BR112020012938A2 - determination of tissue composition by means of an ultrasonic system - Google Patents

Abstract

The present invention discloses several systems and methods for determining tissue composition using an ultrasonic surgical instrument. A control circuit can be configured to monitor the change in resonance frequency of an ultrasonic electromechanical system of the ultrasonic surgical instrument as the ultrasonic blade oscillates against a tissue and determine the tissue composition accordingly. In some aspects, the control circuit can be configured to modify the operation of the ultrasonic electromechanical system or other operational parameters of the ultrasonic surgical instrument according to the tissue composition detected.

Description

Descriptive Report of the Invention Patent for "DETERMINATION OF TISSUE COMPOSITION THROUGH AN ULTRASONIC SYSTEM".

REMISSIVE REFERENCE TO DEPOSIT REQUESTS CORRELATES

[0001] The present application claims priority under 35 U.S.C.§ 119 (e) to US provisional patent application No. 62 / 721,995, entitled

CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION, formulated on August 23, 2018, the disclosure of which is hereby incorporated by reference, in its entirety.

[0002] The present application claims priority under 35 USC§ 119 (e) to US provisional patent application No. 62 / 721,998, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS, filed on August 23, 2018, the disclosure of which is incorporated herein into reference title in its entirety.

[0003] The present application claims priority under 35 U.S.C.§ 119 (e) to US provisional patent application No. 62 / 721,999, entitled

INTERRUPTION 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 35 U.S.C.§ 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 35 U.S.C.§ 119 (e) to US provisional patent application No. 62 / 721,996, entitled

RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING

COMBINED ELECTRICAL SIGNAL, filed on August 23, 2018, the disclosure of which is hereby incorporated by reference in its entirety for reference.

[0006] The present application claims priority under 35 U.S.C.§ 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 provisional patent application for No. 62 / 692,748, entitled SMART ENERGY ARCHITECTURE, filed on June 30, 2018 and to provisional patent application for n ° 62 / 692,768, entitled SMART ENERGY DEVICES, filed on June 30, 2018, with the disclosure of each of which is incorporated herein by reference, in its entirety.

[0007] This application also claims priority benefit under 35 USC§ 119 (e) for US provisional patent application serial number 62 / 640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, filed on March 8 of 2018, and for provisional US patent application serial number 62 / 640,415, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR, filed on March 8, 2018, the disclosure of which is incorporated herein by reference in its wholeness. This application also claims the priority benefit under 35 U.S.C.§ 119 (e) for US provisional patent application No. 62 / 650,898 filed on March 30, 2018, entitled

CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS, for US provisional patent application serial number 62 / 650.887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, filed on March 30, 2018, with US provisional patent application No. series 62 / 650.882, entitled

SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL

PLATFORM, filed on March 30, 2018, and provisional US patent application serial number 62 / 650.877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTROLS, filed on March 30, 2018, the disclosure of which is here incorporated by reference, in its entirety.

[0008] This application claims priority under 35 USC§ 119 (e) to US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, to US provisional patent application n Serial No. 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on December 28, 2017, and provisional US patent application No. Serial No. 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28, 2017 , the disclosure of each of which is incorporated herein by reference, in its entirety.

BACKGROUND

[0009] In a surgical environment, smart energy devices may be needed in an intelligent energy architecture environment.

SUMMARY

[0010] In a general aspect, the present invention discloses an ultrasonic electromechanical system for an ultrasonic surgical instrument. The ultrasonic electromechanical system comprises: an end actuator comprising an ultrasonic blade, an ultrasonic transducer acoustically coupled to the ultrasonic blade and a control circuit coupled to the ultrasonic transducer. The ultrasonic transducer is configured to ultrasonic oscillate the ultrasonic blade in response to a trigger signal. The control circuit is configured to: determine a first resonance frequency of the ultrasonic electromechanical system, determine a second resonance frequency of the ultrasonic electromechanical system as the ultrasonic blade oscillates against a tissue and determine a tissue composition according to a comparison between the first resonance frequency and the second resonance frequency.

[0011] In another general aspect, an ultrasonic generator connectable to an ultrasonic electromechanical system comprising an ultrasonic blade and an ultrasonic transducer acoustically coupled to the ultrasonic blade is revealed. The ultrasonic generator comprises a control circuit attachable to the ultrasonic transducer. The control circuit is configured to: apply a trigger signal to the ultrasonic transducer to cause the ultrasonic transducer to oscillate the ultrasonic blade; determine a first resonance frequency of the ultrasonic electromechanical system; determine a second resonance frequency of the ultrasonic electromechanical system as the ultrasonic blade oscillates against a tissue; and determining a tissue composition according to a comparison between the first resonance frequency and the second resonance frequency.

[0012] In another general aspect, an ultrasonic surgical instrument comprising: an end actuator comprising an ultrasonic blade, an ultrasonic transducer acoustically coupled to the ultrasonic blade, an infrared source configured to emit infrared energy in a tissue within the actuator end point, an infrared detector and a control circuit coupled to the ultrasonic transducer and the infrared detector. The ultrasonic transducer is configured to ultrasonic oscillate the ultrasonic blade in response to a trigger signal. The control circuit is configured to: receive infrared energy reflected by the tissue through the infrared detector and determine the composition of the tissue according to the reflected infrared energy.

FIGURES

[0013] The characteristics and resources 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, taken together with the attached drawings, as shown below.

[0014] Figure 1 is a block diagram of an interactive surgical system implemented by computer, according to at least one aspect of the present disclosure.

[0015] Figure 2 is a surgical system being used to perform a surgical procedure in an operating room, in accordance with at least one aspect of the present disclosure.

[0016] Figure 3 illustrates a central surgical controller paired with a visualization system, a robotic system and an intelligent instrument, according to at least one aspect of the present disclosure.

[0017] Figure 4 is a partial perspective view of a central surgical controller compartment, and a combined generator module received slidingly in a central surgical controller compartment drawer, in accordance with at least one aspect of the present disclosure. .

[0018] Figure 5 is a perspective view of a generator module combined with bipolar, ultrasonic and monopolar contacts and a smoke evacuation component, in accordance with at least one aspect of the present disclosure.

[0019] 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.

[0020] Figure 7 illustrates a vertical modular cabinet configured to receive a plurality of modules, according to at least one aspect of the present disclosure.

[0021] Figure 8 illustrates a surgical data network comprising a central modular communication controller configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a healthcare facility. health specially equipped for surgical operations, to the cloud, according to at least one aspect of the present disclosure.

[0022] Figure 9 illustrates an interactive surgical system implemented by computer, in accordance with at least one aspect of the present disclosure.

[0023] 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.

[0024] Figure 11 illustrates an aspect of a universal serial bus (USB) network central controller device, in accordance with at least one aspect of the present disclosure.

[0025] 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.

[0026] 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.

[0027] 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.

[0028] 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.

[0029] 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.

[0030] Figure 17 is a schematic diagram of a robotic surgical instrument configured to operate a surgical tool described herein, in accordance with at least one aspect of the present disclosure.

[0031] 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.

[0032] 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.

[0033] Figure 20 is a system configured to execute adaptive ultrasound control algorithms on a surgical data network that comprises a central modular communication controller, in accordance with at least one aspect of the present disclosure.

[0034] Figure 21 illustrates an example of a generator, according to at least one aspect of the present disclosure.

[0035] Figure 22 is a surgical system comprising a generator and several surgical instruments that can be used with the generator, in accordance with at least one aspect of the present disclosure.

[0036] Figure 23 is a view of an end actuator, in accordance with at least one aspect of the present disclosure.

[0037] Figure 24 is a diagram of the surgical system of Figure 22, according to at least one aspect of the present disclosure.

[0038] Figure 25 is a model that illustrates the branching current of movement, according to at least one aspect of the present disclosure.

[0039] Figure 26 illustrates a structural view of a generator architecture, according to at least one aspect of the present disclosure.

[0040] Figures 27A to 27C illustrate functional views of a generator architecture, in accordance with at least one aspect of the present disclosure.

[0041] Figures 28A and 28B are structural and functional aspects of a generator, according to at least one aspect of the present disclosure.

[0042] Figure 29 is a schematic diagram of an aspect of an ultrasonic drive circuit.

[0043] Figure 30 is a schematic diagram of a control circuit, according to at least one aspect of the present disclosure.

[0044] Figure 31 shows a simplified block circuit diagram that illustrates another electrical circuit contained within a modular ultrasonic surgical instrument, in accordance with at least one aspect of the present disclosure.

[0045] Figure 32 illustrates a generator circuit divided into multiple stages, according to at least one aspect of the present disclosure.

[0046] Figure 33 illustrates a generator circuit divided into multiple stages, with a first stage circuit being common to the second stage circuit, according to at least one aspect of the present disclosure.

[0047] Figure 34 is a schematic diagram of an aspect of a drive circuit configured to drive a high frequency (RF) current, in accordance with at least one aspect of the present disclosure.

[0048] Figure 35 illustrates an aspect of a fundamental architecture for a digital synthesis circuit such as a digital direct synthesis circuit (DDS) configured to generate a plurality of waveforms for the electrical signal waveform for use in a surgical instrument, in accordance with at least one aspect of the present disclosure.

[0049] Figure 36 illustrates an aspect of the digital direct synthesis circuit (DDS) configured to generate a plurality of waveforms for the electrical signal waveform for use in a surgical instrument, according to at least one aspect of the present revelation.

[0050] Figure 37 illustrates a cycle of a discrete time digital electrical signal waveform, according to at least one aspect of the present disclosure, of an analog waveform (shown superimposed on an electrical signal waveform) discrete time digital for comparison purposes), in accordance with at least one aspect of the present disclosure.

[0051] Figure 38 is a diagram of a control system configured to allow the progressive closing of a closing member as it advances distally to close the clamping arm to apply a load of closing force at a desired rate, according to with an aspect of the present revelation.

[0052] Figure 39 illustrates a feedback control system of the proportional-integral-derivative controller (PID), according to an aspect of the present disclosure.

[0053] Figure 40 is a system diagram of a segmented circuit comprising a plurality of independently operated circuit segments, in accordance with at least one aspect of the present disclosure.

[0054] Figure 41 is a circuit diagram of several components of a surgical instrument with motor control functions, according to at least one aspect of the present disclosure.

[0055] Figure 42 is an alternative system for controlling the frequency of an ultrasonic electromechanical system and detecting its impedance, according to at least one aspect of the present disclosure.

[0056] Figure 43A is a graphical representation of the impedance phase angle as a function of the resonance frequency of the same ultrasonic device with a cold (blue) and hot (red) ultrasonic blade; and

[0057] Figure 43B is a graphical representation of the impedance magnitude as a function of the resonance frequency of the same ultrasonic device with a cold (blue) and hot (red) ultrasonic blade.

[0058] Figure 44 is a diagram of a Kalman filter to improve the temperature estimator and the state space model based on impedance over an ultrasonic transducer measured at a variety of frequencies, according to at least one aspect of the present revelation.

[0059] Figure 45 illustrates three probability distributions employed by a Kalman filter state estimator shown in Figure 44 to maximize the estimates, in accordance with at least one aspect of the present disclosure.

[0060] Figure 46A is a graphical representation of temperature versus time of an ultrasonic device where no temperature control reaches a maximum temperature of 490 ° C.

[0061] Figure 46B is a graphical representation of the temperature as a function of time of an ultrasonic device in which the temperature control reaches a maximum temperature of 320 ° C, according to at least one aspect of the present disclosure.

[0062] Figures 47A and 47B are graphical representations of the feedback control to adjust the ultrasonic energy applied to an ultrasonic transducer when a sudden drop in the temperature of an ultrasonic blade is detected, where

[0063] Figure 47A is a graphical representation of ultrasonic energy as a function of time; and

[0064] Figure 47B is a graph of the temperature of the ultrasonic sheet as a function of time, according to at least one aspect of the present disclosure.

[0065] Figure 48 is a logic flow diagram of a process that represents a control program or a logical configuration to control the temperature of an ultrasonic blade, according to at least one aspect of the present disclosure.

[0066] Figure 49 is a graphical representation of the temperature of the ultrasonic blade as a function of time during the firing of a vessel, according to at least one aspect of the present disclosure.

[0067] Figure 50 is a logic flow diagram of a process that represents a control program or a logical configuration to control the temperature of an ultrasonic blade between two temperature adjustment points, according to at least one aspect of this revelation.

[0068] Figure 51 is a logic flow diagram of a process that represents a control program or a logical configuration to determine the initial temperature of an ultrasonic blade, according to at least one aspect of the present disclosure.

[0069] Figure 52 is a logic flow diagram of a process that represents a control program or a logical configuration to determine when an ultrasonic blade is approaching instability and then adjust the power applied to the ultrasonic transducer to prevent instability of the ultrasonic transducer, in accordance with at least one aspect of the present disclosure.

[0070] Figure 53 is a logic flow diagram of a process that represents a control program or a logical configuration to provide ultrasonic sealing with temperature control, in accordance with at least one aspect of the present disclosure.

[0071] Figure 54 are graphical representations of the current of the ultrasonic transducer and the temperature of the ultrasonic blade as a function of time, according to at least one aspect of the present disclosure.

[0072] Figure 55 is a bottom view of an ultrasonic end actuator showing a clamping arm and an ultrasonic blade outlining the positioning of the tissue within the ultrasonic end actuator, in accordance with at least one aspect of the present disclosure.

[0073] Figure 56 is a graphical representation that shows the change in impedance of the ultrasonic transducer as a function of the location of the tissue within the ultrasonic end actuator over a range of predetermined increases in the power level of the ultrasonic generator, according to at least one aspect of the present revelation.

[0074] Figure 57 is a graphical representation showing the change in impedance of the ultrasonic transducer as a function of time in relation to the location of the tissue within the ultrasonic end actuator, according to at least one aspect of the present disclosure.

[0075] Figure 58 is a logic flow diagram of a process that represents a control program or a logical configuration to identify the operation in a non-therapeutic power range applied to the ultrasonic transducer to determine the position of the tissue, according to at least one aspect of the present revelation.

[0076] Figure 59 illustrates an aspect of an end actuator of an ultrasonic surgical instrument comprising infrared (IR) sensors located on the claw member, in accordance with at least one aspect of the present disclosure.

[0077] Figure 60 illustrates an aspect of a flexible circuit in which the IR sensors shown in Figure 59 can be integrally assembled or formed, in accordance with an aspect of the present disclosure.

[0078] Figure 61 is a sectional view of an ultrasonic end actuator comprising a clamping arm and an ultrasonic blade, in accordance with at least one aspect of the present disclosure.

[0079] Figure 62 illustrates IR refractivity detection sensor circuits mounted on a flexible circuit substrate shown in plan view, in accordance with at least one aspect of the present disclosure.

[0080] Figure 63 is a logic flow diagram of a process that represents a control program or a logical configuration for measuring IR reflectance to determine tissue composition for the purpose of adjusting the amplitude of the ultrasonic transducer, according with at least one aspect of the present revelation.

[0081] Figure 64A is a graphical representation of the closing rate of the clamping arm as a function of time to identify the point of transformation of the collagen according to various aspects of the present disclosure, where time is shown along the horizontal geometric axis and the change in the position of the clamping arm is shown along the vertical geometric axis, in accordance with at least one aspect of the present disclosure.

[0082] Figure 64B is an enlarged portion of the graphical representation shown in Figure 64A.

[0083] Figure 65 is a logic flow diagram of a process that represents a control program or a logical configuration to detect the collagen transformation point to control the closing rate of the clamping arm or the amplitude of the ultrasonic transducer, according to at least one aspect of the present disclosure.

[0084] Figure 66 is a graphical representation of the identification of the collagen transformation temperature point to identify the collagen / elastin ratio according to various aspects of the present disclosure, the tissue temperature being shown along the horizontal geometric axis and the impedance of the ultrasonic transducer is shown along the vertical geometric axis, according to at least one aspect of the present disclosure.

[0085] Figure 67 is a logic flow diagram of a process that represents a control program or a logical configuration to identify the transformation temperature of the collagen to identify the collagen / elastin ratio, according to at least one aspect of this revelation.

[0086] Figure 68 is a graphical representation of the compression load distribution along an ultrasonic sheet, according to at least one aspect of the present disclosure.

[0087] Figure 69 is a graphical representation of the pressure applied to the fabric as a function of time, according to at least one aspect of the present disclosure.

[0088] Figure 70 illustrates an end actuator that includes an array of single clamp electrodes for detecting tissue location, in accordance with at least one aspect of the present disclosure.

[0089] Figure 71 is an activation matrix for the simple clamp electrode matrix of Figure 70, according to at least one aspect of the present disclosure.

[0090] Figure 72 illustrates an end actuator that includes an array of double-claw electrodes to detect tissue location, in accordance with at least one aspect of the present disclosure.

[0091] Figure 73 is an activation matrix for the matrix of double claw electrodes of Figure 72, according to at least one aspect of the present disclosure.

[0092] Figure 74 illustrates sets of opposite electrodes superimposed on a tissue attached by an end actuator that corresponds to the activation matrix in Figure 73, in accordance with at least one aspect of the present disclosure.

[0093] Figure 75 illustrates an end actuator that includes an array of segmented double-claw electrodes, in accordance with at least one aspect of the present disclosure.

[0094] Figure 76 illustrates a tissue superimposed on a claw that includes an array of segmented electrodes, according to at least one aspect of the present disclosure.

[0095] Figure 77 is a schematic diagram of a segmented electrode matrix circuit that includes bandpass filters, in accordance with at least one aspect of the present disclosure.

[0096] Figure 78 is a graphical representation of the frequency response corresponding to the trapped tissue shown in Figure 76, according to at least one aspect of the present disclosure.

[0097] Figure 79 is a graphical representation of the frequency of the ultrasonic transducer system as a function of the activation frequency and temperature deviation of the ultrasonic blade, according to at least one aspect of the present disclosure.

[0098] Figure 80 is a graphical representation of the temperature of the ultrasonic transducer as a function of time, according to at least one aspect of the present disclosure.

[0099] Figure 81 is a graphical representation of the modal shift of the resonance frequency based on the temperature of the ultrasonic sheet that moves the resonance frequency as a function of the temperature of the ultrasonic sheet, according to at least one aspect of the present disclosure.

[00100] Figure 82 shows spectra of an ultrasonic surgical instrument with a variety of different states and conditions of the end actuator where the phase and amplitude of the impedance of an ultrasonic transducer are plotted as a function of frequency, according to at least one aspect of the present revelation.

[00101] Figure 83 illustrates a methodology for classifying data based on a set of training data S, where the magnitude and phase of the impedance are plotted as a function of frequency, according to at least one aspect of the present disclosure .

[00102] Figure 84 is a logic flow diagram representing a control program or logic configuration to determine the condition of the gripper based on the characteristic complex impedance pattern ("fingerprint"), according to at least one aspect of the present revelation.

[00103] Figure 85 is a timeline that represents the situational recognition of a central surgical controller, according to at least one aspect of the present disclosure.

DESCRIPTION

[00104] The applicant for this application holds the following US patent applications, filed on August 28, 2018, with the disclosure of each of which is incorporated herein by reference in its entirety: ● US patent application, no. END8536USNP2 / 180107-2, entitled ESTIMATING STATE OF

ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR; ● US patent application, summary number

END8560USNP2 / 180106-2, entitled TEMPERATURE CONTROL OF

ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR; ● US patent application, summary number END8561USNP1 / 180144-1, entitled RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS; ● US patent application, summary number END8563USNP1 / 180139-1, entitled CONTROLLING AN

ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION; ● US patent application, summary number END8563USNP2 / 180139-2, entitled CONTROLLING ACTIVATION

OF AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO THE PRESENCE OF TISSUE; ● US patent application, summary number END8563USNP4 / 180139-4, entitled DETERMINING THE STATE OF

AN ULTRASONIC ELECTROMECHANICAL SYSTEM ACCORDING TO FREQUENCY SHIFT; ● US patent application, summary number END8563USNP5 / 180139-5, entitled DETERMINING THE STATE OF AN ULTRASONIC END EFFECTOR; ● US patent application, summary number END8564USNP1 / 180140-1, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS; ● US patent application, summary number END8564USNP2 / 180140-2, entitled MECHANISMS FOR

CONTROLLING DIFFERENT ELECTROMECHANICAL SYSTEMS OF AN ELECTROSURGICAL INSTRUMENT; ● US patent application, summary number END8564USNP3 / 180140-3, entitled DETECTION OF END

EFFECTOR IMMERSION IN LIQUID; ● US patent application, summary number END8565USNP1 / 180142-1, entitled INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING; ● US patent application, summary number END8565USNP2 / 180142-2, entitled INCREASING RADIO FREQUENCY TO CREATE PAD-LESS MONOPOLAR LOOP; ● US patent application, summary number END8566USNP1 / 180143-1, entitled BIPOLAR COMBINATION

DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY; and ● US patent application, docket No. END8573USNP1 / 180145-1, entitled ACTIVATION OF ENERGY DEVICES.

[00105] The applicant for the present application holds the following US patent applications, filed on August 23, 2018, with the disclosure of each of which is incorporated herein by reference in its entirety: ● US provisional patent application no. 62 / 721,995, entitled

CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION; ● US Provisional Patent Application No. 62 / 721,998, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS; ● US Provisional Patent Application No. 62 / 721,999, entitled

INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING; ● US Provisional Patent Application No. 62 / 721,994, entitled

BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY; and ● US Provisional Patent Application No. 62 / 721,996, entitled

RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS.

[00106] The applicant for the present application holds the following US patent applications, filed on June 30, 2018, with the disclosure of each of which is incorporated herein by reference in its entirety: ● US provisional patent application no. 62 / 692,747, entitled

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

[00107] The applicant for the present application holds the following US patent applications, filed on June 29, 2018, with the disclosure of each of which is incorporated herein by reference in its entirety: ● US patent application no. series 16 / 024.090, entitled

CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS; ● US patent application serial number 16 / 024,057, entitled

CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS; ● US patent application serial number 16 / 024,067, entitled

SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION; ● US patent application serial number 16 / 024,075, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING; ● US patent application serial number 16 / 024,083, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING;

● US patent application serial number 16 / 024,094, entitled

SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES; ● US patent application serial number 16 / 024,138, entitled

SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE; ● US patent application serial number 16 / 024,150, entitled SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES; ● US patent application serial number 16 / 024,160, entitled VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY; ● US patent application serial number 16 / 024.124, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE; ● US patent application serial number 16 / 024,132, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT; ● US patent application serial number 16 / 024,141, entitled SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY; ● US patent application serial number 16 / 024,162, entitled

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

COMMUNICATION OF SMOKE EVACUATION SYSTEM

PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; ● US patent application serial number 16 / 024,258, entitled

SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTROL CIRCUIT FOR INTERACTIVE SURGICAL PLATFORM; ● US patent application serial number 16 / 024,265, entitled

SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION

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

[00108] The applicant for this application holds the following provisional US patent applications, filed on June 28, 2018, with the disclosure of each of which is incorporated herein by reference in its entirety: ● US provisional patent application n Serial number 62 / 691,228, entitled A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES; ● US provisional patent application serial number 62 / 691,227, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS; ● US provisional patent application serial number 62 / 691,230, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE; ● US provisional patent application serial number 62 / 691,219, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTROL; ● 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; ● US provisional patent application serial number 62 / 691,262, entitled SURGICAL EVACUATION SYSTEM WITH A

COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE; and ● US provisional patent application serial number 62 / 691,251, entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.

[00109] The applicant for this application holds the following provisional US patent applications, filed on April 19, 2018, with the disclosure of each of which is incorporated herein by reference in its entirety: ● US provisional patent application n Serial number 62 / 659,900, entitled METHOD OF HUB COMMUNICATION.

[00110] The applicant for this application holds the following provisional US patent applications, filed on March 30, 2018, with the disclosure of each of which is incorporated herein by reference in its entirety: ● US provisional patent application n ° 62 / 650,898, filed on March 30, 2018, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS; ● US provisional patent application serial number 62 / 650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES; ● US provisional patent application serial number 62 / 650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; and ● US provisional patent application serial number 62 / 650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND

CONTROLS

[00111] The applicant for this application holds the following US patent applications, filed on March 29, 2018, with the disclosure of each of which is incorporated herein by reference in its entirety: ● US provisional patent application no. serial 15 / 940,641, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; ● US provisional patent application serial number 15 / 940,648, entitled INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES; ● US patent application serial number 15 / 940,656, entitled

SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES; ● US patent application serial number 15 / 940,666, entitled

SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS; ● US patent application serial number 15 / 940,670, entitled

COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS; ● US patent application serial number 15 / 940,677, entitled SURGICAL HUB CONTROL ARRANGEMENTS; ● US patent application serial number 15 / 940,632, entitled

DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; ● US patent application serial number 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; ● US patent application serial number 15 / 940,645, entitled

SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING

INSTRUMENT; ● US patent application serial number 15 / 940,649, entitled

DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME; ● US patent application serial number 15 / 940,654, entitled SURGICAL HUB SITUATIONAL AWARENESS; ● US patent application serial number 15 / 940,663, entitled SURGICAL SYSTEM DISTRIBUTED PROCESSING; ● US patent application serial number 15 / 940,668, entitled AGGREGATION AND REPORTING OF SURGICAL HUB DATA; ● US patent application serial number 15 / 940,671, entitled

SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; ● US patent application serial number 15 / 940,686, entitled

DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE; ● US patent application serial number 15 / 940,700, entitled STERILE FIELD INTERACTIVE CONTROL DISPLAYS; ● US patent application serial number 15 / 940,629, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS; ● US patent application serial number 15 / 940,704, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; ● US patent application serial number 15 / 940,722, entitled

CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY; and ● US patent application serial number 15 / 940,742, entitled DUAL CMOS ARRAY IMAGING. ● US patent application serial number 15 / 940,636, entitled

ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL

DEVICES; ● US patent application serial number 15 / 940,653, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS; ● US patent application serial number 15 / 940,660, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER; ● US patent application serial number 15 / 940,679, entitled CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL

USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET; ● US patent application serial number 15 / 940,694, entitled CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION; ● US patent application serial number 15 / 940,634, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES; ● US patent application serial number 15 / 940,706, entitled

DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and ● US patent application serial number 15 / 940,675, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES. ● US patent application serial number 15 / 940,627, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● US patent application serial number 15 / 940,637, entitled COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● US patent application serial number 15 / 940,642, entitled CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● US patent application serial number 15 / 940,676, entitled

AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● US patent application serial number 15 / 940,680, entitled CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● US patent application serial number 15 / 940,683, entitled COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● US patent application serial number 15 / 940,690, entitled DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and ● US patent application serial number 15 / 940,711, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

[00112] The applicant for this application holds the following provisional US patent applications, filed on March 28, 2018, with the disclosure of each of which is incorporated herein by reference in its entirety: ● US provisional patent application n Serial number 62 / 649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; ● US provisional patent application serial number 62 / 649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; ● US provisional patent application serial number 62 / 649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS; ● US provisional patent application serial number 62 / 649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; ● US provisional patent application serial number 62 / 649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL

SYSTEMS; ● US provisional patent application serial number 62 / 649,291, titled USE OF LASER LIGHT AND RED-GREEN-BLUE

COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; ● US provisional patent application serial number 62 / 649,296, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES; ● US provisional patent application serial number 62 / 649,333, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER; ● US provisional patent application serial number 62 / 649,327, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES; ● US provisional patent application serial number 62 / 649,315, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; ● US provisional patent application serial number 62 / 649,313, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES; ● US provisional patent application serial number 62 / 649,320, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● US provisional patent application serial number 62 / 649,307, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT- ASSISTED SURGICAL PLATFORMS; and ● US provisional patent application serial number 62 / 649,323, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

[00113] The applicant for this application holds the following provisional US patent applications, filed on March 8, 2018,

the disclosure of each of which is incorporated herein by reference in its entirety: ● US provisional patent application serial number 62 / 640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR; and ● US provisional patent application serial number 62 / 640,415, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR.

[00114] The applicant for this application holds the following provisional US patent applications, filed on December 28, 2017, with the disclosure of each of which is incorporated herein by reference in its entirety: ● US provisional patent application n Serial number 62 / 611.341, entitled INTERACTIVE SURGICAL PLATFORM; ● US provisional patent application serial number 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS; and ● US provisional patent application serial number 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM.

[00115] Before explaining in detail the various aspects of surgical devices 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 drawings and description attached. Illustrative examples can be implemented or incorporated into other aspects, variations and modifications, and can be practiced or performed in a variety of ways. Furthermore, 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 of the other aspects, expressions of aspects and / or examples described below.

[00116] Several aspects are directed 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. Aspects of electrosurgical devices can be configured to transect, coagulate, scale, weld and / or dry the tissue during surgical procedures, for example.

[00117] 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 storage device 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 visualization system 108, a robotic system 110, an intelligent hand-held surgical instrument 112, which are configured to communicate with each other and / or with 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 smart hand-held surgical instruments 112, where M, N, O, and P are whole numbers greater than or equal to 1.

[00118] 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 the surgical procedure as part of the surgical system 102. The robotic system 110 includes a surgeon console 118, a patient car 120 (surgical robot), and a robotic central surgical controller 122. The patient car 120 can handle at least one surgical tool coupled with removable way 117 through a minimally invasive incision in the patient's body while the surgeon observes 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 using the patient carriage 120 to orient imaging device 124. Robotic central controller 122 can be used to process patient images surgical site for subsequent display to the surgeon via the surgeon's console 118.

[00119] Other types of robotic systems can readily be adapted for use with the surgical system 102. Various examples of robotic systems and surgical tools that are suitable for use with the present disclosure are described in US provisional patent application serial number 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28, 2017, the disclosure of which is incorporated herein by reference in its entirety.

[00120] Several examples of cloud-based analytical processes that are performed by the cloud 104, and 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 for reference.

[00121] In several respects, 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,

charge-coupled device (CCD) sensors and complementary metal oxide semiconductor sensors (CMOS, or "complementary metal-oxide semiconductor").

[00122] 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.

[00123] 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 range from about 380 nm to about 750 nm.

[00124] 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 radiation in the infrared (IR), microwave, radio and electromagnetic bands. Wavelengths smaller than about 380 nm are shorter than the ultraviolet spectrum, and become invisible ultraviolet, x-ray and electromagnetic gamma ray radiation.

[00125] 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 invention include, but are not limited to, an arthroscope, angioscope, bronchoscope, choledocoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagus-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngoscope neproscope, sigmoidoscope, thoracoscope and ureteroscope.

[00126] In one aspect, the imaging device employs multiple spectrum monitoring to discriminate topography and underlying structures. A multispectral image is one that captures image data within wavelength bands across the electromagnetic spectrum. The wavelengths can be separated by filters or 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 multispectral imaging is described in more 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 here incorporated as a reference in its entirety. Multispectral 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.

[00127] It is axiomatic that strict sterilization of the operating room and surgical equipment is a requirement during any surgery. The strict hygiene and sterilization conditions required in an "operating room", that is, an operating or treatment room, require the highest possible sterilization of all medical devices and equipment. Part of this sterilization process is the need to sterilize everything 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 recognized that the sterile field can be considered a specific 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 who has been prepared to perform a surgical procedure. The sterile field may include sterilized team members, who are properly dressed, and all furniture and accessories in the area.

[00128] In several aspects, the visualization system 108 includes one or more imaging sensors, one or more image processing units, one or more storage matrices and one or more screens that are strategically arranged in relation to the sterile field, as illustrated in Figure 2. In one aspect, the display system 108 includes an interface for HL7, PACS and RME. Various components of the 108 display 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, the disclosure of which is incorporated herein as a reference in its entirety.

[00129] 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 maintaining a live broadcast of the site surgical on main screen 119. Snapshot on non-sterile screen 107 or 109 may allow a non-sterile operator to perform a diagnostic step relevant to the surgical procedure, for example.

[00130] In one aspect, the central controller 106 is also configured to route a diagnostic input or feedback by a non-sterile operator in the display tower 111 to the primary screen 119 within the sterile field, where the input or feedback can be viewed 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 106.

[00131] With reference to Figure 2, a 112 surgical instrument is being used in the surgical procedure as part of the surgical system

102. Central controller 106 is also configured to coordinate the flow of information to a screen of surgical instrument 112. For example, in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28 2017, whose disclosure is hereby incorporated by reference in its entirety. 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 surgical instrument screen 115 in the sterile field, where it can be seen by the surgical instrument operator 112. Exemplary surgical instruments that are suitable for use with surgical system 102 are described under the title "Hardware of the surgical instrument" and in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, the disclosure of which is here incorporated by reference in its entirety, for example.

[00132] Now with reference to Figure 3, a central controller 106 is shown in communication with a visualization system 108, a robotic system 110 and a smart 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, central controller 106 additionally includes an evacuation module smoke 126 and / or a suction / irrigation module 128.

[00133] 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 interwoven during the surgical procedure. Valuable time can be wasted in treating this issue during a surgical procedure. To untangle the lines it may be necessary to disconnect them from their respective modules, which may require the modules to be reset. The central compartment of the central controller 136 offers a unified environment for managing the power, data and fluid lines, which reduces the frequency of entanglement between such lines.

[00134] Aspects of the present disclosure feature a central surgical controller for use in a surgical procedure that involves applying energy to tissue at a surgical site. The central surgical controller includes a central controller compartment and a combined generator module received slidingly at 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 application cable to connect the combined generator module to a surgical instrument, at least one smoke evacuation component configured to evacuate smoke, fluid and / or the particulates produced by applying therapeutic energy to the tissue, and a fluid line that extends from the remote surgical site to the smoke evacuation component.

[00135] 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.

[00136] 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.

[00137] 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, the the first power generator module is slidingly movable in an electrical coupling with the power and data contacts, and the first power generator module is slidingly movable out of the electric coupling with the first energy and Dice.

[00138] In addition to the above, the modular compartment also includes a second energy generator module configured to generate a second energy, different from the first energy, for application to the fabric, and a second docking station comprising a second docking port that includes second power and data contacts, the second power generating module being slidably movable in an electrical coupling with the power and data contacts, and the second power generating module being slidingly movable out of the electrical coupling with the second power and data contacts.

[00139] 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 energy generating module and the second energy generating module.

[00140] 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 central controller 136 modular compartment further facilitates interactive communication between modules 140, 126, 128. As illustrated in Figure 5, generator module 140 can be a generator module with integrated monopolar, bipolar and ultrasonic components, supported in a single cabinet unit 139 slidably insertable into the central compartment of the central controller 136. As shown in Figure 5, the generator module 140 can be configured to connect to a monopolar device 146, a bipolar device 147 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 compartment 136 can be configured to facilitate the insertion of multiple generators and interactive communication between generators anchored in the central controller modular compartment 136 so that the generators would act as a single generator.

[00141] In one aspect, the modular compartment of central controller 136 comprises a rear communication and modular power board 149 with external and wireless communication heads to allow the removable connection of modules 140, 126, 128 and interactive communication between the themselves.

[00142] 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 of the central surgical controller compartment 136. A docking port 152 with the power and control contacts data 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 modular compartment 136 as the combined generator module 145 is slid to the position on the corresponding docking station 151 of the modular compartment of the central controller 136. In 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.

[00143] In several respects, the smoke evacuation module 126 includes a fluid line 154 that carries smoke and / or fluid captured / collected 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.

[00144] 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 the irrigation and aspiration of fluids to and from the surgical site.

[00145] In one aspect, the surgical tool includes a drive shaft that has an end actuator at a distal end of the same and at least an energy treatment associated with the end actuator, a suction tube, and an irrigation tube . 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 entrance port close to the power application implement. The power application implement is configured to apply 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.

[00146] 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 control module. suction / irrigation 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.

[00147] In one aspect, modules 140, 126, 128 and / or their corresponding docking stations in the modular compartment of central controller 136 may 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 central compartment of the central controller 136. For example, as shown in Figure 4, the combined generator module 145 includes side supports 155 which are configured to slide the corresponding supports 156 of the corresponding docking station 151 of the compartment. modular central controller 136. The brackets cooperate to guide the coupling port contacts of the combined generator module 145 in an electrical engagement with the coupling port contacts of the central controller 136 modular compartment.

[00148] In some respects, the drawers 151 of the modular compartment of the central controller 136 are 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 supports 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.

[00149] 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 misalignment of contacts.

[00150] As shown in Figure 4, the coupling port 150 of a drawer 151 can be coupled to the coupling 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.

[00151] Figure 6 illustrates individual power bus connectors for a plurality of side coupling ports of a side modular compartment 160 configured to receive a plurality of modules from a central surgical controller 206. Side modular compartment 160 is configured to receive and laterally interconnect modules 161. Modules 161 are slidably inserted into docking stations 162 of side modular compartment 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 side modular cabinet.

[00152] Figure 7 illustrates a vertical modular cabinet 164 configured to receive a plurality of modules 165 from the central surgical controller 106. The modules 165 are slidably inserted into docking stations, or drawers, 167 of the vertical modular cabinet 164, the which includes a rear panel for interconnecting modules 165. Although the drawers 167 of the 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 the data relevant to the operation of modules 165. In addition, the vertical modular compartment 164 includes a master module 178 that houses a plurality of submodules that are received slidingly on master module 178.

[00153] In several aspects, 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 compartment that can be mounted with a light source module and a camera module. The compartment can be a disposable compartment. In at least one example, the disposable compartment 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.

[00154] 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 another light source can be an inefficient practice. 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 surgical field.

[00155] In one aspect, the imaging device comprises a tubular compartment 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 slide the camera module, 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.

[00156] 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.

[00157] 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 reference in its entirety. In addition, US patent No. 7,982,776, entitled SBI 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 image data. Such systems can be integrated with the imaging module 138. In addition to these, the publication of US patent application No. 2011/0306840, entitled CONTROLLABLE

MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPARATUS, 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.

[00158] Figure 8 illustrates a surgical data network 201 comprising a modular central communication controller 203 configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a healthcare facility. public services specially equipped for surgical operations, to a cloud-based system (for example, cloud 204 which may include a remote server 213 coupled to a storage device 205). In one aspect, the modular communication central controller 203 comprises a central network controller 207 and / or a network key 209 in communication with a network router. The central modular 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 can be called a a central controller or controllable key. A central switching controller reads the destination address of each packet and then forwards the packet to the correct port.

[00159] Modular devices 1a to 1n located in the operating room can be coupled to the modular central communication controller 203. The central network controller 207 and / or the network switch 209 can be coupled to a network router 211 to connect devices 1a through 1n to the 204 cloud or the local computer system

210. The 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 1n 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. The 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 the local computer system 210 for processing and manipulation of the local data.

[00160] 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 may be contained in a modular control tower 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 modular communication central 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 may include, for example, various 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 other modular devices which can be connected to the modular communication central controller 203 of the surgical data network 201.

[00161] In one aspect, the surgical data network 201 may comprise a combination of 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 attached to the central network controller or network key can collect data in real time and transfer 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 applied to the modular communication central controller 203 and / or the 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 modular central communication controller 203 and / or the computer 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.

[00162] The application of cloud computer data processing techniques to the 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 the 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. The data collected by devices 1a to 1n / 2a to 2m, including the image data, can be transferred to the cloud 204 or the local computer system 210 or both for data processing and manipulation including image processing and manipulation. The data can be analyzed to improve the results of the surgical procedure by determining whether additional treatment, such as application of endoscopic intervention, emerging technologies, targeted radiation, targeted intervention, accurate robotics at specific tissue sites and conditions, can be followed. This data analysis can additionally use analytical processing of the results, and with the use of standardized approaches they can provide beneficial standardized feedback both to confirm surgical treatments and the surgeon's behavior or to suggest changes to surgical treatments and the surgeon's behavior.

[00163] In an implementation, devices in the operating room 1a to 1n can be connected to the central modular communication controller 203 via a wired channel or a wireless channel depending on the configuration of devices 1a to 1n on a central controller of network. 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 it to the router in "half-duplex" mode. The central network controller 207 does not store any media access control / Internet protocol (MAC / IP) for transferring device data. Only one of the devices 1a to 1n at a time can send data via 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 to a remote server 213 (Figure 9) in the cloud 204. The central network controller 207 can detect basic network errors, such as collisions, but having all the information transmitted to multiple ports of entry can be a security risk and cause strangulation.

[00164] In another implementation, operating room devices 2a to 2m can be connected to a network switch 209 through a wired or wireless channel. The network key 209 works in the data connection layer of the OSI model. The 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 frame form 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.

[00165] The central network controller 207 and / or the network key 209 are coupled to the network router 211 for a connection to the cloud

204. Network router 211 works on the network layer of the OSI model. The network router 211 creates a route to transmit data packets received from the central network controller 207 and / or the network key 211 to a computer with cloud resources for future processing and manipulation of the data collected by any among or all of the 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 health care facility or different networks located in different operating rooms of different service facilities of health. 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.

[00166] In one example, the central network controller 207 can be implemented as a central USB controller, which allows multiple USB devices to be connected to a host computer. The central USB controller can expand a single USB port on several 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 about a wired channel or a wireless channel. In one aspect, a wireless wireless, broadband and short-range wireless USB communication protocol can be used for communication between devices 1a to 1n and devices 2a to 2m located in the operating room.

[00167] In other examples, devices in the operating room 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 via standard Bluetooth wireless technology for exchanging data over short distances (with the use of short-wavelength UHF radio waves in the 2.4 to 2.485 GHz ISM band) from fixed and mobile devices and build personal area networks (PANs). In other respects, operating room devices 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 via a number of wireless and wired communication standards or protocols, including, but not limited to a, 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 +, HSUPA +, 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 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.

[00168] The modular communication central controller 203 can serve as a central connection for one or all devices in the operating room 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 modular central communication controller 203, it is amplified and transmitted to the network router 211, which transfers data to cloud computing resources using a series of wireless communication standards or protocols or wired, as described here.

[00169] The modular communication central controller 203 can be used as a standalone device or be connected to compatible central network controllers and network switches to form a larger network. The 203 modular communication central controller is, in general, easy to install, configure and maintain, which makes it a good option for network operations of devices 1a to 1n / 2a to 2m from the operating room.

