CN111295717A - 用于外科器械的语言选择的系统和方法 - Google Patents
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Abstract
本发明公开了选择用于外科器械的显示语言的各种系统和方法。所述外科器械包括柄部组件和能够可互换地连接至所述柄部组件的模块,诸如轴组件。所述柄部组件包括被配置成能够存储语言参数的第一存储器和操作地联接到所述存储器的控制电路。所述模块包括被配置成能够存储采用多种语言的文本短语的第二存储器。当所述模块和所述柄部组件连接在一起时,所述控制电路被配置成能够从所述第二存储器检索采用对应于所述语言参数的语言的所述文本短语。
Description
技术领域
本公开涉及外科器械,并且在各种情况下,涉及被设计成切割和缝合组织的外科缝合和切割器械。
背景技术
在外科缝合和切割器械中,控制器械的显示器和其他部件以向使用器械的临床医生提供警示,关闭器械的功率,以及根据外科器械的操作状态来采取其他此类动作可能是有用的。外科器械的操作状态(即,无论器械正在切割、缝合、夹持、进行关节运动,还是正在采取其他此类动作)可通过一个或多个传感器来检测,所述一个或多个传感器可通信地联接到控制电路,该控制电路被配置成能够根据由传感器检测到的器械的状态来执行各种过程。在一些情况下,向临床医生提供警示以便警示临床医生外科器械所经历的错误可能是有用的。在其他情况下,当器械已完成其外科缝合和切割操作时,关闭器械功率可能是有用的。在其他情况下,在其击发行程的过程中显示该刀的位置,以便允许临床医生观察切割进度可能是有用的。
发明内容
在一个方面,一种外科器械包括:柄部组件,该柄部组件包括:第一存储器,该第一存储器被配置成能够存储语言参数;和控制电路,该控制电路联接到第一存储器以用于从其检索该语言参数;以及;以及可互换部件,该可互换部件能够可移除地连接至柄部组件,该可互换部件包括被配置成能够存储采用多种语言的文本短语的第二存储器;其中控制电路被配置成能够从第二存储器检索采用对应于该语言参数的语言的文本短语。
在另一方面,一种外科器械的柄部组件,可互换模块能够可移除地连接至该柄部组件,该可互换模块包括被配置成能够存储采用多种语言的文本短语的辅助存储器,该柄部组件包括:存储器,该存储器被配置成能够存储语言参数;和控制电路,该控制电路联接到存储器以用于从其检索该语言参数;其中控制电路被配置成能够从辅助存储器检索采用对应于该语言参数的语言的文本短语。
在另一方面,一种操作包括柄部组件的外科器械的方法,可互换部件能够可移除地连接至该柄部组件,该方法包括:从该柄部组件的第一存储器检索语言参数;从可互换部件的第二存储器检索采用对应于该语言参数的语言的文本短语;以及显示采用对应于该语言参数的语言的文本短语。
附图说明
本文所述方面的新颖特征在所附权利要求书中进行了详细描述。然而,关于组织和操作方法的这些方面可结合附图参考下述说明更好地理解。
图1为根据本公开的一个方面的具有操作地耦接到其的可互换轴组件的外科器械的透视图。
图2是根据本公开的一个方面的图1的外科器械的一部分的分解组装图。
图3为根据本公开的一个方面的可互换轴组件的部分的分解组件视图。
图4为根据本公开的一个方面的图1的外科器械的端部执行器的分解图。
图5A至图5B为根据本公开的一个方面的跨越两个图页的图1的外科器械的控制电路的框图。
图6为根据本公开的一个方面的图1的外科器械的控制电路的框图,其示出了柄部组件与功率组件之间、以及柄部组件与可互换轴组件之间的接口。
图7示出被配置成能够控制根据本公开的一个方面的图1的外科器械的各方面的控制电路。
图8示出被配置成能够控制根据本公开的一个方面的图1的外科器械的各方面的组合逻辑电路。
图9示出被配置成能够控制根据本公开的一个方面的图1的外科器械的各方面的时序逻辑电路。
图10为根据本公开的一个方面的图1的外科器械的绝对定位系统的图,其中绝对定位系统包括受控马达驱动电路布置,该受控马达驱动电路布置包括传感器布置。
图11为根据本公开的一个方面的绝对定位系统的传感器布置的分解透视图,其示出控制电路板组件和传感器元件布置的相对对齐。
图12为根据本公开的一个方面的位置传感器的图,该位置传感器包括磁性旋转绝对定位系统。
图13为根据本公开的一个方面的图1的外科器械的端部执行器的剖视图,其示出了相对于夹持在端部执行器内的组织的击发构件行程。
图14示出根据本公开的一个方面的被编程为控制位移构件的远侧平移的外科器械的框图。
图15示出绘制根据本公开的一个方面执行的两个示例性位移构件行程的图示。
图16为根据本公开的一个方面的外科器械的端部执行器的一部分的局部透视图,示出了处于非关节运动取向的细长轴组件,为清楚起见省略了其一部分。
图17为根据本公开的一个方面的图16的端部执行器的另一个透视图,示出了处于非关节运动取向的细长轴组件。
图18为根据本公开的一个方面的图16的端部执行器的分解组装透视图,示出了细长轴组件方面。
图19为根据本公开的一个方面的图16的端部执行器的顶视图,示出了处于非关节运动取向的细长轴组件。
图20为根据本公开的一个方面的图16的端部执行器的另一个顶视图,示出了处于第一关节运动取向的细长轴组件。
图21为根据本公开的一个方面的图16的端部执行器的另一个顶视图,其示出了处于第二关节运动取向的细长轴组件。
图22为根据本公开的一个方面的外科系统的透视图,该外科系统包括联接到可互换外科工具组件的柄部组件,该可互换外科工具组件被配置成能够与常规外科钉/紧固件仓和射频(RF)仓结合使用。
图23为根据本公开的一个方面的图22的外科系统的分解透视组件视图。
图24为根据本公开的一个方面的图22的可互换外科工具组件的一部分的俯视剖视图,其中其端部执行器处于关节运动位置。
图25为根据本公开的一个方面的板载电路板布置和RF发生器以及配置的透视图。
图26示出根据本公开的一个方面的包括可互换轴组件和柄部组件的外科器械的框图。
图27示出了根据本公开的一个方面的用于设置显示语言的过程的逻辑流程图。
图28示出了根据本公开的一个方面的显示器或其部分的前视图,示出了不具有文本叠层的图像。
图29示出了根据本公开的一个方面的显示器或其部分的前视图,示出了具有文本叠层的图像。
说明书
本申请的申请人拥有与其同时提交且各自全文以引用方式并入本文的以下专利申请:
2017年9月29日提交、发明人为Richard L Leimbach等人且名称为“SYSTEMS ANDMETHODS FOR PROVIDING ALERTS ACCORDING TO THE OPERATIONAL STATE OF A SURGICALINSTRUMENT”的代理人案卷号END8312USNP/170177。
2017年9月29日提交、发明人为Richard L Leimbach等人且名称为“SYSTEMS ANDMETHODS OF DISPLAYING A KNIFE POSITION FOR A SURGICAL INSTRUMENT”的代理人案卷号END8313USNP/170178。
2017年9月29日提交、发明人为Richard L Leimbach等人且名称为“SYSTEMS ANDMETHODS OF INITIATING A POWER SHUTDOWN MODE FOR A SURGICAL INSTRUMENT”的代理人案卷号END8314USNP/170179。
2017年9月29日提交、发明人为Tony C.Seibel等人且名称为“DISPLAY SCREEN ORPORTION THEREOF WITH ANIMATED GRAPHICAL USER INTERFACE”的代理人案卷号END8316USDP/170181D。
2017年9月29日提交、发明人为Tony C.Seibel等人且名称为“DISPLAY SCREEN ORPORTION THEREOF WITH ANIMATED GRAPHICAL USER INTERFACE”的代理人案卷号END8317USDP/170182D。
2017年9月29日提交、发明人为Tony C.Seibel等人且名称为“DISPLAY SCREEN ORPORTION THEREOF WITH ANIMATED GRAPHICAL USER INTERFACE”的代理人案卷号END8318USDP/170183D。
2017年9月29日提交、发明人为Tony C.Seibel等人且名称为“DISPLAY SCREEN ORPORTION THEREOF WITH ANIMATED GRAPHICAL USER INTERFACE”的代理人案卷号END8319USDP/170184D。
2017年9月29日提交、发明人为Richard L.Leimbach等人且名称为“SYSTEM ANDMETHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT”的代理人案卷号END8320USNP/170176M。
示出并且描述了某些方面以提供对所公开的装置和方法的结构、功能、制造和使用的理解。在一个示例中示出或描述的特征可与其他示例的特征组合,并且修改和变型在本公开的范围内。
术语“近侧”和“远侧”相对于操纵外科器械的柄部的临床医生,其中“近侧”是指更靠近临床医生的部分,并且“远侧”是指距临床医生更远的部分。为了方便起见,相对于图使用的空间术语“竖直”、“水平”、“向上”和“向下”并非旨在是限制性的和/或绝对的,因为外科器械可用于许多定向和位置。
提供了用于执行腹腔镜式和微创外科手术操作的示例性装置和方法。然而,此类装置和方法可用于其他外科手术和应用,包括例如开放式外科手术。外科器械可穿过自然孔口或穿过形成在组织中的切口或穿刺孔被插入。器械的工作部分或端部执行器部分可被直接插入身体中或者通过具有工作通道的进入装置插入,外科器械的端部执行器和细长轴可穿过该工作通道推进。
在一些方面,外科器械可包括能够执行切割(如在例如图1和图22中)、缝合(如在例如图1中)、电外科操作(如在例如图22中)和/或超声操作的装置,如下文进一步详细描述。关于超声外科器械的更多细节可见于名称为“METHOD OF BALANCING ASYMMETRICULTRASONIC SURGICAL BLADES”的美国专利6,283,981;名称为“CURVED ULTRASONICWAVEGUIDE HAVING A TRAPEZOIDAL CROSS SECTION”的美国专利6,309,400;以及名称为“BALANCED ULTRASONIC WAVEGUIDE INCLUDING A PLURALITY OF BALANCE ASYMMETRIES”的美国专利6,436,115,这些专利的全部公开内容据此以引用方式并入本文。
图1-图4描绘用于切割和紧固的马达驱动的外科器械10,其可以或可以不重复使用。在例示的示例中,外科器械10包括外壳12,该外壳包括被配置成能够由临床医生抓握、操纵并且致动的柄部组件14。外壳12被配置成能够操作地附接到可互换轴组件200,该可互换轴组件具有操作地联接到其上的端部执行器300,该端部执行器被配置成能够执行一种或多种手术任务或外科手术。根据本公开,可结合机器人控制的外科系统有效地采用各种形式的可互换轴组件。术语“外壳”可涵盖容纳或以其他方式操作地支撑至少一个驱动系统的机器人系统的外壳或类似部分,该至少一个驱动系统被配置成能够生成并且施加可用于致动可互换轴组件的至少一个控制运动。术语“框架”可指手持式外科器械的一部分。术语“框架”还可表示机器人控制的外科器械的一部分和/或机器人系统的可用于操作地控制外科器械的一部分。可互换轴组件可与名称为“SURGICAL STAPLING INSTRUMENTS WITHROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利9,072,535中公开的各种机器人系统、器械、部件和方法一起使用,该专利据此全文以引用方式并入本文。
图1是根据本公开的一个方面的外科器械10的透视图,该外科器械具有操作地联接到其的可互换轴组件200。外壳12包括端部执行器300,该端部执行器包括被配置成能够在其中操作地支撑外科钉仓304的外科切割和紧固装置。外壳12可被配置用于结合可互换轴组件使用,该可互换轴组件包括适于支撑不同尺寸和类型的钉仓的端部执行器,具有不同的轴长度、尺寸和类型。外壳12可与多种可互换轴组件一起采用,多种可互换轴组件包括被配置成能够将其他运动和形式的能量诸如射频(RF)能量、超声能量和/或运动施加给适于结合各种外科应用和手术使用的端部执行器配置的组件。端部执行器、轴组件、柄部、外科器械和/或外科器械系统可利用任何合适的一个紧固件或多个紧固件来紧固组织。例如,包括可移除地被存储在其中的多个紧固件的紧固件仓能够可移除地插入轴组件的端部执行器中和/或附接到轴组件的端部执行器。
柄部组件14可以包括一对可互连柄部外壳段16、18,该对柄部外壳段通过螺钉、按扣特征结构、粘合剂等互连。柄部外壳段16、18配合以形成可被临床医生抓握和操纵的手枪式握把部19。柄部组件14操作地支撑多个驱动系统,该多个驱动系统被配置成能够生成控制运动并且将控制运动施加给操作地附接到其的可互换轴组件的对应部分。显示器可提供于覆盖件45下方。
图2是根据本公开的一个方面的图1的外科器械10的一部分的分解组装图。柄部组件14可包括操作地支撑多个驱动系统的框架20。框架20能够操作地支撑闭合驱动系统30,该闭合驱动系统可向互换轴组件200施加闭合和打开运动。闭合驱动系统30可包括致动器,诸如由框架20枢转地支撑的闭合触发器32。闭合触发器32通过枢轴销33枢转地联接到柄部组件14,以使得闭合触发器32能够由临床医生操纵。当临床医生抓握柄部组件14的手枪式握把部19时,闭合触发器32可从启动或“未致动”位置枢转到“致动”位置并且更具体地枢转到完全压缩或完全致动位置。
