CN111542895A - 用于机器人辅助外科平台的控件 - Google Patents
用于机器人辅助外科平台的控件 Download PDFInfo
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- CN111542895A CN111542895A CN201880084524.XA CN201880084524A CN111542895A CN 111542895 A CN111542895 A CN 111542895A CN 201880084524 A CN201880084524 A CN 201880084524A CN 111542895 A CN111542895 A CN 111542895A
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- Medical Treatment And Welfare Office Work (AREA)
Abstract
本发明公开了各种机器人外科工具。一种机器人外科工具，所述机器人外科工具包括：端部执行器，所述端部执行器包括能量递送表面；通道，该通道延伸到该端部执行器；以及用于与机器人工具驱动器可释放地接合的近侧接口。该近侧接合部包括：多个旋转驱动器，该多个旋转驱动器包括第一旋转驱动器；以及泵，该泵流体地联接到该通道并由该第一旋转驱动器驱动。该第一旋转驱动器被配置为以可变速率旋转以为该泵提供可调节的功率水平。
Description
相关申请的交叉引用
本专利申请按照美国法典第35卷第119条(e)款的规定要求2018年3月28日提交的名称为“DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国临时专利申请62/649,320的优先权，该临时专利申请的公开内容全文以引用方式并入本文。
本专利申请按照美国法典第35卷第119条(e)款的规定还要求2017年12月28日提交的名称为“INTERACTIVE SURGICAL PLATFORM”的美国临时专利申请序列号62/611,341、2017年12月28日提交的名称为“CLOUD-BASED MEDICAL ANALYTICS”的美国临时专利申请序列号62/611,340和2017年12月28日提交的名称为“ROBOT ASSISTED SURGICAL PLATFORM”的美国临时专利申请序列号62/611,339的优先权的权益，这些临时专利申请中的每个申请的公开内容全文以引用方式并入本文。
背景技术
本公开涉及机器人外科系统。机器人外科系统可包括中央控制单元、外科医生的命令控制台以及具有一个或多个机器人臂的机器人。机器人外科工具能够能够释放地安装到一个或多个机器人臂。机器人外科工具的数量和类型可取决于外科手术的类型。机器人外科系统可在外科手术期间与一个或多个显示器和/或一个或多个手持式外科器械结合使用。
发明内容
在一个一般方面，提供了一种机器人外科工具。该机器人外科工具包括：端部执行器，该端部执行器包括能量递送表面；通道，该通道延伸到该端部执行器；以及用于与机器人工具驱动器可释放地接合的近侧接口。该近侧接合部包括：多个旋转驱动器，该多个旋转驱动器包括第一旋转驱动器；以及泵，该泵流体地联接到该通道并由该第一旋转驱动器驱动。该第一旋转驱动器被配置为以可变速率旋转以为该泵提供可调节的功率水平。
在另一个一般方面，提供了一种机器人外科系统。该机器人外科系统包括能量工具。该能量工具包括传感器；通道；旋转驱动器；以及泵，该泵流体地联接到该通道并由该旋转驱动器驱动。该机器人外科系统还包括与该传感器进行信号通信的处理器；和存储器，该存储器通信地联接到处理器。该存储器存储指令，该指令能够由该处理器执行以基于来自该传感器的输入来控制该旋转驱动器的旋转。
在又一个一般方面，提供了一种机器人外科系统。该机器人外科系统包括能量工具。该能量工具包括：传感器；通道；旋转驱动器；以及泵，该泵流体地联接到该通道并由该旋转驱动器驱动。该机器人外科系统还包括控制电路，该控制电路被配置为基于来自该传感器的输入来控制该旋转驱动器的旋转。
在另一个总体方面，提供了一种计算机可读介质。该计算机可读介质是非暂态的并且存储计算机可读指令，该计算机可读指令在被执行时使机器：从机器人外科工具上的传感器接收信号；以及基于该信号调节该机器人外科工具上的旋转驱动器的旋转。该旋转驱动器能够操作地联接到该机器人外科工具上的泵，该泵流体地联接到该机器人外科工具上的排出通道。
附图说明
各种方面的特征在所附权利要求书中进行了特别描述。然而，通过参考以下结合如下附图所作的说明可最好地理解所述多个方面(有关手术组织和方法)及其进一步的目的和优点。
图1为根据本公开的至少一个方面的计算机实现的交互式外科系统的框图。
图2为根据本公开的至少一个方面的用于在手术室中执行外科手术的外科系统。
图3为根据本公开的至少一个方面的与可视化系统、机器人系统和智能器械配对的外科集线器。
图4为根据本公开的至少一个方面的外科集线器壳体和可滑动地容纳在外科集线器壳体的抽屉中的组合发生器模块的局部透视图。
图5为根据本公开的至少一个方面的具有双极、超声和单极接触件以及排烟器件的组合发生器模块的透视图。
图6示出了根据本公开的至少一个方面的用于横向模块化外壳的多个横向对接端口的单个电力总线附接件，该横向模块化外壳被配置为容纳多个模块。
图7示出了根据本公开的至少一个方面的被配置为容纳多个模块的竖直模块化外壳。
图8示出了根据本公开的至少一个方面的包括模块化通信集线器的外科数据网络，该模块化通信集线器被配置为将位于医疗设施的一个或多个手术室中的模块化装置或专用于外科操作的医疗设施中的任何房间连接到云。
图9为根据本公开的至少一个方面的计算机实现的交互式外科系统。
图10示出了根据本公开的至少一个方面的包括联接到模块化控制塔的多个模块的外科集线器。
图11示出了根据本公开的至少一个方面的通用串行总线(USB)网络集线器装置的一个方面。
图12示出了根据本公开的至少一个方面的外科器械或工具的控制系统的逻辑图。
图13示出了根据本公开的至少一个方面的被配置为控制外科器械或工具的各个方面的控制电路。
图14示出了根据本公开的至少一个方面的被配置为控制外科器械或工具的各个方面的组合逻辑电路。
图15示出了根据本公开的至少一个方面的被配置为控制外科器械或工具的各方面的时序逻辑电路。
图16示出了根据本公开的至少一个方面的包括多个马达的外科器械或工具，该多个马达可被激活以执行各种功能。
图17为根据本公开的至少一个方面的被配置为操作本文所述的外科工具的机器人外科器械的示意图。
图18示出了根据本公开的至少一个方面的被编程以控制位移构件的远侧平移的外科器械的框图。
图19为根据本公开的至少一个方面的被配置为控制各个功能的外科器械的示意图。
图20为根据本公开的至少一个方面的被配置为除了其他有益效果之外还提供无电感器调谐的发生器的简化框图。
图21示出了根据本公开的至少一个方面的为图20的发生器的一种形式的发生器的示例。
图22为根据本公开的一个方面的机器人外科系统的示意图。
图23为根据本公开的一个方面的用于执行外科手术的微创遥控机器人外科系统的平面图。
图24为根据本公开的一个方面的图23的外科系统的外科医生的控制台的透视图。
图25为根据本公开的至少一个方面的图23的外科系统的电子器件推车的透视图。
图26为根据本公开的一个方面的遥控外科系统的图示。
图27为根据本公开的一个方面的图23的外科系统的患者侧推车的局部视图。
图28为根据本公开的一个方面的图23的外科系统的远程外科工具的前视图。
图29为根据本公开的一个方面的遥控外科系统的控制示意图。
图30为根据本公开的一个方面的机器人外科系统及其各种通信路径的正视图。
图31为图30的机器人外科系统的机器人工具和工具安装部分之间的接口的分解透视图。
图32为根据本公开的一个方面的图31的接口的细部图。
图33为根据本公开的一个方面的具有与机器人外科系统一起使用的排烟泵的双极射频(RF)机器人工具的透视图。
图34为根据本公开的一个方面的描绘了夹持和处理组织的端部执行器的图33的双极射频机器人工具的端部执行器的透视图。
图35为根据本公开的一个方面的图33的双极射频机器人工具的工具驱动接口的平面图，其中为清楚起见移除了部件。
图36为根据本公开的一个方面的与机器人外科系统一起使用的具有冷却和吹气特征部的超声机器人工具的平面图。
图37为根据本公开的一个方面的与机器人外科系统一起使用的机器人工具的控制算法的流程图。
图38为根据本公开的一个方面的机器人外科工具的驱动系统的透视图。
图39为根据本公开的至少一个方面的图38的驱动系统的分解透视图。
图40为根据本公开的至少一个方面的图38的机器人外科工具的近侧壳体的透视、局部剖视图，描绘了近侧壳体内的传动装置布置。
图41为根据本公开的一个方面的图40的传动装置布置的分解透视图。
图42为图40的传动装置布置的分解透视图，其中为清楚起见移除了各种部件；描绘了根据本公开的一个方面的处于第一构型的传动装置布置，其中第一协作驱动器驱动地联接到第一输出轴，并且第二协作驱动器驱动地联接到第二输出轴。
图43为根据本公开的一个方面的图40的传动装置布置的分解透视图，其中为清楚起见移除了各种部件；描绘了根据本公开的一个方面的处于第二构型的传动装置布置，其中第一协作驱动器和第二协作驱动器驱动地联接到第三输出轴。
图44为根据本公开的一个方面的图40的传动装置布置的分解透视图，其中为清楚起见移除了各种部件；描绘了根据本公开的一个方面的处于第三构型的传动装置布置，其中第一协作驱动器和第二协作驱动器驱动地联接到第四输出轴。
图45为根据本公开的至少一个方面的图40的传动装置布置的横截面正视图。
图46为根据本公开的至少一个方面的图38的机器人外科工具的不同外科功能的输出扭矩的图形显示。
图47为根据本公开的一个方面的处于未致动构型的图38的机器人外科工具的透视图。
图48为根据本公开的一个方面的处于关节运动构型的图38的机器人外科工具的透视图。
图49为根据本公开的一个方面的处于旋转构型的图38的机器人外科工具的透视图。
图50为根据本公开的一个方面的处于夹持和击发构型的图38的机器人外科工具的透视图。
图51为根据本公开的一个方面的外科部位处的机器人控制的端部执行器的视图。
图52为根据本公开的一个方面的图51的机器人控制的端部执行器的视图。
图53为根据本公开的一个方面的图51的机器人控制的端部执行器中的一个端部执行器的力和位移随时间的图形显示。
图54为根据本公开的一个方面的用于与机器人外科系统一起使用的外科工具的控制算法的流程图。
图55为根据本公开的一个方面的涉及机器人外科系统和手持式外科器械的外科手术的正视图，并且描绘了外科手术室中的多个显示器。
图56为根据本公开的一个方面的示出外科集线器的态势感知的时间线。
具体实施方式
本申请的申请人拥有于2018年3月28日提交的以下美国临时专利申请，这些临时专利申请中的每个以引用方式全文并入本文：
·名称为“INTERACTIVE SURGICAL SYSTEMS WITH encrypted COMMUNICATIONCAPABILITIES”的美国临时专利申请序列号62/649,302；
·名称为“DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS ANDCREATE ANONYMIZED RECORD”的美国临时专利申请序列号62/649,294；
·名称为“SURGICAL HUB SITUATIONAL AWARENESS”的美国专利申请序列号62/649,300；
·名称为“SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES INOPERATING THEATER”的美国临时专利申请序列号62/649,309；
·名称为“COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS”的美国临时专利申请序列号62/649,310；
·名称为“USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TODETERMINE PROPERTIES OF BACK SCATTERED LIGHT”的美国临时专利申请序列号62/649,291；
·名称为“ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES”的美国专利申请序列号62/649,296；
·美国临时专利申请序列号62/649,333，其名称为“CLOUD-BASED MEDICALANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER”；
·美国临时专利申请序列号62/649,327，其名称为“CLOUD-BASED MEDICALANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES”；
·名称为“DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICSNETWORK”的美国临时专利申请序列号62/649,315；
·美国专利申请序列号62/649,313，其名称为“CLOUD INTERFACE FOR COUPLEDSURGICAL DEVICES”；
·名称为“DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国临时专利申请序列号62/649,320；
·美国临时专利申请序列号62/649,307，其名称为“AUTOMATIC TOOLADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”；以及
·名称为“SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国临时专利申请序列号62/649,323。
本申请的申请人拥有于2018年3月29日提交的以下美国专利申请，这些专利申请中的每个以引用方式全文并入本文：
·名称为“INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATIONCAPABILITIES”的美国专利申请序列号____________；代理人案卷号END8499USNP/170766；
·名称为“INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OFDEVICES AND DATA CAPABILITIES”的美国专利申请序列号____________；代理人案卷号END8499USNP1/170766-1；
·名称为“Surgical hub coordination of control and communication ofoperating room devices”的美国专利申请序列号____________；代理人案卷号END8499USNP2/170766-2；
·名称为“Spatial awareness of surgical hubs in operating rooms”的美国专利申请序列号____________；代理人案卷号END8499USNP3/170766-3；
·名称为“Cooperative utilization of data derived from secondarysources by intelligent surgical hubs”的美国专利申请序列号____________；代理人案卷号END8499USNP4/170766-4；
·名称为“Surgical hub control arrangements”的美国专利申请序列号____________；代理人案卷号END8499USNP5/170766-5；
·名称为“DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS ANDCREATE ANONYMIZED RECORD”的美国专利申请序列号____________；代理人案卷号END8500USNP/170767；
·名称为“COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERSAND STATUS OF A SURGICAL DEVICE TO BE SHAREd WITH CLOUD BASED ANALYTICSSYSTEMS”的美国专利申请序列号____________；代理人案卷号END8500USNP1/170767-1；
·名称为“SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUINGINSTRUMENT”的美国专利申请序列号____________；代理人案卷号END8500USNP2/170767-2；
·名称为“DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETERWITH AN OUTCOME”的美国专利申请序列号____________；代理人案卷号END8500USNP3/170767-3；
·名称为“SURGICAL HUB SITUATIONAL AWARENESS”的美国专利申请序列号____________；代理人案卷号END8501USNP/170768；·名称为“SURGICAL SYSTEMDISTRIBUTED PROCESSING”的美国专利申请序列号____________；代理人案卷号END8501USNP1/170768-1；
·名称为“AGGREGATION AND REPORTING OF SURGICAL HUB DATA”的美国专利申请序列号____________；代理人案卷号END8501USNP2/170768-2；
·名称为“SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES INOPERATING THEATER”的美国专利申请序列号____________；代理人案卷号END8502USNP/170769；
·名称为“DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEARSTAPLE LINE”的美国专利申请序列号____________；代理人案卷号END8502USNP1/170769-1；
·名称为“STERILE FIELD INTERACTIVE CONTROL DISPLAYS”的美国专利申请序列号____________；代理人案卷号END8502USNP2/170769-2；
·名称为“COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS”的美国专利申请序列号____________；代理人案卷号END8503USNP/170770；
·名称为“USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TODETERMINE PROPERTIES OF BACK SCATTERED LIGHT”的美国专利申请序列号____________；代理人案卷号END8504USNP/170771；
·名称为“CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OFMONO-CHROMATIC LIGHT REFRACTIVITY”的美国专利申请序列号____________；代理人案卷号END8504USNP1/170771-1；以及
·名称为“DUAL CMOS ARRAY IMAGING”的美国专利申请序列号____________；代理人案卷号END8504USNP2/170771-2。
本申请的申请人拥有于2018年3月29日提交的以下美国专利申请，这些专利申请中的每个以引用方式全文并入本文：
·名称为“ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES”的美国专利申请序列号____________；代理人案卷号END8506USNP/170773；
·名称为“ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS”的美国专利申请序列号____________；代理人案卷号END8506USNP1/170773-1；
·名称为“CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION ANDRECOMMENDATIONS TO A USER”的美国专利申请序列号____________；代理人案卷号END8507USNP/170774；
·名称为“CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGETRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET”的美国专利申请序列号____________；代理人案卷号END8507USNP1/170774-1；
·名称为“CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTEDINDIVIDUALIZATION OF INSTRUMENT FUNCTION”的美国专利申请序列号____________；代理人案卷号END8507USNP2/170774-2；
·名称为“CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY ANDAUTHENTICATION TRENDS AND REACTIVE MEASURES”的美国专利申请序列号____________；代理人案卷号END8508USNP/170775；
·名称为“DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICSNETWORK”的美国专利申请序列号____________；代理人案卷号END8509USNP/170776；以及
·名称为“CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES”的美国专利申请序列号____________；代理人案卷号END8510USNP/170777。
本申请的申请人拥有于2018年3月29日提交的以下美国专利申请，这些专利申请中的每个以引用方式全文并入本文：
·名称为“DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMs”的美国专利申请序列号____________；代理人案卷号END8511USNP/170778；
·标题为COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICALPLATFORMS的美国专利申请序列号____________；代理人案卷号END8511USNP1/170778-1；
·名称为“AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICALPLATFORMS”的美国专利申请序列号____________；代理人案卷号END8512USNP/170779；
·名称为“CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国专利申请序列号____________；代理人案卷号END8512USNP1/170779-1；
·名称为“COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICALPLATFORMS”的美国专利申请序列号____________；代理人案卷号END8512USNP2/170779-2；
·名称为“DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国专利申请序列号____________；代理人案卷号END8512USNP3/170779-3；以及
·名称为“SENSING ARRANGEMENTS FOR ROBOT-ASSISTED Surgical PLATFORMS”的美国专利申请序列号____________；代理人案卷号END8513USNP/170780。
在详细说明外科装置和发生器的各个方面之前，应该指出的是，示例性示例的应用或使用并不局限于附图和具体实施方式中所示出的部件的配置和布置方式的细节。示例性示例可以单独实施，或与其它方面、变更形式和修改形式结合在一起实施，并可以通过多种方式实践或执行。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例示性示例进行描述而所选的，并非为了限制性的目的。而且，应当理解，以下描述的方面中的一个或多个、方面和/或示例的表达可以与以下描述的其它方面、方面和/或示例的表达中的任何一个或多个组合。
参见图1，计算机实现的交互式外科系统100包括一个或多个外科系统102和基于云的系统(例如，可包括联接到存储装置105的远程服务器113的云104)。每个外科系统102包括与可包括远程服务器113的云104通信的至少一个外科集线器106。在一个示例中，如图1中所示，外科系统102包括可视化系统108、机器人系统110和手持式智能外科器械112，它们被配置为彼此通信并且/或者与集线器106通信。在一些方面，外科系统102可包括M数量的集线器106、N数量的可视化系统108、O数量的机器人系统110和P数量的手持式智能外科器械112，其中M、N、O和P为大于或等于一的整数。
图3示出了用于对平躺在外科手术室116中的手术台114上的患者执行外科手术的外科系统102的示例。机器人系统110在外科手术中用作外科系统102的一部分。机器人系统110包括外科医生的控制台118、患者侧推车120(外科机器人)和外科机器人集线器122。当外科医生通过外科医生的控制台120观察外科部位时，患者侧推车117可通过患者体内的微创切口操纵至少一个可移除地联接的外科工具118。外科部位的图像可通过医疗成像装置124获得，该医疗成像装置可由患者侧推车120操纵以定向成像装置124。机器人集线器122可用于处理外科部位的图像，以随后通过外科医生的控制台118显示给外科医生。
其它类型的机器人系统可容易地适于与外科系统102一起使用。适用于本公开的机器人系统和外科工具的各种示例在2017年12月28日提交的名称为“ROBOT ASSISTEDSURGICAL PLATFORM”的美国临时专利申请序列号62/611,339中有所描述，该专利的公开内容全文以引用方式并入本文。
由云104执行并且适用于本公开的基于云的分析的各种示例描述于2017年12月28日提交的名称为“CLOUD-BASED MEDICAL ANALYTICS”的美国临时专利申请序列号62/611,340中，其公开内容全文以引用方式并入本文。
在各种方面，成像装置124包括至少一个图像传感器和一个或多个光学部件。合适的图像传感器包括但不限于电荷耦合器件(CCD)传感器和互补金属氧化物半导体(CMOS)传感器。
成像装置124的光学部件可包括一个或多个照明源和/或一个或多个透镜。一个或多个照明源可被引导以照明外科场地的多部分。一个或多个图像传感器可接收从外科场地反射或折射的光，包括从组织和/或外科器械反射或折射的光。
一个或多个照明源可被配置为辐射可见光谱中的电磁能以及不可见光谱。可见光谱(有时被称为光学光谱或发光光谱)是电磁光谱中对人眼可见(即，可被其检测)的那部分，并且可被称为可见光或简单光。典型的人眼将对空气中约380nm至约750nm的波长作出响应。
不可见光谱(即，非发光光谱)是电磁光谱的位于可见光谱之下和之上的部分(即，低于约380nm且高于约750nm的波长)。人眼不可检测到不可见光谱。大于约750nm的波长长于红色可见光谱，并且它们变为不可见的红外(IR)、微波和无线电电磁辐射。小于约380nm的波长比紫色光谱短，并且它们变为不可见的紫外、x射线和γ射线电磁辐射。
在各种方面，成像装置124被配置为用于微创手术中。适用于本公开的成像装置的示例包括但不限于关节镜、血管镜、支气管镜、胆道镜、结肠镜、细胞检查镜、十二指镜、肠窥镜、食道-十二指肠镜(胃镜)、内窥镜、喉镜、鼻咽-肾内窥镜、乙状结肠镜、胸腔镜和子宫内窥镜。
在一个方面，成像装置采用多光谱监测来辨别形貌和底层结构。多光谱图像是捕获跨电磁波谱的特定波长范围内的图像数据的图像。可通过滤波器或通过使用对特定波长敏感的器械来分离波长，特定波长包括来自可见光范围之外的频率的光，例如IR和紫外。光谱成像可允许提取人眼未能用其红色，绿色和蓝色的受体捕获的附加信息。多光谱成像的使用在2017年12月28日提交的名称为“INTERACTIVE SURGICAL PLATFORM”的美国临时专利申请序列号62/611,341的标题“Advanced Imaging Acquisition Module”下更详细地描述，该专利的公开内容全文以引用方式并入本文。在完成外科任务以对处理过的组织执行一个或多个先前所述测试之后，多光谱监测可以是用于重新定位外科场地的有用工具。
不言自明的是，在任何外科期间都需要对手术室和外科设备进行严格消毒。在“外科室”(即，手术室或治疗室)中所需的严格的卫生和消毒条件需要所有医疗装置和设备的最高可能的无菌性。该灭菌过程的一部分是需要对接触患者或穿透无菌场的任何物质进行灭菌，包括成像装置124及其附接件和器件。应当理解，无菌场可被认为是被认为不含微生物的指定区域，诸如在托盘内或无菌毛巾内，或者无菌场可被认为是已准备用于外科手术的患者周围的区域。无菌场可包括被恰当地穿着的擦洗的团队构件，以及该区域中的所有家具和固定件。
在各种方面，可视化系统108包括一个或多个成像传感器、一个或多个图像处理单元、一个或多个存储阵列、以及一个或多个显示器，它们相对于无菌场进行策略布置，如图2中所示。在一个方面，可视化系统108包括用于HL7、PACS和EMR的界面。可视化系统108的各种器件在2017年12月28日提交的名称为“INTERACTIVE SURGICAL PLATFORM”的美国临时专利申请序列号62/611,341的标题“Advanced Imaging Acquisition Module”下有所描述，该专利申请的公开内容全文以引用方式并入本文。
如图2中所示，主显示器119被定位在无菌场中，以对在手术台114处的操作者可见。此外，可视化塔111被定位在无菌场之外。可视化塔111包括彼此背离的第一非无菌显示器107和第二非无菌显示器109。由集线器106引导的可视化系统108被配置为利用显示器107、109和119来将信息流协调到无菌场内侧和外侧的操作者。例如，集线器106可使可视化系统108在非无菌显示器107或109上显示由成像装置124记录的外科部位的快照，同时保持外科部位在主显示器119上的实时馈送。非无菌显示器107或109上的快照可允许非无菌操作者例如执行与外科手术相关的诊断步骤。
在一个方面，集线器106还被配置为将由非无菌操作者在可视化塔111处输入的诊断输入或反馈路由至无菌场内的主显示器119，其中可由操作台上的无菌操作员查看。在一个示例中，该输入可以是对显示在非无菌显示器107或109上的快照的修改形式，其可通过集线器106路由到主显示器119。
参见图2，外科器械112作为外科系统102的一部分在外科手术中使用。集线器106还被配置为协调流向外科器械112的显示器的信息流。例如，在2017年12月28日提交的名称为“INTERACTIVE SURGICAL PLATFORM”的美国临时专利申请序列号62/611,341，其公开内容全文以引用方式并入本文。由非无菌操作者在可视化塔111处输入的诊断输入或反馈可由集线器106路由至无菌场内的外科器械显示器115，其中外科器械112的操作者可观察到该输入或反馈。适用于外科系统102的示例性外科器械描述于2017年12月28日提交的名称为“INTERACTIVE SURGICAL PLATFORM”的美国临时专利申请序列号62/611,341的标题“Surgical Instrument Hardware”下，该专利的公开内容以引用方式全文并入本文。
现在参见图3，集线器106被描绘为与可视化系统108、机器人系统110和手持式智能外科器械112通信。集线器106包括集线器显示器135、成像模块138、发生器模块140、通信模块130、处理器模块132和存储阵列134。在某些方面，如图3中所示，集线器106还包括排烟模块126和/或抽吸/冲洗模块128。
在外科手术期间，用于密封和/或切割的对组织的能量施加通常与排烟、抽吸过量流体和/或冲洗组织相关。来自不同来源的流体管线、功率管线和/或数据管线通常在外科手术期间缠结。在外科手术期间解决该问题可丢失有价值的时间。断开管线可需要将管线与其相应的模块断开连接，这可需要重置模块。集线器模块化壳体136提供用于管理功率管线、数据管线和流体管线的统一环境，这降低了此类管线之间缠结的频率。