[00170] 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, implemented, surgical system per 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 in communication 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 such as, for example, smart surgical instruments, robots and other computerized devices located 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 an imaging module 238 which is coupled to an endoscope 239, a generator module 240 which is coupled 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 array 234, an intelligent device / instrument 235 optionally attached to a screen 237, and a non-contact sensor module 242. Operating room devices are coupled with cloud computing resources and data storage through the tower modular control 236. The robotic central controller 222 can also be connected to the modular control tower 236 and cloud computing resources.

The devices / instruments 235, visualization 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 display systems 208. A The central controller screen can also display the data received from the devices connected to the modular control tower together with images and overlapping images.

[00171] Figure 10 illustrates a central surgical controller 206 comprising a plurality of modules coupled to the modular control tower 236. The modular control tower 236 comprises a central controller for modular communication 203, for example, a network connectivity device , and a computer system 210 for providing local processing, visualization and imaging, for example. As shown in Figure 10, the modular communication central controller 203 can be connected in a layered configuration to expand the number of modules (for example, devices) that can be connected to the modular communication central controller 203 and transfer to the communication system. computer 210 data associated with modules, cloud computing resources, or both. As shown in Figure 10, each of the central controllers / network switches in the modular communication central 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 to the cloud computing resources and a local display 217. Communication with the cloud 204 can be done via a wired communication channel or wireless.

[00172] 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 of the laser or ultrasonic type. An ultrasound-based non-contact sensor module scans the operating room by transmitting a burst of ultrasound and receiving the echo when it bounces off the walls surrounding an operating room, as described under the heading "Surgical Hub Spatial Awareness Within an Operating Room" in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM,

deposited on 28 December 2017, which is hereby incorporated by reference in its entirety, the sensor module being configured to determine the size of the operating room and to adjust the limits of the Bluetooth pairing distance. 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 with the received pulse to determine the operating room size and adjusting the Bluetooth pairing distance limits, for example.

[00173] 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 input / output interface 251 through of a system bus. The system bus can be any 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 available bus architectures including, but not limited to, not limited to, 9-bit bus, industry standard architecture (ISA), Micro-Charmel Architecture (MSA), extended ISA (EISA), smart drive electronic circuits (IDE), VESA local bus (VLB), network interconnection peripheral components (PCI), USB, advanced graphics port (AGP), PCMCIA bus (International Personal Computer Memory Card Association, "Personal Computer Memory Card International Association"), small computer systems interface (SCSI), or any another proprietary bus.

[00174] 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 StellarisWare® program, memory only programmable, electrically erasable (EEPROM) reading of 2 KB, one or more pulse width modulation (PWM) modules, one or more analogs of quadrature encoder (QEI) inputs, one or more analog to digital converters (ADC) 12-bit with 12 channels of analog input, details of which are available for the product data sheet.

[00175] In one aspect, processor 244 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 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.

[00176] 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),

EEPROM 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).

[00177] 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, Jaz drive, Zip drive, LS-60 drive, flash memory card or memory stick (pen drive). 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 (CD-ROM) device recordable (CD-R Drive), rewritable compact disc drive (CD-RW drive), or a versatile digital 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.

[00178] It should be considered that computer system 210 includes software that acts as an intermediary between users and the basic resources of the computer described in an appropriate 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 the management capabilities of the operating system through program modules and program data stored in system memory or on the storage disk. It must be considered that several components described here can be implemented with various operating systems or combinations of operating systems.

[00179] A user enters commands or information in computer system 210 through the input device (s) coupled to the I / O interface 251. 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). 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 information from the computer system 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.

[00180] Computer system 210 can operate in a networked environment using logical connections with 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 many or all 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 fiber distributed data interface (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).

[00181] 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 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 multiple 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.

[00182] 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 serial modems, cable modems and DSL modems, ISDN adapters, and Ethernet cards.

[00183] 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 network controller USB 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. Upstream USB transceiver port 302 is a differential data root port comprising a "minus" (DM0) differential data input paired with a "plus" (DP0) differential data input. The three ports of the downstream USB transceiver 304, 306, 308 are differential data ports, with each port including "plus" differential data outputs (DP1-DP3) paired with "minus" differential data outputs (DM1-DM3) .

[00184] 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 downstream USB transceiver ports 304, 306, 308. The downstream USB transceiver ports 304, 306, 308 support both full speed as low speed automatically configuring the scan rate according to the speed of the device attached to the doors. The USB 300 network central controller device can be configured in bus powered or self powered mode and includes 312 central controller power logic to manage power.

[00185] The USB 300 network central controller device includes a 310 serial interface engine (SIE). The SIE 310 is the front end of the USB 300 central network controller hardware and handles most of the protocol described in chapter 8 of the USB specification. SIE 310 typically comprises signaling down to the transaction level. The functions it handles could include: packet recognition, transaction sequencing, SOP, EOP, RESET, and RESUME signal detection / generation, clock / data separation, data encoding / decoding non-inverted zero (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 SIE 310 receives a clock input 314 and is coupled to a suspend / resume logic circuit and frame timer 316 and a central controller repeat circuit 318 to control communication between the upstream USB transceiver port 302 and the downstream USB transceiver ports 304, 306, 308 via port logic circuits 320, 322, 324. The SIE 310 is coupled to a command decoder 326 via interface logic to control commands from an EEPROM memory serial via a 330 serial EEPROM interface.

[00186] 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. The 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 with individual port power management or grouped port power management, and the self-powered central controller with power management. individual port power or grouped port power management. In one aspect, using a USB cable, the USB 300 central network controller, the USB upstream 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

[00187] Figure 12 illustrates a logic diagram of a module of a 470 control system of an instrument or surgical 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 processor 462. A motor 482, driven by a driver motor 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 to 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 provided at the tool driver interface to control the pipe 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.

[00188] 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 respect, 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-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 StellarisWare® program, memory programmable and electrically erasable read-only (EEPROM) of 2 KB, one or more pulse width modulation (PWM) modules, one or more analogs of quadrature encoder (QEI) inputs, and / or one or more analog converters for 12 bit digital (ADC) with 12 channels of analog input, details of which are available for the product data sheet.

[00189] In one aspect, the 461 microcontroller may comprise a safety controller that comprises two families based on controllers, such as TMS570 and RM4x known under the trade name 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.

[00190] The 461 microcontroller can be programmed to perform various functions, such as the precise control of the speed and position of the scalpel, the articulation systems, the clamping arm, or a combination thereof. In one aspect, the microcontroller 461 includes a processor 462 and a memory 468. The electric motor 482 can be a direct current (DC) motor with brushes with a gearbox and mechanical connections with an articulation 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 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 hereby incorporated by reference in its entirety.

[00191] 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.

[00192] In one aspect, motor 482 can be controlled by motor driver 492 and can be used by the instrument's trigger system or surgical tool. In many ways, the 482 motor can be a brushed direct current (DC) motor with a maximum rotational 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. Motor starter 492 may comprise an H bridge starter comprising field effect transistors (FETs), for example. The 482 motor can be powered by a feed assembly releasably mounted on the handle assembly or tool compartment 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.

[00193] 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 external power semiconductor metal oxide (MOSFET) field transistors. , N-channel, specifically designed for inductive loads, such as brushed DC motors. The 492 actuator comprises a single charge pump regulator that provides full door drive (> 10 V) for batteries with voltage up to 7 V and allows the A3941 to operate with a reduced door drive, up to 5.5 V. A capacitor input control can be used to supply the voltage surpassing 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% duty 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 through the upper and lower FETs. The energy FETs are protected from the shoot-through effect through programmable dead-time resistors. 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.

[00194] The 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 firing 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 closing member of the clamping arm configured to close and open a clamping arm of a stapler, ultrasonic, or electrosurgical device, or combinations thereof. Accordingly, as used in the present invention, the term displacement member is used generically to refer to any movable member of the instrument or surgical tool such as the driving member, the clamping arm, or any element that can be displaced. 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.

[00195] In other aspects, 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 magnet fixed 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.

[00196] The electric motor 482 may 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 driving 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 source supplies 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.

[00197] A single revolution of the sensor element associated with the position sensor 472 is equivalent to a longitudinal linear displacement of d1 of the displacement member, where d1 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.

[00198] 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 position sensor 472. The state of the switches is transmitted back to microcontroller 461 which applies logic to determine a single position signal corresponding to the longitudinal linear displacement of d1 + d2 +… dn 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 arrangement 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 signs or values.

[00199] The position sensor 472 can comprise any number of 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 magnetoresistance, giant magnesium resistance, magnetic tunnel junctions, giant magneto impedance, magnetostrictive / piezoelectric compounds, magnetodiode, magnetic transistor , optical fiber, magneto-optics and magnetic sensors based on microelectromechanical systems, among others.

[00200] In one aspect, the position sensor 472 for the 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, AS5055EQFT 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 (digital computer for coordinate rotation) processor, also known as the digit-for-digit method and Volder algorithm, is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only addition, subtraction, displacement operations bits 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), to the 461 microcontroller. The 472 position sensor provides 12 or 14 bits resolution. The 472 position sensor can be an AS5055 integrated circuit supplied in a small 16-pin QFN package with dimensions of 4 x 4 x 0.85 mm.

[00201] The tracking system 480 comprising an absolute positioning system can comprise and / or be programmed to implement a feedback controller, such as a PID, status feedback, and adaptive controller. A power source 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, the 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 in 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 CONTROL OF

MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, submitted on June 20, 2017, is incorporated by reference in its entirety into this document. In a digital signal processing system, an absolute positioning system is coupled to 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 towards 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.

[00202] 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 driving member to the restart position (zero or initial), as may be required by the encoders conventional rotating machines that merely count the number of progressive or regressive steps that the 482 motor has traveled to infer the position of a device actuator, actuation bar, scalpel, and the like.

[00203] A 474 sensor, such as an effort meter or a micro force meter, is configured to measure one or more parameters of the end actuator, such as, for example, the amplitude of the effort exerted on the anvil during a gripping operation, which may 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. anvil closure on a stapler or clamping arm on 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 clamp arm of the instrument or surgical tool or the force applied by a clamp 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.

[00204] 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 gauge, which is configured to measure one or more parameters of the end actuator, for example. In one aspect, the strain gauge sensor 474 can measure the amplitude or magnitude of the mechanical stress exerted on a claw 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 microcontroller

461. A 476 load sensor can measure the force used to operate the knife element, for example, to cut the tissue captured between the anvil and the staple cartridge. A 476 load sensor can measure the force used to operate the clamping arm element, for example, to capture the tissue between the clamping arm and an ultrasonic blade or to capture the tissue between the clamping arm and a claw of a 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.

[00205] Measurements of tissue compression, tissue thickness and / or force required to close the end actuator on the tissue, as measured by sensors 474, 476, can be used by microcontroller 461 to characterize the selected position of the 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 look-up table that can be used by the 461 microcontroller in the evaluation.

[00206] The control system 470 of the instrument or surgical tool can also comprise wired or wireless communication circuits for communication with the central modular communication controller shown in Figures 8 to 11.

[00207] 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 instructions executable on a machine that, when executed by the processor 502, cause the 502 processor to execute machine instructions to implement several of the processes described here. The 502 processor 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.

[00208] 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 various processes described herein. The combinational logic circuit 510 may comprise a finite state machine comprising a combinational logic 512 configured to receive data associated with the instrument or surgical tool at an input 514, process the data by combinational logic 512 and provide an output 516.

[00209] 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. 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 surgical instrument or tool from an input 526, process the data by combinational logic 522, and provide an output 528. In other respects, the circuit may comprise a combination of a processor (for example , processor 502, Figure 13) and a finite state machine for implementing 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.

[00210] 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 can be activated to perform a first function, a second engine can be activated to perform a second function, a third engine can be activated to perform a third function, a fourth engine can 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 firing, closing, and / or articulation movements in the end actuator. The firing, closing and / or articulation movements can be transmitted to the end actuator through a drive shaft assembly, for example.

[00211] 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 transmit movements trigger points, generated by the 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.

[00212] 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. clamping and compressing 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.

[00213] 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 certain cases, the articulation movements can cause the end actuator to be articulated in relation to the drive shaft assembly, for example.

[00214] 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 articulation motors 606a, 606b can be activated to cause the end actuator to be articulated, 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, closing motor 603 can be activated simultaneously with firing motor 602 to cause the closing tube or closing member to advance distally as described in more detail later in this document.

[00215] In certain cases, the surgical instrument or tool may include a common control module 610 that can be used with a plurality of motors of the instrument 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 surgical instrument or tool motors may share one or more common control modules, such as the common control module 610. In certain cases, a plurality of surgical instrument or tool motors may be individually and selectively engaged to the common control module 610. In certain cases, the common control module 610 can be selectively switched between interfacing with one of a plurality of instrument motors or surgical tool to interface with another among the plurality of instrument motors or surgical tool.

[00216] 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.

[00217] Each of the motors 602, 603, 606a, 606b 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.

[00218] In several cases, as shown in Figure 16, the common control module 610 may comprise a motor starter 626 which may comprise one or more H-Bridge FETs. The motor driver 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.

[00219] In certain cases, 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 memory units 624 can be coupled to the processor 622, for example. In many ways, the 620 microcontroller can communicate via a wired or wireless channel, or combinations thereof.

[00220] In certain cases, the power source 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 the handle to supply power to the surgical instrument 600. Several battery cells connected in series can be used as the 628 power source. In certain cases, the power source 628 power supply can be replaceable and / or rechargeable, for example.

[00221] 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, 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 control device. adequate basic computing 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, as it has internal memory. Processors operate on numbers and symbols represented in the binary numeral system.

[00222] 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 that comprises a 256 KB single cycle flash integrated memory, or other non-volatile memory, up to 40 MHz, an early seek buffer for 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 ADCs 12-bit with 12 channels of analog input, 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.

[00223] In certain cases, memory 624 may include program instructions for controlling each of the motors of the surgical instrument 600 which are attachable to common control module 610. For example, memory 624 may include program instructions for controlling the motor trigger 602, closing motor 603 and hinge motors 606a, 606b. Such program instructions can cause the 622 processor to control the trigger, close, and link functions according to inputs from the instrument or surgical tool control algorithms or programs.

[00224] In certain cases, one or more mechanisms and / or sensors, such as 630 sensors, can be used to alert the 622 processor about the 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, processor 622 can use the program instructions associated with firing the closing member coupled to the clamping arm of the end actuator upon detection, through 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.

[00225] 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 an 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, closing members, driving shaft members, or one or more hinge members, or combinations thereof.

[00226] 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 transducer ultrasonic 719 excited by an ultrasonic generator 721, a drive shaft 740, and one or more hinge 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 timing information and 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 control circuit 710. Motors 704a to 704e can be operated individually by the control circuit 710 in an open loop or closed loop feedback control.

[00227] 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. Timer / counter 731 can be configured to measure elapsed time, count external events, or time external events.

[00228] In one aspect, control circuit 710 can be programmed to control functions of end actuator 702 based on one or more tissue conditions. 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 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 a thinner fabric is present, the 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.

[00229] In one aspect, the control circuit 710 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 drive signals to motors 704a to 704e to drive motors 704a to 704e, as described here. In some instances, motors 704a to 704e may be brushed DC motors. For example, the speed of motors 704a to 704e can be proportional to the respective motor start signals. In some examples, 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.

[00230] 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 of the displacement member. 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 of 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 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.

[00231] 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 a main alternating current power source, a battery, a super capacitor, or any other suitable power source. The motors 704a to 704e can be mechanically coupled to individual moving 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 may 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 aggregating 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.

[00232] In one aspect, control circuit 710 is configured to drive a firing member as the closing member portion 714 of end actuator 702. Control circuit 710 provides a motor setpoint for control of the 708a motor, 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 trigger member for distally and proximally controlling the movement of the closing member 714 along a longitudinal geometric 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 which includes a first knife drive gear and a second gear knife drive. 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 may 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 an end distal position of the stroke relative to the initial position of course. As the closing member 714 moves distally, the clamping arm 716 closes towards the ultrasonic blade 718.

[00233] In one aspect, control circuit 710 is configured to drive a closing member like the clamping arm portion 7 of end actuator 702. Control circuit 710 provides a motor setpoint for control of 708b motor, 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 716 from the open and closed. 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 for 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 to the control circuit 710. Additional sensors 738 on the end actuator 702 can provide the feedback signal of the closing force to the control circuit 710. The articulating clamping arm 716 it is positioned opposite the ultrasonic blade 718. When ready for use, the control circuit 710 can provide a closing signal to the motor control 708b. In response to the closing signal, the motor 704b advances a closing member to secure the fabric between the clamping arm 716 and the ultrasonic blade 718.

[00234] In one aspect, control circuit 710 is configured to rotate a drive shaft member, such as drive shaft 740, to rotate end actuator 702. Control circuit 710 provides a motor setpoint for a 708c engine control, which provides a drive signal for the 704c engine. The output shaft of the 704c motor is coupled to a 744c torque sensor. The torque sensor 744c is coupled to a transmission 706c which is coupled to the shaft 740. The transmission 706c comprises moving mechanical elements, such as rotary elements, to control the rotation of the drive shaft 740 clockwise or counterclockwise until and above 360 °. In one aspect, the 704c engine is coupled to the rotary drive assembly, which includes a pipe gear segment that is formed over (or attached to) the proximal end of the proximal closing tube for operable engagement by a rotational gear assembly that is supported operationally 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 to the control circuit 710. Additional sensors 738, such as a drive shaft encoder, can provide the rotational position of the drive shaft 740 to the control circuit 710.

[00235] 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 704d motor is coupled to a 744d torque sensor. The torque sensor 744d is coupled to a transmission 706d which is coupled to a pivot member 742a. The 706d transmission comprises moving mechanical elements, such as pivoting elements, to control the articulation of the 702 ± 65 ° end actuator. In one aspect, the 704d motor is coupled to a pivot nut, which is rotatably seated on the proximal end portion of the distal column portion and is pivotally driven thereon 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.

[00236] In another aspect, the articulation function of the robotic surgical system 700 may comprise two articulation members, or connections, 742a, 742b. These hinge 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 movement and a load to the head when it is not moving and to provide a movement of articulation 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.

[00237] 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 articulation 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 on 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.

[00238] In one aspect, the position sensor 734 can be implemented as an absolute positioning system. In one aspect, the 734 position sensor may comprise an absolute rotary magnetic positioning system implemented as a single integrated circuit rotary magnetic position sensor

AS5055EQFT, 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 algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions which only require addition, subtraction, bit shift and lookup table operations.

[00239] 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 as a function of time, tissue compression as a function of time, and anvil deformation as a function of 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 such as an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor and / or any other sensor suitable for measuring one or more parameters of end actuator 702. Sensors 738 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, the 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 ultrasonic blade 718 has tissue in it, and (4) the load and the position on both articulation rods.

[00240] In one aspect, the one or more sensors 738 may comprise a stress meter such as, for example, a microstrain meter, configured to measure the magnitude of the stress on the anvil 716 during a clamped condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The sensors 738 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 sensors 738 can be configured to detect the impedance of a section of tissue located between the clamping arm 716 and the ultrasonic blade 718 which is indicative of the thickness and / or the totality of the fabric located between them.

[00241] 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 and inertia sensors, among others.

[00242] 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 clamping arm 716 to detect the closing forces applied by the closing tube to the clamping arm 716. The forces exerted on the clamping arm clamping 716 can be representative of the tissue compression experienced by the tissue section captured between the clamping arm 716 and the ultrasonic blade 718. The one or more sensors 738 can be positioned at various points of interaction throughout 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 actual closing forces applied to the clamping arm 716.

[00243] In one aspect, a current sensor 736 can be used to measure the current drained 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 control circuit 710. 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 feedback controller, which may be one or any of the feedback controllers, including, but not limited to, a PID controller, state feedback, linear quadratic (LQR) and / or an adaptive 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 disclosed 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.

[00244] 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.

[00245] 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 description below, 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 instances, may comprise one or more microcontrollers, microprocessors, or other processors suitable for executing instructions which 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.

[00246] Control circuit 760 can generate a setpoint signal for motor 772. The setpoint signal for motor 772 can be supplied to a motor controller 758. Motor controller 758 can comprise one or more circuits configured to provide a motor 774 drive signal to motor 754 to drive motor 754, as described here. 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 motor drive signal 774 can comprise a PWM signal provided for a or more motor stator windings 754. In addition, in some examples, motor controller 758 may be omitted, and control circuit 760 can generate motor drive signal 774 directly.

[00247] The 754 motor can receive power from an energy 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 784 it can include an encoder configured to supply a series of pulses to the control circuit 760 according to the beam with I-profile 764 transferred distally and proximally. Control circuit 760 can track pulses to determine the position of the 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 motor 754 is a stepper motor, control circuit 760 can track the position of closing member 764 by aggregating the number and orientation of the steps that motor 754 has been instructed to perform. The position sensor 784 can be located on end actuator 752 or any other portion of the instrument.

[00248] 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 span distance as a function of time, tissue compression as a function of time and anvil tension as a function of time. The sensors

788 may comprise a magnetic sensor, a magnetic field sensor, a stress meter, a pressure sensor, a force sensor, an inductive sensor such as an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor and / or any other sensors suitable for measuring one or more parameters of the end actuator 752. The 788 sensors may include one or more sensors.

[00249] The one or more sensors 788 may comprise an effort meter such as, for example, 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 tissue located between the clamping arm 766 and the ultrasonic blade 768 which is indicative of the thickness and / or the totality of the fabric located between them.

[00250] 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 can be at a point of interaction between the closing tube and the clamping 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. 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 of the control circuit 760. The control circuit 760 receives sample measurements in real time to provide and analyze information based on time and evaluate, in real time, the closing forces applied to the clamping arm 766.

[00251] 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 to the control circuit 760.

[00252] The control circuit 760 can be configured to simulate the response of the real system of the instrument 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 one or any of the feedback controllers, including, but not limited to, a PID controller, state feedback, LQR, and / or an adaptive controller, for example. The surgical instrument 750 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.

[00253] 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 an articulation system 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.

[00254] Several exemplifying aspects are directed to a surgical instrument 750 that comprises an end actuator 752 with surgical sealing and cutting implements driven by motor. For example, a motor 754 can drive a displacement member distally and proximally along a longitudinal geometry axis of end actuator 752. End actuator 752 may comprise an articulating clamping arm 766 and, when configured for use, a 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, motor 754 can drive the displacement member distally along 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 fabric between the ultrasonic blade 768 and the clamping arm 766.

[00255] 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 closing member 764, for example, based on one or more tissue conditions. The control circuit 760 can be programmed to detect, directly or indirectly, the conditions of the fabric, 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, control circuit 760 can be programmed to translate the displacement member at a lower speed and / or with a lower power. When a thinner fabric is present, the control circuit 760 can be programmed to move the displacement member at a higher speed and / or with greater power.

[00256] 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 of the displacement member. Based on an instrument response 750 during the open circuit portion of the course, 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-loop shape to translate the displacement member into a constant speed. Additional details are disclosed in US Patent Application Serial No. 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.

[00257] 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 the closing member 764. The 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 electrodes 796 (shown in dashed line). The ultrasonic blade 768 is coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

[00258] 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, the sensors

788 can include driverless electric switches, ultrasonic switches, accelerometers, inertia sensors and, among others.

[00259] In one aspect, the position sensor 784 can be implemented as an absolute positioning system, which comprises a rotary magnetic absolute positioning system implemented as a single integrated circuit rotary magnetic position sensor AS5055EQFT, available from Austria Microsystems , AG. The position sensor 784 can interface with the control circuit 760 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 algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions which only require addition, subtraction, bit shift and lookup table operations.

[00260] 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 the motor has been instructed to perform. Position sensor 784 can be located on end actuator 792 or any other portion of the instrument.

[00261] 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 span distance as a function of time, tissue compression as a function of time and anvil tension as a function of 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.

[00262] An RF power source 794 is coupled to end actuator 792 and is applied to RF electrode 796 when RF electrode 796 is provided on end actuator 792 in place of ultrasonic blade 768 or to function in conjunction with the ultrasonic blade 768. For example, the ultrasonic blade is produced from 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.

[00263] 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 as a reference in its entirety. Generator hardware Adaptive ultrasonic blade control algorithms

[00264] 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 parameters of the device. In one aspect, the ultrasonic blade control algorithms are configured to parameterize the type of tissue. An algorithm to detect the collagen / elastin ratio of the tissue to adjust the amplitude of the distal tip of the ultrasonic blade is described in the following section of the present disclosure. Various aspects of intelligent ultrasonic energy devices are described here in connection with Figures 1 to 85, for example. Consequently, the following description of the adaptive ultrasonic slide control algorithms should be read in conjunction with Figures 1 to 85 and their associated descriptions. Fabric type identification and device parameter settings

[00265] In certain surgical procedures it would be desirable to use adaptive ultrasonic blade control algorithms. In one respect, 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 on the parameterization. For example, the amplitude of the mechanical displacement of the distal tip of the ultrasonic sheet 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 surface emissivity in the infrared (IR). 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 clamp that is covered with tissue.

[00266] Figure 20 is a system 800 configured to execute algorithms for the control of ultrasonic slides adaptable in a surgical data network that comprises a central controller of modular communication, according to at least one aspect of the present disclosure. In one aspect, the generator module 240 is configured to execute the adaptive ultrasonic blade control algorithms 802, as described herein with reference to Figures 43A to 54. In another aspect, the device / instrument 235 is configured to execute the control algorithms of adaptive ultrasonic slides 804, as described herein with reference to Figures 43A to 54. In another aspect, device / instrument 235 is configured to execute the adaptive ultrasonic slide control algorithms 802, 804 as described here with reference to Figures 43A to 54.

[00267] 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 bypass configuration (for example, a central bypass or non-central bypass configuration) for defining the trigger signal outputs in order to deliver trigger signals to 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 root mean square (RMS) trigger signal for a 241 ultrasonic surgical instrument, and the trigger signal outputs can emit an RF electrosurgical drive signal (for example, a 100 V electrosurgical drive signal) for an RF electrosurgical instrument 241. Aspects of generator module 240 are described herein with reference to Figures 21 to 28B.

[00268] Generator module 240 or device / instrument 235 or both are coupled to modular control tower 236 connected to multiple operating room devices, such as smart surgical instruments, robots and other computerized devices located in the operating room , as described with reference to Figures 8 to 11, for example.

[00269] 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 execute adaptive ultrasonic blade control algorithms in a surgical data network comprising a controller modular communication center 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. The 900 generator comprises a 902 processor coupled to a 904 waveform generator. The 902 processor and the waveform generator

904 are configured to generate various signal waveforms based on information stored in a memory coupled to the 902 processor, not shown for clarity of disclosure. The digital information associated with a waveform is provided to the waveform generator 904 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 the amplifier 906 is coupled to a power transformer 908. The signals are coupled via the power transformer 908 to the secondary side, which is the patient isolation side. A first signal of a first energy modality is supplied to the surgical instrument between the terminals identified as ENERGY1 and RETURN. A second signal of a second energy modality is coupled through a capacitor 910 and is supplied to the surgical instrument between the terminals identified as ENERGY2 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 ENERGIAn terminals can be provided, where n is a positive integer greater than 1. It will also be acknowledged that up to "n" return paths, RETURN can be provided without departing from the scope of the present disclosure.

[00270] A first voltage detection circuit 912 is coupled through the terminals identified as ENERGY1 and to the RETURN path to measure the output voltage between them. A second voltage detection circuit 924 is coupled through the terminals identified as ENERGY2 and to the RETURN path to measure the output voltage between them. A current detection circuit 914 is arranged in series with the RETURN branch on the secondary side of the power transformer 908, as shown, to measure the output current for any energy modality. If different return paths are provided for each energy modality, then a separate current detection circuit would be provided on each return branch. 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 further processing and calculations. The output voltages and the output current feedback information can be used to adjust the output voltage and the current supplied to the surgical instrument, and to compute the output impedance, among other parameters. Input / output communications between the 902 processor and the patient's isolated circuits are provided via a 920 interface circuit. The sensors may also be in electrical communication with the 902 processor via the 920 interface circuit.

[00271] In one aspect, the impedance can be determined by processor 902 by dividing the output of the first voltage detection circuit 912 coupled over the terminals identified as ENERGY1 / RETURN or the second voltage detection circuit 924 coupled over the terminals identified as ENERGY2 / RETURN by the output of the current detection circuit 914 arranged in series with the RETURN branch 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 transformer isolations 916, 922, and current detection circuit 914 output is provided to another isolation transformer 916. Digitized current and voltage detection measurements from ADC circuit 926 are provided to processor 902 to calculate impedance. As an example, the first ENERGIA1 energy modality can be ultrasonic energy and the second ENERGIA2 energy modality can 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 illustrated in Figure 21 shows a single RETURN return path that can be provided for two or more energy modes, in other respects, multiple RETURN return paths can be provided for each ENERGY energy mode. 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 tissue impedance can be measured by dividing the output of the second voltage detection circuit 924 by current detection circuit 914.

[00272] As shown in Figure 21, generator 900 comprising at least one output port may include a power transformer 908 with a single output and multiple taps to provide power in the form of one or more energy modalities, 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 that is performed. For example, the 900 generator can supply higher voltage and lower current power to drive an ultrasonic transducer, lower voltage and higher current to drive RF electrodes to seal the tissue or with a coagulation waveform for point clotting using electrosurgical electrodes Monopolar or bipolar RF. The output waveform of generator 900 can be oriented, switched or filtered to provide 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 ENERGY1 and RETURN, as shown in Figure 21. In one example, a connection of bipolar RF electrodes to the output of generator 900 would preferably be located between the output identified as ENERGY2 and the RETURN. In the case of a monopolar output, the preferred connections would be an active electrode (for example, light beam or other probe) for the ENERGIA2 output and a suitable return block connected to the RETURN output.

[00273] Additional details are disclosed in US patent application publication No. 2017/0086914 entitled TECHNIQUES FOR

OPERATING 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.

[00274] 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 using a non-solid medium. The term does not imply that the associated devices do not contain any wires, although in some ways 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, evolution long-term evolution (LTE), 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, 5G, 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.

[00275] 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".

[00276] 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 other 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), Wi-Fi module, or coprocessor. An SoC may or may not contain internal memory.

[00277] 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.

[00278] 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.

[00279] 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 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 StellarisWare® program, memory only programmable, electrically erasable (EEPROM) reading of 2 KB, one or more pulse width modulation (PWM) modules, one or more analogs of quadrature encoder (QEI) inputs, one or more analog to digital converters (ADC) 12-bit with 12 channels of analog input, details of which are available for the product data sheet.

[00280] In one aspect, the processor may comprise a safety controller that comprises 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.

[00281] The modular devices include the modules (as described in connection with Figures 3 and 9, for example) that are receivable within a central surgical controller and the devices or 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 with which the specific modular device is paired, or on both the modular device and the central surgical controller (for example, through a distributed computing architecture). 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). This 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 motor current, or the levels of energy). 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.

[00282] Figure 22 illustrates a form of a surgical system 1000 comprising a generator 1100 and several surgical instruments 1104, 1106 and 1108 that can be used with the generator, with surgical instrument 1104 being an ultrasonic surgical instrument, the instrument surgical 1106 is an RF electrosurgical instrument, and the multifunctional surgical instrument 1108 is a combination of ultrasonic / RF electrosurgical instrument. 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 energies and RF signals 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 adequate signals to program the operation of the 1100 generator. The 1100 generator can be configured for communication wired or wireless.

[00283] 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 (HP) handle, an 1120 ultrasonic transducer, a 1126 drive shaft and a end actuator 1122. End actuator 1122 comprises an ultrasonic blade 1128 acoustically coupled to the ultrasonic transducer 1120 and a clamping arm

1140. The handle 1105 comprises a trigger 1143 to operate the clamping arm 1140 and a combination of toggle buttons 1134a, 1134b, 1134c to energize and activate the ultrasonic blade 1128 or other function. Toggle buttons 1134a, 1134b, 1134c can be configured to power the 1120 ultrasonic transducer with the 1100 generator.

[00284] 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, a 1127 drive shaft and an 1124 end actuator. 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 the 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.

[00285] Generator 1100 is also configured to drive a multifunctional surgical instrument 1108. The multifunctional surgical instrument 1108 comprises a handle 1109, 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 handle 1109 comprises a trigger 1147 for operating the clamping arm 1146 and a combination of toggle buttons 1137a, 1137b, 1137c to energize and drive the blade 1149 ultrasonic 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.

[00286] 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 1104 ultrasonic surgical instrument, the RF 1106 surgical instrument and the 1108 multifunctional surgical instrument that integrates ultrasonic energies and RF signals supplied simultaneously from the generator

1100. Although in the form of Figure 22, generator 1100 is shown separate 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 surgical system unitary. 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. Generator 1100 can also comprise one or more 1112 output devices. Other aspects of generators for digitally generating electrical signal waveforms and surgical instruments are described in patent publication US-2017-0086914-A1, which is incorporated herein by reference, in its entirety.

[00287] Figure 23 is an end actuator 1122 of the exemplary ultrasonic device 1104, according to 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 activated by the ultrasonic transducer 1120, the blade 1128 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 may comprise a set of grippers. The clamping arm 1140 can be pivotally connected to a distal end of a drive shaft 1126 of the instrumental portion 1104. The clamping arm 1140 can include a tissue block of 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 clamped 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 fabric in cooperation with the 1128 blade. 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 1128 blade) of any proper manner. For example, handle 1105 may comprise a jaw closure trigger. When operated by a clinician, the clamshell trigger can rotate the clamping arm 1140 in any suitable manner.

[00288] The 1100 generator can be activated to supply the trigger signal to the 1120 ultrasonic transducer in any suitable way. For example, generator 1100 may comprise a foot switch 1430 (Figure 24) coupled to generator 1100 by means of a foot switch cable 1432. A clinician can activate ultrasonic transducer 1120 and thereby ultrasonic transducer 1120 and blade 1128 by 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 1100 activate the 1120 ultrasonic transducer. In one aspect, for example, the one or more keys may comprise a pair of toggle buttons 1134a, 1134b, 1134c (Figure 22), for example, to determine a mode of operation of the device 1104. When the toggle button 1134a is pressed, for example, the 1100 ultrasonic generator can provide a maximum trigger signal to the 1120 transducer, causing it to produce a maximum of ultrasonic energy output. Pressing the 1134b toggle button 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 for, for example, indicating a position of a clamping trigger to operate the claws through 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 through the clamping arm 1140, an ultrasonic energy can be applied).

[00289] In addition or alternatively, 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 pulse power level may consist of the power levels associated with the toggle buttons 1134a, 1134b (maximum, less than maximum), for example.

[00290] 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 ultrasonic energy output, and a toggle button 1134c to produce a pulsed output, either at the power level maximum 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.

[00291] In certain respects, a two-position switch can be offered as an alternative to a toggle button 1134c (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 holding position, the toggle button 1134b can produce an output in pulses (for example, in a maximum or less than maximum power level, depending on the EEPROM configuration).

[00292] In some respects, the RF electrosurgical end actuator 1124, 1125 (Figure 22) may also comprise a pair of electrodes. The electrodes may 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. Generator 1100 can provide a signal (for example, a non-therapeutic signal) to electrodes. The impedance of the tissue portion can be found, for example, by monitoring the current, voltage, etc. the signal.

[00293] In several aspects, 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 trigger 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 drive the 1104, 1106, 1108 surgical devices. In several respects, each of the ultrasonic and / or generator modules 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 generator

1100. (The modules are shown in dashed 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.

[00294] 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 one or more drive 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 with high resolution, accuracy and repeatability.

[00295] According to the aspects described, the generator module for electrosurgery / RF can generate one or more drive signals with sufficient energy output 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.).

[00296] The generator 1100 can 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 to program the operation of the 1100 generator. In operation, the user can program or otherwise control the operation of the 1100 generator 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, through the 2150 input device, the user can adjust or program various generator operational parameters, such as current (I), voltage (V), frequency (f) and / or period (T) of one or more drive generated by the ultrasonic generator module and / or the electrosurgery / RF generator module.

[00297] The generator 1100 may 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. Such devices may comprise, for example, visual feedback devices (for example, a monitor with an LCD screen, LED indicators), audio feedback devices (for example, a speaker, a bell) or tactile feedback devices. (for example, haptic actuators).

[00298] Although certain modules and / or blocks of the 1100 generator can be described by way of example, it should be considered that one can use a greater or lesser number of modules and / or blocks and, even so, be within the scope of the 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, digital signal processors (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.

[00299] In one aspect, the drive module of the ultrasonic generator and the drive module for electrosurgery / RF 1110 (Figure 22) can comprise one or more integrated applications, implemented as firmware, software, hardware or any combination thereof. The modules can comprise several executable modules, such as software, programs, data, triggers and application program interfaces (API, of "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," random-access memory ") as dynamic RAM (DRAM," dynamic RAM "), DRAM with double data rate (DDRAM," Double " -Date-

Rate DRAM "), and / or synchronous DRAM (SDRAM," synchronous DRAM ").

[00300] 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 corresponding output signal or signals for the operation of devices 1104, 1106, 1108. In aspects where the generator 1100 is used in conjunction with device 1104, the trigger signal can trigger the ultrasonic transducer 1120 in surgical cutting and / or coagulation modes. The electrical characteristics of the 1104 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 aspects where generator 1100 is used in conjunction with device 1106, the trigger signal can supply electrical energy (for example, RF energy) to end actuator 1124 in 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 recorders. 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 ultrasonic transducer 1120 and end actuators 1122, 1124, 1125.

[00301] 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 Vg (t) and alternating current Ig (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 signals Vg (t) and current Ig (t) is zero. In other words, in resonance the inductive impedance is equal to the capacitive impedance. As the ultrasonic blade heats up, the conformity of the ultrasonic blade (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 activation frequency and the resonance frequency of the electromechanical ultrasonic system. The system is now operating "out of resonance". The difference between the drive frequency and the resonance frequency is manifested as a phase difference between the voltage signals Vg (t) and current Ig (t) applied to the ultrasonic transducer. The generator's electronic circuits can easily monitor the phase difference between voltage Vg (t) and current Ig (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.

[00302] As shown in Figure 25, the electromechanical 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 static capacitance at a resonant frequency so that substantially all of the generator's trigger signal current 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 resonance frequency of the ultrasonic transducer. The tuning inductor can also transform the phase impedance curve 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 different ultrasonic transducer having a different static capacitance needs a tuning inductor.

[00303] Figure 25 illustrates an equivalent 1500 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 C0. The drive current Ig (t) can be received from a generator at a drive voltage Vg (t), with the movement current Im (t) flowing through the first branch and the current Ig (t) −Im (t) that flows through the capacitive branch. The control of the electromechanical properties of the ultrasonic transducer can be obtained by properly controlling Ig (t) and Vg (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 C0 at a resonance frequency, so that substantially all the current output of the Ig (t) generator flows through the movement branch. In this way, the current control of the motion branch Im (t) is obtained by controlling the current output of the Ig (t) generator. The Lt tuning inductor is specific to the C0 static capacitance of an ultrasonic transducer, however, and a different ultrasonic transducer having a different static capacitance requires a different Lt tuning inductor. In addition, as the Lt tuning inductor correlates to the Nominal value of static capacitance C0 at a single resonance frequency, accurate control of the branching current of motion Im (t) is guaranteed only at that frequency. As the frequency moves downward with the temperature of the transducer, exact control of the current of the motion branch is compromised.

[00304] Several aspects of the 1100 generator may not have a Lt tuning inductor to monitor the Im (t) branching current. Instead, generator 1100 can use the measured value of static capacitance C0 between power applications for a specific ultrasonic surgical device 1104 (along with drive feedback and current voltage feedback data) to determine the current values of motion branch Im (t) on a dynamic and continuous basis (for example, in real time). These forms of the 1100 generator are therefore capable of providing virtual tuning to simulate a system that is tuned or resonated with any C0 static capacitance value at any frequency, and not just at a single resonance frequency imposed by a nominal capacitance value. static C0.

[00305] Figure 26 is a simplified block diagram of an aspect of generator 1100, to provide tuning without 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 may comprise an isolated stage of patient 1520 in communication with a non-isolated stage 1540 via 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 trigger signal outputs 1600a, 1600b, 1600c to provide output trigger 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 supply a trigger signal (for example, a 420 V RMS trigger signal) to an ultrasonic instrument 1104, and the trigger signal outputs 1600a, 1600b and 1600c can provide a trigger signal (for example, a trigger signal at 100 V RMS) to an electrosurgical device 1106, with output 1600b corresponding to the central bypass of the power transformer 1560. The uninsulated stage 1540 can comprise a power amplifier 1620 that has an output connected to a primary winding 1640 of the power transformer 1560. In some respects, the 1620 power amplifier may comprise a push-pull amplifier, for example.

The non-isolated stage 1540 may further comprise a programmable logic device 1660 for providing a digital output to a 1680 digital-to-analog converter (DAC) which, in turn, provides an analog signal corresponding to a power amplifier input.

1620. In certain respects, the 1660 programmable logic device may comprise a field programmable port array (FPGA), for example. The programmable logic device 1660, by controlling the input of the power amplifier 1620 through the DAC 1680, can therefore control any of a number of parameters (for example, frequency, waveform, amplitude of the waveform) of drive signals appearing at 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 drive signals provided by the 1100 generator.

[00306] 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 voltage 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 some 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 a 1760 analog-to-digital (DAC) converter In one aspect, for example, the 1740 processor can receive as input, through the ADC 1760, the waveform envelope 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, via a pulse width width modulated output ("PWM" - pulse-width modulated) so that the rail voltage provided to the 1620 power amplifier follows the amplified signal wave 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.

