BR112020012520A2 - power interruption due to inadvertent capacitive coupling - Google Patents

Abstract

In some aspects, a surgical system configured to limit or prevent capacitive coupling and its effects is presented. The surgical system can include: an energy generator; a surgical instrument electrically coupled to the energy generator and configured to transmit electrosurgical energy to a patient's tissue at a surgical site; at least one sensor configured to detect energy from a power anomaly; and at least one processor communicatively coupled to at least one sensor, and configured to: receive, from at least one sensor, data that the energy is being emitted in an unintended location within the surgical system; transmit an alert indicating that a parasitic capacitive coupling is taking place; and transmitting an interruption to the power generator to temporarily interrupt power generation.

Description

Invention Patent Descriptive Report for "ENERGY INTERRUPTION DUE TO INADVERTED CAPACITIVE COUPLING". CROSS REFERENCES TO CORRELATE DEPOSIT REQUESTS

TOS

[0001] The present application claims priority under title 35 of the USC (United States Code), $ 119 (e), to provisional US patent application 62 / 721,995, entitled "CONTROLLING AN ULTRA-SONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION ", filed on August 23, 2018, the disclosure of which is incorporated herein, by reference, in its entirety.

[0002] The present application claims priority under title 35 of the USC (United States Code), $ 119 (e), to the provisional US patent application 62 / 721,998, entitled "SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS", filed at August 23, 2018, the disclosure of which is incorporated herein by way of reference in its entirety.

[0003] The present application claims priority under title 35 of the USC (United States Code), $ 119 (e), to US provisional patent application No. 62 / 721,999, entitled "" NTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING ", filed on August 23, 2018, the disclosure of which is hereby incorporated by reference in its entirety.

[0004] The present application claims priority under title 35 of the U.S.C. (United States Code), $ 119 (e), to US provisional patent application No. 62 / 721,994, entitled "BIPOLAR COMBINATION

DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY ", filed on August 23, 2018, the disclosure of which is hereby incorporated by reference in its entirety.

[0005] The present application claims priority under title 35 of the

USC (United States Code), $ 119 (e), to US provisional patent application 62 / 721,996, entitled "RADIO FREQUENCY ENER- GY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNAL", filed on August 23, 2018, whose disclosure it is incorporated here, as a reference, in its entirety.

[0006] The present application claims priority under title 35 of the USC (United States Code), $ 119 (e), to US provisional patent application No. 62 / 692,747, entitled "SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE ", filed on June 30, 2018, to US provisional patent application 62 / 692,748, entitled" SMART ENERGY ARCHITECTURE ", filed on June 30, 2018, and to US provisional patent application 62 / 692,768, entitled "SMART ENERGY DEVICES", deposited on June 30, 2018, the disclosure of which is incorporated herein, by reference, in its entirety.

[0007] This application also claims the priority benefit under title 35 of the USC (United States Code), $ 119 (e), to US provisional patent application No. 62 / 650,898 filed on March 30, 2018, entitled " CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS ", to US provisional patent application serial number 62 / 650.887, entitled" SURGICAL SYS- TEMS WITH OPTIMIZED SENSING CAPABILITIES ", filed in March 2018, to US provisional patent application No. serial number 62 / 650.882, entitled "SMOKE EVACUATION MODULE FOR INTE- RACTIVE SURGICAL PLATFORM", filed on March 30, 2018, and provisional US patent application serial number 62 / 650.877, entitled "SURGICAL SMOKE EVACUATION SENSING AND CON- TROLS ", filed on March 30, 2018, the disclosure of each of which is incorporated herein, by reference, in its entirety.

[0008] This application also claims the priority benefit under title 35 of the USC (United States Code), $ 119 (e), to US provisional patent application serial number 62 / 611,341, entitled "INTERACTIVE SURGICAL PLATFORM ", filed on December 28, 2017, to the provisional patent application US serial number 62 / 611.340, entitled" CLOUD-BASED MEDICAL ANALYTICS ", filed on December 28, 2017, and to the provisional patent application US serial number 62 / 611,339, entitled "ROBOT ASSISTED SURGICAL PLATFORM", deposited on December 28, 2017, the disclosure of which is incorporated herein, by reference, in its entirety.

BACKGROUND

[0009] The present disclosure is related, in general and in several aspects, to surgical systems that use radiofrequency energy (RF - radio frequency) in electrosurgery.

[0010] Electrosurgical systems typically use a generator to supply electrosurgical energy (for example, alternating current in radio frequency levels) to an active electrode that applies electrosurgical energy to a surgical site on a patient's body. The surgical instrument can use energy to perform different types of surgery, such as cutting tissue or coagulating tissue, depending on the need. Monopolar electrosurgery involves applying the surgical instrument to the patient's tissue using a single active electrode, and completes the electrical circuit through the patient with a return electrode on the patient. This return electrode is typically connected back to the monopolar energy generator. However, capacitive coupling is an ever-present problem in this system, and can potentially cause unwanted burns in initially unknown locations on the patient's body. It is desirable to take into account capacitive coupling, in order to minimize or eliminate the occurrence of accidental damage to the patient.

SUMMARY

[0011] In some aspects, a surgical system configured to limit or prevent capacitive coupling and its effects is presented. The surgical system can include: an energy generator; a surgical instrument electrically coupled to the energy generator and configured to transmit electrosurgical energy to a patient's tissue at a surgical site; at least one sensor configured to detect a power anomaly; and at least one processor coupled in a communicative way to at least one sensor, and configured to: receive, from at least one sensor, data that the energy is being emitted in an unintended location within the surgical system; transmit an alert indicating that a parasitic capacitive coupling is taking place; and transmit an interruption to the energy generator to temporarily interrupt the generation of energy.

[0012] In some respects, the surgical system additionally includes an energy dissipation block electrically coupled to a neutral electrode in the energy generator, the energy dissipation block being configured to conductively connect to the patient and dissipate energy in the opposite direction to the patient when energy is applied to the patient's tissue by the surgical instrument.

[0013] In some aspects of the surgical system, the neutral electrode is configured to passively divert energy in the opposite direction to the patient during a caparcitive coupling event.

[0014] In some aspects of the surgical system, the surgical instrument comprises: an end actuator comprising a pair of claws; and a drive shaft electrically coupled to the end actuator and configured to supply the end actuator with energy from the power generator.

[0015] In some aspects of the surgical system, the claws comprise

they hold rounded tips configured to reduce maximum tension spikes as the claws come into contact with the patient's tissue.

[0016] In some aspects of the surgical system, the drive shaft comprises the interruption of the insulating elements configured to prevent the transmission of the capacitive coupling over a long distance within the drive shaft.

[0017] In some aspects of the surgical system, the surgical instrument comprises a blade on a triangular side with a thin upper support blade element configured to reduce the transmission of inductive energy in addition to the upper blade element.

[0018] In some aspects of the surgical system, the end actuator comprises one or more electrodes located in the inner portion of the jaws and configured to channel the excess energy in the opposite direction to the patient's tissue.

FIGURES

[0019] The appeals of several aspects are presented with particularity in the attached claims. The various aspects, however, with regard to both the organization and the methods of operation, together with additional objects and advantages of the same, can be better understood in reference to the description presented below, considered together with the attached drawings as follows.

[0020] Figure 1 is a block diagram of an interactive surgical system implemented by computer, according to at least one aspect of the present disclosure.

[0021] Figure 2 is a surgical system being used to perform a surgical procedure in an operating room, according to at least one aspect of the present disclosure.

[0022] Figure 3 is a central surgical device paired with a visualization system, a robotic system and an intelligent instrument, according to at least one aspect of the present disclosure.

[0023] Figure 4 is a partial perspective view of a compartment of the central surgical controller, and of a generator module in combination received slidingly in a compartment of the central surgical controller, in accordance with at least one aspect of the present revelation.

[0024] Figure 5 is a perspective view of a generator module in combination with bipolar, ultrasonic and monopolar contacts and a smoke evacuation component, in accordance with at least one aspect of the present disclosure.

[0025] Figure 6 illustrates different power bus connectors for a plurality of side coupling ports of a side modular cabinet configured to receive a plurality of modules, in accordance with at least one aspect of the present disclosure.

[0026] Figure 7 illustrates a vertical modular cabinet configured to receive a plurality of modules, according to at least one aspect of the present disclosure.

[0027] Figure 8 illustrates a surgical data network that comprises a central modular communication controller configured to connect modular devices located in one or more operating rooms of a health care facility, or any environment in a hospital. installation of public services specially equipped for surgical operations, to the cloud, in accordance with at least one aspect of the present disclosure.

[0028] Figure 9 illustrates an interactive surgical system implemented by computer, according to at least one aspect of the present disclosure.

[0029] Figure 10 illustrates a central surgical controller that comprises a plurality of modules coupled to the modular control tower, according to at least one aspect of the present disclosure.

[0030] Figure 11 illustrates an aspect of a universal serial bus (USB) central controller device, in accordance with at least one aspect of the present disclosure.

[0031] Figure 12 illustrates a logical diagram of a control system for an instrument or surgical tool, according to at least one aspect of the present disclosure.

[0032] Figure 13 illustrates a control circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present disclosure.

[0033] Figure 14 illustrates a combinational logic circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present disclosure.

[0034] Figure 15 illustrates a sequential logic circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present disclosure.

[0035] Figure 16 illustrates an instrument or surgical tool that comprises a plurality of motors that can be activated to perform various functions, according to at least one aspect of the present disclosure.

[0036] Figure 17 is a schematic diagram of a robotic surgical instrument configured to operate a surgical tool described therein, in accordance with at least one aspect of the present disclosure.

[0037] Figure 18 illustrates a block diagram of a surgical instrument programmed to control the distal translation of the displacement member, according to an aspect of the present disclosure.

[0038] Figure 19 is a schematic diagram of a surgical instrument configured to control various functions, according to at least one aspect of the present disclosure.

[0039] Figure 20 is a system configured to perform adaptive ultrasonic blade control algorithms in a surgical data network that comprises a modular central communication controller, in accordance with at least one aspect of the present disclosure. .

[0040] Figure 21 represents an example of a generator, according to at least one aspect of the present disclosure.

[0041] Figure 22 is a surgical system comprising a generator and several surgical instruments usable with it, according to at least one aspect of the present disclosure.

[0042] Figure 23 is a view of an end actuator, in accordance with at least one aspect of the present disclosure.

[0043] Figure 24 is a diagram of the surgical system of Figure 22, according to at least one aspect of the present disclosure.

[0044] Figure 25 is a model that illustrates the Movement ramification current, according to at least one aspect of the present disclosure.

[0045] Figure 26 illustrates a structural view of a generator architecture, according to at least one aspect of the present disclosure.

[0046] Figures 27A to 27C illustrate functional views of a generator architecture, according to at least one aspect of the present disclosure.

[0047] Figures 28A to 28B are structural and functional aspects of a generator, according to at least one aspect of the present disclosure.

[0048] Figure 29 provides a diagram showing an example system with means for detecting capacitive coupling, according to at least one aspect of the present disclosure.

[0049] Figure 30 is a logical flowchart that represents a control program or a logical configuration of an exemplary methodology to limit the effects of capacitive coupling in a surgical system is revealed, in accordance with at least one aspect of the present disclosure.

[0050] Figure 31 is a logical flowchart that represents a control program or a logical configuration of an exemplary methodology that can be performed by the surgical system using monopolar power generation to determine when to take advantage of the parasitic capacitive coupling, from according to at least one aspect of the present revelation.

[0051] Figure 32 is a timeline that represents the situational perception of a central surgical controller, according to at least one aspect of the present disclosure.

DESCRIPTION

[0052] The applicant for this application holds the following US patent applications, filed on August 28, 2018, the disclosure of which is incorporated herein by reference in its entirety: e US Patent Application , summary number END8536USNP2 / 180107-2, entitled "ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR"; and US patent application, docket number END8560USNP2 / 180106-2, entitled "TEMPERATURE CONTROL OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR"; and US patent application, summary number END8561USNP1 / 180144-1, entitled "RADIO FREQUENCY ENERGY DEVICE FOR

DELIVERING COMBINED ELECTRICAL SIGNALS "; and US patent application, docket number END8563USNP1 / 180139-1, entitled" CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION "; and US patent application, docket number END8563USNP2 / 18013 "CONTROLLING ACTIVATION OF AN ULTRA-

SONIC SURGICAL INSTRUMENT ACCORDING TO THE PRESENCE OF TISSUE "; and US Patent Application, docket number END8563USNP3 / 180139-3, entitled" DETERMINING TISSUE COMPOSITION VIA AN ULTRASONIC SYSTEM "; and US Patent Application, docket number END8563USNP4 / 180139- 4, entitled "DETERMINING THE STATE OF AN ULTRASON-

IC ELECTROMECHANICAL SYSTEM ACCORDING TO FREQUENCY SHIFT "; and US patent application, docket number END8563USNP5 / 180139-5, entitled DETERMINING THE STATE OF AN ULTRASON- IC END EFFECTOR; and US patent application, docket number END8564USNP1 / 180140-1 , entitled SITUATIONAL AWARENESS OF ELECTRO-SURGICAL SYSTEMS; and US patent application, summary number END8564USNP2 / 180140-2, entitled MECHANISMS FOR CONTROLLING DIFFER- ENT ELECTROMECHANICAL SYSTEMS OF AN ELECTROSURGI-CAL INSTRUMENT; and US patent application; END8564USNP3 / 180140-3, entitled DETECTION OF END EFFECTOR IMMERSION IN LIQUID; and US patent application, summary number END8565USNP2 / 180142-2, entitled INCREASING RADIO FREQUENCY TO CREATE

PAD-LESS MONOPOLAR LOOP; and US Patent Application, Summary No. END8566USNP1 / 180143-1, entitled BIPOLAR COMBINATION DEVICE THAT AUTO-MATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALI-TY; and and US Patent Application, Summary No. END8573USNP1 / 180145-1, titled ACTIVATION ENERGY DEVICES.

[0053] The applicant for this application holds the following US patent applications, filed on August 23, 2018, with the disclosure of each of them incorporated herein, by way of reference, in its entirety: and US Provisional Patent Application No. 62 / 721,995, entitled CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT AC- CORDING TO TISSUE LOCATION; and US Provisional Patent Application No. 62 / 721,998, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS; and US Provisional Patent Application No. 62 / 721,999, entitled

INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING; and US Provisional Patent Application No. 62 / 721,994, entitled BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY AD- JUSTS PRESSURE BASED ON ENERGY MODALITY; and e US Provisional Patent Application No. 62 / 721,996, entitled RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBI- NED ELECTRICAL SIGNALS.

[0054] The applicant for the present application holds the following US patent applications, filed on June 30, 2018, the disclosure of which is incorporated herein by reference in its entirety: e Provisional patent application US No. 62 / 692,747, entitled

SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE; and US Provisional Patent Application No. 62 / 692,748, entitled SMART ENERGY ARCHITECTURE; and e US Provisional Patent Application No. 62 / 692,768, entitled SMART ENERGY DEVICES.

[0055] The applicant for this application holds the following US patent applications, filed on June 29, 2018, the disclosure of which is incorporated herein by reference in its entirety: e US patent application Serial No. 16 / 024.090, entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS"; and US Patent Application Serial No. 16 / 024,057, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS; and US Patent Application Serial No. 16 / 024,067, entitled SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BA- SED ON PERIOPERATIVE INFORMATION; and US patent application serial number 16 / 024,075, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING; and US patent application serial number 16 / 024,083, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING; and US patent application serial number 16 / 024,094, entitled

SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES; and US Patent Application Serial No. 16 / 024,138, entitled SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EF- FECTOR TO CANCEROUS TISSUE; and US patent application serial number 16 / 024,150, entitled

SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES; and US patent application serial number 16 / 024,160, entitled VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY; and US patent application serial number 16 / 024.124, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE; and US Patent Application Serial No. 16 / 024,132, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT; and US patent application serial number 16 / 024,141, entitled SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY; and US patent application serial number 16 / 024,162, entitled

SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES; and US patent application serial number 16 / 024,066, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTROL; and US patent application serial number 16 / 024,096, entitled SURGICAL EVACUATION SENSOR ARRANGEMENTS; and US patent application serial number 16 / 024,116, entitled SURGICAL EVACUATION FLOW PATHS; and US patent application serial number 16 / 024,149, entitled SURGICAL EVACUATION SENSING AND GENERATOR CONTROL; and US patent application serial number 16 / 024,180, entitled SURGICAL EVACUATION SENSING AND DISPLAY; and US patent application serial number 16 / 024,245, entitled COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAME-

TERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; and US Patent Application Serial No. 16 / 024,258, entitled SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTRROL CIRCUIT FOR INTERACTIVE SURGICAL PLATFORM; and US Patent Application Serial No. 16 / 024,265, entitled

SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION

CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE; and e US patent application serial number 16 / 024,273, entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.

[0056] The applicant for this application holds the following provisional US patent applications, filed on June 28, 2018, the disclosure of which is incorporated herein by reference in its entirety: e Patent application provisional US serial number 62 / 691,228, entitled A Method of using reinforced flex circuits with multiple sensors with electrosurgical devices; and US Provisional Patent Application Serial No. 62 / 691,227, entitled controlling a surgical instrument according to sensed closure parameters; and US Provisional Patent Application Serial No. 62 / 691,230, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELEC- TRODE; and US Provisional Patent Application Serial No. 62 / 691,219, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTRROL; and US provisional patent application serial number 62 / 691,257, entitled COMMUNICATION OF SMOKE EVACUATION SYSTEM

PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; and US Provisional Patent Application Serial No. 62 / 691,262, entitled SURGICAL EVACUATION SYSTEM WITH A COMMUNICA-

TION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE; and e US Provisional Patent Application Serial No. 62 / 691,251,

titled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.

[0057] The applicant for the present application holds the following provisional US patent applications, filed on April 19, 2018, the disclosure of which is incorporated herein by reference in its entirety: e Patent application US provisional serial number 62 / 659,900, entitled METHOD OF HUB COMMUNICATION.

[0058] The applicant for this application holds the following provisional US patent applications, filed on March 30, 2018, the disclosure of which is incorporated herein by reference in its entirety: e Patent application US Provisional No. 62 / 650,898 deposited on March 30, 2018, entitled CAPACITIVE COUPLED RE-TURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS; and US Provisional Patent Application Serial No. 62 / 650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPA-BILITIES; and US Provisional Patent Application Serial No. 62 / 650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; e e US Provisional Patent Application Serial No. 62 / 650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CON-

TROLS

[0059] The applicant for this application holds the following US patent applications, filed on March 29, 2018, the disclosure of which is incorporated herein by reference in its entirety: e US patent application serial no. 15 / 940,641, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;

and US Patent Application Serial No. 15 / 940,648, entitled

INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES; and US Patent Application Serial No. 15 / 940,656, entitled SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES; and US Patent Application Serial No. 15 / 940,666, entitled SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING RO-WHO; and US patent application serial no. 15 / 940,670, entitled COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS; and US patent application serial no. 15 / 940,677, entitled SURGICAL HUB CONTROL ARRANGEMENTS; and US patent application serial no. 15 / 940,632, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT REC- ORDS AND CREATE ANONYMIZED RECORD; and US Patent Application Serial No. 15 / 940,640, entitled

COMMUNICATION HUB AND STORAGE DEVICE FOR STORING

PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS; and US Patent Application Serial No. 15 / 940,645, entitled

SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT; and US Patent Application Serial No. 15 / 940,649, entitled DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PA- RAMETER WITH AN OUTCOME; and US Patent Application Serial No. 15 / 940,654, entitled SURGICAL HUB SITUATIONAL AWARENESS; and US Patent Application Serial No. 15 / 940,663, entitled

SURGICAL SYSTEM DISTRIBUTED PROCESSING; and US patent application serial number 15 / 940,668, entitled AGGREGATION AND REPORTING OF SURGICAL HUB DATA; and US Patent Application Serial No. 15 / 940,671, entitled

SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; and US Patent Application Serial No. 15 / 940,686, entitled DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LI-NEAR STAPLE LINE; and US patent application serial number 15 / 940,700, entitled STERILE FIELD INTERACTIVE CONTROL DISPLAYS; and US patent application serial no. 15 / 940,629, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS; and US Patent Application Serial No. 15 / 940,704, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; and US Patent Application Serial No. 15 / 940,722, entitled

CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY; and e US patent application serial number 15 / 940,742, entitled DUAL CMOS ARRAY IMAGING.

and US Patent Application Serial No. 15 / 940,636, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES; and US Patent Application Serial No. 15 / 940,653, entitled

ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS; and US Patent Application Serial No. 15 / 940,660, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER;

and US Patent Application Serial No. 15 / 940,679, entitled CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAV- IORS OF LARGER DATA SET; and US Patent Application Serial No. 15 / 940,694, entitled CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION; and US Patent Application Serial No. 15 / 940,634, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AU-THENTICATION TRENDS AND REACTIVE MEASURES; and US Patent Application Serial No. 15 / 940,706, entitled

DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and e US patent application serial number 15 / 940,675, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES.

and US Patent Application Serial No. 15 / 940,627, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and US patent application serial number 15 / 940,637, entitled COMMUNICATION - ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and US patent application serial number 15 / 940,642, entitled CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and US Patent Application Serial No. 15 / 940,676, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and US patent application serial number 15 / 940,680, entitled CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and US patent application serial number 15 / 940,683, entitled COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED

SURGICAL PLATFORMS; and US Patent Application Serial No. 15 / 940,690, entitled DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and e US Patent Application Serial No. 15 / 940,711, entitled "SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS".

[0060] The applicant for the present application holds the following provisional US patent applications, filed on March 28, 2018, the disclosure of which is incorporated herein by reference in its entirety: e Patent application US Provisional Serial No. 62 / 649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; and US Provisional Patent Application Serial No. 62 / 649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; and US Provisional Patent Application Serial No. 62 / 649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS; and US Provisional Patent Application Serial No. 62 / 649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; and US Provisional Patent Application Serial No. 62 / 649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS; and US Provisional Patent Application Serial No. 62 / 649,291, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORED TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; and US Provisional Patent Application Serial No. 62 / 649,296, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGI-

LIM DEVICES; and US Provisional Patent Application Serial No. 62 / 649,333, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER; and US Provisional Patent Application Serial No. 62 / 649,327, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES; and US Provisional Patent Application Serial No. 62 / 649,315, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and US Provisional Patent Application Serial No. 62 / 649,313, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES; and US Provisional Patent Application Serial No. 62 / 649,320, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and US provisional patent application serial number 62 / 649,307, entitled AUTOMATIC. TOOL ADJUSTMENTS FOR ROBOT- ASSISTED SURGICAL PLATFORMS; and e US Provisional Patent Application Serial No. 62 / 649,323, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

[0061] The applicant for the present application holds the following provisional US patent applications, filed on March 8, 2018, the disclosure of which is incorporated herein by reference in its entirety: e Patent application US Provisional Serial No. 62 / 640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR; e e US Provisional Patent Application Serial No. 62 / 640,415, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR

AND CONTROL SYSTEM THEREFOR.

[0062] The applicant for this application holds the following provisional US patent applications, filed on December 28, 2017, the disclosure of which is incorporated herein by reference in its entirety: e Patent application US provisional serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM; and US Provisional Patent Application Serial No. 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS; and e US Provisional Patent Application Serial No. 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM.

[0063] Before explaining in detail the various aspects of surgical instruments and generators, it should be noted that the illustrative examples are not limited, in terms of application or use, to the details of construction and arrangement of parts illustrated in the descriptions in the attached description. Illustrative examples can be implemented or incorporated in other aspects, variations and modifications, and can be practiced or executed in several ways. In addition, except where otherwise indicated, the terms and expressions used in the present invention have been chosen for the purpose of describing illustrative examples for the convenience of the reader and not for the purpose of limiting it. In addition, it should be understood that one or more of the aspects, expressions of aspects, and / or examples described below can be combined with any one or more among the other aspects, expressions of aspects and / or examples described a follow.

[0064] Several aspects are addressed to improved ultrasonic surgical devices, electrosurgical devices and generators for use with them. Aspects of ultrasonic surgical devices can be configured to transect and / or coagulate tissue during surgical procedures, for example. The aspects of electrosurgical devices can be configured to transect, coagulate, scale, weld and / or dry the tissue during surgical procedures, for example.

[0065] Referring to Figure 1, a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (for example, cloud 104 which may include a remote server 113 coupled to a device storage 105). Each surgical system 102 includes at least one central surgical controller 106 in communication with the cloud 104 which can include a remote server 113. In one example, as illustrated in Figure 1, surgical system 102 includes a display system 108, a robotic system 110, a smart handheld surgical instrument 112, which are configured to communicate with each other and / or the central controller 106. In some respects, a surgical system 102 may include an M number of central controllers 106 , an N number of visualization systems 108, an O number of robotic systems 110, and a P number of intelligent hand-held surgical instruments 112, where M, N, O, and P are integers greater than or equal to one .

[0066] Figure 3 represents an example of a surgical system 102 being used to perform a surgical procedure on a patient who is lying on an operating table 114 in a surgical operating room 116. A robotic system 110 is used in surgical procedure as a part of the surgical system 102. The robotic system 110 includes a surgeon console 118, a patient car 120 (surgical robot), and a surgical robotic central controller

122. The patient's carriage 120 can handle at least one removable-coupled surgical tool 117 through a minimally invasive incision in the patient's body while the surgeon

region views the surgical site through the surgeon's console 118. An image of the surgical site can be obtained by a medical imaging device 124, which can be manipulated by the patient's car 120 to guide the imaging device 124. The central controller robotic 122 can be used to process images of the surgical site for subsequent display to the surgeon via the surgeon's console 118.

[0067] Other types of robotic systems can be readily adapted for use with the surgical system 102. Various examples of robotic systems and surgical instruments that are suitable for use with the present disclosure are described in provisional patent application no. 62 / 611,339, entitled ROBOT ASSISTED SURGI-CAL PLATFORM, filed on December 28, 2017, the disclosure of which is hereby incorporated by reference in its entirety.

[0068] Several examples of cloud-based analysis that are performed by the cloud 104, and which are suitable for use with the present disclosure, are described in US provisional patent application serial number 62 / 611.340, entitled "CLOUD-BASED MEDICAL ANALYTICS ", filed on December 28, 2017, the disclosure of which is hereby incorporated by reference, in its entirety.

[0069] In several aspects, the imaging device 124 includes at least one Image sensor and one or more optical components. Suitable image sensors include, but are not limited to, load-coupled device (CCD) sensors and complementary metal oxide semiconductor (CMOS) sensors.

[0070] The optical components of the imaging device 124 may include one or more light sources and / or one or more lenses. One or more light sources can be directed to illuminate portions of the surgical field. The one or more image sensors can receive reflected or refracted light from the surgical field,

including reflected or refracted light from tissue and / or surgical instruments.

[0071] One or more light sources can be configured to radiate electromagnetic energy in the visible spectrum, as well as in the invisible spectrum. The visible spectrum, sometimes called the optical spectrum or light spectrum, is that portion of the electromagnetic spectrum that is visible to (that is, can be detected by) the human eye and can be called visible light or simply light. A typical human eye will respond to wavelengths in the air that are from about 380 nm to about 750 nm.

[0072] The invisible spectrum (that is, the non-luminous spectrum) is that portion of the electromagnetic spectrum located below and above the visible spectrum (that is, wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths greater than about 750 nm are longer than the visible red spectrum, and become invisible infrared (IR), microwave and radio radiation. Wavelengths shorter than about 380 nm are shorter than the ultraviolet spectrum, and they become invisible ultraviolet, x-ray, and gamma-ray electromagnetic radiation.

[0073] In several respects, the imaging device 124 is configured for use in a minimally invasive procedure. Examples of imaging devices suitable for use with the present disclosure include, but are not limited to, an arthroscope, angioscope, bronchoscope, choledocoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagus-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngeal-neproscope, sigmoidoscope, thoracoscope, and ureteroscope.

[0074] In one aspect, the imaging device employs multiple spectrum monitoring to discriminate topography and underlying structures. A multi-spectral image is one that captures image data within wavelength bands across the electromagnetic spectrum. The wavelengths can be separated by filters or by using instruments that are sensitive to specific wavelengths, including light from frequencies beyond the visible light range, for example, IR and ultraviolet light. Spectral images can allow the extraction of additional information that the human eye cannot capture with its receivers for the colors red, green, and blue. The use of multi-spectral imaging is described in greater detail under the heading "Advanced Imaging Acquisition Module" in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28 2017, the disclosure of which is incorporated here as a reference in its entirety. Multi-spectral monitoring can be a useful tool for relocating a surgical field after a surgical task is completed to perform one or more of the tests previously described on the treated tissue.

[0075] It is axiomatic that strict sterilization of the operating room and surgical equipment is necessary during any surgery. The strict hygiene and sterilization conditions required in an "operating room", that is, an operating or treatment room, justify the highest possible sterilization of all medical devices and equipment. Part of this sterilization process is the need to sterilize anything that comes into contact with the patient or enters the sterile field, including the imaging device 124 and its connectors and components. It will be understood that the sterile field can be considered a specified area, such as inside a tray or on a sterile towel, which is considered free of microorganisms, or the sterile field can be considered an area, immediately around a patient, that was prepared for a surgical procedure. The sterile field may include members of the brushing team, who are properly dressed, and all furniture and accessories in the area.

[0076] In several aspects, the visualization system 108 includes one or more imaging sensors, one or more image processing units, one or more storage arrays and one or more screens that are strategically arranged in relation to the field sterile, as shown in Figure 2. In one aspect, the visualization system 108 includes an interface for HL7, PACS and EMR. Various components of the 108 visualization system are described under the heading "Advanced Imaging Acquisition Module" in US provisional patent application serial number 62 / 611.341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, whose disclosure it is hereby incorporated by reference in its entirety.