本公开的各方面提供了用于外科手术的外科集线器，该外科手术涉及将能量施加到外科部位处的组织。外科集线器包括集线器壳体和可滑动地容纳在集线器壳体的对接底座中的组合发生器模块。对接底座包括数据和功率接触件。组合发生器模块包括座置在单个单元中的超声能量发生器器件、双极RF能量发生器器件和单极RF能量发生器器件中的两个或更多个。在一个方面，组合发生器模块还包括排烟器件，用于将组合发生器模块连接到外科器械的至少一根能量递送缆线、被配置为排出通过向组织施加治疗能量而产生的烟雾、流体和/或颗粒的至少一个排烟器件、以及从远程外科部位延伸至排烟器件的流体管线。
在一个方面，流体管线是第一流体管线，并且第二流体管线从远程外科部位延伸至可滑动地容纳在集线器壳体中的抽吸和冲洗模块。在一个方面，集线器壳体包括流体接口。
某些外科手术可需要将多于一种能量类型施加到组织。一种能量类型可更有利于切割组织，而另一种不同的能量类型可更有利于密封组织。例如，双极发生器可用于密封组织，而超声发生器可用于切割密封的组织。本公开的各方面提供了一种解决方案，其中集线器模块化壳体136被配置为容纳不同的发生器，并且有利于它们之间的交互式通信。集线器模块化壳体136的优点之一是能够快速地移除和/或更换各种模块。
本公开的方面提供了在涉及将能量施加到组织的外科手术中使用的模块化外科壳体。模块化外科壳体包括：第一能量发生器模块，该第一能量发生器模块被配置为生成用于施加到组织的第一能量；和第一对接底座，该第一对接底座包括第一对接端口，该第一对接端口包括第一数据和功率接触件，其中第一能量发生器模块可滑动地移动成与该功率和数据接触件电接合，并且其中第一能量发生器模块能够可滑动地移动成不与第一功率和数据接触件电接合。
对上文进行进一步描述，模块化外科壳体还包括：第二能量发生器模块，该第二能量发生器模块被配置为生成不同于第一能量的第二能量以用于施加到组织；和第二对接底座，该第二对接底座包括第二对接端口，该第二对接端口包括第二数据和功率接触件，其中第二能量发生器模块可滑动地移动成与该功率和数据接触件电接合，并且其中第二能量发生器能够可滑动地移动成不与第二功率和数据接触件电接合。
此外，模块化外科壳体还包括在第一对接端口和第二对接端口之间的通信总线，其被配置为有利于第一能量发生器模块和第二能量发生器模块之间的通信。
参见图3-7，本公开的各方面被呈现为集线器模块化壳体136，其允许发生器模块140、排烟模块126和抽吸/冲洗模块128的模块化集成。集线器模块化壳体136还有利于模块140、126、128之间的交互式通信。如图5中所示，发生器模块140可为具有集成的单极器件、双极器件和超声器件的发生器模块，该器件被支撑在可滑动地插入到集线器模块化壳体136中的单个外壳单元139中。如图5中所示，发生器模块140可被配置为连接到单极装置146、双极装置147和超声装置148。另选地，发生器模块140可包括通过集线器模块化壳体136进行交互的一系列单极发生器模块、双极发生器模块和/或超声发生器模块。集线器模块化壳体136可被配置为有利于多个发生器的插入和对接到集线器模块化壳体136中的发生器之间的交互通信，使得发生器将充当单个发生器。
在一个方面，集线器模块化壳体136包括具有外部和无线通信接头的模块化功率和通信底板149，以实现模块140、126、128的可移除附接件以及它们之间的交互通信。
在一个方面，集线器模块化壳体136包括对接底座或抽屉151(本文也称为抽屉)，其被配置为可滑动地容纳模块140、126、128。图4示出了可滑动地容纳在外科集线器壳体136的对接底座151中的外科集线器壳体136和组合发生器模块145的局部透视图。在组合发生器模块145的背面上具有功率和数据接触件的对接端口152被配置为当组合发生器模块145滑动到集线器模块壳体136的对应的对接底座151内的适当位置时，将对应的对接端口150与集线器模块化壳体136的对应对接底座151的功率和数据接触件接合。在一个方面，组合发生器模块145包括一起集成到单个外壳单元139中的双极、超声和单极模块以及排烟模块，如图5中所示。
在各种方面，排烟模块126包括流体管线154，该流体管线154将捕集/收集的烟雾和/或流体从外科部位传送到例如排烟模块126。源自排烟模块126的真空抽吸可将烟雾吸入外科部位处的公用导管的开口中。联接到流体管线的公用导管可以是端接在排烟模块126处的柔性管的形式。公用导管和流体管线限定朝向容纳在集线器壳体136中的排烟模块126延伸的流体路径。
在各种方面，抽吸/冲洗模块128联接到包括吸出流体管线和抽吸流体管线的外科工具。在一个示例中，吸出流体管线和抽吸流体管线为从外科部位朝向抽吸/冲洗模块128延伸的柔性管的形式。一个或多个驱动系统可被配置为冲洗到外科部位的流体和从外科部位抽吸流体。
在一个方面，外科工具包括轴，该轴具有在其远侧端部处的端部执行器以及与端部执行器、吸出管和冲洗管相关联的至少一种能量处理。吸出管可在其远侧端部处具有入口，并且吸出管延伸穿过轴。类似地，吸出管可延伸穿过轴并且可具有邻近能量递送工具的入口。能量递送工具被配置为将超声能量和/或RF能量递送至外科部位，并且通过初始延伸穿过轴的缆线联接到发生器模块140。
冲洗管可与流体源流体连通，并且吸出管可与真空源流体连通。流体源和/或真空源可座置在抽吸/冲洗模块128中。在一个示例中，流体源和/或真空源可独立于抽吸/冲洗模块128座置在集线器壳体136中。在此类示例中，流体接口能够将抽吸/冲洗模块128连接到流体源和/或真空源。
在一个方面，集线器模块化壳体136上的模块140、126、128和/或其对应的对接底座可包括对准特征件，该对准特征件被配置为将模块的对接端口对准成与其在集线器模块化壳体136的对接底座中的对应端口接合。例如，如图4中所示，组合发生器模块145包括侧支架155，侧支架155被配置为与集线器模块化壳体136的对应的对接底座151的对应支架156可滑动地接合。支架配合以引导组合发生器模块145的对接端口接触件与集线器模块化壳体136的对接端口接触件电接合。
在一些方面，集线器模块化壳体136的抽屉151为相同的或大体上相同的大小，并且模块的大小被调节为容纳在抽屉151中。例如，侧支架155和/或156可根据模块的大小而更大或更小。在其它方面，抽屉151的大小不同，并且各自被设计成容纳特定模块。
此外，可对特定模块的接触件进行键控以与特定抽屉的接触件接合，以避免将模块插入到具有不匹配接触件的抽屉中。
如图4中所示，一个抽屉151的对接端口150可通过通信链路157联接到另一个抽屉151的对接端口150，以有利于座置在集线器模块化壳体136中的模块之间的交互式通信。另选地或附加地，集线器模块化壳体136的对接端口150可有利于座置在集线器模块化壳体136中的模块之间的无线交互通信。可采用任何合适的无线通信，诸如例如Air Titan-Bluetooth。
图6示出了用于横向模块化外壳160的多个横向对接端口的单个功率总线附接件，该横向模块化外壳160被配置为容纳外科集线器206的多个模块。横向模块化外壳160被配置为横向容纳和互连模块161。模块161可滑动地插入到横向模块化外壳160的对接底座162中，该横向模块化外壳160包括用于互连模块161的底板。如图6中所示，模块161横向布置在横向模块化外壳160中。另选地，模块161可竖直地布置在横向模块化外壳中。
图7示出了被配置为容纳外科集线器106的多个模块165的竖直模块化外壳164。模块165可滑动地插入到竖直模块化外壳164的对接底座或抽屉167中，该竖直模块化外壳164包括用于互连模块165的底板。尽管竖直模块化外壳164的抽屉167竖直布置，但在某些情况下，竖直模块化外壳164可包括横向布置的抽屉。此外，模块165可通过竖直模块化外壳164的对接端口彼此交互。在图7的示例中，提供了用于显示与模块165的操作相关的数据的显示器177。此外，竖直模块化外壳164包括主模块178，该主模块座置可滑动地容纳在主模块178中的多个子模块。
在各种方面，成像模块138包括集成视频处理器和模块化光源，并且适于与各种成像装置一起使用。在一个方面，成像装置由可装配有光源模块和相机模块的模块化外壳构成。外壳可为一次性外壳。在至少一个示例中，一次性外壳可移除地联接到可重复使用的控制器、光源模块和相机模块。光源模块和/或相机模块可根据外科手术的类型选择性地选择。在一个方面，相机模块包括CCD传感器。在另一方面，相机模块包括CMOS传感器。在另一方面，相机模块被配置用于扫描波束成像。同样，光源模块可被配置为递送白光或不同的光，这取决于外科手术。
在外科手术期间，从外科场地移除外科装置并用包括不同相机或不同光源的另一外科装置替换外科装置可为低效的。暂时失去对外科场地的视线可导致不期望的后果。本公开的模块成像装置被配置为允许在外科手术期间中流替换光源模块或相机模块，而不必从外科场地移除成像装置。
在一个方面，成像装置包括包括多个通道的管状外壳。第一通道被配置为可滑动地容纳相机模块，该相机模块可被配置为与第一通道搭扣配合接合。第二通道被配置为可滑动地容纳光源模块，该光源模块可被配置为与第二通道搭扣配合接合。在另一个示例中，相机模块和/或光源模块可在其相应通道内旋转到最终位置。可采用螺纹接合代替搭扣配合接合。
在各种示例中，多个成像装置被放置在外科场地中的不同位置以提供多个视图。成像模块138可被配置为在成像装置之间切换以提供最佳视图。在各种方面，成像模块138可被配置为集成来自不同成像装置的图像。
适用于本公开的各种图像处理器和成像装置描述于2011年8月9日公布的名称为“COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR”的美国专利7,995,045中，该专利以引用方式全文并入本文。此外，2011年7月19日公布的名称为“SBI MOTION ARTIFACTREMOVAL APPARATUS AND METHOD”的美国专利7,982,776描述了用于从图像数据中去除运动伪影的各种系统，该专利以引用方式全文并入本文。此类系统可与成像模块138集成。此外，2011年12月15日公布的名称为“CONTROLLABLE MAGNETIC SOURCE TO FIXTUREINTRACORPOREAL APPARATUS”的美国专利申请公布2011/0306840和2014年8月28日公布的名称为“SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE”的美国专利申请公布2014/0243597，以上专利中的每个全文以引用方式并入本文。
图8示出了包括模块化通信集线器203的外科数据网络201，该模块化通信集线器203被配置为将位于医疗设施的一个或多个手术室中的模块化装置或专门配备用于外科操作的医疗设施中的任何房间连接到基于云的系统(例如，可包括联接到存储装置205的远程服务器213的云204)。在一个方面，模块化通信集线器203包括与网络路由器通信的网络集线器207和/或网络交换机209。模块化通信集线器203还可联接到本地计算机系统210以提供本地计算机处理和数据操纵。外科数据网络201可被配置为无源的、智能的或交换的。无源外科数据网络充当数据的管道，从而使其能够从一个装置(或区段)转移到另一个装置(或区段)以及云计算资源。智能外科数据网络包括附加特征，以使得能够监测穿过外科数据网络的流量并配置网络集线器207或网络交换器209中的每个端口。智能外科数据网络可被称为可管理的集线器或交换器。交换集线器读取每个包的目标地址，并且然后将包转发到正确的端口。
位于手术室中的模块化装置1a-1n可联接到模块化通信集线器203。网络集线器207和/或网络交换机209可联接到网络路由器211以将装置1a-1n连接至云204或本地计算机系统210。与装置1a-1n相关联的数据可经由路由器传输到基于云的计算机，用于远程数据处理和操纵。与装置1a-1n相关联的数据也可被传输至本地计算机系统210以用于本地数据处理和操纵。位于相同手术室中的模块化装置2a-2m也可联接到网络交换机209。网络交换机209可联接到网络集线器207和/或网络路由器211以将装置2a-2m连接至云204。与装置2a-2n相关联的数据可经由网络路由器211传输到云204以用于数据处理和操纵。与装置2a-2m相关联的数据也可被传输至本地计算机系统210以用于本地数据处理和操纵。
应当理解，可通过将多个网络集线器207和/或多个网络交换机209与多个网络路由器211互连来扩展外科数据网络201。模块化通信集线器203可被包含在模块化控制塔中，该模块化控制塔被配置为容纳多个装置1a-1n/2a-2m。本地计算机系统210也可包含在模块化控制塔中。模块化通信集线器203连接到显示器212以显示例如在外科手术期间由装置1a-1n/2a-2m中的一些获得的图像。在各种方面，装置1a-1n/2a-2m可包括例如各种模块，诸如联接到内窥镜的成像模块138、联接到基于能量的外科装置的发生器模块140、排烟模块126、抽吸/冲洗模块128、通信模块130、处理器模块132、存储阵列134、连接到显示器的外科装置、和/或可连接到外科数据网络201的模块化通信集线器203的其它模块化装置中的非接触传感器模块。
在一个方面，外科数据网络201可包括将装置1a-1n/2a-2m连接至云的(一个或多个)网络集线器、(一个或多个)网络交换机和(一个或多个)网络路由器的组合。联接到网络集线器或网络交换机的装置1a-1n/2a-2m中的任何一个或全部可实时收集数据并将数据传输到云计算机中以进行数据处理和操纵。应当理解，云计算依赖于共享计算资源，而不是使用本地服务器或个人装置来处理软件应用程序。可使用“云”一词作为“互联网”的隐喻，尽管该术语不受此限制。因此，本文可使用术语“云计算”来指“基于互联网的计算的类型”，其中将不同的服务(诸如服务器、存储器和应用程序)递送至位于外科室(例如，固定、移动、临时或现场手术室或空间)中的模块化通信集线器203和/或计算机系统210以及通过互联网连接至模块化通信集线器203和/或计算机系统210的装置。云基础设施可由云服务提供方维护。在这种情况下，云服务提供方可以是协调位于一个或多个手术室中的装置1a-1n/2a-2m的使用和控制的实体。云计算服务可基于由智能外科器械、机器人和位于手术室中的其它计算机化装置所收集的数据来执行大量计算。集线器硬件使多个装置或连接能够连接到与云计算资源和存储器通信的计算机。
对由装置1a-1n/2a-2m所收集的数据应用云计算机数据处理技术，外科数据网络提供改善的外科结果，降低的成本和改善的患者满意度。可采用装置1a-1n/2a-2m中的至少一些来观察组织状态以评估在组织密封和切割手术之后密封的组织的渗漏或灌注。可采用装置1a-1n/2a-2m中的至少一些来识别病理学，诸如疾病的影响，使用基于云的计算检查包括用于诊断目的的身体组织样本的图像的数据。这包括组织和表型的定位和边缘确认。可采用装置1a-1n/2a-2m中的至少一些使用与成像装置和技术(诸如重叠由多个成像装置捕获的图像)集成的各种传感器来识别身体的解剖结构。由装置1a-1n/2a-2m收集的数据(包括图像数据)可被传输到云204或本地计算机系统210或两者以用于数据处理和操纵，包括图像处理和操纵。可分析数据以通过确定是否可继续进行进一步治疗(诸如内窥镜式干预、新兴技术、靶向辐射、靶向干预和精确机器人对组织特异性位点和条件的应用来改善外科手术结果。此类数据分析可进一步采用结果分析处理，并且使用标准化方法可提供有益反馈以确认外科治疗和外科医生的行为，或建议修改外科治疗和外科医生的行为。
在一个具体实施中，手术室装置1a-1n可通过有线信道或无线信道连接至模块化通信集线器203，这取决于装置1a-1n至网络集线器的配置。在一个方面，网络集线器207可被实现为在开放式系统互连(OSI)模型的物理层上工作的本地网络广播装置。该网络集线器提供与位于同一手术室网络中的装置1a-1n的连接。网络集线器207以包的形式收集数据，并以半双工模式将其发送至路由器。网络集线器207不存储任何媒体访问控制/因特网协议(MAC/IP)以传输该装置数据。装置1a-1n中的仅一个可一次通过网络集线器207发送数据。网络集线器207没有关于在何处发送信息并在每个连接上广播所有网络数据以及通过云204向远程服务器213(图9)广播所有网络数据的路由表或智能。网络集线器207可以检测基本网络错误诸如冲突，但将所有信息广播到多个端口可带来安全风险并导致瓶颈。
在另一个具体实施中，手术室装置2a-2m可通过有线信道或无线信道连接到网络交换机209。网络交换机209在OSI模型的数据链路层中工作。网络交换机209是用于将位于相同手术室中的装置2a-2m连接到网络的多点广播装置。网络交换机209以帧的形式向网络路由器211发送数据并且以全双工模式工作。多个装置2a-2m可通过网络交换机209同时发送数据。网络交换机209存储并使用装置2a-2m的MAC地址来传输数据。
网络集线器207和/或网络交换机209联接到网络路由器211以连接到云204。网络路由器211在OSI模型的网络层中工作。网络路由器211创建用于将从网络集线器207和/或网络交换机211接收的数据包发射至基于云的计算机资源的路由，以进一步处理和操纵由装置1a-1n/2a-2m中的任一者或所有收集的数据。可采用网络路由器211来连接位于不同位置的两个或更多个不同的网络，诸如例如同一医疗设施的不同手术室或位于不同医疗设施的不同手术室的不同网络。网络路由器211以包的形式向云204发送数据并且以全双工模式工作。多个装置可以同时发送数据。网络路由器211使用IP地址来传输数据。
在一个示例中，网络集线器207可被实现为USB集线器，其允许多个USB装置连接到主机。USB集线器可以将单个USB端口扩展到多个层级，以便有更多端口可用于将装置连接到主机系统计算机。网络集线器207可包括用于通过有线信道或无线信道接收信息的有线或无线能力。在一个方面，无线USB短距离、高带宽无线无线电通信协议可用于装置1a-1n和位于手术室中的装置2a-2m之间的通信。
在其它示例中，手术室装置1a-1n/2a-2m可经由蓝牙无线技术标准与模块化通信集线器203通信，以用于在短距离(使用ISM频带中的2.4至2.485GHz的短波长UHF无线电波)从固定装置和移动装置交换数据以及构建个人局域网(PAN)。在其它方面，手术室装置1a-1n/2a-2m可经由多种无线或有线通信标准或协议与模块化通信集线器203通信，包括但不限于Wi-Fi(IEEE 802.11系列)、WiMAX(IEEE 802.16系列)、IEEE 802.20、长期演进(LTE)和Ev-DO、HSPA+、HSDPA+、HSUPA+、EDGE、GSM、GPRS、CDMA、TDMA、DECT、及其以太网衍生物、以及指定为3G、4G、5G和以上的任何其它无线和有线协议。计算模块可包括多个通信模块。例如，第一通信模块可专用于较短距离的无线通信诸如Wi-Fi和蓝牙，并且第二通信模块可专用于较长距离的无线通信，诸如GPS、EDGE、GPRS、CDMA、WiMAX、LTE、Ev-DO等。
模块化通信集线器203可用作手术室装置1a-1n/2a-2m中的一者或全部的中心连接，并且处理被称为帧的数据类型。帧携带由装置1a-1n/2a-2m生成的数据。当模块化通信集线器203接收到帧时，其被放大并发射至网络路由器211，该网络路由器211通过使用如本文所述的多个无线或有线通信标准或协议将数据传输到云计算资源。
模块化通信集线器203可用作独立装置或连接到兼容的网络集线器和网络交换机以形成更大的网络。模块化通信集线器203通常易于安装、配置和维护，使得其成为对手术室装置1a-1n/2a-2m进行联网的良好选项。
图9示出了计算机实现的交互式外科系统200。计算机实现的交互式外科系统200在许多方面类似于计算机实现的交互式外科系统100。例如，计算机实现的交互式外科系统200包括在许多方面类似于外科系统102的一个或多个外科系统202。每个外科系统202包括与可包括远程服务器213的云204通信的至少一个外科集线器206。在一个方面，计算机实现的交互式外科系统200包括模块化控制塔236，该模块化控制塔236连接到多个手术室装置，诸如例如智能外科器械、机器人和位于手术室中的其它计算机化装置。如图10中所示，模块化控制塔236包括联接到计算机系统210的模块化通信集线器203。如图9的示例中所示，模块化控制塔236联接到以下模块：联接到内窥镜239的成像模块238、联接到能量装置241的发生器模块240、排烟器模块226、抽吸/冲洗模块228、通信模块230、处理器模块232、存储阵列234、任选地联接到显示器237的智能装置/器械235、和非接触传感器模块242。手术室装置经由模块化控制塔236联接到云计算资源和数据存储。机器人集线器222也可连接到模块化控制塔236和云计算资源。装置/器械235、可视化系统208等等可经由有线或无线通信标准或协议联接到模块化控制塔236，如本文所述。模块化控制塔236可联接到集线器显示器215(例如，监测器、屏幕)以显示和叠加从成像模块、装置/器械显示器和/或其它可视化系统208接收的图像。集线器显示器还可结合图像和叠加图像来显示从连接到模块化控制塔的装置接收的数据。
图10示出了包括联接到模块化控制塔236的多个模块的外科集线器206。模块化控制塔236包括模块化通信集线器203(例如，网络连接性装置)和计算机系统210，以提供例如本地处理、可视化和成像。如图10中所示，模块化通信集线器203可以分层配置连接以扩展可连接到模块化通信集线器203的模块(例如，装置)的数量，并将与模块相关联的数据传输至计算机系统210、云计算资源或两者。如图10中所示，模块化通信集线器203中的网络集线器/交换机中的每个包括三个下游端口和一个上游端口。上游网络集线器/交换机连接至处理器以提供与云计算资源和本地显示器217的通信连接。与云204的通信可通过有线或无线通信信道进行。
外科集线器206采用非接触传感器模块242来测量手术室的尺寸，并且使用超声或激光型非接触测量装置来生成外科室的标测图。基于超声的非接触传感器模块通过发射一阵超声波并在其从手术室的围墙弹回时接收回波来扫描手术室，如在2017年12月28日提交的名称为“INTERACTIVE SURGICAL PLATFORM”的美国临时专利申请序列号62/611,341中的标题“Surgical Hub Spatial Awareness Within an Operating Room”下所述，该临时专利申请全文以引用方式并入本文，其中传感器模块被配置为确定手术室的大小并调节蓝牙配对距离限制。基于激光的非接触传感器模块通过发射激光脉冲、接收从手术室的围墙弹回的激光脉冲，以及将发射脉冲的相位与所接收的脉冲进行比较来扫描手术室，以确定手术室的尺寸并调节蓝牙配对距离限制。
计算机系统210包括处理器244和网络接口245。处理器244经由系统总线联接到通信模块247、存储装置248、存储器249、非易失性存储器250和输入/输出接口251。系统总线可为若干类型的总线结构中的任一者，该总线结构包括存储器总线或存储器控制器、外围总线或外部总线、和/或使用任何各种可用总线架构的本地总线，包括但不限于9位总线、工业标准架构(ISA)、微型Charmel架构(MSA)、扩展ISA(EISA)、智能驱动电子器件(IDE)、VESA本地总线(VLB)、外围器件互连(PCI)、USB、高级图形端口(AGP)、个人计算机存储卡国际协会总线(PCMCIA)、小型计算机系统接口(SCSI)或任何其它外围总线。
控制器244可为任何单核或多核处理器，诸如由德克萨斯器械公司(TexasInstruments)提供的商品名为ARM Cortex的那些处理器。在一个方面，处理器可为购自例如德克萨斯器械公司的LM4F230H5QR ARM Cortex-M4F处理器核心，其包括256KB的单循环闪存或其它非易失性存储器(最多至40MHZ)的片上存储器、用于改善40MHz以上的性能的预取缓冲器、32KB单循环序列随机存取存储器(SRAM)、装载有
软件的内部只读存储器(ROM)、2KB电可擦除可编程只读存储器(EEPROM)、和/或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。
在一个方面，处理器244可包括安全控制器，该安全控制器包括两个基于控制器的系列(诸如TMS570和RM4x)，已知同样由德克萨斯器械公司生产的商品名为Hercules ARMCortex R4。安全控制器可被配置为专门用于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。
系统存储器包括易失性存储器和非易失性存储器。基本输入/输出系统(BIOS)(包含诸如在启动期间在计算机系统内的元件之间传输信息的基本例程，)存储在非易失性存储器中。例如，非易失性存储器可包括ROM、可编程ROM(PROM)、电可编程ROM(EPROM)、EEPROM或闪存。易失存储器包括充当外部高速缓存存储器的随机存取存储器(RAM)。此外，RAM可以多种形式可用，诸如SRAM、动态RAM(DRAM)、同步DRAM(SDRAM)、双数据速率SDRAM(DDRSDRAM)增强SDRAM(ESDRAM)、同步链路DRAM(SLDRAM)和直接Rambus RAM(DRRAM)。
计算机系统210还包括可移除/不可移除的、易失性/非易失性的计算机存储介质，诸如例如磁盘存储器。磁盘存储器包括但不限于诸如装置如磁盘驱动器、软盘驱动器、磁带驱动器、Jaz驱动器、Zip驱动器、LS-60驱动器、闪存存储卡或内存条。此外，磁盘存储器可包括单独地或与其它存储介质组合的存储介质，包括但不限于光盘驱动器诸如光盘ROM装置(CD-ROM)、光盘可记录驱动器(CD-R驱动器)、光盘可重写驱动器(CD-RW驱动器)或数字通用磁盘ROM驱动器(DVD-ROM)。为了有利于磁盘存储装置与系统总线的连接，可使用可移除或非可移除接口。
应当理解，计算机系统210包括充当用户与在合适的操作环境中描述的基本计算机资源之间的中介的软件。此类软件包括操作系统。可存储在磁盘存储装置上的操作系统用于控制并分配计算机系统的资源。系统应用程序利用操作系统通过存储在系统存储器或磁盘存储装置中的程序模块和程序数据来管理资源。应当理解，本文所述的各种器件可用各种操作系统或操作系统的组合来实现。
用户通过联接到I/O接口251的(一个或多个)输入装置将命令或信息输入到计算机系统210中。输入装置包括但不限于指向装置，诸如鼠标、触控球、触笔、触摸板、键盘、麦克风、操纵杆、游戏垫、卫星盘、扫描仪、电视调谐器卡、数字相机、数字摄像机、幅材相机等。这些和其它输入装置经由(一个或多个)接口端口通过系统总线连接到处理器。(一个或多个)接口端口包括例如串口、并行端口、游戏端口和USB。(一个或多个)输出装置使用与(一个或多个)输入装置相同类型的端口。因此，例如，USB端口可用于向计算机系统提供输入并将信息从计算机系统输出到输出装置。提供了输出适配器来说明在其它输出装置中存在需要特殊适配器的一些输出装置(如监测器、显示器、扬声器和打印机。输出适配器以举例的方式包括但不限于提供输出装置和系统总线之间的连接装置的视频和声卡。应当指出，其它装置或装置诸如(一个或多个)远程计算机的系统提供了输入能力和输出能力两者。
计算机系统210可使用与一个或多个远程计算机(诸如(一个或多个)云计算机)或本地计算机的逻辑连接在联网环境中操作。(一个或多个)远程云计算机可为个人计算机、服务器、路由器、网络PC、工作站、基于微处理器的器具、对等装置或其它公共网络节点等，并且通常包括相对于计算机系统所述的元件中的许多或全部。为简明起见，仅示出了具有(一个或多个)远程计算机的存储器存储装置。(一个或多个)远程计算机通过网络接口在逻辑上连接到计算机系统，并且然后经由通信连接物理连接。网络接口涵盖通信网络诸如局域网(LAN)和广域网(WAN)。LAN技术包括光纤分布式数据接口(FDDI)、铜分布式数据接口(CDDI)、以太网/IEEE 802.3、令牌环/IEEE 802.5等。WAN技术包括但不限于点对点链路、电路交换网络如综合业务数字网络(ISDN)及其变体、分组交换网络和数字用户管线(DSL)。
在各种方面，图10的计算机系统210、成像模块238和/或可视化系统208、和/或图9至图10的处理器模块232可包括图像处理器、图像处理引擎、媒体处理器、或用于处理数字图像的任何专用数字信号处理器(DSP)。图像处理器可采用具有单个指令、多数据(SIMD)或多指令、多数据(MIMD)技术的并行计算以提高速度和效率。数字图像处理引擎可执行一系列任务。图像处理器可为具有多核处理器架构的芯片上的系统。
(一个或多个)通信连接是指用于将网络接口连接到总线的硬件/软件。虽然示出了通信连接以便在计算机系统内进行示例性澄清，但其也可位于计算机系统210的外部。连接到网络接口所必需的硬件/软件仅出于示例性目的包括内部和外部技术，诸如调制解调器，包括常规的电话级调制解调器、电缆调制解调器和DSL调制解调器、ISDN适配器和以太网卡。
图11例示了根据本公开的一个方面的USB网络集线器300装置的一个方面的功能框图。在例示的方面，USB网络集线器装置300采用得德克萨斯器械公司的TUSB2036集成电路集线器。USB网络集线器300是根据USB 2.0规范提供上游USB收发器端口302和多达三个下游USB收发器端口304、306、308的CMOS装置。上游USB收发器端口302为差分根数据端口，其包括与差分数据正(DM0)输入配对的差分数据负(DP0)输入。三个下游USB收发器端口304、306、308为差分数据端口，其中每个端口包括与差分数据负(DM1-DM3)输出配对的差分数据正(DP1-DP3)输出。
USB网络集线器300装置用数字状态机而不是微控制器来实现，并且不需要固件编程。完全兼容的USB收发器集成到用于上游USB收发器端口302和所有下游USB收发器端口304、306、308的电路中。下游USB收发器端口304、306、308通过根据附接到端口的装置的速度自动设置转换速率来支持全速度装置和低速装置两者。USB网络集线器300装置可被配置为处于总线供电模式或自供电模式，并且包括用于管理功率的集线器功率逻辑312。
USB网络集线器300装置包括串行接口引擎310(SIE)。SIE 310是USB网络集线器300硬件的前端，并处理USB规范第8章中描述的大多数协议。SIE 310通常包括多达交易级别的信令。其处理的功能可包括：包识别、事务排序、SOP、EOP、RESET和RESUME信号检测/生成、时钟/数据分离、不返回到零反转(NRZI)数据编码/解码和数位填充、CRC生成和校验(令牌和数据)、包ID(PID)生成和校验/解码、和/或串行并行/并行串行转换。310接收时钟输入314并且联接到暂停/恢复逻辑和帧定时器316电路以及集线器中继器电路318，以通过端口逻辑电路320、322、324控制上游USB收发器端口302和下游USB收发器端口304、306、308之间的通信。SIE 310经由接口逻辑联接到命令解码器326，以经由串行EEPROM接口330来控制来自串行EEPROM的命令。
在各种方面，USB网络集线器300可将配置在多达六个逻辑层(层级)中的127功能连接至单个计算机。此外，USB网络集线器300可使用提供通信和电力分配两者的标准化四线电缆连接到所有外装置。功率配置为总线供电模式和自供电模式。USB网络集线器300可被配置为支持四种功率管理模式：具有单独端口功率管理或成套端口功率管理的总线供电集线器，以及具有单独端口功率管理或成套端口功率管理的自供电集线器。在一个方面，使用USB电缆将USB网络集线器300、上游USB收发器端口302插入USB主机控制器中，并且将下游USB收发器端口304、306、308暴露以用于连接USB兼容装置等。
外科器械硬件
图12示出了根据本公开的一个或多个方面的外科器械或工具的控制系统470的逻辑图。系统470包括控制电路。该控制电路包括微控制器461，该微控制器包括处理器462和存储器468。例如，传感器472、474、476中的一个或多个向处理器462提供实时反馈。由马达驱动器492驱动的马达482能够操作地联接纵向可移动的位移构件以驱动I形梁刀元件。跟踪系统480被配置为确定纵向可移动的位移构件的位置。将位置信息提供给处理器462，该处理器可被编程或配置为确定纵向可移动的驱动构件的位置以及击发构件、击发杆和I形梁刀元件的位置。附加马达可设置在工具驱动器接口处，以控制I形梁击发、闭合管行进、轴旋转和关节运动。显示器473显示器械的多种操作条件并且可包括用于数据输入的触摸屏功能。显示在显示器473上的信息可叠加有经由内窥镜式成像模块获取的图像。
在一个方面，微处理器461可为任何单核或多核处理器，诸如已知的由德克萨斯器械公司生产的商品名为ARM Cortex的那些。在一个方面，微控制器461可为购自例如德克萨斯器械公司的LM4F230H5QR ARM Cortex-M4F处理器核心，其包括256KB的单循环闪存或其它非易失性存储器(最多至40MHZ)的片上存储器、用于改善40MHz以上的性能的预取缓冲器、32KB单循环SRAM、装载有