[00307] In certain aspects and as discussed in further detail in connection with Figures 28A and 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 trigger signals provided by generator 1100. In one aspect, for example, programmable logic device 1660 can implement a DDS 2680 control algorithm (Figure 28A) by retrieving samples waveforms 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. Since 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 the resonance. As the waveform of a drive signal provided 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 on voltage and current based on the drive signal can be provided to 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 waveform samples stored in the LUT in a dynamic and continuous basis (for example, in real time). In one aspect, 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 shape of the current wave, the error being determined on a basis of sample by sample. In this way, pre-distorted LUT samples, when processed through the drive circuit, can result in a motion branch trigger signal that has the desired wave shape (for example, sinusoidal) to optimally drive the transducer ultrasonic. In such respects, the LUT waveform samples will therefore not represent the desired waveform of the trigger signal, but rather the waveform that is necessary to ultimately produce the desired waveform of the signal triggering the motion branch, when distortion effects are taken into account.

[00308] 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 sample respectively the voltage and current of the trigger signals emitted by generator 1100. 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 drive 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 aspects of the 1100 generator can make it possible, among other things, to calculate the complex current flowing through the motion branch (which can be used in certain aspects to implement the DDS-based waveform control described above), accurate digital filtering of the sampled signals, and calculation of actual energy consumption with a high degree of accuracy. The voltage and current feedback data provided by ADCs 1780 and 1800 can be received and processed (for example, FIFO buffer memory, multiplexing) by the 1660 programmable logic device and stored in data memory for subsequent retrieval, for example , by the processor

1740. As noted above, the 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 some respects, this may require that each stored voltage and current feedback data pair be indexed based on, or otherwise associated with, a sample of the corresponding LUT that was provided by the 1660 programmable logic device when the data pair feedback on voltage and current was captured. The synchronization of the LUT samples with the feedback data about voltage and current in this way contributes to the correct timing and stability of the pre-distortion algorithm.

[00309] In certain aspects, the feedback data about voltage and current can be used to control the frequency and / or amplitude (for example, current amplitude) of the trigger 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 setpoint (eg 0 °), thereby minimizing or reducing the effects of 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 provided as input to a DDS control algorithm implemented by the programmable logic device 1660.

[00310] The impedance phase can be determined through Fourier analysis. In one aspect, the phase difference between the triggering signals of the generated voltage Vg (t) and the generated current Ig (t) can be determined using the fast Fourier transform (FFT) or the discrete Fourier transform (DFT) as shown below: 𝑉𝑔 (𝑡) = 𝐴1 𝑐𝑜𝑠 (2𝜋𝑓0 𝑡 + 𝜑1) 𝐼𝑔 (𝑡) = 𝐴2 𝑐𝑜𝑠 (2𝜋𝑓0 𝑡 + 𝜑2) 𝐴1 𝜑1 𝑉𝑔 (𝑓) = (𝛿 (𝑓 - 𝑓0) + 𝛿 (𝑓 + 𝑓0)) 𝑒𝑥𝑝 (𝑗2𝜋𝑓) 2 2𝜋𝑓0 𝐴2 𝜑2 𝐼𝑔 (𝑓) = (𝛿 (𝑓 - 𝑓0) + 𝛿 (𝑓 + 𝑓0)) 𝑒𝑥𝑝 (𝑗2𝜋𝑓) 2 2𝜋𝑓0

[00311] The evaluation of the Fourier transform at the sinusoid frequency produces:

𝐴1 𝑉𝑔 (𝑓0) = 𝛿 (0) 𝑒𝑥𝑝 (𝑗𝜑1) 𝑎𝑟𝑔 𝑉 (𝑓0) = 𝜑1 2 𝐴2 𝐼𝑔 (𝑓0) = 𝛿 (0) 𝑒𝑥𝑝 (𝑗𝜑2) 𝑎𝑟𝑔 𝐼 (𝑓0) = 𝜑2 2

[00312] Other approaches include weighted least squares 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 phase angle φ at any point in time can be calculated by: 𝜑 = 2𝜋𝑓𝑡 + 𝜑0 where φ is the phase angle, f is the frequency, t is the time, and φ0 is the phase at t = 0.

[00313] Another technique to determine the phase difference between the voltage signals Vg (t) and current Ig (t) is the zero-crossing method and produces highly accurate results. For voltage signals Vg (t) and current Ig (t) having the same, each passage through zero from negative to positive of the voltage signal Vg (t) triggers the beginning of a pulse, while each passage through zero from negative to positive current signal Ig (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-pass 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 Vg (t) and current Ig (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 edge-triggered and auxiliary RS flip-flop circuit can be used. In yet another aspect, the zeroing technique can use an exclusive gate (XOR).

[00314] 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.engnetbase. com>, which is incorporated here for reference.

[00315] 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 some respects, current amplitude control can be implemented by the control algorithm, such as a proportional-integral-derivative control algorithm (PID), on the 1740 processor. The variables controlled by the control algorithm to properly control the current amplitude of the trigger 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 circuit (which provides input to the power 1620) through an 1860 DAC circuit.

[00316] 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 (USB) interface, communication with the 1430 foot switch, communication with a 2150 data entry 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 UI 1900 processor can primarily support UI functionality, it can also coordinate with the PSD 1740 processor to implement risk mitigation in certain ways. For example, the 1900 processor can be programmed to monitor various aspects of user actions and / or other inputs (for example, 2150 touchscreen inputs, 1430 foot switch inputs, 2160 temperature sensor inputs) and can disable the generator 1100 drive output when an error condition is detected.

[00317] In certain respects, 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 status of the 1100 generator can determine, for example, which control and / or diagnostic processes are implemented by the 1740 processor. For processor 1900, the operational state of generator 1100 can determine, for example, which elements of a user interface (for example, monitor screens , sounds) are presented to a user. Processors 1740 and 1900, respectively, can independently maintain the current operational state of generator 1100, and 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 valid transitions between operational states and can confirm that a particular transition is appropriate. For example, when processor 1740 instructs processor 1900 to transition to a specific state, processor 1900 may 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.

[00318] 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 1100 generator on and off, a capacitive screen touch sensitive). In certain respects, the 1960 controller can comprise at least one processor and / or another controller device in communication with the 1900 processor. In one aspect, for example, the 1960 controller can comprise a processor (for example, an 8-bit Mega168 controller available from Atmel) configured to monitor the user's actions 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 touch data capture from a capacitive sensitive screen to the touch.

[00319] 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, such as the 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 off 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 activation of the "on / off" input device is detected turns off "2150 by a user. Controller 1960 can therefore initiate a sequence to transition generator 1100 to an "on" state. On the other hand, controller 1960 can initiate a sequence to transition the generator 1100 to the off state if activation of the input device "on / off" 2150 is detected, when the generator 1100 is in the on state. In certain respects, for example, controller 1960 may report activation of the "on / off" 2150 input device to processor 1900, which in turn implements the process sequence necessary to transition generator 1100 to the off state. 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.

[00320] In certain aspects, the 1960 controller can cause the 1100 generator to offer audible feedback or other sensory feedback to alert the user that an on or off sequence has been initiated. 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.

[00321] 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 comprising switches handle) and components of the non-isolated stage 1540, 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 1540 components via a link of communication that maintains an adequate degree of electrical isolation between stages 1520 and 1540 such as, for example, an infrared (IR) based communication link. Power can be supplied to the 1980 instrument interface circuit using, for example, a low-loss voltage regulator powered by an isolation transformer driven from the 1540 non-isolated stage.

[00322] In one aspect, the instrument interface circuit 1980 can comprise a programmable logic device 2000 (e.g., 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 (e.g., a 2 kHz square wave) to generate a bipolar 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 a configuration of the control circuit. control. The control circuit can 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 unambiguously discernible, based on that 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 that result from passing the interrogation signal 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.

[00323] In one aspect, the 1980 instrument interface circuit may comprise a first 2040 data circuit interface to enable the exchange of information between programmable logic device 2000 (or another element of the 1980 instrument interface circuit) and a first data circuit disposed in, or otherwise associated with, a surgical device. In certain 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 some respects, the first data circuit may comprise a non-volatile storage device, such as an electrically erasable programmable read-only memory device (EEPROM). In certain respects and again with reference to Figure 26, the first data circuit interface 2040 can be implemented separately from the programmable logic device 2000 and comprises an appropriate circuit (for example, different logic devices, a processor) to enable communication between the programmable logic device 2000 and the first data circuit. In other respects, the first data loop interface 2040 can be integral with the programmable logic device 2000.

[00324] In certain aspects, 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 instrument interface circuit 1980 (for example, by the programmable logic device 2000), transferred to a component of the non-isolated stage 1540 (for example, to the programmable logic device 1660, processor 1740 and / or processor 1900 ) for presentation to a user by means of an output device 2140 and / or to control a function or operation of the generator 1100. In addition, any type of information can be communicated to the first data circuit 2060 for storage in the same through 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.

[00325] 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 such cases, known generators may be limited in their ability to recognize specific instrument configurations being used, as well as to optimize control and diagnostic processes as needed. The addition of readable data circuits to surgical device instruments to address 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.

[00326] 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 may comprise a second data circuit interface 2100 to enable such communication. In one aspect, the second data circuit interface 2100 may comprise a three-state digital interface, although other interfaces may also be used. In certain aspects, 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. Additionally 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 include, 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 respects, the second data circuit can transmit data captured by one or more sensors (for example, an instrument-based temperature sensor). In certain aspects, the second data circuit can receive data from generator 1100 and provide an indication to the user (for example, an LED indication or other visible indication) based on the received data.

[00327] In certain respects, the second data circuit and the second data circuit interface 2100 can be configured so that the communication between the programmable logic device 2000 and the second data circuit can be made without the need to install conductors for this purpose (for example, dedicated cable conductors connecting a handle 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 existing wiring, as one of the conductors used to transmit interrogation signals from from the signal conditioning circuit 2020 to a control circuit on a handle. 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 do not have indispensable data reading functionality, which, therefore, allows the backward compatibility of the surgical device instrument.

[00328] In certain respects, 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 by, for example, example, 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.

[00329] In certain respects, the non-isolated stage 1540 may comprise a power supply 2110 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 power supply 2110 may additionally comprise one or more DC / DC voltage converters 2130 to receive the power supply output to generate DC outputs at the voltages and currents required by the various components of generator 1100. As discussed above In relation 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 operation or awakening of the DC / DC 2130 voltage converters.

[00330] 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 sample feedback signals at high speed (eg 80 Msps) to enable oversampling (eg approximately 200x of 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 stored in a temporary memory ("buffer") and subsequently multiplexed or merged into a single data stream within block 2120 of the 1660 programmable logic device. In the aspect of Figures 28A and 28B, the programmable logic device 1660 comprises an FPGA.

[00331] The multiplexed voltage and current feedback samples can be received by a parallel data capture port (PDAP) implemented inside block 2144 of the 1740 processor. 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 of 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. Either way, the feedback samples can be stored so that the LUT sample address from which a specific set of feedback information originated can be subsequently determined. As discussed above, the synchronization of the LUT sample addresses and the feedback samples in this way contributes to the correct timing and stability of the pre-distortion algorithm. A direct memory access controller (AMD) implemented in block 2166 of the 1740 processor can store the feedback samples (and any sample address data from the LUT, where applicable) in a designated memory location 2180 of the 1740 processor (for example , Internal RAM).

[00332] Block 2200 of the 1740 processor can implement a pre-distortion algorithm to pre-distort or modify the LUT samples stored in the 1660 programmable logic device on a dynamic and continuous basis. As discussed above, the pre-distortion of the LUT samples can compensate for various sources of distortion present in the 1100 generator output drive circuit. The pre-distorted LUT samples, when processed through the drive circuit, will therefore result in a trigger signal having the desired wave shape (for example, sinusoidal) to optimally drive the ultrasonic transducer.

[00333] 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 2180 memory location (which, when properly sized, can be representative of Ig and Vg in the model in Figure 25 discussed above), a value of the static capacitance of the ultrasonic transducer C0 (measured or known a priori) and a known value of the drive frequency. A sample of current from the motion branch can be determined for each set of stored current and voltage feedback information associated with a LUT sample.

[00334] 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 wave shape to determine a difference, or error, of the sample amplitude, 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 sample of the LUT 2260 current waveform used for the comparison can be determined by the LUT sample address associated with the current sample of the movement branch used in the comparison. Consequently, the current input from the motion branch in block 2240 can be synchronized with the input of its associated LUT sample address in block 2240.

The LUT samples stored in the 1660 programmable logic device and the LUT samples stored in the 2260 waveform LUT can therefore be the same in terms of number. In certain respects, the desired current waveform, represented by the LUT samples stored in the 2260 waveform LUT, 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 resonances mechanical in order to obtain beneficial vibrations in transverse or other modes.

[00335] 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 amplitude error sample values for the same LUT address previously received), LUT 2280 (or another programmable logic device control block) 1660) can pre-distort or modify the value of the LUT sample stored at the LUT address, so that the sample amplitude error is reduced or minimized. It should be understood that this pre-distortion or modification of each LUT sample in an iterative way across the LUT address range will cause the waveform of the generator output current to match or adapt to the desired shape of the current wave, represented by the LUT 2260 samples of waveforms.

[00336] 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 memory location 2180. Before determining of these quantities, the feedback samples can be properly 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 induced harmonic components. The filtered voltage and current samples can therefore substantially represent the fundamental frequency of the generator drive output signal. In certain respects, filter 2320 can be a finite impulse response filter (FIR) applied in the frequency domain. These aspects can use the fast Fourier transform (FFT) of the current and voltage output signals of the drive 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.

[00337] 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 an Irms measurement representing the output current of the drive signal.

[00338] 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 trigger signal cycles, to determine a Vrms measurement representing the voltage output of the trigger signal.

[00339] In block 2380, the current and voltage feedback information 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 of the energy of actual generator output.

[00340] In block 2400, the measurement Pa of the apparent output power of the generator can be determined as the product Vrms · Irms.

[00341] In block 2420, the measurement Zm of the magnitude of the load impedance can be determined as the quotient Vrms / Irms.

[00342] In certain aspects, the quantities lrms, Vrms, Pr, Pa and Zm determined in blocks 2340, 2360, 2380, 2400 and 2420, can be used by generator 1100 to implement any of a number of control processes and / or diagnostics. In certain respects, any of these quantities can be communicated to a user through, for example, an output device 2140 integral to the generator 1100, or an output device 2140 connected to the generator 1100 through a suitable communication interface (for example, example, a USB interface). The various diagnostic processes may include, without limitation, grip integrity, instrument integrity, instrument attachment integrity, instrument overload, proximity to instrument overload, frequency locking failure, over voltage condition, over voltage condition current, overpower condition, voltage sensor failure, current sensor failure, audio indication failure, visual indication failure, short circuit condition, power supply failure, or blocking capacitor failure, for example.

[00343] Block 2440 of the 1740 processor can implement a phase control algorithm for determining and controlling the impedance phase of an electrical load (for example, the ultrasonic transducer) triggered 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 setpoint (eg 0 °), the effects of harmonic distortion can be minimized or reduced, and the measurement accuracy is increased phase.

[00344] The phase control algorithm receives the current and voltage feedback information stored in memory location 2180 as input. Before being used in the phase control algorithm, feedback feedback can be appropriately sized and, in certain cases, 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.

[00345] 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 information associated with a LUT sample, a current sample of the movement branch.

[00346] In block 2500 of the phase control algorithm, the impedance phase is determined based on the synchronized input of samples from the motion branch current determined in block 2480 and corresponding to voltage feedback 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.

[00347] In block 2520 of the phase control algorithm, the impedance phase value determined in block 2220 is compared to the setpoint of phase 2540 to determine a difference, or phase error, between the compared values.

[00348] In block 2560 (Figure 28A) of the phase control algorithm, based on a phase error value determined in block 2520 and the magnitude of impedance determined in block 2420, a frequency output is determined to control the frequency 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 at the phase set point (for example, zero phase). In some respects, the impedance phase can be set to a phase setpoint of 0 °. In this way, any harmonic distortion will be centered around the crest of the voltage waveform, accentuating the accuracy of the phase impedance determination.

[00349] 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 set points 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 carried out, for example, by changing the scale of the LUT samples at LUT 2280, and / or by adjusting the output voltage. full scale of the 1680 DAC (which provides input to the 1620 power amplifier) via an 1860 DAC. Block 2600 (which can be implemented as a PID controller in certain respects) can receive current feedback samples ( that can be properly sized and filtered) from memory location 2180. Current feedback samples can be compared to the "demand for color" value rent "Id determined by the controlled variable (for example, current, voltage or power) to determine whether the trigger signal is supplying the necessary current. In aspects where the drive signal current is the control variable, the demand for current Id can be specified directly by a current setpoint 2620A (Isp). For example, an RMS value of the current feedback data (determined as in block 2340) can be compared to the RMS Isp current setpoint specified by the user to determine the appropriate action for the controller. If, for example, the current feedback data indicates an RMS value less than the current set point I sp, 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, block 2600 can adjust a LUT dimensioning and / or the full-scale output voltage of the DAC 1680 to decrease the trigger signal current when the current feedback data indicates a RMS value greater than the cutoff point. current adjustment Isp.

[00350] 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 the load impedance Zm measured in block 2420 (for example, Id = Vsp / Zm). Likewise, in aspects where the signal strength of the inverter is the control variable, the current demand I d can be specified indirectly, for example, based on the current required to maintain a desired power setpoint 2620C (Psp) given the voltage Vrms measured in blocks 2360 (for example, Id = Psp / Vrms).

[00351] Block 2680 (Figure 28A) can implement a DDS control algorithm to control the trigger signal by retrieving LUT samples stored in LUT 2280. In certain aspects, the DDS control algorithm can be an oscillator algorithm numerically controlled (NCO, of "numerically-controlled oscillator") to generate samples of a waveform at a fixed timing rate using a technique of skipping points (locations in memory). The NCO algorithm can implement a phase accumulator, or frequency to phase converter, which acts as an address pointer for retrieving samples from the LUT of the LUT 2280. In one aspect, the phase accumulator can be a phase accumulator with size from step 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 do 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 phase accumulator 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 DAC input 1680 which, in turn, provides an analog signal corresponding to an input of the 1620 power amplifier.

[00352] Block 2700 of the 1740 processor can implement a switch mode converter 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 the output minimum voltage samples being received in block 2720 of the switching mode converter control algorithm. Based on the values of the minimum voltage samples, the 2740 block can control a PWM signal provided by a 2760 PWM generator which, in turn, controls the rail voltage supplied to the 1620 power amplifier by the switching mode regulator. 1700. In certain respects, 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 minimum voltage samples. When voltage samples from the minimum indicate low envelope power levels, for example, block 2740 can cause a low voltage on the rail to be supplied to the 1620 power amplifier, with the total rail voltage being supplied only when the samples voltage ratings 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.

[00353] Figure 29 is a schematic diagram of an aspect of a 2900 electrical circuit, suitable for driving an ultrasonic transducer, such as the 1120 ultrasonic transducer, according to at least one aspect of the present disclosure. The 2900 electrical circuit comprises a 2980 analog multiplexer. The 2980 analog multiplexer multiplexes several signals from the SCL-A, SDA-A upstream channels, such as ultrasonic, battery and power control circuits. A 2982 current sensor is coupled in series with the return or ground branch of the power supply circuit to measure the current supplied by the power supply. A 2984 field effect transistor (FET) temperature sensor provides room temperature. A 2988 pulse width modulation (PWM) surveillance timer automatically generates a system reset if the main program fails to periodically maintain it. It is provided to automatically restart the 2900 electrical circuit when it crashes or freezes due to a software or hardware failure. It will be recognized that the 2900 electrical circuit can be configured as an RF trigger circuit to drive the ultrasonic transducer or to drive the RF electrodes like the 3600 electrical circuit shown in Figure 34, for example. Consequently, with reference now again to Figure 29, the 2900 electrical circuit can be used to interchangeably drive the ultrasonic transducers and the RF electrodes. If activated simultaneously, the filter circuits can be supplied in the corresponding first stage circuits 3404 (Figure 32)

to select both the ultrasonic waveform and the RF waveform. These filtering techniques are described in US Patent Application Publication No. US-2017-0086910-A1, which is commonly owned, entitled TECHNIQUES FOR CIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, which is incorporated herein in full by reference.

[00354] A 2986 drive circuit provides ultrasonic energy outputs on the left and on the right. A digital signal representing the signal waveform is supplied to the SCL-A, SDA-A inputs of the 2980 analog multiplexer from a control circuit, such as the 3200 control circuit (Figure 30). A 2990 digital to analog converter (DAC) converts the digital input to an analog output to drive a 2992 pulse width modulation circuit coupled to a 2994 oscillator. The 2992 pulse width modulation circuit provides a first signal for a first door drive circuit 2996a coupled to a first output stage of transistor 2998a to drive a first ultrasonic energy output (left). The 2992 pulse width modulation circuit also provides a second signal for a second 2996b gate drive circuit coupled to a second 2998b transistor output stage to drive a second (right) ultrasonic energy output. A 2999 voltage sensor is coupled between the left / right ultrasonic output terminals to measure the output voltage. Drive circuit 2986, the first and second drive circuits 2996a, 2996b and the first and second output stages of transistor 2998a, 2998b define a first stage amplifier circuit. In operation, the 3200 control circuit (Figure 30) generates a 4300 digital waveform (Figure 37) that employs circuits such as the 4100, 4200 digital direct synthesis (DDS) circuits (Figures 35 and 36). The 2990 DAC receives the 4300 digital waveform and converts it to an analog waveform, which is received and amplified by the first stage amplifier circuit.

[00355] Figure 30 is a schematic diagram of a 3200 control circuit, like the 3212 control circuit, according to at least one aspect of the present disclosure. The 3200 control circuit is located inside a battery pack compartment. The battery pack is the power source for a variety of local 3215 power supplies. The control circuit comprises a 3214 main processor coupled via a 3218 interface master to various circuits downstream via the SCL-A and SDA-A, SCL-B and SDA-B, SCL-C and SDA-C, for example. In one aspect, the 3218 interface master is a general purpose serial interface, like an I2C serial interface. The 3214 main processor is also configured to trigger the 3224 switches via general purpose input / output (GPIO) 3220, a 3226 screen (for example, an LCD screen), and several 3228 indicators via GPIO 3222. A surveillance 3216 is provided to control the 3214 main processor. A 3230 switch is supplied in series with a 3211 battery to activate the 3212 control circuit by inserting the battery pack into a surgical instrument handle set.

[00356] In one aspect, the main processor 3214 is coupled to the electrical circuit 2900 (Figure 29) through output terminals SCL-A / SDA-A. The main processor 3214 comprises a memory for storing tables of trigger signals or digitized waveforms that are transmitted to the 2900 electrical circuit to drive the 1120 ultrasonic transducer, for example. In other respects, the 3214 main processor can generate a digital waveform and transmit it to the 2900 electrical circuit, or it can store the digital waveform for later transmission to the 2900 electrical circuit. The 3214 main processor can also provide RF drive via via SCL-B / SDA-B output terminals and various sensors (eg Hall effect sensors, magneto-rheological fluid (MRF) sensors, etc.) via SCL-C / SDA-C output terminals . In one aspect, the 3214 main processor is configured to detect the presence of an ultrasonic drive circuit and / or RF drive circuit to enable appropriate software and user interface functionality.

[00357] In one aspect, the 3214 main processor 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 transfer buffer to optimize performance above 40 MHz, 32 KB single cycle serial random access memory (SRAM), internal read-only memory (ROM) loaded with the StellarisWare® program, electrically erasable programmable read-only memory (EEPROM) of 2 KB, one or more pulse width modulation (PWM) modules, one or more quadrature encoder (QED) input analogs, one or more 12-bit analog to digital converters (ADC) with 12 analog input channels , among other resources that are readily available in the product data sheet. Other processors can be easily replaced and, therefore, the present disclosure should not be limited in this context.

[00358] Figure 31 shows a simplified circuit block diagram illustrating another 3300 electrical circuit contained within a 3334 modular ultrasonic surgical instrument, in accordance with an aspect of the present disclosure. The 3300 electrical circuit includes a 3302 processor, a 3330 clock, a 3326 memory, a 3304 power supply (for example, a battery), a 3306 switch, such as a semiconductor metal oxide field effect transistor power switch ( MOSFET), a drive circuit 3308 (PLL), a transformer 3310, a signal smoothing circuit 3312 (also called a correspondence circuit and can be, for example, a tank circuit), a detection circuit 3314, a 1120 transducer, and a drive shaft assembly (for example, drive shaft assembly 1126, 1129) comprising an ultrasonic transmission waveguide that ends in an ultrasonic blade (e.g., ultrasonic blade 1128, 1149) that can be called, in the present invention, simply a waveguide.

[00359] A feature of the present disclosure that stops reliance on high voltage input energy (120 VAC) (a feature of general ultrasonic cut-off devices) is the use of low voltage switching throughout the entire process of forming wave and amplification of the drive signal just directly before the transformer stage. For that reason, in one aspect of the present disclosure, the energy is derived from just one battery, or a group of batteries, small enough to fit inside a handle assembly. State-of-the-art battery technology provides powerful batteries a few inches high and a few millimeters deep. By combining the features of the present disclosure to provide a self-contained, self-powered ultrasonic device, a reduction in production cost can be achieved.

[00360] The output of the 3304 power supply is fed to the 3302 processor and energizes it. The 3302 processor receives and sends signals and, as will be described below, works according to custom logic or according to computer programs that are run by the 3302 processor. As discussed above, electrical circuit 3300 can also include memory 3326, preferably, a random access memory (RAM) that stores computer-readable instructions and data.

[00361] The power supply output 3304 is also directed to switch 3306 having a duty cycle controlled by the processor

3302. By controlling the dwell time of key 3306, processor 3302 is able to determine the total amount of energy that is ultimately supplied to transducer 1120. In one aspect, key 3306 is a MOSFET, although other configurations of key and switch are also adaptable. The output of switch 3306 is fed to a drive circuit 3308 that contains, for example, a phase that detects a phase lock circuit (PLL) and / or a low-pass filter and / or a voltage-controlled oscillator. The output of switch 3306 is sampled by processor 3302 to determine the voltage and current of the output signal (V IN and IIN, respectively). These values are used in a feedback architecture to adjust the pulse width modulation of the switch

3306. For example, the duty cycle of switch 3306 can vary from about 20% to about 80%, depending on the desired and actual output of switch 3306.

[00362] The drive circuit 3308, which receives the signal from switch 3306, includes an oscillatory circuit that transforms the output of switch 3306 into an electrical signal that has an ultrasonic frequency, for example, 55 kHz (VCO). As explained above, a smoothed version of this ultrasonic waveform is ultimately fed to the 1120 ultrasonic transducer to produce a resonant sine wave along the ultrasonic transmission waveguide.

[00363] At the output of the drive circuit 3308 there is a 3310 transformer that is capable of raising the low voltage signal (s) to a higher voltage. It is observed that the upstream switching,

before the 3310 transformer, it is carried out at low voltages (for example, battery operated), something that, until now, was not possible for ultrasonic devices for cutting and cauterization. This is at least partially due to the fact that the device advantageously uses low resistance MOSFET switching devices. Low-resistance MOSFET switches are advantageous, as they produce less switching losses and less heat than a traditional MOSFET device and allow greater current to pass through. Therefore, the switching stage (pre-transformer) can be characterized as low voltage / high current. To ensure the lowest resistance of the amplifier's MOSFET (s), the MOSFET (s) is (are) run, for example, at 10 V. In this case, a 10 VDC power supply A separate can be used to power the MOSFET port, which ensures that the MOSFET is fully connected and that a reasonably low resistance is achieved. In one aspect of the present disclosure, the 3310 transformer raises the battery voltage to 120 V average square value (RMS). Transformers are known in the art and are therefore not explained in detail here.

[00364] In the described circuit configurations, the degradation of the circuit component can negatively affect the circuit performance of the circuit. One factor that directly affects the performance of the component is heat. Known circuits generally monitor switching temperatures (ie, MOSFET temperatures). However, due to technological advances in MOSFET projects and due to the corresponding reduction in size, MOSFET temperatures are no longer a valid indicator of circuit loads and heat. For this reason, according to at least one aspect of the present disclosure, a detection circuit 3314 detects the temperature of transformer 3310. This temperature detection is advantageous, since transformer 3310 is operated at or near its maximum temperature, while using the device. The additional temperature will cause the core material, for example, ferrite, to rupture and permanent damage can occur. The present disclosure can respond to a maximum temperature of transformer 3310, for example, by reducing the drive energy in transformer 3310, signaling the user, turning off the power, pulsating the power or by means of other appropriate responses.

[00365] In one aspect of the present disclosure, the 3302 processor is coupled in communication to the end actuator (for example, 1122, 1125) which is used to bring the material into physical contact with the ultrasonic blade (for example, 1128, 1149 ). Sensors are provided that measure, on the end actuator, a clamping force value (existing within a known range) and, based on the received clamping force value, processor 3302 varies the driving voltage VM. Since high force values, combined with a defined rate of movement, can result in high blade temperatures, a 3332 temperature sensor can be coupled in communication to the 3302 processor, with the 3302 processor being operable to receive and interpret a signal that indicates a current blade temperature from the 3336 temperature sensor and to determine a target blade movement frequency based on the received temperature. In another aspect, force sensors, such as mechanical pressure gauges or pressure sensors, can be coupled to the trigger (for example, 1143, 1147) to measure the force applied to the trigger by the user. In another aspect, force sensors, such as mechanical pressure gauges or pressure sensors, can be coupled to a switch button so that the displacement intensity corresponds to the force applied by the user to the switch button.

[00366] According to at least one aspect of the present disclosure, the PLL portion of the drive circuit 3308, which is coupled to the processor 3302, is capable of determining a frequency of movement of the waveguide and communicating that frequency to the processor 3302. Processor 3302 stores the value of that frequency in memory 3326 when the device is turned off. By reading clock 3330, processor 3302 is able to determine an elapsed time after the device is turned off and to retrieve the last waveform movement frequency if the elapsed time is less than a predetermined value. The device can then start at the last frequency, which, presumably, is the ideal frequency for the current load. Battery-powered modular hand-held surgical instrument with multistage generating circuits

[00367] In another aspect, the present disclosure provides a battery-powered modular surgical hand instrument with multistage generating circuits. A surgical instrument is revealed that includes a battery set, a handle set, and a drive shaft set, the battery set and the drive shaft set being configured to mechanically and electrically connect the handle set. The battery pack includes a control circuit configured to generate a digital waveform. The grip set includes a first stage circuit configured to receive the digital waveform, convert the digital waveform to an analog waveform and amplify the analog waveform. The drive shaft assembly includes a second stage circuit coupled to the first stage circuit to receive, amplify and apply the analog waveform to a load.

[00368] In one aspect, the present disclosure provides a surgical instrument, comprising: a battery pack, comprising a control circuit comprising a battery, a memory attached to the battery, and a processor attached to the memory and battery, the processor being configured to generate a digital waveform; a handle set comprising a first stage circuit coupled to the processor, the first stage circuit comprising a digital to analog converter (DAC) and a first amplifier stage circuit, the DAC being configured to receive the form of digital wave and convert the digital waveform into an analog waveform, the first stage amplifier circuit being configured to receive and amplify the analog waveform; and a drive shaft assembly comprising a second stage circuit coupled to the first stage amplifier circuit to receive the analog waveform, amplify the analog waveform, and apply the analog waveform to a load; the battery pack and the drive shaft set are configured to connect mechanically and electrically to the grip set.

[00369] The charge can comprise any one of an ultrasonic transducer, an electrode or a sensor, or any combination thereof. The first stage circuit can comprise a first ultrasonic drive stage circuit and a first high frequency current drive stage circuit. The control circuit can be configured to drive the first ultrasonic drive stage circuit and the first high frequency current drive stage circuit, independently or simultaneously. The first ultrasonic drive stage circuit can be configured to couple with a second ultrasonic drive stage circuit. The second ultrasonic drive stage circuit can be configured to couple with an ultrasonic transducer. The first high-frequency current drive stage circuit of the first stage can be configured to couple with a second high-frequency stage circuit. The second high frequency drive stage circuit can be configured to couple with an electrode.

[00370] The first stage circuit can comprise a first stage of sensor activation stage. The first sensor drive stage circuit can be configured to a second drive stage circuit. The second sensor drive stage circuit can be configured to couple with a sensor.

[00371] In another aspect, the present disclosure provides a surgical instrument, comprising: a battery pack, comprising a control circuit comprising a battery, a memory attached to the battery, and a processor attached to the memory and battery , the processor being configured to generate a digital waveform; a handle set comprising a first common stage circuit coupled to the processor, the first common stage circuit comprising a digital to analog converter (DAC) and a first common stage amplifier circuit, the DAC being configured to receive the digital waveform and convert the digital waveform into an analog waveform, the first common stage amplifier circuit being configured to receive and amplify the analog waveform; and a drive shaft assembly comprising a second stage circuit coupled to the first common stage amplifier circuit to receive the analog waveform, amplify the analog waveform, and apply the analog waveform to a load; the battery pack and the drive shaft set are configured to connect mechanically and electrically to the grip set.

[00372] The charge can comprise any of an ultrasonic transducer, an electrode or a sensor, or any combination thereof. The first common stage circuit can be configured to drive ultrasonic, high frequency circuits or sensors. The first common drive stage circuit can be configured to couple with a second ultrasonic drive stage circuit, a second high frequency drive stage circuit, or a second sensor drive stage circuit. The second ultrasonic drive stage circuit can be configured to mate with an ultrasonic transducer, the second high frequency drive stage circuit is configured to mate with an electrode, and the second sensor drive stage circuit is configured to attach to a sensor.

[00373] In another aspect, the present disclosure provides a surgical instrument, which comprises: a control circuit comprising a memory coupled to a processor, the processor being configured to generate a digital waveform; a handle assembly comprising a first common stage circuit coupled to the processor, the first common stage circuit configured to receive the digital waveform, convert the digital waveform to an analog waveform, and amplify the waveform analog; and a drive shaft assembly comprising a second stage circuit coupled to the first common stage circuit for receiving and amplifying the analog waveform; the drive shaft assembly is configured to connect mechanically and electrically to the handle assembly.

[00374] The first common stage circuit can be configured to drive ultrasonic, high frequency circuits or sensors. The first common drive stage circuit can be configured to couple with a second ultrasonic drive stage circuit, a second high frequency drive stage circuit, or a second sensor drive stage circuit. The second ultrasonic drive stage circuit can be configured to mate with an ultrasonic transducer, the second high frequency drive stage circuit is configured to mate with an electrode, and the second sensor drive stage circuit is configured to attach to a sensor.

[00375] Figure 32 illustrates a generator circuit 3400 partitioned in a first stage circuit 3404 and a second stage circuit 3406, according to at least one aspect of the present disclosure. In one aspect, the surgical instruments of the surgical system 1000 described herein can comprise a 3400 generator circuit divided into multiple stages. For example, surgical instruments of surgical system 1000 can comprise the 3400 generator circuit divided into at least two circuits: the first stage 3404 circuit and the second stage 3406 amplification circuit allowing the operation of RF energy only, ultrasonic energy only , and / or a combination of RF energy and ultrasonic energy. A combination 3414 modular drive shaft assembly will be powered by the first common stage circuit 3404 located in a 3412 grip assembly and the second modular stage circuit 3406 integral with the 3414 modular drive shaft assembly. As previously discussed in this description in connection with the surgical instruments of the surgical system 1000, a battery set 3410 and the drive shaft set 3414 are mechanically and electrically connected to the handle set 3412. The end actuator set is configured to connect mechanically and electrically to the 3414 drive shaft assembly.

[00376] Now with reference to Figure 32, the generator circuit 3400 is partitioned in multiple stages located in multiple modular sets of a surgical instrument, like the surgical instruments of the surgical system 1000 described here. In one aspect, a 3402 stage control circuit may be located in the 3410 battery pack of the surgical instrument. The 3402 stage control circuit is a 3200 control circuit as described in connection with Figure 30. The 3200 control circuit comprises a 3214 processor, which includes an internal 3217 memory (Figure 32) (for example, volatile and non-volatile memory) volatile), and is electrically coupled to a battery

3211. The 3211 battery supplies power to the first stage 3404 circuit, the second stage 3406 circuit, and a third stage 3408 circuit, respectively. As previously discussed, the 3200 control circuit generates a 4300 digital waveform (Figure 37) using the circuits and techniques described in connection with Figures 35 and 36. Again with reference to Figure 32, the 4300 digital waveform it can be configured to drive an ultrasonic transducer, high frequency electrodes (for example, RF) or a combination of them, independently or simultaneously. If actuated simultaneously, filter circuits can be provided on the corresponding 3404 first stage circuits to select both the ultrasonic waveform and the RF waveform. These filtering techniques are described in US Patent Application Publication No. US-2017-0086910-A1, commonly owned, entitled

TECHNIQUES FOR CIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, which is fully incorporated by reference.

[00377] The first stage circuits 3404 (for example, the first ultrasonic drive stage circuit 3420, the first RF drive stage circuit 3422, and the first sensor drive stage circuit 3424) are located in a surgical instrument handle set 3412. The 3200 control circuit provides the ultrasonic drive signal for the first 3420 ultrasonic drive stage circuit via the SCL-A, SDA-A outputs of the 3200 control circuit. The first 3420 ultrasonic drive stage circuit is described in detail in connection with Figure 29. The 3200 control circuit provides the RF drive signal for the first RF drive stage circuit 3422 through the SCL-B, SDA-B outputs of the 3200 control circuit. The first stage circuit RF drive code 3422 is described in detail in connection with Figure 34. The 3200 control circuit provides the sensor trigger signal to the first 3424 sensor drive stage circuit via the SCL-C, SDA-C outputs of the circuit control panel 3200. In general, each of the first 3404 stage circuits includes a digital to analog converter (DAC) and a first stage amplifier section to drive the second circuits stage 3406. The outputs of the first stage 3404 circuits are provided for the inputs of the second stage 3406 circuits.

[00378] The 3200 control circuit is configured to detect which modules are plugged into the 3200 control circuit. For example, the 3200 control circuit is configured to detect whether the first 3420 ultrasonic drive stage circuit, the first stage circuit RF trigger drive 3422, or the first sensor trigger stage circuit 3424 located in the handle set 3412 is connected to the battery set 3410. Likewise,

each of the first stage circuits 3404 can detect which second stage circuits 3406 are connected to it and what information is provided back to the control circuit 3200 to determine what type of signal waveform to generate. Similarly, each of the second 3406 stage circuits can detect which third 3408 stage circuits or components are connected to it and what information is provided back to the 3200 control circuit to determine what type of signal waveform to generate .

[00379] In one aspect, the second stage circuits 3406 (for example, the second stage of ultrasonic drive stage 3430, the second stage of RF drive stage 3432, and the second stage of sensor drive stage 3434) are located on the 3414 drive shaft assembly of the surgical instrument. The first 3420 ultrasonic drive stage circuit provides a signal to the second 3430 ultrasonic drive stage circuit via US-left / US-direct outputs. The second 3430 ultrasonic drive stage circuit may include, for example, a transformer, a filter, an amplifier and / or signal conditioning circuits. The first high-frequency current (RF) stage circuit 3422 provides a signal to the second 3432 RF drive stage circuit via the left-RF / right-RF outputs. In addition to a transformer and blocking capacitors, the second RF 3432 drive stage circuit can also include filter, amplifier, and signal conditioning circuits. The first sensor drive stage circuit 3424 provides a signal to the second sensor drive stage circuit 3434 via sensor-1 / sensor-2 outputs. The second 3434 sensor drive stage circuit may include filter, amplifier, and signal conditioning circuits depending on the type of sensor. The outputs of the second stage 3406 circuits are provided to the inputs of the third stage 3408 circuits.

[00380] In one aspect, the third stage 3408 circuits (for example, the 1120 ultrasonic transducer, the RF electrodes 3074a, 3074b, and the 3440 sensors) can be located in various 3416 sets of surgical instruments. In one aspect, the second 3430 ultrasonic drive stage circuit provides a drive signal to the piezoelectric stack of the 1120 ultrasonic transducer. In one aspect, the 1120 ultrasonic transducer is located in the ultrasonic transducer assembly of the surgical instrument. In other respects, however, the 1120 ultrasonic transducer can be located on the handle set 3412, the drive shaft set 3414 or the end actuator. In one aspect, the second RF trigger stage circuit 3432 provides a trigger signal to RF electrodes 3074a, 3074b, which are generally located in the end actuator portion of the surgical instrument. In one aspect, the second 3434 sensor drive stage circuit provides a trigger signal to several 3440 sensors located on the surgical instrument.

[00381] Figure 33 illustrates a generator circuit 3500 partitioned in multiple stages in which a first stage circuit 3504 is common for the second stage circuit 3506, according to at least one aspect of the present disclosure. In one aspect, the surgical instruments of the surgical system 1000 described herein can comprise 3500 generator circuit divided into multiple stages. For example, surgical instruments of the surgical system 1000 may comprise the 3500 generator circuit divided into at least two circuits: the first stage 3504 circuit and the second stage 3506 amplification circuit allowing the operation of high frequency RF energy only, energy ultrasonic only, and / or a combination of RF energy and ultrasonic energy. A combination 3514 modular drive shaft assembly will be powered by the first common stage circuit 3504 located on a 3512 handle assembly and the second modular stage circuit 3506 integral with the 3514 modular drive shaft assembly. As previously discussed in this description in connection with surgical instruments of the surgical system 1000, a battery set 3510 and the drive shaft set 3514 are configured to connect mechanically and electrically to the handle set 3512. The end actuator set is configured to connect mechanically and electrically to the 3514 drive shaft assembly.

