CN117337155A - 包括信息访问控制系统的钉仓 - Google Patents
包括信息访问控制系统的钉仓 Download PDFInfo
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- CN117337155A CN117337155A CN202280030786.4A CN202280030786A CN117337155A CN 117337155 A CN117337155 A CN 117337155A CN 202280030786 A CN202280030786 A CN 202280030786A CN 117337155 A CN117337155 A CN 117337155A
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- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/038—Automatic limiting or abutting means, e.g. for safety during shipment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
- A61B2090/065—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
Abstract
公开了一种用于与外科器械一起使用的钉仓,该钉仓包括:仓体,该仓体包括近侧端部、远侧端部和钉腔;钉,该钉以可移除方式储存在所述钉腔中;滑动件,该滑动件能够在钉击发行程期间朝向所述远侧端部移动,以将所述钉从所述钉腔射出;传感器,该传感器被配置为能够检测所述滑动件的位置;和至少一个存储器装置,所述至少一个存储器装置与所述传感器连通,其中所述至少一个存储器装置被配置为能够存储:指示所述钉击发行程是否已被执行的至少一个数据;关于执行所述钉击发行程的时间和日期的至少一个数据;关于用于击发所述钉仓的所述外科器械的至少一个数据;和关于何时所述至少一个存储器装置已被所述外科器械外部的装置访问的至少一个数据。
Description
背景技术
本发明涉及外科器械,并且在各种布置结构中,涉及被设计成缝合和切割组织的外科缝合和切割器械以及与它们一起使用的钉仓。
附图说明
本文所述的实施方案的各种特征连同其优点可结合如下附图根据以下描述来加以理解:
图1是根据至少一个实施方案的外科器械的透视图;
图2是机器人外科系统的控制器的透视图;
图3是图2的机器人外科系统的透视图,该机器人外科系统包括多个机器人外科臂,每个机器人外科臂各自在其上可操作地支撑外科器械;
图4是图3所示的机器人外科臂的侧视图;
图5是根据至少一个实施方案的钉仓的透视图;
图5A是图5的钉仓的分解图;
图5B是图5的钉仓的远侧端部的透视图;
图5C是图5的钉仓的远侧端部的正视图;
图6是根据至少一个实施方案的外科器械与钉仓之间的通信系统的示意图;
图7是根据至少一个实施方案的外科器械与钉仓之间的通信系统的示意图;
图8是根据至少一个实施方案的外科器械与钉仓之间的通信系统的示意图;
图8A是图8的示意图的片段;
图8B是被示为一些部件被移除的图8的外科器械的局部透视图;
图8C是被示为钉仓被移除的图8的外科器械的仓钳口的局部透视图;
图8D是被示为处于闭合或夹紧构型的图8的外科器械的局部透视图;
图9是根据至少一个实施方案的外科器械与钉仓之间的通信系统的示意图;
图10是根据至少一个实施方案的外科器械与钉仓之间的通信系统的示意图;
图11是根据至少一个实施方案的定位在仓钳口中的钉仓的透视图;
图11A是图11的钉仓的局部剖视图;
图11B是从仓钳口移除的图11的钉仓的透视图;
图11C是图11的钉仓的分解图;
图11D是图11的钉仓的滑动件的透视图;
图12是根据至少一个实施方案的钉仓的透视图;
图13是根据本公开的至少一个方面的算法的逻辑流程图,该逻辑流程图描绘了用于优化传感器数据收集、传输和/或处理的控制程序或逻辑配置;
图14是根据本公开的至少一个方面的算法的逻辑流程图,该逻辑流程图描绘了用于优化传感器数据收集、传输和/或处理的控制程序或逻辑配置;
图15是根据本公开的至少一个方面的算法的逻辑流程图,该逻辑流程图描绘了用于优化传感器数据收集、传输和/或处理的控制程序或逻辑配置;
图16是示出了根据本公开的至少一个方面的外科系统的各种特征的简化示意图;
图17是示出了根据本公开的至少一个方面的钉仓的各种特征的简化示意图;
图18是示出了根据本公开的至少一个方面的传感器阵列的采样速率(S)与带宽容量(B)、放电速率(D)和剩余容量(R)的对应值之间的相关性的表;
图19是根据本公开的至少一个方面的算法的逻辑流程图,该逻辑流程图描绘了用于监测和解决无线电力和/或数据信号传输中的信号干扰的控制程序或逻辑配置;
图20是根据本公开的至少一个方面的算法的逻辑流程图,该逻辑流程图描绘了用于无线电力传输中的传输效率的控制程序或逻辑配置;
图21示出了根据本发明的至少一个方面的用于在外科器械1022与钉仓之间进行电力传输的无线传输系统的第一天线电路和第二天线电路的具体实现;
图22示出了根据本公开的至少一个方面的可调串联RLC(电阻器、电感器、电容器)电路;
图23示出了根据本公开的至少一个方面的可调并联RLC电路;
图24是示出了根据本公开的至少一个方面的可调串联RLC电路1130的谐振状态的曲线图;
图25是根据本公开的至少一个方面的算法的逻辑流程图,该逻辑流程图描绘了用于改善钉仓的电力节省或优化钉仓的电力消耗的控制程序或逻辑配置;
图26是根据本处公开的至少一个方面的算法1150的逻辑流程图,该逻辑流程图描绘了用于优化传输系统1045上的无线电力和/或数据信号传输的控制程序或逻辑配置;
图27是根据本公开的至少一个方面的算法的逻辑流程图,该逻辑流程图描绘了用于校准外科器械的传感器阵列的控制程序或逻辑配置;
图28是根据本公开的至少一个方面的算法的逻辑流程图,该逻辑流程图描绘了用于调制外科器械的控制参数的控制程序或逻辑配置;
图29是根据本发明的至少一个方面的包括由止挡构件分开的钉仓和砧座的端部执行器的局部剖视图,该端部执行器处于钉仓与砧座之间没有组织的端部执行器的闭合构型;
图30是根据本公开的至少一个方面的算法的逻辑流程图,该逻辑流程图描绘了用于调制外科器械的控制参数的控制程序或逻辑配置;
图31是根据本公开的至少一个方面的算法的逻辑流程图,该逻辑流程图描绘了用于调制传感器阵列的传感器参数的控制程序或逻辑配置;
图32是根据本公开的至少一个方面的算法的逻辑流程图,该逻辑流程图描绘了用于调制传感器阵列的传感器参数的控制程序或逻辑配置;
图33是根据本公开的至少一个方面的钉仓的顶部示意图;
图34示出了根据本公开的至少一个方面的包括通过一组线圈耦合到控制电路以在仓与位于器械外壳中的控制电路之间传输电力和数据的多个传感器的仓的图;
图35示出了根据本公开的至少一个方面的被配置或编程为控制位移构件的远侧平移的外科器械的框图;
图36示出了根据本公开的至少一个方面的外科缝合和切割器械的端部执行器的透视图;
图37描绘了根据本公开的至少一个方面的示例性组织压缩传感器系统;
图38A和图38B是示出了根据本公开的至少一个方面的一对间隔开的接触板与组织接触时电路的接通的组织接触电路的示意图;
图39是根据本公开的至少一个方面的包括传感器监测和处理电路的外科器械的示意图;
图40是根据本公开的至少一个方面的包括砧座和钉仓的端部执行器的一部分的示意图,该钉仓包括传感器阵列;
图41是根据本公开的至少一个方面的包括多个可独立寻址传感器的图40的仓的局部剖面图;
图42示出了根据本公开的至少一个方面的监测多个传感器的方法的流程图;
图43示出了根据本公开的至少一个方面的监测多个传感器的方法的流程图;
图44示出了根据本公开的至少一个方面的监测多个传感器的方法的流程图;
图45示出了根据本公开的至少一个方面的监测多个传感器的方法的流程图;
图46是根据本公开的至少一个方面的包括多个传感器阵列的端部执行器的分解图;
图47是根据本公开的至少一个方面的定位在仓基座的盘或保持器中的第一传感器阵列和第二传感器阵列的示意图,该第一传感器阵列和第二传感器阵列示出为耦合到电子电路;
图48示出了根据本公开的一个或多个方面的包括导电电路元件的砧座的钉成形凹坑的透视图;
图49示出了根据本公开的一个或多个方面的在钉腿的适当成形期间导电电路元件已经被钉腿切断之后的图48的钉成形凹坑的透视图;
图50示出了根据本公开的至少一个方面的包括电子电路的远侧传感器插头,该电子电路被配置为能够监测和处理来自第一传感器阵列和第二传感器阵列的信号;并且
图51是根据本公开的至少一个方面的监测钉仓的内部系统以检测和跟踪仓部件的运动状态的方法。
在若干视图中,对应的参考符号指示对应的零件。本文所述的范例以一种形式示出了本发明的各种实施方案,且这种范例不应被解释为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人还拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“METHOD OF POWERING AND COMMUNICATING WITH A STAPLE CARTRIDGE”的美国专利申请;代理人案卷END9295USNP1/200837-1M号;
-名称为“METHOD OF POWERING AND COMMUNICATING WITH A STAPLE CARTRIDGE”的美国专利申请;代理人案卷END9295USNP2/200837-2M号;
-名称为“ADJUSTABLE COMMUNICATION BASED ON AVAILABLE BANDWIDTH ANDPOWER CAPACITY”的美国专利申请;代理人案卷END9295USNP3/200837-3号;
-名称为“ADJUSTMENT TO TRANSFER PARAMETERS TO IMPROVE AVAILABLE POWER”的美国专利申请;代理人案卷END9295USNP4/200837-4号;
-名称为“MONITORING OF MANUFACTURING LIFE-CYCLE”的美国专利申请;代理人案卷END9295USNP5/200837-5号;
-名称为“MONITORING OF MULTIPLE SENSORS OVER TIME TO DETECT MOVINGCHARACTERISTICS OF TISSUE”的美国专利申请;代理人案卷END9295USNP6/200837-6号;
-名称为“MONITORING OF INTERNAL SYSTEMS TO DETECT AND TRACK CARTRIDGEMOTION STATUS”的美国专利申请;代理人案卷END9295USNP7/200837-7号;
-名称为“DISTAL COMMUNICATION ARRAY TO TUNE FREQUENCY OF RF SYSTEMS”的美国专利申请;代理人案卷END9295USNP8/200837-8号;
-名称为“STAPLE CARTRIDGE COMPRISING A SENSOR ARRAY”的美国专利申请;代理人案卷END9295USNP9/200837-9号;
-名称为“STAPLE CARTRIDGE COMPRISING A SENSING ARRAY AND A TEMPERATURECONTROL SYSTEM”的美国专利申请;代理人案卷END9295USNP10/200837-10号;
-名称为“STAPLE CARTRIDGE COMPRISING A POWER MANAGEMENT CIRCUIT”的美国专利申请;代理人案卷END9295USNP12/200837-12号;
-名称为“STAPLING INSTRUMENT COMPRISING A SEPARATE POWER ANTENNA AND ADATA TRANSFER ANTENNA”的美国专利申请;代理人案卷END9295USNP13/200837-13号;
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING A POWER TRANSFER COIL”的美国专利申请;代理人案卷END9295USNP14/200837-14号;以及
-名称为“STAPLING INSTRUMENT COMPRISING A SIGNAL ANTENNA”的美国专利申请;代理人案卷END9295USNP15/200837-15号。
本申请的申请人也拥有于2020年10月29日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“SURGICAL INSTRUMENT COMPRISING A RELEASABLE CLOSURE DRIVELOCK”的美国专利申请序列号17/084,179;
-名称为“SURGICAL INSTRUMENT COMPRISING A STOWED CLOSURE ACTUATORSTOP”的美国专利申请序列号17/084,190;
-名称为“SURGICAL INSTRUMENT COMPRISING AN INDICATOR WHICH INDICATESTHAT AN ARTICULATION DRIVE IS ACTUATABLE”的美国专利申请序列号17/084,198;
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION INDICATOR”的美国专利申请序列号17/084,205;
-名称为“METHOD FOR OPERATING A SURGICAL INSTRUMENT”的美国专利申请序列号17/084,258;
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK”的美国专利申请序列号17/084,206;
-名称为“SURGICAL INSTRUMENT COMPRISING A JAW ALIGNMENT SYSTEM”的美国专利申请序列号17/084,215;
-名称为“SURGICAL INSTRUMENT COMPRISING SEALABLE INTERFACE”的美国专利申请序列号17/084,229;
-名称为“SURGICAL INSTRUMENT COMPRISING A LIMITED TRAVEL SWITCH”的美国专利申请序列号17/084,180;
-名称为“SURGICAL STAPLING ASSEMBLY”的美国设计专利申请序列号29/756,615。
-名称为“SURGICAL STAPLING ASSEMBLY”的美国设计专利申请序列号29/756,620。
-名称为“SURGICAL INSTRUMENT COMPRISING A STAGED VOLTAGE REGULATIONSTART-UP SYSTEM”的美国专利申请序列号17/084,188;以及
-名称为“SURGICAL INSTRUMENT COMPRISING A SENSOR CONFIGURED TO SENSEWHETHER AN ARTICULATION DRIVE OF THE SURGICAL INSTRUMENT IS ACTUATABLE”的美国专利申请序列号17/084,193。
本申请的申请人也拥有于2020年4月11日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“METHODS FOR STAPLING TISSUE USING A SURGICAL INSTRUMENT”的美国专利申请序列号16/846,303,现为美国专利申请公布2020/0345353;
-名称为“ARTICULATION ACTUATORS FOR A SURGICAL INSTRUMENT”的美国专利申请序列号16/846,304,现为美国专利申请公布2020/0345354;
-名称为“ARTICULATION DIRECTIONAL LIGHTS ON A SURGICAL INSTRUMENT”的美国专利申请序列号16/846,305,现为美国专利申请公布2020/0345446;
-名称为“SHAFT ROTATION ACTUATOR ON A SURGICAL INSTRUMENT”的美国专利申请序列号16/846,307,现为美国专利申请公布2020/03453549;
-名称为“ARTICULATION CONTROL MAPPING FOR A SURGICAL INSTRUMENT”的美国专利申请序列号16/846,308,现为美国专利申请公布2020/0345355;
-名称为“INTELLIGENT FIRING ASSOCIATED WITH A SURGICAL INSTRUMENT”的美国专利申请序列号16/846,309,现为美国专利申请公布2020/0345356;
-名称为“INTELLIGENT FIRING ASSOCIATED WITH A SURGICAL INSTRUMENT”的美国专利申请序列号16/846,310,现为美国专利申请公布2020/0345357;
-名称为“ROTATABLE JAW TIP FOR A SURGICAL INSTRUMENT”的美国专利申请序列号16/846,311,现为美国专利申请公布2020/0345358;
-名称为“TISSUE STOP FOR A SURGICAL INSTRUMENT”的美国专利申请序列号16/846,312,现为美国专利申请公布2020/0345359;以及
-名称为“ARTICULATION PIN FOR A SURGICAL INSTRUMENT”的美国专利申请序列号16/846,313,现为美国专利申请公布2020/0345360。
2019年4月30日提交的名称为“SURGICAL INSTRUMENT COMPRISING AN ADAPTIVECONTROL SYSTEM”的美国临时专利申请序列号62/840,715的全部公开内容据此以引用方式并入本文。
本申请的申请人拥有于2019年2月21日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“METHODS FOR CONTROLLING A POWERED SURGICAL STAPLER THAT HASSEPARATE ROTARY CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号16/281,658,现为美国专利申请公布2019/0298350;
-名称为“STAPLE CARTRIDGE COMPRISING A LOCKOUT KEY CONFIGURED TO LIFTA FIRING MEMBER”的美国专利申请序列号16/281,670,现为美国专利申请公布2019/0298340;
-名称为“SURGICAL STAPLERS WITH ARRANGEMENTS FOR MAINTAINING A FIRINGMEMBER THEREOF IN A LOCKED CONFIGURATION UNLESS A COMPATIBLE CARTRIDGE HASBEEN INSTALLED THEREIN”的美国专利申请序列号16/281,675,现为美国专利申请公布2019/0298354;
-名称为“SURGICAL INSTRUMENT COMPRISING CO-OPERATING LOCKOUT FEATURES”的美国专利申请序列号16/281,685,现为美国专利申请公布2019/0298341;
-名称为“SURGICAL STAPLING ASSEMBLY COMPRISING A LOCKOUT AND ANEXTERIOR ACCESS ORIFICE TO PERMIT ARTIFICIAL UNLOCKING OF THE LOCKOUT”的美国专利申请序列号16/281,693,现为美国专利申请公布2019/0298342;
-名称为“SURGICAL STAPLING DEVICES WITH FEATURES FOR BLOCKINGADVANCEMENT OF A CAMMING ASSEMBLY OF AN INCOMPATIBLE CARTRIDGE INSTALLEDTHEREIN”的美国专利申请序列号16/281,704,现为美国专利申请公布2019/0298356;
-名称为“STAPLING INSTRUMENT COMPRISING A DEACTIVATABLE LOCKOUT”的美国专利申请序列号16/281,707,现为美国专利申请公布2019/0298347;
-名称为“SURGICAL INSTRUMENT COMPRISING A JAW CLOSURE LOCKOUT”的美国专利申请序列号16/281,741,现为美国专利申请公布2019/0298357;
-名称为“SURGICAL STAPLING DEVICES WITH CARTRIDGE COMPATIBLE CLOSUREAND FIRING LOCKOUT ARRANGEMENTS”的美国专利申请序列号16/281,762,现为美国专利申请公布2019/0298343;
-名称为“SURGICAL STAPLING DEVICES WITH IMPROVED ROTARY DRIVEN CLOSURESYSTEMS”的美国专利申请序列号16/281,666;现为美国专利申请公布2019/0298352;
-名称为“SURGICAL STAPLING DEVICES WITH ASYMMETRIC CLOSURE FEATURES”的美国专利申请序列号16/281,672,现为美国专利申请公布2019/0298353;
-名称为“ROTARY DRIVEN FIRING MEMBERS WITH DIFFERENT ANVIL AND CHANNELENGAGEMENT FEATURES”的美国专利申请序列号16/281,678,现为美国专利申请公布2019/0298355;以及
-名称为“SURGICAL STAPLING DEVICE WITH SEPARATE ROTARY DRIVEN CLOSUREAND FIRING SYSTEMS AND FIRING MEMBER THAT ENGAGES BOTH JAWS WHILE FIRING”的美国专利申请序列号16/281,682,现为美国专利申请公布2019/0298346。
本申请的申请人拥有于2019年2月19日提交且各自全文以引用方式并入本文的以下美国临时专利申请:
-名称为“METHODS FOR CONTROLLING A POWERED SURGICAL STAPLER THAT HASSEPARATE ROTARY CLOSURE AND FIRING SYSTEMS”的美国临时专利申请序列号62/807,310;
-名称为“SURGICAL STAPLING DEVICES WITH IMPROVED LOCKOUT SYSTEMS”的美国临时专利申请序列号62/807,319;以及
-名称为“SURGICAL STAPLING DEVICES WITH IMPROVED ROTARY DRIVEN CLOSURESYSTEMS”的美国临时专利申请序列号62/807,309。
本专利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临时专利申请全文以引用方式并入本文:
-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”的美国临时专利申请序列号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 TO DETERMINEPROPERTIES 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”的美国临时专利申请序列号62/649,296;
-名称为“CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION ANDRECOMMENDATIONS TO A USER”的美国临时专利申请序列号62/649,333;
-名称为“CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATIONTRENDS AND REACTIVE MEASURES”的美国临时专利申请序列号62/649,327;
-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;
-名称为“CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES”的美国临时专利申请序列号62/649,313;
-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;
-名称为“AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICALPLATFORMS”的美国临时专利申请序列号62/649,307;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30日提交的以下美国临时专利申请,该临时专利申请全文以引用方式并入本文:
-名称为“SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES”的美国临时专利申请序列号62/650,887。
本申请的申请人拥有于2018年12月4日提交的以下美国专利申请,该专利申请以引用方式全文并入本文:
-名称为“METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE ANDSIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS”的美国专利申请序列号16/209,423,现为美国专利申请公布2019/0200981。
本申请的申请人拥有于2018年8月20日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“METHOD FOR FABRICATING SURGICAL STAPLER ANVILS”的美国专利申请序列号16/105,101,现为美国专利申请公布2020/0054323;
-名称为“REINFORCED DEFORMABLE ANVIL TIP FOR SURGICAL STAPLER ANVIL”的美国专利申请序列号16/105,183,现为美国专利10,912,559;
-名称为“SURGICAL STAPLER ANVILS WITH STAPLE DIRECTING PROTRUSIONS ANDTISSUE STABILITY FEATURES”的美国专利申请序列号16/105,150,现为美国专利申请公布2020/0054326;
-名称为“FABRICATING TECHNIQUES FOR SURGICAL STAPLER ANVILS”的美国专利申请序列号16/105,098,现为美国专利申请公布2020/0054322;
-名称为“SURGICAL STAPLER ANVILS WITH TISSUE STOP FEATURES CONFIGUREDTO AVOID TISSUE PINCH”的美国专利申请序列号16/105,140,现为美国专利10,779,821;
-名称为“METHOD FOR OPERATING A POWERED ARTICULATABLE SURGICALINSTRUMENT”的美国专利申请序列号16/105,081,现为美国专利申请公布2020/0054320;
-名称为“SURGICAL INSTRUMENTS WITH PROGRESSIVE JAW CLOSUREARRANGEMENTS”的美国专利申请序列号16/105,094,现为美国专利申请公布2020/0054321;
-名称为“POWERED SURGICAL INSTRUMENTS WITH CLUTCHING ARRANGEMENTS TOCONVERT LINEAR DRIVE MOTIONS TO ROTARY DRIVE MOTIONS”的美国专利申请序列号16/105,097,现为美国专利申请公布2020/0054328;
-名称为“POWERED ARTICULATABLE SURGICAL INSTRUMENTS WITH CLUTCHING ANDLOCKING ARRANGEMENTS FOR LINKING AN ARTICULATION DRIVE SYSTEM TO A FIRINGDRIVE SYSTEM”的美国专利申请序列号16/105,104,现为美国专利10,842,492;
-名称为“ARTICULATABLE MOTOR POWERED SURGICAL INSTRUMENTS WITHDEDICATED ARTICULATION MOTOR ARRANGEMENTS”的美国专利申请序列号16/105,119,现为美国专利申请公布2020/0054330;
-名称为“SWITCHING ARRANGEMENTS FOR MOTOR POWERED ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号16/105,160,现为美国专利10,856,870;以及
-名称为“SURGICAL STAPLER ANVILS”的美国设计专利申请序列号29/660,252。
本申请的申请人拥有各自全文以引用方式并入本文的以下美国专利申请和美国专利:
-名称为“SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIESTHEREOF”的美国专利申请序列号15/386,185,现为美国专利10,639,035;
-名称为“ARTICULATABLE SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,230,现为美国专利申请公布2018/0168649;
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS”的美国专利申请序列号15/386,221,现为美国专利10,835,247;
-名称为“SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF”的美国专利申请序列号15/386,209,现为美国专利10,588,632;
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS ANDREPLACEABLE TOOL ASSEMBLIES”的美国专利申请序列号15/386,198,现为美国专利10,610,224;
-名称为“SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR”的美国专利申请序列号15/386,240,现为美国专利申请公布2018/0168651;
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,939,现为美国专利10,835,246;
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FORSHIFTING BETWEEN CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES ANDARTICULATION AND FIRING SYSTEMS”的美国专利申请序列号15/385,941,现为美国专利10,736,629;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,943,现为美国专利10,667,811;
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTIONFEATURES”的美国专利申请序列号15/385,950,现为美国专利10,588,630;