软件的内部ROM、2KB电EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入信道的一个或多个12位ADC，其细节可见于产品数据表。
在一个方面，微控制器461可包括安全控制器，该安全控制器包括两个基于控制器的系列(诸如TMS570和RM4x)，已知同样由德克萨斯器械公司生产的商品名为Hercules ARMCortex R4。安全控制器可被配置为专门用于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。
控制器461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，微控制器461包括处理器462和存储器468。电动马达482可为有刷直流(DC)马达，其具有齿轮箱以及至关节运动或刀系统的机械链路。在一个方面，马达驱动器492可为可购自Allegro微系统公司(Allegro Microsystems,Inc)的A3941。其它马达驱动器可容易地被替换以用于包括绝对定位系统的跟踪系统480中。绝对定位系统的详细描述在2017年10月19日公布的名称为“SYSTEMS AND METHODS FOR CONTROLLING A SURGICALSTAPLING AND CUTTING INSTRUMENT”的美国专利申请公布2017/0296213中有所描述，该专利申请全文以引用方式并入本文。
微控制器461可被编程为提供对位移构件和关节运动系统的速度和位置的精确控制。微控制器461可被配置为计算微控制器461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，这可检测对系统的外部影响。
在一个方面，马达482可由马达驱动器492控制并可被外科器械或工具的击发系统采用。在各种形式中，马达482可为具有大约25,000RPM的最大旋转速度的有刷DC驱动马达。在其他布置中，马达482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492可包括例如包括场效应晶体管(FET)的H桥驱动器。马达482可通过能够释放地安装到柄部组件或工具外壳的功率组件来供电，以用于向外科器械或工具供应控制功率。功率组件可包括电池，该电池可以包括串联连接的、可用作功率源以为外科器械或工具提供电力的多个电池单元。在某些情况下，功率组件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，电池单元可为锂离子电池，其可联接到功率组件并且可与功率组件分离。
驱动器492可为可购自Allegro微系统公司(Allegro Microsystems,Inc)的A3941。A3941 492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信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492包括独特的电荷泵调整器，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的减小的栅极驱动下操作。可采用自举电容器来提供N信道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。整体诊断提供欠压、过热和功率桥故障的指示，并且可被配置为在大多数短路条件下保护功率MOSFET。其它马达驱动器可容易地被替换以用于包括绝对定位系统的跟踪系统480中。
跟踪系统480包括根据本公开的一个方面的包括位置传感器472的受控马达驱动电路布置方式。用于绝对定位系统的位置传感器472提供对应于位移构件的位置的独特位置信号。在一个方面，位移构件表示纵向可移动的驱动构件，其包括用于与齿轮减速器组件的对应驱动齿轮啮合接合的驱动齿的齿条。在其它方面，位移构件表示击发构件，该击发构件可被适配和配置为包括驱动齿的齿条。在又一个方面，该位移构件表示击发杆或I形梁，该两者中的每一者可被适配和配置为包括驱动齿的齿条。因此，如本文所用，术语位移构件一般用来指外科器械或工具的任何可移动构件，诸如驱动构件、击发构件、击发杆、I形梁或可被移位的任何元件。在一个方面，纵向可移动的驱动构件联接到击发构件、击发杆和I形梁。因此，绝对定位系统实际上可通过跟踪纵向可移动的驱动构件的线性位移来跟踪I形梁的线性位移。在各种其它方面，位移构件可联接到适于测量线性位移的任何位置传感器472。因此，纵向可移动的驱动构件、击发构件、击发杆或I形梁或它们的组合可联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、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482可包括能够操作地与齿轮组件交接的可旋转轴，该齿轮组件与驱动齿的组或齿条啮合接合安装在位移构件上。传感器元件可以能够操作地联接到齿轮组件，使得位置传感器472元件的单次旋转对应于位移构件的一些线性纵向平移。传动装置和传感器的布置方式可经由齿条和小齿轮布置方式连接至线性致动器，或者经由直齿齿轮或其它连接连接至旋转致动器。功率源为绝对定位系统供电，并且输出指示器可显示绝对定位系统的输出。位移构件表示纵向可移动驱动构件，该纵向可移动驱动构件包括形成于其上的驱动齿的齿条，以用于与齿轮减速器组件的对应驱动齿轮啮合接合。位移构件表示纵向可移动的击发构件、击发杆、I形梁或它们的组合。
与位置传感器472相关联的传感器元件的单次旋转等同于位移构件的纵向线性位移d1，其中d1为在联接到位移构件的传感器元件的单次旋转之后位移构件从点“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方式，该齿轮减速使得位置传感器472针对位移构件的全行程仅完成一次或多次旋转。位置传感器472可针对位移构件的全行程完成多次旋转。
可单独或结合齿轮减速采用一系列开关(其中n为大于一的整数)以针对位置传感器472的多于一次旋转提供独特位置信号。开关的状态被馈送回微控制器461，该微控制器应用逻辑以确定对应于位移构件的纵向线性位移d1+d2+…dn的独特位置信号。位置传感器472的输出被提供给微控制器461。该传感器布置方式的位置传感器472可包括磁性传感器、模拟旋转传感器(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。
位置传感器472可包括任何数量的磁性感测元件，诸如例如根据它们是否测量磁场的总磁场或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查线圈、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性传感器等等。
在一个方面，用于包括绝对定位系统的跟踪系统480的位置传感器472包括磁性旋转绝对定位系统。位置传感器472可被实现为AS5055EQFT单片磁性旋转位置传感器，其可购自奥地利微系统公司(Austria Microsystems,AG)。位置传感器472与微控制器461交接，以提供绝对定位系统。位置传感器472为低电压和低功率器件，并且包括位于磁体上的位置传感器472的区域中的四个霍尔效应元件。在芯片上还提供了高分辨率ADC和智能功率管理控制器。提供了坐标旋转数字计算机(CORDIC)处理器(也被称为逐位法和Volder算法)以执行简单有效的算法来计算双曲线函数和三角函数，其仅需要加法、减法、数位位移和表格查找操作。角位置、报警位和磁场信息通过标准串行通信接口(诸如串行外围接口(SPI)接口)发射到微控制器461。位置传感器472提供12或14位分辨率。位置传感器472可为以小QFN16引脚4×4×0.85mm封装件提供的AS5055芯片。
包括绝对定位系统的跟踪系统480可包括并且/或者可被编程以实现反馈控制器，诸如PID、状态反馈和自适应控制器。功率源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。其它示例包括电压、电流和力的PWM。除了由位置传感器472所测量的位置之外，可提供(一个或多个)其它传感器来测量物理系统的物理参数。在一些方面，其它传感器可包括传感器布置，诸如在2016年5月24日发布的名称为“STAPLECARTRIDGE TISSUE THICKNESS”的美国专利9,345,481中所述的那些，该专利全文以引用方式并入本文；2014年9月18日公布的名称为“STAPLE CARTRIDGE TISSUE THICKNESS”的美国专利申请公布2014/0263552，该专利全文以引用方式并入本文；以及2017年6月20日提交的名称为“TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICALSTAPLING AND CUTTING INSTRUMENT”的美国专利申请序列号15/628,175，该专利申请全文以引用方式并入本文。在数字信号处理系统中，绝对定位系统联接到数字数据采集系统，其中绝对定位系统的输出将具有有限分辨率和采样频率。绝对定位系统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，该算法驱动计算响应朝向所测量的响应。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。
因此，绝对定位系统在器械上电时提供位移构件的绝对位置，并且不使位移构件回缩或推进至如常规旋转编码器可需要的复位(清零或本位)位置，这些编码器仅对马达482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、刀等等的位置。
传感器474(诸如，例如应变仪或微应变仪)被配置为测量端部执行器的一个或多个参数，诸如例如在夹持操作期间施加在砧座上的应变的幅值，该幅值可以指示施加到砧座的闭合力。将测得的应变转换成数字信号并提供给处理器462。另选地或除了传感器474之外，传感器476(诸如负载传感器)可以测量由闭合驱动系统施加到砧座的闭合力。传感器476诸如例如负载传感器可以测量在外科器械或工具的击发行程中施加到I形梁的击发力。I形梁被配置成能够接合楔形滑动件，该楔形滑动件被配置成能够使钉驱动器向上凸轮运动以将钉推出以与砧座变形接触。I形梁还包括锋利切割刃，当通过击发杆向远侧推进I形梁时，该切割刃可用于切断组织。另选地，可以采用电流传感器478来测量由马达482消耗的电流。推进击发构件所需的力可对应于例如由马达482消耗的电流。将测得的力转换成数字信号并提供给处理器462。
在一种形式中，应变仪传感器474可用于测量由端部执行器施加到组织的力。应变计可联接到端部执行器以测量被端部执行器处理的组织上的力。用于测量施加到由端部执行器抓握的组织的力的系统包括应变仪传感器474，诸如例如微应变仪，其被配置为测量例如端部执行器的一个或多个参数。在一个方面，应变仪传感器474可测量在夹持操作期间施加到端部执行器的钳口构件上的应变的振幅或量值，这可指示组织压缩。将测得的应变转换成数字信号并将其提供到微控制器461的处理器462。负载传感器476可测量用于操作刀元件例如以切割被捕获在砧座和钉仓之间的组织的力。可采用磁场传感器来测量捕集的组织的厚度。磁场传感器的测量值也可被转换成数字信号并提供给处理器462。
微控制器461可使用分别由传感器474、476测量的组织压缩、组织厚度和/或闭合端部执行器所需的力的测量来表征击发构件的所选择的位置和/或击发构件的速度的对应值。在一个实例中，存储器468可存储可由微控制器461在评估中所采用的技术、公式和/或查找表。
外科器械或工具的控制系统470还可包括有线或无线通信电路以与模块化通信集线器通信，如图8-11中所示。
图13示出了控制电路500，该控制电路500被配置为控制根据本公开的一个方面的外科器械或工具的各方面。控制电路500可被配置为实现本文所述的各种过程。电路500可以包括微控制器，该微控制器包括联接到至少一个存储器电路504的一个或多个处理器502(例如，微处理器、微控制器)。存储器电路504存储在由处理器502执行时使处理器502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502可为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504可以包括易失性存储介质和非易失性存储介质。处理器502可以包括指令处理单元506和运算单元508。指令处理单元可以被配置为从本公开的存储器电路504接收指令。
图14示出了组合逻辑电路510，该组合逻辑电路510被配置为控制根据本公开的一个方面的外科器械或工具的各方面。组合逻辑电路510可被配置为实现本文所述的各种过程。组合逻辑电路510可包括有限状态机，该有限状态机包括组合逻辑512，该组合逻辑512被配置为在输入514处接收与外科器械或工具相关联的数据，通过组合逻辑512处理数据并提供输出516。
图15示出了根据本公开的一个方面的被配置为控制外科器械或工具的各个方面的时序逻辑电路520。时序逻辑电路520或组合逻辑522可被配置为实现本文所述的各种过程。时序逻辑电路520可包括有限状态机。时序逻辑电路520可包括例如组合逻辑522、至少一个存储器电路524和时钟529。至少一个存储器电路524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520可以是同步的或异步的。组合逻辑522被配置为从输入526接收与外科器械或工具相关联的数据，通过组合逻辑522处理数据并提供输出528。在其它方面，电路可包括处理器(例如，处理器502，图13)和有限状态机的组合以实现本文的各种过程。在其它实施方案中，有限状态机可以包括组合逻辑电路(例如，组合逻辑电路510，图14)和时序逻辑电路520的组合。
图16示出了包括可被激活以执行各种功能的多个马达的外科器械或工具。在某些情况下，第一马达可被激活以执行第一功能，第二马达可被激活以执行第二功能，并且第三马达可被激活以执行第三功能。在某些情况下，机器人外科器械600的多个马达可被单独地激活以导致端部执行器中的击发运动、闭合运动、和/或关节运动。击发运动、闭合运动、和/或关节运动可例如通过轴组件发射到端部执行器。
在某些情况下，外科器械系统或工具可包括击发马达602。击发马达602能够操作地联接到击发马达驱动组件604，该击发马达驱动组件可被配置为将由马达602生成的击发运动传输到端部执行器，具体地用于使I形梁元件移位。在某些情况下，由马达602产生的击发运动可导致例如钉从钉仓部署到由端部执行器捕获的组织内并且/或者导致I形梁元件的切割刃被推进以切割所捕获组织。I形梁元件可通过反转马达602的方向而回缩。
在某些情况下，外科器械或工具可包括闭合马达603。闭合马达603可以能够操作地联接到闭合马达驱动组件605，该闭合马达驱动组件605被配置为将由马达603生成的闭合运动传递到端部执行器，具体地用于移置闭合管以闭合砧座并且压缩砧座和钉仓之间的组织。闭合运动可使例如端部执行器从打开配置转变成接近配置以捕获组织。端部执行器可通过反转马达603的方向而转变到打开位置。
在某些情况下，外科器械或工具可包括例如一个或多个关节运动马达606a、606b。马达606a、606b可以能够操作地联接到相应的关节运动马达驱动组件608a、608b，该关节运动马达驱动组件可被配置为将由马达606a、606b生成的关节运动传递到端部执行器。在某些情况下，关节运动可使端部执行器相对于轴进行关节运动，例如。
如上所述，外科器械或工具可包括多个马达，该多个马达可被配置为执行各种独立功能。在某些情况下，外科器械或工具的多个马达可被单独地或独立地激活以执行一个或多个功能，而其它马达保持非活动的。例如，关节运动马达606a、606b可被激活以使端部执行器进行关节运动，而击发马达602保持非活动的。另选地，击发马达602可被激活以击发多个钉并且/或者推进切割边缘，而关节运动马达606保持非活动的。此外，闭合马达603可与击发马达602同时启动，以使闭合管和I形梁元件朝远侧推进，如下文更详细地描述。
在某些情况下，外科器械或工具可包括公共控制模块610，该公共控制模块610可与外科器械或工具的多个马达一起使用。在某些情况下，公共控制模块610每次可调节多个马达中的一个马达。例如，公共控制模块610可单独地联接到外科器械的多个马达并且可从外科器械的多个马达分离。在某些情况下，外科器械或工具的多个马达可共用一个或多个公共控制模块诸如公共控制模块610。在某些情况下，外科器械或工具的多个马达可独立地和选择性地接合公共控制模块610。在某些情况下，公共控制模块610可从与外科器械或工具的多个马达中的一个交接切换到与外科器械或工具的多个马达中的另一个交接。
在至少一个示例中，公共控制模块610可在能够操作地接合关节运动马达606a、606b与能够操作地接合击发马达602或闭合马达603之间选择性地切换。在至少一个示例中，如图16中所示，开关614可在多个位置和/或状态之间移动或转变。在第一位置616中，开关614可以将公共控制模块610电联接到击发马达602；在第二位置617中，开关614可以将公共控制模块610电联接到闭合马达603；在第三位置618a中，开关614可以将公共控制模块610电联接到第一关节运动马达606a；并且在第四位置618b中，开关614可以将公共控制模块610电联接到例如第二关节运动马达606b。在某些情况下，单独的公共控制模块610可同时电联接到击发马达602、闭合马达603和关节运动马达606a、606b。在某些情况下，开关614可为机械开关、机电开关、固态开关、或任何合适的开关机构。
马达602、603、606a、606b中的每个可包括扭矩传感器以测量马达的轴上的输出扭矩。可以任何常规方式感测端部执行器上的力，诸如通过钳口的外侧上的力传感器或通过用于致动钳口的马达的扭矩传感器来感测端部执行器上的力。
在各种情况下，如图16中所示，公共控制模块610可包括马达驱动器626，该马达驱动器626可包括一个或多个H桥场效应FET。马达驱动器626可例如基于得自微控制器620(“控制器”)的输入来调节从功率源628发射到联接到公共控制模块610的马达的电力。在某些情况下，当马达联接到公共控制模块610时，可例如采用微控制器620来确定由马达消耗的电流，如上所述。
在某些情况下，微控制器620可包括微处理器622(“处理器”)和一个或多个非暂态计算机可读介质或存储单元624(“存储器”)。在某些情况下，存储器624可存储各种程序指令，该各种程序指令在被执行时可使处理器622执行本文所述的多个功能和/或计算。在某些情况下，存储器单元624中的一个或多个存储器单元可例如联接到处理器622。
在某些情况下，功率源628可例如用于为微控制器620供电。在某些情况下，功率源628可包括电池(或者“电池组”或“功率组”)，诸如锂离子电池，例如。在某些情况下，电池组可被配置为能够释放地安装到柄部以用于给外科器械600供电。可将多个串联连接的电池单元用作电源628。在某些情况下，电源628可为例如可替换的和/或可再充电的。
在各种情况下，处理器622可控制马达驱动器626以控制联接到公共控制器610的马达的位置、旋转方向、和/或速度。在某些情况下，处理器622可发信号通知马达驱动器626，以停止和/或停用联接到公共控制器610的马达。应当理解，如本文所用的术语“处理器”包括任何合适的微处理器、微控制器、或将计算机的中央处理单元(CPU)的功能结合在一个集成电路或至多几个集成电路上的其它基础计算装置。处理器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。处理器的操作对象是以二进制数字系统表示的数字和符号。
在一个实例中，处理器622可为任何单核或多核处理器，诸如已知的由德克萨斯器械公司生产的商品名为ARM Cortex的那些。在某些情况下，微控制器620可为例如可购自德州仪器公司的LM 4F230H5QR。在至少一个示例中，德克萨斯器械公司的LM4F230H5QR为ARMCortex-M4F处理器芯，其包括：256KB的单循环闪存或其它非易失性存储器(最多至40MHZ)的片上存储器、用于改善40MHz以上的性能的预取缓冲器、32KB的单循环SRAM、装载有
软件的内部ROM、2KB的EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入信道的一个或多个12位ADC、以及易得的其它特征。可容易地换用其它微控制器，以与模块4410一起使用。因此，本公开不应限于这一上下文。
在某些情况下，存储器624可包括用于控制可联接到公共控制器610的外科器械600的马达中的每个的程序指令。例如，存储器624可包括用于控制击发马达602、闭合马达603和关节运动马达606a、606b的程序指令。此类程序指令可使得处理器622根据来自外科器械或工具的算法或控制程序的输入来控制击发、闭合和关节运动功能。
在某些情况下，一个或多个机构和/或传感器(诸如传感器630)可用于警示处理器622应当在特定设定中使用的程序指令。例如，传感器630可警示处理器622使用与击发、闭合和关节运动端部执行器相关联的程序指令。在某些情况下，传感器630可包括例如可用于感测开关614的位置的位置传感器。因此，处理器622可以在例如通过传感器630检测到开关614处于第一位置616时使用与击发端部执行器的I形梁相关联的程序指令；处理器622可以在例如通过传感器630检测到开关614处于第二位置617时使用与闭合砧座相关联的程序指令；并且处理器622可以在例如通过传感器630检测到开关614处于第三位置618a或第四位置618b时使用与使端部执行器进行关节运动相关联的程序指令。
图17是根据本公开的一个方面的被配置为操作本文所述的外科工具的机器人外科器械700的示意图。机器人外科器械700可被编程或配置为控制位移构件的远侧/近侧平移、闭合管的远侧/近侧位移、轴旋转、以及具有单个或多个关节运动驱动连杆的关节运动。在一个方面，外科器械700可被编程或配置为单独地控制击发构件、闭合构件、轴构件、和/或一个或多个关节运动构件。外科器械700包括控制电路710，该控制电路被配置为控制马达驱动的击发构件、闭合构件、轴构件、和/或一个或多个关节运动构件。
在一个方面，机器人外科器械700包括：控制电路710，该控制电路被配置为经由多个马达704a-704e来控制端部执行器702的砧座716和I形梁714(包括锋利切割刃)部分；可移除钉仓718；轴740；以及一个或多个关节运动构件742a、742b。位置传感器734可被配置为向控制电路710提供I形梁714的位置反馈。其他传感器738可被配置为向控制电路710提供反馈。定时器/计数器731向控制电路710提供定时和计数信息。可提供能量源712以操作马达704a-704e，并且电流传感器736向控制电路710提供马达电流反馈。马达704a-704e可通过控制电路710在开环或闭环反馈控制中单独操作。
在一个方面，控制电路710可包括用于执行使得一个或多个处理器执行一个或多个任务的指令的一个或多个微控制器、微处理器或其它合适的处理器。在一个方面，定时器/计数器电路731向控制电路710提供输出信号，诸如耗用的时间或数字计数，以将如由位置传感器734确定的I形梁714的位置与定时器/计数器731的输出相关联，使得控制电路710可确定I形梁714在相对于起始位置的特定时间(t)或I形梁714处于相对于起始位置的特定位置时的时间(t)处的位置。定时器/计数器731可被配置为测量所耗用的时间、计数外部事件或时间外部事件。
在一个方面，控制电路710可被编程为基于一个或多个组织条件来控制端部执行器702的功能。控制电路710可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710可被编程为基于组织条件选择击发控制程序或闭合控制程序。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710可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710可被编程为以较高的速度和/或以较高的功率平移位移构件。闭合控制程序可控制由砧座716施加到组织的闭合力。其它控制程序控制轴740和关节运动构件742a、742b的旋转。
在一个方面，控制电路710可生成马达设定点信号。马达设定点信号可以被提供给各种马达控制器708a-708e。马达控制器708a-708e可以包括一个或多个电路，这些电路被配置为向马达704a-704e提供马达驱动信号，以驱动马达704a-704e，如本文所述。在一些示例中，马达704a-704e可为有刷DC电动马达。例如，马达704a-704e的速度可与相应的马达驱动信号成比例。在一些示例中，马达704a-704e可为无刷DC马达，并且相应的马达驱动信号可包括提供给马达704a-704e的一个或多个定子绕组的PWM信号。而且，在一些示例中，可以省略马达控制器708a-708e，并且控制电路710可以直接生成马达驱动信号。
在一些示例中，控制电路710可以针对位移构件的行程的第一开环部分初始以开环配置操作马达704a-704e中的每个。基于在行程的开环部分期间机器人外科器械700的响应，控制电路710可以选择处于闭环配置的击发控制程序。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、在开环部分期间耗用的时间、在开环部分期间提供给马达704a-704e中的一者的能量、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710可以对位移构件行程的第二部分实现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710可以基于以闭环方式描述位移构件的位置的平移数据来调制马达704a-704e中的一者，以使位移构件以恒定速度平移。
在一个方面，马达704a-704e可从能量源712接收电力。能量源712可为由主交流电源、电池、超级电容器或任何其他合适的能量源驱动的直流电源。马达704a-704e可经由相应的传动装置706a-706e机械地联接到单独的可移动机械元件，诸如I形梁714、砧座716、轴740、关节运动742a和关节运动742b。传动装置706a-706e可以包括一个或多个齿轮或其它连杆器件，以将马达704a-704e联接到可移动机械元件。位置传感器734可感测I形梁714的位置。位置传感器734可为或包括能够生成指示I形梁714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734可包括编码器，该编码器被配置为在I形梁714朝远侧和朝近侧平移时向控制电路710提供一系列脉冲。控制电路710可跟踪脉冲以确定I形梁714的位置。可使用其它合适的位置传感器，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714的运动的其他信号。而且，在一些示例中，可省略位置传感器734。在马达704a-704e中的任一个是步进马达的情况下，控制电路710可通过聚合马达704已被指示执行的步骤的数量和方向来跟踪I形梁714的位置。位置传感器734可位于端部执行器702中或器械的任何其他部分处。马达704a-704e中的每个的输出包括用于感测力的扭矩传感器744a-744e，并且具有用于感测驱动轴的旋转的编码器。
在一个方面，控制电路710被配置为驱动击发构件诸如端部执行器702的I形梁714部分。控制电路710向马达控件708a提供马达设定点，该马达控件向马达704a提供驱动信号。马达704a的输出轴联接到扭矩传感器744a。扭矩传感器744a联接到与I形梁714联接的传动装置706a。传动装置706a包括可移动的机械元件诸如旋转元件和击发构件，以控制I形梁714沿端部执行器702的纵向轴线朝远侧和朝近侧的移动。在一个方面，马达704a可联接到刀齿轮组件，该刀齿轮组件包括刀齿轮减速组，该刀齿轮减速组包括第一刀驱动齿轮和第二刀驱动齿轮。扭矩传感器744a向控制电路710提供击发力反馈信号。击发力信号表示击发或移位I形梁714所需的力。位置传感器734可被配置为将I形梁714沿击发行程的位置或击发构件的位置作为反馈信号提供给控制电路710。端部执行器702可包括被配置为向控制电路710提供反馈信号的附加传感器738。当准备好使用时，控制电路710可向马达控件708a提供击发信号。响应于击发信号，马达704a可沿端部执行器702的纵向轴线将击发构件从近侧行程开始位置朝远侧驱动至行程开始位置远侧的行程结束位置。在击发构件朝远侧平移时，具有定位在远侧端部处的切割元件的I形梁714朝远侧推进以切割位于钉仓718和砧座716之间的组织。
在一个方面，控制电路710被配置为驱动闭合构件，诸如端部执行器702的砧座716部分。控制电路710向马达控件708b提供马达设定点，该马达控件708b向马达704b提供驱动信号。马达704b的输出轴联接到扭矩传感器744b。扭矩传感器744b联接到与砧座716联接的传动装置706b。传动装置706b包括可移动机械元件诸如旋转元件和闭合构件，以控制砧座716从打开位置和闭合位置的移动。在一个方面，马达704b联接到闭合齿轮组件，该闭合齿轮组件包括被支撑成与闭合正齿轮啮合接合的闭合减速齿轮组。扭矩传感器744b向控制电路710提供闭合力反馈信号。闭合力反馈信号表示施加到砧座716的闭合力。位置传感器734可被配置为将闭合构件的位置作为反馈信号提供给控制电路710。端部执行器702中的附加传感器738可向控制电路710提供闭合力反馈信号。可枢转砧座716被定位成与钉仓718相对。当准备好使用时，控制电路710可向马达控件708b提供闭合信号。响应于闭合信号，马达704b推进闭合构件以握持砧座716和钉仓718之间的组织。
在一个方面，控制电路710被配置为使轴构件诸如轴740旋转，以使端部执行器702旋转。控制电路710向马达控件708c提供马达设定点，该马达控件708c向马达704c提供驱动信号。马达704c的输出轴联接到扭矩传感器744c。扭矩传感器744c联接到传动装置706c，该传动装置联接到轴740。传动装置706c包括可移动机械元件诸如旋转元件，以控制轴740顺时针或逆时针旋转360°以上。在一个方面，马达704c联接到旋转传动装置组件，该旋转传动装置组件包括管齿轮区段，该管齿轮区段形成于(或附接到)近侧闭合管的近侧端部上，以通过能够操作地支撑在工具安装板上的旋转齿轮组件能够操作地接合。扭矩传感器744c向控制电路710提供旋转力反馈信号。旋转力反馈信号表示施加到轴740上的旋转力。位置传感器734可被配置为将闭合构件的位置作为反馈信号提供给控制电路710。附加传感器738诸如轴编码器可向控制电路710提供轴740的旋转位置。
在一个方面，控制电路710被配置为使端部执行器702进行关节运动。控制电路710向马达控件708d提供马达设定点，该马达控件708d向马达704d提供驱动信号。马达704d的输出联接到扭矩传感器744d。扭矩传感器744d联接到传动装置706d，该传动装置联接到关节运动构件742a。传动装置706d包括可移动的机械元件诸如关节运动元件，以控制端部执行器702±65°的关节运动。在一个方面，马达704d联接到关节运动螺母，该关节运动螺母可旋转地轴颈连接在远侧脊部的近侧端部部分上并且通过关节运动齿轮组件在其上可旋转地驱动。扭矩传感器744d向控制电路710提供关节运动力反馈信号。关节运动力反馈信号表示施加到端部执行器702的关节运动力。传感器738(诸如关节运动编码器)可向控制电路710提供端部执行器702的关节运动位置。
在另一方面，机器人外科系统700的关节运动功能可包括两个关节运动构件或连杆742a、742b。这些关节运动构件742a、742b由位于机器人接口(齿条)上的被两个马达708d、708e驱动的单独的盘驱动。当提供单独的击发马达704a时，关节运动连杆742a、742b中的每个可相对于另一个连杆进行拮抗驱动，以便在头部未运动时向头部提供阻力保持运动和负载，并且在头部进行关节运动时提供关节运动。当头部旋转时，关节运动构件742a、742b以固定的半径附接到头部。因此，当头部旋转时，推拉连杆的机械优点发生变化。机械优点的该变化对于其它关节运动连杆驱动系统可更明显。
在一个方面，一个或多个马达704a-704e可包括具有齿轮箱的有刷DC马达和与击发构件、闭合构件或关节运动构件的机械链路。另一个示例包括操作可移动机械元件诸如位移构件、关节运动连杆、闭合管和轴的电动马达704a-704e。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。此类外部影响可被称为曳力，其相对电动马达704a-704e中的一个作用。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。
