BR112020013093A2 - determine the state of an ultrasonic system - Google Patents

Abstract

The present invention relates to various systems and methods for determining the status of an end actuator of an ultrasonic surgical instrument. a control circuit can be configured to measure a complex impedance of an ultrasonic electromechanical system that includes an ultrasonic blade and compare the complex impedance measurement to reference complex impedance standards that each correspond to an end actuator state. in this way, the control circuit can be further configured to determine the state of the end actuator according to the complex impedance pattern among the plurality of reference complex impedance patterns to which the measured complex impedance corresponds.

Description

Description of the Patent of Invention for "DETERMINING THE STATUS OF AN ULTRASONIC SYSTEM", REFERENCE TO RELATED DEPOSIT REQUESTS

TOS

[001] The present application claims priority under 35 USC $119(e) to US provisional patent application No. 62/721,996 entitled RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS, filed on August 23, 2018, The description is incorporated herein by reference in its entirety.

[002] The present application also claims priority under 35 USC$119(e) to US provisional patent application No. 62/692,748 entitled SMART ENERGY ARCHITECTURE, filed on June 30, 2018 and to the patent application provisional US No. 62/692,768, entitled SMART ENERGY DEVICES, deposited on June 30, 2018, whose description is incorporated herein by reference, in its entirety.

[003] The present application also claims priority under 35 USC$119(e) to US Provisional Patent Application Serial No. 62/640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, filed March 8, 2018, and to US provisional patent application Serial No. 62/640,415, entitled ES-

TIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR, filed on March 8, 2018, the description of which is incorporated herein by reference in its entirety.

[004] The present application also claims priority under 35 USC$119(e) to US provisional patent application No. 62/650,898 filed on March 30, 2018 entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS, whose The description is incorporated herein by reference in its entirety.

BACKGROUND

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

SUMMARY

[006] In a general aspect, an ultrasonic surgical instrument 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 ultrasonically oscillate the ultrasonic blade in response to a trigger signal. The control circuit is configured to: measure a complex impedance of the ultrasonic transducer, compare the complex impedance with a plurality of reference complex impedance standards, each of the plurality of reference complex impedance standards corresponding to a state of the end actuator, and determining the state of the end actuator according to the complex impedance pattern among the plurality of reference complex impedance patterns to which the complex impedance corresponds.

[007] In another general aspect, an ultrasonic generator is described to drive an ultrasonic surgical instrument that comprises an end actuator, an ultrasonic blade and an ultrasonic transducer acoustically coupled to the ultrasonic blade. The ultrasonic transducer is configured to ultrasonically oscillate the ultrasonic blade in response to a trigger signal. The ultrasonic generator comprises a control circuit coupled to the ultrasonic transducer. The control circuit is configured to: apply the drive signal to the ultrasonic transducer, measure a complex impedance of the ultrasonic transducer,

trasonic, compare the complex impedance with a plurality of reference complex impedance standards, each of the plurality of reference complex impedance standards corresponding to an end actuator state, and determine the actuator state according to the complex impedance pattern among the plurality of reference complex impedance patterns to which the complex impedance corresponds.

[008] In another general aspect, a method of controlling an ultrasonic surgical instrument is described, which comprises an end actuator, an ultrasonic blade and an ultrasonic transducer acoustically coupled to the ultrasonic blade. The ultrasonic transducer is configured to ultrasonically oscillate the ultrasonic blade in response to a drive signal from a generator. The method comprises: measuring, by a control circuit coupled to the ultrasonic transducer, a complex impedance of the ultrasonic transducer; compare, through the control circuit, the complex impedance with a plurality of reference complex impedance patterns, each pattern among the plurality of reference complex impedance patterns corresponding to an end actuator state. ity; and determining, by the control circuit, the state of the end actuator according to the complex impedance pattern among the plurality of reference complex impedance patterns to which the complex impedance corresponds.

FIGURES

[009] The characteristics and features of various aspects are presented with particularity in the attached claims. The various aspects, however, as regards both organization and methods of operation, together with objects and additional advantages thereof, can be better understood by referring to the description given below, taken in conjunction with the attached drawings. , as shown below.

[0010] Figure 1 is a block diagram of an interactive computer-implemented surgical system, in accordance with at least one aspect of the present disclosure.

[0011] 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 description.

[0012] Figure 3 is a central surgical controller paired with a visualization system, a robotic system and a smart instrument, in accordance with at least one aspect of the present description.

[0013] Figure 4 is a partial perspective view of a central surgical controller compartment, and a combined generator module slidably received in a drawer of the central surgical controller compartment, according to at least one aspect of the present description.

[0014] Figure 5 is a perspective view of a generator module combined with bipolar, ultrasonic and monopolar contacts and a smoke evacuation component, according to at least one aspect of the present description.

[0015] Figure 6 illustrates different power bus connectors for a plurality of side docking ports of a modular side cabinet configured to receive a plurality of modules, in accordance with at least one aspect of the present description.

[0016] Figure 7 illustrates a modular vertical cabinet configured to receive a plurality of modules, in accordance with at least one aspect of the present description.

[0017] 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 services specially equipped for surgical operations, to the cloud, in accordance with at least one aspect of the present description.

[0018] Figure 9 illustrates an interactive computer-implemented surgical system, according to at least one aspect of the present description.

[0019] 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 description.

[0020] 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 description.

[0021] Figure 12 illustrates a logic diagram of a surgical instrument or tool control system, according to at least one aspect of the present description.

[0022] Figure 13 illustrates a control circuit configured to control aspects of the surgical instrument or tool, in accordance with at least one aspect of the present description.

[0023] Figure 14 illustrates a combinational logic circuit configured to control aspects of the surgical instrument or tool, in accordance with at least one aspect of the present description.

[0024] Figure 15 illustrates a sequential logic circuit configured to control aspects of the surgical instrument or tool, in accordance with at least one aspect of the present disclosure.

[0025] Figure 16 illustrates a surgical instrument or tool comprising a plurality of motors that can be activated to perform various functions, in accordance with at least one aspect of the present description.

[0026] 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.

[0027] Figure 18 illustrates a block diagram of a surgical instrument programmed to control the distal translation of the dislocation limb, according to one aspect of the present description.

[0028] Figure 19 is a schematic diagram of a surgical instrument configured to control various functions, in accordance with at least one aspect of the present disclosure.

[0029] Figure 20 is a system configured to run adaptive ultrasonic blade control algorithms on a surgical data network comprising a central modular communication controller, in accordance with at least one aspect of the present description.

[0030] Figure 21 illustrates an example of a generator, in accordance with at least one aspect of the present description.

[0031] Figure 22 is a surgical system comprising a generator and various surgical instruments that can be used with the generator, in accordance with at least one aspect of the present description.

[0032] Figure 23 is a view of an end actuator, in accordance with at least one aspect of the present description.

[0033] Figure 24 is a diagram of the surgical system of Figure 22, in accordance with at least one aspect of the present disclosure.

[0034] Figure 25 is a model illustrating the branching motion current, in accordance with at least one aspect of the present description.

[0035] Figure 26 illustrates a structural view of a generator architecture, according to at least one aspect of the present description.

[0036] Figures 27A to 27C illustrate functional views of a generator architecture, in accordance with at least one aspect of the present description.

[0037] Figures 28A and 28B are structural and functional aspects of a generator, in accordance with at least one aspect of the present description.

[0038] Figure 29 is a schematic diagram of an aspect of an ultrasonic drive circuit.

[0039] Figure 30 is a schematic diagram of a control circuit, in accordance with at least one aspect of the present description.

[0040] Figure 31 shows a simplified block circuit diagram illustrating another electrical circuit contained within a modular ultrasonic surgical instrument, in accordance with at least one aspect of the present description.

[0041] Figure 32 illustrates a generator circuit divided into multiple stages, according to at least one aspect of the present description.

[0042] Figure 33 illustrates a generator circuit divided into multiple stages, where a first stage circuit is common to the second stage circuit, according to at least one aspect of the present description.

[0043] 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.

[0044] Figure 35 illustrates an aspect of a fundamental architecture for a digital synthesis circuit as a direct digital 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 description.

[0045] Figure 36 illustrates an aspect of the direct digital synthesis (DDS) circuit 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 description.

[0046] Figure 37 illustrates a cycle of a discrete-time digital electrical signal waveform, in accordance with at least one aspect of the present description, of an analog waveform (shown superimposed on an analog waveform). discrete-time digital electrical signal for comparison purposes), in accordance with at least one aspect of the present disclosure.

[0047] Figure 38 is a diagram of a control system configured to enable progressive closure of a closing member as it advances distally to close the clamping arm to apply a closing force load at a de- desired, in accordance with one aspect of the present disclosure.

[0048] Figure 39 illustrates a proportional-integral-derived (PID) controller feedback control system, in accordance with one aspect of the present description.

[0049] 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 description.

[0050] Figure 41 is a circuit diagram of various components of a surgical instrument with motor control functions, in accordance with at least one aspect of the present description.

[0051] 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 description.

[0052] Figure 43A is a graphic representation of the impedance phase angle as a function of the resonant frequency of the same ultrasonic device with a cold (blue) and hot (red) ultrasonic blade; and

[0053] Figure 43B is a graphical representation of the impedance magnitude as a function of the resonant frequency of the same ultrasonic device with a cold (blue) and hot (red) ultrasonic blade.

[0054] Figure 44 is a diagram of a Kalman filter for improving the temperature estimator and impedance-based state space model along an ultrasonic transducer measured at a range of frequencies, according to at least an aspect of the present description.

[0055] Figure 45 illustrates three probability distributions employed by a Kalman filter state estimator shown in Figure 44 to maximize estimates, in accordance with at least one aspect of the present description.

[0056] Figure 46A is a graphic representation of the temperature as a function of time of an ultrasonic device where no temperature control reaches a maximum temperature of 490 ºC.

[0057] 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 description.

[0058] 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 temperature of an ultrasonic blade is detected, where

[0059] Figure 47A is a graphic representation of the ultrasonic energy as a function of time; and

[0060] Figure 47B is a graph of the temperature of the ultrasonic blade as a function of time, according to at least one aspect of the present description.

[0061] Figure 48 is a logic flow diagram of a process representing a control program or a logic configuration for controlling the temperature of an ultrasonic blade, in accordance with at least one aspect of the present description.

[0062] Figure 49 is a graphical representation of the temperature of the ultrasonic blade as a function of time during the firing of a vessel, in accordance with at least one aspect of the present description.

[0063] Figure 50 is a logic flow diagram of a process representing a control program or logic configuration for controlling the temperature of an ultrasonic blade between two temperature set points, in accordance with at least one aspect of the present description.

[0064] Figure 51 is a logic flow diagram of a process representing a control program or a logic configuration to determine the initial temperature of an ultrasonic blade, in accordance with at least one aspect of the present description.

[0065] Figure 52 is a logic flow diagram of a process that represents a control program or logic setup to determine when an ultrasonic slide 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.

[0066] Figure 53 is a logic flow diagram of a process representing a control program or logic configuration to provide temperature controlled ultrasonic sealing, in accordance with at least one aspect of the present description.

[0067] Figure 54 are graphical representations of the ultrasonic transducer current and the ultrasonic blade temperature as a function of time, according to at least one aspect of the present description.

[0068] Figure 55 is a bottom view of an ultrasonic end actuator showing a clamping arm and an ultrasonic blade outlining tissue positioning within the ultrasonic end actuator, according to at least one aspect of the present description.

[0069] Figure 56 is a graphical representation showing the change in impedance of the ultrasonic transducer as a function of tissue location within the ultrasonic end actuator over a range of predetermined increases in generator power level. ultrasonic device, in accordance with at least one aspect of the present disclosure.

[0070] Figure 57 is a graphical representation showing the change in the impedance of the ultrasonic transducer as a function of time in relation to tissue location within the ultrasonic end actuator, in accordance with at least one aspect of the present description. .

[0071] Figure 58 is a logic flow diagram of a process representing a control program or a logic configuration to identify operation in a non-therapeutic power range applied to the ultrasonic transducer to determine tissue positioning, in accordance with at least one aspect of the present description.

[0072] Figure 59 illustrates an aspect of an end actuator of an ultrasonic surgical instrument comprising infrared (IR) sensors located in the gripper member, in accordance with at least one aspect of the present description.

[0073] Figure 60 illustrates an aspect of a flexible circuit in which the IR sensors shown in Figure 59 can be integrally mounted or formed, in accordance with an aspect of the present description.

[0074] Figure 61 is a sectional view of an ultrasonic end actuator comprising a gripping arm and an ultrasonic blade, in accordance with at least one aspect of the present description.

[0075] 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 description.

[0076] Figure 63 is a logic flow diagram of a process that represents a control program or a logic setup for measuring IR reflectance to determine tissue composition for the purpose of adjusting the ultrasonic transducer amplitude accordingly. with at least one aspect of the present description.

[0077] Figure 64A is a graphical representation of the clamping arm closing rate as a function of time to identify the collagen transformation point according to various aspects of the present description, where time is shown along the axis horizontal geometry and the change in gripping arm position is shown along the vertical geometric axis, in accordance with at least one aspect of the present disclosure.

[0078] Figure 64B is an enlarged portion of the graphical representation shown in Figure 64A.

[0079] Figure 65 is a logic flow diagram of a process representing a control program or a logic setup to detect the collagen transformation point to control the clamping arm closing rate or the ultrasonic transducer amplitude, in accordance with at least one aspect of the present description.

[0080] 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 description, with the tissue temperature shown along the horizontal geometric axis and the impedance of the ultrasonic transducer is shown along the vertical axis, in accordance with at least one aspect of the present disclosure.

[0081] Figure 67 is a logic flow diagram of a process that represents a control program or a logic setup to identify the collagen transformation temperature to identify the collagen/elastin ratio, according to at least one aspect of the - feel description.

[0082] Figure 68 is a graphical representation of the compressive load distribution along an ultrasonic sheet, in accordance with at least one aspect of the present description.

[0083] Figure 69 is a graphical representation of pressure applied to tissue as a function of time, in accordance with at least one aspect of the present disclosure.

[0084] Figure 70 illustrates an end actuator that includes an array of single-grip electrodes for detecting tissue location, in accordance with at least one aspect of the present disclosure.

[0085] Figure 71 is an activation matrix for the single-grip electrode array of Figure 70, in accordance with at least one aspect of the present description.

[0086] Figure 72 illustrates an end actuator that includes an array of dual-grip electrodes to detect tissue location, in accordance with at least one aspect of the present disclosure.

[0087] Figure 73 is an activation matrix for the double grip electrode array of Figure 72, in accordance with at least one aspect of the present description.

[0088] Figure 74 illustrates sets of opposing electrodes superimposed on a tissue held by an end actuator that corresponds to the activation matrix in Figure 73, according to at least one aspect of the present description.

[0089] Figure 75 illustrates an end actuator that includes an array of segmented dual-grip electrodes, in accordance with at least one aspect of the present disclosure.

[0090] Figure 76 illustrates a tissue overlaid on a gripper that includes an array of segmented electrodes, in accordance with at least one aspect of the present disclosure.

[0091] Figure 77 is a schematic diagram of a segmented electrode array circuit that includes bandpass filters, in accordance with at least one aspect of the present disclosure.

[0092] Figure 78 is a graphical representation of the frequency response corresponding to the trapped tissue shown in Figure 76, in accordance with at least one aspect of the present description.

[0093] Figure 79 is a graphic representation of the frequency of the ultrasonic transducer system as a function of the drive frequency and the temperature deviation of the ultrasonic blade, according to at least one aspect of the present description.

[0094] 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 description.

[0095] Figure 81 is a graphic representation of the modal shift of the resonant frequency based on the temperature of the ultrasonic blade that moves the resonant frequency as a function of the temperature of the ultrasonic blade, according to at least one aspect of the present description.

[0096] Figure 82 is a spectrum of an ultrasonic surgical instrument with a variety of different end actuator states and conditions where the phase and impedance amplitude of an ultrasonic transducer are plotted as a function of frequency, according to at least one aspect of the present description.

[0097] Figure 83 is a methodology for classifying data based on a training data set S, where the magnitude and impedance phase are plotted as a function of frequency, according to at least one aspect of the present description.

[0098] Figure 84 is a logic flow diagram representing a control program or logic configuration to determine grip conditions based on the characteristic pattern of complex impedance ("fingerprint"), according to at least one aspect of the present description.

[0099] Figure 85 is a timeline representing the situational recognition of a central surgical controller, in accordance with at least one aspect of the present description.

DESCRIPTION

[00100] The applicant of the present application holds the following US patent applications, filed on August 28, 2018, the description of each of which is incorporated herein by reference in its entirety: o US patent application , precedent number END8536USNP2/180107-2, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR; º US patent application, precedent number END8560USNP2/180106-2, entitled TEMPERATURE CONTROL OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR; and US patent application, docket no. END8561USNP1/180144-1, entitled RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS;

º US patent application, precedent number END8563USNP1/180139-1, entitled CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION; º US patent application, precedent number END8563USNP2/180139-2, entitled CONTROLLING ACTIVATION OF

AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO THE PRESENCE OF TISSUE; º US patent application, precedent number END8563USNP3/180139-3, entitled DETERMINING TISSUE COMPOSITION VIA AN ULTRASONIC SYSTEM; º US patent application, precedent number END8563USNP4/180139-4, entitled DETERMINING THE STATE OF

AN ULTRASONIC ELECTROMECHANICAL SYSTEM ACCORDING TO FREQUENCY SHIFT; º US patent application, precedent number END8564USNP1/180140-1, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS; º US patent application, precedent no. END8564USNP2/180140-2, entitled MECHANISMS FOR CONTROLLING DIFFERENT ELECTROMECHANICAL SYSTEMS OF AN ELECTROSURGICAL INSTRUMENT; the US patent application, precedent number END8564USNP3/180140-3, entitled DETECTION OF END EFFECTOR IMMERSION IN LIQUID; º US patent application, precedent number END8565USNP1/180142-1, entitled INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING; º US patent application, precedent number END8565USNP2/180142-2, entitled INCREASING RADIO FREQUENCY TO CREATE PAD-LESS MONOPOLAR LOOP;

and US patent application, precedent number END8566USNP1/180143-1, entitled BIPOLAR COMBINATION DE-

VICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY; and º US patent application, precedent number END8573USNP1/180145-1, entitled ACTIVATION OF ENERGY DEVICES.

[00101] The applicant of the present application holds the following US patent applications, filed on August 23, 2018, the description of each of which is incorporated herein by reference in its entirety: e US Provisional Patent Application No. 62/721,995, entitled CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION; and US Provisional Patent Application No. 62/721,998 entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS; and US Provisional Patent Application No. 62/721,999, entitled IN-

TERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING; and US Provisional Patent Application No. 62/721,994 entitled BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY AD-JUSTS PRESSURE BASED ON ENERGY MODALITY; and and US Provisional Patent Application No. 62/721,996 entitled

RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS.

The applicant of the present application holds the following US patent applications, filed on June 30, 2018, the description of each of which is incorporated herein by reference in its entirety:

and US Provisional Patent Application No. 62/692,747 entitled SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE; and US Provisional Patent Application No. 62/692,748 entitled SMART ENERGY ARCHITECTURE; and and US Provisional Patent Application No. 62/692,768, entitled SMART ENERGY DEVICES.

[00102] The applicant of the present application holds the following US patent applications, filed on June 29, 2018, the description of each of which is incorporated herein by reference in its entirety: and US patent application no. serial 16/024,090, entitled CA-

PACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS; and US Patent Application Serial No. 16/024,057 entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS; and US Patent Application Serial No. 16/024,067 entitled SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION; and US Patent Application Serial No. 16/024,075 entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING; and US Patent Application Serial No. 16/024,083 entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING; and US Patent Application Serial No. 16/024,094 entitled SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES; and US Patent Application Serial No. 16/024,138 entitled SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE;

and US Patent Application Serial No. 16/024,150, entitled SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES; and US Patent Application Serial No. 16/024,160 entitled VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY; and US Patent Application Serial No. 16/024,124 entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE; and US Patent Application Serial No. 16/024,132 entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT; and US Patent Application Serial No. 16/024,141 entitled SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY; and US Patent Application Serial No. 16/024,162 entitled SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES; and US Patent Application Serial No. 16/024,066, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTROL; and US Patent Application Serial No. 16/024,096 entitled SURGICAL EVACUATION SENSOR ARRANGEMENTS; and US Patent Application Serial No. 16/024,116 entitled SURGICAL EVACUATION FLOW PATHS; and US Patent Application Serial No. 16/024,149 entitled SURGICAL EVACUATION SENSING AND GENERATOR CONTROL; and US Patent Application Serial No. 16/024,180 entitled SURGICAL EVACUATION SENSING AND DISPLAY; and US Patent Application Serial No. 16/024,245 entitled COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAME-

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

and US Patent Application Serial No. 16/024,265 entitled SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIR-

CUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE; and and US Patent Application Serial No. 16/024,273 entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.

[00103] The applicant of the present application holds the following US provisional patent applications, filed on June 28, 2018, the description of each of which is incorporated herein by reference in its entirety: e Provisional patent application US Serial No. 62/691,228, entitled A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES; and US Provisional Patent Application Serial No. 62/691,227 entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS; and US Provisional Patent Application Serial No. 62/691,230 entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE; and US Provisional Patent Application Serial No. 62/691,219, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTROL; and US Provisional Patent Application Serial No. 62/691,257 entitled COMMUNICATION OF SMOKE EVACUATION SYSTEM PA-

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

TION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE; and e US Provisional Patent Application Serial No. 62/691,251 entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.

[00104] The applicant of the present application holds the following US provisional patent applications, filed on April 19, 2018, the description of each of which is incorporated herein by reference in its entirety: e Provisional patent application US Serial No. 62/659,900, entitled METHOD OF HUB COMMUNICATION.

The applicant of the present application holds the following US provisional patent applications, filed on March 30, 2018, the description of each of which is incorporated herein by reference in its entirety: e US provisional patent application No. 62/650,898, filed on March 30, 2018, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS; and US Provisional Patent Application Serial No. 62/650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES; and US Provisional Patent Application Serial No. 62/650,882 entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; e e US Provisional Patent Application Serial No. 62/650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTROLS

[00105] The applicant of the present application holds the following US patent applications, filed on March 29, 2018, the description of each of which is incorporated herein by reference in its entirety: e US Provisional Patent Application serial no. 15/940,641, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;

and US Provisional Patent Application Serial No. 15/940,648 entitled INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES; and US Patent Application Serial No. 15/940,656, entitled SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES; and US Patent Application Serial No. 15/940,666 entitled Spatial AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS; and US Patent Application Serial No. 15/940,670 entitled CO-

OPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS; and US Patent Application Serial No. 15/940,677 entitled SURGICAL HUB CONTROL ARRANGEMENTS; and US Patent Application Serial No. 15/940,632 entitled

DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; and US Patent Application Serial No. 15/940,640 entitled

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

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

and US Patent Application Serial No. 15/940,668 entitled AGGREGATION AND REPORTING OF SURGICAL HUB DATA; and US Patent Application Serial No. 15/940,671 entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; and US Patent Application Serial No. 15/940,686 entitled DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE; and US Patent Application Serial No. 15/940,700 entitled STERILE FIELD INTERACTIVE CONTROL DISPLAYS; and US Patent Application Serial No. 15/940,629 entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS; and US Patent Application Serial No. 15/940,704 entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; and US Patent Application Serial No. 15/940,722 entitled CHA-

RACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY; and and US Patent Application Serial No. 15/940,742 entitled DUAL CMOS ARRAY IMAGING.

and US Patent Application Serial No. 15/940,636 entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES; and US Patent Application Serial No. 15/940,653 entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS; and US Patent Application Serial No. 15/940,660 entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER; and US Patent Application Serial No. 15/940,679 entitled CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL

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

DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and and US Patent Application Serial No. 15/940,675 entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES.

and US Patent Application Serial No. 15/940,627 entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLAT-FORMS; and US Patent Application Serial No. 15/940,637 entitled COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and US Patent Application Serial No. 15/940,642 entitled CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and US Patent Application Serial No. 15/940,676 entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and US Patent Application Serial No. 15/940,680 entitled CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and US Patent Application Serial No. 15/940,683 entitled CO-OPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

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

[00106] The applicant of the present application holds the following provisional US patent applications, filed on March 28, 2018, the description of each of which is incorporated herein by reference in its entirety: e Patent application provisional US Serial No. 62/649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; and US Provisional Patent Application Serial No. 62/649,294 entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; and US Provisional Patent Application Serial No. 62/649,300 entitled SURGICAL HUB SITUATIONAL AWARENESS; and US Provisional Patent Application Serial No. 62/649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; and US Provisional Patent Application Serial No. 62/649,310 entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS; and US Provisional Patent Application Serial No. 62/649,291 entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; and US Provisional Patent Application Serial No. 62/649,296 entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;

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

[00107] The applicant of the present application holds the following US provisional patent applications, filed on March 8, 2018, the description of each of which is incorporated herein by reference in its entirety: e Provisional patent application US Serial No. 62/640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR; and e US Provisional Patent Application Serial No. 62/640,415 entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR.

[00108] The applicant of the present application holds the following provisional US patent applications, filed on December 28, 2017, the description of each of which is incorporated herein by reference in its entirety: and Application for US Provisional Patent Serial No. 62/611,341 entitled INTERACTIVE SURGICAL PLATFORM; and US Provisional Patent Application Serial No. 62/611,340 entitled CLOUD-BASED MEDICAL ANALYTICS; and e US Provisional Patent Application Serial No. 62/611,339 entitled ROBOT ASSISTED SURGICAL PLATFORM.

[00109] 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 in the attached description. The illustrative examples may be implemented or incorporated in other aspects, variations and modifications, and may be practiced or performed in various ways. Furthermore, except where otherwise indicated, the terms and expressions used in the present invention have been chosen for the purpose of describing the illustrative examples for the convenience of the reader and not for the purpose of limiting the same. In addition, it is to be understood that one or more of the aspects, aspect expressions, and/or examples described below may be combined with any one or more of the other aspects, aspect expressions, and/or examples described below. follow.

[00110] Various aspects are directed towards improved ultrasonic surgical devices, electrosurgical devices and generators for use therewith. Aspects of ultrasonic surgical devices can be configured to transection and/or coagulate tissue during surgical procedures, for example. Aspects of electrosurgical devices can be configured to transect, coagulate, stagger, weld and/or desiccate tissue during surgical procedures, for example.

[00111] Referring to Figure 1, a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (e.g., cloud 104 which may include a remote server 113 coupled to a device storage 105). Each surgical system 102 includes at least one central surgical controller 106 communicating with the cloud 104 which may include a remote server 113. In one example, as illustrated in Figure 1, the surgical system 102 includes a visualization system 108, a robotic system 110, a handheld smart surgical instrument 112, which are configured to communicate with each other and/or with the central controller 106. In some aspects, a surgical system 102 may include a number M of central controllers 106, a number N of visualization systems 108, a number O of robotic systems 110, and a number P of smart handheld surgical instruments 112, where M, NO, and P are integers greater than or equal to 1.

[00112] 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's console 118, a patient carriage 120 (surgical robot), and a robotic central surgical controller 122. at least one detachably attached surgical tool 117 through a minimally invasive incision in the patient's body while the surgeon views the surgical site through the surgeon's console 118. An image of the surgical site may be obtained by a medical imaging device 124 , which can be manipulated via the patient carriage 120 to orient the imaging device 124. The robotic central controller 122 can be used to process the images. surgical site images for subsequent display to the surgeon via the surgeon's console 118.

[00113] Other types of robotic systems can be readily adapted for use with the Surgical System 102. Several examples of robotic systems and surgical tools that are suitable for use with the present disclosure are described in US Provisional Patent Application Serial No. 62/611,339, titled ROBOT ASSISTED SURGICAL PLATFORM, filed December 28, 2017, the disclosure of which is incorporated herein by reference in its entirety.

[00114] Several examples of cloud-based analytical processes that are performed by cloud 104, and suitable for use with the present description, are described in US Provisional Patent Application Serial No. 62/611,340 entitled CLOUD-BASED MEDICAL ANALYTICS, filed on December 28, 2017, the description of which is incorporated herein by reference in its entirety.

[00115] In various aspects, the imaging device 124 includes at least an 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 (CMOS, or "complementary metal-oxide semiconductor") sensors. ").

[00116] 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.

[00117] One or more lighting sources can be configured to radiate electromagnetic energy in the visible spectrum as well as 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 may be called visible light or simply light. A typical human eye will respond to wavelengths in air that range from about 380 nm to about 750 nm.

[00118] The invisible spectrum (ie the non-luminous spectrum) is that portion of the electromagnetic spectrum lying below and above the visible spectrum (ie wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths longer than about 750 nm are longer than the visible red spectrum and become invisible radiations in the infrared (IR), microwave, radio, and electromagnetic ranges. Wavelengths shorter than about 380 nm are shorter than the ultraviolet spectrum, and become invisible ultraviolet, x-rays and electromagnetic gamma rays.

[00119] In many 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, choledochoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagus-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngo-neproscope, sigmoidoscope, thoracoscope and ureteroscope.

[00120] In one aspect, the imaging device employs multi-spectrum monitoring to discriminate topography and underlying structures. A multispectral image is one that captures image data within wavelength ranges along the electromagnetic spectrum. Wavelengths can be separated by filters or by using instruments that are sensitive to specific wavelengths, including light of frequencies beyond the range of visible light, eg IR and ultraviolet light. Spectral images can allow the extraction of additional information that the human eye cannot capture with its receptors for red, green and blue colors. The use of multispectral imaging is described in more detail under the title "Advanced Imaging Acquisition Module" in US Provisional Patent Application Serial No. 62/611,341 entitled INTERACTIVE SURGICAL PLATFORM, filed December 28, 2017, the description of which is incorporated herein by 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 previously described tests on treated tissue.

[00121] It is axiomatic that rigorous 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", ie 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 124 imaging device and its connectors and components. It will be recognized that the sterile field may be considered a specific area, such as inside a tray or on a sterile towel, which is considered to be free of microorganisms, or the sterile field may be considered an area immediately around a patient who has been prepared to perform a surgical procedure. The sterile field may include sterilized staff members, who are appropriately dressed, and all furniture and fixtures in the area.

[00122] In various aspects, the visualization system 108 includes one or more imaging sensors, one or more image processing units, one or more storage arrays, and one or more screens that are strategically arranged with respect to the field. sterile, as illustrated in Figure 2. In one aspect, the visualization system 108 includes an interface for HL7, PACS, and RME. Various components of the visualization system 108 are described under the title "Advanced Imaging Acquisition Module" in US Provisional Patent Application Serial No. 62/611,341 entitled INTERACTIVE SURGICAL PLATFORM, filed December 28, 2017, the description of which is here incorporated by way of reference in its entirety.

[00123] As illustrated in Figure 2, a primary screen 119 is positioned in the sterile field to be visible to the operator at the operating table 114. In addition, a viewing tower 111 is positioned outside the sterile field. Viewing tower 111 includes a first non-sterile screen 107 and a second non-sterile screen 109, which are opposite each other. The display system 108, guided by the central controller 106, is configured to use screens 107, 109 and 119 to coordinate the flow of information for operators in and out of the sterile field. For example, the central controller 106 may cause the visualization system 108 to 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 stream. of the surgical site on the main screen 119. The snapshot on the non-sterile screen 107 or 109 can allow a non-sterile operator to perform a diagnostic step relevant to the surgical procedure, for example.

[00124] In one aspect, the central controller 106 is also configured to route diagnostic input or feedback by a non-sterile operator at the viewing tower 111 to the primary screen 119 within the sterile field, where the input or feedback can be seen by a sterile operator on the operating table. In one example, the input may be in the form of a modification of the snapshot displayed on the non-sterile screen 107 or 109, which may be routed to the main screen 119 by the central controller 106.

[00125] Referring to Figure 2, a surgical instrument 112 is being used in the surgical procedure as part of the surgical system

102. The central controller 106 is also configured to coordinate the flow of information to a surgical instrument display 112. For example, in US Provisional Patent Application Serial No. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed Dec. December 2017, the description of which is incorporated herein by reference in its entirety. A diagnostic input or feedback entered by a non-sterile operator into 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 viewed by the surgical instrument operator.

112. Exemplary surgical instruments that are suitable for use with the surgical system 102 are described under the heading "Surgical Instrument Hardware" and in US Provisional Patent Application Serial No. 62/611,341 entitled INTERACTIVE SURGICAL PLATFORM, filed on 28 December 2017, the description of which is incorporated herein by reference in its entirety, for example.

[00126] Now referring to Figure 3, a central controller 106 is shown in communication with a display system 108, a robotic system 110 and a handheld smart surgical instrument 112. The central controller 106 includes a central controller display 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132, and a storage matrix 134. In certain aspects, as illustrated in Figure 3, the central controller 106 additionally includes an imaging module. smoke evacuation 126 and/or a suction/irrigation module 128.

[00127] During a surgical procedure, the application of energy to tissue, for sealing and/or cutting, is usually associated with evacuation of smoke, suction of excess fluid and/or tissue irrigation. Lines of fluid, energy and/or data from different sources are often intertwined during the surgical procedure. Valuable time can be lost in dealing with this issue during a surgical procedure. To untangle the lines it may be necessary to disconnect them from their respective modules, which may require a restart of the modules. The modular enclosure of the 136 central controller provides a unified environment to manage the power, data and fluid lines, which reduces the frequency of interlace between these lines.

[00128] Aspects of the present description feature a central surgical controller for use in a surgical procedure that involves the application of energy to tissue at a surgical site. The central surgical controller includes a central controller housing and a combined generator module slidably received in a docking station of the central controller housing. 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 that 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 for connecting 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 the application of therapeutic energy to tissue, and a fluid line extending from the remote surgical site to the smoke evacuation component.

[00129] 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 slidably received in the central controller housing. In one aspect, the central controller housing comprises a fluid interface.

[00130] Certain surgical procedures may require the application of more than one type of energy to tissue. One type of energy may be more beneficial for cutting tissue, while a different type of energy may be more beneficial for sealing tissue. 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 description present a solution in which a modular compartment of the central controller 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the 136 central controller modular enclosure is that it allows for quick removal and/or replacement of multiple modules.

[00131] Aspects of the present description present a modular surgical compartment for use in a surgical procedure that involves application of energy to tissue. The modular surgical compartment includes a first power generator module configured to generate first power for application to tissue, and a first docking station comprising a first docking port that includes first data contacts and power contacts. , wherein the first power generating module is slidingly movable into an electrical coupling with the power and data contacts, and wherein the first power generating module is slidingly movable out of the electrical coupling with the first power and data contacts.

[00132] In addition to the above, the modular housing also includes a second power generating module configured to generate a second power, different from the first power, for application to tissue, and a second docking station comprising a second docking port that includes second power and data contacts, the second power generating module being slidingly movable in electrical engagement with the power and data contacts, and the second power generating module being slidingly movable. sliding out of electrical engagement with the second power and data contacts.

[00133] In addition, the modular surgical compartment also includes a communication bus between the first docking port and the second docking port, configured to facilitate communication between the first power generating module and the second power generating module.

[00134] With reference to Figures 3 to 7, aspects of the present description are presented for a modular housing 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 - tion 128. The modular housing of the central controller 136 further facilitates interactive communication between modules 140, 126, 128. As illustrated in Figure 5, the generator module 140 can be a generator module with monopolar, bipolar and ultrasonic components. integrated, supported in a single 139 cabinet unit that can be slidably inserted into the central controller modular bay

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

[00135] In one aspect, the central controller modular housing 136 comprises a modular power and communication backplane 149 with external and wireless communication heads to allow removable connection of modules 140, 126, 128 and the interactive communication between them.

[00136] In one aspect, the central controller modular housing 136 includes docking stations, or units, 151, here also called units, which are configured to slide-receive modules 140, 126, 128. Figure 4 illustrates a partial perspective view of a central surgical controller housing 136, and a combined generator module 145 slidably received in a docking station 151 of the central surgical controller housing 136. A docking port 152 with the power and data contacts on a rear side of the combined generator module 145 is configured to engage a corresponding docking port 150 with the power and data contacts of a corresponding docking station 151 of the central controller modular compartment 136 as per the combined generator module 145 is slid into position in the corresponding docking station 151 of the central controller modular compartment 136. In one aspect, the combined generator module

145 includes a bipolar, ultrasonic and monopolar module and a smoke evacuation module integrated into a single 139 cabinet unit, as illustrated in Figure 5.

[00137] In various aspects, the smoke evacuation module 126 includes a fluid line 154 that transports smoke and/or captured/collected fluid away from a surgical site and to, for example, the smoke evacuation module 126. Vacuum suction originating from the smoke evacuation module 126 can draw smoke into an opening in a utility conduit at the surgical site. The utility conduit, coupled to the fluid line, may be in the form of a flexible tube terminating at the smoke evacuation module 126. The utility conduit and fluid line define a fluid path that extends toward the smoke evacuation module 126 that is received in the central controller compartment

136.

[00138] In various aspects, the suction/irrigation module 128 is coupled to a surgical tool comprising a fluid aspiration 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 actuation systems can be configured to cause irrigation and aspiration of fluids to and from the surgical site.

[00139] In one aspect, the surgical tool includes a drive shaft that has an end actuator at a distal end thereof and at least one energy treatment associated with the end actuator, a suction tube, and a tube. of irrigation. The suction tube may have an inlet port at a distal end thereof and the suction tube extends through the drive shaft. Similarly, an irrigation tube may extend through the drive shaft and may have an inlet port near the power application implement. The power delivery implement is configured to deliver ultrasonic and/or RF energy to the surgical site and is coupled to generator module 140 by a cable initially extending through the drive shaft.

[00140] 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 may be housed in the suction/irrigation module 128. In one example, the fluid source and/or the vacuum source may be housed in the central controller compartment 136 separately from the suction/irrigation module 128. In such an example, a fluid interface may be configured to connect the suction/irrigation module 128 to the fluid source and/or the vacuum source.

[00141] In one aspect, the modules 140, 126, 128 and/or their corresponding docking stations in the central controller modular bay 136 may include alignment features that are configured to align the docking ports of the modules in engagement with each other. their counterparts in the docking stations of the central controller modular compartment 136. For example, as illustrated in Figure 4, the combined generator module 145 includes side brackets 155 that are configured to slidably engage the corresponding brackets 156 of the docking station. 151 of the central controller modular compartment 136. The brackets cooperate to guide the docking port contacts of the combined generator module 145 into electrical engagement with the docking port contacts of the central controller modular housing 136 .

[00142] In some respects, the units 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 units 151. For example, the side supports 155 and/or 156 can be larger or smaller depending on the module size. In other respects, the 151 drawers are different in size and are each designed to accommodate a specific module.

[00143] Additionally, the contacts of a specific module can be keyed to engage with the contacts of a specific unit to avoid inserting a module into a unit with contact misalignment.

[00144] As illustrated in Figure 4, the docking port 150 of one drawer 151 can be coupled to the docking port 150 of another drawer 151 via a communication link 157 to facilitate interactive communication between modules housed in the central controller modular compartment 136. The docking ports 150 of the central controller modular compartment 136 can alternatively or additionally facilitate interactive wireless communication between modules housed in the central controller modular compartment 136 Any suitable wireless communication can be used, eg Air Titan Bluetooth.

[00145] Figure 6 illustrates individual power bus connectors for a plurality of side docking ports of a side modular compartment 160 configured to receive a plurality of modules from a central surgical controller 206. The side modular compartment 160 is configured to receive and laterally interconnect modules 161. Modules 161 are slidably inserted into docking stations 162 of lateral modular compartment 160, which includes a backplane for interconnecting modules 161. As shown in Figure 6 , modules 161 are arranged sideways in side modular cabinet 160. Alternatively,

161 modules can be arranged vertically in a modular cabinet on the side.

[00146] —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, which includes a back panel for interconnecting modules 165. Although the drawers 167 of the vertical modular cabinet 164 are arranged vertically, in certain cases, a modular vertical cabinet 164 may include drawers that are disposed laterally. In addition, the modules 165 can interact with each other through the docking ports of the vertical modular cabinet 164. In the example of Figure 7, a screen 177 is provided to show data relevant to the operation of the modules. 165. In addition, vertical modular housing 164 includes a master module 178 that houses a plurality of submodules that are slidably received in the master module 178.

[00147] In various 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 housing that can be assembled with a light source module and a camera module. The compartment can be a disposable compartment. In at least one example, the disposable housing is detachably coupled to a reusable controller, a light source module, and a camera module. The light source module and/or the camera module can be selectively chosen 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 to image the scanned beam. Similarly, the light source module can be configured to provide either a white light or a different light depending on the surgical procedure.

[00148] During a surgical procedure, removing a surgical device from the surgical field and replacing it with another surgical device that includes a different camera or other light source can be an inefficient practice. Temporarily losing sight of the surgical field can lead to undesirable consequences. The imaging device module of the present description is configured to allow 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 field. surgical.

[00149] In one aspect, the imaging device comprises a tubular housing that includes a plurality of channels. A first channel is configured to slide in the Camera module, which can be configured to snap-fit with the first channel. A second channel is configured to slide-receive the camera module, which can be configured to snap-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 hitch can be used instead of a snap fit.

[00150] In several examples, multiple imaging devices are placed in different positions in the surgical field to provide multiple views. The imaging module 138 can be configured to switch between imaging devices to provide an optimal view. In various aspects, the imaging module 138 can be configured to integrate images from different imaging devices.

[00151] 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, issued August 9, 2011 which is incorporated herein as a reference in its entirety. In addition, US Patent No. 7,982,776 entitled SBI MOTION ARTIFACT REMOVAL APPARATUS AND METHOD, issued July 19, 2011, which is incorporated herein by reference in its entirety, describes various systems for removing motion artifacts from data. of image. Such systems can be integrated with the imaging module 138. In addition to these, the publication of US patent application No. 2011/0306840, entitled CONTROLLABLE MAGNETIC SOURCE TO FIXTURE INTRA-CORPOREAL APPARATUS, published on December 15, 2011, and the publication of the application US Patent No. 2014/0243597, entitled SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE, published August 28, 2014, which are each incorporated herein by reference in their entirety.

[00152] Figure 8 illustrates a surgical data network 201 comprising a central modular communication controller 203 configured to connect modular devices situated in one or more operating rooms of a healthcare facility, or any environment in a healthcare facility. from utilities specially equipped for surgical operations, to a cloud-based system (e.g., 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 network central controller 207 and/or a network switch 209 in communication with a network router. The central modular communication controller 203 may 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 data, allowing data to be transmitted from one device (or segment) to another and to cloud computing resources. An intelligent surgical data network includes facilities for allowing traffic to pass through the surgical data network to be monitored and for configuring each port on the network central controller 207 or network switch 209. An intelligent surgical data network may be called an intelligent surgical data network. a central controller or controllable switch. A central switching controller reads the destination address of each packet and then forwards the packet to the correct port.

[00153] Modular devices 1a to 1n located in the operating room can be coupled to the central modular 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 to 1h to cloud 204 or local computer system 210. Data associated with devices 1a to 1n can be transferred to cloud-based computers through the router for processing and remote manipulation of the data. Data associated with devices 1a to 1h may 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 coupled to network central controller 207 and/or network router 211 to connect the devices 2a to 2m to cloud 204. Data associated with devices 2a to 2n can be transferred to cloud 204 via network router 211 for data processing and manipulation. Data associated with devices 2a to 2m may also be transferred to the local computer system 210 for processing and manipulation of the local data.