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,945,现为美国专利10,893,864;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,946,现为美国专利申请公布2018/0168633;
-名称为“SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASINGA JAW OPENING DISTANCE”的美国专利申请序列号15/385,951,现为美国专利10,568,626;
-名称为“METHODS OF STAPLING TISSUE”的美国专利申请序列号15/385,953,现为美国专利10,675,026;
-名称为“FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FORSURGICAL END EFFECTORS”的美国专利申请序列号15/385,954,现为美国专利10,624,635;
-名称为“SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOPARRANGEMENTS”的美国专利申请序列号15/385,955,现为美国专利10,813,638;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,948,现为美国专利申请公布2018/0168584;
-名称为“SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号15/385,956,现为美国专利10,588,631;
-名称为“SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTINGFIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT”的美国专利申请序列号15/385,958,现为美国专利10,639,034;
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,947,现为美国专利10,568,625;
-名称为“METHOD FOR RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT”的美国专利申请序列号15/385,896,现为美国专利申请公布2018/0168597;
-名称为“STAPLE-FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENTTYPES OF STAPLES”的美国专利申请序列号15/385,898,现为美国专利10,537,325;
-名称为“SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL”的美国专利申请序列号15/385,899,现为美国专利10,758,229;
-名称为“STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISINGWINDOWSDEFINED THEREIN”的美国专利申请序列号15/385,901,现为美国专利10,667,809;
-名称为“SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER”的美国专利申请序列号15/385,902,现为美国专利10,888,322。
-名称为“STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/ORSPENT CARTRIDGE LOCKOUT”的美国专利申请序列号15/385,904,现为美国专利10,881,401;
-名称为“FIRING ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,905,现为美国专利10,695,055;
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUTAND A FIRING ASSEMBLY LOCKOUT”的美国专利申请序列号15/385,907,现为美国专利申请公布2018/0168608;
-名称为“FIRING ASSEMBLY COMPRISING A FUSE”的美国专利申请序列号15/385,908,现为美国专利申请公布2018/0168609;
-名称为“FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE”的美国专利申请序列号15/385,909,现为美国专利申请公布2018/0168610;
-名称为“STAPLE-FORMING POCKET ARRANGEMENTS”的美国专利申请序列号15/385,920,现为美国专利10,499,914;
-名称为“ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS”的美国专利申请序列号15/385,913,现为美国专利申请公布2018/0168614;
-名称为“METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPES OFSTAPLE CARTRIDGES WITH THE SAME SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/385,914,现为美国专利申请公布2018/0168615;
-名称为“BILATERALLY ASYMMETRIC STAPLE-FORMING POCKET PAIRS”的美国专利申请序列号15/385,893,现为美国专利10,682,138;
-名称为“CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICALINSTRUMENTS WITH SEPARATE ANDDISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号15/385,929,现为美国专利10,667,810;
-名称为“SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING ANDFIRING SYSTEMS”的美国专利申请序列号15/385,911,现为美国专利10,448,950;
-名称为“SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES”的美国专利申请序列号15/385,927,现为美国专利申请公布2018/0168625;
-名称为“STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPINGBREADTHS”的美国专利申请序列号15/385,917,现为美国专利申请公布2018/0168617;
-名称为“STAPLE-FORMING POCKET ARRANGEMENTS COMPRISING PRIMARYSIDEWALLS AND POCKET SIDEWALLS”的美国专利申请序列号15/385,900,现为美国专利10,898,186;
-名称为“NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FORSURGICAL STAPLERS”的美国专利申请序列号15/385,931,现为美国专利申请公布2018/0168627;
-名称为“FIRING MEMBER PIN ANGLE”的美国专利申请序列号15/385,915,现为美国专利10,779,823;
-名称为“STAPLE-FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMINGSURFACE GROOVES”的美国专利申请序列号15/385,897,现为美国专利申请公布2018/0168598;
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES”的美国专利申请序列号15/385,922,现为美国专利10,426,471;
-名称为“SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS”的美国专利申请序列号15/385,924,现为美国专利10,758,230;
-名称为“ANVIL HAVING A KNIFE SLOT WIDTH”的美国专利申请序列号15/385,910,现为美国专利10,485,543;
-名称为“CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号15/385,903,现为美国专利10,617,414;
-名称为“FIRING MEMBER PIN CONFIGURATIONS”的美国专利申请序列号15/385,906,现为美国专利10,856,868;
-名称为“STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES”的美国专利申请序列号15/386,188,现为美国专利10,537,324;
-名称为“STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAPSETTING FEATURES”的美国专利申请序列号15/386,192,现为美国专利10,687,810;
-名称为“STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES”的美国专利申请序列号15/386,206,现为美国专利申请公布2018/0168586;
-名称为“DURABILITY FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIESOF SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,226,现为美国专利申请公布2018/0168648;
-名称为“SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITHPOSITIVE OPENING FEATURES”的美国专利申请序列号15/386,222,现为美国专利申请公布2018/0168647;
-名称为“CONNECTION PORTIONS FOR DEPOSABLE LOADING UNITS FOR SURGICALSTAPLING INSTRUMENTS”的美国专利申请序列号15/386,236,现为美国专利申请公布2018/0168650;
-名称为“METHOD FOR ATTACHING A SHAFT ASSEMBLY TO A SURGICALINSTRUMENT AND,ALTERNATIVELY,TO A SURGICAL ROBOT”的美国专利申请序列号15/385,887,现为美国专利10,835,245;
-名称为“SHAFT ASSEMBLY COMPRISING A MANUALLY-OPERABLE RETRACTIONSYSTEM FOR USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号15/385,889,现为美国专利申请公布2018/0168590;
-名称为“SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE ANDRETRACTABLE SYSTEMS”的美国专利申请序列号15/385,890,现为美国专利10,675,025;
-名称为“SHAFT ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO ADAPT THEOUTPUT OF A ROTARY FIRING MEMBER TO TWO DIFFERENT SYSTEMS”的美国专利申请序列号15/385,891,现为美国专利申请公布2018/0168592;
-名称为“SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO ANARTICULATION STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM”的美国专利申请序列号15/385,892,现为美国专利10,918,385;
-名称为“SHAFT ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,894,现为美国专利10,492,785;
-名称为“SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATIONLOCKOUTS”的美国专利申请序列号15/385,895,现为美国专利10,542,982;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,916,现为美国专利申请公布2018/0168575;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,918,现为美国专利申请公布2018/0168618;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,919,现为美国专利申请公布2018/0168619;
-名称为“SURGICAL STAPLE CARTRIDGE WITH MOVABLE CAMMING MEMBERCONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES”的美国专利申请序列号15/385,921,现为美国专利10,687,809;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,923,现为美国专利申请公布2018/0168623;
-名称为“JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OFA FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN UNFIRED CARTRIDGE ISINSTALLED IN THE END EFFECTOR”的美国专利申请序列号15/385,925,现为美国专利10,517,595;
-名称为“AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYINGCLOSURE MOTIONS TO JAWS OF SURGICAL INSTRUMENTS”的美国专利申请序列号15/385,926,现为美国专利申请公布2018/0168577;
-名称为“PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN AMOVABLE JAW AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT”的美国专利申请序列号15/385,928,现为美国专利申请公布2018/0168578;
-名称为“SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERATING OPENINGFEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS”的美国专利申请序列号15/385,930,现为美国专利申请公布2018/0168579;
-名称为“ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFTARRANGEMENT”的美国专利申请序列号15/385,932,现为美国专利申请公布2018/0168628;
-名称为“ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLELINKAGE DISTAL OF AN ARTICULATION LOCK”的美国专利申请序列号15/385,933,现为美国专利10,603,036;
-名称为“ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR INAN ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE SYSTEM”的美国专利申请序列号15/385,934,现为美国专利10,582,928;
-名称为“LATERALLY ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FORLOCKING AN END EFFECTOR OF A SURGICAL INSTRUMENT IN AN ARTICULATEDCONFIGURATION”的美国专利申请序列号15/385,935,现为美国专利10,524,789;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKEAMPLIFICATION FEATURES”的美国专利申请序列号15/385,936,现为美国专利10,517,596;
-名称为“FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENTCONFIGURATIONS”的美国专利申请序列号14/318,996,现为美国专利申请公布2015/0297228;
-名称为“FASTENER CARTRIDGE COMPRISING FASTENER CAVITIES INCLUDINGFASTENER CONTROL FEATURES”的美国专利申请序列号14/319,006,现为美国专利10,010,324;
-名称为“SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZINGARRANGEMENTS”的美国专利申请序列号14/318,991,现为美国专利9,833,241;
-名称为“SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITORINGARRANGEMENTS”的美国专利申请序列号14/319,004,现为美国专利9,844,369;
-名称为“FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS”的美国专利申请序列号14/319,008,现为美国专利10,299,792;
-名称为“FASTENER CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGINGMEMBERS”的美国专利申请序列号14/318,997,现为美国专利10,561,422;
-名称为“FASTENER CARTRIDGE COMPRISING TISSUE CONTROL FEATURES”的美国专利申请序列号14/319,002,现为美国专利9,877,721;
-名称为“FASTENER CARTRIDGE ASSEMBLIES AND STAPLE RETAINER COVERARRANGEMENTS”的美国专利申请序列号14/319,013,现为美国专利申请公布2015/0297233;和
-名称为“FASTENER CARTRIDGE INCLUDING A LAYER ATTACHED THERETO”的美国专利申请序列号14/319,016,现为美国专利10,470,768。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES”的美国专利申请序列号15/191,775,现为美国专利申请公布2017/0367695;
-名称为“STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPEDSTAPLES”的美国专利申请序列号15/191,807,现为美国专利10,702,270;
-名称为“STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME”的美国专利申请序列号15/191,834,现为美国专利10,542,979;
-名称为“STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES”的美国专利申请序列号15/191,788,现为美国专利10,675,024;以及
-名称为“STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL STAPLE ROWS”的美国专利申请序列号15/191,818,现为美国专利10,893,863。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,218,现为美国设计专利D826,405;
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,227,现为美国设计专利D822,206;
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,259,现为美国设计专利D847,989;以及
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,264,现为美国设计专利D850,617。
本申请的申请人拥有2016年4月1日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM”的美国专利申请序列号15/089,325,现为美国专利申请公布2017/0281171;
-名称为“MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY”的美国专利申请序列号15/089,321,现为美国专利10,271,851;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD”的美国专利申请序列号15/089,326,现为美国专利10,433,849;
-名称为“SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIPPORTION”的美国专利申请序列号15/089,263,现为美国专利10,307,159;
-名称为“ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLEBAILOUT SYSTEM”的美国专利申请序列号15/089,262,现为美国专利10,357,246;
-名称为“SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVILCONCENTRIC DRIVE MEMBER”的美国专利申请序列号15/089,277,现为美国专利10,531,874;
-名称为“INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL ENDEFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS”的美国专利申请序列号15/089,296,现为美国专利10,413,293;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION”的美国专利申请序列号15/089,258,现为美国专利10,342,543;
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVECUTTING OF TISSUE”的美国专利申请序列号15/089,278,现为美国专利10,420,552;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT”的美国专利申请序列号15/089,284,现为美国专利申请公布2017/0281186;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSIONLOCKOUT”的美国专利申请序列号15/089,295,现为美国专利10,856,867;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT”的美国专利申请序列号15/089,300,现为美国专利10,456,140;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT”的美国专利申请序列号15/089,196,现为美国专利10,568,632;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT”的美国专利申请序列号15/089,203,现为美国专利10,542,991;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGELOCKOUT”的美国专利申请序列号15/089,210,现为美国专利10,478,190;
-名称为“SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM”的美国专利申请序列号15/089,324,现为美国专利10,314,582。
-名称为“SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS”的美国专利申请序列号15/089,335,现为美国专利10,485,542;
-名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/089,339,现为美国专利申请公布2017/0281173;
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OFSTAPLES HAVING DIFFERENT HEIGHTS”的美国专利申请序列号15/089,253,现为美国专利10,413,297;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET”的美国专利申请序列号15/089,304,现为美国专利10,285,705;
-名称为“ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS”的美国专利申请序列号15/089,331,现为美国专利10,376,263;
-名称为“STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES”的美国专利申请序列号15/089,336,现为美国专利10,709,446;
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUESUPPORT”的美国专利申请序列号15/089,312,现为美国专利申请公布2017/0281189;
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM”的美国专利申请序列号15/089,309,现为美国专利10,675,021;以及
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL”的美国专利申请序列号15/089,349,现为美国专利10,682,136。
本申请的申请人还拥有于2015年12月30日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE INPOWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/984,488,现为美国专利10,292,704;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/984,525,现为美国专利10,368,865;以及
-名称为“SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROLCIRCUITS”的美国专利申请序列号14/984,552,现为美国专利10,265,068。
本申请的申请人还拥有于2016年2月9日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLYTRANSLATABLE END EFFECTOR”的美国专利申请序列号15/019,220,现为美国专利10,245,029;
-名称为“SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,228,现为美国专利10,433,837;
-名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTEDSECONDARY CONSTRAINT”的美国专利申请序列号15/019,196,现为美国专利10,413,291;
-名称为“SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLYARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY”的美国专利申请序列号15/019,206,现为美国专利10,653,413;
-名称为“SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,215,现为美国专利申请公布2017/0224332;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATIONLINK ARRANGEMENTS”的美国专利申请序列号15/019,227,现为美国专利申请公布2017/0224334;
-名称为“SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLEDRIVEN ARTICULATION SYSTEMS”的美国专利申请序列号15/019,235,现为美国专利10,245,030;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAMARRANGEMENTS”的美国专利申请序列号15/019,230,现为美国专利10,588,625;以及
-名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTIONARRANGEMENTS”的美国专利申请序列号15/019,245,现为美国专利10,470,764。
本申请的申请人还拥有于2016年2月12日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,254,现为美国专利10,258,331;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,259,现为美国专利10,448,948;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,275,现为美国专利申请公布2017/0231627;和
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,289,现为美国专利申请公布2017/0231628。
本申请的申请人拥有2015年6月18日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL END EFFECTORS WITH POSITIVE JAW OPENINGARRANGEMENTS”的美国专利申请序列号14/742,925,现为美国专利10,182,818;