[00382] As shown in the example of Figure 33, the 3510 battery pack portion of the surgical instrument comprises a first 3502 control circuit, which includes the 3200 control circuit previously described. The 3512 handle set, which connects to the 3510 battery pack, comprises a first common drive stage circuit 3420. As previously discussed, the first drive stage circuit 3420 is configured to drive high frequency ultrasonic current (RF) ), and sensor loads. The output of the first common drive stage circuit 3420 can drive any of the second stage circuits 3506 such as the second ultrasonic drive stage circuit 3430, the second high frequency current drive (RF) stage circuit 3432, and / or the second 3434 sensor drive stage circuit. The first 3420 common drive stage circuit detects which second stage circuit 3506 is located on the 3514 drive shaft assembly when the 3514 drive shaft assembly is connected to the assembly handle 3512. After the 3514 drive shaft assembly is connected to the 3512 handle assembly, the first common drive stage circuit 3420 determines which of the second 3506 stage circuits (for example, the second ultrasonic drive stage circuit 3430, the second RF drive stage circuit 3432, and / or the second sense drive stage circuit r 3434) is located in the drive shaft assembly 3514. Information is provided to the control circuit 3200 located in the handle assembly 3512 to provide a suitable digital waveform 4300 (Figure 37) to the second stage circuit 3506 to drive the suitable load, for example, ultrasonic, RF or sensor. It will be understood that identification circuits can be included in several 3516 assemblies on the third stage 3508 circuit such as ultrasonic transducer 1120, electrodes 3074a, 3074b, or 3440 sensors. Thus, when a third stage circuit 3508 is connected to a second stage circuit 3506, the second stage circuit 3506 recognizes the type of load that is required based on the identification information.

[00383] Figure 34 is a schematic diagram of an aspect of an electrical circuit 3600 configured to drive a high frequency current (RF), in accordance with at least one aspect of the present disclosure. The 3600 electrical circuit comprises a 3680 analog multiplexer. The 3680 analog multiplexer multiplexes several signals from the SCL-A, SDA-A upstream channels such as RF, battery and power control circuits. A 3682 current sensor is coupled in series with the return or ground branch of the power supply circuit to measure the current supplied by the power supply. A field effect transistor (FET) 3684 temperature sensor provides room temperature. A 3688 pulse width modulation (PWM) timer automatically generates a system reset if the main program fails to periodically maintain it. It is provided to automatically restart electrical circuit 3600 when it crashes or freezes due to a software or hardware failure. It will be recognized that the 3600 electrical circuit can be configured to drive RF electrodes or to drive the 1120 ultrasonic transducer as described in connection with Figure 29, for example. Consequently, with reference now again to Figure 34, electrical circuit 3600 can be used to drive both ultrasonic and RF electrodes interchangeably.

[00384] A 3686 drive circuit provides left and right RF energy outputs. A digital signal representing the signal waveform is supplied to the SCL-A, SDA-A inputs of the 3680 analog multiplexer from a control circuit, such as the 3200 control circuit (Figure 30). A 3690 digital to analog converter (DAC) converts the digital input to an analog output to generate a 3692 pulse width modulation circuit coupled to a 3694 oscillator. The 3692 pulse width modulation circuit provides a first signal for a first door drive circuit 3696a coupled to a first output stage of transistor 3698a to drive a first RF + energy output (left). The pulse width modulation circuit 3692 also provides a second signal for a second door drive circuit 3696b coupled to a second output stage of transistor 3698b to drive a second RF- (right) energy output. A 3699 voltage sensor is coupled between the left RF / RF output terminals to measure the output voltage. Drive circuit 3686, the first and second drive circuits 3696a, 3696b, and the first and second output stages of transistor 3698a, 3698b define a first stage amplifier circuit. In operation, the 3200 control circuit (Figure 30) generates a 4300 digital waveform (Figure 37) that employs circuits such as the 4100, 4200 digital direct synthesis (DDS) circuits (Figures 35 and 36). The DAC 3690 receives the digital waveform 4300 and converts it into an analog waveform, which is received and amplified by the first stage amplifier circuit.

[00385] In one aspect, the ultrasonic generator or the high frequency current generator of the surgical instrument 1000 can be configured to generate the electrical signal waveform digitally as desired using a predetermined number of phase points stored in a measurement table. query to scan the waveform. The phase points can be stored in a table defined in a memory, a field programmable port matrix (FPGA) or any suitable non-volatile memory. Figure 35 illustrates an aspect of a fundamental architecture for a digital synthesis circuit, such as a 4100 digital direct synthesis circuit (DDS), configured to generate a plurality of waveforms for the electrical signal waveform. The generator's software and digital controls can command the FPGA to scan the addresses in lookup table 4104, which in turn provides variable digital input values for a 4108 DAC circuit that powers a power amplifier. The addresses can be checked according to a frequency of interest. The use of such a 4104 lookup table makes it possible to generate several types of waveforms that can be fed into the tissue or to a transducer, an RF electrode, multiple transducers simultaneously, or a combination of ultrasonic and RF instruments. In addition, multiple 4104 look-up tables representing multiple waveforms can be created, stored and applied to tissue from a generator.

[00386] The signal waveform can be configured to control at least one of an output current, an output voltage or an output power of an ultrasonic transducer and / or RF electrode, or multiples thereof (for example , two or more ultrasonic transducers and / or two or more RF electrodes). Additionally, where a surgical instrument comprises ultrasonic components, the waveform can be configured to trigger at least two modes of vibration for an ultrasonic transducer of at least one surgical instrument. In this way, the generator can be configured to supply a waveform to at least one surgical instrument, where the waveform signal corresponds to at least one waveform of a plurality of waveforms in the table. In addition, the waveform signal supplied to the two surgical instruments can comprise two or more waveforms. The table can comprise information associated with a plurality of waveforms and the table can be stored inside the generator. In one aspect or example, the table can be a direct digital summary table, which can be stored in a generator FPGA. The table can be addressed in any way that is convenient for categorizing waveforms. According to one aspect, the table, which can be a direct digital synthesis table, is addressed according to a frequency of the waveform signal. Additionally, the information associated with the plurality of waveforms can be stored as digital information in the table.

[00387] The analog electrical signal waveform can be configured to control at least one of an output current, an output voltage or an output power of an ultrasonic transducer and / or RF electrode, or multiple of them ( for example, two or more ultrasonic transducers and / or two or more RF electrodes). Additionally, where the surgical instrument comprises ultrasonic components, the analog electrical signal waveform can be configured to trigger at least two vibration modes for an ultrasonic transducer of at least one surgical instrument. In this way, the generator circuit can be configured to provide an analog electrical signal waveform to at least one surgical instrument, with the analog electrical signal waveform corresponding to at least one waveform of a plurality of formats. stored in query table 4104. In addition, the analog electrical signal waveform provided to at least two surgical instruments can comprise two or more waveforms. The look-up table 4104 can comprise information associated with a plurality of waveforms and the look-up table 4104 can be stored inside the generating circuit or inside the surgical instrument. In one aspect or example, query table 4104 can be a digital direct synthesis table, which can be stored in an FPGA of the generator circuit or the surgical instrument. Lookup table 4104 can be addressed in any way that is convenient for categorizing waveforms. According to one aspect, query table 4104, which can be a digital direct synthesis table, is addressed according to a frequency of the desired analog electrical signal waveform. In addition, information associated with the plurality of waveforms can be stored as digital information in query table 4104.

[00388] With the widespread use of digital techniques in instrumentation and communications systems, a digitally controlled method of generating multiple frequencies from a reference frequency source has evolved and is referred to as digital direct synthesis. The basic architecture is shown in Figure 35. In this simplified block diagram, a DDS circuit is coupled to a processor, controller or logic device in the generator circuit and to a memory circuit located in the generator circuit of the surgical system 1000. The DDS 4100 circuit comprises an address counter 4102, a lookup table 4104, a register 4106, a DAC circuit 4108 and a filter

4112. A stable fc clock is received by address counter 4102 and register 4106 triggers a programmable read-only memory (PROM) that stores one or more integer cycles of a sine wave (or other arbitrary waveform) in one lookup table 4104. As address counter 4102 travels through memory locations, the values stored in lookup table 4104 are recorded in register 4106, which is coupled to DAC circuit 4108. The corresponding digital amplitude of the signal at the location The memory of the reference table 4104 drives the DAC circuit 4108, which in turn generates an analog output signal 4110. The spectral purity of the analog output signal 4110 is mainly determined by the DAC circuit 4108. Phase noise is basically the reference clock fc. The first analog output signal 4110 of the DAC circuit 4108 is filtered by the filter 4112 and a second analog output signal 4114 produced by the filter 4112 is supplied to an amplifier that has an output coupled to the output of the generator circuit. The second analog output signal has a fout frequency.

[00389] As the DDS 4100 circuit is a sampled data system, problems involved in sampling need to be considered: quantization noise, distortion, filtering, etc. For example, the higher-order harmonics of the output frequencies of the DAC 4108 circuit bend in the Nyquist bandwidth, making them non-filterable, whereas the higher-order harmonics of the output of synthesizers based on phase lock or phase-locked loop (PLL) can be filtered. Lookup table 4104 contains signal data for an integral number of cycles. The final output frequency fout can be changed by changing the reference clock frequency fc or reprogramming the PROM.

[00390] The DDS 4100 circuit may comprise multiple lookup tables 4104, with lookup table 4104 storing a waveform represented by a predetermined number of samples, the samples defining a predetermined shape of the waveform. In this way, multiple waveforms that have a single shape can be stored in multiple 4104 lookup tables to provide different tissue treatments based on instrument configurations or tissue feedback. Examples of waveforms include high crest factor RF electrical signal waveforms for coagulation of surface tissue, low crest factor RF electrical signal waveform for deeper tissue penetration and signal waveforms that promote efficient retouching coagulation. In one aspect, the DDS 4100 circuit can create multiple 4104 waveform lookup tables and during a tissue treatment procedure (for example, simultaneously or in virtual real time based on user or sensor actions) to switch between different formats waves stored in separate 4104 look-up tables based on the effect of the desired tissue and / or tissue feedback.

[00391] Therefore, the alternation between waveforms can be based on the impedance of the tissue and other factors, for example. In other respects, the 4104 look-up tables can store electrical signal waveforms formatted to maximize the power distributed in the tissue per cycle (i.e., trapezoidal or square wave). In other respects, the 4104 look-up tables can store synchronized waveforms so that they maximize the energy supply by the multifunctional surgical instrument of the surgical system 1000 when it provides trigger signals.

RF and ultrasonic. In yet other aspects, the 4104 look-up tables can store electrical signal waveforms to simultaneously trigger therapeutic and / or subtherapeutic ultrasonic and RF energy, while maintaining ultrasonic frequency blocking. Customized waveforms specific to different instruments and their tissue effects can be stored in the non-volatile memory of the generator or in the non-volatile memory (for example, EEPROM) of the surgical system 1000 and fetched when connecting the multifunctional surgical instrument to the generator circuit. An example of an exponentially damped sinusoid, as used in many high crest factor "coagulation" waveforms, is shown in Figure 37.

[00392] A more flexible and efficient implementation of the DDS 4100 circuit employs a digital circuit called the Numerically Controlled Oscillator (NCO, "Numerically Controlled Oscillator"). A block diagram of a more flexible and efficient digital synthesis circuit, such as a DDS 4200 circuit, is shown in Figure 36. In this simplified block diagram, a DDS 4200 circuit is coupled to a generator processor, controller or logic device and to a memory circuit located on the generator or any of the surgical instruments in the surgical system 1000. The DDS 4200 circuit comprises a charge register 4202, a parallel delta phase register 4204, an adder circuit 4216, a phase register 4208, a lookup table 4210 (phase-amplitude converter), a DAC circuit 4212 and a filter 4214. The summing circuit 4216 and phase register 4208 form part of a phase accumulator 4206. A clock frequency fc is applied to the phase register 4208 and a DAC circuit

4212. Charge register 4202 receives a tuning word that specifies the output frequency as a fraction of the reference clock frequency signal fc. The charge register output

4202 is supplied to the parallel delta recorder 4204 with an M tuning word.

[00393] The DDS 4200 circuit includes a sample clock that generates the clock frequency fc, the phase accumulator 4206 and the query table 4210 (for example, phase to amplitude converter). The content of the 4206 phase accumulator is updated once per fc clock cycle. When the phase accumulator 4206 is updated, the digital number, M, stored in the delta phase register 4204 is added to the number in the phase register 4208 by a 4216 adder circuit. Assuming the number in the parallel delta phase register 4204 is 00 … 01 and that the initial content of the 4206 phase accumulator is 00… 00. The 4206 phase accumulator is updated by 00… 01 per clock cycle. If the phase accumulator 4206 is 32 bits wide, 232 clock cycles (more than 4 billion) are required before the phase accumulator 4206 returns to 00… 00, and the cycle is repeated.

[00394] A truncated output 4218 of phase accumulator 4206 is supplied to a lookup table of the phase converter for amplitude 4210 and the output of lookup table 4210 is coupled to a DAC circuit

4212. The truncated output 4218 of the phase accumulator 4206 serves as the address for a sine (or cosine) lookup table. An address in the lookup table corresponds to a phase point in the sine wave from 0 ° to 360 °. Lookup table 4210 contains the digital amplitude information corresponding to a complete cycle of a sine wave. The 4210 lookup table, therefore, maps the phase information from the 4206 phase accumulator into a digital amplitude word, which in turn drives the 4212 DAC circuit. The DAC circuit output is a first 4220 analog signal and is filtered by a filter 4214. The output of filter 4214 is a second analog signal 4222, which is supplied to a power amplifier coupled to the generator circuit.

[00395] In one aspect, the electrical signal waveform can be digitized at 1024 (210) phase points, although the waveform that can be digitized is any suitable number of 2n phase points ranging from 256 (28) to 281.474.976.710.656 (248), where n is a positive integer, as shown in TABLE 1. The electrical signal waveform can be expressed as An (θn), where a normalized amplitude An at a point n is represented by a phase angle θn is called a phase point at point n. The number of distinct phase points n determines the adjustment resolution of the DDS 4200 circuit (as well as the DDS 4100 circuit shown in Figure 35).

[00396] Table 1 specifies the electrical signal waveform digitized at a number of phase points. N Number of Phase Points 2n 8 256 10 1,024 12 4,096 14 16,384 16 65,536 18 262,144 20 1,048,576 22 4,194,304 24 16,777,216 26 67,108,864 28 268,435,456 ... ... 32 4,294,967,296 ... ... 48 281,474. 976,710,656…… TABLE 1

[00397] The generator circuit algorithms and digital controls can scan the addresses in the query table 4210, which in return provides variable digital input values for the 4212 DAC circuit that supplies the 4214 filter and the power amplifier. The addresses can be checked according to a frequency of interest. The use of the look-up table allows the generation of various types of formats that can be converted into an analog output signal by the DAC 4212 circuit filtered by the 4214 filter, amplified by the power amplifier coupled to the output of the generator circuit and fed to the fabric in the form of of RF energy or fed to an ultrasonic transducer and applied to the tissue in the form of ultrasonic vibrations that provide energy to the tissue in the form of heat. The amplifier output can be applied to an RF electrode, multiple output electrodes simultaneously, an ultrasonic transducer, multiple ultrasonic transducers simultaneously or a combination of RF and ultrasonic transducers, for example. In addition, multiple waveform tables can be created, stored and applied to the fabric from a generator circuit.

[00398] Again with reference to Figure 35, for n = 32 and M = 1, the phase accumulator 4206 passes through 232 of the possible outputs before overflowing and resetting. The corresponding output wave frequency is equal to the input clock frequency divided by

232. If M = 2, then phase register 1708 "rotates" twice as fast, and the output frequency is doubled. This can be generalized as follows.

[00399] For a phase accumulator 4206 configured to accumulate n bits (in general n is in the range of 24 to 32 in most DDS systems, but as previously discussed, n cannot be selected from a wide range of options), there are 2 n possible phase points. The digital word in the delta phase register M represents the amount of phase accumulation that is incremented per clock cycle. If fc is the clock frequency, then the frequency of the output sine wave is equal to: 𝑀 ∙ 𝑓𝑐 𝑓0 = 2𝑛

[00400] The above equation is known as "tuning equation" DDS. It is observed that the frequency resolution of the system is equal to 𝑓𝑜. 2𝑛

[00401] For n = 32, the resolution is greater than one part in four billion. In one aspect of the DDS 4200 system, not all bits outside the phase accumulator 4206 are passed to query table 4210, but are truncated, leaving only the first 13 to 15 most significant bits (MSBs), for example. This reduces the size of the 4210 lookup table and does not affect the frequency resolution. Phase truncation only adds a small but acceptable amount of phase noise to the final output.

[00402] The electrical signal waveform can be characterized by current, voltage or power at a given frequency. In addition, when any of the surgical instruments in the 1000 surgical system comprises ultrasonic components, the electrical signal waveform can be configured to activate at least two modes of vibration of an ultrasonic transducer of at least one surgical instrument. In this way, the generating circuit can be configured to provide an electrical signal waveform to at least one surgical instrument, the electrical signal waveform being characterized by a predetermined waveform stored in query table 4210 (or consultation table 4104 - Figure 35). In addition, the electrical signal waveform can be a combination of two or more waveforms. Lookup table 4210 can comprise information associated with a plurality of waveforms. In one aspect or example, lookup table 4210 can be generated by the DDS 4200 circuit and can be called a digital direct summary table. Direct digital synthesis (DDS) operates by first storing a large repetitive waveform in the integrated memory. A cycle of a waveform (sinusoidal, triangular, square, arbitrary) can be represented by a predetermined number of phase points, as shown in TABLE 1 and stored in memory. Once the waveform is stored in memory, it can be generated at very precise frequencies. The digital direct synthesis table can be stored in a non-volatile memory of the generator circuit and / or can be implemented with an FPGA circuit in the generator circuit. Lookup table 4210 can be addressed by any suitable technique that is convenient for categorizing waveforms. According to one aspect, the lookup table 4210 is addressed according to a frequency of the electrical signal waveform. In addition, information associated with the plurality of waveforms can be stored as digital information in a memory or as part of query table 4210.

[00403] In one aspect, the generating circuit can be configured to supply waveforms of electrical signal to at least two surgical instruments simultaneously. The generator circuit can also be configured to provide the electrical signal waveform, which can be characterized by two or more waveforms, through an output channel of the generator circuit for the two surgical instruments simultaneously. For example, in one aspect, the electrical signal waveform comprises a first electrical signal to drive an ultrasonic transducer (e.g., ultrasonic trigger signal), a second RF trigger signal and / or a combination thereof. In addition, an electrical signal waveform may comprise a plurality of ultrasonic trigger signals, a plurality of RF trigger signals and / or a combination of a plurality of ultrasonic and RF trigger signals.

[00404] Additionally, a method for operating the generator in accordance with the present disclosure comprises generating an electrical signal waveform and supplying the generated electrical signal waveform to any of the surgical instruments in the 1000 surgical system, and generating the electrical signal waveform comprises receiving information associated with the electrical signal waveform from a memory. The generated electrical signal waveform comprises at least one waveform. In addition, supplying the generated electrical signal waveform to at least one surgical instrument comprises supplying the electrical signal waveform to at least two surgical instruments simultaneously.

[00405] The generator circuit, as described here, can allow the generation of several types of digital direct synthesis tables. Examples of waveforms for RF / electrosurgical signals suitable for treating a variety of tissues generated by the generator circuit include RF signals with a high crest factor (which can be used for superficial coagulation in RF mode), RF factor signals low ridge (which can be used for deeper tissue penetration) and waveforms that promote efficient retouching coagulation. The generator circuit can also generate multiple waveforms using a 4210 digital direct synthesis lookup table and, in real time, can switch between specific waveforms based on the desired tissue effect. Alternation can be based on tissue impedance and / or other factors.

[00406] In addition to the traditional sine / cosine waveforms, the generator circuit can be configured to generate waveform (s) that maximize (m) the power in the tissue per cycle (for example, trapezoidal or square wave). The generator circuit can provide waveforms that are synchronized to maximize the power delivered to the load by simultaneously triggering RF and ultrasonic signals and maintaining the ultrasonic frequency lock, as long as the generator circuit includes a circuit topology that allows simultaneous activation of RF and ultrasonic signals. In addition, instrument-specific custom waveforms and their effects on tissue can be stored in a non-volatile memory (NVM) or an instrument EEPROM and can be fetched by connecting any of the surgical instruments in the 1000 surgical system to the generating circuit.

[00407] The DDS 4200 circuit can comprise multiple lookup tables 4104, and lookup table 4210 stores a waveform represented by a predetermined number of phase points (also called samples), where the phase points define a predetermined shape of the waveform. In this way, multiple waveforms that have a unique shape can be stored in multiple 4210 lookup tables to provide different tissue treatments based on instrument configurations or tissue feedback. Examples of waveforms include high crest factor RF electrical signal waveforms for coagulation of surface tissue, low crest factor RF electrical signal waveform for deeper tissue penetration and signal waveforms that promote efficient retouching coagulation. In one aspect, the DDS 4200 circuit can create multiple 4210 waveform lookup tables and during a tissue treatment procedure (for example, simultaneously or in virtual real time based on user or sensor actions) to switch between different formats waves stored in different query tables 4210 based on the effect on the desired tissue and / or tissue feedback.

[00408] Therefore, the alternation between waveforms can be based on the impedance of the tissue and other factors, for example. In other respects, the 4210 look-up tables can store electrical signal waveforms formatted to maximize the power released in the tissue per cycle (i.e., trapezoidal or square wave). In other respects, the 4210 look-up tables can store synchronized waveforms so that they maximize the power supply for any of the surgical instruments in the surgical system 1000 when it provides RF and ultrasonic trigger signals. In yet other aspects, the 4210 lookup tables can store waveforms of electrical signal to simultaneously trigger therapeutic and / or subtherapeutic ultrasonic and RF energy, while maintaining the blocking of the ultrasonic frequency. In general, the output waveform can be in the form of a sine wave, cosine wave, pulse wave, square wave and the like. However, the custom and more complex waveforms specific to different instruments and their tissue effects can be stored in the non-volatile memory of the generating circuit or in the non-volatile memory (eg, EEPROM) of the surgical instrument and fetched when connecting the surgical instrument. in the generator circuit. An example of a custom waveform is an exponentially damped sine wave as used in many high crest factor "coagulation" waveforms, as shown in Figure 37.

[00409] Figure 37 illustrates a cycle of a 4300 discrete time digital electrical signal waveform, according to at least one aspect of the present disclosure, of an analog waveform 4304 (shown superimposed on the signal waveform. 4300 discrete time digital electrical for comparison purposes). The horizontal geometric axis represents Time (t) and the vertical geometric axis represents digital phase points.

The 4300 digital electrical signal waveform is a different time digital version of the desired analog waveform 4304, for example.

The digital electrical signal waveform 4300 is generated by storing an amplitude phase point 4302 representing the amplitude per clock cycle T clk over a cycle or period To.

The 4300 digital electrical signal waveform is generated over a To period by any suitable digital processing circuit.

Amplitude phase points are digital words stored in a memory circuit.

In the example illustrated in Figures 35 and 36, the digital word is a 6-bit word that is capable of storing the amplitude phase points with a resolution of 26 or 64 bits.

It will be recognized that the examples shown in Figures 35 and 36 are for illustrative purposes and that in current implementations the resolution can be much higher.

The digital amplitude phase points 4302 during a cycle T o are stored in memory as a string of words in a query table 4104, 4210, as described in connection with Figures 35 and 36, for example.

To generate the analog version of the analog waveform 4304, the amplitude phase points 4302 are read sequentially from memory 0 to To per clock cycle Tclk and are converted by a DAC circuit 4108, 4212, also described in connection with Figures 35 and 36. Additional cycles can be generated by repeatedly reading amplitude phase points 4302 of the digital electrical signal waveform 4300 from 0 to To for as many cycles or periods as desired.

The smooth analog version of analog waveform 4304 is achieved by filtering the output of the DAC circuit 4108, 4212 through a 4112, 4214 filter (Figures 35 and 36). The filtered analog output signal 4114, 4222 (Figures 35 and 36) is applied to the input of a power amplifier.

[00410] Figure 38 is a diagram of a 12950 control system configured to provide progressive closure of a closing member (eg, closing tube) when the displacement member advances distally and engages a clamping arm ( for example, anvil) to decrease the load of the closing force on the closing member at a desired speed and to decrease the load of the firing force on the firing member according to one aspect of the present disclosure. In one aspect, the 12950 control system can be implemented as a nested PID feedback controller. A PID controller is a feedback loop from the control circuit (controller) to continuously calculate an error value such as the difference between a desired setpoint and a measured process variable and apply a correction based on proportional, integral and derived terms (sometimes indicated P, I, and D respectively). The feedback control system of the nested PID controller 12950 includes a primary controller 12952, on a primary feedback circuit (external) 12954 and a secondary controller 12955 on a secondary feedback (internal) circuit 12956. Primary controller 12952 can be a PID controller 12972, as shown in Figure 39, and secondary controller 12955 can also be a PID 12972 controller, as shown in Figure 39. Primary controller 12952 controls a primary process 12958 and secondary controller 12955 controls a secondary process 12960. A output 12966 of primary processor 12958 is subtracted from a primary setpoint P 1 by a first adder 12962. The first adder 12962 produces a single output sum signal that is applied to primary controller 12952. The output of primary controller 12952 is the secondary setpoint SP2. Output 12968 of secondary processor 12960 is subtracted from a primary setpoint SP2 by a first adder 12964.

[00411] In the context of controlling the displacement of a closing tube, the 12950 control system can be configured so that the primary setpoint SP1 is a desired closing force value and the primary controller 12952 is configured to receive the closing force from a torque sensor coupled to the output of a closing motor and determining a motor speed from setpoint SP2 to the closing motor. In other respects, the closing force can be measured with strain gauges, load cells, or other suitable force sensors. The SP2 closing motor speed setpoint is compared to the actual closing tube speed, which is determined by secondary controller 12955. The actual closing tube speed can be measured by comparing the displacement of the closing tube with the sensor of position and measurement of elapsed time with a timer / counter. Other techniques, such as linear or rotary encoders, can be used to measure the displacement of the closing tube. Output 12968 of secondary process 12960 is the actual speed of the closing tube. This speed output from the closing tube 12968 is provided to the primary processor 12958 which determines the force acting on the closing tube and is fed back to the adder 12962, which subtracts the measured closing force from the primary setpoint SP1. The main setpoint SP1 can be an upper threshold or a lower threshold. Based on the output of adder 12962, primary controller 12952 controls the speed and direction of the closing motor. The secondary controller 12955 controls the speed of the closing motor based on the actual speed of the closing tube measured by the secondary process 12960 and the secondary setpoint SP2, which is based on a comparison of the upper and lower trigger force thresholds and of the actual firing force.

[00412] Figure 39 illustrates a PID 12970 feedback control system, according to one aspect of this disclosure. Primary controller 12952 or secondary controller 12955, or both, can be implemented as a PID controller

12972. In one aspect, the PID controller 12972 can comprise a proportional element 12974 (P), an integral element 12976 (I), and a derivative element 12978 (D). The outputs of elements P, I and D 12974, 12976, 12978 are added by an adder 12986, which supplies the control variable µ (t) to process 12980. The output of process 12980 is the process variable y (t). A 12984 adder calculates the difference between a desired setpoint r (t) and a measured process variable y (t). The PID 12972 controller continuously calculates an error value e (t) (for example, the difference between the closing force threshold and the measured closing force) as the difference between a desired setpoint r (t) (for example , the closing force threshold) and the measured process variable y (t) (for example, the speed and direction of the closing tube) and applies a correction based on the proportional, integral and derivative terms calculated by the proportional element 12974 ( P), the integral element 12976 (I), and the derivative element 12978 (D), respectively. The PID 12972 controller tries to minimize the error e (t) over time by adjusting the control variable µ (t) (for example, the speed and direction of the closing tube).

[00413] According to the PID algorithm, the element "P" 12974 represents the present values of the error. For example, if the error is large and positive, the control output will also be large and positive. According to the present disclosure, the error term e (t) is the difference between the desired closing force and measured closing force of the closing tube. The "I" element 12976 represents the values passed from the error. For example, if the current output is not strong enough, the integral of the error will accumulate over time, and the controller will respond by applying a stronger action. The "D" element 12978 represents possible future trends of the error, based on its actual rate of change. For example, continuing example P above, when the large positive control output manages to bring the error closer to zero, it also puts the process in a major negative error mode in the near future. In this case, the derivative becomes negative and module D reduces the force of the action to avoid this excess.

[00414] It will be understood that other variables and set points can be monitored and controlled according to the feedback control systems 12950, 12970. For example, the adaptive closing member speed control algorithm described here can mediate the minus two of the following parameters: the location of the trigger member, the load of the trigger member, the displacement of the cutting element, the speed of the cutting element, the location of the closing pipe, the loading of the pipe closing, among others.

[00415] Ultrasonic surgical devices, such as ultrasonic scalpels, are finding increasingly widespread applications in surgical procedures, due to their unique performance characteristics. Depending on specific device settings and operational parameters, ultrasonic surgical devices can offer, substantially simultaneously, tissue transection and coagulation homeostasis, desirably minimizing the patient's trauma. An ultrasonic surgical device may comprise a handle containing an ultrasonic transducer, and an instrument coupled to the ultrasonic transducer having a distally mounted end actuator (e.g., a blade tip) to cut and seal the tissue. In some cases, the instrument may be permanently attached to the handle. In other cases, the instrument may be separable from the handle, as in the case of a disposable instrument or an interchangeable instrument. The end actuator transmits ultrasonic energy to the tissues placed in contact with it, to perform the cutting and cauterization action. Ultrasonic surgical devices of this nature can be configured for use in open, laparoscopic or endoscopic surgical procedures, including robotically assisted procedures.

[00416] Ultrasonic energy cuts and coagulates tissues using temperatures lower than those used in electrosurgical procedures and can be transmitted to the end actuator by an ultrasonic generator in communication with the handle. Vibrating at high frequencies (for example, 55,500 cycles per second), the ultrasonic blade denatures the protein present in the tissues to form a sticky clot. The pressure exerted on the tissues by the surface of the slide flattens the blood vessels and allows the clot to form a hemostatic seal. A surgeon can control the cutting and clotting speed through the force applied to the tissues by the end actuator, the time during which the force is applied and the selected excursion level for the end actuator.

[00417] 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 static capacitance at a resonant frequency so that substantially all of the generator's trigger signal current 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 resonance frequency of the ultrasonic transducer. The tuning inductor can also transform the phase impedance curve 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 different ultrasonic transducer having a different static capacitance needs a tuning inductor.

[00418] Additionally, in some ultrasonic generator architectures, the generator trigger signal presents asymmetric harmonic distortion that complicates the magnitude and phase measurements of the impedance. For example, the accuracy of impedance phase measurements can be reduced due to harmonic distortion in current and voltage signals.

[00419] In addition, electromagnetic interference in noisy environments decreases the generator's ability to maintain locking in the resonance frequency of the ultrasonic transducer, increasing the likelihood of invalid inputs from the control algorithm.

[00420] Electrosurgical devices for applying electrical energy to tissues in order to treat and / or destroy said tissues are also finding increasingly widespread applications in surgical procedures. An electrosurgical device may comprise a handle and an instrument that has a distally mounted end actuator (for example, one or more electrodes). The end actuator can be positioned against the fabric, so that electric current is introduced into the fabric. Electrosurgical devices can be configured for bipolar or monopolar operation. During bipolar operation, the current is introduced into the tissue and returned from it through the active and return electrodes, respectively, of the end actuator. During monopolar operation, a current is introduced into the tissue by an active electrode of the end actuator and returned through a return electrode (for example, a grounding plate) separately located on the patient's body. The heat generated by the current flowing through the tissue can form hemostatic seals within the tissue and / or between tissues and, therefore, can be particularly useful for cauterizing blood vessels, for example. The end actuator of an electrosurgical device may also comprise a cutting member that is capable of moving in relation to the tissue and the electrodes, to transect the tissue.

[00421] The electrical energy applied by an electrosurgical device can be transmitted to the instrument by a generator in communication with the handle. The electrical energy may be in the form of radio frequency (RF) energy. RF energy is a form of electrical energy that can be in the frequency range from 300 kHz to 1 MHz, as described in EN60601-2-2: 2009 + A11: 2011, Definition

201.3.218 - HIGH FREQUENCY. For example, the frequency in monopolar RF applications can typically be restricted to less than 5 MHz. However, in bipolar RF applications, the frequency can be almost any. Frequencies above 200 kHz are typically used for monopolar applications to avoid unwanted nerve and muscle stimulation that would result from using a low frequency current. Lower frequencies can be used for bipolar techniques if a risk analysis shows that the possibility of neuromuscular stimulus has been mitigated to an acceptable level. Typically, frequencies above 5 MHz are not used in order to minimize problems associated with high frequency dispersion currents. It is generally accepted that 10 mA is the lower threshold for thermal effects on tissue.

[00422] During this operation, an electrosurgical device can transmit RF energy at low frequency through the tissue, which causes friction, or ionic agitation, that is, resistive heating, which, therefore, increases the tissue temperature. Due to the fact that a precise contour can be created between the affected tissue and the surrounding tissue, surgeons can operate with a high level of precision and control, without sacrificing adjacent non-target tissue. The low operating temperatures of RF energy can be useful for removing, shrinking or sculpting soft tissues while simultaneously cauterizing blood vessels. RF energy can work particularly well in connective tissue, which mainly comprises collagen and shrinks when it comes in contact with heat.

[00423] Due to their unique trigger signal, detection and feedback information, ultrasonic and electrosurgical devices generally require different generators. Additionally, in cases where the instrument is disposable or interchangeable with a handle, ultrasonic and electrosurgical generators are limited in their ability to recognize the configuration of the specific instrument being used and to optimize control and diagnostic processes accordingly. In addition, capacitive coupling between the non-isolated and isolated patient circuits of the generator, especially in cases where higher voltages and frequencies are used, can result in a patient's exposure to unacceptable leakage current levels.

[00424] Furthermore, due to their unique trigger signal, detection and feedback information, ultrasonic and electrosurgical devices generally require different user interfaces for different generators. In such conventional ultrasonic and electrosurgical devices, a user interface is configured for use with an ultrasonic instrument whereas a different user interface can be configured for use with an electrosurgical instrument. Such user interfaces include hand and / or foot activated user interfaces, such as hand activated keys and / or foot activated keys. When various aspects of combined generators for use with both ultrasonic and electrosurgical instruments are contemplated in the subsequent disclosure, additional user interfaces that are configured to operate with both ultrasonic and electrosurgical instrument generators are also contemplated.

[00425] Additional user interfaces to provide feedback, whether to the user or another machine, are contemplated in the subsequent disclosure to provide feedback that indicates a mode of operation or status of an ultrasonic and / or electrosurgical instrument. Providing feedback to the user and / or the machine to operate an ultrasonic and / or electrosurgical instrument in combination will require providing sensory feedback to a user and electrical / mechanical / electromechanical feedback to a machine. Feedback devices that incorporate visual feedback devices (for example, an LCD display screen, LED indicators), audio feedback devices (for example, a speaker, a bell) or tactile feedback devices (for example, eg haptic actuators) for use in combined ultrasonic and / or electrosurgical instruments are contemplated in the subsequent disclosure.

[00426] Other electrical surgical instruments include, without limitation, irreversible and / or reversible electroporation, and / or microwave technologies, among others. Consequently, the techniques disclosed here are applicable to ultrasonic, bipolar or monopolar RF (electrosurgical), irreversible and / or reversible electroporation and / or microwave-based surgical instruments, among others.

[00427] 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. Aspects of electrosurgical devices can be configured to transect, coagulate, scale, weld and / or dry the tissue during surgical procedures, for example.

[00428] Generator aspects use high-speed analog to digital sampling (for example, approximately 200 × over-sampling, depending on frequency) of the current and voltage of the generator trigger signal, along with digital signal processing, to provide numerous advantages and benefits over known generator architectures. In one aspect, for example, based on current and voltage feedback information, a value of the static capacitance of the ultrasonic transducer, and a value of the frequency of the drive signal, the generator can determine the current of the movement branch of a transducer ultrasonic. This provides the benefit of a virtually tuned system and simulates the presence of a system that is tuned or resonated with any static capacitance value (for example, C0 in Figure 25) at any frequency. Consequently, the control of the branching current of the movement can be carried out by canceling the effects of static capacitance without the need for a tuning inductor. In addition, the elimination of the tuning inductor cannot degrade the frequency locking capabilities of the generator, since the frequency locking can be performed by properly processing the current and voltage feedback data.

[00429] Analog to digital high speed sampling of the current and voltage of the generator trigger signal, together with digital signal processing, can also enable accurate digital filtering of samples. For example, aspects of the generator may use a low pass digital filter (for example, a finite impulse response filter (FIR) that rolls out between a fundamental trigger signal frequency and a second order harmonic to reduce asymmetric harmonic distortion) and EMI-induced noise in the current and voltage feedback samples The filtered current and voltage feedback samples substantially represent the frequency of the fundamental trigger signal, thus allowing a more accurate measurement of the impedance phase in relation to the signal frequency of fundamental drive and an improvement in the capacity of the generator to maintain the locking of the resonance frequency.The accuracy of the impedance phase measurement can be further optimized by calculating the average of the falling edge and falling edge measurements, and by regulating of the impedance phase measured at 0 °.

[00430] Various aspects of the generator can also use high-speed analog to digital sampling of the current and voltage of the generator trigger signal, along with digital signal processing, to determine actual energy consumption and other quantities with a high degree of accuracy. This can allow the generator to implement a number of useful algorithms, such as, for example, controlling the amount of power applied to the tissue as the tissue impedance changes and controlling the application of energy to maintain a constant rate of increase in the tissue impedance. Some of these algorithms are used to determine the phase difference between the current and voltage signals of the generator trigger signal. In resonance, the phase difference between the current and voltage signals is zero. The phase changes as the ultrasonic system resonates. Various algorithms can be used to detect the phase difference and adjust the trigger frequency until the ultrasonic system returns to resonance, that is, the phase difference between the current and voltage signals reaches zero. The phase information can also be used to infer the conditions of the ultrasonic sheet. As discussed in particular below, the phase changes as a function of the temperature of the ultrasonic sheet. Therefore, the phase information can be used to control the temperature of the ultrasonic sheet. This can be done, for example, by reducing the power supplied to the ultrasonic sheet when the ultrasonic sheet is very hot and by increasing the power applied to the ultrasonic sheet when the ultrasonic sheet is very cold.

[00431] Various aspects of the generator can have a wide range of frequencies and increased output power required to drive ultrasonic surgical devices and electrosurgical devices. The lower the voltage, the greater the current demand of the electrosurgical devices can be met by a dedicated branch in a broadband power transformer, thus eliminating the need for a separate power amplifier and output transformer. In addition, the generator's detection and feedback circuits can support a wide dynamic range that meets the needs of ultrasonic and electrosurgical applications with minimal distortion.

[00432] Several aspects can provide a simple and economical way for the generator to read and optionally write to a data circuit (for example, a single wire bus device, such as a single wire protocol EEPROM, known under the trade name "1-Wire") arranged in an instrument attached to the handle using existing multi-conductor generator / handle cables. In this way, the generator is able to retrieve and process instrument-specific data from an instrument attached to the grip. This can allow the generator to provide better control and improved diagnostics and error detection. In addition, the generator's ability to record data on the instrument enables new functionality in terms of, for example, tracking instrument usage and capturing operational data. In addition, the use of the frequency range allows for compatibility with previous versions of instruments containing a bus device with existing generators.

[00433] Revealed aspects of the generator provide active leakage current cancellation caused by unintentional capacitive coupling between uninsulated and isolated circuits, from the patient, from the generator. In addition to reducing risks to the patient, reducing the leakage current can also decrease electromagnetic emissions.

[00434] Figure 40 is a 7400 system diagram of a 7401 segmented circuit comprising a plurality of independently operated circuit segments 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440, in accordance with at least one aspect of the present revelation. A circuit segment of the plurality of circuit segments of the segmented circuit 7401 comprises one or more circuits and one or more sets of machine executable instructions stored in one or more memory devices. The one or more circuits in a circuit segment are coupled for electrical communication through one or more means of connecting wired or wirelessly. The plurality of circuit segments is configured to transition between three modes comprising a suspended mode, a standby mode and an operational mode.

[00435] In one aspect shown, the plurality of circuit segments 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440 starts, first, in the standby mode, secondly, goes into the suspended mode and third, it goes into operational mode. However, in other respects, the plurality of circuit segments can transition from any of the three modes to any of the other three modes. For example, the plurality of circuit segments can transition directly from standby to operational mode. Individual circuit segments can be placed in a specific state by the voltage control circuit 7408 based on execution, by a machine executable instruction processor. The states comprise a de-energized state, a low-energy state and an energized state. The de-energized state corresponds to the suspended mode, the low energy state corresponds to the standby mode and the energized state corresponds to the operational mode. The transition to the low energy state can be achieved, for example, by using a potentiometer.

[00436] In one aspect, the plurality of circuit segments 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440 can carry out the transition from suspended or standby mode to operational mode according to a sequence of energization. The plurality of circuit segments can also transition from the operational mode to the standby mode or to the suspended mode according to the de-energization sequence. The energizing sequence and the de-energizing sequence can be different. In some respects, the energizing sequence comprises energizing only a subset of circuit segments of the plurality of circuit segments. In some respects, the de-energizing sequence comprises de-energizing only a subset of circuit segments of the plurality of circuit segments.

[00437] Again with reference to system diagram 7400 in Figure 40, segmented circuit 7401 comprises a plurality of circuit segments comprising a transition circuit segment 7402, a processor circuit segment 7414, a handle circuit segment 7416, a 7420 communication circuit segment, a 7424 screen circuit segment, a 7428 motor control circuit segment, a 7434 power treatment circuit segment and a 7440 drive shaft circuit segment. transition circuit comprises an activation circuit 7404, a current amplification circuit 7406, a voltage control circuit 7408, a 7410 safety controller and a POST controller 7412 ("Power On Self-Test") activation). Transition circuit segment 7402 is configured to implement a de-energizing sequence and an energizing sequence, a security detection protocol and a POST.