[00154] It will be understood that the surgical data network 201 may be expanded by interconnecting the multiple network central controllers 207 and/or the multiple network switches 209 with multiple network routers 211. The modular communication central 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 may 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 various aspects, 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 a surgical device based on energy , a smoke evacuation module 126, a suction/irrigation module 128, a communication module 130, a processor module 132, a storage array 134, a surgical device coupled to a screen and/or a non-contact sensor, among other modular devices that can be connected to the 203 modular communication central controller of the surgical data network

201.

[00155] In one aspect, the surgical data network 201 may comprise a combination of central network controllers, network switches, and network routers that connect 1a to 1n/2a to 2m devices to the cloud. Any or all 1a to 1n/2a to 2m devices attached to the central network controller or network switch can collect data in real time and transfer data to cloud computers for data processing and manipulation. It will be understood that cloud computing relies on sharing computing resources rather than 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" may 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 central communication controller 203 and /or computer system 210 located in the operating room (e.g., a fixed, mobile, temporary room or space, or field of operation) and devices connected to central modular communication controller 203 and/or 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 1a to 1n/2a to 2m devices 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. Central controller hardware allows multiple devices or connections to be connected to a computer that communicates with cloud computing and storage resources.

[00156] Applying cloud computer data processing techniques to data collected by 1a to 1n/2a to 2m devices, the surgical data network provides better surgical outcomes, reduced costs, and better patient satisfaction . At least some of the 1a to 1hn/2a to 2m devices can be used to visualize tissue states to assess the occurrence of leaks or perfusion of sealed tissue after a tissue sealing and cutting procedure. At least some of the 1a to 1n/2a to 2m devices can be used to identify pathology, such as the effects of disease, using cloud-based computing to examine data including images of body tissue samples for of diagnosis. This includes confirmation of tissue location and margin and phenotypes. At least some of the 1a to 1n/2a to 2m devices 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. imaging. Data collected by devices 1a to 1n/2a to 2m, including image data, can be transferred to the cloud 204 or the local computer system 210 or both for data processing and manipulation including image processing and manipulation. Data can be analyzed to improve surgical procedure outcomes by determining whether additional treatment, such as application of endoscopic intervention, emerging technologies, a targeted radiation, targeted intervention, robotics targeted to specific tissue sites and conditions, can be used. be followed. This data analysis can additionally use analytical processing of the results, and using standardized approaches can provide standardized feedback beneficial either to confirm surgical treatments and surgeon behavior or to suggest modifications to surgical treatments and surgeon behavior.

[00157] In one implementation, operating room devices 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 1h on a central controller. network tral. 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", or open systems interconnection). The network central controller provides connectivity to devices 1a to 1n located on the same network as the operating room. The central network controller 207 collects data in the form of packets and sends them to the router in half-duplex mode. The network central controller 207 does not store any media access controls/Internet Protocol (MAC/IP) to transfer the device data. Only one of the devices 1a to 1n at a time can send data through the central network controller 207. The central network controller 207 has no routing tables or intelligence about where to send information and transmits all network data through of 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 inbound ports can be a risk. security and cause bottlenecks.

[00158] In another implementation, operating room devices 2a to 2m can be connected to a network switch 209 via a wired or wireless channel. Network key 209 works at the data connection layer of the OSI model. Network switch 209 is a multicast device for connecting 2a to 2m devices located in the same operation center to the network. Network switch 209 sends data in the form of frames to network router 211 and operates 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.

[00159] Network central controller 207 and/or network switch 209 are coupled to network router 211 for a connection to the cloud

204. Network router 211 works at the network layer of the model

OSI. Network router 211 creates a route to transmit data packets received from network central controller 207 and/or network switch 211 to a cloud-capable computer for further processing and manipulation of data collected by anyone within the network. tre or all devices 1a to 1n/ 2a to 2m. Network Router 211 can be used to connect two or more different networks located in different locations, such as different operating rooms in the same healthcare facility or different networks located in different operating rooms in different facilities. of health services. The network router 211 sends data in the form of packets to the cloud 204 and operates in full duplex mode. Multiple devices can send data at the same time. Network router 211 uses |P addresses to transfer data.

[00160] In one example, the network central controller 207 can be implemented as a USB central controller, which allows multiple USB devices to be connected to a host computer. The USB central controller can expand a single USB port to several levels so that there are more ports available for connecting devices to the system's host computer. The central network controller 207 may include wired or wireless facilities to receive information about a wired channel or a wireless channel. In one aspect, a wireless USB short-range, broadband, wireless radio communication protocol can be used for communication between devices la to In and devices 2a to 2m situated in the living room. operation.

[00161] In other examples, operating room devices 1a to 1n/2a to 2m can communicate with the central modular communication controller 203 via standard wireless Bluetooth technology to exchange data over short distances ( using short-wavelength UHF radio waves in the ISM band from 24 to

2.485 GHz) of fixed and mobile devices and build personal area networks (PANs, "personal area networks"). In other respects, operating room devices 1a to 1n/2a to 2m can communicate with the 203 modular communication central controller via a number of wireless and wired communication standards or protocols, including but not limited to limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, long-term evolution (LTE, "long-term evolution"), and Ev-DO, HSPA+, HSDPA+, 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 may 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.

[00162] The modular communication central controller 203 can serve as a central connection for one or all of the 1a to 1n/2a to 2m operating room devices and handles a type of data known as frames. The frames carry the data generated by devices 1a to 1n/2a to 2m. When a frame is received by the central modular communication controller 203, it is amplified and transmitted to the network router 211, which transfers the data to cloud computing resources using a series of communication standards or protocols. wireless or wired as described here.

[00163] The 203 modular communication core controller can be used as a standalone device or be connected to network core controllers and compatible network switches to form a larger network. The 203 modular communication central controller is generally easy to install, configure, and maintain, making it a good choice for networking devices 1a to 1n/2a to 2m from the operating room.

[00164] Figure 9illustrates an interactive computer-implemented surgical system 200. The interactive computer-implemented surgical system 200 is similar in many respects to the interactive, computer-implemented surgical system 100. For example, the interactive surgical system computer-implemented 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 that may include a server remote 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 intelligent surgical instruments, robots, and other computerized devices. located in the operating room. As shown in Figure 10, the modular control tower 236 comprises a modular central communication controller 203 coupled to a computer system 210. As illustrated in the example of Figure 9, the modular control tower 236 is coupled to a imaging module 238 that is coupled to an endoscope 239, a generator module 240 that is coupled to a power device 241, a smoke evacuation module 226, a suction/irrigation module 228, a communication module 230, a module processor 232, a storage array 234, an intelligent device/instrument 235 optionally coupled to a display 237, and a non-contact sensor module 242. Operating room devices are coupled to cloud computing resources and to the data storage via modular control tower 236. Robotic central controller 222 can also be connected to modular control tower 236 and cloud computing resources. Devices/instruments 235, visualization systems 208, among others, can be coupled to the modular control tower 236 through wired or wireless communication standards or protocols, as described in the present invention. Modular control tower 236 can be coupled to a central controller display 215 (e.g. monitor, display) to display and overlay images received from the imaging module, device/instrument display and/or other display systems 208 The central controller screen can also display data received from devices connected to the modular control tower together with images and overlay images.

[00165] 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 modular communication controller 203, for example, a connectivity device. network, and a computer system 210 to provide 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 (e.g. devices) that can be connected to the modular communication central controller 203 and transfer to the computer system 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/upstream network switch is connected to a processor to provide a communication link with cloud computing resources and a local display 217. Communication with the cloud 204 can be done via a communication channel. wired or wireless.

[00166] 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 laser or ultrasonic measurement devices. An ultrasound-based non-contact sensor module scans the operating room by transmitting a burst of ultrasound and receiving the echo as it bounces off the surrounding walls of an operating room, as described under the heading "Surgical Hub Spatial Awareness Within an Operating Room" in US Provisional Patent Application Serial No. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed December 28, 2017, which is incorporated herein by reference in its entirety, the sensor module being configured to determine the operating room size and to adjust Bluetooth pairing distance limits. 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 size of the operating room and adjust Bluetooth pairing distance limits, for example.

[00167] The computer system 210 comprises a processor 244 and a network interface 245. The processor 244 is coupled to a communication module 247, storage 248, memory 249, non-volatile memory 250, and input/output interface 251 over 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 local bus using any variety of available bus architectures including , but not limited to, 9-bit bus, Industry Standard Architecture (ISA), Micro-Charmel Architecture (MSA), Extended ISA (EISA), Intelligent Drive Electronic Circuits (IDE), VESA Local Bus (VLB), Peripheral Component Interconnect (PCI), USB, Advanced Graphics Port (AGP), Bus

PCMCIA (Personal Computer Memory Card International Association), Small Computer Systems Interface (SCSI), or any other proprietary bus.

[00168] The 244 processor may be any single-core or multi-core processor such as those known under the tradename ARM Cortex available from Texas Instruments. In one aspect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, comprising an integrated 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to optimize performance above 40 MHz, a 32 KB single-cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareO program, memory only programmable and electrically erasable readout (EEPROM) 2 KB, one or more pulse width modulation (PWM) modules, one or more analog quadrature encoder (QEI) inputs, one or more analog converters to 12-bit digital (ADC) with 12 analog input channels, details of which are available for the product data sheet.

[00169] In one aspect, the processor 244 may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the tradename Hercules ARM Cortex R4, also available from Texas Instruments. The safety controller can be configured specifically for safety critical applications IEC 61508 and ISO 26262, among others, to provide advanced built-in safety features while providing scalable performance, connectivity and memory options.

[00170] System memory includes volatile memory 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 may include ROM, programmable ROM (PROM), electrically programmable ROM (EPROM), EEPROM or flash memory. Volatile memory includes random access memory (RAM), which acts as external cache memory. Additionally, 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).

[00171] 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). 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) drive. recordable compact disc (CD-R Drive), rewritable compact disc drive (CD-RW drive), or a digital versatile disc ROM (DVD-ROM) drive. To facilitate the connection of disk storage devices to the system bus, a removable or non-removable interface can be used.

[00172] It should be understood that the computer system 210 includes software that acts as an intermediary between the users and the basic computer resources described in a suitable operating environment.

Such software includes an operating system. The operating system, which can be stored on disk storage, acts to control and allocate computer system resources. System applications benefit from management capabilities by the operating system through program modules and program data stored in system memory or on disk storage. It should be noted that the various components described here may be implemented with various operating systems or combinations of operating systems.

[00173] A user enters commands or information into the computer system 210 through input device(s) coupled to the I/O interface 251. Input devices include, but are not limited to, a device pointer 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, displays, 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 connecting the output device to the system bus. It should be noted that other devices and/or device systems, such as remote computers, provide input and output capabilities.

[00174] Computer system 210 can operate in a networked environment using logical connections to one or more remote computers, such as cloud computers, or local computers. Remote cloud computers can be a personal computer, server, router, network personal computer, workstation, microprocessor-based device, peer device, or other common network node, and the like, and typically include many or all of the elements described in relation to the computer system. For the sake of brevity, only one memory storage device is illustrated with the remote computer. Remote computers are logically connected to the computer system through a network interface and then physically connected through 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 Ring/IEEE 802.5 and the like. WAN technologies include, but are not limited to, point-to-point links, circuit-switched networks such as integrated services digital networks (ISDN) and variations thereof, packet-switched networks, and digital subscriber lines (DSL).

[00175] In various aspects, 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 a 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 instruction multiple data (SIMD) or multiple instruction multiple data (MIMD) technologies to increase speed and efficiency. The digital image processing engine can perform a number of tasks. The image processor can be a system on an integrated circuit with a multi-core processor architecture.

[00176] Communication connections refer 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 may also be external to the computer system 210. The hardware/software required for connection to the network interface includes, for illustrative purposes only, internal technologies. and external ones such as modems, including regular serial telephone modems, cable modems and DSL modems, ISDN adapters and Ethernet cards.

[00177] Figure 11 illustrates a functional block diagram of an aspect of a USB 300 network central controller device, in accordance with at least one aspect of the present disclosure. In the illustrated appearance, the USB 300 network central controller device uses a TUSB2036 integrated circuit central controller available from Texas Instruments. The USB 300 Network Central Controller is a CMOS device that provides one USB upstream transceiver port 302 and up to three USB downstream transceiver ports 304, 306, 308 in compliance with the USB 2.0 specification. Upstream USB transceiver port 302 is a differential data root port comprising a "minus" differential data input (DMO) paired with a "plus" differential data input (DPO). The three downstream USB transceiver ports 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) .

[00178] The USB 300 network central 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 in the circuit for USB upstream transceiver port 302 and all USB downstream transceiver ports 304, 306, 308. USB downstream transceiver ports 304, 306, 308 support both full speed and low speed by automatically setting the scan rate according to the speed of the device attached to the ports. The USB 300 network central controller device can be configured in either bus-powered or self-powered mode and includes central controller 312 power logic to manage power.

[00179] The USB 300 Network Central Controller Device includes a 310 Serial Interface Engine (SIE). The SIE 310 is the hardware front end of the USB 300 network central controller and handles most of the protocol described in Chapter 8 of the USB specification. The SIE 310 typically understands 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, non-return data encoding/decoding to inverted zero (NRZI), CRC generation and verification (token and data), packet ID (PID) generation and verification/decoding, and/or serial-parallel/parallel-series conversion. The SIE 310 receives a clock input 314 and is coupled to a 316 suspend/resume and frame timer logic circuit and a central controller 318 replay circuit to control communication between the upstream USB transceiver port 302 and downstream USB transceiver ports 304, 306, 308 via port logic circuits 320, 322,

324. The SIE 310 is coupled to a command decoder 326 through interface logic to control commands from a serial EEPROM memory through a serial EEPROM interface 330.

[00180] In many ways, the USB 300 network central controller can connect 127 functions configured in up to six logical layers (levels) to a single computer. In addition, the USB 300 network central controller can connect all peripherals using a standard four-wire cable that provides both communication and power distribution. Power settings are bus-powered and self-powered modes. The USB 300 network central controller can be configured to support four power management modes: a bus-powered central controller, with single port power management or grouped port power management, and the self-powered central controller, with single port power management or grouped port power management. In one aspect, with the use of a USB cable, the USB network central controller 300, the USB upstream transceiver port 302 plugs into a USB host controller, and the USB downstream transceiver ports 304, 306, 308 are exposed for connecting USB compatible devices, and so on. Surgical instrument hardware

[00181] Figure 12 illustrates a logic diagram of a module of a control system 470 of a surgical instrument or tool, in accordance with one or more aspects of the present description. System 470 comprises a control circuit. The control circuit includes a microcontroller 461 comprising a processor 462 and a memory.

468. One or more of the sensors 472, 474, 476, for example, provide real-time feedback to the processor 462. A motor 482, driven by a motor driver 492, operatively couples a displacement member. longitudinally movable 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 enclosing member. Additional motors can be provided at the tool driver interface to control tube closing path, drive shaft rotation, articulation, or clamping arm closing, or a combination thereof. A 473 screen displays a variety of instrument operating conditions and may include touch screen functionality for data entry. The information displayed on the 473 screen can be overlaid with images captured using endoscopic imaging modules.

[00182] In one aspect, the 461 microcontroller can be any single-core or multi-core processor, such as those known under the tradename ARM Cortex available from Texas Instruments. In one aspect, the main microcontroller 461 may be an LM4F230H5QR ARM Cortex-M4F processor, available from Texas Instruments, for example, comprising an integrated 256KB single-cycle flash memory, or other nonvolatile memory, up to 40 MHz, a prefetch buffer to optimize performance above 40 MHz, a 32 KB single-cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareO program, programmable and electrically erasable read-only memory (EEPROM) of 2 KB, one or more pulse width modulation (PWM) modules, one or more analogue quadrature encoder (QEI) inputs, and /or one or more 12-bit analog-to-digital converters (ADC) with 12 analog input channels, details of which are available for the product data sheet.

[00183] In one aspect, the microcontroller 461 may comprise a safety controller comprising two controller-based families such as TMS570 and RM4x known under the tradename Hercules ARM Cortex R4, also available from Texas Instruments. The safety controller can be configured specifically for safety critical applications IEC 61508 and ISO 26262, among others, to provide advanced built-in safety features while providing scalable performance, connectivity and memory options.

[00184] The 461 microcontroller can be programmed to perform various functions, such as 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 may be a brushed direct current (DC) motor with a gearbox and mechanical connections with a linkage system or scalpel. In one aspect, a 492 motor starter can be an A3941 available from Allegro Microsystems, Inc. Other motor starters can be readily replaced for use in the 480 tracking system which comprises an absolute positioning system. A detailed description of an absolute positioning system is given in US patent application publication No. 2017/0296213 entitled SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT, published October 19, 2017, which is incorporated herein by reference in its entirety.

[00185] The 461 microcontroller can be programmed to provide precise control of the speed and position of travel members and linkage systems. The 461 microcontroller can be configured to compute a response in the microcontroller software

461. 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, adjusted value that balances the uniform and continuous nature of the simulated response with the measured response, which can detect external influences on the system.

[00186] In one aspect, the 482 motor can be controlled by the 492 motor driver and can be used by the triggering system of the instrument or surgical tool. In various forms, the 482 motor can be a brushed direct current (DC) drive 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 driver 492 may comprise an H-bridge driver comprising field effect transistors (FETs), for example. The 482 motor can be powered by a power pack releasably mounted in the grip assembly or tool housing to provide control power to the instrument or surgical tool. The power pack may comprise a battery which may include a number of battery cells connected in series which may be used as the power source to power the instrument or surgical tool. Under 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 attachable and separable from the power pack.

[00187] The 492 motor driver can be an A3941, available from Allegro Microsystems, Inc. The 492 A3941 driver is a full-bridge driver for use with semiconductor metal oxide field effect (MOSFET) transistors. external power, channel

N, specifically designed for inductive loads such as brushed direct current motors. The 492 driver comprises a single charge pump regulator that provides full port actuation (>10V) for batteries with voltages up to 7V and allows the A3941 to operate with a reduced port actuation, up to 5.5V. V. An input drive capacitor can be used to supply the voltage in excess of that supplied by the battery needed for N-channel MOSFETs. An internal charge pump for the upside drive allows direct current (100% duty cycle) operation. of work). The entire bridge can be driven in fast or slow decay modes using diodes or synchronous rectification. In slow fall mode, current recirculation can take place through the upper and lower FETs. Power FETs are protected from the shoot-through effect by programmable dead-time resistors. Built-in diagnostics provide indication of undervoltage, overtemperature and power bridge faults and can be configured to protect power MOS-FETs under most short circuit conditions. Other motor drives can be readily replaced for use in the 480 tracking system comprising an absolute positioning system.

[00188] Tracking system 480 comprises a controlled motor drive circuit arrangement comprising a position sensor 472 in accordance with an aspect of the present description. 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 in mesh with a corresponding drive gear of a gear reducer assembly. In other aspects, the displacement member represents the trigger member, which may be adapted and configured to include a rack of driving teeth. In yet another aspect, the displacement member represents a longitudinal displacement member for opening and closing a gripping arm, which can be adapted and configured to include a rack of driving teeth. In other aspects, the displacement member represents a clamping arm closing member configured to close and open a clamping arm of a stapling, 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 gripping arm, or any element that can be moved. Consequently, the absolute positioning system can, in effect, track the displacement of the gripping arm by tracking the linear displacement of the movable drive member longitudinally.

[00189] In other respects, the absolute positioning system can be configured to track the position of a clamping arm in the opening or closing process. In various other aspects, the displacement member may be coupled to any 472 position sensor suitable for measuring linear displacement. In this way, the longitudinally movable drive member, or 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 may comprise Variable Differential Linear Transformers (LVDT), Variable Reluctance Differential Transducers (DVRT), a potentiometer, a magnetic detection system comprising a moving magnet and a linearly arranged series in Hall Effect Sensors. , a magnetic detection system comprising a fixed magnet and a series of moving ones, arranged linearly in Hall Effect Sensors, a mobile optical detection system comprising a moving light source and a series of linearly arranged photodiodes or photodetectors, an optical detection system comprising a fixed light source and a moving array of linearly arranged photodiodes or photodetectors, or any combination thereof.

[00190] The 482 electric motor may include a rotating drive shaft, operationally interfacing with a gear assembly, which is mounted in mating engagement with a drive tooth assembly or rack on the drive member. A sensing element may be operatively coupled to a gear assembly so that a single revolution of position sensing 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 via a rack and pinion array, or a rotary actuator via a sprocket or other connection. A power source supplies power to the absolute positioning system and an output indicator can display the output of the absolute positioning system. The drive member represents the longitudinally movable drive member which comprises a rack of drive teeth formed therein for engagement with a corresponding drive gear of the gear reducer assembly. The displacement member represents the longitudinally movable trigger member for opening and closing a clamping arm.

[00191] A single revolution of the sensor element associated with the position sensor 472 is equivalent to a linear longitudinal displacement of d;

of the displacement member, where d: represents the longitudinal linear distance by which the displacement member moves from point "a" to point "b" after a single revolution of the sensing element coupled to the displacement member. The sensor array can be connected via a gear reduction which results in the 472 position sensor completing one or more revolutions for the full stroke of the travel member. Position sensor 472 can complete multiple revolutions for the full stroke of the displacement member.

[00192] A series of switches, where n is an integer greater than one, can be employed alone or in combination with a gear reduction to provide a single position signal for more than one revolution of the 472 position sensor. of the switches is transmitted back to the microcontroller 461 which applies logic to determine a unique position signal corresponding to the longitudinal linear displacement of d; + do + ... dh of the displacement member. The output of position sensor 472 is provided to microcontroller 461. In various embodiments, position sensor 472 of the sensor array may comprise a magnetic sensor, an analog rotary sensor such as a potentiometer, or a series of elements. Hall-effects, which output a unique combination of position signals or values.

[00193] Position sensor 472 may comprise any number of magnetic sensing elements, such as 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 flowmeter, saturated flow, optical pumping, nuclear precession, SQUID, Hall effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive/piezoelectric compounds,

magnetodiode, magnetic transistor, optical fiber, magneto-optic and magnetic sensors based on microelectromechanical systems, among others.

[00194] In one aspect, the position sensor 472 for the tracking system 480 which comprises an absolute positioning system comprises a magnetic rotary absolute positioning system. The 472 position sensor can be implemented as an ASSOSSEQFT single integrated circuit rotating magnetic position sensor available from Austria Microsystems, AG. Position sensor 472 interfaces with microcontroller 461 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 rotating coordinates) processor, also known as the digit-by-digit method and Volder algorithm, is provided to implement a simple and efficient algorithm for computing hyperbolic and trigonometric functions that require only addition operations. , subtraction, bit shift and lookup table. At the angle position, alarm bits and magnetic field information are transmitted through a standard serial communication interface, such as a serial peripheral interface (SPI), to the 461 microcontroller. The 472 position sensor provides 12 or 14 bit resolution. The 472 position sensor can be an ASS055 integrated circuit supplied in a small 16-pin QFN package with dimensions of 4 x 4x0.85 mm.

[00195] The 480 tracking system comprising an absolute positioning system may comprise and/or be programmed to implement a feedback controller, such as a PID, status feedback, and adaptive controller. A power source converts the feedback controller signal into a physical input to the system, in this case voltage. Other examples include a voltage, current, and power PWM. Other sensors may be provided to measure physical system parameters in addition to the position measured by the 472 position sensor. 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 May 24, 2016, which is incorporated by reference in its entirety herein; US Patent Application Serial No. 2014/0263552, titled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, published September 18, 2014, is incorporated by reference in its entirety herein; and US Patent Application Serial No. 15/628,175 entitled

TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, submitted June 2017, is incorporated by reference in its entirety herein. 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 may comprise a compare and match circuit to match a computed response with a measured response through the use of algorithms, such as a weighted average and a theoretical control loop, that drive the calculated response toward to the measured response. The physical system computed response considers properties such as mass, inertia, viscous friction, inductance resistance, etc., to predict from the knowledge of the input what the states and outputs of the physical system will be.

[00196] 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 reset position (zero or start). ), as may be required by conventional rotary encoders that merely count the number of forward or backward steps the 482 motor has taken to infer the position of an actuator device, drive bar, scalpel, and the like.

[00197] A 474 sensor, such as a strain gauge or a micro-strain gauge, is configured to measure one or more end actuator parameters, such as the magnitude of the strain 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 474 sensor. an anvil closing drive system on a stapler or a 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 gripping arm of the instrument or surgical tool or the force applied by a gripping arm to tissue. situated in the grips of an electrosurgical or ultrasonic instrument. Alternatively, a current sensor 478 may be used to measure the current drawn by the motor 482. The displacement member may also be configured to engage a grip arm to open or close the grip arm. The force sensor can be configured to measure the grip force on the tissue. The force required to advance the displacement member may correspond to the current drawn by the 482 motor, for example. The measured power is converted into a digital signal and fed to the 462 processor.

[00198] In one form, a 474 strain gauge sensor can be used to measure the force applied to 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 tissue held by the end actuator comprises a strain gauge sensor 474, such as, for example, a micro strain gauge, which is configured to measure one or more parameters of the end actuator, for example. In one aspect, the strain gauge sensor 474 may measure the magnitude or magnitude of mechanical stress exerted on a gripper member of an end actuator during a gripping operation, which may be indicative of tissue compression. The measured effort is converted into a digital signal and fed to the processor 462 of a microcontroller 461. A load sensor 476 can measure the force used to operate the knife element, for example, to cut the captured tissue. between the anvil and the staple cartridge. A load sensor 476 can measure the force used to operate the grip arm element, for example, to capture tissue between the grip arm and an ultrasonic blade or to capture tissue between the grip arm and a gripper of a electrosurgical instrument. A magnetic field sensor can be used to measure the thickness of captured tissue. The magnetic field sensor measurement can also be converted to a digital signal and fed to the 462 processor.

[00199] Measurements of tissue compression, tissue thickness, and/or force required to close the end actuator in tissue, as respectively measured by sensors 474, 476, can be used by microcontroller 461 to characterize the selected trigger member position and/or the corresponding trigger member speed value. In one case, a memory 468 may store a technique, an equation, and/or a look-up table that may be used by the microcontroller 461 in evaluation.

[00200] The 470 control system of the instrument or surgical tool may also comprise wired or wireless communication circuits for communication with the central modular communication controller shown in Figures 8 to 11.

[00201] Figure 13 illustrates a control circuit 500 configured to control aspects of the surgical instrument or tool in accordance with an aspect of the present disclosure. Control circuit 500 can be configured to implement various processes described here. Control circuit 500 may comprise a microcontroller comprising one or more processors 502 (e.g., microprocessor, microcontroller) coupled to at least one memory circuit 504. Memory circuit 504 stores machine-executable instructions which, when executed by processor 502, cause processor 502 to execute machine instructions to implement various of the processes described herein. Processor 502 can be any of a number of single-core or multi-core processors known in the art. The 504 memory circuit may comprise volatile and non-volatile storage media. Processor 502 may include an instruction processing unit 506 and an arithmetic unit 508. The instruction processing unit may be configured to receive instructions from memory circuit 504 of the present disclosure.

[00202] Figure 14 illustrates a combinational logic circuit 510 configured to control aspects of the instrument or surgical tool in accordance with an aspect of the present disclosure. Combinational logic circuit 510 can be configured to implement various processes described herein. Combinational logic circuit 510 may comprise a finite state machine comprising combinational logic 512 configured to receive data associated with the surgical instrument or tool at an input 514, process the data by combinational logic 512, and provide an output. 516.

[00203] Figure 15 illustrates a sequential logic circuit 520 configured to control aspects of the surgical instrument or tool in accordance with an aspect of the present disclosure. Sequential logic circuit 520 or combinational logic 522 can be configured to implement the process described here. The sequential logic circuit 520 may comprise a finite state machine. The sequential logic circuit 520 may comprise a combinational logic 522, at least a 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 aspects, the circuit may comprise a combination of a processor (e.g. , processor 502, Figure 13) and a finite state machine for implementing various processes of the present invention. In other aspects, the finite state machine may comprise a combination of a combinational logic circuit (e.g., a combinational logic circuit 510, Figure 14) and sequential logic circuit 520.

[00204] —Figure 16 illustrates a surgical instrument or tool comprising a plurality of motors that can be activated to perform various functions. In certain cases, a first motor can be activated to perform a first function, a second motor can be activated to perform a second function, a third motor can be activated to perform a third function, a fourth motor can be activated to perform a fourth function, and so on. In certain cases, the plurality of motors of robotic surgical instrument 600 may be individually activated to cause triggering, closing, and/or pivoting movements in the end actuator. The triggering, closing and/or articulation movements can be transmitted to the end actuator via a drive shaft assembly, for example.

[00205] In certain cases, the instrument system or surgical tool may include a trigger motor 602. The trigger motor 602 may be operatively coupled to a trigger motor drive assembly 604, which may be configured to transmit triggering motions generated by the 602 motor to the end actuator, particularly to displace the clamping arm closing member. The closing member can be retracted by reversing the direction of motor 602, which also causes the clamping arm to open.

[00206] In certain cases, the surgical instrument or tool may include a closing motor 603. The closing motor 603 may be operatively coupled to a closing motor drive assembly 605 which can be configured to transmit closing movements generated by motor 603 to the end actuator, particularly to displace a closure tube to close the anvil and compress tissue between the anvil and staple cartridge. Closing motor 603 may be operatively coupled to a closing motor drive assembly 605 which may be configured to transmit closing movements generated by motor 603 to the end actuator, particularly to displace a closure tube to close the end actuator. clamping arm and compressing tissue between the clamping arm and an ultrasonic blade or clamping arm or gripper 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 transitioned to an open position by reversing the direction of the 603 motor.

[00207] In certain cases, the surgical instrument or tool may include one or more joint motors 606a, 606b, for example. Motors 606a, 606b may be operatively coupled to linkage motor drive assemblies 608a, 608b, which may be configured to transmit linkage motions generated by motors 606a, 606b to the end actuator. In certain cases, linkage movements can cause the end actuator to link with respect to the drive shaft assembly, for example.

[00208] “As described above, the instrument or surgical tool may 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, pivot motors 606a, 606b can be activated to cause the end actuator to pivot while trigger motor 602 remains inactive. Alternatively, firing motor 602 may be activated to fire the plurality of staples, and/or advance the cutting edge, while toggle motor 606 remains inactive. Furthermore, the closing motor 603 can be activated simultaneously with the triggering motor 602 to cause the closing tube or closing member to advance distally as described in more detail later in this document.

[00209] 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 surgical instrument or tool. In certain cases, the 610 common control module can accommodate one of a plurality of motors at a time. For example, the common control module 610 may be attachable to and separable from the plurality of motors of the robotic surgical instrument individually. In certain cases, a plurality of instrument or surgical tool motors may share one or more common control modules, such as the common control module 610. In certain cases, a plurality of instrument motors or surgical tool can be individually and selectively engaged with 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 motors of the instrument or surgical tool to make interfacing with one of the plurality of motors of the instrument or surgical tool.

[00210] In at least one example, the common control module 610 can be selectively switched between operational engagement with linkage motors 606a, 606B, and operational engagement with tripping motor 602 or closing motor 603. In In at least one example, as illustrated in Figure 16, a key 614 may be moved or transitioned between a plurality of positions and/or states. In first position 616, switch 614 can electrically couple common control module 610 to trigger 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, key 614 can electrically couple common control module 610 to first linkage motor 606a; and in a fourth position 618b, the switch 614 can electrically couple the common control module 610 to the second linkage motor 606b,

for example. In certain cases, separate common control modules 610 may be electrically coupled to the trip motor 602, the closing motor 603, and the linkage motors 606a, 606b at the same time. In certain cases, the 614 switch can be a mechanical switch, an electromechanical switch, a solid state switch, or any suitable switching mechanism.

[00211] Each of the motors 602, 603, 606a, 606b may comprise a torque sensor for measuring the output torque on the motor drive shaft. The force on an end actuator can be detected in any conventional way, such as through force sensors on the outer sides of the jaws or by a torque sensor on the motor that drives the jaws.

[00212] In various cases, as illustrated in Figure 16, the common control module 610 may comprise a motor drive 626 which may comprise one or more H-Bridge FETs. Motor driver 626 may modulate power transmitted from a power source 628 to a motor coupled to common control module 610, based on 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.

[00213] In certain examples, the microcontroller 620 may include a microprocessor 622 (the "processor") and one or more non-transient computer readable media or memory units 624 (the "memory"). In certain cases, memory 624 may store multiple program instructions which, when executed, may cause processor 622 to perform a plurality of functions and/or calculations described herein. In certain cases, one or more of the memory units

ria 624 can be coupled to processor 622, for example. In many respects, the 620 microcontroller can communicate over a wired or wireless channel, or combinations thereof.

[00214] In certain cases, the power supply 628 can be used to supply power to the microcontroller 620, for example. In certain cases, the power source 628 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 provide power to the 600 surgical instrument. Multiple battery cells connected in series can be used as the 628 power source. In some cases, the 628 power supply can be replaceable and/or rechargeable, for example.

[00215] In various cases, processor 622 may control 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, processor 622 may 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 herein, includes any microprocessor, microcontroller, or other suitable basic computing device that embodies the functions of a computer central processing unit (CPU) in an integrated circuit, or at most, a few integrated circuits. The 622 processor is a multipurpose programmable 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.

[00216] In one example, the 622 processor can be any single-core or multi-core processor, such as those known by the trade name ARM Cortex from Texas Instruments. In certain cases, the 620 microcontroller may be an LM 4F230H5QR, available from Texas Instruments, for example. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core comprising an integrated 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a seek buffer to optimize performance above 40 MHz, a 32KB single-cycle SRAM, an internal ROM loaded with StellarisWareO software, a 2KB EEPROM, one or more PWM modules, one or more QEI analogues, a or more 12-bit ADCs 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 description should not be limited in that context.

[00217] In certain cases, memory 624 may include program instructions for controlling each of the surgical instrument motors 600 that are attachable to common control module 610. For example, memory 624 may include program instructions for controlling the trigger motor 602, the closing motor 603 and the hinge motors 606a, 606b. Such program instructions can cause the 622 processor to control the trigger, close, and articulation functions according to inputs from the surgical instrument or tool control algorithms or programs.

[00218] In certain cases, one or more mechanisms and/or sensors, such as sensors 630, may be used to alert the processor 622 to program instructions that need to be used in a specific configuration. For example, sensors

630 can prompt the 622 processor to use the program instructions associated with tripping, closing, and linking the end actuator. In certain cases, sensors 630 may comprise position sensors that may be used to detect the position of key 614, for example. Accordingly, processor 622 may use program instructions associated with firing the closing member coupled to the gripping arm of the end actuator upon detection, via sensors 630, for example, that key 614 is in first position 616; processor 622 may use program instructions associated with closing the anvil upon detection through sensors 630, for example, that key 614 is in second position 617; and processor 622 may use program instructions associated with linkage of the end actuator upon detection through sensors 630, for example, that switch 614 is in third or fourth position 618a, 618b.

[00219] Figure 17 is a schematic diagram of a robotic surgical instrument 700 configured to operate a surgical tool described herein, in accordance with one aspect of that description. The 700 robotic surgical instrument can be programmed or configured to control distal/proximal translation of a displacement limb, distal/proximal displacement of a closure tube, rotation of the drive shaft, and articulation, either with single type or multiple linkage drive links. In one aspect, surgical instrument 700 can be programmed or configured to individually control a trigger member, a closure member, a drive shaft member, or one or more hinge members, or combinations thereof. Surgical instrument 700 comprises a control circuit 710 configured to control motor-driven triggering members, closing members,

drive shaft members, or one or more pivot members, or combinations thereof.

[00220] In one aspect, the robotic surgical instrument 700 comprises a control circuit 710 configured to control a gripping arm 716 and a closing member 714, a portion of an end actuator 702, an ultrasonic blade 718 coupled to an ultrasonic transducer 719 driven by an ultrasonic generator 721, a drive shaft 740, and one or more pivot members 742a, 742b via a plurality of motors 704a to 704e. A position sensor 734 may be configured to provide feedback on the position of the closing member 714 to the control circuit 710. Other sensors 738 may be configured to provide feedback to the control circuit 710. A timer/counter 731 provides timing and counting to control circuit 710. A power source 712 can be provided to operate motors 704a through 704e and a current sensor 736 provides current feedback from the motor to control circuit 710. Motors 704a through 704e can be individually operated by the 710 control circuit in an open-loop or closed-loop feedback control.

[00221] 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 output of the timer. /counter 731 so that the control circuit 710 can determine the position of the closing member 714 at a specific time (t) relative to an initial position or time (t)

when the closing member 714 is in a specific position relative to an initial position. The 731 timer/counter can be configured to measure elapsed time, count external events, or time external events.

[00222] In one aspect, the control circuit 710 can be programmed to control functions of the end actuator 702 based on one or more tissue conditions. The 710 control circuit can be programmed to directly or indirectly sense fabric conditions, such as thickness, as described here. The 710 control circuit can be programmed to select a trigger control program or close 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 best handle different tissue conditions. For example, when thicker tissue is present, control circuit 710 can be programmed to translate the displacement member at a slower speed and/or at a lower power. When thinner fabric is present, the control circuit 710 can be programmed to translate the displacement member at a higher speed and/or with greater power. A closure control program may control the closure force applied to the fabric by the gripping arm 716. Other control programs control the rotation of the drive shaft 740 and pivot members 742a, 742b.

[00223] In one aspect, the control circuit 710 can generate motor setpoint signals. Motor setpoint signals can be provided for various 708a to 708e motor controllers. Motor controllers 708a through 708e may comprise one or more circuits configured to provide motor start signals to motors 704a through 704e to drive motors 704a through 704e, as described herein. In some examples, motors 704a to 704e may be brushed direct current electric motors. For example, the speed of motors 704a to 704e may be proportional to the respective motor drive 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 supplied to one or more stator windings of motors 704a to 704e. Also, in some examples, the motor controllers 708a through 708e can be omitted and the control circuit 710 can directly generate the motor drive signals.

[00224] In one aspect, the control circuit 710 may initially operate each of the motors 704a through 704e in an open circuit configuration for a first open circuit portion of the travel member's stroke. Based on the response of the robotic surgical instrument 700 during the open-loop portion of the stroke, the 710 control circuit can select a trigger control program in a closed-loop configuration. The instrument response may include a translation of the distance from the displacement member during the open circuit portion, an elapsed time during the open circuit portion, the power supplied to one of the motors 704a to 704e during the open circuit portion, a sum of pulse widths of a motor drive signal, etc. After the open circuit portion, control circuit 710 may implement the selected trigger control program for a second portion of the displacement member stroke. For example, during a portion of the closed-loop stroke, control circuit 710 may modulate one of motors 704a to 704e based on translating data describing a closed-loop displacement member position to translate the displacement member. at a constant speed.

[00225] In one aspect, the motors 704a through 704e may receive power from a power source 712. The power source 712 may be a DC power source driven by a main AC power source, a battery pack. , a super capacitor, or any other suitable power source. Motors 704a to 704e can be mechanically coupled to individual movable mechanical elements such as closing member 714, clamping arm 716, drive shaft 740, articulation 742a, and articulation 742b, via the respective transmissions. 706a to 706e. Transmissions 706a to 706e may include one or more gears or other connecting components to couple the motors 704a to 704e to the 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 In some examples, position sensor 734 may include an encoder configured to provide a series of pulses to control circuit 710 as closing member 714 translates distally and proximally. Control circuit 710 can track pulses to determine position of closing member

714. Other suitable position sensors may be used, including, for example, a proximity sensor. Other types of position sensors may provide other signals that indicate movement of closing member 714. Also, in some examples, 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 steps that the motor 704 has been instructed to perform. Position sensor 734 may be located on end actuator 702 or any other portion of the instrument. The outputs of each of the 704a to 704e motors include a torque sensor 744a to 744e to sense force and have an encoder to sense the rotation of the drive shaft.

[00226] In one aspect, the control circuit 710 is configured to drive a trigger member as the closing member 714 portion of the end actuator 702. The control circuit 710 provides a motor set point for a motor control. motor 708a, which provides a drive signal to motor 704a.

The motor output drive shaft 704a is coupled to a torque sensor 744a.

The torque sensor 744a is coupled to a transmission 706a which is coupled to the closure member 714. The transmission 706a comprises movable mechanical elements such as rotating elements and a triggering member to distally and proximally control movement of the closure member. 714 along a longitudinal axis of the end actuator 702. In one aspect, the motor 704a may be coupled to the knife gear assembly, which includes a knife gear reduction assembly that includes a first knife drive gear. and a second knife drive gear.

A torque sensor 744a provides a trigger force feedback signal to the control circuit 710. The trigger force signal represents the force required to trigger or dislodge closing member 714. A position sensor 734 can be configured to provide the position of the closing member 714 along the triggering stroke or the position of the triggering member as a feedback signal to the control circuit 710. The end actuator 702 may include additional sensors 738 configured to provide feedback signals. - training for control circuit 710. When ready for use, control circuit 710 can provide a trigger signal to motor control 708a.

In response to the trigger signal, motor 704a may drive the trigger member distally along the longitudinal axis of end actuator 702 from a proximal stroke start position to a stroke terminal distal position relative to the stroke start position. course. As the closing member 714 translates distally, the clamping arm 716 closes towards the ultrasonic blade 718.

[00227] In one aspect, the control circuit 710 is configured to drive a closing member as the grip arm portion 716 of the end actuator 702. The control circuit 710 provides a motor setpoint for a control of the motor. motor 708b, which provides a drive signal to motor 704b. The motor output shaft 704b is coupled to a torque sensor 744b. The torque sensor 744b is coupled to a transmission 706b which is coupled to the clamping arm 716. The transmission 706b comprises movable mechanical elements such as rotating elements and a closing member to control the movement of the clamping arm 716 from positions open and closed. In one aspect, the motor 704b is coupled to a closing gear assembly, which includes a closing reduction gear assembly that is supported in engagement with the closing sprocket. The torque sensor 744b provides a closing force feedback signal to the control circuit 710. The closing force feedback signal represents the closing force applied to the clamping arm 716. 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 in the end actuator 702 can provide the closing force feedback signal to the control circuit. 710. The pivotable grip arm 716 is positioned opposite the ultrasonic blade 718. When ready for use, the control circuit 710 can provide a close signal to the motor control 708b. In response to the closing signal, the motor 704b advances a closing member to clamp the tissue between the clamping arm 716 and the ultrasonic blade.

718.

[00228] 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 motor control, which provides a start signal to the 704c motor. The output shaft of the 704c motor is coupled to a 744c torque sensor. The 744c torque sensor is coupled to a 706c transmission that is coupled to the shaft

740. Transmission 706c comprises movable mechanical elements, such as rotating elements, to control rotation of drive shaft 740 clockwise or counterclockwise up to and above 360°. In one aspect, the 704c motor is coupled to a swivel drive assembly, which includes a tube gear segment that is formed over (or attached to) the proximal end of the proximal closure tube for operable engagement by an assembly. of rotational gear that is operationally supported on the tool mounting plate. The torque sensor 744c provides a rotational force feedback signal to the control circuit 710. The rotational force feedback signal represents the rotational force applied to the drive shaft 740. The torque sensor position 734 may 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, may provide the rotational position of the drive shaft 740 to the circuit. control 710.

[00229] In one aspect, the control circuit 710 is configured to pivot the end actuator 702. The control circuit 710 provides a motor setpoint to a motor control 708d, which provides a drive signal to the motor control 708d. 704d engine. The output shaft of the 704d motor is coupled to a 744d torque sensor. Torque sensor 744d is coupled to a transmission 706d which is coupled to a pivot member 742a. The 706d transmission comprises movable mechanical elements, such as articulation elements, to control the articulation of the 702 + 65º end actuator. In one aspect, the 704d motor is coupled to a pivot nut, which is rotatably seated on the proximal end portion of the distal column portion and is rotatably driven therein by a gear set. articulation. The 744d torque sensor provides a linkage force feedback signal to the 710 control circuit. The linkage force feedback signal represents the linkage force applied to the end actuator 702. The 738 sensors, such as a linkage encoder, can provide the linkage position from the end actuator 702 to the control circuit 710.

