizontal 2584 indica o tempo decorrido. Um eixo geométrico vertical 2582 indica a posição da haste com perfil em I 2514 entre uma posição inicial do curso 2586 e uma posição final do curso 2588. No eixo geométrico horizontal 2584, o circuito de controle 2510 pode receber o sinal de disparo e começar a fornecer a configuração inicial do motor em t0. A porção de circuito aberto do curso do membro de deslocamento é um período de tempo inicial que pode decorrer entre t0 e t1.
[0123] 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 viga com perfil em I 2514 pode atravessar 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 viga com perfil em I 2514 em uma velocidade constante selecionada (Vlenta), indicada pela inclinação do exemplo 2592 após t1 (por exemplo, na porção do circuito fechado). O circuito de controle 2510 pode acionar a viga com perfil em I 2514 para a velocidade Vlenta mediante o monitoramento da posição da viga 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.
[0124] Um segundo exemplo 2590 mostra uma resposta do instrumento cirúrgico 2500 quando o tecido delgado é posicionado entre a bigorna 2516 e o cartucho de grampos 2518. Durante o período de tempo inicial (por exemplo, o período de circuito aberto) entre t0 e t1, a viga com perfil em I 2514 pode atravessar da posição inicial do curso 2586 para a posição 2596. O circuito de controle pode determinar que a posição 2596 corresponde a um programa de controle de disparo que avança o membro de deslocamento em uma velocidade selecionada constante (Vrápida). Porque o tecido no exemplo 2590 é mais fino do que o tecido no exemplo 2592, ele pode fornecer menos resistência ao movimento da haste com perfil em I 2514. Como resultado, a haste com perfil em I 2514 pode mover uma porção maior do curso durante o período de tempo inicial. Além disso, em alguns exemplos, um tecido mais fino (por exemplo, uma porção maior do curso do membro deslocamento percorrido durante o período de tempo inicial) pode corresponder a velocidades maiores do membro de deslocamento após o período de tempo inicial.
[0125] As Figuras 16 a 21 ilustram um atuador de extremidade 2300 de um instrumento cirúrgico 2010 mostrando como o atuador de extremidade 2300 pode ser articulado em relação ao conjunto de eixo de acionamento alongado 2200 em torno de uma junta articulada 2270, de acordo com um aspecto da presente revelação. A Figura 16 é uma vista em perspectiva parcial de uma porção do atuador de extremidade 2300 mostrando um conjunto de eixo de acionamento alongado 2200 em uma orientação não articulada, com algumas de suas porções omitidas para fins de clareza. A Figura 17 é uma vista em perspectiva do atuador de extremidade 2300 da Figura 16 mostrando o conjunto de eixo de acionamento alongado 2200 em uma orientação não articulada. A Figura 18 é uma vista em perspectiva de conjunto explodida do atuador de extremidade 2300 da Figura 16 mostrando o conjunto de eixo de acionamento alongado 2200. A Figura 19 é uma vista de topo do atuador de extremidade 2300 da Figura 16 mostrando o conjunto de eixo de acionamento alongado 2200 em uma orientação não articulada. A Figura 20 é uma vista de topo do atuador de extremidade 2300 da Figura 16 mostrando o conjunto de eixo de acionamento alongado 2200 em uma primeira orientação articulada. A Figura 21 é uma vista de topo do atuador de extremidade 2300 da Figura 16 mostrando o conjunto de eixo de acionamento alongado 2200 em uma segunda orientação articulada.
[0126] Com referência agora às Figuras 16 a 21, o atuador de extremidade 2300 está adaptado para cortar e grampear tecido e inclui uma primeira garra sob a forma de um canal alongado 2302 que é configurado para suportar operacionalmente em seu interior um cartucho de grampos cirúrgicos 2304. O atuador de extremidade 2300 inclui adicionalmente uma segunda garra sob a forma de uma bigorna 2310 que é suportada no canal alongado 2302 para se mover em relação a ele. O conjunto de eixo de acionamento alongado 2200 inclui um sistema de articulação 2800 que usa uma trava de articulação 2810. A trava de articulação 2810 pode ser configurada e operada para travar seletivamente o atuador de extremidade cirúrgico 2300 em várias posições articuladas. Essa disposição permite que o atuador de extremidade cirúrgico 2300 seja girado, ou articulado, em relação ao tubo de fechamento 260 do eixo de acionamento quando a trava de articulação 2810 estiver em seu estado destravado. Especificamente com referência à Figura 18, o conjunto de eixo de acionamento alongado 2200 inclui uma coluna central 210 que é configurada para (1) suportar de maneira deslizante um membro de disparo 220 em seu interior e (2) suportar de maneira deslizante o tubo de fechamento 260 (Figura 16) que se estende ao redor da coluna central 210. O tubo de fechamento do eixo de acionamento 260 é fixado a uma luva de fechamento do atuador de extremidade 272 que é fixada de modo pivotante ao tubo de fechamento 260 por um conjunto de luva de fechamento com dupla articulação 271.
[0127] A coluna central 210 também suporta de maneira deslizante um acionador de articulação proximal 230. O acionador de articulação proximal 230 tem uma extremidade distal 231 que é configurada para se engatar operacionalmente à trava de articulação 2810. A trava de articulação 2810 compreende adicionalmente uma estrutura do eixo de acionamento 2812 que é fixada à coluna central 210 nas várias maneiras aqui reveladas. A estrutura do eixo de acionamento 2812 é configurada para suportar nela, de modo móvel, uma porção proximal 2821 de um acionador de articulação distal 2820. O acionador de articulação distal 2820 é suportado de modo móvel dentro do conjunto de eixo de acionamento alongado 2200 para deslocamento longitudinal seletivo em uma direção distal DD e uma direção proximal PD, ao longo de um eixo geométrico de atuação de articulação AAA que é deslocado lateralmente e paralelo ao eixo geométrico SA-SA do eixo de acionamento, em resposta a movimentos de controle de articulação aplicados ao mesmo.
[0128] Nas Figuras 17 e 18, a estrutura de eixo de acionamento 2812 inclui uma porção de extremidade distal 2814 que tem um pino de pivô 2818 formado sobre ela. O pino de pivô 2818 é adaptado para ser recebido de modo articulado dentro de um orifício de pivô 2397 formado na porção de base de pivô 2395 de um conjunto de montagem do atuador de extremidade 2390. O conjunto de montagem do atuador de extremidade 2390 é fixado à extremidade proximal 2303 do canal alongado 2302 por meio de um pino de mola 2393 ou equivalente. O pino de pivô 2818 define um eixo geométrico de articulação B-B transversal ao eixo geométrico SA-SA do eixo de acionamento para facilitar o deslocamento pivotante (isto é, a articulação) do atuador de extremidade 2300 ao redor do eixo geométrico de articulação B-B em relação à estrutura do eixo de acionamento 2812.
[0129] Conforme mostrado na Figura 18, um pino de elo 2825 é formado em uma extremidade distal 2823 do acionador de articulação distal 2820 e é configurado para ser recebido no interior de um orifício 2904 em uma extremidade proximal 2902 de um elo transversal 2900. O elo transversal 2900 se estende transversalmente através do eixo geométrico SA-SA do eixo de acionamento e inclui uma porção de extremidade distal 2906. Um orifício de elo distal 2908 é fornecido através da porção de extremidade distal 2906 do elo transversal 2900 e é configurado para receber em seu interior, de modo pivotante, um pino de base 2398 que se estende a partir do fundo da porção de base de pivô 2395 do conjunto de montagem do atuador de extremidade 2390. O pino de base 2398 define um eixo geométrico do elo LA que é paralelo ao eixo geométrico de articulação B-B. As Figuras 17 e 20 ilustram o atuador de extremidade cirúrgico 2300 em uma posição não articulada. O eixo geométrico EA do atuador de extremidade, que é definido pelo canal alongado 2302, está alinhado ao eixo geométrico SA-SA do eixo de acionamento. O termo "alinhado a" pode significar "alinhado coaxialmente" ao eixo geométrico SA-SA do eixo de acionamento ou paralelo ao eixo geométrico SA-SA do eixo de acionamento. O movimento do acionador de articulação distal 2820 na direção proximal DD fará com que o elo transversal 2900 mova o atuador de extremidade cirúrgico 2300 no sentido horário CW em torno do eixo geométrico de articulação B-B, conforme mostrado na Figura 19. O movimento do acionador de articulação distal 2820 na direção distal DD fará com que o elo transversal 2900 mova o atuador de extremidade cirúrgico 2300 no sentido anti-horário CCW em torno do eixo geométrico de articulação B-B, conforme mostrado na Figura 21. Como pode ser visto na Figura 21, o elo transversal 2900 tem um formato curvo que possibilita que o elo transversal 2900 se curve em torno do pino de articulação 2818, quando o atuador de extremidade cirúrgico 2300 é articulado nessa direção. Quando o atuador de extremidade cirúrgico 2300 está em uma posição completamente articulada em cada lado do eixo geométrico SA- SA do eixo de acionamento, o ângulo de articulação 2700 entre o eixo geométrico EA do atuador de extremidade e o eixo geométrico SA-SA do eixo de acionamento é de aproximadamente sessenta e cinco graus (65°). Dessa forma, a faixa de articulação em cada um dos lados do eixo geométrico do eixo de acionamento é entre um grau (1°) e sessenta e cinco graus (65°).
[0130] A Figura 19 mostra a junta de articulação 2270 em uma posição reta, isto é, em um ângulo zero θ0 em relação à direção longitudinal mostrada como um eixo geométrico do eixo de acionamento SA de acordo com um aspecto. A Figura 20 mostra a junta articulada 2270 da Figura 19 articulada em uma direção de em um primeiro ângulo θ1 definido entre o eixo geométrico SA do eixo de acionamento e o eixo geométrico EA do atuador de extremidade, de acordo com um aspecto. A Figura 21 ilustra a junta de articulação 2270 da Figura 19 articulada em uma outra direção em um segundo ângulo θ2 definido entre o eixo geométrico do eixo de acionamento SA e o eixo geométrico EA do atuador de extremidade.