[00438] In some respects, the activation circuit 7404 comprises an accelerometer button sensor 7405. In aspects, the transition circuit segment 7402 is configured to be in an energized state, while other circuit segments of the plurality of segments of 7401 segmented circuit circuit are configured to be in a low energy state, a de-energized state or an energized state. The 7405 accelerometer button sensor can monitor the movement or acceleration of the 6480 surgical instrument described in the present invention. For example, the movement may be a change in the orientation or rotation of the surgical instrument. The surgical instrument can be moved in any direction in relation to a three-dimensional Euclidean space, for example, by a user of the surgical instrument. When the 7405 accelerometer button sensor detects movement or acceleration, the 7405 accelerometer button sensor sends a signal to the 7408 voltage control circuit to cause the 7408 voltage control circuit to apply voltage to the processor circuit segment. 7414 to transition the processor and volatile memory to a powered state. In aspects, the processor and volatile memory are in an energized state before the 7409 voltage control circuit applies voltage to the processor and volatile memory. In operational mode, the processor can initiate an energizing sequence or a de-energizing sequence. In many ways, the 7405 accelerometer button sensor can also send a signal to the processor to cause the processor to initiate an energizing sequence or a de-energizing sequence. In some respects, the processor initiates an energizing sequence when most of the individual circuit segments are in a low energy or de-energized state. In other respects, the processor initiates a de-energizing sequence when most of the individual circuit segments are in an energized state.

[00439] Additionally or alternatively, the 7405 accelerometer button sensor can detect external movement within a predetermined vicinity of the surgical instrument. For example, the 7405 accelerometer button sensor can detect the hand movement of a user of the 6480 surgical instrument described here, which moves within the predetermined neighborhood. When the 7405 accelerometer button sensor detects this external movement, the 7405 accelerometer button sensor can send a signal to the 7408 voltage control circuit and a signal to the processor, as previously described. After receiving the signal sent, the processor can initiate an energizing sequence or a de-energizing sequence to transition one or more circuit segments between the three modes. In aspects, the signal sent to the voltage control circuit 7408 is sent to verify that the processor is in operational mode. In some ways, the 7405 accelerometer button sensor can detect when the surgical instrument has been dropped and send a signal to the processor based on the detected drop. For example, the signal may indicate an error in the operation of an individual circuit segment. One or more sensors can detect damage or failure of the affected individual circuit segments. Based on the damage or failure detected, the POST controller 7412 can perform a POST of the corresponding individual circuit segments.

[00440] An energizing sequence or a de-energizing sequence can be defined based on the 7405 accelerometer button sensor. For example, the 7405 accelerometer button sensor can detect a specific movement or a sequence of movements that indicates the selection of a specific circuit segment among the plurality of circuit segments. Based on the detected movement or the series of movements detected, the 7405 accelerometer button sensor can transmit a signal comprising an indication of one or more circuit segments of the plurality of circuit segments to the processor when the processor is in an energized state. Based on the signal, the processor determines an energization sequence comprising the one or more selected circuit segments. In addition or alternatively, a user of the 6480 surgical instruments described here can select a number and order of the circuit segments to define an energizing sequence or a de-energizing sequence based on interaction with a graphical user interface (GUI) of the surgical instrument. .

[00441] In several respects, the 7405 accelerometer button sensor can send a signal to the 7408 voltage control circuit and a signal to the processor only when the 7405 accelerometer button sensor detects movement of the 6480 surgical instrument described here or the movement within a predetermined neighborhood above a predetermined threshold. For example, a signal can only be sent if the movement is detected for 5 or more seconds or if the surgical instrument is moved 5 or more inches. In other respects, the 7405 accelerometer button sensor can send a signal to the 7408 voltage control circuit and a signal to the processor only when the 7405 accelerometer button sensor detects oscillatory movement of the surgical instrument. A predetermined threshold reduces the involuntary transition of the surgical instrument's circuit segments. As previously described, the transition can comprise a transition to the operational mode according to an energizing sequence, a transition to low energy mode according to a de-energizing sequence, or a transition to the suspended mode according to a sequence de-energizing. In some aspects, the surgical instrument comprises an actuator that can be actuated by a user of the surgical instrument. The actuation is detected by the 7405 accelerometer button sensor. The actuator can be a sliding element, a toggle switch or a momentary contact switch. Based on the detected performance, the 7405 accelerometer button sensor can send a signal to the 7408 voltage control circuit and a signal to the processor.

[00442] The current amplification circuit 7406 is coupled to the battery. The current amplification circuit 7406 is a current amplifier, like a relay or transistor, and is configured to amplify the magnitude of a current in an individual circuit segment. The magnitude of the initial current corresponds to the source voltage supplied by the battery to the 7401 segmented circuit. Suitable relays include solenoids. Suitable transistors include field effect transistors (FET), MOSFET and bipolar junction transistors (BJT). The current amplification circuit 7406 can amplify the magnitude of the current corresponding to an individual circuit segment or to the circuit that requires more current extraction during the operation of the 6480 surgical instruments described herein. For example, an increase in current for the 7428 motor control circuit segment can be provided when a surgical instrument motor requires more input power. The increase in the current supplied to an individual circuit segment can cause a corresponding reduction in the current of another circuit segment or circuit segments. Additionally or alternatively, the increase in current may correspond to the voltage supplied by an additional voltage source that operates in conjunction with the battery.

[00443] The voltage control circuit 7408 is coupled to the battery. The voltage control circuit 7408 is configured to supply voltage or remove voltage from the plurality of circuit segments. The voltage control circuit 7408 is also configured to increase or decrease a voltage supplied to a plurality of circuit segments of the segmented circuit 7401. In several aspects, the voltage control circuit 7408 comprises a combinational logic circuit such as a multiplexer (MUX ) to select the inputs, a plurality of electronic switches and a plurality of voltage converters. An electronic switch from the plurality of electronic switches can be configured to switch between an open and a closed configuration to disconnect or connect an individual circuit segment to or from the battery. The plurality of electronic switches can consist of solid state devices such as transistors or other types of switches, such as wireless switches, ultrasonic switches, accelerometers, inertia sensors, among others. The combinational logic circuit is configured to select an individual electronic switch to switch to an open configuration to allow voltage to be applied to the corresponding circuit segment. The combined logic circuit is also configured to select an individual electronic switch to switch to a closed configuration to allow removal of voltage from the corresponding circuit segment. By selecting a plurality of individual electronic switches, the combined logic circuit can implement a de-energizing sequence or an energizing sequence. The plurality of voltage converters can provide a stepped upward voltage or a stepped downward voltage to a plurality of circuit segments. The voltage control circuit 7408 may also comprise a microprocessor and a memory device.

[00444] The 7410 safety controller is configured to perform safety checks on the circuit segments. In some respects, the 7410 safety controller performs safety checks when one or more individual circuit segments are in operational mode. Safety checks can be carried out to determine whether or not there are any errors or defects in the operation or operation of the circuit segments. The 7410 safety controller can monitor one or more parameters of the plurality of circuit segments. The 7410 safety controller can verify the identity and operation of the plurality of circuit segments by comparing the one or more parameters with predefined parameters. For example, if an RF energy modality is selected, the 7410 safety controller can check whether a drive shaft articulation parameter matches a predefined articulation parameter to verify the operation of the 6480 surgical instrument's RF energy modality. described in the present invention. In some respects, the 7410 safety controller can monitor, through the sensors, a predetermined relationship between one or more properties of the surgical instrument to detect a defect. A defect can occur when the one or more properties are inconsistent with the predetermined relationship. When the 7410 safety controller determines that there is a fault, an error or that some operation of the plurality of circuit segments has not been verified, the 7410 safety controller prevents or disables the operation of the specific circuit segment where the defect, error or failure verification code originated.

[00445] The POST controller 7412 performs a POST to verify the proper operation of the plurality of circuit segments. In some respects, POST runs for an individual circuit segment out of the plurality of circuit segments before voltage control circuit 7408 applies voltage to the individual circuit segment to transition the individual circuit segment from standby or from suspended to operational mode. If the individual circuit segment does not pass POST, the specific circuit segment does not transition from standby or suspended mode to operational mode. The POST of the 7416 grip circuit segment can comprise, for example, testing whether the 7418 grip control sensors detect a handhold control actuation of the 6480 surgical instrument described herein. In some ways, the 7412 POST controller can transmit a signal to the 7405 accelerometer button sensor to verify the operation of the individual circuit segment as part of the POST. For example, after receiving the signal, the 7405 accelerometer button sensor can instruct a surgical instrument user to move the surgical instrument to a plurality of different locations to confirm the operation of the surgical instrument. The 7405 accelerometer button sensor can also monitor an output of a circuit segment or a circuit of a circuit segment as part of the POST. For example, the 7405 accelerometer button sensor can detect an incremental engine pulse generated by the 7432 engine to verify operation. A motor controller from the 7430 motor control circuit can be used to control the 7432 motor to generate the incremental motor pulse.

[00446] In several respects, the 6480 surgical instrument described here may comprise additional accelerometer button sensors. The POST controller 7412 can also execute a control program stored in the memory device of the voltage control circuit 7408. The control program can cause the POST controller 7412 to transmit a signal requesting a correlated encrypted parameter from a plurality of circuit segments. Failure to receive a correlated encrypted parameter from an individual circuit segment indicates to the POST 7412 controller that the corresponding circuit segment is damaged or defective. In some respects, if the POST 7412 controller determines, based on POST, that the processor is damaged or defective, the POST 7412 controller can send a signal to one or more secondary processors to cause one or more secondary processors perform critical functions that the processor is unable to perform. In some respects, if the POST 7412 controller determines, based on POST, that one or more circuit segments do not operate properly, the POST 7412 controller may initiate a reduced performance mode from the circuit segments that operate properly and, at the same time, At the same time, block circuit segments that do not pass the POST or that do not operate properly. A blocked circuit segment can function similarly to a circuit segment in standby or suspended mode.

[00447] The processor circuit segment 7414 comprises the processor and volatile memory. The processor is configured to initiate an energizing sequence or a de-energizing sequence. To initiate the energizing sequence, the processor transmits an energizing signal to voltage control circuit 7408 to cause voltage control circuit 7408 to apply voltage to the plurality or to a subset of the plurality of circuit segments according to the power-up sequence. To initiate the de-energizing sequence, the processor transmits a de-energizing signal to voltage control circuit 7408 to cause voltage control circuit 7408 to remove voltage from the plurality or a subset of the plurality of circuit segments according to the de-energizing sequence.

[00448] The 7416 handle circuit segment comprises 7418 handle control sensors. The 7418 handle control sensors can detect the actuation of one or more handle controls of the 6480 surgical instrument described here. In several respects, the one or more grip controls comprise a grapple control, a release button, a toggle switch, an energy activation button and / or any other suitable grip control. The user can activate the power activation button to select between an RF energy mode, an ultrasonic energy mode or a combined RF and ultrasonic energy mode. The 7418 handle control sensors can also facilitate the attachment of a modular handle to the surgical instrument. For example, the 7418 handle control sensors can detect proper attachment of the modular handle to the surgical instrument and indicate the detected attachment to a user of the surgical instrument. The 7426 LCD screen can provide a graphic indication of the detected fixation. In some respects, the 7418 grip control sensors detect the performance of one or more grip controls. Based on the detected performance, the processor can initiate both an energizing sequence and a de-energizing sequence.

[00449] The communication circuit segment 7420 comprises a communication circuit 7422. The communication circuit 7422 comprises a communication interface to facilitate the communication of signals between the individual circuit segments of the plurality of circuit segments. In some respects, the 7422 communication circuit provides a path for the modular components of the 6480 surgical instrument described here to communicate electrically. For example, a modular drive shaft and a modular transducer, when attached together to the handle of the surgical instrument, can load control programs for the handle through the 7422 communication circuit.

[00450] The 7424 screen circuit segment comprises a 7426 LCD screen. The 7426 LCD screen may comprise a liquid crystal display, LED indicators, etc. In some ways, the 7426 LCD screen is an organic light-emitting diode (OLED) screen. A screen can be placed on, embedded or remotely located in relation to the 6480 surgical instrument described here. For example, the screen can be placed on the handle of the surgical instrument. The screen is configured to provide sensory feedback to a user. In several respects, the 7426 LCD screen additionally comprises a backlight. In some respects, the surgical instrument may also comprise audio feedback devices such as a loudspeaker or an audible signal and tactile feedback devices such as a haptic actuator.

[00451] The 7428 motor control circuit segment comprises a 7430 motor control circuit coupled to a motor

7432. The 7432 motor is coupled to the processor by a driver and a transistor, such as a FET. In several respects, the 7430 motor control circuit comprises a motor current sensor in signal communication with the processor to provide a signal indicative of a measurement of the motor current draw to the processor. The processor transmits the signal to the screen. The screen receives the signal and displays the measurement of current draw from the 7432 motor. The processor can use the signal, for example, to monitor that the current draw from the 7432 motor exists within an acceptable range to compare the current draw with one or more parameters of the plurality of circuit segments, and to determine one or more parameters of a patient treatment site. In several respects, the 7430 motor control circuit comprises a motor controller to control the operation of the motor. For example, the 7430 motor control circuit controls various motor parameters, for example, by adjusting the speed, torque and acceleration of the 7432 motor. The adjustment is made based on the current passing through the 7432 motor, measured by the motor current sensor.

[00452] In several respects, the 7430 motor control circuit comprises a force sensor to measure the force and torque generated by the 7432 motor. The 7432 motor is configured to act on a mechanism of the 6480 surgical instruments described here. For example, the 7432 motor is configured to control the actuation of the operating shaft of the surgical instrument to perform the gripping, rotation and articulation functionalities. For example, the 7432 motor can actuate the drive shaft to perform a gripping movement with the claws of the surgical instrument. The motor controller can determine whether the material caught by the claws is fabric or metal. The motor controller can also determine the extent to which the claws hold the material. For example, the motor controller can determine how to open or close the jaws based on the derivation of the detected motor current or motor voltage. In some respects, the 7432 engine is configured to actuate the transducer to cause the transducer to torque the handle or control the articulation of the surgical instrument. The motor current sensor can interact with the motor controller to define a motor current limit. When the current meets the predefined threshold limit, the motor controller initiates a corresponding change in a motor control operation. For example, exceeding the motor current limit causes the motor controller to reduce the motor current draw.

[00453] The 7434 energy treatment circuit segment comprises an RF amplifier and the 7436 safety circuit and a 7438 ultrasonic signal generator circuit to implement the modular energy functionality of the 6480 surgical instrument described here. In several respects, the RF amplifier and the 7436 safety circuit are configured to control the RF modality of the surgical instrument by generating an RF signal. The 7438 ultrasonic signal generator circuit is configured to control the ultrasonic energy mode by generating an ultrasonic signal. The RF amplifier and 7436 safety circuit and a 7438 ultrasonic signal generator circuit can operate together to control the combined RF and ultrasonic energy mode.

[00454] The drive shaft circuit segment 7440 comprises a drive shaft module controller 7442, a modular control actuator 7444, one or more end actuator sensors 7446 and a non-volatile memory 7448. The module controller drive shaft 7442 is configured to control a plurality of drive shaft modules comprising the control programs to be executed by the processor. The plurality of drive shaft modules implement a drive shaft modality, for example, ultrasonic, combination of ultrasonic and RF, blade in profile I of RF and opposite claw by RF. The 7442 drive shaft module controller can select the drive shaft mode by selecting the corresponding drive shaft module for the processor to operate. The 7444 modular control actuator is configured to actuate the drive shaft according to the selected drive shaft modality. After actuation is initiated, the drive shaft articulates the end actuator according to one or more parameters, routines or programs specific to the selected axis mode and the selected end actuator mode. The one or more 7446 end actuator sensors, located on the end actuator, can include force sensors, temperature sensors, current sensors or motion sensors. The one or more end actuator sensors 7446 transmit data about one or more end actuator operations, based on the energy modality implemented by the end actuator. In several respects, the energy modalities include an ultrasonic energy modality, an RF energy modality or a combination of the ultrasonic energy modality and the RF energy modality. The 7448 non-volatile memory stores the drive shaft control programs. A control program comprises one or more parameters, routines or programs specific to the drive axis. In many ways, the 7448 non-volatile memory can be a ROM, EPROM, EEPROM or flash memory. The non-volatile memory 7448 stores the drive shaft modules corresponding to the selected drive shaft of the 6480 surgical instrument described here. The drive shaft modules can be changed or updated in the non-volatile memory 7448 by the drive shaft module controller 7442, depending on the drive shaft of the surgical instrument to be used in the operation.

[00455] Figure 41 is a schematic diagram of a 7925 circuit of various components of a surgical instrument with motor control functions, in accordance with at least one aspect of the present disclosure. In several respects, the 6480 surgical instrument described herein can include a 7930 drive mechanism that is configured to drive drive shafts and / or gear components in order to perform the various operations associated with the 6480 surgical instrument. In one aspect, the mechanism 7930 drive train includes a 7932 rotary drive train configured to rotate an end actuator, for example, around a longitudinal geometric axis in relation to the handle housing. The drive mechanism 7930 further includes a drive train of the closing system 7934 configured to close a claw member to secure the fabric with the end actuator. In addition, the drive mechanism 7930 includes a drive train 7936 configured to open and close a clamp arm portion of the end actuator to secure the fabric with the end actuator.

[00456] The drive mechanism 7930 includes a gearbox set with selector 7938 that can be located on the handle set of the surgical instrument. Proximal to the 7938 selector gearbox assembly, there is a function selection module that includes a first 7942 engine that works to selectively move gear elements in the 7938 selector gearbox assembly to selectively position one of the 7932 drive trains, 7934, 7936 in engagement with an input drive component of an optional second motor 7944 and a motor drive circuit 7946 (shown in dotted line to indicate that the second motor 7944 and the motor drive circuit 7946 are optional components) .

[00457] Still with reference to Figure 41, motors 7942 and 7944 are coupled to motor control circuits 7946, 7948, respectively, which are configured to control the operation of motors 7942 and 7944, including the flow of electrical energy from one 7950 power source for the 7942 and 7944 engines. The 7950 power source can be a DC battery (for example, a lead-based, nickel-based, lithium-ion rechargeable battery, etc.) or any other suitable energy source to supply electrical power to the surgical instrument.

[00458] The surgical instrument additionally includes a 7952 microcontroller ("controller"). In certain cases, the 7952 controller may include a 7954 microprocessor ("processor") and one or more computer-readable media or 7956 memory units ("memory"). In certain cases, memory 7956 can store various program instructions which, when executed, can cause processor 7954 to perform a plurality of functions and / or calculations described herein. The 7950 power source can be configured to supply power to the 7952 controller, for example.

[00459] Processor 7954 can be in communication with the motor control circuit 7946. In addition, memory 7956 can store program instructions that, when executed by processor 7954 in response to a user action 7958 or feedback elements 7960 , can cause the 7946 engine control circuit to induce the 7942 engine to generate at least one rotary motion to selectively move the gear elements within the 7938 selector gearbox assembly to selectively position one of the 7932 drive trains , 7934, 7936 in engagement with the second drive input component of the 7944 motor. In addition, the 7954 processor can be in communication with the 7948 motor control circuit. The 7956 memory can also store program instructions which, when executed processor 7954 in response to user action 7958, can cause the 7948 motor control circuit to induce the 7944 motor to generate at least a rotary movement to drive the drive train engaged in the input drive component of the second 7948 engine, for example.

[00460] The 7952 controller and / or the other controllers of the present disclosure can be implemented using integrated and / or distinct hardware elements, software elements and / or a combination of both. Examples of integrated hardware elements can include processors, microprocessors, microcontrollers, integrated circuits, ASICs, PLDs, DSPs, FPGAs, logic gates, recorders, semiconductor devices, integrated circuits, microcircuits, chipsets, microcontrollers, system on an integrated circuit (chip ) (SoC) and / or single online package (SiP). Examples of different hardware elements may include circuits and / or circuit elements, such as logic gates, field effect transistors, bipolar transistors, resistors, capacitors, inductors and / or relays. In certain embodiments, controller 7952 may include a hybrid circuit comprising elements or components of isolated circuits and integrated into one or more substrates, for example.

[00461] In certain cases, the 7952 controller and / or the other controllers of the present disclosure may be an LM 4F230H5QR, available from Texas Instruments, for example. In certain instances, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core comprising a 256 KB single cycle flash integrated memory or other non-volatile memory, up to 40 MHz, a prefetch buffer to optimize performance above 40 MHz, a 32 KB single cycle SRAM, internal ROM loaded with StellarisWare® software, 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, one or more 12 ADCs bits with 12 analog input channels, among other features that are readily available. Other microcontrollers can be readily replaced for use with the present disclosure. Consequently, the present disclosure should not be limited in that context.

[00462] In several cases, one or more of the various steps described herein can be performed by a finite state machine comprising a combinational logic circuit or a sequential logic circuit, where the combinational logic circuit or the sequential logic circuit is coupled, to the least, to a memory circuit. The at least one memory circuit stores a current state of the finite state machine. The combinational or sequential logic circuit is configured to make the finite state machine perform the steps. The sequential logic circuit can be synchronous or asynchronous. In other examples, one or more of the various steps described herein can be performed by a circuit that includes a combination of the 7958 processor and the finite state machine, for example.

[00463] In several cases, it may be advantageous to be able to assess the state of functionality of a surgical instrument to ensure its proper function. It is possible, for example, that the drive mechanism, as explained above, which is configured to include various motors, drive trains and / or gear components to perform the various operations of the surgical instrument, will wear out over time. This can occur through normal use and, in some cases, the drive mechanism can wear out more quickly due to conditions of abuse. In certain cases, a surgical instrument can be configured to perform self-assessments to determine the state, that is, the health, of the drive mechanism and its various components.

[00464] For example, self-assessment can be used to determine when the surgical instrument is able to perform its function before a new sterilization or when some of the components must be replaced and / or repaired. The evaluation of the drive mechanism and its components, including, but not limited to, the rotating drive train 7932, the closing drive train 7934 and / or the trigger drive train 7936, can be carried out in several ways. The magnitude of the deviation from predicted performance can be used to determine the probability of a detected failure and the severity of that failure. Several metrics can be used, including: Periodic analysis of repeatedly predictable events, increases or decreases that exceed an expected threshold and the extent of failure.

[00465] In several cases, a signature waveform of a drive mechanism operating properly or one or more of its components can be used to assess the state of the drive mechanism or one or more of its components. One or more vibration sensors may be arranged in relation to a drive mechanism operating properly or one or more of its components to record various vibrations that occur during the operation of the drive mechanism operating properly or one or more of its components. The recorded vibrations can be used to create the signature waveform. Future waveforms can be compared to the signature waveform to assess the state of the drive mechanism and its components.

[00466] Still with reference to Figure 41, the surgical instrument 7930 includes a failure detection module of the drive train 7962 configured to register and analyze one or more acoustic outputs of one or more of the drive trains 7932, 7934, 7936. The 7954 processor may be in communication with or otherwise control the 7962 module. As described in more detail below, the 7962 module may be incorporated as various means, such as circuitry, hardware, a computer program product that comprises a computer-readable media (for example, memory 7956) that stores computer-readable program instructions that are executable by a processing device (for example, the 7954 processor), or some combination thereof. In some cases, processor 36 may include or otherwise control module 7962.

[00467] Figure 42 is an alternative 132000 system for controlling the frequency of a 132002 ultrasonic electromechanical system and detecting its impedance, in accordance with at least one aspect of the present disclosure. The 132000 system can be incorporated into a generator. A 132004 processor coupled with a 132026 memory programs a programmable counter 132006 to tune to the output frequency fo of the 132002 ultrasonic electromechanical system. The input frequency is generated by a crystal oscillator 132008 and is inserted into a fixed counter 132010 to scale the frequency to an appropriate value. The outputs of the fixed counter 132010 and the programmable counter 132006 are applied to a phase / frequency detector 132012. The output of the phase / frequency detector 132012 is applied to an active amplifier / filter circuit 132014 to generate a Vt tuning voltage that it is applied to a 132016 voltage controlled oscillator (VCO, "voltage controlled oscillator"). VCO 132016 applies the output frequency fo to an ultrasonic transducer portion of the 132002 ultrasonic electromechanical system, shown here modeled as an equivalent electrical circuit. The voltage and current signals applied to the ultrasonic transducer are monitored by a 132018 voltage sensor and a 132020 current sensor.

[00468] The outputs of the voltage and current sensors 132018, 13020 are applied to another phase / frequency detector 132022 to determine the phase angle between voltage and current as measured by voltage and current sensors 132018, 13020. A output of the 132022 phase / frequency detector is applied to a channel of a 132024 high speed analog to digital converter (ADC) and is supplied to the 132004 processor through it. Optionally, the outputs of the voltage and current sensors 132018, 132020 can be applied to the respective channels of the two channels of ADC 132024 and supplied to the processor 132004 for zero crossing, FFT, or another algorithm described here to determine the phase angle between the voltage and current signals applied to the 132002 ultrasonic electromechanical system.

[00469] Optionally the tuning voltage V t, which is proportional to the output frequency fo, can be fed back to processor 132004 via ADC 132024. This provides processor 132004 with a feedback signal proportional to the output frequency fo and you can use this feedback to adjust and control the output frequency fo. Temperature inference

[00470] Figures 43A and 43B are graphical representations 133000, 133010 of complex impedance spectra of the same ultrasonic device with a cold ultrasonic blade (room temperature) and a hot ultrasonic blade, in accordance with at least one aspect of the present disclosure. As used in the present invention, a cold ultrasonic blade refers to an ultrasonic blade at room temperature and a hot ultrasonic blade refers to an ultrasonic blade after it is heated by friction during use. Figure 43A is a 133000 graphical representation of the impedance phase angle φ as a function of the resonant frequency fo of the same ultrasonic device with a cold ultrasonic blade and a hot ultrasonic blade, and Figure 43B is a 133010 graphic representation of impedance magnitude. | Z | as a function of the resonance frequency fo of the same ultrasonic device with a cold ultrasonic blade and a hot ultrasonic blade. The phase angle of the impedance φ and the magnitude of the impedance | Z | are at least at the fo resonance frequency.

[00471] The impedance of the ultrasonic transducer Zg (t) can be measured as the ratio between the voltage activation signals of generator Vg (t) and current of generator Ig (t): 𝑉𝑔 (𝑡) 𝑍𝑔 (𝑡) = 𝐼𝑔 (𝑡)

[00472] As shown in Figure 43A, when the ultrasonic blade is cold, for example, at room temperature and not heated by friction, the electromechanical resonance frequency of the ultrasonic device is approximately 55,500 Hz and the excitation frequency of the ultrasonic transducer is adjusted to

55,500 Hz. Thus, when the ultrasonic transducer is excited at the electromechanical resonance frequency fo and the ultrasonic blade is cold, the phase angle φ is at least or approximately equal to 0 rad as indicated by the 133002 cold blade curve. As shown in Figure 43B, when the ultrasonic blade is cold and the ultrasonic transducer is excited at the electromechanical resonance frequency fo, the magnitude of impedance | Z | is 800 Ω, for example, the magnitude of impedance | Z | is at a minimum of impedance, and the amplitude of the trigger signal is at a maximum due to the equivalent series resonance circuit of the ultrasonic electromechanical system as shown in Figure 25.

[00473] Again with reference to Figures 43A and 43B, when the ultrasonic transducer is activated by voltage signals from the generator Vg (t) and current signals from the generator Ig (t) at the electromechanical resonance frequency fo 55,500 Hz, the angle phase φ between generator voltage signals Vg (t) and generator current Ig (t) is zero, the magnitude of impedance | Z | it is at a minimum impedance, for example 800 Ω, and the signal amplitude is at a peak or maximum due to the equivalent series resonance circuit of the ultrasonic electromechanical system. As the temperature of the ultrasonic blade increases, due to the frictional heat generated in use, the frequency of electromechanical resonance fo 'of the ultrasonic device decreases. As the ultrasonic transducer is still activated by the voltage signals of the generator Vg (t) and the current of the generator Ig (t) at the previous resonant electromechanical frequency (cold blade) fo of 55,500 Hz, the ultrasonic device operates out of fo 'resonance, causing a shift in the phase angle φ between the generator voltage signals Vg (t) and the generator current Ig (t). There is also an increase in the magnitude of impedance | Z | and a drop in the peak magnitude of the trigger signal in relation to the previous electromechanical resonance frequency (cold blade) of 55,500 Hz. Consequently, the temperature of the ultrasonic blade can be inferred by measuring the phase angle φ between the voltage signals the generator Vg (t) and the current of the generator Ig (t) when the electromechanical resonance frequency fo changes due to changes in the temperature of the ultrasonic blade.

[00474] As previously described, an electromechanical ultrasonic system includes an ultrasonic transducer, a waveguide and an ultrasonic blade. As previously discussed, the ultrasonic transducer can be modeled as an equivalent series resonant circuit (see Figure 25) which comprises a first branch having a static capacitance and a second branch "in motion" having a series connected inductance, resistance and capacitance that define the electromechanical properties of a resonator. The electromechanical ultrasonic system has an initial electromechanical 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 Vg (t) and alternating current Ig (t) at a frequency equal to the frequency of electromechanical resonance, for example, resonance frequency of the electromechanical ultrasonic system. When the electromechanical ultrasonic system is excited at the resonance frequency, the phase angle φ between the voltage signals Vg (t) and current Ig (t) is zero.

[00475] Put another way, in resonance, the analog inductive impedance of the electromechanical ultrasonic system is equal to the analog capacitive impedance of the electromechanical ultrasonic system. As the ultrasonic blade heats up, for example due to frictional engagement with the fabric, the conformity of the ultrasonic blade (modeled as an analog capacitance) causes a shift in the resonance frequency of the electromechanical ultrasonic system. In the present example, the resonance frequency of the electromechanical ultrasonic system decreases as the temperature of the ultrasonic blade increases. In this way, the analog inductive impedance of the electromechanical ultrasonic system is no longer equal to the analog capacitive impedance of the electromechanical ultrasonic system, causing a mismatch between the activation frequency and the new resonance frequency of the electromechanical ultrasonic system. In this way, with a hot ultrasonic blade, the electromechanical ultrasonic system operates "out of resonance". The difference between the drive frequency and the resonance frequency is manifested as a phase angle φ between the voltage signals Vg (t) and current Ig (t) applied to the ultrasonic transducer.

[00476] As previously discussed, the generator electronic circuit can easily monitor the phase angle φ between the voltage signals Vg (t) and current Ig (t) applied to the ultrasonic transducer. The phase angle φ can be determined using Fourier analysis, estimation of weighted least squares, Kalman filtration, space-vector based techniques, zero crossing method, Lissajous figures, three voltmeter method, "crossed-coil method ", vector voltmeter and vector impedance methods, standard phase instruments, phase-locked loops and other techniques previously described. The generator can continuously monitor the phase angle φ and adjust the trigger frequency until the phase angle φ is zero. At this point, the new drive frequency is equal to the resonance frequency of the new electromechanical ultrasonic system. The change in phase angle φ and / or frequency of activation of the generator can be used as an indirect or inferred measurement of the temperature of the ultrasonic blade.

[00477] There are a variety of techniques available to estimate the temperature from the data in these spectra. Most notably, a nonlinear, time-varying set of state space equations can be used to model the dynamic relationship between the ultrasonic blade temperature and the measured impedance: 𝑉𝑔 (𝑡) 𝑍𝑔 (𝑡) = 𝐼𝑔 (𝑡) through a generator frequency range, and the generator frequency range is specific to the device model. Temperature estimation methods

[00478] An aspect of estimating or inferring the temperature of an ultrasonic blade can include three steps. First, define a temperature and frequency state space model that is dependent on time and energy. To model temperature as a function of frequency content, a set of nonlinear state space equations are used to model the relationship between the frequency of electromechanical resonance and the temperature of the ultrasonic blade. Second, apply a Kalman filter to improve the accuracy of the temperature estimator and the state space model over time. Third, a state estimator is provided in the feedback circuit of the Kalman filter to control the power applied to the ultrasonic transducer, and consequently the ultrasonic blade, to regulate the temperature of the ultrasonic blade. The three steps are described later in this document. Step 1

[00479] The first step is to define a temperature and frequency state space model that is dependent on time and energy. To model temperature as a function of frequency content, a set of nonlinear state space equations are used to model the relationship between the frequency of electromechanical resonance and the temperature of the ultrasonic blade. In one aspect, the state space model is defined by: 𝐹𝑛̇ [] = 𝑓 (𝑡, 𝑇 (𝑡), 𝐹𝑛 (𝑡), 𝐸 (𝑡)) 𝑇̇ 𝑦̇ = ℎ (𝑡, 𝑇 (𝑡), 𝐹𝑛 (𝑡), 𝐸 (𝑡))

[00480] The state space model represents the rate of change in the natural frequency of the electromechanical ultrasonic system 𝐹𝑛̇ and the rate of change in temperature 𝑇̇ of the ultrasonic blade with respect to natural frequency 𝐹𝑛 (𝑡), temperature 𝑇 (𝑡), energy 𝐸 (𝑡), and time t. 𝑦̇ represents the observability of the variables that are measurable and observable such as the natural frequency 𝐹𝑛 (𝑡) of the electromechanical ultrasonic system, the temperature 𝑇 (𝑡) of the ultrasonic sheet, the energy 𝐸 (𝑡) applied to the ultrasonic sheet, and the time t. The temperature 𝑇 (𝑡) of the ultrasonic sheet is observable as an estimate. Step 2

[00481] The second step is to apply a Kalman filter to improve the temperature estimator and the state space model. Figure 44 is a diagram of a Kalman 133020 filter to improve the temperature estimator and the state space model based on impedance according to the equation: 𝑉𝑔 (𝑡) 𝑍𝑔 (𝑡) = 𝐼𝑔 (𝑡) representing impedance through an ultrasonic transducer measured at a variety of frequencies, according to at least one aspect of the present disclosure.

[00482] The Kalman 133020 filter can be used to improve the performance of the temperature estimate and allows the increase of external sensors, models, or previous information to improve the temperature forecast in the midst of noisy data. The Kalman 133020 filter includes a 133022 regulator and a 133024 plant. In control theory, a 133024 plant is the combination of process and actuator. A 133024 plant can be called a transfer function that indicates the relationship between an input signal and the output signal of a system. The 133022 regulator includes a 133026 state estimator and a 133028 K controller. The 133026 state regulator includes a 133030 feedback circuit. The 133026 state regulator receives y, the plant output 133024, as an input and feedback variable u . The state estimator 133026 is an internal feedback system that converges to the real state value of the system. The output of the state estimator 133026 is 𝑥̂, the complete feedback control variable including 𝐹𝑛 (𝑡) of the electromechanical ultrasonic system, the temperature estimate 𝑇 (𝑡) of the ultrasonic blade, the energy 𝐸 (𝑡) applied to the ultrasonic blade, the phase angle φ, and the time t. The input into the K 133028 controller is 𝑥̂ and the K 133028 u controller output is fed back to the 133026 and t plant estimator 133024.

[00483] Kalman filtration, also known as linear quadratic estimation (LQE), is an algorithm that uses a series of measurements observed over time, containing noise and other statistical inaccuracies, and produces estimates of unknown variables that tend to be more accurate than those based on a single measurement only, by estimating a joint probability distribution over the variables for each time period and thereby calculating the maximum probability estimate of actual measurements. The algorithm works in a two-step process. In a forecasting stage, the Kalman filter 133020 produces estimates of the current state variables, together with their uncertainties. After the result of the next measurement (necessarily corrupted with some amount of error, including random noise) is observed, these estimates are updated using a weighted average, with more weight being given to the estimates with greater certainty. The algorithm is recursive and can be executed in real time, using only the input measurements present and the previously calculated state and its uncertainty matrix; no additional past information is required.

[00484] The Kalman filter 133020 uses a dynamic model of the electromechanical ultrasonic system, control inputs known for that system, and multiple sequential measurements (observations) of the natural frequency and phase angle of the applied signals (for example, magnitude and phase of the electrical impedance of the ultrasonic transducer) to the ultrasonic transducer to form an estimate of the varying amounts of the electromechanical ultrasonic system (its state) to predict the temperature of the ultrasonic blade portion of the electromechanical ultrasonic system that is better than an estimate obtained using only a single measurement only. As such, the Kalman 133020 filter is an algorithm that includes sensor and data fusion to provide the maximum probability estimate of the ultrasonic blade temperature.

[00485] The Kalman 133020 filter effectively estimates the uncertainty due to the noise measurements of the signals applied to the ultrasonic transducer to measure the natural frequency and phase shift data and also effectively estimates the uncertainty due to external random factors. The Kalman filter 133020 produces an estimate of the state of the electromechanical ultrasonic system as a weighted average of the predicted state of the system and the new measurement. Weighted values provide better (that is, less) estimated uncertainty and are more "reliable" than unweighted values. Weights can be calculated from covariance, a measure of the estimated uncertainty of predicting the state of the system. The result of the weighted average is a new estimate of the state that lies between the predicted and measured state, and has a better estimated uncertainty than one or the other alone. This process is repeated at each stage of time, with the new estimate and its covariance generating the prediction used in the next iteration. This recursive nature of the Kalman 133020 filter requires only the last "best guess", rather than the whole story, of the state of the electromechanical ultrasonic system to calculate a new state.

[00486] The relative certainty of the measurements and the estimation of the current state is an important consideration, and it is common to discuss the filter response in terms of the K gain of the Kalman 133020 filter. The Kalman K gain is the relative weight assigned to measurements and the estimation of the current state, and can be "adjusted" to obtain a specific performance. With a high K gain, the Kalman 133020 filter puts more weight on the most recent measurements, and thus follows them more responsively. With a low K gain, the Kalman 133020 filter follows the model's predictions more closely. From both extremes, a high gain close to one will result in a more irregular estimated trajectory, while a low gain close to zero will level the noise but decrease the responsiveness.

[00487] When real calculations are performed for the Kalman filter 133020 (as discussed below), the state estimate and covariance are encoded in covariance matrices to deal with the multiple dimensions involved in a single set of calculations. This allows a representation of the linear relationships between variables of different states (such as position, speed, and acceleration) in any of the transition models or covariance. The use of a Kalman 133020 filter does not assume that the errors are Gaussian. However, the Kalman filter 133020 produces the exact conditional probability estimate in the special case that all errors are distributed Gaussians. Step 3

[00488] The third step uses an estimator 133026 in the 133032 feedback state of the Kalman filter 133020 to control the power applied to the ultrasonic transducer, and consequently the ultrasonic blade, to regulate the temperature of the ultrasonic blade.

[00489] Figure 45 illustrates a graphical representation 133040 of three probability distributions employed by the state estimator 133026 of the Kalman filter 133020 shown in Figure 44 to maximize the estimates, in accordance with at least one aspect of the present disclosure. Probability distributions include the previous probability distribution 133042, the prediction probability (state) distribution 133044 and the observation probability distribution 133046. The three probability distributions 133042, 133044, 1330467 are used in an energy feedback control applied to an ultrasonic transducer to regulate temperature based on impedance across the ultrasonic transducer measured at a variety of frequencies, in accordance with at least one aspect of the present disclosure. The estimator used in the feedback control of the power applied to an ultrasonic transducer to regulate the temperature based on the impedance is given by the expression: 𝑉𝑔 (𝑡) 𝑍𝑔 (𝑡) = 𝐼𝑔 (𝑡) which is the impedance through the ultrasonic transducer measured in a variety of frequencies, in accordance with at least one aspect of the present disclosure.

[00490] The previous probability distribution 133042 includes a state variation defined by the expression:

(𝜎𝑘−) 2 = 𝜎𝑘 − 1 2 + 𝜎𝑃2𝑘

[00491] The state variance (𝜎𝑘−) is used to predict the next state of the system, which is represented as the forecast probability distribution (state) 133044. The observation probability distribution 133046 is the observation probability distribution real state of the system where the observation variance 𝜎𝑚 is used to define the gain, which is given by the following expression: (𝜎𝑘−) 2 𝐾 = - 2 2 (𝜎𝑘) + 𝜎𝑚 Feedback feedback control

[00492] The energy input is decreased to ensure that the temperature (as estimated by the state estimator and the Kalman filter) is controlled.

[00493] In one aspect, the first proof of concept assumed a static linear relationship between the natural frequency of the electromechanical ultrasonic system and the temperature of the ultrasonic blade. By reducing the power as a function of the natural frequency of the electromechanical ultrasonic system (that is, temperature regulation with feedback control), the temperature of the tip of the ultrasonic blade can be controlled directly. In this example, the temperature of the distal tip of the ultrasonic blade can be controlled to not exceed the melting point of the Teflon block.

[00494] Figure 46A is a 133050 graphical representation of the temperature as a function of time of an ultrasonic device without temperature feedback control. The temperature (° C) of the ultrasonic sheet is shown along the vertical geometric axis and the time (s) is shown along the horizontal geometric axis. The test was conducted with a chamois located in the claws of the ultrasonic device. One claw is the ultrasonic blade and the other claw is the clamping arm with a Teflon pad. The ultrasonic blade was excited at the resonance frequency while in friction engagement with the chamois stuck between the ultrasonic blade and the clamping arm. Over time, the temperature (° C) of the ultrasonic blade increases due to friction coupling with the suede. Over time, the temperature profile 133052 of the ultrasonic blade increases until the chamois sample is cut after about 19.5 seconds at a temperature of 220 ° C as indicated in point 133054. Without temperature feedback control, after the cutting of the suede sample, the temperature of the ultrasonic blade increases to a temperature well above the melting point of the Teflon ~ 380 ° C to ~ 490 ° C. At point 133056, the temperature of the ultrasonic blade reaches a maximum temperature of 490 ° C until the Teflon block is completely melted. The temperature of the ultrasonic sheet drops slightly from the temperature peak at point 133056 after the block has completely disappeared.