[00230] In another aspect, the articulation function of the robotic surgical system 700 may comprise two articulation members, or links, 742a, 742b. These pivot members 742a, 742b are driven by separate disks on the robot interface (the rack), which are driven by the two motors 708d, 708e. When separate trigger motor 704a is provided, each linkage link 742a, 742b can be actuated antagonistically with respect to the other link to provide resistive holding motion and a load to the head when it is not moving and to stop provide a pivoting movement when the head is pivoted. The pivot members 742a, 742b attach to the head at 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 may be more pronounced with other linkage drive systems.

[00231] In one aspect, the one or more motors 704a to 704e may comprise a brushed DC motor with a gearbox and mechanical links to a trigger member, closing member or pivot member. Another example includes electric motors 704a to 704e that operate moving mechanical elements such as the displacement member, pivot links, closing tube, and drive shaft. An external influence is an inordinate and unpredictable influence of things like fabric, surrounding bodies, and friction on the physical system. This external influence can be called drag, which acts in opposition to one of the electric motors 704a to 704e. External influences such as drag can cause the functioning of the physical system to deviate from a desired operation of the physical system.

[00232] In one aspect, the 734 position sensor can be implemented as an absolute positioning system. In one aspect, the 734 position sensor may comprise an absolute rotating magnetic positioning system implemented as a single integrated circuit rotating magnetic position sensor ASSOSSEQFT, available from Austria Microsystems, AG. Position sensor 734 can interface with 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 to calculate hyperbolic and trigonometric functions that require only addition, subtraction, bit shift, and lookup table operations.

[00233] 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 the several 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 a current sensor for rasita, a resistive sensor, a capacitive sensor, an optical sensor, and/or any other sensor suitable for measuring one or more parameters of the end actuator 702. Sensors 738 may include one or more sensors. Sensors 738 may be located on gripping arm 716 to determine tissue location using segmented electrodes. The 744a to 744e torque sensors can be configured to detect forces such as trigger force, closing force, and/or linkage 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 firing member in the rack and its position, (3) which portion of the ultrasonic blade 718 has tissue on it, and (4) the load and position on both pivot rods.

[00234] In one aspect, one or more sensors 738 may comprise a strain gauge, such as a micro strain gauge, configured to measure the magnitude of strain on anvil 716 during a pinched condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. Sensors 738 may comprise a pressure sensor configured to detect a pressure generated by the presence of tissue compressed between the gripping arm 716 and the ultrasonic blade 718. Sensors 738 may 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 tissue situated therebetween.

[00235] In one aspect, 738 sensors can be implemented as one or more limit switches, electromechanical devices, solid state switches, Hall effect devices, magneto-resistive (MR) devices, giant magneto-resistive (GMR) devices. , 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, switches can be solid-state devices such as transistors (eg, FET, junction FET, MOSFET, bipolar, and the like). In other implementations, 738 sensors may include conductorless electrical switches, ultrasonic switches, accelerometers, and inertia sensors, among others.

[00236] 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 a point of interaction between the clamping tube and the clamping arm 716 to detect the clamping forces applied by the clamping tube to the clamping arm 716. The forces exerted on the clamping arm 716 clamping arm 716 may be representative of the tissue compression experienced by the section of tissue captured between the clamping arm 716 and the ultrasonic blade 718. The one or more sensors 738 may be positioned at various interaction points along the closing drive system to detect the closing forces applied to the grip arm 716 by the closing drive system. The one or more sensors 738 may be sampled in real time during a gripping operation by the control circuit processor 710. The control circuit 710 receives real-time sample measurements to provide and analyze time-based information and evaluate, in real time, the closing forces applied to the clamping arm 716.

[00237] In one aspect, a current sensor 736 can be used to measure the current drawn by each of the motors 704a to 704e. The force required to advance any of the movable mechanical elements such as the closing member 714 corresponds to the current drawn by one of the motors 704a to 704e. The power is converted to a digital signal and supplied to the control circuit 710. The control circuit 710 can be configured to simulate the instrument's actual system response in the controller software. A displacement member may be actuated to move the closing member 714 on the end actuator 702 at or near a target speed. The robotic surgical instrument 700 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, linear quadratic (LQR) and/or a adaptive controller, for example. The robotic surgical instrument 700 may include a power source to convert the feedback controller signal into a physical input such as case voltage, PWM voltage, frequency modulated voltage, current, torque, and/or force, for example. Additional details are described in US Patent Application Serial No. 15/636,829 entitled CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT, filed June 29, 2017, which is incorporated herein by reference in its entirety.

[00238] Figure 18 illustrates a schematic diagram of a surgical instrument 750 configured to control distal translation of the displacement limb in accordance with 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 which may comprise a gripping arm 766, a closure 764 and an ultrasonic blade 768 coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

[00239] 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 array, and a position sensor 784. Because the closure member 764 is coupled to a longitudinally movable drive member, the position of the closure member 764 can be determined by measuring the position of the longitudinally movable drive member using position sensor 784. Consequently, in the following description, the position, displacement and/or translation of the closing member 764 can be obtained by the position sensor 784, as described in the present invention. A control circuit 760 may be programmed to control the translation of the displacement member, such as the closing member 764. The control circuit 760, in some examples, may comprise one or more microcontrollers, microprocessors, or other processors. suitable for executing instructions that cause the processor or processors to control the shift 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 time output. - timer/counter 781 so that the control circuit 760 can determine the position of the closing member 764 at a specific time (t) relative to an initial position. The 781 timer/counter can be configured to measure elapsed time, count external events, or measure eternal events.

[00240] Control circuit 760 may generate a motor setpoint signal 772. The motor setpoint signal 772 may be provided to a motor controller 758. Motor controller 758 may comprise one or more circuits configured to provide a start signal from the 774 engine to the 754 engine to start the 754 engine, as described here. In some examples, the 754 motor may be a DC motor with a brushed DC electric motor. For example, the speed of motor 754 may be proportional to the drive signal of motor 774. In some examples, motor 754 may be a brushless DC electric motor and the drive signal of motor 774 may comprise a PWM signal supplied to a or more motor stator windings

754. Also, in some examples, the motor controller 758 may be omitted, and the control circuit 760 may generate the motor drive signal 774 directly.

[00241] Motor 754 can receive power from a power source

762. Power source 762 may be or include a battery, super capacitor, or any other suitable power source. Motor 754 may be mechanically coupled to enclosing member 764 via a transmission 756. Transmission 756 may include one or more gears or other connecting components to couple motor 754 to enclosing member 764. A position sensor 784 may 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 may include an encoder configured to provide a series of pulses to the 760 control circuit as per the profiled beam | 764 translates distally and proximally. Control circuit 760 can track pulses to determine the position of closing member 764. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors may provide other signals that indicate movement of closing member 764. Also, in some examples, 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 steps that motor 754 has been instructed to perform. Position sensor 784 may be located on end actuator 752 or any other portion of the instrument.

[00242] Control circuit 760 can be in communication with one or more sensors 788. Sensors 788 can be positioned on end actuator 752 and adapted to work with surgical instrument 750 to measure various derived parameters such as distance span as a function of time, tissue compression as a function of time and anvil tension as a function of time. 788 sensors may comprise a magnetic sensor, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor such as an eddy current sensor, a resistive sensor, a sensor capacitive, an optical sensor, and/or any other sensors suitable for measuring one or more parameters of the 752 end actuator. The 788 sensors may include one or more sensors.

[00243] One or more sensors 788 may comprise a strain gauge, such as a micro strain gauge, configured to measure the magnitude of strain on 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 may comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the gripping arm 766 and the ultrasonic blade 768. The 788 sensors may 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 tissue situated therebetween.

[00244] The 788 sensors can be configured to measure the forces exerted on the clamp arm 766 by the closing drive system. For example, one or more sensors 788 may be at a point of interaction between the clamping tube and the clamping arm 766 to detect the clamping forces applied by a clamping tube to the clamping arm 766. the grip arm 766 may be representative of the tissue compression experienced by the tissue section captured between the grip arm 766 and the ultrasonic blade 768. The one or more sensors 788 may be positioned at various interaction points along the drive system. closing force 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 760 control circuit processor. The 760 control circuit receives real-time sample measurements to provide and analyze information based on in time and evaluate, in real time, the closing forces applied to the clamping arm 766.

[00245] A current sensor 786 may be used to measure the current drawn by the motor 754. The force required to advance the closing member 764 corresponds to the current drawn by the motor.

754. The power is converted to a digital signal and supplied to the 760 control circuit.

[00246] —The 760 control circuit can be configured to simulate the instrument's actual system response in the controller software.

A displacement member can be actuated to move a closing member 764 on the end actuator 752 at or near a target speed. 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, status feedback, LOR, and/or an adaptive controller, e.g. example. The surgical instrument 750 may include a power source to convert the feedback controller signal into a physical input such as case voltage, PWM voltage, frequency modulated voltage, current, torque and/or force, for example.

[00247] 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 DC motor with brushes with gearbox and mechanical links to a linkage system and /or knife. Another example is the 754 electric motor which operates the displacement member and linkage driver, for example, from an interchangeable drive shaft assembly. An outside influence is an unreasonable and unpredictable influence of things like tissue, surrounding bodies, and friction on the physical system. This external influence can be called drag, which acts in opposition to the 754 electric motor. External influence, such as drag, can cause the functioning of the physical system to deviate from a desired operation of the physical system.

[00248] Several exemplifying aspects are directed to a surgical instrument 750 comprising an end actuator 752 with motor-driven surgical sealing and cutting implements. For example, a motor 754 may drive a displacement member distally and proximally along a longitudinal axis of the end actuator 752. The end actuator 752 may comprise a pivotable grip arm 766 and, when configured to the use, an ultrasonic blade 768 positioned opposite the gripping arm 766. A clinician may grasp tissue between the gripping arm 766 and the ultrasonic blade 768 as described in the present invention. When ready to use the 750 instrument, the clinician can provide a trigger signal, for example, by pressing a trigger on the 750 instrument. In response to the trigger signal, the 754 motor can drive the displacement limb distally. along the longitudinal axis of end actuator 752 from a proximal travel start position to a distal travel end position of the travel start position. As the displacement member moves distally, the closing member 764 with a cutting member positioned at a distal end, can cut tissue between the ultrasonic blade 768 and the clamping arm 766.

[00249] In various examples, the surgical instrument 750 may comprise a control circuit 760 programmed to control the distal translation of the displacement member, such as the closing member 764, for example, based on one or more more tissue conditions. The 760 control circuit can be programmed to sense, directly or indirectly, tissue conditions, such as thickness, as described here. The 760 control circuit can be programmed to select a control program based on tissue conditions. A control program can describe the distal movement of the displacement limb. Different control programs can be selected to better treat different tissue conditions. For example, when thicker tissue is present, the control circuit 760 can be programmed to translate the displacement member at a slower speed and/or at a lower power. When thinner fabric is present, control circuit 760 can be programmed to translate the displacement member at a higher speed and/or with greater power.

[00250] In some examples, the control circuit 760 may initially operate the motor 754 in an open circuit configuration for a first open circuit portion of a travel member stroke. Based on a response from the instrument 750 during the open circuit portion of the stroke, the control circuit 760 can select a trigger control program. The instrument response may include a translation distance of the displacement member during the open circuit portion, an elapsed time during the open circuit portion, the power supplied to motor 754 during the open circuit portion, a sum of pulse widths of a motor start signal, etc. After the open circuit portion, control circuit 760 may implement the selected trigger control program for a second portion of the displacement member stroke. For example, during the closed-loop portion of the stroke, control circuit 760 may modulate motor 754 based on translation data describing a position of the displacement member in a closed-loop fashion to translate the displacement member in a closed-loop fashion. constant speed. Additional details are described in US Patent Application Serial No. 15/720,852, entitled SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT, filed September 29, 2017, which is incorporated herein by reference in its entirety. .

[00251] Figure 19 is a schematic diagram of a surgical instrument 790 configured to control various functions in accordance with one aspect of the present disclosure. In one aspect, surgical instrument 790 is programmed to control distal translation of a displacement member such as closing member 764. Surgical instrument 790 comprises an end actuator 792 which may comprise a gripping arm 766, a closure member 764, and an ultrasonic blade 768 that can be interchanged with or function in conjunction with one or more RF electrodes 796 (shown in dashed line). The 768 ultrasonic blade is coupled to a 769 ultrasonic transducer driven by a 771 ultrasonic generator.

[00252] In one aspect, 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, the 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, switches can be solid-state devices such as transistors (eg, FET, junction FET, MOSFET, bipolar, and the like). In other implementations, 788 sensors may include conductorless electrical switches, ultrasonic switches, accelerometers, inertia sensors, and more.

[00253] In one aspect, the 784 position sensor can be implemented as an absolute positioning system, which comprises a rotating magnetic absolute positioning system implemented as a single integrated circuit rotating magnetic position sensor ASSOSSEQFT , available from Austria Microsystems, AG. The 784 position sensor can interface with the 760 control circuit to provide an absolute positioning system. 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 computing hyperbolic and trigonometric functions. that only require addition, subtraction, bit shift, and lookup table operations.

[00254] In some examples, position sensor 784 may be omitted. When motor 754 is a stepper motor, control circuit 760 can track the position of enclosing member 764 by aggregating the number and orientation of steps the motor has been instructed to perform. Position sensor 784 may be located on end actuator 792 or any other portion of the instrument.

[00255] Control circuit 760 can be in communication with one or more sensors 788. Sensors 788 can be positioned on end actuator 792 and adapted to work with surgical instrument 790 to measure the various derived parameters such as distance span as a function of time, tissue compression as a function of time and anvil tension as a function of time. 788 sensors may comprise a magnetic sensor, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor such as an eddy current sensor, a resistive sensor, a sensor capacitive, an optical sensor, and/or any other sensors suitable for measuring one or more parameters of the 792 end actuator. The 788 sensors may include one or more sensors.

[00256] “A 794 RF power source is coupled to the 792 end actuator and is applied to the 796 RF electrode when the 796 RF electrode is provided in the 792 end actuator in place of the 768 ultrasonic blade or to work together with the ultrasonic blade

768. For example, the ultrasonic sheet is produced from electrically conductive metal and can be used as the return path for electrosurgical RF current. Control circuit 760 controls the delivery of RF energy to RF electrode 796.

[00257] Additional details are described in US patent application Serial No. 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 incorporated herein by reference in its entirety. Generator Hardware Adaptive Ultrasonic Blade Control Algorithms

[00258] In various aspects, intelligent ultrasonic power devices can comprise adaptive algorithms to control the operation of the ultrasonic blade. In one aspect, adaptive ultrasonic blade control algorithms are configured to identify tissue type and adjust device parameters. In one aspect, the ultrasonic blade control algorithms are configured to parameterize the tissue type. An algorithm for detecting the tissue collagen/elastin ratio to adjust the amplitude of the distal tip of the ultrasonic blade is described in the following section of the present description. Various aspects of smart ultrasonic power devices are described herein in connection with Figures 1 to 85, for example. Consequently, the following description of adaptive ultrasonic blade control algorithms should be read in conjunction with Figures 1 through 85 and their associated descriptions. Tissue type identification and device parameter adjustments

[00259] In certain surgical procedures it would be desirable to use adaptive ultrasonic blade control algorithms. In one aspect, adaptive ultrasonic blade control algorithms can be used to adjust the parameters of the ultrasonic device based on the type of tissue in contact with the ultrasonic blade. In one aspect, the parameters of the ultrasonic device can be adjusted based on the location of tissue within the jaws of the ultrasonic end actuator, for example, the location of tissue between the clamping arm and the ultrasonic blade. The ultrasonic transducer impedance can be used to differentiate the percentage of tissue that is situated at the distal or proximal end of the end actuator. Ultrasonic device reactions can be based on tissue type or tissue compressibility. In another aspect, the ultrasonic device parameters can be adjusted based on the identified tissue type or parameterization. For example, the amplitude of the mechanical displacement of the distal tip of the ultrasonic blade can be adjusted based on the tissue collagen to elastin ratio detected during the tissue identification procedure. The tissue collagen to elastin ratio can be detected using a variety of techniques including infrared (IR) surface reflectance and emissivity. The force applied to the fabric by the grip arm and/or the stroke of the grip arm to produce span and compression. Electrical continuity through a gripper equipped with electrodes can be used to determine the percentage of the gripper that is covered with tissue.

[00260] Figure 20 is a system 800 configured to run adaptive ultrasonic blade control algorithms on a surgical data network comprising a central modular communication controller, in accordance with at least one aspect of the present description. In one aspect, generator module 240 is configured to execute adaptive ultrasonic blade control algorithms 802, as described herein with reference to Figures 43A to 54. In another aspect, device/instrument 235 is configured to execute the algorithms. 804 adaptive ultrasonic blade control algorithms, as described herein with reference to Figures 43A to 54. In another aspect, the device/instrument 235 is configured to perform adaptive ultrasonic blade control algorithms 802, 804 as described herein with reference to the adaptive ultrasonic blade control algorithms 802, 804. Figures 43A to 54.

[00261] Generator module 240 may comprise an isolated patient stage communicating with a non-isolated stage via a power transformer. A secondary winding of the power transformer is contained in the isolated stage and may comprise a tapped configuration (e.g. a center tapped or non center tapped configuration) to define the drive signal outputs to deliver signals. different surgical instruments, such as an ultrasonic surgical device and an RF electrosurgical instrument, and a multifunctional surgical instrument that includes ultrasonic and RF energy modes that can be released alone or simultaneously. In particular, the trigger signal outputs can output an ultrasonic trigger signal (e.g., a 420 V root mean square (RMS) trigger signal for a 241 ultrasonic surgical instrument, and the signal outputs triggers can output an RF electrosurgical trigger signal (eg, a 100V electrosurgical trigger signal) to an RF electrosurgical instrument 241. Aspects of generator module 240 are described herein with reference to Figures 21 through 28B.

[00262] 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 localized computerized devices in the operating room, as described with reference to Figures 8 to 11, for example.

[00263] Figure 21 illustrates an example of a generator 900, which is a form of a generator configured to couple with an ultrasonic instrument and further configured to run adaptive ultrasonic blade control algorithms on a surgical data network comprising a modular communication central controller as shown in Figure 20. Generator 900 is configured to supply multiple modalities of power to a surgical instrument.

The Generator 900 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 supply multiple energy modalities (e.g., ultrasonic, bipolar or monopolar RF, irreversible and/or reversible electroporation, and/or microwave energy, among others) through a single port, and these signals can be supplied separately or simultaneously to the end actuator to treat tissue.

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

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

The analog output is fed to a 1106 amplifier for signal conditioning and amplification.

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

A first signal of a first energy modality is provided to the surgical instrument between the terminals labeled POWER; and RETURN.

A second signal from a second power mode is coupled across a capacitor 910 and is supplied to the surgical instrument between the terminals labeled POWER? and RETURN.

It will be recognized that more than two modes of power may be emitted and therefore the subscript "n" may be used to denote that up to n POWER terminals may be provided, where n is a positive integer greater than 1. Also it will be recognized that up to "n" return paths, RETURN, may be provided without departing from the scope of the present description.

[00264] A first voltage sensing circuit 912 is coupled across the terminals identified as POWER; and the RETURN path to measure the output voltage between them. A second voltage sensing circuit 924 is coupled across the terminals labeled POWER, and to the RETURN path to measure the output voltage between them. A current sensing circuit 914 is arranged in series with the RETURN branch of the secondary side of power transformer 908, as shown, to measure the output current for any power mode. If different return paths are provided for each power mode, then a separate current sensing circuit would be provided on each return branch. The outputs of the first and second voltage sensing circuits 912, 924 are supplied to respective isolation transformers 916, 922, and the output of the current sensing circuit 914 is supplied to another isolation transformer 918 The outputs of isolation transformers 916, 928, 922 on the primary side of power transformer 908 (non-isolated patient side) are supplied to one or more ADC circuits 926. The digitized output of ADC circuit 926 is supplied to processor 902 for further processing and calculations. Output voltages and output current feedback information can be used to adjust the output voltage and current supplied to the surgical instrument, and to compute the output impedance, among other parameters. Input/output communications between the 902 processor and the

Isolated parts of the patient are provided through interface circuit 920. Sensors may also be in electrical communication with processor 902 through interface circuit 920.

[00265] In one aspect, the impedance can be determined by the processor 902 by dividing the output of the first voltage sensing circuit 912 coupled over the terminals identified as POWER/RETURN or the second voltage sensing circuit 924 coupled over the terminals identified as POWER/RETURN by the output of the current sensing circuit 914 arranged in series with the RETURN branch of the secondary side of the power transformer 908. The outputs of the first and second voltage sensing circuits 912, 924 are provided to separate isolation transformers 916, 922, and the output from current sensing circuit 914 is provided to another isolation transformer 916. Digitized voltage and current sensing measurements from ADC circuit 926 are provided to the processor 902 to calculate impedance. As an example, the first energy modality ENERGY could be ultrasonic energy and the second energy modality ENERGY could be RF energy. However, in addition to ultrasonic and bipolar or monopolar RF energy modalities, other energy modalities include irreversible and/or reversible electroporation and/or microwave energy, among others. Furthermore, while 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 herein, the impedance of the ultrasonic transducer can be measured by dividing the output of the first voltage sensing circuit 912 by the current sensing circuit 914, and the tissue impedance can be measured by dividing the output from the second voltage sensing circuit 924 by the current sensing circuit 914.

[00266] “As shown in Figure 21, the 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 modes. energy, 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 Generator 900 can supply power with higher voltage and lower current to drive an ultrasonic transducer, with lower voltage and higher current to drive RF electrodes to seal tissue, or with a coagulation waveform for spot coagulation using monopolar or bipolar RF electrosurgical electrodes. The output waveform of the Generator 900 can be oriented, switched, or filtered to provide the frequency to the surgical instrument end actuator. The connection of an ultrasonic transducer to the output of generator 900 would preferably be located between the output labeled POWER; and RETURN, as shown in Figure 21. In an example, would a bipolar RF electrode connection to the output of generator 900 be preferentially situated between the output labeled POWER? and the RETURN. In the case of a monopolar output, the preferred connections would be an active electrode (eg light beam or other probe) to the ENERGY output, and a suitable return block connected to the RETURN output.

[00267] Additional details are described 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 March 30, 2017, which is incorporated herein by reference in its entirety.

[00268] “As used throughout this description, the term “wireless” and its derivatives may be used to describe circuits, devices, systems, methods, techniques, communication channels, etc., which can communicate data through the use of of electromagnetic radiation modulated through a non-solid medium. The term does not imply that the associated devices do not contain any wires, although in some respects they may not. The communication module can implement any of a number of wireless and wired communication standards or protocols, including, but not limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20 , long-term evolution (LTE, "long-term evolution"), Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, Bluetooth, Ethernet derivatives thereof, as well as any other wireless and wired protocols that are designated as 3G, 4G, 5G, and beyond. The computing module may 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.

[00269] As used in the present invention a processor or processing unit is an electronic circuit that performs operations on some external data source, usually memory or some other data stream. 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".

[00270] As used here, a system-on-a-chip or system-on-chip (SoC or SOC) is an integrated circuit (also known as an "IC" or "chip") that integrates all the components of a computer or other components. 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. A SoC may or may not contain internal memory.

[00271] 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 may include a microcontroller as one of its components. A microcontroller may 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 distinct integrated circuits.

[00272] As used in the present invention, the term controller or microcontroller can be an independent chip or IC (integrated circuit) device that interfaces with a peripheral device. This could be a link between two parts of a computer or a controller on an external device that manages the operation of (and connection to) that device.

[00273] “Any of the processors or microcontroller in the present invention may 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 aspect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, comprising an integrated 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to optimize performance above 40 MHz, a 32 KB single-cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareO program, memory only programmable and electrically erasable readout (EEPROM) 2 KB, one or more pulse width modulation (PWM) modules, one or more analog quadrature encoder (QEI) inputs, one or more analog converters to 12-bit digital (ADC) with 12 analog input channels, details of which are available for the product data sheet.

[00274] In one aspect, the processor may comprise a security controller comprising two controller-based families, such as TMS570 and RM4x, known under the tradename Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for safety critical applications IEC 61508 and ISO 26262, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.

[00275] 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 surgical devices or 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. Control algorithms can be run on the modular device itself, on the central surgical controller to which the specific modular device is paired, or both on the modular device and on the central surgical controller (e.g. via a distributed computing architecture). In some examples, the modular devices' control algorithms control the devices based on data detected by the modular device itself (ie, by sensors in, on, or connected to the modular device). This data may be related to the patient being operated on (e.g. tissue properties or inflation pressure) or the modular device itself (e.g. the rate at which a knife is being advanced, motor current, or energy). For example, a control algorithm for a surgical stapling and cutting instrument might control the rate at which the instrument's motor drives its knife through the tissue according to the resistance encountered by the knife as it advances.

[00276] Figure 22 illustrates a form of a surgical system 1000 comprising a generator 1100 and various surgical instruments 1104, 1106 and 1108 that can be used with the generator, with the surgical instrument 1104 being an ultrasonic surgical instrument, the 1106 surgical instrument is an RF electrosurgical instrument, and the 1108 multipurpose surgical instrument is an ultrasonic/RF electrosurgical instrument combination. The 1100 generator is configurable for use with a variety of surgical instruments. In various ways, the generator 1100 can be configurable for use with different surgical instruments of different types, including, for example, the 1104 ultrasonic surgical instrument, the 1106 RF electrosurgical instruments, and the 1108 multifunctional surgical instrument that integrates energies. Ultrasonic and RF signals delivered simultaneously from the generator

1100. Although in the form of Figure 22 the generator 1100 is shown separate from the surgical instruments 1104, 1106, 1108 in one form, the generator 1100 may be integrally formed with any of the surgical instruments 1104, 1106 and 1108 to form a unitary surgical system. Generator 1100 comprises an input device 1110 located on a front panel of generator console 1100. Input device 1110 may comprise any suitable device that generates signals suitable for programming the operation of generator 1100. Generator 1100 may be configured for wired or wireless communication.

[00277] The generator 1100 is configured to drive multiple surgical instruments 1104, 1106, 1108. The first surgical instrument is an ultrasonic surgical instrument 1104 and comprises a handle 1105 (HP), an ultrasonic transducer 1120, a shaft of drive 1126 and an end actuator 1122. The end actuator 1122 comprises an ultrasonic blade 1128 acoustically coupled to the ultrasonic transducer 1120 and a grip arm 1140. The grip 1105 comprises a trigger 1143 for operating the grip arm 1140 and a combination of toggle buttons 1134a, 1134b, 1134c to energize and trigger the 1128 ultrasonic blade or other function. Toggle buttons 1134a, 1134b, 1134c can be configured to power the 1120 ultrasonic transducer with the 1100 generator.

[00278] The 1100 generator is also configured to drive a second surgical instrument 1106. The second surgical instrument

1106 is an RF electrosurgical instrument and comprises a handle 1107 (HP), a drive shaft 1127 and an end actuator 1124. The end actuator 1124 comprises electrodes on grip arms 1142a and 1142b and return through the end actuator 1124. electrically conductive portion of drive shaft 1127. Electrodes are coupled to and energized by a bipolar power source within generator 1100. Handle 1107 comprises a trigger 1145 for operating grip arms 1142a, 1142b and a power button 1135 to actuate a power switch to energize the electrodes on the 1124 end actuator.

[00279] The generator 1100 is also configured to drive a multi-purpose surgical instrument 1108. The multi-purpose surgical instrument 1108 comprises a handle 1109, a drive shaft 1129, and an end actuator 1125. The grip 1125 comprises an ultrasonic blade 1149 and a gripping arm 1146. The ultrasonic blade 1149 is acoustically coupled to the ultrasonic transducer 1120. The grip 1109 comprises a trigger 1147 for operating gripping arm 1146 and a combination of toggle buttons 1137a, 1137b , 1137c to power and trigger the 1149 ultrasonic blade or other function. Toggle buttons 1137a, 1137b, 1137c can be configured to power the ultrasonic transducer 1120 with the generator 1100 and power the ultrasonic blade 1149 with a bipolar power source also contained within the generator 1100.

[00280] The 1100 generator is configurable for use with a variety of surgical instruments. According to various forms, the generator 1100 can be configurable for use with different surgical instruments of different types, including, for example, the ultrasonic surgical instrument 1104, the RF surgical instrument 1106 and the multifunctional surgical instrument. 1108 that integrates ultrasonic and RF energies delivered simultaneously from 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 may be integrally formed. with any of the surgical instruments 1104, 1106, 1108 to form a unitary surgical system. As discussed above, generator 1100 comprises an input device 1110 located on a front panel of generator console 1100. Input device 1110 may comprise any suitable device that generates signals suitable for programming the operation of generator 1100. The generator 1100 may also comprise one or more output devices 1112. 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 title. reference in its entirety.

[00281] - Figure 23 is an end actuator 1122 of the ultrasonic exemplifying device 1104, in accordance with at least one aspect of the present disclosure. The end actuator 1122 may comprise a blade 1128 which can be coupled to the ultrasonic transducer 1120 through a Waveguide. When driven by the ultrasonic transducer 1120, the blade 1128 can vibrate and, when placed in contact with tissues, can cut and/or coagulate the same, as described in the present invention. In accordance with various aspects, and as illustrated in Figure 23, the end actuator 1122 may also comprise a gripping arm 1140 which may be configured for cooperative action with the blade 1128 of the end actuator 1122. 1128, the gripping arm 1140 may comprise a set of claws. Clamping arm 1140 may be pivotally connected to a distal end of a drive shaft 1126 of instrumental portion 1104. Clamping arm 1140 may include a tissue block for clamping arm 1163, which may be formed of Teflon& or other suitable low friction material. Block 1163 may be assembled for cooperation with blade 1128, with pivoting movement of grip arm 1140 which positions grip block 1163 in a substantially parallel relationship with and in contact with blade 1128. For this construction, a portion tissue to be tightened can get caught between the tissue block 1163 and the blade

1128. The tissue block 1163 may be provided with a sawtooth-like configuration including a plurality of axially spaced and proximally extending gripping teeth 1161 to improve gripping of tissue in cooperation with the blade.

1128. Gripping arm 1140 may transition from the open position shown in Figure 23 to a closed position (with gripping arm 1140 in contact with or near blade 1128) in any suitable manner. For example, the 1105 handle may comprise a jaw-closing trigger. When actuated by a clinician, the jaw-closing trigger can rotate the 1140 grip arm in any suitable manner.

[00282] “The 1100 generator can be activated to provide the drive signal to the 1120 ultrasonic transducer in any suitable manner. For example, generator 1100 may comprise a foot switch 1430 (Figure 24) coupled to generator 1100 via a foot switch cable 1432. A clinician may activate the ultrasonic transducer 1120 and thereby the ultrasonic transducer 1120 and blade 1128 by pressing foot switch 1430. In addition, or instead of foot switch 1430, some aspects of the 1104 ultrasonic device may utilize one or more switches positioned on handle 1105 which, when activated, may cause the generator to 1100 activate the ultrasonic transducer 1120. In one aspect, for example, the one or more switches may comprise a pair of toggle buttons 1134a, 1134b,

1134c (Figure 22), for example, to determine a mode of operation of device 1104. When toggle button 1134a is pressed, for example, ultrasonic generator 1100 can provide a maximum drive signal to transducer 1120, causing that it produces maximum ultrasonic energy output. Pressing the 1134b toggle button may cause the 1100 ultrasonic generator to provide a user selectable trigger signal to the 1120 ultrasonic transducer, causing the 1120 ultrasonic transducer to produce less than the maximum ultrasonic power output. Device 1104 may additionally or alternatively comprise a second key for, for example, indicating a position of a jaw-closing trigger for operating the jaws through gripping arm 1140 of end actuator 1122. In some respects, the 1100 ultrasonic generator can be activated based on the position of the jaw-closing trigger, (e.g., as the clinician presses the jaw-closing trigger to close through the 1140 clamping arm, ultrasonic energy may be applied ).

[00283] In addition or alternatively, the one or more switches may comprise a toggle button 1134c which, when pressed, causes generator 1100 to provide a pulsed output (Figure 22). Pulses can be provided at any suitable frequency and grouping, for example. In certain aspects, the power level of the pulses may consist of the power levels associated with the toggle buttons 1134a, 1134b (maximum, less than maximum), for example.

[00284] It will be recognized that a device 1104 may comprise any combination of toggle buttons 1134a, 1134b, 1134c (Figure 22). For example, the 1104 device could be configured to have only two toggle buttons: a toggle button 1134a to produce maximum ultrasonic power output, and a toggle button 1134c to produce a pulsed output, either at the PO level. - maximum voltage or less than the maximum. Thus, the output configuration of the drive signal of generator 1100 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 setting can be controlled based, for example, on the EEPROM settings on the 1100 generator and/or user power level selections.

[00285] In certain respects, a two-position switch may be offered as an alternative to a toggle switch 1134c (Figure 22). For example, a device 1104 may include a toggle switch 1134a to produce continuous output at a maximum power level and a two-position toggle switch 1134b. In a first predetermined position, toggle switch 1134b can produce a continuous output at a power level less than the maximum, and in a second detent position, toggle switch 1134b can produce a pulsed output (e.g. , at a maximum or lower power level than the maximum, depending on the EEPROM configuration).

[00286] 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 generator 1100, for example, via a cable. The electrodes can be used, for example, to measure an impedance of a portion of tissue present between the gripping arm 1142a, 1146 and the blade 1142b, 1149. Generator 1100 can provide a signal (e.g., a non-therapeutic signal) to electrodes. The tissue portion impedance can be found, for example, by monitoring current, voltage, etc. of the signal.

[00287] In various aspects, the generator 1100 may comprise several separate functional elements such as modules and/or blocks, as shown in Figure 24, a diagram of the surgical system 1000 of Figure 22. Different modules or functional elements may be configured to drive different types of surgical devices 1104, 1106, 1108. For example, an ultrasonic generator module can drive an ultrasonic device such as the ultrasonic instrument

1104. A generator module for electrosurgery/RF can drive the electrosurgical device 1106. The modules can generate the respective drive signals to drive the surgical devices 1104, 1106,

1108. In various respects, each of the ultrasonic generator module and/or the electrosurgery/RF generator module can be formed integrally with the 1100 generator. Alternatively, one or more of the modules can be supplied as a separate circuit module electrically coupled to the 1100 generator. (Modules are shown in dashed line to illustrate this option.) In addition, in some respects the electrosurgery/RF generator module can be formed integrally with the module. ultrasonic generator, or vice versa.

[00288] “According to the good aspects described, the ultrasonic generator module can produce one or more drive signals with specific voltages, currents and frequencies (for example, 55,500 cycles per second, or Hz). The one or more trigger signals may be provided to the ultrasonic device 1104, and specifically to the transducer 1120, which may operate, for example, as described above. In one aspect, generator 1100 can be configured to produce a drive signal of a specific voltage, current, and/or frequency output signal that can be performed with high resolution, accuracy, and repeatability.

[00289] According to the aspects described, the generator module for electrosurgery/RF can generate one or more trigger signals with sufficient energy output to perform bipolar electrosurgery using radio frequency (RF) energy. In bipolar electrosurgery applications, the trigger signal can be provided, for example,

to the electrodes of the 1106 electrosurgical device, for example, as described above. Accordingly, generator 1100 can be configured for therapeutic purposes by applying sufficient electrical energy to tissue to treat said tissue (eg, coagulation, cauterization, tissue welding, etc.).

[00290] Generator 1100 may comprise an input device 2150 (Figure 27B) situated, for example, on a front panel of generator console 1100. Input device 2150 may comprise any suitable device that generates suitable signals. to program the operation of the generator 1100. In operation, the user may program or otherwise control the operation of the generator 1100 using input device 2150. Input device 2150 may comprise any suitable device that generates signals that can be used by the generator (e.g., by one or more processors contained in the generator) to control the operation of the 1100 generator (e.g., 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, switches, rotary controls, keyboard, numeric keypad, touchscreen monitor, pointing device, and remote connection to a general-purpose computer. or dedicated. In other aspects, input device 2150 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 operating parameters of the generator, such as current (|), voltage (V), frequency (f) and/or period (T) of one or more voltage signals. actuation generated by the ultrasonic generator module and/or by the generator module for electrosurgery/RF.

[00291] Generator 1100 may comprise an output device 2140 (Figure 27B) situated, for example, on a front panel of generator console 1100. Output device 2140 includes one or more devices for providing the user with sensory feedback. serial. These devices may comprise, for example, visual feedback devices (for example, a monitor with an LCD screen, LED indicators), audio feedback devices (for example, a loudspeaker, a doorbell) or tactile feedback (eg haptic actuators).

[00292] Although certain modules and/or blocks of the generator 1100 can be described by way of example, it must be considered that a greater or lesser number of modules and/or blocks can be used and still be in the scope of the aspects. Additionally, although various aspects can be described in terms of modules and/or blocks for ease of description, these modules and/or blocks can be implemented by one or more hardware components, e.g. processors, digital signal processors ( DSPs), programmable logic devices (PLDs), application-specific integrated circuits (ASICs), circuits, registers, and/or software components, e.g., programs, subroutines, logic, and/or combinations of hardware and software components .

[00293] In one aspect, the ultrasonic generator drive module and the 1110 electrosurgery/RF drive module (Figure 22) may comprise one or more integrated applications, implemented as firmware, software, hardware, or any combination thereof. . Modules can comprise various executable modules, such as software, programs, data, triggers, and application program interfaces (APIs), among others. Firmware can be stored in non-volatile memory (NVM), such as bitmasked read-only memory (ROM),

or flash memory. In many implementations, storing the firmware in ROM can preserve flash memory. The NVM may comprise other types of memory including, for example, programmable ROM (PROM, from "programmable ROM"), erasable programmable ROM (EPROM, from "erasable programmable ROM"), electrically erasable programmable ROM (EEPROM, "electrically erasable programmable ROM"), or battery-backed random-access memory (RAM) such as dynamic RAM (DRAM), dual-rate DRAM (DDRAM, for "Double-Data-Rate DRAM"), and/or synchronous DRAM (SDRAM, for "synchronous DRAM").

[00294] 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 trigger signal or signals for operation. of devices 1104, 1106, 1108. In aspects where generator 1100 is used in conjunction with device 1104, the trigger signal may drive ultrasonic transducer 1120 in surgical cutting and/or coagulation modes. The electrical characteristics of the device 1104 and/or tissue can be measured and used to control the operational aspects of the generator 1100 and/or be provided as feedback to the user. In aspects where generator 1100 is used in conjunction with device 1106, the trigger signal may supply electrical energy (eg, RF energy) to end actuator 1124 in cutting, coagulation, and/or desiccation modes. The electrical characteristics of the device 1106 and/or the tissue can be measured and used to control the operational aspects of the generator 1100 and/or be provided as feedback to the user. In many respects, as previously discussed, hardware components can be implemented as PSD, PLD, ASIC, circuits and/or registers. In one aspect, the processor may be configured to store and execute computer software program instructions so as to generate the step function output signals for driving various components of devices 1104, 1106, 1108, such as the 1120 ultrasonic transducer and 1122, 1124, 1125 end actuators.

[00295] An electromechanical ultrasonic system includes an ultrasonic transducer, a waveguide, and an ultrasonic blade. The electromechanical ultrasonic system has an initial resonant 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 V,(t) and an alternating current /7(t) equal to the resonant frequency of the electromechanical ultrasonic system. When the electromechanical ultrasonic system is in resonance, the phase difference between the voltage signals Va(t) and current signals /74(t) is zero. In other words, at resonance the inductive impedance is equal to the capacitive impedance. As the ultrasonic blade heats up, the conformance of the ultrasonic blade (modeled as an equivalent capacitance) causes the resonant frequency of the electromechanical ultrasonic system to shift. In this way, the inductive impedance is no longer equal to the capacitive impedance causing a difference between the drive frequency and the resonant frequency of the electromechanical ultrasonic system. The system is now operating "out of resonance". The difference between the drive frequency and the resonant frequency is manifested as a phase difference between the voltage V,1(t) and current signals Ia(t) applied to the ultrasonic transducer. The electronic circuits of the generator can easily monitor the phase difference between the voltage Va(t) and current /4(t) signals and can continuously adjust the drive frequency until the phase difference is more than one. time equals zero. At this point, the new drive frequency is equal to the resonant 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 blade.

[00296] “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 “moving” branch that has an inductance, series-connected resistance and capacitance 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 drive signal current flows into the moving branch. Consequently, through the use of a tuning inductor, the generator drive signal current represents the branch current in motion, and the generator is thus able to control its drive signal to maintain the resonant frequency. of the ultrasonic transducer. The tuning inductor can also transform the phase impedance curve of the ultrasonic transducer to optimize the generator's frequency locking capabilities. However, the tuning inductor needs to be matched to the specific static capacitance of an ultrasonic transducer at the operating resonant frequency. In other words, a different ultrasonic transducer having a different static capacitance needs a different inductor tuning.

[00297] Figure 25 illustrates an equivalent circuit 1500 of an ultrasonic transducer, such as the ultrasonic transducer 1120, according to one aspect. Circuit 1500 comprises a first "moving" branch having, connected in series, inductance Ls, resistance Rs; and capacitance Cs which define the electromechanical properties of the resonator, and a second capacitive branch having a static capacitance Co. The drive current lg(t)pbode can be received from a generator at a drive voltage Va(t), with the motion current /m(t) flowing through the first branch and the current /l7(t)-Im(t) flowing through the capacitive branch. Control of the electromechanical properties of the ultrasonic transducer can be obtained by properly controlling /,(t) and Va(t). As explained above, conventional generator architectures can include a tuning inductor L: (shown in dashed line in Figure 25) to cancel, in a parallel resonance circuit, the static capacitance Co at a frequency of resonance, so that substantially all of the generator current output /g(t) flows through the motion branch. In this way, the current control of the movement branch /m(t) is obtained by controlling the current output of the generator /14(t). The tuning inductor Lt is specific to the static capacitance Co of an ultrasonic transducer, however, and a different ultrasonic transducer having a different static capacitance requires a different tuning inductor Li. Also, like the tuning inductor Lt correlates to the nominal value of the static capacitance Co at a single resonant frequency, accurate control of the motion branch current Im(t) is guaranteed only at that frequency. As the frequency shifts downward with the temperature of the transducer, accurate control of the motion branch current is compromised.

[00298] —Generator 1100 forms may not rely on a tuning inductor L: to monitor motion branch current Im(t). Instead, the 1100 generator can use the measured value of static capacitance Co between power applications for a specific 1104 ultrasonic surgical device (along with drive signal voltage and current feedback data) to determine the motion branch current values /m(t) on a dynamic and continuous basis (eg real-time). These forms of generator 1100 are therefore capable of providing virtual tuning to simulate a system that is tuned or resonant with any value of static capacitance Co at any frequency, not just a single resonant frequency imposed by a nominal value of static capacitance Co.