-名称为“SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSINGFEATURES”的美国专利申请序列号14/742,941,现为美国专利10,052,102;
-名称为“SURGICAL STAPLING INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FORPREVENTING FIRING SYSTEM ACTUATION WHEN A CARTRIDGE IS SPENT OR MISSING”的美国专利申请序列号14/742,933,现为美国专利10,154,841;
-名称为“MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,914,现为美国专利10,405,863;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAMSTRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT”的美国专利申请序列号14/742,900,现为美国专利10,335,149;
-名称为“DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,885,现为美国专利10,368,861;以及
-名称为“PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,876,现为美国专利10,178,992。
本申请的申请人拥有2015年3月6日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“POWERED SURGICAL INSTRUMENT”的美国专利申请序列号14/640,746,现为美国专利9,808,246;
-名称为“MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/640,795,现为美国专利10,441,279;
-名称为“ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURERATES FOR MULTIPLE TISSUE TYPES”的美国专利申请序列号14/640,832,现为美国专利10,687,806;
-名称为“OVERLAID MULTI SENSOR RADIO FREQUENCY(RF)ELECTRODE SYSTEM TOMEASURE TISSUE COMPRESSION”的美国专利申请序列号14/640,935,现为美国专利10,548,504;
-名称为“MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTORFOR POWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/640,831,现为美国专利9,895,148;
-名称为“TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINESTABILITY,CREEP,ANDVISCOELASTIC ELEMENTS OF MEASURES”的美国专利申请序列号14/640,859,现为美国专利10,052,044;
-名称为“INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/640,817,现为美国专利申请公布9,924,961;
-名称为“CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULARSHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE”的美国专利申请序列号14/640,844,现为美国专利10,045,776;
-名称为“SMART SENSORS WITH LOCAL SIGNAL PROCESSING”的美国专利申请序列号14/640,837,现为美国专利9,993,248;
-名称为“SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGEINTO A SURGICAL STAPLER”的美国专利申请序列号14/640,765,现为美国专利10,617,412;
-名称为“SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON AROTATABLE SHAFT”的美国专利申请序列号14/640,799,现为美国专利9,901,342;和
-名称为“SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING”的美国专利申请序列号14/640,780,现为美国专利10,245,033。
本申请的申请人拥有于2015年2月27日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION”的美国专利申请序列号14/633,576,现为美国专利10,045,779;
-名称为“SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCEPARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND”的美国专利申请序列号14/633,546,现为美国专利10,180,463;
-名称为“SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONEOR MORE BATTERIES”的美国专利申请序列号14/633,560,现为美国专利申请公布2016/0249910;
-名称为“CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FORCHARGING A BATTERY”的美国专利申请序列号14/633,566,现为美国专利10,182,816;
-名称为“SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TOBE SERVICED”的美国专利申请序列号14/633,555,现为美国专利10,321,907;
-名称为“REINFORCED BATTERY FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,542,现为美国专利9,931,118;
-名称为“POWER ADAPTER FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,548,现为美国专利10,245,028;
-名称为“ADAPTABLE SURGICAL INSTRUMENT HANDLE”的美国专利申请序列号14/633,526,现为美国专利9,993,258;
-名称为“MODULAR STAPLING ASSEMBLY”的美国专利申请序列号14/633,541,现为美国专利10,226,250;和
-名称为“SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFEPARAMETER”的美国专利申请序列号14/633,562,现为美国专利10,159,483。
本申请的申请人拥有2014年12月18日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE ENDEFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER”的美国专利申请序列号14/574,478,现为美国专利9,844,374;
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS”的美国专利申请序列号14/574,483,现为美国专利10,188,385;
-名称为“DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS”的美国专利申请序列号14/575,139,现为美国专利9,844,375;
-名称为“LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITHARTICULATABLE SURGICAL END EFFECTORS”的美国专利申请序列号14/575,148,现为美国专利10,085,748;
-名称为“SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLEABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE”的美国专利申请序列号14/575,130,现为美国专利10,245,027;
-名称为“SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS”的美国专利申请序列号14/575,143,现为美国专利10,004,501;
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDMOVABLE FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,117,现为美国专利9,943,309;
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDIMPROVED FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,154,现为美国专利9,968,355;
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLEARTICULATION SYSTEM”的美国专利申请序列号14/574,493,现为美国专利9,987,000;和
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLEARTICULATION SYSTEM”的美国专利申请序列号14/574,500,现为美国专利10,117,649。
本申请的申请人拥有2013年3月1日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYSFOR SIGNAL COMMUNICATION”的美国专利申请序列号13/782,295,现为美国专利9,700,309;
-名称为“ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号13/782,323,现为美国专利9,782,169;
-名称为“THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号13/782,338,现为美国专利申请公布2014/0249557;
-名称为“ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAYARRANGEMENT”的美国专利申请序列号13/782,499,现为美国专利9,358,003;
-名称为“MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/782,460,现为美国专利9,554,794;
-名称为“JOYSTICK SWITCH ASSEMBLIES FOR SURGICAL INSTRUMENTS”的美国专利申请序列号13/782,358,现为美国专利9,326,767;
-名称为“SENSOR STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGHTROCAR”的美国专利申请序列号13/782,481,现为美国专利9,468,438;
-名称为“CONTROL METHODS FOR SURGICAL INSTRUMENTS WITH REMOVABLEIMPLEMENT PORTIONS”的美国专利申请序列号13/782,518,现为美国专利申请公布2014/0246475;
-名称为“ROTARY POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OFFREEDOM”的美国专利申请序列号13/782,375,现为美国专利9,398,911;和
-名称为“SURGICAL INSTRUMENT SOFT STOP”的美国专利申请序列号13/782,536,现为美国专利9,307,986。
本申请的申请人还拥有于2013年3月14日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE”的美国专利申请序列号13/803,097,现为美国专利9,687,230;
-名称为“CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICALINSTRUMENT”的美国专利申请序列号13/803,193,现为美国专利申请公布9,332,987;
-名称为“INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICALINSTRUMENT”的美国专利申请序列号13/803,053,现为美国专利9,883,860;
-名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATIONLOCK”的美国专利申请序列号13/803,086,现为美国专利申请公布2014/0263541;
-名称为“SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FORSURGICAL INSTRUMENTS”的美国专利申请序列号13/803,210,现为美国专利9,808,244;
-名称为“MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT”的美国专利申请序列号13/803,148,现为美国专利10,470,762;
-名称为“DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/803,066,现为美国专利9,629,623;
-名称为“ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICALINSTRUMENTS”的美国专利申请序列号13/803,117,现为美国专利申请公布9,351,726;
-名称为“DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/803,130,现为美国专利9,351,727;和
-名称为“METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT”的美国专利申请序列号13/803,159,现为美国专利9,888,919。
本申请的申请人还拥有于2014年3月7日提交且全文以引用方式并入本文的以下专利申请:
-名称为“CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/200,111,现为美国专利9,629,629。
本申请的申请人还拥有于2014年3月26日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,106,现为美国专利申请公布2015/0272582;
-名称为“STERILIZATION VERIFICATION CIRCUIT”的美国专利申请序列号14/226,099,现为美国专利9,826,977;
-名称为“VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT”的美国专利申请序列号14/226,094,现为美国专利申请公布2015/0272580;
-名称为“POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUITAND WAKE UP CONTROL”的美国专利申请序列号14/226,117,现为美国专利10,013,049;
-名称为“MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFTASSEMBLIES”的美国专利申请序列号14/226,075,现为美国专利9,743,929;
-名称为“FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICALINSTRUMENTS”的美国专利申请序列号14/226,093,现为美国专利10,028,761;
-名称为“SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION”的美国专利申请序列号14/226,116,现为美国专利申请公布2015/0272571;
-名称为“SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETYPROCESSOR”的美国专利申请序列号14/226,071,现为美国专利9,690,362;
-名称为“SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS”的美国专利申请序列号14/226,097,现为美国专利9,820,738;
-名称为“INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,126,现为美国专利申请公布10,004,497;
-名称为“MODULAR SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号14/226,133,现为美国专利申请公布2015/0272557;
-名称为“SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT”的美国专利申请序列号14/226,081,现为美国专利9,804,618;
-名称为“POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLEVOLTAGE PROTECTION”的美国专利申请序列号14/226,076,现为美国专利9,733,663;
-名称为“SURGICAL STAPLING INSTRUMENT SYSTEM”的美国专利申请序列号14/226,111,现为美国专利9,750,499;和
-名称为“SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT”的美国专利申请序列号14/226,125,现为美国专利10,201,364。
本申请的申请人还拥有于2014年9月5日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,103,现为美国专利10,111,679;
-名称为“ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUECOMPRESSION”的美国专利申请序列号14/479,119,现为美国专利9,724,094;
-名称为“MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION”的美国专利申请序列号14/478,908,现为美国专利9,737,301;
-名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'SOUTPUT OR INTERPRETATION”的美国专利申请序列号14/478,895,现为美国专利9,757,128;
-名称为“POLARITY OF HALL MAGNET TO IDENTIFY CARTRIDGE TYPE”的美国专利申请序列号14/479,110,现为美国专利10,016,199;
-名称为“SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION”的美国专利申请序列号14/479,098,现为美国专利10,135,242;
-名称为“MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,115,现为美国专利9,788,836;和
-名称为“LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION”的美国专利申请序列号14/479,108,现为美国专利申请公布2016/0066913。
本申请的申请人还拥有于2014年4月9日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVESHAFTS”的美国专利申请序列号14/248,590,现为美国专利9,826,976;
-名称为“SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRINGDRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT”的美国专利申请序列号14/248,581,现为美国专利9,649,110;
-名称为“SURGICAL SYSTEM COMPRISING FIRST AND SECOND DRIVE SYSTEMS”的美国专利申请序列号14/248,595,现为美国专利9,844,368;
-名称为“POWERED LINEAR SURGICAL STAPLER”的美国专利申请序列号14/248,588,现为美国专利10,405,857;
-名称为“SURGICAL INSTRUMENT COMPRISING A GAP SETTING SYSTEM”的美国专利申请序列号14/248,591,现为美国专利10,149,680;
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENTFEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS”的美国专利申请序列号14/248,584,现为美国专利9,801,626;
-名称为“POWERED SURGICAL STAPLER”的美国专利申请序列号14/248,587,现为美国专利9,867,612;
-名称为“DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICALINSTRUMENT”的美国专利申请序列号14/248,586,现为美国专利10,136,887;和
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUSINDICATION ARRANGEMENTS”的美国专利申请序列号14/248,607,现为美国专利9,814,460。
本申请的申请人还拥有于2013年4月16日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,365;
-名称为“LINEAR CUTTER WITH POWER”的美国临时专利申请序列号61/812,376;
-名称为“LINEAR CUTTER WITH MOTOR AND PISTOL GRIP”的美国临时专利申请序列号61/812,382;
-名称为“SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS ANDMOTOR CONTROL”的美国临时专利申请序列号61/812,385;以及
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,372。
本专利申请的申请人拥有于2017年12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一者的公开内容全文以引用方式并入本文:
-名称为“INTERACTIVE SURGICAL PLATFORM”的美国临时专利申请序列号62/611,341;
-名称为“CLOUD-BASED MEDICAL ANALYTICS”的美国临时专利申请序列号62/611,340;以及
-名称为“ROBOT ASSISTED SURGICAL PLATFORM”的美国临时专利申请序列号62/611,339。
本专利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临时专利申请全文以引用方式并入本文:
-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”的美国临时专利申请序列号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 TO DETERMINEPROPERTIES 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”的美国临时专利申请序列号62/649,296;
-名称为“CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION ANDRECOMMENDATIONS TO A USER”的美国临时专利申请序列号62/649,333;
-名称为“CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATIONTRENDS AND REACTIVE MEASURES”的美国临时专利申请序列号62/649,327;
-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;
-名称为“CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES”的美国临时专利申请序列号62/649,313;
-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;
-名称为“AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICALPLATFORMS”的美国临时专利申请序列号62/649,307;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一项全文以引用方式并入本文:
-名称为“INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATIONCAPABILITIES”的美国专利申请序列号15/940,641,现为美国专利申请公布2019/0207911;
-名称为“INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OFDEVICES AND DATA CAPABILITIES”的美国专利申请序列号15/940,648,现为美国专利申请公布2019/0206004;
-名称为“SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OFOPERATING ROOM DEVICES”的美国专利申请序列号15/940,656,现为美国专利申请公布2019/0201141;
-名称为“SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS”的美国专利申请序列号15/940,666,现为美国专利申请公布2019/0206551;
-名称为“COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARYSOURCES BY INTELLIGENT SURGICAL HUBS”的美国专利申请序列号15/940,670,现为美国专利申请公布2019/0201116;
-名称为“SURGICAL HUB CONTROL ARRANGEMENTS”的美国专利申请序列号15/940,677,现为美国专利申请公布2019/0201143;
-名称为“DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS ANDCREATE ANONYMIZED RECORD”的美国专利申请序列号15/940,632,现为美国专利申请公布2019/0205566;
-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15/940,640,现为美国专利申请公布2019/0200863;
-名称为“SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUINGINSTRUMENT”的美国专利申请序列号15/940,645,现为美国专利10,892,899;
-名称为“DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITHAN OUTCOME”的美国专利申请序列号15/940,649,现为美国专利申请公布2019/0205567;
-名称为“SURGICAL HUB SITUATIONAL AWARENESS”的美国专利申请序列号15/940,654,现为美国专利申请公布2019/0201140;
-名称为“SURGICAL SYSTEM DISTRIBUTED PROCESSING”的美国专利申请序列号15/940,663,现为美国专利申请公布2019/0201033;
-名称为“AGGREGATION AND REPORTING OF SURGICAL HUB DATA”的美国专利申请序列号15/940,668,现为美国专利申请公布2019/0201115;以及
-名称为“SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES INOPERATING THEATER”的美国专利申请序列号15/940,671,现为美国专利申请公布2019/0201104;
-名称为“DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEARSTAPLE LINE”的美国专利申请序列号15/940,686,现为美国专利申请公布2019/0201105;
-名称为“STERILE FIELD INTERACTIVE CONTROL DISPLAYS”的美国专利申请序列号15/940,700,现为美国专利申请公布2019/0205001;
-名称为“COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS”的美国专利申请序列号15/940,629,现为美国专利申请公布2019/0201112;
-名称为“USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINEPROPERTIES OF BACK SCATTERED LIGHT”的美国专利申请序列号15/940,704,现为美国专利申请公布2019/0206050;
-名称为“CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OFMONO-CHROMATIC LIGHT REFRACTIVITY”的美国专利申请序列号15/940,722,现为美国专利申请公布2019/0200905;以及
-名称为“DUAL CMOS ARRAY IMAGING”的美国专利申请序列号15/940,742,现为美国专利申请公布2019/0200906。
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一项全文以引用方式并入本文:
-名称为“ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES”的美国专利申请序列号15/940,636,现为美国专利申请公布2019/0206003;
-名称为“ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS”的美国专利申请序列号15/940,653,现为美国专利申请公布2019/0201114;
-名称为“CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION ANDRECOMMENDATIONS TO A USER”的美国专利申请序列号15/940,660,现为美国专利申请公布2019/0206555;
-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15/940,679,现为美国专利申请公布2019/0201144;
-名称为“CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTEDINDIVIDUALIZATION OF INSTRUMENT FUNCTION”的美国专利申请序列号15/940,694,现为美国专利申请公布2019/0201119;
-名称为“CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATIONTRENDS AND REACTIVE MEASURES”的美国专利申请序列号15/940,634,现为美国专利申请公布2019/0201138;
-名称为“DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICSNETWORK”的美国专利申请序列号15/940,706,现为美国专利申请公布2019/0206561;以及
-名称为“CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES”的美国专利申请序列号15/940,675,现为美国专利10,849,697。
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一项全文以引用方式并入本文:
-名称为“DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国专利申请序列号15/940,627,现为美国专利申请公布2019/0201111;
-名称为“COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICALPLATFORMS”的美国专利申请序列号15/940,637,现为美国专利申请公布2019/0201139;
-名称为“CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国专利申请序列号15/940,642,现为美国专利申请公布2019/0201113;
-名称为“AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICALPLATFORMS”的美国专利申请序列号15/940,676,现为美国专利申请公布2019/0201142;
-名称为“CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国专利申请序列号15/940,680,现为美国专利申请公布2019/0201135;
-名称为“COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICALPLATFORMS”的美国专利申请序列号15/940,683,现为美国专利申请公布2019/0201145;
-名称为“DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国专利申请序列号15/940,690,现为美国专利申请公布2019/0201118;以及
-名称为“SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国专利申请序列号15/940,711,现为美国专利申请公布2019/0201120。
本文列出了许多具体细节,以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件,以免使说明书中描述的实施方案模糊不清。读者将会理解,本文所述和所示的实施方案为非限制性示例,从而可认识到,本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求的范围的情况下,可对这些实施方案进行变型和改变。
术语“包括(comprise)”(以及“包括(comprise)”的任何形式,诸如“包括(comprises)”和“包括(comprising)”)、“具有(have)”(以及“具有(have)”的任何形式,诸如“具有(has)”和“具有(having)”)、“包含(include)”(以及“包含(include)”的任何形式,诸如“包含(includes)”和“包含(including)”)、以及“含有(contain)”(以及“含有(contain)”的任何形式,诸如“含有(contains)”和“含有(containing)”)为开放式系动词。因此,“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件,但不限于仅具有这些一个或多个元件。同样,“包括”、“具有”、“包含”或“含有”一个或多个特征部的系统、装置、或设备的元件具有那些一个或多个特征部,但不限于仅具有那些一个或多个特征部。
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,外科器械在许多取向和方位中使用,并且这些术语并非是限制性的和/或绝对的。
提供各种示例性装置和方法以用于执行腹腔镜式和微创外科手术。然而,读者将容易理解,本文所公开的各种方法和装置可用于多种外科手术和应用中,包括例如与开放式外科手术结合。继续参阅本具体实施方式,读者将进一步理解,本文所公开的各种器械能够以任何方式插入体内,诸如通过自然腔道、通过成形于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可直接插入患者体内或者可通过具有工作通道的进入装置插入,外科器械的端部执行器和细长轴可通过所述工作通道推进。
外科缝合系统可包括轴和从轴延伸的端部执行器。所述端部执行器包括第一钳口和第二钳口。第一钳口包括钉仓。钉仓能够插入第一钳口中并且能够从第一钳口移除;然而,设想到其中钉仓不能够从第一钳口移除或至少能够易于从第一钳口替换的其他实施方案。第二钳口包括被构造成能够使从钉仓射出的钉变形的砧座。第二钳口能够围绕闭合轴线相对于第一钳口枢转;然而,可设想到其中第一钳口能够相对于第二钳口枢转的其他实施方案。外科缝合系统还包括被构造成能够允许端部执行器相对于轴旋转或进行关节运动的关节运动接头。端部执行器能够围绕延伸穿过关节运动接头的关节运动轴线旋转。设想了不包括关节运动接头的其他实施方案。
所述钉仓包括仓体。仓体包括近侧端部、远侧端部和在近侧端部与远侧端部之间延伸的平台。在使用中,钉仓被定位在待缝合的组织的第一侧上,并且砧座被定位在组织的第二侧上。砧座朝向钉仓运动以将组织压缩并抵靠平台夹持。然后,以可移除方式存储在仓体中的钉可被部署到组织中。仓体包括限定于仓体中的钉腔,其中钉以可移除方式存储在钉腔中。钉腔被布置成六个纵向排。三排钉腔被定位在纵向狭槽的第一侧上且三排钉腔被定位在纵向狭槽的第二侧上。钉腔和钉的其他布置结构也是可能的。
钉由仓体中的钉驱动器支撑。驱动器能够在第一或非击发位置和第二或击发位置之间运动,以从钉仓射出钉。驱动器通过保持器保留在仓体中,所述保持器围绕仓体的底部延伸并且包括被构造成能够抓持仓体以及将保持器保持至仓体的弹性构件。驱动器能够通过滑动件在其非击发位置与其击发位置之间运动。滑动件能够在与近侧端部相邻的近侧位置和与远侧端部相邻的远侧位置之间运动。滑动件包括多个斜坡表面,该斜坡表面被构造成能够朝向砧座在驱动器下方滑动以及提升驱动器,并且钉在驱动器上受到支撑。
除上述以外,滑动件还可通过击发构件朝远侧运动。击发构件被构造成能够接触滑动件并朝向远侧端部推动滑动件。限定于仓体中的纵向狭槽被构造成能够接纳击发构件。砧座还包括被构造成能够接纳击发构件的狭槽。击发构件还包括接合第一钳口的第一凸轮和接合第二钳口的第二凸轮。随着击发构件朝远侧推进,第一凸轮和第二凸轮可控制钉仓的平台和砧座之间的距离或组织间隙。击发构件还包括被构造成能够切入在钉仓和砧座中间捕获的组织的刀。希望刀定位成至少部分接近斜坡表面,使得钉先于刀被射出。
外科器械10000示于图1中。外科器械10000包括柄部10100(该柄部包括柄部外壳10120)、从柄部10100延伸的轴10200,以及端部执行器10400。端部执行器10400包括被构造成能够接纳钉仓的第一钳口10410和能够相对于第一钳口10410运动的第二钳口10420。第二钳口10420包括砧座,该砧座包括限定于其中的钉成形凹坑。外科器械10000还包括闭合致动器10140,该闭合致动器被构造成能够驱动外科器械10000的闭合系统并使第二钳口10420在未夹紧位置和夹紧位置之间运动。闭合致动器10140与闭合管10240可操作地联接,当闭合致动器10140闭合时,该闭合管朝远侧推进。在此类情况下,闭合管10240接触第二钳口并且用凸轮带动和/或向下推动第二钳口10420进入其夹紧位置。
除上述以外,第二钳口10420围绕枢转轴线可枢转地联接到第一钳口10410。在各种实施方案中,第二钳口可随着其移动到其夹紧位置而平移和旋转。在各种另选实施方案中,外科器械包括钉仓钳口,该钉仓钳口可相对于砧座钳口在未夹紧位置和夹紧位置之间运动。在任何情况下,柄部10100包括被构造成能够将闭合致动器10140可释放地保持在其夹紧位置的锁。柄部10100还在其相对两侧上包括释放致动器10180b,当该释放致动器被致动时,解锁闭合致动器10140,使得端部执行器10400可被重新打开。在各种另选实施方案中,柄部10100包括电动马达,该电动马达被构造成当由临床医生致动时能够使闭合管10240朝近侧和/或朝远侧运动。
端部执行器10400围绕关节运动接头10500附接到轴10200并且能够在平面内围绕关节运动轴线旋转。轴10200限定纵向轴线,并且端部执行器10400能够在端部执行器10400与纵向轴线对准的未关节运动位置和端部执行器10400相对于纵向轴线以横向角度延伸的关节运动位置之间进行关节运动。在各种实施方案中,例如,外科器械10000包括允许端部执行器10400在第一平面中进行关节运动的第一关节运动接头,以及允许端部执行器10400在与第一平面正交的第二平面中进行关节运动的第二关节运动接头。柄部10100包括至少一个电动马达和控制系统,该控制系统被配置为能够响应于关节运动致动器10160和10170而控制电动马达的操作。电动马达包括无刷直流马达;然而,电动马达可包括任何合适的马达,诸如有刷直流马达。
2018年12月11日公布的名称为“POWERED SURGICAL CUTTING AND STAPLINGAPPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM”的美国专利10,149,683的完整公开内容以引用方式并入本文。2018年5月10日公布的名称为“MOTOR-DRIVEN SURGICALCUTTING INSTRUMENT”的美国专利申请公布2018/0125481的全部公开内容以引用方式并入本文。柄部10100还包括能够附接到柄部外壳的可替换和/或可再充电电池10300,该可替换和/或可再充电电池为外科器械10000供电。2014年1月21日公布的名称为“POWER CONTROLARRANGEMENTS FOR SURGICAL INSTRUMENTS AND BATTERIES”的美国专利8,632,525的全部公开内容以引用方式并入本文。
除上述以外,轴10200可围绕延伸穿过轴10200的纵向轴线旋转。轴10200围绕旋转接头10220可旋转地连接到柄部10100,并且轴10200包括限定在其中的一个或多个指状凹槽,该一个或多个指状凹槽便于临床医生使用缝合器械10000来旋转轴10200。在各种实施方案中,外科器械10000包括电动马达和旋转致动器,当由临床医生致动时,该旋转致动器给电动马达提供动力以取决于旋转致动器被致动的方向在第一方向或第二方向上旋转轴10200。
除上述以外,外科器械10000还包括钉击发驱动装置,该钉击发驱动装置被配置为能够将钉从钉仓中射出。钉击发驱动装置包括电动马达和击发构件,该击发构件由电动马达朝远侧驱动通过钉击发行程。在钉击发行程期间,击发构件朝远侧推动钉仓中的滑动件以将钉从钉仓中射出。2017年4月25日公布的名称为“CONTROL SYSTEMS FOR SURGICALINSTRUMENTS”的美国专利9,629,629的全部公开内容以引用方式并入本文。
本文所述的外科器械系统由电动马达促动;但是本文所述的外科器械系统可以任何合适的方式促动。在某些实例中,本文公开的马达可包括机器人控制系统的一部分或多个部分。例如,名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS”的美国专利申请序列13/118,241号(现为美国专利9,072,535号)更详细地公开了机器人外科器械系统的若干示例,该公开内容全文以引用方式并入本文。2017年5月18日公布的名称为“STAPLER WITH COMPOSITE CARDAN AND SCREW DRIVE”的国际专利公布WO 2017/083125;2017年5月18日公布的名称为“STAPLE PUSHER WITH LOSTMOTION BETWEEN RAMPS”的国际专利公布WO 2017/083126;2015年10月8日公布的名称为“SURGICAL INSTRUMENT WITH SHIFTABLE TRANSMISSION”的国际专利公布2015/153642;2017年3月17日提交的名称为“STAPLER WITH CABLE-DRIVEN ADVANCEABLE CLAMPINGELEMENT AND DUAL DISTAL PULLEYS”的美国专利申请公布2017/0265954(现为美国专利10,350,016);2017年2月15日提交的名称为“STAPLER WITH CABLE-DRIVEN ADVANCEABLECLAMPING ELEMENT AND DISTAL PULLEY”的美国专利申请公布2017/0265865(现为美国专利10,631,858);以及2017年3月29日提交的名称为“STAPLING CARTRIDGE”的美国专利申请公布2017/0290586(现为美国专利10,722,233)的公开内容全文以引用方式并入本文。
本文所公开的各种实施方案可例如结合诸如图1至图3中描绘的机器人系统1000的机器人外科系统来采用。图1描绘了可结合图2中描绘的机器人臂车5100使用的主控制器5001。主控制器5001和机器人臂车5100以及它们各自的部件和控制系统在本文中统称为机器人系统5000。此类系统和装置的示例在名称为“MECHANICAL ACTUATOR INTERFACESYSTEM FOR ROBOTIC SURGICAL TOOLS”的美国专利7,524,320,以及名称为“SURGICALSTAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利9,072,535中公开,这些专利申请各自全文以引用方式并入本文。为简洁起见,本文不再重复此类系统和装置的细节。主控制器5001包括控制件5003,当外科医生经由显示器1002观察患者时,该控制件由外科医生抓持和操纵。控制件5003可包括例如以多个自由度移动的手动输入装置,并且还可包括可致动触发器,该可致动触发器用于致动外科器械或工具,以例如闭合抓持钳口、缝合和切入组织,和/或向电极施加电势。
参见图2和图3,机器人臂车5100被配置为能够响应于来自主控制器5001的输入而致动一个或多个外科器械,诸如外科器械6000。在各种形式中,机器人臂车5100包括基座5002、包括装配接头5104的臂连杆以及器械操纵器5106。此类布置可有利于外科器械6000围绕空间点的旋转,这在名称为“REMOTE CENTER POSITIONING DEVICE WITH FLEXIBLEDRIVE”的美国专利5,817,084中描述,该专利的全部公开内容据此以引用方式并入本文。这种布置提供外科器械6000围绕轴线5112a或俯仰轴的枢转旋转。该布置还提供外科器械6000围绕轴线5112b或偏航轴的旋转。俯仰轴5112a和偏航轴5112b在远程中心5114处相交,该远程中心沿外科器械6000的细长轴对准。外科器械6000可具有另外的从动自由度,包括沿纵向轴线LT-LT的滑动运动。当外科器械6000相对于器械操纵器5106沿纵向纵向轴线LT-LT滑动(箭头5112c)时,远程中心5114相对于器械操纵器5106的基座5116保持固定。为了移动远程中心5114,连杆5108由一个或多个马达5120驱动,该一个或多个马达响应于来自主控制器5001的命令而移动连杆5108以在外科部位内定位和/或操纵外科器械6000。各种其他布置在名称为“AUTOMATED ENDOSCOPE SYSTEM FOR OPTIMAL POSITIONING”的美国专利5,878,193中公开,该专利的全部公开内容据此以引用方式并入本文。
另外,虽然结合外科器械或工具与主控制器5001之间的通信在本文中初步描述了机器人部件与机器人外科系统的处理器之间的数据通信,但应当理解,类似的通信可发生在操纵器、装配接头、内窥镜或其他图像捕获装置等的电路与机器人外科系统的处理器之间,该机器人外科系统的处理器用于部件兼容性确认、部件类型识别、部件校正(诸如偏移等)通信、部件与机器人外科系统的联接确认等。根据至少一个方面,本文所公开的各种外科器械可结合其他机器人控制的或自动外科系统使用,并且不一定限于与图1至图3所示和上述参考文献中所述的特定机器人系统部件一起使用。各种机器人手术系统和方法在名称为“MULTI-COMPONENT TELEPRESENCE SYSTEM AND METHOD”的美国专利6,132,368中公开,该专利的全部公开内容据此以引用方式并入本文。
图5至图5C中示出了钉仓11000。钉仓11000包括仓体11100,该仓体包括近侧端部11110和远侧端部11120。仓体11100还包括在近侧端部11110与远侧端部11120之间延伸的平台11130,以及限定在平台11130中的钉腔11140。钉腔11140在限定于仓体11100中的纵向狭槽11150的相对两侧上布置成纵向排。纵向狭槽11150被配置为能够在其中接纳组织切割刀,该组织切割刀在钉击发行程期间被朝远侧推动以切割抵靠钉仓11000的平台11130捕获的组织。钉仓11000还包括定位在每个钉腔11140中的钉11200和钉驱动器11300,该钉驱动器在钉击发行程期间支撑钉11200并将钉11200驱动出钉腔11140。钉仓11000还包括滑动件11400,该滑动件由钉击发驱动装置的击发构件朝远侧推动,以在钉击发行程期间接触钉驱动器11300并朝向仓体11100的平台11130提升该钉驱动器。钉仓11000还包括附接到仓体11100的盘11700,该盘被配置为能够保持驱动器11300和/或钉11200不从仓体11100的底部掉落。
钉仓11000还包括电子电路。虽然未在图5至图5C中示出,但钉仓11000包括图11至图11C中描绘的电子电路11500。参见图11至图11C,电子电路11500包括近侧端部11510和第二端部11520。近侧端部11510包括仓天线11530,当钉仓11000安置在端部执行器10400的钳口10410中时,该仓天线被放置成与外科器械10000的器械天线10530连通。例如,电子电路11500包括诸如柔性电路的柔性基板、限定在柔性基板中和/或柔性基板上的导电迹线,以及安装到柔性基板的与导电迹线电连通的电子部件。在各种实施方案中,电子电路11500由绝缘体、限定在绝缘体中和/或绝缘体上的导电迹线以及安装到柔性基板的与导电迹线电连通的电子部件构成。
除上述以外,再次参见图11至图11C,电子电路11500嵌入仓体11100中。仓体11100包括限定在平台11130中的电路狭槽11160,并且电子电路11500定位在电路狭槽11160中。仓体11100还包括第一横向侧11170、第二横向侧11180,以及连接第一横向侧11170和第二横向侧11180的远侧部分11120。电路狭槽11160在仓体11100的第一横向侧11170上的纵向排钉腔11140周围和/或之间在远侧部分11120周围延伸,并且然后朝近侧延伸到第二横向侧11180中。类似于第一横向侧11170,电路狭槽11160在第二横向侧11180上的纵向排钉腔11140周围/或之间延伸。作为这种布置的结果,电子电路11500可以在仓体11100的两个横向侧内延伸,而不必跨过纵向狭槽11150。此外,此类布置允许电子电路11500延伸到仓体11100的远端部分11120中。在各种实施方案中,电子电路11500嵌入仓体11100中。在至少一个实施方案中,电子电路11500卡扣配合和/或压配合到电路狭槽11160中。在至少一个实施方案中,仓体11100由注塑在电子电路11500的至少一部分周围的塑料构成。
在各种实施方案中,再次参见图11至图11C,钉仓11000包括弹性体连接器,该弹性体连接器将传感器11600以机械的方式和电的方式连接到仓体11100。在至少一个实施方案中,弹性体连接器包括在橡胶或弹性体基体中的导电和绝缘区域,以产生整体各向异性传导性质。基体被模制成三维形状,并且然后附接到仓体11100。在各种实施方案中,基体的形状匹配仓体上的特征。在至少一个实施方案中,短的细金属线嵌入橡胶片中以将传感器11600连接到钉仓11000的控制系统。在至少一个实例中,金属线由例如银构成。例如,在至少一个实例中,基体中金属线的密度在约300根线/cm2与约2000根线/cm2之间。在橡胶片的表面处,线的端部或者从表面延伸或者朝向橡胶基板向后弯曲。至少一种材料(商标为ZEBRA)可购自Fuji Polymer Industries Company。
在各种实施方案中,传感器系统包括由钉仓的控制系统选择性地供电的多个部分。例如,在至少一个实施方案中,传感器系统包括第一传感器部分和第二传感器部分,并且控制系统的处理器被配置为能够在第一操作模式期间仅对第一传感器部分供电,在第二操作模式期间仅对第二传感器部分供电,并且在第三操作模式期间对两个传感器部分供电。此类实施方案可减少由钉仓产生的热的量,等等。在各种实施方案中,第一传感器部分和第二传感器部分包括相同数量的传感器,而在其他实施方案中,第一传感器部分和第二传感器部分具有不同数量的传感器。在某些实施方案中,第一传感器部分在其中包括第一密度的连接线,并且第二传感器部分在其中包括不同于第一密度的第二密度的连接线。
参见图6,仓天线11530包括线圈11540,该线圈被限定在与由器械天线10530的线圈10540限定的平面平行的平面中。线圈10540和11540被定尺寸、配置和定位成能够提供足够的和/或最佳的传输系数,使得数据和/或电力可以在器械天线10530与仓天线11530之间有效地传输。在各种实例中,器械线圈10540包括初级线圈,并且仓线圈11540包括次级线圈,并且在使用中,电力从器械线圈10540以无线方式传输到仓线圈11540。在至少这个实施方案中,数据信号也可以在器械线圈10540与仓线圈11540之间传输。更具体地,数据信号可从外科器械10000传输到钉仓11000并且/或者从钉仓11000传输到外科器械10000。可以使用任何合适的软件协议和/或硬件部件来协调包括器械线圈10540和仓线圈11540的单对线圈上的电力和数据的传输。在至少一个实施方案中,电力和数据信号在器械线圈10540与仓线圈11540之间同时传输。在至少一个另选实施方案中,参见图7,电力和数据信号在器械线圈10540与仓线圈11540之间相继地传输。在各种实施方案中,器械天线10530和/或仓天线11530包括例如多路复用器,该多路复用器协调天线10530与11530之间的信号传输。
再次参见图6,外科器械10000包括与器械天线10530连通的处理器10610。例如,在至少一个实施方案中,处理器10610包括近场通信(NFC)读取器芯片。例如,NFC读取器芯片使用频率为13.56MHz、数据速率约为426kbits/s的高频射频识别。在各种实例中,处理器10610包括例如以约120kHz与约150kHz之间的频率进行通信的低频RFID读取器。在各种实例中,处理器10610包括例如以约13.6MHz的频率进行通信的高频RFID读取器。在各种实例中,处理器10610包括例如以约868MHz的频率进行通信的超高频RFID读取器。2020年12月31日公布的名称为“METHOD FOR AUTHENTICATING THE COMPATIBILITY OF A STAPLECARTRIDGE WITH A SURGICAL INSTRUMENT”的美国专利申请公布2020/0405301的全部公开内容以引用方式并入本文。在各种示例中,处理器10610包括例如以约2.4GHz的频率进行通信的蓝牙部件。在各种示例中,处理器10610包括例如以约105kHz与约205kHz之间的频率进行通信的Qi无线充电部件。在任何情况下,处理器10610包括与器械天线10530连通的输入通道和输出通道,该器械天线便于与NFC标签的直接对等连通,例如与仓天线11530连通,如下文所讨论。
除上述以外,器械天线10530被配置为能够经由仓天线11530向钉仓11000供应电力和数据信号。如上所讨论,钉仓电路11500包括多个传感器11600,该多个传感器测量钉仓11000的至少一个性质和/或由钉仓11000支撑的组织的至少一个性质。例如,在至少一个实施方案中,传感器11600包括电容传感器,该电容传感器被配置为能够检测组织的厚度和/或包含在组织中的流体或水肿的量。在至少一个实施方案中,传感器11600包括电阻传感器,诸如应变仪,该电阻传感器测量例如仓体11100内的应变或力加载。在任何情况下,传感器11600需要电力来测量性质并产生可由钉仓11000的仓处理器11610检测到的输出电压。在使用中,电力从器械线圈10540递送到仓线圈11540,由整流器11620整流,并且然后在该电力被供应到传感器11600之前由电容器11630滤波。整流器11620被配置为能够针对整流器11620的输出通道中的至少一个输出通道将交流输入整流为直流输出。在各种实例中,整流器11620还被配置为能够在无整流的情况下将交流输入传导到该整流器的输出通道中的至少一个输出通道。电容器11630可包括低通滤波器和/或高通滤波器,该低通滤波器和/或高通滤波器可以滤除由仓天线11530接收的噪声和/或外来信号。上述布置和/或任何另一合适的布置可用于向传感器11600和/或仓处理器11610供应适当的电压电势和电流。传感器11600的输出电压被供应到仓处理器11610的输入门。在至少一个实例中,处理器11610包括例如多路复用器(MUX),该多路复用器被配置为能够将传感器11600的输出信号协调成单个数据信号,该单个数据信号经由仓天线11530传输回器械天线10530。
除上述以外,钉仓11000还包括与器械天线10530、整流器11620、处理器11610和仓天线11530连通的NFC标签11640。NFC标签11640包括与整流器11620连通的输入,该输入被配置为能够控制和/或限制施加到NFC标签11640的电压电势。在至少一个实例中,NFC标签11640包括其自己的整流器。当接收到来自整流器11620的输入时,NFC标签11640被配置为能够向仓天线11530输出数据信号,该数据信号包括关于钉仓11000的数据。NFC标签11640在其中存储有信息,该信息是关于数据信号中所包括的存储在该信息中的钉仓11000的标识的。由NFC标签11640输出的数据信号经由仓天线11530传输到器械天线10530,然后该数据信号被传输到外科器械10000的控制系统(诸如器械处理器10610),例如以验证钉仓11000的标识或认证该钉仓。
在各种实例中,除上述以外,许多不同类型的钉仓可与外科器械10000一起使用。例如,一些钉仓可以不包括传感器阵列,而其他钉仓(诸如钉仓11000)例如可包括一个或多个传感器阵列。如果钉仓不包括传感器阵列,则钉仓可能不需要或不能使用可由外科器械10000供应的电力。因此,外科器械10000的控制系统被配置为能够在钉仓未适当地响应于在询问程序期间由外科器械10000供应到钉仓的询问信号的情况下,向或不向安置在外科器械10000中的钉仓供应功率信号。在钉仓安置在外科器械10000中之后,在至少一个此类实例中,外科器械10000的控制系统可指示器械处理器10610向器械天线10530发送询问信号,该询问信号被发射到仓天线11530并由该仓天线接收。在各种实例中,询问信号以约10mW到约30mW的低功率发射,例如,以将穿过仓电路11500中的滤波的频率发射,使得询问信号到达NFC标签11640。NFC标签11640被配置为能够在接收到询问信号时向仓天线11530传输响应信号。响应信号由仓天线11530发射,由器械天线10530接收,并传导到器械处理器10610。如果由器械处理器10610接收到的响应信号与由器械处理器预期的响应信号相匹配,则由外科器械10000识别或认证钉仓11000,并且器械处理器10610可向器械天线10530供应高瓦特数功率信号以向钉仓11000供电。例如,在至少一个实例中,高瓦特数功率信号可以是约1W和/或超过1W。在各种实例中,供应到器械天线10530的功率信号的瓦特数可取决于已识别出的钉仓。例如,如果识别出第一类型的钉仓,则使用第一瓦特数,并且如果识别出第二类型的钉仓,则使用第二或不同的瓦特数。然而,外科器械10000的控制系统被配置为能够在未从钉仓接收到响应信号的情况下不向器械天线10530供应功率信号。如果从安置在外科器械10000中的钉仓接收到响应信号,但该响应信号未被识别,则控制系统可被配置为能够执行两个响应中的一个响应。在第一实例中,控制系统被配置为能够在接收到的响应信号未被识别的情况下不向钉仓供应功率信号,而在第二实例中,控制系统被配置为能够在接收到的响应信号未被识别的情况下供应低功率信号。在至少一个实例中,较低功率信号可为例如约0.1W。在此类实例中,传感器和电子电路可被充分供电以传输包括来自传感器的数据的返回数据信号,同时降低对钉仓进行过供电的风险。
在各种实例中,外科器械10000被配置为能够在外科器械10000最初通电时和/或在外科器械10000从低功率睡眠模式唤醒时启动仓询问例程。在此类实例中,外科器械10000询问钉仓以评估是否向钉仓供应电力以及向外科器械10000供应的功率电平。即便如此,在没有附加信息的情况下,如果在询问信号之后没有接收到响应信号,则外科器械10000的控制系统可能不能区分钉仓是不可识别的还是完全丢失。为此,外科器械10000包括仓存在传感器,该仓存在传感器被配置为能够检测钉仓是否安置在端部执行器10400的仓钳口中。在至少一个实例中,仓存在传感器包括安装在端部执行器10400的仓钳口中的霍尔(Hall)效应传感器,该霍尔效应传感器被配置为能够例如检测钉仓中的金属元件。在至少一个实例中,仓存在传感器包括压力传感器,当钉仓安置在端部执行器10400的仓钳口中时,该压力传感器被钉仓压缩。在任何情况下,仓存在传感器与外科器械10000的控制系统连通。在各种实例中,如果控制系统接收到钉仓安置在仓钳口中的信号但未接收到来自钉仓的响应信号,则控制系统不向钉仓供应功率信号,而是允许外科器械10000被操作以从钉仓击发钉。如果控制系统接收到钉仓从仓钳口丢失的信号,则控制系统不供应功率信号并且还以电子方式锁定钉击发系统,直到钉仓安置在仓钳口中。