柄部组件14和框架20能够操作地支撑击发驱动系统80,该击发驱动系统被配置成能够将击发运动施加给附接到其的可互换轴组件的对应部分。击发驱动系统80可采用位于柄部组件14的手枪式握把部19中的电动马达82。电动马达82可为具有例如约25,000RPM的最大旋转速度的DC有刷马达。在其他布置中,马达可包括无刷马达、无绳马达、同步马达、步进马达、或任何其他合适的电动马达。电动马达82可由功率源90供电,该功率源可包括可移除电源组92。可移除电源组92可包括被配置成能够附接到远侧外壳部分96的近侧外壳部分94。近侧外壳部分94和远侧外壳部分96被配置成能够操作地支撑其中的多个电池98。电池98可各自包括例如锂离子(LI)或其他合适的电池。远侧外壳部分96被配置用于以可移除方式操作地附接到操作地联接到电动马达82的控制电路板100。串联连接的若干电池98可向外科器械10供电。功率源90可为可替换的和/或可再充电的。位于覆盖件45下方的显示器43电耦接到控制电路板100。可移除覆盖件45以暴露显示器43。
电动马达82可包括与齿轮减速器组件84操作地交接的可旋转轴(未示出),该齿轮减速器组件安装成与纵向可移动驱动构件120上的一组或一齿条的驱动齿122啮合接合。纵向可移动驱动构件120具有形成在其上的一齿条的驱动齿122,以用于与齿轮减速器组件84的对应驱动齿轮86啮合接合。
在使用中,功率源90所提供的电压极性可沿顺时针方向操作电动马达82,其中由电池施加给电动马达的电压极性可被反转,以便沿逆时针方向操作电动马达82。当电动马达82在一个方向上旋转时,纵向可移动驱动构件120将在远侧方向“DD”上被轴向地驱动。当电动马达82在相反的旋转方向上被驱动时,纵向可移动驱动构件120将在近侧方向“PD”上被轴向地驱动。柄部组件14可包括开关,该开关可被配置成能够使由功率源90施加给电动马达82的极性反转。柄部组件14可包括传感器,该传感器被配置成能够检测纵向可移动驱动构件120的位置和/或纵向可移动驱动构件120正在移动的方向。
电动马达82的致动由被枢转地支撑在柄部组件14上的击发触发器130控制。击发触发器130可在未致动位置和致动位置之间枢转。
往回转到图1,可互换轴组件200包括端部执行器300,该端部执行器包括被配置成能够在其中操作地支撑外科钉仓304的细长通道302。端部执行器300可包括砧座306,该砧座相对于细长通道302被枢转地支撑。可互换轴组件200可包括关节运动接头270。端部执行器300和关节运动接头270的配置和操作在名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING AN ARTICULATION LOCK”的美国专利申请公布2014/0263541中阐述,该专利申请据此全文以引用方式并入本文。可互换轴组件200可包括近侧外壳或喷嘴201,该近侧外壳或喷嘴由喷嘴部分202、203构成。可互换轴组件200可包括可被利用来闭合和/或打开端部执行器300的砧座306的沿着轴轴线SA延伸的闭合管260。
返回转到图1,闭合管260朝远侧(方向“DD”)平移以例如响应于闭合触发器32的致动而以前述参考文献美国专利申请公布2014/0263541中所述的方式闭合砧座306。通过朝近侧平移闭合管260来打开砧座306。在砧座打开位置,闭合管260移动至其近侧位置。
图3为根据本公开的一个方面的可互换轴组件200的部分的另一个分解组件视图。可互换轴组件200可包括被支撑用于在脊210内的轴向行进的击发构件220。击发构件220包括被配置成能够附接到远侧切割部分或刀杆280的中间击发轴222。中间击发轴222可包括位于远侧端部中的被配置成能够接收刀杆280的近侧端部282上的突片284的纵向狭槽223。纵向狭槽223和近侧端部282可被配置成能够允许它们之间的相对移动,并且可包括滑动接头286。滑动接头286可允许击发构件220的中间击发轴222在不移动或至少基本上不移动刀杆280的情况下使端部执行器300围绕关节运动接头270进行关节运动。一旦端部执行器300已合适地取向,中间击发轴222便可朝远侧推进,直到纵向狭槽223的近侧侧壁与插片284发生接触,以便推进刀杆280并击发定位在细长通道302内的钉仓。脊210在其中具有细长开口或窗口213,以便于将中间击发轴222组装和插入脊210中。一旦中间击发轴222已被插入轴框架中,顶部框架段215就可与轴框架212接合,以封闭其中的中间击发轴222与刀杆280。击发构件220的操作可见于美国专利申请公布号2014/0263541中。脊210可被配置成能够可滑动地支撑击发构件220和围绕脊210延伸的闭合管260。脊210可以可滑动地支撑关节运动驱动器230。
可互换轴组件200可包括被配置成能够选择性地且可释放地将关节运动驱动器230耦接到击发构件220的离合器组件400。离合器组件400包括围绕击发构件220定位的锁定衬圈或锁定套筒402,其中锁定套筒402可在接合位置和脱离接合位置之间旋转,在接合位置,锁定套筒402将关节运动驱动器230耦接到击发构件220,在脱离接合位置,关节运动驱动器230未操作地耦接到击发构件220。当锁定套筒402处于接合位置时,击发构件220的远侧移动可使关节运动驱动器230朝远侧移动;并且相应地,击发构件220的近侧移动可使关节运动驱动器230朝近侧移动。当锁定套筒402处于脱离位置时,击发构件220的移动不传输到关节运动驱动器230;并且因此,击发构件220可独立于关节运动驱动器230移动。喷嘴201可用于以在美国专利申请公布2014/0263541中描述的各种方式来使关节运动驱动系统与击发驱动系统操作地接合和脱离接合。
可互换轴组件200可包括滑环组件600,该滑环组件可被配置成能够例如将电力传导到端部执行器300和/或从该端部执行器传导电力,和/或将信号传达到端部执行器300和/或从该端部执行器传达信号。滑环组件600可包括定位在限定于喷嘴部分202、203中的狭槽内的近侧连接器凸缘604和远侧连接器凸缘601。近侧连接器凸缘604可包括第一面,并且远侧连接器凸缘601可包括与第一面相邻且可相对于第一面移动的第二面。远侧连接器凸缘601可围绕轴轴线SA-SA相对于近侧连接器凸缘604旋转(图1)。近侧连接器凸缘604可包括限定在其第一面中的多个同心或至少基本上同心的导体602。连接器607可安装在远侧连接器凸缘601的近侧面上,并且可具有多个触点,其中每个触点对应于导体602中的一个并与之电接触。这种布置在保持近侧连接器凸缘604和远侧连接器凸缘601之间的电接触的同时允许这它们之间的相对旋转。近侧连接器凸缘604可包括可例如使导体602与轴电路板进行信号通信的电连接器606。在至少一个实例中,包括多个导体的线束可在电连接器606和轴电路板之间延伸。电连接器606可朝近侧延伸穿过限定在底盘安装凸缘中的连接器开口。有关滑环组件600的更多细节可见于美国专利申请公布2014/0263541。
可互换轴组件200可包括可固定地安装到柄部组件14的近侧部分,以及可围绕纵向轴线旋转的远侧部分。可旋转远侧轴部分可围绕滑环组件600相对于近侧部分旋转。滑环组件600的远侧连接器凸缘601可定位在可旋转的远侧轴部分内。
图4为根据本公开的一个方面的图1的外科器械10的端部执行器300的分解视图。端部执行器300可包括砧座306和外科钉仓304。砧座306可耦接到细长通道302。例如,开孔199可限定在细长通道302中,以接收从砧座306延伸的销152,以便允许砧座306相对于细长通道302和外科钉仓304从打开位置枢转到闭合位置。击发杆172被配置成能够纵向平移到端部执行器300中。击发杆172可由一个实心区段配置,或可包括层压材料,该层压材料包括钢板堆叠。击发杆172包括I形梁178和在其远侧端部处的切割刃182。击发杆172的远侧突出端部可附接到I形梁178,以在砧座306处于闭合位置时有助于将砧座306与定位在细长通道302中的外科钉仓304间隔开。I形梁178可包括在通过击发杆172朝远侧推进I形梁178时用于切断组织的锋利切割刃182。在操作中,I形梁178可致动或击发外科钉仓304。外科钉仓304可包括模塑的仓体194,该仓体保持多个钉191,这些多个钉安置在钉驱动器192上,这些钉驱动器位于分别向上打开的钉腔195中。楔形滑动件190由I形梁178朝远侧驱动,从而在外科钉仓304的仓托盘196上滑动。楔形滑动件190使钉驱动器192向上进行凸轮运动,以将钉191挤出成与砧座306变形接触,同时I形梁178的切割刃182切断被夹持的组织。
I形梁178可包括在击发期间接合砧座306的上部销180。I形梁178可包括接合仓体194、仓托盘196和细长通道302的各部分的中间销184和底部基座186。当外科钉仓304定位在细长通道302内时,限定在仓体194中的狭槽193可与限定在仓托盘196中的纵向狭槽197以及限定在细长通道302中的狭槽189对齐。在使用中,I形梁178可滑动穿过对齐的纵向狭槽193、197和189,其中,如图4所示,I形梁178的底部基座186可沿着狭槽189的长度接合沿着细长通道302的底表面延伸的沟槽,中间销184可沿着纵向狭槽197的长度接合仓托盘196的顶表面,并且上部销180可接合砧座306。在击发杆172朝远侧推进以从外科钉仓304击发钉和/或切入捕获在砧座306和外科钉仓304之间的组织时,I形梁178可隔开或限制砧座306和外科钉仓304之间的相对移动。击发杆172和I形梁178可朝近侧回缩,从而允许打开砧座306,以释放两个缝合和切割的组织部分。
图5A至图5B为根据本公开的一个方面的跨越两个图页的图1的外科器械10的控制电路700的框图。主要参见图5A至图5B,柄部组件702可包括马达714,该马达可由马达驱动器715控制,并可由外科器械10的击发系统使用。在各种形式中,马达714可为具有大约25,000RPM的最大旋转速度的DC有刷驱动马达。在其他布置中,马达714可包括无刷马达、无绳马达、同步马达、步进马达或任何其他合适的电动马达。马达驱动器715可包括例如包括场效应晶体管(FET)719的H桥驱动器。马达714可由功率组件706供电,该功率组件可释放地安装到柄部组件14,以用于向外科器械10提供控制功率。功率组件706可包括电池,该电池可包括串联连接的、可用作功率源为外科器械10供电的多个电池单元。在某些情况下,功率组件706的电池单元可以是可替换的和/或可再充电的。在至少一个示例中,电池单元可以是能够可分离地联接到功率组件706的锂离子电池。
轴组件704可包括轴组件控制器722,在轴组件704与功率组件706联接到柄部组件702时,该轴组件控制器可通过接口与安全控制器和功率管理控制器716通信。例如,接口可包括第一接口部分725和第二接口部分727,其中第一接口部分可包括一个或多个用于与对应的轴组件电连接器实现联接接合的电连接器,第二接口部分可包括一个或多个用于与对应的功率组件电连接器实现联接接合的电连接器,从而在轴组件704与功率组件706联接到柄部组件702时,允许轴组件控制器722与功率管理控制器716之间进行电通信。可通过接口传输一个或多个通信信号,以将附接的可互换轴组件704的一个或多个功率要求传送到功率管理控制器716。作为响应,功率管理控制器可依据附接轴组件704的功率要求,调节功率组件706的电池的功率输出,如下文更详细地描述。连接器可包括开关,这些开关可在柄部组件702机械联接接合到轴组件704和/或功率组件706,以允许轴组件控制器722与功率管理控制器716之间进行电通信之后被启动。
例如,接口将一个或多个通信信号路由通过位于柄部组件702内的主控制器717,由此可利于在功率管理控制器716与轴组件控制器722之间传输这类通信信号。在其他情况下,当轴组件704和功率组件706联接到柄部组件702时,接口可有利于功率管理控制器716与轴组件控制器722之间的直接通信线路穿过柄部组件702。
主控制器717可以是任何单核或多核处理器,诸如由Texas Instruments提供的商品名为ARM Cortex的那些处理器。在一个方面,主控制器717可为例如购自TexasInstruments公司的LM4F230H5QR ARM Cortex-M4F处理器内核,其包括:256KB的单循环闪存或其他非易失性存储器(最多至40MHZ)的片上存储器、用于使性能改善超过40MHz的预取缓冲器、32KB的单循环串行随机存取存储器(SRAM)、装载有软件的内部只读存储器(ROM)、2KB的电可擦除可编程只读存储器(EEPROM)、一个或多个脉宽调制(PWM)模块、一个或多个正交编码器输入(QEI)模拟、具有12个模拟输入信道的一个或多个12位模数转换器(ADC),其细节可见于产品数据表。
安全控制器可以是包括两个基于控制器的系列(诸如TMS570和RM4x,已知同样由Texas Instruments生产且商品名为Hercules ARM Cortex R4)的安全控制器平台。安全控制器可被配置成能够专门用于IEC 61508和ISO 26262安全关键应用等等,以提供先进的集成安全特征件,同时递送可定标的性能、连接性和存储器选项。
功率组件706可包括功率管理电路,该功率管理电路可包括功率管理控制器716、功率调制器738和电流感测电路736。在轴组件704与功率组件706联接到柄部组件702时,功率管理电路可被配置成能够基于轴组件704的功率要求调节电池的功率输出。功率管理控制器716可被编程用于控制功率调制器738调节功率组件706的功率输出,电流感测电路736可用于监视功率组件706的功率输出,以便为功率管理控制器716提供与电池的功率输出有关的反馈,使得功率管理控制器716可调节功率组件706的功率输出以维持理想的输出。功率管理控制器716和/或轴组件控制器722各自可包括一个或多个可存储多个软件模块的处理器和/或存储器单元。
外科器械10(图1-图4)可包括输出装置742,该输出装置可包括用于将感官反馈提供给用户的装置。此类装置可包括例如视觉反馈装置(例如,LCD显示器、LED指示器)、音频反馈装置(例如,扬声器、蜂鸣器)或触觉反馈装置(例如,触觉致动器)。在某些情况下,输出装置742可包括显示器743,该显示器可包含在柄部组件702中。轴组件控制器722和/或功率管理控制器716可通过输出装置742向外科器械10的使用者提供反馈。接口可被配置成将轴组件控制器722和/或功率管理控制器716连接到输出装置742。作为替代,输出装置742可与功率组件706集成。在此类情况下,当轴组件704联接到柄部组件702时,输出装置742与轴组件控制器722之间的通信可通过接口实现。