[00495] Figure 46B is a graph of temperature versus time for an ultrasonic device with temperature feedback control, in accordance with at least one aspect of the present disclosure. The temperature (° C) of the ultrasonic sheet is shown along the vertical geometric axis and the time (s) is shown along the horizontal geometric axis. The test was conducted with a chamois sample located in the claws of the ultrasonic device. One claw is the ultrasonic blade and the other claw is the clamping arm with a Teflon pad. The ultrasonic blade was excited at the resonance frequency while in friction engagement with the chamois stuck between the ultrasonic blade and the clamping arm block. Over time, the temperature profile 133062 of the ultrasonic blade increases until the chamois sample is cut after about 23 seconds at a temperature of 220 ° C as indicated in 133064. With temperature feedback control, the temperature of the blade ultrasound increases to a maximum temperature of about 380 ° C, just below the melting point of TEFLON, as indicated in point 133066 and then is reduced to an average of about 330 ° C as indicated generically in region 133068, thus preventing the merger of the TEFLON block. Application of intelligent ultrasonic blade technology

[00496] When an ultrasonic sheet is immersed in a surgical field filled with fluid, the ultrasonic sheet cools during activation becoming less effective for sealing and cutting tissue in contact with it. Cooling the ultrasonic sheet can lead to longer activation times and / or hemostasis problems because adequate heat is not applied to the tissue. To overcome the cooling of the ultrasonic blade, more energy may be needed to shorten the transection times and achieve adequate hemostasis under these fluid immersion conditions. With the use of a frequency-temperature feedback control system, if the temperature of the ultrasonic blade is detected to start below, or remain below a certain temperature for a certain period of time, the output power of the generator can be increased to compensate for the cooling due to blood / saline / other fluid present in the surgical field.

[00497] Consequently, the temperature-frequency feedback control system described here can optimize the performance of an ultrasonic device especially when the ultrasonic blade is located or immersed, partially or totally, in a surgical field filled with fluid. The frequency-temperature feedback control system described here minimizes long activation times and / or potential problems with the performance of the ultrasonic device in the fluid-filled surgical field.

[00498] As previously described, the temperature of the ultrasonic blade can be inferred by detecting the impedance of the ultrasonic transducer given by the following expression: 𝑉𝑔 (𝑡) 𝑍𝑔 (𝑡) = 𝐼𝑔 (𝑡) or equivalent, the detection of the phase angle φ between the voltage signals Vg (t) and current Ig (t) applied to the ultrasonic transducer. Phase angle information φ can also be used to infer ultrasonic sheet conditions. As discussed in particular here, the phase angle φ changes as a function of the temperature of the ultrasonic sheet. Therefore, phase angle information φ can be used to control the temperature of the ultrasonic sheet. This can be done, for example, by reducing the power supplied to the ultrasonic sheet when the ultrasonic sheet is very hot and by increasing the power applied to the ultrasonic sheet when the ultrasonic sheet is very cold. Figures 58A to 58B are graphical representations of the temperature feedback control to adjust the ultrasonic energy applied to an ultrasonic transducer when a sudden drop in the temperature of an ultrasonic blade is detected.

[00499] Figure 47A is a graphical representation of the 133070 ultrasonic energy output as a function of time, according to at least one aspect of the present disclosure. The output power of the ultrasonic generator is shown along the vertical geometric axis and the time (s) is shown along the horizontal geometric axis. Figure 47B is a graphical representation of the temperature of the 133080 ultrasonic sheet as a function of time, according to at least one aspect of the present disclosure. The temperature of the ultrasonic sheet is shown along the vertical geometric axis and the time (s) is shown along the horizontal geometric axis. The temperature of the ultrasonic blade increases with the application of constant energy 133072 as shown in Figure 47A. During use, the temperature of the ultrasonic blade drops suddenly. This can result from a variety of conditions, however, during use, it can be inferred that the temperature of the ultrasonic blade drops when it is immersed in a surgical field filled with fluid (eg, blood, saline, water, etc.). At time t0, the temperature of the ultrasonic blade drops below the desired minimum temperature 133082 and the frequency-temperature feedback control algorithm detects the drop in temperature and begins to increase or "raise" the power as shown by the provided power increase 133074 to the ultrasonic blade to start raising the temperature of the ultrasonic blade above the minimum desired temperature 133082.

[00500] With reference to Figures 47A and 47B, the ultrasonic generator provides substantially constant power outputs 133072 as long as the temperature of the ultrasonic blade remains above the minimum desired temperature 133082. In t0, the processor or the control circuit in the generator or in instrument, or both, detects the drop in temperature of the ultrasonic blade below the desired minimum temperature 133072 and initiates a frequency-temperature feedback control algorithm to raise the temperature of the ultrasonic blade above the desired minimum temperature 133082. Consequently, the energy of the generator starts to rise 133074 at t1 corresponding to the detection of a sudden drop in the temperature of the ultrasonic blade at t0. Under the frequency-temperature feedback control algorithm, the energy continues to rise 133074 until the temperature of the ultrasonic blade is above the desired minimum temperature 133082.

[00501] Figure 48 is a 133090 logic flow diagram of a process that represents a control program or a logical configuration for controlling the temperature of an ultrasonic blade, according to at least one aspect of the present disclosure.

According to the process, the processor or the generator or instrument control circuit, or both, performs an aspect of a frequency-temperature feedback control algorithm discussed in connection with Figures 47A and 47B to apply a level 133092 of power to the ultrasonic transducer to achieve a desired temperature on the ultrasonic blade.

The 133094 generator monitors the phase angle φ between the voltage Vg (t) and current Ig (t) signals applied to drive the ultrasonic transducer.

Based on the phase angle φ, the generator infers 133096 infers the temperature of the ultrasonic blade using the techniques described here in connection with Figures 43A to 45. The generator determines 133098 if the temperature of the ultrasonic blade is below a minimum temperature by comparing the inferred temperature of the ultrasonic sheet with a predetermined desired temperature.

The generator then adjusts the power level applied to the ultrasonic transducer based on the comparison.

For example, the process continues along the NO branch when the ultrasonic sheet temperature is at or above the desired minimum temperature and continues along the YES branch when the ultrasonic sheet temperature is below the desired minimum temperature.

When the temperature of the ultrasonic blade is below the desired minimum temperature, the generator increases the power level for the ultrasonic transducer by 133100, for example, by increasing the voltage signals V g (t) and / or current I g (t), to raise the temperature of the ultrasonic blade and continues to increase the power level applied to the ultrasonic transducer until the temperature of the ultrasonic blade increases above the desired minimum temperature.

Adaptive advanced tissue treatment block saving mode

[00502] Figure 49 is a 133110 graphical representation of the temperature of the ultrasonic blade as a function of time during the firing of a vessel, according to at least one aspect of the present disclosure. A 133112 graph of the ultrasonic blade temperature is plotted along the vertical geometric axis as a function of time along the horizontal geometric axis. The frequency-temperature feedback control algorithm combines the control temperature of the ultrasonic blade with the claw detection capability. The frequency-temperature feedback control algorithm provides optimal balanced hemostasis with device durability and can intelligently distribute energy for better sealing while protecting the clamping arm block.

[00503] As shown in Figure 49, the optimum temperature 133114 for the vessel seal is marked as a first target temperature T1 and the optimum temperature 133116 for the "infinite" life of the clamping arm block is marked as a second temperature target T2. The frequency-temperature feedback control algorithm infers the ultrasonic blade temperature and maintains the ultrasonic blade temperature between the first and second target temperature thresholds T1 and T2. The energy output of the generator is thus activated to obtain optimal temperatures from the ultrasonic blade to seal the vessels and prolong the life of the clamping arm block.

[00504] Initially, the temperature of the ultrasonic blade increases as the blade heats and eventually exceeds the first target temperature threshold T1. The frequency-temperature feedback control algorithm takes control of the slide temperature to T1 until the vessel transection is completed 133118 at t0 and the ultrasonic slide temperature falls below the second target temperature threshold T2. A processor or generator or instrument control circuit, or both, detects when the ultrasonic blade comes into contact with the clamping arm block. When the transfection of the vessel is completed at t0 and detected, the frequency-temperature feedback control algorithm changes to control the temperature of the ultrasonic blade at the second target threshold T 2 to extend the life of the clamping arm block. The optimum temperature of the clamping arm block for a TEFLON clamping arm block is approximately 325 ° C. In one aspect, advanced tissue treatment can be announced to the user in a second activation tone.

[00505] Figure 50 is a 133120 logic flow diagram of a process that represents a control program or a logical configuration for controlling the temperature of an ultrasonic blade between two temperature adjustment points, as shown in Figure 49, according to with at least one aspect of the present revelation. According to the process, the generator performs an aspect of the frequency-temperature feedback control algorithm to apply 133122 a first power level to the ultrasonic transducer, for example, by adjusting the voltage signals Vg (t) and / or Ig (t) current applied to the ultrasonic transducer, to adjust the ultrasonic blade to a first target temperature T1 optimized for vessel sealing. As previously described, the generator monitors 133124 the phase angle φ between the voltage signals Vg (t) and current Ig (t) applied to the ultrasonic transducer, and based on the phase angle φ, generator 133126 infers the temperature of the ultrasonic blade using the techniques described here in connection with Figures 43A to 45. According to the frequency-temperature feedback control algorithm, a generator or instrument control circuit or processor, or both, maintains the temperature of the ultrasonic slide at the first target temperature T1 until the transection is completed. The frequency-temperature feedback control algorithm can be used to detect the completion of the vessel's transection process. The processor or control circuit of the generator or instrument, or both, determines 133128 when the vessel's transection is complete. The process continues along the NO branch when the vessel transection is not complete and continues along the YES branch when the vessel transection is complete.

[00506] When the transection of the vessel is not complete, the processor or control circuit of the generator or instrument, or both, determines 133130 if the temperature of the ultrasonic blade is set at the temperature T1 optimized for sealing and transection of the vessel. If the temperature of the ultrasonic blade is set to T1, the process continues along the SIM branch and the processor or generator or instrument control circuit, or both, continues to monitor 133124 the phase angle φ between voltage signals Vg ( t) and Ig current (t) applied to the ultrasonic transducer and based on the phase angle φ. If the temperature of the ultrasonic blade is not adjusted to T1, the process continues along the NO branch and the processor or control circuit of the generator or instrument, or both, continues to apply 133122 a first power level to the ultrasonic transducer.

[00507] When the vessel transection is complete, the processor or control circuit of the generator or instrument, or both, 133132 applies a second level of power to the ultrasonic transducer to adjust the ultrasonic blade to a second target temperature 2 optimized to preserve or extend the life of the clamping arm block. The processor or control circuit of the generator or instrument, or both, determines 133134 whether the temperature of the ultrasonic blade is at the set temperature T2. If the temperature of the ultrasonic blade is set to T2, the process completes the 133136 vessel transection procedure. Blade Start Temperature

[00508] Knowing the temperature of the ultrasonic blade at the beginning of a transection can allow the generator to provide the adequate amount of energy to heat the blade for a quick cut or if the blade is already hot add energy only in the amount that would be needed. This technique can achieve more consistent transection times and extends the life of the clamping arm block (for example, a TEFLON clamping arm block). Knowing the temperature of the ultrasonic blade at the beginning of the transection can allow the generator to deliver the right amount of power to the ultrasonic transducer to generate a desired amount of displacement of the ultrasonic blade.

[00509] Figure 51 is a 133140 logic flow diagram of a process that represents a control program or a logical configuration to determine the initial temperature of an ultrasonic blade, according to at least one aspect of the present disclosure. To determine the initial temperature of an ultrasonic blade, at the manufacturing facilities, the resonance frequencies of ultrasonic sheets are measured at room temperature or at a predetermined room temperature. Baseline frequency values are recorded and stored in a lookup table for the generator or instrument or both. Baseline values are used to generate a transfer function. At the start of an ultrasonic transducer activation cycle, the generator measures 133142 the resonance frequency of the ultrasonic blade 133144 and compares the resonance frequency measured to the resonance frequency value in the baseline and determines the frequency difference (Δf). Δf is compared to a look-up table or transfer function to obtain the corrected temperature of the ultrasonic sheet. The resonance frequency of the ultrasonic blade can be determined by scanning the frequency of the voltage signals Vg (t) and current Ig (t) applied to the ultrasonic transducer. The resonance frequency is the frequency at which the phase angle φ between the voltage signals Vg (t) and current Ig (t) is zero as described here.

[00510] After the resonance frequency of the ultrasonic blade is determined, the processor or control circuit of the generator or instrument, or both, determines 133146 the initial temperature of the ultrasonic blade based on the difference between the measured resonance frequency and the frequency of baseline resonance. The generator adjusts the power level supplied to the ultrasonic transducer, for example, by adjusting the voltage activation signals Vg (t) or current Ig (t), or both, to one of the following values before activating the ultrasonic transducer.

[00511] The processor or control circuit of the generator or instrument, or both, determines 133148 if the initial temperature of the ultrasonic blade is low. If the initial temperature of the ultrasonic blade is low, the process continues along the SIM branch and the processor or generator or instrument control circuit, or both, 133152 applies a high power level to the ultrasonic transducer to increase the temperature of the ultrasonic blade and complete 133156 the vessel transection procedure.

[00512] If the initial temperature of the ultrasonic blade is not low, the process continues along the NO branch and the processor or control circuit of the generator or instrument, or both, determines 133150 if the initial temperature of the ultrasonic blade is high. If the initial temperature of the ultrasonic blade is low, the process continues along the YES branch and the processor or generator or instrument control circuit, or both, 133154 applies a low power level to the ultrasonic transducer to decrease the temperature of the ultrasonic blade and complete 133156 the vessel transection procedure. If the initial temperature of the ultrasonic blade is not high, the process continues along the NO branch and the processor or control circuit of the generator or instrument, or both, completes the vessel's transection. Intelligent blade technology to control blade instability

[00513] The temperature of an ultrasonic blade and the contents within the claws of an ultrasonic end actuator can be determined using the frequency-temperature feedback control algorithms described in the present invention. The frequency / temperature ratio of the ultrasonic blade is used to control the instability of the ultrasonic blade instability with temperature.

[00514] As described here, there is a well-known relationship between frequency and temperature in ultrasonic sheets. Some ultrasonic sheets have displacement instability or modal instability with increasing temperature. This known relationship can be used to interpret when an ultrasonic blade is approaching instability and then adjust the power level by activating the ultrasonic transducer (for example, by adjusting the trigger signals for voltage Vg (t) or current Ig (t), or both, applied to the ultrasonic transducer) to modulate the temperature of the ultrasonic blade to prevent instability of the ultrasonic blade.

[00515] Figure 52 is a 133160 logic flow diagram of a process that represents a control program or a logical configuration to determine when an ultrasonic blade is approaching instability and then adjust the power applied to the ultrasonic transducer to prevent the instability of the ultrasonic transducer, according to at least one aspect of the present disclosure. The frequency / temperature relationship of an ultrasonic blade that presents a displacement or modal instability is mapped by scanning the frequency of the triggering signals of voltage Vg (t) or current Ig (t), or both, in the temperature of the ultrasonic blade and record the results. A function or relation is developed that can be used / interpreted by a control algorithm executed by the generator. Trigger points can be established using the relationship to notify the generator that an ultrasonic blade is approaching known blade instability. The generator performs a processing function of the frequency-temperature feedback control algorithm and the closed-loop response so that the power level of the drive is reduced (for example, by reducing the voltage Vg (t) or current Ig ( t) drive, or both, applied to the ultrasonic transducer) to modulate the temperature of the ultrasonic blade at or below the drive point to prevent a given blade from reaching instability.

[00516] The advantages include simplifying the settings of the ultrasonic blade so that the instability characteristics of the ultrasonic blade do not need to be designed and can be compensated with the use of the present instability control technique. The present instability control technique also allows for new ultrasonic sheet geometries and can improve the stress profile in heated ultrasonic sheets. In addition, ultrasonic sheets can be configured to decrease the performance of the ultrasonic sheet if used with generators that do not use this technique.

[00517] According to the process shown by logic flow diagram 133160, the processor or control circuit of the generator or instrument, or both, monitors 133162 the phase angle φ between the voltage signals Vg (t) and current Ig (t) applied to the ultrasonic transducer. The processor or control circuit of the generator or instrument, or both, infer 133164 the temperature of the ultrasonic blade based on the phase angle V between the voltage signals Vg (t) and current Ig (t) applied to the ultrasonic transducer. The processor or control circuit of the generator or instrument, or both, compares 133166 the inferred temperature of the ultrasonic blade to an ultrasonic blade instability trigger point threshold. The processor or control circuit of the generator or instrument, or both, determines 133168 whether the ultrasonic blade is approaching instability. If not, the process proceeds along the NO branch and monitors 133162 the phase angle φ, infers 133164 the temperature of the ultrasonic blade, and compares 133166 the inferred temperature of the ultrasonic blade to a trigger point threshold of instability of the ultrasonic blade up to the ultrasonic sheet approaches instability. The process then proceeds along the SIM branch and the processor or control circuit of the generator or instrument, or both, adjusts the 133170 power level applied to the ultrasonic transducer to modulate the temperature of the ultrasonic blade. Ultrasonic sealing algorithm with temperature control

[00518] Ultrasonic sealing algorithms for temperature control of the ultrasonic blade can be used to optimize hemostasis using a frequency-temperature feedback control algorithm described here to explore the frequency / temperature ratio of the ultrasonic sheets.

[00519] In one aspect, a frequency-temperature feedback control algorithm can be used to change the applied power level of the ultrasonic transducer based on the measured resonance frequency (using spectroscopy) that refers to the temperature, as described in various aspects of the present revelation. In one respect, the frequency-temperature feedback control algorithm can be activated by a power button on the ultrasonic instrument.

[00520] It is known that great tissue effects can be obtained by increasing the power level that drives the ultrasonic transducer (for example, by increasing the Vg (t) voltage or driving Ig (t) current, or both, applied to the ultrasonic transducer) at the beginning of the sealing cycle to quickly heat and dry the tissue, and then decrease the power level that drives the ultrasonic transducer (for example, decreasing the voltage Vg (t) or the driving current Ig (t) , or both, applied to the ultrasonic transducer) to slowly allow the formation of the final seal. In one aspect, a frequency-temperature feedback feedback algorithm in accordance with the present disclosure sets a threshold in the temperature threshold that the tissue can reach as the tissue warms up during the highest power level stage and then reduces the power level to control the temperature of the ultrasonic blade based on the melting point of the clamping clamp block (eg Teflon) to complete the seal. The control algorithm can be implemented by activating a power button on the instrument for a more responsive / adaptable seal to further reduce the complexity of the hemostasis algorithm.

[00521] Figure 53 is a 133180 logic flow diagram of a process that represents a control program or a logical configuration to provide ultrasonic sealing with temperature control, in accordance with at least one aspect of the present disclosure. According to the control algorithm, the processor or control circuit of the generator or instrument, or both, activates 133182 ultrasonic blade detection using spectroscopy (for example, smart blade) and measures 133184 the resonance frequency of the blade ultrasound (for example, the resonance frequency of the ultrasonic electromechanical system) to determine the temperature of the ultrasonic blade using a frequency-temperature feedback (algorithm) control algorithm as described here. As previously described, the resonance frequency of the ultrasonic electromechanical system is mapped to obtain the temperature of the ultrasonic blade as a function of the resonance frequency of the electromechanical ultrasonic system.

[00522] A first desired resonance frequency fx of the ultrasonic electromechanical system corresponds to a first desired temperature Z ° of the ultrasonic blade. In one aspect, the first temperature of the desired ultrasonic blade Z ° is the optimum temperature (for example, 450 ° C) for tissue coagulation. A second desired frequency fY of the ultrasonic electromechanical system corresponds to a second desired temperature ZZ ° of the ultrasonic blade. In one aspect, the second temperature of the desired ultrasonic blade ZZ ° is a temperature of 330 ° C, which is below the melting point of the clamping arm block, approximately 380 ° C which is for Teflon.

[00523] The processor or control circuit of the generator or instrument, or both, compares 133186 the measured resonance frequency of the ultrasonic electromechanical system to the first desired frequency fx. In other words, the process determines whether the temperature of the ultrasonic blade is less than the temperature for optimal tissue coagulation. If the measure of the resonance frequency of the ultrasonic electromechanical system is less than the first desired frequency fx, the process continues along the NO branch and the processor or control circuit of the generator or instrument, or both, 133188 increases the applied power level to the ultrasonic transducer to increase the temperature of the ultrasonic blade until the measured resonance frequency of the ultrasonic electromechanical system exceeds the first desired frequency fx. In this case, the tissue coagulation process is completed and the process controls the temperature of the ultrasonic sheet to the second desired temperature corresponding to the second desired frequency fy.

[00524] The process continues along the SIM branch and the processor or control circuit of the generator or instrument, or both, decreases 133190 the power level applied to the ultrasonic transducer to decrease the temperature of the ultrasonic blade. The processor or control circuit of the generator or instrument, or both, measures 133192 the resonance frequency of the ultrasonic electromechanical system and compares the measured resonance frequency to the second desired frequency fY. If the measured resonance frequency is not less than the desired second frequency fY, the processor or control circuit of the generator or instrument, or both, decreases the ultrasonic power level 133190 until the measured resonance frequency is less than the second frequency desired fY. The frequency-temperature feedback control algorithm keeps the measured resonance frequency of the ultrasonic electromechanical system below the desired second frequency fY, for example, the temperature of the ultrasonic blade is less than the melting point temperature of the clamping arm block the generator then performs the power level increases applied to the ultrasonic transducer to increase the temperature of the ultrasonic blade until the completion of the tissue transection process

133196.

[00525] Figure 54 is a 133200 graphical representation of the ultrasonic transducer current and the ultrasonic blade temperature as a function of time, according to at least one aspect of the present disclosure. Figure 54 illustrates the results of applying the frequency-temperature feedback control algorithm described in Figure 53. Graph 133200 shows a first plot 133202 of the ultrasonic blade temperature as a function of time in relation to a second plot 133204 of the current of the ultrasonic transducer Ig (t) as a function of time. As shown, the Ig (t) transducer is kept constant until the temperature of the ultrasonic blade reaches 450 °, which is an optimal coagulation temperature. When the temperature of the ultrasonic blade reaches 450 °, the frequency-temperature feedback control algorithm decreases the current of the Ig (t) transducer until the temperature of the ultrasonic blade drops below 330 °, which is below the melting point of a Teflon block, for example. Identification or parameterization of the type of fabric

[00526] In several aspects, a surgical instrument (for example, an ultrasonic surgical instrument) is configured to identify or parameterize the tissue attached by the end actuator and adjust various operating parameters of the surgical instrument accordingly. The identification or parameterization of the tissue may include the type of tissue (for example, the physiological tissue type), the physical characteristics or properties of the tissue, the composition of the tissue, the location of the tissue within or in relation to the end actuator, and so on. In an example discussed in more detail below, the ultrasonic surgical instrument is configured to adjust the displacement amplitude of the distal tip of the ultrasonic blade according to the collagen / elastin ratio of the tissue detected in the claws of the end actuator. As previously discussed, an ultrasonic instrument comprises an ultrasonic transducer acoustically coupled to an ultrasonic blade using an ultrasonic waveguide. The displacement of the ultrasonic blade is a function of the electrical energy applied to the ultrasonic transducer and, consequently, the electrical energy supplied to the ultrasonic transducer can be modulated according to the tissue collagen / elastin ratio detected. In another example discussed in more detail below, the force exerted by the clamping arm on the fabric can be modulated according to the location of the fabric in relation to the end actuator. Various techniques for identifying or parameterizing the tissue are described in the present disclosure and additional details can be found, for example, in US provisional patent application No. 62 / 692,768, entitled SMART ENERGY DEVICES, filed on June 30, 2018, the disclosure of which is hereby incorporated by reference in its entirety. Determination of tissue location by changing impedance

[00527] Again with reference to Figure 23, an end actuator 1122 is illustrated which comprises an ultrasonic blade 1128 and a clamping arm 1140, in accordance with at least one aspect of the present disclosure. Figure 55 is a bottom view of an ultrasonic end actuator 1122 showing a clamping arm 1140 and an ultrasonic blade 1128 and outlining the positioning of the tissue within the ultrasonic end actuator 1122, according to at least one aspect of the present revelation. The positioning of the tissue between the clamping arm 1140 and the ultrasonic blade 1128 can be delineated according to the region or zone in which the tissue is located, such as a distal region 130420 and a proximal region 130422.

[00528] Now with reference to Figures 23 and 55, as described here, the ultrasonic end actuator 1122 holds the fabric between the ultrasonic blade 1128 and the clamping arm 1140. When the fabric is attached, the ultrasonic generator (for example, the generator 1100 described in connection with Figure 22) can be activated to apply power to the ultrasonic transducer, which is acoustically coupled to the 1128 ultrasonic blade by means of an ultrasonic waveguide. The power applied to the ultrasonic transducer can be in a therapeutic or non-therapeutic range of energy levels. In a non-therapeutic range of applied power, the resulting displacement of the 1128 ultrasonic blade does not affect, or minimally affects, the trapped tissue in order not to clot or cut the tissue. Non-therapeutic excitation can be particularly useful for determining the impedance of the ultrasonic transducer, which will vary based on a variety of conditions present on the 1122 end actuator, including, for example, the type of tissue, the location of the tissue within the actuator edge, the ratio between different types of tissue and the temperature of the ultrasonic sheet, among other conditions. Several of these conditions are described in the present disclosure. The impedance of the ultrasonic transducer is given by: 𝑉𝑔 (𝑡) 𝑍𝑔 (𝑡) =, 𝐼𝑔 (𝑡) as described here. Since conditions on the 1122 ultrasonic end actuator are determined using non-therapeutic ultrasonic energy levels, therapeutic ultrasonic energy can be applied based on the conditions of the 1122 end actuator determined to optimize tissue treatment, sealing efficiency, transection and duration, among other variables associated with a specific surgical procedure. The therapeutic energy is sufficient to clot and cut the tissue.

[00529] In one aspect, the present disclosure provides a control process, such as an algorithm, to determine the thickness and type of the fabric located within the jaws (that is, between the clamping arm 1140 and the ultrasonic blade 1128) of an 1122 ultrasonic end actuator as shown in Figures 23 and 55. Additional details regarding the detection of various states and properties of objects attached by an 1122 end actuator are discussed below under the heading "Determination of claw status" and in the order for US provisional patent No. 62 / 692,768, entitled SMART ENERGY DEVICES.

[00530] Figure 56 is a graphical representation 130000 showing the change in the impedance of the ultrasonic transducer as a function of the location of the tissue within the ultrasonic end actuator 1122 over a range of predetermined increases in the power level of the ultrasonic generator, from according to at least one aspect of the present disclosure. The horizontal geometric axis 130004 represents the location of the tissue and the vertical geometric axis 130002 represents the impedance of the transducer (Ω). Several limits along the horizontal geometry axis 130004, such as a first limit or proximal limit 130010 and a second limit or distal limit 130012, can outline or correspond to different positions of the tissue trapped within the 1122 ultrasonic end actuator. The delineation of the proximal locations and distal tissue is shown schematically in Figure 55 (i.e., proximal portion 130422 and distal portion 130420). Plots 130006, 130008 represent the change in impedance of the transducer (Ω) as the power applied to the ultrasonic transducer changes from a minimum value or first non-therapeutic power level L1 to a maximum value or second non-therapeutic power level L2. The greater the change in the transducer impedance (Ω), the closer the resulting plot will be to the distal limit

130012. Consequently, the location of the tissue corresponds to the position of the resulting plot in relation to the various limits (for example, the proximal limit 130010 and the distal limit 130012). In the first plot 130006, δ1 represents the change in the impedance of the transducer when the tissue is located in the proximal portion 130422 of the end actuator 1122. This can be seen by the fact that the first plot 130006 does not exceed the proximal limit 130010. In the second plot 130008, δ2 represents the change in the impedance of the transducer when the tissue is located at the distal end 130012 of the end actuator 1122. This can be seen by the fact that the first plot 130006 exceeds the proximal limit 130010 and / or is located close to the limit distal 130012. As indicated by plots 130006, 130008, δ2 is much larger than δ1.

[00531] When power (voltage and current) is applied to the ultrasonic transducer to activate the 1128 ultrasonic blade in the non-therapeutic range (for example, a power that is not sufficient to cut or clot the tissue), the transducer impedance (Ω) The resulting measurement is a useful indicator of the position of the tissue within the jaws of the end actuator 1122, either at the distal end 130420 or at the proximal end 130422 of the ultrasonic blade 1128, as shown in Figure 55. The location of the tissue within the end actuator 1122 can be determined based on the change in impedance of the δ transducer as the non-therapeutic power level applied to the ultrasonic transducer varies from a minimum power level (eg L1) to a maximum power level (eg L2) . In some respects, the level (or levels) of non-therapeutic power applied to the ultrasonic transducer can cause the 1128 ultrasonic blade to oscillate in a detection range or below the minimum therapeutic range (for example, less than or equal to 35 µm in the distal and / or proximal end of the 1128 ultrasonic blade). The impedance calculation is discussed earlier in this disclosure. A measurement of the first impedance of the Z1 transducer is taken when a first power level L 1 is applied, which provides an initial measurement, and a subsequent measurement of the impedance

Z2 is done again when the applied power is increased to a second power level L2. In one aspect, the first power level L1 = 0.2 A and the second power level L2 = 0.4 A, or twice the first power level L1, although the voltage is kept constant. The amplitude of the longitudinal displacement resulting from the 1128 ultrasonic blade, based on the applied power level, provides an indication of the location of the tissue within the claws of the 1122 end actuator. In an exemplary implementation, the first L1 power level produces an amplitude of longitudinal displacement of 35 µm at the distal end 130420 and 15 µm at the proximal end 130422. Additionally in this example, the second power level L2 produces a longitudinal amplitude of 70 µm at the distal end 130420 and 35 µm at the proximal end

130422. An algorithm calculates the impedance difference of the δ transducer between the first and second measurements to find the change in impedance ΔZg (t). The change in impedance δ is plotted against the location of the tissue and shows that a greater change in impedance represents the location of the tissue distributed at the distal end 130012 and a minor change in impedance represents the location of the tissue distributed at the proximal end 130010 of the actuator. end 1122. In short, if there is a large change in impedance as the power level is increased from L1 to L2, then the fabric will be positioned distally only within the end actuator 1122; on the other hand, if there is only a small change in impedance as the power level is increased from L1 to L2, then the fabric will be more evenly distributed within the 1122 end actuator.

[00532] Figure 57 is a graphical representation 130050 showing the change in impedance of the ultrasonic transducer as a function of time in relation to the location of the tissue within the ultrasonic end actuator, according to at least one aspect of the present disclosure. The horizontal geometric axis 130054 represents time (t) and the vertical geometric axis 130052 represents the change in transducer impedance (δ) between the first and the second measurements. Plots 130060, 130066 represent the change in impedance of the transducer (δ) as a function of time (t), in relation to the proximal and distal locations of the tissue at the bite of the clamping arm 1140. For the proximal and distal locations of the tissue, it is a force of the clamping arm 1140 is applied to hold the tissue on the ultrasonic end actuator 1122 and a delay period is applied before a first low power level is applied and the impedance of the transducer is measured. Subsequently, the system applies a second higher power level and measures the impedance again. It will be recognized that the first and second power levels applied to the ultrasonic transducer are non-therapeutic power levels. The algorithm performed by a processor or a portion of the generator's control circuit, or surgical instrument (for example, processor 902 in Figure 21 or control circuit 760 in Figure 18) calculates the difference in transducer impedance (δ) between the first power level and the second power level for the proximal and distal locations of the tissue. As shown in relation to the first plot 130060, if the difference in transducer impedance (δ) is below a first threshold 130056, the algorithm determines that the tissue is located in the proximal portion 130422 of end actuator 1122. In the first curve 130060, the transducer impedance difference between measurements increases 130062 over time until it stabilizes or remains 130064 below the first threshold

130056. As shown in relation to the first plot 130066, if the difference in transducer impedance (δ) is above a second threshold 130058, the algorithm determines that the tissue is located in the distal portion 130420 of end actuator 1122. In the second plot 130066, the transducer impedance difference between measurements increases 130068 over time until it stabilizes or remains 130070 above the second threshold 130058. If the transducer impedance difference (δ) is between the first and second thresholds 130056, 130058 , the algorithm determines that the tissue is located in the intermediate portion 130424 of the end actuator 1122, for example, between the proximal and distal portions of the end actuator.

[00533] Figure 58 is a logic flow diagram of a 130100 process that represents a control program or a logical configuration to identify the operation in the non-therapeutic power range of power applied to the instrument to determine the tissue position, according to with at least one aspect of the present revelation. Process 130100 can be performed by a processor or control circuit of a surgical instrument, such as control circuit 760 in Figure 18, or a generator, such as processor 902 in Figure 21. For the sake of brevity, process 130100 will be described as being executed by a processor, but it should be understood that the following description covers the above variations.

[00534] According to one aspect of the 130100 process, a processor applies a control signal to close the clamping arm 1140 to capture the fabric between the clamping arm 1140 and the ultrasonic blade 1128. After the clamping arm 1140 has closes on the fabric, the processor waits for a predetermined delay period to allow the fabric to relax and release part of the moisture content. After this delay period, the 130102 processor adjusts the power level applied to the ultrasonic transducer to a first non-therapeutic power level. Optionally, an aspect of the 130100 process includes a feedback control that can be used to verify that the first power is set below a therapeutic power level.

In this respect, the processor determines 130106 if the first power level is less than a therapeutic power level.

If the first power level is not less than a therapeutic power level, the 130100 process continues along the NO branch and the 130108 processor decreases the applied energy and performs an iteration until the first power level is less than a level of therapeutic potency.

The 130100 process then continues along the SIM branch and the processor measures 130110 a first impedance Zg1 (t) of the ultrasonic transducer corresponding to the first power level.

The processor then sets 130112, then, the power level applied to the ultrasonic transducer to a second non-therapeutic power level, the second power level being greater than the first power level and is below a therapeutic power level.

Again, optionally, a feedback control can be used to verify that the second power level is not only greater than the first power level, but is also below a therapeutic power level.

In this respect, the processor determines 130114 if the second power level is less than a therapeutic power level.

If the second power level is greater than a therapeutic power level, the 130100 process continues along the NO branch and the processor decreases 130108 the second power level and iterates until the second power level is less than a threshold of the therapeutic potency level.

The 130100 process then continues along the SIM branch and the processor measures 130116 a second impedance Zg2 (t) of the ultrasonic transducer corresponding to the second power level.

The impedance of the ultrasonic transducer can be measured using a variety of techniques as discussed in this document.

The processor then calculates 130118 the difference in the impedance of the transducer between the first and second applied power levels: δ = Zg2 (t) - Zg1 (t).

[00535] The processor then provides 130120 to the user with an indication of the position of the tissue. The processor can indicate the position of the tissue via a surgical instrument output device (for example, visual feedback devices, such as the screen shown in Figure 31, audio feedback devices and / or tactile feedback devices), a screen 135 (Figure 3) or another output device of a central surgical controller 106 communicatively connected to the surgical instrument and / or an output device 2140 (Figure 27B) of a generator 1100 (for example, visual feedback devices, devices audio feedback and / or tactile feedback devices).

[00536] The processor compares the difference in the impedance of the transducer with a first and a second threshold and, as shown in Figure 57, if the difference in the impedance of the transducer (δ) is below a first threshold 130056, the algorithm determines that the tissue is located in the proximal portion 130422 of the end actuator 1122, and if the difference in the transducer impedance (δ) is above a second threshold 130058, the algorithm determines that the tissue is located in the distal portion 130420 of the end actuator

1122. If the difference in transducer impedance (δ) is between the first and second thresholds 130056, 130058, the algorithm determines that the tissue is located in the middle portion 130424 of the end actuator 1122, for example, between the proximal and distal 130422, 130420 of end actuator 1122. According to the described process, the impedance of the ultrasonic transducer can be used to differentiate the percentage of tissue that is located in a distal portion, in a proximal portion or in an intermediate location of the actuator 1122 and then apply an appropriate therapeutic potency level. Keyless mode based on tissue placement

[00537] In several respects, the reactions of the ultrasonic instrument may depend on whether the tissue is present in the end actuator, the type of tissue located in the end actuator or the compressibility or composition of the tissue located in the end actuator. Consequently, the generator or the ultrasonic surgical instrument may contain and / or execute instructions to execute algorithms to control the time between gripping the tissue in the claws of the end actuator and activating the ultrasonic transducer to treat the tissue. If tissue is not detected, the buttons or pedals for activating the ultrasonic generator can have different meanings to perform different functions. In one aspect, an advanced energy device can use the detection of the presence of tissue between the claws of the end actuator as the indication to activate the ultrasonic transducer, thus initiating the tissue clotting cycle. In another aspect, the compression properties and situational recognition can allow automatic activation of the device to also adjust the parameters of the algorithm for the type of tissue detected. For example, the advanced generator can ignore the activation buttons or pedals, unless the tissue is detected as being in contact with the end actuator claws. This setting would eliminate involuntary activation indications that would allow the device to be operated in a simpler way.

[00538] Consequently, an advanced generator, such as the advanced generators described in connection with Figures 1 to 42, and / or surgical instruments, such as the ultrasonic surgical instruments described throughout this disclosure, can be configured to operate in a keyless mode. or buttons. In a keyless mode, the ultrasonic device is automatically activated in coagulation mode when tissue is detected in the claws of the end actuator. In one aspect, when operating in automatic power activation mode (or "keyless" mode), the control algorithm that controls activation of the ultrasonic surgical instrument can be configured to apply less energy initially to the ultrasonic instrument than if activated when not operating in keyless mode. Additionally, the generator or the ultrasonic instrument can be configured to determine the contact and type of tissue located in the claws of the end actuator. Based on the detection of the presence of tissue in the claws of the end actuator, control algorithms executed by a processor or control circuit of the generator or the ultrasonic instrument could execute the ultrasonic instrument in keyless mode and could adjust the algorithm to achieve the best general tissue coagulation in the claws of the end actuator. In other respects, instead of automatically activating the surgical instrument and / or the generator, the control algorithms performed by a processor or control circuit of the generator or the ultrasonic instrument could prevent the activation of the generator or the ultrasonic instrument, unless the presence of tissue is detected in the end actuator.

[00539] In one aspect, the present disclosure provides an algorithm performed by a processor or control circuit located on the generator or handheld ultrasonic instrument to determine the presence of tissue and the type of tissue located in the claws of the end actuator. In one aspect, the control algorithm can be configured to determine that the tissue is located within the end actuator using techniques described here to determine the location of the tissue as described below under the heading "Determining the location of the tissue through continuity between electrodes ". For example, a control algorithm can be configured to determine if the tissue is located inside the end actuator by checking if there is any continuity between the electrodes (as described below) and, consequently, activating the surgical instrument (for example, causing the the generator to which the surgical instrument is attached begins to apply power to the surgical instrument) automatically upon detection of the tissue or allows the activation of the surgical instrument.

When the surgical instrument and / or the generator are operated in keyless mode, the control algorithm can be additionally configured to activate the surgical instrument at a specific power level, which may or may not be different from an initial activation power level standard for the surgical instrument.

In some aspects, a control algorithm can be configured to activate or allow the activation of the surgical instrument according to the type or specific composition of the tissue, which can be detected using, for example, the techniques described below under the heading "Determination of the collagen / elastin ratio of the tissue according to reflectance and surface emissivity in the infrared (IV)". For example, the control algorithm can be configured to activate the surgical instrument when tissue with a high collagen content is attached, but not necessarily activate the surgical instrument when tissue with a high elastin content is attached. .

In some aspects, a control algorithm can be configured to activate or allow the activation of the surgical instrument according to the possibility that the trapped tissue is located in a specific position within the end actuator or if a certain amount of tissue has been trapped by the end actuator using, for example, the techniques described below under the heading "Determination of tissue location through continuity between electrodes". For example, the control algorithm can be configured to activate the surgical instrument when the trapped tissue covers a specific percentage of the end actuator. As another example, the control algorithm can be configured to activate the surgical instrument when the trapped tissue is located at the distal end of the end actuator.

[00540] In other respects, a control algorithm can be configured to determine whether the tissue has been trapped by the end actuator, the type of tissue or tissue composition and other characteristics of the end actuator or tissue by means of a system of situational recognition, as described in US provisional patent application serial number 62 / 659,900, entitled METHOD OF HUB COMMUNICATION, filed on April 19, 2018, which is hereby incorporated by reference in its entirety, and as described herein under the heading "Situational recognition". In these aspects, a central surgical controller 106 (Figures 1 to 11) to which the surgical instrument and / or the generator are connected can receive data from the surgical instrument, the generator and / or other medical devices used in the operating room and make inferences about the surgical procedure, or a specific stage of it, that is performed. Consequently, the situational recognition system can infer whether and what type (or types) of tissue is (are) being operated on at any given time or step, and then a control algorithm can control the surgical instrument properly, including activating the surgical instrument automatically. For example, the control algorithm could be configured to automatically activate or allow activation of the surgical instrument when the tissue attached by the end actuator matches the type of tissue or tissue composition expected by the situational recognition system.

[00541] With the ability to detect whether or not the instrument is in contact with the tissue, and what type of tissue is in contact, the ultrasonic instrument can be operated in a keyless operation mode in which operation is permitted based on the detection capacity of the ultrasonic instrument. In some respects, a control algorithm can be configured to ignore the actuations of activation buttons and pedals, and other input devices coupled to the generator and / or the ultrasonic surgical instrument, unless tissue is detected in contact with the claws / end actuator of the surgical instrument, thus avoiding unintentional activations of the instrument. In some aspects, a control algorithm can be configured to assign different meanings to the inputs of activation buttons and pedals, and of other input devices coupled to the generator and / or the ultrasonic surgical instrument based on the detection of tissue in contact with the claws / the end actuator of the surgical instrument. For example, when the presence of tissue is detected in the end actuator, a control algorithm can be configured to activate the surgical instrument in response to an activation button that is actuated; however, when the presence of tissue is not detected in the end actuator, the control algorithm can be configured to perform a different or secondary action when the activation button is actuated.