当钉仓11000安置在外科器械10000的仓钳口中时,再次参见图6,功率信号和数据信号可同时地从器械天线10530传输到仓天线11530。此外,在电力从外科器械10000递送到钉仓11000的同时,数据信号可从钉仓11000递送到外科器械10000。现在参见图7,外科器械10000'的控制系统被配置和布置成间歇地向钉仓11000'供应电力和数据信号。在至少一个实例中,控制系统被配置为能够将低功率信号和高功率信号交替地递送到器械天线10530,以分别将数据和电力传输到钉仓11000’的电子电路11500’,但不是同时传输。例如,在至少一个此类实例中,控制系统递送具有约0.1W的功率的低功率信号和超过1W的高功率信号。如上文结合图6所讨论,器械处理器10610包括NFC读取器芯片,该NFC读取器芯片生成电力信号和数据信号两者并同时地向钉仓11000供应电力信号和数据信号。另一方面,图7描绘了包括生成数据信号的NFC读取器芯片10610'和生成功率信号的单独功率驱动器10620'的控制系统。NFC读取器芯片10610'和功率驱动器10620'与器械天线10530连通,并且被配置为能够经由器械天线10530向仓天线11530相继地供应单独的数据和功率信号。在至少一个实例中,NFC读取器芯片10610'和功率驱动器10620'与例如多路复用器连通,该多路复用器协调数据和功率信号到钉仓11000'的相继传输。
如上文结合图7所讨论,数据信号和功率信号以交替方式在外科器械与钉仓11000'之间传输。在各种实例中,外科器械向钉仓11000'供应电力,直到器械处理器具有要传输到钉仓11000'的数据。此时,器械处理器停止功率信号并且然后发射数据信号。在器械处理器已经发射数据信号之后,该器械处理器被配置为能够恢复功率信号。数据信号和功率信号以不同频率传输,但在其他实施方案中可以以相同频率发射。在任一情况下,以比数据信号更高的强度发射功率信号。在各种实施方案中,钉仓11000的处理器被配置为能够在处理器具有要传输到外科器械的数据时向外科器械发射暂停信号。在接收到暂停信号之后,器械处理器停止功率信号或者直到从钉仓11000接收到数据之后才生成功率信号。在至少一个此类实施方案中,外科器械可在从钉仓接收到暂停信号之后将暂停信号发射回钉仓11000'。在从外科器械接收到暂停信号时,钉仓被配置为能够将数据信号发射到外科器械。
现在参见图8和图8A,外科器械10000”包括数据天线10530”和单独的电力传输天线10535”,该数据天线和该单独的电力传输天线用于与安置在外科器械10000”的仓钳口中的钉仓11000通信,并向该钉仓供应电力。数据天线10530”与NFC读取器芯片10610’连通。功率驱动器10620’与电力传输天线10535”连通。数据天线10530”包括线圈10540”,当钉仓11000”安置在仓钳口中时,该线圈与仓数据天线11530”的线圈11540”对准。在至少一个实例中,线圈10540”在与限定仓线圈11540”的平面平行或至少基本上平行的平面中卷绕。器械线圈10540”和仓线圈11540”具有相同的尺寸,或至少基本上相同的尺寸,但可以是任何合适的尺寸。器械线圈10540”包括具有第一数量的绕组的初级线圈,并且仓线圈11540”包括具有第二数量的绕组的次级线圈,在至少一个实施方案中,该第二数量的绕组大于该第一数量的绕组。由此,可以提高计量器械数据天线10530”与仓数据天线11530”之间的传输系数。电力传输天线10535”包括线圈10545”,当钉仓11000”安置在仓钳口中时,该线圈与仓电力天线11535”的线圈11545”对准。在至少一个实例中,器械线圈10545”在与限定仓线圈11545”的平面平行或至少基本上平行的平面中卷绕。器械线圈10545”和仓线圈11545”具有相同的尺寸,或至少基本上相同的尺寸,但可以是任何合适的尺寸。器械线圈10545”包括具有第一数量的绕组的初级线圈,并且仓线圈11545”包括具有第二数量的绕组的次级线圈,在至少一个实施方案中,该第二数量的绕组大于该第一数量的绕组。此类布置可以提高电力传输天线10535”与仓电力天线11535”之间的传输系数。
除上述以外,钉仓11000”包括与仓电力天线11535”连通的整流器11620和电容器11630。类似于上文,整流器11620和电容器11630被配置为能够在向钉仓11000”的传感器供应电力之前,对从电力传输天线10535”向钉仓11000”供应的功率信号进行整流、滤波和/或修改。钉仓11000”还包括与仓数据天线11530”连通的NFC标签11640。类似于上文,外科器械10000”的控制系统可以利用询问信号询问NFC标签11640,该询问信号由NFC读取器芯片10610”生成并且经由联接的数据天线10530”和11530”发射到NFC标签11640。当接收到询问信号时,NFC标签11640被配置为能够生成响应信号,该响应信号经由联接的数据天线10530”和11530”发射回NFC读取器芯片10610’。NFC标签11640还与钉仓11000”的仓处理器11610”连通,类似于上文,该仓处理器被配置为能够从仓传感器接收数据,生成包括传感器数据的数据信号,并将该数据信号供应到NFC标签11640和仓数据天线11530”。供应到仓数据天线11530”的数据信号经由器械数据天线10530”传输到NFC读取器芯片10610’,并且然后由控制系统用于解释例如外科器械10000”、钉仓11000”和/或被钉仓11000”捕获的组织的性质。值得注意的是,仓处理器11610”还与钉仓11000”的仓电力天线11535”连通,并且在各种实施方案中可从仓电力天线11535”向NFC标签11640供应电力。
如上所述,外科器械10000”和钉仓11000”包括用于传达数据的第一成对天线系统和用于传达电力的第二成对天线系统。在各种实施方案中,第一成对天线系统定位在钉仓11000”的第一横向侧11170上,并且第二成对天线系统定位在钉仓11000”的第二或相对横向侧11180上。在至少一个此类实施方案中,外科器械10000”的仓钳口包括通道,该通道包括底壁、从底壁的第一侧延伸的第一横向侧壁,以及从底壁的第二或相对侧延伸的第二横向侧壁。当钉仓11000”安置在仓钳口中时,钉仓11000”定位在第一横向侧壁与第二横向侧壁之间并且被朝向底壁向下推动,直到钉仓11000”的卡扣特征部和/或锁定特征部接合仓钳口,这可释放地将钉仓11000”锁定在仓钳口中的适当位置。在至少一个此类实施方案中,第一器械天线安装到第一侧壁并且第二器械天线安装到第二侧壁,并且此外,第一仓天线安装到仓体的第一横向侧并且第二仓天线安装到仓体的第二横向侧。当钉仓11000”安置在仓钳口中时,第一仓天线变得与第一器械天线对准,并且同样地,第二仓天线变得与第二器械天线对准。通过将第一成对天线系统放置在一个横向侧上并且将第二成对天线系统放置在相对的横向侧上,降低了一个成对天线系统干扰另一成对天线系统的可能性。在各种实例中,第一成对天线系统在第一频率范围内操作,并且第二成对天线系统在不与第一频率范围重叠的第二或不同频率范围内操作,使得降低了一个成对天线系统干扰另一成对天线系统的可能性。为此,除上述以外,器械天线和/或仓天线可包括一个或多个电容器,该一个或多个电容器可对成对天线系统中的每个天线系统的预期操作频率范围之外的频率进行滤波。
在各种实例中,除上述以外,仓数据天线11530”安装到仓体11100的第一横向侧,并且仓电力天线11535”安装到仓体11100的第二横向侧。更具体地,天线11530”和11535”的线圈11540”和11545”分别安装在该天线的相应侧的近侧端部上,即,该天线定位成比起远侧端部11120更靠近钉仓11000”的近侧端部11110。因此,仓数据天线11530”和仓电力天线11535”可以比它们定位在钉仓11000”的远侧端部11120处的情况下短,并且因此更不容易受到干扰。在各种另选实施方案中,线圈11540”和11545”安装在钉仓11000”的近侧端部11110与远侧端部11120之间的中心线处或附近。在此类布置中,与当仓数据线圈11540”安装到仓体11100的近侧端部11110时相比,仓数据线圈11540”与安装到仓体11100的传感器之间的距离可以被缩短,从而降低在传感器输出被处理并经由仓数据线圈11540”传输之前传感器输出被损坏的可能性。
在各种实施方案中,除上述以外,线圈11540”和11545”安装到钉仓的仓体11100和/或盘11700(图5A)。在至少一个实施方案中,仓体11100包括限定在其横向侧中的凹陷凹坑,并且线圈11540”和11545”定位在该凹陷凹坑中。在至少一个此类实施方案中,灌封材料被浇注到凹陷凹坑中以将线圈11540”和11545”固定、密封和/或保护在凹坑内。灌封材料可包括密封胶,诸如来自Eastern Adhesive Systems Technology,Inc.的TECHNOMELT,例如来自Henkel Corporation的LOCTITE 3321的光固化丙烯酸粘合剂,例如蜡和/或石蜡。在各种实例中,灌封材料可包括空气固化材料。
在各种实施方案中,使用一种或多种制造工艺将天线线圈11540”和11545”包封在仓体中。在至少一个实施方案中,仓体11100通过两次注塑工艺形成。在至少一个此类实施方案中,在第一注塑工艺期间模制第一塑料部件或芯,线圈11540”和11545”附接到芯,并且接着使用第二注塑工艺来至少部分地覆盖、包封、密封和/或保护线圈11540”和11545”。在至少一个实施方案中,线圈11540”和11545”定位在限定于仓体中的凹部或凹坑中,并且盖附接到仓体11100,该盖至少部分地覆盖、包封、密封和/或保护线圈11540”和11545”。在至少一个此类实施方案中,盖卡扣配合和/或压配合到仓体11100。在某些实施方案中,使用超声铆接工艺将盖附接到仓体11000。
用于将天线线圈11540”和11545”附接到仓体11100的上述材料和方法也可用于将RFID标签附接到滑动件11400和/或钉驱动器11300。在此类实施方案中,滑动件11400和/或钉驱动器11300的位置和/或运动可由钉仓11000的控制系统使用附接到滑动件11400和/或钉驱动器11300和/或嵌入该滑动件和/或该钉驱动器内的RFID标签来跟踪。
如上所讨论,外科器械10000包括从柄部和/或器械外壳朝远侧延伸的轴10200,该柄部和/或器械外壳被配置为能够安装到机器人外科系统的臂。在各种实例中,轴10200、柄部10100、器械外壳和/或机器人外科系统可包括通过一个或多个天线对与钉仓连通的器械处理器,如上文所讨论。为了便于器械处理器与仓处理器之间的通信,轴10200包括具有器械天线的线束。在至少一个此类实施方案中,线束包括柔性电路10900(图11B),该柔性电路包括柔性基板和在柔性基板内延伸的导线或迹线。在各种实施方案中,柔性电路10900包括例如导电层和绝缘层的堆叠。参见图8C,外科器械10000”的柔性电路的远侧端部包括线圈11540”和11545”,该线圈包括柔性电路的非导电基板内的嵌入线。
除上述以外,柔性电路的远侧端部例如通过一种或多种粘合剂安装到第一钳口10410的侧壁。在至少一个实施方案中,铁氧体部件可以安装到柔性电路的基板和/或嵌入该基板内,以控制由线圈11540”和11545”发射的场。在至少一个实施方案中,铁氧体部件定位在第一钳口10410和线圈11540”和11545”中间。此外,电子部件可以安装到柔性电路的基板和/或嵌入该基板内,这调节和/或放大由线圈11540”和11545”发射的信号。在至少一个此类实施方案中,一个或多个电容器被嵌入在柔性电路中,这滤除低频和/或高频。此外,在至少一个此类实施方案中,一个或多个放大电路被嵌入在柔性电路中,这可以提升和/或控制由线圈11540”和11545”发射的信号的功率。在各种实施方案中,第一钳口10410和/或第二钳口10420由金属构成,并且被配置为能够使金属钳口对由线圈11540”和11545”发射的场的影响最小化。在至少一个实施方案中,金属钳口的横截面被设计成产生均匀的或基本上均匀的区,该区屏蔽或基本上屏蔽外部信号以免干扰端部执行器10400内的信号。
在线圈11540”和11545”安装到仓体11000并且线圈10540”和10545”安装到第一钳口10410的实施方案中,盘11700可包括限定在其中的一个或多个窗口,使得数据线圈组的线圈10540”和11540”具有彼此的直接视线,并且电力线圈组的线圈10545”和11545”具有彼此的直接视线。在线圈11540”和11545”安装到盘11700的实施方案中,数据线圈组的线圈10540”和11540”具有彼此的直接视线,并且电力线圈组的线圈10545”和11545”具有彼此的直接视线。
在各种实施方案中,外科器械10000”的天线和/或钉仓11000”的天线包括线圈天线。即便如此,外科器械和/或钉仓可包括任何合适类型的天线。在至少一个实例中,外科器械和/或钉仓可包括缝隙天线。在至少一个此类实施方案中,缝隙天线包括具有切出的一个或多个孔或缝隙的平板。一个或多个缝隙天线可安装到第一钳口10410的侧壁和/或底壁,同时一个或多个缝隙天线可安装到盘11700。在各种实施方案中,例如,缝隙天线可与第一钳口10410和/或盘11700一体地形成。
在各种实施方案中,外科器械和/或钉仓可包括主动抵消系统,该主动抵消系统包括控制系统,该控制系统监测环境磁场和/或电场以及它们的频率,并通过一个或多个天线发射信号以抵消或至少部分地抵消环境场。
例如,在各种实施方案中,钉仓的仓体包括镀在塑料基板上的导电迹线,该塑料基板可由液晶聚合物制成,诸如来自Ticona的VECTRA。在至少一个实施方案中,例如使用气相沉积工艺将导电迹线电镀在塑料基板上和/或镀到塑料基板上。例如,在至少一个实施方案中,电迹线由印刷到塑料基板上的导电墨水构成。在各种实例中,迹线例如由银和/或铜构成。在各种实施方案中,仓体包括限定在塑料基板中的凹部,其中导电迹线被镀到凹部中的塑料基板上。在至少一个实施方案中,凹部被激光蚀刻到塑料基板中。在各种实施方案中,非导电材料被印刷到导电迹线上以在不期望组织例如接触导电迹线的地方覆盖导电迹线。此类非导电材料还可控制由导电迹线产生的场。在各种实施方案中,塑料基板通过使用非导电材料和导电材料(诸如石墨烯嵌入的聚乳酸(PLA))的三维印刷工艺形成。在至少一个此类实施方案中,将导电材料印刷到至少部分地嵌入非导电材料中的导电迹线中。
在各种实施方案中,除上述以外,钉腔11140在仓平台11130的第一侧上布置成三个纵向排,并且在仓平台11130的第二或相对侧上布置成三个纵向排。在已经执行钉击发行程之后,已经利用切口的两侧上的三排钉来切入患者组织以密封或至少基本上密封组织。即便如此,在切口的两侧植入两排钉而不是三排钉已被证明是临床上可接受的。因此,第三排钉不需要包括连续的一排钉。实际上,在至少一个实施方案中,最外排中的钉腔11140中的至少一些钉腔在其中容纳传感器而不是钉和钉驱动器。在至少一个此类实施方案中,力敏传感器定位在钉腔11140中。力敏传感器包括可在钉腔11140内滑动的组织接触元件,该组织接触元件被定尺寸和配置为能够匹配或至少基本上匹配钉腔11140的周边,使得组织接触元件的运动被限制或至少基本上被限制到钉腔11140的射出轴线。力敏传感器还包括安装到仓平台11130的基座,以及定位在基座和组织接触元件中间的弹簧,诸如线性螺旋弹簧。当端部执行器10400被夹紧到患者组织上时,该组织接触组织接触元件并压缩弹簧。力敏传感器还包括安装到组织接触元件的磁性元件,该磁性元件的运动例如可由仓平台11130中的霍尔效应电路检测和测量。霍尔效应电路与仓处理器连通,该仓处理器被配置为能够分析电压输出以评估是否存在定位在力敏传感器上方的组织以及在力敏传感器处施加到组织的力。钉仓11000可包括任何合适数量的力敏传感器。例如,在至少一个实施方案中,最外排钉腔11140均包括钉仓11000远侧端部处的传感器、钉仓11000的近侧端部处的传感器,以及位于远侧传感器和近侧传感器中间的至少一个传感器。如上所述,钉仓可在钉腔中包括任何合适类型的传感器和/或任何合适数量的传感器。
在至少一个实施方案中,除上述以外,钉腔11300中的一些钉腔可包括定位在其中的典型钉驱动器,但不包括钉,并且传感器的至少一部分在钉腔上方延伸。在至少一个此类实施方案中,传感器的在钉腔上方延伸的部分是易碎的,并且被配置为能够当钉驱动器在钉击发行程期间被朝向砧座向上驱动时断裂或折断。当钉击发行程进行时,此类布置可用于从仓处理器逐渐切断传感器。此类布置可用于节省处理能力和/或跟踪钉击发行程的进程,等等。
名称为“MOTORIZED CUTTING AND FASTENING INSTRUMENT HAVING CONTROLCIRCUIT FOR OPTIMIZING BATTERY USAGE”的美国专利8,622,274、名称为“SMARTCARTRIDGE WAKE UP OPERATION AND DATA RETENTION”的美国专利10,135,242、名称为“OVERLAID MULTI SENSOR RADIO FREQUENCY(RF)ELECTRODE SYSTEM TO MEASURE TISSUECOMPRESSION”的美国专利10,548,504、名称为“SMART SENSORS WITH LOCAL SIGNALPROCESSING”的美国专利9,993,248、名称为“OVERLAID MULTI SENSOR RADIO FREQUENCY(RF)ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION”的美国专利申请公布2016/0256071(现为美国专利10,548,504)、名称为“SURGICAL STAPLING INSTRUMENTS WITHSMART STAPLE CARTRIDGES”的美国专利申请2018/0168625、名称为“POWERED SURGICALDEVICES HAVING TISSUE SENSING FUNCTION”的美国专利申请2018/0250002以及名称为“STAPLER RELOAD DETECTION AND IDENTIFICATION”的国际专利公开WO 2018/049206的全部公开内容通过引用并入本文。
在各种实例中,参见图9,钉仓12000包括彼此独立的识别电路12100和电源电路12200。识别电路12100包括例如无源RFID系统12110,当询问信号从器械数据天线10530”传输到仓数据天线11530”时,该无源RFID系统被通电。识别电路12100是自给式的并且不从电源电路接收电力。无源RFID系统12110不包括电源,并且由询问信号供电。一旦无源RFID系统12110已接收到询问信号,无源RFID系统12110就经由仓数据天线11530”将响应信号传输回外科器械,该响应信号包括关于钉仓12000的标识的数据。外科器械包括RFID读取器芯片12610,该RFID读取器芯片被配置为能够接收和处理来自无源RFID系统12110的响应信号。在至少一个可选实施方案中,独立识别电路包括有源RFID系统,该有源RFID系统包括其自己的电源。在此类实施方案中,有源RFID系统可包括周期性地发射识别信号的信标,该识别信号具有足够的功率以由器械数据天线10530”接收。
在各种实施方案中,除上述以外,钉仓12000的独立电源电路12200包括被配置为能够从外科器械的电力传输天线10535”接收电力的仓电力天线11535”。在各种实例中,类似于上文,钉仓12000被配置为能够在包括天线10535”和11535”的电力天线对上将数据信号传输回外科器械,该数据信号包括来自钉仓12000的传感器阵列11600的数据。在某些实例中,钉仓12000包括第三天线,该第三天线被配置为能够在低功率天线对上将传感器数据传输回外科器械,该低功率天线对与电源电路12200和仓识别电路12100的电力天线对分开且独立。在此类实例中,电力在电力天线对上从外科器械传输到钉仓,识别信号在识别信号天线对上在外科器械与钉仓之间传输,并且传感器数据在传感器数据信号天线对上从钉仓传输到外科器械。
在各种实施方案中,参见图10,钉仓13000包括均联接到单个器械天线13530的仓电力天线11535”和仓数据天线11530”。在至少一个此类实施方案中,单个器械天线13530包括限定在器械线圈平面中的线圈13540,仓数据天线11530”包括限定在数据线圈平面中的线圈11540”,并且仓电力天线11535”包括限定在电力线圈平面中的线圈11545”。线圈13540、11540”和11545”被堆叠,使得由单个器械天线13530发射的信号被仓数据天线11530”和仓电力天线11535”接收。在至少一个实例中,线圈13540、11540”和11545”可定位在钉仓13000的一个横向侧上。在各种实例中,线圈13540、11540”和11545”可定位在钉仓13000的底部上。在各种实例中,可能期望仓数据天线11530”以比仓电力天线11535”低的功率接收信号。在至少一个此类实例中,线圈13540、11540”和11545”被堆叠,使得仓电力线圈11545”被定位在器械天线线圈13540和仓数据线圈11540”中间。在此类实例中,因此,由器械天线线圈13540发射的信号的强度在仓电力线圈11545”处比在仓数据线圈11540”处大。在各种实例中,线圈13540、11540”和11545”彼此均等或等距地间隔开。在其他实例中,仓数据线圈11540”与仓电力线圈11545”之间的间隙大于仓电力线圈11545”与器械天线线圈13540之间的间隙。在此类实例中,传输到仓数据线圈11540”的功率可以显著低于传输到仓电力线圈11545”的功率。在各种另选实施方案中,器械天线线圈13540定位在仓数据线圈11540”和仓电力线圈11545”中间,并且线圈11540”和11545”可以定位在距器械天线线圈13540任何合适距离处。
再次参见图10,器械天线10530”和10535”用于发射与仓天线11530”和11535”相互作用的场。在各种实例中,由器械天线10530”和10535”发射的场是全向发射的。因此,大量的功率可能由器械天线10530”和10535”发射,而不被仓天线11530”和11535”接收。在各种实例中,外科器械被配置为能够使由器械天线10530”和10535”发射的场成形。在至少一个实例中,外科器械包括例如包围器械数据天线10530”和/或电力传输天线10535”的一个或多个金属壁。此类金属壁可以限制在未朝向仓天线11530”和11535”的方向上发射的场的强度。在至少一个实例中,金属壁形成喇叭,该喇叭将来自器械天线的线圈的发射场朝向对应仓天线的线圈引导。在至少一个此类实例中,金属壁例如从仓钳口的金属侧壁和/或金属底壁延伸。在各种实例中,例如,铁氧体环可以围绕器械天线的线圈定位,以将发射场朝向对应仓天线的线圈隧穿。例如,在至少一个此类实例中,铁氧体环安装到仓钳口的侧壁和/或底壁。在各种实例中,钉仓11000”包括金属壁,该金属壁将从器械天线发射的场朝向对应仓天线的线圈引导。例如,在至少一个此类实例中,金属壁形成安装到钉仓的仓体的喇叭,该仓体由塑料构成。另外,在各种实例中,钉仓包括铁氧体材料,该铁氧体材料被配置为能够将由器械天线的线圈发射的场引导和/或放大到对应仓天线。2018年11月20日公布的名称为“SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION”的美国专利10,135,242、2016年5月24日公布的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利9,345,481以及2018年1月23日公布的名称为“WAKE-UP SYSTEM AND METHOD FORPOWERED SURGICAL INSTRUMENTS”的美国专利9,872,722的全部公开内容以引用方式并入本文。
如上所讨论,再次参见图5A,钉仓11000包括附接到仓体11100的金属盘11700。金属盘11700包括围绕仓体11100的底部延伸的底板11710,并且该底板被配置为能够防止钉驱动器11300和/或钉从钉仓11000的底部掉出。金属盘11700包括沿着仓体11100的第一横向侧延伸的第一侧壁11720,以及沿着仓体11100的第二横向侧延伸的第二侧壁11720。例如,第一侧壁11720经由一个或多个附接特征部11730(诸如钩和/或肩部保持器)附接到仓体11100。例如,类似于第一侧壁11720,第二侧壁11720经由一个或多个附接特征部11730(诸如钩和/或肩部保持器)附接到仓体11100。例如,金属盘11700由诸如不锈钢的任何合适金属构成。在各种实施方案中,金属盘11700还可包括由塑料和/或任何其他合适材料构成的部分。在各种实例中,仓天线安装到金属盘11700。在至少一个此类实例中,仓数据线圈11540”和/或仓电力线圈11545”安装到金属盘11700,这可以将线圈定位成更靠近它们相应的器械天线并且改善天线的传输效率。
在各种实施方案中,外科器械和/或钉仓可包括遮罩或屏蔽件,该遮罩或屏蔽件被配置为能够控制、阻挡和/或引导由外科器械和/或钉仓发射的信号。在至少一个实施方案中,遮罩例如由铁氧体构成。在至少一个实施方案中,仓钳口包括从侧壁和/或底壁延伸的金属壁屏蔽件。在至少一个实施方案中,钉仓的盘和/或仓体包括包含在该盘和/或仓体中和/或从该盘和/或仓体延伸的金属壁屏蔽件。在至少一个实施方案中,遮罩被配置为能够限制发射和/或接收信号的方向。在各种实施方案中,外科器械和/或钉仓包括喇叭天线,该喇叭天线被配置为能够引导从其发射的信号。在至少一个实施方案中,外科器械和/或钉仓可包括由金属壁构成的天线。在至少一个此类实施方案中,外科器械的仓钳口由金属壁构成,该金属壁中的至少一个金属壁用作天线。此外,在至少一个此类实施方案中,钉仓的盘由金属壁构成,该金属壁中的至少一个金属壁用作天线。在各种实施方案中,一个或多个电容器或电容元件被焊接到钉仓的盘,这可滤除在盘内传导和/或通过盘传输的不期望的频率。
参见图11,诸如钉仓14000的钉仓例如包括仓体11100,以及包括传感器11600的电子电路11500。钉仓14000在许多方面类似于本文所公开的其他钉仓,并且为简洁起见,本文中未讨论此类方面。如上所讨论,仓体11100包括平台11130和限定在平台11130中的纵向排钉腔11140。每个钉腔11140包括存储在其中的钉,该钉在钉击发行程期间由钉驱动器向上驱动出钉腔11140。每个钉包括基座和从基座延伸的两个腿,使得腿大致向上并向外延伸以形成V形构型。在各种实例中,当钉被存储在钉腔11140中时,钉的腿由钉腔11140的近侧端部壁和远侧端部壁向内弹性地偏转。当钉被向上驱动出钉腔11140时,钉的腿从钉腔11140露出并在平台11130上方延伸,而钉的其余部分被向上推出钉腔11140。仓体11100包括从平台11130延伸的突出部11132(图5B),该突出部被配置为能够在钉从钉腔11140射出时导引和/或控制钉的腿。突出部11132定位在每个钉腔11140的远侧端部处和每个钉腔11140的近侧端部处。然而,设想了另选实施方案,在该另选实施方案中,突出部11132定位在每个钉腔11140的仅一个端部处。此外,设想了各种实施方案,在该各种实施方案中,钉腔11140中的一些钉腔在其端部处不包括突出部11132。突出部11132被进一步配置为能够接合抵靠平台11130定位的患者组织,并且限制患者组织相对于平台11130的流动或移动。
在各种实施方案中,电子电路11500包括基板,该基板包括与突出部11132接合的特征部。在至少一个实施方案中,基板包括限定在其中的开孔,该开孔的侧壁与突出部11132接合。这些开孔与突出部11132成卡扣配合和/或压配合布置,使得电子电路11500相对于仓体11100保持就位。在至少一个实施方案中,突出部11132包括至少部分地环形或周向的肩部,该肩部使传感器电路11500抵靠仓体11100保持。
在各种实施方案中,钉仓的传感器电路由印刷在仓体的平台上的导电材料构成。在至少一个实施方案中,导电材料由结合到平台的金属颗粒构成,该金属颗粒形成连接传感器的电路。在至少一个此类实施方案中,用三维打印机将印刷电路印刷到仓体上。在各种实施方案中,传感器电路包括印刷到仓体上的电极或接触件。在至少一个实施方案中,传感器电路包括电极,该电极包括被配置为能够接触组织的多边形表面。在至少一个另选实施方案中,电极包括平台表面上的弯曲和/或曲折路径,在各种实例中,该弯曲和/或曲折路径可增加电极与组织之间的接触面积。在至少一个实施方案中,电极包括从其延伸的针,该针被配置为能够穿透组织。在至少一个实施方案中,针包括例如约1μm的直径。在各种实例中,针在一个电极内提供组织与传感器电路之间的平行信号路径以改善传感器电路的灵敏度。在至少一个实施方案中,导电油脂或导电粘性剂覆盖传感器电路的组织接触点,这改善了电极与组织之间的接触。在各种实施方案中,传感器电路的各部分嵌入仓体中。在至少一个此类实施方案中,传感器电路包括扁平的薄导体,当例如塑料材料被包覆成型到该导体的各部分上时,该导体被嵌入到仓体中。然而,导体的各部分保持暴露以提供组织接合垫和/或导电附接点,用于将传感器焊接到该组织接合垫和/或导电附接点。在至少一个实施方案中,仓传感器电路的一部分可限定在仓钳口的横向侧壁上。在至少一个此类实施方案中,传感器电路的近侧部分和远侧部分限定在仓体上,并且传感器电路的中间部分限定在仓钳口上,该中间部分将传感器电路的近侧部分和远侧部分电连接。在至少一个实施方案中,安装到仓钳口的传感器电路的各部分包括安装到侧壁的导电条。当钉仓安置在钉仓钳口中时,仓传感器电路接合导电条以使电路接通。
如上所讨论,传感器电路可包括传导性组织接触表面。在各种实施方案中,传感器电路可包括非传导性组织接触表面。在至少一个实施方案中,传感器电路包括一个或多个电容电极。在各种实例中,投射电容测量技术用于测量电容电极上组织的存在和/或电容电极上组织的性质。在至少一个实施方案中,每个电容电极包括绝缘盖,该绝缘盖覆盖包含在其中的电容垫。在各种实例中,除上述以外,可以使用表面电容测量技术。在各种实施方案中,传感器电路包括一个或多个电感式传感器。在至少一个实施方案中,在电感式传感器中的每个电感式传感器中感应出涡流,该涡流在组织接触传感器时改变。在此类实施方案中,传感器涡流的变化由钉仓的控制系统检测。在各种实施方案中,传感器电路可包括温度传感器,该温度传感器用于检测温度传感器上组织的存在。在至少一个实施方案中,传感器电路包括由掺杂多晶陶瓷构成的电极,该掺杂多晶陶瓷例如包括钛酸钡(BaTiO3)。这些陶瓷材料的电阻诸如在患者组织抵靠电极定位时响应于温度变化而变化。仓处理器被配置为能够采用算法来监测陶瓷材料中的电阻波动,以评估组织是否抵靠电极定位。在各种实例中,传感器电路的电极是平行布置的,使得检测到的电阻、电容、电压和/或电流变化可以与传感器的位置直接相关。利用这个信息,处理器可评估组织是否定位在钉仓上方以及组织定位在钉仓上方的位置。
参见图11A和图11D,钉仓14000还包括层压材料14900,该层压材料安装到钉仓14000的一个或多个部件,以控制由从钉仓14000发射的和/或包围该钉仓的电场在仓部件内产生的电影响。在至少一个实例中,层压材料14900包括磁通场定向材料,该磁通场定向材料包括至少两层——第一层14910或盖,以及附接到第一层14910的第二层14920磁性材料。第一层14910例如由保护第二层14920的聚对苯二甲酸乙二醇酯构成,但是可由任何合适的材料构成。例如,第二层14920由烧结的铁氧体片构成,但是可由任何合适的材料构成。在至少一个实例中,由压敏粘合剂构成的粘合剂层14930例如结合到第二层14920,并且用于将层压材料14900附接到钉仓14000的一个或多个部件,如下文进一步所讨论。在至少一个实例中,层压材料14900是例如由3M制造的磁通场定向材料EM15TF。
在各种实施方案中,除上述以外,层压材料14900结合到仓体11100并且被布置成改变和/或控制从仓天线延伸的场的形状。在至少一个实施方案中,层压材料14900将场远离外科器械10000的安置钉仓14000的金属仓钳口聚焦。在至少一个实例中,仓体11100由塑料构成,并且层压材料14900安装到仓体11100,使得层压材料14900包围或至少基本上包围仓天线。在至少一个实例中,层压材料14900在仓数据线圈11540”和仓电力线圈11545”中间的位置处安装到仓体11100,使得仓线圈11540”和11545”由层压材料14900分开。在各种实施方案中,层压材料14900结合到仓钳口10410的金属壁。在至少一个实例中,层压材料14900在器械数据线圈10540”和电力传输线圈10545”中间的位置处安装到仓钳口10410的金属壁。在各种实施方案中,层压材料14900将仓数据天线11530”和/或仓电力天线11535”结合到仓体11100。在至少一个实施方案中,层压材料14900将器械数据天线10530”和/或器械电力天线10535”结合到金属仓钳口10410。