[0131] O atuador de extremidade cirúrgico 2300 nas Figuras de 16 a 21 compreende um dispositivo de corte e grampeamento cirúrgico que usa um membro de disparo 220 dentre os vários tipos e configurações aqui descritos. Entretanto, o atuador de extremidade cirúrgico 2300 pode compreender outras formas de atuadores de extremidade cirúrgicos que não cortam e/ou grampeiam tecido. Um membro de suporte intermediário 2950 é suportado de modo pivotante e deslizante em relação ao dorso 210. Na Figura 18, o membro de suporte intermediário 2950 inclui uma fenda 2952 que é adaptada para receber em seu interior um pino 2954 que se projeta a partir do dorso 210. Isso possibilita que o membro de suporte intermediário 2950 gire e traslade em relação ao pino 2954, quando o atuador de extremidade cirúrgico 2300 é articulado. Um pino de pivô 2958 se projeta a partir do lado inferior do membro de suporte intermediário 2950 para ser recebido de forma articulada dentro de um orifício de pivô correspondente 2399 fornecido na porção de base 2395 do conjunto de montagem do atuador de extremidade 2390. O membro de suporte intermediário 2950 inclui adicionalmente uma fenda 2960 para receber um membro de disparo 220 através dela. O membro de suporte intermediário 2950 serve para fornecer suporte lateral ao membro de disparo 220 à medida que este se flexiona para acomodar a articulação do atuador de extremidade cirúrgico 2300.
[0132] O instrumento cirúrgico pode adicionalmente ser configurado para determinar o ângulo no qual o atuador de extremidade 2300 é orientado. Em várias modalidades, o sensor de posição 1112 da disposição do sensor 1102 pode compreender um ou mais sensores magnéticos, sensores giratórios analógicos (como um potenciômetro), matrizes de sensores de efeito Hall analógicos, que emitem uma combinação única de sinais ou valores, dentre outros, por exemplo. Em um aspecto, a junta articulada 2270 do aspecto ilustrado nas Figuras de 16 a 21 pode adicionalmente compreender uma disposição do sensor de articulação que é configurada para determinar a posição angular, isto é, ângulo de articulação, do atuador de extremidade 2300 e fornecer um sinal de posição único correspondente a ela.
[0133] A disposição do sensor de articulação pode ser similar à disposição do sensor 1102 descrita acima e ilustrada nas Figuras de 10 a 12. Nesse aspecto, a disposição do sensor de articulação pode compreender um sensor de posição e um magneto que é acoplado operacionalmente à junta articulada 2270 de modo que gire de uma maneira consistente com a rotação da junta articulada 2270. O magneto pode, por exemplo, ser acoplado ao pino de pivô 2818. O sensor de posição compreende um ou mais elementos de detecção magnética, como sensores de efeito Hall e é colocado próximo ao magneto, dentro ou adjacente à junta articulada 2270. Consequentemente, à medida que o magneto gira, os elementos de detecção magnética do sensor de posição determinam a posição angular absoluta do magneto. À medida que o magneto é acoplado à junta articulada 2270, a posição angular do magneto em relação ao sensor de posição corresponde à posição angular do atuador de extremidade 2300. Portanto, a disposição do sensor de articulação é capaz de determinar a posição angular do atuador de extremidade à medida que o atuador de extremidade é articulado.
[0134] Em outro aspecto, o instrumento cirúrgico é configurado para determinar o ângulo no qual o atuador de extremidade 2300 é posicionado de forma indireta pelo monitoramento da posição absoluta do acionador de articulação 230 (Figura 3). À medida que a posição do acionador de articulação 230 corresponde ao ângulo no qual o atuador de extremidade 2300 é orientado de maneira conhecida, a posição absoluta do acionador de articulação 230 pode ser rastreado e, então, trasladado para a posição angular do atuador de extremidade 2300. Nesse aspecto, o instrumento cirúrgico compreende uma disposição do sensor de articulação que é configurada para determinar a posição linear absoluta do acionador de articulação 230 e fornecer um sinal de posição único correspondendo a ela. Em alguns aspectos, a disposição do sensor de articulação ou o controlador operacionalmente acoplado à disposição do sensor de articulação disposição é configurada adicionalmente para trasladar ou calcular a posição angular do atuador de extremidade 2300 de um sinal de posição único.
[0135] A disposição do sensor de articulação nesse aspecto pode, de modo semelhante, ser similar à disposição do sensor 1102 descrita acima e ilustrada nas Figuras de 10 a 12. Em um aspecto similar ao aspecto ilustrado na Figura 10 em relação ao membro de deslocamento 1111, a disposição do sensor de articulação compreende um sensor de posição e um magneto que gira uma vez a cada curso completo do acionador de articulação longitudinalmente móvel 230. O sensor de posição compreende um ou mais elementos de detecção magnética, como sensores de efeito Hall, e está posicionado próximo ao magneto. Consequentemente, à medida que o magneto gira, os elementos de detecção magnética do sensor de posição determinam a posição angular absoluta do magneto durante uma revolução.
[0136] Em um aspecto, uma única revolução do elemento sensor associado ao sensor de posição é equivalente a um deslocamento linear longitudinal d1 do acionador de articulação longitudinalmente móvel
230. Em outras palavras, d1 é a distância linear longitudinal pela qual o acionamento de articulação longitudinalmente móvel 230 se move do ponto "a" até o ponto "b" depois de uma única revolução de um elemento sensor acoplado ao acionador de articulação longitudinalmente móvel
230. A disposição do sensor de articulação pode ser conectada por meio de uma redução de engrenagem que resulta no sensor de posição completando apenas uma única revolução do curso completo do acionador de articulação longitudinalmente móvel 230. Em outras palavras, d1 pode ser igual ao curso completo do acionador de articulação 230. O sensor de posição é configurado para transmitir um sinal de posição único correspondente à posição absoluta do acionador de articulação 230 ao controlador 1104, como naqueles aspectos representados na Figura 10 mediante o recebimento de um sinal de posição único, o controlador 1104 é, então, configurado para executar uma lógica para determinar a posição angular do atuador de extremidade correspondente à posição linear do acionador de articulação 230, por exemplo, consultando uma tabela de consulta que retorna o valor da posição angular pré-calculada do atuador de extremidade 2300, calculando por meio de um algoritmo a posição angular do atuador de extremidade 2300 com o uso da posição linear do acionador de articulação 230 como entrada, ou realizando qualquer outro método conforme é conhecido na técnica.
[0137] Em vários aspectos, qualquer número de elementos de detecção magnética pode ser empregado na disposição do sensor de articulação, como, por exemplo, sensores magnéticos classificados de acordo com sua capacidade de medir o campo magnético total ou os componentes vetoriais do campo magnético. O número de elementos de detecção magnética utilizado corresponde à resolução desejada a ser detectada pela disposição do sensor de articulação. Em outras palavras, quanto maior número de elementos de detecção magnética usados, maior o grau de articulação que pode ser detectado pela disposição do sensor de articulação. 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/piezoelétricos, magnetodiodo, transistor magnético, fibra óptica, magneto-óptica e sensores magnéticos baseados em sistemas microeletromecânicos, dentre outros.
[0138] Em um aspecto, o sensor de posição dos vários aspectos da disposição do sensor de articulação pode ser implementado de maneira similar ao sistema de posicionamento ilustrado na Figura 12 para rastrear a posição do membro de deslocamento 1111. Em um aspecto, a disposição do sensor de articulação pode ser implementada como um sensor de posição giratório magnético de circuito integrado único AS5055EQFT, disponível junto à Austria Microsystems, AG. O sensor de posição faz interface com o controlador para fornecer um sistema de posicionamento absoluto para determinar a posição angular absoluta do atuador de extremidade 2300, seja diretamente ou indiretamente. O sensor de posição 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 localizada acima do magneto 1202 (Figura 11). Um conversor A-D de alta resolução 1232 e um controlador de gerenciamento de potência inteligente 1238 são apresentados, também, no circuito integrado. Um processador CORDIC (Coordinate Rotation DIgital Computer) 1236, também conhecido como método de 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 consulta. A posição angular, os bits de alarme e as 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.
[0139] Com referência às Figuras 1 a 4 e 10 a 12, a posição da junta de articulação 2270 e a posição da viga com perfil em I 178 (Figura 4) podem ser determinadas com o sinal/valor de retroinformação de posição absoluta do sistema de posicionamento absoluto 1100. Em um aspecto, o ângulo de articulação θ pode ser determinado com base no membro de acionamento 120 do instrumento cirúrgico 10. Conforme descrito acima, o movimento do membro de acionamento longitudinalmente móvel 120 (Figura 2) pode ser rastreado pelo sistema de posicionamento absoluto 1100 sendo que, quando o acionador de articulação é operacionalmente acoplado ao membro de disparo 220 (Figura 3) pelo conjunto de embreagem 400 (Figura 3), por exemplo, o sistema de posicionamento absoluto 1100 pode, com efeito, rastrear o movimento do sistema de articulação por meio do membro de acionamento 120. Como resultado de rastrear o movimento do sistema de articulação, o controlador do instrumento cirúrgico pode registrar o ângulo de articulação θ do atuador de extremidade 2300. Em várias circunstâncias, como resultado, o ângulo de articulação θ pode ser determinado como função do deslocamento longitudinal DL do membro de acionamento 120. Como o deslocamento longitudinal DL do membro de acionamento 120 pode ser determinado com precisão com base no sinal/valor de posição absoluto fornecido pelo sistema de posicionamento absoluto 1100, o ângulo de articulação θ pode ser determinado como função do deslocamento longitudinal.