在一个方面，位置传感器734可被实现为绝对定位系统。在一个方面，位置传感器734可包括磁性旋转绝对定位系统，该磁性旋转绝对定位系统被实现为AS5055EQFT单片磁性旋转位置传感器，其可购自奥地利微系统公司(Austria Microsystems,AG)。位置传感器734可与控制电路710交接，以提供绝对定位系统。位置可包括位于磁体上方并联接到CORDIC处理器的霍尔效应元件，该CORDIC处理器也被已知为逐位方法和Volder算法，提供该CORDIC处理器以实现用于计算双曲线函数和三角函数的简单有效的算法，双曲线函数和三角函数仅需要加法操作、减法操作、数位位移操作和表格查找操作。
在一个方面，控制电路710可与一个或多个传感器738通信。传感器738可定位在端部执行器702上并且适于与机器人外科器械700一起操作以测量各种衍生参数，诸如间隙距离对时间、组织压缩与时间、以及砧座应变与时间。传感器738可包括磁性传感器、磁场传感器、应变仪、负载传感器、压力传感器、力传感器、扭矩传感器、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702的一个或多个参数的任何其他合适的传感器。传感器738可包括一个或多个传感器。传感器738可位于钉仓718平台上，以使用分段电极来确定组织位置。扭矩传感器744a-744e可被配置为感测力诸如击发力、闭合力和/或关节运动力等。因此，控制电路710可感测(1)远侧闭合管所经受的闭合负载及其位置，(2)在齿条处的击发构件及其位置，(3)超声刀718在其上具有组织的部分，以及(4)两个关节运动杆上的负载和位置。
在一个方面，一个或多个传感器738可包括应变仪诸如微应变仪，该应变仪被配置为在夹持条件期间测量砧座716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738可包括压力传感器，该压力传感器被配置为检测由砧座716和钉仓718之间的压缩组织的存在所生成的压力。传感器738可被配置为检测位于砧座716与钉仓718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。
在一个方面，传感器738可实现为一个或多个限位开关、机电装置、固态开关、霍尔效应装置、磁阻(MR)装置、巨磁电阻(GMR)装置、磁力计等等。在其它具体实施中，传感器738可被实现为在光的影响下操作的固态开关，诸如光学传感器、IR传感器、紫外线传感器等等。同样，开关可为固态装置，诸如晶体管(例如，FET、结型FET、MOSFET、双极型晶体管等)。在其它具体实施中，传感器738可包括无电导体开关、超声开关、加速度计和惯性传感器等等。
在一个方面，传感器738可被配置为测量由闭合驱动系统施加在砧座716上的力。例如，一个或多个传感器738可位于闭合管和砧座716之间的交互点处，以检测由闭合管施加到砧座716的闭合力。施加在砧座716上的力可表示在砧座716和钉仓718之间捕获到的组织区段所经受的组织压缩。一个或多个传感器738可沿闭合驱动系统定位在各种交互点处，以检测由闭合驱动系统施加到砧座716的闭合力。一个或多个传感器738可在夹持操作期间由控制电路710的处理器实时取样。控制电路710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716的闭合力。
在一个方面，电流传感器736可用于测量由马达704a-704e中的每个所消耗的电流。推进可移动的机械元件(诸如I形梁714)中的任一者所需的力对应于由马达704a-704e中的一个马达所消耗的电流。将该力转换成数字信号并将其提供给处理电路710。控制电路710可被配置为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702中的I形梁714以目标速度或接近目标速度移动。机器人外科系统700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者，包括但不限于例如PID、状态反馈、线性平方(LQR)和/或自适应控制器。机器人外科器械700可包括功率源，以例如将来自反馈控制器的信号转换成物理输入，诸如外壳电压、PWM电压、频率调制电压、电流、扭矩和/或力。附加细节公开于2017年6月29日提交的名称为“CLOSED LOOP VELOCITY CONTROLTECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT”的美国专利申请序列号15/636,829中，该专利全文以引用方式并入本文。
图18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750的框图。在一个方面，外科器械750被编程为控制位移构件诸如I形梁764的远侧平移。外科器械750包括端部执行器752，该端部执行器可包括砧座766、I形梁764(包括锋利切割刃)和可移除钉仓768。
线性位移构件诸如I形梁764的位置、移动、位移和/或平移可通过绝对定位系统、传感器布置和位置传感器784来测量。由于I形梁764联接到纵向可移动的驱动构件，因此I形梁764的位置可通过采用位置传感器784测量纵向可移动的驱动构件的位置来确定。因此，在以下描述中，I形梁764的位置、位移和/或平移可通过如本文所述的位置传感器784来实现。控制电路760可被编程为控制位移构件诸如I形梁764的平移。在一些示例中，控制电路760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764)的指令。在一个方面，定时器/计数器781向控制电路760提供输出信号，诸如耗用的时间或数字计数，以将如由位置传感器784确定的I形梁764的位置与定时器/计数器781的输出相关联，使得控制电路760可确定I形梁764在相对于起始位置的特定时间(t)处的位置。定时器/计数器781可被配置为测量耗用的时间、对外部事件计数或对外部事件定时。
控制电路760可生成马达设定点信号772。马达设定点信号772可被提供给马达控制器758。马达控制器758可包括一个或多个电路，该一个或多个电路被配置为向马达754提供马达驱动信号774以驱动马达754，如本文所述。在一些示例中，马达754可为有刷DC电动马达。例如，马达754的速度可与马达驱动信号774的电压成比例。在一些示例中，马达754可为无刷DC电动马达，并且马达驱动信号774可以包括提供给马达754的一个或多个定子绕组的PWM信号。而且，在一些示例中，可以省略马达控制器758，并且控制电路760可以直接生成马达驱动信号774。
马达754可从能量源762处接收功率。能量源762可以是或包括电池、超级电容器或任何其它合适的能量源。马达754可经由传动装置756机械地联接到I形梁764。传动装置756可包括一个或多个齿轮或其他连杆部件，以将马达754联接到I形梁764。位置传感器784可感测I形梁764的位置。位置传感器784可为或包括能够生成指示I形梁764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784可包括编码器，该编码器被配置为在I形梁764朝远侧和朝近侧平移时向控制电路760提供一系列脉冲。控制电路760可跟踪这些脉冲以确定I形梁764的位置。可使用其它合适的位置传感器，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764的运动的其他信号。而且，在一些示例中，可省略位置传感器784。在马达754是步进马达的情况下，控制电路760可通过聚合马达754已被指示执行的步骤的数量和方向来跟踪I形梁764的位置。位置传感器784可位于端部执行器752中或器械的任何其他部分处。
控制电路760可与一个或多个传感器788通信。传感器788可定位在端部执行器752上并且适于与外科器械750一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788可包括磁性传感器、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752的一个或多个参数的任何其他合适的传感器。传感器788可包括一个或多个传感器。
一个或多个传感器788可包括应变仪诸如微应变仪，该应变仪被配置为在夹持条件期间测量砧座766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788可包括压力传感器，该压力传感器被配置为检测由砧座766和钉仓768之间的压缩组织的存在所生成的压力。传感器788可被配置为检测位于砧座766与钉仓768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788可被配置为测量由闭合驱动系统施加在砧座766上的力。例如，一个或多个传感器788可位于闭合管和砧座766之间的交互点处，以检测由闭合管施加到砧座766的闭合力。施加在砧座766上的力可表示在砧座766和钉仓768之间捕获的组织区段所经受的组织压缩。一个或多个传感器788可沿闭合驱动系统定位在各种交互点处，以检测由闭合驱动系统施加到砧座766的闭合力。一个或多个传感器788可在夹持操作期间由控制电路760的处理器实时取样。控制电路760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766的闭合力。
可以采用电流传感器786来测量由马达754消耗的电流。推进I形梁764所需的力对应于由马达754消耗的电流。将该力转换成数字信号并将其提供给控制电路760。
控制电路760可被配置为在控制器的软件中模拟器械的实际系统的响应。可致动位移构件以将端部执行器752中的I形梁764以目标速度或接近目标速度移动。外科器械750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者，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750可包括功率源，以例如将来自反馈控制器的信号转换为物理输入，诸如外壳电压、PWM电压、频率调制电压、电流、扭矩和/或力。
外科器械750的实际驱动系统被配置为通过具有齿轮箱和与关节运动和/或刀系统的机械连接件的有刷直流马达来驱动位移构件、切割构件或I形梁764。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754。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。此类外部影响可被称为相对电动马达754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。
各种示例性方面涉及外科器械750，该外科器械包括具有马达驱动的外科密封和切割工具的端部执行器752。例如，马达754可沿端部执行器752的纵向轴线朝远侧和朝近侧驱动位移构件。端部执行器752可包括可枢转砧座766，并且当被配置为用于使用时，钉仓768被定位成与砧座766相对。临床医生可握持砧座766与钉仓768之间的组织，如本文所述。当准备好使用器械750时，临床医生可例如通过按下器械750的触发器来提供击发信号。响应于该击发信号，马达754可沿端部执行器752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位于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764可切割钉仓768与砧座766之间的组织。
在各种示例中，外科器械750可包括控制电路760，该控制电路被编程用于基于一个或多个组织条件控制位移构件(诸如I形梁764)的远侧平移。控制电路760可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760可被编程为基于组织条件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760可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760可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760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754。基于在行程的开环部分期间器械750的响应，控制电路760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、在开环部分期间耗用的时间、在开环部分期间提供给马达754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760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760可基于描述位移构件的位置的平移数据以闭环方式来调节马达754，以使位移构件以恒定速度平移。附加细节公开于2017年9月29日提交的名称为“SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT”的美国专利申请序列号15/720,852中，该专利申请全文以引用方式并入本文。
图19是根据本公开的一个方面的被配置为控制各种功能的外科器械790的示意图。在一个方面，外科器械790被编程为控制位移构件诸如I形梁764的远侧平移。外科器械790包括端部执行器792，该端部执行器可以包括砧座766、I形梁764和可移除钉仓768，该可移除钉仓可以与RF仓796(以虚线示出)互换。
在一个方面，传感器788可被实现为限位开关、机电装置、固态开关、霍尔效应装置、MR装置、GMR装置、磁力计等等。在其它具体实施中，传感器638可被实现为在光的影响下操作的固态开关，诸如光学传感器、IR传感器、紫外线传感器等等。同样，开关可为固态装置，诸如晶体管(例如，FET、结型FET、MOSFET、双极型晶体管等)。在其他具体实施中，传感器788可包括无电导体开关、超声开关、加速度计和惯性传感器等等。
在一个方面，位置传感器784可被实现为绝对定位系统，该绝对定位系统包括被实现为AS5055EQFT单片磁性旋转位置传感器，其可购自奥地利微系统公司(AustriaMicrosystems,AG)。位置传感器784与控制电路760交接，以提供绝对定位系统。位置可包括位于磁体上方并联接到CORDIC处理器的霍尔效应元件，该CORDIC处理器也被已知为逐位方法和Volder算法，提供该CORDIC处理器以实现用于计算双曲线函数和三角函数的简单有效的算法，双曲线函数和三角函数仅需要加法操作、减法操作、数位位移操作和表格查找操作。
在一个方面，I形梁764可被实现为包括刀主体的刀构件，该刀主体将组织切割刀片能够操作地支撑在其上，并且该I形梁还可包括砧座接合插片或特征部以及通道接合特征部或脚部。在一个方面，钉仓768可被实现为标准(机械)外科紧固件仓。在一个方面，RF仓796可被实现为RF仓。这些和其他传感器布置在共同拥有的2017年6月20日提交的名称为“TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING ANDCUTTING INSTRUMENT”的美国专利申请序列号15/628,175中有所描述，该专利申请全文以引用方式并入本文。
线性位移构件诸如I形梁764的位置、移动、位移和/或平移可通过绝对定位系统、传感器布置和表示为位置传感器784的位置传感器来测量。由于I形梁764联接到纵向可移动的驱动构件，因此I形梁764的位置可通过采用位置传感器784测量纵向可移动的驱动构件的位置来确定。因此，在以下描述中，I形梁764的位置、位移和/或平移可通过如本文所述的位置传感器784来实现。控制电路760可被编程为控制位移构件诸如I形梁764的平移，如本文所述。在一些示例中，控制电路760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764)的指令。在一个方面，定时器/计数器781向控制电路760提供输出信号，诸如耗用的时间或数字计数，以将如由位置传感器784确定的I形梁764的位置与定时器/计数器781的输出相关联，使得控制电路760可确定I形梁764在相对于起始位置的特定时间(t)处的位置。定时器/计数器781可被配置为测量耗用的时间、对外部事件计数或对外部事件定时。
控制电路760可生成马达设定点信号772。马达设定点信号772可被提供给马达控制器758。马达控制器758可包括一个或多个电路，该一个或多个电路被配置为向马达754提供马达驱动信号774以驱动马达754，如本文所述。在一些示例中，马达754可为有刷DC电动马达。例如，马达754的速度可与马达驱动信号774的电压成比例。在一些示例中，马达754可为无刷DC电动马达，并且马达驱动信号774可以包括提供给马达754的一个或多个定子绕组的PWM信号。而且，在一些示例中，可以省略马达控制器758，并且控制电路760可以直接生成马达驱动信号774。
马达754可从能量源762处接收功率。能量源762可以是或包括电池、超级电容器或任何其它合适的能量源。马达754可经由传动装置756机械地联接到I形梁764。传动装置756可包括一个或多个齿轮或其他连杆部件，以将马达754联接到I形梁764。位置传感器784可感测I形梁764的位置。位置传感器784可为或包括能够生成指示I形梁764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784可包括编码器，该编码器被配置为在I形梁764朝远侧和朝近侧平移时向控制电路760提供一系列脉冲。控制电路760可跟踪这些脉冲以确定I形梁764的位置。可使用其它合适的位置传感器，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764的运动的其他信号。而且，在一些示例中，可省略位置传感器784。在马达754是步进马达的情况下，控制电路760可通过聚合该马达已被指示执行的步骤的数量和方向来跟踪I形梁764的位置。位置传感器784可位于端部执行器792中或器械的任何其他部分处。
控制电路760可与一个或多个传感器788通信。传感器788可定位在端部执行器792上并且适于与外科器械790一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788可包括磁性传感器、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792的一个或多个参数的任何其他合适的传感器。传感器788可包括一个或多个传感器。
一个或多个传感器788可包括应变仪诸如微应变仪，该应变仪被配置为在夹持条件期间测量砧座766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788可包括压力传感器，该压力传感器被配置为检测由砧座766和钉仓768之间的压缩组织的存在所生成的压力。传感器788可被配置为检测位于砧座766与钉仓768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788可被配置为测量由闭合驱动系统施加在砧座766上的力。例如，一个或多个传感器788可位于闭合管和砧座766之间的交互点处，以检测由闭合管施加到砧座766的闭合力。施加在砧座766上的力可表示在砧座766和钉仓768之间捕获的组织区段所经受的组织压缩。一个或多个传感器788可沿闭合驱动系统定位在各种交互点处，以检测由闭合驱动系统施加到砧座766的闭合力。一个或多个传感器788可在夹持操作期间由控制电路760的处理器部分实时取样。控制电路760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766的闭合力。
可以采用电流传感器786来测量由马达754消耗的电流。推进I形梁764所需的力对应于由马达754消耗的电流。将该力转换成数字信号并将其提供给控制电路760。
当RF仓796代替钉仓768被装载在端部执行器792中时，RF能量源794联接到端部执行器792并且被施加到RF仓796。控制电路760控制RF能量到RF仓796的递送。
附加细节公开于2017年6月28日提交的美国专利申请序列号15/636,096，其名称为“SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCYCARTRIDGE,AND METHOD OF USING SAME”，该专利全文以引用方式并入本文。
发生器硬件
图20为被配置为除了其他有益效果之外还提供无电感器调谐的发生器800的简化框图。发生器800的附加细节在公布于2015年6月23日的名称为“SURGICAL GENERATOR FORULTRASONIC AND ELECTROSURGICAL DEVICES”的美国专利序列号9,060,775中有所描述，该专利全文以引用方式并入本文。发生器800可包括患者隔离台802，该患者隔离台经由功率变压器806与非隔离台804通信。功率变压器806的次级绕组808包含在隔离台802中，并且可包括分接配置(例如，中心分接或非中心分接配置)以限定驱动信号输出810a、810b、810c，以用于将驱动信号递送至不同的外科器械，诸如超声外科器械、RF电外科器械和包括能够单独递送或同时递送的超声能量模式和RF能量模式的多功能外科器械。具体地，驱动信号输出810a、810c可将超声驱动信号(例如，420V均方根(RMS)驱动信号)输出至超声外科器械，且驱动信号输出810b、810c可将RF电外科驱动信号(例如，100V RMS驱动信号)输出至电外科器械，其中驱动信号输出810b对应于功率变压器806的中心抽头。
在某些形式中，超声驱动信号和电外科驱动信号可同时提供至不同的外科器械和/或具有将超声能和电外科能两者递送至组织的能力的单个外科器械，诸如多功能外科器械。应当理解，提供至专用电外科器械和/或提供至组合多功能超声/电外科器械的电外科信号可以是治疗电平信号或亚治疗电平信号，其中可以使用亚治疗信号来例如监测组织或器械状况并向发生器提供反馈。例如，超声信号和RF信号可从具有单个输出端口的发生器分别或同时递送，以便向外科器械提供期望的输出信号，如将在下文更详细地讨论。因此，发生器可组合超声能量和电外科RF能量并且将组合的能量递送到多功能超声/电外科器械。双极电极可被放置在端部执行器的一个或两个钳口上。除了电外科RF能量之外，一个钳口可由超声能量同时驱动。超声能量可用于解剖组织，而电外科RF能量可用于脉管密封。
非隔离台804可包括功率放大器812，该功率放大器具有连接到功率变压器806的初级绕组814的输出。在某些形式中，功率放大器812可包括推挽放大器。例如，非隔离台804还可包括逻辑装置816，该逻辑装置用于向数模转换器(DAC)电路818供应数字输出，该数模转换器电路继而将对应的模拟信号供应至功率放大器812的输入。在某些形式中，例如除其他逻辑电路之外，逻辑装置816可包括可编程门阵列(PGA)、FPGA、可编程逻辑装置(PLD)。因此，由于经由DAC电路818控制功率放大器812的输入，逻辑装置816可控制在驱动信号输出810a、810b、810c处出现的驱动信号的多个参数(例如，频率、波形形状、波形振幅)中的任一个。在某些形式中，如下所述，逻辑装置816结合处理器(例如，以下讨论的DSP)可实施多个基于DSP的算法和/或其他控制算法，以控制由发生器800输出的驱动信号的参数。
可通过开关模式调节器820(例如，功率转换器)向功率放大器812的功率轨供电。在某些形式中，开关模式调节器820例如可包括可调式降压调节器。非隔离台804还可包括第一处理器822，例如，在一种形式中，第一处理器可包括DSP处理器，诸如可购自美国麻萨诸塞州诺伍德的亚德诺半导体公司(Analog Devices,Norwood,MA)的Analog DevicesADSP-21469SHARC DSP，但可在各种形式中采用任何合适的处理器。在某些形式中，DSP处理器822可响应于由DSP处理器822经由ADC电路824从功率放大器812接收的电压反馈数据来控制对开关模式调节器820的操作。在一种形式中，例如，DSP处理器822可经由ADC电路824接收由功率放大器812放大的信号(例如，射频信号)的波形包络作为输入。随后，DSP处理器822可控制开关模式调节器820(例如，经由PWM输出)，使得被供应至功率放大器812的干线电压跟踪放大信号的波形包络。通过基于波形包络以动态方式调制功率放大器812的干线电压，功率放大器812的效率相对于固定干线电压放大器方案可显著升高。
在某些形式中，逻辑装置816结合DSP处理器822可实施数字合成电路诸如直接数字合成器控制方案，以控制由发生器800输出的驱动信号的波形形状、频率和/或振幅。在一种形式中，例如逻辑装置816可通过调用存储于动态更新的查找表(LUT)(诸如RAM LUT)中的波形样本来实施DDS控制算法，该动态更新的查找表可被嵌入FPGA中。该控制算法尤其可用于如下超声应用，其中超声换能器诸如超声换能器可由其谐振频率下的纯正弦式电流驱动。因为其它频率可激发寄生谐振，因此最小化或降低动态支路电流的总失真可相应地最小化或降低不利的谐振效应。因为由发生器800输出的驱动信号的波形形状受输出驱动电路(例如，功率变压器806、功率放大器812)中所存在的各种畸变源的影响，所以基于驱动信号的电压和电流反馈数据可被输入至算法(诸如由DSP处理器822实施的误差控制算法)中，该算法通过适当地以动态行进方式(例如，实时)使存储于LUT中的波形样本预先畸变或修改来补偿畸变。在一种形式中，对LUT样本所施加的预先畸变量或程度可根据所计算的动态支路电流与期望的电流波形形状之间的误差而定，其中所述误差可基于逐一样本确定。以该方式，预先失真的LUT样本在通过驱动电路进行处理时，可使动态支路驱动信号具有所期望的波形形状(例如，正弦形状)，以最佳地驱动超声换能器。因此，在此类形式中，当考虑到畸变效应时，LUT波形样本将不呈现驱动信号的期望波形形状，而是呈现要求最终产生动态支路驱动信号的期望波形形状的波形形状。
非隔离台804还可包括经由相应的隔离变压器830、832联接到功率变压器806的输出端的第一ADC电路826和第二ADC电路828，以用于分别对由发生器800输出的驱动信号的电压和电流进行采样。在某些形式中，ADC电路826、828可被配置为以高速(例如，80兆样本每秒(MSPS))进行采样，以能够对驱动信号进行过采样。在一种形式中，例如ADC电路826、828的采样速度可实现驱动信号的约200x(根据频率而定)的过采样。在某些形式中，可通过令单个ADC电路经由二路式多路复用器接收输入电压和电流信号来执行ADC电路826、828的采样操作。通过在发生器800的形式中使用高速采样，除可实现其他事物之外，还可实现对流过动态支路的复杂电流的计算(这在某些形式中可用于实施上述基于DDS的波形形状控制)、对采样信号进行精确的数字滤波，以及以高精度计算实际功耗。由ADC电路826、828输出的电压和电流反馈数据可由逻辑装置816接收并处理(例如，先进先出(FIFO)缓冲器、多路复用器)，并且被存储在数据存储器中，以供由例如DSP处理器822后续检索。如上所述，电压和电流反馈数据可用作算法的输入用于以动态行进方式使LUT波形样本预先失真或修改。在某些形式中，当采集到电压和电流反馈数据对时，可能需要基于由逻辑装置816输出的对应LUT样本或以其他方式与该对应LUT样本相关联，来对每一存储的电压和电流反馈数据对进行编索引。以此方式使LUT样本和电压和电流反馈数据同步有助于预失真算法的准确计时和稳定性。
在某些形式中，可使用电压和电流反馈数据来控制驱动信号的频率和/或振幅(例如，电流振幅)。在一种形式中，例如，可使用电压和电流反馈数据来确定阻抗相位。随后，可控制驱动信号的频率以最小化或减小所确定阻抗相位与阻抗相位设定点(例如，0°)之间的差值，从而最小化或减小谐波畸变的影响，并相应地提高阻抗相位测量精确度。相位阻抗和频率控制信号的确定可在DSP处理器822中实现，例如，其中频率控制信号作为输入被供应至由逻辑装置816实现的DDS控制算法。
在另一形式中，例如可监视电流反馈数据，以便将驱动信号的电流振幅保持在电流振幅设定点。电流振幅设定点可被直接指定或基于特定的电压振幅和功率设定点而间接地确定。在某些形式中，例如可通过DSP处理器822中的控制算法(诸如比例积分微分(PID)控制算法)来实现对电流振幅的控制。由控制算法控制以适当地控制驱动信号的电流振幅的变量可包括：例如，存储在逻辑装置816中的LUT波形样本的标度和/或经由DAC电路834的DAC电路818(其向功率放大器812供应输入)的满标度输出电压。
非隔离台804还可包括第二处理器836，该第二处理器除其他之外还用于提供用户界面(UI)功能。在一种形式中，UI处理器836可包括例如购自Atmel公司(San Jose,California)的具有ARM 926EJ-S核的Atmel AT91SAM9263处理器。UI处理器836所支持的UI功能的示例可包括听觉和视觉用户反馈、与外围装置(例如，经由USB接口)的通信、与脚踏开关的通信、与输入装置(例如，触摸屏显示器)的通信，以及与输出装置(例如，扬声器)的通信。UI处理器836可(例如，经由SPI总线)与DSP处理器822和逻辑装置816通信。尽管UI处理器836可主要支持UI功能，然而在某些形式中，该UI处理器也可与DSP处理器822相协调以减缓风险。例如，UI处理器836可被编程为监测用户输入和/或其他输入(例如，触摸屏输入、脚踏开关输入、温度传感器输入)的各个方面，并且当检测到错误状况时停用发生器800的驱动输出。
在某些形式中，例如DSP处理器822与UI处理器836两者可确定并监测发生器800的操作状态。对于DSP处理器822，发生器800的操作状态可指示例如由DSP处理器822实施的是哪些控制和/或诊断过程。对于UI处理器836，发生器800的操作状态可指示例如UI的哪些元素(例如，显示屏、声音)呈现给用户。相应的DSP处理器822和UI处理器836可独立地保持发生器800的当前操作状态并识别和评估该当前操作状态的可能转变。DSP处理器822可用作此关系中的主体并确定何时会发生操作状态间的转变。UI处理器836可注意到操作状态间的有效转变并可确认特定的转变是否适当。例如，当DSP处理器822命令UI处理器836转变至特定状态时，UI处理器836可证实所要求的转变是有效的。如果UI处理器836确定所要求的状态间转变是无效的，则UI处理器836可使发生器800进入故障模式。
非隔离台804还可包括控制器838，以用于监测输入装置(例如，用于接通和断开发生器800的电容式触摸传感器、电容式触摸屏)。在某些形式中，控制器838可包括至少一个处理器和/或与UI处理器836通信的其他控制器装置。在一种形式中，例如控制器838可包括处理器(例如，可购自Atmel的Meg168 8位控制器)，该处理器被配置为监测经由一个或多个电容触摸传感器提供的用户输入。在一种形式中，控制器838可包括触摸屏控制器(例如，可购自爱特梅尔公司(Atmel)的QT5480触摸屏控制器)，以控制和管理从电容式触摸屏对触摸数据的采集。
在某些形式中，当发生器800处于“断电”状态时，控制器838可继续接收操作功率(例如，经由来自发生器800的电源的线，诸如以下讨论的电源854)。这样，控制器838可继续监测输入装置(例如，位于发生器800的前面板上的电容式触摸传感器)，以用于接通和断开发生器800。当发生器800处于断电状态时，如果检测到用户“接通/断开”输入装置的启动，则控制器838可启动电源(例如，启用电源854的一个或多个DC/DC电压转换器856的操作)。控制器838可因此启动用于将发生器800转变至“通电”状态的序列。相反，当发生器800处于通电状态时，如果检测到“接通/断开”输入装置的启动，则控制器838可启动用于将发生器800转变至断电状态的序列。在某些形式中，例如，控制器838可向UI处理器836报告“接通/断开”输入装置的启动，该处理器继而实施所需的过程序列以用于将发生器800转变至断电状态。在此类形式中，控制器838可能不具有在建立起发生器800的通电状态之后从发生器800移除功率的独立能力。
在某些形式中，控制器838可使发生器800提供听觉或其他感官反馈，以用于警示用户通电或断电序列已启动。可在功率开或功率关序列开始时以及在与序列相关联的其它过程开始之前提供此类警示。
在某些形式中，隔离台802可包括器械接口电路840以例如在外科器械的控制电路(例如，包括手持件开关的控制电路)与非隔离台804的部件(诸如逻辑装置816、DSP处理器822和/或UI处理器836)之间提供通信接口。器械接口电路840可经由通信连接件(诸如基于IR的通信连接件)与非隔离台804的部件交换信息，该通信连接件在隔离台802与非隔离台804之间保持合适程度的电隔离。例如，可使用由隔离变压器供电的低压降调压器为器械接口电路840供电，该低压降调压器从非隔离台804被驱动。