[0077] As shown in Figure 2, a primary screen 119 is positioned in the sterile field to be visible to the operator on the operating table 114. In addition, a viewing tower 111 is positioned outside the sterile field. The display tower 111 includes a first non-sterile screen 107 and a second non-sterile screen 109, which are opposite each other. The visualization system 108, guided by the central controller 106, is configured to use screens 107, 109, and 119 to coordinate the flow of information to operators inside and outside the sterile field. For example, central controller 106 can have visualization system 108 display a snapshot of a surgical site, as recorded by an imaging device 124, on a non-sterile screen 107 or 109, while transmitting to the live from the surgical site on the main screen 119. The instant on the non-sterile screen 107 or 109 can allow a non-sterile operator to perform a diagnostic step relevant to the surgical procedure, for example.

[0078] In one aspect, the central controller 106 is also configured to route an entry or diagnostic feedback by a non-sterile operator in the viewing tower 111 to the primary screen 119 within the sterile field, where it can be seen by a sterile operator on the operating table. In one example, the entry may be in the form of a modification of the snapshot displayed on the non-sterile screen 107 or 109, which can be routed to the main screen 119 by the central controller ("central device") 106.

[0079] With reference to Figure 2, a surgical instrument 112 is being used in the surgical procedure as part of the surgical system 102. The central controller 106 is also configured to coordinate the flow of information to a screen of the surgical instrument 112. For For example, in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, deposited on December 28, 2017, the disclosure of which is hereby incorporated by reference in its entirety for reference. An entry or diagnostic feedback inserted by a non-sterile operator in the viewing tower 111 can be routed by the central controller 106 to the screen of the surgical instrument 115 in the sterile field, where it can be seen by the operator of the surgical instrument 112. Exemplary surgical instruments that are suitable for use with surgical system 102 are described under the title "Surgical Instrument Hardware" and in the provisional patent application serial number 62 / 611.341, entitled INTE-RACTIVE SURGICAL PLATFORM, filed on December 28, 2017, whose disclosure is hereby incorporated by reference in its entirety, for example.

[0080] Now with reference to Figure 3, a central controller 106 is shown in communication with a visualization system 108, a robotic system 110 and an intelligent handheld surgical instrument 112. Central controller 106 includes a central controller screen

135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132 and a storage matrix 134. In certain respects, as shown in Figure 3, the central controller 106 additionally includes an smoke evacuation 126 and / or a suction / irrigation module 128.

[0081] During a surgical procedure, the application of energy to the tissue, for sealing and / or cutting, is generally associated with the evacuation of smoke, suction of excess fluid and / or irrigation of the tissue. Fluid, power, and / or data lines from different sources are often intertwined during the surgical procedure. Valuable time can be wasted in addressing this issue during a surgical procedure. To untangle the lines, it may be necessary to disconnect the lines from their respective modules, which may require a restart of the modules. The modular compartment of the central controller 136 offers a unified environment to manage power, data and fluid lines, which reduces the frequency of interleaving between such lines.

[0082] Aspects of the present disclosure feature a central surgical controller for use in a surgical procedure that involves applying energy to the tissue at a surgical site. The central surgical controller includes a central controller compartment and a combination generator module received slidingly in a central controller compartment docking station. The docking station includes data and power contacts. The combined generator module includes two or more of an ultrasonic energy generating component, a bipolar RF energy generating component, and a monopolar RF energy generating component which are housed in a single unit. In one aspect, the combined generator module also includes a smoke evacuation component, at least one power cable to connect the

generator module combined with a surgical instrument, at least one smoke evacuation component configured to evacuate smoke, fluid, and / or particulates generated by the application of therapeutic energy to the tissue, and a fluid line that extends from the remote surgical site to the smoke evacuation component.

[0083] In one aspect, the fluid line is a first fluid line and a second fluid line extends from the remote surgical site to a suction and irrigation module received slidingly in the central controller compartment. In one aspect, the central controller compartment comprises a fluid interface.

[0084] Certain surgical procedures may require the application of more than one type of energy to the tissue. One type of energy may be more beneficial for cutting the fabric, while another type of energy may be more beneficial for sealing the fabric. For example, a bipolar generator can be used to seal the tissue while an ultrasonic generator can be used to cut the sealed tissue. Aspects of the present disclosure present a solution in which a modular compartment of central controller 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the modular compartment of the central controller 136 is that it allows the quick removal and / or replacement of several modules.

[0085] Aspects of the present disclosure feature a modular surgical compartment for use in a surgical procedure that involves applying energy to the tissue. The modular surgical compartment includes a first energy generator module, configured to generate a first energy for application to the tissue, and a first docking station that comprises a first docking port that includes first data contacts and energy contacts, being that the first power generator module is slidingly movable in an electric hitch with power and data contacts and the first power generator module is slidingly movable out of the electric hitch with the first - other power and data contacts.

[0086] In addition to the above, the modular surgical compartment also includes a second energy generator module configured to generate a second energy, different from the first energy, for application to the tissue, and a second docking station comprising a second docking port which includes second data and power contacts, the second power generating module is slidingly movable in an electrical coupling with the power and data contacts, and the second power generating module is slidingly mobile. out of the electrical coupling with the second power and data contacts.

[0087] In addition, the modular surgical compartment also includes a communication bus between the first coupling port and the second coupling port, configured to facilitate communication between the first power generator module and the second generator module power.

[0088] With reference to Figures 3 to 7, aspects of the present disclosure are presented for a modular compartment of the central controller 136 that allows the modular integration of a generator module 140, a smoke evacuation module 126, and a suction / irrigation module 128. The modular compartment of the central controller 136 further facilitates interactive communication between modules 140, 126, 128. As illustrated in Figure 5, generator module 140 can be a generator module with monopoly components, integrated bipolar and ultrasonic devices, supported in a single cabinet unit 139 slidably insertable in the central compartment of the central controller 136. As shown in Figure 5, generator module 140 can be configured to connect to a mobile device nopolar 146, a bipolar 147 device and an ultrasonic device

148. Alternatively, generator module 140 may comprise a series of monopolar, bipolar and / or ultrasonic generator modules that interact through the central controller modular compartment 136. The central controller modular module 136 can be configured to facilitate the insertion of multiple generators and the interactive communication between the generators anchored in the modular compartment of the central controller 136, so that the generators would act as a single generator.

[0089] In one aspect, the modular compartment of the central controller 136 comprises a modular back plate with modular power and a communication board 149 with external and wireless communication heads to allow removable fixing of modules 140, 126, 128 and interactive communication between them.

[0090] In one aspect, the modular compartment of central controller 136 includes docking stations, or drawers, 151, here also called drawers, which are configured to receive modules 140, 126, 128 in a sliding manner. Figure 4 illustrates a partial perspective view of a central surgical controller compartment 136, and a combined generator module 145 slidably received at a docking station 151 in the central surgical controller compartment 136. A docking port 152 with power and data contacts on a rear side of the combined generator module 145 is configured to engage a corresponding docking port 150 with the power and data contacts of a corresponding docking station 151 of the central controller 136 modular compartment according to the module combined generator 145 is slid into position on the correct docking station

responder 151 of the central controller modular compartment

136. In one aspect, the combined generator module 145 includes a bipolar, ultrasonic and monopolar module and a smoke evacuation module integrated into a single cabinet unit 139, as shown in Figure 5.

[0091] In several respects, the smoke evacuation module 126 includes a fluid line 154 that transports fluid captured / collected smoke away from a surgical site and to, for example, the smoke evacuation module 126. The vacuum suction that originates from the smoke evacuation module 126 can pull the smoke into an opening of a utility conduit at the surgical site. The utility conduit, coupled to the fluid line, can be in the form of a flexible tube that ends in the smoke evacuation module 126. The utility conduit and the fluid line define a fluid path that extends towards the smoke evacuation module 126 which is received in the central controller compartment 136.

[0092] In several aspects, the suction / irrigation module 128 is coupled to a surgical tool comprising a fluid suction line and a fluid suction line. In one example, the suction and suction fluid lines are in the form of flexible tubes that extend from the surgical site towards the suction / irrigation module 128. One or more drive systems can be configured to cause irrigation and aspiration of fluids from the surgical site.

[0093] In one aspect, the surgical tool includes a drive shaft that has an end actuator at a distal end of it and at least an energy treatment associated with the end actuator, a suction tube, and a irrigation pipe. The suction tube can have an inlet port at a distal end of it and the suction tube extends through the drive shaft. Similarly, an irrigation pipe can extend through the drive shaft and may have an inlet port close to the power application implement. The energy application implement is configured to supply ultrasonic and / or RF energy to the surgical site and is coupled to the generator module 140 by a cable that initially extends through the drive shaft.

[0094] The irrigation tube can be in fluid communication with a fluid source, and the suction tube can be in fluid communication with a vacuum source. The fluid source and / or the vacuum source can be housed in the suction / irrigation module 128. In one example, the fluid source and / or the vacuum source can be housed in the central controller compartment 136 separately from the suction / irrigation module 128. In such an example, a fluid interface can be configured to connect the suction / irrigation module 128 to the fluid source and / or the vacuum source.

[0095] In one aspect, modules 140, 126, 128 and / or their corresponding docking stations in the central controller modular bay 136 can include alignment features that are configured to align the docking ports of the modules in engagement with their counterparts in the docking stations of the modular compartment of the central controller 136. For example, as shown in Figure 4, the combined generator module 145 includes side brackets 155 that are configured to slide the corresponding brackets in a sliding way 156 corresponding docking station 151 of the central controller modular compartment

136. The brackets cooperate to guide the coupling port contacts of the combined generator module 145 in an electrical coupling with the coupling port contacts of the central controller 136 modular compartment.

[0096] In some respects, the drawers 151 of the modular compartment of the central controller 136 have the same, or substantially the same, size, and the modules are adjusted in size to be received in the drawers 151. For example, the side brackets 155 and / or 156 can be larger or smaller depending on the size of the module. In other respects, drawers 151 are different in size and are each designed to accommodate a specific module.

[0097] In addition, the contacts of a specific module can be switched to engage with the contacts of a specific drawer to avoid the insertion of a module in a drawer with unpaired contacts.

[0098] As shown in Figure 4, the docking port 150 of one drawer 151 can be coupled to the docking port 150 of another drawer 151 via a communication link 157 to facilitate interactive communication between the modules housed in the modular compartment of the central controller 136. The coupling ports 150 of the modular compartment of the central controller 136 can, alternatively or additionally, facilitate interactive wireless communication between the modules housed in the modular compartment of the central controller 136. Any suitable wireless communication can be used, such as Air Titan Bluetooth.

[0099] Figure 6 illustrates individual power bus connectors for a plurality of side coupling ports of a side modular cabinet 160 configured to receive a plurality of modules from a central surgical controller 206. The side modular cabinet 160 it is configured to receive and interconnect the modules 161 laterally. The modules 161 are slidably inserted in the docking stations 162 of the modular housing

160, which includes a back plate for interconnecting modules 161. As shown in Figure 6, modules 161 are arranged laterally in the side modular cabinet 160. Alternatively, modules 161 can be arranged vertically in a modular cabinet side.

[0100] Figure 7 illustrates a vertical modular cabinet 164 configured to receive a plurality of modules 165 from the central surgical controller 106. Modules 165 are slidably inserted into docking stations, or drawers, 167 of vertical modular cabinet 164, which includes a rear panel for interconnection of modules 165. Although drawers 167 of vertical modular cabinet 164 are arranged vertically, in certain cases, a vertical modular cabinet 164 may include drawers that are arranged laterally . In addition, modules 165 can interact with each other through the coupling ports of the vertical modular cabinet 164. In the example in Figure 7, a screen 177 is provided to show data relevant to the operation of modules 165. In addition, the vertical modular cabinet 164 includes a master module 178 that houses a plurality of submodules that are received slidingly in the master module 178.

[0101] In several respects, the imaging module 138 comprises an integrated video processor and a modular light source and is adapted for use with various imaging devices. In one aspect, the imaging device is comprised of a modular cabinet that can be mounted with a light source module and a camera module. The cabinet can be a disposable cabinet. In at least one example, the disposable case is removably coupled to a reusable controller, a light source module, and a camera module. The light source module and / or the camera module can be selected selectively depending on the type of surgical procedure. In one aspect, the camera module comprises a CCD sensor. In another aspect, the camera module comprises a CMOS sensor. In another aspect, the camera module is configured for imaging the scanned beam. Similarly, the light source module can be configured to provide a white light or a different light, depending on the surgical procedure.

[0102] During a surgical procedure, removing a surgical device from the surgical field and replacing it with another surgical device that includes a different camera or other light source may be inefficient. Temporarily losing sight of the surgical field can lead to undesirable consequences. The imaging device module of the present disclosure is configured to allow the replacement of a light source module or a "midstream" camera module during a surgical procedure, without the need to remove the imaging device from the cyclic field. surgical.

[0103] In one aspect, the imaging device comprises a tubular cabinet that includes a plurality of channels. A first channel is configured to receive the Camera module in a sliding way, which can be configured for a snap-fit fit (pressure fit) with the first channel. A second channel is configured to receive the camera module in a sliding way, which can be configured for a snap-fit fit (pressure fit) with the first channel. In another example, the camera module and / or the light source module can be rotated to an end position within their respective channels. A threaded coupling can be used instead of a pressure fitting.

[0104] In several examples, multiple imaging devices are placed in different positions in the surgical field to provide

multiple views. Imaging module 138 can be configured to switch between imaging devices to provide an ideal view. In several respects, imaging module 138 can be configured to integrate images from different imaging devices.

[0105] Various image processors and imaging devices suitable for use with the present disclosure are described in US patent No. 7,995,045 entitled COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR, granted on August 9, 2011 which is incorporated herein as a reference in its entirety. In addition, US patent No. 7,982,776, entitled SBIl MOTION ARTIFACT REMOVAL APPARATUS AND METHOD, issued on July 19, 2011, which is incorporated herein by reference in its entirety, describes various systems for removing motion artifacts from the data of image. Such systems can be integrated with the imaging module 138. In addition to these, the publication of US patent application No. 2011/0306840, entitled CONTROLLA-BLE MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPA- RATUS, published on December 15, 2011, and the publication of US patent application No. 2014/0243597, entitled SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE, published on August 28, 2014, which are each incorporated herein by reference in their entirety.

[0106] Figure 8 illustrates a surgical data network 201 comprising a central modular communication controller 203 configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a facility. public service provider specially equipped for surgical operations, to a cloud-based system (for example, cloud 204 which may include a remote server

to 213 coupled to a storage device 205). In one aspect, the modular central communication controller 203 comprises a central network controller 207 and / or a network key 209 in communication with a network router. The modular central communication controller 203 can also be coupled to a local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 can be configured as a passive, intelligent, or switching network. A passive surgical data network serves as a conduit for the data, allowing the data to be transmitted from one device (or segment) to another and to cloud computing resources. An intelligent surgical data network includes features to allow traffic to pass through the surgical data network to be monitored and to configure each port on the central network controller 207 or network key 209. An intelligent surgical data network it can be called a central controller or a controllable key. A central switching controller reads the destination address of each packet and then forwards the packet to the correct port.

[0107] Modular devices 1a to 1n located in the operating room can be coupled to the central communication controller modular 203. The central network controller 207 and / or the network switch 209 can be coupled to a network router 211 to connect devices 1a to 1h to the 204 cloud or the local computer system

210. Data associated with devices 1a to 1n can be transferred to cloud-based computers via the router for remote data processing and manipulation. The data associated with devices 1a to 1h can also be transferred to the local computer system 210 for processing and manipulation of the local data. Modular devices 2a to 2m located in the same operating room can also be coupled to a network switch 209. Network switch 209 can be attached to the central network controller 207 and / or to network router 211 to connect devices 2a 2m to cloud 204. Data associated with devices 2a to 2n can be transferred to cloud 204 via network router 211 for data processing and manipulation. The data associated with devices 2a to 2m can also be transferred to local computer system 210 for processing and manipulation of local data.

[0108] It will be understood that the surgical data network 201 can be expanded by interconnecting multiple central network controllers 207 and / or multiple network keys 209 with multiple network routers 211. The central communication controller 203 can be contained in a modular control roaster configured to receive multiple devices 1a to 1n / 2a to 2m. The local computer system 210 can also be contained in a modular control tower. The central modular communication controller 203 is connected to a screen 212 to display the images obtained by some of the devices 1a to 1n / 2a to 2m, for example, during surgical procedures. In several respects, devices 1a to 1n / 2a to 2m can include, for example, several modules such as an imaging module 138 coupled to an endoscope, a generator module 140 coupled to an energy-based surgical device, an evacuation module smoke 126, a suction / irrigation module 128, a communication module 130, a processor module 132, a storage matrix 134, a surgical device attached to a screen, and / or a non-contact sensor module, among others modular devices that can be connected to the modular communication central controller 203 of the surgical data network 201.

[0109] In one aspect, the surgical data network 201 may comprise a combination of one or more central network controllers, network switches and network routers that connect devices 1a to 1n / 2a to 2m to the cloud . Any or all devices 1a to 1n / 2a to 2m coupled to the central network controller or network key can collect data in real time and transfer the data to cloud computers for data processing and manipulation. It will be understood that cloud computing depends on sharing computing resources instead of having local servers or personal devices to handle software applications. The word "cloud" can be used as a metaphor for "the Internet", although the term is not limited as such. Consequently, the term "cloud computing" can be used here to refer to "a type of Internet-based computing", in which different services - such as servers, storage, and applications - are provided to the central data controller. modular communication 203 and / or computer system 210 located in the operating room (for example, a fixed, mobile, temporary, or operating room or operating space) and devices connected to the 203 central communication controller and / or the system 210 through the Internet. The cloud infrastructure can be maintained by a cloud service provider. In this context, the cloud service provider may be the entity that coordinates the use and control of devices 1a to 1n / 2a to 2m located in one or more operating rooms. Cloud computing services can perform a large number of calculations based on data collected by smart surgical instruments, robots, and other computerized devices located in the operating room. The central controller hardware allows multiple devices or connections to be connected to a computer that communicates with cloud computing and storage resources.

[0110] The application of cloud computer data processing techniques to data collected by devices 1a to 1n / 2a to 2m, the surgical data network provides better surgical results, reduced costs, and better patient satisfaction.

At least some of the devices 1a to 1n / 2a to 2m can be used to view tissue status to assess leakage or perfusion of sealed tissue after a tissue sealing and cutting procedure.

At least some of the devices 1a to 1n / 2a to 2m can be used to identify pathology, such as the effects of disease, with the use of cloud-based computing to examine data including images of body tissue samples for diagnostic purposes. .

This includes confirmation of the location and margin of the tissue and phenotypes.

At least some of the devices 1a to 1n / 2a to 2m can be used to identify anatomical structures of the body using a variety of sensors integrated with imaging devices and techniques such as overlaying images captured by multiple imaging devices.

Data collected by devices 1a to 1n / 2a to 2m, including image data, can be transferred to the cloud 204 or the local computer system 210 or both for data processing and manipulation including data processing and manipulation. Image.

The data can be analyzed to improve the results of the surgical procedure by determining whether additional treatment, such as the application of endoscopic intervention, emerging technologies, targeted radiation, targeted intervention, precise robotics at specific sites and conditions of fabric, can be followed.

This data analysis can additionally use analytical processing of the results, and with the use of standardized approaches they can provide standardized feedback that is beneficial both to confirm surgical treatments and the surgeon's behavior, as well as to suggest changes to surgical treatments and the surgeon's behavior.

[0111] In an implementation, operating room devices 1a to 1n can be connected to the modular central communication controller 203 via a wired channel or a wireless channel depending on the configuration of devices 1a to 1n in a central network controller. The central network controller 207 can be implemented, in one aspect, as a local network transmission device that acts on the physical layer of the OSI model ("open system interconnection"). The central network controller provides connectivity to devices 1a to 1n located on the same network as the operating room. The central network controller 207 collects data in the form of packets and sends them to the router in half-duplex mode. The central network controller 207 does not store any media access control / Internet protocol (MAC / IP) to transfer data from the device. Only one of the devices 1a to 1n at a time can send data through the central network controller 207. The central network controller 207 does not have routing tables or intelligence about where to send information and transmits all network data through each connection and a remote server 213 (Figure 9) in the cloud 204. The central network controller 207 can detect basic network errors, such as collisions, but transmitting all information to multiple ports can be a security risk and cause bottlenecks .

[0112] In another implementation, operating room devices 2a to 2m can be connected to a network switch 209 via a wired or wireless channel. The network key 209 works in the data connection layer of the OSI model. Network switch 209 is a multicast device for connecting devices 2a to 2m located in the same operation center to the network. The network key 209 sends data in frames to the network router 211 and works in full duplex mode. Multiple devices 2a to 2m can send data at the same time via network key 209. Network key 209 stores and uses MAC addresses of devices 2a to 2m to transfer data.

[0113] The central network controller 207 and / or the network switch 209 are coupled to network router 211 to obtain connection to cloud 204. Network router 211 works on the network layer of the OSI model. The network router 211 creates a route to transmit packets of data received from the central network controller 207 and / or the network key 211 to a computer with cloud resources for further processing and manipulation of the data collected by any one. between or all devices 1a to 1n / 2a to 2m. The network router 211 can be used to connect two or more different networks located in different locations, such as different operating rooms in the same healthcare facility or different networks located in different operating rooms of different ins - health service facilities. Network router 211 sends data in packet form to cloud 204 and works in full duplex mode. Multiple devices can send data at the same time. The network router 211 uses IP addresses to transfer data.

[0114] In one example, the central network controller 207 can be implemented as a USB hub, which allows multiple USB devices to be connected to a host computer. The USB hub can expand a single USB port on multiple levels so that more ports are available to connect the devices to the system's host computer. The central network controller 207 can include wired or wireless capabilities to receive information via a wired channel or a wireless channel. In one aspect, a wireless, wide-band, short-range wireless USB radio communication protocol can be used for communication between devices 1a to 1n and devices 2a to 2m located on the operation room.

[0115] In other examples, devices in the operating room 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 via the Bluetooth wireless technology standard for short-distance exchange (using short-wave UHF radio waves in the 2.4 to 2.485 GHz ISM band) of data from fixed and mobile devices, and to form personal area networks (PANs). In other respects, operating room devices 1a to 1n / 2a to 2m can communicate with the modular 203 central communication controller via various wireless and wired communication standards or protocols including, but not limited to , Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, long-term evolution (LTE, "long-term evolution"), and Ev-DO, HSPA +, HSDPA +, HSUPAr, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and Ethernet derivatives thereof, as well as any other wireless and wired protocols that are designated as 3G, 4G, 5G, and beyond. The computer module can include a plurality of communication modules. For example, a first communication module can be dedicated to short-range wireless communications like Wi-Fi and Bluetooth, and a second communication module can be dedicated to longer-range wireless communications like GPS, EDGE, GPRS, CDMA , Wi-MAX, LTE, Ev-DO, and others.

[0116] The modular communication central controller 203 can serve as a central connection for one or all operating room devices 1a to 1n / 2a to 2m and handles a data type known as frames. The tables carry the data generated by the devices 1a to 1n / 2a to 2m. When a frame is received by the central modular communication controller 203, it is amplified and transmitted to the network router 211, which transfers the data to the cloud computing resources using a series of standards or protocols wireless or wired communication, as described in the present invention.

[0117] The modular communication central controller 203 can be used as a standalone device or be connected to compatible network central controllers and network switches to form a larger network. The 203 modular communication central controller is, in general, easy to install, configure and maintain, making it a good option for the network of devices 1a to 1n / 2a to 2m from the operating room.

[0118] Figure 9 illustrates an interactive surgical system, implemented by computer 200. The interactive surgical system implemented by computer 200 is similar in many ways to the interactive surgical system, implemented by computer 100. For example, the interactive, surgical system , implemented by computer 200 includes one or more surgical systems 202, which are similar in many respects to surgical systems 102. Each surgical system 202 includes at least one central surgical controller 206 communicating with a cloud 204 which may include a remote server 213. In one aspect, the computer-implemented interactive surgical system 200 comprises a modular control tower 236 connected to multiple operating room devices, for example, smart surgical instruments, robots and other localized computerized devices - used in the operating room. As shown in Figure 10, the modular control tower 236 comprises a central modular communication controller 203 coupled to a computer system 210. As illustrated in the example in Figure 9, the modular control tower 236 is coupled to a imaging module 238 that is attached to an endoscope 239, a generator module 240 that is attached to a power device 241, a smoke evacuation module 226,

a suction / irrigation module 228, a communication module 230, a processor module 232, a storage matrix 234, an intelligent device / instrument 235 optionally coupled to a screen 237, and a non-contact sensor module 242. The devices - the operating room is coupled with cloud computing resources and data storage via the modular control tower 236. A robotic central controller 222 can also be connected to the modular control tower 236 and computer resources in a cloud. Devices / Instruments 235, display systems 208, among others, can be coupled to the modular control tower 236 by means of wired or wireless communication standards or protocols, as described in the present invention. The modular control tower 236 can be coupled to a central controller screen 215 (for example, monitor, screen) to display and overlay images received from the imaging module, device / instrument screen and / or other control systems. 208. The central controller screen can also display the data received from the devices connected to the modular control tower together with images and overlaid images.

[0119] Figure 10 illustrates a central surgical controller 206 that comprises a plurality of modules coupled to the modular control tower 236. The modular control tower 236 comprises a central modular communication controller 203, for example, a device - network connectivity device, and a computer system 210 to provide local processing, visualization, and imaging, for example. As shown in Figure 10, the 203 modular central communication controller can be connected in a layered configuration to expand the number of modules (for example, devices) that can be connected to the 203 modular central communication controller and transfer data associated with modules to computer system 210, cloud computing resources, or both. As shown in Figure 10, each of the central controllers / network switches in the modular central communication controller 203 includes three downstream ports and one upstream port. The central controller / network switch upstream is connected to a processor to provide a communication connection with the cloud computing resources and a local display 217. Communication with the cloud 204 can be done via a channel of wired or wireless communication.

[0120] The central surgical controller 206 employs a non-contact sensor module 242 to measure the dimensions of the operating room and generate a map of the operating room using non-contact measuring devices such as laser or ultrasonic. An ultrasound-based non-contact sensor module scans the operating room by transmitting an ultrasound explosion and receiving an echo when it bounces outside the perimeter of the operating room walls, as described under the heading "Surgical Hub Spatial Hardware Within an Operating Room "in US provisional patent application serial number 62 / 611,341, entitled" INTERACTIVE SURGICAL PLAT-FORM ", filed on December 28, 2017, which is incorporated herein by reference in its all, in which the sensor module is configured to determine the size of the operating room and to adjust the limits of the pairing distance with Bluetooth. A laser-based non-contact sensor module scans the operating room by transmitting pulses of laser light, receiving pulses of laser light that bounce off the perimeter walls of the operating room, and comparing the phase of the transmitted pulse to the received pulse to determine the size of the operating room and to adjust the Bluetooth pairing distance limits, for example.

[0121] Computer system 210 comprises a processor

244 and a network interface 245. Processor 244 is coupled to a communication module 247, storage 248, memory 249, non-volatile memory 250, and an input / output interface 251 via a system bus. The system bus can be any one of several types of bus structures, including the memory bus or memory controller, a peripheral bus or external bus, and / or a local bus that uses any variety of architectures available bus speeds including, but not limited to, 9-bit bus, industry standard architecture (ISA), Micro-Charmel Architecture (MSA), extended ISA (EISA), smart drive electronics (IDE), local bus VESA (VLB), Peripheral Component Interconnection (PCI), USB, Accelerated Graphics Port (AGP), PCMCIA bus (International Memory Card Association for Personal Computers, Personal Computer Memory Card International Association), Interface small computer systems (SCSI), or any other proprietary bus.

[0122] Processor 244 can be any single-core or multi-core processor, such as those known under the ARM Cortex trade name available from Texas Instruments. In one respect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz , a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareGO program, read-only memory programmable and electrically erasable (EEPROM) of 2 KB, one or more pulse width modulation (PWM) modules, one or more analog inputs

quadrature encoder (QEI) tracks, one or more 12-bit analog to digital converters (ADC) with 12 analog input channels, details of which are available for the product data sheet.

[0123] In one aspect, processor 244 may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the tradename Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.

[0124] System memory includes volatile and non-volatile memory. The basic input / output system (BIOS), containing the basic routines for transferring information between elements within the computer system, such as during startup, is stored in non-volatile memory. For example, non-volatile memory can include ROM, programmable ROM (PROM), electrically programmable ROM (EPROM), EE-PROM or flash memory. Volatile memory includes random access memory (RAM), which acts as an external cache memory. In addition, RAM is available in many forms such as SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), Synchlink DRAM (SLDRAM), and direct RAM Rambus RAM (DRRAM).

[0125] Computer system 210 also includes removable / non-removable, volatile / non-volatile computer storage media, such as disk storage. Disk storage includes, but is not limited to, devices such as a magnetic disk drive, floppy disk drive, tape drive, drive

dor Jaz, Zip trigger, LS-60 trigger, flash memory card or memory stick (pen-drive). In addition, the storage disc may include storage media separately or in combination with other storage media including, but not limited to, an optical disc drive such as a compact disc ROM device ( CD-ROM) writeable compact disc drive (CD-R Drive), rewritable compact disc drive (CD-RW drive), or a versatile digital disk ROM drive (DVD-ROM). To facilitate the connection of disk storage devices to the system bus, a removable or non-removable interface can be used.

[0126] It is to be understood that computer system 210 includes software that acts as an intermediary between users and the basic computer resources described in a suitable operating environment. Such software includes an operating system. The operating system, which can be stored on disk storage, acts to control and allocate computer system resources. System applications benefit from management capabilities by the operating system through program modules and “program data stored in the system's memory or storage disk. It is to be understood that the various components described in the present invention can be implemented with various operating systems or combinations of operating systems.