在各种实施方案中,除上述以外,层压材料14900安装到金属盘11700。在至少一个此类实例中,层压材料14900定位在金属盘11700和仓数据天线11530”中间,并且也定位在金属盘11700和仓电力天线11535”中间。此类布置可以将由天线11530”和11535”产生的场远离金属盘11700聚焦,以使场对金属盘11700的电影响最小化。在各种实施方案中,层压材料14900安装到钉仓14000的可移动部件。在至少一个实例中,参见图11D,层压材料14900安装到滑动件11400。例如,在至少一个此类实例中,层压材料14900安装到滑动件11400的横向侧11410。在至少一个实例中,参见图11A,例如,层压材料14900安装到钉驱动器11300中的一个或多个钉驱动器。在至少一个此类实例中,层压材料14900安装到钉驱动器11300的横向侧11310。例如,层压材料14900可安装到所有钉驱动器11300,或仅安装到邻近仓天线11530”和11535”的钉驱动器11300。
除上述以外,由仓天线和/或器械天线生成的场可以影响传感器11600的输出。例如,此类影响可由层压材料14900减小或减轻。在各种实例中,钉仓14000的处理器被配置为能够以电子方式说明天线场将对传感器11600的影响。在至少一个此类实例中,仓处理器可监测信号何时在天线对之间传输,并且在此类实例中,在将从传感器11600接收的传感器输出传输到外科器械处理器和/或将该传感器输出记录在钉仓14000中的存储器装置中之前修改该传感器输出。当信号不在天线对之间传输时,传感器输出在传输到外科器械处理器和/或记录在钉仓14000中的存储器装置中之前可能不需要由处理器修改。在各种实例中,处理器可在电力天线对正传输信号时将第一补偿因子应用于传感器输出,在信号天线对正传输信号时将第二补偿因子应用于传感器输出,并且在两个天线均正传输信号时将第三补偿因子应用于传感器输出。在至少一个此类实例中,例如,第三补偿因子大于第一补偿因子并且第一补偿因子大于第二补偿因子。
除上述以外,电路11500与平台11130的顶表面齐平并且/或者相对于平台11130的顶表面凹陷。在各种实例中,钉仓11000还包括可旋转地安装到该钉仓的闩锁,该闩锁可从未闩锁位置旋转到闩锁位置以将电路11500保持在电路狭槽11160中。当闩锁处于其闩锁位置时,闩锁以压配合和/或卡扣配合方式接合仓体11100。当闩锁处于其闩锁位置时,闩锁与平台11130的顶表面齐平和/或凹陷到该顶表面下方。在至少一个实施方案中,突出部11132安装到闩锁和/或任何其他合适的限制特征部并且/或者与闩锁和/或任何其他合适的限制特征部一体地形成。在任何情况下,电路11500包括一个或多个传感器,作为上述的结果,该一个或多个传感器相对于仓体11100保持就位。
如上所讨论,传感器11600可能受其周围环境影响。在各种实例中,当外科器械的端部执行器10400插入患者体内时,传感器11600可能受到温度变化的影响。参见图12,钉仓(诸如钉仓15000)例如可包括热管理系统。钉仓15000在许多方面类似于本文所公开的其他钉仓,并且为简洁起见,未重复此类方面。钉仓15000包括仓体15100和附接到仓体15100的传感器11600。钉仓15000还包括散热系统15800,该散热系统移动和/或均衡与仓体15100的热能。仓体15100包括第一横向侧15170和第二横向侧15180,并且散热器系统15800包括嵌入在第一横向侧15170中的第一散热器15870和嵌入在第二横向侧15180中的第二散热器15880。第一散热器15870包括沿着仓体15100的第一横向侧15170延伸的第一纵向导轨15872和从第一纵向导轨15872横向延伸的横向导轨15874。横向导轨15874在钉腔11140之间和周围延伸,并将热向外远离邻近第一纵向导轨15872定位的传感器11600传导。即便如此,设想了其他实施方案,在该其他实施方案中,导轨15872和15874被布置成将热向内远离沿着仓体15100的外周边定位的传感器11600传导。第二散热器15880包括沿着第二横向侧15180延伸的第二纵向导轨15882和从第二纵向导轨15882延伸的横向导轨15884。横向导轨15884在钉腔11400之间和周围延伸,并将热向外远离邻近第二纵向导轨15882定位的传感器11600传导。即便如此,设想了其他实施方案,在该其他实施方案中,导轨15882和15884被布置成将热向内远离沿着仓体15100的外周边定位的传感器11600传导。
除上述以外,第一散热器15870和第二散热器15880被配置为能够将热从钉仓15000的一个区域传导到另一区域。在各种实例中,第一散热器15870包括由具有第一热导率的第一材料构成的第一区域和具有高于第一热导率的第二热导率的第二区域。在至少一个实例中,第一区域邻近传感器11600定位,使得第二区域快速地从第一区域吸热。以此方式,第一散热器15870包括热泵。第二散热器15880可包括类似的布置。在各种实例中,第一散热器15870包括由具有第一热容的第一材料构成的第一区域和由具有第二热容的第二材料构成的第二区域,第二热容高于第一热容。在此类实施方案中,第二区域可存储远离传感器11600的热。第二散热器15880可包括类似的布置。
除上述以外,在各种实例中,第一纵向导轨15872包括沿其长度的恒定横截面。在使用中,热能将沿着第一纵向导轨15872从沿着第一纵向导轨15872具有较高温度的位置流动到具有较低温度的位置。在至少一个另选实施方案中,第一纵向导轨15872的横截面沿着该第一纵向导轨的长度变化。在使用中,热能可沿着第一纵向导轨15872从具有较小横截面的位置流动到具有较大横截面的位置。在至少一个实例中,第一纵向导轨15872从一个端部到另一端部线性地渐缩。在至少一个此类实例中,第一纵向导轨15872的较大端部位于钉仓15000的远侧端部处。在此类实例中,热可朝向钉仓15000的远侧端部流动,而不是朝向例如钉仓15000的近侧端部中的处理器和/或其他电子器件。第二散热器15880可包括类似的布置。
除上述以外,在各种实例中,横向导轨15874包括沿其长度的恒定横截面。在使用中,热能将沿着横向导轨15874从具有较高温度的位置流动到具有较低温度的位置。在至少一个另选实施方案中,横向导轨15874的横截面沿着该横向导轨的长度变化。在使用中,热能可沿着横向导轨15874从具有较小横截面的位置流动到具有较大横截面的位置。在至少一个实例中,每个横向导轨15874从一个端部到另一端部线性地渐缩。在至少一个此类实例中,横向导轨15874的较大端部位于钉仓15000的横向侧处。在此类实例中,热可从第一纵向导轨15872朝向钉仓15000的横向侧流动,在该横向侧处,热可容易地从钉仓15000消散。第二散热器15880可包括类似的布置。即便如此,可以使用散热器的任何合适的构型。
在各种实例中,除上述以外,散热器的一部分与钉仓15000的至少一个电子部件直接接触。例如,在至少一个实例中,钉仓15000包括安装到仓体15100的微处理器,并且散热器与微处理器直接邻接接触。在各种实施方案中,仓体15100直接接触钉仓15000的至少一个电子部件。在至少一个实例中,仓体15100包括从其延伸的翅片,该翅片提高对流表面积和电子组件可被冷却的速率。在至少一个此类实例中,参见图11A,仓体15100包括纵向导轨11105,该纵向导轨限定纵向狭槽11115,该纵向狭槽被配置为能够接纳滑动件11400的钉驱动导轨11415,其中纵向导轨11015是用于冷却钉仓15000的电子部件的热路径的一部分。在至少一个实施方案中,仓体15100的纵向导轨11105至少部分地涂覆有改善电子部件与纵向导轨11105之间以及纵向导轨11105与周围环境之间的热导率、对流和/或辐射的材料。在各种实施方案中,钉仓15000的金属盘11700与钉仓的一个或多个电子部件邻接接触并且被配置为能够将热远离电子部件传导。在至少一个实施方案中,仓体15100和/或金属盘11700中包括窗口或通孔,该窗口或通孔被配置为能够在端部执行器10400在患者体内时允许体液进入钉仓15000中。在此类实施方案中,钉仓15000的电子部件涂覆有密封剂,例如环氧树脂,当体液进入钉仓15000中时,该密封剂保护电子部件。此类开口也可定位和布置成便于体液与钉仓15000的散热器接触。
在各种实施方案中,钉仓15000还包括温度传感器电路,该温度传感器电路包括与钉仓15000的处理器连通的至少一个温度传感器15900。在至少一个实施方案中,温度传感器15900包括例如热敏电阻、热电偶和/或电阻式温度检测器。在各种实例中,钉仓15000的钉处理器、电子硬件、组织传感器和/或天线生成热,该热在一些情况下可能不利地影响这些装置的功能。利用从温度传感器15900提供给钉仓处理器的数据,钉仓处理器可调整其组织传感器的采样或处理速率,例如,以减少由钉仓处理器生成的热。在至少一个实例中,钉仓处理器被配置为能够在由温度传感器15900感测到的温度超过阈值时降低组织传感器的数据采样或处理速率。在至少一个实施方案中,钉仓处理器可维持组织传感器的较低采样速率,而不管温度是保持高于温度阈值还是回落低于温度阈值。在其他实施方案中,在由温度传感器15900感测到的温度回落低于温度阈值之后,钉仓处理器可提高或恢复组织传感器的采样速率。类似地,钉仓处理器可被配置为能够在由温度传感器15900感测到的温度超过阈值时降低钉仓15000与外科器械之间在数据天线对上的数据传输速率。在至少一个实施方案中,钉仓处理器可维持较低传输速率,而不管温度是保持高于温度阈值还是回落低于温度阈值。在其他实施方案中,在由温度传感器15900感测到的温度回落低于温度阈值之后,钉仓处理器可提高或恢复在数据天线对上的数据传输速率。
在至少一个实施方案中,除上述以外,钉仓15000的处理器和/或外科器械10000的处理器被配置为能够在由温度传感器15900感测到的温度超过阈值时减少钉仓15000与外科器械10000之间在电力天线对上传输的电力。在至少一个实施方案中,一个或多个处理器可维持较低电力传输速率,而不管温度是保持高于温度阈值还是回落低于温度阈值。在其他实施方案中,在由温度传感器15900感测到的温度回落低于温度阈值之后,一个或多个处理器可提高或恢复电力传输速率。
在各种实施方案中,钉仓处理器被配置为能够在修改钉仓15000的操作之前,在由温度传感器15900感测到的温度超过温度阈值时评估钉仓15000的操作状态。例如,如果当感测到的温度超过温度阈值时钉仓处理器感测到外科器械10000尚未启动钉击发行程,则钉仓处理器被配置为能够例如通过改变或停止钉仓处理器的功能来修改或降低传感器采样速率、数据传输速率和/或电力传输速率,和/或以其他方式减少由钉仓处理器生成的热。此类布置可减少在使用期间由钉仓15000生成的热。在至少一个此类实施方案中,如果当感测到的温度超过温度阈值时钉仓处理器感测到已由外科器械10000启动钉击发行程,则钉仓处理器不例如在钉击发行程期间修改传感器采样速率、数据传输速率和/或电力传输速率。在钉击发行程之后,在此类实例中,钉仓处理器可以以某种方式修改钉仓15000的操作以减少由钉仓15000生成的热。在各种实例中,钉仓15000包括传感器,该传感器被配置为能够检测滑动件的位置,或至少检测滑动件是否处于其近侧未击发位置,以确定钉击发行程是否已被启动。在各种实施方案中,外科器械10000的控制系统被配置为能够向钉仓处理器传达正在启动钉击发行程。钉仓15000还可包括传感器以确定滑动件何时已到达该滑动件的完全击发位置,并且/或者外科器械10000的控制系统被配置为能够向钉仓处理器传达正在启动钉击发系统的回缩行程。
在各种实施方案中,除上述以外,钉仓处理器被配置为能够在感测到的温度超过第一温度阈值时修改第一系统的操作,并且在感测到的温度超过第二或更高温度阈值时修改第二系统的操作。例如,钉仓处理器可在已超过第一温度阈值时降低传感器采样速率,并且然后还在已超过第二温度阈值时降低去往外科器械的数据传输速率。
在各种实施方案中,除上述以外,钉仓15000的处理器包括内部温度传感器,该内部温度传感器与温度传感器15900协作使用或代替该温度传感器。在各种实施方案中,仓体15100由用作温度传感器的正温度系数(PTC)材料构成。在此类实施方案中,仓体15100是与钉仓15000的处理器连通的温度传感器电路的一部分。在各种实例中,仓体15100包括除了本文所公开的其他温度传感器或代替本文所公开的其他温度传感器的温度传感器。例如,在至少一个实例中,PTC材料由包括钛酸钡BaTiO3的掺杂多晶陶瓷构成。在至少一个实施方案中,钉仓15000的处理器与温度传感器15900和外科器械10000中的至少一个温度传感器连通。在此类实施方案中,钉仓处理器可评估多个位置处的温度,并且采用在修改钉仓15000的操作之前考虑两个温度传感器的温度读数的算法。在各种实施方案中,钉仓15000可包括两个或更多个温度传感器,并且钉仓处理器可采用在修改钉仓15000的操作之前考虑所有温度传感器的温度读数的算法。
在各种实施方案中,例如由仓处理器生成的热可能影响传感器电路的部件和/或由传感器电路的传感器产生的电压电势。在各种实例中,感测到的温度的增加可以是例如由处理器产生的增加的磁场或电场的结果。在至少一个实施方案中,处理器采用被配置为能够利用校正因子来补偿温度增加对传感器输出的影响的算法。在至少一个此类实施方案中,在感测到的温度超过阈值时应用补偿因子。在各种实施方案中,例如,根据修改函数(诸如线性和/或非线性函数)修改电压输出。在各种实施方案中,仓控制系统包括传感器,该传感器被配置为能够直接检测由处理器生成的场并且采用算法来补偿场对传感器输出的影响。
在各种实施方案中,本文所公开的钉仓被配置为能够以低功率模式和高功率模式操作。钉仓的处理器被配置为能够在钉仓处理器已接收到一个或多个输入或触发器时从低功率模式切换到高功率模式。在此类实施方案中,当钉仓处理器等待信号或信号组合以切换成高功率模式时,钉仓消耗较少的功率并生成较少量的热。在低功率模式下,在至少一个实施方案中,钉仓处理器被配置为能够以低采样速率处理来自钉仓传感器的数据,并且/或者例如以低传输速率在数据天线对上将数据传输到外科器械10000。在高功率模式下,在至少一个实施方案中,钉仓处理器被配置为能够以更高的采样速率处理来自钉仓传感器的数据,并且/或者以更高的传输速率在数据天线对上将数据传输到外科器械10000。在至少一个实施方案中,钉仓包括例如安装到仓体的至少一个应变仪,该应变仪与钉仓处理器连通并且被配置为能够感测仓体何时被压缩。当响应于仓体经受高应变而由应变仪输出的电压电势超过阈值时,钉仓处理器从低功率模式切换到高功率模式。在此类实例中,钉仓可检测到外科器械10000的端部执行器10400已被夹紧到患者组织上。除了上述应变仪之外或代替上述应变仪,外科器械10000的处理器可例如在外科器械10000已被夹紧时在数据天线对上向钉仓的处理器发射信号。在任一情况下,当钉仓的处理器确定外科器械10000处于其夹紧状态时,该处理器从其低功率模式切换到其高功率模式。在此类实例中,钉仓处理器可例如提高其组织传感器输出的采样速率和/或提高回到外科器械10000的处理器的数据传输速率。
在至少一个实施方案中,除上述以外,当外科器械10000处于未夹紧状态并且钉仓处于未击发状态时,钉仓处于低功率模式。当外科器械10000被夹紧时,钉仓进入第一高功率模式,其中钉仓的一个或多个功能(但不是所有功能)被开启和/或修改。当由外科器械10000启动钉击发行程时,钉仓进入第二高功率模式,其中钉仓的所有功能均被开启并完全操作。在至少一个此类实施方案中,钉仓的处理器被配置为能够向外科器械10000发射指示钉仓已进入第一高功率模式的第一信号,并且向外科器械10000发射指示钉仓已进入第二高功率模式的第二信号。当外科器械10000的器械处理器接收到第一信号时,器械处理器增大去往钉仓的功率信号的瓦特数,以在钉仓的第一高功率模式下为该钉仓供电。同样地,当器械处理器接收到第二信号时,器械处理器增大去往钉仓的功率信号的瓦特数,以在钉仓的第二高功率模式下为该钉仓供电。
在至少一个实施方案中,外科器械被配置为能够在钉仓安置在外科器械的端部执行器中并且端部执行器处于未夹紧状态时以第一瓦特数向钉仓供应电力,在端部执行器在钉击发行程之前处于夹紧状态时以第二瓦特数向钉仓供应电力,并且在钉击发行程期间以第三瓦特数向钉仓供应电力。在至少一个此类实施方案中,第二瓦特数高于第一瓦特数和第三瓦特数,使得仓处理器可以以较高速率处理来自组织传感器的数据以在钉击发行程之前评估组织,而不在端部执行器被夹紧之前和/或在钉击发行程期间生成过量的热。在至少一个另选实施方案中,第三瓦特数高于第一瓦特数和第二瓦特数,使得仓处理器可以以较高速率处理来自组织传感器的数据以在钉击发行程期间评估组织,而不在钉击发行程之前生成过量的热。
在至少一个实施方案中,在钉仓安置在外科器械10000中之前,钉仓处于低功率模式。当钉仓安置在外科器械10000中时,钉仓进入第一高功率模式,其中钉仓的一个或多个功能(但不是所有功能)被开启和/或修改。例如,当钉仓处于第一高功率模式时,钉仓的识别电路被接通。当外科器械10000被夹紧时,钉仓进入第二高功率模式,其中钉仓的一个或多个附加功能(但不是所有功能)被开启和/或修改。例如,当钉仓处于第二高功率模式时,钉仓的组织感测电路被接通。当由外科器械10000启动钉击发行程时,钉仓进入第三高功率模式,其中钉仓的所有功能均被开启并完全操作。在至少一个此类实施方案中,钉仓的处理器被配置为能够向外科器械10000发射指示钉仓已进入第一高功率模式的第一信号、向外科器械10000发射指示钉仓已进入第二高功率模式的第二信号,并且向外科器械10000发射指示钉仓已进入第三高功率模式的第三信号。当外科器械10000的器械处理器接收到第一信号时,器械处理器增大去往钉仓的功率信号的瓦特数,以在钉仓的第一高功率模式下为该钉仓供电。同样地,当器械处理器接收到第二信号时,器械处理器增大去往钉仓的功率信号的瓦特数,以在钉仓的第二高功率模式下为该钉仓供电。同样地,当器械处理器接收到第三信号时,器械处理器增大去往钉仓的功率信号的瓦数,以在钉仓的第三高功率模式下为该钉仓供电。
如上所讨论,钉仓的处理器是响应于输入或触发器的,当接收到触发器时,该输入或触发器激活钉仓的一个或多个系统。在各种实施方案中,钉仓包括控制系统,该控制系统包括唤醒电路和机载电源。当由来自钉仓外部的电源(即,非机载电源)通电时,唤醒电路将机载电源与控制系统的数据传输电路连接,以经由数据天线对将数据传输到外科器械10000。在至少一个实例中,数据传输电路向外科器械10000发射识别信标。如果钉仓的控制系统在发射识别信标之后的预定时间段内未与外科器械10000建立认证通信,则控制系统通过将机载电源与数据传输电路断开连接来关闭数据传输电路,直到唤醒电路由非机载电源重新通电。然而,如果钉仓在发射识别信标之后的预定时间段内与外科器械10000建立了认证通信,则控制系统进入完全唤醒高功率操作模式。
在各种实施方案中,除上述以外,钉仓的控制系统将在接收到两个输入或触发器之后从低功率或睡眠模式切换到高功率或唤醒模式。在至少一个实施方案中,参见图5A,钉仓包括附接到仓体的保持器或盖11900,该保持器或盖在仓体的顶部或平台上方延伸。盖11900包括被配置为能够将盖11900可释放地保持到钉仓的一个或多个附接特征部11910。钉仓还包括盖传感器电路,该盖传感器电路包括例如与仓控制系统的处理器连通的传感器,诸如霍尔效应传感器。当盖11900附接到仓体时,安装到盖11900的磁性元件干扰由霍尔效应传感器发射的场,并且当盖11900从仓体移除时,磁性元件不再干扰霍尔效应传感器场。霍尔效应传感器场的这种变化反映在霍尔效应传感器的电压输出中,该电压输出是由仓控制系统用来将钉仓切换成该钉仓的唤醒模式的触发器中的一个触发器。除上述之外,外科器械的仓钳口还包括仓存在传感器电路,当钉仓安置在仓钳口中时,该仓存在传感器电路是接通的或闭合的。在至少一个实例中,例如当钉仓安置在仓钳口中时,钉仓使接近开关闭合。类似于盖传感器电路,仓存在传感器电路是唤醒电路的一部分。控制系统的处理器被配置为能够在处理器接收到钉仓安置在仓钳口中的输入和盖11900已从钉仓移除的输入时,从该处理器的低功率或睡眠模式切换到该处理器的高功率或唤醒模式。在睡眠模式下,处理器不从组织传感器采样数据、不处理从外科器械传达到钉仓的数据并且/或者不将数据传输到外科器械。在唤醒模式下,处理器从组织传感器采样数据、处理从外科器械传达到钉仓的数据并且将数据传输到外科器械。
除上述以外,唤醒事件或触发器的任何合适的组合都可用于将钉仓的控制系统从该控制系统的睡眠模式切换到该控制系统的唤醒模式。在至少一个实施方案中,第一触发器是从钉仓移除盖,并且第二触发器包括完整的认证序列。在至少一个实例中,由控制系统的处理器感测盖从钉仓的移除,该处理器将钉仓从该钉仓的睡眠模式切换成认证模式。在认证模式下,钉仓的处理器通过数据天线对发射识别信标。如果器械处理器识别出识别信标,则器械信标将唤醒信号发射回钉仓。当接收到唤醒信号时,处理器从其认证模式切换到其唤醒模式。在唤醒模式下,钉仓的控制系统是功能完善的,而在认证模式下,钉仓的控制系统可能不是功能完善的。例如,在至少一个实施方案中,当钉仓处于其认证模式时,钉仓的控制系统不处理来自组织传感器的输入。此外,处理器包括例如在该处理器进入其认证模式时被激活的定时器电路、功能和/或时钟。处理器被配置为能够使得在该处理器在由定时器电路测量的预定时间段内没有接收到唤醒信号的情况下,该处理器返回到其睡眠模式。在各种实例中,对识别信标和/或唤醒信号进行编码或加密。在至少一个此类实例中,器械处理器被配置为能够对识别信标进行解码或解密,并且/或者仓处理器被配置为能够对唤醒信号进行解码或解密。
各种唤醒触发器可包括例如将电池安装到外科器械中、将外科器械从充电站移除和/或将外科器械附接到机器人外科系统。在至少一个实施方案中,外科器械包括电接触件,该电接触件与机器人外科系统的臂上的对应电接触件配合,该对应电接触件闭合由外科器械的处理器和/或机器人外科系统的处理器感测的电路。在此类实例中,外科器械和/或机器人外科系统向安置在外科器械中的钉仓发送唤醒触发器信号。在至少一个实施方案中,机器人外科系统包括视觉系统,该视觉系统包括一个或多个相机,该一个或多个相机被配置为能够在视觉上确认缝合器械附接到机器人外科系统的臂和/或钉仓在仓钳口中的存在,并且然后向安置在外科器械中的钉仓发送唤醒触发器信号。在至少一个此类实施方案中,机器人外科系统的臂和/或外科器械包括将外科器械可释放地保持到臂的夹子,并且视觉系统被配置为能够在发射唤醒触发器信号之前确认夹子处于它们的锁定位置。在各种实施方案中,手术室或外科手术室包括控制系统,该控制系统被配置为能够直接地并且/或者通过机器人外科系统和/或外科器械向钉仓发送唤醒信号。
在各种实施方案中,钉仓包括与钉仓的处理器连通的电路。该电路包括在仓体的平台上的两个接触件和该接触件之间的间隙。当钉仓安置在仓钳口中并且端部执行器处于打开构型时,电路处于断开状态。在此类实例中,不能访问钉仓的存储器装置。当端部执行器闭合时,砧座钳口桥接接触件,并且电路处于闭合状态。在此类实例中,可访问钉仓的存储器装置。在各种实施方案中,电路包括唤醒电路,该唤醒电路在闭合时将电压电势提供到处理器的输入门,该输入门在被接收时使得处理器从睡眠模式切换到唤醒模式。在至少一个此类实施方案中,在端部执行器闭合时闭合唤醒电路使得钉仓中的电池或电源与钉仓的控制系统连通。在各种其他实施方案中,闭合砧座使与处理器连通的唤醒电路断开。在至少一个此类实施方案中,砧座包括切割元件,例如刀,该切割元件切割钉仓中的电路,从而使电路处于断开状态。在此类实例中,处理器可将输入门处的电压电势的损失解释为唤醒信号。
在各种实例中,除上述以外,钉仓被存储在密封封装件中。在将钉仓装载到外科器械中之前,临床医生必须打开封装件并取出钉仓。在至少一个实例中,从封装件取出钉仓激活唤醒触发器,该唤醒触发器使得钉仓从睡眠模式切换到唤醒模式。在至少一个实施方案中,标贴附接到封装件和钉仓。在此类实例中,标贴将钉仓中的唤醒电路维持在断开状态。当从封装件中取出钉仓时,标贴脱离钉仓,并且唤醒电路变为闭合。在此类实例中,处理器将唤醒触发器信号接收到该处理器的输入端。在至少一个此类实例中,钉仓包括机载电源,例如电池和/或电荷积聚器,当标贴脱离钉仓时,该机载电源将电压电势递送到处理器输入端,从而将唤醒触发器信号提供到处理器。在至少一个实施方案中,钉仓包括唤醒电路,该唤醒电路包括电池和弹簧装载的电池接触件,当钉仓定位在封装件中时,该电池和弹簧装载的电池接触件通过突片保持在打开状态。在至少一个实例中,例如,封装件由塑料材料构成,诸如TYVEK。突片附接到封装件,并且当钉仓从封装件中取出时,突片从电池和弹簧装载的电池接触件之间移除,使得电池接触件接合电池并闭合唤醒电路。此时,钉仓的处理器被供电并且是功能完善的。
如上所讨论,钉仓可包括附接到仓体的盖或保持器11900,并且当盖11900从仓体移除时,钉仓中的唤醒电路闭合并且处理器进入唤醒状态中。类似于上文,在至少一个实施方案中,钉仓包括唤醒电路,该唤醒电路包括电池和弹簧装载的电池接触件,当盖11900附接到钉仓时,该电池和弹簧装载的电池接触件通过附连到盖11900的突片保持在打开状态。当盖11900从钉仓移除时,突片从电池和弹簧装载的电池接触件之间移除,使得电池接触件接合电池并闭合唤醒电路。此时,钉仓的处理器被供电并且是功能完善的。在其他实施方案中,当移除盖11900时,处理器进入第一供电模式。在至少一个此类实施方案中,例如,作为仓认证过程的结果,处理器进入第二供电模式。
在各种实施方案中,除上述以外,钉仓包括唤醒电路,该唤醒电路包括霍尔效应传感器和磁体,该霍尔效应传感器例如安装到仓体的第一横向侧,该磁体安装到仓体的第二或相对横向侧。当钉仓的盖11900附接到仓体时,盖11900定位在霍尔效应传感器与磁体之间。当盖11900从仓体移除时,由霍尔效应传感器检测到的场改变,并且因此霍尔效应传感器的电压输出改变,这由仓处理器检测到。电压电势的此类变化由处理器解释为唤醒触发器,并且响应于此唤醒触发器和/或包括此唤醒触发器的唤醒触发器组合,处理器从睡眠模式切换到唤醒模式。在各种实例中,盖11900包括例如由铁氧体构成的翅片,当盖11900附接到仓体时,该翅片定位在磁体与霍尔效应传感器之间。
一旦钉仓从其包装中取出,除上述以外,钉仓就安置在外科器械的仓钳口中。在各种实例中,在钉仓与仓钳口之间存在卡扣配合和/或压配合布置。当在此类情况下将钉仓插入到仓钳口中时,当临床医生向钉仓施加足够的力以克服卡扣配合和/或压配合特征部时,钉仓可能会突然加速进入其安置位置。在各种实施方案中,钉仓包括电源,例如电池和/或电荷积聚器,并且另外包括唤醒电路,该唤醒电路包括与钉仓的处理器连通的加速度计。加速度计与电源和处理器的输入门连通,并且当钉仓随着其安置在外科器械中而加速时,加速度计的供应到处理器的输入门的电压输出增大到高于唤醒电压阈值,并且因此,例如,钉仓从其睡眠模式切换到其唤醒模式。在其他实施方案中,当钉仓被安置时,处理器进入第一供电模式。在至少一个此类实施方案中,例如,作为仓认证过程的结果,处理器进入第二供电模式。
一旦钉仓安置在仓钳口中,除上述以外,就可将外科器械的端部执行器插入患者体内。在各种实例中,外科器械的端部执行器通过大的或开放的切口插入患者体内,并且然后夹紧到患者组织上。在其他实例中,外科器械的端部执行器通过套管或套管针插入患者体内。在此类实例中,端部执行器被闭合,通过套管针插入,并且然后一旦端部执行器在患者体内就重新打开。此时,然后将端部执行器夹紧到患者组织上。在任一情况下,端部执行器在用于患者体内之前可被打开和闭合一次或多次,并且端部执行器的夹紧可向钉仓提供唤醒触发器。在至少一个实施方案中,钉仓包括处理器、电源以及与处理器和电源连通的唤醒电路。唤醒电路包括处于断开状态的开关,当外科器械的端部执行器被夹紧时,该开关闭合。当开关闭合时,处理器进入其全供电状态中。在至少一个此类实施方案中,可移动砧座钳口物理地接触钉仓以闭合唤醒电路。在至少一个实施方案中,唤醒电路包括霍尔效应传感器,当砧座钳口处于其闭合位置时,该霍尔效应传感器检测安装到砧座钳口的磁性元件的存在。当霍尔效应传感器的电压输出由于磁性元件的存在而改变时,处理器将电压输出变化解释为唤醒触发器。在至少一个实施方案中,唤醒电路包括感应传感器,该感应传感器检测处于闭合位置的金属砧座钳口的存在。当感应传感器的电压输出由于砧座钳口闭合而变化时,处理器将电压输出变化解释为唤醒触发器。
在各种实施方案中,除上述以外,套管针包括:包括密封端口的近侧端部;包括被配置为能够切入患者组织的锋利尖端的远侧端部;以及在近侧端部与远侧端部之间延伸的管。密封端口包括扩大的开口和柔性密封件,该柔性密封件被配置为能够在端部执行器和/或外科器械的轴插入穿过该柔性密封件时抵靠该端部执行器和/或外科器械的轴形成基本上气密的密封。在各种实施方案中,套管针包括数据发射器,该数据发射器包括天线,该天线被配置为能够在钉仓穿过套管针时向钉仓发射唤醒信号。在各种实例中,来自套管针数据发射器的唤醒信号是将钉仓的控制系统从该控制系统的睡眠模式切换到该控制系统的唤醒模式的足够的触发器,并且在其他实例中,来自套管针数据发射器的唤醒信号是将钉仓的控制系统从该控制系统睡眠模式切换到该控制系统唤醒模式所需的若干触发器中的一个触发器。在至少一个实施方案中,套管针包括磁性构件,例如永磁体,并且钉仓包括唤醒电路,该唤醒电路包括被配置为能够检测磁性构件的传感器。在至少一个此类实施方案中,钉仓包括与传感器连通的电源,该传感器包括例如霍尔效应传感器。当钉仓安置在端部执行器中并且端部执行器通过套管针插入时,由霍尔效应传感器发射的场被套管针中的磁性构件扭曲,这改变了霍尔效应传感器的电压输出。传感器电压输出的这种变化由钉仓的处理器检测,并且当该变化超过预定阈值时,处理器被配置为能够从其睡眠模式切换到其唤醒模式。在各种实施方案中,套管针的管包括嵌入该管中和/或安装到该管的铁环,并且钉仓包括唤醒电路,该唤醒电路包括被配置为能够检测铁环的电感式传感器。在至少一个实施方案中,电感式传感器包括例如场传感器、振荡器、解调器、触发器和输出。当钉仓安置在端部执行器中并且端部执行器通过套管针插入时,铁环改变电感式传感器的电压输出。传感器电压输出的这种变化由钉仓的处理器检测,并且当该变化超过预定阈值时,处理器被配置为能够从其睡眠模式切换到其唤醒模式。在各种实例中,电感式传感器针对电感式传感器经过的每个铁环输出电压脉冲。在此类实例中,处理器被配置为能够在其已经从电感式传感器接收到超过预定脉冲数量的数量的脉冲之后切换到该处理器的唤醒模式。
再次参见图7,钉仓可包括电力管理系统,该电力管理系统包括处理器和电荷积聚器,例如电荷积聚器11800。电力管理系统还包括与电荷积聚器11800连通的充电电路,并且包括天线,该天线被配置为能够在钉仓安置在外科器械中时从外科器械接收电力。在各种实例中,外科器械能够以第一或最大充电速率向钉仓供应电力;然而,在钉仓的使用期间可能存在钉仓以高于最大充电速率的第二速率使用电力的情况。为了适应这种较高的电力使用率,当钉仓的电力使用率低于最大充电速率时,电荷积聚器11800存储电力。钉仓的处理器被配置为能够管理存储在电荷积聚器11800中的电力,并且当电荷积聚器11800达到其最大容量时,处理器向外科器械发送信号以减少由外科器械供应到钉仓的电力。在至少一个此类实例中,信号包括关于钉仓的实际电力使用率的数据。外科器械的处理器在接收到信号时减少供应到钉仓的电力,使得充电速率与钉仓使用速率匹配。在许多实例中,钉仓的电力使用率可增大到高于充电速率,并且电力管理系统被配置为能够利用来自电荷积聚器11800的电力,直到电荷积聚器11800的电荷降到低于再充电阈值。当处理器检测到电荷积聚器11800的电荷已下降到低于再充电阈值时,钉仓的处理器向外科器械发送信号以将充电速率恢复到最大充电速率,以便对电荷积聚器11800进行再充电。除了电荷积聚器11800或代替该电荷积聚器,钉仓可包括任何合适的电力存储装置,例如电荷泵、电池和/或超级电容器。
在各种实例中,除上述以外,外科器械不主动对电荷积聚器11800进行充电,直到至少一个触发事件已经发生。在至少一个实例中,仓电力管理系统在接收到来自外科器械的NFC天线的信号之后对电荷积聚器11800进行充电。在至少一个此类实例中,从NFC天线传输的电力充分地对电荷积聚器11800进行充电,以在钉仓进入全供电模式之前将钉仓置于充电模式。在某些实例中,在电荷积聚器11800已由从NFC天线传输的电力至少部分地充电之后,仓处理器向外科器械发射识别信标。当器械处理器从钉仓接收到识别信标时,器械处理器在NFC天线上并且/或者在电力天线上向钉仓递送额外的电力,使得钉仓电力管理系统完全地对电荷积聚器11800进行充电。在各种实例中,电荷积聚器11800至少部分地由从手术室的控制系统传输到仓NFC天线的电力充电。