[00299] Figure 26 is a simplified block diagram of one aspect of the generator 1100, to provide inductorless tuning 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 patient stage 1520 in communication with an unisolated stage 1540 via a power transformer 1560. A secondary winding 1580 of power transformer 1560 is contained in isolated stage 1520 and may comprise a tapped configuration (e.g. a center tapped or non center tapped configuration) to set 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 provide a trigger signal (for example, a trigger signal at 420 V RMS) to an ultrasonic instrument 1104, and the trigger signal outputs 1600a, 1600b, and 1600c can provide a trigger signal (for example, a trigger signal 100V RMS) to an electrosurgical device 1106, with the output 1600b corresponding to the center tap of the power transformer 1560. The uninsulated stage 1540 may comprise a power amplifier 1620 that has an output connected to a primary winding 1640 of power transformer 1560. In certain aspects, power amplifier 1620 may comprise a push-pull type amplifier, for example. The non-isolated stage 1540 may further comprise a programmable logic device 1660 for providing a digital output to a digital-to-analog converter (DAC) 1680 which, in turn, provides an analog signal corresponding to an input of the power amplifier 1620. In certain aspects, programmable logic device 1660 may comprise a field programmable gate array (FPGA), for example. Programmable logic device 1660, by controlling the input of power amplifier 1620 through DAC 1680, can therefore control any of a number of parameters (e.g., frequency, waveform, waveform amplitude, ) of trigger signals appearing on trigger signal outputs 1600a, 1600b, and 1600c. In certain aspects and as discussed below, programmable logic device 1660, in conjunction with a processor (e.g., processor 1740 discussed below), may implement a number of control algorithms based on digital signal processing (DSP) and/or or other control algorithms for control parameters of the trigger signals provided by the 1100 generator.

[00300] Power can be supplied to a 1620 power amplifier power rail by a switch mode regulator

1700. In certain aspects, switch mode regulator 1700 may comprise an adjustable voltage regulator, for example. As discussed above, the non-isolated stage 1540 may further comprise a processor 1740 which in one aspect may comprise a DSP processor such as an ADSP-21469 SHARC DSP, available from Analog Devices, Norwood, Mass., USA, for example. In certain respects, processor 1740 may control the operation of switch-mode power converter 1700 responsive to voltage feedback data received from power amplifier 1620 by the processor.

1740 via an analog-to-digital converter (DAC) 1760. In one aspect, for example, the processor 1740 may receive as input, through the ADC 1760, the waveform envelope of a signal (for example , an RF signal) being amplified by power amplifier 1620. Processor 1740 may then control key-mode regulator 1700 (e.g., via a pulse-width modulated ("PWM") output. modulated) so that the rail voltage supplied to the power amplifier 1620 follows the waveform envelope of the amplified signal. Dynamically modulating the rail voltage of the power amplifier 1620 based on the waveform envelope. wave, the efficiency of the 1620 power amplifier can be significantly improved over a fixed-rail voltage amplifier scheme. The 1740 processor can be configured for wired or wireless communication.

[00301] In certain respects and as discussed in further detail in connection with Figures 28A and 28B, the programmable logic device 1660, in conjunction with the processor 1740, can implement a direct digital synthesizer control scheme. (DDS) to control the waveform, frequency, and/or amplitude of trigger signals provided by generator 1100. In one aspect, for example, programmable logic device 1660 may implement a DDS control algorithm 2680 (Figure 28A). ) by retrieving waveform samples stored in a dynamically updated lookup table (LUT), such as a LUT RAM that can be integrated into an FPGA. This control algorithm is particularly useful for ultrasonic applications where an ultrasonic transducer, such as the 1120 ultrasonic transducer, can be driven by a clean sinusoidal current at its resonant frequency. As other frequencies can excite parasitic resonances, mini-

mizing or reducing the total distortion of the motion branch current can correspondingly minimize or reduce the undesired effects of 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 (e.g., power transformer 1560, power amplifier 1620), Voltage and current feedback data based on the trigger signal can be fed to an algorithm, such as an error control algorithm implemented by the 1740 processor, that compensates for distortion by properly pre-distorting or modifying the sample shapes of waveforms stored in the LUT on a dynamic and continuous basis (e.g. in real time). In one aspect, the amount or degree of predistortion applied to LUT samples may be based on the error between a computerized motion branch current and a desired waveform of the current, with the error being determined in a sample-by-sample basis. In this way, pre-distorted LUT samples, when processed through the trigger circuit, can result in a motion branch trigger signal that has the desired waveform (e.g., sinusoidal) to trigger optimally. the ultrasonic transducer. 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 motion branch trigger signal, when distortion effects are taken into account.

[00302] “The uninsulated 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 drive signals emitted by the 1100 generator. In certain respects, the 1780 and 1800 ADCs can be configured to sample at high speeds (eg, 80 Msps) to enable oversampling of trigger signals. In one respect, for example, the sampling speed of the 1780 and 1800 ADCs can enable approximately 200X oversampling (depending on the trigger frequency) of the trigger signals. In certain respects, the sampling operations of the 1780, 1800 ADCs can be performed by a single ADC receiving input voltage and current signals through a bidirectional multiplexer. The use of high-speed sampling on 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 waveform control based on DDS described above), accurate digital filtering of the sampled signals, and calculation of the actual power consumption with a high degree of accuracy. Voltage and current feedback data provided by ADCs 1780 and 1800 can be received and processed (e.g., FIFO-type buffering, multiplexing) by programmable logic device 1660 and stored in data memory for subsequent retrieval, for example by the processor

1740. As noted above, voltage and current feedback data can be used as input to an algorithm to pre-distort or modify waveform samples in the LUT dynamically and continuously. In certain respects, this may require that each pair of stored voltage and current feedback data be indexed based on, or otherwise associated with, a sample of the corresponding LUT that was provided by the programmable logic device 1660 when the pair of voltage and current feedback data was captured. Synchronizing the LUT samples with the voltage and current feedback data in this way contributes to the correct timing and stability of the pre-distortion algorithm.

[00303] In certain aspects, voltage and current feedback data can be used to control the frequency and/or amplitude (eg current amplitude) of drive signals. In one aspect, for example, voltage and current feedback data can be used to determine the impedance phase, for example, the phase difference between voltage and current trigger signals. The frequency of the trigger signal can then be controlled to minimize or reduce the difference between the determined impedance phase and an impedance phase set point (e.g. 0°), thus minimizing or reducing the effects of distortion. harmonic and correspondingly enhancing the accuracy of the impedance phase measurement. Phase impedance determination 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.

[00304] The impedance phase can be determined through Fourier analysis. In one aspect, the phase difference between the generator voltage drive signals V,(t) and the generator current /a(t) can be determined using the fast Fourier transform (FFT) or the discrete transform Fourier method (DFT) as shown below: Vac = A, cos(2nfot + q) Igtw = 42 cos(2nfot + q.) Flight = 6 = fo) + SG + fo)) exp (f2ns 2)

logo = PSF fo) + 8F + fo) exv (iens L2) 2 2n7fo

[00305] The evaluation of the Fourier transform at the sine frequency produces: A, 2 Vac = 2 500) expGo) arg V(fo) = 4, Az : Ig = 2 5(0) expg2) arg I1(fo ) = ox

[00306] Other approaches include weighted least squares estimation, Kalman filtering, and space- and vector-based techniques. Virtually all the processing in an FFT or DFT technique can be performed in the digital domain with the aid of the high-speed two-channel ADC, 1780, 1800, for example. In one technique, digital signal samples of voltage and current signals are Fourier transformed with an FFT or a DFT. The phase angle q at any point in time can be calculated by: çq=27nftt+qo, where q is the phase angle, f is the frequency, t is the time, and qo is the phase not=0.

[00307] Another technique for determining the phase difference between voltage signals V,(t) and current signals /7(t) is the zero-crossing method and produces highly accurate results. For voltage signals V,(t) and current /7(t) having the same, each zero crossing from negative to positive of voltage signal Va(t) triggers the start of a pulse, while each zero crossing of negative to positive current signal /74(t) triggers the end of the pulse. The result is a pulse train with a pulse width proportional to the phase angle between the voltage signal and the current signal. In one aspect, the pulse train can be passed through an averaging filter to produce a measure of the phase difference. Furthermore, if zero crossings from positive to negative are also used in a similar way, and the results are averaged, any effects of dc components and harmonics can be reduced. In one implementation, analog voltage V,(t) and current Il9(t) signals are converted to 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 highs and lows. In one aspect, a Schmitt trigger along with an RC stabilization network can be used to convert analog signals to digital signals. In other respects, an auxiliary and edge-triggered RS flip-flop circuit can be used. In yet another aspect, the zero crossing technique can use an exclusive OR (XOR) gate.

[00308] 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 cross-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://Awww.engnetbase. com>, which is incorporated herein by reference.

[00309] In another aspect, for example, current feedback data can be monitored to maintain the current amplitude of the trigger signal at a current amplitude setpoint. The current span setpoint can be specified directly or determined indirectly based on the specified voltage and power span setpoints. In certain respects, control of the current amplitude may be implemented by the control algorithm, such as a proportional-integral-derived (PID) control algorithm, in the 1740 processor. The variables controlled by the control algorithm to properly control the current amplitude of the trigger signal may include, for example, scaling the LUT waveform samples stored in the programmable logic device 1660 and/or the full scale output voltage of the DAC 1680 circuit (which provides input to the power 1620) through a DAC 1860 circuit.

[00310] The non-isolated 1540 stage may also contain a 1900 processor to provide, among other things, user interface (UI) functionality. In one aspect, the processor 1900 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 user feedback, communication with peripheral devices (for example, through a universal serial bus (USB) interface), communication with the footswitch 1430, communication with an input device 2150 (eg, a touch screen), and communication with an output device 2140 (eg, a speaker). Processor 1900 can communicate with processor 1740 and programmable logic device (eg, via serial peripheral interface (SPI) buses). While 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 (e.g., 2150 touchscreen inputs, 1430 footswitch inputs, 1430 temperature sensor inputs, etc.). 2160) and can disable the generator drive output 1100 when an error condition is detected.

[00311] In certain respects, both processor 1740 (Figure 26, 27A) and processor 1900 (Figure 26, 27B) may determine and monitor the operating state of generator 1100. For processor 1740, the operating state of generator 1100 may determine , for example, which control and/or diagnostic processes are implemented by the processor

1740. For processor 1900, the operating state of generator 1100 can determine, for example, which elements of a user interface (eg, monitor screens, sounds) are presented to a user. Processors 1740 and 1900, respectively, can independently maintain the current operating state of generator 1100, and recognize and evaluate possible transitions out of the current operating state. The 1740 processor can function as the master in this relationship and can determine when transitions between operating states should occur. The 1900 processor can be aware of valid transitions between operational states and can confirm that a given transition is appropriate. For example, when processor 1740 instructs processor 1900 to transition to a specific state, processor 1900 can verify that the requested transition is valid. If a requested transition between states is determined to be invalid by processor 1900, processor 1900 may cause generator 1100 to enter a failure mode.

[00312] The non-isolated stage 1540 may further comprise a controller 1960 (Figures 26, 27B) for monitoring the input devices 2150 (e.g., a capacitive touch sensor used to turn generator 1100 on and off, a capacitive display touch sensitive).

In certain aspects, controller 1960 may comprise at least one processor and/or other controller device in communication with processor 1900. In one aspect, for example, controller 1960 may comprise a processor (e.g., an 8-bit Mega168 controller). available from Atmel) configured to monitor user actions via one or more capacitive touch sensors. In one aspect, the 1960 controller may comprise a touchscreen controller (e.g., a QT5480 touchscreen controller available from Atmel) to control and manage the capture of touch data from a capacitive touch screen.

[00313] In certain respects, when generator 1100 is in an "off" state, controller 1960 may continue to receive operating power (e.g., through a line from a power supply to generator 1100, such as the 2110 power supply (Figure 26) discussed below). In this way, the 1960 controller can continue to monitor an input device 2150 (for example, a capacitive touch sensor located on a front panel of the generator 1100) to turn the generator 1100 on and off. When the generator 1100 is in the off state, the 1960 controller can wake up the power supply (e.g. enable one or more 2130 DC/DC voltage converters (Figure 26) from the 2110 power supply to operate), if activation of the 2110 power supply is detected. 2150 "on/off" input device by a user. Controller 1960 can therefore initiate a sequence to transition generator 1100 to an "on" state. On the other hand, controller 1960 may initiate a sequence to transition generator 1100 to the off state if activation of "on/off" input device 2150 is detected when generator 1100 is in the on state. . In certain respects, for example, controller 1960 may report activation of "on/off" input device 2150 to processor 1900 which, in turn, implements the process sequence necessary to transition generator 1100 to the off state. In these respects, the controller 1960 may not have any independent capability to cause the generator 1100 to remove power after its on state has been established.

[00314] In certain aspects, the controller 1960 may cause the generator 1100 to provide audible 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.

[00315] In certain respects, the isolated stage 1520 may comprise an instrument interface circuit 1980 to, for example, provide a communication interface between a control circuit of a surgical device (e.g., a control circuit of a surgical device). control comprising grip switches) and 1540 non-isolated stage components, such as the 1660 programmable logic device, 1740 processor, and/or 1900 processor. The 1980 instrument interface circuit can exchange information with non-isolated stage components 1540 via a communication link that maintains an adequate degree of electrical isolation between the 1520 and 1540 stages, such as an infrared (IR) based communication link. Power can be supplied to the interface circuit of the 1980 instrument using, for example, a low-loss voltage regulator powered by an isolation transformer driven from the non-isolated 1540 stage.

[00316] In one aspect, the instrument interface circuit 1980 may 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 may be configured to receive a periodic signal from programmable logic device 2000 (e.g., a 2 kHz square wave) to generate a bipolar interrogation signal that has an identical frequency. The interrogation signal can be generated, for example, using a bipolar current source powered by a differential amplifier. The interrogation signal may be communicated to a surgical device control circuit (for example, by using a lead pair on a wire connecting the 1100 generator to the surgical device) and monitored to determine a state or configuration of the surgical device. control circuit. The control circuit may comprise a number of switches, resistors and/or diodes to modify one or more characteristics (e.g. amplitude, rectification) of the interrogation signal so that a state or configuration of the control circuit is discernible, so that unequivocally, based on this one or more characteristics. In one aspect, for example, the signal conditioning circuit 2020 may comprise an ADC for generating samples of a voltage signal appearing between inputs of the control circuit that result from the interrogation signal passing therethrough. The programmable logic device 2000 (or a component of the non-isolated stage 1540) can then determine the state or configuration of the control circuit based on the ADC samples.

[00317] In one aspect, the instrument interface circuit 1980 may comprise a first data circuit interface 2040 to enable the exchange of information between the programmable logic device 2000 (or other instrument interface circuit element 1980) and a first data circuit disposed in, or otherwise associated with, a surgical device. In certain aspects, for example, a first data circuit 2060 may be disposed on a wire integrally attached to a surgical device handle, or in an adapter to interface a specific type or model of surgical device and the generator. 1100. In certain aspects, the first data circuit may comprise a non-volatile storage device, such as an electrically erasable programmable read-only memory (EEPROM) device. 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 suitable circuitry (e.g. separate logic devices, a processor) to enable communication between the programmable logic device 2000 and the first data circuit. In other aspects, the first data circuit interface 2040 may be integral to the programmable logic device 2000.

[00318] In certain aspects, the first data circuit 2060 may 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 (e.g., programmable logic device 2000), transferred to a component of non-isolated stage 1540 (e.g., programmable logic device 1660, processor 1740 and/or processor 1900) for presentation to a user via an output device 2140 and/or for controlling a function or operation of generator 1100. Additionally, any type of information may be communicated to the first data circuit 2060 for storage thereon via first data circuit interface 2040 (e.g. using 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.

[00319] As discussed earlier, a surgical instrument may be removable from a handle (eg, instrument 1106 may be removable from 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 settings being used, as well as to optimize control and diagnostic processes as needed. Adding readable data circuitry 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 backwards compatible with generators lacking 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.

[00320] — Additionally, aspects of the 1100 generator may enable communication with instrument-based data circuits. For example, generator 1100 may be configured to communicate with a second data circuit (e.g., a data circuit) contained in an instrument (e.g., instrument 1104, 1106, or 1108) of a surgical device. 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 may generally be any circuit for transmitting and/or receiving data. In one aspect, for example, the second data circuit may 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 may be communicated to the second data circuit for storage therein through the second data circuit interface 2100 (e.g., using programmable logic device 2000). This information may include, for example, an up-to-date number of operations in which the surgical instrument was used and/or the dates and/or times of its use. In certain aspects, the second data circuit may transmit data captured by one or more sensors (eg, an instrument-based temperature sensor). In certain aspects, the second data circuit may receive data from generator 1100 and provide an indication to the user (eg, an LED indication or other visible indication) based on the data received.

[00321] In certain aspects, the second data circuit and the second data circuit interface 2100 can be configured so that communication between the programmable logic device 2000 and the second data circuit can be done without the need to install conductors additional elements for this purpose (for example, dedicated conductors of a cable 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 one-wire bus communication scheme, implemented in existing wiring, as one of the conductors used transmitting interrogation signals. from the 2020 signal conditioning circuit to a control circuit in a handle. In this way, changes or modifications to the design of the surgical device that might otherwise be necessary are minimized or reduced. Furthermore, 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 the indispensable data read-out functionality, which therefore allows for surgical device instrument backward compatibility.

[00322] In certain respects, isolated stage 1520 may comprise at least one blocking capacitor 2960-1 (Figure 27C) connected to the trigger signal output 1600b, to prevent direct current passing 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, this type of failure can still have negative consequences. In one aspect, a second blocking capacitor 2960-2 can be placed in series with the blocking capacitor 2960-1, with one point leakage current between the blocking capacitors 2960-1 and 2960-2 being monitored by, for example, an ADC 2980 for sampling a voltage induced by the leakage current. Samples can be received by programmable logic device 2000, for example. Based on changes in leakage current (as indicated by the voltage samples in Figure 26 aspect), generator 1100 can determine when at least one of blocking capacitors 2960-1 and 2960-2 has failed. Consequently, the appearance of Figure 26 can provide a benefit over single-capacitor designs having a single point of failure.

[00323] In certain respects, the unisolated stage 1540 may comprise a power supply 2110 for outputting DC power 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 output from the power supply to generate DC outputs at the voltages and currents required by the various components of the power supply. generator 1100. As discussed above with respect to controller 1960, one or more of the DC/DC voltage converters 2130 can receive an input from controller 1960 when activation of "on/off" input device 2150 by a user is detected by the 1960 controller, to allow the 2130 DC/DC voltage converters to run or wake up.

[00324] —Figures 28A and 28B illustrate certain functional and structural aspects of an aspect of generator 1100. Feedback indicating current and voltage output from secondary winding 1580 of power transformer 1560 is received by ADCs 1780 and 1800 , respectively. As shown, the 1780 and 1800 ADCs can be implemented as a 2-channel ADC and can sample the feedback signals at a high speed (e.g. 80 Msps) to allow for oversampling (e.g. approx. 200x oversampling) of the trigger signals. Current and voltage feedback signals can be suitably conditioned in the analog domain (eg, amplified, filtered) prior to processing by the 1780 and 1800 ADCs. The current and voltage feedback samples from the 1780 and 1780 ADCs 1800 can be individually stored in a temporary memory ("buffer") and subsequently multiplexed or interleaved into a single data stream within block 2120 of programmable logic device 1660. In the aspect of Figures 28A and 28B, programmable logic device 1660 comprises an FPGA.

[00325] The multiplexed current and voltage feedback samples can be received by a data capture parallel port (PDAP) implemented inside the processor block 2144

1740. The PDAP may comprise a packaging unit to implement any of a number of methodologies for correlating feedback samples multiplexed with a memory address. In one aspect, for example, feedback samples corresponding to a specific LUT sample output by programmable logic device 1660 may be stored in one or more memory addresses that are correlated or indexed to the sample's LUT address. of LUT. In another aspect, feedback samples corresponding to a specific LUT sample by programmable logic device 1660 can be stored, along with the LUT address of the LUT sample, in a common memory location. In any case, the feedback samples can be stored so that the address of the LUT sample from which a specific set of feedback samples originated can be subsequently determined. As discussed above, synchronizing the addresses of the LUT samples and the feedback samples in this way contributes to the correct timing and stability of the predistortion algorithm. A direct memory access (AMD) controller implemented in block 2166 of processor 1740 may store the feedback samples (and any LUT sample address data, where applicable) in a designated memory location 2180 of the processor. 1740 (eg internal RAM).

[00326] Block 2200 of processor 1740 may implement a pre-warping algorithm to pre-warp or modify LUT samples stored in programmable logic device 1660 on a dynamic and continuous basis. As discussed above, pre-distortion of LUT samples can compensate for various sources of distortion present in the output drive circuit of generator 1100. Pre-distorted LUT samples when processed through the drive circuit will therefore result , into a drive signal having the desired waveform (eg, sinusoidal) to optimally drive the ultrasonic transducer.

[00327] —In block 2220 of the pre-distortion algorithm, the current through the motion branch of the ultrasonic transducer is determined. The motion branch current can be determined using Kirchoff's current law based, for example, on current and voltage feedback samples stored in memory location 2180 (which when properly sized, can be representative of of lg and Vg in the model of Figure 25 discussed above), a value of the static capacitance of the ultrasonic transducer Co (measured or known a priori) and a known value of the drive frequency. A motion branch current sample can be determined for each set of stored current and voltage feedback samples associated with an LUT sample.

[00328] “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 waveform current waveform to determine a difference, or amplitude error. of the sample, between the samples compared. For this determination, the desired current waveform sample can be supplied, for example, from a waveform LUT 2260 containing amplitude samples for one cycle of a desired current waveform. The specific 2260 LUT current waveform sample used for the comparison can be determined by the LUT sample address associated with the motion branch current sample used in the comparison. Consequently, the motion branch current input at block 2240 can be synchronized with its associated LUT sample address input at block 2240. LUT samples stored in programmable logic device 1660 and LUT samples stored in the LUT of 2260 waveforms can therefore be equal in number. In certain respects, the desired current waveform, represented by the LUT samples stored in the 2260 waveform LUT, may be a fundamental sine wave. Other waveforms may be desirable. For example, it is contemplated that a fundamental sine wave could be used to drive the main longitudinal motion of an ultrasonic transducer, superimposed on one or more other drive signals at other frequencies, such as an ultrasonic waveform. third order to trigger at least two mechanical resonances in order to obtain beneficial vibrations in transverse mode or other modes.

[00329] Each sample amplitude error value determined in block 2240 can be transmitted to the LUT of programmable logic device 1660 (shown in block 2280 in Figure 28A) along 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), the LUT 2280 (or other con- - 1660 programmable logic device trolley) can pre-distort or modify the sample value of the LUT stored in 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 iteratively over the LUT address range will cause the waveform of the generator output current to match or adapt to the desired shape of the LUT. current wave, represented by the LUT 2260 samples of waveforms.

[00330] Current and voltage amplitude measurements, power measurements, and impedance measurements can be determined in block 2300 of processor 1740 based on current and voltage feedback samples stored in memory location 2180. Before From the determination of these quantities, the feedback samples can be suitably sized and, in certain respects, processed through a suitable 2320 filter to remove noise resulting from, for example, the data capture process and components. induced harmonics. The filtered voltage and current samples can therefore substantially represent the fundamental frequency of the generator drive output signal. In certain aspects, filter 2320 may be a finite impulse response (FIR) filter applied in the frequency domain. These aspects can use the fast Fourier transform (FFT) of the current and voltage output signals of the drive signal. In certain aspects, the resulting frequency spectrum can be used to provide additional functionality to the generator. In one aspect, for example, the ratio between the second and/or third order harmonic component in relation to the fundamental frequency component can be used as a diagnostic indicator.

[00331] In block 2340 (Figure 28B), a root-mean-square (RMS) calculation can be applied to a sample size of current feedback samples representing an integral number of cycles of the trigger signal, to generate a lms measurement representing the drive signal output current.

[00332] In block 2360, a root-mean-square (RMS) calculation can be applied to a sample size of voltage feedback samples representing an integral number of cycles of the trigger signal, to determine a Vmms measurement representing the output voltage of the trigger signal.

[00333] In block 2380, the current and voltage feedback samples can be multiplied point by point, and an average calculation is applied to the samples representing an integral number of cycles of the trigger signal, to determine a measurement Pr; of the actual output power of the generator.

[00334] In block 2400, the measurement Pa of the apparent output power of the generator can be determined as the product Vrms'lrms.

[00335] In block 2420, the load impedance magnitude Zm measurement can be determined as the quotient Vrms/lrms-

[00336] In certain respects, 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 and/or diagnostic processes. In certain respects, any of these quantities may be communicated to a user through, for example, an output device 2140 integral to generator 1100, or an output device 2140 connected to generator 1100 through a suitable communication interface. (eg a USB interface). The various diagnostic processes may include, without limitation, grip integrity, instrument integrity, instrument fixture integrity, instrument overload, proximity to instrument overload, frequency lock failure, over voltage condition, over current condition, over power 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.

[00337] Block 2440 of processor 1740 may implement a phase control algorithm for determining and phase controlling the impedance of an electrical load (eg, the ultrasonic transducer) driven by generator 1100. As discussed above, By controlling the frequency of the drive signal to minimize or reduce the difference between the determined impedance phase and an impedance phase set point (e.g. 0°), harmonic distortion effects can be minimized or reduced. , increasing the accuracy of the phase measurement.

[00338] The phase control algorithm receives as input the current and voltage feedback samples stored in memory location 2180. Prior to their use in the phase control algorithm, the feedback samples can be properly sized and, in certain respects, processed through a suitable filter 2460 (which may be identical to the filter 2320) to remove noise resulting from the data capture process and induced harmonic components, for example. The filtered voltage and current samples can therefore substantially represent the fundamental frequency of the generator drive output signal.

[00339] In block 2480 of the phase control algorithm, the current through the motion branch of the ultrasonic transducer is determined. This determination may be identical to that described above in connection with block 2220 of the pre-distortion algorithm. Thus, the output of block 2480 may be, for each set of stored current and voltage feedback samples associated with a sample of the LUT, a current sample of the motion branch.

[00340] — In block 2500 of the phase control algorithm, the impedance phase is determined based on the synchronized input of motion branch current samples determined in block 2480 and corresponding to voltage feedback samples. In certain respects, the phase of the impedance is determined as the average between the phase of the impedance measured at the rising edge of the waveforms and the phase of the impedance measured at the falling edge of the waveforms.

[00341] In block 2520 of the phase control algorithm, the impedance phase value determined in block 2220 is compared to the phase setpoint 2540 to determine a difference, or phase error, between the compared values.

[00342] In block 2560 (Figure 28A) of the phase control algorithm, based on a phase error value determined in block 2520 and the impedance magnitude determined in block 2420, a frequency output is determined to control the frequency of the trigger signal. The frequency output value can be continuously adjusted by block 2560 and transferred to a DDS control block 2680 (discussed below) in order to keep the phase of the impedance determined in block 2500 at the phase set point (e.g., zero phase error). In certain respects, the impedance phase can be regulated to a phase set point of 0º. In this way, any harmonic distortion will be centered around the crest of the voltage waveform, enhancing the accuracy of the phase impedance determination.

[00343] Block 2580 of processor 1740 can implement an algorithm for modulating the current amplitude of the trigger signal in order to control the current, voltage and power of the trigger signal according to setpoints specified by the user, or in accordance with requirements specified by other processes or algorithms implemented by the generator 1100. Control of these quantities can be performed, for example, by scaling the LUT samples in the LUT 2280, and/or by adjusting of the full-scale output voltage of the DAC 1680 (which supplies the input to the power amplifier

1620) via an 1860 DAC. Block 2600 (which can be implemented as a PID controller in certain respects) can receive current feedback samples (which can be properly sized and filtered) from the current input as input. memory location

2180. Current feedback samples can be compared to the "demand for current" value la determined by the controlled variable (eg, current, voltage, or power) to determine if the drive signal is providing the required current. In aspects where the drive signal current is the control variable, the current demand la can be specified directly by a 2620A current setpoint (Isp). For example, an RMS value from the current feedback data (determined as in block 2340) can be compared to the user-specified RMS current setpoint ls to determine the appropriate action for the controller. If for example the current feedback data indicates an RMS value lower than the current setpoint ls., LUT scaling and/or full scale output voltage of the DAC 1680 can be adjusted by block 2600, so so that the trigger signal current is increased. On the other hand, the 2600 block can adjust a LUT scaling and/or the full scale output voltage of the 1680 DAC to decrease the trigger signal current when the current feedback data indicates an RMS value greater than the Isp-current set point

[00344] 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 setpoint 2620B (Vsp) given the magnitude of load impedance Zm measured at block 2420 (eg la = VsW/Zm). Likewise, in aspects where the drive signal power is the control variable, the current demand lg can be specified indirectly, for example, based on the current required to maintain a desired power setpoint. 2620C (Psp) given the voltage Vrms measured at the 2360 blocks (eg la = Psp/Vrms).

[00345] Block 2680 (Figure 28A) can implement a DDS control algorithm to control the trigger signal by retrieving samples from the LUT stored in LUT 2280. In certain respects, the DDS control algorithm can be an algorithm numerically-controlled oscillator (NCO) to sample a waveform at a fixed timing rate using a technique of skipping points (memory locations). The NCO algorithm can implement a phase accumulator, or frequency-to-phase converter, which functions as an address pointer for retrieving samples from the LUT 2280 LUT. In one aspect, the phase accumulator can be an accumulator. phase with step size D, modulo N, where D is a positive integer representing a frequency control value, and N is the number of samples from the LUT in the LUT

2280. A frequency control value D=1, for example, can cause the phase accumulator to point sequentially to each LUT 2280 address, resulting in a waveform output that replicates the waveform stored in the LUT 2280. LUT 2280. When D>1, the phase accumulator may skip addresses on the 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 suitably varying the frequency control value. In certain aspects, the frequency control value may be determined based on the output of the phase control algorithm implemented in block 2440. The output of block 2680 may provide input to DAC 1680 which in turn provides a analog signal corresponding to an input of the 1620 power amplifier.

[00346] Block 2700 of the 1740 processor can implement a switch mode converter control algorithm to dynamically modulate the rail voltage of the 1620 power amplifier based on the waveform envelope of the signal being amplified, thus improving the efficiency of the power amplifier 1620. In certain aspects, the characteristics of the waveform envelope can be determined by monitoring one or more signals contained in the power amplifier 1620. In one aspect, for example, the characteristics of the waveform envelope can be determined by monitoring the minimum of a drain voltage (eg, a MOSFET drain voltage) that is modulated according to the envelope of the amplified signal.

A low voltage signal can be generated, for example, by a low voltage 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, block 2740 can control a PWM signal supplied by a PWM generator 2760 which, in turn, controls the rail voltage supplied to power amplifier 1620 by the mode regulator. 1700 switching. In certain respects, as long as the values of the minimum voltage samples are less than a target input for the 2780 minimum in block 2720, the voltage on the rail can be modulated according to the waveform envelope, as characterized by the minimum voltage samples.

When minimum voltage samples indicate low envelope power levels, for example, block 2740 can cause low rail voltage to be supplied to power amplifier 1620, with full rail voltage being supplied only when the minimum voltage samples indicate maximum envelope power levels.

When the voltage samples from the minimum drop below the target to the minimum 2780, the 2740 block can cause the rail voltage to be kept at an adequate minimum value to ensure proper operation of the 1620 power amplifier.

[00347] Figure 29 is a schematic diagram of an aspect of an electrical circuit 2900 suitable for driving an ultrasonic transducer, such as the ultrasonic transducer 1120, in accordance with at least one aspect of the present disclosure. The 2900 electrical circuit comprises a 2980 analog multiplexer. The 2980 analog multiplexer multiplexes various signals from the SCL-A, SDA-A upstream channels such as ultrasonic, battery, and power control circuitry. 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 ambient temperature. A 2988 pulse-width modulation (PWM) watchdog timer automatically generates a system reset if the main program fails to do its periodic maintenance. It is provided to automatically restart the 2900 electrical circuit when it crashes or freezes due to software or hardware failure. It will be recognized that the 2900 electrical circuit can be configured as an RF driver circuit to drive the ultrasonic transducer or to drive the RF electrodes like the 3600 electrical circuit shown in Figure 34, for example. Consequently, referring now again to Figure 29, the 2900 electrical circuit can be used to drive the ultrasonic transducers and RF electrodes interchangeably. If driven simultaneously, filter circuits can be provided 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 commonly owned US Patent Application Publication No. US-2017-0086910-A1, entitled TECHNIQUES FOR CIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, which is hereby fully incorporated by reference.

[00348] “A 2986 drive circuit provides left and right ultrasonic power outputs. 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 to a first gate drive circuit 2996a coupled to a first output stage of transistor 2998a to drive a first ultrasonic power output (left). The pulse width modulation circuit 2992 also provides a second signal to a second gate drive circuit 2996b coupled to a second output stage of transistor 2998b to drive a second ultrasonic power output (right). A 2999 voltage sensor is coupled between the left/right ultrasonic output terminals to measure the output voltage. Driver circuit 2986, first and second driver circuits 2996a, 2996b, and first and second transistor output stages 2998a, 2998b define a first stage amplifier circuit. In operation, the control circuit 3200 (Figure 30) generates a digital waveform 4300 (Figure 37) that employs circuits such as the direct digital synthesis (DDS) circuits 4100, 4200 (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.

[00349] Figure 30 is a schematic diagram of a control circuit 3200, like control circuit 3212, in accordance with at least one aspect of the present description. The 3200 control circuit is located inside a battery pack compartment. The battery pack is the power supply for a variety of 3215 local power supplies. The control circuit comprises a 3214 main processor coupled via a 3218 interface master to various downstream circuits via the outputs. 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 a serial I?C interface. The 3214 main processor is also configured to drive 3224 switches via the 3220 General Purpose Input/Output (GPIO), a 3226 display (e.g., an LCD display), and various 3228 indicators via the 3222 GPIO. A 3216 surveillance processor is provided to control the main processor

3214. A 3230 switch is supplied in series with a 3211 battery to activate the 3212 control circuit upon insertion of the battery pack into a surgical instrument handle assembly.

[00350] In one aspect, main processor 3214 is coupled to electrical circuit 2900 (Figure 29) via SCL-A/SDA-A output terminals. Main processor 3214 comprises a memory for storing tables of drive signals or digitized waveforms that are transmitted to electrical circuit 2900 to drive ultrasonic transducer 1120, for example. In other aspects, main processor 3214 may generate a digital waveform and transmit it to electrical circuit 2900 or may store the digital waveform for later transmission to electrical circuit 2900. Main processor 3214 may also provide RF triggering via SCL-B/SDA-B output terminals and various sensors (e.g. Hall effect sensors, magneto-rheological fluid (MRF) sensors, etc.) via SCL output terminals -C/SDA-C. 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 proper software and user interface functionality.

[00351] 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, a 32 KB single-cycle random access memory (SRAM), internal read-only memory (ROM) loaded with the StellarisWareGO program, electrically erasable programmable read-only memory (2KB) EEPROM, one or more pulse width modulation (PWM) modules, one or more analog quadrature encoder (QED) input, one or more 12-bit analog-to-digital converters (ADC) with 12 analog input channels, among other features that are readily available in the product data sheet. Other processors can be easily replaced and therefore the present description should not be limited in this context.

[00352] Figure 31 shows a simplified circuit block diagram illustrating another electrical circuit 3300 contained within a modular ultrasonic surgical instrument 3334, in accordance with one aspect of the present disclosure. Electrical circuit 3300 includes a processor 3302, a clock 3330, a memory 3326, a power supply 3304 (e.g., a battery), a switch 3306, such as a field-effect transistor power switch 3304. semiconductor metal oxide (MOSFET), a 3308 drive circuit (PLL),

a transformer 3310, a signal smoothing circuit 3312 (also called a matching circuit and may be, for example, a tank circuit), a detection circuit 3314, a transducer 1120, and a set of drive shaft (e.g., drive shaft assembly 1126, 1129) comprising an ultrasonic transmission waveguide terminating in an ultrasonic blade (e.g., ultrasonic blade 1128, 1149) which may be called, in the present invention, simply waveguide.

[00353] A feature of the present description that breaks reliance on high voltage (120 VAC) input power (a feature of general ultrasonic cutting devices) is the use of low voltage switching throughout the entire switching process. waveforming and amplification of the trigger signal only directly before the transformer stage. For that reason, in one aspect of the present description, power is derived from just one battery, or group of batteries, small enough to fit inside a handle assembly. Prior art battery technology provides powerful batteries a few centimeters high and wide 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.

[00354] The output of the 3304 power supply is fed to the 3302 processor and energizes it. Processor 3302 receives and sends signals and, as will be described below, operates according to custom logic or computer programs that are executed by processor 3302. As discussed above, electrical circuit 3300 may also include a memory. 3326, preferably a random access memory (RAM) that stores computer-readable instructions and data.

[00355] The 3304 power supply output is also routed to the 3306 switch having a processor-controlled duty cycle

3302. By controlling the dwell time of switch 3306, processor 3302 is able to determine the total amount of power that is ultimately supplied to transducer 1120. In one aspect, switch 3306 is a MOSFET, although in others switch and switching settings are also adaptable. The output of switch 3306 is fed to a drive circuit 3308 which contains, for example, a phase detecting 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 (Vin and li, respectively). These values are used in a feedback architecture to adjust the pulse width modulation of the 3306 switch. For example, the duty cycle of the 3306 switch can vary from about 20% to about 80%, depending on the desired output. and real of key 3306.

[00356] The drive circuit 3308, which receives the signal from the switch 3306, includes an oscillatory circuit that transforms the output of the 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 finally fed to the ultrasonic transducer 1120 to produce a resonant sine wave along the ultrasonic transmission waveguide.

[00357] At the output of the drive circuit 3308 there is a transformer 3310 that is capable of raising the low voltage signal(s) to a higher voltage. It is observed that upstream switching, before the 3310 transformer, is performed at low voltages (eg battery-powered), something that, until now, was not possible for ultrasonic cutting and cauterizing devices. 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 lower switching losses and less heat than a traditional MOSFET device and allow for more current to flow. 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 at, for example, 10V. In this case, a 10VDC power supply separately can be used to power the MOSFET port, which ensures that the MOSFET is fully powered and that reasonably low resistance is achieved. In one aspect of the present disclosure, transformer 3310 raises the battery voltage to 120 V root mean square (RMS). Transformers are known in the art and therefore are not explained in detail here.

[00358] In the described circuit configurations, circuit component degradation can adversely affect the circuit performance of the circuit. One factor that directly affects component performance is heat. Known circuits generally monitor switching temperatures (ie MOSFET temperatures). However, due to technological advances in MOSFET designs and due to the corresponding reduction in size, MOSFET temperatures are no longer a valid indicator of circuit loads and heat. For this reason, in accordance with at least one aspect of the present description, a sensing circuit 3314 detects the temperature of transformer 3310. This temperature detection is advantageous as transformer 3310 is operated at its maximum temperature or very close to it while using the device. The additional temperature will cause the core material, eg ferrite, to rupture and permanent damage may occur. The present description can respond to a maximum temperature of the 3310 transformer,

for example, reducing the drive power on the 3310 transformer, signaling the user, turning the power off, pulsing the power, or through other appropriate responses.

[00359] In one aspect of the present description, the 3302 processor is coupled in communication to the end actuator (e.g. 1122, 1125) which is used to bring the material into physical contact with the ultrasonic blade (e.g. 1128, 1149) . Sensors are provided that measure, at the end actuator, a pinch force value (existing within a known range) and, based on the received pinch force value, the 3302 processor varies the motive voltage Vu. Since high force values, combined with a defined rate of motion, can result in high blade temperatures, a 3332 temperature sensor can be coupled in communication to the 3302 processor, with the 3302 processor operable to receive and interpreting a signal indicating a current blade temperature from the 3336 temperature sensor and to determine a target frequency of blade movement based on the received temperature. In another aspect, force sensors such as mechanical strain gauges or pressure sensors can be attached to the trigger (eg 1143, 1147) to measure the force applied to the trigger by the user. In another aspect, force sensors, such as mechanical strain gauges or pressure sensors, can be coupled to a switch button so that the amount of displacement corresponds to the force applied by the user to the switch button.

[00360] In accordance with at least one aspect of the present description, the PLL portion of the drive circuit 3308, which is coupled to the processor 3302, is capable of determining a waveguide motion frequency and communicating that frequency to the processor

3302. Processor 3302 stores the value of this frequency in memory 3326 when the device is powered off. By reading the 3330 clock, the 3302 processor is able to determine an elapsed time after the device is turned off and retrieve the last waveguide motion frequency if the elapsed time is less than a predetermined value. The device can then start at the last frequency, which is presumably the optimal frequency for the current load. Battery-powered modular hand-held surgical instrument with multi-stage generator circuits

[00361] In another aspect, the present disclosure provides a modular battery-powered hand-held surgical instrument with multistage generator circuits. A surgical instrument is described that includes a battery pack, a grip assembly, and a drive shaft assembly, wherein the battery pack and drive shaft assembly are configured to mechanically and electrically connect the grip assembly. The battery pack includes a control circuit configured to generate a digital waveform. The grip assembly 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 for receiving, amplifying and applying the analog waveform to a load.

[00362] In one aspect, the present description provides a surgical instrument, comprising: a battery pack, comprising a control circuit comprising a battery, a battery-coupled memory, and a battery-coupled memory processor, being that the processor is configured to generate a digital waveform; a handle assembly comprising a first stage circuit coupled to the processor, the first stage circuit comprising a digital-to-analog converter (DAC) and a first stage amplifier circuit, the DAC being configured to receiving the digital waveform and converting 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 for receiving the analog waveform, amplifying the analog waveform, and applying the analog waveform to a load; where the battery pack and drive shaft assembly are configured to connect mechanically and electrically to the grip assembly.

[00363] —Load may comprise any one of an ultrasonic transducer, electrode, or sensor, or any combination thereof. The first stage circuit may comprise an ultrasonic driving first stage circuit and a high frequency current driving first stage circuit. The control circuit can be configured to drive the first stage ultrasonic drive circuit and the first stage high frequency current drive circuit independently or simultaneously. The first stage ultrasonic drive circuit can be configured to mate with a second stage ultrasonic drive circuit. The ultrasonic drive second stage circuit can be configured to mate with an ultrasonic transducer. The first stage high frequency current driving stage circuit can be configured to mate with a second stage high frequency circuit. The high frequency drive second stage circuit can be configured to mate with an electrode.

[00364] The first stage circuit may comprise a sensor trigger first stage circuit. The first sensor trigger stage circuit can be configured to a second trigger stage circuit. The second sensor trigger stage circuit can be configured to mate with a sensor.

[00365] In another aspect, the present description provides a surgical instrument, comprising: a battery pack, which comprises a control circuit comprising a battery, a memory coupled to the battery, and a processor coupled to memory and battery, and the processor is configured to generate a digital waveform; a handle assembly 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 to 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 for receiving the analog waveform, amplifying the analog waveform, and applying the analog waveform to a load; where the battery pack and drive shaft assembly are configured to connect mechanically and electrically to the grip assembly.

[00366] The load may comprise any one 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 common first stage drive circuit can be configured to mate with a second stage ultrasonic drive circuit, a second stage high-frequency drive circuit, or a second stage sensor drive circuit. The second stage ultrasonic drive circuit can be configured to couple to an ultrasonic transducer, the second stage circuit of high frequency drive is configured to couple to an electrode, and the second stage circuit to drive a sensor is configured to mate with a sensor.

[00367] In another aspect, the present description provides a surgical instrument, which comprises: a control circuit that comprises a memory coupled to a processor, the processor being configured to generate a waveform digital; a grip 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 form analog waveform; and a drive shaft assembly comprising a second stage circuit coupled to the common first stage circuit for receiving and amplifying the analog waveform; where the drive shaft assembly is configured to connect mechanically and electrically to the grip assembly.

[00368] The first common stage circuit can be configured to drive ultrasonic, high frequency, or sensor circuits. The common first stage drive circuit can be configured to mate with an ultrasonic second stage drive circuit, a second high frequency drive stage circuit, or a second sensor drive stage circuit. The ultrasonic drive second stage circuit can be configured to mate with an ultrasonic transducer, the second

The second high-frequency drive stage circuit is configured to couple to an electrode, and the second sensor drive stage circuit is configured to couple to a sensor.