[0127] A user enters commands or information into computer system 210 via the input device (s) coupled to the 1 / O 251. interface. Input devices include, but are not limited to, a pointing device such as a mouse, trackball, stylus, touchpad, keyboard, microphone, joystick, game pad, satellite card, scanner, TV tuner card, digital camera, digital video camera, web camera, and the like. These and other input devices connect to the processor via the system bus via the interface port (s). The interface ports include, for example, a serial port, a parallel port, a game port and a USB. Output devices use some of the same types of ports as input devices. In this way, for example, a USB port can be used to provide input to the computer system and to provide computer system information to an output device. An output adapter is provided to illustrate that there are some output devices such as monitors, screens, speakers, and printers, among other output devices, that need special adapters. Output adapters include, by way of illustration and not limitation, video and sound cards that provide a means of connection between the output device and the system bus. It should be noted that other devices and / or device systems, such as remote computers, provide input and output capabilities.

[0128] Computer system 210 can operate in a networked environment using logical connections to one or more remote computers, such as cloud computers, or local computers. Remote cloud computers can be a personal computer, server, router, personal network computer, workstation, microprocessor-based device, peer device, or other common network node, and the like, and typically include - in many or all of the elements described in relation to the computer system. For the sake of brevity, only one memory storage device is illustrated with the remote computer. Remote computers are logically connected to the computer system via a network interface and then physically connected via a communication connection. The network interface covers communication networks such as local area networks (LANs) and wide area networks (WANs). LAN technologies include interfaces

fiber distributed data (FDDI), copper distributed data interface (CDDI), Ethernet / IEEE 802.3, Token / IEEE 802.5 ring and the like. WAN technologies include, but are not limited to, point-to-point links, circuit switching networks such as digital integrated service networks (ISDN) and variations in them, packet switching networks and digital subscriber lines (DSL ).

[0129] In several respects, the computer system 210 of Figure 10, the imaging module 238 and / or display system 208, and / or the processor module 232 of Figures 9 to 10, may comprise an image processor. image, image processing engine, media processor, or any specialized digital signal processor (DSP) used for processing digital images. The image processor can employ parallel computing with single multi-data instruction (SIMD) or multi-data instruction (MIMD) technologies to increase speed and efficiency. The digital image processing engine can perform a number of tasks. The image processor can be an integrated circuit system with a multi-core processor architecture.

[0130] The communication connection (s) refers to the hardware / software used to connect the network interface to the bus. Although the communication connection is shown for illustrative clarity within the computer system, it can also be external to computer system 210. The hardware / software required for connection to the network interface includes, for illustrative purposes only internal and external technologies such as modems, including regular telephone series modems, cable modems and DSL modems, ISDN adapters and Ethernet cards.

[0131] Figure 11 illustrates a functional block diagram of an aspect of a USB 300 central network controller device, in accordance with at least one aspect of the present disclosure. In the illustrated aspect, the USB 300 network central controller device uses a TUSB2036 integrated circuit central controller available from Texas Instruments. The central USB network controller 300 is a CMOS device that provides a USB transceiver port 302 and up to three USB transceiver ports downstream 304, 306, 308, in accordance with the USB 2.0 specification. The upstream USB transceiver port 302 is a differential data root port comprising a "less" differential data input (DMO) paired with a "more" differential data input (DPO). The three ports of the downstream USB transceiver 304, 306, 308 are differential data ports, with each port including "more" differential data outputs (DP1-DP3) paired with different "less data outputs. "(DM1-DM3).

[0132] The USB 300 central network controller device is implemented with a digital state machine instead of a microcontroller, and no firmware programming is required. Fully compatible USB transceivers are integrated into the circuit for the upstream USB transceiver port 302 and all the downstream USB transceiver ports 304, 306, 308. The downstream USB transceiver ports 304, 306, 308 support both full speed and low speed devices automatically configuring the scan rate according to the speed of the device attached to the ports. The USB 300 central network controller device can be configured in bus powered or self-powered mode and includes 312 central power logic to manage power.

[0133] The USB 300 central network controller device includes a 310 serial interface (SIE) engine. The SIE 310 is the hardware frontcend of the USB 300 central network controller and handles most of the protocol described in chapter 8 of the USB specification. The SIE

310 typically comprises signaling down to the transaction level. The functions it handles could include: package recognition, transaction sequencing, SOP, EOP, RESET, and RESUME signal detection / generation, clock / data separation, non-zero data encoding / decoding inverted (NRZI), generation and verification of CRC (token and data), generation and verification / decoding of packet ID (PID), and / or series-parallel / parallel-series conversion. The 310 receives a clock input 314 and is coupled with a suspend / resume logic, a frame timer circuit 316 and a central circuit repeat loop 318 to control communication between the upstream USB transceiver port 302 and the USB transceiver ports downstream 304, 306, 308 through the logic circuits of ports 320, 322, 324. The SIE 310 is coupled to a command decoder 326 through the logic interface to control the commands of a serial EEPROM via a 330 series EEPROM interface.

[0134] In several aspects, the USB 300 central network controller can connect 127 functions configured in up to six logical layers (levels) to a single computer. In addition, the USB 300 central network controller can connect all peripherals using a standardized four-wire cable that provides both communication and power distribution. Power settings are bus-powered and self-powered modes. The USB 300 central network controller can be configured to support four power management modes: a bus-powered central controller, or with individual port power management or with grouped port power management, and the self-powered central controller , either with individual port power management or with grouped port power management. In one aspect, using a USB cable, the central network controller of

USB 300, the upstream USB transceiver port 302 is plugged into a USB host controller, and the downstream USB transceiver ports 304, 306, 308 are exposed to connect compatible USB devices, and so on.

Surgical instrument hardware

[0135] Figure 12 illustrates a logic diagram of a 470 control system module of a surgical instrument or tool, according to one or more aspects of the present disclosure. The 470 system comprises a control circuit. The control circuit includes a microcontroller 461 comprising a processor 462 and a memory 468. One or more of the sensors 472, 474, 476, for example, provide real-time feedback to the processor

462. A motor 482, driven by a motor drive 492, operationally couples a longitudinally movable displacement member to drive a clamping arm of the closing member. A tracking system 480 is configured to determine the position of the longitudinally movable displacement member. Position information is provided for processor 462, which can be programmed or configured to determine the position of the longitudinally movable drive member as well as the position of the closing member. Additional motors can be supplied at the tool driver interface to control the pipe's closing path, the rotation of the drive shaft, the joint, or the closing of the clamping arm, or a combination thereof. A 473 screen displays a variety of instrument operating conditions and can include touchscreen functionality for data entry. The information displayed on screen 473 can be overlaid with images captured using endoscopic imaging modules.

[0136] In one aspect, the 461 microcontroller can be any single-core or multi-core processor, such as those known under the ARM Cortex trade name available from Texas Instruments. In one aspect, the main microcontroller 461 can be an LM4F230H5QR ARM Cortex-M4F processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single cycle flash memory, or other non-memory. volatile, up to 40 MHz, a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle series random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellaRisWareO program, programmable and electronically erasable 2K read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder (QEI) input analogues , and / or one or more 12-bit analog to digital converters (ADC) with 12 channels of analog input, details of which are available for the product data sheet.

[0137] In one aspect, the 461 microcontroller can comprise a safety controller that comprises two families based on controllers, such as TMS570 and RM4x known under the trade name of Hercules ARM Cortex R4, also available from Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.

[0138] The 461 microcontroller can be programmed to perform various functions such as precise control of the scalpel speed and position, the articulation systems, the clamping arm, or a combination thereof. In one respect, the 461 microcontroller includes a 462 processor and a 468 memory. The 482 electric motor can be a brushed direct current (DC) motor with a gearbox and mechanical connections with a hinge or scalpel system. . In one aspect, a motor drive 492 can be an A3941 available from Allegro Microsystems, Inc. Other motor drives can be readily replaced for use in the tracking system 480 which comprises an absolute positioning system. A detailed description of an absolute positioning system is given in US patent application publication 2017/0296213, entitled SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT, published on October 19, 2017, which is incorporated herein by reference in its entirety.

[0139] The 461 microcontroller can be programmed to provide precise control of the speed and position of the displacement members and articulation systems. The 461 microcontroller can be configured to compute a response in the 461 microcontroller software. The computed response is compared to a measured response from the real system to obtain an "observed" response, which is used for actual feedback-based decisions. The observed response is a favorable and adjusted value, which balances the uniform and continuous nature of the simulated response with the measured response, which can detect external influences in the system.

[0140] In one aspect, the 482 motor can be controlled by the 492 motor actuator and can be used by the instrument trigger system or surgical tool. In many ways, the 482 motor can be a brushed direct current (DC) drive motor, with a maximum speed of approximately 25,000 RPM, for example. In other arrangements, the 482 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable type of electric motor. The acci-

Motor driver 492 may comprise an H bridge driver comprising field effect transistors (FETs), for example. The 482 motor can be powered by a release assembly mounted releasably on the handle assembly or tool cabinet to provide control power for the instrument or surgical tool. The power pack may comprise a battery that may include several battery cells connected in series, which can be used as the power source to power the instrument or surgical tool. In certain circumstances, the battery cells in the power pack may be replaceable and / or rechargeable battery cells. In at least one example, the battery cells can be lithium-ion batteries that can be coupled and separable from the power pack.

[0141] The 492 motor driver can be an A3941, available from Allegro Microsystems, Inc. The 492 A3941 driver is an entire bridge controller for use with semiconductor metal oxide field effect transistors (MOSFET). external power, N channel, specifically designed for inductive loads, such as brushed DC motors. The 492 drive comprises a unique charge pump regulator that provides full door drive (> 10 V) for 7 V battery voltages and allows the A3941 to operate with a reduced door drive, up to 5.5 V. A bootstrap capacitor it can be used to supply the voltage exceeding that supplied by the battery required for the N channel MOSFETs. An internal charge pump for the upper side drive allows operation in direct current (100% working cycle). The entire bridge can be triggered in fast or slow drop modes using diodes or synchronized rectification. In the slow drop mode, the current can be recirculated using the upper and lower FETs. Energy FETs are protected from the shoot-

through resistors with programmable dead time. Integrated diagnostics provide indication of undervoltage, overtemperature and faults in the power bridge, and can be configured to protect power MOSFETs in most short-circuit conditions. Other motor drives can be readily replaced for use in the tracking system 480 comprising an absolute positioning system.

[0142] Tracking system 480 comprises a controlled motor drive circuit arrangement comprising a position sensor 472 in accordance with an aspect of the present disclosure. The position sensor 472 for an absolute positioning system provides a unique position signal that corresponds to the location of a displacement member. In one aspect, the displacement member represents a longitudinally movable drive member comprising a rack of drive teeth for engagement with a corresponding drive gear of a gear reduction assembly. In other respects, the displacement member represents the trigger member, which can be adapted and configured to include a rack of drive teeth. In yet another aspect, the displacement member represents a longitudinal displacement member for opening and closing a clamping arm, which can be adapted and configured to include a rack of driving teeth. In other respects, the displacement member represents a clamping arm closing member configured to close and open a clamping arm of a stapler, ultrasonic, or electrosurgical device, or combinations thereof. Consequently, as used in the present invention, the term displacement member is used generically to refer to any moving member of the surgical instrument or tool such as the driving member,

the clamping arm, or any element that can be moved. Consequently, the absolute positioning system can, in effect, track the displacement of the clamping arm by tracking the linear displacement of the movable drive member longitudinally.

[0143] In other respects, the absolute positioning system can be configured to track the position of a clamping arm in the opening or closing process. In several other respects, the displacement member can be coupled to any position sensor 472 suitable for measuring linear displacement. In this way, the longitudinally movable drive member, or the clamping arm, or combinations thereof, can be coupled to any linear displacement sensor. Linear displacement sensors can include contact or non-contact displacement sensors. Linear displacement sensors can comprise Variable Differential Linear Transformers (LVDT), Variable Reluctance Differential Transducers (DVRT), a potentiometer, a magnetic detection system comprising a moving magnet and a series linearly arranged in Hall Effect Sensors , a magnetic detection system comprising a fixed magnet and a series of furniture, linearly arranged in Hall Effect Sensors, a mobile optical detection system comprising a mobile light source and a series of linearly arranged photodiodes or photodetectors, an optical detection system comprising a fixed light source and a mobile series of linearly arranged photodiodes or photodetectors, or any combination thereof.

[0144] The 482 electric motor can include a rotary drive shaft, which interfaces operationally with a gear set, which is mounted on a coupling coupling with a set or rack of driving teeth on the drive member. A sensor element can be operationally coupled to a gear assembly so that a single revolution of the position sensor element 472 corresponds to some linear longitudinal translation of the displacement member. An array of gears and sensors can be connected to the linear actuator by means of a rack and pinion arrangement, or by a rotary actuator, by means of a sprocket or other connection. A power supply provides power to the absolute positioning system and an output indicator can display the output from the absolute positioning system. The drive member represents the longitudinally movable drive member comprising a rack of drive teeth formed thereon for engagement with a corresponding drive gear of the gear reducer assembly. The displacement member represents the longitudinally movable firing member for opening and closing a clamping arm.

[0145] A single revolution of the sensor element associated with the position sensor 472 is equivalent to a linear longitudinal displacement of d1 of the displacement member, where d; represents the longitudinal linear distance by which the displacement member moves from point "a" to point "b" after a single revolution of the sensor element coupled to the displacement member. The sensor arrangement can be connected by means of a gear reduction which results in the position sensor 472 completing one or more revolutions for the complete travel of the displacement member. The 472 position sensor can complete multiple revolutions for the full travel of the displacement member.

[0146] A series of keys, where n is an integer greater than one, can be used alone or in combination with a gear reduction to provide a single position signal for more than one revolution of the 472 position sensor. of the calls

ves is transmitted back to microcontroller 461 which applies logic to determine a single position signal corresponding to the longitudinal linear displacement of d1 + from + ... dh of the displacement member. The output of the position sensor 472 is supplied to the microcontroller 461. In several embodiments, the position sensor 472 of the sensor array may comprise a magnetic sensor, an analog rotary sensor, such as a potentiometer, or a series of analog Hall effect elements, which emit a unique combination of position of signals or values.

[0147] The position sensor 472 can comprise several magnetic detection elements such as, for example, magnetic sensors classified according to whether they measure the total magnetic field or the vector components of the magnetic field. The techniques used to produce both types of magnetic sensors cover many aspects of physics and electronics. Technologies used for magnetic field detection include flow meter, saturated flow, optical pumping, nuclear precession, SQUID, Hall effect, anisotropic magnesium resistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive / piesoelectric compounds, magnetodiode, magnetic transistors, fiber optics, magneto-optics and magnetic sensors based on microelectromechanical systems, among others.

[0148] In one aspect, the position sensor 472 for tracking system 480 which comprises an absolute positioning system comprises a magnetic rotating absolute positioning system. The 472 position sensor can be implemented as a rotary, magnetic, single-circuit, ASSOSSEQFT position sensor, available from Austria Microsystems, AG. The position sensor 472 interfaces with the 461 microcontroller to provide an absolute positioning system. The 472 position sensor is a low voltage, low power component and includes four effect elements in an area of the 472 position sensor located above a magnet. A high-resolution ADC and an intelligent power management controller are also provided on the integrated circuit. A CORDIC processor (digital computer for coordinate rotation), also known as the digit by digit method and Volder algorithm, is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only operations addition, subtraction, bit shift and lookup table. The angle position, alarm bits and magnetic field information are transmitted via a standard serial communication interface, such as a serial peripheral interface (SPI - "Serial Peripheral Interface"), to the microcontroller 461. The 472 position sensor provides 12 or 14 bits of resolution. The position sensor 472 can be an AS5055 integrated circuit supplied in a small 16-pin QFN package whose measurement corresponds to 4x4x0.85 mm.

[0149] The tracking system 480 which comprises an absolute positioning system can comprise and / or be programmed to implement a feedback controller, such as a PID, state feedback, and adaptive controller. A power supply converts the signal from the feedback controller to a physical input to the system, in this case the voltage. Other examples include a voltage, current and force PWM. Other sensors can be provided in order to measure the parameters of the physical system in addition to the position measured by the position sensor 472. In some respects, other sensors may include sensor arrangements as described in US patent No. 9,345 .481 entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, granted on May 24, 2016, which is incorporated by reference in its entirety into this document; US patent application serial number 2014/0263552, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, published on September 18, 2014, is incorporated by reference in its entirety into this document; and US patent application serial number 15 / 628,175, entitled TECHNIQUES FOR ADAPTIVE CONTRROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CU- TTING INSTRUMENT, submitted on June 20, 2017, is incorporated by reference in its entirety in this document. In a digital signal processing system, an absolute positioning system is coupled with a digital data capture system where the output of the absolute positioning system will have a finite resolution and sampling frequency. The absolute positioning system can comprise a comparison and combination circuit to combine a computed response with a measured response through the use of algorithms, such as a weighted average and a theoretical control loop, that trigger the calculated response in the direction to the measured response. The computed response of the physical system considers properties such as mass, inertia, viscous friction, resistance to inductance, etc., to predict, by knowing the input, what the states and outputs of the physical system will be.

[0150] The absolute positioning system provides an absolute positioning of the displaced member on the activation of the instrument without having to retract or advance the longitudinally movable drive member to the restart position (zero or initial), as may be required by conventional rotary encoders that merely count the number of progressive or regressive steps that the 482 motor has traversed to infer the position of a device actuator, actuation bar, scalpel, and the like.

[0151] A 474 sensor, such as a strain gauge or a micro strain gauge, is configured to measure one or more parameters of the end actuator, such as the amplitude of the strain exerted on the anvil during a gripping operation, which can be indicative of tissue compression. The measured effort is converted into a digital signal and fed to the 462 processor. Alternatively, or in addition to the 474 sensor, a 476 sensor, such as a load sensor, can measure the closing force applied by the drive system. closing the anvil in a stapler or clamping arm in an electrosurgical or ultrasonic instrument. The 476 sensor, such as a load sensor, can measure the trigger force applied to a closing member coupled to a clamping arm of the instrument or surgical tool or the force applied via a clamping arm to the tissue located in the claws of an electrosurgical or ultrasonic instrument. Alternatively, a current sensor 478 can be used to measure the current drained by the motor 482. The displacement member can also be configured to engage a clamping arm to open or close the clamping arm. The force sensor can be configured to measure the grip force on the fabric. The force required to advance the displacement member can correspond to the current drained by the 482 motor, for example. The measured force is converted into a digital signal and supplied to the 462 processor.

[0152] In one form, a 474 strain gauge sensor can be used to measure the force applied to the tissue by the end actuator. A strain gauge can be attached to the end actuator to measure the force applied to the tissue being treated by the end actuator. A system for measuring forces applied to the tissue attached by the end actuator comprises a 474 strain gauge sensor, such as, for example, a microstrain meter, which is configured to measure one or more parameters of the end actuator, for example. In one aspect, the 474 strain gauge sensor can measure the amplitude or magnitude of the mechanical stress exerted on a clamp member of an end actuator during a gripping operation, which can be indicative of tissue compression. The measured effort is converted into a digital signal and fed to the 462 processor of a 461 microcontroller. A 476 load sensor can measure the force used to operate the knife element, for example, to cut the captured tissue between the anvil and staple cartridge. A 476 load sensor can measure the force used to operate the clamping arm element, for example, to capture the fabric between the clamping arm and an ultrasonic blade or to capture the fabric between the clamping arm and a claw of an electrosurgical instrument. A magnetic field sensor can be used to measure the thickness of the captured tissue. The measurement of the magnetic field sensor can also be converted into a digital signal and supplied to the 462 processor.

[0153] Measurements of tissue compression, tissue thickness and / or force required to close the end actuator on the tissue, as measured by sensors 474, 476 respectively, can be used by microcontroller 461 to characterize the position trigger member and / or the corresponding trigger member speed value. In one case, a 468 memory can store a technique, an equation and / or a query table that can be used by the 461 microcontroller in the evaluation.

[0154] The control system 470 of the instrument or surgical tool can also comprise wired or wireless communication circuits for communication with the modular central communication controller shown in Figures 8 to 11.

[0155] Figure 13 illustrates a control circuit 500 configured to control aspects of the instrument or surgical tool according to an aspect of the present disclosure. The control circuit 500 can be configured to implement various processes described herein. The control circuit 500 may comprise a microcontroller comprising one or more processors 502 (for example, microprocessor, microcontroller) coupled to at least one memory circuit 504. The memory circuit 504 stores machine-executable instructions which, when executed by the 502 processor, cause the 502 processor to execute machine instructions to implement several of the processes described here. The processor 502 can be any one of a number of single-core or multi-core processors known in the art. The memory circuit 504 may comprise volatile and non-volatile storage media. The processor 502 can include an instruction processing unit 506 and an arithmetic unit 508. The instruction processing unit can be configured to receive instructions from the memory circuit 504 of the present disclosure.

[0156] Figure 14 illustrates a combinational logic circuit 510 configured to control aspects of the instrument or surgical tool according to an aspect of the present disclosure. The combinational logic circuit 510 can be configured to implement the various processes described here. The combinational logic circuit 510 can comprise a finite state machine that comprises a combinational logic 512 configured to receive data associated with the instrument or surgical tool at an input 514, process the data by the combinational logic 512 and provide an output 516.

[0157] Figure 15 illustrates a sequential logic circuit 520 configured to control aspects of the instrument or surgical tool according to an aspect of the present disclosure. Sequential logic circuit 520 or combinational logic 522 can be configured to implement the process described herein. The sequential logic circuit

520 may comprise a finite state machine. Sequential logic circuit 520 may comprise combinational logic 522, at least one memory circuit 524, a clock 529 and, for example. The at least one memory circuit 524 can store a current state of the finite state machine. In certain cases, the sequential logic circuit 520 may be synchronous or asynchronous. Combinational logic 522 is configured to receive data associated with the tool or surgical instrument from an input 526, process the data using combinational logic 522, and provide an output 528. In other respects, the circuit can comprise a combination of one processor (for example, processor 502, Figure 13) and a finite state machine to implement various processes of the present invention. In other respects, the finite state machine may comprise a combination of a combinational logic circuit (for example, a combinational logic circuit 510, Figure 14) and the sequential logic circuit 520.

[0158] Figure 16 illustrates an instrument or surgical tool that comprises a plurality of motors that can be activated to perform various functions. In certain cases, a first engine may be activated to perform a first function, a second engine may be activated to perform a second function, a third engine may be activated to perform a third function, a fourth engine may be activated to perform a fourth function, and so on. In certain cases, the plurality of motors of the robotic surgical instrument 600 can be individually activated to cause triggering, closing, and / or articulation movements in the end actuator. The triggering, closing and / or articulation movements can be transmitted to the end actuator through a set of drive axes, for example.

[0159] In certain cases, the instrument or surgical tool system may include a 602 firing motor. The 602 firing motor can be operationally coupled to a 604 firing motor drive assembly, which can be configured to transmitting firing movements generated by motor 602 to the end actuator, particularly to move the closing member of the clamping arm. The closing member can be retracted by reversing the direction of the motor 602, which also causes the clamping arm to open.

[0160] In certain cases, the surgical instrument or tool may include a closing motor 603. The closing motor 603 can be operationally coupled to a drive assembly of the closing motor 605 that can be configured to transmit closing movements , generated by the motor 603 to the end actuator, particularly to move a closing tube to close the anvil and compress the fabric between the anvil and the staple cartridge. The closing motor 603 can be operationally coupled to a drive assembly of the closing motor 605 that can be configured to transmit closing movements generated by the motor 603 to the end actuator, particularly to move a closing tube to close the closing arm. squeeze and compress the tissue between the clamping arm and an ultrasonic blade or the clamping arm or the claw member of an electrosurgical device. Closing movements can cause the end actuator to transition from an open configuration to an approximate configuration to capture tissue, for example. The end actuator can be moved to an open position by reversing the direction of the 603 motor.

[0161] In certain cases, the surgical instrument or tool may include one or more articulation motors 606a, 606b, for example. The motors 606a, 606b can be operationally coupled to the drive assemblies of the articulation motor 608a, 608b, which can be configured to transmit articulation movements generated by the motors 606a, 606b to the end actuator. In some cases, articulation movements can cause the end actuator to be articulated in relation to the drive shaft assembly, for example.

[0162] As described above, the surgical instrument or tool can include a plurality of motors that can be configured to perform various independent functions. In certain cases, the plurality of motors of the instrument or surgical tool can be activated individually or separately to perform one or more functions, while other motors remain inactive. For example, the hinge motors 606a, 606b can be activated to cause the end actuator to be pivoted, while the firing motor 602 remains inactive. Alternatively, the firing motor 602 can be activated to fire the plurality of clamps, and / or advance the cutting edge, while the hinge motor 606 remains inactive. In addition, the closing motor 603 can be activated simultaneously with the firing motor 602 to cause the closing tube or closing member to advance distally as described in more detail later in this document.

[0163] In certain cases, the surgical instrument or tool may include a common control module 610 that can be used with a plurality of the instrument's instruments or surgical tool. In certain cases, the common control module 610 can accommodate one of the plurality of motors at a time. For example, the common control module 610 can be coupled to and separable from the plurality of motors of the robotic surgical instrument individually. In certain cases, a plurality of the instrument's engines or tools

surgical tool can share one or more common control modules, such as the common control module 610. In certain cases, a plurality of instrument motors or surgical tool can be individually and selectively coupled to the common control module 610. In certain cases In such cases, the common control module 610 can be selectively switched between interfacing with one of a plurality of motors of the instrument or surgical tool to interface with another among the plurality of motors of the instrument or surgical tool.

[0164] In at least one example, the common control module 610 can be selectively switched between the operating coupling with the 606a, 606B articulation motors, and the operating coupling with the 602 firing motor or the 603 closing motor. at least one example, as shown in Figure 16, a key 614 can be moved or transitioned between a plurality of positions and / or states. In the first position 616, the switch 614 can electrically couple the common control module 610 to the trip motor 602; in a second position 617, the switch 614 can electrically couple the control module 610 to the closing motor 603; in a third position 618a, the switch 614 can electrically couple the common control module 610 to the first articulation motor 606a; and in a fourth position 618b, the switch 614 can electrically couple the common control module 610 to the second articulation motor 606b, for example. In certain cases, separate common control modules 610 can be electrically coupled to the firing motor 602, closing motor 603, and hinge motors 606a, 606b at the same time. In certain cases, key 614 can be a mechanical key, an electromechanical key, a solid state key, or any suitable switching mechanism.

[0165] Each of the 602, 603, 606a, 606b motors can comprise a torque sensor to measure the output torque on the motor drive shaft. The force on an end actuator can be detected in any conventional manner, such as by means of force sensors on the outer sides of the jaws or by a motor torque sensor that drives the jaws.

[0166] In several cases, as shown in Figure 16, the common control module 610 may comprise a motor starter 626 that may comprise one or more H-Bridge FETs. The motor drive 626 can modulate the energy transmitted from a power source 628 to a motor coupled to the common control module 610, based on an input from a microcontroller 620 (the "controller"), for example. In certain cases, the microcontroller 620 can be used to determine the current drawn by the motor, for example, while the motor is coupled to the common control module 610, as described above.

[0167] In certain examples, the microcontroller 620 may include a microprocessor 622 (the "processor") and one or more non-transitory computer-readable media or 624 memory units (the "memory"). In certain cases, memory 624 can store various program instructions which, when executed, can cause processor 622 to perform a plurality of functions and / or calculations described herein. In certain cases, one or more of the 624 memory units can be attached to the 622 processor, for example. In many ways, the 620 microcontroller can communicate via a wired or wireless channel, or combinations thereof.

[0168] In certain cases, the power supply 628 can be used to supply power to the microcontroller 620, for example. In certain cases, the 628 power source may comprise a battery (or "battery pack" or "power source"), such as a Li ion battery, for example. In certain cases, the battery pack can be configured to be releasably mounted to a handle in order to supply power to the surgical instrument 600. Several battery cells connected in series can be used as the power source 628. In certain cases, the power source 628 can be replaceable and / or rechargeable, for example.

[0169] In several cases, the 622 processor can control the motor driver 626 to control the position, direction of rotation and / or speed of a motor that is coupled to the common control module 610. In certain cases cases, the processor 622 can signal the motor driver 626 to stop and / or disable a motor that is coupled to the common control module 610. It should be understood that the term "processor", as used here, includes any microprocessor , microcontroller or other suitable basic computing device that incorporates the functions of a central computer processing unit (CPU) in an integrated circuit or, at most, some integrated circuits. The 622 processor is a programmable multipurpose device that accepts digital data as input, processes it according to instructions stored in its memory, and provides results as output. This is an example of sequential digital logic, since it has internal memory. Processors operate on numbers and symbols represented in the binary numeral system.

[0170] In one example, the 622 processor can be any single-core or multi-core processor, such as those known by the Texas Instruments ARM Cortex trade name. In certain cases, the 620 microcontroller may be an LM 4F230H5QR, available from Texas Instruments, for example. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core comprising an integrated 256 KB single cycle flash memory, or other non-volatile memory, up to 40 MHz, a search buffer anticipated to optimize performance above 40 MHz, a 32 KB single cycle SRAM, an internal ROM loaded with StellarisWare & software, 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, one or more 12-bit ADCs with 12 analog input channels, among other features that are readily available for the product data sheet. Other microcontrollers can be readily replaced for use with the 4410 module. Consequently, the present disclosure should not be limited in this context.

[0171] In certain cases, memory 624 may include program instructions for controlling each of the motors of the surgical instrument 600 that are attachable to the common control module 610. For example, memory 624 may include program instructions for controlling the firing motor 602, the closing motor 603 and the hinge motors 606a, 606b. Such program instructions can cause the 622 processor to control the trigger, close, and pivot functions according to inputs from the instrument or surgical tool control algorithms or programs.