[0140] Em outro aspecto, o ângulo de articulação θ pode ser determinado pelos sensores de localização na junta articulada 2270. Os sensores podem ser configurados para detectar a rotação da junta articulada 2270 com o uso do sistema de posicionamento absoluto 1100 de uma maneira adaptada para medir a rotação absoluta da junta articulada 2270, em vez do deslocamento longitudinal do membro de acionamento 120, conforme descrito acima. Por exemplo, a disposição do sensor 1102 compreende um sensor de posição 1200, um magneto 1202 e um suporte de magneto 1204 adaptado para detectar a rotação da junta articulada 2270. O sensor de posição 1200 compreende um ou mais elementos de detecção magnética, como elementos de Hall, e está posicionado próximo ao magneto 1202. O sensor de posição 1200 descrito na Figura 12 pode ser adaptado para medir o ângulo de rotação da junta articulada 2270. Consequentemente, à medida que o magneto 1202 gira, os elementos de detecção magnética do sensor de posição 1200 determinam a posição angular absoluta do magneto 1202 localizado na junta articulada 2270. Essas informações são fornecidas ao controlador 1104 para calcular o ângulo de articulação da junta articulada 2270. Consequentemente, o ângulo de articulação do atuador de extremidade 2300 pode ser determinado pelo sistema de posicionamento absoluto 1100 adaptado para medir a rotação absoluta da junta articulada 2270.
[0141] Em um aspecto, a taxa ou velocidade de disparo da viga com perfil em i 178 pode ser variada como uma função do ângulo de articulação do atuador de extremidade 2300 para diminuir a força para disparar no sistema de acionamento de disparo 80 e, em particular, a força para disparar da viga com perfil em i 178, entre outros componentes do sistema de acionamento de disparo 80 aqui discutido. Para adaptar a força de disparo variável da viga com perfil em i 178 como função do ângulo de articulação do atuador de extremidade 2300, uma tensão de controle de motor variável pode ser aplicada ao motor 82 para controlar a velocidade do motor 82. A velocidade do motor 82 pode ser controlada mediante a comparação da força de disparo da viga com perfil em i 178 com diferentes limites máximos com base no ângulo de articulação do atuador de extremidade 2300. A velocidade do motor elétrico 82 pode ser variada através do ajuste da tensão, da corrente, da modulação por largura de pulso (PWM) ou do ciclo de trabalho (0 a 100%) aplicados ao motor 82, por exemplo.
[0142] As Figuras 22 e 23 retratam um sistema cirúrgico acionado por motor 10 que pode ser usado para executar uma variedade de procedimentos cirúrgicos diferentes. O instrumento cirúrgico 10 pode compreender um atuador de extremidade 3602, que pode compreender um ou mais eletrodos. O atuador de extremidade 3602 pode ser posicionado contra o tecido, de modo que a corrente elétrica possa ser introduzida no tecido. Os dispositivos cirúrgicos 10 podem ser configurados para a operação monopolar ou bipolar. Durante a operação monopolar, a corrente pode ser introduzida no tecido por um eletrodo (ou fonte) ativo no atuador de extremidade 3602 e retornada através de um eletrodo de retorno. O eletrodo de retorno pode ser um bloco de aterramento situado separadamente no corpo de um paciente. Durante a operação bipolar, a corrente pode ser introduzida no tecido e retornada a partir do mesmo respectivamente pelos eletrodos ativos e de retorno do atuador de extremidade.
[0143] O atuador de extremidade 3602 pode compreender um membro de primeira garra 3604 e de segunda garra 3608. Pelo menos um dos membros de garra 3604, 3608 pode ter ao menos um eletrodo. Pelo menos um dos membros de garra 3604, 3608 pode ser móvel a partir de uma posição espaçada da garra oposta para receber tecidos em uma posição na qual o espaço entre os membros de garra 3604, 3608 é menor do que aquele da primeira posição. Esse movimento da garra móvel pode comprimir o tecido retido entre a mesma. O calor gerado pelo fluxo de corrente através do tecido em combinação com a compressão obtida pelo movimento da garra pode formar vedações hemostáticas no interior do tecido e/ou entre tecidos e, dessa forma, pode ser particularmente útil para vedação de vasos sanguíneos, por exemplo. O instrumento cirúrgico 10 pode compreender um membro de faca 3628 que é extensível através do atuador de extremidade 3602. O elemento de faca 3628 pode ser móvel em relação ao tecido e aos eletrodos para fazer a transecção do tecido.
[0144] O instrumento cirúrgico 10 pode incluir mecanismos para prender o tecido em conjunto, como um dispositivo de grampeamento, e/ou mecanismos para cortar o tecido, como uma faca de tecido. O instrumento eletrocirúrgico 10 pode incluir um eixo de acionamento para colocar o atuador de extremidade 3602 adjacente ao tecido que está sendo submetido a tratamento. O eixo de acionamento pode ser reto ou curvo, dobrável ou não dobrável. Em um instrumento eletrocirúrgico 10 que inclui um eixo de acionamento reto e dobrável, o eixo de acionamento pode ter uma ou mais juntas articuladas para permitir a flexão controlada do eixo de acionamento. Tais juntas podem permitir que um usuário do dispositivo eletrocirúrgico 10 coloque o atuador de extremidade em contato com o tecido em um ângulo em relação ao eixo de acionamento quando o tecido que é tratado não é prontamente acessível com o uso de um dispositivo eletrocirúrgico que tem um eixo de acionamento reto não dobrável.
[0145] A energia elétrica aplicada por dispositivos eletrocirúrgicos pode ser transmitida ao instrumento por um gerador 3400 em comunicação com o conjunto de empunhadura 3500. A energia elétrica pode estar sob a forma de energia de radiofrequência ("RF"). A energia de RF é uma forma de energia elétrica que pode estar na faixa de frequências de 200 quilohertz (kHz) a 1 megahertz (MHz). Em aplicação, um instrumento eletrocirúrgico pode transmitir energia de RF em baixa frequência através do tecido, o que causa atrito, ou agitação iônica, ou seja, aquecimento resistivo, o que, portanto, aumenta a temperatura do tecido. Devido ao fato de que um limite preciso é criado entre o tecido afetado e o tecido circundante, os cirurgiões podem operar com um alto nível de precisão e controle, sem sacrificar o tecido adjacente não alvo. As baixas temperaturas de operação da energia de RF são úteis para remoção, encolhimento ou escultura de tecidos moles enquanto, simultaneamente, cauterizam-se os vasos sanguíneos. A energia de RF funciona particularmente bem no tecido conjuntivo, que compreende principalmente colágeno e encolhe quando entra em contato com calor.
[0146] A energia de RF pode estar em uma faixa de frequências descrita no documento EN 60601-2-2:2009+A11:2011, Definição
201.3.218 – "HIGH FREQUENCY". Por exemplo, a frequência em aplicações de RF monopolar pode ser tipicamente restrita a menos do que 5 MHz. Entretanto, em aplicações de RF bipolar, a frequência pode se quase qualquer uma. Frequências acima de 200 kHz podem ser tipicamente usadas para aplicações monopolares a fim de evitar o estímulo indesejado dos nervos e músculos, o que resultaria do uso de uma corrente de frequência baixa. Frequências inferiores podem ser usadas para aplicações bipolares se a análise de risco mostrar que a possibilidade de estímulo neuromuscular foi mitigada até um nível aceitável. Normalmente, frequências acima de 5 MHz não são usadas, a fim de minimizar problemas associados correntes de dispersão de alta frequência. Frequências mais altas podem, entretanto, ser usadas no caso de aplicações bipolares. É geralmente aceito que 10 mA é o limiar inferior dos efeitos térmicos em tecido.
[0147] Na disposição ilustrada, o sistema cirúrgico 10 compreende um conjunto de ferramenta cirúrgica intercambiável 3600 que é operacionalmente acoplado a um conjunto de empunhadura 3500. Em outro aspecto do sistema cirúrgico, o conjunto de ferramenta cirúrgica intercambiável 3600 pode ser eficazmente empregado com um conjunto de acionamento de ferramenta de um sistema cirúrgico controlado roboticamente ou automatizado. Por exemplo, o conjunto de ferramenta cirúrgica 3600 aqui revelado pode ser empregado com vários sistemas robóticos, instrumentos, componentes e métodos como, mas sem limitação, aqueles revelados na patente US N° 9.072.535, intitulada "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS", a qual está aqui incorporada na presente invenção a título de referência, em sua totalidade.
[0148] No aspecto ilustrado, o conjunto de empunhadura 3500 pode compreender um compartimento de empunhadura 3502 que inclui uma porção de empunhadura de pistola que pode ser segurada e manipulada pelo médico.
Como será resumidamente discutido abaixo, o conjunto de empunhadura 3500 sustenta operacionalmente uma pluralidade de sistemas de acionamento, que são configurados para gerar e aplicar vários movimentos de controle às porções correspondentes do conjunto de ferramenta cirúrgica intercambiável 3600. Conforme mostrado na Figura 22, o conjunto de empunhadura 3500 pode também incluir uma estrutura de empunhadura 3506 que sustenta operacionalmente a pluralidade de sistemas de acionamento.
Por exemplo, a estrutura de empunhadura 3506 pode suportar operacionalmente um "primeiro" sistema ou sistema de acionamento de fechamento, designado, de modo geral, como 3510, o qual pode ser empregado para aplicar movimentos de fechamento e abertura ao conjunto de ferramenta cirúrgica intercambiável 3600. Em ao menos uma forma, o sistema de acionamento de fechamento 3510 pode incluir um atuador sob a forma de um gatilho de fechamento 3512, sustentado de forma articulada pela estrutura de empunhadura 3506. Essa disposição possibilita que o gatilho de fechamento 3512 seja manipulado por um médico, de modo que, quando o médico empunhar a porção do conjunto de empunhadura da pistola 504 do conjunto de empunhadura 3500, o gatilho de fechamento 3512 possa ser facilmente girado de uma posição inicial ou "não atuada" para uma posição "atuada" e, mais particularmente, para uma posição completamente comprimida ou completamente atuada.