[00369] Figure 32 illustrates a generator circuit 3400 partitioned into a first stage circuit 3404 and a second stage circuit 3406, in accordance with at least one aspect of the present description. In one aspect, the surgical instruments of the surgical system 1000 described herein may comprise a generator circuit 3400 divided into multiple stages. For example, surgical instruments of surgical system 1000 may comprise generator circuit 3400 divided into at least two circuits: first stage 3404 circuit and second stage 3406 amplifier circuit allowing operation of RF power only, ultrasonic power only , and/or a combination of RF energy and ultrasonic energy. A combination 3414 modular drive shaft assembly will be powered by the 3404 first common stage circuit located in a 3412 grip assembly and the 3406 modular second stage circuit integral with the 3414 modular drive shaft assembly. previously discussed in this description in connection with the surgical instruments of the surgical system 1000, a battery pack 3410 and drive shaft assembly 3414 are configured to mechanically and electrically connect to the handle assembly 3412. - rado to connect mechanically and electrically to the 3414 drive shaft assembly.

[00370] — Now referring to Figure 32, the generator circuit 3400 is partitioned into multiple stages located in multiple modular assemblies of a surgical instrument, such as the surgical instruments of the surgical system 1000 described herein. In one aspect, a stage control circuit 3402 may be located in the battery pack 3410 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 memory 3217 (Figure 32) (e.g., volatile memory). and non-volatile), and is electrically coupled to a 3211 battery. The 3211 battery supplies power to the 3404 first stage circuit, the 3406 second stage circuit, and a 3408 third stage circuit, respectively. As previously discussed, the control circuit 3200 generates a digital waveform 4300 (Figure 37) using circuits and techniques described in connection with Figures 35 and 36. Again with reference to Figure 32, the digital waveform 4300 it can be configured to drive an ultrasonic transducer, high frequency (eg RF) electrodes, or a combination thereof, independently or simultaneously. If driven 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 commonly owned US Patent Application Publication No. US-2017-0086910-A1, titled TECHNIQUES FOR CIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, which is hereby fully incorporated by reference.

[00371] The 3404 first stage circuits (e.g., the 3420 ultrasonic trigger stage first circuit, 3422 RF trigger stage first circuit, and 3424 sensor trigger stage first circuit) are located in a 3412 surgical instrument handle assembly. The 3200 control circuit supplies the ultrasonic drive signal to the 3420 first stage ultrasonic drive circuit through the SCL-A, SDA-A outputs of the 3200 control circuit. The first stage 3420 ultrasonic drive circuit is described in detail in connection with Figure 29. The 3200 control circuit supplies the RF trigger signal to the 3422 first stage RF trigger circuit through the SCL-B, SDA-B outputs of the 3200 control circuit. 3422 first RF trigger stage circuit is described in detail in connection with Figure 34. The 3200 control circuit supplies the sensor trigger signal to the 3424 first sensor trigger stage circuit through the SCL-C outputs , SDA-C of the 3200 control circuit. In general, each of the 3404 first stage circuits includes a digital-to-analog converter (DAC) and a first stage amplifier section to drive the second. 3406 stage circuits. The outputs of the first stage 3404 circuits are supplied to the inputs of the second stage 3406 circuits.

[00372] 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 3420 ultrasonic drive first stage circuit, the first circuit 3422 RF trigger stage circuit, or the 3424 first stage sensor trigger circuit located in the 3412 grip assembly is connected to the 3410 battery pack. Likewise, each of the 3404 first stage circuits can detect which second stage 3406 circuitry is connected thereto and what information is fed back to the control circuit 3200 to determine what type of signal waveform to generate. Similarly, each of the 3406 second stage circuits can detect which 3408 third stage circuits or components are connected to it and what information is fed back to the 3200 control circuit to determine what kind of form of signal wave generate.

[00373] In one aspect, the 3406 second stage circuits (e.g., the ultrasonic drive second stage circuit

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

[00374] In one aspect, third stage circuits 3408 (e.g., ultrasonic transducer 1120, RF electrodes 3074a, 3074b, and sensors 3440) may be located in various assemblies 3416 of the surgical instruments. In one aspect, the 3430 ultrasonic drive second 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 may be located on the 3412 grip assembly, 3414 drive shaft assembly, or end actuator. In one aspect, the 3432 RF trigger second stage circuit provides a trigger signal to the RF electrodes 3074a, 3074b, which are generally located on the end actuator portion of the surgical instrument. In one aspect, the second sensor trigger stage circuit 3434 provides a trigger signal to various sensors 3440 located on the surgical instrument.

[00375] Figure 33 illustrates a multistage partitioned generator circuit 3500 wherein a first stage circuit 3504 is common to second stage circuit 3506, in accordance with at least one aspect of the present description. In one aspect, the surgical instruments of the surgical system 1000 described herein may comprise generator circuit 3500 divided into multiple stages. For example, the surgical instruments of the surgical system 1000 may comprise the generator circuit 3500 divided into at least two circuits: the first stage 3504 circuit and the second stage 3506 amplifier circuit allowing high frequency power operation. RF only, ultrasonic energy only, and/or a combination of RF energy and ultrasonic energy. A combination 3514 modular drive shaft assembly will be powered by the 3504 common stage first circuit located in a 3512 grip assembly and the 3506 modular second stage circuit integral with the 3514 modular drive shaft assembly. previously discussed in this description in connection with the 1000 Surgical System Surgical Instruments, a 3510 Battery Pack and 3514 Drive Shaft Assembly are configured to connect mechanically and electrically to the 3512 Handle Assembly. end actuator is configured to connect mechanically and electrically to the 3514 drive shaft assembly.

[00376] As shown in the example of Figure 33, the battery pack portion 3510 of the surgical instrument comprises a first control circuit 3502, which includes the previously described control circuit 3200. The grip assembly 3512, which connects to the battery pack 3510, comprises a common first stage drive circuit 3420. As previously discussed, the first stage drive circuit 3420 is configured to drive current. high-frequency (RF) ultrasonics, and sensor loads. The output of the 3420 common drive first stage circuit can drive any of the 3506 second stage circuits such as the 3430 ultrasonic drive second stage circuit, the 3432 high frequency (RF) current drive second stage circuit , and/or the second sensor drive stage circuit 3434. The common first stage drive circuit 3420 senses which second stage circuit 3506 is situated on the drive shaft assembly 3514 when the drive shaft assembly 3514 is connected to the 3512 grip assembly. After the 3514 drive shaft assembly is connected to the 3512 grip assembly, the 3420 common first stage drive circuit determines which of the 3506 second stage circuits (for example, the second 3430 ultrasonic drive stage circuit, the 3432 RF drive second stage circuit, and/or the second drive stage circuit sensor assembly 3434) is located on the drive shaft assembly 3514. Information is provided to the control circuit 3200 located on the grip assembly 3512 to provide a suitable 4300 digital waveform (Figure 37) to the 3506 second stage circuit. to trigger the appropriate load, eg ultrasonic, RF or sensor. It will be understood that identification circuitry may be included in various assemblies 3516 in the third stage circuit 3508 such as the ultrasonic transducer 1120, the electrodes 3074a, 3074b, or the sensors 3440. Thus, when a third stage circuit 3508 is connected to a second stage circuit 3506, second stage circuit 3506 recognizes the type of load that is required based on the identification information.

[00377] Figure 34 is a schematic diagram of an aspect of an electrical circuit 3600 configured to drive a high frequency (RF) current, in accordance with at least one aspect of the present disclosure. Electrical circuit 3600 comprises an analog multiplexer 3680. Analog multiplexer 3680 multiplexes various 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 3684 Field Effect Transistor (FET) temperature sensor provides the ambient temperature. A 3688 pulse-width modulation (PWM) watchdog timer automatically generates a system reset if the main program fails to do its periodic maintenance. It is provided to automatically reset the 3600 electrical circuit when it crashes or freezes due to 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, the 3600 electrical circuit can be used to drive both ultrasonic and RF electrodes interchangeably.

[00378] A 3686 drive circuit provides left and right RF power 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 an oscillator

3694. Pulse width modulation circuit 3692 provides a first signal to a first gate drive circuit 3696a coupled to a first output stage of transistor 3698a to drive a first RF+ power output (left) . The 3692 pulse width modulation circuit also provides a second signal to a second 3696b gate drive circuit coupled to a second output stage of the 3698b transistor to drive a second RF power output (right) . A 3699 voltage sensor is coupled between the left RF/RF output terminals to measure the output voltage. Driver circuit 3686, first and second driver circuits 3696a, 3696b, and first and second transistor output stages 3698a, 3698b define a first stage amplifier circuit. In operation, the control circuit 3200 (Figure 30) generates a digital waveform 4300 (Figure 37) that employs circuits such as the direct digital synthesis (DDS) circuits 4100, 4200 (Figures 35 and 36). The 3690 DAC receives the 4300 digital waveform and converts it to an analog waveform, which is received and amplified by the first stage amplifier circuit.

[00379] 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 lookup table to digitize the waveform. Phase points can be stored in a table defined in memory, a field programmable gate array (FPGA), or any suitable non-volatile memory. Figure 35 illustrates one aspect of a fundamental architecture for a digital synthesis circuit, such as a 4100 direct digital synthesis (DDS) circuit, 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 the 4104 lookup table, which in turn provides variable digital input values to a 4108 DAC circuit that powers a power amplifier. Addresses can be verified according to a frequency of interest. The use of such a 4104 lookup table makes it possible to generate various types of waveforms that can be fed into the tissue either to a transducer, an RF electrode, multiple transducers simultaneously, or a combination of ultrasonic and ultrasonic instruments. RF. In addition, multiple 4104 look-up tables representing multiple waveforms can be created, stored, and applied to tissue from one generator.

[00380] —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 (e.g. , two or more ultrasonic transducers and/or two or more RF electrodes). Additionally, where a surgical instrument comprises ultrasonic components, the waveform may be configured to drive at least two modes of vibration from an ultrasonic transducer of at least one surgical instrument. In this way, the generator can be configured to provide a waveform to at least one surgical instrument, wherein the waveform signal corresponds to at least one waveform of a plurality of waveforms in the table. Additionally, the waveform signal supplied to the two surgical instruments may comprise two or more waveforms. The table may comprise information associated with a plurality of waveforms and the table may be stored within the generator. In one aspect or example, the table can be a direct digital synthesis 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 may be a digital direct synthesis table, is addressed according to a frequency of the waveform signal. Additionally, information associated with the plurality of waveforms can be stored as digital information in the table.

[00381] The analog electrical signal waveform may 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 (e.g. 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 drive at least two modes of vibration of an ultrasonic transducer of at least one surgical instrument. In this way, the generator circuit can be configured to supply an analog electrical signal waveform to at least one surgical instrument, the analog electrical signal waveform corresponding to at least one waveform of a plurality of signal formats. waveform stored in lookup table 4104. Additionally, the analog electrical signal waveform supplied to at least two surgical instruments may comprise two or more waveforms. Look-up table 4104 may comprise information associated with a plurality of waveforms, and look-up table 4104 may be stored within the generator circuit or within the surgical instrument. In one aspect or example, lookup table 4104 can be a direct digital 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, lookup table 4104, which may be a direct digital synthesis table, is addressed according to a frequency of the desired analog electrical signal waveform. Additionally, information associated with the plurality of waveforms can be stored as digital information in lookup table 4104.

[00382] “With 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 direct digital 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 surgical system 1000. The DDS circuit 4100 comprises an address counter 4102, a lookup table 4104, a register 4106, a DAC circuit 4108 and a filter 4112. A steady clock fc is received by the address counter 4102 and the register 4106 drives a memory. programmable read-only (PROM) that stores one or more integer numbers of cycles of a sine wave (or other arbitrary waveform) in a lookup table 4104. As the address counter 4102 cycles through memory locations, the values stored in lookup table 4104 are written to register 4106, which is coupled to DAC circuit 4108. The corresponding digital amplitude of the signal in the memory location of the control table sulta 4104 aci-

4108 DAC circuit, 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. The phase noise is basically that of the reference clock f.. 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 circuit. generator. The second analog output signal has a frequency of fout.

[00383] “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 the Nyquist bandwidth, making them unfilterable, whereas the higher order harmonics of the synthesizer output based on phase-locked loop or phase-locked loop (PLL, for "phase-locked loop") can be filtered. Lookup table 4104 contains signal data for an integral number of cycles. The final output frequency can be changed by changing the fc reference clock frequency or reprogramming the PROM.

[00384] The DDS circuit 4100 may comprise multiple look-up tables 4104, the look-up table 4104 storing a waveform represented by a predetermined number of samples, the samples defining a predetermined waveform format. In this way, multiple waveforms that have a unique shape can be stored in multiple 4104 lookup tables to provide different tissue treatments based on instrument settings or tissue feedback. Examples of waveforms include high crest factor RF electrical signal waveforms for surface tissue coagulation, low crest factor RF electrical signal waveforms for deeper tissue penetration, and signal waveforms electrical devices that promote efficient touch-up coagulation. In one aspect, the DDS 4100 circuit can create multiple 4104 and waveform lookup tables during a tissue treatment procedure (e.g., simultaneously or in virtual real-time based on user or sensor actions) switch between different waveforms stored in separate 4104 lookup tables based on desired tissue effect and/or tissue feedback.

[00385] Therefore, switching between waveforms can be based on tissue impedance and other factors, for example. In other aspects, look-up tables 4104 may store electrical signal waveforms formatted to maximize tissue-distributed power per cycle (i.e., trapezoidal or square wave). In other aspects, look-up tables 4104 may store synchronized waveforms so that they maximize power delivery by the multipurpose surgical instrument of the surgical system 1000 when it provides RF and ultrasonic trigger signals. In still other aspects, the 4104 lookup tables can store electrical signal waveforms to simultaneously trigger ultrasonic and RF therapeutic and/or subtherapeutic energy while maintaining ultrasonic frequency lock. Custom waveforms specific to different instruments and their tissue effects can be stored in the generator's non-volatile memory or in the non-volatile memory (e.g. EEPROM) of the Surgical System 1000 and retrieved when connecting the multifunctional surgical instrument to the circuit. generator. An example of an exponentially smoothed sinusoid, as used in many high crest factor "clotting" waveforms, is shown in Figure 37.

[00386] A more flexible and efficient implementation of the DDS 4100 circuit employs a digital circuit called a Nu-Controlled Oscillator.

numerically (NCO, for "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 processor, controller, or device. generator logic and to a memory circuit located in the generator or in any of the surgical instruments of the surgical system 1000. The DDS circuit 4200 comprises a load register 4202, a parallel delta phase register 4204, an adder circuit 4216 , a phase register 4208, a look-up table 4210 (phase-to-amplitude converter), a DAC circuit 4212, and a filter 4214. The adder circuit 4216 and the phase register 4208 form part of a phase accumulator 4206. clock frequency fc is applied to phase register 4208 and a DAC circuit 4212. Load register 4202 receives a tuning word that specifies the output frequency as a fraction of the reference clock frequency signal. erence fc. The output of load register 4202 is provided to parallel delta phase register 4204 with a tuning word M.

[00387] The DDS 4200 circuit includes a sample clock that generates the clock frequency fe, the phase accumulator 4206, and the lookup table 4210 (eg, phase to amplitude converter). The content of the 4206 phase accumulator is updated once per clock cycle fe. 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 an adder circuit 4216. Assuming the number in the phase delta register parallel 4204 is 00...01 and that the initial content of phase accumulator 4206 is 00...00. The 4206 phase accumulator is updated by 00...01 per clock cycle. If the 4206 phase accumulator is 32 bits wide, it takes 232 clock cycles (over 4 billion) before the 4206 phase accumulator returns to 00...00, and the cycle repeats.

[00388] “A truncated output 4218 of phase accumulator 4206 is supplied to a look-up table of phase to amplitude converter 4210 and the output of look-up table 4210 is coupled to a DAC circuit

4212. Truncated output 4218 of 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 on the sine wave from 0º to 360º. Lookup table 4210 contains digital amplitude information corresponding to a complete cycle of a sine wave. Lookup table 4210 therefore maps the phase information from phase accumulator 4206 to a digital amplitude word, which in turn drives DAC circuit 4212. The output of the DAC circuit is a first analog signal. 4220 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.

[00389] In one aspect, the electrical signal waveform can be digitized into 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(8rn), where a normalized amplitude Ar at a point n is represented by a phase angle 8n is called the phase point at point n. The number of distinct phase points n determines the tuning resolution of the DDS 4200 circuit (as well as the DDS 4100 circuit shown in Figure 35).

[00390] Table 1 specifies the electrical signal waveform digitized at a number of phase points. CR O Neat — [Co [| the Number of 2nd Phase Points — => | the | the | TABLE 1

[00391] Generator circuit algorithms and digital controls can scan addresses in lookup table 4210, which in return provides variable digital input values to the 4212 DAC circuit that powers the 4214 filter and power amplifier. Addresses can be scanned according to a frequency of interest. The use of the lookup table makes it possible to generate several types of formats that can be converted into an analog output signal by the DAC circuit 4212 filtered by the filter 4214, amplified by the power amplifier coupled to the output of the generator circuit and fed to the tissue in the form of RF energy or fed to an ultrasonic transducer and applied to 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 tissue from a generator circuit.

[00392] Again with reference to Figure 35, for n=32e M=11, phase accumulator 4206 passes through 232 possible outputs before overflowing and resetting. The corresponding output waveform frequency is equal to the input clock frequency divided by 232. If M = 2, then phase register 1708 "runs" twice as fast, and the output frequency is doubled. This can be generalized as follows.

[00393] For a 4206 phase accumulator configured to accumulate n bits (usually not in the range 24 to 32 on most DDS systems, but as previously discussed, cannot be selected from a wide range of range of options), there are 2" possible phase points. The digital word in the delta phase register M represents the amount of phase buildup that is incremented per clock cycle. If f. is the clock frequency, then the output sine wave frequency is equal to: fh= TE

[00394] The above equation is known as the DDS "tuning equation". It is observed that the frequency resolution of the system is equal to - For n = 32, the resolution is greater than one part in four billion. In one aspect of the 4200 DDS system, not all bits outside the 4206 phase accumulator are passed to the 4210 lookup table, 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 frequency resolution. Phase truncation only adds a small but acceptable amount of phase noise to the final output.

[00395] —The electrical signal waveform can be characterized by current, voltage or power at a given frequency. Additionally, when any of the surgical instruments of the surgical system 1000 comprises ultrasonic components, the electrical signal waveform can be configured to drive at least two modes of vibration of an ultrasonic transducer of at least one surgical instrument. In this way, the generator circuit can be configured to supply an electrical signal waveform to at least one surgical instrument, with the electrical signal waveform being characterized by a predetermined waveform stored in the table of query 4210 (or lookup table 4104 - Figure 35). Also, the electrical signal waveform can be a combination of two or more waveforms. Lookup table 4210 may comprise information associated with a plurality of waveforms. In one aspect or example, lookup table 4210 may be generated by the DDS circuit 4200 and may be called a direct digital synthesis table. Direct digital synthesis (DDS) operates by first storing a large repeating waveform in onboard memory. A cycle of a waveform (sine, triangle, 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 direct digital synthesis table can be stored in a non-volatile memory of the generator circuit and/or it can be implemented with an FPGA circuit in the generator circuit. The lookup table 4210 can be addressed by any suitable technique that is convenient for categorizing waveforms. According to one aspect, lookup table 4210 is addressed according to a frequency of the electrical signal waveform. In addition, information associated with the plurality of waveforms may be stored as digital information in a memory or as part of lookup table 4210.

[00396] In one aspect, the generator circuit may be configured to provide electrical signal waveforms to at least two surgical instruments simultaneously. The generator circuit can also be configured to provide the electrical signal waveform, which may be characterized by two or more waveforms, through an output channel from the generator circuit to 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. . Furthermore, 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. .

[00397] — Additionally, a method of operating the generator in accordance with the present disclosure comprises generating an electrical signal waveform and providing the generated electrical signal waveform to any of the surgical instruments of the surgical system 1000, wherein 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. Furthermore, providing the generated electrical signal waveform to at least one surgical instrument comprises providing the electrical signal waveform to at least two surgical instruments simultaneously.

[00398] The generator circuit as described here can allow the generation of various types of direct digital 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 surface coagulation in RF mode), RF signals of low crest (which can be used for deeper tissue penetration) and waveforms that promote efficient touch-up coagulation. The generator circuit can also generate multiple waveforms employing a 4210 digital direct synthesis lookup table and, in real time, can switch between specific waveforms based on the desired tissue effect. Alternation may be based on tissue impedance and/or other factors.

[00399] In addition to traditional sine/cosine waveforms, the generator circuit can be configured to generate waveform(s) that maximize(s) tissue power per cycle (e.g. trapezoidal or square wave). ). The generator circuit can provide waveforms that are synchronized to maximize the power delivered to the load by simultaneously driving RF and ultrasonic signals and maintain the ultrasonic frequency lock, as long as the generator circuit includes a circuit topology. that allows the 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 instrument EEPROM and can be retrieved by connecting any of the system's surgical instruments. surgical 1000 to the generator circuit.

[00400] —The DDS 4200 circuit can comprise multiple look-up tables 4104, with the look-up table 4210 storing a waveform represented by a predetermined number of phase points (also called samples), with the phase points defining a predetermined waveform shape. 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 settings or tissue feedback. Examples of waveforms include high crest factor RF electrical signal waveforms for surface tissue coagulation, low crest factor RF electrical signal waveform for deeper tissue penetration, and low crest factor RF electrical signal waveforms for deeper tissue penetration. signal waveforms that promote efficient touch-up coagulation. In one aspect, the DDS 4200 circuit can create multiple 4210 waveform lookup tables and during a tissue treatment procedure (e.g., simultaneously or in virtual real-time based on user or sensor actions) switch between Different waveforms stored in different 4210 query tables based on desired tissue effect and/or tissue feedback.

[00401] — Therefore, switching between waveforms can be based on tissue impedance and other factors, for example. In other aspects, lookup tables 4210 may store electrical signal waveforms formatted to maximize the power delivered to tissue per cycle (i.e., trapezoidal or square wave). In other respects, the 4210 lookup tables can store synchronized waveforms so that they maximize the power delivery by any of the surgical instruments in the 1000 surgical system when it provides RF and ultrasonic trigger signals. . In still other aspects, the 4210 lookup tables can store electrical signal waveforms to simultaneously drive ultrasonic and RF therapeutic and/or subtherapeutic energy while simultaneously maintaining ultrasonic frequency lock. Generally speaking, the output waveform can be in the form of a sine wave, cosine wave, pulse wave, square wave, and the like. However, custom and more complex waveforms specific to different instruments and their tissue effects can be stored in the generator circuit's non-volatile memory or in the surgical instrument's non-volatile memory (e.g. EEPROM) and retrieved from the connect the surgical instrument to the generator circuit. An example of a custom waveform is an exponentially smoothed sine wave as used in many high crest factor "clotting" waveforms, as shown in Figure 37.

[00402] Figure 37 illustrates a cycle of a discrete-time digital electrical signal waveform 4300, in accordance with at least one aspect of the present description, of an analog waveform 4304 (shown superimposed on the form 4300 discrete-time digital electrical signal waveform for comparison purposes). The horizontal axis represents Time (t) and the vertical axis represents the digital phase points. The digital electrical signal waveform 4300 is a time-differentiated 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 that represents the amplitude per clock cycle Tek over a cycle or period To. The 4300 digital electrical signal waveform is generated over a period To 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 amplitude-phase points with either 26-bit or 64-bit resolution. 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. Digital amplitude phase points 4302 during a To cycle are stored in memory as a string of words chained to a lookup table 4104, 4210, as described in connection with Figures 35 and 36, for example. To generate the analog version of the 4304 analog waveform, the 4302 amplitude phase points are read sequentially from memory O through To. per clock cycle Toa and are converted by a DAC circuit 4108, 4212, also described in connection with Figures and 36. Additional cycles can be generated by repeatedly reading the amplitude phase points 4302 of the digital electrical signal waveform 4300 from O to To for as many cycles or periods as desired. The smooth analog version of the analog waveform 4304 is achieved by filtering the output of the DAC circuit 4108, 4212 through a filter 4112, 4214 (Figures 35 and 36). The filtered analog output signal 4114, 4222 (Figures 35 and 36) is applied to the input of a power amplifier.

[00403] Figure 38 is a diagram of a 12950 control system configured to provide progressive closure of a closure member (e.g., closure tube) when the displacement member advances distally and engages a clamping arm ( e.g. anvil) to lessen the load of the closing force on the closing member at a desired speed and lessening the load of the firing force on the firing member in accordance with an 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 mechanism from the control circuit (controller) to continuously calculate an error value as the difference between a desired set point and a measured process variable and apply a correction based on proportional terms. , integrals and derivatives (sometimes denoted P, |, and D respectively). The 12950 nested PID controller feedback control system includes a

12952 primary side, on a 12954 primary (external) feedback circuit, and a 12955 secondary controller on a 12956 secondary (internal) feedback circuit. The 12952 primary controller can be a 12972 PID controller, as shown in Figure 39 , and the secondary controller 12955 can also be a PID controller 12972, as shown in Figure 39. The primary controller 12952 controls a primary process 12958, and the secondary controller 12955 controls a secondary process 12960. Output 12966 of the 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 the primary controller 12952. The output of the primary controller 12952 is the secondary setpoint SP2 . The 12968 output of the 12960 secondary processor is subtracted from a primary SP2 setpoint by a second adder 12964.

[00404] In the context of controlling the displacement of a closing tube, the 12950 control system can be configured so that the primary setpoint SP is a desired closing force value and the primary controller 12952 is set to receiving the closing force from a torque sensor coupled to the output of a closing motor and determining a motor speed from the SP2 setpoint for the closing motor. In other respects, the closing force can be measured with strain gauges, load cells, or other suitable force sensors. The clamping motor speed setpoint SP> is compared to the actual speed of the clamping tube, which is determined by the 12955 slave controller. The actual speed of the clamping tube can be measured by comparing the tube displacement. closing with the position sensor and the measurement of elapsed time with a timer/counter. Other techniques such as linear or rotary encoders can be used to measure closure tube displacement. The output 12968 of the secondary process 12960 is the actual velocity of the closing tube. This 12968 clamp tube speed output is fed to the 12958 primary processor which determines the force acting on the clamp tube and is fed back to the adder 12962, which subtracts the measured clamp force from the primary set point SP ,. The main SP setpoint can be an upper threshold or a lower threshold. Based on the output of the 12962 adder, the 12952 primary controller controls the speed and direction of the closing motor. The 12955 secondary controller controls the closing motor speed based on the actual closing tube speed measured by the 12960 secondary process and the SP2 secondary setpoint, which is based on a comparison of the upper and lower trigger force thresholds and of the actual firing force.

[00405] Figure 39 illustrates a PID 12970 feedback control system, in accordance with one aspect of this description. The primary controller 12952 or the secondary controller 12955, or both, may be implemented as a PID controller 12972. In one aspect, the PID controller 12972 may comprise a proportional element 12974 (P), an integral element 12976 (|), and a derivative element 12978 (D). The outputs of the elements P, | and D 12974, 12976, 12978 are summed by an adder 12986, which supplies the control variable u(t) to process 12980. The output of process 12980 is process variable Y(t. An adder 12984 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) (e.g. the closing force threshold) and the measured process variable y(t) (e.g. the speed and closing tube direction) and applies a correction based on the proportional, integral, and derivative terms calculated by the proportional element 12974 (P), the integral element 12976 (1), and the derivative element 12978 (D), respectively. PID controller 12972 tries to minimize the error e(t) over time by adjusting the control variable u(t) (e.g. , the speed and direction of the closing tube).

[00406] “According to the PID algorithm, 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 description, the error term e(t) is the difference between the desired closing force and measured closing force of the closing tube. Element "I" 12976 represents the values passed from the error. For example, if the current output is not strong enough, the error integral will accumulate over time, and the controller will respond by applying a stronger action. Element "D" 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 into a large negative error mode in the near future. In this case, the derivative becomes negative and the magnitude D reduces the force of the action to avoid this excess.

[00407] It will be understood that other variables and setpoints may be monitored and controlled in accordance with the 12950, 12970 feedback control systems. For example, the adaptive closing member speed control algorithm described herein may measure at least two of the following parameters: the firing member travel location, the firing member load, the cutting element displacement, the cutting element speed, the closing tube travel location, the closing tube load, among others.

[00408] Ultrasonic surgical devices, such as ultrasonic scalpels, are finding increasingly widespread applications in surgical procedures because of their unique performance characteristics. Depending on specific device configurations and operating parameters, ultrasonic surgical devices can substantially simultaneously offer tissue transection and coagulation homeostasis, desirably minimizing patient 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 (eg, a blade tip) to cut and seal 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 tissues placed in contact with it to perform the cutting and cauterizing action. Ultrasonic surgical devices of this nature can be configured for use in open, laparoscopic or endoscopic surgical procedures, including robotically assisted procedures.

[00409] Ultrasonic energy cuts and coagulates tissue 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 (eg, 55,500 cycles per second), the ultrasonic blade denatures protein present in tissues to form a sticky clot. The pressure exerted on the tissues by the surface of the blade flattens the blood vessels and allows the clot to form a hemostatic seal. A surgeon can control the speed of cutting and clotting through the force applied to the tissues by the end actuator, the time for which force is applied, and the level of excursion selected for the end actuator.

[00410] The ultrasonic transducer can be modeled as an equivalent circuit comprising a first branch that has a static capacitance and a second "moving" branch that has a series-connected inductance, resistance and capacitance 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 drive signal current flows into the moving branch. Consequently, through the use of a tuning inductor, the generator drive signal current represents the branch current in motion, and the generator is thus able to control its drive signal to maintain the transducer resonant frequency. ultrasonic. The tuning inductor can also transform the phase impedance curve of the ultrasonic transducer to optimize the generator's frequency latching capabilities. However, the tuning inductor needs to be matched to the specific static capacitance of an ultrasonic transducer at the operating resonant frequency. In other words, a different ultrasonic transducer having a different static capacitance needs a tuning inductor.

[00411] — Additionally, in some ultrasonic generator architectures, the generator drive signal exhibits asymmetric harmonic distortion that complicates impedance magnitude and phase measurements. For example, the accuracy of impedance phase measurements can be reduced due to harmonic distortion in current and voltage signals.

[00412] In addition, electromagnetic interference in noisy environments decreases the generator's ability to maintain latching at the resonant frequency of the ultrasonic transducer, increasing the likelihood of invalid control algorithm inputs.

[00413] 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 (eg, one or more electrodes). The end actuator can be positioned against the tissue so that the electrical current is introduced into the tissue. Electrosurgical devices can be configured for bipolar or monopolar operation. During bipolar operation, current is introduced into the tissue and returned from the tissue by 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 (eg, 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 thus can be particularly useful for cauterization of blood vessels, for example. The end actuator of an electrosurgical device may also comprise a cutting member which is capable of moving with respect to tissue and electrodes to transection tissue.

[00414] Electrical energy applied by an electrosurgical device may be transmitted to the instrument by a generator in communication with the handle. 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 of 300 kHz to 1 MHz, as “described in ENG6O601-2-2:2009+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 anything. Frequencies above 200 kHz are typically used for monopolar applications in order to avoid the unwanted stimulation of nerves and muscles that would result from using a low frequency current. Lower frequencies may be used for bipolar techniques if a risk analysis shows that the possibility of neuromuscular stimulation has been mitigated to an acceptable level. Typically, frequencies above 5 MHz are not used in order to minimize problems associated with high frequency leakage currents. It is generally accepted that 10 mA is the lower threshold of tissue thermal effects.

[00415] During this operation, an electrosurgical device can transmit RF energy at low frequency through the tissue, which causes friction, or ionic agitation, i.e. resistive heating, which therefore increases the temperature of the tissue. Because 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 tissue while simultaneously cauterizing blood vessels. RF energy can work particularly well on connective tissue, which mainly comprises collagen and shrinks when it comes in contact with heat.

[00416] Due to their unique triggering, detection and feedback signal needs, ultrasonic and electrosurgical devices often 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 uninsulated and isolated patient circuits of the generator, especially in cases where higher voltages and frequencies are used, can result in exposing a patient to unacceptable levels of leakage current.

[00417] —Furthermore, due to their unique trigger, detection, and feedback signal needs, ultrasonic and electrosurgical devices often require different user interfaces for different generators. In such conventional ultrasonic and electrosurgical devices, one 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 switches and/or foot-activated switches. When various aspects of combination generators for use with both ultrasonic and electrosurgical instruments are contemplated in the subsequent description, additional user interfaces that are configured to operate with ultrasonic as well as electrosurgical instrument generators are also contemplated.

[00418] Additional user interfaces to provide feedback, whether to the user or another machine, are contemplated in the subsequent description 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 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 (eg, an LCD display screen, LED indicators), audio feedback devices (eg, a loudspeaker, a doorbell) or tactile feedback (eg, haptic actuators) for use in combined ultrasonic and/or electrosurgical instruments is contemplated in the subsequent description.

[00419] Other electrical surgical instruments include, without limitation, irreversible and/or reversible electroporation, and/or microwave technologies, among others. Consequently, the techniques described here are applicable to ultrasonic, bipolar or monopolar (electrosurgical) RF, irreversible and/or reversible electroporation and/or microwave-based surgical instruments, among others.

[00420] Various aspects are directed towards improved ultrasonic surgical devices, electrosurgical devices and generators for use therewith. Aspects of ultrasonic surgical devices can be configured to transection and/or coagulate tissue during surgical procedures, for example. Aspects of electrosurgical devices can be configured to transect, coagulate, stagger, weld and/or desiccate tissue during surgical procedures, for example.

[00421] Generator aspects utilize high-speed analog to digital sampling (e.g. approximately 200x oversampling, depending on frequency) of the generator drive signal current and voltage, 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 data, a value of the static capacitance of the ultrasonic transducer, and a value of the drive signal frequency, the generator can determine the current of the movement branch of an ultrasonic transducer. This provides the benefit of a virtually tuned system and simulates the presence of a system that is tuned or resonant with any value of static capacitance (eg, Co in Figure 25) at any frequency. Consequently, control of the branch current of motion can be accomplished by canceling the effects of static capacitance without the need for a tuning inductor. Additionally, eliminating the tuning inductor cannot degrade the frequency locking capabilities of the generator, as frequency locking can be accomplished by properly processing current and voltage feedback data.

[00422] High-speed analog-to-digital sampling of the generator drive signal current and voltage, along with digital signal processing, can also enable accurate digital filtering of samples. For example, aspects of the generator may utilize a digital low-pass filter (e.g., a finite impulse response (FIR) filter that rolls off between a fundamental drive signal frequency and a second-order harmonic to reduce distortion). Asymmetric harmonics and EMI-induced noise in current and voltage feedback samples The filtered current and voltage feedback samples substantially represent the frequency of the fundamental drive signal, thus allowing a more accurate measurement of impetus phase. -dance with respect to the frequency of the fundamental drive signal and an improvement in the generator's ability to maintain the resonant frequency lock. The impedance phase measurement accuracy can be further optimized by averaging the falling edge measurements and the falling edge, and by adjusting the phase of the measured impedance to 0º.

[00423] Various aspects of the generator may also utilize high-speed analog-to-digital sampling of the generator drive signal current and voltage, along with digital signal processing, to determine actual power consumption and other quantities with a high degree of accuracy. This can allow the generator to implement a number of useful algorithms, such as controlling the amount of power applied to tissue as tissue impedance changes and controlling energy delivery to maintain a constant rate of increase in impedance. of the fabric. Some of these algorithms are used to determine the phase difference between the current and voltage signals of the generator drive signal. At 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 drive frequency until the ultrasonic system returns to resonance, ie the phase difference between the current and voltage signals reaches zero. Phase information can also be used to infer ultrasonic slide conditions. As discussed in particular below, the phase changes as a function of the temperature of the ultrasonic blade. Therefore, the phase information can be used to control the temperature of the ultrasonic blade. This can be done, for example, by reducing the power supplied to the ultrasonic blade when the ultrasonic blade is too hot and by increasing the power applied to the ultrasonic blade when the ultrasonic blade is too cold.

[00424] Various aspects of the generator may 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 electrosurgical devices can be met by a dedicated tap in a wideband power transformer, thus eliminating the need for a separate power amplifier and output transformer. In addition, the generator's sensing and feedback circuitry can support a wide dynamic range that meets the needs of ultrasonic and electrosurgical applications with minimal distortion.

[00425] Various aspects can provide a simple and cost-effective means for the generator to read and optionally write to a data circuit (e.g. a single-wire bus device such as a single-wire protocol EEPROM). , known under the trade name "1-Wire") disposed on 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 handle. This can allow the generator to provide better control and improved diagnostics and error detection. Additionally, the generator's ability to write data to 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 earlier versions of instruments containing a bus device with existing generators.

[00426] Described aspects of the generator provide active cancellation of leakage current caused by unintentional capacitive coupling between uninsulated and isolated patient and generator circuits. In addition to reducing patient risks, reducing leakage current can also reduce electromagnetic emissions.

[00427] Figure 40 is a system diagram 7400 of a segmented circuit 7401 comprising a plurality of independently operated circuit segments 7402, 7414, 7416, 7420, 7424, 7428, T434, 7440, in accordance with at least an aspect of the present description. 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 of a circuit segment are coupled for electrical communication through one or more wired or wireless connection means. The plurality of circuit segments are configured to transition between three modes comprising a suspend mode, a standby mode and an operating mode.

[00428] In one aspect shown, the plurality of circuit segments 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440 first start in standby mode, secondly go into suspend mode and thirdly, it switches to operational mode. However, in other aspects, the plurality of circuit segments may 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 mode to operational mode. Individual circuit segments can be put into a specific state by the 7408 voltage control circuit based on execution by a processor of machine-executable instructions. The states comprise a de-energized state, a low-power state, and an energized state. The off state corresponds to the suspend mode, the low power state corresponds to the standby mode, and the on state corresponds to the operational mode. The transition to the low energy state can be achieved, for example, by using a potentiometer.

[00429] In one aspect, the plurality of circuit segments 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440 may transition from sleep mode or standby mode to operational mode in accordance with a sequence of energizing. The plurality of circuit segments may also transition from operating mode to standby mode or suspend mode in accordance with the power-down sequence. The power-on sequence and the power-off sequence may be different. In some aspects, the power-up sequence comprises powering up 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.

[00430] Referring again to the system diagram 7400 in Figure 40, the segmented circuit 7401 comprises a plurality of circuit segments comprising a transition circuit segment 7402, a processor circuit segment 7414, a circuit segment handle 7416, a communication circuit segment 7420, a display circuit segment 7424, a motor control circuit segment 7428, a power handling circuit segment 7434, and a drive shaft circuit segment 7440. The transition circuit segment comprises an enable circuit 7404, a current boost circuit 7406, a voltage control circuit 7408, a safety controller 7410, and a POST controller 7412 ("Power On Self-Test" , or activation self-test). The 7402 transition circuit segment is configured to implement a power-off sequence and a power-on sequence, a security detection protocol, and a POST.

[00431] In some aspects, 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 Circuit segments of the 7401 segmented circuit are configured to be in a low power state, an off state, or an on 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 could 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 motion 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 circuit segment. 7414 processor to transition the processor and volatile memory to a powered state.

In aspects, the processor and volatile memory are in a powered state before the 7409 voltage control circuit applies voltage to the processor and volatile memory.

In operational mode, the processor can initiate either a power-up sequence or a power-off sequence.

In various aspects, the 7405 accelerometer button sensor can also send a signal to the processor to cause the processor to initiate a power-up sequence or a power-off sequence.

In some respects, the processor initiates a power-up sequence when most individual circuit segments are in a low-power state or an off state.

In other respects, the processor initiates a power-down sequence when most individual circuit segments are in an energized state.

[00432] — In addition or alternatively, the 7405 accelerometer button sensor can detect external movement within a predetermined vicinity of the surgical instrument. For example, the accelerometer button sensor 7405 can detect the movement of a user's hand of the surgical instrument 6480 described herein, which moves within the predetermined vicinity. When the 7405 Accelerometer Button Sensor detects this external motion, 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 sent signal, the processor can initiate a power-up sequence or a power-off sequence to transition one or more circuit segments between the three modes. In aspects, the signal sent to the 7408 voltage control circuit is sent to verify that the processor is in operational mode. In some respects, the 7405 accelerometer button sensor can detect when the surgical instrument has been dropped and send a signal to the processor based on the drop detected. 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 individual affected circuit segments. Based on the damage or failure detected, the 7412 POST controller can POST the corresponding individual circuit segments.

[00433] “A power-up sequence or a power-down 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. which indicates the selection of a specific circuit segment from among the plurality of circuit segments. Based on the detected motion or series of detected motions, the accelerometer button sensor 7405 may 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 operation. an energized state. Based on the signal, the processor determines a power-up sequence comprising the one or more selected circuit segments. Additionally or alternatively, a user of the 6480 surgical instruments described here can select a quantity and order of circuit segments to define a power-up sequence or a power-down sequence based on interaction with a graphical user interface (GUI). ) of the surgical instrument.

[00434] In many 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 herein or the movement outside within a predetermined neighborhood above a predetermined threshold. For example, a signal can only be sent if motion is detected for 5 seconds or more or if the surgical instrument is moved 5 inches or more. 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 motion of the surgical instrument. A predetermined threshold reduces the involuntary transition of the circuit segments of the surgical instrument. As previously described, the transition may comprise a transition to operational mode according to a power-up sequence, a transition to low power mode according to a power-down sequence, or a transition to sleep mode according to a sequence. of de-energization. In some aspects, the surgical instrument comprises an actuator that can be actuated by a user of the surgical instrument. Actuation is detected by the 7405 accelerometer push-button sensor. The actuator can be a slider, toggle switch, or momentary contact switch. Based on the detected actuation, the 7405 accelerometer button sensor can send a signal to the 7408 voltage control circuit and a signal to the processor.

[00435] The current amplifier circuit 7406 is coupled to the battery. The 7406 current amplifying circuit is a current amplifier, like a relay or transistor, and is configured to amplify the magnitude of a current from 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 7406 current amplifying circuit can amplify the magnitude of current corresponding to an individual circuit segment or circuit that requires more current draw during operation of the 6480 surgical instruments described herein. For example, an increase in current to the 7428 motor control circuit segment can be provided when a surgical instrument motor requires more input power. The increase in current supplied to an individual circuit segment may 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 operating in conjunction with the battery.

[00436] The 7408 voltage control circuit is coupled to the battery. 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 various aspects, the voltage control circuit

7408 comprises a combinational logic circuit such as a multiplexer (MUX) for selecting inputs, a plurality of electronic switches and a plurality of voltage converters. One electronic switch of 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 perform switching to a closed configuration to allow the removal of voltage from the corresponding circuit segment. By selecting a plurality of individual electronic switches, the combined logic circuit can implement either a turn-off sequence or an turn-on sequence. The plurality of voltage converters may supply a stepped up voltage or a stepped down voltage to a plurality of circuit segments. The voltage control circuit 7408 may also comprise a microprocessor and a memory device.

[00437] The 7410 safety controller is configured to perform safety checks on 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 may be performed to determine whether or not there are any errors or defects in the function or operation of the circuit segments. Safety controller 7410 may monitor one or more parameters of the plurality of circuit segments. Safety controller 7410 can verify the identity and operation of the plurality of circuit segments by comparing one or more parameters with predefined parameters. For example, if an RF power mode is selected, the 7410 safety controller can verify that a drive shaft pivot parameter matches a predefined pivot parameter to verify the power mode operation. of the 6480 surgical instrument described in the present invention. In some aspects, the 7410 safety controller may monitor, via sensors, a predetermined relationship between one or more properties of the surgical instrument to detect a defect. A defect can occur when one or more properties are inconsistent with the predetermined relationship. When the 7410 safety controller determines that a fault exists, an error exists, 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 verification failure originated.