[0172] In certain cases, one or more mechanisms and / or sensors, such as 630 sensors, can be used to alert the 622 processor to program instructions that need to be used in a specific configuration. For example, sensors 630 can alert the 622 processor to use the program instructions associated with triggering, closing, and pivoting the end actuator. In certain cases, sensors 630 may comprise position sensors that can be used to detect the position of switch 614, for example. Consequently, the 622 processor can use the program instructions associated with triggering the closing member coupled to the clamping arm of the end actuator.

detection by means of sensors 630, for example, that switch 614 is in the first position 616; the processor 622 can use the program instructions associated with closing the anvil upon detection through sensors 630, for example, that switch 614 is in second position 617; and processor 622 can use the program instructions associated with the articulation of the end actuator upon detection through sensors 630, for example, that switch 614 is in the third or fourth position 618a, 618b.

[0173] Figure 17 is a schematic diagram of a robotic surgical instrument 700 configured to operate a surgical tool described in this document, in accordance with one aspect of that disclosure. The robotic surgical instrument 700 can be programmed or configured to control the distal / proximal translation of a displacement member, the distal / proximal displacement of a closing tube, the rotation of the drive shaft, and articulation, either with a single type or multiple articulation drive links. In one aspect, the surgical instrument 700 can be programmed or configured to individually control a firing member, a closing member, a driving shaft member, or one or more hinge members, or combinations thereof. Surgical instrument 700 comprises a control circuit 710 configured to control motor-driven firing members, locking members, drive shaft members, or one or more hinge members, or combinations thereof.

[0174] In one aspect, the robotic surgical instrument 700 comprises a control circuit 710 configured to control a clamping arm 716 and a closing member 714, a portion of an end actuator 702, an ultrasonic blade 718 coupled to a 719 ultrasonic transducer excited by an ultrasonic generator

single 721, a drive shaft 740, and one or more link members 742a, 742b through a plurality of motors 704a to 704e. A position sensor 734 can be configured to provide feedback on the position of closing member 714 to control circuit 710. Other sensors 738 can be configured to provide feedback to control circuit 710. A timer / counter 731 provides information about timing and counting to control circuit 710. A power source 712 can be provided to operate motors 704a to 704e and a current sensor 736 provides motor current feedback to the control circuit

710. Motors 704a to 704e can be operated individually by control circuit 710 in an open loop or closed loop feedback control.

[0175] In one aspect, the control circuit 710 may comprise one or more microcontrollers, microprocessors or other processors suitable for executing instructions that cause the processor or processors to perform one or more tasks. In one aspect, a timer / counter 731 provides an output signal, such as elapsed time or a digital count, to control circuit 710 to correlate the position of closing member 714 as determined by position sensor 734 with the timer output. / counter 731 so that the control circuit 710 can determine the position of the closing member 714 at a specific time (t) in relation to an initial position or the time (t) when the closing member 714 is in a specific position in relation to a starting position. The timer / counter 731 can be configured to measure elapsed time, count external events, or measure eternal events.

[0176] In one aspect, control circuit 710 can be programmed to control functions of end actuator 702 based on one or more tissue conditions. The control circuit 710 can be programmed to directly or indirectly detect tissue conditions, such as thickness, as described here. Control circuit 710 can be programmed to select a trigger control program or closing control program based on tissue conditions. A trigger control program can describe the distal movement of the displacement member. Different trigger control programs can be selected to better treat different tissue conditions. For example, when a thicker tissue is present, control circuit 710 can be programmed to translate the displacement member at a lower speed and / or with a lower power. When thinner tissue is present, control circuit 710 can be programmed to move the displacement member at a higher speed and / or with greater power. A closing control program can control the closing force applied to the fabric by the clamping arm 716. Other control programs control the rotation of the drive shaft 740 and the hinge members 742a, 742b.

[0177] In one aspect, the 710 motor control circuit can generate motor setpoint signals. Motor setpoint signals can be provided for various motor controllers 708a through 708e. Motor controllers 708a to 708e can comprise one or more circuits configured to provide motor start signals for motors 704a to 704e to drive motors 704a to 704e, as described here. In some examples, motors 704a to 704e can be brushed DC (direct current) electric motors. For example, the speed of motors 704a to 704e can be proportional to the respective motor start signals. In some instances, motors 704a to 704e may be brushless DC electric motors, and the respective motor drive signals may comprise a PWM signal provided for one or more stator windings of motors 704a to 704e. In addition, in some instances, motor controllers 708a through 708e can be omitted and control circuit 710 can directly generate motor drive signals.

[0178] In one aspect, the control circuit 710 can initially operate each of the motors 704a to 704e in an open circuit configuration for a first open circuit portion of the travel member travel. Based on the response of the robotic surgical instrument 700 during the open circuit portion of the stroke, control circuit 710 can select a trigger control program in a closed circuit configuration. The instrument response may include a translation of the distance from the displacement member during the open circuit portion, a time elapsed during the open circuit portion, the energy supplied to one of the motors 704a to 704e during the open circuit portion, a sum of pulse widths of a motor start signal, etc. After the open circuit portion, control circuit 710 can implement the selected trigger control program for a second portion of the travel member travel. For example, during a portion of the closed loop course, control circuit 710 can modulate one of the motors 704a to 704e based on the translation of data describing a position of the closed displacement member to translate the displacement member to a constant speed.

[0179] In one aspect, motors 704a to 704e can receive power from a 712 power source. Power source 712 can be a DC power source powered by an alternating main power supply, a battery, a supercapacitor , or any other suitable energy source. The 704a to 704e engines

they can be mechanically coupled to individual movable mechanical elements such as the closing member 714, the clamping arm 716, drive shaft 740, joint 742a, and the joint 742b, through the respective transmissions 706a to 706e. Transmissions 706a through 706e may include one or more gears or other connecting components for coupling motors 704a to 704e to moving mechanical elements. A position sensor 734 can detect a position of the closing member 714. The position sensor 734 can be or can include any type of sensor that is capable of generating position data that indicates a position of the closing member

714. In some examples, the position sensor 734 may include an encoder configured to supply a series of pulses to the control circuit 710 as the closing member 714 translates distally and proximally. Control circuit 710 can track pulses to determine the position of closing member 714. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals that indicate the movement of the closing member 714. In addition, in some examples, the position sensor 734 can be omitted. When any of the motors 704a to 704e is a stepper motor, the control circuit 710 can track the position of the closing member 714 by adding the number and direction of the steps that the motor 704 has been instructed to perform. Position sensor 734 can be located on end actuator 702 or any other portion of the instrument. The outputs of each of the engines 704a to 704e include a torque sensor 744a to 744e to detect force and have an encoder to detect the rotation of the drive shaft.

[0180] In one aspect, control circuit 710 is configured to drive a firing member, such as closing member portion 714 of end actuator 702. Control circuit 710 provides a motor setpoint for control motor 708a, which provides a drive signal for motor 704a. The output shaft of the motor 704a is coupled to a torque sensor 744a. The torque sensor 744a is coupled to a transmission 706a which is coupled to the closing member 714. The transmission 706a comprises moving mechanical elements such as rotating elements and a firing member to control the movement of the limb distally and proximally. closing mechanism 714 along a longitudinal axis of the end actuator 702. In one aspect, the motor 704a can be coupled to the knife gear assembly, which includes a knife gear reduction assembly that includes a first gear and a second knife drive gear. A torque sensor 744a provides a trigger force feedback signal to control circuit 710. The trigger force signal represents the force required to fire or dislodge the closing member

714. A position sensor 734 can be configured to provide the position of closing member 714 along the firing stroke or the position of the firing member as a feedback signal to control circuit 710. End actuator 702 can include additional sensors 738 configured to provide feedback signals to control circuit 710. When ready for use, control circuit 710 can provide a trip signal to the 708a motor control. In response to the trigger signal, motor 704a can drive the trigger member distally along the longitudinal geometry axis of end actuator 702 from an initial proximal position of the stroke to a distal end position of the stroke relative to the position initial course. As the closing member 714 moves distally, the clamping arm 716 closes towards the ultrasonic blade 718.

[0181] In one aspect, control circuit 710 is configured to drive a closing member, such as the clamping arm portion 716 of end actuator 702. Control circuit 710 provides a motor setpoint for control motor 708b, which provides a drive signal for motor 704b. The output shaft of the 704b motor is coupled to a 744b torque sensor. The torque sensor 744b is coupled to a transmission 706b which is coupled to the clamping arm 716. The transmission 706b comprises moving mechanical elements such as rotating elements and a closing member to control the movement of the clamping arm. tightening 716 from the open and closed positions. In one aspect, the 704b motor is coupled to a closing gear assembly, which includes a closing reduction gear assembly that is supported in gear engaged with the closing sprocket. The torque sensor 744b provides a closing force feedback signal to control circuit 710. The closing force feedback signal represents the closing force applied to the clamping arm 716. The position sensor 734 can be configured to provide the position of the closing member as a feedback signal for control circuit 710. Additional sensors 738 on end actuator 702 can provide the feedback signal for closing force to control circuit 710. The arm articulating clamp 716 is positioned opposite the ultrasonic blade 718. When ready for use, control circuit 710 can provide a closing signal to motor control 708b. In response to the closing signal, motor 704b advances a closing member to hold the fabric between the clamping arm 716 and the ultrasonic blade 718.

[0182] In one aspect, control circuit 710 is configured to rotate a drive shaft member, such as drive shaft 740, in order to rotate end actuator 702. Control circuit 710 provides a point motor setting for motor control 708c, which provides a drive signal for motor 704c. The output shaft of the motor 704c is coupled to a torque sensor 744c. The torque sensor 744c is coupled to a transmission 706c which is coupled to the axis 740. The transmission 706c comprises moving mechanical elements, such as rotary elements, to control the rotation of the drive shaft 740 clockwise or counterclockwise. up and over 360º. In one aspect, the 704c motor is coupled to the rotary transmission assembly, which includes a pipe gear segment that is formed over (or attached to) the proximal end of the proximal closing tube for inlet operable by a set rotational gear that is operationally supported on the tool mounting plate. The torque sensor 744c provides a rotation force feedback signal for control circuit 710. The rotation force feedback signal represents the rotation force applied to the drive shaft 740. The position sensor 734 can be configured to provide the position of the closing member as a feedback signal for control circuit 710. Additional sensors 738, such as a drive shaft encoder, can provide the rotational position of the drive shaft 740 to the circuit of control

710.

[0183] In one aspect, control circuit 710 is configured to articulate end actuator 702. Control circuit 710 provides a motor setpoint for a 708d motor control, which provides a drive signal for the motor 704d. The output shaft of the motor 704d is coupled to a torque sensor 744d. The 744d torque sensor is coupled to a transmission

706d which is coupled to a hinge member 742a. The 706d transmission comprises moving mechanical elements, such as articulation elements, to control the articulation of the 702 + 65º end actuator. In one aspect, the 704d motor is coupled to a pivot nut, which is rotatably seated over the proximal end portion of the distal column portion and is pivotally driven by a pivot gear assembly. The torque sensor 744d provides a hinge force feedback signal to control circuit 710. The hinge force feedback signal represents the hinge force applied to the end actuator 702. The 738 sensors, as a hinge encoder , can provide the pivoting position of end actuator 702 for control circuit 710.

[0184] In another aspect, the articulation function of the robotic surgical system 700 may comprise two articulation members, or connections, 742a, 742b. These articulation members 742a, 742b are driven by separate disks at the robot interface (the rack), which are driven by the two motors 708d, 708e. When the separate firing motor 704a is provided, each hinge link 742a, 742b can be antagonistically driven with respect to the other link to provide a resistive holding motion and a load to the head when it is not moving and to provide a articulation movement when the head is articulated. The hinge members 742a, 742b attach to the head in a fixed radius when the head is rotated. Consequently, the mechanical advantage of the push and pull link changes when the head is rotated. This change in mechanical advantage can be more pronounced with other drive systems for the articulation connection.

[0185] In one aspect, the one or more motors 704a to 704e may comprise a brushed DC motor with a gearbox and

mechanical connections to a firing member, closing member or joint member. Another example includes electric motors 704a to 704e that operate the moving mechanical elements such as the displacement member, the articulation connections, the closing tube and the drive shaft. An external influence is an excessive and unpredictable influence of things like tissue, surrounding bodies, and friction in the physical system. This external influence can be called drag, which acts in opposition to one of the electric motors 704a to 704e. External influence, such as drag, can cause the functioning of the physical system to deviate from a desired operation of the physical system.

[0186] In one aspect, the position sensor 734 can be implemented as an absolute positioning system. In one aspect, the 734 position sensor can comprise an absolute rotary magnetic positioning system implemented as a single integrated circuit rotary magnetic position sensor, ASSOSSEQFT, available from Austria Microsystems, AG. The position sensor 734 can interface with the control circuit 710 to provide an absolute positioning system. The position can include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit by digit method and Volder's algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic functions and trigonometry that require only addition, subtraction, bit shift and lookup table operations.

[0187] In one aspect, the control circuit 710 can be in communication with one or more sensors 738. The sensors 738 can be positioned on the end actuator 702 and adapted to work with the robotic surgical instrument 700 to measure various derived parameters such as span distance in relation to time, compression of the tissue in relation to time, and deformation of the anvil in relation to time. The 738 sensors can comprise a magnetic sensor, a magnetic field sensor, a strain gauge, a load cell, a pressure sensor, a force sensor, a torque sensor, an inductive sensor as a sensor eddy current, a resistive sensor, a capacitive sensor, an optical sensor and / or any other sensor suitable for measuring one or more parameters of the end actuator 702. The 738 sensors may include one or more sensors. Sensors 738 can be located on the clamping arm 716 to determine the location of tissue using segmented electrodes. The torque sensors 744a to 744e can be configured to detect force such as firing force, closing force, and / or articulation force, among others. Consequently, control circuit 710 can detect (1) the closing load experienced by the distal closing tube and its position, (2) the trigger member on the rack and its position, (3) which portion of the blade ultrasonic 718 has tissue in it, and (4) the load and position on both articulation rods.

[0188] In one aspect, the one or more sensors 738 may comprise an effort meter such as, for example, a microstrain meter, configured to measure the magnitude of the stress on the 716 during a pinched condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The 738 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the clamping arm 716 and the ultrasonic blade 718. The 738 sensors can be configured to detect the impedance of a section of fabric located between the clamping arm 716 and the ultrasonic sheet 718 which is indicative of the thickness and / or completeness of the fabric located between them.

[0189] In one aspect, the 738 sensors can be implemented as one or more limit switches, electromechanical devices, solid state switches, Hall effect devices, magneto-resistive devices (MR) giant magneto-resistive devices (GMR), magnetometers, among others. In other implementations, the 738 sensors can be implemented as solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, MOSFET, bipolar, and the like). In other implementations, the 738 sensors can include driverless electric switches, ultrasonic switches, accelerometers, inertia sensors and, among others.

[0190] In one aspect, sensors 738 can be configured to measure the forces exerted on the clamping arm 716 by the closing drive system. For example, one or more sensors 738 may be at an interaction point between the closing tube and the clamp arm 716 to detect the closing forces applied by the closing tube to the clamping arm 716. The forces exerted on the clamping arm 716 may be representative of the tissue compression experienced by the section of fabric trapped between the clamping arm 716 and the ultrasonic blade 718. The one or more sensors 738 can be positioned at various points of interaction along the closing drive system to detect the closing forces applied to the clamping arm 716 by the closing drive system. The one or more sensors 738 can be sampled in real time during a gripping operation by the processor of the control circuit 710. The control circuit 710 receives sample measurements in real time to provide and analyze information based on time and evaluate, in real time real,

the closing forces applied to the clamping arm 716.

[0191] In one aspect, a current sensor 736 can be used to measure the current drawn by each of the 704a to 704e motors. The force required to advance any of the moving mechanical elements such as the closing member 714 corresponds to the current drawn by one of the motors 704a to 704e. The force is converted into a digital signal and supplied to the control circuit 710. The control circuit 710 can be configured to simulate the response of the instrument's actual system in the controller software. A displacement member can be actuated to move closing member 714 on end actuator 702 at or near a target speed. The robotic surgical instrument 700 may include a re-information controller, which may be one or any of the re-information controllers, including, but not limited to, a PID controller, state feedback, linear quadratic (LOR) and / or an adaptable controller, for example. The robotic surgical instrument 700 can include a power source to convert the signal from the feedback controller to a physical input such as case voltage, PWM voltage, frequency modulated voltage, current, torque and / or force, for example. Additional details are revealed in US patent application serial number 15 / 636,829, entitled CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT, filed on June 29, 2017, which is hereby incorporated by reference in its entirety.

[0192] Figure 18 illustrates a schematic diagram of a surgical instrument 750 configured to control the distal translation of the displacement member according to an aspect of the present disclosure. In one aspect, the surgical instrument 750 is programmed to control the distal translation of the displacement member as the closing member 764. The surgical instrument 750 comprises an end actuator 752 that can comprise a clamping arm 766, a closing member 764 and an ultrasonic blade 768 coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

[0193] The position, movement, displacement, and / or translation of a linear displacement member, such as the closing member 764, can be measured by an absolute positioning system, sensor arrangement, and a 784 position sensor. Because the closing member 764 is coupled to a longitudinally movable driving member, the position of the closing member 764 can be determined by measuring the position of the longitudinally mobile driving member using the position sensor.

784. Consequently, in the following description, the position, displacement and / or translation of the closing member 764 can be obtained by the position sensor 784, as described in the present invention. A control circuit 760 can be programmed to control the translation of the displacement member, such as closing member 764. The control circuit 760, in some examples, may comprise one or more microcontrollers, microprocessors, or other processors suitable for executing instructions that cause the processor or processors to control the displacement member, for example, the closing member 764, in the manner described. In one aspect, a timer / counter 781 provides an output signal, such as elapsed time or a digital count, to control circuit 760 to correlate the position of closing member 764 as determined by position sensor 784 with the timer output. / counter 781 so that the control circuit 760 can determine the position of the closing member 764 at a specific time (t) in relation to an initial position. The 781 timer / counter can be configured to measure elapsed time, count external events, or measure timeless events.

[0194] Control circuit 760 can generate a 772 motor setpoint signal. The 772 motor setpoint signal can be supplied to a 758 motor controller. The 758 motor controller can comprise one or more circuits configured to provide a motor 774 drive signal to motor 754 to drive motor 754, as described in the present invention. In some instances, the 754 motor may be a DC motor with a brushed DC electric motor. For example, the speed of motor 754 can be proportional to the drive signal of motor 774. In some instances, motor 754 can be a brushless DC electric motor and the drive signal of motor 774 can comprise a supplied PWM signal for one or more motor stator windings 754. In addition, in some examples, motor controller 758 can be omitted, and control circuit 760 can generate motor drive signal 774 directly.

[0195] The 754 motor can receive power from a power source

762. The 762 power source can be or include a battery, a super capacitor, or any other suitable power source. Motor 754 can be mechanically coupled to closing member 764 via a transmission 756. Transmission 756 may include one or more gears or other connecting components to couple motor 754 to closing member 764. A position sensor 784 can detect a position of the closing member 764. The position sensor 784 can be or can include any type of sensor that is capable of generating position data that indicates a position of the closing member 764. In some examples, the position sensor tion 784 may include an encoder configured to supply a series of pulses to the control circuit 760 as the closing member 764 translates distally and proximally. Control circuit 760 can track pulses to determine the position of closing member 764. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals that indicate the movement of the closing member 764. In addition, in some examples, the position sensor 784 may be omitted. When the motor 754 is a stepper motor, the control circuit 760 can track the position of the closing member 764 by aggregating the number and orientation of the steps that the motor 754 has been instructed to perform. The 784 position sensor can be located on the 752 end actuator or any other portion of the instrument.

[0196] The control circuit 760 can be in communication with one or more sensors 788. The sensors 788 can be positioned on the end actuator 752 and adapted to work with the surgical instrument 750 to measure the various derived parameters, such as distance span in relation to time, compression of the tissue in relation to time and tension of the anvil in relation to time. The 788 sensors can comprise a magnetic sensor, a magnetic field sensor, a stress meter, a pressure sensor, a force sensor, an inductive sensor such as a eddy current sensor, a resistive sensor, a capacitive sensor, a sensor optical and / or any other sensors suitable for measuring one or more parameters of the 752 end actuator. The 788 sensors may include one or more sensors.

[0197] The one or more 788 sensors may comprise an effort meter, such as a microstrain meter, configured to measure the magnitude of the stress on the anvil 766 during a tight condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The 788 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the clamping arm 766 and the ultrasonic blade 768. The 788 sensors can be configured to detect the impedance of a section of fabric located between the clamping arm 766 and the ultrasonic sheet 768 which is indicative of the thickness and / or completeness of the fabric located between them.

[0198] The 788 sensors can be configured to measure the forces exerted on the clamping arm 766 by the closing drive system. For example, one or more sensors 788 may be at an interaction point between the closing tube and the clamp arm 766 to detect the closing forces applied by a closing tube to the clamping arm 766. The forces exerted on the arm clamping 766 can be representative of the tissue compression experienced by the tissue section captured between the clamping arm 766 and the ultrasonic blade 768. The one or more sensors 788 can be positioned at various points of interaction throughout the closing drive system to detect the closing forces applied to the clamping arm 766 by the closing drive system. The one or more 788 sensors can be sampled in real time during a gripping operation by a processor from the 760 control circuit. The 760 control circuit receives sample measurements in real time to provide and analyze information based on in real time and evaluate, in real time, the closing forces applied to the clamping arm 766.

[0199] A current sensor 786 can be used to measure the current drained by the motor 754. The force required to advance the closing member 764 corresponds to the current drained by the motor 754. The force is converted into a digital signal and supplied control circuit 760.

[0200] Control circuit 760 can be configured to simulate

display the response of the instrument's actual system in the controller software. A displacement member can be actuated to move a closing member 764 on end actuator 752 at or near a target speed. The surgical instrument 750 may include a feedback controller, which can be any or any feedback controller, including, but not limited to, a PID controller, status feedback, LOR, and / or an adaptive controller , for example. The surgical instrument 750 can include a power source to convert the signal from the re-information controller to a physical input such as case voltage, PWM voltage, frequency modulated voltage, current, torque and / or force, for example.

[0201] The actual drive system of the surgical instrument 750 is configured to drive the displacement member, the cutting member or the closing member 764, by a brushed DC motor, with gearbox and mechanical connections to a system articulation and / or knife. Another example is the 754 electric motor that operates the displacement member and the articulation drive, for example, from an interchangeable drive shaft assembly. An external influence is an excessive and unpredictable influence on things like tissue, surrounding bodies, and friction in the physical system. This external influence can be called drag, which acts in opposition to the 754 electric motor. External influence, like drag, can cause the functioning of the physical system to deviate from a desired operation of the physical system.

[0202] Several exemplifying aspects are directed to a 750 surgical instrument that comprises a 752 end actuator with motor-operated surgical sealing and cutting implements. For example, a 754 motor can drive a displacement member distally and proximally along a long geometric axis

end actuator 752. End actuator 752 may comprise an articulating clamping arm 766 and, when configured for use, an ultrasonic blade 768 positioned opposite the clamping arm 766. A clinician can hold the tissue between the clamping arm 766 and the ultrasonic blade 768, as described in the present invention. When ready to use the 750 instrument, the physician can provide a trigger signal, for example, by pressing a trigger on the 750 instrument. In response to the trigger signal, the 754 motor can drive the displacement member distally along from the longitudinal geometric axis of the end actuator 752 from a proximal start position to an end position distal from the start position. As the displacement member moves distally, the closing member 764 with a cutting member positioned at a distal end, can cut the tissue between the ultrasonic blade 768 and the clamping arm 766.

[0203] In several examples, the surgical instrument 750 may comprise a control circuit 760 programmed to control the distal translation of the displacement member, such as the closing member 764, for example, based on one or more tissue conditions . The control circuit 760 can be programmed to directly or indirectly detect tissue conditions, such as thickness, as described here. Control circuit 760 can be programmed to select a control program based on tissue conditions. A control program can describe the distal movement of the displacement member. Different control programs can be selected to better treat different tissue conditions. For example, when a thicker tissue is present, the control circuit 760 can be programmed to transfer the displacement member at a lower speed and / or with a lower power. When a thinner tissue is present, the control circuit 760 can be programmed to move the displacement member at a higher speed and / or with greater power.

[0204] In some examples, control circuit 760 may initially operate motor 754 in an open circuit configuration for a first open circuit portion of a travel member travel. Based on an instrument response 750 during the open circuit portion of the stroke, control circuit 760 can select a trip control program. The response of the instrument may include a travel distance of the displacement member during the open circuit portion, a time elapsed during the open circuit portion, the power supplied to the motor 754 during the open circuit portion, a sum of pulse widths a motor start signal, etc. After the open circuit portion, control circuit 760 can implement the selected trigger control program for a second portion of the travel member travel. For example, during the closed loop portion of the stroke, control circuit 760 can modulate motor 754 based on translation data that describes a position of the displacement member in a closed circuit manner to translate the displacement member into a constant speed. Additional details are revealed in US patent application serial number 15 / 720,852, entitled SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT, filed on September 29, 2017, which is hereby incorporated by reference in its entirety.

[0205] Figure 19 is a schematic diagram of a 790 surgical instrument configured to control various functions in accordance with an aspect of the present disclosure. In one aspect, the surgical instrument 790 is programmed to control the distal translation of a displacement member such as closing member 764. Surgical instrument 790 comprises an end actuator 792 which may comprise a clamping arm 766, a closing member 764, and an ultrasonic blade 768 that can be interchanged with or work in conjunction with one or more RF 796 electrodes (shown in dashed line). The ultrasonic blade 768 is coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

[0206] In one aspect, the 788 sensors can be implemented as a limit switch, electromechanical device, solid state switches, Hall effect devices, MRI devices, GMR devices, magnetometers, among others. In other implementations, 638 sensors can be solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid-state devices such as transistors (for example, FET, junction FET, MOSFET, bipolar, and the like). In other implementations, 788 sensors can include driverless electric switches, ultrasonic switches, accelerometers, inertia sensors and, among others.

[0207] In one aspect, the 784 position sensor can be implemented as an absolute positioning system, which comprises a rotating magnetic absolute positioning system implemented as a rotating, magnetic position sensor. single integrated, ASSOSSEQFT, available from Austria Microsystems, AG. The position sensor 784 can interface with the control circuit 760 to provide an absolute positioning system. The position may include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit by digit method and Volder algorithm,

which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only addition, subtraction, bit shift and lookup table operations.

[0208] In some examples, the position sensor 784 can be omitted. When the motor 754 is a stepper motor, the control circuit 760 can track the position of the closing member 764 by aggregating the number and orientation of the steps that the motor has been instructed to perform. Position sensor 784 can be located on end actuator 792 or any other portion of the instrument.

[0209] The control circuit 760 can be in communication with one or more sensors 788. The sensors 788 can be positioned on the end actuator 792 and adapted to work with the surgical instrument 790 to measure the various derived parameters, such as distance span in relation to time, compression of the tissue in relation to time and tension of the anvil in relation to time. The 788 sensors can comprise a magnetic sensor, a magnetic field sensor, a stress meter, a pressure sensor, a force sensor, an inductive sensor such as a eddy current sensor, a resistive sensor, a capacitive sensor, a sensor optical and / or any other sensors suitable for measuring one or more parameters of the end actuator 792. The 788 sensors may include one or more sensors.

[0210] An RF 794 power source is coupled to the end actuator 792 and is applied to the RF electrode 796 when the RF electrode 796 is provided on the end actuator 792 in place of the ultrasonic blade 768 or to function in together with the 768 ultrasonic sheet. For example, the ultrasonic sheet is made of electrically conductive metal and can be used as the return path for the RF electrosurgical current. The control circuit

760 controls the supply of RF energy to the RF electrode 796.

[0211] Additional details are disclosed in US patent application serial number 15 / 636,096, entitled SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, filed on June 28, 2017, which is hereby incorporated into reference title in its entirety. Generator hardware Adaptive ultrasonic blade control algorithms

[0212] In several respects, intelligent ultrasonic energy devices can comprise adaptive algorithms to control the operation of the ultrasonic blade. In one respect, the adaptive ultrasonic blade control algorithms are configured to identify the type of tissue and adjust the device parameters. In one aspect, the ultrasonic blade control algorithms are configured to parameterize the type of tissue. An algorithm to detect the collagen / tissue ratio to adjust the amplitude of the distal tip of the ultrasonic blade is described in the following section of the present report. Various aspects of intelligent ultrasonic devices are described here in connection with Figures 1 to 94, for example. Consequently, the following description of the adaptive ultrasonic blade control algorithms should be read in conjunction with Figures 1 to 94 and the description associated with them. Fabric type identification and device parameter settings

[0213] In certain surgical procedures it would be desirable to use adaptive ultrasonic blade control algorithms. In one aspect, adaptive ultrasonic blade control algorithms can be used to adjust the parameters of the ultrasonic device based on the type of tissue in contact with the ultrasonic blade. In one aspect, the parameters of the ultrasonic device can be adjusted based on the location of the tissue within the claws of the ultrasonic end actuator, for example, the location of the tissue between the clamping arm and the ultrasonic blade. The impedance of the ultrasonic transducer can be used to differentiate the percentage of tissue that is located at the distal or proximal end of the end actuator. The reactions of the ultrasonic device can be based on the type of tissue or the compressibility of the tissue. In another aspect, the parameters of the ultrasonic device can be adjusted based on the type of tissue identified or the parameterization. For example, the amplitude of the mechanical displacement of the distal tip of the ultrasonic blade can be adjusted based on the ratio between collagen and elastin in the tissue detected during the tissue identification procedure. The ratio of collagen to tissue elastin can be detected using a variety of techniques including reflectance and infrared (IR) surface emissivity. The force applied to the fabric by the clamping arm and / or the travel of the clamping arm to produce span and compression. Electrical continuity through a clamp equipped with electrodes can be used to determine the percentage of the claw that is covered with tissue.