在一种形式中，器械接口电路840可包括与信号调节电路844通信的逻辑电路842(例如，逻辑电路、可编程逻辑电路、PGA、FPGA、PLD)。信号调节电路844可被配置为从逻辑电路842接收周期性信号(例如，2kHz的方波)，以生成具有相同频率的双极性询问信号。例如，可使用由差分放大器馈送的双极电流源生成询问信号。该询问信号可被发送到外科器械控制电路(例如，通过使用将发生器800连接到外科器械的缆线中的导体对)并被监测，以确定控制电路的状态或配置。控制电路可包括多个开关、电阻器和/或二极管，以修改询问信号的一个或多个特性(例如，振幅、整流)，使得可基于该一个或多个特性唯一地辨别控制电路的状态或配置。在一种形式中，例如信号调节电路844可包括ADC电路，以用于产生由于询问信号通过控制电路而出现在控制电路输入中的电压信号的样本。随后，逻辑电路842(或非隔离台804的部件)可基于ADC电路样本来确定控制电路的状态或配置。
在一种形式中，器械接口电路840可包括第一数据电路接口846，以实现逻辑电路842(或器械接口电路840的其他元件)与设置于外科器械中的或以其他方式与外科器械相关联的第一数据电路之间的信息交换。在某些形式中，例如，第一数据电路可设置于整体地附接到外科器械手持件的缆线中，或设置于用于使特定的外科器械类型或模型与发生器800交接的适配器中。第一数据电路可以任何合适的方式实施并且可根据包括例如本文相对于第一数据电路所述的任何合适的协议与发生器连通。在某些形式中，第一数据电路可包括非易失性存储装置，诸如EEPROM装置。在某些形式中，第一数据电路接口846可与逻辑电路842分开实施并且包括合适的电路(例如，分立的逻辑装置、处理器)，以实现逻辑电路842与第一数据电路之间的通信。在其他形式中，第一数据电路接口846可与逻辑电路842形成一体。
在某些形式中，第一数据电路可存储与其相关联的特定外科器械相关的信息。此类信息可包括例如型号、序列号、其中已使用外科器械的多个操作、和/或任何其它类型的信息。此类信息可被器械接口电路840(例如，通过逻辑电路842)读取、被传输至非隔离台804的部件(例如，至逻辑装置816、DSP处理器822和/或UI处理器836)，以经由输出装置呈现给用户并且/或者控制发生器800的功能或操作。另外，任何类型的信息均可经由第一数据电路接口846(例如，使用逻辑电路842)被发送到第一数据电路以存储于其中。此类信息可包括例如其中使用外科器械的操作的更新数目和/或其使用的日期和/或时间。
如前所述，外科器械可从手持件拆卸(例如，多功能外科器械可从手持件拆卸)以促进器械可互换性和/或可任意处置性。在此类情形中，常规发生器的识别所使用特定器械构型和相应地优化控制和诊断过程的能力可受限。然而，从兼容性角度来看，通过对外科器械添加可读数据电路来解决此问题是有问题的。例如，设计外科器械来保持与缺少必备数据读取功能的发生器的向后兼容可能由于例如不同的信号方案、设计复杂性和成本而不切实际。本文所述器械的形式通过使用数据电路来解决这些问题，这些数据电路可经济地实施于现有外科器械中并具有最小的设计变化，以保持外科器械与电流发生器平台的兼容性。
另外，发生器800的形式可实现与基于器械的数据电路的通信。例如，发生器800可被配置为与器械(例如，多功能外科器械)中所包含的第二数据电路连通。在一些形式中，第二数据电路可以类似于本文所述的第一数据电路的方式来实施。器械接口电路840可包括用于实现该通信的第二数据电路接口848。在一种形式中，第二数据电路接口848可包括三态数字接口，然而也可使用其他接口。在某些形式中，第二数据电路通常可为用于传输和/或接收数据的任何电路。在一种形式中，例如第二数据电路可存储与相关联的特定外科器械相关的信息。此类信息可包括例如型号、序列号、其中已使用外科器械的多个操作、和/或任何其它类型的信息。
在一些形式中，第二数据电路可存储关于相关联的超声换能器、端部执行器或超声驱动系统的电性能和/或超声性能的信息。例如，第一数据电路可指示老化频率斜率，如本文所述。附加地或另选地，任何类型的信息均可经由第二数据电路接口848(例如，使用逻辑电路842)被发送到第二数据电路以存储于其中。此类信息例如可包括其中使用外科器械的操作的更新数目和/或其使用的日期和/或时间。在某些形式中，第二数据电路可传输由一个或多个传感器(例如，基于器械的温度传感器)采集的数据。在某些形式中，第二数据电路可从发生器800接收数据并基于所接收的数据向用户提供指示(例如，发光二极管指示或其他可视指示)。
在某些形式中，第二数据电路和第二数据电路接口848可被配置为使得可实现逻辑电路842与第二数据电路之间的通信而无需提供用于此目的的附加导体(例如，用于将手持件连接到发生器800的缆线的专用导体)。在一种形式中，例如可使用实施于现有缆线(诸如，用于将询问信号从信号调节电路844传输至手持件中的控制电路的导体中的一个)上的单总线通信方案而使信息以通信方式到达和离开第二数据电路。以此方式，可最小化或减少原本可能必要的外科器械的设计变化或修改。此外，因为在共用物理信道上实施的不同类型的通信可为频带分离的，所以第二数据电路的存在对于不具有必备数据读取功能的发生器而言可为“隐形的”，因此能够实现外科器械的向后兼容。
在某些形式中，隔离台802可包括至少一个阻挡电容器850-1，该至少一个阻挡电容器连接到驱动信号输出810b以防止直流电流流向患者。例如，可要求信号阻挡电容器符合医疗规则或标准。尽管相对而言单电容器设计中很少出现错误，然而此类错误可造成不良后果。在一种形式中，可设置有与阻挡电容器850-1串联的第二阻挡电容器850-2，其中例如通过ADC电路852来监测从阻挡电容器850-1、850-2之间的点发生的电流渗漏，以对由泄漏电流感应的电压进行采样。这些样本例如可由逻辑电路842接收。基于渗漏电流的变化(如电压样本所指示)，发生器800可以确定阻挡电容器850-1、850-2中的至少一个何时发生故障，从而提供优于具有单个故障点的单电容器设计的有益效果。
在某些形式中，非隔离台804可包括电源854，以用于在适当的电压和电流下递送直流功率。电源可包括例如400W的电源，以用于递送48V直流的系统电压。电源854还可包括一个或多个DC/DC电压转换器856，以用于接收电源的输出，从而在发生器800的各种部件所需的电压和电流下产生直流输出。如以上结合控制器838所述，当控制器838检测到用户启动“接通/断开”输入装置以启用DC/DC电压转换器856的操作或唤醒DC/DC电压转换器856时，这些DC/DC电压转换器中的一者或多者可从控制器838接收输入。
图21示出了发生器900的示例，该发生器是发生器800(图20)的一种形式。发生器900被配置为将多个能量模态递送至外科器械。发生器900提供用于独立地或同时将能量递送至外科器械的RF信号和超声信号。RF信号和超声信号可单独或组合提供，并且可同时提供。如上所述，至少一个发生器输出可通过单个端口递送多种能量模态(例如，超声、双极或单极RF、不可逆和/或可逆电穿孔和/或微波能量等等)，并且这些信号可分开或同时被递送到端部执行器以处理组织。
发生器900包括联接到波形发生器904的处理器902。处理器902和波形发生器904被配置为基于存储在联接到处理器902的存储器中的信息来生成各种信号波形，为了本公开清楚起见而未示出该存储器。与波形相关联的数字信息被提供给波形发生器904，该波形发生器904包括一个或多个DAC电路以将数字输入转换成模拟输出。模拟输出被馈送到放大器1106用于信号调节和放大。放大器906的经调节和放大的输出联接到电力变压器908。信号通过电力变压器908联接到患者隔离侧中的次级侧。第一能量模态的第一信号被提供给被标记为ENERGY1和RETURN的端子之间的外科器械。第二能量模态的第二信号耦合在电容器910上并被提供给位于被标记为ENERGY2和RETURN的端子之间的外科器械。应当理解，可输出超过两种能量模态，并且因此下标“n”可被用来指定可提供多至n个ENERGYn端子，其中n是大于1的正整数。还应当理解，在不脱离本公开的范围的情况下，可提供多至“n”个返回路径RETURNn。
第一电压感测电路912联接被标记为ENERGY1和RETURN路径的端子的两端，以测量两端子间的输出电压。第二电压感测电路924联接被标记为ENERGY2和RETURN路径的端子的两端，以测量两端子间的输出电压。如图所示，电流感测电路914与电力变压器908的次级侧的RETURN支路串联设置，以测量任一能量模态的输出电流。如果为每种能量模态提供不同的返回路径，则应在每个返回支路中提供单独的电流感测电路。第一电压感测电路912和第二电压感测电路924的输出被提供给相应的隔离变压器916、922，并且电流感测电路914的输出被提供给另一隔离变压器918。电力变压器908(非患者隔离侧)的初级侧上的隔离变压器916、928、922的输出被提供给一个或多个ADC电路926。ADC电路926的数字化输出被提供给处理器902用于进一步处理和计算。可采用输出电压和输出电流反馈信息来调整提供给外科器械的输出电压和电流，并且计算输出阻抗等参数。处理器902和患者隔离电路之间的输入/输出通信通过接口电路920提供。传感器也可通过接口920与处理器902电气通信。
在一个方面，阻抗可由处理器902通过以下方式来确定：通过将联接在被标记为ENERGY1/RETURN的端子的两端的第一电压感测电路912或联接在被标记为ENERGY2/RETURN的端子的两端的第二电压感测电路924的输出除以与功率变压器908的次级侧的RETURN支路串联设置的电流感测电路914的输出。第一电压感测电路912和第二电压感测电路924的输出被提供给单独的隔离变压器916、922，并且电流感测电路914的输出被提供给另一隔离变压器916。来自ADC电路926的数字化电压和电流感测测量值被提供给处理器902以用于计算阻抗。例如，第一能量模态ENERGY1可以是超声能量，并且第二能量模态ENERGY2可以是RF能量。然而，除了超声和双极或单极RF能量模态之外，其它能量模态还包括不可逆和/或可逆电穿孔和/或微波能量等。而且，虽然图21所示的示例示出了可为两种或更多种能量模态提供单个返回路径RETURN，但在其他方面，可为每种能量模态ENERGYn提供多个返回路径RETURNn。因此，如本文所述，超声换能器阻抗可通过将第一电压感测电路912的输出除以电流感测电路914的输出来测量，并且组织阻抗可通过将第二电压感测电路924的输出除以电流感测电路914的输出来测量。
如图21中所示，包括至少一个输出端口的发生器900可包括具有单个输出和多个分接头的电力变压器908，以例如根据正在执行的组织处理类型以一种或多种能量模态(诸如超声、双极或单极RF、不可逆和/或可逆电穿孔和/或微波能量等等)的形式向端部执行器提供功率。例如，发生器900可用较高电压和较低电流递送能量以驱动超声换能器，用较低电压和较高电流递送能量以驱动RF电极以用于密封组织，或者用凝固波形递送能量以用于使用单极或双极RF电外科电极。来自发生器900的输出波形可被操纵、切换或滤波，以向外科器械的端部执行器提供频率。超声换能器与发生器900输出端的连接将优选地位于被标记为ENERGY1和RETURN的输出端之间，如图21中所示。在一个示例中，RF双极电极与发生器900输出端的连接将优选地位于被标记为ENERGY2和RETURN的输出端之间。在单极输出的情况下，优选的连接将是ENERGY2输出端的有源电极(例如，铅笔或其他探头)以及连接至RETURN输出端的合适的返回垫。
附加细节公开于2017年3月30日公布的名称为“TECHNIQUES FOR OPERATINGGENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICALINSTRUMENTS”的美国专利申请公布2017/0086914中，该专利申请全文以引用方式并入本文。
如本说明书通篇所用，术语“无线”及其衍生物可用于描述可通过使用经调制的电磁辐射通过非固体介质来传送数据的电路、装置、系统、方法、技术、通信信道等。该术语并不意味着相关联的组织不包含任何电线，尽管在一些方面它们可能不包含。通信模块可实现多种无线或有线通信标准或协议中的任一种，包括但不限于Wi-Fi(IEEE 802.11系列)、WiMAX(IEEE 802.16系列)、IEEE 802.20、长期演进(LTE)、Ev-DO、HSPA+、HSDPA+、HSUPA+、EDGE、GSM、GPRS、CDMA、TDMA、DECT、蓝牙、及其以太网衍生物、以及被指定为3G、4G、5G和以上的任何其它无线和有线协议计算模块可包括多个通信模块。例如，第一通信模块可专用于较短距离的无线通信诸如Wi-Fi和蓝牙，并且第二通信模块可专用于较长距离的无线通信诸如GPS、EDGE、GPRS、CDMA、WiMAX、LTE、Ev-DO等。
如本文所用，处理器或处理单元是对一些外部数据源(通常为存储器或一些其它数据流)执行操作的电子电路。本文所用术语是指组合多个专门的“处理器”的一个或多个系统(尤其是片上系统(SoC))中的中央处理器(中央处理单元)。
如本文所用，片上系统或芯片上系统(SoC或SOC)为集成了计算机或其它电子系统的所有器件的集成电路(也被称为“IC”或“芯片”)。它可以包含数字、模拟、混合信号以及通常射频功能—全部在单个基板上。SoC将微控制器(或微处理器)与高级外围装置如图形处理单元(GPU)、Wi-Fi模块或协处理器集成。SoC可以包含或可不包含内置存储器。
如本文所用，微控制器或控制器为将微处理器与外围电路和存储器集成的系统。微控制器(或微控制器单元的MCU)可被实现为单个集成电路上的小型计算机。其可类似于SoC；SoC可包括作为其器件之一的微控制器。微控制器可包含一个或多个核心处理单元(CPU)以及存储器和可编程输入/输出外围装置。以铁电RAM、NOR闪存或OTP ROM形式的程序存储器以及少量RAM也经常包括在芯片上。与个人计算机或由各种分立芯片组成的其它通用应用中使用的微处理器相比，微控制器可用于嵌入式应用。
如本文所用，术语控制器或微控制器可为与外围装置交接的独立式IC或芯片装置。这可为计算机的两个部件或用于管理该装置的操作(以及与该装置的连接)的外部装置上的控制器之间的链路。
如本文所述的处理器或微控制器中的任一者可为任何单核或多核处理器，诸如由德克萨斯器械公司提供的商品名为ARM Cortex的那些。在一个方面，处理器可为例如购自德克萨斯器械公司的LM4F230H5QR ARM Cortex-M4F处理器内核，其包括：256KB的单循环闪存或其它非易失性存储器(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)、以及易得的其它特征。
在一个示例中，处理器可包括安全控制器，该安全控制器包括两个基于控制器的系列，诸如同样由德克萨斯器械公司提供的商品名为Hercules ARM Cortex R4的TMS570和RM4x。安全控制器可被配置为专门用于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。
模块化装置包括可容纳在外科集线器内的模块(如结合图3和图9所述)和外科装置或器械，该外科装置或器械可连接到各种模块以便与对应的外科集线器连接或配对。模块化装置包括例如智能外科器械、医疗成像装置、抽吸/冲洗装置、排烟器、能量发生器、呼吸机、吹气器和显示器。本文所述的模块化装置可通过控制算法来控制。控制算法可在模块化装置自身上、在与特定模块化装置配对的外科集线器上或在模块化装置和外科集线器两者上执行(例如，经由分布式计算架构)。在一些示例中，模块化装置的控制算法基于由模块化装置自身感测到的数据来控制装置(即，通过模块化设备之中、之上或连接到模块化装置的传感器)。该数据可与正在手术的患者(例如，组织特性或吹气压力)或模块化装置本身相关(例如，刀被推进的速率、马达电流或能量水平)。例如，外科缝合和切割器械的控制算法可根据刀在其前进时遇到的阻力来控制器械的马达驱动其刀穿过组织的速率。
态势感知
态势感知是外科系统的一些方面根据从数据库和/或器械接收到的数据确定或推断与外科手术相关的信息的能力。该信息可包括正在进行的手术的类型、正在手术的组织的类型或作为手术对象的体腔。利用与外科手术相关的上下文信息，外科系统可例如改善该外科系统控制连接到其的模块化装置(例如，机器人臂和/或机器人外科工具)的方式，并且在外科手术的过程期间向外科医生提供背景信息或建议。
现在参见图56，描绘了时间线5200，其描绘集线器(诸如，外科集线器106或206)的态势感知。时间轴5200是说明性的外科手术以及外科集线器106、206可以从外科手术中每个步骤从数据源接收的数据导出的背景信息。时间轴5200描绘了护士、外科医生和其它医疗人员在肺段切除手术期间将采取的典型步骤，从建立手术室开始到将患者转移到术后恢复室为止。
态势感知外科集线器106、206在整个外科手术过程中从数据源接收数据，包括每次医疗人员利用与外科集线器106、206配对的模块化装置时生成的数据。外科集线器106、206可从配对的模块化装置和其他数据源接收该数据，并且在接收到新数据时不断导出关于正在进行的手术的推论(即，背景信息)，诸如在任何给定时间正在执行手术的哪个步骤。外科集线器106、206的态势感知系统能够例如记录与用于生成报告的过程相关的数据，验证医务人员正在采取的步骤，提供可能与特定过程步骤相关的数据或提示(例如，经由显示屏)，基于背景调节模块化装置(例如，激活监测器，调节医学成像装置的视场(FOV)，或者改变超声外科器械或RF电外科器械的能量水平)，以及采取上述任何其它此类动作。
作为该示例性手术中的第一步5202，医院工作人员从医院的电子医疗记录(EMR)数据库中检索患者的EMR。基于EMR中的选择的患者数据，外科集线器106、206确定待执行的手术是胸腔手术。
第二步5204，工作人员扫描用于手术的进入的医疗用品。外科集线器106、206与在各种类型的手术中使用的用品列表交叉引用扫描的用品，并确认供应的混合物对应于胸腔手术。另外，外科集线器106、206还能够确定手术不是楔形手术(因为进入的用品缺乏胸腔楔形手术所需的某些用品，或者在其它方面不对应于胸腔楔形手术)。
第三步5206，医疗人员经由可通信地连接到外科毂集线器106、206的扫描器来扫描患者带。然后，外科集线器106、206可基于所扫描的数据来确认患者的身份。
第四步5208，医务工作人员打开辅助设备。所利用的辅助设备可根据外科手术的类型和外科医生待使用的技术而变化，但在此示例性情况下，它们包括排烟器、吹气器和医学成像装置。当激活时，作为其初始化过程的一部分，作为模块化装置的辅助设备可以自动与位于模块化装置特定附近的外科集线器106、206配对。然后，外科集线器106、206可通过检测在该术前阶段或初始化阶段期间与其配对的模块化装置的类型来导出关于外科手术的背景信息。在该具体示例中，外科集线器106、206确定外科手术是基于配对模块化装置的该特定组合的VATS手术。基于来自患者的EMR的数据的组合，手术中使用的医疗用品的列表以及连接到集线器的模块化装置的类型，外科集线器106、206通常可推断外科小组将执行的具体手术。一旦外科集线器106、206知道正在执行什么具体手术，外科集线器106、206便可从存储器或云中检索该手术的步骤，然后交叉参照其随后从所连接的数据源(例如，模块化装置和患者监测装置)接收的数据，以推断外科团队正在执行的外科手术的什么步骤。
第五步5210，工作人员成员将EKG电极和其它患者监测装置附接到患者。EKG电极和其它患者监测装置能够与外科集线器106、206配对。当外科集线器106、206开始从患者监测装置接收数据时，外科集线器106、206因此确认患者在手术室中。
第六步5212，医疗人员诱导患者麻醉。外科集线器106、206可基于来自模块化装置和/或患者监测装置的数据(包括例如EKG数据、血压数据、呼吸机数据、或它们的组合)推断患者处于麻醉下。在第六步5212完成时，肺分段切除手术的术前部分完成，并且手术部分开始。
第七步5214，折叠正在操作的患者肺部(同时通气切换到对侧肺)。例如，外科集线器106、206可从呼吸机数据推断出患者的肺已经塌缩。外科集线器106、206可推断手术的手术部分已开始，因为其可将患者的肺部塌缩的检测与手术的预期步骤(可先前访问或检索)进行比较，从而确定使肺塌缩是该特定手术中的手术步骤。
第八步5216，插入医疗成像装置(例如，内窥镜)，并启动来自医疗成像装置的视频。外科集线器106、206通过其与医疗成像装置的连接来接收医疗成像装置数据(即，视频或图像数据)。在接收到医疗成像装置数据之后，外科集线器106、206可确定外科手术的腹腔镜式部分已开始。另外，外科集线器106、206可确定正在执行的特定手术是分段切除术，而不是叶切除术(注意，楔形手术已经基于外科集线器106、206基于在手术的第二步5204处接收到的数据而排除)。来自医疗成像装置124(图2)的数据可用于以多种不同的方式确定与正在执行的手术类型相关的背景信息，包括通过确定医疗成像装置相对于患者解剖结构的可视化取向的角度，监测所利用的医疗成像装置的数量(即，被激活并与外科集线器106、206配对)，以及监测所利用的可视化装置的类型。例如，一种用于执行VATS肺叶切除术的技术将摄像机放置在隔膜上方的患者胸腔的下前拐角中，而一种用于执行VATS分段切除术的技术将摄像机相对于分段裂缝放置在前肋间位置。例如，使用模式识别或机器学习技术，可对态势感知系统进行训练，以根据患者解剖结构的可视化识别医疗成像装置的定位。作为另一个示例，一种用于执行VATS肺叶切除术的技术利用单个医疗成像装置，而用于执行VATS分段切除术的另一种技术利用多个摄像机。作为另一示例，一种用于执行VATS分段切除术的技术利用红外光源(其可作为可视化系统的一部分可通信地联接到外科集线器)以可视化不用于VATS肺部切除术中的分段裂隙。通过从医疗成像装置跟踪这些数据中的任何或所有，外科集线器106、206因此可确定正在进行的外科手术的具体类型和/或用于特定类型的外科手术的技术。
第九步5218，外科团队开始手术的解剖步骤。外科集线器106、206可推断外科医生正在解剖以调动患者的肺，因为其从RF发生器或超声发生器接收指示正在击发能量器械的数据。外科集线器106、206可将所接收的数据与外科手术的检索步骤交叉，以确定在过程中的该点处(即，在先前讨论的手术步骤完成之后)击发的能量器械对应于解剖步骤。在某些情况下，能量器械可为安装到机器人外科系统的机械臂的能量工具。
第十步5220，外科团队继续进行手术的结扎步骤。外科集线器106、206可推断外科医生正在结扎动脉和静脉，因为其从外科缝合和切割器械接收指示器械正在被击发的数据。与先前步骤相似，外科集线器106、206可通过将来自外科缝合和切割器械的数据的接收与该过程中的检索步骤进行交叉引用来推导该推论。在某些情况下，外科器械可以是安装到机器人外科系统的机器人臂的外科工具。
第十一步5222，执行手术的分段切除术部分。外科集线器106、206可推断外科医生正在基于来自外科缝合和切割器械的数据(包括来自其仓的数据)横切软组织。仓数据可对应于例如由器械击发的钉的大小或类型。由于不同类型的钉用于不同类型的组织，因此仓数据可指示正被缝合和/或横切的组织的类型。在这种情况下，被击发的钉的类型用于软组织(或其它类似的组织类型)，这允许外科集线器106、206推断手术的分段切除术部分正在进行。
第十二步5224中，执行节点解剖步骤。外科集线器106、206可基于从发生器接收的指示正在击发RF或超声器械的数据来推断外科团队正在解剖节点并且执行泄漏测试。对于该特定手术，在横切软组织后使用的RF或超声器械对应于节点解剖步骤，该步骤允许外科集线器106、206进行此类推论。应当指出的是，外科医生根据手术中的具体步骤定期在外科缝合/切割器械和外科能量(即，RF或超声)器械之间来回切换，因为不同器械更好地适于特定任务。因此，其中使用缝合/切割器械和外科能量器械的特定序列可指示外科医生正在执行的手术的步骤。此外，在某些情况下，机器人工具可用于外科手术中的一个或多个步骤，并且/或者手持式外科器械可用于外科手术中的一个或多个步骤。(一个或多个)外科医生可例如在机器人工具与手持式外科器械之间交替和/或可同时使用装置。在第十二步5224完成时，切口被闭合并且手术的术后部分开始。
第十三步5226，逆转患者的麻醉。例如，外科集线器106、206可基于例如呼吸机数据(即，患者的呼吸率开始增加)推断出患者正在从麻醉中醒来。
最后，第十四步5228是医疗人员从患者移除各种患者监测装置。因此，当集线器从患者监测装置丢失EKG、BP和其它数据时，外科集线器106、206可推断患者正在被转移到恢复室。如从该示例性手术的描述可以看出，外科集线器106、206可根据从可通信地联接到外科集线器106、206的各种数据源接收的数据来确定或推断给定外科手术的每个步骤何时发生。
态势感知在2017年12月28日提交的名称为“INTERACTIVE SURGICAL PLATFORM”的美国临时专利申请序列号62/611,341中有进一步描述，该专利申请的公开内容全文以引用方式并入本文。在某些情况下，机器人外科系统(包括本文所公开的各种机器人外科系统)的操作可由集线器106、206基于其态势感知和/或来自其部件的反馈和/或基于来自云104的信息来控制。
机器人系统
机器人外科系统可用于微创医疗手术。在此类医疗手术期间，患者可被放置在与机器人外科系统相邻的平台上，并且外科医生可定位在远离平台和/或远离机器人的控制台处。例如，外科医生可定位在围绕外科部位的无菌场之外。外科医生经由控制台处的输入装置向用户界面提供输入以操纵联接到机器人系统的臂的外科工具。例如，输入装置可为机械输入装置诸如控制柄部或操纵杆，或非接触式输入装置诸如光学手势传感器。
机器人外科系统可包括支撑一个或多个机器人臂的机器人塔。至少一个外科工具(例如，端部执行器和/或内窥镜)可安装到机器人臂。例如，外科工具可被配置为经由关节运动式腕组件相对于相应的机器人臂进行关节运动和/或经由线性滑动机构相对于机器人臂平移。在外科手术期间，外科工具可例如经由插管或套管针插入患者体内的小切口中，或者插入患者的自然孔口中，以将外科工具的远侧端部定位在患者体内的外科部位处。附加地或另选地，在某些情况下，机器人外科系统可用于开放式外科手术中。
图22描绘了机器人外科系统15000的示意图。机器人外科系统15000包括中央控制单元15002、外科医生的控制台15012、包括一个或多个机器人臂15024的机器人15022，以及能够操作地联接到控制单元15002的主显示器15040。外科医生的控制台15012包括显示器15014和允许外科医生远程操纵机器人15022的机器人臂15024的至少一个手动输入装置15016(例如，开关、按钮、触摸屏、操纵杆、万向支架等)。读者将理解，可采用附加的和另选的输入装置。
中央控制单元15002包括能够操作地联接到存储器15006的处理器15004。控制器15004包括用于与机器人外科系统15000的部件交接的多个输入部和输出部。处理器15004可被配置为接收输入信号并且/或者生成输出信号以控制机器人外科系统15000的各种部件(例如，一个或多个马达、传感器和/或显示器)中的一者或多者。输出信号可包括和/或可基于可由外科医生或另一临床医生预先编程和/或输入的算法指令。处理器15004可被配置为接受来自用户(诸如在控制台15012处的外科医生)的多个输入，并且/或者可与远程系统进行交互。存储器15006可直接和/或间接地联接到处理器15004以存储指令和/或数据库。
机器人15022包括一个或多个机器人臂15024。每个机器人臂15024包括一个或多个马达15026，并且每个马达15026联接到一个或多个马达驱动器15028。例如，可分配给不同驱动器和/或机构的马达15026可容纳在托架组件或壳体中。在某些情况下，马达15026与一个或多个驱动器15028中间的传输可允许马达15026与一个或多个驱动器15028联接和脱离。驱动器15028可被配置为实现一个或多个外科功能。例如，一个或多个驱动器15028可负责通过旋转机器人臂15024和/或其连杆和/或接头来移动机器人臂15024。另外，一个或多个驱动器15028可联接到外科工具15030并且可例如实现关节运动、旋转、夹持、密封、缝合、供能、击发、切割和/或打开。在某些情况下，外科工具15030可以是可互换的和/或可替换的。本文进一步描述了机器人外科系统和外科工具的示例。
读者将容易理解，计算机实现的交互式外科系统100(图1)和计算机实现的交互式外科系统200(图9)可结合机器人外科系统15000。附加地或另选地，机器人外科系统15000可包括计算机实现的交互式外科系统100和计算机实现的交互式外科系统200的各种特征部和/或部件。
在一个示例中，机器人外科系统15000可涵盖机器人系统110(图2)，该机器人系统包括外科医生的控制台118、外科机器人120和机器人集线器122。附加地或另选地，机器人外科系统15000可与另一集线器(诸如外科集线器106)通信。在一种情况下，机器人外科系统15000可结合到外科系统中，诸如计算机实现的交互式外科系统100(图1)或计算机实现的交互式外科系统200(图9)。在此类情况下，机器人外科系统15000可分别与云104或云204以及外科集线器106或外科集线器206进行交互。在某些情况下，机器人集线器或外科集线器可包括中央控制单元15002并且/或者中央控制单元15002可与云通信。在其他情况下，外科集线器可实现为与中央控制单元15002分开并且可与中央控制单元15002通信的分立单元。
另一个外科机器人系统是由美国加利福尼亚州森尼韦尔的直觉外科公司(Intuitive Surgical,Inc,Sunnyvale,California)制造的da
外科机器人系统。图23至图29描绘了系统的示例。图23描绘了通常用于对躺在手术台12014上的患者12012执行微创诊断或外科手术的微创机器人外科(MIRS)系统12010。系统12010包括供外科医生12018在手术期间使用的外科医生的控制台12016。一个或多个助手12020也可参与该手术。MIRS系统12010还可包括患者侧推车12022，即外科机器人和电子器件推车12024。当外科医生12018通过控制台12016观察外科部位时，外科机器人12022可通过患者12012体内的微创切口来操纵至少一个可移除地联接的工具组件12026(以下称为“工具”)。外科部位的图像可通过成像装置诸如立体内窥镜12028来获得，该成像装置可由外科机器人12022操纵以对内窥镜12028进行取向。本文进一步描述了各种另选的成像装置。
电子器件推车12024可用于处理外科部位的图像，以随后通过外科医生的控制台12016显示给外科医生12018。一次性使用的机器人工具12026的数量通常将取决于诊断或外科手术以及手术室内的空间限制等因素。如果有必要改变在手术期间使用的机器人工具12026中的一个或多个，助手12020可从外科机器人12022移除机器人工具12026，并将其替换为来自手术室中的托盘12030的另一个工具12026。
主要参见图24，外科医生的控制台12016包括左眼显示器12032和右眼显示器12034以用于向外科医生12018呈现实现深度感知的外科部位的协调立体视图。控制台12016还包括一个或多个输入控制装置12036，该一个或多个输入控制装置继而使外科机器人12022(图23)操纵一个或多个工具12026(图23)。输入控制装置12036可提供与其相关联的工具12026(图23)相同的自由度以向外科医生提供远程存在或输入控制装置12036与机器人工具12026形成一体的感知，使得该外科医生具有直接控制机器人工具12026的有力感测。为此，可使用位置传感器、力传感器和触觉反馈传感器通过输入控制装置12036将来自机器人工具12026的位置、力和触感传输回外科医生的手。外科医生的控制台12016通常与患者12012位于同一房间中，以便外科医生12018可直接监测该手术，必要时可亲自在场，并且可直接与助手12020对话，而不是通过电话或其他通信介质。然而，外科医生12018可与患者12012位于不同的房间、完全不同的建筑物或其他远程位置，从而允许进行远程外科手术。无菌场可被限定在外科部位周围。在各种情况下，外科医生12018可定位在无菌场之外。无菌适配器可限定无菌场的边界的部分。用于机器人臂的无菌适配器的示例在2015年3月17日提交的名称为“BACKUP LATCH RELEASE FOR SURGICAL INSTRUMENT”的美国专利申请公布2015/0257842中有所描述，该专利申请公布作为美国专利序列号9,839,487于2017年12月12日公布，该专利申请全文以引用方式并入本文。
现在主要参见图25，电子器件推车12024可与内窥镜12028联接，并且可包括处理器以处理所捕获的图像以供后续显示，诸如在外科医生的控制台上或在本地和/或远程定位的另一个合适的显示器上显示给外科医生。例如，在使用立体内窥镜12028的情况下，电子器件推车12024可处理所捕获的图像以向外科医生呈现外科部位的协调立体图像。此类协调可包括相反图像之间的对准，并且可包括调节立体内窥镜的立体工作距离。又如，图像处理可包括使用先前确定的相机校准参数来补偿图像捕获装置的成像误差，诸如光学像差。