控制电路700包括被配置成控制电动外科器械10的操作的电路段。安全控制器段(段1)包括安全控制器和主控制器717段(段2)。安全控制器和/或主控制器717被配置成与一个或多个附加电路段(诸如加速度段、显示器段、轴段、编码器段、马达段和功率段)相互作用。电路段中的每个都可联接到安全控制器和/或主控制器717。主控制器717还联接到闪存存储器。主控制器717还包括串行通信接口。主控制器717包括联接到例如一个或多个电路段、电池和/或多个开关的多个输入。分段电路可通过任何合适的电路(诸如电动外科器械10内的印刷电路板组件(PCBA))来实施。应当理解,本文使用的术语“处理器”包括任一种微处理器、处理器、微控制器、控制器,或者将计算机的中央处理单元(CPU)的功能结合到一个集成电路或最多几个集成电路上的其他基础计算装置。主控制器717是多用途的可编程装置,该装置接收数字数据作为输入,根据其存储器中存储的指令来处理输入,然后提供结果作为输出。因为处理器具有内部存储器,所以是顺序数字逻辑的示例。控制电路700可被配置成实现本文所述的一个或多个过程。
加速度段(段3)包括加速度计。加速度计被配置成检测电动外科器械10的移动或加速度。来自加速度计的输入可用于例如转换到休眠模式和从休眠模式转换到其他模式、识别电动外科器械的取向,并且/或者识别外科器械何时已被放下。在一些示例中,加速度段联接到安全控制器和/或主控制器717。
显示器段(段4)包括联接到主控制器717的显示器连接器。显示器连接器通过显示器的一个或多个集成电路驱动器将主控制器717联接到显示器。显示器的集成电路驱动器可与显示器集成,并且/或者可与显示器分开定位。显示器可包括任一种合适的显示器,诸如有机发光二极管(OLED)显示器、液晶显示器(LCD)和/或任何其他合适的显示器。在一些示例中,显示器段联接到安全控制器。
轴段(段5)包括用于耦接到外科器械10(图1-图4)的可互换轴组件200(图1和图3)的控件,和/或用于耦接到可互换轴组件200的端部执行器300的一个或多个控件。轴段包括轴连接器,该轴连接器被配置成将主控制器717联接到轴PCBA。轴PCBA包括具有铁电随机存取存储器(FRAM)、关节运动开关、轴释放霍尔效应开关和轴PCBA EEPROM的低功率微控制器。轴PCBA EEPROM包括特定于可互换轴组件200和/或轴PCBA的一个或多个参数、例程和/或程序。轴PCBA可联接到可互换轴组件200和/或与外科器械10一体成型。在一些示例中,轴段包括第二轴EEPROM。第二轴EEPROM包括对应于可与加电外科器械10交接的一个或多个轴组件200和/或端部执行器300的多个算法、例程、参数和/或其他数据。
位置编码器段(段6)包括一个或多个磁性角旋转位置编码器。一个或多个磁性角旋转位置编码器被配置成能够标识外科器械10(图1-图4)的马达714、可互换轴组件200(图1和图3)和/或端部执行器300的旋转位置。在一些示例中,磁性角旋转位置编码器可联接到安全控制器和/或主控制器717。
马达电路段(段7)包括被配置成能够控制电动外科器械10(图1-图4)的移动的马达714。马达714通过包括一个或多个H桥场效应晶体管(FET)的H桥驱动器和马达控制器联接到主控制器717。H桥驱动器也联接到安全控制器。马达电流传感器与马达串联联接,用于测量马达的电流消耗。马达电流传感器与主控制器717和/或安全控制器进行信号通信。在一些示例中,马达714联接到马达电磁干扰(EMI)滤波器。
马达控制器控制第一马达标记和第二马达标记,以向主控制器717指示马达714的状态和位置。主控制器717通过缓冲器向马达控制器提供脉宽调制(PWM)高信号、PWM低信号、方向信号、同步信号和马达复位信号。功率段被配置成向电路段中的每一者提供段电压。
功率段(段8)包括联接到安全控制器、主控制器717和附加电路段的电池。电池通过电池连接器和电流传感器联接到分段电路。电流传感器被配置成测量分段电路的总电流消耗。在一些示例中,一个或多个电压转换器被配置成能够向一个或多个电路段提供预先确定的电压值。例如,在一些示例中,分段电路可包括3.3V的电压转换器和/或5V的电压转换器。升压转换器被配置成能够提供最高为预先确定的量(诸如,最高至13V)的升压电压。升压转换器被配置成能够在功率密集操作期间提供附加的电压和/或电流,并且能够防止电压降低状况或低功率状况。
多个开关联接到安全控制器和/或主控制器717。这些开关可被配置成能够控制外科器械10(图1-图4)的分段电路的操作,和/或指示外科器械10的状态。用于应急的应急门开关和霍尔效应开关被配置成指示应急门的状态。多个关节运动开关(诸如左侧向左关节运动开关、左侧向右关节运动开关、左侧向中心关节运动开关、右侧向左关节运动开关、右侧向右关节运动开关和右侧向中心关节运动开关)被配置成能够控制互换轴组件200(图1和图3)和/或端部执行器300(图1和图4)的关节运动。左侧换向开关和右侧换向开关联接到主控制器717。左侧开关(包括左侧向左关节运动开关、左侧向右关节运动开关、左侧向中心关节运动开关和左侧换向开关)通过左挠性连接器联接到主控制器717。右侧开关(包括右侧向左关节运动开关、右侧向右关节运动开关、右侧向中心关节运动开关和右侧换向开关)通过右挠性连接器联接到主控制器717。击发开关、夹持释放开关和轴接合开关联接到主控制器717。
任何合适的机械开关、机电开关或固态开关可任意组合,用于实施多个开关。例如,开关可为通过与外科器械10(图1-图4)相关联的部件的运动或对象的存在来操作的限位开关。此类开关可用于控制与外科器械10相关联的各种功能。限位开关是由机械地连接到一组触点的致动器构成的机电装置。当某个物体与致动器接触时,该装置操作触点以形成或断开电连接。限位开关不仅耐用、安装简便,还操作可靠,故适用于多种应用和环境。限位开关可确定物体的存在或不存在、经过、定位、以及物体行程的结束。在其他具体实施中,开关可以是在磁场影响下操作的固态开关,诸如霍尔效应装置、磁阻(MR)装置、巨磁阻(GMR)装置、磁力计等等。在其他具体实施中,开关可以是在光影响下操作的固态开关,诸如光学传感器、红外线传感器、紫外线传感器及其他。同样,开关可以是固态装置,诸如晶体管(例如,FET、结型FET、金属氧化物半导体FET(MOSFET)、双极型晶体管等)。其他开关可包括无线开关、超声开关、加速度计、惯性传感器及其他。
图6为根据本公开的一个方面的图1的外科器械的控制电路700的另一个框图,其示出了柄部组件702与功率组件706之间、以及柄部组件702与可互换轴组件704之间的接口。柄部组件702可包括主控制器717、轴组件连接器726和功率组件连接器730。功率组件706可包括功率组件连接器732、功率管理电路734,该功率管理电路可包括功率管理控制器716、功率调制器738和电流感测电路736。功率组件连接器730、732形成接口727。功率管理电路734可被配置成在可互换轴组件704与功率组件706联接到柄部组件702时,基于可互换轴组件704的功率要求调节电池707的功率输出。功率管理控制器716可被编程用于控制功率调制器738调节功率组件706的功率输出,电流感测电路736可用于监视功率组件706的功率输出,以便为功率管理控制器716提供与电池707的功率输出有关的反馈,使得功率管理控制器716可调节功率组件706的功率输出以维持理想的输出。轴组件704包括轴组件控制器722,该轴组件控制器联接到非易失性存储器721和轴组件连接器728以将轴组件704电联接到柄部组件702。轴组件连接器726、728形成接口725。主控制器717、轴组件控制器722和/或功率管理控制器716可被配置成能够实现本文所述的过程中的一者或多者。
外科器械10(图1-图4)可包括用于将感官反馈提供给用户的输出装置742。此类装置可以包括视觉反馈装置(例如,LCD显示器、LED指示器)、听觉反馈装置(例如,扬声器、蜂鸣器)或触觉反馈装置(例如,触觉致动器)。在某些情况下,输出装置742可包括显示器743,该显示器可包含在柄部组件702中。轴组件控制器722和/或功率管理控制器716可通过输出装置742向外科器械10的使用者提供反馈。接口727可被配置成能够将轴组件控制器722和/或功率管理控制器716连接至输出装置742。输出装置742可与功率组件706集成。当可互换轴组件704联接到柄部组件702时,输出装置742与轴组件控制器722之间的通信可通过接口725实现。在描述用于控制外科器械10(图1至图4)的操作的控制电路700(图5A-图5B和图6)后,本公开现在转向外科器械10(图1-图4)和控制电路700的各种配置。
图7示出根据本公开的一个方面的被配置成能够控制外科器械10(图1-图4)的各方面的控制电路800。控制电路800可被配置成能够实现本文所述的各种过程。控制电路800可以包括控制器,该控制器包括联接接到至少一个存储器电路804的一个或多个处理器802(例如,微处理器、微控制器)。存储器电路804存储在由处理器802执行时使处理器802执行机器指令以实现本文所述的各种过程的机器可执行指令。处理器802可以是本领域中已知的多种单核或多核处理器中的任一种。存储器电路804可以包括易失性存储介质和非易失性存储介质。处理器802可以包括指令处理单元806和运算单元808。指令处理单元可被配置成能够从存储器电路804接收指令。
图8示出根据本公开的一个方面的被配置成能够控制外科器械10(图1-图4)的各方面的组合逻辑电路810。组合逻辑电路810可被配置成能够实现本文所述的各种过程。电路810可包括有限状态机,该有限状态机包括组合逻辑电路812,该组合逻辑电路被配置成能够在输入814处接收与外科器械10相关联的数据,通过组合逻辑812处理数据,并且提供输出816。
图9示出根据本公开的一个方面的被配置成能够控制外科器械10(图1-图4)的各方面的时序逻辑电路820。时序逻辑电路820或组合逻辑电路822可被配置成能够实现本文所述的各种过程。电路820可包括有限状态机。时序逻辑电路820可包括例如组合逻辑电路822、至少一个存储器电路824和时钟829。至少一个存储器电路820可以存储有限状态机的当前状态。在某些情况下,时序逻辑电路820可以是同步的或异步的。组合逻辑电路822被配置成能够在输入826处接收与外科器械10相关联的数据,通过组合逻辑电路822处理数据,并且提供输出828。在其他方面,电路可包括处理器802和有限状态机的组合以实现本文的各种过程。在其他方面,有限状态机可以包括组合逻辑电路810和时序逻辑电路820的组合。
各方面可实现为制造制品。制造制品可包括被布置成存储用于执行一个或多个方面的各种操作的逻辑、指令和/或数据的计算机可读存储介质。例如,制造制品可包括磁盘、光盘、闪速存储器或固件,这些制造制品包括适用于由通用处理器或专用处理器执行的计算机程序指令。
图10为根据本公开的一个方面的外科器械10(图1-图4)的绝对定位系统1100的图示,其中绝对定位系统1100包括有包括传感器布置1102的受控马达驱动电路布置。用于绝对定位系统1100的位置传感器1102提供对应于位移构件1111的位置的独特位置信号。简单地转到图2-图4,在一个方面,位移构件1111表示可纵向移动的驱动构件120(图2),其包括用于与齿轮减速器组件84的对应驱动齿轮86啮合接合的驱动齿122的齿条。在其他方面,位移构件1111表示击发构件220(图3),其可被适配和配置为包括驱动齿的齿条。在另一方面,位移构件1111表示击发杆172(图4)或I形梁178(图4),它们中的每一者均可被适配和配置成能够包括一齿条的驱动齿。因此,如本文所用,术语位移构件通常用于指外科器械10的任何可移动的构件诸如驱动构件120、击发构件220、击发杆172、I形梁178或可进行移位的任何元件。在一个方面,可纵向移动的驱动构件120耦接到击发构件220、击发杆172和I形梁178。因此,绝对定位系统1100实际上可通过跟踪可纵向移动的驱动构件120的线性位移来跟踪I形梁178的线性位移。在各种其他方面,位移构件1111可耦接到适于测量线性位移的任何传感器。因此,可纵向移动的驱动构件120、击发构件220、击发杆172或I形梁178或它们的组合可耦接到任何合适的线性位移传感器。线性位移传感器可包括接触式位移传感器或非接触式位移传感器。线性位移传感器可包括线性可变差分变压器(LVDT)、差分可变磁阻换能器(DVRT)、滑动电位计、包括可移动磁体和一系列线性布置的霍尔效应传感器的磁感测系统、包括固定磁体和一系列可移动的线性布置的霍尔效应传感器的磁感测系统、包括可移动光源和一系列线性布置的光电二极管或光电检测器的光学感测系统、或包括固定光源和一系列可移动的线性布置的光电二极管或光电检测器的光学感测系统或它们的任何组合。
电动马达1120可包括与齿轮组件1114操作地对接的可旋转轴1116,该齿轮组件安装成与位移构件1111上的一组或齿条的驱动齿啮合接合。传感器元件1126可以操作地联接到齿轮组件1114,使得传感器元件1126的单次旋转对应于位移构件1111的一些线性纵向平移。传动装置和传感器的布置可经由齿条和小齿轮布置连接至线性致动器,或者经由直齿齿轮或其他连接连接至旋转致动器。功率源1129将电力供应到绝对定位系统1100,并且输出指示器1128可显示绝对定位系统1100的输出。在图2中,位移构件1111表示可纵向移动的驱动构件120,该可纵向移动的驱动构件包括形成于其上用于与齿轮减速器组件84的对应驱动齿轮86啮合接合的一齿条的驱动齿122。位移构件1111表示可移动纵向的击发构件220、击发杆172、I形梁178或它们的组合。
与位置传感器1112相关联的传感器元件1126的单周旋转等同于位移构件1111的纵向线性位移d1,其中d1为在耦接到位移构件1111的传感器元件1126的单周旋转之后位移构件1111从点“a”移动到点“b”的纵向线性距离。可经由齿轮减速连接传感器布置1102,该齿轮减速使得位置传感器1112针对位移构件1111的全行程完成一次或多次旋转。位置传感器1112可针对位移构件1111的全行程完成多次旋转。
一系列开关1122a至1122n(其中n为大于一的整数)可单独或结合齿轮减速使用以针对位置传感器1112的不止一次旋转提供独特位置信号。开关1122a至1122n的状态被馈送回控制器1104,该控制器应用逻辑以确定对应于可移动构件1111的纵向线性位移d1+d2+…dn的独特位置信号。位置传感器1112的输出1124被提供给控制器1104。传感器布置1102的位置传感器1112可包括磁性传感器、模拟旋转传感器(比如电位差计)、模拟霍尔效应元件的阵列,该霍尔效应元件的阵列输出位置信号或值的独特组合。