在各种实施方案中,外科器械被配置为能够一旦钉仓安置在外科器械中就向钉仓供应电力。在至少一个实施方案中,例如,当钉仓安置在外科器械中时,外科器械立即经由低功率数据天线对(诸如NFC天线对)向钉仓供应电力。在此类实例中,作为充电模式的一部分,仓电力管理系统对电荷积聚器11800进行充电。在至少一个实例中,在充电模式期间将例如小于0.1W供应到仓电力管理系统。在钉仓的处理器已接收到将钉仓切换到该钉仓的唤醒模式所需的唤醒触发器或唤醒触发器的组合之后,处理器向外科器械提供钉仓处于该钉仓的唤醒模式的唤醒信号。一旦外科器械的处理器接收到唤醒信号,外科器械就开始通过高功率天线对向钉仓供应电力。在此类实例中,如果电荷积聚器11800还没有被完全充电,则仓电力管理系统可以完成该电荷积聚器的充电。在至少一个实例中,在唤醒模式期间将多于1.0W供应到仓电力管理系统。在各种另选实施方案中,在钉仓与外科器械之间仅存在一个天线对。在此类实施方案中,外科器械可基于器械处理器是否已接收到来自钉仓的唤醒信号来控制经由天线向钉仓供应低功率还是高功率。在任何情况下,如果仓电力管理系统确定电荷积聚器11800已被完全充电并且仓处理器尚未接收到必要的一个或多个唤醒触发器以将钉仓切换成该钉仓的唤醒模式,则仓电力管理系统可切换断开向电荷积聚器11800供应电力的充电电路以停止对电荷积聚器11800进行充电。在至少一个实施方案中,钉仓处理器可向器械处理器发射带电但不是唤醒信号,器械处理器在接收到此信号时被配置为能够停止向钉仓供应电力,直到器械处理器已从钉仓接收到唤醒信号。一旦器械处理器已经接收到唤醒信号,在此类情况下,器械处理器被配置为能够开始以高功率电平向钉仓供应电力。
在各种实施方案中,如上所述,钉仓的处理器被配置为能够当处理器接收到唤醒触发器的组合时从低功率或睡眠模式切换到高功率或唤醒模式。在各种实施方案中,处理器需要触发器的特定组合以进入该处理器的唤醒模式。例如,当足够的电压电势被施加到处理器的第一输入门并且足够的电压电势被施加到处理器的第二输入门时,仓处理器切换成其唤醒模式。在各种实施方案中,处理器被配置为能够在处理器已接收到来自较大触发器集合的触发器子集之后从该处理器的睡眠模式切换到该处理器的唤醒模式。在至少一个此类实施方案中,处理器被配置为能够接收三个唤醒触发器,但是被配置为能够在已经接收到唤醒触发器中的任何两个唤醒触发器之后切换成该处理器的唤醒模式。电压电势不需要同时施加到处理器门,但设想了唤醒触发器必须同时施加到处理器以供处理器切换成该处理器的唤醒模式的实施方案。在至少一个实施方案中,处理器被配置为能够同时接收两个特定唤醒触发器以从该处理器的睡眠模式切换到该处理器的唤醒模式。在至少一个此类实施方案中,例如,唤醒触发器中的一个唤醒触发器是电荷积聚器11800达到足够的电荷电平,并且另一触发器是事件。即便如此,在本文所公开的包括电荷积聚器11800和/或另一其他合适的电力存储器装置的任何实施方案中,电荷积聚器11800达到足够的电荷水平可以用作唤醒触发器。此外,设想了各种另选实施方案,在该另选实施方案中,直到仓处理器已经从其睡眠模式切换到其唤醒模式之后才对电荷积聚器11800进行充电。
在各种实施方案中,本文所公开的钉仓包括至少一个存储器装置,该至少一个存储器装置被配置为能够存储关于钉仓在钉击发行程之前、期间和/或之后的性质和/或关于组织在钉击发行程之前、期间和/或之后的性质的数据。存储器装置与处理器连通,并且处理器被配置为能够从存储器装置读取数据并在所存储的数据信号中传达数据,该所存储的数据信号被传输到钉仓的天线。在各种实施方案中,处理器被配置为能够仅在接收到解锁处理器的此功能的密钥或密钥信号之后发射所存储的数据信号。每当处理器访问存储器装置以生成所存储的数据信号时,事件就被记录在存储器装置上。以此方式,存储器装置包括关于存储器装置已被访问的次数以及何时被访问的数据。此类存取数据可包括在所存储的数据信号中。如果提供到仓处理器的密钥信号与存储在仓处理器和/或存储器装置中的预期密钥信号不匹配,则仓处理器不生成所存储的数据信号。实际上,失败的尝试被记录在存储器装置上。以此方式,存储器装置包括关于对存储器装置数据的存取被拒绝的次数的数据。当适当的密钥信号被提供到仓处理器时,此类存取拒绝数据可以被包括在所存储的数据信号中。在至少一个实施方案中,仓处理器在访问存储器装置的失败尝试的数量已经超过阈值之后进入锁定模式。在至少一个实例中,该阈值例如是五次失败尝试。一旦仓处理器处于锁定模式,仓处理器就被配置为能够即使此后提供了适当的密钥信号也不生成所存储的数据信号。在此类实例中,存储在存储器装置上的数据不再是可存取的。在至少一个另选实施方案中,当主密钥或主密钥信号被提供给处理器时,在处理器已经进入其锁定模式之后,该处理器是可解锁的。主密钥与密钥不同,并且在各种实例中,例如可仅由钉仓的原始制造商持有。即使处理器不处于锁定模式,向处理器提供主密钥信号也会使得处理器发射所存储的数据信号。
除上述以外,存储在存储器装置上的数据可以根据任何合适的协议被加密或编码。在接收到密钥和/或主密钥之后,处理器被配置为能够对存储在存储器装置上的数据进行解密或解码,并且在所存储的数据信号中传输经解密或解码的数据。然而,设想了各种另选实施方案,在该另选实施方案中,处理器被配置为能够发射经加密或编码的数据作为所存储的数据信号的一部分。在至少一个此类实施方案中,存储在存储器装置上的解密密钥或代码被包括在所存储的数据信号中。在此类实施方案中,外科器械和/或任何合适的系统可对所存储的数据系统中的数据进行解密或解码。
在各种实例中,仓处理器必须接收唯一的识别密钥以创建以上讨论的所存储的数据信号。此唯一识别密钥是预定义的并且是静态的,并且向仓处理器提供该唯一识别密钥的任何人都可以存取存储在存储器装置上的数据。在其他实施方案中,存取存储在存储器装置上的数据所需的密钥是动态的。在至少一个实施方案中,动态密钥包括关于钉仓的性能信息。此类性能信息可包括关于机械特征部和/或电气特征部的数据。例如,动态密钥可包括例如关于在钉击发行程之后滑动件在钉仓中的最终位置的信息。另外,例如,动态密钥可包括关于例如在钉击发行程期间由钉击发系统的电动马达消耗的最大电流的信息。在此类实例中,性能信息可在钉击发行程期间和/或之后在钉仓与外科器械之间共享。例如,钉仓可包括滑动件位置传感器,并且可将滑动件在钉击发行程之后的最终位置传达给外科器械。另外,例如,外科器械可包括电动马达电流传感器,并且可将在钉击发行程期间由电动马达消耗的峰值电流传达到钉仓。例如,此性能信息也可以与机器人外科系统和/或手术室控制系统共享。在任何情况下,此类共享性能数据可包括用于存取存储在钉仓的存储器装置上的数据的动态密钥。
除了上述内容或代替上述内容,钉仓包括安全电路,当钉仓的可移动部件以特定布置布置时,该安全电路闭合。安全电路与处理器连通,并且当安全电路处于闭合状态时,处理器处于解锁状态,这允许处理器响应于询问信号而生成所存储的数据信号,并且/或者以其他方式允许存储在存储器装置上的数据由例如外科器械、机器人手术系统和/或手术室控制系统存取。当安全电路处于断开状态时,处理器处于锁定状态并且被配置为能够不发射所存储的数据信号或不允许存取存储在存储器装置上的数据。在至少一个实施方案中,当盖11900未附接到仓体并且滑动件未处于其未击发位置时,钉仓的安全电路处于闭合状态。在各种实施方案中,例如当安全电路处于其断开状态时,安全电路阻止处理器由外科器械供电。当安全电路处于其闭合状态时,处理器可由外科器械供电。在此类实施方案中,当处理器由外科器械供电时,处理器可生成所存储的数据信号。在至少一个此类实施方案中,钉仓必须安置在外科器械中,例如以接通安全电路。在至少一个实施方案中,安全电路包括电接触件,该电接触件接合外科器械中的对应电接触件,例如,当钉仓安置在外科器械中时,该对应电接触件使安全电路闭合。
在各种实施方案中,安全电路包括安全天线,例如当钉仓安置在外科器械中时,该安全天线与外科器械中的对应安全天线连通。在至少一个此类实施方案中,当滑动件处于其未击发位置时,滑动件定位在仓安全天线与器械安全天线之间。在此类实例中,滑动件抑制或防止钉仓与外科器械之间跨安全天线对的连通。在滑动件已朝远侧移动之后,滑动件不再阻挡数据和/或电力在钉仓与外科器械之间的传输。
在各种实施方案中,如上所讨论,钉仓的安全电路可被配置为能够处于断开状态和闭合状态。设想了各种另选实施方案,在该另选实施方案中,安全电路处于闭合状态,但由于钉仓的可移动部件处于特定构型或构型范围内,因此安全电路的可检测性质改变。在至少一个实施方案中,当盖11900附接到仓体且滑动件处于其未击发位置时,安全电路两端的电压电势在第一电压范围内,当盖11900从仓体移除且滑动件处于其未击发位置时,安全电路两端的电压电势在第二电压范围内,并且当盖11900从仓体移除且滑动件处于击发位置时,安全电路两端的电压电势在第三电压范围内。当安全电路两端的电压电势在第三电压范围内时,处理器处于其解锁状态。例如,当安全电路两端的电压电势在第一电压范围或第二电压范围内时,处理器处于其锁定状态。
在各种实施方案中,钉仓包括进口盖,当钉仓安置在外科器械的仓钳口中时,该进口盖打开。当进口盖打开时,数据存取电路闭合,这允许外科器械访问钉仓的存储器装置。在至少一个实例中,仓钳口包括导电接触元件,当钉仓安置在仓钳口中并且进口盖被打开时,该导电接触元件桥接数据存取电路中的开口。在至少一个实施方案中,进口门包括例如箔片。在至少一个实施方案中,例如,存储器装置包括RFID标签。然而,当钉仓未安置在外科器械中时,数据存取电路处于断开状态,并且不能访问外科器械的存储器装置。
2015年3月31日公布的名称为“SURGICAL INSTRUMENT WITH STOWING KNIFEBLADE”的美国专利8,991,678、2018年10月2日公布的名称为“SURGICAL APPARATUS WITHCONDUCTOR STRAIN RELIEF”的美国专利10,085,749以及2015年11月12日公开的名称为“AUTHENTICATION AND INFORMATION SYSTEM FOR REUSABLE SURGICAL INSTRUMENTS”的美国专利申请公布2015/0324317的全部公开内容通过引用并入本文。
除上述以外,钉仓的存储器装置可存储任何合适的数据。例如,所存储的数据可包括存储在钉仓中的钉的尺寸、存储在钉仓中的钉的未成形高度(其可以反映在仓体的颜色上)、存储在钉仓中的钉的数量、存储在钉仓中的钉的布置和/或存储在钉仓中的钉的钉图案的长度(例如,诸如30mm、45mm或60mm)。另外,例如,所存储的数据可包括钉仓是否已被击发、钉仓被击发的时间、滑动件在钉击发行程期间行进的距离、钉击发行程期间流逝的时间、钉击发行程的速度、钉击发行程期间发生的钉击发系统的加速和减速、钉击发行程期间经历的击发力,和/或在钉击发行程期间是否遇到和/或切入了外来物体。另外,例如,所存储的数据可包括钉仓中的传感器的数量、传感器的类型和/或传感器在仓体中的位置。另外,例如,所存储的数据可包括由传感器感测到的数据。另外,例如,所存储的数据可包括正被缝合的组织的类型、正被缝合的组织的厚度、正被缝合的组织的性质和/或组织在端部执行器的钳口之间的位置。另外,例如,所存储的数据可包括钉仓的制造日期、钉仓所属的批次、钉仓的制造位置、钉仓的制造商、钉仓的灭菌日期、用于对钉仓进行灭菌的灭菌剂的类型、钉仓的有效期和/或钉仓是否在有效期之后被击发以及击发了多少。
根据至少一种方法,将钉仓从其封装件中取出并安置在缝合器械的仓钳口中。缝合器械然后附接到机器人外科系统的臂,并且机器人外科系统通电和/或从睡眠模式切换到唤醒模式。机器人外科系统的控制系统被配置为能够通过外科器械向下传输电力以评估钉仓是否安置在仓钳口中,并且然后通过外科器械向下传输机械动力以评估钉仓是否处于未击发状态。在至少一个实施方案中,除上述以外,机器人外科系统向外科器械中的数据天线(例如,NFC天线)发送电力以向钉仓供应电力。如上所讨论,钉仓被配置为能够将识别信号返回到外科器械。在各种实例中,在外科器械上和/或在机器人外科系统中处理此识别信号。在任一情况下,如果认证程序成功,则钉仓通过验证。如果认证程序不成功,则机器人外科系统被配置为能够通知操作机器人外科系统的临床医生。为了验证钉仓是否未耗尽(即,先前未击发),钉击发构件通过外科器械和/或机器人外科系统的马达驱动装置朝远侧推进较小行程。如果钉击发驱动装置被外科器械中的机械特征部阻挡,则机器人外科系统被配置为能够确定钉仓先前已耗尽并且防止钉仓被击发。如果钉击发系统未被机械特征部阻挡,则机器人外科系统被配置为能够在较小行程之后停止钉击发驱动装置并确定钉仓未被击发。除了从钉仓传输到外科器械和/或机器人外科系统的识别数据之外,钉仓还可传输存储在仓存储器装置上的数据,包括钉仓的有效期、存储在钉仓中的钉图案的长度、存储在钉仓中的钉的未成形高度、塑料仓体的颜色、钉仓的制造商和/或钉仓是否已被击发。如果所接收的钉仓参数与所需的钉仓参数不匹配,则通知操作机器人外科系统的临床医生。
除上述以外,钉仓、外科器械和/或机器人外科系统被配置为能够减轻由钉仓提供的仓数据中的错误和/或从该仓数据中丢失的数据。例如,数据可能由于传感器内的短路、腐蚀、所使用的不兼容或不正确的钉仓、来自相邻外科器械和/或外科系统的电子干扰、软件缺陷、有缺陷的硬件和/或灭菌过程而丢失或具有错误。因此,可采用一种或多种形式的冗余来提高外科器械和/或机器人外科系统从钉仓接收数据的可能性。例如,在至少一个实施方案中,相同的数据被存储在所存储的数据信号内的不同位置中。在此类实例中,一些数据可能在信号的一部分中丢失或损坏,但是可以从信号的另一部分获得。另外,所存储数据可包括来自两个不同来源的数据,这两个来源可以被视为功能等效物。例如,来自钉击发驱动装置中的力或负荷传感器的数据和来自监测由钉击发驱动装置的电动马达消耗的电流的电流传感器的数据都可以是所存储数据的一部分。在此类实例中,如果力传感器数据在信号中丢失或损坏,则处理器可依赖于当前传感器数据来评估例如钉击发驱动装置所经受的力。
在至少一个实施方案中,钉仓可包括具有所存储数据的多于一个存储器装置。在至少一个此类实施方案中,作为钉仓的认证或询问过程的一部分,钉仓的处理器发射包括来自第一存储器装置的数据的第一所存储的数据信号,并且然后发射包括来自第二存储器装置的数据的第二所存储的数据信号。如果来自第一存储器装置和第二存储器装置的数据未被损坏,则在至少一个实施方案中,第一所存储的数据信号将与第二所存储的数据信号匹配。在至少一个实施方案中,第一所存储的数据信号在第一所存储的数据信号的开始处包括第一信号标头,并且第二所存储的数据信号在第二所存储的数据信号的开始处包括不同于第一信号标头的第二信号标头。在此类实例中,外科器械处理器和/或机器人外科系统的控制系统能够区分第一所存储的数据信号和第二数据信号。如果外科器械处理器和/或机器人外科系统的控制系统确定信号中的任一者被损坏和/或丢失数据,则该外科器械处理器和/或机器人外科系统的控制系统被配置为能够建立对另一信号的偏好。在各种实例中,第一存储器装置位于钉仓的第一横向侧上,而第二存储器装置位于钉仓的第二或相对横向侧上。此类布置可以降低电子干扰影响两个信号的可能性。在至少一个实施方案中,钉仓包括用于传输第一所存储的数据信号的第一数据天线和用于传输第二数据信号的第二数据天线。
钉仓、外科器械和/或机器人外科系统可被配置为能够在所存储的数据信号中所包含的数据被损坏和/或丢失的情况下采取其他缓解措施。在各种实例中,如果数据从由外科器械和/或机器人外科系统接收的信号中丢失,则钉仓可增大所存储的数据信号的功率。在至少一个实例中,如果从钉仓接收的数据被损坏,则外科器械和/或机器人外科系统的处理器可增大该处理器的噪声阈值。
在各种实施方案中,在外科器械与钉仓之间传输的数据和/或电力可以是连续的或间歇的。在各种实施方案中,所传输的数据可包括例如离散数字数据和/或连续模拟数据。当传输数字数据时,可以使用RFID、NFC、Hitachi UHF、蓝牙、Zigbee、毫米波、WiFi802.11和/或任何另一合适的无线系统。另外,当传输数字数据时,可以使用有线LAN通信、1线通信、EPROM IC、I2C和/或任何其他合适的装置。可以传输的各种类型的数字数据包括马达反馈,该马达反馈包括例如电流量值、电流的时间变化率、转矩量值、转矩的时间变化率、来自编码器的位置数据、转矩常数、磁强度、导线匝数、电枢长度、关于转矩-电流曲线的数据、马达调节、EMF常数、动态电阻、反EMF、角速度、马达速度和/或马达速度时间变化率。其他所传输的数据可包括例如器械柄部硬件构型和/或关于物理接触件和/或开关的数据。
除上述以外,所传输的模拟数据可包括电导出的数据和机械导出的数据。电导出的数据可包括磁性指示器、霍尔效应传感器数据、关于开关状态的数据、二极管数据、电路的断开或闭合和/或例如当滑动件和/或组织切割刀在钉击发行程期间切割电路时对电路的破坏。例如,机械导出的数据可包括例如与钉击发行程的特定事件相关的基于量值的数据,诸如由马达传输的力和/或马达电流,该特定事件诸如击发构件接触滑动件、滑动件从其近侧未击发位置移出、钉的成形,和/或击发构件接触和/或破坏钉仓的制动件特征部。例如,机械导出的数据还可包括将马达的性能数据与事件发生的时间进行比较的基于时间的数据,和/或将马达的性能数据与钉击发驱动装置的位置进行比较的基于位置的数据。例如,机械导出的数据还可包括基于特征的数据,诸如当钉击发驱动装置打开和/或闭合门时和/或当钉仓的制动件特征部被钉击发驱动装置破坏时。
在各种实施方案中,例如,外科系统(诸如机器人外科系统)可包括可视化系统,该可视化系统包括至少一个相机,该至少一个相机被配置为能够例如观察钉仓的参数,并且基于该观察来修改机器人外科系统、外科器械和/或钉仓的操作。例如,可视化系统被配置为能够检测和评估钉仓和仓钳口上的物理特征或标记,以评估钉仓是否完全安置在仓钳口中。如果钉仓和仓钳口上的标记未适当地对准,则可视化系统可指示机器人外科系统闭锁例如机器人外科系统的钳口夹紧和/或钉击发功能。在各种实施方案中,可视化系统可指示机器人外科系统警告操作者钉仓可能未正确地安置在仓钳口中。另外,例如,可视化系统被配置为能够检测可植入辅助件是否附接到钉仓的平台和/或可植入辅助件是否与钉仓的平台对准。类似于上文,可植入辅助件和钉仓包括标记,可视化系统可检测并比较该标记以评估可植入辅助件是否充分对准,并且如果未充分对准,则指示机器人外科系统警告操作者。
在各种实施方案中,除上述以外,可视化系统被配置为能够观察仓体的颜色并将此数据提供给机器人外科系统,该机器人外科系统可向操作者显示此数据。在各种实例中,仓体的颜色表示包含在仓体中的钉的尺寸和/或未成形高度。机器人外科系统被配置为能够评估容纳在钉仓中的钉是否适合于所执行的外科规程,并且如果它们不适合,则警告操作者。在各种实例中,可视化系统被配置为能够读取例如钉仓上的条形码和/或QR码,并将此数据提供给机器人外科系统,该机器人外科系统可向操作者显示此数据。类似于上文,此数据可包括包含在仓体中的钉的尺寸和/或未成形高度。机器人外科系统被配置为能够评估容纳在钉仓中的钉是否适合于所执行的外科规程,并且如果它们不适合,则警告操作者。例如,QR码可包括例如钉仓的序列号、制造日期和/或标识钉仓的制造商的数据。在各种实施方案中,QR码包含解密密钥或解密密钥的一部分,以访问钉仓中的存储器装置。在各种实施方案中,QR码例如被模制到仓体中、被激光蚀刻到仓体和/或盘中,并且/或者例如被印刷在仓体和/或盘上。
如上所讨论,再次参见图1,外科器械10000包括轴10200和围绕关节运动接头10500可旋转地联接到轴10200的端部执行器10400。参见图8至图8D,外科器械10000”在许多方面与外科器械10000类似,为简洁起见,其中的大多数方面本文将不再讨论。与外科器械10000类似,外科器械10000”包括钉击发驱动装置,该钉击发驱动装置可操作以执行钉击发行程以从钉仓11000”中射出钉。钉击发驱动装置包括电动马达、组织切割刀10630和击发杆10640,该击发杆由电动马达朝远侧驱动以在钉击发行程期间推动组织切割刀10630穿过钉仓11000”。在此类实例中,组织切割刀10630接触钉仓11000”的滑动件11400,并且在组织切割刀10630朝远侧推进通过钉击发行程时朝远侧推动滑动件11400以射出钉。组织切割刀10630还包括被配置为能够在钉击发行程期间接合第一钳口10410的第一凸轮10610,以及被配置为能够在钉击发行程期间接合第二钳口10420的第二凸轮10620。第一凸轮10610和第二凸轮10620被配置为能够在钉抵靠第二钳口10420变形时将钳口10410和10420相对于彼此协作地保持就位。
在各种实施方案中,钉击发驱动装置还可用于闭合端部执行器10400。在至少一个此类实施方案中,组织切割刀10630在闭合冲程期间朝远侧推进,使得第二凸轮10620接触第二钳口10420并且将第二钳口10420从打开位置移动到闭合位置。在闭合行程之后,钉击发驱动装置可被重新致动以执行以上所讨论的钉击发行程。在另选实施方案中,外科器械包括分开且相异的闭合和钉击发驱动装置。在至少一个此类实施方案中,闭合驱动装置被致动以闭合第二钳口10420,并且钉击发驱动装置随后被单独地致动以执行钉击发驱动装置。在任一情况下,凸轮10610和10620可协作以在钉击发行程期间将钳口10410和10420保持在一起。即便如此,设想了不具有凸轮10610和10620中的一者或两者的其他实施方案。
除上述以外,与外科器械10000类似,外科器械10000”包括闭锁件10700,如果第一钳口10410是空的(即,缺少钉仓)、钉仓定位在第一钳口10410中但未完全安置在第一钳口10410中和/或钉仓安置在第一钳口10410中但先前已被击发,则该闭锁件防止执行钉击发行程。在这些实例中的任一个实例中,当钉击发行程启动时,组织切割刀10630被(轴10200中的)弹簧向下推入限定在第一钳口10410中的凹部10710中,使得组织切割刀10630接触锁定肩部10720并且阻止组织切割刀10630进一步朝远侧推进。此时,外科器械10000”被锁定,并且钉击发行程不能被执行,直到未耗尽的钉仓完全安置在第一钳口10410中。当未耗尽的钉仓完全安置在第一钳口10410中并且钉击发行程被重新启动时,组织切割刀10630越过闭锁件10700的锁定肩部10720并且钉击发行程可完成。更具体地,钉仓11000”的滑动件11400在滑动件11400在钉击发行程开始时处于该滑动件的近侧未击发位置时将组织切割刀10630支撑在锁定肩部10720上方。如上所述,可使用任何合适的闭锁件。
以下专利的全部公开内容以引用方式并入本文:公布于2006年12月5日的名称为“SURGICAL STAPLING INSTRUMENT HAVING A FIRING LOCKOUT FOR AN UNCLOSED ANVIL”的美国专利号7,143,923;公布于2006年5月16日的名称为“SURGICAL STAPLINGINSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING”的美国专利号7,044,352;公布于2006年2月21日的名称为“SURGICAL STAPLING INSTRUMENTHAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利号7,000,818;公布于2006年1月24日的名称为“SURGICAL STAPLING INSTRUMENT HAVING A SPENTCARTRIDGE LOCKOUT”的美国专利号6,988,649;和公布于2005年12月27日的名称为“SURGICAL STAPLING INSTRUMENT INCORPORATING AN E-BEAM FIRING MECHANISM”的美国专利号6,978,921。
除上述以外,仓体11100包括限定在其中的纵向狭槽11150,该纵向狭槽被配置为能够在钉击发行程期间接纳组织切割刀10630。纵向狭槽11150包括通向纵向部分11156的较宽近侧端部11152。纵向狭槽11150还包括向内延伸到纵向部分11156中的凸块或突出部11154。凸块11154将滑动件11400可释放地保持在该滑动件的近侧未击发位置,直到滑动件11400在钉击发行程期间被组织切割刀10630朝远侧推动。例如,当钉仓11000”安置在第一钳口10410中时,此类布置防止或减小滑动件11400被意外地朝远侧推动的可能性。凸块11154也可在钉击发行程期间由组织切割刀10630接触。在此类实例中,组织切割刀10630可以使凸块11154中的一个或两个凸块弯曲、塑性变形和/或破坏。此类事件可产生瞬时脉冲或使组织切割刀10630朝远侧移动所需的力增加,这可由操作钉击发驱动装置的控制系统检测到,如下文进一步所讨论。值得注意的是,凸块11154相对于闭锁件11700朝远侧定位,并且因此,组织切割刀10630将在钉击发行程开始时经过闭锁件11700并且然后经过凸块11154。如上所述,设想了具有两组凸块的另选实施方案,一组凸块11154用于将滑动件11400保持就位,而第二组凸块用于产生可检测的力脉冲。
外科器械的端部执行器中的传感器测量允许外科器械执行多个任务的各种组织参数和器械参数。虽然更高的传感器采样速率通常与更准确的传感器数据相关联,但是在外科器械活动时无区别地使端部执行器内的所有传感器的采样速率最大化在功率消耗、数据传输和/或数据处理方面是相当繁重的。
本公开的各个方面涉及用于基于数据带宽或容量、电力传输或放电速率和/或剩余功率容量的实时约束来优化传感器数据收集、传输和/或处理的电路和/或算法。
附加地或另选地,本公开的各种方面涉及基于外科器械的一个或多个检测到的方面、由外科器械执行的外科任务和/或来自态势感知外科集线器的信号(该信号可表示传感器数据的优先级水平)来优化传感器数据收集、传输和/或处理的电路和/或算法,如下文更详细讨论。
在各种方面,外科器械可能需要用于不同任务的不同传感器布置。另外,传感器数据分辨率要求可以在不同任务之间变化,并且在某些实例中,在单个任务的持续时间内变化。本公开的各个方面涉及基于从各种数据源导出的各种上下文信息来优化传感器数据收集、传输和/或处理的电路和/或算法,如下文更详细讨论。
可通过调制、调适或调整与数据收集、发射和/或处理相关联的一个或多个传感器参数(例如,传感器采样速率、采样驱动电流和/或电压、收集速率、传感器数据分辨率、传感器数据传输速率、激活持续时间和/或激活频率)来实现优化传感器数据收集、传输和/或处理。在至少一个示例中,可将传感器或传感器群组切换到非活动模式、空闲模式或活动模式以优化传感器数据收集、传输和/或处理。
图13是描绘了用于结合传感器阵列来优化传感器数据收集、传输和/或处理的控制程序或逻辑配置的算法1000的逻辑流程图,该传感器阵列被配置为能够检测外科器械的端部执行器的一个或多个状况。在所示示例中,算法1000包括:检测1002传感器阵列与远程处理单元之间的数据传输的带宽或容量(B);检测1004被配置为能够向端部执行器供应电力的电源的放电速率(D);以及基于带宽(B)的检测值和放电速率(D)的检测值来调制1008传感器阵列的传感器或传感器子集的传感器参数。在某些实例中,算法1000还包括检测1006电源的剩余容量(R),以及基于远程电源的剩余容量(R)的检测值来调制1008传感器阵列的传感器或传感器子集的传感器参数。在某些实例中,如下文更详细描述,可通过基于带宽(B)、放电速率(D)和/或剩余容量(R)的检测值选择传感器参数值来实现传感器参数调制。
图14是描绘了用于结合传感器阵列优化传感器数据收集、传输和/或处理的控制程序或逻辑配置的另一算法1010的逻辑流程图,该传感器阵列被配置为能够检测外科器械的端部执行器的一个或多个状况。算法1010包括接收1012指示传感器阵列的传感器子集的传感器数据的优先级水平的一个或多个信号,以及基于检测到的传感器数据的优先级水平来调制1014传感器子集的传感器参数。附加地或另选地,算法1010可还包括基于传感器数据的优先级水平来调制1016另一传感器子集的传感器参数。
如上所讨论,可对与数据收集、传输和/或处理相关联的一个或多个传感器参数执行传感器参数调制(例如,1014、1016),该一个或多个传感器参数例如传感器采样速率、采样驱动电流和/或电压、收集速率、传感器数据分辨率、传感器数据传输速率、激活持续时间和/或激活频率。在某些实例中,传感器子集的传感器参数的调制(例如,1014、1016)还基于例如数据带宽(B)、电力放电速率(D)和/或功率剩余容量(C)的实时约束。
在某些实例中,传感器参数调制包括调整采样波形/信号的内容(即,光谱、振动频率、交流频率等)。在其他实例中,传感器参数调制包括调整信号分析器的采样时间、减少有源传感器的数量、将各个传感器复用/组合成单个传感器,和/或分析传感器的不同组合。
此外,传感器参数调制可包括对传感器参数的一个或多个步进式调整,该一个或多个步进式调整可在一个或多个预定时间段内实现。附加地或另选地,传感器参数调制可包括对采样参数的一个或多个逐渐调整,该一个或多个逐渐调整可在一个或多个预定时间段内实现。
在某些实例中,传感器参数可被调制为等于或至少基本上等于零的值。此外,例如,传感器参数调制可以以无调制的时段相隔。在各种实例中,传感器参数调制可根据一个或多个预设等式、表和/或数据库来实现,如下文更详细讨论。
除上述以外,算法1010可包括基于从传感器阵列的第二子集接收的传感器数据的优先级水平来调整传感器阵列的第一传感器子集的传感器参数。例如,在端部执行器的关节运动期间,算法1010可减小与端部执行器的闭合和/或击发相关的第一传感器子集的采样参数,并且可增大与关节运动相关的第二传感器子集的采样参数。调整提高了关节运动传感器数据的分辨率,而不会造成数据和/或电力负担过重。在另一示例中,在端部执行器的击发期间,算法1010可减小与端部执行器的闭合相关的第二传感器子集的采样参数,并且可增大与击发相关的第一传感器子集的采样参数。附加地或另选地,在闭合期间,算法1010可增大与端部执行器的闭合相关的第二传感器子集的采样参数,并且可增大与击发相关的第一传感器子集的采样参数。在至少一个示例中,可基于态势感知数据来确定关节运动、击发和/或闭合持续时间,如下文更详细讨论。
图15是描绘了用于结合传感器阵列优化传感器数据收集、传输和/或处理的控制程序或逻辑配置的另一算法1080的逻辑流程图,该传感器阵列被配置为能够检测外科器械的端部执行器的一个或多个状况。在所示示例中,算法1080确定1081传感器阵列的一个或多个传感器子集的优先级水平。在某些实例中,可基于指示优先级水平的一个或多个信号(例如,外科器械正在执行或将要执行的任务)来确定优先级水平。在任何情况下,如果1082优先级水平被确定为高优先级水平,则一个或多个传感器子集被切换到例如活动模式1083。然而,如果1082优先级水平被确定为低优先级水平,则一个或多个传感器子集被切换到例如空闲模式1084。
在各种方面,活动模式1083由与数据收集、传输和/或处理相关联的传感器参数的一个或多个较高值限定,该传感器参数例如传感器采样速率、采样驱动电流和/或电压、收集速率、传感器数据分辨率、传感器数据传输速率、激活持续时间和/或激活频率。相反,与活动模式1083相比,空闲模式1084由此类传感器参数的较低值限定。因此,空闲模式1084中的传感器数据可与较高噪声和较低分辨率相关联。在某些实例中,如果检测到高噪声/低分辨率传感器数据中的变化或尖峰,则将传感器子集的优先级水平确定为高优先级水平,这触发到活动模式1082的切换。
图16示出了外科系统1020的各个方面,该外科系统被配置为能够实现用于优化传感器数据收集、传输和/或处理的一个或多个算法(例如,算法1000、1010、1080)的方面。在所示示例中,外科系统1020包括外科器械1022,该外科器械包括控制电路1026。外科器械1022还可包括有线和/或无线通信电路以与外科集线器1024、本地服务器和/或基于云的系统通信。在某些实例中,外科器械1022是手持式外科器械。在其他实例中,外科器械1022是机器人外科工具。
在所示示例中,控制电路1026包括微控制器1028,该微控制器包括联接到至少一个存储器电路1032的一个或多个处理器1030(例如,微处理器、微控制器)。存储器电路1032存储机器可执行指令,该机器可执行指令在由处理器1030执行时使得处理器1030实现本文所述的各种过程或算法。处理器1030可以是本领域中已知的多种单核或多核处理器中的任一种。存储器电路1032可包括易失性存储介质和非易失性存储介质。处理器1030可包括指令处理单元和运算单元。指令处理单元可被配置成能够从本公开的存储器电路1032接收指令。控制电路1026可包括模拟或数字电路(例如,可编程逻辑装置(PLD)、场可编程门阵列(FPGA)、离散逻辑,或其他硬件电路、软件和/或固件,或其他机器可执行指令)以执行在本说明书中解释的功能。