图26示意性地示出了机器人外科系统12050，诸如图23的MIRS系统12010。如本文所讨论，外科医生的控制台12052(诸如图23中的外科医生的控制台12016)可被外科医生用于在微创手术期间控制外科机器人12054(诸如图23中的外科机器人12022)。外科机器人12054可使用成像装置(诸如立体内窥镜)来捕获手术部位的图像并将所捕获的图像输出到电子器件推车12056(诸如图23的电子器件推车12024)。如本文所述，电子器件推车12056可以在任何后续显示之前以各种方式处理所捕获的图像。例如，在经由外科医生的控制台12052向外科医生显示组合的图像之前，电子器件推车12056可利用虚拟控制界面覆盖所捕获的图像。外科机器人12054可输出所捕获的图像以用于在电子器件推车12056外部进行处理。例如，外科机器人12054可将所捕获的图像输出到处理器12058，该处理器可用于处理所捕获的图像。这些图像还可通过电子器件推车12056和处理器12058的组合来处理，该电子器件推车和处理器可联接在一起以共同地、顺序地和/或它们的组合来处理所捕获的图像。一个或多个单独的显示器12060还可与处理器12058和/或电子器件推车12056联接，以用于图像(诸如手术部位的图像或其他相关的图像)的本地和/或远程显示。
图27和28分别示出了外科机器人12022和机器人工具12062。机器人工具12062是机器人工具12026(图23)的示例。读者将理解，另选的机器人工具可与外科机器人12022一起使用，并且本文描述了示例性机器人工具。所示的外科机器人12022提供对三个机器人工具12026和成像装置12028(诸如用于捕获手术部位的图像的立体内窥镜)的操纵。由具有多个机器人接头的机器人机构提供操纵。成像装置12028和机器人工具12026可通过患者体内的切口被定位和操纵，以便在切口处保持运动远程中心或虚拟枢轴以最小化切口的大小。外科部位的图像可包括当机器人工具12026的远侧端部位于成像装置12028的视场(FOV)内时的图像。每个工具12026可从相应的外科操纵器12031拆卸并由其承载，该外科操纵器位于这些机器人接头中的一个或多个机器人接头的远侧端部处。外科操纵器12031提供可移动平台以用于经由机器人接头的移动相对于外科机器人12022移动整个工具12026。外科操纵器12031还提供功率以使用一个或多个机械接口和/或电接口来操作机器人工具12026。
图29为遥控外科系统12100的示意图。外科系统12100包括外科医生的控制台12102，该外科医生控制台例如可以是外科医生的控制台12052(图26)。外科医生控制台12102驱动外科机器人12104，该外科机器人例如可以是外科机器人12022(图23)。外科机器人12104包括外科操纵器12106，该外科操纵器例如可以是外科操纵器12031(图27)。外科操纵器12106包括马达单元12108和机器人工具12110。马达单元12108是保持五个马达的托架组件，这五个马达可被分配给不同的机构。在一些示例中仅使用五个马达，而在其他示例中可使用多于或少于五个马达。马达单元12108包括动力马达12112、凸轮轴马达12140、俯仰马达12116、偏航马达12118和低力握持马达12120，但这些马达可根据所附接的器械用于不同的目的。一般来讲，每个马达是与机器人工具12110的对应输入机械地联接和电联接的电动马达。在一些示例中，马达单元12108可位于与机器人工具共用的底盘中的机器人工具12110的近侧端部处，如图28中所示的近侧壳体大致所描绘的。马达壳体在2011年11月15日提交的名称为“METHOD FOR PASSIVELY DECOUPLING TORQUE APPLIED BY A REMOTEACTUATOR INTO AN INDEPENDENTLY ROTATING MEMBER”的美国专利申请公布2012/0150192中有进一步描述，该专利申请公布作为美国专利序列号9,095,362于2015年8月4日公布，该专利申请全文以引用方式并入本文。
机器人工具12110例如可以是本文所述的机器人工具12026(图23)。机器人工具12110包括细长执行器单元12122，该细长执行器单元包括各自通过外科操纵器12106分别与俯仰马达12116、偏航马达12118和低力握持马达12120机械地联接的三个分立输入。机器人工具12110还包括与动力马达12112和凸轮轴马达12140机械地联接的传动装置12124。工具的示例在2015年3月31日提交的名称为“SURGICAL INSTRUMENT WITH SHIFTABLETRANSMISSION”的国际专利申请公布WO 2015/153642和2015年3月31日提交的名称为“CONTROL INPUT ACCURACY FOR TELEOPERATED SURGICAL INSTRUMENT”的国际专利申请公布WO 2015/153636中有进一步描述，这些临时专利申请中的每个的全文以引用方式并入本文。
外科端部执行器12126位于执行器单元12122的远侧端部处。外科端部执行器12126和执行器单元12122通过可移动腕部连接。此类腕部的示例在2010年11月12日提交的名称为“DOUBLE UNIVERSAL JOINT”的美国专利申请公布2011/0118708和2012年2月15日提交的名称为“SEALS AND SEALING METHODS FOR A SURGICAL INSTRUMENT HAVING ANARTICULATED END EFFECTOR ACTUATED BY A DRIVE SHAFT”的美国专利序列号9,216,062中示出，这两个专利中的每个的全文以引用方式并入本文。简而言之，外科端部执行器的特征可在于多个分立但相互关联的机构，其中每个机构为外科端部执行器12126提供自由度(DOF)。如本文相对于外科系统12100所用，DOF是用于影响对应运动的一个或多个相互关联的机构。这些DOF向外科端部执行器12126提供可同时或分立地操作的不同操作模式。例如，腕部使外科端部执行器12126能够相对于外科操纵器12106俯仰和偏航，并且因此包括俯仰DOF 12128和偏航DOF 12130。外科端部执行器12126还包括使外科端部执行器12126围绕细长轴旋转的滚动DOF 12132。不同的机器人工具可具有不同的DOF，如本文进一步所述。
外科端部执行器12126可包括夹持和切割机构，诸如外科缝合器。此类器械(包括其钉仓)的示例在2012年10月26日提交的名称为“CARTRIDGE STATUS AND PRESENCEDETECTION”的美国专利申请公布序列号2013/0105552和2012年10月26日提交的名称为“SURGICAL INSTRUMENT WITH INTEGRAL KNIFE BLADE”的美国专利申请公布2013/0105545中有进一步描述，这两个专利申请公布的全文以引用方式并入本文。夹持机构可根据两种模式握持，并因此包括两种DOF。低力DOF 12134(例如，缆线致动机构)用于以低力扳动夹具以轻轻地操纵组织。低力DOF 12134可用于准备外科端部执行器来进行切割或缝合操作。高力DOF 12136(例如，导螺杆致动机构)用于利用相对高的力进一步打开夹具或闭合组织上的夹具，例如，用于捆绑组织以准备进行切割或缝合操作。一旦夹持，外科端部执行器12126就采用工具致动DOF 12138来进一步影响组织，例如，通过缝合、切割和/或烧灼装置来影响组织。用于外科端部执行器的夹持系统在以下专利中有进一步描述：2012年5月15日提交的名称为“METHODS AND SYSTEMS FOR DETECTING STAPLE CARTRIDGE MISFIRE OR FAILURE”的美国专利序列号9,393,017，该专利于2016年7月19日公布；2012年1月13日提交的名称为“METHODS AND SYSTEMS FOR INDICATING A CLAMPING PREDICTION”的美国专利序列号8,989,903，该专利于2015年3月2日公布；以及2015年3月2日提交的名称为“METHODS ANDSYSTEMS FOR INDICATING A CLAMPING PREDICTION”的美国专利序列号9,662,177，该专利于2017年5月30日公布，这些专利中的全部以引用方式并入本文。
如图29中所示，俯仰马达12116、偏航马达12118和低力握持马达12120分别驱动俯仰DOF 12128、偏航DOF 12130和低力握持DOF 12134。因此，俯仰DOF 12128、偏航DOF 12130和低力握持DOF 12134中的每一者与马达分立地配对，并且可相对于其他DOF独立且同时地操作。然而，高力握持DOF 12136、滚动DOF 12132和工具致动DOF 12138经由传动装置12124与动力马达12112共享单个输入。因此，由于与动力马达12112的联接分立地发生，因此一次仅可操作高力握持DOF 12136、滚动DOF 12132和工具致动DOF 12138中的一者。致动凸轮轴马达12140以使动力马达12112的输出在高力握持DOF 12136、滚动DOF 12132和工具致动DOF 12138之间切换。因此，与每个马达专用于单个DOF的布置相比，传动装置12124有利地允许更大数量的DOF。
外科机器人系统(诸如图23至图29的机器人外科系统)的附加特征部和操作在以下参考文献中有进一步描述，这些参考文献各自的全文以引用方式并入本文：
·2010年11月12日提交的名称为“DOUBLE UNIVERSAL JOINT”的美国专利申请公布2011/0118708；
·2011年11月15日提交的名称为“METHOD FOR PASSIVELY DECOUPLING TORQUEAPPLIED BY A REMOTE ACTUATOR INTO AN INDEPENDENTLY ROTATING MEMBER”的美国专利序列号9,095,362，该专利于2015年8月4日公布；
·2012年1月13日提交的名称为“METHODS AND SYSTEMS FOR INDICATING ACLAMPING PREDICTION”的美国专利序列号8,989,903，该专利于2015年3月24日公布；
·2012年2月15日提交的名称为“SEALS AND SEALING METHODS FOR A SURGICALINSTRUMENT HAVING AN ARTICULATEDEND EFFECTOR ACTUATED BY A DRIVE SHAFT”的美国专利序列号9,216,062，该专利于2015年12月22日公布；
·2012年5月15日提交的名称为“METHODS AND SYSTEMS FOR DETECTING STAPLECARTRIDGE MISFIRE OR FAILURE”的美国专利序列号9,393,017，该专利于2016年7月19日公布；
·2012年10月26日提交的名称为“CARTRIDGE STATUS AND PRESENCE DETECTION”的美国专利申请公布2013/0105552；
·2012年10月26日提交的名称为“SURGICAL INSTRUMENT WITH INTEGRAL KNIFEBLADE”的美国专利申请公布2013/0105545；
·2015年3月17日提交的名称为“SURGICAL CANNULA MOUNTS AND RELATEDSYSTEMS AND METHODS”的国际专利申请公布WO 2015/142814；
·2015年3月17日提交的名称为“BACKUP LATCH RELEASE FOR SURGICALINSTRUMENT”的美国专利申请公布2015/0257842；
·2015年3月17日提交的名称为“LATCH RELEASE FOR SURGICAL INSTRUMENT”的美国专利申请公布2015/0257841；
·2015年3月31日提交的名称为“SURGICAL INSTRUMENT WITH SHIFTABLETRANSMISSION”的国际专利申请公布WO2015/153642；
·2015年3月31日提交的名称为“CONTROL INPUT ACCURACY FOR TELEOPERATEDSURGICAL INSTRUMENT”的国际专利申请公布序列号WO 2015/153636；以及
·2015年3月2日提交的名称为“METHODS AND SYSTEMS FOR INDICATING ACLAMPING PREDICTION”的美国专利序列号9,662,177，该专利于2017年5月30日公布。
本文所公开的机器人外科系统和特征部可与本文引用的da
外科机器人系统和/或图23至图29的系统一起使用。读者还将理解，本文所公开的各种系统和/或特征部也可与另选的外科系统一起使用，这些另选的外科系统包括例如计算机实现的交互式外科系统100、计算机实现的交互式外科系统200、机器人外科系统110、机器人集线器122、机器人集线器222和/或机器人外科系统15000。
在各种情况下，机器人外科系统可包括机器人控制塔，该机器人控制塔可容纳系统的控制单元。例如，处理器12058(图26)可容纳在机器人控制塔内。例如，机器人控制塔可包括机器人集线器，诸如机器人集线器122(图2)或机器人集线器222(图9)。此类机器人集线器可包括用于与一个或多个发生器(诸如超声发生器和/或射频发生器)和/或一个或多个模块(诸如成像模块、抽吸模块、冲洗模块、排烟模块和/或通信模块)联接的模块化接口。
机器人集线器可包括可被配置为合成来自多个来源的数据以确定对外科事件的适当响应的态势感知模块。例如，态势感知模块可确定外科手术的类型、外科手术中的步骤、组织的类型和/或组织特性，如本文进一步所述。此外，此类模块可基于合成的数据推荐特定的动作过程或可能的选择。在各种情况下，涵盖分布在整个机器人系统中的多个传感器的传感器系统可向态势感知模块提供数据、图像和/或其他信息。此类态势感知模块可例如被处理器12058访问。在各种情况下，态势感知模块可从非机器人外科集线器和/或云(诸如外科集线器106(图1)、外科集线器206(图10)、云104(图1)和/或云204(图9))获得数据和/或信息。外科系统的态势感知在本文和2017年12月28日提交的名称为“INTERACTIVESURGICAL PLATFORM”的美国临时专利申请序列号62/611,341以及2017年12月28日提交的名称为“CLOUD-BASED MEDICAL ANALYTICS”的临时专利申请序列号62/611,340中有进一步描述，这些美国临时专利申请的公开内容全文以引用方式并入本文。
包括机器人、可视化系统(诸如可视化系统108或可视化系统208)和一个或多个集线器(诸如集线器106、机器人集线器122、集线器206和/或机器人集线器222)的外科系统可受益于用于数据收集和传播的稳健通信系统。例如，关于外科部位、外科器械和/或外科手术的各种参数可以是对机器人、可视化系统和集线器的重要信息。此外，机器人可包括一个或多个子组件，诸如控制台，该控制台可能需要关于例如外科部位、外科器械和/或外科手术的信息。例如，实时或近乎实时地收集和传播信息并将其传播到适当的组件和/或子组件，以通知机器学习和/或决策过程可能是有帮助的。在某些情况下，数据收集和传播可通知包括一个或多个机器人系统的外科系统的态势感知。
在一个方面，机器人外科系统可包括附加通信路径。例如，机器人外科系统可包括主有线通信路径和辅助无线通信路径。在某些情况下，这两个通信路径可以是独立的，使得辅助路径是冗余的和/或平行于主路径。在各种情况下，可沿主路径传输第一类型和/或量的数据，并且可沿辅助路径传输第二类型和/或量的数据。多个通信路径可改善机器人和/或机器人外科工具到手术室、控制台和/或控制单元内的一个或多个显示器的连接性。通信路径可将外科机器人连接到例如中央控制单元(例如，集线器)和/或可视化系统(例如，显示器)。在各种情况下，附加通信路径可向机器人和/或发生器模块和/或与发生器模块通信的处理器提供附加数据。
主要参见图30，描绘了包括控制台12216和机器人12222的机器人外科系统12200。控制台12216可在许多方面类似于控制台12016(图23和图24)，并且机器人12222可在许多方面类似于机器人12022(图23和图27)。例如，可在许多方面类似于机器人工具12026(图23)的机器人工具12226被定位在机器人12222的臂中的一个臂的远侧端部处。机器人工具12226是能量装置。例如，可通过联接到机器人工具12226的发生器将能量供应至机器人工具12226。
机器人外科系统12200还包括集线器12224，该集线器在许多方面可类似于机器人集线器122(图2)和/或机器人集线器222(图9)。集线器12224包括发生器模块12230，该发生器模块在许多方面类似于发生器模块140(图3)；以及无线通信模块12238，该无线通信模块在许多方面类似于通信模块130(图3)。发生器模块12230被配置为经由第一有线连接12244向机器人工具12226供应能量。
在一种情况下，第一有线连接12244可以是机器人工具12226和外科集线器12224之间的双向通信路径。第一有线连接12244可在机器人工具12226和外科集线器12224之间传送高级能量参数或其他电数据。例如，外科集线器12224可向机器人工具12226供应关于向其供应的功率水平的信息(例如，RF装置的电流以及超声装置的振幅和/或频率)。另外，机器人工具12226可向机器人12222提供关于在组织界面处检测的电导率和/或阻抗的信息，该电导率和/或阻抗对应于组织的特性和/或能量装置的有效性。
另外，控制台12216和安装到机器人12222的机器人工具12226之间的第二有线连接12240为从机器人控制台12216到机器人工具12226的控制信号提供通信路径。在一种情况下，第二有线连接12240可以是相对于由机器人12222和/或机器人工具12226收集的控制参数或其他机械数据从机器人12222到控制台12216的单向通信路径。例如，机器人12222可向控制台12216提供关于机器人工具的外科致动的信息，诸如闭合运动和/或击发运动。更具体地，机器人可例如将夹持力参数(例如，机器人工具12226对组织的夹持压力)和/或击发力参数从机器人工具12226传送到控制台12216。
仍然参见图30，不存在无线通信路径12242和12246的情况下，机器人集线器12224可能无法与控制台12216通信，反之亦然。另外，机器人工具12226可能无法与集线器12224连通。在集线器12224与机器人12222和/或机器人工具12226之间缺少通信路径的情况下，来自机器人工具12226的机械控制参数(例如，夹持力)可不发送到机器人集线器12224及其发生器模块12230。另外，可不将电高级能量参数从机器人12222发送到机器人集线器12224和/或控制台12216。在此类情况下，系统12200将包括开环控件。
不同的能量参数和不同的夹持压力可更好地适用于某些类型的组织和/或某些应用。例如，超声焊接通常是换能器振幅和夹持压力随时间推移的函数。类似地，RF焊接通常是电流和夹持压力随时间推移的函数。然而，在没有上述无线通信路径12242和12246的情况下，发生器模块12230可不知道夹持压力。类似地，控制台12216可能不知道能量参数。
为了优化机器人工具12226的控制，机器人工具12226可将一个或多个机械控制参数传送到机器人集线器12224。另外，集线器12224可将一个或多个高级能量参数传送到控制台12216。数据传输可为系统12200提供闭环控制。在一种情况下，可针对不同类型的组织和/或特定应用来平衡机械控制参数和高级能量参数。例如，可降低夹持压力并且可增加到机器人工具12226的功率，或反之亦然。
仍参见图30，机器人工具12226包括无线通信模块12228，如本文进一步所述。无线通信模块12228经由无线通信路径12242与机器人集线器12224的无线通信模块12238进行信号通信。例如，无线通信模块12238可包括被配置为接收来自机器人工具12226的无线信号的第一接收器12232。无线通信模块12238还包括第二接收器12234，该第二接收器可经由第二无线通信路径12246从控制台12216接收信号。在此类情况下，例如，第一无线通信路径12242和第二无线通信路径12246可分别完成经由外科集线器12224从机器人工具12226回到控制台12216的通信电路。
在其他情况下，无线通信模块12228可位于机器人12222上。例如，无线通信模块12228可被定位在机器人的臂和/或机器人12222的工具安装部分上。
附加地或另选地，可在机器人工具12226和控制台12216之间提供无线通信路径。
本文所述的无线路径可提供数据传输，而不会阻碍机器人工具12226的移动性和/或产生缠结或绳索和/或导线的附加机会。在其他情况下，本文所述的一个或多个无线通信路径可利用一个或多个有线连接替换。
在一个方面，机器人工具12226和/或集线器12224可共享关于感测到的组织参数(例如，对应于组织的特性的电导率或电感)和/或用于使组织通电的控制算法(例如，功率水平)的信息，该控制算法可基于感测到的组织参数。例如，机器人工具12226可向集线器12224提供关于状态、激活状态、识别信息和/或智能数据的信息。提供给集线器12224的数据可由集线器12224存储、分析和/或进一步传播，诸如传播到其显示屏12236。在此类情况下，集线器12224是用于经由有线或无线连接将数据传输到附加位置的导管或中继站。
在某些情况下，集线器12224包括态势感知模块，如本文进一步所述。态势感知模块可被配置为基于从各种源(包括机器人12222和控制台12216)接收到的信息确定和/或确认外科手术中的步骤和/或建议特定外科动作。将集线器12224分别连接到机器人12222和控制台12216的无线通信路径12242和12246可被配置为通知态势感知模块。例如，关于夹持和/或击发的机械控制参数可经由第二无线通信路径12246发送到集线器12224及其态势感知模块。附加地或另选地，关于能量工具的激活的能量参数和/或感测到的组织参数可经由第一无线通信路径12242发送到集线器12224及其态势感知模块。
在某些情况下，无线传输到集线器12224的数据可通知其态势感知模块。例如，基于由机器人工具12226检测到并沿第一无线通信路径12242传输的感测到的组织参数，态势感知模块可确定和/或确认外科手术中涉及的组织的类型，并且在某些情况下，可基于遇到的组织的类型建议治疗响应。
仍然参见图30，从机器人12222到控制台12216的第二有线连接12240提供了第一通信路径。此外，机器人12222和集线器12224之间的有线或无线连接结合集线器12224和控制台12216之间的无线通信路径12246形成从机器人12222到控制台12212的第二平行通信路径。因为第二通信路径经由集线器12224及其无线通信模块12238进行通信，所以第二通信路径不同于第一通信路径。然而，此类路径提供了与机器人12222和控制台12216之间的第二有线连接12240的平行和另选的路径。类似地，也经由机器人12222与集线器12224之间的无线路径12242和有线路径12244提供平行和/或冗余的路径。另选的平行通信路径可加固通信系统的完整性，并且实现外科系统的各种部件之间的机器人通信。
附加地或另选地，信息可例如直接被发送到具有无线能力的装置或系统，诸如可视化系统或显示器，如可视化系统108或可视化系统208。图55中描绘的外科系统12300包括用于外科医生S的控制台12216、包括安装到其上的机器人工具12226的机器人12222以及外科集线器12224。外科系统12300还包括定位在外科手术室内的监测器12350。附加的临床医生可在手术室内，包括护士N、医疗助手MA和麻醉师A。某些临床医生可被定位在无菌场内。例如，站在支撑多个医疗器械和机器人工具的桌子12352处的护士N可以是无菌的。握持手持式外科器械的医疗助手MA和麻醉师A可被定位在无菌场之外。临床医生可在无菌场内和无菌场外看到监测器12350。附加显示器12354可被定位在无菌场内。附加显示器12354可以是例如具有无线、蜂窝和/或蓝牙功能的移动计算机。在一种情况下，附加显示器12354可以是可定位在患者P或患者台12358上的平板电脑，诸如
平板电脑。在此类情况下，显示器12354被定位在无菌场内。
机器人工具12226上的无线通信模块12228(图30)可与监测器12350和/或显示器12354进行信号通信。在此类情况下，在外科部位处和/或通过机器人工具12226获得的数据和/或信息可直接发送到外科手术室内的屏幕，并且可立即被外科手术室的各个临床医生(包括无菌场内或无菌场外的临床医生)看到。在此类情况下，可实时或近乎实时地提供数据，以在外科手术期间通知临床医生的决策。另外，某些信息可被发送到集线器12224以用于进一步存储、分析和/或传播，如本文进一步所述。
由于无线通信路径，在某些情况下，监测器12350和/或显示器12354还可显示来自集线器的信息，该信息包括能量参数。例如，集线器12224可获得指示发生器模块12230(图30)的激发状态或激发电平的数据并且/或者可从机器人工具12226接收指示感测到的组织参数的数据，如本文进一步所述。在此类情况下，激活信息和/或组织信息可显示在监测器12350和/或显示器12354上，使得在无菌场内和无菌场外的操作者都容易获得信息。
在一个方面，集线器12224可最终与云(诸如云104或云204)通信，以进一步通知与机器人工具12226的高级能量参数和/或机械控制参数相关的机器学习和决策过程。例如，云可基于存储在其中的聚合的数据针对特定组织参数、外科手术和/或患者人口统计来确定适当的外科动作和/或治疗响应。为了保护患者保密性，集线器12224可例如发送数据的红化和/或机密版本。
如本文相对于图30所述，机器人工具12226包括无线通信模块12228。图31中还示出了无线通信模块12228。具体地，图31描绘了包括无线通信模块12228的机器人工具12226的近侧部分，以及用于能够释放地附接机器人工具12226的近侧壳体的机器人12222的工具安装部分或附接部分12250。图32描绘了机器人工具12226与工具安装部分12250之间的机械接口和电接口的详细视图。
机器人工具12226包括与工具安装部分12250上的第二驱动接口12254驱动地联接的第一驱动接口12252。工具安装部分12250包括容纳多个马达的托架或马达壳体，该多个马达可在许多方面类似于例如马达12112、12116、12118、12120和12140(图29)。这些马达在第二驱动接口12254处驱动联接到旋转输出12256，该第二驱动接口接合机器人工具12226上的旋转输入12258。例如，旋转输入12258被定位和构造成与工具安装部分12250上的旋转输出12256机械地配合。
图31中示出了用于向马达供电的插头12260。插头12260还联接到无线通信模块12228。在此类情况下，无线通信模块12228可经由插头12260供应的电流来供电。插头12260最终可接线到集线器12224中的发生器模块12230以完成机器人工具12226与集线器12224之间的有线连接12244(参见图30)。
现在主要参见图31，工具安装部分12250还包括电接触件12262，并且机器人工具12226包括被定位和构造成与工具安装部分12250上的电接触件12262配合的电接触件12264。电信号可经由配合电接触件12262、12264在机器人工具12226和机器人12222(图30)之间发送。在某些情况下，来自机器人工具12262的机械控制参数可经由电接触件12262、12264发送到机器人12222，如本文进一步所述。附加地或另选地，可经由配合电接触件12262、12264将高级能量参数发送到机器人12222和/或机器人工具12226，反之亦然，如本文进一步所述。
如图32所描绘的，当机器人工具12226安装到工具安装部分12250时，柔性电路12270被定位在机器人工具12226的配合电接触件12264与工具安装部分12250的电接触件12262之间以有利于数据传输。柔性电路12270被定位成拦截机器人工具12262与工具安装部分12250之间的通信信号。在此类情况下，柔性电路12270被配置为捕获在那些接触件12262、12264之间传递的信号。在某些情况下，柔性电路12270可向机器人工具12226提供智能特征部。
在各种情况下，柔性电路12270可包括反馈绞编引线连接器。绞编引线连接器可拦截机器人工具12226和工具安装部分12250之间的连接。
在各种情况下，图31柔性电路12270还可包括被配置为经由无线通信路径12242与集线器12224(图30)通信的无线发射器。在其他情况下，柔性电路12270可联接到无线通信模块(如图30和图31中的模块12228)，该无线通信模块可包括无线发射器和/或无线接收器。
柔性电路12270在工具安装部分12250与机器人工具12226之间占据小的占有面积。在一个方面，现有机器人系统可利用此类柔性电路来改装。换句话讲，现有机器人工具和工具安装部分可在不修改当前机器人工具和/或工具安装部分的情况下利用本文所述的稳健通信系统。
在各种情况下，柔性电路12270或另一个中间绞编引线连接器可被配置为采集外部控制器(例如，集线器106(图3)中的发生器模块140的能量发生器)与机器人工具12226之间的一个或多个信号。此外，此类电路或连接器可用于经由拦截连接件将信号递送至机器人工具12226。
在一个方面，机器人集线器包括处理器和通信地联接到该处理器的存储器，如本文所述。该存储器存储可由处理器执行的指令，以在机器人和控制台之间中继无线信号，如本文所述。在某些情况下，该存储器存储指令，这些指令可由处理器执行以基于由柔性电路拦截和/或沿无线通信路径传输的信号来调节发生器的控制参数(例如，功率水平)。附加地或另选地，存储器存储指令，该指令可由处理器执行以基于指示被柔性电路拦截和/或沿无线通信路径传输的组织特性的信号来调节能量工具的控制参数(例如，夹持压力)。
在各个方面，本公开提供了一种控制电路以在机器人和控制台之间中继无线信号、调节发生器的控制参数并且/或者调节能量工具的控制参数，如本文所述。在各个方面，本公开提供了存储计算机可读指令的非暂态计算机可读介质，这些计算机可读指令在被执行时使得机器在机器人和控制台之间中继无线信号、调节发生器的控制参数并且/或者调节能量工具的控制参数，如本文所述。
在一个方面，机器人控制的外科工具及其端部执行器的一个或多个特征部和/或效应可由控制算法控制。例如，端部执行器效应的强度可通过存储在机器人的存储器中并且可由处理器执行的控制算法来控制。在一种情况下，端部执行器效应可以是排烟、吹气和/或冷却。在另一种情况下，端部执行器效应可以是关节运动和/或回缩。例如，机器人可实施用于机器人工具的关节运动的负载控制保持算法，该负载控制保持算法在组织上产生预定义侧向负载并且受到位移极限的限制，如本文进一步所述。
在某些情况下，可能期望将泵结合到机器人控制的外科工具中，诸如包括RF电极和/或超声刀的能量工具。泵可向外科部位提供吹气气体或空气。在某些情况下，泵可向外科部位提供冷却剂和/或可从外科部位提取烟雾和/或蒸汽。
机器人控制的外科工具包括用于与机器人能够释放地接合并且将驱动运动从机器人传输到机器人工具的驱动系统。例如，机器人控制的外科工具可包括接口，该接口包括被配置为接收来自马达壳体或工具安装部分中的一个或多个马达的旋转输入的一个或多个旋转驱动器。本文进一步描述了示例性驱动系统及其接口。
例如，机器人工具中的旋转驱动器被配置为致动各种外科功能，诸如轴的旋转、端部执行器钳口的闭合和端部执行器的关节运动。接口构型的示例在本文和2015年3月31日提交的名称为“SURGICAL INSTRUMENT WITH SHIFTABLE TRANSMISSION”的国际专利申请公布WO 2015/153642、2015年3月31日提交的名称为“CONTROL INPUT ACCURACY FORTELEOPERATED SURGICAL INSTRUMENT”的国际专利申请公布WO2015/153636和2011年11月15日提交的名称为“METHOD FOR PASSIVELY DECOUPLING TORQUE APPLIED BY A REMOTEACTUATOR INTO AN INDEPENDENTLY ROTATING MEMBER”的美国专利序列号9,095,362中有进一步描述，这些专利中的每个的全文以引用方式并入本文。
在某些情况下，马达的数量、旋转驱动器的数量和/或马达和/或旋转驱动器的布置可由驱动系统的占有面积和/或机器人工具和工具安装部分之间的联接来限制或约束。在一个方面，可能期望新的和/或改善的机器人控制的外科工具与现有机器人平台兼容。例如，在不扩大马达壳体或工具安装部分的情况下，可期望改变功能和/或增加用于与现有马达壳体和工具安装部分一起使用的机器人工具的功能。在此类情况下，将某些特征部例如泵结合到与现有外科机器人兼容的机器人工具中可能是具有挑战性的。此外，可能期望在外科机器人的现有架构内包括用于此类泵的控制和/或控制算法。