绝对定位系统1100在器械上电时提供位移构件1111的绝对位置,而不使位移构件1111回缩或推进到如常规旋转编码器可能需要的复位(清零或本位)位置,这些常规旋转编码器仅对马达1120采取的向前或向后的步骤数进行计数以推断装置致动器、驱动棒、刀等的位置。
控制器1104可被编程为执行各种功能,诸如对刀和关节运动系统的速度和位置的精确控制。在一个方面,控制器1104包括处理器1108和存储器1106。电动马达1120可为有刷直流马达,其具有齿轮箱以及到关节运动或刀系统的机械链接。在一个方面,马达驱动器1110可为可购自Allegro Microsystems公司的A3941。其他马达驱动器可容易地被替换以用于绝对定位系统1100中。绝对定位系统1100的更详细的描述在名称为“SYSTEMS ANDMETHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT”的美国专利申请15/130,590中有所描述,该专利申请的全部公开内容据此以引用方式并入本文。
控制器1104可被编程为提供对位移构件1111和关节运动系统的速度和位置的精确控制。控制器1104可被配置成能够计算控制器1104的软件中的响应。将计算的响应与实际系统的所测量响应进行比较,以获得“观察到的”响应,其用于实际反馈决定。观察到的响应为有利的调谐值,该值使所模拟响应的平滑连续性质与所测量响应均衡,其可感测对系统的外部影响。
绝对定位系统1100可包括反馈控制器并且/或者可被编程为实现反馈控制器,诸如PID、状态反馈和自适应控制器。电源1129将来自反馈控制器的信号转换为对系统的物理输入,在这种情况下为电压。其他示例包括电压、电流和力的脉宽调制(PWM)。除了位置传感器1112所测量的位置之外,可提供一个或多个其他传感器1118以测量物理系统的物理参数。在一些方面,(一个或多个)其他传感器1118可包括传感器布置,诸如以下专利申请中所述的那些:名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利9,345,481,该专利据此全文以引用方式并入本文;名称为“STAPLE CARTRIDGE TISSUETHICKNESS SENSOR SYSTEM”的美国专利申请公布2014/0263552,该专利申请据此全文以引用方式并入本文;以及名称为“TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITYOF A SURGICAL STAPLING AND CUTTING INSTRUMENT”的美国专利申请15/628,175,该专利申请据此全文以引用方式并入本文。在数字信号处理系统中,绝对定位系统1100耦接到数字数据采集系统,其中绝对定位系统1100的输出将具有有限分辨率和采样频率。绝对定位系统1100可包括比较和组合电路,以使用算法(诸如加权平均和理论控制环路)将计算响应与测量响应进行组合,该算法朝向测量响应驱动计算响应。物理系统的计算响应将特性如质量、惯性、粘性摩擦、电感电阻考虑在内,以通过得知输入预测物理系统的状态和输出。控制器1104可为控制电路700(图5A至图5B)。
马达驱动器1110可为可购自Allegro Microsystems公司的A3941。A3941驱动器1110为全桥控制器,其用于与针对电感负载(诸如有刷DC马达)特别设计的外部N沟道功率金属氧化物半导体场效应晶体管(MOSFET)一起使用。驱动器1110包括独特的电荷泵稳压器,其为低至7V的电池电压提供完整的(>10V)栅极驱动并且允许A3941在低至5.5V的减速栅极驱动下工作。可采用自举电容器提供N沟道MOSFET所需的上述电池供电电压。高边驱动装置的内部电荷泵允许直流(100%占空比)操作。可使用二极管或同步整流在快衰减模式或慢衰减模式下驱动全桥。在慢衰减模式下,电流再循环可穿过高边或低边FET。通过电阻器可调式空载时间保护功率FET不被击穿。整体诊断指示欠压、过热和功率桥故障,并且可被配置成能够在大多数短路情况下保护功率MOSFET。其他马达驱动器可容易地被替换以用于绝对定位系统1100中。
在描述用于针对传感器布置1102实现绝对定位系统1100的各方面后,本公开现在转向图11和图12以获得对绝对定位系统1100的传感器布置1102的一个方面的描述。图11为根据一个方面的绝对定位系统1100的传感器布置1102的分解透视图,其示出电路1205以及传感器布置1102的元件的相对对齐。绝对定位系统1100的传感器布置1102包括位置传感器1200、磁体1202传感器元件、位移构件1111的每次全冲程进行转动的磁体保持器1204以及用于提供齿轮减速的齿轮组件1206。简单地参考图2,位移构件1111可表示可纵向移动的驱动构件120,该可纵向移动的驱动构件包括用于与齿轮减速器组件84的对应驱动齿轮86啮合接合的一齿条的驱动齿122。参考图11,结构元件诸如托架1216被设置为支撑齿轮组件1206、磁体保持器1204和磁体1202。位置传感器1200包括磁性感测元件诸如霍尔元件并且接近磁体1202放置。在磁体1202旋转时,位置传感器1200的磁性感测元件确定经过一次旋转的磁体1202的绝对角位置。
传感器布置1102可包括任何数目的磁性感测元件,诸如例如根据它们是测量总磁场还是磁场的矢量分量而被分类的磁性传感器。用于产生上述两种类型磁性传感器的技术涵盖物理学和电子学的多个方面。用于磁场感测的技术包括探测线圈、磁通门、光泵、核旋、超导量子干涉仪(SQUID)、霍尔效应、各向异性磁电阻、巨磁电阻、磁性隧道结、巨磁阻抗、磁致伸缩/压电复合材料、磁敏二极管、磁敏晶体管、光纤、磁光,以及基于微机电系统的磁传感器等。
齿轮组件包括啮合接合以提供3:1齿轮齿数比连接的第一齿轮1208和第二齿轮1210。第三齿轮1212围绕轴1214旋转。第三齿轮1212与位移构件1111(或如图2所示的120)并且在位移构件1111沿远侧方向D推进时沿第一方向旋转而在位移构件1111沿近侧方向P回缩时沿第二方向旋转。第二齿轮1210也围绕轴1214旋转,并且因此,第二齿轮1210围绕轴1214的旋转对应于位移构件1111的纵向平移。因此,位移构件1111沿远侧方向D或近侧方向P中的一个全行程对应于第二齿轮1210的三周旋转和第一齿轮1208的单周旋转。由于磁体保持器1204耦接到第一齿轮1208,因此磁体保持器1204随着位移构件1111的每个全行程进行一次完整旋转。
位置传感器1200由位置传感器保持器1218支撑,该位置传感器保持器限定适于包含与在下方磁体保持器1204内旋转的磁体1202精确对齐的位置传感器1200的开孔1220。夹具耦接到托架1216以及电路1205,并且在磁体1202随磁体保持器1204旋转时保持静止。轮毂1222被设置为与第一齿轮1208和磁体保持器1204配合。还示出耦接到轴1214的第二齿轮1210和第三齿轮1212。
图12为根据本公开的一个方面的绝对定位系统1100的位置传感器1200的图,该绝对定位系统包括磁性旋转绝对定位系统。位置传感器1200可被实现为AS5055EQFT单片磁性旋转位置传感器,其可购自Austria Microsystems,AG。位置传感器1200与控制器1104交接,以提供绝对定位系统1100。位置传感器1200为低电压且低功率部件,并且包括在位置传感器1200的位于磁体1202(图15和图16)上方的区域1230中的四个霍尔效应元件1228A、1228B、1228C、1228D。在芯片上也提供了高分辨率ADC 1232和智能型电源管理控制器1238。CORDIC处理器1236(用于坐标旋转数字计算机(COordinate Rotation DIgitalComputer)),也称为逐位法和Volder算法,被设定为实施简单有效的算法来计算双曲线函数和三角函数,这些函数仅需要加法操作、减法操作、位位移操作和表查找操作。角位置、报警位和磁场信息通过诸如SPI接口1234的标准串行通信接口传输到控制器1104。位置传感器1200提供12或14位分辨率。位置传感器1200可为以小QFN 16引脚4×4×0.85mm封装提供的AS5055芯片。
霍尔效应元件1228A、1228B、1228C、1228D位于旋转磁体1202(图11)正上方。霍尔效应是众所周知的效应,并且为了方便,本文中将不对其进行详细描述,但是,通常,霍尔效应在整个电导体上产生横向于导体中的电流的电压差(霍尔电压)以及垂直于电流的磁场。霍尔系数被限定为感应电场与电流密度和所施加磁场的乘积的比率。其为从中制备导体的材料的特性,因为其值取决于构成电流的电荷载体的类型、数目和性能。在AS5055位置传感器1200中,霍尔效应元件1228A、1228B、1228C、1228D能够产生电压信号,该电压信号根据磁体1202经过单周旋转之后的角度指示磁体1202的绝对位置。由CORDIC处理器1236计算角度的这个值(其为独特位置信号),并且将其以机载方式存储在寄存器或存储器中的AS5055位置传感器1200上。在多种技术中,如在加电时或在控制器1104发出请求时,向控制器1104提供角度的值,其指示经过一次转动的磁体1202的位置。
AS5055位置传感器1200在连接至控制器1104时仅需要几个外部部件就可操作。使用单一电源的简单应用需要六根电线:两根电线用于电力,四根电线1240用于与控制器1104的SPI接口1234。可加入第七连接,以便向控制器1104发送中断以通知可读取新的有效角度。在加电时,AS5055位置传感器1200执行完全加电序列,包括一个角度测量。该循环的完成表示为INT输出1242,并且角度值存储在内部寄存器中。一旦设定了这一输出,AS5055位置传感器1200就暂停为休眠模式。控制器1104可通过SPI接口1234从AS5055位置传感器1200读取角度值来响应INT输出1242处的INT请求。一旦控制器1104读取了角度值,就再次清除INT输出1242。由控制器1104通过SPI接口1234向位置传感器1200发送“读取角度”命令也自动使芯片加电并且启动另一个角度测量。控制器1104一完成角度值的读取,就清除INT输出1242并且将新的结果存储在角度寄存器中。通过设定INT输出1242和状态寄存器中的对应标志再次指示角度测量的完成。
由于AS5055位置传感器1200的测量原理,每个加电序列之后,在非常短的时间(~600μs)内仅执行单次角度测量。一个角度的测量一完成,AS5055位置传感器1200就暂停为掉电状态。未执行根据数字平均化的角度值的片上过滤,因为这将需要不止一个角度测量并且因此需要更长加电时间,这在低功率应用中是不期望的。可通过在控制器1104中对数个角度样品进行平均来减少角度抖动。例如,平均四个采样可使抖动减少6dB(50%)。
图13为根据本公开的一个方面的外科器械10(图1-图4)的端部执行器2502的剖视图,其示出相对于夹持在端部执行器2502内的组织2526的I形梁2514击发行程。端部执行器2502被配置成能够与图1至图4所示的外科器械10一起操作。端部执行器2502包括砧座2516和细长通道2503,其中钉仓2518定位在细长通道2503中。击发杆2520能够沿着端部执行器2502的纵向轴线2515朝远侧和朝近侧平移。当端部执行器2502不进行关节运动时,端部执行器2502与器械的轴成一直线。在击发构件2520的远侧区段处示出了包括切割刃2509的I形梁2514。楔形滑动件2513定位在钉仓2518中。当I形梁2514朝远侧平移时,切割刃2509接触并可切割定位在砧座2516与钉仓2518之间的组织2526。而且,I形梁2514接触楔形滑动件2513并朝远侧推动它,从而使得楔形滑动件2513接触钉驱动器2511。钉驱动器2511可以被向上驱动到钉2505中,从而使得钉2505推进穿过组织并进入限定在砧座2516中的凹坑2507中,该凹坑使钉2505成形。
示例性I形梁2514击发行程由与端部执行器2502对齐的图表2529示出。还示出了示例性组织2526与端部执行器2502对齐。击发构件行程可包括行程开始位置2527和行程结束位置2528。在I形梁2514击发行程期间,I形梁2514可以从行程开始位置2527朝远侧推进到行程结束位置2528。I形梁2514示出在行程开始位置2527的一个示例性位置处。I形梁2514击发构件行程图表2529示出了五个击发构件行程区域2517,2519,2521,2523,2525。在第一击发行程区域2517中,I形梁2514可以开始朝远侧推进。在第一击发行程区域2517中,I形梁2514可以接触楔形滑动件2513并开始朝远侧移动。然而,在第一区域中,切割刃2509可以不接触组织,并且楔形滑动件2513可以不接触钉驱动器2511。在克服静摩擦力之后,在第一区域2517中驱动I形梁2514的力可以是基本恒定的。
在第二击发构件行程区域2519中,切割刃2509可以开始接触并切割组织2526。而且,楔形滑动件2513可以开始接触钉驱动器2511以驱动钉2505。驱动I形梁2514的力可以开始上升。如图所示,由于砧座2516相对于钉仓2518枢转的方式,起初遇到的组织可以被压缩和/或变薄。在第三击发构件行程区域2521中,切割刃2509可以连续地接触并切割组织2526,并且楔形滑动件2513可以重复地接触钉驱动器2511。驱动I形梁2514的力可以在第三区域2521中平稳。通过第四击发行程区域2523,驱动I形梁2514的力可能开始下降。例如,端部执行器2502的对应于第四击发区域2523的区段中的组织可以比靠近砧座2516的枢转点的组织压缩得更少,从而需要更少的切割力。而且,切割刃2509和楔形滑动件2513可以在第四区域2523中到达组织2526的端部。当I形梁2514到达第五区域2525时,组织2526可以被完全切断。楔形滑动件2513可以在组织的端部处或附近接触一个或多个钉驱动器2511。可以减小使I形梁2514推进通过第五区域2525的力,并且在一些示例中,该力可以类似于在第一区域2517中驱动I形梁2514的力。在击发构件行程结束时,I形梁2514可以到达行程结束位置2528。图18中的击发构件行程区域2517、2519、2521、2523、2525的定位仅是一个示例。在一些示例中,例如,基于组织在砧座2516和钉仓2518之间的定位,不同区域可以沿着端部执行器纵向轴线2515在不同位置处开始。