[00542] The ability to determine the lack of tissue present in the claws of the end actuator acts as a tolerance to allow the instrument to switch to keyless mode and then initiate an automatic clotting operation cycle when tissue is then , detected, resulting in a longer time of use of the instrument and allowing the user to proceed based on his predictive ability of the instrument. The ability to additionally detect the type of tissue in addition to detecting the presence of tissue allows the algorithm to adjust and calculate the best coagulation opportunity. Adjustment of an ultrasonic system according to the composition of the tissue

[00543] In several respects, an ultrasonic surgical instrument may include a processor or control circuit that performs an adaptive ultrasonic blade control algorithm to detect the composition of tissue trapped by or located on the end actuator and control the operating parameters of the transducer ultrasonic and / or ultrasonic blade appropriately. The composition of the fabric may include, for example, the ratio of collagen to elastin in the fabric, the stiffness of the fabric or the thickness of the fabric. Operational parameters controlled or regulated by the adaptive ultrasonic blade control algorithm may include, for example, the amplitude of the ultrasonic blade, the temperature or heat flow of the ultrasonic blade, etc. The adaptive ultrasonic blade control algorithm can be executed by a control circuit or a processor located on the generator or the surgical instrument.

[00544] In an example described in more detail below, the adaptive ultrasonic blade control algorithm can be configured to control the amplitude of the ultrasonic blade according to the ratio between tissue collagen and elastin. The ratio of collagen to tissue elastin can be determined using a variety of techniques, such as those described below. In another example described in more detail below, the adaptive ultrasonic blade control algorithm can be configured to control the ultrasonic transducer / ultrasonic blade to provide a longer warm-up time and a lower final temperature of the ultrasonic blade the lower the collagen content of the tissue. Determination of the collagen / elastin ratio of the tissue according to the frequency shift

[00545] In several aspects, a control algorithm can be configured to determine the collagen / elastin ratio of a tissue (for example, to adjust the amplitude of the distal tip of an ultrasonic blade) by detecting the natural frequency of an ultrasonic blade and the displacements in the waveform of the ultrasonic blade. For example, the techniques described in connection with Figures 1 to 54 can be used to detect the ratio of collagen to elastin in the tissue located on an end actuator of an ultrasonic instrument. In one aspect, the present disclosure provides an adaptive ultrasonic blade control algorithm to detect the natural frequency of the ultrasonic blade and the shift in the waveform to detect the tissue composition in contact with the ultrasonic blade. In another aspect, the adaptive ultrasonic blade control algorithm can be configured to detect the tissue's collagen and elastin composition content and adjust the therapeutic heat flow of the ultrasonic blade based on the tissue's detected collagen content. Techniques for monitoring the deviation from the natural frequency of the ultrasonic blade based on the type of tissue located in the claws of the end actuator of the ultrasonic instrument are described here in connection with Figures 1 to 54. Consequently, for the sake of brevity and clarity, such techniques will not be repeated here.

[00546] The ratio between elastin and collagen can be determined by monitoring the displacement in the natural frequency of the ultrasonic blade and comparing the natural frequency with a look-up table. The look-up table can be stored in memory (for example, memory 3326 in Figure 31) and contains the ratio between elastin and collagen and an offset from the corresponding natural frequency for a given empirically determined ratio. Determination of the collagen / elastin ratio of the tissue according to reflectance and surface emissivity in the infrared (IV)

[00547] In several aspects, a control algorithm can be configured to determine the collagen / elastin ratio of a tissue (for example, adjusting the amplitude of the distal tip of an ultrasonic blade) by determining the IR reflectivity of the tissue. For example, Figure 59 illustrates an ultrasonic system 130164 that comprises an ultrasonic generator 130152 coupled to an ultrasonic instrument 130150. The ultrasonic instrument 130150 is coupled to an ultrasonic end actuator 130400 via an ultrasonic waveguide 130154. The ultrasonic generator 130152 can be integral with the 130150 ultrasonic instrument or can be connected to the 130150 ultrasonic instrument using wired or wireless electrical / electronic coupling techniques. The end actuator 130400 of the 130150 ultrasonic surgical instrument comprises IR sensors located on the clamping arm 130402 (e.g., claw member), in accordance with at least one aspect of the present disclosure. The ultrasonic generator 130152 and / or the ultrasonic instrument 130150 can be coupled to the central surgical controller 130160 and / or the cloud 130162 via wired or wireless connections, as described in connection with Figures 1 to 11.

[00548] Figure 60 illustrates a sensor circuit 130409 for detecting IR reflectivity that can be assembled or formed integrally with the clamping arm 130402 of the ultrasonic end actuator 130400 to detect the composition of fabrics, according to at least one aspect of the present revelation. The IR sensor circuit 130409 includes an IR source 130416 (for example, an IR transmitter) and an IR detector 130418 (for example, an IR receiver). The IR source 130416 is coupled to a voltage source V. A current is generated through R2 when the control circuit 130420 closes switch SW1. When switch SW1 is closed, the IR source 130416 emits IR energy towards the fabric 130410 (for example, tissue stuck or located between the clamping arm 130402 and the ultrasonic blade 130404). Part of the emitted IV energy is absorbed by the 130410 tissue, part is transmitted through the 130410 tissue, and part is reflected by the 130410 tissue. The 130418 IR detector receives the IR energy reflected by the 130410 tissue and generates an output voltage Vo or a signal , which are applied to the 130420 control circuit for processing.

[00549] With reference to Figures 59 and 60, in one aspect, the ultrasonic generator 130152 includes the control circuit 130420 to activate the IR source 130416 and the IR detector 130418 located on or inside the clamping arm 130402 of the actuator ultrasonic end cap 130400. In other respects, the ultrasonic instrument 130150 includes the control circuit 130420 to drive the IR source 130416 and the IR detector 130418 located on or inside the clamping arm 130402 of the ultrasonic end actuator 130400. In any of these aspects, when the fabric 130410 is trapped between the ultrasonic blade 130404 and the clamping arm 130402, the IR source 130416 is energized by the control circuit 130420 closing the switch SW1, for example, to illuminate the fabric with IR energy . In one aspect, the IR detector 130418 generates a Vo voltage that is proportional to the IR energy reflected by the 130410 tissue. The total IR energy emitted by the IR source 130416 is equal to the sum of the IR energy reflected by the 130410 tissue, of the absorbed IV energy through fabric 130410 and the IV energy that passes through fabric 130410, plus any losses. Consequently, the 130420 control circuit or processor can be configured to detect the collagen content of the 130410 tissue by the amount of IR energy detected by the IR detector 130418 in relation to the total amount of IR energy emitted by the IR source 130416. An algorithm takes into account the amount of energy absorbed by and / or transmitted through the 130410 tissue to determine the collagen content of the 130410 tissue. The 130416 IR source, the 130418 IR detector and the algorithms are calibrated to provide useful measurements of the tissue collagen 130410 using the principles of IR reflectivity.

[00550] The 130409 IR reflectivity detection sensor circuit shown in Figure 60 provides IR reflectance and surface emissivity to determine the ratio between elastin and collagen. IR reflectance can be used to determine tissue composition to adjust the amplitude of an ultrasonic transducer. The refractive index is an optical constant that controls the luminous reflection of infrared light. The refractive index can be used to differentiate types of tissue. For example, the refractive index contrast is shown to differentiate between normal liver tissue and liver metastases. The refractive index could be used as an absolute or comparative measure for tissue differentiation.

[00551] A comparative method employs an energy-powered dissection device, such as a 130404 ultrasonic blade, for example, to determine the exact ratio (as detailed above) and then predict the collagen ratio for all additional performances using this index as a baseline. In this way, an endoscope can update the dissection device (for example, the 130404 ultrasonic blade) based on the collagen ratio. The dissection device can fine-tune the forecast each time it is triggered to make a real trigger for collagen denaturation. An alternative method can employ an absolute index with a lookup table that can differentiate between surface irregularities and collagen concentration under the surface. Additional information on the tissue's IR refractive index properties can be found in "Visible To Near- Infrared Refractive Properties of Freshly-Excised Human-Liver Tissues:

Marking Hepatic Malignancies "; Panagiotis Giannios, Konstantinos G. Toutouzas, Maria Matiatou, Konstantinos Stasinos, Manousos M. Konstadoulakis, George C. Zografos, and Konstantinos Moutzourisa; Sci. Rep. 2016; 6: 27910, the content of which is incorporated herein by title of reference.

[00552] In other respects, the ultrasonic dissection device can be configured to change the optimal temperature of the ultrasonic blade control algorithm in proportion to the collagen ratio. For example, the ultrasonic blade temperature control algorithm can be modified based on the collagen ratio received from the 130420 control circuit. As a specific example, the ultrasonic blade temperature control algorithm can be configured to reduce the set of temperatures at which the 130404 ultrasonic sheet is maintained and increase the retention time in which the 130404 ultrasonic sheet is in contact with the 130410 tissue for higher concentrations of collagen in the trapped 130410 tissue. As another example, the waiting time for the algorithm going through a complete activation cycle could be modified based on the collagen ratio. Various temperature control algorithms for ultrasonic sheets are described in connection with Figures 43 to 54.

[00553] Figure 61 is a sectional view of an ultrasonic end actuator 130400 comprising a clamping arm 130402 and an ultrasonic blade 130404, in accordance with an aspect of the present disclosure. The clamping arm 130402 comprises IR reflectance sensing circuits 130409a, 130409b that can be assembled or formed integrally with the clamping arm 130402 of the ultrasonic end actuator 130400 to detect the composition of the 130410 fabric. IR reflectivity 130409a, 130409b can be mounted on a flexible circuit substrate 130412, which is shown in plan view in Figure 62. The flexible circuit substrate 130412 includes three elongated elements 130408a, 130408b, 130408c on which the sensor sensors are mounted IR reflectivity detection 130409a, 130409b and the IR sensors 130414a, 130414b. The IR sensors 130414a, 130414b can include IR sources 130416 and IR detectors 130418, as shown in Figure 60.

[00554] Figure 63 is a logic flow diagram of a 130200 process that represents a control program or a logical configuration for measuring IR reflectance to determine tissue composition to adjust the amplitude of the ultrasonic transducer. Process 130200 can be performed by a processor or control circuit of a surgical instrument, such as control circuit 760 in Figure 18, or a generator, such as processor 902 in Figure 21. For the sake of brevity, process 130200 will be described as being executed by a control circuit, but it should be understood that the description below covers the above variations.

[00555] Consequently, with reference to Figures 1 to 54 and Figures 59 to 63, in one aspect, the control circuit energizes 130202 the IR source 130416 to apply IR energy to the fabric 130410 trapped in an end actuator 13400 of a ultrasonic instrument

130150. The control circuit 130204 then detects, via an IR detector 130418, the IR energy reflected by the 130410 tissue. Consequently, the control circuit determines 130206 the ratio between collagen and elastin in the 130410 tissue based on the IV energy. detected reflected by the 130410 tissue. The control circuit sets 130208 the ultrasonic blade temperature control algorithm, as discussed in US provisional patent application 62 / 692,768, entitled SMART ENERGY DEVICES, based on the determination of the ratio between collagen and elastin from the fabric. In one aspect, the collagen content of 130410 tissue can be detected according to the reflectivity of an IR 130416 light source. In another aspect, the lower the collagen content of 130410 tissue, the longer the heating time and lower the final temperature of the 130404 ultrasonic sheet. In yet another aspect, the composition of the 130410 tissue may be the thickness or stiffness of the tissue and could be used to affect the ultrasonic blade transducer control program.

[00556] The ratio between elastin and collagen can be determined by monitoring the tissue's IR reflectance and comparing the detected IR reflectance with a look-up table. The look-up table can be stored in memory (for example, memory 3326 in Figure 31) and contains the ratio between elastin and collagen and a corresponding IR reflectance for a specific ratio as determined empirically. Determination of the collagen / elastin ratio of the tissue according to the collagen transformation point

[00557] Different types of tissues are composed of different amounts of structural proteins, such as collagen and elastin, which provide different types of tissue with different properties. As heat is applied to the tissue (for example, by an ultrasonic sheet), the structural proteins denature, which affects the integrity and other properties of the tissue. However, structural proteins denature at different known temperatures. For example, collagen denatures before elastin. Consequently, by detecting at what temperature the properties of the tissue change, one can infer the composition of the tissue (for example, the ratio of collagen to elastin in the tissue). In many ways, a control algorithm can be configured to determine the ratio of collagen to elastin in a tissue by determining the collagen transformation point of the tissue. The control algorithm can, in turn, control various operating parameters of the surgical instrument, such as the amplitude of the ultrasonic blade, according to the determined tissue composition. In one aspect, the control algorithm can determine the collagen transformation point of the tissue by measuring the position of the actuating member of the clamping arm and the rate of change of its displacement while the load on the clamping arm is kept constant. . In another aspect, the control algorithm can determine the collagen transformation point of the tissue by directly measuring the temperature at the tissue / blade interface to identify the collagen / elastin percentage.

[00558] Figures 16 to 19 schematically illustrate motorized clamping arm closing mechanisms. Figure 40 is a 7400 system diagram of a 7401 segmented circuit comprising a plurality of independently operated circuit segments 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440, in accordance with an aspect of the present disclosure, and Figure 35 is a circuit diagram of the various components of a surgical instrument with motor control functions, in accordance with an aspect of the present disclosure. For example, Figure 35 illustrates a drive mechanism 7930, which includes a closing drive train 7934 configured to close a claw member to secure the fabric with the end actuator. Figures 38 and 39 illustrate control systems 12950, 12970 for controlling the claw member closure rate, as a portion of the clamping arm of an ultrasonic end actuator, Figure 38 is a diagram of a control system 12950 configured to provide progressive closure of a closing member as it advances distally to close the clamping arm to apply a load of closing force at a desired rate in accordance with an aspect of the present disclosure, and Figure 39 illustrates a feedback control system for the proportional-integral-derivative controller (PID) 12970, according to one aspect of the present disclosure. Consequently, in the following description of an ultrasonic system comprising a motorized clamping arm controller to control the closing rate and / or the position of the clamping arm, reference should be made to Figures 16 to 19 and 38 to 41.

[00559] In one aspect, a control algorithm can be configured to detect the collagen transformation point of a trapped tissue and, thus, control the application of ultrasonic energy to the tissue by controlling the phase and / or amplitude of the trigger signal of the ultrasonic transducer or the closing rate of the clamping arm. For example, in one aspect, a control algorithm can be configured to control the force applied to the tissue by the clamping arm according to the point of transformation of the collagen. This can be done by measuring the position of the actuating member of the clamping arm and its rate of change while the load on the clamping arm is kept constant within the coaptation pressure in a defined operating range (eg 130 to 180 psi) corresponding to the specific instrument type.

[00560] Figure 64A is a graphical representation 130250 of the displacement of the clamping arm 1140 (Figure 23) as a function of time as the clamping arm 1140 is closed to identify the collagen transformation point, according to at least one aspect of the present revelation. Figure 64B is an enlarged portion 130256 of the graphical representation 130250 shown in Figure 64A. The horizontal geometric axis 130254 represents time (for example, in seconds) and the vertical geometric axis 130252 represents the displacement of the clamping arm δ (for example, in millimeters). In one aspect, a control algorithm can be configured to control the load applied to the fabric by the clamping arm 1140 (for example, controlling the closing rate of the clamping arm 1140) as the ultrasonic blade 1128 (Figure 23) heats up the tissue according to the collagen transformation point of the tissue. In this respect, a control algorithm is configured to close the clamping arm 1140 until the clamping arm's load reaches a threshold, which may include a specific value (for example, 4.5 lb) or a range of values (for example, within a range of 3.5 to 5 lb). At this point, the control algorithm adjusts the threshold θ of the rate of change of the clamping arm's displacement, and monitors the displacement of the clamping arm 1140. As long as the rate of change of the clamping arm's displacement remains within a predefined negative limit (that is, below the threshold θ), the control algorithm can determine that the tissue is below the transformation temperature. As shown in the graphical representation of Figures 64A and 64B, when the control algorithm determines that the rate of change in the clamping arm's displacement exceeds the θ threshold, the control algorithm can determine that the collagen melting temperature has been reached.

[00561] In one aspect, when the control algorithm determines that the transition temperature has been reached, the control algorithm can be configured to change the operation of the ultrasonic instrument appropriately. For example, the control algorithm can switch the surgical instrument from the load control mode (from the clamping arm 1140) to the temperature control mode. In another aspect, the control algorithm can maintain control of the load of the clamping arm after the collagen transformation temperature is reached, and monitor when a threshold of the rate of change in the clamping arm is reached. The second threshold of the rate of change of displacement of the clamping arm may correspond, for example, to the transition temperature of the elastin. The locations of the collagen and / or elastin transition temperatures on plot 130258 of the displacement of the clamping arm over time can be called the "knee" points of the 130258 curve. Consequently, in this respect, the control algorithm can be configured to change the operation of the ultrasonic instrument in the event that the second threshold of the rate of change in the clamping arm (or elastin "knee") is reached and change the operation of the ultrasonic instrument accordingly. For example, the control algorithm can switch the surgical instrument from load control mode (from clamping arm 1140) to temperature control mode when the elastin knee in plot 130258 is detected.

[00562] The transformation of collagen must be constant for a given heat flow between 45 ° C and 50 ° C for collagen, with elastin having a different melting temperature. In addition, the temperature must stabilize as the collagen absorbs heat. In some ways, the control algorithm can be configured to sample the position of the clamping arm and / or the displacement member of the clamping arm at a higher rate around specific temperatures or within temperature ranges (for example, temperature ranges expected for the transformation of collagen and / or elastin) to determine exactly when monitored events occur.

[00563] In the aspect shown in Figures 64A and 64B, the control algorithm acts to switch the surgical instrument from the load control mode to the temperature control mode when the collagen transformation point is detected in time tm. Without changing the surgical instrument to temperature control mode, the displacement of the clamping arm would increase geometrically,

as shown in the projected curve 130260. In one aspect, the control algorithm operating in temperature control mode decreases the amplitude of the ultrasonic transducer trigger signal to alter the heat flow generated by the 1128 ultrasonic blade, as shown by the flat portion of plot 130258 after the threshold θ is reached. In some respects, the control algorithm can be configured to increase the amplitude of the trigger signal of the ultrasonic transducer after a given period of time, for example, to measure the rate of temperature rise to determine when the transformation temperature of the elastin has been reached. Consequently, when the closing rate of the clamping arm approaches the next knee (i.e., the elastin knee), the closing rate of the clamping arm may decrease. The load control of the 1140 clamping arm can be beneficial because, in some cases, it can provide the best vessel seal.

[00564] Figure 65 is a logic flow diagram of a 130300 process that represents a control program or a logical configuration for detecting the collagen transformation point to control the closing rate of the clamping arm or the amplitude of the ultrasonic transducer , in accordance with at least one aspect of the present disclosure. The 130300 process can be performed by a control circuit or a processor located on the surgical instrument or the generator. Consequently, the control circuit that performs the 130300 process measures 130302 a position of the actuating member of the clamping arm and its rate of change while keeping the load on the gripper constant. As previously described, in one aspect, the load on the clamping arm is kept within the coaptation pressure in an appropriate range (130 to 180 psi) defined by the ultrasonic surgical instrument. When the jaws are subjected to a specific clamp arm load (for example, 4.5 lb) or the clamp arm load is within a specific range (for example, 3.5 to 5 lb), the The control will adjust 130304 the clamping arm displacement rate and monitor the position of the clamping arm actuation member for the period of time that the clamping arm displacement rate remains within a predefined negative limit ( corresponding to the tissue being below the collagen transformation temperature). Consequently, the control determines 130306 if the rate of change of displacement of the clamping arm exceeds the established threshold, or, in other words, determines whether the tissue has reached the transition temperature. If the transition temperature has been reached, then the process proceeds along the SIM 130300 branch, and the control circuit switches 130308 the surgical instrument to temperature control mode (for example, controls the ultrasonic transducer to decrease or maintain the ultrasonic blade temperature). In one aspect, the control circuit continues to monitor the collagen's transformation temperature. Alternatively, in the aspect shown in Figure 65, if the transition temperature has not been reached, then process 130300 proceeds along the NO branch and the control circuit maintains 130310 load control of the clamping arm 1140 and monitors the rate of changing the clamping arm offset to determine when the next transition point (for example, the elastin transition point) will occur for the trapped tissue. The control circuit can do this to, for example, prevent the fabric temperature from increasing beyond the transformation temperature of the elastin.

[00565] It will be recognized that the transformation of collagen must be constant for a given heat flow (45 ° C to 50 ° C). It will also be recognized that the load control of the clamping arm 1140 can, in some cases, provide the best seal for specific types of fabrics (for example, vases). During the period of time that the collagen transformation is taking place, the tissue temperature must stabilize as the collagen absorbs heat. The control circuit can be configured to modulate the rate at which data points are collected around a specific temperature or temperatures of interest (for example, transformation temperatures). In addition, the control circuit can adjust the amplitude of the trigger signal of the ultrasonic transducer to control the heat flow generated by the 1128 ultrasonic blade at different points in the surgical procedure. For example, the control circuit can decrease the amplitude of the ultrasonic transducer during the collagen transformation period. As another example, the control circuit can increase the amplitude of the ultrasonic transducer to measure the rate at which the temperature increases when the elastin knee occurs. It will be recognized that as the elastin knee point approaches, the rate of temperature change will decrease.

[00566] In another aspect, a control algorithm can be configured to detect the transformation temperature of the collagen to identify the percentage of collagen / elastin of the trapped tissue. As discussed above, the control algorithm can then control various operating parameters of the surgical instrument according to the identified tissue composition identified.

[00567] Figure 66 is a graphical representation 130350 of the identification of the collagen transformation temperature point to identify the collagen / elastin ratio, according to at least one aspect of the present disclosure. The vertical geometric axis 130352 represents the impedance of the ultrasonic transducer, and the horizontal geometric axis 130632 represents the tissue temperature. The point where the rate of change in the impedance change of the ultrasonic transducer occurs corresponds to the collagen / tissue composition of the tissue determined empirically. For example, if the shift in the rate of change in the impedance of the ultrasonic transducer occurs at the first temperature 130362, then the tissue composition will be 100% collagen. Consequently, if the shift in the rate of change in the impedance of the ultrasonic transducer occurs at the second temperature 130364, then the tissue composition will be 100% elastin. If the shift in the rate of change in the impedance of the ultrasonic transducer occurs between the first temperature 130362 and the second temperature 130364, then the tissue composition will be a mixture of collagen and elastin.

[00568] The collagen transformation temperature can be used to directly identify the percentage of collagen / elastin in the tissue, and a control algorithm can be configured to adjust the operation of the ultrasonic device appropriately. As shown in Figure 66, a 130356 plot represents the empirical relationship between the impedance of the ultrasonic transducer and the temperature of the tissue. As indicated by curve 130356, the impedance (Z) of the ultrasonic transducer increases linearly at a first rate of change (slope) as a function of temperature (T) in the area of contact with the tissue. At the collagen transformation temperature shown in the graph at point 130358, the rate of change of impedance (Z) as a function of temperature (T) decreases to a second rate of change. At point 130358 where the slope of plot 130356 changes, the ratio of collagen to elastin may correspond to an empirically determined temperature 130360 (eg 85%). In one aspect, a control circuit or a processor that runs the aforementioned algorithm can be configured to determine the temperature at which the impedance rate of the ultrasonic transducer changes and then obtain the corresponding tissue composition (for example, the percentage of collagen, the percentage of elastin, or the collagen / elastin ratio) of a memory (for example, a look-up table).

[00569] Figure 67 is a flow diagram of a 130450 process for identifying the composition of a tissue according to the change in impedance of the ultrasonic transducer, according to at least one aspect of the present disclosure. The 130450 process can be performed by a control circuit or a processor located, for example, in the surgical instrument or in the generator. Consequently, control circuit 130452 monitors the impedance (Z) of the ultrasonic transducer as a function of temperature (T). As previously described, the temperature (T) at the interface between the tissue and the ultrasonic sheet can be inferred by the algorithms described here. The control circuit determines 130454 the rate of change in the impedance ΔZ / ΔT of the ultrasonic transducer. As the temperature at the interface between the ultrasonic blade and the tissue increases, the impedance (Z) increases linearly at a first rate, as shown in Figure 66. With this, the control circuit determines 130456 if the slope ΔZ / ΔT changed (for example, decreased). If the slope ΔZ / ΔT has not changed, then the 130450 process continues along the NO branch and continues to determine the slope ΔZ / ΔT 130454. If the slope ΔZ / ΔT has changed, control circuit 130458 determines that the collagen transition temperature has been reached.

[00570] The ratio between elastin and collagen can be determined by monitoring the collagen transformation point of the tissue and comparing the detected collagen transformation point with a look-up table. The look-up table can be stored in memory (for example, memory 3326 in Figure 31) and contains the ratio between elastin and collagen and a corresponding collagen transformation point for a specific empirically determined ratio. Adjusting the strength of the clamping arm according to the location of the fabric

[00571] In several respects, a control algorithm can be configured to determine the location of a tissue within or in relation to an end actuator, and adjust the clamping arm strength accordingly. In one aspect, the tissue can be identified or parameterized by measuring the load of the compression force on the clamping arm and the position of the tissue within the gripper, for example, the location along the length of the ultrasonic blade where the tissue is placed on. In one aspect, the time until the initial load measured on the clamping arm is measured, and then the compression ratio on the fabric is measured to determine the compressibility of the fabric as a function of the amount of fabric located along the length of the gripper. The rate of change in the position of the clamping arm actuator is monitored in the load control mode as a way of determining the compressibility of the tissue and, therefore, the type of tissue / disease state.

[00572] Figure 68 is a graphical representation 130500 of the compression load distribution along an ultrasonic sheet 130404, according to at least one aspect of the present disclosure. The vertical geometric axis 130502 represents the force applied to the fabric by the clamping arm 1140, and the horizontal geometric axis 130504 represents the position. The 130404 ultrasonic blade is dimensioned so that there are periodic knots and antinodes that occur along the length of the blade. The location of the nodes / antinodes is determined by the wavelength of the ultrasonic displacement induced on the 130404 ultrasonic blade by the ultrasonic transducer. The ultrasonic transducer is driven by an electrical signal of adequate amplitude and frequency. As is known in the art, a node is a minimum or zero displacement point of the 130404 ultrasonic sheet and a antinox is a maximum displacement point of the ultrasonic sheet

130404.

[00573] In the 130500 graphical representation, the 130404 ultrasonic sheet is represented so that the nodes and antinodes are aligned with their corresponding position along the horizontal geometric axis

130504. The 130500 plot includes a first plot 130506 and a second plot 130508. As represented by any of the curves 130506, 130508, the compression force applied to the ultrasonic sheet 130404 decreases exponentially from a proximal end of the 130404 ultrasonic sheet to one end distal of the 130404 ultrasonic sheet. Thus, the 130410 tissue located at the distal end of the 130404 ultrasonic sheet is subjected to a much lower compression force compared to the 130410 tissue located closer to the proximal end of the 130404 ultrasonic sheet. The first plot 130506 it can represent a standard closure of the clamping arm 1140 where the resulting force applied to the distal tissue 130410 is represented as F1. In general, the amount of force applied by the clamping arm 1140 to the fabric 130410 cannot be greatly increased arbitrarily because, in such a case, an excessive amount of force could be applied to the fabric 130410 located proximally along the ultrasonic blade 130404. However, by monitoring the location of tissue 130410 along the ultrasonic sheet 130404 (for example, as discussed above under the heading "Determining the location of the tissue by changing the impedance" and as discussed below under the heading "Determining the location of the tissue through continuity between electrodes "), a control algorithm can amplify the force applied to tissue 130410 by the clamping arm 1140 in situations where tissue 130410 is located only at the distal end of the 130404 ultrasonic blade, as in the situation shown in Figure 68. For example, second plot 130508 may represent a modified closure of the close 1140 and the control algorithm determines that the fabric 130410 is located only at the distal end of the ultrasonic sheet 130404 and, correspondingly, increases the force applied to the distal fabric 130410 by the clamping arm 1140 to an F2 value (F2> F1 ).

[00574] Figure 69 is a 130520 graphical representation of the pressure applied to the fabric as a function of time, according to an aspect of the present disclosure. The vertical geometric axis 130522 represents the pressure (for example, in N / mm2) applied to the fabric, and the horizontal geometric axis 130524 represents time. The first plot 130526 represents a normal or standard compression force applied to the distal tissue 130410 without amplification. During a standard closing of the clamping arm 1140, the compressive force applied to the fabric 130410 is maintained at a constant value after an initial lifting period. The second plot 130528 represents the amplified compression force applied to the distal tissue 130410 to compensate for the presence of only distal tissue 130410. In the modified closure of the clamping arm 1140, the pressure is increased 130530 compared to the standard closure until eventually the force of amplified compression return 130532 to normal compression levels to avoid burning / melting through the 1140 clamping arm block. Determination of tissue location through continuity between electrodes

[00575] In several respects, a control algorithm can be configured to determine the location of a tissue within or in relation to an end actuator according to electrical continuity in an array of bipolar electrodes (ie, positive and negative) ) positioned along a jaw or jaws of the end actuator. The location of the tissue detectable by the bipolar electrode array may correspond to the specific position of the tissue in relation to the clamp (s) and / or the percentage of the claw (s) covered by the tissue. In one aspect, the positive and negative electrodes are separated by a physical space in order to establish electrical continuity between the electrodes when the tissue connects the positive and negative electrodes. The positive and negative electrodes are configured in a matrix or arrangement so that a processor or control circuit can be configured to detect where the tissue is located between the positive and negative electrodes by monitoring or scanning the electrode matrix. In one aspect, the array of bipolar electrodes can be positioned along a jaw of an end actuator. Consequently, a control circuit or processor coupled to the array of bipolar electrodes can be configured to detect electrical continuity between adjacent electrodes to detect the presence of tissue against them. In another aspect, the array of bipolar electrodes can be positioned along opposite jaws of an end actuator. Consequently, a control circuit or processor coupled to the array of bipolar electrodes can be configured to detect electrical continuity between the opposing jaws to detect the presence of tissue between them.

[00576] Determining which surface area of the clamp (s) is covered with tissue allows a control algorithm to determine the appropriate coaptation pressure for the amount of tissue trapped by the end actuator and then calculate the corresponding load of the clamping arm. The clamping arm load can be expressed in terms of applied pressure (eg 130 to 180 psi) or applied force (eg 3.5 to 5 lb or nominally 4.5 lb). In some aspects, the matrix of bipolar electrodes can receive power from a bipolar or monopolar RF electrosurgical generator in the positive and negative electrodes. The power output of the generator can be a variety of constant, variable or minimum values (for example, 45 W, 35 W or 5 W), a function of several variables associated with the surgical instrument and / or the generator (for example, amplitude of the ultrasonic blade or clamping arm strength), or dictated by an algorithm to control the generator according to its power curve (for example, when increasing the generator).

[00577] Figure 70 illustrates an end actuator 130400 that includes an array of single clamp electrodes to detect tissue location, in accordance with at least one aspect of the present disclosure. In the aspect shown, end actuator 130400 includes a first jaw 130430 that has an array of electrodes 130431 disposed on it and a second jaw 130432. The array of electrodes 130431 includes electrodes 130429 coupled to a power source, such as a power generator. RF. The end actuator 130400 can include an end actuator for an ultrasonic surgical instrument where the second claw 130432 is, for example, an 1128 ultrasonic blade (Figure 23), an electrosurgical instrument, an end actuator for a stapling instrument and surgical cut, and so on. The second jaw 130432 may include, for example, an ultrasonic blade 1128 (Figure 23) or a cooperating jaw of an electrosurgical or surgical stapling and cutting instrument. In the aspect shown, the electrode array 130431 includes 12 electrodes 130429 arranged in a pattern generally shaped in zigzag; however, the number, shape and arrangement of electrodes 130429 in the electrode array 130431 are for illustrative purposes only. Consequently, the array of electrodes 130431 can include various numbers, shapes and / or arrangements of electrodes 130429. For example, the number of electrodes 130429 can be adjusted according to the desired resolution to detect the position of the tissue.

[00578] In one aspect, the electrode array 130431 may include electrodes 130429 that are separated by a physical gap and alternate in polarity or are coupled to opposite terminals (i.e., a supply terminal and a return terminal) of a power supply. For example, in the aspect shown, the even numbered electrodes 130429 can be of a first polarity (for example, positive polarity or coupled to a power terminal of a power source), and the odd numbered electrodes 130429 can be electrodes of a second polarity (for example, negative or coupled to a return terminal of a power source). Consequently, when fabric 130410 comes into contact with adjacent electrodes 130429, fabric 130410 physically and electrically connects bipolar electrodes 130429 and allows current to flow between them. The current flow between the bipolar electrodes 130429 can be detected by a control algorithm executed by a control circuit or a processor coupled to the 130431 electrode array, thus allowing the control circuit or the processor to detect the presence of fabric

130410.

[00579] The tissue detection by the electrode matrix 130431 can be represented graphically by an activation matrix. For example, Figure 71 illustrates an activation matrix 130550 that indicates the position of tissue 130410 according to the matrix of electrodes 130431 shown in Figure 70. The vertical geometric axis 130554 and the horizontal geometric axis 130555 represent the electrodes 130429 of the matrix of electrodes 130431, where the numbers along the geometric axes 130554, 130555 represent electrodes 130429 numbered accordingly. Activation regions 130552 indicate where continuity is present between the corresponding electrodes 130429, that is, where tissue 130410 is present. In Figure 70, a fabric 130410 is present in the first, second and third electrodes 130429 and, as discussed above, in some respects, the polarity of the electrodes 130429 can alternate. Consequently, there is electrical continuity between the first and second electrodes 130429 and between the second and third electrodes

130429. It should be noted that, in this aspect described, there would be no continuity between the first and third electrodes 130429 because they would have the same polarity. The continuity between these 130429 electrodes is graphically indicated by the 130552 activation regions in the 130550 activation matrix. It should also be noted that the 130553 region delimited by the 130552 activation regions is not indicated as activated because, in this aspect, an 130429 electrode is not he can continue with himself. A control algorithm performed by a control circuit or a processor coupled to the 130431 electrode array can be configured to infer the position of the fabric 130410 on the end actuator 130400 (as the locations of the electrodes 130429 would be known), the proportion of the claws 130430 , 130432 of the end actuator 130400 covered by the fabric 130410, etc., because the location of the fabric corresponds to the specific electrodes 130429 where the electrical continuity has been established.

[00580] Figure 72 illustrates an end actuator 130400 that includes an array of double-claw electrodes to detect tissue location, in accordance with at least one aspect of the present disclosure. In the aspect shown, end actuator 130400 includes a first jaw 130430 that has a first array of electrodes 130431 arranged thereon, and a second jaw 130432 that has a second array of electrodes 130433 arranged thereon. Electrode arrays 130431, 130433 each include electrodes 130429 coupled to a power source, such as an RF generator. The 130400 end actuator can include an end actuator for an electrosurgical instrument, an end actuator for a surgical cutting and stapling instrument, and so on. As discussed above, the number, shape and / or arrangement of the 130429 electrodes can vary in several ways. For example, in Figure 75 the electrode arrays 130431, 130433 are arranged in rectangular or overlapping tile patterns.

[00581] In one aspect, the opposite electrodes 130429 in the electrode arrays 130431, 130433 are separated by a physical gap, and each electrode array 130431, 130433 is of an opposite polarity or is coupled to an opposite terminal (that is, a terminal and a return terminal) of a power source. For example, in the aspect shown, the first array of electrodes 130431 can be of a first polarity (for example, positive polarity or coupled to a power terminal of a power source), and the second array of electrodes 130433 can be of a second polarity (for example, negative or coupled to a return terminal of a power source). Consequently, when fabric 130410 comes in contact with an electrode 130429 from each of the opposing electrode arrays 130431, 130433, fabric 130410 physically and electrically connects bipolar electrodes 130429 and allows current to flow between them. The current flow between the bipolar electrodes 130429 can be detected by a control algorithm executed by a control circuit or a processor coupled to the electrode arrays 130431, 130433, thus allowing the control circuit or the processor to detect the presence of 130410 fabric.

[00582] As discussed above, an activation matrix can graphically represent the presence of tissue.

For example, Figure 73 illustrates an activation matrix 130556 that indicates the position of tissue 130410 as shown in Figure 74. The vertical geometric axis 130557 represents electrodes 130429 of the first matrix of electrodes 130431 and the horizontal geometric axis 130558 represents electrodes 130429 of the second array of electrodes 130433, where the numbers along the axes 130557, 130558 represent the electrodes 130429 correspondingly numbered for each array of electrodes 130431, 130433. The activation regions 130552 indicate where continuity is present between the corresponding electrodes 130429 , that is, where fabric 130410 is present.

In Figure 74, a fabric 130410 is positioned against the first, second and third electrodes 130431a, 130431b, 130431c of the first array of electrodes 130431 and against the first, second and third electrodes 130433a, 130433b, 130433c of the second array of electrodes 130433. Consequently, there is electrical continuity between each of these electrode sets of the opposing electrode arrays 130431, 130433 since current can flow between such opposing electrode sets.

The electrodes between which there is continuity due to the position of the trapped tissue 130410 are graphically indicated by the activation regions 130552 in the activation matrix 130556 in Figure 73. Additionally, due to the fact that the 130410 tissue is not positioned against the fourth, fifth and the sixth electrodes 130431d, 130431e, 130431f of the first array of electrodes 130431, and against the fourth, fifth and sixth electrodes 130433d, 130433e, 130433f of the second array of electrodes 130433, there is no electrical continuity between these electrodes.

A control algorithm performed by a control circuit or a processor coupled to the electrode arrays 130431, 130433 can be configured to infer the position of the tissue 130410 within the end actuator 130400 (since the locations of the electrodes 130429 would be known, as shown in Figure 74), the proportion of the claws 130430, 130432 of the end actuator 130400 covered by the fabric 130410, etc., because the location of the fabric corresponds to the specific electrodes 130429 where the electrical continuity has been established. In the example shown, the activated electrodes of the first and second electrode arrays 130431, 130433 are the overlapping electrodes 130429 and where there is tissue 130410 located between them.

[00583] In another aspect, the end actuator can be configured to transmit a plurality of signals or "pings" at different frequencies and the electrode array can be coupled to a circuit, including corresponding bandpass filters that can, each, detect a signal or signals of specific frequency through a transform in the frequency domain. Various portions of the electrode matrix circuit may include bandpass filters adjusted to different frequencies. Therefore, the location of the tissue trapped by the end actuator corresponds to the specific signals detected. The signals can be transmitted, for example, at a non-therapeutic frequency (for example, frequencies above the therapeutic frequency range for RF electrosurgical instruments). The electrode matrix circuit can include, for example, a flexible circuit.

[00584] Figure 75 illustrates an end actuator 130400 that includes a first jaw 130430 with a first array of segmented electrodes 130431 and a second jaw 130432 with a second array of segmented electrodes 130433, in accordance with at least one aspect of the present disclosure . Additionally, Figure 76 illustrates a fabric 130410 attached by the end actuator 130400, overlapping the second jaw 130432. In one aspect, the first array of electrodes 130431 is configured to transmit signals at various frequencies (for example, non-therapeutic frequencies) , and the second array of electrodes 130433 is configured to receive signals through a fabric 130410 attached by the end actuator 130400 (i.e., when a fabric 130410 is in contact with both electrode arrays 130431, 130433). The second electrode array 130433 can include a segmented electrode array circuit 130600, as shown in Figure 77, with each segment of the circuit including a bandpass filter 130601 coupled to each electrode 130602 of the second array of electrodes 130433. Each bandpass filter 130601 can include one or more capacitors 130604 and one or more inductors 130606, the number, arrangement and values of capacitors 130604 and inductors 130606 can be selected to synchronize each bandpass filter 130601 with a specific frequency or frequency band.

As the fabric 130410 acts as the signal conducting medium between the electrode arrays 130431, 130433, and different portions of the second electrode array 130433 are adjusted to detect signals of varying frequencies (through differently adjusted bandpass filters 130601 ), a control algorithm performed by a control circuit or a processor coupled to the electrode arrays 130431, 130433 can be configured to infer the position of the tissue 130410 based on which signals are detected.

In the aspect shown, the electrode arrays 130431, 130433 include six electrode segments 130602 arranged in a generally tiled pattern with a semicircular end segment; however, the number, shape and arrangement of electrodes 130602 in the electrode array 130431, 130433 are for illustrative purposes only.

Consequently, the electrode arrays 130431, 130433 can include various numbers, shapes and / or electrode arrangements 130602. For example, the number of electrodes 130602 can be adjusted according to the desired resolution to detect the position of the tissue.

[00585] Figure 78 is a graphical representation 130650 of the frequency response corresponding to the trapped tissue 130410 shown in Figure 76, in accordance with at least one aspect of the present disclosure. The vertical geometric axis 130652 represents the amplitude and the horizontal geometric axis 130654 represents the RF frequency. In one aspect, the second array of electrodes 130433 includes a first segment of electrode circuit 130602a set in a frequency band defined by a first central frequency fS1 (for example, 5 MHz), a second segment of electrode circuit 130602b set in a frequency band defined by a second central frequency fS2 (for example, 10 MHz), a third segment of electrode circuit 130602c set in a frequency band defined by a third central frequency fS3 (for example, 15 MHz) and a fourth 130602d electrode circuit segment set in a frequency band defined by a fourth central frequency fS4 (for example, 20 MHz). As shown in Figure 78, the detection frequency bands define a detection frequency range 130658 above the therapeutic frequency range 130656 defined by fT1 (for example, 300 kHz) to fT2 (for example, 500 kHz) and / or a preferred therapeutic frequency (eg 350 kHz). In one aspect, the central detection frequencies fS1, fS2, fS3, fS4 in the detection frequency range 130658 are each separated by a defined frequency value (for example, 5 MHz). In addition, although the detection frequency range 130658 is shown including four detection frequency bands, this is for illustrative purposes only. In the example shown, the trapped tissue 130410 is in contact with the second, third and fourth electrode circuit segments 130602b, 130602c,

130602d. Consequently, the detected frequency response includes peaks 130655b, 130655c, 130655d at each of the corresponding frequencies. A control algorithm could, therefore, infer the position of the fabric 130410 from the detected frequency response, that is, the control circuit can determine that the fabric 130410 is positioned inside the end actuator 130400 and is therefore in contact with the second, third and fourth electrode circuit segments 130602b, 130602c, 130602d and not with other circuit segments. The control algorithm can therefore infer the position of tissue 130410 in relation to grips 130430, 130432 of end actuator 130400 and / or the percentage of grips 130430, 130432 in contact with tissue 130410. Ultrasonic blade temperature monitoring adaptable

[00586] In one aspect, an adaptive ultrasonic blade control algorithm can be used to adjust various operating parameters of the ultrasonic system based on the temperature of the ultrasonic blade. Operational parameters controlled or regulated by the adaptive ultrasonic blade control algorithm can include, for example, the amplitude of the ultrasonic blade, the ultrasonic transducer drive control signal, the pressure applied by the clamping arm, etc. The adaptive ultrasonic blade control algorithm can be performed by a control circuit or processor located on the generator or the surgical instrument.