在一个方面，用于机器人工具的泵可由机器人工具接口的旋转驱动装置供电。因此，旋转驱动装置和泵可以可变速率驱动，这可取决于机器人工具和/或外科手术的需要。例如，联接到泵的旋转驱动装置的速度可以与正从外科部位抽出的烟雾的体积和/或机器人工具向组织施加的能量相关。在一种情况下，机器人工具可以是智能工具，该智能工具包括处理器，该处理器被配置为基于机器人工具上的传感器和/或机器人工具的其他输入来确定泵的适当速率。在其他情况下，机器人的控制单元中的处理器可被配置为基于机器人和/或其模块(诸如机器人集线器中的排烟模块)上的传感器来确定泵的适当速率。
能量装置利用能量来影响组织。在能量装置中，能量由发生器供应。能量装置包括具有组织接触电极的装置(诸如具有一个或多个射频(RF)电极的电外科装置)，以及具有振动表面的装置(诸如具有超声刀的超声装置)。对于电外科装置，发生器被配置为生成振荡电流以使电极通电。对于超声装置，发生器被配置为生成超声振动以使超声刀通电。
如本文所提供，能量装置将机械能或电能递送至目标组织，以便处理该组织(例如，切割组织和/或烧灼目标组织内和/或目标组织附近的血管)。组织的切割和/或烧灼可导致流体和/或颗粒被释放到空气中。在外科手术期间排出的此类流体和/或颗粒可构成烟雾，例如，该烟雾可包括悬浮在空气中的碳和/或其他颗粒。
在各种情况下，与机器人系统一起使用的能量工具可包括联接到泵的抽吸端口，该泵由工具驱动器上的马达供电。例如，用于da
外科机器人系统的能量工具可包括联接到泵的抽吸端口，该泵由工具驱动器上的马达供电。泵可被配置为经由抽吸端口从外科部位提取烟雾。在此类情况下，能量工具可包括排烟系统。在一个方面，机器人工具可包括泵。另选地，机器人工具可联接到泵。
读者将理解，此类排放系统可称为“排烟系统”，但此类系统可被配置为不仅仅是从外科部位排放烟雾。在整个本公开中，由排放系统排放的“烟雾”不仅限于烟雾。相反，本文所公开的排放系统可用于排放各种流体，包括液体、气体、蒸气、烟雾、蒸汽或它们的组合。这些流体可为生物来源的和/或可在手术期间从外部源引入外科部位。例如，这些流体可包括水、盐水、淋巴、血液、流出物和/或化脓性排出物。此外，流体可包括由排放系统排放的颗粒或其他物质(例如，细胞物质或碎片)。例如，此类颗粒可悬浮在流体中。
主要参见图33至图35，描绘了与外科端部执行器一起使用的机器人工具12426。机器人工具12426可与例如机器人外科系统12010(图23)一起使用。机器人工具12426是双极射频(RF)机器人工具。例如，该工具可在许多方面类似于2008年7月16日提交的名称为“BIPOLAR CAUTERY INSTRUMENT”的美国专利序列号8,771,270中所公开的工具，该专利全文以引用方式并入本文。
在其他情况下，机器人工具12426可以是单极RF工具、超声工具或超声-RF组合工具。例如，机器人工具12426在许多方面可类似于2013年3月13日提交的名称为“ROBOTICULTRASONIC SURGICAL DEVICE WITH ARTICULATING END EFFECTOR”的美国专利序列号9,314,308中所公开的工具，该专利全文以引用方式并入本文。
机器人工具12426包括近侧壳体12437、从近侧壳体12437延伸的轴12438和从轴12438的远侧端部延伸的端部执行器12428。主要参见图34，端部执行器12428包括相反的钳口12430a、12430b。每个钳口12430a、12430b包括具有电极的组织接触表面。例如，钳口12430a可包括供给电极，并且钳口12430b可包括返回电极，或反之亦然。端部执行器12428在图34中被示出为处于夹持构型并且生成RF焊接。在此类情况下，来自RF焊接的烟雾S可积聚在端部执行器12428周围。例如，在某些情况下，烟雾S可能积聚在患者的腹腔中。
机器人工具12426可包括排放系统12436。例如，为了改善机器人工具12426的可见度和效率，外科部位处的烟雾S可沿从端部执行器12428朝近侧延伸的排放通道或抽吸导管12440排放。排放通道12440可延伸穿过机器人工具12426的轴12438到达近侧壳体12437。排放导管12440终止于与端部执行器12428相邻的抽吸端口12442处。在排放系统12436的操作期间，外科部位处的烟雾S被抽吸到抽吸端口12442中并通过排放导管12440。
在各种情况下，机器人工具12426也可包括吹气、冷却和/或冲洗能力。例如，排放系统12436可被配置为选择性地朝端部执行器12428泵送流体(诸如盐水或CO2)并将其泵送到外科部位中。
在各种情况下，排放通道12440可以联接到泵，以用于在机器人工具12426的轴12438内沿抽放通道12440排放烟雾S。主要参见图35，排放系统12436包括泵12446。泵12446容纳在机器人工具12426的近侧壳体12437中。泵12446为凸轮泵，该泵已结合到机器人工具12426的驱动接口12448中。驱动接口12448包括旋转驱动器12450，该旋转驱动器由来自机器人的工具安装部分中的马达的旋转输出驱动，如本文所述(参见例如旋转输出12256(图31)和旋转输出12824a-12824e(图39))。
凸轮泵可为低体积且安静或无噪声的，并且因此在某些情况下是期望的。例如，凸轮泵可确保由排放系统12436产生的噪声不会分散临床医生的注意力并且/或者允许外科手术室中的临床医生之间的通信。读者将容易理解，在其他情况下，排放系统12436可使用不同的泵。
图33和图35中的终止于接头12454的通道12452从泵12446延伸。接头12454为鲁尔接头，然而，读者将容易理解，设想了另选的接头。鲁尔接头可选择性地联接到贮存器，该贮存器被配置为例如从外科部位接收烟雾S。附加地或另选地，鲁尔接头可将来自泵12446的排放物供应至过滤器。
仍然参见图35，描绘了驱动接口12448的内部部件，然而，为清楚起见排除了某些部件。排放通道12440延伸穿过轴12438到达近侧壳体12437中的凸轮泵12446。泵12446由接口12448的旋转驱动器12450驱动。在各种情况下，接口12448可包括四个旋转驱动器12450。在一个示例中，第一旋转驱动器12450被配置为驱动关节运动，第二旋转驱动器12450被配置为驱动钳口闭合运动，第三旋转驱动器12450被配置为驱动轴旋转，并且第四旋转驱动器12450被配置为驱动泵12446。读者将理解，另选的接口布置可包括多于或少于四个旋转驱动器12450。另外，由旋转驱动器12450生成的驱动运动可根据机器人工具12426的所需功能而变化。此外，在某些情况下，驱动接口12448可包括传动装置或切换器，使得旋转驱动器12450可在多种外科功能之间切换，如本文进一步所述(例如，参见图29中的传动装置12124和图40至图45中的传动组件12840)。在一种情况下，联接到泵12446的旋转驱动器12450还可例如致动端部执行器12428的夹持运动。
在一个方面，机器人工具12426的泵12446的激活可与机器人工具12426的能量施加相协调。在各种情况下，用于泵12446的旋转驱动器12450的控制算法可与烟雾S从外科部位提取的速率相关。在此类情况下，机器人(例如，图23和图27中的机器人12022)可直接控制从外科部位排放和/或提取的体积。
在一种情况下，基于来自相机(诸如像内窥镜一样的成像装置124(图2)的相机)的输入来控制对泵12446的接通/断开控制。成像装置124可被配置为检测外科部位处的视场中烟雾S的存在。在另一方面，基于来自烟雾传感器12453(图34)的输入来控制泵12446的接通/断开控制，该烟雾传感器与泵送出患者的流体串联。例如，只要烟雾传感器12453检测到阈值量的烟雾S，泵12446就可保持接通，并且可在检测的烟雾S的体积下降到阈值量以下时断开或暂停。在又一方面，当能量被激活时，泵12446被接通，并且在某些情况下可在能量停止后保持接通一段时间。例如，泵12446在能量停止之后可保持接通的持续时间可为固定的，或者可与能量被激活的时长成比例。
主要参见图37，示出了描绘用于操作泵(诸如泵12446)的逻辑步骤的流程图。与机器人进行信号通信的机器人(例如，机器人12022)的处理器和/或集线器(例如，集线器106、集线器206、机器人集线器122和机器人集线器222)的处理器可以确定或估计烟雾从外科部位排放的速率。在步骤12510处，可以通过一个或多个因素或输入确定排烟速率，这些因素或输入包括由机器人工具对能量的激活(第一输入12502)、与排烟通道串联的烟雾传感器(第二输入12504)和/或被配置为查看外科部位的成像装置(第三输入12506)。第一输入12502可对应于例如能量施加的持续时间和/或功率水平。基于该一个或多个因素，可在步骤12512处调节泵。例如，可调节旋转驱动器驱动泵的速率。在其他情况下，当检测的排烟速率低于阈值体积时，旋转驱动器可以停止或暂停泵的操作。图37中的流程图可在机器人工具的整个操作过程中继续。在某些情况下，步骤12510和12512可在外科手术期间和/或当临床医生请求和/或集线器推荐时以预定义的间隔重复。
现在参见图36，描绘了与机器人外科系统一起使用的机器人工具12526。机器人工具12526可与例如机器人外科系统12010(图23)一起使用。机器人工具12526为具有冷却和吹气能力的超声机器人工具。例如，机器人工具12526可在许多方面类似于2013年3月13日提交的名称为“ROBOTIC ULTRASONIC SURGICAL DEVICE WITH ARTICULATING ENDEFFECTOR”的美国专利序列号9,314,308中所公开的机器人工具，该专利全文以引用方式并入本文。
机器人工具12526包括近侧壳体12537、从近侧壳体12537延伸的轴12538和从轴12538的远侧端部延伸的端部执行器12528。端部执行器12528包括超声刀12530a和相对的夹持臂12530b。机器人工具12526还包括冲洗系统12536，该冲洗系统被配置为向外科部位提供冷却剂，诸如盐水或冷的CO2。冲洗可被配置为例如冷却组织和/或超声刀12530a。冲洗系统12536包括冲洗通道12540，该冲洗通道延伸穿过轴12538到达近侧壳体12537。冲洗通道12540终止于与端部执行器12528相邻的冲洗端口处。
在各种情况下，冲洗通道12540可联接到鼓风机，该鼓风机被配置为沿机器人工具12526的轴12538内的冲洗通道12540引导流体。冲洗系统12536包括鼓风机12546。鼓风机12546容纳在机器人工具12526的近侧壳体12537中。鼓风机12546为再生鼓风机，该鼓风机已结合到机器人工具12526的驱动接口12548中。驱动接口12548包括旋转驱动器12550，该旋转驱动器由来自机器人的工具安装部分中的马达的旋转输出驱动，如本文所述(参见例如旋转输出12256(图31)和旋转输出12824a-12824e(图39))。
终止于接头12554的通道12552从鼓风机12546延伸。接头12554为鲁尔接头，然而，读者将容易理解，设想了另选的接头。鲁尔接头可选择性地联接到贮存器，该贮存器被配置为向鼓风机12546提供冲洗流体。在操作中，冷却剂可通过接头12554进入吹气管线，并且鼓风机12546可在驱动接口12548处将冷却剂朝向鼓风机12546抽吸，然后沿机器人工具12526的轴12538将冷却剂朝向端部执行器12528向远侧吹送。冷却剂可在端部执行器12528处或临近该端部执行器排出，该冷却剂可冷却超声刀和/或保持外科部位吹气，诸如腹腔吹气。
在图36中，描绘了驱动接口12548的内部部件，然而，为清楚起见排除了某些部件。冲洗通道12540延伸穿过轴12538到达近侧壳体12537中的鼓风机12546。鼓风机12546由驱动接口12548的旋转驱动器12550驱动。类似于接口12448(图35)，接口12548包括四个旋转驱动器12550。在一个示例中，第一旋转驱动器12550被配置为驱动关节运动，第二旋转驱动器12550被配置为驱动钳口闭合运动，第三旋转驱动器12550被配置为驱动轴旋转，并且第四旋转驱动器12550被配置为驱动冲洗系统12536。读者将理解，另选的接口布置可包括多于或少于四个旋转驱动器12550。另外，由旋转驱动器12550生成的驱动运动可根据机器人工具的所需功能而变化。此外，在某些情况下，驱动接口12548可包括传动装置或切换器，使得旋转驱动器12550可在多种外科功能之间切换，如本文进一步所述(例如，参见图29中的传动装置12124和图40至图45中的传动组件12840)。在一种情况下，联接到鼓风机12546的旋转驱动器12550还可例如致动端部执行器12528的夹持运动。
如本文相对于图35中的泵12446所述，图36中的鼓风机12546的操作可与机器人工具12526施加的能量相协调。例如，鼓风机12546可在能量被激活时被接通，并且在某些情况下，鼓风机12546可在能量停止后保持接通一段时间。例如，鼓风机12546在能量停止之后可保持接通的持续时间可为固定的，或者可与能量被激活的时长成比例。附加地或另选地，鼓风机12546的功率水平可与机器人工具12526的激活电平成比例或以其他方式相关。例如，高功率水平可对应于第一速率，并且较低功率水平可对应于第二速率。在一个示例中，第二速率可不同于第一速率。
在一个方面，机器人工具12526还可包括位于再生鼓风机12546上游的吹气泵。吹气泵可将第一体积的流体引导到套管针中并且将第二体积的流体引导到再生鼓风机12546中。提供给套管针的流体可被配置为吹气外科部位，例如患者的腹腔。由再生鼓风机12546提供的流体可被配置为例如冷却超声刀。
机器人外科工具12426和12526可结合集线器(诸如机器人集线器122或机器人集线器222)使用。在一个方面，机器人集线器可包括态势感知模块，如本文所述。态势感知模块可被配置为基于从各种源(包括一个或多个机器人外科工具和/或发生器模块)接收到的信息来确定和/或确认外科手术中的步骤和/或建议特定外科动作。在一种情况下，机器人外科工具上的泵的致动可以通知态势感知模块已经采用了排放和/或冲洗，这可以得出关于特定外科手术或一组外科手术的结论。类似地，可将来自态势感知模块的数据供应至处理器。在某些情况下，处理器可通信地联接到存储指令的存储器，这些指令可由处理器执行以基于来自态势感知模块的数据来调节泵的泵送速率，该数据可指示例如外科手术的类型和/或外科手术中的步骤。例如，态势感知可指示吹气对于特定外科手术的至少一部分是必要的。在此类情况下，泵诸如鼓风机12546(图36)可被激活和/或保持在某一电平以保持足够的吹气。
在一个方面，机器人外科系统包括处理器和通信地联接到该处理器的存储器，如本文所述。存储器存储可由处理器执行的指令，以使机器人工具中的驱动器以可变速率旋转，以向机器人工具中的泵提供可调节的功率水平，如本文所述。
在各个方面，本公开提供了使机器人工具中的旋转驱动器以可变速率旋转的控制电路，如本文所述。在各个方面，本公开提供了存储计算机可读指令的非暂态计算机可读介质，这些计算机可读指令在被执行时使得机器以可变速率旋转机器人工具中的旋转驱动器，以向机器人工具中的泵提供可调节的功率水平，如本文所述。
现在参见图51和图52，描绘了利用两个机器人工具的外科手术。在图51中，机器人工具与外科部位处的组织接合。在该示例中，第一工具为柔性机器人牵开器12902，该柔性机器人牵开器向患者的肝脏L的部分施加回缩力。在图52中，柔性机器人牵开器12902可沿工具轴的纵向轴线在方向A上移动和/或可在方向B上横向移动(例如，在机器人牵开器中的两个刚性联接件之间的接头处枢转)。
在该示例中，第二工具为正被夹持在组织上的关节运动式双极工具12904。例如，关节运动式双极工具12904可被配置为利用双极RF电流将肝脏附接件A移动到肝脏。关节运动式双极工具12904可在方向C上侧向地进行关节运动(例如，在机器人工具12904的双极钳口近侧的关节运动接头处枢转)。在图52中用箭头指示了方向A、B和C。
在所描绘的示例中，当关节运动式双极工具12904的双极钳口试图切割和/或密封夹持的组织以移动肝脏附接件A时，柔性机器人牵开器12902试图挡住器官肝脏L。在一个方面，柔性机器人牵开器12902对肝脏L的移动可被配置为在双极工具12904使肝脏附接件A移动到肝脏L时保持恒定回缩力。负载控制算法可被配置为保持组织上的恒定回缩力。在某些情况下，负载控制算法可为在关节运动式双极工具12904和/或柔性机器人牵开器12902的关节运动接头处提供设定或预先确定的扭矩的关节运动控制算法。例如，可基于供应至关节运动马达的电流来近似关节运动接头处的设定扭矩。
在某些情况下，柔性机器人牵开器12902可能存在肝脏L过度回缩的风险或以其他方式危及肝脏L的过度回缩。例如，如果柔性机器人牵开器12902的位移接近设定的位移极限，则柔性机器人牵开器12902可能存在撕裂组织的一部分的风险。为了防止此类过度回缩，当柔性机器人牵开器12902的位移接近位移极限时，可通过负载控制算法减小由柔性机器人牵开器12902生成的力。例如，当已满足位移极限时，力可减小到低于恒定或基本上恒定的回缩力。
现在参见图53中的图形显示12910，随时间推移绘制了施加在器官上的回缩力F和通过延伸该器官机器人工具的位移δ。读者将理解，机器人工具12902和12904(如图51和图52中的外科手术所描绘的)可用于生成图形显示12910。还可设想另选的外科工具和外科手术。在一个方面，操作者可设定回缩力阈值Y和位移极限X，如图53所描绘的。在其他情况下，回缩力阈值Y和/或位移极限X可基于来自外科集线器和/或云的信息来确定和/或计算。在某些情况下，可基于存储在机器人、外科集线器和/或云的存储器中的数据向临床医生推荐特定回缩力阈值Y和/或位移极限X。回缩力阈值Y和/或位移极限X可取决于例如患者信息。
在外科手术期间，如果回缩力F降至低于恒定回缩力阈值Y，或相对于恒定回缩力阈值Y下降预定义的百分比或量，如时间t1、t2和t3，则柔性机器人牵开器12902可进一步移位以移位器官，并且将回缩力F朝向阈值Y增加。类似地，如果位移δ接近位移极限X，如在时间t4时，则可减小回缩力以限制位移进一步超过位移极限X。例如，再次参见图51，肝脏L被描绘为处于指示为L'的第二位置。肝脏L'的位置可对应于柔性机器人牵开器12902的位移极限X。
现在参见图54，示出了描绘用于操作机器人工具诸如工具12902(图51和图52)的逻辑步骤的流程图。在步骤12920处，用于机器人(例如，机器人12022)的处理器和/或与机器人进行信号通信的集线器(例如，集线器106、集线器206、机器人集线器122和机器人集线器222)的处理器可设定位移极限。另外，处理器可在步骤12922处设定力极限。位移极限和力极限可基于来自一个或多个源的输入来选择，这些输入包括临床医生输入12930、机器人输入12932、集线器输入12934和/或云输入12936，如本文进一步所述。在某些情况下，集线器可基于由机器人收集、提供给集线器和/或存储在云中的数据来建议特定极限。例如，态势感知模块可基于由态势感知模块探知的外科手术或其步骤来建议特定极限。附加地或另选地，临床医生可提供输入和/或从集线器的建议中选择极限。在其他情况下，临床医生可覆写集线器的建议。例如，这些极限可对应值的范围，诸如极限±1％、±5％或±10％。
机器人工具最初可以恒力模式操作。在步骤12924处，在恒力模式下，由机器人工具施加的力可保持在力极限处。处理器可监测力以确保力保持低于力极限Y。如果力超过力极限Y，则位移值可在步骤12926处增大，直到力达到或充分地接近力极限Y。当力在对应于力极限的值的范围内时，力可充分地接近力极限。处理器可监测位移以确保位移保持低于位移极限X。
如果位移接近位移极限X(或进入对应于位移极限的值的范围)，则机器人工具可切换至位移极限模式。在位移极限模式下，可在步骤12928处减小力值以确保机器人工具保持在位移极限内。可在步骤12922处设置新的力极限，以确保位移保持在位移极限内。在此类情况下，机器人工具可切换回恒力模式(具有新的减小的力极限)，并且可重复步骤12924、12926和12928。
在某些情况下，可将机器人工具中的一个或多个的轴的刚度纳入到负载控制算法中，以便在器官(如肝脏L)上实现所需量的侧向力。例如，柔性机器人牵开器12902可限定影响由该柔性机器人牵开器的端部执行器施加在组织上的侧向负载的刚度。
在某些情况下，用于机器人工具的驱动壳体可包括多个旋转驱动器，该多个旋转驱动器可由一个或多个马达能够操作地驱动。这些马达可定位在马达托架中，该马达托架可位于机器人臂的远侧端部处。在其他情况下，这些马达可结合到机器人工具中。在某些情况下，马达能够能够操作地驱动多个旋转驱动器，并且传动装置可被配置为在该多个旋转驱动器之间切换。在此类情况下，机器人工具不能同时致动与单个驱动马达相关联的两个或更多个旋转驱动器。例如，如本文相对于图29所述，马达12112可选择性地为滚动DOF12132、高力握持DOF 12136或工具致动DOF 12138中的一者供电。传动装置12124可选择性地将马达12112联接到适当的DOF。
在某些情况下，可能期望增加递送至机器人工具的输出的扭矩。例如，在某些情况下(诸如当待切割和/或缝合的组织特别厚或坚韧时)，对外科缝合器的夹持和/或击发可受益于附加扭矩。尤其是对于较长的端部执行器和/或较长的击发行程，可能需要附加扭矩来完成该击发行程。在某些情况下，可利用I形梁击发结构，尤其是用于较长的端部执行器和/或较长的击发行程。I形梁可限制例如击发行程的远侧末端处的柔性。然而，I形梁可能需要增加的扭矩。
另外，某些机器人工具可能需要关于同时操作多个DOF或外科端部执行器功能的附加灵活性。为了增加机器人系统的功率、扭矩和灵活性，可将附加马达和/或较大马达结合到马达托架中。然而，马达的添加和/或较大马达的利用可增加马达托架和驱动壳体的尺寸。
在某些情况下，机器人外科工具可包括紧凑的驱动壳体。紧凑的驱动壳体可改善机器人臂的进入包络。此外，紧凑的驱动壳体可使臂碰撞和缠结的风险最小化。尽管驱动壳体是紧凑的，但其仍可为机器人工具提供足够的功率、扭矩和灵活性。
在某些情况下，可利用驱动轴中的一个来实现端部执行器功能之间的切换。旋转驱动装置的切换和锁定可仅在例如机器人外科系统处于静止模式时发生。在一个方面，基于切换驱动装置的凸轮结构使三个旋转驱动装置根据需要操作尽可能多的端部执行器功能可能是可行的。在一个方面，通过配合使用三个旋转驱动装置，机器人外科工具可在四种不同的可能功能而不是三种不同的功能之间切换。例如，三个旋转驱动装置可影响轴旋转、独立的头部旋转、击发、闭合和辅助闭合装置。在其他情况下，旋转驱动装置可选择性地为泵供电，诸如分别在图35和图36中的外科工具12426和12526中。
附加地或另选地，在某些情况下，多个旋转驱动装置可协作地驱动单个输出轴。例如，为了增加递送至外科工具的扭矩，多个马达可被配置为在给定时间将扭矩递送至相同的输出轴。例如，在某些情况下，两个驱动马达可驱动单个输出。切换器驱动装置可被配置为使两个驱动马达与单个输出件独立地接合和脱离接合。在此类情况下，增加的扭矩可通过与多个旋转驱动器和端部执行器功能相关联的紧凑的驱动壳体递送至输出。因此，可增加外科工具的负载能力。此外，驱动壳体可容纳需要不同外科功能(包括对多个DOF或外科功能的操作)的外科工具。
现在参见图38至图45，描绘了用于机器人外科工具12830的驱动系统12800。驱动系统12800包括壳体12832和马达托架12828。外科工具12830的轴12834从壳体12832延伸。马达托架12828类似于马达托架12108(图29)容纳五个马达12826。在其他情况下，马达托架12828可容纳少于五个马达或多于五个马达。在其他情况下，马达12826可容纳在机器人外科工具12830中。
每个马达12826联接到旋转输出部12824，并且每个旋转输出部12824在驱动接口12822处联接到壳体12832中的旋转输入部12836。来自马达12826和对应旋转输出部12824的旋转运动被传输到相应旋转输入部12836。旋转输入部12836对应于壳体12832中的旋转驱动器或旋转驱动轴。在一个示例中，第一马达12826a可以是左/右关节运动(或偏航)马达，第二马达12826b可以是上/下关节运动(或俯仰)马达，第三马达12826c可以是切换器马达，第四马达12826d可以是第一协作马达，并且第五马达12826e可以是第二协作马达。类似地，第一旋转输出部12824a可以是左/右关节运动(或偏航)输出部，第二旋转输出部12824b可以是上/下关节运动(或俯仰)输出部，第三旋转输出部12824c可以是切换器输出部，第四旋转输出部12824d可以是第一协作输出部，并且第五旋转输出部12824e可以是第二协作输出部。此外，第一旋转输入部12836a可以是左/右关节运动(或偏航)驱动轴，第二旋转输入部12836b可以是上/下关节运动(或俯仰)驱动轴，第三旋转输入部12836c可以是切换器驱动轴，第四旋转输入部12836d可以是第一协作驱动轴，并且第五旋转输入部12836e可以是第二协作驱动轴。在其他情况下，驱动轴12836a-12836e能够在不同的取向上能够操作地定位以实现不同的齿轮系构型，从而传输所需旋转输出部。
图47至图50描绘了多种不同的构型下的外科工具12830。例如，在图47中外科工具12830处于未致动构型。在图48中，轴12834已经围绕偏航轴和俯仰轴(在箭头A和B的方向上)进行关节运动。第一旋转输入12836a和第二旋转输入12836b的旋转分别被配置为使轴12834围绕偏航轴和俯仰轴进行关节运动。在图49中，轴12834已在箭头C的方向上围绕轴12834的纵向轴线旋转，并且端部执行器12835的钳口已利用在箭头D的方向上的低力致动而闭合。第四旋转输出12836d的旋转被配置为选择性地影响轴12834的旋转，并且第五旋转输出12836e的旋转被配置为选择性地影响端部执行器12835的低力闭合。在图50中，端部执行器12835的钳口已被在箭头E的方向上的高力致动夹持，并且击发构件已在箭头F的方向上前进。第四旋转输出12836d和第五旋转输出12836e的旋转被配置为分别选择性地且协作地影响端部执行器12835的高力闭合和对其中的击发部件的击发。
现在主要参见图40至图45，壳体12832包括多层齿轮系组件。具体地，壳体12832包括层叠在第二齿轮系组件12838b下方的第一齿轮系组件12838a，该第二齿轮系组件层叠在第三齿轮系组件12838c下方，该第三齿轮系组件层叠在第四齿轮系组件12838d下方。例如，第一齿轮系组件12838a对应于第一DOF，诸如轴12834的旋转。例如，第二齿轮系组件12838b对应于第二DOF，诸如以低闭合力闭合(即快速闭合)端部执行器12835。例如，第三齿轮系组件12838c对应于第三DOF，诸如以高闭合力夹持(即缓慢闭合)端部执行器12835。例如，第四齿轮系组件12838d对应于第四DOF，诸如对端部执行器12835中的击发元件的击发。五个旋转输入部12836a-12836e延伸穿过四层齿轮系组件12838a-12838d。
第一马达12826a驱动地联接到第一旋转输入部12836a。在此类情况下，第一马达12826a被特别配置为驱动影响第一DOF的第一旋转输入部12836a。例如，主要参见图41，关节运动导线12842可从第一旋转输入部12836a穿过机器人工具12830的轴12834朝向端部执行器12835延伸。第一旋转输入部12836a的旋转被配置为致动关节运动导线12842以实现端部执行器12835的左/右关节运动。类似地，第二马达12826b驱动地联接到第二旋转输入部12836b。在此类情况下，第二马达12826b被特别配置为驱动影响第二DOF的第二旋转输入部12836b。仍然参见图41，关节运动导线12844可从第二旋转输入部12836b穿过机器人工具12830的轴12834朝向端部执行器12835延伸。第二旋转输入部12836b的旋转被配置为致动关节运动导线12844以影响端部执行器12835的上/下关节运动。在其他情况下，第一旋转输入部12836a和第二旋转输入部12836b中的至少一者可对应于不同的DOF或不同的外科功能。
壳体12832还包括传动组件12840。例如，第三旋转输入部12836c为传动组件12840的切换器驱动轴。如图40至图45所描绘的，第三旋转输入部12836c可以是凸轮轴，该凸轮轴包括多个凸轮凸角。凸轮凸角12839的布置可对应于层叠在壳体12832中的每个齿轮系组件12838a-12838d。此外，每个齿轮系组件12838a-12838d包括由第三旋转输入部12836c能够操作地接合的相应梭动件12846a-12846d。例如，第三旋转输入部12836c可延伸穿过每个梭动件12846a-12846d中的开口，并且选择性地接合梭动件12846a-12846d上的至少一个突起12848，以影响相应梭动件12846a-12846d相对于第三旋转输入部12836c的切换。换句话讲，第三旋转输入部12836c的旋转被配置为影响梭动件12846a-12846d的切换。当梭动件12846a-12846d分别在每个齿轮系组件12838a-12838d内切换时，协作驱动轴12836d和12836e选择性地驱动地联接到机器人工具12830的一个或多个输出轴，如本文进一步所述。
在其他情况下，用于机器人工具的驱动系统可包括竖直切换齿轮选择器，该竖直切换齿轮选择器可被配置为使梭动件12846a-12846d切换或以其他方式将马达的输出驱动装置接合到机器人工具12830上的一个或多个输入驱动装置。
仍然参见图38至图45，第四输出驱动和第五输出驱动或者第一协作驱动轴12836d和第二协作驱动轴12836e可分别独立地或以协调的同步方式操作。例如，在某些情况下，每个协作驱动轴12836d和12836e可与单个输出齿轮或输出轴配对。在其他情况下，协作驱动装置12836d和12836e可与单个输出齿轮或输出轴配对。
主要参见图42，在传动装置布置12840的第一构型中，第一协作驱动轴12836d与第一齿轮系组件12838a的第一输出齿轮12852驱动地接合。例如，第一齿轮系组件12838a包括一个或多个第一惰轮12850a。在图42中，第一齿轮系组件12838a包括两个第一惰轮12850a。第一惰轮12850a定位在第一齿轮系组件12838a中的第一梭动件12846a上。在第一构型(图42)中，第一梭动件12846a已通过凸轮轴12836c朝第一输出齿轮12852切换，使得第一梭动件12846a上的第一惰轮12850a中的一个移动成与第一输出齿轮12852啮合接合，并且第一惰轮12850a中的一个移动成与第一协作驱动轴12836d啮合接合。换句话讲，第一配合驱动轴12836d与第一输出齿轮12852驱动地接合。
第一输出齿轮12852的旋转对应于特定DOF。例如，第一输出齿轮12852的旋转被配置为使机器人工具12830的轴12834旋转。换句话讲，在传动装置布置12840(图42)的第一构型中，第四马达12826d和第四旋转输出12824d的旋转被配置为使第一协作驱动轴12836d旋转，该第一协作驱动轴经由第一惰轮齿轮12850a联接到第一输出齿轮12852并且使轴12834旋转(或滚动)。
第一齿轮系组件12838a还包括第一锁定臂12860a。第一锁定臂12860a从第一梭动件12846a延伸。第一梭动件12846a的移动被配置为移动第一锁定臂12860a。例如，在图42的第一构型中，第一锁定臂12860a与第一齿轮系组件12838a脱离接合，使得第一输出齿轮12852可旋转。第一梭动件12846a的移动可使第一锁定臂12860a移动成与第一输出齿轮12852接合。例如，当第一惰轮12850a移动成不与第一输出齿轮12852接合时，第一锁定臂12860a可接合第一输出齿轮12852或第一齿轮系组件12838a中的另一个齿轮以防止第一输出齿轮12852的旋转。
仍参见图42，在传动装置布置12840的第一构型中，第二协作驱动轴12836e与第二齿轮系组件12838b的第二输出齿轮12854驱动地接合。例如，第二齿轮系组件12838b包括一个或多个第二惰轮12850b以及与第二输出齿轮12854啮合接合的行星齿轮12853。在图42中，第二齿轮系组件12838b包括两个第二惰轮12850b。第二惰轮12850b定位在第二齿轮系组件12838b中的第二梭动件12846b上。在第一构型中，第二梭动件12846b已通过凸轮轴12836c朝第二输出齿轮12854切换，使得第二梭动件12846b上的第二惰轮12850b中的一个移动成与行星齿轮12853啮合，并且第二惰轮12850b中的一个移动成与第二协作驱动轴12836e啮合。换句话讲，第二协作驱动轴12836e经由第二惰轮12850b和行星齿轮12853与第二输出齿轮12854驱动地接合。第二输出齿轮12854被配置为驱动第二输出轴12864(图43至图45)，该第二输出轴将驱动运动传输到端部执行器12835。
第二输出齿轮12854的旋转对应于特定DOF。例如，第二输出齿轮12854的旋转被配置为以低闭合力闭合机器人工具12830的端部执行器12835。换句话讲，在传动装置布置12840的第一构型中，第五马达12826e和第五旋转输出部12824e的旋转被配置为使第二协作驱动轴12836e旋转，该第二协作驱动轴经由第二惰轮12850b和行星齿轮12853联接到第二输出齿轮12854，并且以低闭合力闭合机器人工具12830的端部执行器12835。