Em uso, para atuar o sistema de acionamento de fechamento 3510, o médico pressiona o gatilho de fechamento 3512 em direção à porção de empunhadura da pistola 504. Conforme descrito em mais detalhes no pedido de patente US N° de série 2015/0272575, intitulado "SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM", que está aqui incorporado por referência em sua totalidade, quando o médico pressiona o gatilho de fechamento 3512 completamente para atingir um curso de fechamento pleno, o sistema de acionamento de fechamento 3510 é configurado para travar o gatilho de fechamento 3512 na posição completamente pressionada ou completamente atuada. Quando o médico deseja destravar o gatilho de fechamento 3512 para permitir que o mesmo seja propendido para a posição não atuada, o médico simplesmente ativa um conjunto de botão de liberação de fechamento 3518 que permite que o gatilho de fechamento retorne à posição não atuada. O conjunto de botão de liberação de fechamento 3518 pode também ser configurado para interagir com vários sensores que se comunicam com um microcontrolador no conjunto de empunhadura 3500 para rastrear a posição do gatilho de fechamento 3512. Uma discussão adicional em relação à configuração e à operação do conjunto de botão de liberação de fechamento 3518 pode ser encontrada na Publicação do Pedido de Patente US N° 2015/0272575.
[0149] Em pelo menos uma forma, o conjunto de empunhadura 3500 e a estrutura de empunhadura 3506 podem sustentar operacionalmente outro sistema de acionamento chamado na presente invenção de um sistema de acionamento de disparo 3530, que é configurado para aplicar movimentos de disparo às porções correspondentes do conjunto de ferramenta cirúrgica intercambiável que é fixado ao mesmo. Conforme foi descrito em detalhes na Publicação de Pedido de Patente US N° 2015/0272575, o sistema de acionamento de disparo 3530 pode empregar um motor elétrico 3505 que está situado na porção de empunhadura de pistola 504 do conjunto de empunhadura 3500. Em várias formas, o motor 3505 pode ser um motor de acionamento de corrente contínua com escovas, com uma rotação máxima de, aproximadamente, 25.000 RPM, por exemplo. Em outras disposições, o motor 3505 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 motor 3505 pode ser alimentado por uma fonte de alimentação 3522 que, sob uma forma, pode compreender uma fonte de energia removível. A fonte de energia pode suportar uma pluralidade de baterias de íons de lítio ("íons de Li") ou outras adequadas na mesma. Várias baterias, que podem ser conectadas em série, podem ser usadas como a fonte de energia 3522 para o sistema cirúrgico 10. Além disso, a fonte de energia 3522 pode ser substituível e/ou recarregável.
[0150] O motor elétrico 3505 é configurado para acionar axialmente um membro de acionamento longitudinalmente móvel 3540 nas direções distal e proximal dependendo da polaridade do motor. Por exemplo, quando o motor 3505 for acionado em uma direção de rotação, o membro de acionamento longitudinalmente móvel será axialmente acionado em uma direção distal "DD". Quando o motor 3505 for acionado na direção giratória oposta, o membro de acionamento longitudinalmente móvel 3540 será axialmente conduzido na direção proximal "PD". O conjunto de empunhadura 3500 pode incluir uma chave 3513 que pode ser configurada para reverter a polaridade aplicada ao motor elétrico 3505 pela fonte de energia 3522 ou de outro modo controlar o motor 3505. O conjunto de empunhadura 3500 pode incluir também um sensor ou sensores (não mostrados) que são configurados para detectar a posição do membro de acionamento e/ou a direção na qual o membro de acionamento está sendo movido. A atuação do motor 3505 pode ser controlada por um gatilho de disparo (não mostrado) que está em posição adjacente ao gatilho de fechamento 3512 e suportado de modo pivotante no conjunto de empunhadura 3500. O gatilho de disparo pode ser pivotado entre uma posição não atuada e uma posição atuada. O gatilho de disparo pode ser propendido para a posição não atuada por meio de uma mola ou outra disposição de propensão de modo que, quando o médico libera o gatilho de disparo, o mesmo possa ser girado ou, de outro modo, retornado à posição não atuada por meio da mola ou da disposição de propensão. Em ao menos uma forma, o gatilho de disparo pode ser posicionado "afastado do centro" do gatilho de fechamento 3512. Conforme discutido na Publicação de Pedido de Patente US N° 2015/0272575, o conjunto de empunhadura 3500 pode ser equipado com um botão de segurança do gatilho de disparo (não mostrado) para evitar a atuação inadvertida do gatilho de disparo. Quando o gatilho de fechamento 3512 está na posição não atuada, o botão de segurança está contido no conjunto de empunhadura 3500, onde o médico não pode acessá-lo prontamente e movê-lo entre uma posição de segurança, o que evita a atuação do gatilho de disparo, e uma posição de disparo na qual o gatilho de disparo pode ser disparado. À medida que o médico pressiona o gatilho de fechamento, o botão de segurança e o gatilho de disparo pivotam para baixo, para uma posição em que eles possam, então, ser manipulados pelo médico.
[0151] Em ao menos uma forma, o membro de acionamento longitudinalmente móvel 3540 pode ter uma cremalheira de dentes 542 formada no mesmo para engate engrenado com uma disposição de engrenagem de acionamento correspondente (não mostrada) que faz interface com o motor. Detalhes adicionais em relação àqueles recursos podem ser encontrados na publicação de pedido de patente US N° 2015/0272575. Em ao menos uma disposição, entretanto, o elemento de acionamento longitudinalmente móvel é isolado para o proteger o mesmo contra energia de RF inadvertida. Ao menos uma forma inclui também um conjunto de retração manualmente atuável, que é configurado para possibilitar que o médico retraia manualmente o membro de acionamento longitudinalmente móvel, caso o motor 3505 deixe de funcionar. O conjunto de retração pode incluir uma alavanca ou conjunto de empunhadura de retração que é armazenado no interior do conjunto de empunhadura 3500 sob uma porta removível 3550. A alavanca pode ser configurada para ser manualmente articulada em engate de catraca com os dentes no membro de acionamento. Dessa forma, o médico pode retrair manualmente o membro de acionamento 3540 usando o conjunto de empunhadura de retração para engrenar o membro de acionamento na direção proximal "PD". A Patente US N°
8.608.045, intitulada POWERED SURGICAL CUTTING AND
STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, cuja descrição está aqui incorporada a título de referência na presente invenção, revela disposições de resgate e outros componentes, disposições e sistemas que também podem ser empregados com qualquer um dos vários conjuntos de ferramenta cirúrgica intercambiáveis revelados na presente invenção.
[0152] Conforme mostrado na Figura 22, em pelo menos uma disposição, o conjunto de ferramenta cirúrgica intercambiável 3600 inclui um conjunto de estrutura de ferramenta 3610 que compreende um chassi de ferramenta 1210 que sustenta operacionalmente um conjunto de bocal 3612 no mesmo. Conforme discutido adicionalmente em detalhes no Pedido de Patente US N° 15/635.631, intitulado SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER, o qual é aqui incorporado por referência em sua totalidade, a ferramenta de chassi 3612 e o conjunto do bocal 3612 facilitam a rotação do atuador de extremidade cirúrgico 3602 em torno de um eixo geométrico SA do eixo de acionamento em relação à ferramenta do chassi. Tal deslocamento rotacional é representado pela seta R na Figura 22. O conjunto de ferramenta cirúrgica intercambiável 3600 inclui um conjunto de coluna central 3630 (consulte as Figuras 3 e 24) que suporta operacionalmente o tubo de fechamento proximal 3622 e é acoplado ao atuador de extremidade cirúrgico 3602. Em várias circunstâncias, para facilitar a montagem, o conjunto da coluna central 3630 pode ser fabricado a partir de um segmento da coluna central superior e um segmento de coluna central inferior que são interconectados juntos por recursos de encaixe por pressão, adesivo, solda etc. Na forma montada, o conjunto de coluna central 3630 inclui uma extremidade proximal que é giratoriamente apoiada no chassi da ferramenta. Em uma disposição, por exemplo, a extremidade proximal do conjunto de coluna central 3630 é fixada a um rolamento dorsal (não mostrado) que é configurado para ser apoiado dentro do chassi da ferramenta. Essa disposição facilita a fixação giratória do conjunto de coluna central 3630 ao chassi de ferramenta, de modo que o conjunto de coluna central possa ser girado seletivamente ao redor de um eixo geométrico SA do eixo de acionamento em relação ao chassi de ferramenta.
[0153] No aspecto ilustrado, o conjunto de ferramenta cirúrgica intercambiável 3600 inclui um atuador de extremidade cirúrgico 3602 que compreende uma primeira garra 3604 e uma segunda garra 3608. Em uma disposição, a primeira garra compreende um canal alongado 3614 que é configurado para suportar operacionalmente um cartucho de grampos/prendedores cirúrgicos convencionais (mecânico) 304 (Figura 4) ou um cartucho de radiofrequência (RF) 3606 (Figuras 22 e 23) no mesmo. A segunda garra 3608 compreende uma bigorna 3616 que é suportado de modo pivotante em relação ao canal alongado 3614. A bigorna 3616 pode ser seletivamente movida em direção e na direção oposta a um cartucho cirúrgico suportado no canal alongado 3614, entre as posições aberta e fechada por meio da atuação do sistema de acionamento de fechamento 3510. Na disposição ilustrada, a bigorna 3616 é suportada de modo pivotante em uma porção de extremidade proximal do canal alongado 3614 para deslocamento pivotante seletivo em torno de um eixo geométrico de pivô que é transversal ao eixo geométrico SA do eixo de acionamento. A atuação do sistema de acionamento de fechamento 3510 pode resultar no movimento axial distal de um membro de fechamento proximal ou tubo de fechamento proximal 3622 que é fixado a um conector de articulação 3618. A atuação do tubo de fechamento proximal 3622 resultará no deslocamento distal do segmento do tubo de fechamento distal 3620 para por fim aplicar um movimento de fechamento à bigorna 3616.