[00438] The 7412 POST controller performs a POST to verify proper operation of the plurality of circuit segments. In some aspects, POST is performed for an individual circuit segment out of the plurality of circuit segments before the voltage control circuit 7408 applies a voltage to the individual circuit segment to transition the individual circuit segment from standby mode. standby or from sleep mode to operating mode. If the individual circuit segment fails POST, the specific circuit segment does not transition from standby or suspend mode to operational mode. The POST of the 7416 grip circuit segment may comprise, for example, testing whether the 7418 grip control sensors detect an actuation of a 6480 surgical instrument grip control described herein. In some respects, the 7412 POST controller may transmit a signal to the 7405 accelerometer button sensor to verify the operation of the individual circuit segment as part of 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 from a circuit segment or a circuit from a circuit segment as part of POST. For example, the 7405 accelerometer button sensor can detect an incremental motor pulse generated by the 7432 motor to verify operation. A 7430 motor control circuit motor driver can be used to control the 7432 motor to generate the incremental motor pulse.

[00439] “In various aspects, the 6480 surgical instrument described herein may comprise additional accelerometer button sensors. The 7412 POST controller can also run a control program stored in the voltage control circuit memory device.

7408. The control program may cause the 7412 POST controller 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 7412 POST controller determines, based on POST, that the processor is damaged or defective, the 7412 POST controller may send a signal to one or more secondary processors.

tools to make 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 are not operating properly, the POST 7412 controller may initiate a reduced performance mode of the circuit segments that operate properly while blocking circuit segments that do not pass POST or do not operate properly. A locked circuit segment can function similarly to a circuit segment in standby or suspend mode.

[00440] Processor circuit segment 7414 comprises the processor and volatile memory. The processor is configured to initiate either a power-up sequence or a power-off sequence. To initiate the power-up sequence, the processor transmits a power-up signal to voltage control circuit 7408 to cause voltage control circuit 7408 to apply voltage to the plurality or a subset of the plurality of circuit segments in accordance with the power-up sequence. To initiate the power-off sequence, the processor transmits a power-off 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 in accordance with the power-down sequence.

[00441] The 7416 grip circuit segment comprises 7418 grip control sensors. The 7418 grip control sensors can detect an actuation of one or more grip controls of the 6480 surgical instrument described herein. In many respects, the one or more grip controls comprise a grip control, a release button, a toggle switch, a power enable button, and/or any other suitable grip control. The user can activate the power activation button to select between an RF power mode, an ultrasonic power mode, or a combined RF and ultrasonic power mode. The 7418 grip control sensors can also facilitate attachment of a modular grip to the surgical instrument. For example, 7418 grip control sensors can detect proper attachment of the modular grip to the surgical instrument and indicate the detected attachment to a user of the surgical instrument. The 7426 LCD screen can provide a graphical indication of the detected fixture. In some respects, the 7418 grip control sensors detect the actuation of one or more grip controls. Based on the detected actuation, the processor can initiate either a power-up sequence or a power-off sequence.

[00442] Communication circuit segment 7420 comprises communication circuit 7422. Communication circuit 7422 comprises a communication interface for facilitating signal communication between 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 modular transducer, when attached together to the surgical instrument handle, can carry control programs to the handle via the 7422 communication circuit.

[00443] The display circuit segment 7424 comprises an LCD display 7426. The LCD display 7426 may comprise a liquid crystal display, LED indicators, etc. In some respects, the 7426 LCD display is an organic light-emitting diode (OLED) display. A mesh may be placed on top of, recessed into, or located remotely from the 6480 surgical instrument described herein. For example, the mesh can be placed on the handle of the surgical instrument. The screen is configured to provide sensory feedback to a user. In many respects, the 7426 LCD display additionally features a backlight. In some aspects, 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.

[00444] “The 7428 motor control circuit segment comprises a 7430 motor control circuit coupled to a 7432 motor. The 7432 motor is coupled to the processor by a driver and a transistor, such as a FET. In various aspects, 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 current draw from the motor to the processor. The processor transmits the signal to the screen. The screen receives the signal and displays the 7432 motor draw current measurement. The processor can use the signal, for example, to monitor that the 7432 motor draw current exists within an acceptable range to compare draw current with one or more parameters of the plurality of circuit segments, and for determining one or more parameters of a patient treatment site. In many respects, the 7430 engine control circuit comprises an engine controller to control engine operation. 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 flowing through the 7432 motor, measured by the motor current sensor.

[00445] 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 actuate a mechanism of the 6480 surgical instruments described herein. For example, the 7432 motor is configured to control the actuation of the surgical instrument drive shaft to perform grip, rotation and articulation functionalities. For example, the 7432 motor can actuate the drive shaft to perform a gripping motion with the jaws of the surgical instrument. The motor controller can determine whether the material held by the grips is fabric or metal. The motor controller can also determine the extent to which the grips hold the material. For example, the motor controller can determine how to open or close the jaws based on the shunt of the motor sensed current or the motor voltage. In some respects, the 7432 motor is configured to actuate the transducer to cause the transducer to apply torque to the handle or control the articulation of the surgical instrument. The motor current sensor can interact with the motor controller to set a motor current limit. When the current satisfies 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 current draw from the motor.

[00446] The 7434 power handling circuit segment comprises an RF amplifier and 7436 safety circuit and a 7438 ultrasonic signal generator circuit to implement the modular power functionality of the 6480 surgical instrument described herein. . In several respects, the RF amplifier and 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 power mode by generating an ultrasonic signal. The 7436 RF amplifier and safety circuit and a 7438 ultrasonic signal generator circuit can operate together to control the combined modality of RF and ultrasonic energy.

[00447] The 7440 Drive Shaft Circuit Segment comprises a 7442 Drive Shaft Module Controller, a 7444 Modular Control Actuator, one or more 7446 End Actuator Sensors, and a 7448 Nonvolatile Memory. drive axis module 7442 is configured to control a plurality of drive axis modules comprising the control programs to be executed by the processor.

The plurality of drive shaft modules implements a drive shaft modality, eg ultrasonic, combination of ultrasonic and RF, blade in profile | of RF and by clamp opposed by RF.

The 7442 drive axis module controller can select the drive axis mode by selecting the corresponding drive axis module for the processor to operate.

The 7444 Modular Control Actuator is configured to actuate the drive shaft according to the selected drive shaft mode.

After actuation is initiated, the drive shaft pivots the end actuator according to one or more parameters, routines or programs specific to the selected axis mode and selected end actuator mode.

The one or more 7446 end actuator sensors, located on the end actuator, may include force sensors, temperature sensors, current sensors, or motion sensors.

The one or more 7446 end actuator sensors transmit data about one or more end actuator operations, based on the power mode implemented by the end actuator.

In many respects, 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 drive shaft control programs. A control program comprises one or more parameters, routines or programs specific to the drive axis. In many respects, the 7448 non-volatile memory can be ROM, EPROM, EEPROM, or flash memory. The 7448 non-volatile memory stores the drive axis modules corresponding to the selected drive axis of the 6480 surgical instrument described here. Drive axis modules can be changed or updated in the 7448 non-volatile memory by the 7442 drive axis module controller, depending on the drive axis of the surgical instrument to be used in the operation.

[00448] 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 description. In various aspects, the surgical instrument 6480 described herein may include a drive mechanism 7930 that is configured to drive drive shafts and/or gear components in order to perform the various operations associated with the surgical instrument 6480. In one aspect, the 7930 drive mechanism includes a 7932 rotation drive train configured to rotate an end actuator, for example, about a longitudinal axis with respect to the grip housing. The 7930 drive mechanism further includes a 7934 closure system drive train configured to close a gripper member for gripping the fabric with the end actuator. In addition, the 7930 drive mechanism includes a 7936 fire drive train configured to open and close an end actuator grip arm portion to grip tissue with the end actuator.

[00449] The 7930 drive mechanism includes a 7938 selector gearbox assembly that may be located on the surgical instrument handle assembly. Proximal to the 7938 selector gearbox assembly is a function selection module that includes a 7942 first motor that functions 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 optional 7944 second engine input drive component and 7946 engine drive circuit (shown in dashed line to indicate that the 7944 second engine and 7946 engine drive circuit are components options).

[00450] — Still referring to Figure 41, the 7942 and 7944 motors are coupled to the 7946, 7948 motor control circuits, respectively, which are configured to control the operation of the 7942 and 7944 motors, including power flow power source from a 7950 power source for the 7942 and 7944 engines. The 7950 power source can be a DC battery (eg, a lead-based, nickel-based, lithium-ion, rechargeable battery pack). , etc.) or any other source of energy suitable for supplying electrical energy to the surgical instrument.

[00451] 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 may store multiple program instructions which, when executed, may cause processor 7954 to perform a plurality of functions and/or calculations described herein. The 7950 power supply can be configured to supply power to the 7952 controller, for example.

[00452] The 7954 processor can be in communication with the 7946 motor control circuit. In addition, the 7956 memory can be archived.

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

[00453] The 7952 controller and/or the other controllers of the present description may be implemented using integrated and/or discrete hardware elements, software elements and/or a combination of both. Examples of integrated hardware elements may include processors, microprocessors, microcontrollers, integrated circuits, ASICs, PLDs, DSPs, FPGAs, logic gates, registers, semiconductor devices, integrated circuits, microcircuits, chipsets, microcontrollers, system on an integrated circuit (chip)(SoC) and/or single in-line package (SiP). Examples of discrete 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, the 7952 controller may include a hybrid circuit comprising elements or components of isolated circuits and integrated into one or more substrates, for example.

[00454] In certain examples, the 7952 controller and/or the other controllers of the present description 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 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to optimize performance above 40 MHz, a 32KB single-cycle SRAM, internal ROM loaded with StellarisWareG& software, 2KB EEPROM, one or more PWM modules, one or more QEI analogues, one or more 12-bit ADCs 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 description should not be limited in that context.

[00455] In various examples, one or more of the various steps described herein can be performed by a finite state machine that comprises a combinational logic circuit or a sequential logic circuit, where the combinational logic circuit or the sequential logic circuit is coupled, along with 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 execute the steps. The sequential logic circuit can be synchronous or asynchronous. In other examples, one or more of the various steps described here can be performed by a circuit that includes a combination of the 7958 processor and the finite state machine, for example.

[00456] In many 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 multiple motors, drive trains, and/or gear components to perform the various operations of the surgical instrument, wears out over time. . This can occur through normal use, and in some cases, the drive mechanism may wear out more quickly due to conditions of abusive use. In certain cases, a surgical instrument can be configured to perform self-assessments to determine the status, ie health, of the actuation mechanism and its various components.

[00457] For example, self-assessment can be used to determine when the surgical instrument is able to perform its function before re-sterilization or when some of the components need to be replaced and/or repaired. The evaluation of the drive mechanism and its components, including but not limited to the 7932 rotation drive train, the 7934 closing drive train, and/or the 7936 firing drive train, can be performed in a variety of ways. shapes. The magnitude of deviation from predicted performance can be used to determine the probability of a detected failure and the severity of that failure. Various metrics can be used, including: Periodic analysis of repeatedly predictable events, rises or falls that exceed an expected threshold, and the extent of failure.

[00458] “In many cases, a signature waveform of a properly operating drive mechanism or one or more of its components may be employed 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 properly operating drive mechanism or one or more of its components to record various vibrations that occur during the operation of the properly operating drive mechanism or one or more of its components. . The recorded vibrations can be employed 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.

[00459] Still referring to Figure 41, the 7930 surgical instrument includes a 7962 drive train failure detection module configured to record and analyze one or more acoustic outputs from one or more of the 7932, 7934 drive trains, 7936. The 7954 processor can be in communication with or otherwise control the 7962 module. As described in more detail below, the 7962 module can be incorporated as various means, such as circuits, hardware, a software program product, computer comprising computer-readable media (for example, the 7956 memory) 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.

[00460] Figure 42 is an alternative system 132000 for controlling the frequency of an ultrasonic electromechanical system 132002 and detecting the impedance thereof, in accordance with at least one aspect of the present disclosure. The 132000 system can be incorporated into a generator. A processor 132004 coupled to a memory 132026 programs a programmable counter 132006 to tune to the output frequency fo of the ultrasonic electromechanical system 132002. The input frequency is generated by a crystal oscillator 132008 and is entered into a fixed counter 132010 to scale the frequency to a suitable 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 132012 phase/frequency detector is applied to a 132014 active filter amplifier/circuit to generate a tuning voltage V: which is applied to a 132016 voltage controlled oscillator (VCO, "voltage controlled oscillator" ). The VCO 132016 applies the output frequency f. to an ultrasonic transducer portion of the 132002 ultrasonic electromechanical system, shown here modeled as an electrical equivalent circuit. The voltage and current signals applied to the ultrasonic transducer are monitored by a 132018 voltage sensor and a 132020 current sensor.

[00461] The outputs of 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 The 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 therethrough. Optionally, the outputs of the voltage and current sensors 132018, 132020 can be applied to the respective channels of the two ADC channels 132024 and fed to the 132004 processor for zero crossing, FFT, or other algorithm described here to determine the phase angle between the voltage and current signals applied to the 132002 ultrasonic electromechanical system.

[00462] — Optionally the tuning voltage V ;, which is proportional to the output frequency f., can be fed back to the 132004 processor via the 132024 ADC. This provides the 132004 processor with a feedback signal proportional to the input frequency. exit f. and can use this feedback to adjust and control the output frequency fo.

temperature inference

[00463] 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 description . 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 phase angle of impedance q 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 graphical representation of magnitude of impedance |Z| as a function of the resonant frequency f, of the same ultrasonic device with a cold ultrasonic blade and a hot ultrasonic blade. The phase angle of the impedance q and the impedance magnitude |Z| they are at least at the resonant frequency fo.

[00464] —The impedance of the ultrasonic transducer Za(t) can be measured as the ratio between the generator voltage drive signals Va(t) and generator current la(t): V,(t) Zgc) = O)

[00465] — As shown in Figure 43A, when the ultrasonic blade is cold, for example at room temperature and not heated by friction, the electromechanical resonant frequency f. of the ultrasonic device is approximately 55,500 Hz and the excitation frequency of the ultrasonic transducer is set to 55,500 Hz. Thus, when the ultrasonic transducer is excited at the electromechanical resonance frequency f, and the ultrasonic blade is cold, the phase angle q is at least or approximately equal to O rad as indicated by the cold blade curve 133002. As shown in Figure 43B, when the ultrasonic blade is cold and the ultrasonic transducer is excited at the electromechanical resonant frequency fo, the impedance magnitude |Z] is 800 O, for example, impedance magnitude |Z| is at an impedance minimum, and the trigger signal amplitude is at a maximum due to the series resonance equivalent circuit of the ultrasonic electromechanical system as depicted in Figure 25.

[00466] Again with reference to Figures 43A and 43B, when the ultrasonic transducer is driven by generator voltage signals Va(t) and generator current signals /9(t) at electromechanical resonance frequency f, 55,500 Hz, the phase angle q between the generator voltage signals V,1(t) and the generator current /74(t) is zero, the impedance magnitude |Z| is at an impedance minimum, for example 800 O, and the signal amplitude is at a peak or maximum due to the series resonance equivalent circuit of the ultrasonic electromechanical system. As the temperature of the ultrasonic blade increases, due to frictional heat generated in use, the electromechanical resonant frequency f.' of the ultrasonic device decreases. As the ultrasonic transducer is still driven by the generator voltage V,6(t) and generator current /7(t) signals at the anterior resonant electromechanical frequency (cold blade) f, 55,500 Hz, the ultrasonic device operates out of resonance f', causing a shift in phase angle q between the generator voltage signals V,(t) and generator current signals /4(t). There is also an increase in the impedance magnitude |Z| and a drop in the peak magnitude of the trigger signal from the previous electromechanical resonant frequency (cold blade) of 55,500 Hz. Consequently, the temperature of the ultrasonic blade can be inferred by measuring the phase angle. q between the generator voltage Va(t) and generator current signals /7(t) when the electromechanical resonance frequency f, changes due to changes in the temperature of the ultrasonic blade.

[00467] 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) that comprises a first branch having a static capacitance and a second "moving" branch having an inductance, resistance, and series connected 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 Va,(t) and an alternating current /1(t) at a frequency equal to the electromechanical resonant frequency, eg resonant frequency of the electromechanical ultrasonic system. When the electromechanical ultrasonic system is excited at the resonant frequency, the phase angle q between the voltage signals Va(t) and current signals /7(t) is zero.

[00468] In other words, at 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 sheet heats up, for example due to frictional engagement with tissue, the conformance of the ultrasonic sheet (modeled as an analog capacitance) causes a shift in the resonant frequency of the electromechanical ultrasonic system. In the present example, the resonant frequency of the ultrasound system

The electromechanical noise 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 shift between the drive frequency and the new resonant frequency of the electromechanical ultrasonic system. Thus, with a hot ultrasonic blade, the electromechanical ultrasonic system operates "out of resonance". The difference between the drive frequency and the resonant frequency is manifested as a phase angle q between the voltage signals V,a(t) and current /1(t) applied to the ultrasonic transducer.

[00469] As previously discussed, the electronic circuit of the generator can easily monitor the phase angle q between the voltage signals Va(t) and current /14(t) applied to the ultrasonic transducer. The phase angle q can be determined by Fourier analysis, weighted least squares estimation, Kalman filtration, vector-space based techniques, zero crossing method, Lissajous figures, three voltmeter method, "crossed" method. -coil", 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 q and adjust the drive frequency until the phase angle q becomes zero. At this point, the new drive frequency is equal to the resonant frequency of the new electromechanical ultrasonic system. The change in phase angle q and/or generator drive frequency can be used as an indirect or inferred measurement of the temperature of the ultrasonic blade.

[00470] There are a variety of techniques available to estimate 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 temperature of the ultrasonic blade and the measured impedance: Zoo = o across a range of drive frequencies generator, and the generator drive frequency range is specific to the device model. Temperature estimation methods

[00471] One aspect of estimating or inferring the temperature of an ultrasonic slide may include three steps. First, define a temperature and frequency state space model that is time and energy dependent. To model temperature as a function of frequency content, a set of nonlinear state space equations are used to model the relationship between electromechanical resonance frequency and ultrasonic blade temperature. 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 hence the ultrasonic blade, to regulate the temperature of the ultrasonic blade. The three steps are described later in this document. Step 1

[00472] The first step is to define a temperature and frequency state space model that is time and energy dependent. To model temperature as a function of frequency content, a set of nonlinear state space equations are used to model the relationship between electromechanical resonance frequency and ultrasonic blade temperature. In one aspect, the state space model is defined by:

FAITH, E] = f(t,T(O), F.(O), EM) 3 = h(t, T(O), E, (t), E(t))

[00473] “The state space model represents the rate of change of the natural frequency of the electromechanical ultrasonic system £, and the rate of change of the temperature 7 of the ultrasonic blade with respect to the natural frequency Fw, temperature T(t), energy E(t), and time t. y represents the observability of variables that are measurable and observable, such as the natural frequency F,.«, of the electromechanical ultrasonic system, the temperature T(t) of the ultrasonic blade, the energy E(t) applied to the ultrasonic blade, and the time t. The temperature T(t) of the ultrasonic blade is observable as an estimate. step 2

[00474] 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 filter 133020 to improve the temperature estimator and the impedance-based state space model according to the equation: V, (t) Zac) = O) which represents the impedance across of an ultrasonic transducer measured at a variety of frequencies, in accordance with at least one aspect of the present disclosure.

[00475] —The Kalman 133020 filter can be employed to improve temperature estimation performance and allows augmentation of external sensors, models, or prior information to improve temperature prediction in the midst of noisy data. The 133020 Kalman 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 a variable of feedback u. The state estimator 133026 is an internal feedback system that converges to the actual value of the state of the system. The output of the 133026 state estimator is Z, the complete feedback control variable including Fry of the electromechanical ultrasonic system, the estimate of the temperature T(t) of the ultrasonic blade, the energy E(t) applied to the ultrasonic blade, the phase angle q, and time t. The input into the K 133028 controller is X and the output of the K 133028 controller u is fed back to the state estimator 133026 and t of the 133024 plant.

[00476] Kalman filtering, 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 the unknown variables that tend to occur. may 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 thus calculating the maximum probability estimate of actual measurements. The algorithm works in a two-step process. In a prediction step, the Kalman filter 133020 produces estimates of the current state variables, along 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 given to the estimates with greater certainty. The algorithm is recursive and can be executed in real time, using only the present input measurements and the previously calculated state and its uncertainty matrix; no additional past information is required.

[00477] The 133020 Kalman filter uses a dynamic model of the electromechanical ultrasonic system, known control inputs for that system, and multiple sequential measurements (observations) of the natural frequency and phase angle of the applied signals (e.g., mag - nitude and phase of the electrical impedance of the ultrasonic transducer) to the ultrasonic transducer to form an estimate of the variable quantities 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 just a single measurement. As such, the 133020 Kalman filter is an algorithm that includes sensor and data fusion to provide the maximum probability estimate of the temperature of the ultrasonic blade.

[00478] The ffilttodeKalman 133020 effectively estimates the uncertainty due to 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 133020 Kalman filter produces an estimate of the state of the electromechanical ultrasonic system as a weighted average of the predicted state of the system and the remeasurement. Weighted values provide better (ie, lower) estimated uncertainty and are more "reliable" than unweighted values. Weights can be calculated from covariance, a measure of the estimated uncertainty of the prediction of the state of the system. The weighted average result is a new state estimate that lies between the predicted and measured state, and has a better estimated uncertainty than either one alone. This process is repeated at each time step, with the new estimate and its covariance generating the prediction used in the next iteration. This recursive nature of the 133020 Kalman filter requires only the last "best guess", rather than the entire history, of the state of the electromechanical ultrasonic system to calculate a new state.

[00479] —The relative accuracy of measurements and current state estimation is an important consideration, and it is common to discuss the filter response in terms of the K gain of the 133020 Kalman filter. The Kalman K gain is the relative weight assigned to the measurements and current state estimation, and can be "tuned" to achieve a specific performance. With a high K gain, the Kalman 133020 filter puts more weight on the latest measurements, and thus follows them more responsively. With a low K gain, the 133020 Kalman filter more closely follows the model predictions. Of either extreme, a high gain close to one will result in a more irregular estimated trajectory, while a low gain close to zero will flatten noise but decrease responsiveness.

[00480] “When performing the actual calculations for the Kalman filter 133020 (as discussed below), the state estimate and covariances are encoded in covariance matrices to handle 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, velocity, and acceleration) in any of the models or transition covariances. Using a 133020 Kalman 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 Gaussian distributed.

Step 3

[00481] The third step uses a 133026 estimator in the 133032 feed-back state of the Kalman filter 133020 to control the power applied to the ultrasonic transducer, and consequently to the ultrasonic blade, to regulate the temperature of the ultrasonic blade.

[00482] 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 estimates, in accordance with at least one aspect of the present description. The probability distributions include the prior 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 a feedback control. of energy 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 impedance is given by the expression: V(t Zotw) = what is the impedance across the ultrasonic transducer measured at a range of frequencies, from according to at least one aspect of the present description.

[00483] The previous probability distribution 133042 includes a state variance defined by the expression:

(0x)? = of, +oê,

[00484] The variance of state (07) is used to predict the next state of the system, which is represented as the probability distribution of prediction (state) 133044. The probability distribution of observation 133046 is the probability distribution of actual observation of the state of the system where the observation variance o,, is used to define the gain, which is given by the following expression: or 2 K= ts í oz Feedback control circuit

[00485] —Power input is decreased to ensure that the temperature (as estimated by the state estimator and the Kalman filter) is controlled.

[00486] 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 (ie temperature regulation with feedback control), the temperature of the ultrasonic blade tip can be directly controlled. 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.

[00487] Figure 46A is a 133050 graphical representation of temperature versus time of an ultrasonic device without temperature feedback control. The temperature (ºC) of the ultrasonic blade is shown along the vertical axis and the time

(s) is shown along the horizontal axis. The test was conducted with a chamois located in the grips of the ultrasonic device. One grip is the ultrasonic blade and the other grip is the grip arm with a Teflon block. The ultrasonic blade was excited at the resonant frequency while in frictional engagement with the chamois clamped between the ultrasonic blade and the clamping arm. Over time, the temperature (°C) of the ultrasonic blade increases due to frictional engagement with the suede. Over time, the 133052 temperature profile of the ultrasonic blade increases until the suede sample is cut after approximately 19.5 seconds at a temperature of 220°C as indicated in 133054. No temperature feedback control after the When cutting the suede sample, the temperature of the ultrasonic blade rises to a temperature well above the melting point of Teflon -380ºC to -490ºC. At point 133056, the temperature of the ultrasonic blade reaches a maximum temperature of 490ºC until the Teflon block is completely melted. The temperature of the ultrasonic blade drops slightly from the peak temperature at point 133056 after the block disappears completely.

[00488] 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 description. The temperature (*C) of the ultrasonic blade is shown along the vertical axis and the time (s) is shown along the horizontal axis. The test was conducted with a suede sample located in the jaws of the ultrasonic device. One grip is the ultrasonic blade and the other grip is the grip arm with a Teflon block. The ultrasonic blade was excited at the resonant frequency while in frictional engagement with the suede clamped between the ultrasonic blade and the clamping arm block. Over time, the temperature profile 133062 of the ultrasonic blade increases until the suede sample is cut after about 23 seconds at a temperature of 220°C as indicated in point 133064. With temperature feedback control, the temperature of the blade The ultrasonic beam rises 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 melting of the TE-FLON block. Application of smart ultrasonic blade technology

[00489] — When an ultrasonic blade is immersed in a fluid-filled surgical field, the ultrasonic blade cools during activation and becomes less effective for sealing and cutting tissue in contact with it. Ultrasonic blade cooling can lead to longer activation times and/or hemostasis problems because adequate heat is not applied to the tissue. To overcome ultrasonic blade cooling, more energy application may be required to shorten 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 stay below a certain temperature for a certain period of time, the output power of the generator may change. be increased to compensate for cooling due to blood/saline/other fluid present in the surgical field.

[00490] —Consequently, the temperature-frequency feedback control system described herein can optimize the performance of an ultrasonic device especially when the ultrasonic blade is situated or immersed, partially or fully, in a fluid-filled surgical field. The frequency-temperature feedback control system described herein minimizes long turn-on times and/or potential problems with the performance of the ultrasonic device in the fluid-filled surgical field.

[00491] — 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: V,(t) Zac) = O) or equivalently, the detection of the phase angle q between the voltage signals Va(t) and current /74(t) applied to the ultrasonic transducer. The phase angle information q can also be used to infer the conditions of the ultrasonic slide. As particularly discussed here, the phase angle q changes as a function of the temperature of the ultrasonic blade. Therefore, the information from the phase angle q can be used to control the temperature of the ultrasonic blade. This can be done, for example, by reducing the power supplied to the ultrasonic blade when the ultrasonic blade is too hot and by increasing the power applied to the ultrasonic blade when the ultrasonic blade is too 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 temperature of an ultrasonic blade is detected.

[00492] Figure 47A is a graphical representation of the 133070 ultrasonic power output as a function of time, in accordance with at least one aspect of the present description. The output power of the ultrasonic generator is shown along the vertical axis and the time (s) is shown along the horizontal axis. Figure 47B is a graphical representation of the temperature of the 133080 ultrasonic blade as a function of time, in accordance with at least one aspect of the present description. The temperature of the ultrasonic blade is shown along the vertical axis and the time(s) is shown along the horizontal axis. The temperature of the ultrasonic blade increases with the application of constant power 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 fluid-filled surgical drape (e.g. blood, saline, water, etc.). ). At time to, the temperature of the ultrasonic blade drops below the minimum desired 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 increase of power 133074 supplied to the ultrasonic blade to start raising the temperature of the ultrasonic blade above the minimum desired temperature 133082.

[00493] “Referring 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 to, the processor or control circuit in the generator or instrument, or both, detects the drop in temperature of the ultrasonic blade below the minimum desired temperature 133072 and initiates a frequency-temperature feedback control algorithm to raise the temperature of the ultrasonic blade above the minimum desired temperature 133082. Consequently, the generator power starts to rise 133074 in t, corresponding to the detection of a sudden drop in the temperature of the ultrasonic blade in to. Under the frequency feedback control algorithm-

temperature, power continues to rise 133074 until the temperature of the ultrasonic blade is above the minimum desired temperature

133082.

[00494] Figure 48 is a 133090 logic flow diagram of a process representing a control program or logic configuration for controlling the temperature of an ultrasonic blade, in accordance with at least one aspect of the present disclosure. Depending on the process, the processor or control circuit of the generator or instrument, or both, performs one aspect of a frequency-temperature feedback control algorithm discussed in connection with Figures 47A and 47B for apply a 133092 power level to the ultrasonic transducer to achieve a desired temperature on the ultrasonic blade. The 133094 generator monitors the phase angle q between the voltage signals Va(t) and current /g4(t) applied to drive the ultrasonic transducer. Based on the phase angle q, the generator infers 133096 infers the temperature of the ultrasonic blade using the techniques described herein in connection with Figures 43A to 45. The generator determines 133098 if the temperature of the ultrasonic blade is below a minimum temperature. - target temperature by comparing the inferred temperature of the ultrasonic blade with a predetermined target 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 blade temperature is at or above the desired minimum temperature and continues along the YES branch when the ultrasonic blade temperature is below the desired minimum temperature . When the temperature of the ultrasonic blade is below the minimum desired temperature, the generator increases the power level to the ultrasonic transducer by 133100, for example by increasing the voltage signals V 1(t) and/or current / 4(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 rises above the minimum desired temperature. Adaptive advanced fabric treatment block saver mode

[00495] Figure 49 is a graphical representation 133110 of the temperature of the ultrasonic blade as a function of time during the firing of a vessel, in accordance with at least one aspect of the present description. A 133112 graph of the temperature of the ultrasonic blade is plotted along the vertical axis as a function of time along the horizontal axis. Frequency-temperature feedback control algorithm combines ultrasonic blade control temperature with grip detection capability. Frequency-temperature feedback control algorithm provides optimal hemostasis balanced with device durability and can intelligently distribute energy for better sealing while protecting the clamp arm block.

[00496] “As shown in Figure 49, the optimum temperature 133114 for the vessel seal is marked as a first target temperature T, and the optimum temperature 133116 for the "infinite" life of the clamp arm block is marked as a second target temperature T2. Frequency-temperature feedback control algorithm infers the temperature of the ultrasonic slide and maintains the temperature of the ultrasonic slide between the first and second target temperature thresholds T; and T2. The generator's power output is thus driven to obtain optimal temperatures from the ultrasonic blade to seal the vessels and extend the life of the clamp arm block.

[00497] Initially, the temperature of the ultrasonic blade increases as the blade heats up and eventually exceeds the first target temperature threshold T,. The frequency-temperature feedback control algorithm assumes control of the temperature of the slide for T, until the vessel transection is completed 133118 in to and the temperature of the ultrasonic slide falls below the second target temperature threshold T2. A processor or control circuit of the generator or instrument, or both, detects when the ultrasonic blade makes contact with the clamp arm block. When vessel transfection is completed in to and detected, the frequency-temperature feedback control algorithm switches to control the temperature of the ultrasonic blade to the second target threshold T2 to prolong the life of the clamp arm block. The optimum clamp arm block temperature for a TEFLON clamp arm block is approximately 325°C. In one aspect, advanced fabric treatment can be announced to the wearer in a second activation tone.

[00498] Figure 50 is a 133120 logic flow diagram of a process representing a control program or logic setup to control the temperature of an ultrasonic blade between two temperature set points, as shown in Figure 49, in accordance with at least one aspect of the present disclosure. According to the process, the generator performs an aspect of the frequency-temperature feedback control algorithm to apply a first power level 133122 to the ultrasonic transducer, for example, by adjusting the voltage signals V,(t) and /or current /74(t) applied to the ultrasonic transducer, to adjust the ultrasonic blade to a first target temperature T, optimized for vessel sealing. As previously described, the generator 133124 monitors the phase angle q between the voltage signals Va(t) and current /7(t) applied to the ultrasonic transducer, and based on the phase angle q, the generator 133126 infers the temperature of the ultrasonic blade using the techniques described herein in connection with Figures 43A to 45. According to the frequency-temperature feedback control algorithm, a processor or control circuit of the generator or instrument, or both maintain the temperature of the ultrasonic slide at the first target temperature T, until the transection is complete. The frequency-temperature feedback control algorithm can be used to detect completion of the vessel transection process. The generator or instrument processor or control circuit, or both, determines 133128 when vessel 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.

[00499] “When the vessel transection is not complete, the processor or control circuit of the generator or instrument, or both, determines 133130 whether the temperature of the ultrasonic blade is set at temperature T, optimized for sealing and vessel transection . If the temperature of the ultrasonic blade is set to T1, the process continues along the SIM branch and the processor or control circuit of the generator or instrument, or both, continues to monitor 133124 the phase angle q between the signals voltage V,(t) and current Ia(t) applied to the ultrasonic transducer and based on the phase angle q. If the ultrasonic blade temperature is not set 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.

[00500] — When 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 optimized target temperature 2 to preserve or extend the life of the clamp arm block. The processor or control circuit of the generator or instrument, or both, determines

133134 if the temperature of the ultrasonic blade is at the set temperature T2. If the temperature of the ultrasonic blade is set to 12, the process completes the vessel transection procedure. Blade Start Temperature

[00501] — Knowing the temperature of the ultrasonic blade at the beginning of a transection can allow the generator to supply the proper 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 necessary. This technique can achieve more consistent transection times and prolongs the life of the clamp arm block (eg a TEFLON clamp arm block). Knowing the temperature of the ultrasonic blade at the beginning of the transection can allow the generator to supply the right amount of power to the ultrasonic transducer to generate a desired amount of displacement of the ultrasonic blade.

[00502] Figure 51 is a 133140 logic flow diagram of a process representing a control program or logic configuration for determining the initial temperature of an ultrasonic blade, in accordance with at least one aspect of the present description. To determine the starting temperature of an ultrasonic slide, in manufacturing facilities, the resonant frequencies of ultrasonic slides are measured at room temperature or at a predetermined room temperature. Baseline frequency values are recorded and stored in a lookup table of the generator or instrument or both. Baseline values are used to generate a transfer function. At the beginning of an ultrasonic transducer activation cycle, the generator measures 133142 the resonant frequency of the ultrasonic blade 133144 and compares the measured resonance frequency to the resonant frequency value at baseline and determines the frequency difference (4f). The Af is compared to a look-up table or transfer function to obtain the corrected temperature of the ultrasonic slide. The resonant frequency of the ultrasonic blade can be determined by scanning the frequency of voltage signals V,(t) and current /4(t) applied to the ultrasonic transducer. The resonant frequency is the frequency at which the phase angle q between the voltage signals V,(t) and current signals /J(t) is zero as described herein.

[00503] After the resonant 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 resonant frequency and the baseline resonance frequency. The generator adjusts the power level supplied to the ultrasonic transducer, for example by setting the voltage trigger signals V,a(t) or current /79(t), or both, to one of the following values before activating the ultrasonic transducer.

[00504] The processor or control circuit of the generator or instrument, or both, determines 133148 if the start 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 control circuit of the generator or instrument, or both, 133152 applies a high level of power to the ultrasonic transducer to increase the temperature of the blade. 133156 ultrasonic slide and complete the vessel transection procedure.

[00505] If the start 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 start temperature of the ultrasonic blade is high. If the initial temperature of the ultrasonic blade is low, the process continues along the SIM branch and the processor or control circuit of the generator or instrument, or both, 133154 applies a low level of power to the ultrasonic transducer to decrease the ultrasonic slide temperature and completes 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 133156 transection of the vessel. Smart blade technology to control blade instability

[00506] —The temperature of an ultrasonic blade and the contents within the jaws 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.

[00507] — As described here, there is a well-known relationship between frequency and temperature in ultrasonic slides. Some ultrasonic slides exhibit 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 driving the ultrasonic transducer (for example, by adjusting the voltage drive signals V,(t) ) or current /7(t), or both, applied to the ultrasonic transducer) to modulate the temperature of the ultrasonic blade to prevent instability of the ultrasonic blade.

[00508] Figure 52 is a 133160 logic flow diagram of a process representing a control program or logic setup 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. The frequency/temperature relationship of an ultrasonic blade that exhibits a shift or modal instability is mapped by scanning the frequency of the voltage trigger signals V,(t) or current /1(t), or both. , at the temperature of the ultrasonic slide 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 drive power level is reduced (e.g. by reducing the voltage Va(t) or /7(t) drive current, or both, applied to the ultrasonic transducer) to modulate the temperature of the ultrasonic blade at or below the trigger point to prevent a given blade from becoming unstable.

[00509] Advantages include simplification of ultrasonic blade settings so that the instability characteristics of the ultrasonic blade do not need to be designed and can be compensated for using the present instability control technique. The present instability control technique also allows for new ultrasonic slide geometries and can improve the stress profile on heated ultrasonic slides. In addition, ultrasonic blades can be configured to decrease the performance of the ultrasonic blade if used with generators that do not use this technique.

[00510] 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 q between the voltage signals Va(t) and voltage current /4(t) applied to the ultrasonic transducer. The processor or control circuit of the generator or instrument, or both, infers 133164 the temperature of the ultrasonic blade based on the phase angle q between the voltage signals V,(t) and current /7(t) applied to the ultrasonic transducer. The generator or instrument processor or control circuit, or both, compares 133166 the inferred temperature of the ultrasonic blade to a trigger point threshold of the ultrasonic blade instability. The generator or instrument processor or control circuit, or both, determines 133168 if the ultrasonic blade is approaching instability. If not, the process proceeds along the NO branch and monitors 133162 the phase angle q, infers 133164 the temperature of the ultrasonic blade, and compares 133166 the inferred temperature of the ultrasonic blade to an ultrasonic blade instability trigger point threshold up to the ultrasonic blade approaches instability. The process then proceeds along the SIM branch and either the processor or control circuit of the generator or instrument, or both, adjusts 133170 the power level applied to the ultrasonic transducer to modulate the temperature of the ultrasonic blade. Ultrasonic sealing algorithm with temperature control

[00511] — Ultrasonic sealing algorithms for ultrasonic blade temperature control can be used to optimize hemostasis by using a frequency-temperature feedback control algorithm described here to explore the frequency/ temperature of the ultrasonic slides.

[00512] 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 resonant frequency (using spectroscopy) that refers to temperature, as described in various aspects of the present disclosure. In one aspect, the frequency-temperature feedback control algorithm can be activated by a power button on the ultrasonic instrument.

[00513] It is known that optimal tissue effects can be obtained by increasing the power level that drives the ultrasonic transducer (eg, by increasing the voltage Va(t) or driving current /7(t), or both, applied to the ultrasonic transducer) at the beginning of the sealing cycle to rapidly heat and dry the tissue, and then decrease the power level that drives the ultrasonic transducer (e.g., by decreasing the voltage Va(t) or the drive current /7(t), or both, applied to the ultrasonic transducer) to slowly allow the final seal to form. In one aspect, a frequency-temperature feedback control algorithm in accordance with the present description sets a threshold on the threshold temperature that tissue can reach as tissue heats 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 gripper 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/adaptive seal to further reduce the complexity of the hemostasis algorithm.

[00514] Figure 53 is a 133180 logic flow diagram of a process representing a control program or logic configuration to provide temperature controlled ultrasonic sealing in accordance with at least one aspect of the present description. According to the control algorithm, the processor or control circuit of the generator or instrument, or both, activates 133182 ultrasonic blade detection using spectroscopy (e.g. smart blade) and measures 133184 the resonant frequency of the ultrasonic blade

(eg, the resonant frequency of the electromechanical ultrasonic system) to determine the temperature of the ultrasonic blade using a frequency-temperature feedback control algorithm (spectroscopy) as described herein. As previously described, the resonant frequency of the electromechanical ultrasonic system is mapped to obtain the temperature of the ultrasonic blade as a function of the resonant frequency of the electromechanical ultrasonic system.

[00515] A first desired resonant frequency f. of the ultrasonic electromechanical system corresponds to a first desired temperature Zº of the ultrasonic blade. In one aspect, the first desired ultrasonic blade temperature Z° is the optimum temperature (eg, 450°C) for tissue coagulation. A second target frequency fy of the ultrasonic electromechanical system corresponds to a second target temperature ZZº of the ultrasonic blade. In one aspect, the second desired ultrasonic blade temperature ZZº is a temperature of 330ºC, which is below the melting point of the clamp arm block, approximately 380ºC which is for TEFLON.

[00516] The processor or control circuit of the generator or instrument, or both, compares 133186 the measured resonant frequency of the ultrasonic electromechanical system to the first desired frequency f.. In other words, the process determines whether the blade temperature ul - trasonic is lower than the temperature for optimal tissue coagulation. If the resonant frequency measurement of the ultrasonic electromechanical system is less than the first desired frequency f., the process continues along the NO branch and the processor or control circuit of the generator or instrument, or both, 133188 increases the power level applied to the ultrasonic transducer to increase the temperature of the ultrasonic blade until the measured resonant frequency of the ultrasonic electromechanical system exceeds the first desired frequency f. - cess controls the temperature of the ultrasonic blade to the second desired temperature corresponding to the second desired frequency f,.

[00517] 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 generator or instrument processor or control circuit, or both, measures 133192 the resonant frequency of the ultrasonic electromechanical system and compares the measured resonant frequency to the second desired frequency fy. If the measured resonant frequency is not less than the second desired frequency fy, the processor or control circuit of the generator or instrument, or both, decreases the ultrasonic power level by 133190 until the measured resonant frequency is less. than the second desired frequency fy. Frequency-temperature feedback control algorithm keeps the measured resonant frequency of the ultrasonic electromechanical system below the second desired frequency fy, e.g. the temperature of the ultrasonic blade is lower than the melting point temperature of the block Then, the generator performs the power level increases applied to the ultrasonic transducer to increase the temperature of the ultrasonic blade until the completion of the 133196 tissue transection process.

[00518] Figure 54 is a 133200 graphical representation of the ultrasonic transducer current and the ultrasonic blade temperature as a function of time, in accordance with at least one aspect of the present description. 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 against a second plot 133204 of the ultrasonic blade. ultrasonic transducer current /4(t) as a function of time. As shown, the /7(t) transducer is held constant until the temperature of the ultrasonic slide reaches 450º, which is an optimal coagulation temperature. When the temperature of the ultrasonic blade reaches 450º, the frequency-temperature feedback control algorithm decreases the transducer current /74(t) until the temperature of the ultrasonic blade drops below 330º, which is below the set point. fusion of a TEFLON block, for example.

Identification or parameterization of the type of fabric

[00519] In many respects, a surgical instrument (eg, an ultrasonic surgical instrument) is configured to identify or parameterize tissue trapped by the end actuator and adjust various operating parameters of the surgical instrument accordingly. Tissue identification or parameterization may include tissue type (eg, physiological tissue type), tissue physical characteristics or properties, tissue composition, tissue location within or in relation to the actuator end, 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 end actuator grips. As previously discussed, an ultrasonic instrument comprises an ultrasonic transducer acoustically coupled to an ultrasonic blade via 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 collagen/elastin ratio of the tissue detected. In another example discussed in more detail below, the force exerted by the gripping arm on the tissue can be modulated according to the tissue's location relative to the end actuator. Various techniques for identifying or parameterizing tissue are described in the present description and additional details can be found, for example, in US provisional patent application No. incorporated by way of reference in its entirety. Determining tissue location by changing impedance

[00520] — Again with reference to Figure 23, an end actuator 1122 comprising an ultrasonic blade 1128 and a clamping arm 1140 is illustrated, in accordance with at least one aspect of the present description. Figure 55 is a bottom view of an ultrasonic end actuator 1122 showing a gripping arm 1140 and an ultrasonic blade 1128 and delineating tissue positioning within the ultrasonic end actuator 1122 in accordance with at least one aspect of the present description. The positioning of the tissue between the gripping arm 1140 and the ultrasonic blade 1128 can be delineated according to the region or zone in which the tissue is situated, such as a distal region 130420 and a proximal region 130422.