第二齿轮系组件12838b还包括第二锁定臂12860b。第二锁定臂12860b从第二梭动件12846b延伸。第二梭动件12846b的移动被配置为移动第二锁定臂12860b。例如，在图42的第一构型中，第二锁定臂12860b与行星齿轮12853脱离接合。第二梭动件12846b的移动可使第二锁定臂12860b移动成与第二行星齿轮12853接合。例如，当第二惰轮12850b移动成不与第二齿轮系组件12838b或其行星齿轮12853接合时，第二锁定臂12860b可接合第二齿轮系组件12838b的部分，诸如行星齿轮12853，以防止行星齿轮12853和第二输出齿轮12854的旋转。
在第一构型中，旋转驱动运动可分别同时施加到第一协作驱动轴12836d和第二协作驱动轴12836e，以同时影响多个自由度。例如，传动装置布置12840可允许轴12834的同时旋转以及端部执行器钳口的闭合。在其他情况下，当输出齿轮12852、12854中的一者驱动地联接到相应协作驱动轴12836d、12836e时，输出齿轮12852、12854中的另一者可由相应锁定臂锁定。
仍然参见图42，在传动装置布置12840的第一构型中，第三齿轮系组件12838c中的第三输出齿轮12856和第四齿轮系组件12838d中的第四输出齿轮12858分别经由锁定臂12860c和12860d锁定。因此，通过第一构型防止了第三输出齿轮12856的旋转，该旋转对应于端部执行器钳口的夹持或高力闭合。另外，还防止了第四输出齿轮12858的旋转，该旋转对应于击发端部执行器12835中的击发构件。换句话讲，当传动装置布置12840被配置为递送旋转运动以影响低力闭合DOF或轴旋转DOF时，防止了高力夹持和击发。在此类情况下，高力夹持功能和击发功能可由传动装置布置12840选择性地锁定。
现在参见图43，描绘了传动装置布置12840的第二构型。在第二构型中，第一协作驱动轴12836d和第二协作驱动轴12836e与第三齿轮系组件12838c的第三输出齿轮12856驱动地接合。第三输出齿轮12856被配置为驱动第三输出轴12866(图43至图45)，该第三输出轴将驱动运动传输到端部执行器12835。例如，第三齿轮系组件12838c包括一个或多个第三惰轮12850c和与第三输出齿轮12856啮合接合的行星齿轮12855。在图43中，第三齿轮系组件12838c包括三个第三惰轮12850c。第三惰轮12850c定位在第三齿轮系组件12838c中的第三梭动件12846c上。在第二构型中，第三梭动件12846c已通过凸轮轴12836c朝向第三输出齿轮12856切换，使得第三惰轮12850c中的一个移动成与行星齿轮12855啮合接合，第三惰轮12850c中的一个移动成与第一协作驱动轴12836d啮合接合，并且第三惰轮12850c中的一个移动成与第二协作驱动轴12836e啮合接合。换句话讲，协作驱动轴12836d和12836e两者经由第三惰轮12850c和行星齿轮12855与第三输出齿轮12856驱动地接合。
第三输出齿轮12856的旋转对应于特定DOF。例如，第三输出齿轮12856的旋转被配置为以高闭合力夹持机器人工具12830的端部执行器12835。换句话讲，在传动装置布置12840的第二构型中，第四马达12826d和第五马达12826e的旋转以及第四旋转输出部12824d和第五旋转输出部12824e的对应旋转分别被配置为使协作驱动轴12836d和12836e旋转。在此类情况下，由协作驱动轴12836d和12836e两者供应的扭矩经由第三惰轮12850c联接到第三输出齿轮12856，以高闭合力夹持机器人工具12830的端部执行器12835。
仍然参见图43，在传动装置布置12840的第二构型中，第三输出齿轮12856被解锁。更具体地，第三锁定臂12860c与第三齿轮系组件12838c脱离接合，使得第三输出齿轮12856可旋转。另外，凸轮轴12836c已使第一锁定臂12860a移动成与第一齿轮系组件12838a接合，使第二锁定臂12860b移动成与第二齿轮系组件12838b接合，并且使第四锁定臂12860d移动成与第四齿轮系组件12838d接合，以分别防止第一输出齿轮12852、第二输出齿轮12854和第四输出齿轮12858的旋转。因此，处于第二构型的传动装置布置12840防止轴12834的旋转、对端部执行器钳口的低力闭合、以及对端部执行器12835的击发。在此类情况下，轴旋转功能、低力闭合功能和击发功能可由传动装置布置12840选择性地锁定。
现在参见图44，描绘了传动装置布置12840的第三构型。在第三构型中，第一协作驱动轴12836d和第二协作驱动轴12836e与第四齿轮系组件12838d的第四输出齿轮12858驱动地接合。例如，第四齿轮系组件12838d包括一个或多个第四惰齿轮12850d和与第四输出齿轮12858啮合接合的行星齿轮12857。在图44中，第四齿轮系组件12838d包括三个第四惰轮12850d。第四惰轮12850d定位在第四齿轮系组件12838d中的第四梭动件12846d上。在第三构型中，第四梭动件12846d已通过凸轮轴12836d朝向第四输出齿轮12858切换，使得第四惰轮12850d中的一个移动成与行星齿轮12857啮合接合，第四惰轮12850d中的一个移动成与第一协作驱动轴12836d啮合接合，并且第四惰轮12850d中的一个移动成与第二协作驱动轴12836e啮合接合。换句话讲，协作驱动轴12836e和12836e两者经由第四惰轮12850d和行星齿轮12857与第四输出齿轮12858驱动地接合。第四输出齿轮12858被配置为驱动第三输出轴12868(图43至图45)，该第三输出轴将驱动运动传输到端部执行器12835。
第四输出齿轮12858的旋转对应于特定DOF。例如，第四输出齿轮12858的旋转被配置为击发机器人工具12830的端部执行器12835中的击发构件。换句话讲，在传动装置布置12840的第三构型中，第四马达12826d和第五马达12826e的旋转以及第四旋转输出部12824d和第五旋转输出部12824e的对应旋转分别被配置为使协作驱动轴12836d和12836e旋转。在此类情况下，由协作驱动轴12836d和12836e两者供应的扭矩经由第四惰齿轮12850d和行星齿轮12857联接到第四输出齿轮12858，以击发机器人工具12830的端部执行器12835。
仍然参见图44，在传动装置布置12840的第三构型中，第四输出齿轮12858被解锁。更具体地，第四锁定臂12860d与第四齿轮系组件12838d脱离接合，使得第四输出齿轮12858可旋转。另外，凸轮轴12836c已使第一锁定臂12860a移动成与第一齿轮系组件12838a接合，使第二锁定臂12860b移动成与第二齿轮系组件12838b接合，并且使第三锁定臂12860c移动成与第三齿轮系组件12838c接合，以分别防止第一输出齿轮12852、第二输出齿轮12854和第三输出齿轮12856的旋转。因此，处于第三构型的传动装置布置12840防止轴12852的旋转、对端部执行器钳口的低力闭合、以及对端部执行器钳口的高力夹持。在此类情况下，轴旋转功能、低力闭合功能和高力夹持功能可由传动装置布置12840选择性地锁定。
在一个方面，双驱动马达12826d和12826e可与切换马达12826c相协调以提供实现多个端部执行器功能的紧凑的驱动壳体12832。此外，可经由协作驱动轴12836d和12836e为一个或多个端部执行器功能供应更大的扭矩。
在一个方面，当协作驱动轴12836d和12836e一起操作时，该两个驱动轴12836d和12836e同步。例如，驱动轴12836d和12836e均可驱动共用输出轴，诸如输出轴12866和/或12868。可经由驱动轴12836d和12836e两者向共用输出轴12866和/或12868提供扭矩。
现在参见图46，描绘了用于机器人工具(诸如机器人工具12830(图38至图45))的不同外科功能的输出扭矩的图形显示12890。用于经由第一协作驱动轴旋转工具轴(例如，轴12834)以及用于经由第二协作驱动轴低力闭合端部执行器钳口的输出扭矩小于t1(来自单个轴的最大输出扭矩)。例如，用于轴旋转和低力钳口闭合的较低输出扭矩可在可从主轴上的缆线获得的负载范围内。在某些情况下，外科工具的其他较低负载功能可受到来自单个轴的输出的影响。
为了影响高力夹持，扭矩接近t2，即来自协作驱动轴(例如，协作驱动轴12836d和12836e)的最大输出扭矩。例如，t2可为t1值的两倍。图46中的值“a”和“b”示出了机器人工具的相对力。值“a”为低力闭合和高力夹持之间的负载差值，诸如利用闭合管系统的闭合和经由I形梁的夹持。在某些情况下，闭合管系统和I形梁系统可如图46中所示在时间上配合或重叠，以完成对端部执行器的夹持。值“b”可等于或小于值“a”。例如，击发端部执行器所需的扭矩可与低力闭合和高力夹持之间的扭矩差值相同或基本上相同。值“a”和“b”大于来自单个轴的最大输出扭矩，但小于来自协作驱动轴的最大输出扭矩。
在一种情况下，多个驱动轴(例如，协作驱动轴12836d和12836e)的同步可以是一个驱动轴对随后的另一个驱动轴的从属。例如，可在从属驱动轴上设定不同的最大扭矩阈值，使得它可以向上推动至第一驱动轴的极限，但不能超过该极限。在一个方面，可监测输出轴的速度以提高和/或降低旋转速度。例如，传感器可被定位成检测输出轴的旋转速度。此外，当协作驱动轴中的一个开始减慢或制动输出轴而不是两个协作驱动轴使其加速时，这些协作驱动轴可被协调以平衡扭矩。
本文所述的马达容纳在机器人臂上的工具架中。在其他情况下，这些马达中的一个或多个可容纳在机器人工具中。
在一个方面，机器人工具的接口处的输入驱动器被配置为与工具架中的输出驱动器机械地联接和电联接。如本文所述，工具架中的马达被配置为将旋转驱动运动递送至机器人工具中的驱动器。在其他情况下，机器人工具中的驱动器可被配置为从工具架中的输出驱动器接收线性驱动运动。例如，一种或多种线性驱动运动可跨工具架和机器人工具之间的接口进行传输。
当单个马达驱动地联接到输出轴时，与其中多于一个马达驱动地联接到输出轴的高扭矩操作状态相比，传输组件处于低扭矩操作状态。在高扭矩操作状态下可递送至输出轴的最大扭矩大于在低扭矩操作状态下可递送至输出轴的最大扭矩。在一种情况下，高扭矩操作状态下的最大扭矩可为低扭矩操作状态下的最大扭矩的两倍。可递送至输出轴的最大扭矩可基于马达的尺寸和扭矩能力。
在一个方面，机器人外科系统包括处理器和通信地联接到该处理器的存储器，如本文所述。该存储器存储指令，这些指令可由处理器执行以选择性地将第一旋转驱动器和第二旋转驱动器能够操作地联接到工具壳体的输出轴，其中第一旋转驱动器和第二旋转驱动器中的一者被配置为在低扭矩操作状态下向输出轴供应扭矩，并且其中第一旋转驱动器和第二旋转驱动器被配置为在高扭矩操作状态下同时向输出轴供应扭矩，如本文所述。
在各个方面，本公开提供了一种控制电路，以选择性地将第一旋转驱动器和/或第二旋转驱动器能够操作地联接到输出轴，如本文所述。在各个方面，本公开提供了存储计算机可读指令的非暂态计算机可读介质，这些计算机可读指令在被执行时使得机器选择性地将第一旋转驱动器和/或第二旋转驱动器能够操作地联接到输出轴，如本文所述。
以下专利的全部公开内容：
·2011年5月27日提交的名称为“SURGICAL STAPLING INSTRUMENTS WITHROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利序列号9,072,535，该专利于2015年7月7日公布；
·2012年6月28日提交的名称为“DIFFERENTIAL LOCKING ARRANGEMENTS FORROTARY POWERED SURGICAL INSTRUMENTS”的美国专利序列号9,072,536，该专利于2015年7月7日公布；
·2012年6月28日提交的名称为“FLEXIBLE DRIVE MEMBER”的美国专利序列号9,204,879，该专利于2015年12月8日公布；
·2012年6月28日提交的名称为“INTERCHANGEABLE CLIP APPLIER”的美国专利序列号9,561,038，该专利于2017年2月7日公布；
·2014年9月5日提交的名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTINGA SECOND SENSOR’S OUTPUT OR INTERPRETATION”的美国专利序列号No.9,757,128，该专利于2017年9月12日公布；
·2015年3月6日提交的名称为“OVERLAID MULTI SENSOR RADIO FREQUENCY(RF)ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION”的美国专利申请序列号14/640,935，现为美国专利申请公布2016/0256071；
·2016年12月16日提交的名称为“MODULAR BATTERY POWERED HANDHELDSURGICAL INSTRUMENT WITH SELECTIVE APPLICATION OF ENERGY BASED ON TISSUECHARACTERIZATION”的美国专利申请序列号15/382,238，现为美国专利申请公布2017/0202591；以及
·2016年8月16日提交的名称为“CONTROL OF ADVANCEMENT RATE ANDAPPLICATION FORCE BASED ON MEASURED FORCES”的美国专利申请序列号15/237,753，现为美国专利申请公布2018/0049822；
这些专利申请的相应全文以引用方式并入本文。
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1.一种机器人外科工具，所述机器人外科工具包括：端部执行器，所述端部执行器包括能量递送表面；通道，所述通道延伸到所述端部执行器；以及用于与机器人工具驱动器可释放地接合的近侧接口，其中所述近侧接口包括：多个旋转驱动器，所述多个旋转驱动器包括第一旋转驱动器；以及泵，所述泵流体地联接到所述通道并由所述第一旋转驱动器驱动，其中所述第一旋转驱动器被配置为以可变速率旋转以为所述泵提供可调节的功率水平。
实施例2.根据实施例1所述的机器人外科工具，其中，所述可变速率取决于沿所述通道的烟雾排出的速率。
实施例3.根据实施例1和2中任一项所述的机器人外科工具，还包括传感器，所述传感器被配置为检测通过所述通道的烟雾排出的速率。
实施例4.根据实施例1至3中任一项所述的机器人外科工具，其中，所述可变速率取决于所述能量递送表面的激活。
实施例5.根据实施例1至4中任一项所述的机器人外科工具，其中，所述端部执行器还包括超声刀。
实施例6.根据实施例1至5中任一项所述的机器人外科工具，还包括在所述端部执行器和所述近侧接口中间延伸的轴，其中所述轴包括穿过其的所述通道。
实施例7.根据实施例1至6中任一项所述的机器人外科工具，其中，所述泵包括凸轮泵。
实施例8.根据实施例1至7中任一项所述的机器人外科工具，还包括：处理器和通信地联接到所述处理器的存储器，其中所述存储器存储指令，所述指令能够由所述处理器执行以基于沿所述通道的烟雾排出的速率来控制所述第一旋转驱动器的旋转。
实施例9.根据实施例1至8中任一项所述的机器人外科工具，还包括控制电路，所述控制电路被配置为基于沿所述通道的烟雾排出的速率来控制所述第一旋转驱动器的旋转。
实施例10.根据实施例1至9中任一项所述的机器人外科工具，其中，所述外科工具被配置为从处理器接收控制信号以控制所述第一旋转驱动器的所述可变速率。
实施例11.根据实施例1至10中任一项所述的机器人外科工具，其中，所述泵还被配置为使吹入气体运动。
实施例12.一种机器人外科系统，所述机器人外科系统包括：能量工具，所述能量工具包括：传感器；通道；旋转驱动器；以及泵，所述泵流体地联接到所述通道并由所述旋转驱动器驱动。处理器，所述处理器与所述传感器进行信号通信；以及存储器，所述存储器通信地联接到所述处理器，其中所述存储器存储指令，所述指令能够由所述处理器执行以基于来自所述传感器的输入来控制所述旋转驱动器的旋转。
实施例13.根据实施例12所述的机器人外科系统，其中，所述传感器被配置为向所述处理器提供指示由所述传感器检测的烟雾体积的信号。
实施例14.根据实施例12和13中任一项所述的机器人外科系统，其中，所述能量工具包括组织接触电极，并且其中所述存储器存储指令，该指令能够由所述处理器执行以基于所述组织接触电极的激活来控制所述旋转驱动器的旋转。
实施例15.根据实施例12至14中任一项所述的机器人外科系统，其中，所述传感器包括成像装置。
实施例16.根据实施例12至15中任一项所述的机器人外科系统，还包括与所述旋转驱动器驱动地接合的马达，并且其中所述处理器与所述马达进行信号通信。
实施例17.根据实施例12至16中任一项所述的机器人外科系统，其中，所述能量工具包括所述处理器。
实施例18.根据实施例12至17中任一项所述的机器人外科系统，还包括外科集线器，所述外科集线器包括态势感知模块，其中所述存储器存储指令，该指令能够由所述处理器执行以基于来自所述态势感知模块的输入来控制所述旋转驱动器的旋转。
实施例19.一种机器人外科系统，所述机器人外科系统包括：能量工具，所述能量工具包括：传感器；通道；旋转驱动器；以及泵，所述泵流体地联接到所述通道并由所述旋转驱动器驱动。以及控制电路，所述控制电路被配置为基于来自所述传感器的输入来控制所述旋转驱动器的旋转。
实施例20.一种存储计算机可读指令的非暂态计算机可读介质，所述计算机可读指令在被执行时使机器：从机器人外科工具上的传感器接收信号；以及基于所述信号调节所述机器人外科工具上的旋转驱动器的旋转，其中所述旋转驱动器能够操作地联接到所述机器人外科工具上的泵，所述泵流体地联接到所述机器人外科工具上的排出通道。
尽管已举例说明和描述了多个形式，但是申请人的意图并非将所附权利要求的范围约束或限制在此类细节中。在不脱离本公开的范围的情况下，可实现对这些形式的许多修改、变化、改变、替换、组合和等同物，并且本领域技术人员将想到这些形式的许多修改、变化、改变、替换、组合和等同物。此外，另选地，可将与所描述的形式相关联的每个元件的结构描述为用于提供由所述元件执行的功能的器件。另外，在公开了用于某些部件的材料的情况下，也可使用其他材料。因此，应当理解，上述具体实施方式和所附权利要求旨在涵盖属于本发明所公开的形式范围内的所有此类修改形式、组合和变型形式。所附权利要求旨在涵盖所有此类修改、变化、改变、替换、修改和等同物。
上述具体实施方式已通过使用框图、流程图和/或示例阐述了装置和/或方法的各种形式。只要此类框图、流程图和/或示例包含一个或多个功能和/或操作，本领域的技术人员就要将其理解为此类框图、流程图和/或示例中的每个功能和/或操作都可以单独和/或共同地通过多种硬件、软件、固件或实际上它们的任何组合来实施。本领域的技术人员将会认识到，本文公开的形式中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(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(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，设计电子电路和/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。另外，本领域的技术人员将会认识到，本文所述主题的机制能够作为多种形式的一个或多个程序产品进行分布，并且本文所述主题的示例性形式适用，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。
用于编程逻辑以执行各种所公开的方面的指令可存储在系统内的存储器内，诸如动态随机存取存储器(DRAM)、高速缓存、闪存存储器或其它存储器。此外，指令可经由网络或通过其它计算机可读介质来分发。因此，机器可读介质可包括用于存储或发射以机器(例如，计算机)读形式的信息的机构，但不限于软盘、光学盘、光盘、只读存储器(CD-ROM)、磁光盘、只读存储器(ROM)、随机存取存储器(RAM)、可擦除可编程只读存储器(EPROM)、电可擦除可编程只读存储器(EEPROM)、磁卡或光卡、闪存存储器、或经由电信号、光学信号、声学信号或其它形式的传播信号(例如，载波、红外信号、数字信号等)在因特网上发射信息时使用的有形的、机器可读存储装置。因此，非暂态计算机可读介质包括适于以机器(例如，计算机)可读的形式存储或发射电子指令或信息的任何类型的有形机器可读介质。
如本文任一方面所用，术语“控制电路”可指例如硬连线电路系统、可编程电路系统(例如，计算机处理器，该计算机处理器包括一个或多个单独指令处理内核、处理单元，处理器、微控制器、微控制器单元、控制器、数字信号处理器(DSP)、可编程逻辑装置(PLD)、可编程逻辑阵列(PLA)、场可编程门阵列(FPGA))、状态机电路系统、存储由可编程电路系统执行的指令的固件、以及它们的任何组合。控制电路可以集体地或单独地实现为形成更大系统的一部分的电路系统，例如集成电路(IC)、专用集成电路(ASIC)、片上系统(SoC)、台式计算机、膝上型计算机、平板计算机、服务器、智能电话等。因此，如本文所用，“控制电路”包括但不限于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(如，至少部分地实施本文所述的方法和/或设备的由计算机程序配置的通用计算机，或至少部分地实施本文所述的方法和/或设备的由计算机程序配置的微处理器)、形成存储器设备(如，形成随机存取存储器)的电子电路，和/或形成通信设备(如，调节解调器、通信开关或光电设备)的电子电路。本领域的技术人员将会认识到，可以模拟或数字方式或它们的一些组合实施本文所述的主题。
如本文的任何方面所用，术语“逻辑”可指被配置为执行前述操作中的任一者的应用程序、软件、固件和/或电路系统。软件可体现为记录在非暂态计算机可读存储介质上的软件包、代码、指令、指令集和/或数据。固件可以体现为在存储器设备中硬编码(例如，非易失性)的代码、指令或指令集和/或数据。
如本文任一方面所用，术语“器件”、“系统”、“模块”等可指计算机相关实体、硬件、硬件和软件的组合、软件或执行中的软件。
如本文任一方面中所用，“算法”是指导致所需结果的有条理的步骤序列，其中“步骤”是指物理量和/或逻辑状态的操纵，物理量和/或逻辑状态可以(但不一定)采用能被存储、转移、组合、比较和以其它方式操纵的电或磁信号的形式。常用于指这些信号，如位、值、元素、符号、字符、术语、数字等。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和/或状态的方便的标签。
网络可包括分组交换网络。通信装置可能够使用所选择的分组交换网络通信协议来彼此通信。一个示例性通信协议可包括可允许使用传输控制协议/因特网协议(TCP/IP)进行通信的以太网通信协议。以太网协议可符合或兼容电气和电子工程师学会(IEEE)于2008年12月发布的名为“IEEE 802.3标准”的以太网标准和/或本标准的更高版本。另选地或附加地，通信装置可以能够使用X.25通信协议彼此通信。X.25通信协议可符合或符合国际电信联盟电信标准化部门(ITU-T)颁布的标准。另选地或附加地，通信装置可能能够使用帧中继通信协议彼此通信。帧中继通信协议可符合或符合国际电话和电话协商委员会(CCITT)和/或美国国家标准学会(ANSI)发布的标准。另选地或附加地，收发器可能能够使用异步传输模式(ATM)通信协议彼此通信。ATM通信协议可符合或兼容ATM论坛于2001年8月发布的名为“ATM-MPLS网络互通2.0”的ATM标准和/或该标准的更高版本。当然，本文同样设想了不同的和/或之后开发的连接取向的网络通信协议。
除非上述公开中另外明确指明，否则可以理解的是，在上述公开中，使用术语如“处理”、“估算”、“计算”、“确定”、“显示”的讨论是指计算机系统或类似的电子计算设备的动作和进程，其操纵表示为计算机系统的寄存器和存储器内的物理(电子)量的数据并将其转换成类似地表示为计算机系统存储器或寄存器或其他此类信息存储、传输或显示设备内的物理量的其他数据。
一个或多个部件在本文中可被称为“被配置为”、“可被配置为”、“能够操作/能够操作地”、“适于/可适于”、“能够”、“可适形/适形于”等。本领域的技术人员将会认识到，除非上下文另有所指，否则“被配置为”通常可涵盖活动状态的部件和/或未活动状态的部件和/或待机状态的部件。
术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分，术语“远侧”是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而，外科器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。
本领域的技术人员将认识到，一般而言，本文、以及特别是所附权利要求(例如，所附权利要求的正文)中所使用的术语通常旨在为“开放”术语(例如，术语“包括”应解释为“包括但不限于”，术语“具有”应解释为“至少具有”，术语“包含”应解释为“包含但不限于”等)。本领域的技术人员还应当理解，如果所引入权利要求叙述的具体数目为预期的，则这样的意图将在权利要求中明确叙述，并且在不存在这样的叙述的情况下，不存在这样的意图。例如，为有助于理解，下述所附权利要求可含有对介绍性短语“至少一个”和“一个或多个”的使用以引入权利要求。然而，对此类短语的使用不应视为暗示通过不定冠词“一个”或“一种”引入权利要求表述将含有此类引入权利要求表述的任何特定权利要求限制在含有仅一个这样的表述的权利要求中，甚至当同一权利要求包括介绍性短语“一个或多个”或“至少一个”和诸如“一个”或“一种”(例如，“一个”和/或“一种”通常应解释为意指“至少一个”或“一个或多个”)的不定冠词时；这也适用于对用于引入权利要求表述的定冠词的使用。
另外，即使明确叙述引入权利要求叙述的特定数目，本领域的技术人员应当认识到，此种叙述通常应解释为意指至少所叙述的数目(例如，在没有其它修饰语的情况下，对“两个叙述”的裸叙述通常意指至少两个叙述、或两个或更多个叙述)。此外，在其中使用类似于“A、B和C中的至少一者等”的惯例的那些情况下，一般而言，这种结构意在具有本领域的技术人员将理解所述惯例的意义(例如，“具有A、B和C中的至少一者的系统”将包括但不限于具有仅A、仅B、仅C、A和B一起、A和C一起、B和C一起和/或A、B和C一起等的系统)。在其中使用类似于“A、B或C中的至少一者等”的惯例的那些情况下，一般而言，这种结构意在具有本领域的技术人员将理解所述惯例的意义(例如，“具有A、B或C中的至少一者的系统”应当包括但不限于具有仅A、仅B、仅C、A和B一起、A和C一起、B和C一起和/或A、B和C一起等的系统)。本领域的技术人员还应当理解，通常，除非上下文另有指示，否则无论在具体实施方式、权利要求或附图中呈现两个或更多个替代术语的转折性词语和/或短语应理解为涵盖包括所述术语中的一者、所述术语中的任一个或这两个术语的可能性。例如，短语“A或B”通常将被理解为包括“A”或“B”或“A和B”的可能性。
对于所附的权利要求，本领域的技术人员将会理解，其中表述的操作通常可以任何顺序进行。另外，尽管以(一个或多个)序列出了多个操作流程图，但应当理解，可以不同于所示顺序的其它顺序进行所述多个操作，或者可以同时进行所述多个操作。除非上下文另有规定，否则此类替代排序的示例可包括重叠、交错、中断、重新排序、增量、预备、补充、同时、反向，或其他改变的排序。此外，除非上下文另有规定，否则像“响应于”、“相关”这样的术语或其它过去式的形容词通常不旨在排除此类变体。
值得一提的是，任何对“一个方面”、“一方面”、“一范例”、“一个范例”的提及均意指结合所述方面所述的具体特征、结构或特性包括在至少一个方面中。因此，在整个说明书的不同位置出现的短语“在一个方面”、“在一方面”、“在一范例”、“在一个范例”不一定都指同一方面。此外，具体特征、结构或特性可在一个或多个方面中以任何合适的方式组合。
本说明书提及和/或在任何申请数据表中列出的任何专利申请，专利，非专利公布或其它公开材料均以引用方式并入本文，只要所并入的材料在此不一致。因此，并且在必要的程度下，本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其他公开材料相冲突的任何材料或其部分，将仅在所并入的材料与现有的公开材料之间不产生冲突的程度下并入。
概括地说，已经描述了由采用本文所述的概念产生的许多有益效果。为了举例说明和描述的目的，已经提供了一个或多个形式的上述具体实施方式。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。选择和描述的一个或多个形式是为了说明原理和实际应用，从而使本领域的普通技术人员能够利用适用于预期的特定用途的所述多个形式和多种修改形式。与此一同提交的权利要求书旨在限定完整范围。
Claims (20)
1.一种机器人外科工具，所述机器人外科工具包括：
端部执行器，所述端部执行器包括能量递送表面；
通道，所述通道延伸到所述端部执行器；和
近侧接口，所述近侧接口用于与机器人工具驱动器可释放地接合，其中所述近侧接口包括：
多个旋转驱动器，所述多个旋转驱动器包括第一旋转驱动器；和
泵，所述泵流体地联接到所述通道并由所述第一旋转驱动器驱动，其中所述第一旋转驱动器被配置为以可变速率旋转以为所述泵提供可调节的功率水平。
2.根据权利要求1所述的机器人外科工具，其中，所述可变速率取决于沿所述通道的烟雾排出的速率。
3.根据权利要求1所述的机器人外科工具，还包括传感器，所述传感器被配置为检测通过所述通道的烟雾排出的速率。
4.根据权利要求1所述的机器人外科工具，其中，所述可变速率取决于所述能量递送表面的激活。
5.根据权利要求1所述的机器人外科工具，其中，所述端部执行器还包括超声刀。
6.根据权利要求1所述的机器人外科工具，还包括在所述端部执行器和所述近侧接口中间延伸的轴，其中所述轴包括穿过其的所述通道。
7.根据权利要求1所述的机器人外科工具，其中，所述泵包括凸轮泵。
8.根据权利要求1所述的机器人外科工具，还包括：
处理器；和
存储器，所述存储器通信地联接到所述处理器，其中所述存储器存储指令，所述指令能够由所述处理器执行以基于沿所述通道的烟雾排出的速率来控制所述第一旋转驱动器的旋转。
9.根据权利要求8所述的机器人外科工具，还包括控制电路，所述控制电路被配置为基于沿所述通道的烟雾排出的速率来控制所述第一旋转驱动器的旋转。
10.根据权利要求1所述的机器人外科工具，其中，所述外科工具被配置为从处理器接收控制信号以控制所述第一旋转驱动器的所述可变速率。
11.根据权利要求1所述的机器人外科工具，其中，所述泵还被配置为使吹入气体运动。
12.一种机器人外科系统，所述机器人外科系统包括：
能量工具，所述能量工具包括：
传感器；
通道；
旋转驱动器；和
泵，所述泵流体地联接到所述通道并由所述旋转驱动器驱动；
处理器，所述处理器与所述传感器进行信号通信；和
存储器，所述存储器通信地联接到所述处理器，其中所述存储器存储指令，所述指令能够由所述处理器执行以基于来自所述传感器的输入来控制所述旋转驱动器的旋转。
13.根据权利要求12所述的机器人外科系统，其中，所述传感器被配置为向所述处理器提供指示由所述传感器检测的烟雾体积的信号。
14.根据权利要求12所述的机器人外科系统，其中，所述能量工具包括组织接触电极，并且其中所述存储器存储指令，该指令能够由所述处理器执行以基于所述组织接触电极的激活来控制所述旋转驱动器的旋转。
15.根据权利要求12所述的机器人外科系统，其中，所述传感器包括成像装置。
16.根据权利要求12所述的机器人外科系统，还包括与所述旋转驱动器驱动地接合的马达，并且其中所述处理器与所述马达进行信号通信。
17.根据权利要求12所述的机器人外科系统，其中，所述能量工具包括所述处理器。
18.根据权利要求12所述的机器人外科系统，还包括外科集线器，所述外科集线器包括态势感知模块，其中所述存储器存储指令，该指令能够由所述处理器执行以基于来自所述态势感知模块的输入来控制所述旋转驱动器的旋转。
19.一种机器人外科系统，包括：
能量工具，所述能量工具包括：
传感器；
通道；
旋转驱动器；和
泵，所述泵流体地联接到所述通道并由所述旋转驱动器驱动；和
控制电路，所述控制电路被配置为基于来自所述传感器的输入来控制所述旋转驱动器的旋转。
20.一种存储计算机可读指令的非暂态计算机可读介质，所述计算机可读指令在被执行时使机器：
从机器人外科工具上的传感器接收信号；以及
基于所述信号调节所述机器人外科工具上的旋转驱动器的旋转，其中所述旋转驱动器能够操作地联接到所述机器人外科工具上的泵，所述泵流体地联接到所述机器人外科工具上的排出通道。
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