[0214] Figure 20 is an 800 system configured to execute adaptive ultrasonic blade control algorithms in a surgical data network that comprises a central modular communication controller, in accordance with at least one aspect of the present disclosure. In one aspect, the generator module 240 is configured to execute the 802 ultrasonic adaptive blade control algorithms, as described here with reference to Figures 53 to 105. In one aspect, the device / instrument 235 is configured to execute the control algorithms of the adaptive ultrasonic blade 804, as described here with reference to Figures 53 to 105. In another aspect, both the device / instrument 235 and the device / instrument 235 are configured to execute the adaptive ultrasonic blade control algorithms 802, 804 as described in the present invention with reference to Figures 53 to 105.

[0215] The generator module 240 may comprise an isolated patient stage in communication with a non-isolated stage by means of a power transformer. A secondary winding of the power transformer is contained in the isolated stage and can comprise a branching configuration (for example, a central branching or non-central branching configuration) to define the drive signal outputs in order to deliver itself - actuation signals for different surgical instruments, such as an ultrasonic surgical device and an RF electrosurgical instrument, and a multifunctional surgical instrument that includes RF and ultrasonic energy modes that can be released alone or simultaneously. In particular, the trigger signal outputs can emit an ultrasonic trigger signal (for example, a 420 V medium square root trigger signal (RMS) for a 241 ultrasonic surgical instrument, and the acoustic signal outputs - instruments can emit an RF electrosurgical drive signal (for example, a 100 V electrosurgical drive signal) for an RF 241 electrosurgical instrument. Aspects of generator module 240 are described here with reference to Figures 21 to 28B.

[0216] The generator module 240 or the device / instrument 235 or both are coupled to the modular control tower 236 connected to multiple operating room devices, such as intelligent surgical instruments, robots, and other computerized devices located in the operating room, as described with reference to Figures 8 to 11, for example.

[0217] Figure 21 illustrates an example of a 900 generator, which is a form of a generator configured to couple with an ultrasonic instrument and additionally configured to perform something-

control rhythms of the ultrasonic blade adaptable in a surgical data network comprising a central modular communication controller as shown in Figure 20. The 900 generator is configured to supply multiple types of energy to a surgical instrument.

The 900 generator provides ultrasonic and RF signals to power a surgical instrument, independently or simultaneously.

Ultrasonic and RF signals can be provided alone or in combination and can be provided simultaneously.

As indicated above, at least one generator output can provide multiple types of energy (for example, ultrasonic, bipolar or monopolar RF, irreversible and / or reversible electroporation, and / or microwave energy, among others) through a single port, and these signals can be supplied separately or simultaneously to the end actuator to treat tissue.

Generator 900 comprises a processor 902 coupled to a waveform generator 904. Processor 902 and waveform generator 904 are configured to generate various signal waveforms based on information stored in a memory attached to the processor 902, not shown for clarity of disclosure.

The digital information associated with a waveform is provided to the 904 waveform generator that includes one or more DAC circuits to convert the digital input to an analog output.

The analog output is powered by an amplifier 1106 for signal conditioning and amplification.

The conditioned and amplified output of amplifier 906 is coupled to a power transformer 908. The signals are coupled by the power transformer 908 to the secondary side, which is on the patient isolation side.

A first signal of a first energy modality is supplied to the surgical instrument between the terminals identified as ENERGY; and RETURN.

A second signal from a second energy modality is coupled by a 910 capacitor and is supplied to the surgical instrument between the terminals identified as ENERGY? and RETURN. It will be recognized that more than two modes of energy can be issued and, therefore, the subscript "n" can be used to designate that up to n ENERGY terminals can be provided, where n is a larger positive integer that 1. It will also be recognized that up to "n" return paths, RETURN can be provided without departing from the scope of the present disclosure.

[0218] A first 912 voltage detection circuit is coupled through the terminals identified as ENERGY; and the RETURN path to measure the output voltage between them. A second voltage detection circuit 924 is coupled through the terminals identified as ENERGY, and the RETURN path to measure the output voltage between them. A current detection circuit 914 is arranged in series with the RETURN leg on the secondary side of the power transformer 908 as shown to measure the output current for any type of energy. If different return paths are provided for each energy modality, then a separate current detection circuit would be provided on each return leg. The outputs of the first and second voltage detection circuits 912, 924 are supplied to the respective isolation transformers 916, 922 and the output of the current detection circuit 914 is supplied to another isolation transformer 918. The outputs of the voltage transformers isolation 916, 928, 922 on the primary side of the power transformer 908 (non-isolated side of the patient) are supplied to one or more ADC 926 circuits. The digitized output from the ADC 926 circuit is provided to processor 902 for processing additional and computing. Output voltages and output current feedback information can be used to adjust the output voltage and the current supplied to the device.

surgical instrument, and to compute the output impedance, among other parameters. Input / output communications between processor 902 and isolated patient circuits are provided via a 920 interface circuit. The sensors can also be in electrical communication with the 902 processor via the 920 interface circuit.

[0219] In one aspect, impedance can be determined by processor 902 by dividing the output of the first voltage detection circuit 912 coupled over the terminals identified as ENERGIAV / RETORNO or the second voltage detection circuit 924 connected over the terminals identified as ENERGY / RETURN, through the output of the current detection circuit 914 arranged in series with the RETURN leg on the secondary side of the power transformer 908. The outputs of the first and second voltage detection circuits 912, 924 are provided to separate the transforming isolations 916, 922 and the output of the current sensing circuit 914 is provided to another isolating transformer 916. The digitalized voltage and current detection measurements of the ADC 926 circuit are provided to the 902 processor to compute the impedance. As an example, the first ENERGY energy modality: may be ultrasonic energy and the second ENERGY> z energy modality may be RF energy. However, in addition to the ultrasonic and bipolar or monopolar RF energy modalities, other energy modalities include irreversible and / or reversible electroporation and / or microwave energy, among others. In addition, although the example shown in Figure 21 shows a single RETURN return path that can be provided for two or more types of energy, in other respects, multiple RETURN return paths can be provided for each ENERGY energy modality. Thus, as described here, the impedance of the ultrasonic transducer can be measured by dividing the output of the first voltage detection circuit 912 by the current detection circuit 914 and the fabric impedance can be measured by dividing the output of the second circuit detecting voltage 924 by current detection circuit 914.

[0220] As shown in Figure 21, generator 900 comprising at least one output port can include a power transformer 908 with a single output and multiple taps to provide power in the form of one or more types of energy technology, such as ultrasonic, bipolar or monopolar RF, irreversible and / or reversible electroporation, and / or microwave energy, among others, for example to the end actuator depending on the type of tissue treatment being performed. For example, the 900 generator can supply energy with higher voltage and lower current to drive an ultrasonic transducer, with lower voltage and higher current to conduct RF electrodes to seal the tissue or with a coagulation waveform. for point coagulation using monopolar or bipolar RF electrosurgical electrodes. The output waveform of the 900 generator can be oriented, switched or filtered to supply the frequency to the end actuator of the surgical instrument. The connection of an ultrasonic transducer to the output of generator 900 would preferably be located between the output identified as ENERGY: and RETURN, as shown in Figure 21. In one example, a connection of bipolar RF electrodes at the output of generator 900 it would preferably be located between the output identified as ENERGY, and the RETURN. In the case of monopolar output, the preferred connections would be an active electrode (for example, light beam or other probe) for the ENERGY output, and a suitable return block connected to the RETURN output.

[0221] Additional details are revealed in US patent application publication 2017/0086914 entitled TECHNIQUES FOR OPE-

RATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS, which was published on March 30, 2017, which is hereby incorporated by reference in its entirety.

[0222] As used throughout this description, the term "wireless" and its derivatives can be used to describe circuits, devices, systems, methods, techniques, communication channels, etc., which can communicate data through the use of electromagnetic radiation modulated through a non-solid medium. The term does not imply that the associated devices do not contain any wires, although in some respects they may not. The communication module can implement any of a number of wireless and wired communication standards or protocols, including, but not limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20 , long-term evolution (LTE, "long-term evolution"), Ev-DO, HSPA +, HSDPA +, HSUPA +, EDGE, GSM, GPRS, CDMA, TDMA, DECT, Bluetooth, Ethernet derivatives thereof, as well as any other wireless and wired protocols that are designated as 3G, 4G, 56, and beyond. The computing module can include a plurality of communication modules. For example, a first communication module can be dedicated to short-range wireless communications like Wi-Fi and Bluetooth, and a second communication module can be dedicated to longer-range wireless communications like GPS, EDGE, GPRS , CDMA, WiMAX, LTE, Ev-DO, and others.

[0223] As used here, a processor or processing unit is an electronic circuit that performs operations on some external data source, usually memory or some other data flow. The term is used in the present invention to refer to the central processor (central processing unit) in a computer system or systems (specifically systems on a chip

(SoCs)) that combine several specialized "processors".

[0224] As used here, a system on a chip or system on the chip (SoC or SOC) is an integrated circuit (also known as an "IC" or "chip") that integrates all components of a computer or others electronic systems. It can contain digital, analog, mixed and often radio frequency functions - all on a single substrate. A SoC integrates a microcontroller (or microprocessor) with advanced peripherals such as a graphics processing unit (GPU), i-Fi module, or coprocessor. An SoC may or may not contain internal memory.

[0225] As used here, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuits and memory. A microcontroller (or MCU for microcontroller unit) can be implemented as a small computer on a single integrated circuit. It can be similar to a SoC; a SoC can include a microcontroller as one of its components. A microcontroller can contain one or more core processing units (CPUs) along with memory and programmable input / output peripherals. Program memory in the form of ferroelectric RAM, NOR flash or OTP ROM is also often included on the chip, as well as a small amount of RAM. Microcontrollers can be used for integrated applications, in contrast to microprocessors used in personal computers or other general-purpose applications that consist of several separate integrated circuits.

[0226] As used here, the term controller or microcontroller can be an independent chip or IC (integrated circuit) device that interfaces with a peripheral device. This can be a connection between two parts of a computer or a controller on an external device that manages the operation of (and connection to) data

that device.

[0227] Any of the processors or microcontrollers described here, can be implemented by any single-core or multi-core processor, such as those known under the trade name ARM Cortex by Texas Instruments. In one respect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single-cycle flash memory, or other non-volatile memory , up to 40 MHz, a prefetch buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the program StellarisWare, 2 KB electronically erasable, programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder (QEI) input analogues, one or more 12-bit analog to digital converters (ADC) with 12 channels of analog input, details of which are available for the product data sheet.

[0228] In one aspect, the processor may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the tradename Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.

[0229] The modular devices include the modules (as described in connection with Figures 3 and 9, for example) that are received within a central surgical controller and the devices or instruments

surgical instruments that can be connected to the various modules in order to connect or pair with the corresponding central surgical controller. Modular devices include, for example, smart surgical instruments, medical imaging devices, suction / irrigation devices, smoke evacuators, power generators, fans, insufflators and displays. The modular devices described here can be controlled by control algorithms. The control algorithms can be executed on the modular device itself, on the central surgical controller to which the specific modular device is paired, or on both the modular device and the central surgical controller (for example, surgical (for example, through a distributed computing) In some examples, the control algorithms of the modular devices control the devices based on the data detected by the modular device itself (that is, by sensors on, over or connected to the modular device). - to the patient being operated on (for example, tissue properties or insufflation pressure) or to the modular device itself (for example, the rate at which a knife is being advanced, the motor current, or the levels For example, a control algorithm for a surgical stapling and cutting instrument can control the rate at which the instrument's motor drives u the knife through the fabric according to the resistance encountered by the knife as it progresses.

[0230] Figure 22 illustrates a form of a surgical system 1000 that comprises a generator 1100 and several surgical instruments 1104, 1106 and 1108 that can be used with it, whereas surgical instrument 1104 is an ultrasonic surgical instrument, the surgical instrument co 1106 is an electrosurgical RF instrument, and the multifunctional surgical instrument 1108 is a combination of electrosurgical instrument

ultrasonic / RF surgery. The 1100 generator is configurable for use with a variety of surgical instruments. According to various forms, the 1100 generator can be configurable for use with different surgical instruments of different types, including, for example, the ultrasonic surgical instrument 1104, the RF electrosurgical instruments 1106 and the multifunctional surgical instrument 1108 that integrates ultrasonic and RF energies supplied simultaneously from generator 1100. Although in the form of Figure 22 generator 1100 is shown separately from surgical instruments 1104, 1106, 1108 in one form, generator 1100 can be formed integrally with any of the surgical instruments 1104, 1106 and 1108 to form a unitary surgical system. The 1100 generator comprises an 1110 input device located on a front panel of the 1100 generator console. The 1110 input device can comprise any suitable device that generates signals suitable for programming the operation of the 1100 generator. The 1100 generator can be configured for wired or wireless communication.

[0231] Generator 1100 is configured to drive multiple surgical instruments 1104, 1106, 1108. The first surgical instrument is a 1104 ultrasonic surgical instrument and comprises a 1105 handle (HP), an 1120 ultrasonic transducer, a drive 1126 and an end actuator 1122. The end actuator 1122 comprises an ultrasonic blade 1128 acoustically coupled to the ultrasonic transducer 1120 and a clamping arm 1140. The grip 1105 comprises a trigger 1143 for operating the tightening 1140 and a combination of toggle buttons 1134a, 1134b, 1134c to energize and activate the 1128 ultrasonic blade or other function. Toggle buttons 1134a, 1134b, 1134c can be configured to power the 1120 ultrasonic transducer with the 1100 generator.

[0232] Generator 1100 is also configured to drive a second surgical instrument 1106. The second surgical instrument 1106 is an RF electrosurgical instrument and comprises a 1107 (HP) handle, an 1127 drive shaft and an actuator. end 1124. The end actuator 1124 comprises electrodes on the clamping arms 1142a and 1142b and return through the electrical conductor portion of the drive shaft 1127. The electrodes are coupled to, and energized by, a bipolar power source inside generator 1100. The handle 1107 comprises a trigger 1145 to operate the clamping arms 1142a, 1142b and a power button 1135 to actuate a power switch to energize the electrodes on the end actuator 1124.

[0233] Generator 1100 is also configured to drive a multifunctional surgical instrument 1108. The multifunctional surgical instrument 1108 comprises a handle 1109 (HP), a drive shaft 1129 and an end actuator 1125. The end actuator 1125 comprises an ultrasonic blade 1149 and a clamping arm 1146. The ultrasonic blade 1149 is acoustically coupled to the ultrasonic transducer 1120. The grip 1109 comprises a trigger 1147 to operate the clamping arm 1146 and a combination of toggle buttons 1137a, 1137b, 1137c to energize and activate the 1149 ultrasonic blade or other function. Toggle buttons 1137a, 1137b, 1137c can be configured to power the 1120 ultrasonic transducer with the 1100 generator and power the 1149 ultrasonic blade with a bipolar power source also contained within the 1100 generator.

[0234] The 1100 generator is configurable for use with a variety of surgical instruments. According to various forms, the 1100 generator can be configurable for use with different surgical instruments of different types, including, for example, the surgical instrument.

ultrasonic generator 1104, the RF surgical instrument 1106 and the multifunctional surgical instrument 1108 that integrates ultrasonic and RF energies supplied simultaneously from generator 1100. Although in the form of Figure 22 generator 1100 is shown separately from surgical instruments 1104, 1106, 1108 in another form, generator 1100 can be integrally formed with any of the surgical instruments 1104, 1106, 1108 to form a unitary surgical system. As discussed above, generator 1100 comprises an input device 1110 located on a front panel of the generator 1100 console. Input device 1110 can comprise any suitable device that generates signals suitable for programming the operation of generator 1100. The 1100 generator may also comprise one or more 1112 output devices. Other aspects of generators for digitally generating electrical signal waveforms and surgical instruments are described in the patent publication US-2017-0086914-A1, which is incorporated herein reference, in its entirety.

[0235] Figure 23 is an end actuator 1122 of the exemplary ultrasonic device 1104, in accordance with at least one aspect of the present disclosure. The end actuator 1122 can comprise a blade 1128 that can be coupled to the ultrasonic transducer 1120 through a waveguide. When operated by the 1120 ultrasonic transducer, the 1128 blade can vibrate and, when placed in contact with tissues, it can cut and / or coagulate them, as described in the present invention. According to several aspects, and as shown in Figure 23, the end actuator 1122 can also comprise a clamping arm 1140 that can be configured for cooperative action with the blade 1128 of the end actuator 1122. With the blade 1128, the arm clamp 1140 can comprise a set of grippers. The clamping arm 1140 can be pivotally connected to a distal end of a drive shaft 1126 of the instrument portion 1104. The clamping arm 1140 can include a block of fabric from the clamping arm 1163, which can be formed of Teflon & or other suitable low-friction material. Block 1163 can be mounted for cooperation with blade 1128, with pivoting movement of the clamping arm 1140 that positions the clamping block 1163 in a substantially parallel relationship to, and in contact with, the blade 1128. For this construction, a portion tissue to be tightened can be caught between the tissue block 1163 and the blade 1128. The tissue block 1163 can be provided with a sawtooth-like configuration including a plurality of gripping teeth 1161 axially spaced and extending proximally to improve the grip of the tissue in cooperation with the blade 1128. The clamping arm 1140 can transition from the open position shown in Figure 23 to a closed position (with the clamping arm 1140 in contact with or close to the blade 1128) in any suitable manner. For example, handle 1105 may comprise a jaw closure trigger. When activated by a clinician, the clamshell trigger can rotate the clamping arm 1140 in any suitable manner.

[0236] The 1100 generator can be activated to supply the trigger signal to the 1120 ultrasonic transducer in any suitable manner. For example, generator 1100 may comprise a foot switch 1430 (Figure 24) coupled to generator 1100 by means of a 1432 pedal wrench cable. A clinician can activate the 1120 ultrasonic transducer and thus the ultrasonic transducer 1120 and blade 1128, pressing the foot switch 1430. In addition, or instead of the foot switch 1430, some aspects of the ultrasonic device 1104 may use one or more keys positioned on the handle 1105 which, when activated, can cause the generator to

1100 activate the 1120 ultrasonic transducer. In one aspect, for example, the one or more switches may comprise a pair of toggle buttons 1134a, 1134b, 1134c (Figure 22), for example, to determine an operating mode of device 1104. When the toggle button 1134a is pressed, for example, the ultrasonic generator 1100 can provide a maximum trigger signal to the 1120 transducer, causing it to produce a maximum ultrasonic energy output. Pressing the toggle button 1134b can cause the 1100 ultrasonic generator to provide a user-selectable drive signal to the 1120 ultrasonic transducer, causing it to produce less than the maximum ultrasonic energy output. The device 1104 additionally or alternatively may comprise a second key to, for example, indicate a position of a jaw lock trigger to operate the jaws via the clamping arm 1140 of the end actuator 1122. In addition, in some respects , the 1100 ultrasonic generator can be activated based on the position of the clamping trigger, (for example, as the clinician presses the clamping trigger to close via the clamping arm 1140, ultrasonic energy can be applied ).

[0237] In addition or alternatively, the one or more keys may comprise a toggle button 1134c which, when pressed, causes generator 1100 to provide a pulse output (Figure 22). The pulses can be provided at any suitable frequency and grouping, for example. In some respects, the power level of the pulses may consist of the power levels associated with the toggle buttons 1134a, 1134b (maximum, less than maximum), for example.

[0238] It will be recognized that a device 1104 can comprise any combination of toggle buttons 1134a, 1134b,

1134c (Figure 22). For example, device 1104 could be configured to have only two toggle buttons: a toggle button 1134a to produce a maximum of ultrasonic power output and a toggle button 1134c to produce a pulsed output, either at the maximum power level or less than the maximum. Thus, the output setting of the generator 1100 trigger signal could be five continuous signals, or any discrete number of individual pulsed signals (1, 2, 3, 4 or 5). In certain aspects, the specific trigger signal configuration can be controlled based, for example, on the EEPROM settings on the 1100 generator and / or power level selections by the user.

[0239] In certain respects, a two-position switch can be offered as an alternative to an 1134c toggle button (Figure 22). For example, a device 1104 may include a toggle button 1134a to produce a continuous output at a maximum power level and a two-position toggle button 1134b. In a first predetermined position, the toggle button 1134b can produce a continuous output at a power level less than the maximum, and in a second stop position, the toggle button 1134b can produce a pulse output (for example , at a maximum or less than maximum power level, depending on the EEPROM configuration).

[0240] In some respects, the RF electrosurgical end actuator 1124, 1125 (Figure 22) may also comprise a pair of electrodes. The electrodes can be in communication with the 1100 generator, for example, via a cable. The electrodes can be used, for example, to measure the impedance of a tissue portion present between the clamping arm 1142a, 1146 and the blade 1142b,

1149. The 1100 generator can supply a signal (for example, a non-therapeutic signal) to the electrodes. The impedance of the tissue portion can

to be found, for example, by monitoring the current, voltage, etc. the signal.

[0241] In several respects, the generator 1100 can comprise several separate functional elements, such as modules and / or blocks, as shown in Figure 24, a diagram of the surgical system 1000 in Figure 22. Different modules or functional elements can be configured to drive different types of surgical devices 1104, 1106, 1108. For example, an ultrasonic generator module can drive an ultrasonic device, such as the ultrasonic instrument

1104. An electrosurgery / RF generator module can drive the 1106 electrosurgical device. The modules can generate the respective trigger signals to trigger the 1104, 1106, 1108 surgical devices. In several respects, each of the ultrasonic and / or the electrosurgery / RF generator module can be formed integrally with the 1100 generator. Alternatively, one or more of the modules can be supplied as a separate circuit module electrically coupled to the 1100 generator. (The modules are shown in dotted line to illustrate this option.) In addition, in some aspects the generator module for electrosurgery / RF can be formed entirely with the ultrasonic generator module, or vice versa.

[0242] According to the aspects described, the ultrasonic generator module can produce one or more trigger signals with specific voltages, currents and frequencies (for example, 55,500 cycles per second, or Hz). The signal or trigger signals can be supplied to the ultrasonic device 1104 and specifically to the transducer 1120, which can operate, for example, as described above. In one aspect, generator 1100 can be configured to produce a trigger signal for a specific voltage, current and / or frequency output signal that can be performed at high resolution.

accuracy, accuracy and repeatability.

[0243] According to the aspects described, the generator module for electrosurgery / RF can generate one or more drive signals with sufficient output power to perform bipolar electrosurgery using radiofrequency (RF) energy. In bipolar electrosurgery applications, the trigger signal can be supplied, for example, to the electrodes of the electrosurgical device 1106, for example, as described above. Consequently, generator 1100 can be configured for therapeutic purposes by applying sufficient electrical energy to the tissue to treat said tissue (for example, coagulation, cauterization, tissue welding, etc.).

[0244] The generator 1100 may comprise an input device 2150 (Figure 27B) located, for example, on a front panel of the generator 1100 console. The input device 2150 can comprise any suitable device that generates adequate signals for programming the operation of generator 1100. In operation, the user can program or otherwise control the operation of generator 1100 using the 2150 input device. The 2150 input device can comprise any suitable device that generates signals that can be used by the generator (for example, by one or more processors contained in the generator) to control the operation of the 1100 generator (for example, the operation of the ultrasonic generator module and / or the generator module for electrosurgery / RF). In many respects, the 2150 input device includes one or more of buttons, keys, rotary controls, keyboard, numeric keypad, touchscreen monitor, pointing device and remote connection to a general purpose or dedicated computer. In other respects, the 2150 input device may comprise a suitable user interface, such as one or more user interface screens displayed on a touchscreen monitor, for example. Consequently, using the 2150 input device, the user can adjust or program various operational parameters of the generator, such as current (Il), voltage (V), frequency (f) and / or period (T) of a or more trigger signals generated by the ultrasonic generator module and / or the electrosurgery / RF generator module.

[0245] The generator 1100 may also comprise an output device 2140 (Figure 27B) located, for example, on a front panel of the generator 1100 console. The output device 2140 includes one or more devices to provide the user with sensory feedback . These devices may comprise, for example, visual feedback devices (for example, a monitor with LCD screen, LED indicators), hearing feedback devices (for example, a speaker, a bell) or feedback devices. - tactile information (for example, haptic actuators).

[0246] Although certain modules and / or blocks of the 1100 generator can be described by way of example, it should be considered that a greater or lesser number of modules and / or blocks can be used and, even so, be in the scope of aspects. In addition, although several aspects can be described in terms of modules and / or blocks to facilitate description, these modules and / or blocks can be implemented by one or more hardware components, for example, processors, processors digital signal systems (DSPs), programmable logic devices (PLDs), application-specific integrated circuits (ASICS), circuits, registers and / or software components, for example, programs, subroutines, logic and / or combinations of hardware and software components.

[0247] In one aspect, the ultrasonic generator drive module and the electrosurgery / RF 1110 drive module (Figure 22) can comprise one or more integrated applications, implemented as firmware, software, hardware or any other component.

combination. The modules can comprise several executable modules, such as software, programs, data, triggers and application program interfaces (API, "application program interfaces"), among others. The firmware can be stored in non-volatile memory (NVM, of "non-volatile memory"), as in read-only memory (ROM) with bit mask, or flash memory. In many implementations, storing firmware in ROM can preserve flash memory. The NVM can comprise other types of memory including, for example, programmable ROM (PROM, "programmable ROM"), erasable programmable ROM (EPROM, "erasable programmable ROM"), electrically erasable programmable ROM (EEPROM, "electrically erasable programmable ROM"), or battery backed random-access memory (RAM) as dynamic RAM (DRAM, "dynamic RAM"), DRAM with double data rate (DDRAM , "Double-Data-Rate DRAM"), and / or synchronous DRAM (SDRAM, "synchronous DRAM").

[0248] In one aspect, the modules comprise a hardware component implemented as a processor for executing program instructions for monitoring various measurable characteristics of devices 1104, 1106, 1108 and generating a signal or signal of corresponding output drive for the operation of devices 1104, 1106, 1108. In aspects where generator 1100 is used in conjunction with device 1104, the trigger signal can drive ultrasonic transducer 1120 in ci modes - cutting and / or coagulation surgeons. The electrical characteristics of device 1104 and / or fabric can be measured and used to control the operational aspects of the 1100 generator and / or be provided as feedback to the user. In aspects where generator 1100 is used in conjunction with device 1106, the trigger signal can supply electrical energy (eg RF energy) to end actuator 1124 in the cut, coagulation and / or desiccation modes. The electrical characteristics of the 1106 device and / or the fabric can be measured and used to control the operational aspects of the 1100 generator and / or be provided as feedback to the user. In several aspects, as previously discussed, hardware components can be implemented as PSD, PLD, ASIC, circuits and / or registers. In one aspect, the processor can be configured to store and execute computer software program instructions in order to generate the step function output signals for driving various components of devices 1104, 1106, 1108, such as the 1120 ultrasonic transducer and the 1122, 1124, 1125 end actuators.

[0249] An electromechanical ultrasonic system includes an ultrasonic transducer, a waveguide, and an ultrasonic blade. The electromechanical ultrasonic system has an initial resonance frequency defined by the physical properties of the ultrasonic transducer, the waveguide, and the ultrasonic blade. The ultrasonic transducer is excited by a voltage signal Va (t) and alternating current /, 7 (t) equal to the resonance frequency of the electromechanical ultrasonic system. When the electromechanical ultrasonic system is in resonance, the phase difference between the voltage Va (t) and current / 1 (t) signals is zero. In other words, in resonance the inductive impedance is equal to the capacitive impedance. As the ultrasonic sheet heats up, the conformity of the ultrasonic sheet (modeled as an equivalent capacitance) causes the resonance frequency of the electromechanical ultrasonic system to shift. In this way, the inductive impedance is no longer equal to the capacitive impedance causing a difference between the drive frequency and the resonance frequency of the electromechanical ultrasonic system. The system is now operating "out of resonance". The difference between the frequency of

resonance frequency is manifested as a phase difference between voltage signals V, (t) and current / 7 (t) applied to the ultrasonic transducer. The generator's electronic circuits can easily monitor the phase difference between the voltage Va (t) and current / 7 (t) signals and can continuously adjust the drive frequency until the phase difference is again equal to zero. At this point, the new drive frequency is equal to the resonance frequency of the new electromechanical ultrasonic system. The change in phase and / or frequency can be used as an indirect measurement of the temperature of the ultrasonic sheet.

[0250] As shown in Figure 25, the electro-mechanical properties of the ultrasonic transducer can be modeled as an equivalent circuit comprising a first branch that has a static capacitance and a second branch "in motion" that has an inductance, resistance and capacitance connected in series that define the electromechanical properties of a resonator. Known ultrasonic generators may include a tuning inductor to cancel the static capacitance at a resonant frequency so that substantially all of the current from the generator's drive signal flows to the moving branch. Consequently, using a tuning inductor, the current of the generator's trigger signal represents the current of the branch in motion, and the generator is thus able to control its trigger signal to maintain the resonant frequency. - ultrasonic transducer size. The tuning inductor can also transform the phase impedance plot of the ultrasonic transducer to optimize the frequency locking capabilities of the generator. However, the tuning inductor must be combined with the specific static capacitance of an ultrasonic transducer at the operational resonance frequency. In other words, a transducer

Different ultrasonic motors having a different static capacitance need a tuning inductor.