[0154] Em ao menos uma disposição, a energia de RF é fornecida ao conjunto de ferramenta cirúrgica 3600 por um gerador de RF convencional 3400 através de um condutor de suprimento 3402. Em ao menos uma disposição, o condutor de suprimento 3402 inclui um conjunto de plugue macho 3406 que é configurado para ser plugado nos conectores fêmeas 3410 correspondentes que são fixados a um circuito de RF segmentado 3656 sobre uma placa de circuito integrado 3654. Consulte a Figura 25. Essa disposição facilita o deslocamento rotacional do atuador de extremidade do eixo de acionamento 3602 em torno do eixo geométrico SA do eixo de acionamento em relação ao chassi da ferramenta mediante a rotação do conjunto de bocal 3612 sem enrolamento do condutor de suprimento 3402 a partir do gerador 3400. Uma chave liga/desliga integrada 3420 é suportada no conjunto de fecho 3624 e no chassi de ferramenta 1210 para ligar e desligar o gerador de RF. Quando o conjunto de ferramenta 3600 é operacionalmente acoplado ao conjunto de empunhadura 3500 ou sistema robótico, o circuito de RF segmentado 3656 integrado se comunica com o microprocessador 3560 através dos conectores 3668 e, em algumas disposições, um conector de compartimento (não mostrado). Conforme mostrado na Figura 22, o conjunto de empunhadura 3500 pode incluir também um monitor de exibição 3430 para visualização das informações sobre o andamento de vedação, grampeamento, local de corte, estado do cartucho, tecido, temperatura, etc. Como também pode ser visto na Figura 25, o conjunto de anel deslizante 3652 inclui um conector proximal 3666 que faz interface com um conector distal 3658 que inclui um conjunto ou tira de circuito flexível de eixo de acionamento 3646 que pode incluir uma pluralidade de condutores elétricos estreitos 3662 para atividades relacionadas a grampeamento e condutores elétricos mais largos 3664 usados para propósitos de RF. Conforme mostrado nas Figuras 24 e 25, a tira de circuito flexível de eixo de acionamento 3646 é centralmente suportada entre as placas ou barras laminadas 3636 que formam a barra de corte
3626. Essa disposição facilita a flexão suficiente da barra de faca 3626 e da tira de circuito flexível de eixo de acionamento 3646 durante a articulação do atuador de extremidade 3602 enquanto permanece suficientemente rígida de modo a permitir que o membro de faca 3628 seja avançado distalmente através do tecido preso.
[0155] Em ao menos uma disposição, a canaleta alongada 3614 inclui um circuito de canaleta 3642 suportado em um recesso que se estende da extremidade proximal da canaleta alongada 3614 até um local distal na porção inferior da canaleta alongada 3614. O circuito de canal 3642 inclui uma porção de contato proximal 3642 que entra em contato com uma porção de contato distal 3644 da tira de circuito flexível de eixo de acionamento 3646 para o contato elétrico com a mesma. Em ao menos uma disposição, a extremidade distal do circuito de canal 3642 é recebida dentro de uma reentrância de parede correspondente formada em uma das paredes do canal alongado 3614 e é dobrada sobre e fixada a uma borda superior da parede do canal alongado 3614. Uma série de contatos expostos correspondentes são fornecidos na extremidade distal do circuito de canaleta 3642. De modo correspondente, o cartucho 3606 pode incluir um circuito flexível do cartucho que é fixado a um microcircuito distal e é afixado à porção de extremidade distal do corpo do cartucho 3606. Uma extremidade do circuito flexível do cartucho pode ser dobrada sobre a borda da superfície de plataforma do cartucho 3606 e inclui os contatos expostos configurados para fazer contato elétrico com os contatos expostos do circuito do canal 3642. Dessa forma, quando o cartucho de RF 3606 é instalado na canaleta alongada 3614, os eletrodos, bem como o microcircuito integrado distal do cartucho de RF 3606 são alimentados e se comunicam com a placa de circuito integrado 3654 através do contato entre o circuito de cartucho flexível, o circuito de canaleta flexível 3642, o circuito de eixo de acionamento flexível 3646 e conjunto de anel deslizante 3652. Mais detalhes sobre os cartuchos de RF 3606 e o circuito e disposições de sensor correspondentes do instrumento cirúrgico 10 que se comunicam e/ou interagem com os cartuchos de RF 3606 podem ser encontrados no pedido de patente US N°. 15/636.096, intitulado SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, que está aqui incorporado a título de referência em sua totalidade.
[0156] A Figura 26 ilustra um fluxograma lógico de um processo 6000 para determinar quando iniciar um desligamento de baixa energia do instrumento cirúrgico 10 (Figuras 1, 22), conforme executado pelo controlador 1104 (Figura 10), de acordo com um aspecto desta revelação. Em vários aspectos, o instrumento cirúrgico 10 pode ser configurado para executar processos, como o processo 6000, que são configurados para monitorar os vários estados operacionais do instrumento cirúrgico 10 e, em seguida, iniciar um modo de baixa energia ou de desligamento de energia de acordo com os estados operacionais determinados. Essa funcionalidade pode ser útil para, por exemplo, reduzir a energia extraída da fonte de energia 2512 (Figura 14) quando o processo 6000 determina que os estados operacionais do instrumento cirúrgico 10 foram concluídos, o que permite que o instrumento cirúrgico 10 geralmente economize energia. Na descrição a seguir do processo 4000, também deve ser feita referência às Figuras
3, 10 e 16 a 23. Para uso na presente invenção, o termo "faca" pode se referir coletivamente à barra de faca 280 (também chamada de barra de disparo 172), ao gume cortante 182 e aos outros componentes relacionados que são avançados distalmente para fazer a transeção do tecido.
[0157] Consequentemente, o controlador 1104 verifica 6002 o estado da lâmina do instrumento cirúrgico 10. O estado de lâmina ou disparo é um estado operacional do instrumento cirúrgico 10 em que a barra de corte 280 está sendo transladada para cortar o tecido capturado no atuador de extremidade 2300. O controlador 1104 pode determinar se a barra de corte 280 está sendo disparada, por exemplo, detectando a posição de um componente do sistema de corte por meio de um sensor de posição 1112, detectando se uma tensão está sendo aplicada ao motor 1120, detectando a posição do gatilho de disparo, detectando se o sistema de acionamento de fechamento 3510 foi ativado, detectando as posições relativas das garras 3604, 3608 (ou a bigorna 3616 e o cartucho 3606) do atuador de extremidade 2300, ou por combinações dos mesmos. Em um aspecto geral, se o controlador 1104 detectar que o sistema de disparo para a lâmina foi ativado e o atuador de extremidade 2300 é preso, então o processo 5000 determinar que o instrumento cirúrgico 10 está no estado de disparo.
[0158] O controlador 1104 pode detectar que o sistema de disparo para a lâmina foi ativado em uma variedade de formas diferentes. Em um aspecto, o controlador 1104 é configurado para detectar diretamente a translação da barra de faca 280. Neste aspecto, o membro de deslocamento 1111 rastreado pelo sensor de posição 1112 representa a barra de faca 280. Em outros aspectos, o controlador 1104 é configurado para detectar indiretamente a translação da barra de faca 280 em vez de detectar a translação de um componente que é acoplado à barra de faca 280. Nestes aspectos, o membro de deslocamento 1111 rastreado pelo sensor de posição 1112 representa o membro de acionamento longitudinalmente móvel 120 (Figura 2), a viga com perfil em I 178 (Figura 4) ou outro componente do sistema de faca ou do sistema de acionamento de disparo 80. Em qualquer um desses aspectos, quando o sensor de posição 1112 detecta que o membro de deslocamento 1111 está avançando a partir de uma primeira posição (ou seja, proximal ou inicial) para uma segunda posição (ou seja, distal), o controlador 1104 pode determinar, assim, que a barra de faca 280 está sendo disparada. Em um outro aspecto, o controlador 1104 pode ser acoplado de modo comunicável a um sensor de corrente 2536 (Figura 14) que é configurado para detectar quando o motor 2504 está extraindo energia da fonte de energia 2512. Quando o sensor de corrente 2536 detecta que o motor 2504 está drenando energia (ou seja, que uma tensão está sendo aplicada ao motor 2504), o controlador 1104 pode determinar, deste modo, que a barra de faca 280 está sendo disparada porque o motor 2504 aciona a barra de faca 280 quando uma tensão é aplicada ao mesmo. Em ainda outro aspecto, o(s) outro(s) sensor(es) 1118 pode(m) incluir um sensor de gatilho de disparo configurado para determinar quando o gatilho de disparo (não mostrado) foi acionado. Conforme o gatilho de disparo faz com que o sistema de corte dispare, a detecção de se o gatilho de disparo foi acionado serve como um substituto para determinar o estado de disparo do instrumento cirúrgico 10. O sensor de gatilho de disparo pode incluir, por exemplo, um sensor de posição configurado para detectar a posição do gatilho de disparo em relação ao conjunto de empunhadura 3500. Vários outros aspectos incluem combinações das referidas disposições de sensor e/ou de vários sensores adicionais configurados para detectar quando o sistema de faca ou o sistema de acionamento de disparo 80 é ativado.
[0159] O controlador 1104 pode detectar que o atuador de extremidade 2300 está preso de uma variedade de formas diferentes.
Em um aspecto, o(s) outro(s) sensor(es) 1118 pode(m) incluir um sensor de gatilho de fechamento configurado para determinar quando o gatilho de fechamento 3512 foi atuado.
À medida que o gatilho de fechamento 3512 faz com que o sistema de acionamento de fechamento 3510 seja ativado, detectando se o gatilho de fechamento 3512 foi acionado, ele atua como um indicador para determinar se o atuador de extremidade 2300 está em uma posição presa ou solta.