[00587] In an example described in more detail below, the adaptive ultrasonic blade control algorithm dynamically monitors the temperature of the ultrasonic blade and adjusts the amplitude of the ultrasonic blade and / or the signal supplied to the ultrasonic transducer as appropriate. In another example described in more detail below, the adaptive ultrasonic blade control algorithm dynamically monitors the temperature of the ultrasonic blade and adjusts the pressure of the clamping arm as appropriate. The adaptive ultrasonic blade control algorithm can measure the temperature of the ultrasonic blade through various techniques, such as by analyzing the frequency spectrum of the ultrasonic transducer, as discussed above under the heading "Temperature inference". Other techniques for determining the temperature of the ultrasonic sheet employ non-contact imaging. These and other techniques are described in detail in the present disclosure and additional details can be found in US provisional patent application No. 62 / 692,768, entitled SMART ENERGY DEVICES. Setting parameters of the ultrasonic system according to temperature

[00588] In one aspect, the adaptive ultrasonic blade control algorithm can be used to adjust the operating parameters of the ultrasonic system based on the temperature of the ultrasonic blade. As discussed above under the heading "Temperature inference", the natural frequency of the ultrasonic blade / transducer varies with temperature and, thus, the temperature of the ultrasonic blade can be inferred from the phase angle between the voltage and voltage signals. current applied to drive the ultrasonic transducer. In addition, the temperature of the ultrasonic sheet corresponds to the temperature of the tissue. In some respects, the adaptive ultrasonic blade control algorithm can be configured to detect the temperature of the ultrasonic blade and modulate the operating parameters of the surgical instrument according to temperature. Operational parameters may include, for example, the frequency of the ultrasonic transducer trigger signal, the amplitude of the ultrasonic blade (which may, for example, correspond to the magnitude or amplitude of the electrical current supplied to the ultrasonic transducer), the pressure applied by the arm tightening, and so on. The adaptive ultrasonic blade control algorithm can be performed by a control circuit or processor located on the generator or the surgical instrument.

[00589] Consequently, in one aspect, the adaptive ultrasonic blade control algorithm detects the resonance frequency of the ultrasonic blade, as previously described under the heading "Temperature inference", and then monitors the resonance frequency over the time to detect a modal shift in the resonance frequency waveform. A shift in the resonant waveform can be correlated with the occurrence of a change in the system, such as an increase in the temperature of the ultrasonic sheet. In some respects, an adaptive ultrasonic blade control algorithm can be configured to adjust the amplitude of the ultrasonic trigger signal, and therefore the amplitude of the ultrasonic blade displacement, to measure tissue temperature. In other respects, an adaptive ultrasonic blade control algorithm can be configured to control the amplitude of the ultrasonic trigger signal, and therefore the amplitude of the ultrasonic blade displacement, according to the temperature of the ultrasonic blade and / or the tissue to keep the temperature of the ultrasonic sheet and / or tissue at a predefined value or within predefined limits (for example, to allow the ultrasonic sheet to cool if its temperature is becoming too high). In yet other respects, an adaptive ultrasonic blade control algorithm can be configured to modulate the RF energy and waveform of an electrosurgical instrument to, for example, minimize excess temperature or change the heat flow of the ultrasonic blade , based on tissue impedance, tissue temperature and / or ultrasonic sheet temperature. More details on these and other functions have been described with reference to Figures 95 to

100, for example.

[00590] Figure 79 is a 130700 graphical representation of the frequency of the ultrasonic transducer system as a function of the drive frequency and temperature deviation of the ultrasonic blade, according to at least one aspect of the present disclosure. The 130704 horizontal geometry axis represents the drive frequency (for example, in Hz) applied to the ultrasonic system (for example, the ultrasonic transducer and / or the ultrasonic blade), and the 130702 vertical geometry axis represents the phase angle of the resulting impedance (for example, in rads). The first 130706 plot represents a resonant waveform characteristic of the ultrasonic system at room or normal temperature. As can be seen in the first plot 130706, the ultrasonic system is in phase when activated at excitation frequency fe (because the impedance phase angle is equal to or close to 0 rad). Consequently, f e represents the resonance frequency of the ultrasonic system at room temperature. The second 130708 plot represents a waveform characteristic of the ultrasonic system after the temperature rise of the ultrasonic system. As shown in Figure 79, as the temperature of the ultrasonic system increases, the characteristic waveform (represented by the first 130706 plot) of the ultrasonic blade and the ultrasonic transducer moves to the left, for example, to a lower frequency range. Due to the frequency waveform shift of the ultrasonic system, it is no longer in phase when activated at the excitation frequency fe. Instead, the resonance frequency has shifted to a value lower than f′e. Therefore, a control circuit coupled to the ultrasonic system can detect or infer the temperature change in the ultrasonic system by detecting the variation in the resonance frequency of the ultrasonic system and / or by detecting when the ultrasonic system is out of phase when activated in a previously established resonance frequency.

[00591] Correspondingly, in some aspects, a control circuit coupled to the ultrasonic system can be configured to control the trigger signal applied to the ultrasonic system by the generator according to the inferred ultrasonic system temperature to keep the ultrasonic system in phase . Keeping the ultrasonic system in phase can be a technique used, for example, to control the temperature of the ultrasonic system. As discussed above, the resonance frequency at which the voltage and current signals are in phase changes from fe (for example, 55.5 kHz) at normal temperature to f′e according to the temperature of the ultrasonic blade and / or the transducer ultrasonic increases. Therefore, as the temperature of the ultrasonic system increases, a control circuit can control the generator to change the frequency at which the ultrasonic system is powered from fe to f′e to keep the ultrasonic system in phase with the generator's trigger signal. For an additional description of the adaptive ultrasonic blade control algorithms, see the description associated with Figures 43A to 54 mentioned earlier in this document.

[00592] Figure 80 is a 130750 graphical representation of the temperature of the ultrasonic transducer as a function of time, according to at least one aspect of the present disclosure. The vertical geometric axis 130752 represents the temperature of the ultrasonic transducer, and the horizontal geometric axis 130754 represents time. In one aspect, as the temperature of the ultrasonic transducer (represented by plot 130756) meets or exceeds a temperature threshold T1, the adaptive ultrasonic blade control algorithm controls the ultrasonic transducer to maintain the ultrasonic transducer temperature at an equal value or less than the temperature threshold T1. The adaptive ultrasonic blade control algorithm can control the temperature of the ultrasonic transducer, for example, by modulating the power and / or the trigger signal applied to the ultrasonic transducer. An additional description of algorithms and techniques for controlling the temperature of an ultrasonic blade / transducer can be found under the titles "Feedback feedback circuit" and "Temperature controlled ultrasonic sealing algorithm" in this description, and in the patent application. US Provisional No. 62 / 640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, filed on March 8, 2018, the disclosure of which is hereby incorporated by reference.

[00593] Figure 81 is a graphical representation of the modal shift of the resonance frequency based on the temperature of the ultrasonic sheet, varying the resonance frequency as a function of the temperature of the ultrasonic sheet, according to at least one aspect of the present disclosure. In the first graph 130800, the vertical geometric axis 130802 represents the change in the resonance frequency (Δf), and the horizontal geometric axis 130804 represents the activation frequency of the generator's ultrasonic transducer. In the second, third and fourth graphs 130810, 130820, 130830, the vertical geometric axes 130812, 130822, 130832 represent, respectively, frequency (f), current (I) and temperature (T), and horizontal geometric axes 130814 , 130824, 130834 represent time (t). The first graph 130810 represents the frequency shift of the ultrasonic system due to the temperature change. The second graphic 130820 represents the current in the ultrasonic transducer, or the amplitude adjustment, to keep the frequency and temperature stable. The third graphic 130830 represents the temperature change of the tissue and / or the ultrasonic system. The graphics 130800, 130810, 130820, 130830 demonstrate together the operation of a control algorithm configured to control the temperature of an ultrasonic system.

[00594] The control algorithm can be configured to control the ultrasonic system (for example, the ultrasonic transducer and / or the ultrasonic blade) when the temperature of the ultrasonic system approaches a T1 temperature threshold. In one aspect, the control algorithm can be configured to determine that the temperature threshold T1 is approaching or has been reached, depending on whether the resonance frequency of the ultrasonic system has decreased by a ΔfR threshold. As indicated by the first graph 130800, the change in the frequency threshold ΔfR corresponding to the temperature threshold T1 can, in turn, be a function of the activation frequency fD of the ultrasonic system (as represented by plot 130806). As indicated by the second graph 130810 and the fourth graph 130830, as the temperature of the tissue and / or the ultrasonic blade increases (as represented by the plot of the temperature 130836), the resonance frequency decreases correspondingly (as represented by the plot of the frequency 130816). As the temperature plot 130836 approaches a temperature threshold T1 (for example, 130 ° C) at time t1, the resonance frequency drops from f1 to f2, causing the resonance frequency to reach the frequency change threshold ΔfR of the control algorithm, and thus causing the control algorithm to act to stabilize the temperature of the ultrasonic system. By monitoring the change in the resonance frequency of the ultrasonic system, the adaptive ultrasonic blade control algorithm can monitor the temperature of the ultrasonic system. Additionally, the adaptive ultrasonic blade control algorithm can be configured to adjust (for example, decrease) the electrical current applied to the ultrasonic transducer or otherwise adjust the amplitude of the ultrasonic blade (represented by plotting the 130826 current) to stabilize the temperature tissue and / or ultrasound sheet and / or the resonance frequency when the temperature is equal to or exceeds the temperature threshold T1.

[00595] In another aspect, the adaptive ultrasonic blade control algorithm can be configured to adjust (for example, decrease) the pressure applied by the tightening arm to the fabric when the temperature is equal to or exceeds the temperature threshold T 1. In In many other respects, the adaptive ultrasonic blade control algorithm can be configured to adjust a variety of other operating parameters associated with the ultrasonic system according to temperature. In another aspect, the adaptive ultrasonic blade control algorithm can be configured to monitor multiple temperature thresholds. For example, a second temperature threshold T2 can represent, for example, a melting or failure temperature of the clamping arm. Consequently, the adaptive ultrasonic blade control algorithm can be configured to act similarly or differently based on the specific temperature threshold that has been reached or exceeded.

[00596] In several aspects, non-contact imaging can be used to determine the temperature of the ultrasonic sheet in addition to or in place of the aforementioned techniques. For example, shortwave thermography can be used to measure ultrasonic sheet temperature by imaging the sheet from the surrounding stationary floor with the use of a CMOS imaging sensor. Non-contact thermographic monitoring of the ultrasonic waveguide or ultrasonic blade temperature can be used to control tissue temperature. In other respects, non-contact imaging can be used to determine the surface and finish conditions of the ultrasonic sheet to improve the temperature of the tissue and / or the ultrasonic sheet through near infrared (IR) detection techniques. Determination of the condition of the claws

[00597] A challenge of applying ultrasonic energy is that the ultrasonic acoustics applied to the wrong materials or the wrong tissue can result in device failures, for example, complete burning of the clamping arm block or breaking of the ultrasonic blade. It is also desirable to detect what is located in the claws of an end actuator of an ultrasonic device and the state of the claws without including additional sensors in the claws. Installing sensors in the claws of an ultrasonic end actuator poses challenges of reliability, cost and complexity.

[00598] Intelligent ultrasound spectroscopy algorithm techniques can be used to estimate the state of the claw (complete burning of the clamping arm block, clamps, broken blade, presence of bone in the claw, presence of tissue in the claw, retrograde cut with the claw closed, etc.) based 𝑉𝑔 (𝑡) on the impedance 𝑍𝑔 (𝑡) = of an ultrasonic transducer configured 𝐼𝑔 (𝑡) to drive an ultrasonic blade, in accordance with at least one aspect of the present disclosure. The impedance 𝑍𝑔 (𝑡), the magnitude | 𝑍 | and phase 𝜑 are plotted as a function of frequency f.

[00599] Dynamic mechanical analysis (AMD), also known as dynamic mechanical spectroscopy or simply mechanical spectroscopy, is a technique used to study and characterize materials. A sinusoidal mechanical stress is applied to the material, and the stretch in the material is measured, allowing the determination of the complex modulus of the material. Spectroscopy applied to ultrasonic devices includes exciting the tip of the ultrasonic blade with a frequency scan (composite signals or traditional frequency scans) and measuring the resulting complex impedance at each frequency. The complex impedance measurements of the ultrasonic transducer over a frequency range are used in a classifier or model to infer the characteristics of the ultrasonic end actuator. In one aspect, the present disclosure provides a technique for determining the state of an ultrasonic end actuator (clamping arm, claw) to trigger automation on the ultrasonic device (how to disable power to protect the device, run adaptive algorithms, retrieve information , identify tissue, etc.).

[00600] Figure 82 shows spectra 132030 of an ultrasonic device with a variety of different states and conditions of the end actuator where the impedance 𝑍𝑔 (𝑡), the magnitude | 𝑍 | and phase 𝜑 are plotted as a function of frequency f, according to at least one aspect of the present disclosure. The 132030 spectra are plotted in a three-dimensional space where the frequency (Hz) is plotted along the geometric axis x, the phase (rad) is plotted along the geometric axis y, and the magnitude (ohms) is plotted along the axis geometric z.

[00601] The spectral analysis of different claw bites and device states produces different characteristic patterns of complex impedance (fingerprints) over a frequency range for different conditions and states. Each state or condition has a different characteristic pattern in 3D space when plotted. These characteristic patterns can be used to estimate the condition and state of the end actuator. Figure 82 shows the spectra for air 132032, clamping arm block 132034, suede 132036, clamp 132038 and broken blade 132040. Suede 132036 can be used to characterize different types of fabric.

[00602] The 132030 spectra can be evaluated by applying a low power electrical signal through the ultrasonic transducer to produce non-therapeutic excitation of the ultrasonic blade. The low power electrical signal can be applied in the form of a scan or a composite Fourier series to measure impedance 𝑉𝑔 (𝑡) 𝑍𝑔 (𝑡) = through the ultrasonic transducer over a range of 𝐼𝑔 (𝑡) frequencies in series ( scan) or in parallel (composite signal) using an FFT. New data classification methods

[00603] For each characteristic pattern, a parametric line can be adjusted to the data used for training using a polynomial, a Fourier series, or any other form of parametric equation dictated by convenience. A new data point is then received and is classified using the Euclidean perpendicular distance between the new data point and the trajectory that has been adjusted to the training data of the characteristic pattern. The perpendicular distance from the new data point to each of the paths (each path representing a different state or condition) is used to assign the point to a state or condition.

[00604] The probability distribution of the distance from each point in the training data to the fitted curve can be used to estimate the probability of a new correctly classified data point. This essentially builds a two-dimensional probability distribution on a plane perpendicular to the adjusted path at each new data point on the adjusted path. The new data point can then be added to the training set based on its probability of correct classification to create an adaptive learning classifier that readily detects high frequency changes in states, but adapts to slow occurring deviations in system performance. , such as a device that gets dirty or the block that wears out.

[00605] Figure 83 is a graphical representation of a 132042 plot of a 3D training data set (S), where the impedance 𝑍𝑔 (𝑡), the magnitude | 𝑍 | and phase 𝜑 of the ultrasonic transducer are plotted as a function of frequency f, according to at least one aspect of the present disclosure. Plot 132042 of the 3D training data set (S) is plotted in three-dimensional space where the phase (rad) is plotted along the geometric axis x, the frequency (Hz of) is plotted along the geometric axis y, the amplitude (kOhms) is plotted along the geometric z axis, and a parametric Fourier series is fitted to the 3D training data set (S). A methodology for classifying data is based on the 3D training data set (S0 is used to generate the 132042 plot).

[00606] The parametric Fourier series adjusted to the 3D training data set (S) is given by: ∞ 𝑛𝜋𝑡 𝑛𝜋𝑡 𝑝⃑ = 𝑎⃑0 + ∑ (𝑎⃑𝑛 cos + 𝑏⃑⃑𝑛 sin)

𝐿 𝐿 𝑛 = 1

[00607] For a new point 𝑧⃑, the perpendicular distance between 𝑝⃑ and 𝑧⃑ is given by: 𝐷 = ‖𝑝⃑ - 𝑧⃑‖

[00608] When: 𝜕𝐷 = 0 𝜕𝑇

[00609] So: 𝐷 = 𝐷⊥

[00610] A probability distribution of D can be used to estimate the probability of a data point 𝑧⃑ belonging to group S. Control

[00611] Based on the classification of the data measured before, during or after the activation of the ultrasonic transducer / blade, a variety of automated tasks and safety measures can be implemented. Similarly, the state of the tissue in the end actuator and the temperature of the ultrasonic blade can also be inferred to some extent and used to provide the user with more accurate information about the state of the ultrasonic device or to protect critical structures, etc. The temperature control of an ultrasonic blade is described in Commonly Owned US Provisional Patent Application No. 62 / 640,417, filed on March 8, 2018, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, which is hereby incorporated by reference in its entirety.

[00612] Similarly, the energy application can be reduced when there is a high probability that the ultrasonic blade is in contact with the clamping arm block (for example, there is no fabric between the blade and the block) or if there is a likelihood that the ultrasonic sheet has broken or is touching metal (for example, a clamp). In addition, retrograde cutting may not be allowed if the claw is closed and no tissue is detected between the ultrasonic blade and the clamping arm block. Integration of other data to improve classification

[00613] This system can be used in conjunction with other information provided by sensors, by the user, metrics about the patient, environmental factors, etc., by combining the data obtained from this process with the aforementioned data using functions of probability and a Kalman filter. The Kalman filter determines the maximum probability that a state or condition will occur given a multitude of uncertain measurements with varying degrees of confidence. As this method allows the assignment of a probability to a newly classified data point, the information from this algorithm can be implemented with other measures or estimates in a Kalman filter.

[00614] Figure 84 is a 132044 logic flow diagram of a process that represents a control program or a logical configuration to determine the conditions of the jaws based on the characteristic complex impedance pattern (fingerprint), according to at least an aspect of the present revelation. Before determining the condition of the claws based on the characteristic complex impedance pattern (fingerprint), a database is filled in with reference to characteristic complex impedance patterns or training data sets (S) that characterize various claw conditions , including, without limitation, air 132032, clamping arm block 132034, suede 132036, clamp 132038, broken blade 132040, as shown in Figure 82, and a variety of fabric types and conditions. Dry or wet chamois, in a full bite or just the tip, can be used to characterize different types of fabric. The data points used to generate characteristic patterns of complex impedance or a set of training data (S) are obtained by applying a subtherapeutic trigger signal to the ultrasonic transducer, scanning the trigger frequency over a predetermined frequency range , from frequencies below resonance to frequencies above resonance, measurement of complex impedance at each frequency and recording of data points. The data points are then fitted to a curve using a variety of numerical methods that include polynomial curve fitting, Fourier series and / or parametric equation. The adjustment of the parametric Fourier series to characteristic patterns of complex impedance or reference training data sets (S) is described in the present disclosure.

[00615] Once the characteristic complex impedance patterns or training data sets (S) have been generated, the ultrasonic instrument measures new data points, classifies the new points and determines whether the new data points should be added to the characteristic patterns of complex impedance or a reference training (S) data set.

[00616] Now with reference to the logic flow diagram of Figure 84, in one aspect, the processor or control circuit measures 132046 a complex impedance of an ultrasonic transducer, with the complex 𝑉𝑔 (𝑡) impedance being defined as 𝑍𝑔 (𝑡 ) =. The processor or 𝐼𝑔 (𝑡) control circuit receives 132048 a complex impedance measurement data point and compares 132050 the complex impedance measurement data point with a data point in a characteristic reference standard complex impedance. The processor or control circuit sorts 132052 the complex impedance measurement data point based on a comparison analysis result and assigns 132054 a state or condition of the end actuator based on the comparison analysis result.

[00617] In one aspect, the processor or control circuit receives the characteristic reference pattern of complex impedance from a database or memory coupled to the processor. In one respect, the processor or control circuit generates the characteristic complex impedance reference pattern as described below. A drive circuit coupled to the processor or control circuit applies a non-therapeutic drive signal to the ultrasonic transducer starting at a starting frequency, ending at a final frequency and a plurality of frequencies between the starting and ending frequencies. The processor or control circuit measures the impedance of the ultrasonic transducer at each frequency and stores a data point corresponding to each impedance measurement. The processor or the control circuit performs a curve fit for a plurality of data points to generate a three-dimensional curve representative of the characteristic complex impedance reference pattern, with the magnitude | 𝑍 | and phase 𝜑 are plotted as a function of frequency f. The curve fit includes a polynomial curve fit, a Fourier series and / or a parametric equation.

[00618] In one aspect, the processor or control circuit receives a new impedance measurement data point and classifies the new impedance measurement data point using a perpendicular Euclidean distance between the new impedance measurement data point and a trajectory that was adjusted to the characteristic reference pattern of complex impedance. The processor or control circuit calculates a probability that the new impedance measurement data point will be classified correctly. The processor or control circuit adds the new impedance measurement data point to the characteristic complex impedance reference pattern based on the probability of the estimated correct rating of the new impedance measurement data point. In one aspect, the processor or control circuit classifies the data based on a training data set (S), the training data set (S) comprising a plurality of complex impedance measurement data, and perform a curve fit of the training data set (S) using a parametric Fourier series, where S is defined here and the probability distribution is used to estimate the probability that the new impedance measurement data point belongs to the group S.

[00619] Additional details regarding the determination or estimation of a condition of the jaws or of the surgical instrument as a whole can be found in the provisional patent application US No. 62 / 692,768, entitled SMART ENERGY DEVICES. Situational recognition

[00620] Now with reference to Figure 85, a time line 5200 is shown representing the situational recognition of a central controller, such as the central surgical controller 106 or 206 (Figures 1 to 11), 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 of 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 an operating room. postoperative recovery.

[00621] 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 derive inferences (that is, contextual information) about the ongoing procedure as new data is received, such as procedure step is being performed at any given time. The situational recognition system of the central surgical controller 106, 206 is capable of, for example, recording data related to the procedure to generate reports, checking the steps being taken by medical personnel, providing data or warnings (for example, through a display) 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 a ultrasonic surgical instrument or RF electrosurgical instrument), and take any other action described above.

[00622] As the first step 5202 in this illustrative procedure, members of the hospital team obtain the electronic medical record (RME) of the patient from the hospital's RMEs database. Based on the patient selection data in the RME, the central surgical controller 106, 206 determines that the procedure to be performed is a thoracic procedure.

[00623] In the second step 5204, the team members scan the entry of medical supplies for the procedure. Central surgical controller 106, 206 cross-references 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 resection procedure (because the inlet supplies have an absence of certain supplies that are necessary for a thoracic wedge resection procedure or, otherwise, that the inlet supplies do not correspond to a thoracic wedge resection procedure).

[00624] In the third step 5206, medical personnel scan the patient's band 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.

[00625] In the fourth step 5208, the medical staff turns on 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 in a specific neighborhood 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 paired with it during that 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 the patient's electronic medical record (RME) data, 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 a memory or from the cloud and then cross the data it subsequently receives from the connected data sources (for example, modular devices and patient monitoring devices) to infer which stage of the surgical procedure the surgical team is performing.

[00626] In the fifth step 5210, the team members fix the electrocardiogram (ECG) electrodes and other patient monitoring devices on the patient. ECG electrodes and other patient monitoring devices are able to pair with central surgical controller 106, 206. As central surgical controller 106, 206 begins to receive data from patient monitoring devices, central surgical controller 106, 206 thus confirming that the patient is in the operating room.

[00627] In the sixth step 5212, the 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 (PS) data, ventilator data, or combinations thereof, 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.

[00628] In the seventh step 5214, the lung of the patient 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. 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 at the expected stages of the procedure (which can be accessed or retrieved earlier) and thus determine that the retraction of the patient lung is the first operative step in this specific procedure.

[00629] In the eighth step 5216, the medical imaging device (for example, a display 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.

Upon receipt of data from the medical imaging device, the central surgical controller 106, 206 can determine which portion of the laparoscopic surgical procedure has been initiated.

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 resection procedure has already been discarded by the central surgical controller 106, 206 based on the data received in the second step 5204 of the procedure). The medical imaging device data 124 (Figure 2) can be used to determine contextual information about the type of procedure being performed in a number of different ways, including by determining the angle at which the medical imaging device is oriented in regarding the visualization of the patient's anatomy, monitor the number or medical imaging devices being used (ie, that are activated and paired with the central surgical controller 106, 206), and monitor 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 segment fissure.

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 communicably coupled 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.

[00630] 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 fired. 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 being fired at that point in the process (that is, after the completion of the previously discussed steps of the procedure) corresponds to the step of dissection. In certain cases, the energy instrument may be a power tool mounted on a robotic arm in a robotic surgical system.

[00631] In the tenth step 5220 of the procedure, the surgical team proceeds to the connection step. Central surgical controller 106, 206 can infer that the surgeon is ligating the arteries and veins because he receives data from the surgical stapling and 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.

[00632] 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 which segmentectomy portion of the procedure is being performed.

[00633] In the twelfth step 5224, the node dissection step is then performed. The central surgical controller 106, 206 can infer that the surgical team is dissecting the node and performing a leak test based on the 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 surgeons regularly switch between surgical stapling / cutting instruments and surgical energy instruments (that is, RF or ultrasonic) depending on the specific step in the procedure because different instruments are better adapted for specific tasks.

Therefore, the specific sequence in which cutting / stapling instruments and surgical energy instruments are used can indicate which step of the procedure the surgeon is performed on. 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.

[00634] 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 (i.e., the patient's respiratory rate begins to increase), for example.

[00635] 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 thus 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 coupled in communication with the central surgical controller 106, 206.

[00636] Situational recognition is further described in US provisional patent application serial number 62 / 659,900, entitled

METHOD OF HUB COMMUNICATION, filed on April 19, 2018, the content of which is hereby incorporated by reference in its entirety for reference. 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 recognition and / or the feedback provided by its components and / or based on information from the cloud 102.

[00637] 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 associated with the shape can alternatively be described as a means of providing 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.

[00638] 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, 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 virtually any combination thereof. Those skilled in the art will recognize, however, that some aspects of the aspects disclosed herein, in whole or in part, can be implemented in an equivalent manner in integrated circuits, such as one or more computer programs running on one or more computers (for example, 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 as any combination of them, and that designing the circuitry 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 herein 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 transmission medium. signals used to effectively carry out the distribution.

[00639] 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. Thus, machine-readable media 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 discs, read-only compact disc ( 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), cards magnetic or optical, flash memory, or machine-readable tangible storage media used to transmit information over the Internet via an electrical, optical, acoustic cable or other forms of propagation signals (for example, carrier waves, infrared signal, digital signals, etc.). Consequently, computer-readable non-transitory 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).

[00640] 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 cores individual instruction processing units, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic matrix (PLA), or field programmable port matrix ( 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 here, "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 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 performs processes and / or devices described herein, or a microprocessor 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 a communications device (for example, a modem, communication key, or optical equipment -electric). 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.

[00641] As used in any aspect of the present invention, the term "logical" can refer to an application, software, firmware and / or circuit configured to perform any of the aforementioned operations. The software may 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 embedded as code, instructions or instruction sets and / or data that are hard-coded (for example, non-volatile) in memory devices. 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 running software. As used in any aspect of the present disclosure, a

"algorithm" refers to the self-consistent sequence of steps that lead to the desired result, where a "step" refers to the manipulation of physical quantities and / or logical states that can, although not necessarily need to, 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.

[00642] A network may 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 to or be compatible with a standard promulgated by the Consultative Committee for International 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 to 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 that standard. Obviously, different and / or post-developed connection-oriented network communication protocols are also contemplated in the present invention.

[00643] 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 data represented in the form of physical (electronic) quantities in the registers and memories of the computer in other data represented in a similar way in the form of physical quantities in the memories or registers of the computer, or in other similar information storage, transmission or display devices.

[00644] One or more components in the present invention may be called "configured for", "configurable for", "operable / operational for", "adapted / adaptable for", "capable of", "conformable / conformed for", etc. Those skilled in the art will recognize that "configured for" may, in general, cover components in an active state and / or components in an inactive state and / or components in a standby state, except when the context determines otherwise.

[00645] The terms "proximal" and "distal" are used here with reference to a case in which a doctor manipulates 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 opposite the doctor. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down" can be used in the present invention with respect to the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.

[00646] Persons skilled in the art will recognize that, in general, the terms used here, and especially in the appended claims (for example, bodies of the appended claims) are generally intended as "open" terms (for example, 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 mention of the claim entered to claims that contain only such a mention, 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, "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.

[00647] 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, "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, in general this construction is intended to have the meaning in which the convention would be understood by (for example, "a system that have 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, any of the terms or both terms, except where the context dictates something different. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "A and B".

[00648] With respect to the attached claims, those skilled in the art will understand that the operations mentioned in them 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, merged, interrupted, reordered, incremental, preparatory, supplementary, simultaneous, inverse or other variant orders, unless the context otherwise requires. In addition, terms such as "responsive to", "related to" or other adjectival participles are not intended in general to exclude these variants, unless the context otherwise requires.

[00649] 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 feature described in connection with the aspect 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 does not necessarily refer the same aspect. In addition, specific resources, structures or characteristics can be combined in any appropriate way in one or more aspects.

[00650] 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 materials incorporated are not inconsistent with that. Accordingly, and to the extent necessary, the disclosure as explicitly presented herein replaces any conflicting material incorporated by reference to the present 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 existing disclosure material.

[00651] 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.

[00652] Various aspects of the subject described in this document are defined in the following numbered examples:

[00653] Example 1. An ultrasonic electromechanical system for an ultrasonic surgical instrument. The ultrasonic electromechanical system comprises: an end actuator comprising an ultrasonic blade, an ultrasonic transducer acoustically coupled to the ultrasonic blade and a control circuit coupled to the ultrasonic transducer. The ultrasonic transducer is configured to ultrasonic oscillate the ultrasonic blade in response to a trigger signal. The control circuit is configured to: determine a first resonance frequency of the ultrasonic electromechanical system, determine a second resonance frequency of the ultrasonic electromechanical system as the ultrasonic blade oscillates against a tissue and determine a tissue composition according to a comparison between the first resonance frequency and the second resonance frequency.

[00654] Example 2. The ultrasonic electromechanical system, according to Example 1, in which the fabric composition comprises a ratio between fabric and elastin.

[00655] Example 3. The ultrasonic electromechanical system, according to Example 1 or 2, in which the control circuit is configured to adjust an operational parameter of the ultrasonic surgical instrument according to the tissue composition.

[00656] Example 4. The ultrasonic electromechanical system, according to Example 3, in which the operational parameter comprises at least one of a temperature limit of the tissue, a heating time of the ultrasonic blade or a temperature limit of the ultrasonic blade .

[00657] Example 5. The ultrasonic electromechanical system, according to any of Examples 1 to 4, in which the control circuit is configured to control the ultrasonic transducer to oscillate the ultrasonic blade at a non-therapeutic frequency to determine the first frequency resonance frequency and the second resonance frequency.

[00658] Example 6. The ultrasonic electromechanical system, according to any of Examples 1 to 5, which additionally comprises a memory coupled to the control circuit. The memory stores a plurality of tissue compositions according to a shift in the resonance frequency. The control circuit is configured to determine the tissue composition by obtaining, from memory, an indication of which of the plurality of tissue compositions corresponds to a difference between the first resonance frequency and the second resonance frequency.

[00659] Example 7. The ultrasonic electromechanical system, according to any of Examples 1 to 6, in which the control circuit is configured to: apply the drive signal to the ultrasonic transducer in a plurality of frequencies over a range of frequencies and determine the first resonance frequency or the second resonance frequency according to a frequency within the frequency range in which a voltage signal and a current signal from the ultrasonic electromechanical system resulting from the trigger signal are in phase.

[00660] Example 8. An ultrasonic generator connectable to an ultrasonic electromechanical system comprising an ultrasonic blade and an ultrasonic transducer acoustically coupled to the ultrasonic blade. The ultrasonic generator comprises a control circuit attachable to the ultrasonic transducer. The control circuit is configured to: apply a trigger signal to the ultrasonic transducer to cause the ultrasonic transducer to oscillate the ultrasonic blade; determine a first resonance frequency of the ultrasonic electromechanical system; determine a second resonance frequency of the ultrasonic electromechanical system as the ultrasonic blade oscillates against a tissue; and determining a tissue composition according to a comparison between the first resonance frequency and the second resonance frequency.

[00661] Example 9. The ultrasonic generator, according to Example 8, in which the fabric composition comprises a ratio between fabric and elastin.

[00662] Example 10. The ultrasonic generator, according to Example 8 or 9, in which the control circuit is configured to adjust an operational parameter of the ultrasonic electromechanical system according to the tissue composition. Example 11. The ultrasonic generator, according to Example 10, in which the operational parameter comprises at least one of a temperature limit of the tissue, a heating time of the ultrasonic blade or a temperature limit of the ultrasonic blade.

[00663] Example 12. The ultrasonic generator, according to any of Examples 8 to 11, in which the control circuit is configured to control the ultrasonic transducer to oscillate the ultrasonic blade at a non-therapeutic frequency to determine the first frequency of resonance and the second resonance frequency.

[00664] Example 13. The generator, according to any of Examples 8 to 12, which additionally comprises a memory coupled to the control circuit. The memory stores a plurality of tissue compositions according to a shift in the resonance frequency. The control circuit is configured to determine the tissue composition by obtaining, from memory, an indication of which of the plurality of tissue compositions corresponds to a difference between the first resonance frequency and the second resonance frequency.

[00665] Example 14. The ultrasonic generator, according to any of Examples 8 to 13, in which the control circuit is configured to: apply the drive signal to the ultrasonic transducer at a plurality of frequencies over a range of frequencies and determine the first resonance frequency or the second resonance frequency according to a frequency within the frequency range in which a voltage signal and a current signal from the ultrasonic electromechanical system resulting from the trigger signal are in phase.

[00666] Example 15. An ultrasonic surgical instrument comprising: an end actuator comprising an ultrasonic blade, an ultrasonic transducer acoustically coupled to the ultrasonic blade, an infrared source configured to emit infrared energy in a tissue within the end actuator, an infrared detector and a control circuit coupled to the ultrasonic transducer and the infrared detector. The ultrasonic transducer is configured to ultrasonic oscillate the ultrasonic blade in response to a trigger signal. The control circuit is configured to: receive infrared energy reflected by the tissue through the infrared detector and determine the composition of the tissue according to the reflected infrared energy.

[00667] Example 16. The ultrasonic surgical instrument, according to Example 15, in which the tissue composition comprises a ratio between tissue and elastin.

[00668] Example 17. The ultrasonic surgical instrument, according to Example 15 or 16, in which the control circuit is additionally configured to adjust an operational parameter of the ultrasonic surgical instrument according to the tissue composition.

[00669] Example 18. The ultrasonic surgical instrument, according to Example 17, in which the operational parameter comprises at least one of a temperature limit of the tissue, a heating time of the ultrasonic blade or a temperature limit of the ultrasonic blade .

[00670] Example 19. The ultrasonic surgical instrument, according to any of Examples 15 to 18, which additionally comprises a memory coupled to the control circuit. The memory stores a plurality of fabric compositions according to the reflected infrared energy. The control circuit is configured to determine the fabric composition by obtaining, from memory, an indication of which of the plurality of fabric compositions corresponds to the reflected infrared energy.

[00671] Example 20. The ultrasonic surgical instrument, according to any of Examples 15 to 19, in which the end actuator additionally comprises a movable clamping arm articulated in relation to the ultrasonic blade and at least one among the source infrared detector and the infrared detector is arranged on the clamping arm.

Claims (20)

1. Electromechanical ultrasonic system for an ultrasonic surgical instrument, characterized by comprising: an ultrasonic blade; an ultrasonic transducer acoustically coupled to the ultrasonic blade, the ultrasonic transducer being configured to oscillate the ultrasonic blade in response to a trigger signal; and a control circuit coupled to the ultrasonic transducer, the control circuit being configured to: determine a first resonance frequency of the ultrasonic electromechanical system; determine a second resonance frequency of the ultrasonic electromechanical system as the ultrasonic blade oscillates against a tissue; and determining a tissue composition according to a comparison between the first resonance frequency and the second resonance frequency. 2. Ultrasonic electromechanical system according to claim 1, characterized in that the fabric composition comprises a ratio between fabric and elastin. 3. Electromechanical ultrasonic system, according to claim 1, characterized in that the control circuit is configured to adjust an operational parameter of the ultrasonic surgical instrument according to the tissue composition. 4. Ultrasonic electromechanical system, according to claim 3, characterized in that the operational parameter comprises at least one of a temperature limit of the tissue, a heating time of the ultrasonic blade or a temperature limit of the ultrasonic blade. 5. Electromechanical ultrasonic system according to claim 1, characterized in that the control circuit is configured to control the ultrasonic transducer to oscillate the ultrasonic blade at a non-therapeutic frequency to determine the first resonance frequency and the second resonance frequency. 6. Ultrasonic electromechanical system, according to claim 1, characterized by additionally comprising: a memory coupled to the control circuit, the memory storing a plurality of tissue compositions according to a resonance frequency shift; the control circuit being configured to determine the tissue composition of the tissue by obtaining, from memory, an indication of which of the plurality of tissue compositions corresponds to a difference between the first resonance frequency and the second frequency resonance. 7. Electromechanical ultrasonic system, according to claim 1, characterized in that the control circuit is configured to: apply the drive signal to the ultrasonic transducer in a plurality of frequencies over a frequency range; and determining the first resonance frequency or the second resonance frequency according to a frequency within the frequency range in which a voltage signal and a current signal from the ultrasonic electromechanical system resulting from the trigger signal are in phase. 8. Ultrasonic generator connectable to an ultrasonic electromechanical system comprising an ultrasonic blade and an ultrasonic transducer acoustically coupled to the ultrasonic blade, the ultrasonic generator being characterized by comprising: a control circuit attachable to the ultrasonic transducer, with the control circuit configured for: apply a trigger signal to the ultrasonic transducer to cause the ultrasonic transducer to oscillate the ultrasonic blade; determine a first resonance frequency of the ultrasonic electromechanical system; determine a second resonance frequency of the ultrasonic electromechanical system as the ultrasonic blade oscillates against a tissue; and determining a tissue composition of the tissue according to a comparison between the first resonance frequency and the second resonance frequency. An ultrasonic generator according to claim 8, characterized in that the fabric composition comprises a ratio between fabric and elastin. 10. Ultrasonic generator, according to claim 8, characterized in that the control circuit is configured to adjust an operational parameter of the ultrasonic surgical electromechanical system according to the tissue composition. 11. Ultrasonic generator, according to claim 10, characterized in that the operational parameter comprises at least one of a temperature limit of the tissue, a heating time of the ultrasonic blade or a temperature limit of the ultrasonic blade. 12. Ultrasonic generator according to claim 8, characterized in that the control circuit is configured to control the ultrasonic transducer to oscillate the ultrasonic blade at a non-therapeutic frequency to determine the first resonance frequency and the second resonance frequency. 13. Ultrasonic generator, according to claim 8, characterized in that it further comprises: a memory coupled to the control circuit, the memory storing a plurality of tissue compositions according to a resonance frequency shift; the control circuit being configured to determine the tissue composition by obtaining, from memory, an indication of which of the plurality of tissue compositions corresponds to a difference between the first resonance frequency and the second resonance frequency . 14. Ultrasonic generator, according to claim 8, characterized in that the control circuit is configured to: apply the drive signal to the ultrasonic transducer in a plurality of frequencies over a frequency range; and determining the first resonance frequency or the second resonance frequency according to a frequency within the frequency range in which a voltage signal and a current signal from the ultrasonic electromechanical system resulting from the trigger signal are in phase. 15. Ultrasonic surgical instrument, characterized by comprising: an end actuator that comprises an ultrasonic blade; an ultrasonic transducer acoustically coupled to the ultrasonic blade, the ultrasonic transducer being configured to oscillate the ultrasonic blade in response to a trigger signal; an infrared source configured to emit infrared energy in a tissue within the end actuator; an infrared detector; and a control circuit coupled to the ultrasonic transducer and the infrared detector, the control circuit being configured to: receive infrared energy reflected by the tissue through the infrared detector; and determining a tissue composition according to the reflected infrared energy. 16. Ultrasonic surgical instrument according to claim 15, characterized in that the tissue composition comprises a ratio between tissue and elastin. 17. Ultrasonic surgical instrument, according to claim 15, characterized in that the control circuit is additionally configured to adjust an operational parameter of the ultrasonic surgical instrument according to the tissue composition. 18. Ultrasonic surgical instrument, according to claim 17, characterized in that the operational parameter comprises at least one of a tissue temperature limit, an ultrasonic blade heating time or an ultrasonic blade temperature limit. 19. Ultrasonic surgical instrument, according to claim 15, characterized by additionally comprising: a memory coupled to the control circuit, the memory storing a plurality of tissue compositions according to the reflected infrared energy; the control circuit being configured to determine the tissue composition of the tissue by obtaining, from memory, an indication of which of the plurality of tissue compositions corresponds to the reflected infrared energy. 20. Ultrasonic surgical instrument according to claim 15, characterized in that: the end actuator additionally comprises a movable clamping arm articulated in relation to the ultrasonic blade; and at least one of the infrared source and the infrared detector is arranged on the clamping arm.