[00521] — Now with reference to Figures 23 and 55, as described herein, the ultrasonic end actuator 1122 grips the tissue between the ultrasonic blade 1128 and the clamping arm 1140. When the tissue is gripped, 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 ultrasonic blade 1128 via 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 so as not to clot or cut the tissue. Non-therapeutic excitation can be particularly useful in determining the ultrasonic transducer impedance, which will vary based on a variety of conditions present in the 1122 end actuator, including, for example, tissue type, location of tissue inside the end actuator, the ratio between different types of tissue and the temperature of the ultrasonic blade, among other conditions. Several such conditions are described in the present description. The impedance of the ultrasonic transducer is given by: Zoc = ve as described here. Since conditions in the 1122 ultrasonic end actuator are determined using non-therapeutic ultrasonic energy levels, therapeutic ultrasonic energy can be applied based on the determined 1122 end actuator conditions to optimize tissue treatment, effective sealing, transection and duration, among other variables associated with a specific surgical procedure. The therapeutic energy is enough to clot and cut tissue.

[00522] In one aspect, the present description provides a control process, such as an algorithm, for determining the thickness and type of tissue situated within the jaws (i.e., between the gripping arm 1140 and the ultrasonic blade 1128) of a 1122 ultrasonic end actuator as shown in Figures 23 and 55. Additional details regarding the detection of various states and properties of gripped objects by a 1122 end actuator are discussed below under the heading "Determining the State of the Jaws" and in the US provisional patent application No. 62/692,768, entitled SMART ENERGY DEVICES.

[00523] Figure 56 is a 130000 graphical representation showing the change in ultrasonic transducer impedance as a function of tissue location within the 1122 ultrasonic end actuator over a range of predetermined increases in ultrasonic generator power level , in accordance with at least one aspect of the present description. Horizontal axis 130004 represents tissue location and vertical axis 130002 represents transducer impedance (OQ). Various boundaries along the horizontal axis 130004, such as a first boundary or proximal boundary 130010 and a second boundary or distal boundary 130012, may delineate or correspond to different positions of trapped tissue within the ultrasonic end actuator

1122. The delineation of the proximal and distal locations of the tissue is shown schematically in Figure 55 (i.e., proximal portion 130422 and distal portion 130420). Plots 130006, 130008 plot the change in transducer impedance (OQ) as the power applied to the ultrasonic transducer changes from a minimum value or first non-therapeutic power level L, to a maximum value or second non-therapeutic power level. therapeutic L2. The greater the change in transducer impedance (OQ), the closer the resulting plot will be to the distal limit.

130012. Consequently, the tissue location corresponds to the position of the resulting plot in relation to the various limits (eg, proximal limit 130010 and distal limit 130012). In the first plot 130006, à represents the change in transducer impedance when the tissue is situated in the proximal portion 130422 of the end actuator

1122. This can be seen from the fact that the first plot 130006 does not exceed the proximal limit 130010. In the second plot 130008, d2 represents the change in transducer impedance when the tissue is situated at the distal end 130012 of the actuator. end 1122. This can be seen from the fact that the first plot 130006 exceeds the proximal limit 130010 and/or is situated close to the distal limit 130012. As indicated by the plots 130006, 130008, 52 is much larger than a.

[00524] 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 coagulate tissue), the impedance of the The resulting measured transducer (OQ) is a useful indicator of the position of tissue within the jaws of the 1122 end actuator, either at the 130420 distal end or 130422 proximal end of the 1128 ultrasonic blade, as shown in Figure 55. of tissue within the 1122 end actuator can be determined based on the change in transducer impedance δ as the non-therapeutic power level applied to the ultrasonic transducer varies from a minimum power level (e.g., L1) to a maximum power level (eg L2). In some respects, the non-therapeutic power level (or levels) applied to the ultrasonic transducer may cause the 1128 ultrasonic blade to oscillate at or below the minimum therapeutic range (e.g., less than or equal to 35 one at the distal and/or proximal end of the 1128 ultrasonic blade). Impedance calculation is discussed earlier in this description.

A measurement of the first impedance of the transducer Z is taken when a first power level L is applied, which provides an initial measurement, and a subsequent measurement of the impedance Z is taken again when the applied power is increased to a second power level L2. In one aspect, the first power level L1 = 0.2A and the second power level L2 = 0.4A, or twice the first power level L1, although the voltage is held constant.

The amplitude of the resulting longitudinal displacement of the 1128 ultrasonic blade, based on the applied power level, provides an indication of tissue location within the 1122 end actuator jaws. In an exemplary implementation, the first power level L ; produces a longitudinal displacement amplitude 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 distal end 130420. one at the proximal end 130422. An algorithm calculates the difference in transducer impedance ô between the first and second measurements to find the change in impedance AZa(t). The change in impedance a is plotted as a function of tissue location and shows that a larger change in impedance represents the location of tissue distributed at the distal end 130012 and a smaller change in impedance represents the location of tissue distributed at the proximal end 130010 of the 1122 end actuator. In short, if there is a large change in impedance as the power level is increased from L, to L2, then the tissue will be positioned distally just inside the 1122 end actuator; on the other hand, if there is only a small change in impedance as the power level is increased by L; to L2, then the tissue will be more evenly distributed inside the end actuator

1122.

[00525] Figure 57 is a graphical representation of 130050 showing the change in ultrasonic transducer impedance as a function of time with respect to tissue location within the ultrasonic end actuator, in accordance with at least one aspect of the present description. The horizontal axis 130054 represents time (t) and the vertical axis 130052 represents the change in impedance of the transducer (5) between the first and second measurements. Plots 130060, 130066 plot the change in transducer impedance (5) as a function of time (t) in relation to the proximal and distal tissue locations at the bite of the grip arm 1140. For the proximal locations and distal to the tissue, a force is applied from the gripping arm 1140 to hold the tissue in the ultrasonic end actuator 1122 and a delay period is applied before a first low power level is applied and the transducer impedance is measured. Subsequently, the system applies a second higher power level and measures 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 executed by a processor or a portion of the generator control circuit, or the surgical instrument (e.g., processor 902 in Figure 21 or control circuit 760 in Figure 18) calculates the difference in impedance of the transducer (5) between the first power level and the second power level for proximal and distal tissue locations. As shown with respect to the first plot 130060, if the difference in impedance of the transducer (5) is below a first threshold 130056, the algorithm determines that the tissue is situated in the proximal portion 130422 of the end actuator 1122. On the first curve 130060, the transducer impedance difference between measurements increases by 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 ( 5) is above a second threshold 130058, the algorithm determines that the tissue is located in the distal portion 130420 of the end actuator

1122. In the second plot 130066, the transducer impedance difference between measurements increases 130068 over time until it stabilizes or stays 130070 above the second threshold 130058. If the transducer impedance difference (5) is between the first and the according to 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.

[00526] Figure 58 is a logic flow diagram of a 130100 process that represents a control program or a logic configuration to identify operation in the non-therapeutic power range of power applied to the instrument to determine tissue positioning in accordance with with at least one aspect of the present description. Process 130100 may be performed by a surgical instrument control circuit or processor, such as control circuit 760 of Figure 18, or a generator, such as processor 902 of Figure

21. For the sake of brevity, process 130100 will be described as being performed by a processor, but it should be understood that the following description encompasses the aforementioned variations.

[00527] — In accordance with an aspect of the 130100 process, a processor applies a control signal to close the squeezing arm 1140 to capture tissue between the squeezing arm 1140 and the ultrasonic blade 1128. After the clamping arm 1140 closes over the fabric. The processor waits for a predetermined delay period to allow the fabric to relax and release some 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 regard, the processor determines 130106 whether 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 power and iterates until the first power level is lower. than a therapeutic potency level. Process 130100 then continues along the SIM branch and the processor measures 130110 a first impedance Za1(t) of the ultrasonic transducer corresponding to the first power level.

tension. The processor then adjusts 130112, then the power level applied to the ultrasonic transducer to a second, non-therapeutic power level, with the second power level being greater than the first power level and below a non-therapeutic power level. therapeutic potency. Again, optionally, a feedback control can be used to verify that the second potency level is not only greater than the first potency level, but is also below a therapeutic potency level. In this regard, the processor determines 130114 whether the second power level is less than a therapeutic power level. If the second power level is greater than a therapeutic power level, process 130100 continues along the NO branch and the processor 130108 decreases the second power level and iterates until the second power level is less than a threshold of therapeutic potency level. Process 130100 then continues along the SIM branch and the processor measures 130116 a second impedance Za2(t) of the ultrasonic transducer corresponding to the second power level. The ultrasonic transducer impedance can be measured using a variety of techniques as discussed in this document. The processor then calculates 130118 the difference in transducer impedance between the first and second applied power levels: Ô = Za2(t) - Za1(t).

[00528] The processor then 130120 provides the user with an indication of the tissue position. The processor may indicate tissue position through an output device of a surgical instrument (e.g. visual feedback devices such as the screen shown in Figure 31, audio feedback devices and/or

tactile feedback), a display 135 (Figure 3) or other 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 (e.g. visual feedback devices, audio feedback devices and/or tactile feedback devices).

[00529] 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 (5) 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 impedance of the transducer (5) 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 impedance of transducer (5) is between the first and second thresholds 130056, 130058, the algorithm determines that the tissue is situated in the middle portion 130424 of end actuator 1122, for example , between the proximal and distal portions 130422, 130420 of the end actuator 1122. According to the described process, the impedance of the ultrasonic transducer can be used to differentiate the percentage of the tec ido that is situated at a distal portion, a proximal portion, or an intermediate location of the 1122 End Actuator, and then apply an appropriate therapeutic potency level. Keyless mode based on fabric positioning

[00530] In many respects, ultrasonic instrument reactions may depend on whether 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. - dy. Consequently, the ultrasonic surgical instrument or generator may contain and/or execute instructions to execute algorithms to control the time between grasping the tissue in the end actuator grips and activating the ultrasonic transducer to treat the tissue. If the presence of tissue is not detected, the ultrasonic generator activation buttons or pedals may 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 jaws of the end actuator as the cue 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 algorithm parameters for the type of tissue detected. For example, the advanced generator can ignore activation buttons or pedals unless tissue is detected as being in contact with the end actuator grips. This configuration would eliminate involuntary activation indications that would allow the device to be operated in a simpler way.

[00531] — 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 description, can be configured to operate in a keyless or buttonless mode. In a switchless mode, the ultrasonic device is automatically activated in coagulation mode when the presence of tissue is detected in the end actuator grips. 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 initially apply less power to the ultrasonic instrument than if activated when not operating in keyless mode. Additionally, the generator or ultrasonic instrument can be configured to determine the contact and tissue type situated in the end actuator grips. Based on the detection of the presence of tissue in the grips of the end actuator, control algorithms executed by a processor or control circuit of the generator or the ultrasonic instrument could run the ultrasonic instrument in switchless mode and could adjust the algorithm. to achieve the best overall tissue coagulation in the end actuator grips. In other respects, rather than automatically activating the surgical instrument and/or generator, control algorithms executed by a processor or control circuit of the generator or ultrasonic instrument could prevent the generator or ultrasonic instrument from activating. , unless the presence of tissue is detected at the end actuator.

[00532] In one aspect, the present disclosure provides an algorithm executed by a processor or control circuit located in the generator or handheld ultrasonic instrument to determine the presence of tissue and the type of tissue situated in the jaws of the end actuator. . In one aspect, the control algorithm can be configured to determine that tissue is situated within the end actuator using techniques described herein to determine tissue location as described below under the heading "Determining tissue location by means of continuity between electrodes". For example, a control algorithm can be configured to determine if tissue is situated within the end actuator by checking for any continuity between the electrodes (as described below) and consequently activating the surgical instrument (e.g. by doing the generator to which the surgical instrument is attached begins to apply power to the surgical instrument) automatically upon tissue detection or allowing the surgical instrument to be activated. When the surgical instrument and/or 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 respects, a control algorithm can be configured to activate or allow activation of the surgical instrument according to the specific tissue type or composition that can be detected, using, for example, the techniques described below. under the title "Determination of tissue collagen/elastin ratio according to infrared (IR) surface reflectance and emissivity". For example, the control algorithm can be configured to activate the surgical instrument when tissue that has a high collagen content is trapped, but not necessarily activate the surgical instrument when tissue with a high elastin composition is trapped. . In some respects, a control algorithm can be configured to activate or allow activation of the surgical instrument depending on whether the trapped tissue is situated in a specific position within the end actuator or if a certain amount of tissue was clamped by the end actuator using, for example, the techniques described below under the heading "Determining 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 situated at the distal end of the end actuator.

[00533] In other respects, a control algorithm can be configured to determine whether the fabric has been gripped by the end actuator, the fabric type or fabric composition, and other characteristics of the end actuator or fabric by through a situational recognition system, as described in US provisional patent application Serial No. 62/659,900, entitled METHOD OF HUB COMMUNICATION, filed on April 19, 2018, which is hereby incorporated by way of 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. operation and make inferences about the surgical procedure, or a specific step thereof, that is performed. Consequently, the situational recognition system can infer if 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 automatically activating the surgical instrument. For example, the control algorithm could be configured to automatically activate or allow activation of the surgical instrument when the tissue gripped by the end actuator matches the tissue type or tissue composition expected by the situational recognition system.

[00534] With the ability to detect whether or not the instrument is in contact with tissue, and what is the type of tissue when in contact, the ultrasonic instrument can be operated in a keyless mode of operation in which operation is allowed with based on the detection capability of the ultrasonic instrument. In some respects, a control algorithm can be configured to ignore actuations of activation buttons and pedals, and other input devices coupled to the generator and/or the ultrasonic surgical instrument, unless detected. tissue in contact with the grips/actuator end of the surgical instrument, thus preventing unintentional activations of the instrument. In some respects, a control algorithm can be configured to assign different meanings to inputs from activation buttons and pedals, and from other input devices coupled to the generator and/or the ultrasonic surgical instrument based on the detection of tissue in contact. with the jaws/actuator at the end of the surgical instrument. For example, when the presence of tissue in the end actuator is detected, 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 in the end actuator is not detected, the control algorithm can be configured to perform a certain different or secondary action when the activation button is actuated.

[00535] The ability to determine the lack of tissue present in the end actuator grips acts as a tolerance to allow the instrument to switch to keyless mode and then initiate an automatic coagulation run cycle when tissue is , then detected, resulting in longer instrument uptime and allowing the user to proceed based on their instrument's predictive capability. The ability to additionally detect tissue type in addition to detecting the presence of tissue allows the algorithm to adjust and calculate the best clotting opportunity. Adjustment of an ultrasonic system according to tissue composition

[00536] In various aspects, an ultrasonic surgical instrument may include a processor or control circuit that executes an adaptive ultrasonic blade control algorithm to detect the composition of tissue trapped by or situated in the end actuator and con- troll the operating parameters of the ultrasonic transducer and/or the ultrasonic blade properly. Tissue composition may include, for example, the ratio of collagen to elastin in the tissue, tissue stiffness, or tissue thickness. Operating 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 flux of the ultrasonic blade, and so on. The adaptive ultrasonic blade control algorithm can be executed by a control circuit or a processor located in the generator or in the surgical instrument.

[00537] 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 tissue collagen to elastin ratio. The tissue collagen to elastin ratio 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 temperature. tissue collagen content. Determination of tissue collagen/elastin ratio according to frequency shift

[00538] In many ways, a control algorithm can be configured to determine the collagen/elastin ratio of a tissue (e.g. to adjust the amplitude of the distal tip of an ultrasonic blade) by detecting the natural frequency of an ultrasonic sheet and the shifts in the waveform of the ultrasonic sheet. For example, the techniques described in connection with Figures 1 to 54 can be used to detect the collagen to elastin ratio of tissue located in an end actuator of an ultrasonic instrument. In one aspect, the present disclosure provides an adaptive ultrasonic blade control algorithm for detecting the natural frequency of the ultrasonic blade and waveform shift 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 collagen and elastin composition content of the tissue and adjust the therapeutic heat flux of the ultrasonic blade based on the collagen content detected from the tissue. tissue. Techniques for monitoring the deviation from the natural frequency of the ultrasonic blade based on the type of tissue situated on the end actuator jaws of the ultrasonic instrument are described here in connection with Figures 1 through

54. Consequently, for the sake of brevity and clarity, such techniques will not be repeated here.

[00539] The ratio of elastin to collagen can be determined by monitoring the shift in the natural frequency of the ultrasonic slide and comparing the natural frequency with a look-up table. The lookup table can be stored in memory (eg memory 3326 of Figure 31) and contains the ratio of elastin to collagen and a corresponding natural frequency offset for a given empirically determined ratio. Determination of tissue collagen/elastin ratio according to infrared (IR) surface reflectance and emissivity

[00540] In many ways, a control algorithm can be configured to determine the collagen/elastin ratio of a tissue (eg, adjust the amplitude of the distal tip of an ultrasonic blade) by determining the reflectivity. tissue IV. For example, Figure 59 illustrates a 130164 ultrasonic system comprising 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.

End actuator 130400 of ultrasonic surgical instrument 130150 comprises IR sensors located on gripping arm 130402 (e.g., gripper member), in accordance with at least one aspect of the present disclosure. The 130152 Ultrasonic Generator and/or the 130150 Ultrasonic Instrument can be coupled to the 130160 Central Surgical Controller and/or the 130162 Cloud via wired or wireless connections, as described in connection with Figures 1 to 11.

[00541] Figure 60 illustrates an IR reflectivity detection sensor circuit 130409 that can be assembled or integrally formed with the grip arm 130402 of the 130400 ultrasonic end actuator to detect tissue composition, according to at least an aspect of the present description. The IR sensor circuit 130409 includes an IR source 130416 (e.g., a µV transmitter) and an IR detector 130418 (e.g., 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 SW!1 is closed, IR source 130416 emits IR energy towards tissue 130410 (eg, tissue trapped or situated between clamping arm 130402 and ultrasonic blade 130404). Part of the emitted IR 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.

[00542] Referring to Figures 59 and 60, in one aspect, the 130152 ultrasonic generator includes the 130420 control circuit for driving the 130416 IR source and 130418 IR detector located on or inside the actuator clamp arm 130402 end-end ultrasonic

130400. In other respects, the 130150 ultrasonic instrument includes the 130420 control circuit for driving the 130416 IR source and the 130418 IR detector located on or inside the 130402 clamping arm of the 130400 ultrasonic end actuator. In aspects, when tissue 130410 is clamped between ultrasonic blade 130404 and clamping arm 130402, IR source 130416 is energized by control circuit 130420 by closing switch SW1, for example, to illuminate tissue with IR energy. In one aspect, the 130418 IR detector generates a voltage Vo that is proportional to the IR energy reflected by the 130410 tissue. The total IR energy emitted by the 130416 IR source is equal to the sum of the IR energy reflected by the 130410 tissue, the IR energy absorbed - life through the 130410 tissue and the IR energy passing through the 130410 tissue, plus any losses. Consequently, the 130420 control circuit or processor can be configured to detect the collagen content of tissue 130410 by the amount of IR energy detected by the IR detector 130418 relative 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 tissue 130410 to determine the collagen content of tissue 130410. IR source 130416, IR detector 130418, and algorithms are calibrated to provide useful measurements of the collagen content of tissue 130410 using the principles of IR reflectivity.

[00543] The 130409 IR reflectivity detection sensor circuit shown in Figure 60 provides surface IR reflectance and emissivity to determine the ratio of elastin to 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 light reflection of infrared light. The Refractive Index can be used to differentiate tissue types. For example, 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.

[00544] — A comparative method employs a power-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 actuations that use this Index as a baseline. In this way, an endoscope can update the dissection device (eg, the 130404 ultrasonic blade) based on the collagen ratio. The dissection device can fine-tune the prediction each time it is triggered to make an actual collagen denaturation trigger. An alternative method may employ an absolute index with a lookup table that can differentiate between surface irregularities and collagen concentration under the surface. Additional information on the IR refractive index properties of tissue can be found in "Visible To Near-lnfrared 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 contents of which are incorporated herein by reference.

[00545] In other respects, the ultrasonic dissection device can be configured to change the optimal temperature of the ultrasonic blade control algorithm proportionally 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 blade is held and increase the retention time at which the ul-

130404 is in contact with tissue 130410 for higher collagen concentrations in trapped tissue 130410. As another example, the wait time for the algorithm to go through a complete activation cycle could be modified based on the collagen ratio . Various temperature control algorithms for ultrasonic slides are described in connection with Figures 43 to 54.

[00546] Figure 61 is a sectional view of an ultrasonic end actuator 130400 comprising a gripping arm 130402 and an ultrasonic blade 130404, in accordance with an aspect of the present description. The gripping arm 130402 comprises IR reflectivity detecting circuits 130409a, 130409b that can be integrally mounted or formed with the gripping arm 130402 of the ultrasonic end actuator 130400 for detecting tissue composition 130410. IR reflectivity detection 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 elongate elements 130408a, 130408b, 130408c on which they are mounted. - 130409a, 130409b reflectivity detection sensor circuits and IR sensors 130414a, 130414b are used. The 130414a, 130414b IR sensors can include 130416 IR sources and 130418 IR detectors, as shown in Figure 60.

[00547] Figure 63 is a logic flow diagram of a 130200 process representing a control program or logic setup for measuring IR reflectance to determine tissue composition to adjust the amplitude of the ultrasonic transducer. Process 130200 may be performed by a surgical instrument control circuit or processor, such as control circuit 760 of Figure 18, or a generator, such as processor 902 of Figure 21. For brevity, the process 130200 will be described as being run by a control circuit, but it should be understood that the following description covers the aforementioned variations.

[00548] —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 power to tissue 130410 attached to an end actuator 13400 of an ultrasonic instrument

130150. The control circuit 130204 then detects, by means of an IR detector 130418, the IR energy reflected by the tissue 130410. Consequently, the control circuit 130206 determines the collagen to elastin ratio of the tissue 130410 based on the detected IR energy reflected by tissue 130410. The control circuit adjusts the 130208 ultrasonic blade temperature control algorithm, as discussed in US Provisional Patent Application No. 62/692,768, entitled SMART ENERGY DEVICES, based on in determining the ratio between tissue collagen and elastin. In one aspect, the collagen content of tissue 130410 can be detected according to the reflectivity of an IR light source 130416. In another aspect, the lower the collagen content of tissue 130410, the longer the aging time. heating and lower the final temperature of the ultrasonic blade

130404. In yet another aspect, the composition of tissue 130410 may be the thickness or stiffness of the tissue and could be used to affect the ultrasonic blade transducer control program.

[00549] The ratio of elastin to collagen can be determined by monitoring the tissue |V reflectance and comparing the detected IR reflectance with a lookup table. The lookup table can be stored in memory (eg memory 3326 of Figure 31) and contains the ratio of elastin to collagen and a corresponding IR reflectance for a specific ratio as determined empirically.

Determination of tissue collagen/elastin ratio according to collagen transformation point

[00550] 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 tissue (eg, by an ultrasonic slide), structural proteins denature, which affects tissue integrity and other properties. However, structural proteins denature at different known temperatures. For example, collagen is denatured before elastin. Consequently, by detecting at what temperature tissue properties change, one can infer tissue composition (eg, the ratio of collagen to elastin in tissue). In many ways, a control algorithm can be configured to determine the collagen to elastin ratio of a tissue by determining the collagen transformation point of the tissue. The control algorithm can, in turn, control various operational 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 actuation member of the clamping arm and the rate of change of its displacement while the load on the clamping arm is maintained. - so much. In another aspect, the control algorithm can determine the collagen transformation point of the tissue by directly measuring the temperature at the tissue/lamina interface to identify the collagen/elastin percentage.

[00551] Figures 16 to 19 schematically illustrate motorized clamping arm closing mechanisms. Figure 40 is a system diagram 7400 of a segmented circuit 7401 comprising a plurality of independently operated circuit segments.

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

[00552] In one aspect, a control algorithm can be configured to detect the collagen transformation point of a trapped tissue and, in this way, control the application of ultrasonic energy to the tissue by controlling the phase and/or the amplitude of the ultrasonic transducer drive signal or clamping arm closing rate. 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 collagen transformation point. This can be done by measuring the position of the actuating member of the gripping arm and its rate of change while the gripping arm load is held constant within the coaptation pressure over a defined operating range (e.g. from 130 to 180 psi) corresponding to the specific instrument type.

[00553] Figure 64A is a 130250 graphic representation 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 point of collagen transformation, so in accordance with at least one aspect of the present disclosure. Figure 64B is an enlarged portion 130256 of the graphical representation 130250 shown in Figure 64A. The horizontal axis 130254 represents time (e.g., in seconds) and the vertical axis 130252 represents the displacement of the grip arm (e.g., in millimeters). In one aspect, a control algorithm can be configured to control the load applied to the fabric by the squeezing arm 1140 (e.g., controlling the rate of closing of the squeezing arm 1140) as the ultrasonic blade 1128 (Figure 23) heats up. the tissue according to the collagen transformation point of the tissue. In such an aspect, a control algorithm is configured to close the grip arm 1140 until the grip arm load reaches a threshold, which may include a specific value (e.g. 4.5 lb) or a range of values (eg within a range of 3.5 to 5 |b). At this point, the control algorithm adjusts threshold 8 of the rate of change of grip arm travel, and monitors the travel of grip arm 1140. As long as the rate of change of grip arm travel remains within a predefined negative limit (ie, below threshold 9), 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 of clamping arm displacement exceeds threshold 8, the control algorithm can determine that the collagen melting temperature has been reached.

[00554] In one aspect, when the control algorithm determines that the transition temperature has been reached, the control algorithm can be configured to alter the operation of the ultrasonic instrument accordingly. For example, the control algorithm can switch the surgical instrument from load control mode (from grip arm 1140) to temperature control mode. In another aspect, the control algorithm can keep track of the clamping arm load after the collagen transformation temperature is reached, and monitor when a threshold of clamping arm displacement rate of change is reached. The second threshold of the rate of change of displacement of the gripping arm may correspond, for example, to the transition temperature of the elastin. The locations of the collagen and/or elastin transition temperatures in the 130258 plot of the clamping arm displacement over time can be called the "knee" points of the 130258 curve. Consequently, in this respect, the algorithm control can be configured to change the operation of the ultrasonic instrument in the event that the second threshold of the rate of change of grip arm displacement (or elastin "knee") is reached and change the operation of the ultrasonic instrument from appropriate way. For example, the control algorithm can switch the surgical instrument from load control mode (from grip arm 1140) to temperature control mode when the elastin knee in plot 130258 is detected.

[00555] The transformation of collagen must be constant for a given heat flux between 45ºC and 50ºC for collagen, and elastin has a different melting temperature. Additionally, the temperature must stabilize as the collagen absorbs heat. In some respects, the control algorithm can be configured to sample the position of the grip arm and/or the grip arm displacement member at a higher rate around specific temperatures or within temperature ranges (e.g. , the expected temperature ranges for collagen and/or elastin transformation) to determine exactly when the monitored events occur.

[00556] In the aspect shown in Figures 64A and 64B, the control algorithm acts to switch the surgical instrument from load control mode to temperature control mode when the collagen transformation point is detected at time tm. Without switching the surgical instrument to temperature control mode, the displacement of the grip arm would increase geometrically, as shown in the projected curve 130260. In one aspect, the control algorithm operating in temperature control mode decreases the temperature. amplitude of the ultrasonic transducer drive signal to change the heat flux generated by the ultrasonic blade 1128, as shown by the flat portion of plot 130258 after threshold 8 is reached. In some respects, the control algorithm can be configured to increase the amplitude of the ultrasonic transducer drive signal after a given period of time to, for example, measure the rate of increase in temperature to determine when the transformation temperature of the elastin has been reached. Consequently, as the closing rate of the grip arm approaches the next knee (i.e., the elastin knee), the closing rate of the grip arm may decrease. The 1140 clamping arm's load control can be beneficial because, in some cases, it can provide the best sealing of vessels.

[00557] Figure 65 is a logic flow diagram of a 130300 process that represents a control program or logic setup for detecting the collagen transformation point to control clamping arm closing rate or clamping amplitude. ultrasonic transducer, according to at least one aspect of the present description.

The 130300 process can be executed by a control circuit or a processor located in the surgical instrument or in the generator.

Consequently, the control circuit running the 130300 process measures 130302 a position of the gripping arm's actuating member and its rate of change while keeping the load on the grip constant.

As described above, in one aspect, the load on the clamping arm is maintained within the coaptation pressure within a suitable range (130 to 180 psi) defined by the ultrasonic surgical instrument.

When the grips are subjected to a certain clamp arm load (e.g. 4.5 µb) or the clamp arm load is within a specific range (e.g. 3.5a 5 lb), the clamp circuit control will adjust 130304 the rate of change of displacement of the grip arm and monitor the position of the actuating member of the grip arm for the period of time that the rate of change of travel of the grip arm remains within a predefined negative threshold (which corresponds to the tissue being below the collagen transformation temperature). Consequently, the control determines 130306 if the rate of change of displacement of the grip arm exceeds the set threshold, or, in other words, determines if 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 130308 switches the surgical instrument to temperature control mode (e.g., controls the ultrasonic transducer to decrease or maintain the temperature of the ultrasonic blade). In one aspect, the control circuit continues to monitor the collagen 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 130310 maintains load control of the clamping arm 1140 and monitors the rate of clamp arm offset change to determine when the next transition point (eg, the elastin transition point) will occur for the clamped tissue. The control circuit can do this to, for example, prevent the tissue temperature from rising beyond the elastin transformation temperature.

[00558] It will be recognized that collagen transformation must be constant for a given heat flux (45°C to 50°C). It will also be recognized that the load control of the clamp arm 1140 may, in some cases, provide the best seal for specific tissue types (eg, vessels). During the period of time that 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 (eg transformation temperatures). In addition, the control circuit can adjust the amplitude of the ultrasonic transducer drive signal 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.

[00559] — In another aspect, a control algorithm can be configured to detect the collagen transformation temperature to identify the collagen/elastin percentage of the trapped tissue. As discussed above, the control algorithm can then control various operating parameters of the surgical instrument according to the identified trapped tissue composition.

[00560] Figure 66 is a 130350 graphic representation of the identification of the collagen transformation temperature point to identify the collagen/elastin ratio, according to at least one aspect of the present description. Vertical axis 130352 represents the impedance of the ultrasonic transducer, and horizontal axis 130632 represents tissue temperature. The point where the shift in the rate of change in the impedance of the ultrasonic transducer occurs corresponds to the empirically determined collagen/tissue tissue composition. For example, if the shift in the rate of change of the ultrasonic transducer impedance occurs at the first temperature 130362, then the tissue composition will be 100% collagen. Consequently, if the shift in the rate of change of the ultrasonic transducer impedance occurs at the second temperature 130364, then the tissue composition will be 100% elastin. If the shift in the rate of change of the ultrasonic transducer impedance occurs between the first temperature 130362 and the second temperature 130364, then the tissue composition will be a mixture of collagen and elastin.

[00561] 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 ultrasonic device operation accordingly. As shown in Figure 66, a 130356 plot represents the empirical relationship between the ultrasonic transducer impedance and tissue temperature. 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 tissue contact area. 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 can correspond to an empirically determined temperature 130360 (eg 85%). In one aspect, a control circuit or processor that executes 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 (e.g., the percentage of collagen, the percentage of elastin, or the collagen/elastin ratio) from a memory (for example, a lookup table).

[00562] 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, in accordance with at least one aspect of the present disclosure. Process 130450 can be carried out by a control circuit or a processor located, for example, in the surgical instrument or in the generator. Consequently, the 130452 control circuit 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 blade can be inferred by the algorithms described herein. The control circuit determines 130454 the rate of change of the AZ/AT impedance of the ultrasonic transducer. As the temperature at the interface between the ultrasonic blade and the fabric increases, the impedance (Z) increases linearly at a first rate, as shown in Figure 66. With this, the control circuit determines 130456 if the coefficient angular AZIAT has changed (eg decreased). If the slope AZ/AT has not changed, then process 130450 proceeds along the NO branch and continues to determine 130454 the slope AZ/AT. If the AZ/AT slope has changed, the 130458 control circuit determines that the collagen transition temperature has been reached.

[00563] The ratio of elastin to 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 lookup table can be stored in memory (eg memory 3326 of Figure 31) and contains the ratio of elastin to collagen and a corresponding collagen transformation point for a specific empirically determined ratio. Adjusting the clamping arm force according to the location of the fabric

[00564] In various aspects, a control algorithm can be configured to determine the location of a tissue within or in relation to an end actuator, and adjust the grip arm force accordingly. In one aspect, tissue can be identified or parameterized by measuring the compressive force load on the gripping arm and the position of the tissue within the gripper, for example, the location along the length of the ultrasonic blade. where the fabric is located. In one aspect, the time to the initial measured load on the clamping arm is measured, and then the compression ratio on the tissue is measured to determine the compressibility of the tissue as a function of the amount of tissue lying along the length. claw ment. The rate of change in grip arm actuator position is monitored in load control mode as a way of determining tissue compressibility and therefore tissue type/disease status.

[00565] Figure 68 is a graphical representation 130500 of the compressive load distribution along a 130404 ultrasonic blade, in accordance with at least one aspect of the present disclosure. The vertical axis 130502 represents the force applied to the fabric by the clamping arm 1140, and the horizontal axis 130504 represents the position. The 130404 ultrasonic blade is sized so that there are periodic nodes and antinodes that occur along the length of the blade. The location of the nodes/anti-nodes is determined by the wavelength of the ultrasonic displacement induced in the 130404 ultrasonic blade by the ultrasonic transducer. The ultrasonic transducer is driven by an electrical signal of suitable amplitude and frequency. As is known in the art, a knot is a point of minimum or zero displacement of the 130404 ultrasonic blade and an antinode is a point of maximum displacement of the 130404 ultrasonic blade.

[00566] In the graphical representation 130500, the ultrasonic blade 130404 is represented so that the nodes and antinodes are aligned with their corresponding position along the horizontal geometric axis

130504. Graph 130500 includes a first plot 130506 and a second plot 130508. As represented by any of the curves 130506, 130508, the compressive force applied to the ultrasonic blade 130404 exponentially decreases from a proximal end of the ultrasonic blade 130404 to a distal end of the 130404 ultrasonic blade. Thus, the 130410 tissue located at the distal end of the 130404 ultrasonic blade is subjected to a much lower compressive force compared to the 130410 tissue located closer to the proximal end of the ultrasonic blade. - nica 130404. The first plot 130506 may represent a standard closing of the grip arm 1140 where the resultant force applied to the distal tissue 130410 is represented as F1. Generally speaking, the amount of force applied by the clamping arm 1140 to the tissue 130410 cannot be arbitrarily vastly increased because, in such a case, an excessive amount of force could be applied to the tissue 130410 lying proximally along the ultrasonic blade 130404 However, by monitoring the location of tissue 130410 along the ultrasonic slide 130404 (e.g., as discussed above under the heading "Determining Tissue Location by Changing Impedance" and as discussed below under the heading " Determination of tissue location through continuity between electrodes"), a control algorithm can amplify the force applied to tissue 130410 by the clamp arm 1140 in situations where tissue 130410 is located only at the distal end of the ultrasonic blade 130404, as in the situation shown in Figure 68. For example, the second plot 130508 might represent a modified close of the clamping arm 1140 wherein the control algorithm determines that tissue 130410 is situated only at the distal end of ultrasonic blade 130404 and correspondingly increases the force applied to distal tissue 130410 by clamping arm 1140 to a value F2 (F2 > F1).

[00567] Figure 69 is a graphical representation 130520 of pressure applied to tissue as a function of time, in accordance with one aspect of the present disclosure. The vertical axis 130522 represents the pressure (eg, in N/mm?) applied to the fabric, and the horizontal axis 130524 represents time. The first plot 130526 represents a normal or standard compressive force applied to 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 compressive 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 amplified compression force returns 130532 to normal compression levels to avoid burning/melting through the clamp arm block 1140. Determination of tissue location through continuity between electrodes

[00568] In many 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 (i.e., positive) electrodes. and negatives) positioned along an end actuator jaw or jaws. The location of tissue detectable by the bipolar electrode array may correspond to the specific position of the tissue in relation to the claw(s) and/or the percentage of the claw(s) covered by 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 an array or array so that a processor or control circuit can be configured to detect where tissue is situated between the positive and negative electrodes by monitoring or scanning the electrode array. 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 may be positioned along opposing jaws of an end actuator. Consequently, a control circuit or processor coupled to the bipolar electrode array can be configured to detect electrical continuity between opposing grips to detect the presence of tissue between them.

[00569] Determining which surface area of the jaw(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. Clamping arm load can be expressed in terms of applied pressure (eg 130 to 180 psi) or applied force (eg 3.5 to 5 lbs or nominally 4.5 lbs). In some respects, the bipolar electrode array can be powered by a bipolar or monopolar RF electrosurgical generator on both positive and negative electrodes. The generator power output can be a variety of constant, variable or minimum values (e.g. 45 W, 35 W or 5 W), a function of several variables associated with the surgical instrument and/or generator (e.g. , ultrasonic blade amplitude, or grip arm force), or dictated by an algorithm to control the generator according to its power curve (e.g. during generator ramp-up).

[00570] Figure 70 illustrates a 130400 end actuator that includes an array of single-grip electrodes for detecting tissue location, in accordance with at least one aspect of the present disclosure. In the aspect shown, the end actuator 130400 includes a first jaw 130430 which has an array of electrodes 130431 disposed thereon and a second jaw 130432. The array of electrodes 130431 includes electrodes 130429 coupled to a power source, as an RF generator. The 130400 end actuator may include an end actuator for an ultrasonic surgical instrument where the second jaw 130432 is, for example, an ultrasonic blade 1128 (Figure 23), an electrosurgical instrument.

gico, an end actuator for a surgical stapling and cutting instrument, 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 appearance shown, the electrode array 130431 includes 12 electrodes 130429 arranged in a generally zigzag pattern; 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 tissue position. .

[00571] In one aspect, the 130431 electrode array may include 130429 electrodes 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 130429 electrodes may be of a first polarity (e.g. positive polarity or coupled to a power terminal of a power source), and the odd numbered electrodes 130429 may be a second polarity (eg negative or coupled to a return terminal of a power source). Consequently, when tissue 130410 comes into contact with adjacent electrodes 130429, tissue 130410 physically and electrically links the bipolar electrodes 130429 and allows current to flow between them. Current flow between the 130429 bipolar electrodes can be detected by a control algorithm executed by a control circuit or processor coupled to the 130431 electrode array, thereby allowing the control circuit or processor to detect the presence of tissue 130410.

[00572] Tissue detection by the 130431 electrode array can be graphically represented by an activation matrix.

For example, Figure 71 illustrates an activation matrix 130550 that indicates the position of tissue 130410 according to the electrode array 130431 represented in Figure 70. The vertical axis 130554 and the horizontal axis 130555 represent the electrodes 130429 of the 130431 electrode array, where the numbers along the geometric axes 130554, 130555 represent the correspondingly numbered 130429 electrodes.

Activation regions 130552 indicate where continuity is present between corresponding electrodes 130429, that is, where tissue 130410 is present.

In Figure 70, tissue 130410 is present on the first, second and third electrodes 130429 and, as discussed above, in some respects the polarity of the electrodes 130429 may 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 enclosed by the 130552 activation regions is not indicated as activated because, in this described aspect, a 130429 electrode is not can have continuity with itself.

A control algorithm executed by a control circuit or a processor coupled to the electrode array 130431 can be configured to infer the position of the tissue 130410 in the end actuator 130400 (as the locations of the electrodes 130429 would be known), the proportion of the grips 130430, 130432 of the 130400 end actuator covered by the 130410 fabric, etc., because the location of the fabric corresponds to the specific electrodes 130429 where electrical continuity has been established.

[00573] Figure 72 illustrates a 130400 end actuator that includes an array of dual grip electrodes to detect tissue location, in accordance with at least one aspect of the present description. In the aspect shown, the end actuator 130400 includes a first jaw 130430 having a first array of electrodes 130431 disposed thereon, and a second jaw 130432 having a second array of electrodes 130433 disposed thereon. The electrode arrays 130431, 130433 each include electrodes 130429 coupled to a power source, such as an RF generator. The 130400 end actuator may include an end actuator for an electrosurgical instrument, an end actuator for a surgical stapling and cutting instrument, and so on. As discussed above, the number, shape and/or arrangement of the 130429 electrodes can vary in several respects. For example, in Figure 75 the electrode arrays 130431, 130433 are arranged in rectangular or overlapping tile patterns.

[00574] In one aspect, the opposing 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 (i.e., a terminal power supply and a return terminal) from a power source. For example, in the aspect shown, the first electrode array 130431 may be of a first polarity (e.g., positive polarity or coupled to a power supply terminal of a power source), and the second electrode array 130433 may be of a second polarity (eg negative or coupled to a return terminal of a power source). Consequently, when fabric 130410 comes into contact with an electrode 130429 of each of opposing electrode arrays 130431, 130433, the fabric 130410 physically and electrically binds together.

130429 bipolar electrodes and allows current to flow between them. The current flow between the 130429 bipolar electrodes can be detected by a control algorithm executed by a control circuit or a processor coupled to the 130431, 130433 electrode arrays, thus allowing the control circuit or the processor detect the presence of tissue 130410.

[00575] — 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 depicted in Figure 74. Vertical axis 130557 represents electrodes 130429 of the first electrode array 130431 and horizontal axis 130558 represents electrodes 130429 of the second array of electrodes 130433, where the numbers along the axes 130557, 130558 represent the correspondingly numbered electrodes 130429 for each array of electrodes 130431, 130433. The activation regions 130552 indicate where continuity is present between the corresponding electrodes 130429 , that is, where tissue 130410 is present. In Figure 74, a tissue 130410 is positioned against the first, second and third electrodes 130431a, 130431b, 130431c of the first electrode array 130431 and against the first, second and third electrodes 130433a, 130433b, 130433c of the second electrode array. electrodes

130433. Consequently, there is electrical continuity between each of these sets of electrodes of the opposing electrode arrays 130431, 130433 since current can flow between such sets of opposing electrodes. 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 of Figure 73. Additionally, due to the fact that the tissue 130410 is not positioned against the fourth, the fifth and 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 electrode array 130433, there is no electrical continuity between these electrodes. A control algorithm performed by a control circuit or processor coupled to electrode arrays 130431, 130433 can be configured to infer the position of tissue 130410 within end actuator 130400 (since the locations of electrodes 130429 would be known, with - as indicated in Figure 74), the proportion of jaws 130430, 130432 of end actuator 130400 covered by fabric 130410, etc., because the location of the fabric corresponds to the specific electrodes 130429 where electrical continuity has been established. In the example shown, the activated electrodes of the first and second electrode arrays 130431, 130433 are electrodes 130429 that overlap and where there is tissue 130410 situated between them.

[00576] 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 specific frequency signal or signals through a frequency domain transform. Various portions of the electrode array circuit may include bandpass filters set to different frequencies. Therefore, the location of tissue trapped by the end actuator corresponds to the specific signals detected. 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 array circuit may include, for example, a flexible circuit.

[00577] 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 held by the end actuator 130400, overlapping the second jaw 130432. In one aspect, the first electrode array 130431 is configured to transmit signals at various frequencies (e.g., frequencies not included). therapeutics), and the second electrode array 130433 is configured to receive the signals through a tissue 130410 held by the end actuator 130400 (i.e. when a tissue 130410 is in contact with both electrode arrays 130431, 130433) . The second electrode array 130433 may include a segmented circuit of electrode array 130600, as shown in Figure 77, with each circuit segment including a bandpass filter 130601 coupled to each electrode 130602 of the second electrode array 130433 Each 130601 bandpass filter can include one or more 130604 capacitors and one or more 130606 inductors, and the number, arrangement and values of 130604 capacitors and 130606 inductors can be selected to synchronize each 130601 bandpass filter with a specific frequency or frequency band.