O sensor de gatilho de fechamento pode incluir, por exemplo, um sensor de posição configurado para detectar a posição do gatilho de fechamento 3512 em relação ao conjunto de empunhadura 3500. Outros aspectos podem incluir um sensor de gatilho de disparo ou um sensor de botão de disparo para detectar a atuação dos controles de disparo.
O(s) outro(s) sensor(es) 1118 podem incluir adicionalmente um sensor do sistema de acionamento de fechamento configurado para detectar a ativação do sistema de acionamento de fechamento 3510. Por exemplo, o(s) outro(s) sensor(es) 1118 pode(m) incluir um sensor configurado para medir as forças exercidas sobre a bigorna 3616 pelo tubo de fechamento 3620 ou um sensor configurado para medir a posição relativa do tubo de fechamento 3620 ou outro componente móvel do sistema de acionamento de fechamento que translada entre uma primeira posição e uma segunda posição para efetuar o fechamento do atuador de extremidade 2300. O(s) outro(s) sensor(es) 1118 pode(m) incluir adicionalmente um sensor de garra configurado para determinar se as garras 3604, 3608 do atuador de extremidade 2300 estão em uma posição presa ou solta.
Por exemplo, o(s) outro(s) sensor(es) 1118 pode(m) incluir um sensor configurado para detectar uma distância entre a primeira garra 3604 e a segunda garra 3608, um sensor de pressão disposto sobre ao menos uma dentre a primeira garra 3604 e/ou a segunda garra 3608 que é configurado para detectar quando o atuador de extremidade 2300 está preso em um objeto (por exemplo, tecido), ou um sensor de impedância configurado para detectar a impedância do tecido localizado entre a primeira garra 3604 e a segunda garra 3608.
[0160] O processo 6000 executado pelo controlador 1104 determina 6004 assim, se a barra de corte 280 está disparando de acordo com se o processo 6000 determinou que o estado da lâmina está ativo ou inativo. Em um exemplo específico, o instrumento cirúrgico 10 inclui um sensor de gatilho de disparo, conforme descrito acima, e um sensor de garra, conforme descrito acima. Se o controlador 1104 detectar que o gatilho de disparo foi acionado e que as garras 3604, 3608 do atuador de extremidade 2300 são presas através dos sensores supracitados, então o processo 6000 determina 6004 que o instrumento cirúrgico 10 está em um estado de disparo, isto é, a barra de corte 280 está sendo avançada para cortar o tecido. Vários outros aspectos podem incluir as disposições de sensor descritas acima quer em isolamento ou em outras combinações para determinar se o instrumento cirúrgico 10 está no estado de disparo. Informações adicionais referentes a várias disposições de sensor podem ser encontradas no Pedido de patente US N° 15/628.175, intitulado TECHNIQUES FOR ADAPTIVE CONTROL
OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, que está aqui incorporado a título de referência em sua totalidade.
[0161] Se a barra de corte 280 estiver disparando, o processo 6000 continuará ao longo da ramificação SIM e prossegue para determinar 6006 se a barra de corte 280 está na posição inicial. A posição da barra de corte 280 pode ser detectada diretamente ou indiretamente, conforme descrito acima. Independentemente de se o membro de deslocamento 1111 representa a barra de corte 280, o membro de acionamento móvel longitudinalmente 120 (Figura 2), ou um outro componente longitudinalmente móvel do sistema de corte ou do sistema de acionamento de disparo 80, o processo 6000 pode determinar 6004 se a barra de corte 280 está na posição inicial mediante a detecção da posição do membro de deslocamento 1111 em relação à sua posição inicial. Mesmo que o membro de deslocamento 1111 não represente diretamente a barra de corte 280, a posição do membro de deslocamento 1111 corresponde à posição da barra de corte 280 porque eles estão operacionalmente acoplados juntos. Em outras palavras, a translação de, por exemplo, o membro de acionamento móvel longitudinalmente 120 causa uma translação correspondente na barra de corte 280, conforme descrito acima. Portanto, quando o deslocamento 1111 está situado em sua primeira posição ou posição não disparada, a barra de corte 280 esta da mesma forma situada em sua posição não disparada. O controlador 1104 pode ser configurado para recuperar a posição inicial do membro de deslocamento 1111, por exemplo, a memória 1106, e então comparar a posição atual do membro de deslocamento 1111 com a posição inicial recuperada do membro de deslocamento 1111 para determinar se o membro de deslocamento 1111 está na posição inicial.
[0162] Se a barra de corte 280 não estiver situada na sua posição inicial, então o processo 6000 continua ao longo da ramificação NÃO e prossegue para permitir que a barra de corte 280 continue 6008 a transecção (isto é, tecido de corte ou disparo). Após permitir que a barra de corte 280 continue 6008 a transecção, o processo 6000 então volta e redetermina 6006 se a barra de corte 280 estiver na posição inicial. Em vários aspectos, o processo 6000 pode continuar seu circuito continuamente até que ele determine 6006 que a barra de corte 280 está na posição inicial. A etapa de deixar a barra de corte 280 continuar 6008 a transecção pode incluir, por exemplo, um atraso antes da redeterminação 6006 de se a barra de corte 280 está situada na posição inicial.
[0163] Uma vez que o processo 6000 determina 6006 que a barra de corte 280 está na posição inicial, o processo 6000 prossegue ao longo da ramificação SIM e, em seguida, verifica 6010 o estado de articulação do instrumento cirúrgico 10. Em um aspecto, o processo 6000 também prossegue para verificar 6010 o estado de articulação do instrumento cirúrgico 10 se o processo 6000 prosseguisse ao longo da ramificação NÃO da etapa de determinação 6004 de se a barra de corte 280 está disparando. Em um outro aspecto, o processo 6000 determina 6006 se a barra de corte 280 está na posição inicial independentemente de se a barra de corte 280 está disparando ou não, conforme determinado 6004 pelo processo 6000. Nesse aspecto, o processo 6000 apenas prossegue para verificar 6010 o estado de articulação uma vez que o processo 6000 determina 6006 que a barra de corte 280 está na posição inicial. Em outras palavras, neste aspecto o processo 6000 apenas continua quando a barra de corte 280 está na posição inicial.
[0164] O estado de articulação corresponde a se o atuador de extremidade 2300 está articulado ou está em uma posição estática. Quando o atuador de extremidade 2300 está articulado, pode-se dizer que o mesmo está em um estado operacional ativo. Quando o atuador de extremidade 2300 está articulado, pode-se dizer que o mesmo está em um estado operacional inativo. O controlador 1104 pode determinar o estado de articulação, por exemplo, por detecção de uma posição de um componente no sistema de articulação 2800 por meio de um sensor de posição 1112, detecção de uma posição angular do atuador de extremidade 2300, ou combinações dos mesmos. Em um aspecto, o membro de deslocamento 1111 rastreado pelo sensor de posição 1112 representa o acionador de articulação 230 ou outro componente do sistema de articulação 2800 ou do sistema de acionamento de disparo
80. Nesse aspecto, o instrumento cirúrgico pode incluir uma disposição do sensor de articulação que por sua vez pode incluir um sensor de posição e um magneto que é acoplado operacionalmente à junta de articulação 2270 de modo que o mesmo gire de uma maneira consistente com a rotação da junta de articulação 2270. Conforme descrito acima, à medida que o magneto gira, os elementos sensores magnéticos do sensor de posição determinam a posição angular absoluta do magneto, que corresponde à posição angular (isto é, posição de articulação) do atuador de extremidade 2300.
[0165] Após verificar 6010 o estado de articulação do instrumento cirúrgico 10, o processo 6000 então determina 6012 se o atuador de extremidade 2300 está na posição inicial. Em um aspecto, o processo 6000 determina se o atuador de extremidade 2300 está na posição inicial pela determinação da posição do membro de deslocamento 1111 (que pode corresponder ao membro acionador longitudinalmente móvel 3540, ao acionador de articulação 230, ou outro componente móvel no sistema de articulação 2800) em relação aos limites proximal e distal entre os quais o membro de deslocamento 1111 é transladado. Como articulação do atuador de extremidade 2300 é acionada pelo membro de deslocamento 1111, os limites da faixa de translação do membro de deslocamento 1111 correspondem aos limites da faixa de articulação do atuador de extremidade 2300. Dessa forma, a posição proximal do membro de deslocamento 1111 corresponde a um primeiro limite da faixa de articulação do atuador de extremidade 2300 e, consequentemente, a posição distal do membro de deslocamento 1111 corresponde a um segundo limite da faixa de articulação do atuador de extremidade 2300. Portanto, o processo 6000 executado pelo controlador 1104 pode determinar 6012 se o atuador de extremidade 2300 está em sua posição inicial de acordo com a posição do membro de deslocamento 1111 em relação aos limites da faixa de translação 1111 do membro de deslocamento. A posição inicial do atuador de extremidade 2300 pode corresponder a um dos limites de sua faixa de articulação, um ponto médio entre os limites da sua faixa de articulação, ou em qualquer outra posição entre os mesmos. Em um aspecto, a posição inicial do atuador de extremidade 2300 corresponde à posição em sua faixa de articulação onde o atuador de extremidade 2300 está alinhado com o eixo geométrico longitudinal do eixo de acionamento do instrumento cirúrgico 10. As posições proximal e distal do membro de deslocamento 1111 podem ser, por exemplo, armazenadas na memória 1106 e recuperadas pelo controlador 1104 para calcular a posição angular relativa do atuador de extremidade 2300. Em um outro aspecto, o processo 4000 determina a posição de articulação relativa do atuador de extremidade 2300 detectando diretamente o ângulo em que a junta de articulação 2270 e/ou o atuador de extremidade 2300 é orientado, por exemplo, por uma disposição de sensor de articulação. O ângulo de articulação detectado do atuador de extremidade 2300 pode ser comparado com os limites da sua faixa de articulação, que podem ser, por exemplo, armazenados na memória 1106 e recuperados pelo controlador 1104 para calcular a posição relativa do atuador de extremidade 2300.