[0251] Figure 25 illustrates a 1500 equivalent circuit of an ultrasonic transducer, such as the 1120 ultrasonic transducer, according to one aspect. Circuit 1500 comprises a first "motion" branch having, connected in series, inductance Ls, resistance Rs and capacitance Cs that define the electromechanical properties of the resonator, and a second capacitive branch having a static capacitance Co. The drive current / 19 (t) can be received from a generator at a drive voltage Va (t), with the movement current / m (t) flowing through the first branch and the current / 4 (t) -Im (t) flowing through the capacitive branch. Control of the electromechanical properties of the ultrasonic transducer can be achieved by properly controlling / g (t) and Va (t). As explained above, conventional generator architectures can include a Lt tuning inductor (shown in dashed line in Figure 25) to cancel, in a parallel resonance circuit, the static capacitance Co at a resonance frequency, so that substantially the entire current output of the generator / 9 (t) flows through the motive of movement. In this way, the current control of the movement branch / m (t) is obtained by controlling the generator current output / 74 (t). The tuning inductor L: is specific to the static Co capacitance of an ultrasonic transducer, however, and a different ultrasonic transducer having a different static capacitance requires a different tuning inductor Lt. In addition, as the tuning inductor L: correlates to the nominal value of the static capacitance Co at a single resonance frequency, the accurate control of the branching current of motion / m (t) is guaranteed only at that frequency. As the frequency moves down with the temperature of the transducer, the exact control of the branch current

movement is compromised.

[0252] Several aspects of the 1100 generator may not have a tuning inductor L: to monitor the branching current of movement / m (t). Instead, generator 1100 can use the measured value of static capacitance Co between power applications for a specific ultrasonic surgical device 1104 (along with drive feedback and current voltage feedback data) to determine the values of the branching current of movement / m (t) on a dynamic and continuous basis (for example, in real time). Such aspects of the 1100 generator are, therefore, capable of providing virtual tuning to simulate a system that is tuned or resonant with any static Co capacitance value at any frequency, and not just at a single resonance frequency imposed by a static capacitance nominal value Co.

[0253] Figure 26 is a simplified block diagram of an aspect of generator 1100, to provide tuning without an inductor, as described above, among other benefits. Figures 27A to 27C illustrate an architecture of the generator 1100 of Figure 26, according to one aspect. Referring to Figure 26, generator 1100 can comprise an isolated stage of patient 1520 in communication with a non-isolated stage 1540 by means of a power transformer 1560. A secondary winding 1580 of power transformer 1560 is contained in isolated stage 1520 and can comprise a bypass configuration (for example, a central bypass or non-central bypass configuration) for defining the drive signal outputs 1600a, 1600b, 1600c to provide output drive signals to different surgical devices, such as an ultrasonic surgical device 1104 and an electrosurgical device 1106. In particular, the trigger signal outputs 1600a, 1600b and 1600c can provide a trigger signal (for example, a 420 V trigger signal) RMS) to an ultrasonic instrument 1104, and the trigger signal outputs 1600a, 1600b and 1600c can provide a trigger signal (for example, a trigger signal 100 V RMS) to an electrosurgical device 1106, with output 1600b corresponding to the central bypass of the power transformer 1560. The non-isolated stage 1540 can comprise a power amplifier 1620 that has an output connected to a primary winding 1640 of the transformer power 1560. In some respects, the 1620 power amplifier may comprise a push-pull amplifier, for example. The non-isolated stage 1540 can also comprise a programmable logic device 1660 to provide a digital output to a 1680 digital-to-analog converter (DAC) which, in turn, provides an analog signal corresponding to an input of the amplifier. power

1620. In certain respects, the 1660 programmable logic device may comprise a field-programmable gate array (FPGA) arrangement, for example. The programmable logic device 1660, by controlling the input of the 1620 power amplifier through the DAC 1680, can therefore control any of a number of parameters (eg frequency, waveform, amplitude of the waveform) of drive signals appearing on the drive signal outputs 1600a, 1600b and 1600c. In certain aspects and as discussed below, the programmable logic device 1660, in conjunction with a processor (for example, processor 1740 discussed below), can implement a number of control algorithms based on digital signal processing (DSP) and / or other control algorithms for control parameters of the trigger signals provided by the generator

1100.

[0254] Power can be supplied to a power rail of the 1620 power amplifier by a key mode regulator

1700. In certain respects, the 1700 key mode regulator may comprise an adjustable antagonistic regulator, for example. As discussed above, the non-isolated stage 1540 may further comprise a 1740 processor which, in one respect, may comprise a DSP processor such as an ADSP-21469 SHARC DSP, available from Analog Devices, Norwood, Mass., USA, for example. In certain respects, the 1740 processor can control the operation of the 1700 key mode power converter responsive to voltage feedback data received from the 1620 power amplifier by the 1740 processor via an analog-to-converter -digital (DAC) 1760. In one aspect, for example, the 1740 processor can receive as input, through the ADC 1760, the waveform aging of a signal (for example, an RF signal) being amplified by the 1620 power amplifier. The 1740 processor can then control the 1700 key mode regulator (for example, through a pulse-width modulated PWM output) so that the rail voltage provided to the power amplifier 1620 follow the waveform envelope of the amplified signal By dynamically modulating the rail voltage of the 1620 power amplifier based on the waveform envelope, the efficiency of the 1620 power amplifier can be significantly Improved over an amplifier scheme with fixed rail voltage. The 1740 processor can be configured for wired or wireless communication.

[0255] In certain aspects and as discussed in further detail in connection with Figures 28A to 28B, the programmable logic device 1660, in conjunction with the 1740 processor, can implement a control scheme with direct digital synthesizer (DDS ) to control the waveform, frequency and / or amplitude of the supply of trigger signals by the 1100 generator. In one aspect, for example, the 1660 programmable logic device can implement a DDS 2680 control algorithm (Figure 28A) by retrieving waveform samples stored in a dynamically updated lookup table (LUT), such as a RAM LUT that can be integrated into an FPGA.

This control algorithm is particularly useful for ultrasonic applications in which an ultrasonic transducer, such as the 1120 ultrasonic transducer, can be driven by a clean sinusoidal current at its resonant frequency.

As other frequencies can excite parasitic resonances, minimizing or reducing the total distortion of the branching current can correspondingly minimize or reduce the undesirable effects of resonance.

As the waveform of a drive signal output by generator 1100 is impacted by various sources of distortion present in the output drive circuit (for example, power transformer 1560, power amplifier 1620), feedback data over voltage and current based on the trigger signal can be provided at an algorithm, such as an error control algorithm implemented by the 1740 processor, which compensates for the distortion by adequate pre-distortion or modification of the weapon waveform samples - dynamically and continuously closed in the LUT (for example, in real time). In one respect, the amount or degree of pre-distortion applied to the LUT samples can be based on the error between a current from the computerized motion branch and a desired current waveform, the error being determined in a sample by sample basis.

In this way, pre-distorted LUT samples, when processed through the drive circuit, can result in a trigger signal of the motion branch that has the desired waveform (for example, sinusoidal)

to optimally drive the ultrasonic transducer. In such aspects, the LUT waveform samples will therefore not represent the desired waveform of the trigger signal, but the waveform that is necessary to ultimately produce the waveform. desired wave of the trigger signal of the motion branch, when distortion effects are taken into account.

[0256] The non-isolated stage 1540 may additionally comprise an ADC 1780 and an ADC 1800 coupled to the output of the power transformer 1560 by means of the respective isolation transformers, 1820 and 1840, to respectively sample the voltage and current of trigger signals emitted by the 1100 generator. In certain aspects, ADCs 1780 and 1800 can be configured for sampling at high speeds (for example, 80 Msps) to enable over-sampling of the trigger signals. In one aspect, for example, the sampling speed of ADCs 1780 and 1800 can enable an oversampling of approximately 200X (depending on the trigger frequency) of the trigger signals. In certain aspects, the sampling operations of ADCs 1780, 1800 can be performed by a single ADC receiving input voltage and current signals through a bidirectional multiplexer. The use of high-speed sampling in the 1100 generator aspects can make it possible, among other things, to calculate the complex current flowing through the branch of motion (which can be used in certain aspects to implement waveform control based on DDS described above), accurate digital filtering of the sampled signals, and calculating the actual energy consumption with a high degree of accuracy. The output of the feedback data about voltage and current through ADCs 1780 and 1800 can be received and processed (for example, FIFO buffering, multiplexing) by the 1660 programmable logic device and stored in data memory for subsequent retrieval, for example, by 1740 processor. As noted above, feedback data on voltage and current can be used as an input for an algorithm for pre-distortion or modification of waveform samples in the LUT, in a dynamic and continuous manner. In certain respects, this may require that each stored voltage and current feedback data pair be indexed based on, or otherwise associated with, a corresponding LUT sample that was provided by the 1660 programmable logic device when the pair of feedback data on voltage and current was captured. The synchronization of the LUT samples with the feedback data on voltage and current in this way contributes to the correct timing and stability of the pre-distortion algorithm.

[0257] In certain respects, voltage and current feedback data can be used to control the frequency and / or amplitude (for example, current amplitude) of the drive signals. In one aspect, for example, voltage and current feedback data can be used to determine the impedance phase, for example, the phase difference between the voltage and current trigger signals. The frequency of the trigger signal can then be controlled to minimize or reduce the difference between the determined impedance phase and an impedance phase set point (eg 0º), thus minimizing or reducing the effects. - harmonic distortion and, correspondingly, accentuating the accuracy of the impedance phase measurement. The determination of phase impedance and a frequency control signal can be implemented in the 1740 processor, for example, with the frequency control signal being supplied as input to a DDS control algorithm implemented by the device programmable logic 1660.

[0258] The impedance phase can be determined using Fourier analysis. In one aspect, the phase difference between the triggering signals of the generated voltage V, (t) and the generated current Ila (t) can be determined using the fast Fourier transform (FFT) or the transform Fourier discrete (DFT) as explained below: WV, (t) = A, cos (2nfot + q.) 1 / (t) = Azcos (2nfot + q.)

A PA VP) == (6 fo) + SF + fo) exp (i2nf—) 2 2nfo Az: P2 LP ==> (SF fo) + SF + fo) expGi2nf—) 2 2nfo

[0259] The evaluation of the Fourier transform in the sinusoidal frequency produces: Az: Vo) == 5 (0) exp (ig.) Arg VIR) = e,

A 14h) = S (0) exp (ipa) arg (fo) = q

[0260] Other approaches include weighted minimum square estimation, Kalman filtering and space and vector based techniques. Virtually all processing in an FFT or DFT technique can be performed in the digital domain with the aid of two-channel high-speed ADC, 1780, 1800, for example. In one technique, samples of digital signals from voltage and current signals are transformed from Fourier with an FFT or DFT. The angle of phase q at any point in time can be calculated by: p = 2nft + o, where q is the phase angle, f is the frequency, t is the time, and qo is the phase at t = 0.

[0261] Another technique to determine the phase difference between the voltage signals Va (t) and current / 7 (t) is the zeros method.

ro ("zero-crossing") and produces highly accurate results. For voltage signs V, (t) and current / 7 (t) having the same, each passage through zero from negative to positive of the voltage signal Va, (t) triggers the beginning of a pulse, while each passage by zero from negative to positive current signal / 74 (t) triggers the end of the pulse. The result is a pulse train with a pulse width proportional to the phase angle between the voltage signal and the current signal. In one aspect, the pulse train can be passed through an average filter to produce a measurement of the phase difference. In addition, if zero passages from positive to negative are also used in a similar way, and the results are averaged, any effects of DC and harmonic components can be reduced. In an implementation, the analog signals of voltage V, (t) and current / 7 (t) are converted into digital signals that are high if the analog signal is positive and low if the analog signal is negative. High accuracy phase estimates require sharp transitions between high and low. In one aspect, a Schmitt trigger together with an RC stabilization network can be used to convert analog signals to digital signals. In other respects, an RS-edge and auxiliary flip-flop circuit can be used. In yet another aspect, the zero-crossing technique can use an exclusive door (XOR).

[0262] Other techniques for determining the phase difference between voltage and current signals include Lissajous figures and image monitoring; methods such as the three voltmeter method, the "crossed-coil" method, the vector voltmeter and vector impedance methods; and the use of standard phase instruments, phase-locked loops and other techniques as described in Phase Measurement, Peter O'Shea, 2000 CRC Press LLC, <http: //Www.eng- netbase.com>, which is incorporated by reference.

[0263] In another aspect, for example, the current feedback data can be monitored in order to maintain the current amplitude of the drive signal at a current amplitude setpoint. The current amplitude set point can be specified directly or indirectly determined based on the specified set points for voltage and power amplitude. In certain aspects, the control of the current amplitude can be implemented by the control algorithm, such as a proportional-integral-derivative control algorithm (PID), in the 1740 processor. The variables controlled by the control algorithm to properly control - the current amplitude of the drive signal may include, for example, the scaling of the LUT waveform samples stored in the 1660 programmable logic device and / or the full-scale output voltage of the 1680 DAC (which provides input to the power amplifier 1620) by means of a DAC 1860.

[0264] The non-isolated stage 1540 may also contain a 1900 processor to provide, among other things, the functionality of the user interface (UI). In one aspect, the 1900 processor may comprise an Atmel AT91 SAM9263 processor with an ARM 926EJ-S core, available from Atmel Corporation, of San Jose, California, USA, for example. Examples of UI functionality supported by the 1900 processor may include audible and visual feedback from the user, communication with peripheral devices (for example, via a universal serial bus interface (USB)), communication with the 1430 foot switch, communication with a 2150 data input device (for example, a touch screen) and communication with a 2140 output device (for example, a speaker). The 1900 processor can communicate with the 1740 processor and the programmable logic device (for example, via serial peripheral interface (SPI) buses).

Although the 1900 processor can primarily support Ul functionality, it can also coordinate with the 1740 processor to implement risk mitigation in certain respects. For example, the 1900 processor can be programmed to monitor various aspects of user inputs and / or other inputs (for example, 2150 touchscreen inputs, 1430 foot switch inputs, 2160 temperature sensor inputs) and can disable the drive output of generator 1100 when an error condition is detected.

[0265] In certain aspects, both the 1740 processor (Figure 26, 27A) and the 1900 processor (Figure 26, 27B) can determine and monitor the operational status of the 1100 generator. For the 1740 processor, the operational state of the 1100 generator can determine, for example, which control and / or diagnostic processes are implemented by the 1740 processor. For the 1900 processor, the operating status of generator 1100 can determine, for example, which elements of a user interface ( eg monitor screens, sounds) are presented to a user. The 1740 and 1900 processors can independently maintain the current operational status of the 1100 generator, as well as recognize and evaluate possible transitions out of the current operational state. The 1740 processor can act as the master in this relationship, and can determine when transitions between operational states should occur. The 1900 processor can be aware of the valid transitions between operational states, and can confirm whether a particular transition is suitable. For example, when processor 1740 instructs processor 1900 to transition to a specific state, processor 1900 can verify that the requested transition is valid. If a requested transition between states is determined to be invalid by processor 1900, processor 1900 may cause generator 1100 to enter a fault mode.

[0266] The non-isolated stage 1540 may further comprise a 1960 controller (Figures 26, 27B) for monitoring the 2150 input devices (for example, a capacitive touch sensor used to turn the generator 1100 on and off, a capacitive screen touch sensitive). In certain aspects, the 1960 controller may comprise at least one processor and / or another controller device in communication with the 1900 processor. In one aspect, for example, the 1960 controller may comprise a processor (for example, a Mega168 8 bits available from Atmel) configured to monitor the inputs provided by the user through one or more capacitive touch sensors. In one aspect, the 1960 controller can comprise a touchscreen controller (for example, a QT5480 touchscreen controller available from Atmel) to control and manage the capture of touch data from a capacitive touchscreen. Touch.

[0267] In certain respects, when generator 1100 is in an "off" state, the 1960 controller can continue to receive operational power (for example, through a line from a generator 1100 power source, as the source power supply 2110 (Figure 26) discussed below). In this way, the 1960 controller can continue to monitor a 2150 input device (for example, a capacitive touch sensor located on a front panel of generator 1100) to turn generator 1100 on and off. When generator 1100 is in the state the 1960 controller can wake up the power supply (for example, enable the operation of one or more DC / DC voltage converters 2130 (Figure 26) of the power supply 2110), if the activation of the input device is detected "on / off" switch 2150 by a user. Controller 1960 can therefore initiate a sequence to transition generator 1100 to an "on" state. On the other hand, the 1960 controller can start

air a sequence to transition the generator 1100 to the off state if activation of the "on / off" input device 2150 is detected, when the generator 1100 is in the on state. In certain respects, for example, the 1960 controller can report the activation of the 2150 "on / off" input device to the 1900 processor, which in turn implements the necessary process sequence to transition the generator 1100 to the state off. In these respects, the 1960 controller may not have any independent capacity to cause the removal of power from generator 1100, after its on state has been established.

[0268] In certain respects, the 1960 controller can cause the 1100 generator to provide audible feedback or other sensory feedback to alert the user that an on or off sequence has started. This type of alert can be provided at the beginning of an on or off sequence, and before the start of other processes associated with the sequence.

[0269] In certain respects, the isolated stage 1520 may comprise an 1980 instrument interface circuit to, for example, offer a communication interface between a control circuit of a surgical device (for example, a control circuit that (includes cable switches) and non-isolated stage 1540 components, such as the 1660 programmable logic device, the 1740 processor and / or the 1900 processor. The 1980 instrument interface circuit can exchange information with non-isolated stage components 1540 for through a communication link that maintains an adequate degree of electrical isolation between stages 1520 and 1540 such as, for example, an infrared (IR) "infrared" communication link. Power can be supplied to the 1980 instrument interface circuit using, for example, a low-drop voltage regulator powered by an acoustic isolation transformer.

from the non-isolated stage 1540.

[0270] In one aspect, the instrument interface circuit 1980 can comprise a programmable logic device 2000 (for example, an FPGA) in communication with a signal conditioning circuit 2020 (Figure 26 and Figure 27C). The signal conditioning circuit 2020 can be configured to receive a periodic signal from the programmable logic device 2000 (for example, a 2 kHz square wave) to generate an interrogation signal that has an identical frequency. The question mark can be generated, for example, using a bipolar current source powered by a differential amplifier. The question mark can be communicated to a control circuit of the surgical device (for example, using a conductive pair on a wire that connects the 1100 generator to the surgical device) and monitored to determine a state or configuration of the control circuit. . The control circuit may comprise numerous switches, resistors and / or diodes to modify one or more characteristics (for example, amplitude, rectification) of the question mark so that a state or configuration of the control circuit is discernible, unequivocally, based on this one or more characteristics. In one aspect, for example, the signal conditioning circuit 2020 may comprise an ADC for generating samples of a voltage signal appearing between inputs of the control circuit, resulting in the passage of the question mark through it. The programmable logic device 2000 (or a non-isolated stage component 1540) can then determine the status or configuration of the control circuit based on the ADC samples.

[0271] In one aspect, the 1980 instrument interface circuit may comprise a first 2040 data circuit interface to enable the exchange of information between the programmable logic device 2000 (or another element of the instrument interface circuit)

1980) and a first data circuit disposed in, or otherwise associated with, a surgical device. In some respects, for example, a first 2060 data circuit may be arranged on a wire integrally attached to a handle of the surgical device, or on an adapter to interface between a specific type or model of surgical device and the 1100 generator. In certain aspects, the first data circuit may comprise a non-volatile storage device, such as an electrically erasable programmable read-only memory device (EEPROM). In certain aspects and again with reference to Figure 26, the first data loop interface 2040 can be implemented separately from the programmable logic device 2000 and comprises a suitable set of circuits (for example, different logic devices, a program to enable communication between programmable logic device 2000 and the first data circuit. In other respects, the first 2040 data circuit interface can be integral to the programmable logic device 2000.

[0272] In some respects, the first 2060 data circuit can store information related to the specific surgical device with which it is associated. This information may include, for example, a model number, a serial number, a number of operations in which the surgical device was used, and / or any other types of information. This information can be read by the interface circuit of the 1980 instrument (for example, the programmable logic device 2000), transferred to a non-isolated stage component 1540 (for example, to the programmable logic device 1660, processor 1740 and / or processor 1900) for presentation to a user via an output device 2140 and / or to control a function or operation of the 1100 generator. In addition, any type of information can be communicated to the first circuit data 2060 for storage in the same via the first interface of the 2040 data circuit (for example, using the programmable logic device 2000). This information may include, for example, an updated number of operations in which the surgical device was used and / or the dates and / or times of its use.

[0273] As discussed earlier, a surgical instrument can be removable from a handle (for example, the instrument 1106 can be removable from the handle 1107) to promote interchangeability and / or disposability of the instrument. In these cases, known generators may be limited in their ability to recognize specific instrument configurations being used, as well as to optimize the control and diagnostic processes as needed. The addition of readable data circuits to surgical device instruments to resolve this issue is problematic from a compatibility point of view, however. For example, it may be impractical to design a surgical device so that it remains compatible with previous versions of generators that lack the indispensable data reading functionality due to, for example, different signaling schemes, design complexity and cost. Other aspects of the instruments address these concerns through the use of data circuits that can be implemented in existing surgical instruments, economically and with minimal design changes to preserve the compatibility of surgical devices with current generator platforms.

[0274] Additionally, aspects of the 1100 generator can enable communication with instrument-based data circuits. For example, generator 1100 can be configured to communicate with a second data circuit (for example, a data circuit) contained in an instrument (for example, instrument 1104,

1106, or 1108) of a surgical device. The instrument interface circuit 1980 can comprise a second data circuit interface 2100 to enable such communication. In one aspect, the second data circuit interface 2100 may comprise a three-wire digital interface, although other interfaces may also be used. In certain respects, the second data circuit can generally be any circuit for transmitting and / or receiving data. In one aspect, for example, the second data circuit can store information related to the specific surgical instrument with which it is associated. This information may include, for example, a model number, a serial number, a number of operations in which the surgical instrument was used, and / or any other types of information. In addition or alternatively, any type of information can be communicated to the second data circuit for storage in it via the second data circuit interface 2100 (for example, using the programmable logic device 2000). This information may comprise, for example, an updated number of operations in which the surgical instrument was used and / or the dates and / or times of its use. In certain aspects, the second data circuit can transmit data captured by one or more sensors (for example, an instrument-based temperature sensor). In certain respects, the second data circuit can receive data from the 1100 generator and provide an indication to the user (for example, an LED indication or other visible indication) based on the received data.

[0275] In certain respects, the second data circuit and the second data circuit interface 2100 can be configured so that communication between programmable logic device 2000 and the second data circuit can be achieved without the need for provide additional drivers for this purpose (for example,

dedicated wire conductors connecting a cable to the 1100 generator). In one aspect, for example, information can be communicated to and from the second data circuit using a wire bus communication scheme, implemented in the existing wiring, as one of the conductors used to transmit signals. marks from the signal conditioning circuit 2020 to a control circuit on a cable. In this way, changes or modifications to the design of the surgical device that may otherwise be necessary are minimized or reduced. In addition, due to the fact that different types of communications can be implemented on a common physical channel (with or without frequency band separation), the presence of a second data circuit can be "invisible" to generators that are not. they have the indispensable functionality of reading data, which, therefore, allows the backward compatibility of the surgical device instrument.

[0276] In certain aspects, the isolated stage 1520 may comprise at least one blocking capacitor 2960-1 (Figure 27C) connected to the output of the trigger signal 1600b, to prevent the passage of direct current to a patient. A single blocking capacitor may be required to comply with medical regulations and standards, for example. Although failures in single-capacitor designs are relatively uncommon, such failures can still have negative consequences. In one aspect, a second 2960-2 blocking capacitor can be placed in series with the 2960-1 blocking capacitor, with one point current leakage between the 2960-1 and 2960-2 blocking capacitors being monitored, for example, by an ADC 2980 for sampling a voltage induced by the leakage current. Samples can be received by the programmable logic device 2000, for example. Based on changes in leakage current (as indicated by the voltage samples in the aspect of Figure 26), generator 1100 can determine when at least one of the blocking capacitors 2960-1 and 2960-2 has failed. Consequently, the appearance of Figure 26 can provide a benefit over designs with only one capacitor, having a single point of failure.

[0277] In certain respects, the non-isolated stage 1540 may comprise a 2110 power supply for DC power output with adequate voltage and current. The power supply may comprise, for example, a 400 W power supply to provide a system voltage of 48 VDC. As discussed above, the 2110 power supply can additionally comprise one or more 2130 DC / DC voltage converters to receive the power supply output to generate DC outputs at the voltages and currents required by the various components of the 1100 generator. As discussed above with respect to the 1960 controller, one or more of the 2130 DC / DC voltage converters can receive an input from the 1960 controller when the activation of the 2150 "on / off" input device by a user is detected by the 1960 controller , to allow the 2130 DC / DC voltage converters to function or wake up.

[0278] Figures 28A and 28B illustrate certain functional and structural aspects of an aspect of generator 1100. The feedback indicating current and voltage output of secondary winding 1580 of power transformer 1560 is received by ADCs 1780 and 1800, respectively. As shown, ADCs 1780 and 1800 can be implemented in the form of a 2-channel ADC and can take samples of the feedback signals at high speed (for example, 80 Msps) to enable oversampling (for example, approximately 200x oversampling) of the trigger signals. Current and voltage feedback signals can be properly conditioned in the analog domain (for example, amplified, filtered) before processing by ADCs 1780 and

1800. Samples of current and voltage feedback from ADCs 1780 and 1800 can be individually buffered and subsequently multiplexed or merged into a single data stream within block 2120 of the programmable logic device.

1660. In the aspect of Figures 28A and 28B, the programmable logic device 1660 comprises an FPGA.

[0279] The multi-plexed voltage and current feedback samples can be received by a parallel data capture port (PDAP) implemented inside the processor block 2144

1740. The PDAP can comprise a packaging unit to implement any of the numerous methodologies for correlating multiplexed feedback information with a memory address. In one aspect, for example, feedback samples corresponding to a specific LUT sample output by the 1660 programmable logic device can be stored in one or more memory addresses that are correlated or indexed to the LUT address. in the LUT sample. In another aspect, the feedback data corresponding to a specific LUT sample by the 1660 programmable logic device can be stored, together with the LUT address of the LUT sample, in a common memory location. In any case, the feedback samples can be stored so that the address of the LUT sample from which a specific set of feedback reports originated can be subsequently determined. As discussed above, the synchronization of the addresses of the LUT samples and the feedback data in this way contributes to the correct timing and stability of the pre-distortion algorithm. A direct access controller

straight to memory (DMA) implemented in block 2166 of the 1740 processor can store the feedback samples (and any LUT sample address data, where applicable) in a designated memory location 2180 of the 1740 processor (for example, internal RAM ).

[0280] Block 2200 of the 1740 processor can implement a pre-distortion algorithm to pre-distort or modify the LUT samples stored in the programmable logic device 1660 in a dynamic and continuous way. As discussed above, the pre-distortion of the LUT samples can compensate for various sources of distortion present in the output drive circuit of the 1100 generator. The pre-distorted LUT samples, when processed through the drive circuit, will therefore result , in a drive signal having the desired waveform (for example, sinusoidal) to activate the ultrasonic transducer optimally.

[0281] In block 2220 of the pre-distortion algorithm, the current is determined through the movement branch of the ultrasonic transducer. The current of the motion branch can be determined using the Kirchoff current law based, for example, on the current and voltage feedback information stored at the memory location 2180 (which, when properly sized, can be representative of ly and Vg in the model in Figure 25 discussed above), a value of the static capacitance of the ultrasonic transducer Co (measured or known a priori) and a known value of the drive frequency. A sample of current from the movement branch can be determined for each set of stored current and voltage feedback reports associated with a LUT sample.

[0282] In block 2240 of the pre-distortion algorithm, each current sample of the motion branch determined in block 2220 is compared to a sample of a desired current waveform to determine a difference, or error, of the amplitude of the current. sample, between the compared samples. For this determination, the sample with the desired current waveform can be supplied, for example, from a LUT 2260 waveform containing amplitude samples for a cycle of a desired current waveform. The specific LUT 2260 current waveform sample used for the comparison can be determined by the LUT sample address associated with the current sample of the motion branch used in the comparison. As needed, the current input from the motion branch in block 2240 can be synchronized with the entry of its associated LUT sample address in block 2240. LUT samples stored in the 1660 programmable logic device and LUT samples stored in the LUT of 2260 waveforms, they can therefore be the same in terms of number. In certain respects, the desired current waveform, represented by the LUT samples stored in the LUT of 2260 waveforms, can be a fundamental sine wave. Other waveforms may be desirable. For example, it is contemplated that a fundamental sine wave could be used to trigger the main longitudinal movement of an ultrasonic transducer, superimposed on one or more other trigger signals at other frequencies, such as a third-order ultrasonic to trigger at least two mechanical resonances in order to obtain beneficial vibrations in transverse or other modes.

[0283] Each value of the sample amplitude error determined in block 2240 can be transmitted to the LUT of programmable logic device 1660 (shown in block 2280 in Figure 28A) together with an indication of its associated LUT address. Based on the amplitude error sample value and its associated address (and,

optionally, the values of the amplitude error sample for the same LUT address previously received), the LUT 2280 (or other control block of the 1660 programmable logic device) can pre-distort or modify the value of the stored LUT sample at the LUT address, so that the amplitude error sample is reduced or minimized. It must be understood that this pre-distortion or modification of each LUT sample in an iterative way over the LUT address range will cause the waveform of the generator output current to match or adapt to the format current waveform, represented by the LUT 2260 samples of waveforms.

[0284] Current and voltage amplitude measurements, power measurements and impedance measurements can be determined in block 2300 of the 1740 processor, based on the current and voltage feedback samples stored in the memory location. 2180. Before determining these quantities, the feedback samples can be appropriately sized and, in certain aspects, processed through a suitable 2320 filter to remove the noise resulting, for example, from the data capture process and the harmonic components induced. The filtered voltage and current samples can therefore substantially represent the fundamental frequency of the generator drive output signal. In certain aspects, the 2320 filter can be a finite impulse response (FIR) filter applied in the frequency domain. These aspects can use the fast Fourier transform (FFT) of the current and voltage output signals of the trigger signal. In some respects, the resulting frequency spectrum can be used to provide additional functionality to the generator. In one aspect, for example, the ratio of the second- and / or third-order harmonic component to the fundamental frequency component can be used as a diagnostic indicator.