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

In the aspect shown, electrode arrays 130431, 130433 include six electrode segments 130602 arranged in a generally tiled pattern with a semi-circular end segment; however, the number, shape and arrangement of electrodes 130602 in electrode array 130431, 130433 are for illustrative purposes only. Consequently, electrode arrays 130431, 130433 can include various numbers, shapes, and/or arrangements of 130602 electrodes. For example, the number of electrodes 130602 can be adjusted to the desired resolution to detect tissue position.

[00578] -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 description. Vertical axis 130652 represents amplitude and horizontal axis 130654 represents RF frequency. In one aspect, the second electrode array 130433 includes a first electrode circuit segment 130602a set in a frequency band defined by a first center frequency fs; (e.g. MHz), a second segment of electrode circuit 130602b set in a frequency band defined by a second center frequency fs2 (e.g. 10 MHz), a third segment of electrode circuit 130602c set to a frequency band defined by a third center frequency fs3 (e.g. 15 MHz) and a fourth electrode circuit segment 130602d set in a frequency band defined by a fourth center frequency fsa (e.g. 20 MHz ). As shown in Figure 78, the detection frequency bands define a range of detection frequencies 130658 above the therapeutic frequency range 130656 defined by fr: (eg 300 kHz) through fr2 (eg 500 kHz) and /or a preferred therapeutic frequency (eg 350 kHz). In one aspect, the sensing center frequencies fs1, fs2, fsa, fsa in the sensing frequency range 130658 are each separated by a defined frequency value (eg, 5 MHz). Additionally, although the 130658 detection frequency range is shown to include 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 tissue 130410 from the detected frequency response, i.e., the control circuit can determine that tissue 130410 is positioned within 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 thus infer the position of the fabric 130410 in relation to the jaws 130430, 130432 of the end actuator 130400 and/or the percentage of the jaws 130430, 130432 in contact with the fabric 130410. adaptive ultrasonic blade

[00579] 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. Operating parameters controlled or regulated by the adaptive ultrasonic blade control algorithm may include, for example, the amplitude of the ultrasonic blade, the drive control signal of the ultrasonic transducer, the pressure applied by the clamping arm, etc. The adaptive ultrasonic blade control algorithm can be executed by a control circuit or a processor located in the generator or surgical instrument.

[00580] 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 clamping arm pressure 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 slide employ non-contact imaging. These and other techniques are described in detail in the present description and further details can be found in US Provisional Patent Application No. 62/692,768 entitled SMART ENERGY DEVICES.

Adjustment of ultrasonic system parameters according to temperature

[00581] 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 current signals applied to drive the ultrasonic transducer. Additionally, the temperature of the ultrasonic blade 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. Operating parameters may include, for example, the frequency of the drive signal of the ultrasonic transducer, 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 clamping arm, and so on. The adaptive ultrasonic blade control algorithm can be executed by a control circuit or a processor located in the generator or surgical instrument.

[00582] —Consequently, in one aspect, the adaptive ultrasonic blade control algorithm detects the resonant frequency of the ultrasonic blade, as described earlier under the heading "Temperature Inference", and then monitors the resonant frequency. - cia over time to detect a modal shift in the resonant 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 blade. 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 of tissue to maintain the temperature of the ultrasonic blade and/or tissue at a pre-set value or within pre-defined limits (e.g. to allow the ultrasonic blade to cool if its temperature is becoming too high). In still other aspects, 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 alter the flow of energy. heat from the ultrasonic blade, based on the

tissue, tissue temperature and/or ultrasonic blade temperature. More details on these and other functions have been described with reference to Figures 95 to 100, for example.

[00583] Figure 79 is a 130700 graphic representation of the frequency of the ultrasonic transducer system as a function of drive frequency and temperature deviation of the ultrasonic blade, in accordance with at least one aspect of the present description. The horizontal axis 130704 represents the drive frequency (e.g. in Hz) applied to the ultrasonic system (e.g. the ultrasonic transducer and/or the ultrasonic blade), and the vertical axis 130702 represents the angle of phase of the resulting impedance (eg, in rads). The first plot 130706 represents a characteristic resonant waveform 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 driven at the excitation frequency fe (because the impedance phase angle is equal to or close to O rad). Consequently, f represents the resonant frequency of the ultrasonic system at room temperature. The second plot 130708 represents a characteristic waveform of the ultrasonic system after raising the temperature of the ultrasonic system. As indicated in Figure 79, as the temperature of the ultrasonic system increases, the characteristic waveform (represented by the first plot 130706) of the ultrasonic blade and the ultrasonic transducer shifts to the left, for example, to a range of lower frequencies. Due to the shift in the waveform of the frequency of the ultrasonic system, it is no longer in phase when driven at the excitation frequency fe. Instead, the resonant frequency has shifted to a value lower than f. 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 resonant frequency of the ultrasonic system and/or by detecting when the ultrasonic system is out of phase when triggered at a previously established resonant frequency.

[00584] — Correspondingly, in some respects, a control circuit coupled to the ultrasonic system can be configured to control the trigger signal applied to the ultrasonic system by the generator in accordance with the inferred ultrasonic system temperature to keep the ultrasonic system in check. phase. Keeping the ultrasonic system in phase can be a technique used to, for example, control the temperature of the ultrasonic system. As discussed above, the resonant frequency at which the voltage and current signals are in phase changes from f (for example, 55.5 kHz) at normal temperature to f and depending on the temperature of the ultrasonic blade and/or 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 driven from f to f to keep the ultrasonic system in phase with the drive signal of the generator. generator. For a further description of adaptive ultrasonic blade control algorithms, see the description associated with Figures 43A through 54 mentioned earlier in this document.

[00585] Figure 80 is a 130750 graphic representation of the temperature of the ultrasonic transducer as a function of time, in accordance with at least one aspect of the present description. The vertical axis 130752 represents the temperature of the ultrasonic transducer, and the horizontal axis 130754 represents time. In one aspect, as the temperature of the ultrasonic transducer (represented by plot 130756) meets or exceeds a T1 temperature threshold, the adaptive ultrasonic blade control algorithm controls the ultrasonic transducer to maintain the temperature of the ultrasonic transducer at a value equal to 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 drive signal applied to the ultrasonic transducer. A further description of algorithms and techniques for controlling the temperature of an ultrasonic slide/transducer can be found under the headings "Feedback Control Circuit" and "Temperature Controlled Ultrasonic Sealing Algorithm" in the present description, and in the application. US Provisional Patent No. 62/640,417 entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, filed March 8, 2018, the disclosure of which is incorporated herein by reference.

[00586] Figure 81 is a graphical representation of the modal shift of the resonant frequency based on the temperature of the ultrasonic blade by varying the resonant frequency as a function of the temperature of the ultrasonic blade, in accordance with at least one aspect of the present description. In the first graph 130800, the vertical axis 130802 represents the change in resonant frequency (AI), and the horizontal axis 130804 represents the drive 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, the frequency (f), current (|) and temperature (T), and the geometric axes horizontal 130814, 130824, 130834 represent time (t). The first graph 130810 represents the frequency shift of the ultrasonic system due to temperature change. The second graph 130820 represents the current in the ultrasonic transducer, or the span adjustment, to maintain stable frequency and temperature. The third graph 130830 represents the temperature change of the tissue and/or the ultrasonic system. Graphs 130800, 130810, 130820, 130830 together show the operation of a control algorithm configured to control the temperature of an ultrasonic system.

[00587] The control algorithm can be configured to control the ultrasonic system (eg, 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 T; is approaching or has been reached, depending on whether the resonant frequency of the ultrasonic system has decreased by an Afrg threshold. As indicated by the first graph 130800, the change in frequency threshold Afr corresponding to the temperature threshold T, may in turn be a function of the drive frequency fp of the ultrasonic system (as represented by plot 130806). As indicated by the second graph 130810 and the fourth graph 130830, as tissue and/or ultrasonic blade temperature increases (as represented by the temperature plot 130836), the resonant frequency correspondingly decreases (as represented by the temperature plot 130836). frequency 130816). As the temperature plot 130836 approaches a threshold temperature T, (e.g., 130°C) at time t1, the resonant frequency drops from f to fo, causing the resonant frequency to reach the frequency change threshold Afr 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 resonant 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 (e.g. decrease) the electrical current applied to the ultrasonic transducer or otherwise adjust the amplitude of the ultrasonic blade (represented by current plot 130826) to stabilize tissue and/or ultrasonic blade temperature and/or resonant frequency when the temperature equals or exceeds the T1 temperature threshold.

[00588] “In another aspect, the adaptive ultrasonic blade control algorithm can be configured to adjust (e.g. decrease) the pressure applied by the grip arm to the tissue when the temperature equals or exceeds the temperature threshold Ti. 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.

[00589] In several respects, non-contact imaging can be used to determine the temperature of the ultrasonic slide in addition to or in place of the aforementioned techniques. For example, shortwave thermography can be used to measure ultrasonic blade temperature by imaging the blade from the stationary surrounding floor using 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 slide to improve tissue and/or ultrasonic slide temperature through infrared (IR) detection techniques. next. Determining the state of the claws

[00590] A challenge of applying ultrasonic energy is that ultrasonic acoustics applied to the wrong materials or wrong tissue can result in device failures, e.g. complete burnout of the clamp arm block or breakage of the ultrasonic blade . It is also desirable to detect what is located in the jaws of an end actuator of an ultrasonic device and the status of the jaws without including additional sensors in the jaws. Installing sensors in the jaws of an ultrasonic end actuator poses challenges of reliability, cost and complexity.

[00591] Ultrasonic spectroscopy smart blade algorithm techniques can be employed to estimate the state of the grip (complete burning of the grip arm block, staples, broken blade, presence of bone in the grip, presence of tissue in the grip). clamp, retrograde cut with clamp closed, etc.) based on impedance VV (O) Zac) = nO of an ultrasonic transducer configured to drive an ultrasonic blade, in accordance with at least one aspect of the present description. dog. The impedance Z,(y, the magnitude |Z| and the phase is are plotted as a function of the frequency f.

[00592] Dynamic mechanical analysis (AMD), also known as dynamic mechanical spectroscopy or simply mechanical spectroscopy, is a technique used to study and characterize ma-

would. 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 sweep of frequencies (composite signals or traditional frequency sweeps) and measuring the resulting complex impedance at each frequency. The ultrasonic transducer's complex impedance measurements 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 description provides a technique for determining the state of an ultrasonic end actuator (clamping arm, gripper) to trigger automation in the ultrasonic device (such as disabling power to protect the device, running algorithms, etc.). adaptive, retrieve information, identify tissue, etc.).

[00593] Figure 82 shows 132030 spectra of an ultrasonic device with a variety of different states and end actuator conditions where impedance Za(w, magnitude |Z| and phase q are plotted as a function of the frequency f, in accordance with at least one aspect of the present description. The 132030 spectra are plotted in a three-dimensional space where the frequency (Hz) is plotted along the geometric x axis, the phase (rad) is plotted along the geometric axis y, and the magnitude (ohms) is plotted along the geometric z axis.

[00594] Spectral analysis of different claw bites and device states produces different characteristic patterns of complex impedance (fingerprints) over a range of frequencies 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, grip arm block 132034, suede 132036, staple 132038 and broken blade 132040. Suede 132036 can be used to characterize different types of fabric.

[00595] 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 slide. The low power electrical signal can be applied in the form of a sweep or a composite Fourier series to measure the impedance VV(O)Zac) = nO across the ultrasonic transducer over a range of frequencies in series (sweep) or in parallel (composite signal) using an FFT. New data classification methods

[00596] —For each characteristic pattern, a parametric line can be fitted 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 classified using the Euclidean perpendicular distance between the new data point and the trajectory that has been fitted to the characteristic pattern training data. The perpendicular distance from the new data point to each of the trajectories (each trajectory representing a different state or condition) is used to assign the point to a state or condition.

[00597] 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.

fallen. This essentially builds a two-dimensional probability distribution in a plane perpendicular to the fitted trajectory at each new data point of the fitted trajectory. The new data point can then be included in the training set based on its correct classification probability to create an adaptive learning classifier that readily detects high-frequency changes in states but adapts to slowly occurring deviations. system performance, such as a device getting dirty or the block wearing out.

[00598] Figure 83 is a graphical representation of a 132042 plot of a 3D training dataset (S), where the impedance Z,(Ww, the magnitude |Z| and the phase q of the ultrasonic transducer are plotted as a function of frequency f, in accordance with at least one aspect of the present description. Plot 132042 of the 3D training dataset (S) is plotted in three-dimensional space where the phase (rad) is plotted along along the x-axis, the frequency (Hz de) is plotted along the y-axis, the amplitude (kKOhms) is plotted along the z-axis, and a parametric Fourier series is fitted to the training dataset 3D(S) A methodology for classifying data is based on the 3D training dataset (SO is used to generate plot 132042).

[00599] The parametric Fourier series fitted to the 3D training dataset (S) is given by: a S a not —- nat p=a,+ > (ancos E + bisin =) n=1

[00600] For a new point z, the perpendicular distance between p and z is given by: D=|p—-zl

When: Dao oT Then: D=D,

[00601] A probability distribution of D can be used to estimate the probability of a data point Zz belonging to the S group. Control

[00602] “Based on the classification of the measured data before, during or after activation of the ultrasonic transducer/blade, a variety of automated tasks and safety measures can be implemented. Similarly, the tissue state 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 structures. reviews, etc. Controlling the temperature of an ultrasonic blade is described in Common Property US Provisional Patent Application No. 62/640,417 filed March 8, 2018 entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, which is here incorporated by reference in its entirety.

[00603] “Similarly, the application of energy can be reduced when there is a high probability that the ultrasonic blade is in contact with the clamp arm block (e.g. there is no tissue between the blade and the block) or if there is a probability that the ultrasonic blade has broken or is touching metal (eg a staple). In addition, retrograde cutting may not be permitted if the jaw is closed and no tissue is detected between the ultrasonic blade and the clamp arm block.

[00604] Integration of other data to improve classification

[00605] This system can be used in conjunction with other information provided by sensors, the user, patient metrics, environmental factors, etc., by combining the data obtained from this process with the aforementioned data using probability functions and a Kalman filter. The Kalman filter determines the maximum probability that a state or condition will occur given an infinity 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.

[00606] Figure 84 is a 132044 logic flow diagram of a process representing a control program or logic configuration to determine grip conditions based on the characteristic complex impedance pattern (fingerprint) , in accordance with at least one aspect of the present description. Before determining grip conditions based on the characteristic pattern of complex impedance (fingerprint), a database is populated with reference to characteristic patterns of complex impedance or training data sets (S) that characterize various conditions. of grippers, including, without limitation, air 132032, grip arm block 132034, suede 132036, staple 132038, broken blade 132040, as shown in Figure 82, and a variety of fabric types and conditions. Dry or wet suede, in full bite or

point, can be used to characterize different types of tissue. Data points used to generate complex impedance characteristic patterns or a training dataset (S) are obtained by applying a subtherapeutic trigger signal to the ultrasonic transducer, sweeping the triggering frequency over a predetermined range of frequencies , from frequencies below resonance to frequencies above resonance, measuring the complex impedance at each of the frequencies and recording the data points. The data points are then fitted to a curve using a variety of numerical methods including polynomial curve fitting, Fourier series and/or parametric equations. Fitting the parametric Fourier series to characteristic patterns of complex impedance or to reference training (S) data sets is described in the present description.

[00607] “Once the complex impedance characteristic patterns or training data sets (S) are generated, the ultrasonic instrument measures new data points, classifies the new points and determines whether new data points should be added to the new data points. complex impedance characteristic patterns or a reference training (S) dataset.

[00608] Now referring 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 impedance being defined as Zac = o

[00609] The processor or 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 complex impedance characteristic pattern of reference. The processor or control circuit classifies 132052 the complex impedance measurement data point based on a result of the comparison analysis and assigns 132054 an end actuator state or condition based on the result of the comparison analysis.

[00610] In one aspect, the processor or control circuit receives the complex reference impedance characteristic pattern from a database or memory attached to the processor. In one aspect, the processor or control circuit generates the characteristic complex impedance reference pattern in the manner described below. A trigger circuit coupled to the processor or control circuit applies a non-therapeutic trigger signal to the ultrasonic transducer starting at a start frequency, ending at an ending 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 control circuit performs a curve fit for a plurality of data points to generate a three-dimensional curve representative of the characteristic pattern of complex reference impedance, the magnitude |Z| and phase e are plotted as a function of frequency f. Curve fitting includes a polynomial curve fit, a Fourier series and/or a parametric equation.

[00611] 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 measurement data point of impedance and a trajectory that was fitted to the characteristic pattern of complex reference impedance. The processor or control circuit calculates a probability that the new impedance measurement data point is classified correctly. The processor or control circuit adds the new impedance measurement data point to the complex reference impedance characteristic pattern based on the estimated probability of correct classification of the new impedance measurement data point. In one aspect, the processor or control circuit sorts 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 fitting of the training dataset (S) using a parametric Fourier series, where S is defined here and the probability distribution is used to estimate the probability of the new impedance measurement data point belong to the S group.

[00612] Additional details regarding the determination or estimation of a state of the jaws or the surgical instrument as a whole can be found in US Provisional Patent Application No. 62/692,768, entitled SMART ENERGY DEVICES. situational recognition

[00613] — Now referring to Figure 85, a timeline 5200 is shown representing the situational awareness 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 contextual information that the central surgical controller 106, 206 can derive from data received from data sources at each step of the surgical procedure. Timeline 5200 represents typical steps that would be taken by nurses, surgeons, and other medical personnel during the course of a lung segmentectomy procedure, beginning with operating room setup and ending with patient transfer to a postoperative recovery room.

[00614] Situational awareness central surgical controller 106, 206 receives data from data sources throughout the course of the surgical procedure, including data generated each time medical personnel use a modular device that is paired with the surgical controller central 106, 206. The central surgical controller 106, 206 can receive this data from the paired modular devices and other data sources and continually derive inferences (i.e., contextual information) about the procedure in progress as new data emerge. are received, such as which step of the procedure is being performed at any given time. The situational recognition system of the central surgical controller 106, 206 is capable of, for example, recording data regarding the procedure to generate reports, verifying steps being taken by medical personnel, providing data or warnings (for example, through a display screen) that may be pertinent to the specific step of the procedure, adjusting modular devices based on context (e.g. activating monitors, adjusting the field of view (FOV) of the medical imaging device, or changing the power level of an ultrasonic surgical instrument or RF electrosurgical instrument), and take any other action described above.

[00615] As the first step 5202 in this illustrative procedure, hospital staff members obtain the patient's electronic medical record (EMR) from the hospital's EMR 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.

[00616] In the second step 5204, team members scan the entry of medical supplies for the procedure. The central surgical controller 106, 206 cross-references the scanned supplies with a list of supplies that are used in various types of procedures and confirms that the mix of supplies corresponds to a thoracic procedure. Additionally, the central surgical controller 106, 206 is also able to determine that the procedure is not a wedge resection procedure (because the inlet supplies lack certain supplies that are required for a thoracic wedge resection procedure). or, otherwise, that the inlet supplies do not correspond to a thoracic wedge resection procedure).

[00617] 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 data. scanned.

[00618] In the fourth step 5208, the medical personnel turn 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 are modular devices can automatically pair with the central surgical controller 106, 206 that is situated in a specific neighborhood of the modular devices as part of their startup 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 this preoperative or start-up 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 (EMR) 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 generally , 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-reference the data that subsequently receives from connected data sources (e.g. modular devices and patient monitoring devices) to infer which step of the surgical procedure the surgical team is performing.

[00619] In the fifth step 5210, team members attach electrocardiogram (ECG) electrodes and other patient monitoring devices to the patient. ECG electrodes and other patient monitoring devices are able to pair with the central surgical controller 106, 206. As the central surgical controller 106, 206 begins to receive data from the patient monitoring devices , the central surgical controller 106, 206 thereby confirms that the patient is in the operating room.

[00620] In the sixth step 5212, medical personnel induce anesthesia in the patient. The 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 (BP) data, fan, or combinations thereof, for example. Upon completion of the sixth step 5212, the preoperative portion of the lung segmentectomy procedure is completed and the operative portion begins.

[00621] 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. The central surgical controller 106, 206 can infer that the operative portion of the procedure has started when it can compare the detection of the patient's lung collapse to the expected steps of the procedure (which can be accessed or retrieved earlier) and thus determine that lung retraction is the first operative step in this specific procedure.

[00622] In the eighth step 5216, the medical imaging device (eg, a display device) is inserted and video from the medical imaging device is started. The central surgical controller 106, 206 receives data from the medical imaging device (i.e., the 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. Additionally, the central surgical controller 106, 206 may determine that the specific procedure being performed is a segmentectomy rather than a lobectomy (note that a wedge resection procedure has already been ruled out by the central surgical controller 106, 206 based on the data received in the second step 5204 of the procedure). Data from the medical imaging device 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 toward visualizing the patient's anatomy, monitoring the number or medical imaging devices being used (i.e., which are activated and paired with the central surgical controller 106, 206), and monitoring the types of disorders visualization positives 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 intercostal position anterior to the fissure. of the segment. Using standard recognition techniques or machine learning, 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, one 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 fissure, which is not used in a VATS lobectomy. By tracking any or all of this 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 surgical procedure.

[00623] In the ninth step 5218 of the procedure, the surgical team starts the dissection step. The 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 indicates that an energy instrument is being fired. The central surgical controller 106, 206 can cross-reference the received data with the steps retrieved from the surgical procedure to determine that a power instrument is being fired at that point in the process (i.e., after completion of the previously discussed steps of the procedure) corresponds to the dissection stage. In certain cases, the power instrument may be a power tool mounted on a robotic arm of a robotic surgical system.

[00624] In the tenth step 5220 of the procedure, the surgical team proceeds to the ligation step. The central surgical controller 106, 206 can infer that the surgeon is ligating the arteries and veins because he receives data from the surgical clipping and cutting instrument indicating that the instrument is being triggered. Similar to the previous step, the central surgical controller 106, 206 can derive this inference by crossing the reception data from the surgical stapling and cutting instrument with the steps retrieved in the process. In certain cases, the surgical instrument may be a surgical tool mounted on a robotic arm of a robotic surgical system.

[00625] In the eleventh step 5222, the segmentectomy portion of the procedure is performed. The 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. Cartridge data may correspond to the size or type of staple being fired 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 staple 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.

[00626] “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 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 (ie, RF or ultrasonic) depending on the specific step in the procedure because different instruments are better suited 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 performing. Furthermore, in certain cases, robotic tools may be used for one or more steps in a surgical procedure and/or hand-held surgical instruments may 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. Upon completion of the twelfth step 5224, the incisions are closed and the post-operative portion of the process begins.

[00627] In the thirteenth step 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.

[00628] Finally, in the fourteenth step 5228 is that the medical personnel removes the various patient monitoring devices from the patient. The 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 data received from the various data sources that are coupled in communication with the central surgical controller 106, 206.

[00629] — Situational recognition is further described in US Provisional Patent Application Serial No. 62/659,900, entitled METHOD OF HUB COMMUNICATION, filed on April 19, 2018, the contents of which are incorporated herein by reference in its entirety. In certain cases, the operation of a robotic surgical system, including the various robotic surgical systems described herein, for example, may be controlled by the central controller 106, 206 based on its situational recognition and/or feedback provided by its components. - ned and/or based on information coming from the cloud 102.

[00630] While various forms have been illustrated and described, it is not the intent of the claimant to restrict or limit the scope of the claims appended 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 description. Furthermore, the structure of each element associated with the form can alternatively be described as a means to provide the function performed by the element. In addition, where materials are described for certain components, other materials may be used. It is to be understood, therefore, that the foregoing description and the appended claims are intended to cover all such modifications, combinations, and variations within the scope of the embodiments presented. The appended claims are intended to cover all such modifications, variations, alterations, substitutions, modifications and the like.

[00631] The preceding 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 may be implemented, individually and/or collectively, across 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 described herein, in whole or in part, may be equivalently implemented on 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 thereof, and that designing the circuitry and/or writing the code for the software and firmware would be within the scope of practice of one skilled in the art, in light of this description. Furthermore, those skilled in the art will understand that the mechanisms of the subject matter described herein may be distributed as one or more program products in a variety of ways and that a form illustrative of the subject matter described herein is applicable irrespective of the specific type of transmission medium. signals used to effectively carry out the distribution.

[00632] The instructions used to program the logic to perform various aspects described may 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 for storing or transmitting information in a form readable by a machine (e.g., a computer), but is not limited to floppy disks, optical disks, compact memory disks, etc. read-only memory (CD-ROMs), and optical-dynamo disks, read-only memory (ROM), random access memory (RAM), erasable programmable read-only memory (EPROM), read-only memory electrically erasable programmable (EEPROM), magnetic or optical cards, flash memory, or a tangible, machine-readable storage media used to transmit information over the Internet over electrical, optical, acoustic, or other forms of propagated (eg carrier waves, infrared signal, digital signals, etc.). Accordingly, non-transient computer-readable media includes any type of machine-readable media suitable for storing or transmitting instructions or electronic information in a form readable by a machine (eg, a computer).

[00633] "As used in any aspect of the present invention, the term "control circuit" may refer to, for example, a set of wired, programmable circuits (e.g., a computer processor comprising a or more individual instruction processing cores, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic array (PLA), or field programmable gate array (FPGA)), state machine circuits, firmware that stores instructions executed by the programmable circuit, and any combination thereof. The control circuit may, collectively or individually, be incorporated as an electrical circuit that is part of a larger system, e.g. an integrated circuit (IC), an application-specific integrated circuit (ASIC), an on-chip system. (SoC), desktop computers, laptop computers, tablet computers, servers, smart phones, etc. Accordingly, as used herein, "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 circuit application-specific, electrical circuits that form a general-purpose computing device configured by a computer program (e.g., a general-purpose computer configured by a computer program that at least partially runs processes and/or devices described herein, or a microprocessor configured by a computer program that at least partially executes the processes and/or devices described herein), electrical circuits that form a memory device (e.g., forms of random access memory ), and/or electrical circuits that form a communications device (for example, a modem, communication switch, or optical-electrical unit). Those skilled in the art will recognize that the subject matter described herein may be implemented in an analog or digital fashion, or some combination thereof.

[00634] As used in any aspect of the present invention, the term "logic" may refer to an application, software, firmware and/or circuit configured to perform any of the aforementioned operations. The software may be embedded as a software package, code, instructions, instruction sets, and/or data recorded on computer-readable, non-transient storage media.

ache. Firmware can be embedded as code, instructions, or sets of instructions and/or data that are hard-coded (eg, non-volatile) in memory devices.

[00635] "As used in any aspect of the present invention, the terms "component", "system", "module" and the like may refer to a computer-related entity, whether hardware, a combination of hardware and software, running software or software.

[00636] As used in any aspect of the present description, an "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 they do not necessarily need to, take the form of electrical or magnetic signals that can be stored, transferred, combined, compared and otherwise manipulated. It is common usage 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 those quantities and/or states.

[00637] 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 example communications protocol may include an Ethernet communications protocol which may be capable of enabling communication using a transmission control protocol/Internet protocol (TCP/IP). The Ethernet protocol may conform 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 additionally, communication devices may be able to communicate with each other using an X.25 communications protocol. The X.25 communications protocol may conform or be compliant with a standard promulgated by the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, communication devices may be able to communicate with each other using a frame-relay communications protocol. The frame-relay communications protocol may conform or be compliant 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, the transceivers may be able to communicate with each other using an ATM (asynchronous transfer mode) communication protocol. The ATM communication protocol may conform or be compatible with an ATM standard published by the ATM forum titled "ATM-MPLS Network Interworking 2.0" published in August 2001, and/or later versions of that standard. Of course, different and/or post-developed connection-oriented network communication protocols are also contemplated in the present invention.

[00638] Unless expressly stated to the contrary, as is evident from the preceding description, it is understood that throughout the preceding description, discussions that use terms such as "processing", or "computation", or "calculus ", or "determination", or "display", or the like, refer 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 quantities. (electronic) in computer registers and memories on other data similarly represented in the form of physical quantities in computer memories or registers, or in other similar information storage, transmission or display devices.

[00639] One or more components may be referred to in the present invention as "configured for", "configurable for", "operable/operable for", "adapted/adaptable for", "capable of", "compliant mable/conformed to", etc. Those skilled in the art will recognize that "configured for" can generally encompass active-state components and/or idle-state components and/or standby-state components, unless the context dictates otherwise.

[00640] The terms "proximal" and "distal" are used here with reference to a case where a physician manipulates the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the physician, and the term "distal" refers to the portion located away from the physician. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "upwards" and "downwards" may be used in the present invention in connection with 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.

[00641] Persons skilled in the art will recognize that, in general, terms used herein, and particularly in the appended claims (e.g. bodies of appended claims) are generally intended as "open" terms (e.g. the term "including" shall be interpreted as "including, but not limited to", the term "having" shall be interpreted as "having at least", the term "includes" shall be interpreted as "includes, but not limits to", etc.). It will further be understood by those skilled in the art that when a specific number of an introduced claim mention is intended, such 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 mentions. However, the use of such phrases should not be interpreted as implying that the introduction of a mention of the claim by the indefinite articles "a, an" or "an, an" limits any specific claim containing the mention of the introduced claim 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" (e.g., "one, ones" and /or "one, a few" should typically be interpreted to mean "at least one" or "one or more"); the same goes for the use of definite articles used to introduce claim mentions.

[00642] Furthermore, even if a specific number of an entered claim mention is explicitly mentioned, those skilled in the art will recognize that such mention typically needs to be interpreted to mean at least the mentioned number (e.g., the mere mention of "two mentions", with no other modifiers, typically means at least two mentions, or two or more mentions). Furthermore, in cases where a convention analogous to "at least one of A, B, and C, etc." is used, this construction is generally intended to have the sense in which the convention would be understood by (for For example, "a system that has at least one of A, B, and C" would include, but not be limited to, systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B and C together, etc.). In cases where a convention analogous to "at least one of A, B, or C, etc." is used, this construction is generally intended to have the sense in which the convention would be understood by (e.g., "a system that has at least one of A, B and C" would include,

but not 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 further be understood by those skilled in the art that typically a disjunctive word and/or phrase having two or more alternative terms, whether in the description, claims or drawings, is to be understood as contemplating the possibility of including one of the terms, any of the terms or both terms, unless the context dictates otherwise. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "AeB".

[00643] With respect to the appended claims, those skilled in the art will understand that the operations mentioned therein can, in general, be performed in any order. Furthermore, although various operational flow diagrams are presented in one or more sequences, it should be understood that the various operations may be performed in orders other than those illustrated, or may be performed simultaneously. Examples of such alternative orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplementary, simultaneous, inverse, or other variant orderings, unless the context dictates otherwise. Furthermore, terms such as "responsive to," "related to," or other adjectival participles are not generally intended to exclude these variants, unless the context dictates otherwise.

[00644] It is worth noting that any reference to "one (1) aspect", "an aspect", "an exemplification" or "one (1) exemplification"", and the like means that a particular feature, structure or characteristic 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 one exemplification", "in one (1) exemplification", in various places throughout this descriptive report does not necessarily refer to the same aspect. Furthermore, specific features, structures or features can be combined in any suitable way in one or more aspects.

[00645] "Any patent application, patent, non-patent publication or other descriptive material mentioned in this specification and/or mentioned in any application data sheet is hereby incorporated by reference, to the extent where the materials incorporated are not inconsistent therewith. Accordingly, and to the extent necessary, the description as explicitly presented herein supersedes any conflicting material incorporated by the present invention by reference. Any material, or portion thereof, which is incorporated herein by reference, but which conflicts with existing definitions, statements, or other descriptive materials presented herein, is incorporated herein only to the extent that there is no conflict between the embedded material and existing description material.

[00646] In summary, numerous benefits have been described that result from employing the concepts described in this document. The aforementioned description of one or more embodiments 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 described. Modifications or variations are possible in light of the above teachings. One or more embodiments have been chosen and described for the purpose of illustrating the principles and practical application to thereby enable one skilled in the art to use the various embodiments and with various modifications as may be convenient for the particular use contemplated. The attached claims are intended to define the global scope.

[00647] Various aspects of the matter described in this document are defined in the following numbered examples:

[00648] “Example 1. An ultrasonic surgical instrument 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 ultrasonically oscillate the ultrasonic blade in response to a trigger signal. The control circuit is configured to: measure a complex impedance of the ultrasonic transducer, compare the complex impedance with a plurality of complex impedance reference standards, each of the plurality of complex impedance reference standards corresponding to a end actuator state, and determine the end actuator state according to the complex impedance pattern from among the plurality of reference complex impedance patterns to which the complex impedance corresponds.

[00649] “Example 2.00The ultrasonic surgical instrument, according to Example 1, wherein the plurality of reference complex impedance patterns corresponds to at least one of the ultrasonic blade in contact with air, the ultrasonic blade being that - brada or the ultrasonic blade in contact with metal.

[00650] Example 3. The surgical instrument, according to Example 1 or 2, which additionally comprises a memory coupled to the control circuit. The memory stores the plurality of complex impedance reference patterns. The control circuit is configured to retrieve the plurality of complex impedance reference patterns from memory.

[00651] Example 4. The ultrasonic surgical instrument according to any one of Examples 1 to 3, wherein the reference complex impedance patterns comprise fitted curves plotted from data points of the complex impedance patterns of reference.

[00652] Example 5. The ultrasonic surgical instrument, according to Example 4, wherein the control circuit is configured to determine the pattern among the plurality of reference complex impedance standards to which the complex impedance corresponds, according to a perpendicular Euclidean distance between the complex impedance and the fitted curves.

[00653] Example 6. The ultrasonic surgical instrument, according to Example 5, in which the complex impedance corresponds to the fitted curve, among the fitted curves, of which the complex impedance has the smallest Euclidean perpendicular distance.

[00654] Example 7. The ultrasonic surgical instrument according to any one of Examples 1 to 6, wherein the complex impedance corresponds to a ratio of a voltage signal to a current signal that excites the ultrasonic transducer.

[00655] Example 8. An ultrasonic generator to drive an ultrasonic surgical instrument comprising an end actuator, an ultrasonic blade and an ultrasonic transducer acoustically coupled to the ultrasonic blade. The ultrasonic transducer is configured to ultrasonically oscillate the ultrasonic blade in response to a trigger signal. The ultrasonic generator comprises a control circuit coupled to the ultrasonic transducer. The control circuit is configured to: apply the drive signal to the ultrasonic transducer, measure a complex impedance of the ultrasonic transducer, compare the complex impedance with a plurality of complex impedance reference standards, each of which is a plurality of reference complex impedance corresponds to an end actuator state, and determine the end actuator state according to the complex impedance pattern among the plurality of reference complex impedance patterns to which the complex impedance corresponds.

[00656] Example 9. The ultrasonic generator, according to Example 8, in which the plurality of reference complex impedance standards corresponds to at least one of the ultrasonic blade in contact with air, the ultrasonic blade being broken or the ultrasonic blade in contact with metal.

[00657] Example 10. The ultrasonic generator, according to Example 8 or 9, which additionally comprises a memory coupled to the control circuit. The memory stores the plurality of complex impedance reference patterns. The control circuit is configured to retrieve the plurality of complex impedance reference patterns from memory.

[00658] “Example 11. The ultrasonic generator, according to at least one of Examples 8 to 10, wherein the reference complex impedance standards comprise fitted curves plotted from data points of the reference complex impedance standards.

[00659] Example 12. The ultrasonic generator, according to Example 11, wherein the control circuit is configured to determine the pattern among the plurality of reference complex impedance standards to which the complex impedance corresponds, according to with a perpendicular Euclidean distance between the complex impedance and the fitted curves.

[00660] Example 13. The ultrasonic generator, according to Example 12, in which the complex impedance corresponds to the fitted curve, among the fitted curves, of which the complex impedance has a smaller Euclidean perpendicular distance.

[00661] Example 14. The ultrasonic generator, according to any one of Examples 8 to 13, wherein the complex impedance corresponds to a ratio between a voltage signal and a current signal that excites the ultrasonic transducer.

[00662] Example 15. A method of controlling an ultrasonic surgical instrument comprising an end actuator, an ultrasonic blade and an ultrasonic transducer acoustically coupled to the ultrasonic blade. The ultrasonic transducer is configured to ultrasonically oscillate the ultrasonic blade in response to a trigger signal from a generator. The method comprises: measuring, through a control circuit coupled to the ultrasonic transducer, a complex impedance of the ultrasonic transducer; comparing, via the control circuit, the complex impedance with a plurality of reference complex impedance patterns, each pattern among the plurality of reference complex impedance patterns corresponding to an end actuator state; and determining, by the control circuit, the state of the end actuator according to the complex impedance pattern among the plurality of complex impedance reference patterns to which the complex impedance corresponds.

[00663] Example 16. The method, according to Example 15, wherein the plurality of reference complex impedance standards corresponds to at least one of the ultrasonic blade in contact with air, the ultrasonic blade being broken or the blade ultrasonic in contact with metal.

[00664] Example 17. The method according to Example 15 or 16, which further comprises retrieving, by means of the control circuit, the plurality of reference complex impedance patterns from memory.

[00665] “Example 18. The method, according to any one of Examples 15 to 17, wherein the reference complex impedance standards comprise fitted curves plotted from data points of the reference complex impedance standards.

[00666] Example 19. The method, according to Example 18, which further comprises determining, by means of the control circuit, to which pattern, among the plurality of patterns of complex reference impedance, the complex impedance corresponds, according to a perpendicular Euclidean distance between the complex impedance and the fitted curves.

[00667] Example 20. The method, according to Example 19, in which the complex impedance corresponds to the fitted curve, among the fitted curves, of which the complex impedance has a smaller Euclidean perpendicular distance.

[00668] “Example 21. The method, according to any one of Examples 15 to 20, wherein the complex impedance corresponds to a ratio of a voltage signal to a current signal that excites the ultrasonic transducer.

Claims (21)

1. Ultrasonic surgical instrument, characterized by comprising: an end actuator comprising an ultrasonic blade; an ultrasonic transducer acoustically coupled to the ultrasonic blade, the ultrasonic transducer being configured to ultrasonically oscillate the ultrasonic blade in response to an activation signal; and a control circuit coupled to the ultrasonic transducer, the control circuit being configured to: measure a complex impedance of the ultrasonic transducer; comparing the complex impedance to a plurality of reference complex impedance patterns, each pattern among the plurality of reference complex impedance patterns corresponding to an end actuator state; and determining the state of the end actuator in accordance with the complex impedance pattern from among the plurality of reference complex impedance patterns to which the complex impedance corresponds. 2. Ultrasonic surgical instrument according to claim 1, characterized in that the plurality of reference complex impedance patterns correspond to at least one of the ultrasonic blade in contact with air, the ultrasonic blade being broken or the ultrasonic blade in contact with metal. 3. Ultrasonic surgical instrument, according to claim 1, characterized in that it additionally comprises: a memory coupled to the control circuit, the memory storing the plurality of complex impedance reference patterns; wherein the control circuit is configured to retrieve the plurality of complex impedance reference patterns from memory. 4. Ultrasonic surgical instrument according to claim 1, characterized in that the reference complex impedance standards comprise fitted curves plotted from data points of the reference complex impedance standards. 5. Ultrasonic surgical instrument according to claim 4, characterized in that the control circuit is configured to determine the pattern among the plurality of reference complex impedance standards to which the complex impedance corresponds, in accordance with with a perpendicular Euclidean distance between the complex impedance and the fitted curves. 6. Ultrasonic surgical instrument, according to claim 5, characterized in that the complex impedance corresponds to the fitted curve, among the fitted curves, of which the complex impedance has the smallest Euclidean perpendicular distance. 7. Ultrasonic surgical instrument according to claim 1, characterized in that the complex impedance corresponds to a ratio between a voltage signal and a current signal that excites the ultrasonic transducer. 8. Ultrasonic generator for driving an ultrasonic surgical instrument comprising an end actuator, an ultrasonic blade and an ultrasonic transducer acoustically coupled to the ultrasonic blade, the ultrasonic transducer being configured to ultrasonically oscillate the ultrasonic blade in response to a signal drive, the ultrasonic generator being characterized by comprising: a control circuit coupled to the ultrasonic transducer, the control circuit being configured to: apply the drive signal to the ultrasonic transducer; measure a complex impedance of the ultrasonic transducer; comparing the complex impedance to a plurality of reference complex impedance patterns, each pattern among the plurality of reference complex impedance patterns corresponding to an end actuator state; and determining the state of the end actuator in accordance with the complex impedance pattern from among the plurality of reference complex impedance patterns to which the complex impedance corresponds. 9. Ultrasonic generator, according to claim 8, characterized in that the plurality of reference complex impedance standards correspond to at least one of the ultrasonic blade in contact with air, the ultrasonic blade being broken or the blade ultrasonic in contact with metal. 10. Ultrasonic generator, according to claim 8, characterized in that it additionally comprises: a memory coupled to the control circuit, wherein the memory stores the plurality of reference complex impedance patterns; wherein the control circuit is configured to retrieve the plurality of complex impedance reference patterns from memory. 11. Ultrasonic generator, according to claim 8, characterized in that the reference complex impedance patterns comprise fitted curves plotted from data points of the reference complex impedance patterns. 12. Ultrasonic generator, according to claim 11, characterized in that the control circuit is configured to determine the pattern among the plurality of reference complex impedance patterns to which the complex impedance corresponds, according to a Euclidean perpendicular distance between the complex impedance and the fitted curves. 13. Ultrasonic generator, according to claim 12, characterized in that the complex impedance corresponds to the fitted curve, among the fitted curves, of which the complex impedance has the smallest Euclidean perpendicular distance. 14. Ultrasonic generator, according to claim 8, characterized in that the complex impedance corresponds to a ratio between a voltage signal and a current signal that excites the ultrasonic transducer. 15. A method for controlling an ultrasonic surgical instrument comprising an end actuator, an ultrasonic blade, and an ultrasonic transducer acoustically coupled to the ultrasonic blade, the ultrasonic transducer being configured to ultrasonically oscillate the ultrasonic blade in response to a triggering signal from a generator, the method being characterized by comprising: measuring, by a control circuit coupled to the ultrasonic transducer, a complex impedance of the ultrasonic transducer; compare, through the control circuit, the complex impedance with a plurality of reference complex impedance patterns, each pattern among the plurality of reference complex impedance patterns corresponding to an end actuator state. ity; and determining, by the control circuit, the state of the end actuator in accordance with the complex impedance pattern among the plurality of reference complex impedance patterns to which the complex impedance corresponds. Method according to claim 15, characterized in that the plurality of complex impedance reference standards correspond to at least one of the ultrasonic blade in contact with air, the ultrasonic blade being broken or the ultrasonic blade being broken. in contact with metal. A method according to claim 15, characterized in that it further comprises retrieving, by the control circuit, the plurality of reference complex impedance patterns from a memory. A method according to claim 15, characterized in that the reference complex impedance patterns comprise fitted curves plotted from data points of the reference complex impedance patterns. 19. Method according to claim 18, characterized in that it additionally comprises determining, by means of the control circuit, to which pattern, among the plurality of reference complex impedance patterns, the complex impedance corresponds, according to with a perpendicular Euclidean distance between the complex impedance and the fitted curves. Method according to claim 19, characterized in that the complex impedance corresponds to the fitted curve, among the fitted curves, of which the complex impedance has the smallest Euclidean perpendicular distance. Method according to claim 15, characterized in that the complex impedance corresponds to a ratio between a voltage signal and a current signal that excites the ultrasonic transducer.