如上所论述并且现在参考图10-图13,可利用定位在外科器械10(图1-图4)的柄部组件内的电动马达1122来使轴组件的击发系统包括I形梁2514相对于轴组件的端部执行器2502推进和/或回缩,以便缝合和/或切入捕获在端部执行器2502内的组织。I形梁2514可以以期望的速度或在期望的速度范围内推进或回缩。控制器1104可被配置成能够控制I形梁2514的速度。控制器1104可被配置成能够基于例如向电动马达1122提供的电力的各种参数(诸如电压和/或电流)和/或电动马达1122的其他操作参数或外部影响来预测I形梁2514的速度。控制器1104可被配置成能够基于向电动马达1122提供的电流和/或电压的先前值和/或系统的先前状态(如速度、加速度和/或位置)来预测I形梁2514的当前速度。控制器1104可被配置成能够利用本文所述的绝对定位传感器系统感测I形梁2514的速度。控制器可被配置成能够将I形梁2514的预测速度与I形梁2514的感测速度进行比较,确定是否应当增加电动马达1122的功率以便增加I形梁2514的速度以及/或者减小功率以便减小I形梁2514的速度。另外关于由电动马达1122驱动的外科器械10可见于名称为“MOTOR-DRIVEN SURGICALCUTTING INSTRUMENT”的美国专利8,210,411,该专利据此全文以引用方式并入本文。关于包括传感器布置的外科器械10的更多细节可见于名称为“SURGICAL INSTRUMENT HAVINGRECORDING CAPABILITIES”的美国专利7,845,537,该专利据此全文以引用方式并入本文。
可以使用各种技术来确定作用在I形梁2514上的力。I形梁2514力可通过测量马达2504电流来确定,其中马达2504电流基于I形梁2514朝远侧推进时所经受的负荷。I形梁2514力可通过将应变仪定位在驱动构件120(图2)、击发构件220(图2)、I形梁2514(I形梁178,图20)、击发杆172(图2),和/或定位在切割刃2509的近侧端部上。I形梁2514的力可通过监测在预先确定的经过时间段T1之后基于马达2504的当前设定速度以预期速度移动的I形梁2514的实际位置,并且在时间段T1结束时基于马达2504的当前设定速度将I形梁2514的实际位置与I形梁2514的预期位置进行比较来确定。因此,如果I形梁2514的实际位置小于I形梁2514的期望位置,则I形梁2514上的力大于标称力。相反,如果I形梁2514的实际位置大于I形梁2514的期望位置,则I形梁2514上的力小于标称力。I形梁2514的实际位置和预期位置之间差值跟I形梁2514上的力与标称力的偏差成比例。此类技术在名称为“SYSTEMSAND METHODS FOR CONTROLLING MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTINGINSTRUMENT”的美国专利申请15/628,075中有所描述,该专利申请据此全文以引用方式并入本文。
图14示出根据本公开的一个方面的被编程为控制位移构件的远侧平移的外科器械2500的框图。在一个方面,外科器械2500被编程为控制位移构件1111诸如I形梁2514的远侧平移。外科器械2500包括端部执行器2502,该端部执行器可包括砧座2516、I形梁2514(包括锋利切割刃2509)和可移除钉仓2518。端部执行器2502、砧座2516、I形梁2514和钉仓2518可例如参考图1至图13如本文所述进行配置。
衬件位移构件1111诸如I形梁2514的位置、移动、位移和/或平移可由绝对定位系统1100、传感器布置1102以及如图10-图12所示并且在图14中表示为位置传感器2534的位置传感器1200测量。由于I形梁2514联接到纵向可移动的驱动构件120,因此I形梁2514的位置可通过采用位置传感器2534测量纵向可移动的驱动构件120的位置来确定。因此,在以下描述中,I形梁2514的位置、位移和/或平移可通过如本文所述的位置传感器2534来实现。控制电路2510诸如图5A和图5B所述的控制电路700可被编程为控制位移构件1111诸如I形梁2514的平移,如结合图10-图12所述。在一些示例中,控制电路2510可包括一个或多个微控制器、微处理器或其他合适的处理器,以用于执行使一个或多个处理器以所述方式控制位移构件(例如,I形梁2514)的指令。在一个方面,定时器/计数器电路2531向控制电路2510提供输出信号,诸如流逝时间或数字计数,以将如由位置传感器2534确定的I形梁2514的位置与定时器/计数器电路2531的输出相关联,使得控制电路2510可确定I形梁2514在相对于起始位置的特定时间(t)处的位置。定时器/计数器电路2531可被配置成能够测量流逝时间、对外部事件进行计数或对外部事件进行计时。
控制电路2510可生成马达设定点信号2522。马达设定点信号2522可被提供给马达控制器2508。马达控制器2508可包括一个或多个电路,这些电路被配置成能够向马达2504提供马达驱动信号2524,以驱动马达2504,如本文所述。在一些示例中,马达2504可为有刷DC马达,诸如图1、图5B、图10所示的马达82、714、1120。如,马达2504的速度可与马达驱动信号2524的电压成比例。在一些示例中,马达2504可为无刷直流(DC)电动马达,并且马达驱动信号2524可包括提供给马达2504的一个或多个定子绕组的脉宽调制(PWM)信号。而且,在一些示例中,可省略马达控制器2508,并且控制电路2510可直接生成马达驱动信号2524。
马达2504可从能量源2512处接收电力。能量源2512可为或包括电池、超级电容器或任何其他合适的能量源2512。马达2504可经由传输装置2506机械联接到I形梁2514。传输装置2506可包括一个或多个齿轮或其他连杆部件,以将马达2504联接到I形梁2514。位置传感器2534可感测I形梁2514的位置。位置传感器2534可为或包括能够生成指示I形梁2514的位置的位置数据的任何类型的传感器。在一些示例中,位置传感器2534可包括编码器,该编码器被配置成能够在I形梁2514向远侧和向近侧平移时向控制电路2510提供一系列脉冲。控制电路2510可跟踪脉冲以确定I形梁2514的位置。可使用其他合适的位置传感器,包括例如接近传感器。其他类型的位置传感器可提供指示I形梁2514的动作的其他信号。而且,在一些示例中,可省略位置传感器2534。在马达2504为步进马达的情况下,控制电路2510可通过聚合马达2504已被指示执行的步骤的数量和方向来跟踪I形梁2514的位置。位置传感器2534可位于端部执行器2502中或器械的任何其他部分处。
控制电路2510可与一个或多个传感器2538通信。传感器2538可定位在端部执行器2502上并且适于与外科器械2500一起操作以测量各种衍生参数,诸如间隙距离与时间、组织压缩与时间、以及砧座应变与时间。传感器2538可包括例如磁性传感器、磁场传感器、应变仪、压力传感器、力传感器、电感式传感器(诸如涡流传感器)、电阻式传感器、电容式传感器、光学传感器、和/或用于测量端部执行器2502的一个或多个参数的任何其他合适的传感器。传感器2538可包括一个或多个传感器。
一个或多个传感器2538可包括应变仪,诸如微应变仪,其被配置成能够在夹持条件期间测量砧座2516中的应变的量值。应变仪提供电信号,该电信号的幅值随着应变量值而变化。传感器2538可包括压力传感器,该压力传感器被配置成能够检测由砧座2516和钉仓2518之间的压缩组织的存在所生成的压力。传感器2538可被配置成能够检测位于砧座2516与钉仓2518之间的组织区段的阻抗,该阻抗指示位于其间的组织的厚度和/或完全性。
传感器2538可被配置成能够测量由闭合驱动系统30施加在砧座2516上的力。例如,一个或多个传感器2538可位于闭合管260(图3)和砧座2516之间的交互点处,以检测由闭合管260施加到砧座2516的闭合力。施加在砧座2516上的力可表示在砧座2516和钉仓2518之间捕集的组织区段所经受的组织压缩。一个或多个传感器2538可沿着闭合驱动系统30(图2)定位在各种交互点处,以检测由闭合驱动系统30施加到砧座2516的闭合力。一个或多个传感器2538可在夹持操作期间由如图5A至图5B所述的处理器实时地取样。控制电路2510接收实时样本测量值以提供和分析基于时间的信息,并实时评估施加到砧座2516的闭合力。
可采用电流传感器2536来测量由马达2504消耗的电流。推进I形梁2514所需的力对应于例如由马达2504消耗的电流。将力转换成数字信号并将其提供给处理器2510。
使用本文结合图1至图13并且参考图14所公开的器械的物理特性,控制电路2510可被配置成能够模拟器械的实际系统在控制器的软件中的响应。可致动位移构件以将端部执行器2502中的I形梁2514以目标速度或接近目标速度移动。外科器械2500可包括反馈控制器,该反馈控制器可为任何反馈控制器中的一种,包括但不限于例如PID、状态反馈、LQR和/或自适应控制器。外科器械2500可包括用于将来自反馈控制器的信号转换为物理输入诸如例如外壳电压、脉宽调制(PWM)电压、频率调制电压、电流、扭矩和/或力的功率源。
外科器械2500的实际驱动系统被配置成能够通过具有齿轮箱和与关节运动和/或刀系统的机械链路的有刷DC马达来驱动位移构件、切割构件或I形梁2514。另一示例为操作例如可互换轴组件的位移构件和关节运动驱动器的电动马达2504。外部影响是事物如组织、周围身体和摩擦对物理系统的未测量的、不可预测的影响。这种外部影响可被称为相对电动马达2504作用的曳力。外部影响诸如曳力可导致物理系统的操作偏离物理系统的期望操作。
在详细解释外科器械2500的各个方面之前,应当指出的是,示例性方面在应用或使用上并不限于附图和说明中所示的零件的配置和布置的细节。示例性方面可单独实施,也可与其他方面、变型和修改结合实施,并且可以各种方式实践或执行。此外,除非另外指明,否则本文所用的术语和表达是为了方便读者而对示例性方面进行描述而所选的,并非为了限制性的目的。而且,应当理解,下述方面、方面和/或示例的表达中的一者或多者可与其他下述方面、方面和/或示例的表达中的任一者或多者组合。
各种示例性方面涉及外科器械2500,其包括带有马达驱动的外科密封和切割工具的端部执行器2502。例如,马达2504可沿着端部执行器2502的纵向轴线朝远侧和朝近侧驱动位移构件。端部执行器2502可包括可枢转砧座2516,并且当被配置用于使用时,钉仓2518与砧座2516相对定位。临床医生可握持砧座2516与钉仓2518之间的组织,如本文所述。当准备好使用器械2500时,临床医生可例如通过按下器械2500的触发器来提供击发信号。响应于击发信号,马达2504可沿着端部执行器2502的纵向轴线将位移构件从近侧行程开始位置朝远侧驱动到行程开始位置远侧的行程结束位置。当位移构件朝远侧平移时,带有定位在远侧端部处的切割元件的I形梁2514可切割钉仓2518与砧座2516之间的组织。
在各种示例中,外科器械2500可包括控制电路2510,该控制电路被编程为例如基于一个或多个组织状况来控制位移构件诸如I形梁2514的远侧平移。控制电路2510可以被编程为直接或间接地感测组织条件,诸如厚度,如本文所述。控制电路2510可被编程为基于组织状况来选择击发控制程序。击发控制程序可以描述位移构件的远侧运动。可以选择不同的击发控制程序以更好地处理不同的组织状况。例如,当存在较厚的组织时,控制电路2510可以被编程为以较低的速度和/或以较低的功率平移位移构件。当存在较薄的组织时,控制电路2510可以被编程为以较高的速度和/或以较高的功率平移位移构件。
在一些示例中,控制电路2510可针对位移构件的行程的第一开环部分初始以开环构型来操作马达2504。基于在行程的开环部分期间器械2500的响应,控制电路2510可选择击发控制程序。器械的响应可以包括在开环部分期间位移构件的平移距离、在开环部分期间流逝的时间、在开环部分期间提供给马达2504的能量、马达驱动信号的脉冲宽度之和等。在开环部分之后,控制电路2510可以对位移构件行程的第二部分实施所选择的击发控制程序。例如,在行程的闭环部分期间,控制电路2510可基于以闭环方式描述位移构件的位置的平移数据来调节马达2504,以使位移构件以恒定速度平移。
图15示出绘制根据本公开的一个方面执行的两个示例性位移构件行程的图示2580。图2580包括两个轴线。水平轴线2584指示经过的时间。竖直轴线2582指示I形梁2514在行程开始位置2586与行程结束位置2588之间的位置。在水平轴线2584上,控制电路2510可接收击发信号并开始在t0处提供初始马达设置。位移构件行程的开环部分为在t0和t1之间可能流逝的初始时间段。
第一示例2592示出了当厚组织定位在砧座2516与钉仓2518之间时外科器械2500的响应。在位移构件行程的开环部分期间,例如在t0和t1之间的初始时间段期间,I形梁2514可从行程开始位置2586横穿到位置2594。控制电路2510可确定位置2594对应于击发控制程序,该击发控制程序以所选恒定速度(V慢)推进I形梁2514,该速度由示例2592在T1之后(例如,在闭合回路部分中)的斜率指示。控制电路2510可通过监测I形梁2514的位置并调节马达设定点信号2522和/或马达驱动信号2524来将I形梁2514驱动到速度V慢以维持V慢。
第二示例2590示出了当薄组织定位在砧座2516与钉仓2518之间时外科器械2500的响应。在t0和T1之间的初始时间段(例如,开环时间段)期间,I形梁2514可从行程开始位置2586横穿到位置2596。控制电路可确定位置2596对应于击发控制程序,该击发控制程序以所选恒定速度(V快)推进位移构件。因为示例2590中的组织比示例2592中的组织薄,所以它可向I形梁2514的运动提供较小的阻力。因此,I形梁2514可在初始时间段期间横穿行程的较大部分。而且,在一些示例中,较薄组织(例如,在初始时间段期间横穿的位移构件行程的较大部分)可对应于初始时间段之后的较高位移构件速度。