[0166] Se o atuador de extremidade 2300 não está localizado na sua posição inicial, então o processo 6000 continua ao longo da ramificação NÃO e prossegue para permitir que o atuador de extremidade 2300 continue a articulação 6014. Após permitir que o atuador de extremidade 2300 continue 6014 a articulação, o processo 6000 então volta e redetermina 6012 se o atuador de extremidade 2300 está na posição inicial. Em vários aspectos, o processo 6000 pode continuar este circuito continuamente até que ele determina 6012 que a posição angular do atuador de extremidade 2300 é a posição inicial. A etapa de permitir que o atuador de extremidade 2300 continue 6014 a articulação pode incluir, por exemplo, um atraso antes de redeterminar 6012 se o atuador de extremidade 2300 está situado na posição inicial.
[0167] Se o processo 6000 determina 6012 que o atuador de extremidade 2300 está localizado na posição inicial, então o processo 6000 continua ao longo da ramificação SIM e inicia 6016 um modo de desligamento de energia. O modo de desligamento de energia faz com que o controlador 1104 desative um ou mais processos que estão sendo executados por esse meio, e/ou desative vários componentes do instrumento cirúrgico 10 que estão drenando energia a partir de fontes de energia (por exemplo, fonte de energia 2512), como o sensor de posição 1112, o(s) outro(s) sensor(es) 1118, o monitor de exibição 3430 (Figura 23), e o motor 2504 (Figura 14). Em um aspecto representado na Figura 27, o controlador 1104 faz com que o monitor de exibição 6030 exiba uma imagem 6032 para indicar visualmente ao médico que o instrumento cirúrgico 10 entrou no modo de desligamento de energia. A imagem 6032 pode ser mostrada indefinidamente ou apenas por um determinado período de tempo. Em suma, o processo 6000 conforme executado pelo controlador 1104 faz com que o instrumento cirúrgico 10 entre em um modo de baixo consumo de energia ou modo de desligamento de energia quando o processo 6000 detecta que a barra de corte 280 e o atuador de extremidade 2300 estão ambos em suas respectivas posições. Em um aspecto, o processo 6000 inclui uma etapa adicional de espera por uma variável ou período de tempo predeterminado antes de iniciar o modo de desligamento de energia
6016. Em outras palavras, em alguns aspectos o processo 6000 apenas inicia 6016 o modo de baixa energia se a lâmina e o atuador de extremidade 2300 estiverem situados em suas respectivas posições iniciais por um período de tempo que excede uma duração de limiar específica.
[0168] Em vários aspectos, o instrumento cirúrgico 10 é configurado para reativar o modo de energia total do modo de desligamento de energia quando um médico insere um comando através de um monitor capacitivo (por exemplo, monitor de exibição 3430) ou quando um sensor de movimento detecta que o instrumento cirúrgico 10 é agitado ou de outro modo manipulado.
[0169] As funções ou processos para controlar um instrumento cirúrgico para iniciar um modo de desligamento de energia de acordo com o estado operacional do instrumento cirúrgico aqui descrito podem ser executados por qualquer um dos circuitos de processamento aqui descritos, como o circuito de controle 700 descrito em conexão com as Figuras 5A a 6, os circuitos 800, 810, 820 descritos nas Figuras 7 a 9, o controlador 1104 descrito em conexão com as Figuras 10 e 12 e/ou o circuito de controle 2510 descrito na Figura 14.
[0170] Aspectos do instrumento cirúrgico motorizado podem ser praticados sem os detalhes específicos aqui revelados. Alguns aspectos foram mostrados como diagramas de bloco em vez de detalhes. Partes desta revelação podem ser apresentadas em termos de instruções que operam em dados armazenados em uma memória do computador. Um algoritmo se refere a uma 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 que possam ser 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.
[0171] 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, o termo "circuito elétrico" inclui circuitos elétricos que tenham ao menos um circuito elétrico isolado, 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 para finalidades gerais ou processador configurado por um programa de computador que ao menos parcialmente execute 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.
[0172] 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 operações. Cada função e/ou operação dentro de tais diagramas de blocos, fluxogramas ou exemplos pode ser implementada, individualmente e/ou coletivamente, por uma ampla gama de hardware, software, firmware ou virtualmente qualquer combinação dos mesmos. Em um aspecto, várias porções do assunto aqui descrito podem ser implementadas por meio de circuitos integrados de aplicação específica (ASICs), arranjos de portas programáveis em campo (FPGAs), processadores de sinais digitais (DSPs), dispositivos lógicos programáveis (PLDs), circuitos, registradores e/ou componentes de software, por exemplo, programas, sub-rotinas, lógica e/ou combinações de componentes de hardware e software, portas lógicas, ou outros formatos integrados. Alguns aspectos aqui revelados, no todo ou em parte, podem ser implementados de modo equivalente em circuitos integrados, como um ou mais programas de computador executando em um ou mais computadores (por exemplo, como um ou mais programas operando em um ou mais sistemas de computador), como um ou mais programas operando em um ou mais processadores (por exemplo, como um ou mais programas operando em um ou mais microprocessadores), como firmware, ou virtualmente como qualquer combinação dos mesmos, e que projetar o conjunto de circuitos e/ou escrever o código para o software e firmware estaria dentro do âmbito de prática de uma pessoa versada na técnica à luz desta revelação.
[0173] 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.).
[0174] 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 reivindicações apresentadas em anexo definam o escopo global.
[0175] Vários aspectos da matéria descrita no presente documento são definidos nos seguintes exemplos numerados:
[0176] Exemplo 1. Um instrumento cirúrgico compreendendo: um atuador de extremidade articulável entre uma posição não articulada e uma posição articulada; um membro de deslocamento acoplado ao atuador de extremidade, o membro de deslocamento sendo móvel entre uma primeira posição e uma segunda posição para acionar o atuador de extremidade entre a posição não articulada e a posição articulada; uma barra de corte móvel entre uma posição não disparada e uma posição disparada; um sistema de controle configurado para: determinar um estado de disparo de acordo com se a barra de faca está em movimento entre a posição não disparada e a posição disparada; determinar um estado de articulação de acordo com se o membro de deslocamento está em movimento entre a primeira posição e a segunda posição; e iniciar um modo de desligamento de energia de acordo com o estado de disparo e o estado de articulação.
[0177] Exemplo 2. O instrumento cirúrgico, de acordo com o Exemplo 1, sendo que o circuito de controle é configurado para não iniciar o modo de desligamento de energia a menos que a barra de corte esteja na posição não disparada.
[0178] Exemplo 3. O instrumento cirúrgico, de acordo com o Exemplo 2, sendo que o circuito de controle é configurado para não iniciar o modo de desligamento de energia a menos que o membro de deslocamento esteja na primeira posição.
[0179] Exemplo 4. O instrumento cirúrgico de acordo com ao menos um dentre o Exemplo 1 ao Exemplo 3, que compreende adicionalmente:
um gatilho de disparo acoplado à barra de corte, o gatilho de disparo configurado para acionar a barra de corte entre a posição não disparada e a posição disparada; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com uma posição do gatilho de disparo.
[0180] Exemplo 5. O instrumento cirúrgico de acordo com ao menos um dentre o Exemplo 1 ao Exemplo 4, que compreende adicionalmente: um motor acoplado à barra de corte, sendo o motor configurado para acionar a barra de corte entre a posição não disparada e a posição disparada; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com a tensão elétrica do motor.
[0181] Exemplo 6. O instrumento cirúrgico de pelo menos um dentre o Exemplo 1 ao Exemplo 6, que compreende adicionalmente: um sensor configurado para detectar uma posição da barra de faca e fornecer um sinal indicativo da mesma; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com o sinal.
[0182] Exemplo 7. O instrumento cirúrgico de acordo com ao menos um dentre o Exemplo 1 ao Exemplo 6, que compreende adicionalmente: um sensor configurado para detectar uma posição do membro de deslocamento e fornecer um sinal indicativo do mesmo; sendo que o circuito de controle é configurado para determinar se o membro de deslocamento está em movimento de acordo com o sinal.
[0183] Exemplo 8. Um instrumento cirúrgico compreendendo: um atuador de extremidade articulado a partir de uma posição inicial de articulação; uma barra de corte móvel a partir de uma posição inicial de corte; e um circuito de controle configurado para: determinar se a barra de faca está em movimento; determinar se o atuador de extremidade está em movimento; e iniciar um modo de desligamento de energia sobre a barra de faca e o atuador de extremidade que não está em movimento.
[0184] Exemplo 9. O instrumento cirúrgico, de acordo com o Exemplo 8, sendo que o circuito de controle é configurado para não iniciar o modo de desligamento de energia a menos que a barra de corte esteja na posição inicial de corte.
[0185] Exemplo 10. O instrumento cirúrgico, de acordo com o Exemplo 9, sendo que o circuito de controle é configurado para não iniciar o modo de desligamento de energia a menos que o atuador de extremidade esteja na posição inicial de articulação.
[0186] Exemplo 11. O instrumento cirúrgico de acordo com ao menos um dentre o Exemplo 8 ao Exemplo 10, que compreende adicionalmente: um gatilho de disparo acoplado à barra de corte, o gatilho de disparo configurado para acionar a barra de corte a partir da posição inicial da lâmina; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com uma posição do gatilho de disparo.
[0187] Exemplo 12. O instrumento cirúrgico de acordo com ao menos um dentre o Exemplo 8 ao Exemplo 11, que compreende adicionalmente: um motor acoplado à barra de corte, o motor configurado para acionar a barra de corte a partir da posição inicial; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com a tensão elétrica do motor.
[0188] Exemplo 13. O instrumento cirúrgico de acordo com ao menos um dentre o Exemplo 8 ao Exemplo 12, que compreende adicionalmente: um sensor configurado para detectar uma posição da barra de corte e fornecer um sinal indicativo do mesmo; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com o sinal.