[0285] In block 2340 (Figure 28B), an average square value (RMS) calculation can be applied to a sample size of the current feedback samples representing an integral number of drive signal cycles, to generate a measurement | l: ms representing the output current of the drive signal.

[0286] In block 2360, an average square value (RMS) calculation can be applied to a sample size of the voltage feedback samples representing an integral number of drive signal cycles, to determine a Vrms measurement representing the output voltage of the trigger signal.

[0287] In block 2380, the current and voltage feedback samples can be multiplied point by point, and an average calculation is applied to the samples representing an integral number of cycles of the trigger signal, to determine a Pr measurement; the actual output energy of the generator.

[0288] In block 2400, the measurement P, that of the apparent output power of the generator can be determined as the product Vrms'lrms-

[0289] In block 2420, the Zm measurement of the magnitude of the load impedance can be determined as the quotient Vrms / lrms.

[0290] In certain aspects, the quantities ltms, Vrms, Pr, Pa & Zm determined in blocks 2340, 2360, 2380, 2400 and 2420, can be used by generator 1100 to implement any of several control and / or diagnostic processes. In certain aspects, any of these quantities can be communicated to a user using, for example, an output device 2140 integral to the generator 1100, or an output device 2140 connected to the generator 1100 through an appropriate communication interface ( for example, a USB interface). The various diagnostic processes can include,

without limitation, cable integrity, instrument integrity, instrument fixation integrity, instrument overload, instrument overload proximity, frequency locking failure, over voltage condition, over current condition, over current condition overpower, voltage sensor failure, current sensor failure, audio indication failure, visual indication failure, short circuit condition, power supply failure, or blocking capacitor failure, for example.

[0291] Block 2440 of the 1740 processor can implement a phase control algorithm for determining and controlling the impedance phase of an electrical charge (for example, the ultrasonic transducer) conducted by the 1100 generator. As discussed above, when controlling the frequency of the trigger signal to minimize or reduce the difference between the determined impedance phase and an impedance phase adjustment point (eg 0º), the effects of harmonic distortion can be minimized or reduced, and increased accuracy in phase measurement.

[0292] The phase control algorithm receives the current and voltage feedback samples stored in memory location 2180 as input. Before being used in the phase control algorithm, the feedback feedback samples can be appropriately sized and, in certain aspects, processed through a suitable filter 2460 (which can be identical to the filter 2320) to remove the noise resulting from the data capture process and the induced harmonic components, for example. The filtered voltage and current samples can therefore substantially represent the fundamental frequency of the generator drive output signal.

[0293] In block 2480 of the phase control algorithm, the current is determined through the movement branch of the ultrasonic transducer. This determination can be identical to that described above in connection with block 2220 of the pre-distortion algorithm. Thus, the output of block 2480 can be, for each set of stored current and voltage feedback samples associated with a LUT sample, a current sample of the movement branch.

[0294] In block 2500 of the phase control algorithm, the impedance phase is determined based on the synchronized input of samples from the current of the motion branch determined in block 2480 and corresponding to voltage feedback information samples. In some respects, the impedance phase is determined as the average between the impedance phase measured at the rising edge of the waveforms and the impedance phase measured at the falling edge of the waveforms.

[0295] In block 2520 of the phase control algorithm, the impedance phase value determined in block 2220 is compared to the set point of phase 2540 to determine a difference, or error of phase, between the compared values.

[0296] In block 2560 (Figure 28A) of the phase control algorithm, based on a phase error value determined in block 2520 and the impedance magnitude determined in block 2420, a frequency output is determined to control the frequency of the trigger signal. The value of the frequency output can be continuously adjusted by block 2560 and transferred to a DDS 2680 control block (discussed below) in order to maintain the impedance phase determined in block 2500 of the phase setpoint (for example, zero phase error). In some respects, the impedance phase can be set to a phase setpoint of 0º. In this way, any harmonic distortion will be centered around the crest of the voltage waveform, accentuating the accuracy of the de-

phase impedance termination.

[0297] Block 2580 of the 1740 processor can implement an algorithm for modulating the current amplitude of the drive signal, in order to control the current, voltage and power of the drive signal, according to adjustment specified by the user, or according to requirements specified by other processes or algorithms implemented by the 1100 generator. The control of these quantities can be performed, for example, by measuring the LUT samples in the LUT 2280, and / or by adjustment of the full-scale output voltage of the DAC 1680 (which provides input to the 1620 power amplifier) via an DAC 1860. Block 2600 (which can be implemented as a PID controller in certain respects) can receive samples as input current feedback (which can be properly sized and filtered) from memory location 2180. Current feedback samples can be compared to the "demand" value a per current "lg determined by the controlled variable (for example, current, voltage or power) to determine whether the trigger signal is supplying the required current. In aspects where the drive signal current is the control variable, the demand for current la can be specified directly by a current setpoint 2620A (ls5). For example, an RMS value of the current feedback data (determined as in block 2340) can be compared to the RMS | s current setpoint, specified by the user to determine the appropriate action for the controller. If, for example, the current feedback data indicates a lower RMS value than the current sp setpoint, LUT dimensioning and / or full-scale output voltage of the DAC 1680 can be adjusted by block 2600, so that the current of the trigger signal is increased. On the other hand, the block

2600 can adjust a LUT design and / or the full-scale output voltage of the 1680 DAC to decrease the drive signal current when the current feedback data indicates a RMS value greater than the current set point | lsp.

[0298] In aspects where the drive signal voltage is the control variable, the current demand Id can be specified indirectly, for example, based on the current required to maintain a desired voltage reference value 2620B (Vsp) given the magnitude of load impedance Zm measured in block 2420 (for example, la = Vsp / Zm). Likewise, in aspects where the signal strength of the inverter is the control variable, the current demand can be specified indirectly, for example, based on the current required to maintain a desired power setpoint 2620C (Psp) given the voltage Vms measured in blocks 2360 (for example, la = Psp / Vrms).

[0299] Block 2680 (Figure 28A) can implement a DDS control algorithm to control the trigger signal by recovering LUT samples stored in LUT 2280. In certain aspects, the DDS control algorithm can be an algorithm numerically-controlled oscillator (NCO) to generate samples of a waveform at a fixed timing rate using a jump-point technique (locations in memory). The NCO algorithm can implement a phase accumulator, or frequency to phase converter, which functions as an address pointer for retrieving LUT samples from the LUT 2280. In one aspect, the phase accumulator can be an accumulator phase with step size D, module N, where D is a positive integer representing a frequency control value, and N is the number of LUT samples in LUT 2280. A frequency control value D = 1 , for example, can cause the phase accumulator to point sequentially to each LUT 2280 address, resulting in a waveform output that replicates the waveform stored in LUT 2280. When D> 1, the accumulator of phase can skip addresses on LUT 2280, resulting in a waveform output that has a higher frequency. Consequently, the frequency of the waveform generated by the DDS control algorithm can therefore be controlled by varying the frequency control value accordingly. In certain aspects, the frequency control value can be determined based on the output of the phase control algorithm implemented in block 2440. The output of block 2680 can provide the input of DAC 1680 which, in turn, provides an analog signal corresponding to an input from the 1620 power amplifier.

[0300] Block 2700 of the 1740 processor can implement a switch mode control algorithm to dynamically modulate the 1620 power amplifier rail voltage based on the signal waveform envelope being amplified, thereby improving efficiency of the 1620 power amplifier. In certain respects, the characteristics of the waveform envelope can be determined by monitoring one or more signals contained in the 1620 power amplifier. In one aspect, for example, the characteristics of the waveform envelope. wave can be determined by monitoring the minimum of a drain voltage (for example, a MOSFET drain voltage) that is modulated according to the amplified signal envelope. A minimum voltage signal can be generated, for example, by a voltage minimum detector coupled to the drain voltage. The minimum voltage signal can be sampled by the ADC 1760, with samples of the minimum voltage output being received in block 2720 of the switching mode converter control algorithm. Based on the

minimum voltage samples, block 2740 can control a PWM signal output by a 2760 PWM generator, which in turn controls the rail voltage supplied to the 1620 power amplifier by the 1700 switching mode regulator. aspects, as long as the values of the minimum voltage samples are less than a target input for the minimum 2780 in block 2720, the voltage on the rail can be modulated according to the waveform envelope, as characterized by the samples of the minimum voltage. When the minimum voltage samples indicate low levels of envelope power, for example, block 2740 can cause a low voltage on the rail to be supplied to the 1620 power amplifier, with the total voltage of the rail being supplied only when the Minimum voltage samples indicate maximum envelope power levels. When voltage samples from the minimum drop below the target to the minimum 2780, the 2740 block can keep the rail voltage at an adequate minimum to ensure the proper operation of the 1620 power amplifier.

Limitation of capacitive coupling and its effects

[0301] Aspects of the present disclosure are presented for a surgical instrument with improved device capabilities to reduce unwanted operational side effects. In particular, the surgical instrument may include means to limit the capacitive coupling to enhance monopolar insulation for use independently or in cooperation with another advanced energy modality. Capacitive coupling generally occurs when there is an energy transfer between nodes, induced by an electric field. During surgery, capacitive coupling can occur when two or more electrical surgical instruments are being used on or around a patient. Although in some cases capacitive coupling may be desirable, as the devices

Additional assets can be fed inductively by capacitive coupling, the occurrence of capacitive coupling accidentally during surgery or around a patient can generally have extremely harmful consequences. Parasitic or accidental capacitive coupling can occur in unknown or unpredictable locations, causing energy to be applied to undesirable areas. When the patient is under anesthesia and unable to provide any response, the parasitic capacitive coupling can burn a patient while the surgeon cannot know whether the same is occurring. It is, therefore, desirable to limit parasitic or accidental capacitive coupling in surgical instruments and during surgery in general.

[0302] In some aspects, a system that includes a surgical instrument and a generator can be configured to interrupt the transmission of energy from the generator to the surgical instrument when the capacitive coupling has been detected. One or more fuses, sensors, controls and / or safety algorithms can be in place to automatically trigger a generator interruption in these scenarios. Alerts, including audio signals, vibrations and visual messages, can be issued to inform the surgery team that the generator has been interrupted due to the detection of capacitive coupling.

[0303] In some ways, the system includes means to detect that a capacitive coupling event has occurred. For example, an algorithm that includes inputs from one or more sensors to monitor events around the system can apply situational awareness and other programmatic means to conclude that capacitive coupling is occurring somewhere within the system and react accordingly. . A system with situational awareness means that the system can be configured to anticipate scenarios that may arise based on the present environment and system data and to determine that the present conditions follow a pattern that gives rise to predictable next steps. As an example, the system can apply situational awareness in the context of handling capacitive coupling events by recalling cases in surgeries located in a similar way in which various sensor data are detected. Sensor data can indicate an increase in current at two specific locations along a closed-circuit electrosurgical system, which based on previous data from similarly situated surgeries, indicates a high probability that a capacitive coupling event is imminent .

[0304] In some aspects, surgical instruments may have a modified structure to limit the occurrence of capacitive coupling, or in other cases, reduce collateral damage caused by capacitive coupling. For example, the additional insulation strategically placed on or around the surgical instrument can help limit the incidence of capacitive coupling. In other cases, the surgical instrument end actuator may include modified structures that reduce the incidence of current displacement, such as rounding the end actuator tips or specifically formatting the end actuator blade to behave more like a blade. monopolar while still acting as a bipolar device.

[0305] In some respects, the system may include passive means to mitigate or limit the effects of capacitive coupling. For example, the system may include cables that can divert power to a neutral node through passive conductive components. In general, any and all of these aspects can be combined or included in a single system to address the challenges posed by multiple electrical components that could cause electrical coupling.

during the patient's surgery.

[0306] Figure 29 provides a diagram showing an example 134000 system with means for detecting capacitive coupling, in accordance with at least one aspect of the present disclosure. The 134000 system includes a monopolar UDE generator 134002 that is electrically coupled to a 134008 surgical instrument. Surgical instrument 134008 is used to perform surgery on a patient, where patient tissue 134016 is shown to represent the surgical site of the patient where the surgery is being performed. The 134008 surgical instrument may include means for applying electrosurgical or ultrasonic energy to an end actuator, and in some cases, may include a blade and / or a pair of claws to secure or hold the tissue. The energy supplied by the UDE 134002 generator can touch the patient through the end actuator, through any of the possible various components of the end actuator. At least a portion of the patient can rest on a 134014 return path block, such as a Smart Megasoft Pad'Y, for example, which is configured to deflect excess energy in the opposite direction of the patient when the surgical instrument 134008 touches the patient and applies electrosurgical energy.

[0307] Like the multiple electrical sources close to the patient, the parasitic capacitive coupling is always present and always a danger to harm the patient during surgery. As the patient is not expected to express any reaction during the surgery, if unknown or unforeseen capacitive coupling occurs, the patient may present burns in undesirable places as a result. In general, energy anomalies such as capacitive coupling should be reduced or otherwise corrected in order to improve patient safety. In order to limit the occurrence of

or other types of power anomalies, multiple sensors or smart monitors, such as the Smart sensors CT1 (134006), CT2 (134010), and CT3 (134012) can be integrated into the electrosurgical system as indicators to determine whether excess energy or inductive energy is radiating out from one or more of the electrical sources. As shown in Figure 29, the Smart sensors CT1 (134006), CT2 (134010) and CT3 (134012) are placed in places where the energy is likely to radiate inductively. The sensors or monitors can be configured to detect the capacitance, and if placed in strategic locations within the system, a reading of the capacitance may imply that capacitive leakage is occurring near the sensor or monitor. Together with the knowledge of other sensors nearby or throughout the system that do not indicate a capacitance reading, it can be concluded that capacitive leakage is occurring near the sensor or monitor that is providing a positive indication. Other sensors can be used, such as monitors or capacitive leak detectors. These sensors can be configured to provide an alert, such as lighting or providing noise or ultimately transmitting a signal to a display monitor. In addition, the monopolar UDE 134002 can be configured to automatically trigger an interruption in power generation to stop the occurrence of any additional mandatory coupling.

[0308] In some respects, a neutral electrode 134004 can be included in monopolar UDE 1340002 and can be electrically coupled to the return path block 134014, such as a Smart Megasoft PadO, for example, as another solution to reduce capacitive coupling . The energy can reach the neutral node 134004 conductively as the electrosurgical instrument 134008 touches the patient, the patient is touching the return path block 134014,

and the block is conductively connected to neutral electrode 134004. In this way, energy can be diverted to neutral node 134004 from monopolar UDE 134002 or surgical instrument 134008 and thus reduce the incidence of capacitive coupling.

[0309] In some respects, a cloud analysis system coupled communicatively to the monopolar UDE, such as through a central medical controller, can be configured to employ situational awareness that can help predict when capacitive coupling may occur during surgery. The cloud analysis system and / or the medical central controller can use a capacitive coupling algorithm to monitor the incidence of energy flowing through the surgical system and, based on previous data on the energy status in the system for a similar procedure , it can be concluded that capacitive coupling is likely to occur if no further action is taken. For example, during a surgery involving methods prescribed for how the surgical instrument and how much energy should be used during specific steps in the surgery, the cloud analysis module can extract previous surgeries from it and notes that the capacitive coupling has a strong probability of occurring after a specific step in the surgery. During the monitoring of the steps in surgery, when the same or very similar energy profiles occur during or immediately before the expected step that tends to induce capacitive coupling, the cloud analysis system can provide an alert that indicates that this likely to cause capacitive coupling. The surgeon can be given the option to reduce the peak voltage on the 134008 surgical instrument or to interrupt the power generation by mono-polar UDE 134002, or the cloud analysis module can automatically cause the central medical controller take these steps. This can lead to the elimination of the possibility of capacitive coupling

before it has a chance to occur, or at least it can limit any unwanted effects caused by a momentary occurrence of capacitive coupling.

[0310] In some respects, the surgical instrument, as shown in Figure 29, may include structural means to reduce or prevent capacitive coupling. For example, the insulation on the drive shaft of the 134008 surgical instrument can reduce the incidence of inductance. In other cases, the monopolar wire that connects the monopolar UDE 134002 to the surgical instrument 134008 can be shielded. As another example, the interruption of plastic elements inside the drive shaft may be present intermittently to prevent the transmission of the capacitive coupling over a long distance inside the drive shaft. Other elements of the insulating type can be used to achieve similar effects. In some respects, the monopolar wire that electrically connects surgical instrument 134008 to generator 134002 can be shielded to also reduce the incidence of capacitive coupling.

[0311] In some ways, the structure of the end actuator can be modified to reduce the effects of capacitive coupling as the end actuator comes into contact with the patient. As an example, the end actuator jaws can be designed to have only one side of each jaw directed to provide power, thus making the end actuator act as a monopolar blade while still really functionally structured as a bipolar device. In an example of this, the ends or tips of the end actuator can be shaped like a duckbill, with rounded ends to reduce any voltage spikes that may arise from pointed ends. The direction of energy in the end actuator can still be directed to an area or point.

along the ends of the duckbill, but the dispersion of any excess energy can be contained by the end of the duckbill. As another example, the blade may be structured to be slightly thicker on one side, as having a triangular cross-sectional area, and having a thin vertical upper blade element on the opposite side. This can allow any energy being applied to the blade to be focused on one point, which can help the surgical instrument to act as a monopolar blade, although it is still a bipolar device. In this way, energy dispersion that would make the surgical instrument more likely to cause capacitive coupling will not occur. As a final example, the claws of the surgical instrument may have electrodes placed inside the end actuator, allowing the outer portions of the end actuator to act as a shield for protection against capacitive coupling. The electrodes can also be placed sufficiently in contact with the patient's tissue during surgery, while having one or more edges of the end actuator shielding the energy dispersion beyond the focused surgical area.

[0312] Figure 30 is a 134100 logic flow diagram that represents a control program or a logical configuration of an exemplary methodology to limit the effects of capacitive coupling in a surgical system, according to some aspects. The example methodology may be consistent with the above descriptions in relation to the various means listed to limit capacitive coupling or mitigate its effects during surgery with the use of one or more surgical instruments.

[0313] As shown and consistent with the examples discussed above, the 134100 methodology can start with the surgical system being configured to monitor 134102 energy generation.

gia. For example, multiple sensors can be strategically placed at potentially vulnerable points that are more susceptible to energy leakage that can cause capacitive coupling. These sensors can be configured to provide an alert when a power anomaly occurs.

[0314] Continuing, sensors or other means of detection can detect 134104 a voltage anomaly, such as a maximum voltage or peak voltage in one or more locations throughout the surgical system that would not normally be expected to produce such a product. - energy supply. The system can be configured to complete these scenarios, can give rise to a parasitic capacitive coupling, potentially burn the patient without the knowledge of the surgery team in the absence of any alerts. As a result, an alert or message can be provided indicating the power anomaly and the danger of capacitive coupling occurring.

[0315] In some respects, situational awareness can also be used to predict 134106 when capacitive coupling is most likely to occur during the usual course of surgery. Situational awareness can be used to refer back to the latest surgical operations of a similar type or circumstances to identify which variables may be present when it is determined that capacitive coupling has occurred. If there are certain steps in the procedure that are more likely to cause capacitive coupling, the system can anticipate these situations particularly by monitoring the sensors at these times, and / or taking measures to reduce the incidents of caparcitive coupling.

[0316] If the capacitive coupling is detected or considered imminent, based on the methodology above 134100 performed by the surgical system, measures taken to reduce, eliminate or mitigate the effects of the capacitive coupling may include automatic interruption

134108 of power generation in the monopolar energy generator, according to some aspects. It is observed that some loss in the surgical operation can occur momentarily at the moment that this interruption is allowed, but the prevention of undesirable damage to the patient would be of great importance in any case. The surgery can continue as planned after a brief interruption.

[0317] When measuring the energy outside in relation to the energy inside, take advantage of the leakage of eddy current to improve the contact with the block, or turn off the energy, the generator knows how much current it is generating, and you is measuring the energy that is spent. Increased frequency in the presence of capacitive coupling

[0318] In some aspects, the presence of parasitic capacitive coupling can be used to perform energy coagulation or energy cauterization. In certain cases, it may be desirable to increase the power generation of the electrosurgical instrument in order to conduct the monopolar circuit to earth, through the patient's body. Although there may be several instances where the monopolar circuit is closed via the conductivity drained by a 134014 conductive return block, such as the Smart Megasoft Pad & (see Figure 29), in some cases, the block may be defective or worn out, so that the conductivity of the return block 134014 is not sufficient to drain the current from the electrosurgical instrument (for example, 134008) through the patient's body. In these cases, the current may not have enough ground for the energy to travel, effectively causing the patient's body to act as a short circuit. This can render electrosurgery ineffective, as the energy provided by the surgical instrument 134008 will not pass through the patient's tissue and therefore will not heat the tissue as intended. A similar situation can occur when there is no return block. That is, without a 134014 conductive return block, such as the Smart Megasoft PadO, to provide a wide conductive return path, there may not be an available ground connected to the patient. This can also cause the patient to act as a short circuit if the energy from the surgical instrument is applied to the patient.

[0319] To adjust to these situations, in some aspects, monopolar power generation can be increased to a very high frequency, such as 500 KHz at 3 to 4 MHz, to take advantage of the patients' eddy current leak to perform electrosurgery without block (or electrosurgery with insufficient conductivity in the block). By increasing the frequency of the alternating current, the eddy current leakage current will increase. The strongest leakage current can then pass more effectively and radiatively through the patient's body. After reaching the patient's body, the leakage current from the capacitive coupling can be coupled more effectively and radioactively to a ground state as a result, which can effectively direct the current radiatively to another object that acts like land. For example, if the DC frequency is high enough, the current leak can reach the grounding terminal of the monopolar generator. This will help to remove the short circuit effect from the patient, thus allowing energy coagulation to occur. Therefore, in situations where there is a system without a block or a system with low conductivity in a block, it may be desirable to increase the current leakage to take advantage of the higher leakage return that can be used to complete the monopolar circuit. That is, in some cases, the return path can be formed by the leakage of radioactive current caused by the capacitive coupling. To help ensure that the radiative return path reaches a ground plane, the energy of the surgical instrument can be increased to a very high frequency.

[0320] In some cases, the weakly conductive return block can be purposefully connected to a grounding point, table or a nearby support surface, while the return connector on the generator can also be connected to ground. This will deflect the circuit to flow through the radiative return path, instead of having any attempt at energy to travel through the weakly conductive return block and return to the generator, which can cause burns to the patient.

[0321] Note that when there is a system with a block, and the block provides sufficient conductivity under the patient, the typical monopolar circuit that conducts the current through the body to the return block can be a method preferential. In such cases, it may be useful to build insulation barriers for the externally connected power source, such as the 134002 power generator (see Figure 29). Alternatively, battery powered instruments may be the most ideal system for reducing leakage current that will help to isolate the energy path through the conductive return block.

[0322] In some respects, the surgical system may include a detection circuit configured to determine the capacity of the return path block. The detection circuit can then provide information as to whether it is best to use radioactive current leakage to complete the circuit, rather than trying to rely on a weakly conductive feedback block or simply no block at all. The detection circuit can measure a quantity of conductivity in the return path block. If the conductivity measure meets a predetermined threshold, the system can determine that the return path block can be used to perform the surgery and provide a return path for monopolar energy. If the conductivity is below the threshold, then the detection circuit can be configured to send a signal to the system, as in a processor in the central surgical controller or in the monopolar generator,

that the frequency of monopolar energy must be increased dramatically and the return path block must be eliminated or at least isolated from consideration. The increase in frequency will complete the monopolar circuit by creating a radiant return path.

[0323] In some respects, the monopolar generator may include one or more control circuits coupled to one or more sensors that are configured to determine whether the current leak has reached the monopolar generator ground terminal. The sensor, combined with the detection circuit and a control circuit of the monopolar generator, can be used to create a closed feedback loop system that can automatically adjust the frequency to create a sufficient return path based on the high leakage current. For example, the detection circuit can determine if there is sufficient conductivity in the return path block. Otherwise, the control circuit of the monopolar generator can cause the power generation to increase the AC frequency. The sensor to the generator can continuously monitor whether any leakage of radioactive current has reached the grounding terminal of the monopolar generator, based on increased frequency. The control circuit can gradually increase the frequency until it is detected that the leakage of radioactive current has reached the ground terminal. Therefore, the surgical system may depend on a predetermined frequency threshold if it is determined that there is no return path block or insufficient conductivity in the block, or a closed feedback system can be used to find a sufficient frequency. that can create a return path through radioactive coupling.

[0324] Figure 31 is a 134200 logical flowchart that represents a control program or a logical configuration of a method.

exemplary logic that can be performed by the surgical system using monopolar power generation to determine when to take advantage of parasitic capacitive coupling. Consistent with the descriptions above, a detection circuit as part of the surgical system can be configured to measure 134202 a level of conductivity in the return path of a monopolar electrosurgical configuration. The return path can originally be identified to pass through a conductive block, such as a Soft Megasoft Pad & or another conductive return path block. In some cases, the conductivity of the block may offer poor conductivity. In other cases, no block can exist as part of the configuration of the surgery. This can cause the patient's body to act as a short circuit in the monopolar circuit, which would reduce or eliminate the effectiveness of trying to apply monopolar energy to a surgical site in the patient.

[0325] The detection circuit can determine 134204 that the conductivity measure falls below a predetermined threshold, indicating that the level of conductivity in the return path is sufficiently weak, which prevents the completion of the monopolar circuit . As a result, the surgical system can cause the generator to increase the current leakage by 134206, increasing the frequency of the alternating current in the monopolar generator. The surgical system can instead use the leakage of radioactive current to create a return path. When the frequency is increased, the current leak also increases, which increases the range of the radioactive current leak to reach a ground plane and complete the circuit. Thus, by increasing the frequency, the low conductivity of the block of the return path 134014 - or even the lack of any block - can be reversed. In some cases, the increase in leakage can be determined based on a closed feedback sensor system that adjusts the frequency until it is determined that the radiative current leak has reached the ground terminal on the monopolar generator.

[0326] In some respects, the surgical system can also provide an instruction to isolate 134208 any return path blocks and secure the return connector of the monopolar generator to a ground. These measures can be taken to eliminate other alternative return trajectories that, inadvertently, can cause burns in undesirable places of the patient. Situational recognition

[0327] Referring again to Figure 32, a timeline 5200 represents the situational recognition of a central controller, such as the central surgical controller 106 or 206, for example. Timeline 5200 is an illustrative surgical procedure and the contextual information that the central surgical controller 106, 206 can derive from data received from data sources at each stage in the surgical procedure. Timeline 5200 represents the typical steps that would be taken by nurses, surgeons, and other medical personnel during the course of a pulmonary segmentectomy procedure, starting with the setup of the operating room and ending with the transfer of the patient to a post-op recovery room.

[0328] The central surgical controller with situational recognition 106, 206 receives data from data sources throughout the course of the surgical procedure, including the data generated each time medical personnel use a modular device that is paired with the central surgical controller 106, 206. Central surgical controller 106, 206 can receive this data from paired modular devices and other data sources and continuously derives inferences (ie contextual information) about the ongoing procedure as new data is received, such as which step of the procedure is being performed at any given time. The situational recognition system of the central surgical controller 106, 206 is, for example, able to record data related to the procedure to generate reports, verify the steps being taken by medical personnel, provide data or warnings (for example, through a display screen) that may be relevant to the specific step of the procedure, adjust the modular devices based on the context (for example, activate monitors, adjust the field of view (FOV) of the medical imaging device, or change the energy level of an ultrasonic surgical instrument or RF electrosurgical instrument), and take any other action described above.

[0329] As in the first step 5202, in this illustrative procedure, members of the hospital team retrieve the patient's electronic medical record (PEP) from the hospital's PEP database. Based on patient selection data in the PEP, the central surgical controller 106, 206 determines that the procedure to be performed is a thoracic procedure.

[0330] In the second step 5204, the team members scan the incoming medical supplies for the procedure. Central surgical controller 106, 206 cross-references the scanned supplies with a list of supplies that are used in various types of procedures and confirms that the supply mix corresponds to a thoracic procedure. In addition, the central surgical controller 106, 206 is also able to determine that the procedure is not a wedge procedure (because the inlet supplies have an absence of certain supplies that are necessary for a thoracic wedge procedure or, otherwise, that inlet supplies do not correspond to a thoracic wedge procedure).

[0331] In the third step 5206, medical personnel scan the pulse

the patient's chest with a scanner that is communicably connected to the central surgical controller 106, 206. The central surgical controller 106, 206 can then confirm the patient's identity based on the scanned data.

[0332] In the fourth step 5208, the medical staff connects the auxiliary equipment. The auxiliary equipment being used may vary according to the type of surgical procedure and the techniques to be used by the surgeon, but in this illustrative case they include a smoke evacuator, an insufflator and a medical imaging device. When activated, auxiliary equipment that is modular devices can automatically pair with the central surgical controller 106, 206 which is located within a specific vicinity of the modular devices as part of its initialization process. The central surgical controller 106, 206 can then derive contextual information about the surgical procedure by detecting the types of modular devices that correspond with it during this preoperative or initialization phase. In this particular example, the central surgical controller 106, 206 determines that the surgical procedure is a VATS (video-assisted thoracic surgery) procedure based on this specific combination of paired modular devices. Based on the combination of data from the electronic patient record (PEP), the list of medical supplies to be used in the procedure, and the type of modular devices that connect to the central controller, the central surgical controller 106, 206 can, in general , infer the specific procedure that the surgical team will perform. After the central surgical controller 106, 206 recognizes which specific procedure is being performed, the central surgical controller 106, 206 can then retrieve the steps of that process from memory or from the cloud and then cross over the data that subsequently

frequently receives from connected data sources (for example, modular devices and patient monitoring devices) to infer which stage of the surgical procedure the surgical team is performing.