图16至图21示出了根据本公开的一个方面的外科器械2010的端部执行器2300,显示了端部执行器2300可如何相对于细长轴组件2200围绕关节运动接头2270进行关节运动。图16为端部执行器2300的一部分的局部透视图,显示了处于非关节运动取向的细长轴组件2200,其中为清楚起见省略了其多个部分。图17为图16的端部执行器2300的透视图,显示了处于非关节运动取向的细长轴组件2200。图18为图16的端部执行器2300的分解组装透视图,显示了细长轴组件2200。图19为图16的端部执行器2300的顶视图,显示了处于非关节运动取向的细长轴组件2200。图20为图16的端部执行器2300的顶视图,显示了处于第一关节运动取向的细长轴组件2200。图21为图16的端部执行器2300的顶视图,显示了处于第二关节运动取向的细长轴组件2200。
现在参考图16至图21,端部执行器2300适于切割并缝合组织并且包括细长通道2302形式的第一钳口,该第一钳口被配置成能够操作地支撑其中的外科钉仓2304。端部执行器2300还包括砧座2310形式的第二钳口,该第二钳口被支撑在细长通道2302上以相对于其移动。细长轴组件2200包括采用关节运动锁2810的关节运动系统2800。关节运动锁2810可被配置成能够并操作以选择性地将外科端部执行器2300锁定在各种关节运动位置。当关节运动锁2810处于其解锁状态时,这种布置使外科端部执行器2300能够相对于轴闭合管260旋转或做关节运动。具体参见图18,细长轴组件2200包括脊210,该脊被配置成能够:(1)可滑动地支撑其中的击发构件220,以及(2)可滑动地支撑围绕脊210延伸的闭合套筒260(图16)。轴闭合管260附接到端部执行器闭合套筒272,该端部执行器闭合套筒通过双枢轴闭合套筒组件271枢转地附接到闭合管260。
脊210还可滑动地支撑近侧关节运动驱动器230。近侧关节运动驱动器230具有远侧端部231,该远侧端部被配置成能够操作地接合关节运动锁2810。关节运动锁2810还包括以本文公开的各种方式附接到脊210的轴框架2812。该轴框架2812被配置成能够在其中运动地支撑远侧关节运动驱动器2820的近侧部分2821。远侧关节运动驱动器2820被可移动地支撑在细长轴组件2200内,以响应于对其施加的关节运动控制动作而沿从轴轴线SA-SA侧向地偏移且平行于轴轴线SA-SA的关节运动致动轴线AAA在远侧方向DD和近侧方向PD上选择性纵向行进。
在图17和图18中,轴框架2812包括其上形成有枢轴销2818的远侧端部部分2814。枢轴销2818适于枢转地接纳在形成于端部执行器安装组件2390的枢轴基础部分2395中的枢轴孔2397内。端部执行器安装组件2390通过弹簧销2393或等同物附接到细长通道2302的近侧端部2303。枢轴销2818限定横向于轴轴线SA-SA的关节运动轴线BB,以促进端部执行器2300围绕关节运动轴线BB相对于轴框架2812的枢转行进(即,关节运动)。
如图18中所示,连接销2825形成在远侧关节运动连接驱动器2820的远侧端部2823上并且被配置成能够接纳在交叉连接件2900的近侧端部2902中的孔2904内。交叉连接件2900跨过轴轴线SA-SA横向地延伸并且包括远侧端部部分2906。远侧连接孔2908穿过交叉连接件2900的远侧端部部分2906设置,并且被配置成能够在其中可枢转地接纳从端部执行器安装组件2390的枢轴基部2395的底部延伸的基础销2398。基础销2398限定连接轴线LA,该连接轴线平行于关节运动轴线B-B。图17和图20示出了处于非关节运动位置的外科端部执行器2300。由细长通道2302限定的端部执行器轴线EA与轴轴线SA-SA对准。术语“与...对准”可表示与轴轴线SA-SA“同轴地对准”或者与轴轴线SA-SA平行。远侧关节运动驱动器2820沿近侧方向PD的移动将使得交叉连接件2900将外科端部执行器2300围绕关节运动轴线B-B沿顺时针CW方向拉动,如图19所示。远侧关节运动驱动器2820沿远侧方向DD的移动将使得交叉连接件2900使外科端部执行器2300围绕关节运动轴线B-B沿逆时针CCW方向移动,如图21所示。如图21所示,交叉连接件2900具有弯曲形状,这允许当外科端部执行器2300沿该方向进行关节运动时,交叉连接件2900围绕枢轴销2818弯曲。当外科端部执行器2300在轴轴线SA-SA的任一侧上处于完全关节运动位置时,端部执行器轴线EA与轴轴线SA-SA之间的关节运动角度2700为约六十五度(65°)。因此,在轴轴线的任一个上的关节运动范围为一度(1°)至六十五度(65°)。
图19示出了根据一个方面的处于竖直位置的关节运动接头2270,即相对于示为轴轴线SA的纵向成零度角θ0。图20示出了根据一个方面的图19的关节运动接头2270,其以限定在轴轴线SA和端部执行器轴线EA之间的第一角度θ1沿一个方向进行关节运动。图21示出了图19的关节运动接头2270,其以限定在轴轴线SA和端部执行器轴线EA之间的第二角度θ2沿另一个方向进行关节运动。
图16至图21中的外科端部执行器2300包括外科切割和缝合装置,该外科切割和缝合装置采用本文所述的各种类型和构型的击发构件220。然而,外科端部执行器2300可包括不切割和/或缝合组织的其他形式的外科端部执行器。中间支撑构件2950相对于脊210枢转地且可滑动地支撑。在图18中,中间支撑构件2950包括狭槽2952,该狭槽适于在其中接纳销2954,该销从脊210突出。当外科端部执行器2300进行关节运动时,这使得中间支撑构件2950能够相对于销2954枢转和平移。枢轴销2958从中间支撑构件2950的下侧突出,以枢转地接纳在设置于端部执行器安装组件2390的基座部分2395中的对应的枢轴孔2399内。中间支撑构件2950还包括用于接纳穿过其的击发构件220的狭槽2960。中间支撑构件2950用于在击发构件220挠曲以适应外科端部执行器2300的关节运动时为击发构件提供侧向支撑。
外科器械可另外被配置成能够确定端部执行器2300取向的角度。在各种方面,传感器布置1102的位置传感器1112可包括例如一个或多个磁性传感器、模拟旋转传感器(如电位差计)、模拟霍尔效应传感器阵列等,该模拟霍尔效应传感器阵列输出位置信号或值的独特组合。在一个方面,图16至图21中所示的方面的关节运动接头2270可另外包括关节运动传感器布置,该关节运动传感器布置被配置成能够确定端部执行器2300的角位置,即关节运动角度,并提供与其对应的唯一位置信号。
关节运动传感器布置可类似于上文描述并且在图10至图12中示出的传感器布置1102。在此方面,关节运动传感器布置可包括位置传感器和磁体,该磁体操作地联接到关节运动接头2270,使得其以与关节运动接头2270的旋转一致的方式旋转。磁体可例如联接到枢轴销2818。位置传感器包括一个或多个磁感测元件诸如霍尔效应传感器,并且被设置成邻近磁体,位于关节运动接头2270内或附近。因此,随着磁体旋转,位置传感器的磁感测元件确定磁体的绝对角位置。当磁体联接到关节运动接头2270时,磁体相对于位置传感器的角位置对应于端部执行器2300的角位置。因此,当端部执行器进行关节运动时,关节运动传感器布置能够确定端部执行器的角位置。
在另一方面,外科器械被配置成能够通过监视关节运动驱动器230(图3)的绝对位置来以间接方式确定端部执行器2300所定位的角度。由于关节运动驱动器230的位置对应于端部执行器2300以已知方式取向的角度,所以可跟踪关节运动驱动器230的绝对位置,然后将其转换为端部执行器2300的角位置。在此方面,外科器械包括被配置成能够确定关节运动驱动器230的绝对线性位置并提供与其对应的唯一位置信号的关节运动传感器布置。在一些方面,关节运动传感器布置或操作地联接到该关节运动传感器布置的控制器另外地被配置成能够根据唯一位置信号转换或计算端部执行器2300的角位置。
在此方面,关节运动传感器布置可同样类似于上文描述并且在图10至图12中示出的传感器布置1102。在与图10中关于位移构件1111示出的方面类似的一个方面中,关节运动传感器布置包括位置传感器和磁体,该磁体在纵向可移动关节运动驱动器230的每次全行程转动一次。位置传感器包括一个或多个磁性感测元件诸如霍尔效应传感器,并且被设置成邻近磁体。因此,当磁体旋转时,位置传感器的磁性感测元件确定经过一次转动的磁体的绝对角位置。
在一个方面,与位置传感器相关联的传感器元件的单次转动等同于纵向可移动关节运动驱动器230的纵向线性位移d1。换句话讲,d1为联接到纵向可移动关节运动驱动器230的传感器元件的单次转动之后纵向可移动关节运动驱动器230从点“a”向点“b”移动的纵向线性距离。可经由齿轮减速连接关节运动传感器布置,这使得位置传感器针对纵向可移动关节运动驱动器230的全行程仅完成一次转动。换句话讲,d1可等于关节运动驱动器230的全行程。位置传感器被配置成能够随后将对应于关节运动驱动器230的绝对位置的唯一位置信号传输到控制器1104,诸如在图10所示的那些方面中。在接收到唯一位置信号时,控制器1104随后被配置成能够执行逻辑,以通过例如查询返回预先计算的端部执行器2300的角位置值的查找表,通过算法计算端部执行器2300的角位置,利用关节运动驱动器230的线性位置作为输入,或者执行本领域已知的任何其他此类方法,来确定对应于关节运动驱动器230的线性位置的端部执行器的角位置。
在各种方面,可在关节运动传感器布置上采用任何数量的磁感测元件,例如根据其测量整个磁场还是磁场的矢量分量归类的磁传感器。所利用的磁感测元件的数量对应于由关节运动传感器布置感测的期望分辨率。换句话讲,所使用的磁感测元件的数量越多,可通过关节运动传感器布置感测到的关节运动的程度越细。用于产生上述两种类型磁性传感器的技术涵盖物理学和电子学的多个方面。用于磁场感测的技术包括探测线圈、磁通门、光泵、核旋、超导量子干涉仪(SQUID)、霍尔效应、各向异性磁电阻、巨磁电阻、磁性隧道结、巨磁阻抗、磁致伸缩/压电复合材料、磁敏二极管、磁敏晶体管、光纤、磁光,以及基于微机电系统的磁传感器等。
在一个方面,关节运动传感器布置的各个方面的位置传感器可以类似于图12所示的定位系统的方式实现,用于跟踪位移构件1111的位置。在一个此类方面,关节运动传感器布置可被实现为AS5055EQFT单片磁性旋转位置传感器,其可得自Austria Microsystems,AG。位置传感器与控制器交接,以提供用于直接或间接地确定端部执行器2300的绝对角位置的绝对定位系统。位置传感器为低电压和低功率部件,并且包括位于磁体1202(图11)上的位置传感器1200的区域1230中的四个霍尔效应元件1228A、1228B、1228C、1228D。在芯片上也提供了高分辨率ADC 1232和智能型电源管理控制器1238。CORDIC处理器1236(用于坐标旋转数字计算机(COordinate Rotation DIgital Computer)),也称为逐位法和Volder算法,被设定为实施简单有效的算法来计算双曲线函数和三角函数,这些函数仅需要加法操作、减法操作、位位移操作和表查找操作。角位置、报警位和磁场信息通过诸如SPI接口1234的标准串行通信接口传输到控制器1104。位置传感器1200提供12或14位分辨率。位置传感器1200可为以小QFN 16引脚4×4×0.85mm封装提供的AS5055芯片。
参考图1至图4和图10至图12,可利用来自绝对定位系统1100的绝对位置反馈信号/值来确定关节运动接头2270的位置和I形梁178(图4)的位置。在一个方面,可基于外科器械10的驱动构件120来确定关节运动角度θ。如上所述,纵向可移动的驱动构件120(图2)的运动可由绝对定位系统1100跟踪,其中当关节运动驱动器通过例如离合器组件400(图3)操作地联接到击发构件220(图3)时,绝对定位系统1100可实际上通过驱动构件120跟踪关节运动系统的运动。作为跟踪关节运动系统的移动的结果,外科器械的控制器可跟踪端部执行器2300的关节运动角度θ。在各种情况下,作为结果,可根据驱动构件120的纵向位移DL来确定关节运动角度θ。由于驱动构件120的纵向位移DL可基于由绝对定位系统1100提供的绝对位置信号/值来精确地确定,关节运动角度θ可根据纵向位移DL来确定。
在另一方面,可通过在关节运动接头2270处定位传感器来确定关节运动角度θ。传感器可被配置成能够以适于测量关节运动接头2270的绝对旋转而不是驱动构件120的纵向位移的方式使用绝对定位系统1100来感测关节运动接头2270的旋转。例如,传感器布置1102包括位置传感器1200、磁体1202和磁体保持器1204,该磁体保持器适于感测关节运动接头2270的旋转。位置传感器1200包括一个或多于一个磁性感测元件(诸如,霍尔元件)并且被设置成邻近磁体1202。在图12中描述的位置传感器1200可适于测量关节运动接头2270的旋转角度。因此,当磁体1202旋转时,位置传感器1200的磁性感测元件确定位于关节运动接头2270上的磁体1202的绝对角位置。该信息被提供给微控制器1104以计算关节运动接头2270的关节运动角度。因此,端部执行器2300的关节运动角度可由适于测量关节运动接头2270的绝对旋转的绝对定位系统1100确定。
在一个方面,I形梁178的击发速率或速度可根据端部执行器2300的关节运动角度而变化,以降低击发驱动系统80上的击发力,尤其是I形梁178的击发力,以及本文讨论的击发驱动系统80的其他部件的击发力。为了适应随端部执行器2300的关节运动角度变化的I形梁178的可变击发力,可将可变的马达控制电压施加到马达82,以控制马达82的速度。马达82的速度可通过基于端部执行器2300的关节运动角度将I形梁178的击发力与不同的最大阈值进行比较来控制。例如,可通过调节施加到马达82的电压、电流、脉宽调制(PWM)或占空比(0-100%)来改变电动马达82的速度。
图22和图23描绘了可用于执行多种不同外科规程的马达驱动外科器械10。外科器械10可包括端部执行器3602,该端部执行器可包括一个或多个电极。端部执行器可3602可抵靠组织定位,使得电流可被引入到组织中。外科器械10可被配置用于单极或双极操作。在单极操作期间,电流由端部执行器3602上的有源(或源)电极引入到组织中,并通过返回电极返回。返回电极可以是接地垫,并且单独地位于患者的身体上。在双极操作期间,电流可分别通过端部执行器的有源电极和返回电极被引入到组织中并从组织返回。