[0189] Exemplo 14. O instrumento cirúrgico de acordo com ao menos um dentre o Exemplo 8 ao Exemplo 13, que compreende adicionalmente: um sensor configurado para detectar uma posição do atuador de extremidade e fornecer um sinal indicativo do mesmo; sendo que o circuito de controle é configurado para determinar se o atuador de extremidade está em movimento de acordo com o sinal.
[0190] Exemplo 15. Um método para controlar um instrumento cirúrgico que compreende um atuador de extremidade, um membro de deslocamento acoplado ao atuador de extremidade, sendo o membro de deslocamento móvel entre uma primeira posição e uma segunda posição, e uma barra de corte móvel entre uma posição não disparada e uma posição disparada, sendo que o método compreende: determinar um estado de disparo de acordo com se a barra de corte está se movendo entre a posição não disparada e a posição disparada; determinar um estado de articulação de acordo com se o membro de deslocamento se move entre a primeira posição e a segunda posição; iniciar um modo de desligamento de energia de acordo com o estado de disparo e o estado de articulação.
[0191] Exemplo 16. O método, de acordo com o Exemplo 15, sendo que o modo de desligamento de energia não é iniciado a menos que a barra de corte esteja na posição não disparada.
[0192] Exemplo 17. O método, de acordo com o Exemplo 15 ou Exemplo 16, sendo que o modo de desligamento de energia não é iniciado a menos que o membro de deslocamento esteja na primeira posição.
[0193] Exemplo 18. O método, de acordo com ao menos um entre o Exemplo 15 ao Exemplo 17, sendo que compreende adicionalmente determinar se a barra de corte está em movimento de acordo com uma posição de um gatilho de disparo acoplado à barra de corte.
[0194] Exemplo 19. O método, de acordo com ao menos um dentre o Exemplo 15 ao Exemplo 18, sendo que compreende adicionalmente determinar se a barra de corte está em movimento de acordo com uma tensão elétrica do motor acoplado à barra de corte.
[0195] Exemplo 20. O método, de acordo com ao menos um dentre o Exemplo 15 ao Exemplo 19, sendo que compreende adicionalmente determinar se a barra de corte está em movimento de acordo com um sensor configurado para detectar uma posição da barra de corte.
[0196] Exemplo 21. O método, de acordo com ao menos um dentre o Exemplo 15 ao Exemplo 20, sendo que compreende adicionalmente determinar se o membro de deslocamento se move de acordo com um sensor configurado para detectar uma posição do membro de deslocamento.
Claims (21)
1. Instrumento cirúrgico caracterizado por compreender: um atuador de extremidade pivotante entre uma posição não articulada e uma posição articulada; um membro de deslocamento acoplado ao atuador de extremidade, o membro de deslocamento sendo móvel entre uma primeira posição e uma segunda posição para acionar o atuador de extremidade entre a posição não articulada e a posição articulada; uma barra de corte móvel entre uma posição não disparada e uma posição disparada; um circuito de controle configurado para: determinar um estado de disparo de acordo com se a barra de corte está em movimento entre a posição não disparada e a posição disparada; determinar um estado de articulação de acordo com se o membro de deslocamento está em movimento entre a primeira posição e a segunda posição; e iniciar um modo de desligamento de energia de acordo com o estado de disparo e o estado de articulação.
2. Instrumento cirúrgico, de acordo com a reivindicação 1, caracterizado por o circuito de controle ser configurado para não iniciar o modo de desligamento de energia a menos que a barra de corte esteja na posição não disparada.
3. Instrumento cirúrgico, de acordo com a reivindicação 1, caracterizado por o circuito de controle ser configurado para não iniciar o modo de desligamento de energia a menos que o membro de deslocamento esteja na primeira posição.
4. Instrumento cirúrgico, de acordo com a reivindicação 1, caracterizado por compreender ainda: um gatilho de disparo acoplado à barra de corte, sendo o gatilho de disparo configurado para acionar a barra de corte entre a posição não disparada e a posição disparada; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com uma posição do gatilho de disparo.
5. Instrumento cirúrgico, de acordo com a reivindicação 1, caracterizado por compreender ainda: um motor acoplado à barra de corte, sendo o motor configurado para acionar a barra de corte entre a posição não disparada e a posição disparada; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com a tensão elétrica do motor.
6. Instrumento cirúrgico, de acordo com a reivindicação 1, caracterizado por compreender ainda: um sensor configurado para detectar uma posição da barra de corte e fornecer um sinal indicativo do mesmo; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com o sinal.
7. Instrumento cirúrgico, de acordo com a reivindicação 1, caracterizado por compreender ainda: um sensor configurado para detectar uma posição do membro de deslocamento e fornecer um sinal indicativo do mesmo; sendo que o circuito de controle é configurado para determinar se o membro de deslocamento está em movimento de acordo com o sinal.
8. Instrumento cirúrgico caracterizado por compreender: um atuador de extremidade pivotante a partir de uma posição inicial de articulação;
uma barra de corte móvel a partir de uma posição inicial de corte; e um circuito de controle configurado para: determinar se a barra de corte está em movimento; determinar se o atuador de extremidade está em movimento; e iniciar um modo de desligamento de energia sobre a barra de corte e o atuador de extremidade que não está em movimento.
9. Instrumento cirúrgico, de acordo com a reivindicação 8, caracterizado por o circuito de controle ser configurado para não iniciar o modo de desligamento de energia a menos que a barra de corte esteja na posição inicial de corte.
10. Instrumento cirúrgico, de acordo com a reivindicação 8, caracterizado por o circuito de controle ser configurado para não iniciar o modo de desligamento de energia a menos que o atuador de extremidade esteja na posição inicial de articulação.
11. Instrumento cirúrgico, de acordo com a reivindicação 8, caracterizado por compreender ainda: um gatilho de disparo acoplado à barra de corte, sendo o gatilho de disparo configurado para acionar a barra de corte a partir da posição inicial de corte; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com uma posição do gatilho de disparo.
12. Instrumento cirúrgico, de acordo com a reivindicação 8, caracterizado por compreender ainda: um motor acoplado à barra de corte, sendo o motor configurado para acionar a barra de corte a partir da posição inicial de corte; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com a tensão elétrica do motor.
13. Instrumento cirúrgico, de acordo com a reivindicação 8, caracterizado por compreender ainda: um sensor configurado para detectar uma posição da barra de corte e fornecer um sinal indicativo do mesmo; sendo que o circuito de controle é configurado para determinar se a barra de corte está em movimento de acordo com o sinal.
14. Instrumento cirúrgico, de acordo com a reivindicação 8, caracterizado por compreender ainda: um sensor configurado para detectar uma posição do atuador de extremidade e fornecer um sinal indicativo do mesmo; sendo que o circuito de controle é configurado para determinar se o atuador de extremidade está em movimento de acordo com o sinal.
15. Método para controlar um instrumento cirúrgico que compreende um atuador de extremidade, um membro de deslocamento acoplado ao atuador de extremidade, sendo o membro de deslocamento móvel entre uma primeira posição e uma segunda posição, e uma barra de corte móvel entre uma posição não disparada e uma posição disparada, o método sendo caracterizado por compreender: determinar um estado de disparo de acordo com se a barra de corte está em movimento entre a posição não disparada e a posição disparada; determinar um estado de articulação de acordo com se o membro de deslocamento se move entre a primeira posição e a segunda posição; e iniciar um modo de desligamento de energia de acordo com o estado de disparo e o estado de articulação.
16. Método, de acordo com a reivindicação 15, caracterizado por o modo de desligamento de energia não ser iniciado a menos que a barra de corte esteja na posição não disparada.
17. Método, de acordo com a reivindicação 15, caracterizado por o modo de desligamento de energia não ser iniciado a menos que o membro de deslocamento esteja na primeira posição.
18. Método, de acordo com a reivindicação 15, caracterizado por compreender ainda determinar se a barra de corte está em movimento de acordo com uma posição de um gatilho de disparo acoplado à barra de corte.
19. Método, de acordo com a reivindicação 15, caracterizado por compreender ainda determinar se a barra de corte está em movimento de acordo com uma tensão elétrica do motor acoplado à barra de corte.
20. Método, de acordo com a reivindicação 15, caracterizado por compreender ainda determinar se a barra de corte está em movimento de acordo com um sensor configurado para detectar uma posição da barra de corte.
21. Método, de acordo com a reivindicação 15, caracterizado por compreender ainda determinar se o membro de deslocamento se move de acordo com um sensor configurado para detectar uma posição do membro de deslocamento.
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US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
US20200405292A1 (en) | 2019-06-28 | 2020-12-31 | Ethicon Llc | Surgical instrument including a battery unit |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
US20200405307A1 (en) | 2019-06-28 | 2020-12-31 | Ethicon Llc | Control circuit comprising a coating |
US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
US11350938B2 (en) | 2019-06-28 | 2022-06-07 | Cilag Gmbh International | Surgical instrument comprising an aligned rfid sensor |
-
2017
- 2017-09-29 US US15/720,829 patent/US11399829B2/en active Active
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2018
- 2018-09-21 JP JP2020517839A patent/JP7383603B2/ja active Active
- 2018-09-21 BR BR112020006065-8A patent/BR112020006065A2/pt unknown
- 2018-09-21 WO PCT/IB2018/057313 patent/WO2019064148A1/en active Application Filing
- 2018-09-21 CN CN201880071006.4A patent/CN111278379B/zh active Active
- 2018-10-01 EP EP18198028.5A patent/EP3461447A1/en active Pending
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JP7383603B2 (ja) | 2023-11-20 |
US20190099179A1 (en) | 2019-04-04 |
EP3461447A1 (en) | 2019-04-03 |
WO2019064148A1 (en) | 2019-04-04 |
CN111278379B (zh) | 2023-09-19 |
CN111278379A (zh) | 2020-06-12 |
US11399829B2 (en) | 2022-08-02 |
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