[0333] In the fifth step 5210, team members fix electrocardiogram (ECG) electrodes and other patient monitoring devices on the patient. ECG electrodes and other patient monitoring devices are able to pair with the central surgical controller 106, 206. As central surgical controller 106, 206 begins to receive data from the patient's monitoring devices, the central surgical controller 106, 206 thus confirms that the patient is in the operating room.

[0334] In the sixth step 5212, medical personnel induced anesthesia in the patient. Central surgical controller 106, 206 can infer that the patient is under anesthesia based on data from modular devices and / or patient monitoring devices, including ECG data, blood pressure data, ventilator data, or combinations of them, for example. After the completion of the sixth step 5212, the preoperative portion of the lung segmentectomy procedure is completed and the operative portion begins.

[0335] In the seventh step 5214, the lung of the patient who is being operated on is retracted (while ventilation is switched to the contralateral lung). The central surgical controller 106, 206 can infer from the ventilator data that the patient's lung has been retracted, for example. The central surgical controller 106, 206 can infer that the operative portion of the procedure started when it can compare the detection of the patient's lung collapse in the expected stages of the procedure (which can be accessed or retrieved earlier) and thus determine that lung retraction is the first operative step in this specific procedure.

[0336] In the eighth step 5216, the medical imaging device (for example, a visualization device) is inserted and the video from the medical imaging device is started.

Central surgical controller 106, 206 receives data from the medical imaging device (i.e., video or image data) through its connection to the medical imaging device.

After receiving the data from the medical imaging device, the central surgical controller 106, 206 can determine that the portion of the laparoscopic surgical procedure has started.

In addition, the central surgical controller 106, 206 can determine that the specific procedure being performed is a segmentectomy, rather than a lobectomy (note that a wedge procedure has already been discarded by the central surgical controller 106, 206 based on the received data. - obtained in the second step 5204 of the procedure). The data from the medical imaging device 124 (Figure 2) can be used to determine contextual information about the type of procedure being performed in several ways, including by determining the angle at which the medical imaging device is. oriented towards visualizing the patient's anatomy, monitoring the number or medical imaging devices being used (ie, which are activated and paired with the operating room 106, 206), and monitoring the types of visualization devices used.

For example, a technique for performing a VATS lobectomy places the camera in the lower anterior corner of the patient's chest cavity above the diaphragm, while a technique for performing a VATS segmentectomy places the camera in an anterior intercostal position in relation to the fissure. segmental.

With the use of standard recognition or machine learning techniques, for example, the situational recognition system can be trained to recognize the positioning of the medical imaging device according to the visualization of the patient's anatomy. As another example, a technique for performing a VATS lobectomy uses a single medical imaging device, while another technique for performing a VATS segmentectomy uses multiple cameras. As yet another example, a technique for performing a VATS segmentectomy uses an infrared light source (which can be connected in a communicable way to the central surgical controller as part of the visualization system) to visualize the segment crack, which is not used in a VATS lobectomy. By tracking any or all of these data from the medical imaging device, the central surgical controller 106, 206 can thus determine the specific type of surgical procedure being performed and / or the technique being used for a specific type of procedure. surgical procedure.

[0337] In the ninth step 5218 of the procedure, the surgical team starts the dissection step. Central surgical controller 106, 206 can infer that the surgeon is in the process of dissecting to mobilize the patient's lung because he receives data from the RF or ultrasonic generator that indicate that an energy instrument is being triggered. The central surgical controller 106, 206 can cross-check the received data with the steps retrieved from the surgical procedure to determine that an energy instrument is being fired at that point in the process (that is, after completion of the steps previously discussed in the procedure) corresponds to the dissection step. In certain cases, the energy instrument can be a power tool mounted on a robotic arm of a robotic surgical system.

[0338] In the tenth step 5220 of the procedure, the surgical team proceeds to the connection step. The central surgical controller 106, 206 can infer that the surgeon is ligating the arteries and veins because he receives data from the stapling and surgical cutting instrument indicating that the instrument is being fired. Similar to the previous step, the central surgical controller 106, 206 can derive this inference by crossing the reception data of the stapling and surgical cutting instrument with the steps recovered in the process. In certain cases, the surgical instrument can be a surgical tool mounted on a robotic arm of a robotic surgical system.

[0339] In the eleventh step 5222, the segmentectomy portion of the procedure is performed. Central surgical controller 106, 206 can infer that the surgeon is transecting the parenchyma based on data from the surgical stapling and cutting instrument, including data from its cartridge. The cartridge data can correspond to the size or type of clamp being triggered by the instrument, for example. As different types of staples are used for different types of fabrics, the cartridge data can thus indicate the type of fabric being stapled and / or transected. In this case, the type of clamp that is fired is used for the parenchyma (or other similar types of tissue), which allows the central surgical controller 106, 206 to infer that the segmentectomy portion of the procedure is being performed.

[0340] In the twelfth step 5224, the node dissection step is then performed. Central surgical controller 106, 206 can infer that the surgical team is dissecting the node and performing a leak test based on data received from the generator that indicates which ultrasonic or RF instrument is being fired. For this specific procedure, an RF or ultrasonic instrument being used after the parenchyma has been transected corresponds to the node dissection step, which allows the central surgical controller 106, 206 to make this inference. It should be noted that citizens

surgeons regularly alternate between surgical stapling / cutting instruments and surgical energy instruments (ie, RF or ultrasonic) depending on the specific step in the procedure because different instruments are best adapted for specific tasks. Therefore, the specific sequence in which cutting / stapling instruments and surgical energy instruments are used can indicate which stage of the procedure the surgeon is performing. In addition, in certain cases, robotic tools can be used for one or more steps in a surgical procedure and / or Hand held surgical instruments can be used for one or more steps in the surgical procedure. The surgeon can switch between robotic tools and hand-held surgical instruments and / or can use the devices simultaneously, for example. After the completion of the twelfth stage 5224, the incisions are closed and the post-operative portion of the process begins.

[0341] In the thirteenth stage 5226, the patient's anesthesia is reversed. The central surgical controller 106, 206 can infer that the patient is emerging from anesthesia based on ventilator data (that is, the patient's respiratory rate begins to increase), for example.

[0342] Finally, in the fourteenth step 5228 is that medical personnel remove the various patient monitoring devices from the patient. Central surgical controller 106, 206 can therefore infer that the patient is being transferred to a recovery room when the central controller loses ECG, blood pressure and other data from patient monitoring devices. As can be seen from the description of this illustrative procedure, the central surgical controller 106, 206 can determine or infer when each step of a given surgical procedure is taking place according to the data received from the various data sources that are communicably coupled to the central surgical controller 106, 206.

[0343] Situational awareness is further described in US provisional patent application serial number 62 / 611.341, entitled INTE-RACTIVE SURGICAL PLATFORM, filed on December 28, 2017, which is incorporated herein by reference in its entirety. in. In certain cases, the operation of a robotic surgical system, including the various robotic surgical systems disclosed here, for example, can be controlled by the central controller 106, 206 based on its situational perception and / or feedback from the components of the and / or based on information from the cloud 102.

[0344] Although several forms have been illustrated and described, it is not the applicant's intention to restrict or limit the scope of the claims attached to such detail. Numerous modifications, variations, alterations, substitutions, combinations and equivalents of these forms can be implemented and will occur to those skilled in the art without departing from the scope of the present disclosure. In addition, the structure of each element in association with the described shapes can alternatively be described as a means to provide the function performed by the element. In addition, where materials are revealed for certain components, other materials can be used. It should be understood, therefore, that the preceding description and the appended claims are intended to cover all these modifications, combinations and variations that fall within the scope of the modalities presented. The attached claims are intended to cover all such modifications, variations, alterations, substitutions, modifications and equivalents.

[0345] The previous detailed description presented various forms of devices and / or processes through the use of block diagrams, flowcharts and / or examples. Although these block diagrams

co, flowcharts and / or examples contain one or more functions and / or operations, it will be understood by those skilled in the art that each function and / or operation within these block diagrams, flowcharts and / or examples can be implemented, individually and / or collectively , through a wide range of hardware, software, firmware or practically any combination of these. Those skilled in the art will recognize, however, that some aspects of the aspects disclosed here, in whole or in part, can be implemented in an equivalent way in integrated circuits, such as one or more computer programs running on one or more computers (for example , such as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (for example, as one or more programs running on one or more microprocessors), as firmware, or virtually like any combination thereof, and that designing the set of circuits and / or writing the code for the software and firmware would be within the scope of practice of those skilled in the art, in light of this disclosure. In addition, those skilled in the art will understand that the mechanisms of the subject described here can be distributed as one or more program products in a variety of ways and that an illustrative form of the subject described here is applicable regardless of the specific type of program. means of signal transmission used to effectively execute the distribution.

[0346] The instructions used to program the logic to execute various revealed aspects can be stored in a memory in the system, such as dynamic random access memory (DRAM), cache, flash memory or other storage. In addition, instructions can be distributed over a network or through other computer-readable media. In this way, a machine-readable medium can include any mechanism to store or transmit information in a machine-readable form (for example, a computer), but is not limited to floppy disks, optical disks, compact memory disc read-only (CD-ROMs), and optical-dynamos discs, read-only memory (ROM), random access memory (RAM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory ( EEPROM), magnetic or optical cards, flash memory, or a machine-readable tangible storage medium used to transmit information over the Internet via an electrical, optical, acoustic cable or other forms of propagation signals (for example, waves carriers, infrared signal, digital signals, etc.). Consequently, non-transitory, computer-readable media includes any type of machine-readable media suitable for storing or transmitting instructions or electronic information in a machine-readable form (for example, a computer).

[0347] As used throughout this description, the term "wireless" and its derivatives can be used to describe circuits, devices, systems, methods, techniques, communication channels, etc., which can communicate data through the use of electromagnetic radiation modulated through a non-solid medium. The term does not imply that the associated devices do not contain any wires, although in some respects they may not. The communication module can implement any of a number of wireless and wired communication standards or protocols, including, but not limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20 , long-term evolution (LTE, "long-term evolution"), Ev-DO, HSPA +, HSDPA +, HSUPA +, EDGE, GSM, GPRS, CDMA, TDMA, DECT, Bluetooth, Ethernet derivatives thereof, as well as any other wireless and wired protocols that are designated as 3G, 4G, 56, and beyond. The computing module can include a plurality of modules

communication. For example, a first communication module can be dedicated to short-range wireless communications like Wi-Fi and Bluetooth, and a second communication module can be dedicated to longer-range wireless communications like GPS, EDGE, GPRS , CDMA, WiMAX, LTE, Ev-DO, and others.

[0348] As used in any aspect of the present invention, the term "control circuit" can refer to, for example, a set of wired circuits, programmable circuits (for example, a computer processor comprising one or more individual instruction processing cores, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic matrix (PLA), or arrangement field programmable ports (FPGA)), state machine circuits, firmware that stores instructions executed by the programmable circuit, and any combination thereof. The control circuit can, collectively or individually, be incorporated as an electrical circuit that is part of a larger system, for example, an integrated circuit (IC), an application-specific integrated circuit (ASIC), an on-chip system (SoC), desktop computers, laptop computers, tablet computers, servers, smart headsets, etc. Consequently, as used in the present invention, "control circuit" includes, but is not limited to, electrical circuits that have at least one discrete electrical circuit, electrical circuits that have at least one integrated circuit, electrical circuits that have at least one integrated circuit for a specific application, electrical circuits that form a general-purpose computing device configured by a computer program (for example, a general-purpose computer configured by a computer program that at least partially runs processes and / or devices described herein, or a micropro-

processor configured by a computer program that at least partially performs the processes and / or devices described here), electrical circuits that form a memory device (for example, forms of random access memory), and / or electrical circuits that form form a communications device (for example, a model, communication switch, or optical-electrical equipment). Those skilled in the art will recognize that the subject described here can be implemented in an analog or digital way, or in some combination of these.

[0349] As used here, a processor or processing unit is an electronic circuit that performs operations on some external data source, usually memory or some other data flow. The term is used in the present invention to refer to the central processor (central processing unit) in a computer system or systems (specifically systems on a chip (SoCs)) that combine several specialized "processors".

[0350] As used here, a system on a chip or system on the chip (SoC or SOC) is an integrated circuit (also known as an "IC" or "chip") that integrates all components of a computer or others electronic systems. It can contain digital, analog, mixed and often radio frequency functions - all on a single substrate. A SoC integrates a microcontroller (or microprocessor) with advanced peripherals such as a graphics processing unit (GPU), i-Fi module, or coprocessor. An SoC may or may not contain internal memory.

[0351] As used here, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuits and memory. A microcontroller (or MCU for microcontroller unit) can be implemented as a small computer on a single integrated circuit. It can be similar to a SoC; a SoC can include

include a microcontroller as one of its components. A microcontroller can contain one or more core processing units (CPUs) along with memory and programmable input / output peripherals. Program memory in the form of ferroelectric RAM, NOR flash or OTP ROM is also often included on the chip, as well as a small amount of RAM. Microcontrollers can be used for integrated applications, in contrast to microprocessors used in personal computers or other general-purpose applications that consist of several separate integrated circuits.

[0352] As used here, the term controller or microcontroller can be an independent chip or IC (integrated circuit) device that interfaces with a peripheral device. This can be a connection between two parts of a computer or a controller on an external device that manages the operation of (and connection to) that device.

[0353] Any of the processors or microcontrollers in the present invention can be any implemented by any single-core or multi-core processor, such as those known under the trade name ARM Cortex by Texas Instruments. In one respect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single cycle flash memory, or other non-volatile memory , up to 40 MHz, a prefetch buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareO program, programmable and electrically erasable read-only memory (EEPROM) of 2 KB, one or more pulse width modulation (PWM) modules, one or more

logos for quadrature encoder (QEI) inputs, one or more 12-bit analog to digital converters (ADC) with 12 analog input channels, details of which are available for the product data sheet.

[0354] In one aspect, the processor may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the trade name Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.

[0355] As used in any aspect of the present invention, the term "logic" can refer to an application, software, firmware and / or circuit configured to perform any of the aforementioned operations. The software can be incorporated as a software package, code, instructions, instruction sets and / or data recorded on the computer-readable non-transitory storage media. The firmware can be incorporated as code, instructions or instruction sets and / or data that are hard-coded (for example, non-volatile) in memory devices.

[0356] As used in any aspect of the present invention, the terms "component", "system", "module" and the like may refer to a computer-related entity, be it hardware, a combination of hardware and software, software or software running.

[0357] As used here in one aspect of the present invention, an "algorithm" refers to the self-consistent sequence of steps that lead to the desired result, where a "step" refers to the manipulation of

tion of physical quantities and / or logical states that can, although not necessarily need, take the form of electrical or magnetic signals that can be stored, transferred, combined, compared and manipulated in any other way. It is common use to call these signs bits, values, elements, symbols, characters, terms, numbers or the like. These terms and similar terms may be associated with the appropriate physical quantities and are merely convenient identifications applied to these quantities and / or states.

[0358] A network can include a packet-switched network. Communication devices may be able to communicate with each other using a selected packet switched network communications protocol. An exemplary communications protocol may include an Ethernet communications protocol that may be able to allow communication using a transmission control protocol / Internet protocol (TCP / IP). The Ethernet protocol can conform to or be compatible with the Ethernet standard published by the Institute of Electrical and Electronics Engineers (IEEE) entitled "IEEE 802.3 Standard", published in December 2008 and / or later versions of this standard. Alternatively or in addition, communication devices may be able to communicate with each other using an X.25 communications protocol. The X.25 communications protocol can conform or be compatible with a standard promulgated by the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T). Alternatively or in addition, communication devices may be able to communicate with each other using a frame-relay communications protocol. The frame-relay communications protocol can conform or be compatible with a standard promulgated by the Consultative Committee for Internati-

onal Telegraph and Telephone (CCITT) and / or the American National Standards Institute (ANSI). Alternatively or additionally, transceivers may be able to communicate with each other using an ATM communication protocol ("asynchronous transfer mode"). The ATM communication protocol can conform or be compatible with an ATM standard published by the ATM forum entitled "ATM-MPLS Network Interworking 2.0" published in August 2001, and / or later versions of this standard. Obviously, different and / or post-developed connection-oriented network communication protocols are also contemplated in the present invention.

[0359] Unless otherwise stated, as is evident from the preceding disclosure, it is understood that, throughout the preceding disclosure, discussions that use terms such as "processing", or "computation", or "calculation ", or" determination ", or" display ", or similar, refers to the action and processes of a computer, or similar electronic computing device, that manipulates and transforms the represented data in the form of physical quantities (electronic) in computer records and memories in other data represented in a similar way in the form of physical quantities in memories or computer records, or in other similar information storage, transmission or display devices .

[0360] One or more components in the present invention may be called "configured for", "configurable for", "operable / operational for", "adapted / adaptable for", "capable of", "according to movable / conformed to ", etc. Those skilled in the art will recognize that "configured for" can generally encompass components in an active state and / or components in an inactive state and / or components in a standby state, except when the context determines the con-

trario.

[0361] The terms "proximal" and "distal" are used in the present invention with reference to a physician who handles the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the doctor, and the term "distal" refers to the portion located in the opposite direction to the doctor. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down", "left" and "right" can be used in the present invention with respect to drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.

[0362] The modular devices include the modules (as described in connection with Figures 3 and 9, for example) that are received within a central surgical controller and the devices or surgical instruments that can be connected to the various modules a in order to connect or pair with the corresponding central surgical controller. Modular devices include, for example, smart surgical instruments, medical imaging devices, suction / irrigation devices, smoke evacuators, power generators, fans, insufflators and displays. The modular devices described here can be controlled by control algorithms. The control algorithms can be executed on the modular device itself, on the central surgical controller to which the specific modular device is paired, or on both the modular device and the central surgical controller (for example, surgical (for example, through a distributed computing). In some examples, the control algorithms of modular devices control devices based on data detected by the modular device itself (that is, by sensors in, over or

connected to the modular device). These data can be related to the patient being operated on (for example, tissue properties or insufflation pressure) or to the modular device itself (for example, the rate at which a knife is being advanced, the current of the tor, or energy levels). For example, a control algorithm for a surgical stapling and cutting instrument can control the rate at which the instrument's motor drives its knife through the fabric according to the resistance encountered by the knife as it progresses.

[0363] Persons skilled in the art will recognize that, in general, the terms used here, and especially in the appended claims (eg, bodies of the appended claims) are generally intended as "open" terms (eg, the term "including" should be interpreted as "including, but not limited to", the term "having" should be interpreted as "having, at least", the term "includes" should be interpreted as "includes, but is not limited to ", etc.). It will also be understood by those skilled in the art that, when a specific number of a claim statement entered is intended, that intention will be expressly mentioned in the claim and, in the absence of such mention, no intention will be present. For example, as an aid to understanding, the following appended claims may contain the use of the introductory phrases "at least one" and "one or more" to introduce claim statements. However, the use of such phrases should not be interpreted as implying that the introduction of a claim statement by the indefinite articles "one, ones" or "one, ones" limits any specific claim containing the claim mention. claims that contain only such a mention are introduced, even when the same claim includes the introductory phrases "one or more" or "at least one" and indefinite articles, such as "one, ones" or "one, ones" (for example, example

("one, ones" and / or "one, ones" should typically be interpreted as meaning "at least one" or "one or more"); the same goes for the use of defined articles used to introduce claims.

[0364] Furthermore, even if a specific number of an introduced claim statement is explicitly mentioned, those skilled in the art will recognize that that statement must typically be interpreted as meaning at least the number mentioned (for example, the mere mention of "two mentions", without other modifiers, typically means at least two mentions, or two or more mentions). In addition, in cases where a convention analogous to "at least one of A, B and C, etc." is used, in general this construction is intended to have the meaning in which the convention would be understood by (for example, For example, "a system that has at least one of A, B and C" would include, but not be limited to, systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and / or A, B and C together, etc.). In cases where a convention analogous to "at least one of A, B or C, etc." is used, this construct is generally intended to have the meaning in which the convention would be understood by (for example, "a system that has at least one of A, B and C" would include, but not be limited to, systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and / or A, B and C together, etc.). It will be further understood by those skilled in the art that typically a disjunctive word and / or phrase presenting two or more alternative terms, whether in the description, in the claims or in the drawings, should be understood as contemplating the possibility of including one of the terms , either term, or both terms, except where the context dictates to indicate something different. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "AeB".

[0365] With respect to the attached claims, those skilled in the art will understand that the operations mentioned in the same can, in general, be performed in any order. In addition, although several operational flow diagrams are presented in one or more sequences, it must be understood that the various operations can be performed in other orders than those shown, or can be performed simultaneously. Examples of such alternative orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplementary, simultaneous, inverse or other variant orders, unless the context determines otherwise. Furthermore, terms such as "responsive to", "related to" or other adjectival principles are not generally intended to exclude these variants, except when the context determines otherwise.

[0366] It is worth noting that any reference to "one (1) aspect", "one aspect", "an exemplification" or "one (1) exemplification" ", and the like means that a particular feature, structure or characteristic described in connection with the aspect it is included in at least one aspect. Thus, the use of expressions such as "in one (1) aspect", "in one aspect", "in an exemplification", "in one (1) exemplification", in several places throughout this specification it does not necessarily refer to the same aspect. In addition, specific resources, structures or characteristics can be combined in any appropriate way in one or more aspects.

[0367] Any patent application, patent, non-patent publication or other description material mentioned in this specification and / or mentioned in any order data sheet is hereby incorporated by reference, to the extent that the Embedded materials are not inconsistent with this. In this way, and to the extent necessary, the disclosure as explicitly presented here

replaced any conflicting material incorporated by reference into this invention. Any material, or portion thereof, which is incorporated herein by reference, but which conflicts with the definitions, statements, or other disclosure materials contained herein, will be incorporated here only to the extent that there is no conflict. between the embedded material and the existing developer material.

[0368] In short, numerous benefits have been described that result from the use of the concepts described in this document. The previously mentioned description of one or more modalities has been presented for purposes of illustration and description. This description is not intended to be exhaustive or to limit the invention to the precise form disclosed. Modifications or variations are possible in light of the above teachings. One or more modalities were chosen and described in order to illustrate the principles and practical application to, thus, allow those skilled in the art to use the various modalities and with various modifications, as they are convenient to the specific use contemplated. It is intended that the claims presented in the annex define the global scope.

[0369] Various aspects of the subject described in this document are defined in the numbered examples presented below.

[0370] Example 1. A surgical system comprising: an energy generator; a surgical instrument electrically coupled to the energy generator and configured to transmit electrosurgical energy to a patient's tissue at a surgical site; at least one sensor configured to detect a power anomaly; and at least one processor communicatively coupled to at least one sensor, and configured to: receive, from at least one sensor, data that the energy is being emitted in an unintended location within the surgical system; transmit an alert indicating that a parasitic capacitive coupling is taking place; and transmit an interruption to the power generator to temporarily interrupt power generation.

[0371] Example 2. The surgical system, according to Example 1 which additionally comprises an energy dissipation block electrically coupled to a neutral electrode in the energy generator, the energy dissipation block being configured to connect conductively to the patient and dissipate energy in the opposite direction to the patient when energy is applied to the patient's tissue by the surgical instrument.

[0372] Example 3. The surgical system, according to either of Examples 1 or 2, the neutral electrode being configured to passively divert energy in the opposite direction to the patient during a caparcitive coupling event.

[0373] Example 4. The surgical system, according to any of Examples 1 to 3, the surgical instrument comprising: an end actuator comprising a pair of claws; and a drive shaft electrically coupled to the end actuator and configured to supply the end actuator with energy from the power generator.

[0374] Example 5. The surgical system, according to Example 4, with the claws comprising rounded tips configured to reduce the maximum tension peaks as the claws come into contact with the patient's tissue.

[0375] Example 6. The surgical system, according to Example 4, and the drive shaft comprises the interruption of the insulating elements configured to prevent the transmission of the capacitive coupling over a long distance within the drive shaft.

[0376] Example 7. The surgical system, according to Example

4, the surgical instrument comprising a triangular-sided blade with a thin support upper blade element configured to reduce the transmission of inductive energy beyond the upper blade element.

[0377] Example 8. The surgical system, according to Example 4, with the end actuator comprising one or more electrodes located in the inner portion of the claws and configured to channel the excess energy in the direction against the tissue of the patient.

[0378] Example 9. A method of a surgical system to detect parasitic capacitive coupling, the surgical system comprising an energy generator, a surgical instrument, and at least one sensor to detect an energy anomaly, the method comprises: receiving, from at least one sensor, data that the energy is being emitted in an unintended location within the surgical system; transmit an alert indicating that a parasitic capacitive coupling is taking place; and transmitting an interruption to the power generator to temporarily interrupt power generation.

[0379] Example 10. A surgical instrument configured to mitigate the parasitic capacitive coupling during surgery, which comprises: an electrical input configured to be electrically coupled to a power generator; a drive shaft; an end actuator at a distal end of the drive shaft; at least one sensor configured to detect a power anomaly; and at least one processor communicatively coupled to at least one sensor, and configured to: receive, from at least one sensor, data that the energy is being emitted in an unintended location within the surgical system; transmit an alert indicating that a parasitic capacitive coupling is taking place; and transmitting an interruption to the power generator to temporarily interrupt power generation.

[0380] Example 11. The surgical instrument, according to Example 10, with the end actuator comprising a pair of jaws, and the jaws comprising rounded tips configured to reduce the maximum peak tension as the jaws come into contact. contact with the patient's tissue.

[0381] Example 12. The surgical instrument, according to Example 10 or 11, with the drive shaft comprising the interruption of the insulating elements configured to prevent the transmission of the capacitive coupling over a long distance inside the drive shaft.

[0382] Example 13. The surgical instrument, according to any one of Examples 10 to 12, additionally comprising a triangular side blade with a thin upper support blade element configured to reduce the transmission of inductive energy beyond upper blade element.

[0383] Example 14. The surgical instrument, according to any of Examples 10 to 13, the end actuator comprising one or more electrodes located on the inner portion of the claws and configured to channel the excess energy in the direction contrary to the patient's tissue.

Claims (14)

1. Surgical system, characterized by comprising: an energy generator; a surgical instrument electrically coupled to the energy generator and configured to transmit electrosurgical energy to a patient's tissue at a surgical site; at least one sensor configured to detect an energy malfunction; and at least one processor communicatively coupled to at least one sensor, and configured to: receive, from at least one sensor, data that the energy is being emitted in an unintended location within the surgical system; transmit an alert indicating that a parasitic capacitive coupling is taking place; and transmit an interruption to the energy generator to temporarily interrupt the generation of energy. 2. Surgical system, according to claim 1, characterized by additionally comprising an energy dissipation block electrically coupled to a neutral electrode in the energy generator, the energy dissipation block being configured to connect conductively to the dissipate energy in the opposite direction to the patient, when energy is applied to the patient's tissue by the surgical instrument. 3. Surgical system, according to claim 2, characterized in that the neutral electrode is configured to passively deflect the energy in the opposite direction to the patient, during a capacitive coupling event. 4. Surgical system, according to claim 1, characterized by comprising: an end actuator comprising a pair of claws; and a drive shaft electrically coupled to the end actuator and configured to supply the end actuator with energy from the power generator. 5. Surgical system, according to claim 4, characterized in that the jaws comprise rounded tips configured to reduce the maximum tension peaks as the jaws come into contact with the patient's tissue. 6. Surgical system, according to claim 4, characterized in that the drive shaft comprises insulating switch elements configured to prevent the capacitive coupling from being transmitted over a long distance inside the drive shaft. 7. Surgical system according to claim 4, characterized in that the surgical instrument comprises a unilateral three-sided blade with a thin vertical upper blade element configured to reduce the transmission of inductive energy beyond the blade element higher. 8. Surgical system, according to claim 4, characterized in that the end actuator comprises one or more electrodes located inside the jaws and configured to channel the excess energy in the opposite direction to the patient's tissue. 9. Method of a surgical system to detect parasitic capacitive coupling, with the surgical system comprising an energy generator, a surgical instrument, and at least one sensor to detect an energy anomaly, characterized by understanding: receiving, at least one sensor, data that energy is being emitted in an unintended location within the surgical system; transmit an alert indicating that a parasitic capacitive coupling is taking place; and transmit an interruption to the energy generator to temporarily interrupt the generation of energy. 10. Surgical instrument configured to mitigate the parasitic capacitive coupling during surgery, characterized by comprising: an electrical input configured to be electrically coupled to an energy generator; a drive shaft; an end actuator at a distal end of the drive shaft; at least one sensor configured to detect energy from a power anomaly; and at least one processor communicatively coupled to at least one sensor, and configured to: receive, from at least one sensor, data that the energy is being emitted in an unintended location within the surgical system; transmit an alert indicating that a parasitic capacitive coupling is taking place; and transmit an interruption to the energy generator to temporarily interrupt the generation of energy. 11. Surgical instrument, according to claim 10, characterized in that the end actuator comprises a pair of jaws, and the jaws comprise rounded tips configured to reduce the maximum peak tension, as the jaws come into contact with the patient's tissue. 12. Surgical instrument, according to claim 10, characterized in that the drive shaft comprises insulating switch elements configured to prevent the capacitive coupling from being transmitted over a long distance inside the drive shaft. Surgical instrument according to claim 10, characterized in that it additionally comprises a unilateral three-sided blade with a thin vertical upper blade element configured to reduce the transmission of inductive energy in addition to the upper blade element. 14. Surgical instrument, according to claim 10, characterized in that the end actuator comprises one or more electrodes located in the inner portion of the jaws and configured to channel the excess energy in the opposite direction to the patient's tissue.