端部执行器3602可包括第一钳口3604和第二钳口3608。钳口构件3604、3608中的至少一个可具有至少一个电极。钳口构件3604、3608中的至少一个可从与相反钳口间隔开以用于接收组织的位置移动到钳口构件3604、3608之间的空间小于第一位置的钳口构件之间的空间的位置。可移动钳口的该移动可以压缩保持在其间的组织。由流过组织的电流所产生的热结合通过钳口的移动实现的压缩可以在组织内和/或在组织之间形成止血密封并因此可尤其适用于例如密封血管。外科器械10可包括可延伸穿过端部执行器3602的刀构件3628。刀构件3628可相对于组织和电极移动以横切组织。
外科器械10可包括将组织夹持在一起的机构,诸如缝合装置,和/或切断组织的机构,诸如组织刀。电外科器械10可包括轴,该轴用于将端部执行器3602邻近接受治疗的组织放置。轴可为直的或弯曲的、可弯曲的或不可弯曲的。在包括直的和可弯曲轴的电外科器械10中,轴可具有一个或多个关节运动接头以允许轴的受控弯曲。当使用具有直的非弯曲轴的电外科器械10不容易接近待处理的组织时,此类接头可允许电外科装置的使用者以与轴成角度的方式将端部执行器放置成与组织接触。
由电外科装置施加的电能可通过与柄部组件3500连通的发生器3400传递至器械。电能可为射频(“RF”)能量的形式。RF能量为可在200千赫兹(kHz)至1兆赫兹(MHz)频率范围内的电能形式。在应用中,电外科器械可通过组织传递低频RF能量,这会引起离子振荡或摩擦,实际上造成电阻加热,从而升高组织的温度。由于受影响的组织与周围组织之间形成明显的边界,因此外科医生能够以高精确度进行操作,并在不损伤相邻的非目标组织的情况下进行控制。射频能的低操作温度适用于在密封血管的同时移除、收缩软组织、或对软组织塑型。RF能量尤其奏效地适用于结缔组织,所述结缔组织主要由胶原构成并且在接触热时收缩。
RF能量可在EN 60601-2-2:2009+A11:2011,定义201.3.218-高频率中所述的频率范围内。例如,单极RF应用中的频率通常可被限制为小于5MHz。然而,在双极RF应用中,频率几乎可为任何值。单极应用通常可使用高于200kHz的频率,以便避免由于使用低频电流而导致不希望的对神经和肌肉的刺激。如果风险分析显示神经肌肉刺激的可能性已减轻至可接受的水平,则双极应用可使用较低频率。通常,不使用高于5MHz的频率以最小化与高频渗漏电流相关联的问题。然而,在双极应用的情况下,可使用较高的频率。通常认为,10mA是组织热效应的下限阈值。
在例示的布置中,外科器械10包括操作地联接到柄部组件3500的可互换外科工具组件3600。在另一个外科系统方面,可互换外科工具组件3600还可有效地与机器人控制的外科系统或自动外科系统的工具驱动组件一起使用。例如,本文所公开的外科工具组件3600可与各种机器人系统、器械、部件和方法诸如但不限于名称为“SURGICAL STAPLINGINSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利9,072,535中公开的那些一起使用,该专利据此全文以引用方式并入本文。
在例示的方面,柄部组件3500可包括柄部外壳3502,该柄部外壳包括可由临床医生抓持和操纵的手枪式握把部。如将在下文简要讨论的,柄部组件3500操作地支撑多个驱动系统,这些多个驱动系统被配置成能够生成各种控制动作并将各种控制动作施加到可互换外科工具组件3600的对应部分。如图22所示,柄部组件3500还可包括操作地支撑该多个驱动系统的柄部机架3506。例如,柄部机架3506可以操作地支撑“第一”或闭合驱动系统(通常表示为3510),其可用于将闭合和打开动作施加到可互换外科工具组件3600。在至少一种形式中,闭合驱动系统3510可包括以柄部机架3506枢转地支撑的闭合触发器3512形式的致动器。这种布置使得闭合触发器3512将能够由临床医生操纵,使得当临床医生抓持柄部组件3500的手枪式握把部504时,闭合触发器3512可容易从启动或“未致动”位置枢转到“致动”位置并且更具体地枢转到完全压缩或完全致动位置。在使用中,为了致动闭合驱动系统3510,临床医生将闭合触发器3512朝向手枪式握把部按压。如名称为“SURGICALINSTRUMENT COMPRISING A SENSOR SYSTEM”的美国专利申请公布2015/0272575(该专利申请据此全文以引用方式并入本文)中进一步详细描述的,当临床医生完全按压闭合触发器3512以达到完全闭合行程时,闭合驱动系统3510被配置成能够将闭合触发器3512锁定到完全按压或完全致动的位置。当临床医生期望将闭合触发器3512解锁以允许其被偏压到未致动位置时,临床医生简单地启动使闭合触发器能够返回到未致动位置的闭合释放按钮组件3518。闭合释放按钮组件3518还可被配置成能够与各种传感器相互作用,这些传感器与柄部组件3500中的微控制器通信以跟踪闭合触发器3512的位置。关于闭合释放按钮组件3518的配置和操作的进一步的细节可见于美国专利申请公布2015/0272575中。
在至少一种形式中,柄部组件3500和柄部机架3506可以操作地支撑在本文中被称为击发驱动系统3530的另一个驱动系统,该驱动系统被配置成能够将击发动作施加到附接到其上的可互换外科工具组件的对应部分。如在美国专利申请公布2015/0272575中详细描述的,击发驱动系统3530可采用位于柄部组件3500的手枪式握把部中的电动马达3505。在各种形式中,马达3505例如可为具有约25,000RPM的最大旋转的DC有刷驱动马达。在其他布置中,马达3505可包括无刷马达、无绳马达、同步马达、步进马达或任何其他合适的电动马达。马达3505可由功率源3522供电,在一种形式中,该功率源可包括可移除电源组。电源组可将多个锂离子(“LI”)或其他合适的电池支撑在其中。可以使用可串联连接的多个电池作为外科器械10的功率源3522。此外,功率源3522可为可更换的和/或可充电的。
电动马达3505被配置成能够根据马达的极性在远侧和近侧方向上轴向驱动可纵向移动的驱动构件3540。例如,当马达3505在一个旋转方向上被驱动时,可纵向移动的驱动构件将在远侧方向“DD”上被轴向地驱动。当马达3505在相反的旋转方向上被驱动时,可纵向移动驱动构件3540将在近侧方向“PD”上被轴向地驱动。柄部组件3500可包括开关3513,该开关可被配置成能够使由功率源3522施加到电动马达3505的极性反转或以其他方式控制马达3505。柄部组件3500还可包括被配置成能够检测驱动构件的位置和/或驱动构件移动的方向的一个或多个传感器(未示出)。马达3505的致动可由与闭合触发器3512相邻并且被可枢转地支撑在柄部组件3500上的击发触发器(未示出)控制。击发触发器可在未致动位置与致动位置之间枢转。击发触发器可以由弹簧或其他偏置布置偏置到未致动位置中,使得当临床医生释放击发触发器时,该击发触发器可以由弹簧或偏置布置枢转或以其他方式返回到未致动位置。在至少一种形式中,击发触发器可被定位在闭合触发器3512的“外侧”。如美国专利申请公布No.2015/0272575中所讨论的,柄部组件3500可配备有击发触发器安全按钮(未示出),以防止击发触发器的无意致动。当闭合触发器3512处于未致动位置时,安全按钮被容纳在柄部组件3500中,在此情况下,临床医生不能容易地接近安全按钮并使安全按钮在防止击发触发器的致动的安全位置和其中可击发击发触发器的击发位置之间移动。当临床医生压下闭合触发器时,安全按钮和击发触发器向下枢转,其中它们可由临床医生操纵。
在至少一种形式中,可纵向移动的驱动构件3540可具有形成在其上的齿条,以用于与和马达相接的对应驱动齿轮布置(未示出)啮合接合。关于那些特征的进一步的细节可见于美国专利申请公布2015/0272575。然而,在至少一种布置中,可纵向移动驱动构件被绝缘,以保护其免受无意的Rf能量的影响。至少一种形式还包括可手动致动的“救助”组件,该组件被配置成能够允许临床医生在马达3505变得停用的情况下手动地回缩可纵向移动的驱动构件。救助组件可包括杠杆或救助柄部组件,其在可释放门3550下方储存在柄部组件3500内。杠杆可被配置成被手动枢转成与驱动构件中的齿棘轮接合。因此,临床医生可以通过使用救助柄部组件来手动地使驱动构件3540回缩,以在近侧方向“PD”上棘齿配合驱动构件。名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利8,608,045(该专利的全部公开内容据此以引用方式并入本文)公开了救助布置以及其他部件、布置和系统,它们也可与本文所公开的各种可互换外科工具组件中的任一个一起使用。
如图22所示,在至少一种布置中,可互换外科工具组件3600包括工具机架组件3610,该工具机架组件包括将喷嘴组件3612操作地支撑其上的工具底座。如在名称为“SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER”的美国专利申请15/635,631(该专利申请据此全文以引用方式并入本文)中进一步详细讨论的,工具底座和喷嘴组件3612有利于外科端部执行器3602相对于工具底座围绕轴轴线SA旋转。此类旋转行进由图22中的箭头R表示。可互换外科工具组件3600包括脊组件3630(参见图3和图24),该脊组件操作地支撑近侧闭合管3622并且联接到外科端部执行器3602。在各种情况下,为了便于组装,脊组件3630可从由按扣特征部、粘合剂、焊接等互连在一起的上脊段和下脊段制成。在组装形式中,脊组件3630包括可旋转地支撑在工具底座中的近侧端部。在一种布置中,例如,脊组件3630的近侧端部附接到脊轴承(未示出),该脊轴承被配置成能够被支撑在工具底座内。此类布置有利于脊组件3630到工具底座的可旋转附接,使得脊组件可选择性地相对于工具底座围绕轴轴线SA旋转。
在例示的方面,可互换外科工具组件3600包括外科端部执行器3602,该外科端部执行器包括第一钳口3604和第二钳口3608。在一种布置中,第一钳口包括细长通道3614,该细长通道被配置成能够将常规(机械)外科钉/紧固件仓304(图4)或射频(RF)仓3606(图22和图23)操作地支撑在其中。第二钳口3608包括相对于细长通道3614被枢转地支撑的砧座3616。通过致动闭合驱动系统3510,砧座3616可在打开位置与闭合位置之间选择性地朝向和远离支撑在细长通道3614中的外科仓移动。在例示的布置中,砧座3616被枢转地支撑在细长通道3614的近侧端部部分上,以用于围绕横向于轴轴线SA的枢转轴线的选择性枢转行进。闭合驱动系统3510的致动可导致附接到关节运动连接器3618的近侧闭合构件或近侧闭合管3622的远侧轴向移动。近侧闭合管3622的致动将导致远侧闭合管段3620向远侧行进,以最终向砧座3616施加闭合动作。
在至少一种布置中,RF能量由常规的RF发生器3400通过电源引线3402供应到外科工具组件3600。在至少一种布置中,电源引线3402包括凸形插头组件3406,该凸形插头组件被配置成能够插入对应的凹形连接器3410,该凹形连接器附接到机载电路板3654上的分段RF电路3656。参见图25。这种布置通过使喷嘴组件3612旋转而不使来自发生器3400的电源引线3402缠绕而有利于轴和端部执行器3602围绕轴轴线SA相对于工具底座的旋转行进。机载开/关功率开关3420被支撑在闩锁组件3624和工具底座上以用于打开和关闭RF发生器。当工具组件3600操作地联接到柄部组件3500或机器人系统时,机载分段RF电路3656通过连接器3668以及在一些布置中的外壳连接器与微处理器3560通信。如图22所示,柄部组件3500还可以包括显示器3430,该显示器用于查看关于密封、缝合、刀位置、仓的状态、组织、温度等的信息。如图25中同样可见,滑环组件3652包括与远侧连接器3658交接的近侧连接器3666,该远侧连接器包括柔性轴电路带或组件3646,该柔性轴电路带或组件可包括用于缝合相关活动的多个窄电导体3662和用于RF目的的较宽电导体3664。如图24和图25所示,柔性轴电路带3646被居中地支撑在形成刀杆3626的层压板或杆3636之间。此类布置有利于在端部执行器3602的关节运动期间刀杆3626和柔性轴电路带3646的充分挠曲,同时保持足够的刚度以使得刀构件3628能够向远侧推进穿过被夹持的组织。
在至少一种布置中,细长通道3614包括支撑在凹槽中的通道电路3642,该凹槽从细长通道3614的近端延伸到细长通道3614的底部部分中的远侧位置。通道电路3642包括近侧接触部分,该近侧接触部分接触柔性轴电路带3646的远侧接触部分3644以与该电路带电接触。在至少一种布置中,通道电路3642的远端被容纳在形成于细长通道3614的壁中的一个中的对应壁凹槽内,并且折叠并附接到细长通道3614壁的上边缘。在通道电路3642的远侧端部中提供了一系列对应的暴露触点。相应地,仓3606可包括柔性仓电路,该柔性仓电路附接到远侧微型芯片并且附连到仓3606的主体的远端部分。柔性仓电路的一端可折叠在仓3606的平台表面的边缘上,并且包括被配置成能够与通道电路3642的暴露触点电接触的暴露触点。因此,当RF仓3606安装在细长通道3614中时,电极以及RF仓的3606的远侧微芯片通过柔性仓电路、柔性通道电路3642、柔性轴电路3646与滑环组件3652之间的接触供电并与机载电路板3654通信。关于RF仓3606以及与该RF仓3606连通和/或相互作用的外科器械10的对应电路和传感器布置的更多细节可见于名称为“SURGICAL SYSTEM COUPLABLE WITHSTAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE,AND METHOD OF USING SAME”的美国专利申请15/636,096中,该专利申请据此全文以引用方式并入本文。
图26示出根据本公开的一个方面的包括可互换轴组件7002和柄部组件7004的外科器械7000的框图。在各个方面,外科器械7000包括可移除地或可互换地连接至柄部组件7004的可互换部件或模块。该模块可包括例如可互换轴组件7002,如结合图1、图5A至图6和图22至图23进一步详细讨论的。外科器械7000的柄部组件7004包括联接到寄存器或存储器7012(也被称为“第一存储器”)的控制器7010,该寄存器或存储器被配置成能够存储包括语言参数7014的数据。可互换部件(例如,轴组件7002)包括被配置成能够存储数据(包括采用多种不同语言的文本短语7008)的寄存器或存储器7006(也被称为“第二存储器”或“辅助存储器”)。可互换轴组件7002和柄部组件7004可各自包括限定接口的电连接器的对应组件,从而在可互换轴组件7002联接到柄部组件7004时,允许轴组件存储器7006和柄部组件控制器7010之间进行电通信,这允许柄部组件控制器7010访问或查询轴组件存储器7006。
语言参数7014为具有对应于存储在轴组件存储器7006中的特定语言的值的标记或其他变量。在各个方面,语言参数7014可由临床医生经由用户界面设置或者与外科器械10相关联地被预先编程。文本短语7008可存储在轴组件存储器7006中,作为例如根据文本短语7008中的每一个的图像类型和语言而布置的查找表。图像类型为具有对应于可显示在外科器械7000的显示器7030上的特定图像或一组特定图像的值的标记或其他变量。因此,轴组件存储器7006可表示为条目的m×n阵列,其中文本m,n为对应于第m个语言参数和第n个图像类型的文本短语。因此,给定语言参数7014的值和图像类型的值,可从文本短语7008的阵列中检索各个短语。文本短语7008可被存储为文本串、显示文本的图像或者任何其他此类格式。
图27示出了根据本公开的一个方面的由控制器7010执行的用于设置显示语言的过程7100的逻辑流程图。在图27的以下描述中,还应当参考图26。过程7100首先检测7102模块是否已连接至柄部组件7004。模块为外科器械7000的能够可移除地连接至柄部组件7004的可互换部件(例如,轴组件7002)。如果模块未连接至柄部组件7004,则过程7100沿着“否”分支继续并循环回到继续监测模块的连接。在其他方面,如果过程7100沿着“否”分支继续,则过程7100简单地结束,并且控制器7010执行下一个流程—适当的过程或算法。在一个方面,过程7100可通过接收响应于模块正在连接而生成的信号来检测7102模块何时已连接至柄部组件7004。
如果过程7100检测到7102模块已连接至柄部组件7004,则过程7100沿着“是”分支继续,并且接下来确定7104是否要显示图像。使得图像显示的过程可由外科器械7000出于各种原因而启动。如本文所用,静态图像和动态图像两者统称为“图像”。例如,外科器械7000可使得图像显示在显示器7030上,以便提供例如关于如何使用外科器械7000的指令、与由外科器械7000检测到的错误或警报相关联的警告、或关于外科器械7000的操作状态的更新。图像可具有与其相关联的文本,该文本可从轴组件存储器7006检索。如果当前没有设置要显示的图像,则过程7100沿着“否”分支继续并循环回到继续监测是否要显示图像。在其他方面,如果过程7100沿着“否”分支继续,则过程7100简单地结束,并且控制器7010执行下一个流程—适当的过程或算法。在一个方面,过程7100可通过接收响应于辅助过程正在启动而生成的信号来确定要显示7104图像,该辅助过程至少部分地包括使得一个或多个图像显示在显示器7030上的步骤。
如果过程7100确定7104要显示的图像,则过程7100沿着“是”分支继续,并且接下来使用语言参数7014和要显示的图像的类型来向轴组件存储器7006查询7106,以便检索图像和用于图像的语言适当的文本。语言参数7014可例如由控制器7010从柄部组件存储器7012检索。在各种方面,要显示的图像的类型可例如由控制器7010从柄部组件存储器7012检索或者由控制器7010与指示要显示的图像的信号并行地接收。如果过程7100确定7108不存在对应于语言参数7014和图像类型的文本短语,则过程7100沿着“否”分支继续并返回7110错误。响应于该错误,控制器7010可引起显示指示存在错误的警报,或者可引起显示不具有对应文本的基础图像7032,如图28所示。如果过程7100确定7108轴组件存储器7006中存在对应于语言参数7014和图像类型的文本短语,则过程7100沿着“是”分支继续并返回7112采用对应于语言参数7014的语言的特定文本短语。然后,控制器7010可使得显示器7030显示包括基础图像7032和具有检索到的文本短语的叠层7036的合成图像7034。虽然图29以英语描绘了叠层7036上的文本短语,但文本短语可以任何数量的语言存储。
本文所述的用于控制外科器械的语言选择的功能或过程可由本文所述的任何处理电路诸如结合图5A至图6所述的控制电路700、图7至图9中所述的电路800、810、820、结合图10和图12所述的微控制器1104和/或图14中所述的控制电路2510来执行。
可以在没有本文公开的具体细节的情况下实践机动外科器械的各方面。一些方面已被显示为框图而不是细节。本公开的部分可以呈现为对存储在计算机存储器中的数据进行操作的指令。算法是指导致所需结果的步骤的自相容序列,其中“步骤”是指物理量的操纵,物理量可以采用能被存储、转移、组合、比较和以其他方式操纵的电或磁信号的形式。这些信号可以称为位、值、元素、符号、字符、项、数字。这些和类似的术语可与适当的物理量相关联并且仅仅是应用于这些量的方便的标签。
一般来讲,可以用多种硬件、软件、固件或它们的任何组合单独和/或共同实施的本文所述的各方面可以被看作是由多种类型的“电子电路”组成。因此,“电子电路”包括具有至少一个离散电路的电子电路、具有至少一个集成电路的电子电路、具有至少一个专用集成电路的电子电路、形成由计算机程序配置的通用计算设备的电子电路(例如,至少区段地实施本文描述的过程和/或设备的由计算机程序配置的通用计算机或处理器)、形成存储器设备(例如,形成随机存取存储器)的电子电路,和/或形成通信设备(例如,调制解调器、通信开关或光电设备)的电子电路。这些方面可以模拟或数字形式或其组合来实现。
前面的描述已经经由使用框图、流程图和/或示例阐述了装置和/或过程的各方面,这些方面可包含一个或多个功能和/或操作。此类框图、流程图或示例内的每个功能和/或操作可通过各种硬件、软件、固件或其实际上的任何组合来单独和/或共同地实现。在一个方面,本文所述的主题的若干部分可经由专用集成电路(ASIC)、现场可编程门阵列(FPGA)、数字信号处理器(DSP)、可编程逻辑器件(DSP)、电路、寄存器和/或软件部件(例如,程序、子例程、逻辑和/或硬件和软件组件的组合)、逻辑门或其他集成格式来实现。本文公开的一些方面可作为在一台或多台计算机上运行的一个或多个计算机程序(例如,作为在一个或多个计算机系统上运行的一个或多个程序),作为在一个或多个处理器上运行的一个或多个程序(例如,作为在一个或多个微处理器上运行的一个或多个程序),作为固件,或作为实际上它们的任何组合全部或部分地在集成电路中等效地实现,并且根据本发明,设计电路和/或编写软件和/或硬件的代码将在本领域技术人员的技术范围内。
本文公开的主题的机构能够作为多种形式的程序产品进行分布,并且本文所述主题的示例性方面适用,而不管用于实际进行分布的信号承载介质的具体类型是什么。信号承载介质的示例包括如下:可录式媒体,诸如软盘、硬盘驱动器、光盘(CD)、数字视频光盘(DVD)、数字磁带、计算机存储器等;和传输式介质,诸如数字和/或模拟通信介质(例如,光纤缆线、波导、有线通信链路、无线通信链路(例如,发射器、接收器、传输逻辑、接收逻辑)等)。
为了举例说明和描述的目的,已经提供了这些方面的上述说明。这些具体实施方式并非意图为详尽的或限定到本发明所公开的精确形式。可以按照上述教导内容对本发明进行修改或变型。所选择和描述的这些方面是为了示出原理和实际应用,从而使得本领域的普通技术人员能够利用各方面,并且在适合设想的具体应用的情况下进行修改。与此一同提交的权利要求书旨在限定完整范围。
本文所述主题的各个方面在以下编号的实施例中陈述:
实施例1.一种外科器械,包括:柄部组件,所述柄部组件包括:第一存储器,所述第一存储器被配置成能够存储语言参数;和控制电路,所述控制电路联接到所述第一存储器以用于从其检索所述语言参数;以及;以及可互换部件,所述可互换部件能够可移除地连接至所述柄部组件,所述可互换部件包括被配置成能够存储采用多种语言的文本短语的第二存储器;其中所述控制电路被配置成能够从所述第二存储器检索采用对应于所述语言参数的语言的所述文本短语。
实施例2.根据实施例1所述的外科器械,还包括显示器,其中所述控制电路被配置成能够使得所述显示器显示从所述第二存储器检索到的所述文本短语。
实施例3.根据实施例2所述的外科器械,其中,所述控制电路被配置成能够使得所述显示器将所述文本短语显示为在所述显示器上显示的图像上的叠层。
实施例4.根据实施例2或实施例3所述的外科器械,其中,所述文本短语对应于由所述控制电路确定的要在所述显示器上显示的图像类型。
实施例5.根据实施例1至实施例4中的至少一项所述的外科器械,其中,所述可互换部件包括轴组件。
实施例6.根据实施例1至实施例5中的至少一项所述的外科器械,其中,当所述可互换部件连接至所述柄部组件时,所述控制电路能够通信地联接到所述第二存储器。
实施例7.一种外科器械的柄部组件,可互换模块能够可移除地连接至所述柄部组件,所述可互换模块包括被配置成能够存储采用多种语言的文本短语的辅助存储器,所述柄部组件包括:存储器,所述存储器被配置成能够存储语言参数;和控制电路,所述控制电路联接到所述存储器以用于从其检索所述语言参数;其中所述控制电路被配置成能够从所述辅助存储器检索采用对应于所述语言参数的语言的所述文本短语。
实施例8.根据实施例7所述的柄部组件,还包括显示器,其中所述控制电路被配置成能够使得所述显示器显示从所述辅助存储器检索到的所述文本短语。
实施例9.根据实施例8所述的柄部组件,其中,所述控制电路被配置成能够使得所述显示器将所述文本短语显示为在所述显示器上显示的图像上的叠层。
实施例10.根据实施例8或实施例9所述的柄部组件,其中,所述文本短语对应于由所述控制电路确定的要在所述显示器上显示的图像类型。
实施例11.根据实施例7至实施例10中的至少一项所述的柄部组件,其中,所述可互换模块包括轴组件。
实施例12.根据实施例7至实施例11中的至少一项所述的外科器械,其中,当所述可互换模块连接至所述柄部组件时,所述控制电路能够通信地联接到所述辅助存储器。
实施例13.一种操作包括柄部组件的外科器械的方法,可互换部件能够可移除地连接至所述柄部组件,所述方法包括:从所述柄部组件的第一存储器检索语言参数;从所述可互换部件的第二存储器检索采用对应于所述语言参数的语言的文本短语;以及显示采用对应于所述语言参数的语言的所述文本短语。
实施例14.根据实施例13所述的方法,其中,所述文本短语被显示为在与所述文本短语相关联的图像上的叠层。
实施例15.根据实施例13或实施例14所述的方法,其中,所述可互换部件包括轴组件。
实施例16.根据实施例13至实施例15中的至少一项所述的方法,还包括确定要显示的图像,其中从所述第二存储器检索到的所述文本短语对应于所述语言参数和所述图像两者。
Claims (16)
1.一种外科器械,包括:
柄部组件,所述柄部组件包括:
第一存储器,所述第一存储器被配置成能够存储语言参数;和
控制电路,所述控制电路联接到所述第一存储器以用于从其检索所述语言参数;和
可互换部件,所述可互换部件能够可移除地连接至所述柄部组件,所述可互换部件包括被配置成能够存储采用多种语言的文本短语的第二存储器;
其中所述控制电路被配置成能够从所述第二存储器检索采用对应于所述语言参数的语言的所述文本短语。
2.根据权利要求1所述的外科器械,还包括显示器,其中所述控制电路被配置成能够使得所述显示器显示从所述第二存储器检索到的所述文本短语。
3.根据权利要求2所述的外科器械,其中,所述控制电路被配置成能够使得所述显示器将所述文本短语显示为在所述显示器上显示的图像上的叠层。
4.根据权利要求2所述的外科器械,其中,所述文本短语对应于由所述控制电路确定的要在所述显示器上显示的图像类型。
5.根据权利要求1所述的外科器械,其中,所述可互换部件包括轴组件。
6.根据权利要求1所述的外科器械,其中,当所述可互换部件连接至所述柄部组件时,所述控制电路能够通信地联接到所述第二存储器。
7.一种外科器械的柄部组件,可互换模块能够可移除地连接至所述柄部组件,所述可互换模块包括被配置成能够存储采用多种语言的文本短语的辅助存储器,所述柄部组件包括:
存储器,所述存储器被配置成能够存储语言参数;和
控制电路,所述控制电路联接到所述存储器以用于从其检索所述语言参数;
其中所述控制电路被配置成能够从所述辅助存储器检索采用对应于所述语言参数的语言的所述文本短语。
8.根据权利要求7所述的柄部组件,还包括显示器,其中所述控制电路被配置成能够使得所述显示器显示从所述辅助存储器检索到的所述文本短语。
9.根据权利要求8所述的柄部组件,其中,所述控制电路被配置成能够使得所述显示器将所述文本短语显示为在所述显示器上显示的图像上的叠层。
10.根据权利要求8所述的柄部组件,其中,所述文本短语对应于由所述控制电路确定的要在所述显示器上显示的图像类型。
11.根据权利要求7所述的柄部组件,其中,所述可互换模块包括轴组件。
12.根据权利要求7所述的外科器械,其中,当所述可互换模块连接至所述柄部组件时,所述控制电路能够通信地联接到所述辅助存储器。
13.一种操作包括柄部组件的外科器械的方法,可互换部件能够可移除地连接至所述柄部组件,所述方法包括:
从所述柄部组件的第一存储器检索语言参数;
从所述可互换部件的第二存储器检索采用对应于所述语言参数的语言的文本短语;以及
显示采用对应于所述语言参数的所述语言的所述文本短语。
14.根据权利要求13所述的方法,其中,所述文本短语被显示为在与所述文本短语相关联的图像上的叠层。
15.根据权利要求13所述的方法,其中,所述可互换部件包括轴组件。
16.根据权利要求13所述的方法,还包括确定要显示的图像,其中从所述第二存储器检索到的所述文本短语对应于所述语言参数和所述图像两者。
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JP7163373B2 (ja) | 2022-10-31 |
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BR112020006071A2 (pt) | 2020-10-06 |
EP3462458B1 (en) | 2020-06-24 |
WO2019064149A1 (en) | 2019-04-04 |
JP2020534951A (ja) | 2020-12-03 |
US10729501B2 (en) | 2020-08-04 |
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