除上述以外,控制电路1026与马达驱动器1034、反馈系统1038、电源1043(例如,电池、超级电容器或任何另一合适的能量源)和传感器阵列1036进行信号通信,该传感器阵列被配置为能够检测外科器械1022的端部执行器1040的一个或多个状况。由马达驱动器1034驱动的电动马达1042可操作地联接到可纵向移动的移位构件1044,该移位构件被配置为能够驱动端部执行器1040处的击发、闭合和/或关节运动,如本文别处更详细解释。在某些实例中,外科器械1022可包括用于击发、闭合和/或关节运动的专用马达驱动器和/或马达。
在某些实例中,控制电路1026可通过生成马达设定点信号来控制马达1042。马达设定点信号可被提供给马达驱动器1034。马达驱动器1034可包括一个或多个电路,该一个或多个电路被配置为能够向马达1042提供马达驱动信号以驱动马达1042,如本文所述。在一些示例中,马达1042可为有刷DC电动马达。例如,马达1042的速度可与马达驱动信号成比例。在一些示例中,马达1042可以是无刷直流电动马达,并且马达驱动信号可包括提供给马达1042的一个或多个定子绕组的PWM信号。另外,在一些示例中,可省略马达驱动器1034,并且控制电路1026可直接生成马达驱动信号。
在各种布置中,传感器阵列1036可包括用于检测端部执行器1040处的一个或多个状况的任何合适的传感器,该任何合适的传感器包括但不限于组织厚度传感器,诸如霍尔效应传感器、磁簧开关传感器、光学传感器、磁感传感器、力传感器、压力传感器、压阻膜传感器、超声传感器、电涡流传感器、加速度计、脉搏血氧传感器、温度传感器、被配置为能够检测组织通路的电特性(诸如电容或电阻)的传感器,或它们的任何组合。在某些实例中,并且非限制性地,传感器阵列1036可包括位于外科器械1022的关节运动接头处或周围的一个或多个传感器,例如电位计、电容传感器(滑动电位计)、压阻膜传感器、压力传感器、压力传感器或任何另一合适的传感器类型。在一些布置中,传感器阵列1036可包括位于端部执行器1040中或上的多个位置中的多个传感器。
仍参见图16,外科器械1022还包括传输系统1045,该传输系统被配置为能够将数据/通信信号从微控制器1028传输到端部执行器1040。附加地或另选地,传输系统1045可进一步被配置为能够将电力从电源1040传输到端部执行器1040。在至少一个范例中,通过有线连接实现数据传输和/或电力传输。在另一范例中,通过无线连接实现数据传输和/或电力传输。在某些实例中,传输系统1045包括无线连接部分和有线连接部分。无线连接部分便于电力和/或数据在外科器械1022的移动部件(例如,关节运动接头)上的可靠传输。
在各种范例中,传输系统1045采用一个或多个无线通信协议,例如低频RFID协议、高频RFID协议、近场通信(NFC)协议、超高频RFID协议、蓝牙通信协议、Qi协议或专有通信协议,或任何另一合适的通信协议。2015年10月27日公布的名称为“RFID TAG”的美国专利U.S.9,171,244公开了一种短程无线通信机制,该专利以引用方式全文并入本文。
在至少一个示例中,NFC协议可利用426千比特/s的总比特率。本公开设想了其他总比特率。在某些实例中,例如,由于过多的噪声,传输系统1045将以较低的比特率运行。在某些实例中,NFC通信协议利用半双工通信。
传输系统1045将端部执行器1040连接到远程处理单元(例如,处理器1030)和/或远程电源(例如,电源1043)。在某些范例中,远程处理单元和/或电源可位于距端部执行器1040较远的近侧位置处,例如在外科器械1022的近侧外壳或柄部中。传输系统1045确保端部执行器1040与远程处理单元和/或远程电源之间的可靠连接。
如上所讨论,端部执行器1040可包括传感器阵列1036,该传感器阵列被配置为能够监测外科器械1022和/或由端部执行器1040抓持的组织的一个或多个方面。在至少一个范例中,传感器阵列1036结合或部分地结合到可释放地联接到端部执行器1040的仓通道1048的钉仓1046中。仓通道1048和砧座1031中的至少一者可相对于另一者移动,以抓持砧座1031与钉仓1046之间的组织。传输系统1045可被配置为能够将电力传输到钉仓1046以用于传感器阵列1036的操作。附加地或另选地,传输系统1045可在例如钉仓1046与微控制器1028之间传输数据/通信信号。
如下文更详细地描述,传输系统1045的各种部件以便于电力和/或数据信号在端部执行器1040内例如从端部执行器1040的仓支撑通道无线传输到可释放地插入到仓支撑通道中的钉仓1046的方式布置或定位。附加地或另选地,例如,传输系统1045可以便于电力和/或数据信号从外科器械1022的轴跨连接轴和端部执行器1040的关节运动接头无线传输到端部执行器1040的方式布置或定位。
在各种实例中,钉仓1046可容纳或至少部分地容纳传感器阵列1036。电源1043可被配置为能够向传感器阵列1036供电。由电源1043供应的电力可通过传输系统1045以无线方式传输到钉仓1046。此外,微控制器1028可以与传感器阵列1036进行信号通信。数据/通信信号可通过传输系统1045在外科器械1022与钉仓1046之间以无线方式传输。此外,还可以使用传输系统1045将各种命令信号传输到传感器阵列1036。
参见图16和图17,在某些实例中,钉仓1046包括与传感器阵列1036连通的本地控制电路1049。本地控制电路1049和/或传感器阵列1036可以由电源1043通过传输系统1045以无线方式供电。图17示出了本地控制电路1049的示例性具体实现。在所示示例中,本地控制电路1049包括具有本地处理器1041和本地存储器电路1047的本地微控制器1076。本地存储器电路1047可存储机器可执行指令,该机器可执行指令在由处理器1041执行时可使得处理器1041实现根据本公开的各种过程或算法。处理器1041可以是本领域中已知的多种单核或多核处理器中的任一种。存储器电路1047可包括易失性存储介质和非易失性存储介质。处理器1041可包括指令处理单元和运算单元。指令处理单元可被配置为能够从本公开的存储器电路1047接收指令。在某些实例中,控制电路1049可包括模拟或数字电路(诸如可编程逻辑装置(PLD)、场可编程门阵列(FPGA)、离散逻辑,或其他硬件电路、软件和/或固件,或其他机器可执行指令)以执行在以下描述中解释的功能。
在某些实例中,控制电路1049包括传感器电路。来自传感器阵列1036的传感器的信号(例如,电压、电流、电阻、阻抗、电容、电感、频率、相位等)可由传感器电路调节。
除上述以外,本地微控制器1076可以通过传输系统1045与微控制器1028进行无线信号通信。传感器阵列1036的传感器数据可被收集并准备由本地控制电路1049传输。本地微控制器1076可被配置为能够在通过传输系统1045传输到控制电路1026之前压缩传感器数据。
本公开所描述的一个或多个算法的各种方面可由控制电路1026、控制电路1049或两者协作执行。为了简洁,下面的描述将仅集中于控制电路1049的执行或控制电路1026的执行,但是这不应当被解释为限制。
图6至图8示出了传输系统1045的不同具体实现1051、1052、1053。读者将理解,本公开设想了其他具体实现。图8示出了传输系统1045的示例性具体实现1053,其中使用两个独立的路径单独地以无线方式传输数据和电力。另选地,图7示出了传输系统1045的示例性具体实现1052,其中使用单个路径相继地以无线方式传输数据和电力。另选地,图6示出了传输系统1045的示例性具体实现1051,其中使用单个路径同时地以无线方式传输数据和电力。
通过传输系统1045,并且如图6至图8的具体实现1051、1052、1053中所述,钉仓1046可由电源1043以无线方式供应电力。所供应的电力用于传感器阵列1036的传感器数据的收集和/或信号处理。在某些实例中,电力由电源1043直接供应到传感器阵列1036。另选地,例如电荷积聚器11800(图7)的本地电源可将电力供应到传感器阵列1036。电荷积聚器11800可包括可通过由电源1043供应的电力充电的存储电容器。在各种方面,放电速率(D)和/或剩余充电容量(C)可由充电计检测或监测。
除上述以外,控制电路1049可被配置为或编程为根据例如存储在存储器电路1032或存储器电路1047中的一个或多个等式、表和/或数据库来调制1008传感器阵列1036的一个或多个传感器子集的传感器参数以平衡电力消耗与剩余功率容量。如图18所示,可以基于带宽(B)、放电速率(D)和/或剩余容量(R)的检测值从表1090中选择采样速率(S)。例如,检测值B1、D1、R1使得控制电路1049选择采样速率(S1)。例如,接着可将传感器阵列1036的一个或多个传感器子集的采样速率(S)调整到采样速率(S1)。因此,传感器阵列1036的传感器数据的收集和/或信号处理可由控制电路1026或本地控制电路1049自动调整,以平衡电力消耗与剩余容量。
主要参见图15和图16,控制电路1026可被配置为能够基于指示优先级水平的一个或多个信号来确定从传感器阵列1036的传感器子集接收的传感器数据的优先级水平。在某些实例中,将信号从外科集线器1024传输到控制电路1026。在其他实例中,将一个或多个信号从一个或多个传感器传输到控制电路1026。在其他实例中,将一个或多个信号从反馈系统1038传输到控制电路1026。
在某些实例中,一个或多个信号传达从接收到的关于外科规程、外科器械1022和/或患者的数据导出的上下文信息。上下文信息可由态势感知外科集线器1024导出。在一个范例中,上下文信息可由外科集线器1024的控制电路导出。在另一范例中,上下文信息可由云计算系统导出。在又一范例中,例如,上下文信息可由分布式计算系统导出,该分布式计算系统包括前述云计算系统和/或与外科器械1022的控制电路1026组合的外科集线器1024的控制电路中的至少一者。为了经济起见,下面的描述集中于由外科集线器1024的控制电路导出的上下文信息;然而,应当理解,可以通过上述范例中的任一个范例来实现上下文信息的导出。
在某些实例中,从一个或多个数据源(例如,数据库、患者监测装置和模块化装置)导出上下文信息。在一个范例中,数据库可包括与外科规程正在被执行所处的医疗设施相关联的患者EMR数据库。从数据源接收的数据可包括围术期数据,该围术期数据包括与给定外科规程相关联的术前数据、术中数据和/或术后数据。从数据库接收的数据可包括正在被执行的外科规程的类型或患者的病史(例如,可能是或可能不是本外科规程的对象的医学病症)。在一个范例中,外科集线器1024的控制电路可通过用与患者相关联的唯一标识符查询患者EMR数据库来接收患者或外科规程数据。外科集线器可从例如用于扫描患者的腕带的扫描仪接收该唯一标识符,该腕带在患者进入手术室时对与该患者相关联的唯一标识符进行编码。
在一个范例中,患者监测装置包括BP监测器、EKG监测器以及被配置为能够监测与患者相关联的一个或多个参数的其他此类装置。患者监测装置可以与外科集线器2034成对,使得该外科集线器从该患者监测装置接收数据。在一个范例中,从与外科集线器1024成对(即,可通信地联接)的模块化装置接收的数据包括例如激活数据(即,装置是否通电或在使用中)、模块化装置的内部状态的数据(例如,用于外科切割和缝合装置的击发力或闭合力、吹入器或排烟器的压差,或者RF或超声外科器械的能量水平)或患者数据(例如,组织类型、组织厚度、组织机械性质、呼吸速率或气道容积)。
在某些实例中,在上下文信息可包括例如正在被执行的规程的类型、正在被执行的外科规程中的特定步骤、患者的状态(例如,患者是否处于麻醉下或患者是否在手术室中)或正在手术的组织的类型。在某些实例中,上下文信息是从围术期数据导出的,该围术期数据包括例如关于模块化装置的数据(例如,压差、马达电流、内力或马达扭矩)或与模块化装置一起使用的关于患者的数据(例如,组织性质、呼吸速率、气道容积或腹腔镜图像数据)。在2018年12月4日提交的名称为“METHOD OF HUB COMMUNICATION”的美国专利申请序列号16/209,395(现为美国专利申请公布2019/0201136)中公开了另外的细节,该专利申请以引用方式全文并入本文。
在某些实例中,从接收自一个或多个成像装置的成像数据导出上下文信息。成像数据可以表示各个图像或视频流。医学成像装置可包括光学部件和生成成像数据的图像传感器。例如,光学部件包括透镜或光源。例如,图像传感器包括电荷耦合器件(CCD)或互补金属氧化物半导体(CMOS)。在各种范例中,医学成像装置包括内窥镜、腹腔镜、胸腔镜和其他此类成像装置。来自医学成像装置的图像或视频数据(或表示用于数字医学成像装置的视频的数据流)可由模式识别系统或机器学习系统进行处理以例如在医学成像装置5108的视场(FOV)中识别特征(例如,器官或组织类型)。可从识别出的特征中导出的上下文信息可包括例如正在被执行的外科规程(或其步骤)的类型、正在手术的器官或正在其中进行手术的体腔。
在各种方面,控制电路1026被配置为能够根据算法1010基于上下文信息来选择传感器阵列1036的一个或多个传感器子集的优先级水平。此外,控制电路1026可根据算法1080基于上下文信息在活动模式1083与空闲模式1084之间切换传感器阵列1036的一个或多个传感器子集。在至少一个示例中,控制电路1026可以利用从手术室成像/视频馈送导出的上下文信息来识别外科规程中的步骤,并且进一步基于正在执行的步骤来区分传感器数据收集、传输和/或处理的优先级。例如,控制电路1026可基于上下文信息来识别吻合术外科规程中的步骤,例如初始组织接合步骤。初始组织接合步骤的识别接着使得控制电路1026将一个或多个传感器子集切换到活动模式1083。
仍参见图13和图16,控制电路1026可被配置为能够基于指示外科器械1022的外科状态的一个或多个信号来确定传感器阵列1036的一个或多个传感器子集的优先级水平。信号可包括与外科器械1022的操作参数相关的数据。例如,信号可包括与马达(例如,马达1042)的功能相关的数据。
马达数据可指示端部执行器1040是处于关节运动、闭合运动还是击发运动。控制电路(例如,控制电路1026、049)可被配置或编程为基于端部执行器1040所进行的运动类型来区分外科器械1022的一个或多个传感器的优先级。例如,闭合和击发通常发生在关节运动完成之后,此时使用者对端部执行器1040的关节运动位置完全满意。因此,例如,控制电路可被配置或编程为响应于检测到关节运动而向闭合和/或击发传感器数据分配比关节运动传感器数据低的优先级。例如,控制电路可以调整关联于与关节运动相关的传感器子集的传感器参数,以提高子集的采样速率。另外,控制电路还可以调整关联于与闭合和/或击发相关的传感器子集的传感器参数,以降低关节运动期间子集的采样速率。
可采用类似的布置以在端部执行器1040的闭合期间使闭合传感器数据优先于击发传感器数据,并且/或者在端部执行器1040的击发期间使击发传感器数据优先于闭合传感器数据。如上所讨论,这种实时平衡方法确保电力资源和数据传输和/或数据处理资源不会负担过重。
仍参见图14、图15和图16,控制电路1026可被配置为能够基于指示外科器械1022的粗大移动的一个或多个信号来确定1081传感器阵列1036的一个或多个传感器子集的优先级水平。外科器械1022可包括被配置为能够测量外科器械1022的粗大移动的一个或多个传感器,例如加速度计。检测外科器械1022的粗大移动可指示端部执行器1040的状况。例如,粗大移动可指示端部执行器1040在患者体腔外。因此,控制电路1026可被配置或编程为响应于指示外科器械1022的粗大移动的信号而使闭合和/或击发传感器数据的优先级降低。在至少一个示例中,使闭合和/或击发传感器数据的优先级降低包括将与闭合和/或击发相关联的传感器阵列1036的传感器切换到空闲模式1084。在至少一个示例中,使闭合和/或击发传感器数据的优先级降低包括调整与闭合和/或击发相关联的传感器阵列1036的传感器的一个或多个传感器参数,例如控制传感器数据收集、处理和/或传输的传感器参数。
除上述以外,可响应于指示装载程序的信号、包括启动数据和/或工具对接数据的信号、指示高端部执行器速度的信号和/或指示在特定阶段不需要仓感测的任何其他信号而采取类似的方法。控制电路1026可被配置或编程为响应于检测到此类状况中的一个或多个状况而调整传感器阵列1036的一个或多个传感器参数,以使传感器功率/数据负担过重最小化。
根据一个或多个算法(例如,算法1010、1080)确定1081一个或多个传感器子集的优先级水平可以以多种方式实现。在一个示例中,优先级水平可以是二进制优先级水平,其中控制电路1026被配置为能够在例如高优先级水平或低优先级水平之间进行选择。在某些实例中,高优先级水平与活动模式1083相关联,而低优先级水平与空闲模式1084相关联。在其他示例中,优先级水平包括可基于例如存储在存储器电路1032中的一个或多个等式、表和/或数据库来确定的值。根据以等式、表和或数据库的形式存储的预设值,一个或多个条件可以对优先级水平做出贡献。
主要参见图13和图16,如上所讨论,算法1000包括检测1002通过传输系统1045的数据传输带宽(B)或最大数据传输速率。可以以多种方式检测1002数据传输带宽(B)。例如,数据可以通过传输系统1045以逐渐增加或递增的速率传输,直到检测到错误,或者信号强度不再能够允许更高的传输速率。利用每个传输,可以请求数据接收确认和/或数据完整性确认。如果接收到确认,则提高后续传输的传输速率。然而,如果没有接收到确认,则可以推断最近的传输速率超出了传输系统1045的带宽能力。在此类实例中,例如,可以将比最近的传输速率更早的传输速率确定为传输系统的数据传输带宽(B)。在某些实例中,使用默认传输速率来执行初始传输。然后根据预定值使用逐渐增加或递增的传输速率来执行随后的传输,直到例如由于缺少确认而检测到数据传输带宽(B)。
附加地或另选地,可以在初始确认或握手期间检测1002数据传输带宽(B)。确认和/或握手信号可通过传输系统1045在控制电路1026与本地控制电路1049之间传输,作为例如钉仓1046和/或外科器械1022的激活、初始化和/或唤醒序列的一部分。
在某些实例中,与外科器械1022的一个或多个先前使用期间的成功传输相关联的传输速率被存储,并且然后被用于检测1002外科器械1022或其他类似外科器械1022的后续使用中的带宽(B)。在一个示例中,成功的传输速率可被存储在存储器电路1032中以供在将来使用的初始确认或握手期间共享。控制电路1026可被配置或编程为监测与外科器械1022一起使用的仓重新装载,该仓重新装载各自试图使数据吞吐量最大化,并且可随后向未来仓重新装载建议先前仓重新装载能够实现的最大传输速率。
在另一示例中,成功的传输速率可以被传输到外科集线器(例如,外科集线器1024)和/或基于云的系统以用于数据聚合和分析。例如,数据传输带宽(B)可以基于从外科集线器或基于云的系统接收的指示数据传输带宽(B)的信号来检测1002。
图19是描绘了用于监测和解决钉仓1046与外科器械1022之间的电力和/或数据信号传输中的信号干扰的控制程序或逻辑配置的算法1100的逻辑流程图。如本文别处所述,钉仓1046的重新装载通过安置在端部执行器1040的仓通道1048中而可释放地联接到外科器械1022。此外,当钉仓1046安置在仓通道1048中时,可在钉仓1046与外科器械1022之间建立无线连接,从而以无线方式传输1102电力和/或数据信号。电力和/或数据信号可通过在仓通道中延伸的线束传输,并且然后通过传输系统1045的无线电力和/或数据传输电路传输。电力和/或数据信号传输受到各种内部和外部干扰的影响。
各种内部和外部因素可导致信号干扰,例如来自环境因素(包括组织和/或流体在端部执行器1040中的存在)的信号干扰、来自其他外科工具或甚至外科器械1022的其他部件的信号干扰。无线电力和/或数据传输电路可以至少部分地附连到金属仓通道1048。在某些实例中,通过金属仓通道1048的寄生损失、无线电力和/或数据传输电路中的天线未对准和/或次级磁场生成也可能促成信号干扰。
为了管理信号干扰,算法1100监测1104外科器械1022与钉仓1046之间的电力和/或数据信号传输中的干扰。算法1100进一步基于干扰来调制1106外科器械1022的操作参数。在至少一个范例中,调制1106操作参数包括基于检测到的干扰来调整数据信号的强度、数据传输的速率和/或电力传输的速率。在某些实例中,调制1106操作参数包括调整与数据收集、传输和/或处理相关联的一个或多个传感器参数,例如传感器采样速率、采样驱动电流和/或电压、收集速率、传感器数据分辨率、传感器数据传输速率、激活持续时间和/或激活频率。在至少一个示例中,可将传感器或传感器群组切换到非活动模式、空闲模式或活动模式以减轻干扰。
除上述以外,可以通过比较预期的数据传输和传输系统1045的实际数据传输来实现监测1104干扰,以考虑由于干扰而造成的损失。如果预期数据传输与实际数据传输之间的差异大于或等于预定阈值,则传输系统1045调整外科器械1022的一个或多个操作参数(例如数据信号的强度),以减轻干扰。在各种方面,监测1104干扰包括监测信号稳定性、丢失数据分组的数量和/或可区分信号与随机噪声的比率。如果信号稳定性、丢失数据分组的数量和/或可区分信号与随机噪声的比率大于或等于预定阈值,则传输系统1045调整外科器械1022的一个或多个操作参数,如先前所讨论。
此外,监测1104干扰可包括基于对推断水平做出贡献的一个或多个因素来确定干扰水平。该因素可包括例如预期数据传输与实际数据传输的比率、信号稳定性、丢失数据分组的数量和/或可区分信号与随机噪声的比率。可以从可以存储在存储器电路(例如,存储器电路1032、1047)中的干扰等式、干扰表和/或干扰数据库来确定各个因素对干扰水平的贡献。例如,控制电路1026可被配置或编程为基于各个因素的各个贡献来计算干扰水平。控制电路1026还可以将所确定的干扰水平与预定阈值进行比较。如果所确定的干扰水平大于或等于预定阈值,则如先前所讨论,处理器可调制1016外科器械1022的一个或多个操作参数,直到所监测的干扰水平降低到例如低于预定阈值的值。
主要参见图6至图8和图17,钉仓1046可被配置为能够检测传输系统1045的具体实现1051、1052、1053中的哪一者可用于钉仓1046与外科器械1022之间的无线信号传输。钉仓1046可进一步选择与可用具体实现相关联的各种协议和/或算法。在一个示例中,控制电路1049可以通过检测一个或两个本地天线阵列的存在来检测传输系统1045的可用具体实现。如果检测到两个天线阵列,如图8的具体实现1053所体现,则控制电路1049可以调整外科器械1022的一个或多个操作参数,并且/或者选择与单独的电力和数据传输相关联的一个或多个算法和/或通信协议。另选地,如果仅检测到单个天线阵列,如图6、图7的具体实现1051、1052所体现,则控制电路1049可以调整外科器械1022的一个或多个操作参数,并且/或者选择与同时/相继的电力和数据传输相关联的一个或多个算法和/或通信协议。
在各种方面,在由控制电路1049实现或至少部分地实现的唤醒或激活序列或握手协议期间执行天线阵列检测。在至少一个示例中,天线阵列检测由控制电路1049使用预定义测试信号来执行。在某些实例中,控制电路1049检测并监测短程和/或长程数据传输活动以确定连接特性和/或指令分级结构。在某些实例中,控制电路1049基于传感器阵列能力来执行选择性成对。
图20是描绘了用于优化从外科器械1022到钉仓1046的电力传输的控制程序或逻辑配置的算法1110的逻辑流程图。如上所讨论,当钉仓1046安置在端部执行器1040的钳口中时,传输系统1045可以无线方式使外科器械1022和钉仓1046电耦合。在至少一个范例中,算法1110的一个或多个方面由电力管理电路执行,该电力管理电路可以至少部分地由控制电路1026、控制电路1049和/或单独的电力管理电路来实现。在所示示例中,算法1110包括将电力从外科器械1022以无线方式传输1112到钉仓1046,监测1114电力从外科器械1022到钉仓1046的传输效率,以及基于传输效率来调整1116外科器械1022的操作参数。
在各种方面,监测1114电力传输的效率包括将预期电力传输与实际电力传输进行比较。在某些实例中,监测1114电力传输的效率包括将传输参数(例如,传输速率)与预定阈值进行比较。另外,电力传输的效率可能受若干环境因素影响,包括寄生损失、干扰、天线未对准和/或次级磁场生成。在某些实例中,监测1114电力传输的效率包括监测此类环境因素中的一个或多个环境因素。
仍参见图20,外科器械的经调整1116的操作参数可以是传输系统1045的传输参数。在某些实例中,调整1116外科器械1022的操作参数包括调整电力传输的波形的一个或多个方面、调整电力传输的速率和/或调整电力传输的频率。附加地或另选地,调整1116外科器械1022的操作参数可包括自适应电压缩放。附加地或另选地,调整1116外科器械1022的操作参数可包括实时调谐传输系统1045的至少一个部件,如下文更详细描述。
关联于外科器械1022与一个或多个钉仓1046之间的先前电力传输的一个或多个传输参数由例如存储器电路1032存储。附加地或另选地,与先前电力传输相关联的传输参数可被上载到例如本地服务器和/或基于云的系统以用于数据聚合和分析。在某些实例中,外科器械1022的电力管理电路可至少部分地基于与先前电力传输相关联的所存储的传输参数来确定未来电力传输的传输参数。在至少一个范例中,电力管理电路可以确定用于未来电力传输的传输参数,然后在实现所确定的传输参数之前,将所确定的传输参数与所存储的传输参数进行比较,以确保所确定的传输参数在基于所存储的传输参数的可接受阈值内。
在某些实例中,调整1116外科器械1022的操作参数包括基于当前操作条件来调整传输系统1045的功率驱动频率。由于存在关于EM频率的使用的限制规则(该EM频率可在不同的区域之间变化),所以电力管理电路可以实现选择也符合此类规则的最佳功率驱动频率的一个或多个算法。换句话说,在选择最佳功率驱动频率时,电力管理电路可以被限制到区域性可用的未授权频带。
除上述以外,选择最佳功率驱动频率还可取决于传输系统1045的哪种具体实现是可用的。例如,在表示分开的数据和电力传输的图8的具体实现1053中,电力传输不受数据传输频率标准的限制。在此类实例中,从不同于数据传输频率的值中选择最佳功率驱动频率。然而,表示同时或相继的电力和数据传输的图6和图7的具体实现1051、1052受到数据传输频率标准的限制。因此,电力管理电路可至少部分地基于传输系统1045的可用具体实现来实现选择最佳功率驱动频率的一个或多个算法。如上所讨论,检测传输系统1045的可用具体实现可以通过检测一个或两个本地天线阵列的存在来执行。另选地,电力管理电路可以通过各种测试信号来检测传输系统1045的可用具体实现。
在某些实例中,调整1116外科器械1022的操作参数包括用于共振、频率匹配和/或阻抗匹配的电路调谐。图21示出了用于在外科器械1022与钉仓1046之间传输电力的1045的传输系统的第一天线电路1121和第二天线电路1122的示例性具体实现1120。本公开设想了其他具体实现。在所示示例中,第一天线电路1121连接到输入电压Vin。输入电压Vin可为电源1043,该电源可定位在例如外科器械1022的外壳或柄部中的端部执行器1040的近侧。第二天线电路1122连接到负荷电阻器RL,该负荷电阻器表示传感器阵列1036、控制电路1049和/或钉仓1046的其他功率消耗部件。
在所示示例中,天线电路1121、1122协作以将由电源1043供应的电力以无线方式传输到钉仓1046。第一天线电路1021还包括电压驱动电阻器Rin、初级电感器L1和初级线圈电阻器R1。第二天线电路1122还包括次级电感器L2和次级线圈电阻器R2。功率从由初级电感器L1和初级线圈电阻器R1实现的第一天线传输到由次级电感器L2和次级线圈电阻器R2实现的第二天线。输入电压Vin驱动电流通过初级线圈,这在次级线圈中感生电压,并且因此在负荷电阻器RL两端感生电流。当电流在次级线圈中流动时,取决于耦合系数(k),该电流在初级线圈中感生电压。
仍参见图21,第一天线电路1121还包括与初级线圈并联的第一谐振电容器C1。另外,第二天线电路1122包括与次级线圈串联的第二谐振电容器C2。在各种实例中,电力管理电路在针对谐振、频率匹配和/或阻抗匹配的调谐中利用第一谐振电容器C1和第二谐振电容器C2。谐振是通过增加初级线圈周围的磁场中的功率来补偿较低耦合系数(k)的方式。如果耦合系数不变,则次级线圈两端的所得功率增加。因此,谐振使初级线圈中的无功功率最小化,并且使负荷电阻器RL两端的功率最大化。
为了优化通过传输系统1045的电力传输,电力管理电路被配置为能够执行传输系统1045的各种部件(例如,传输电容器、电感器和电阻器)的实时电/机械算法驱动的调整和调谐以优化电力传输。在某些实例中,电力管理电路采用各种调整/调谐机制,例如,电位计、电阻器组、电容器和/或电感器。此外,电力管理电路可以采用可变电容器和/或可变电感器。在某些实例中,优化通过传输系统1045的电力传输包括阻抗匹配。在某些实例中,优化通过传输系统1045的电力传输包括使耦合系数k最大化。
图22和图23分别示出了可调整串联RLC(电阻器、电感器、电容器)电路1130和可调整并联RLC电路1135,该可调整串联RLC电路和该可调整并联RLC电路可由电力管理电路用于调谐传输系统1045的初级或驱动线圈以优化通过该初级或驱动线圈的无线电力传输。可调整串联RLC电路1130和可调整并联RLC电路1135包括可调整部件(例如,电阻器R、电感器L、电容器C),该可调整部件可被调制以将初级或驱动线圈调谐为频率等于或至少实质上等于传输系统1045的次级或接收线圈的频率。在某些实例中,电力管理电路被配置为能够采用可调整串联RLC电路1130或可调整并联RLC电路1135来将初级线圈或驱动线圈的驱动频率调整到次级线圈或接收器线圈的谐振频率或最有效频率,或至少在谐振频带内。传输系统1045的实时频率匹配通过消除制造可变性(例如,部件、安装和/或使用可变性)来优化电力传输。
在各种方面,还可采用可调整串联RLC电路1130或可调整并联RLC电路1135来以类似于初级或驱动线圈的方式调谐传输系统1045的次级或接收器线圈。因此,电力管理电路可被配置为能够通过将初级线圈或驱动线圈以及次级线圈或接收器线圈两者调谐到所要频率来实现频率匹配。在各种方面,电力管理电路可将一个或多个RLC电路用作带通滤波器、带阻滤波器、低通滤波器或高通滤波器。
图24是示出可调整串联RLC电路1130的谐振状态的曲线图1246。曲线图1136描绘了X轴上的频率和Y轴上的阻抗。在谐振时,在串联RLC电路中,电感器电抗XL和电容器电抗XC相等并且抵消。因此,在谐振串联RLC电路中,电流流动的相反仅仅是由于电阻R。另外,电感器电压VL和电容器电压VC也是相反且相等的值,从而彼此抵消。在谐振时,串联RLC电路纯粹地充当电阻性电路,该电阻性电路使穿过其中的电流最大化。
如图6至图8所示的传输系统1045的各种具体实现(例如,1051、1052、1053)包括被配置为能够将交流信号整流成直流输出的整流器11620。在某些实例中,整流器11620是全桥整流器。将交流信号整流成直流输出的需要可能降低通过传输系统1045的电力传输的效率和/或使该传输系统的谐振失调。在某些实例中,监测1114电力传输的效率包括基于功率电平和转换效率来监测由交流到直流调节和/或整流引起的变化。可以基于电力转换效率来调节传输系统1045的各种受控方面。
在某些实例中,调整1116外科器械1022的操作参数包括例如基于钉仓1046和电力贮存器的电力消耗,和/或电源1043(图16)和/或电荷积聚器11800(图7)的电力传输能力的自适应电压缩放。电力管理电路可以通过选择性地确定哪些系统被允许消耗电力以及可以消耗电力的电压电平来实现用于节省功率的算法。
在一个示例中,电力管理电路可实现使得传感器阵列1036的两个传感器子集取决于例如来自该两个子集的传感器数据的优先级水平而以不同电压电平消耗电力的算法。电力管理电路可使得第一传感器子集在空闲模式或不活动模式下操作,且可使得不同于第一传感器子集的第二传感器子集在活动模式下操作。电力管理电路可通过改变传感器子集的电力消耗许可和/或通过调整传感器子集可消耗电力的电压电平来实现活动模式、空闲模式和/或非活动模式。
除优化电力传输以外,外科器械1022的电力管理电路还可实现一种或多种算法以用于钉仓1046的电力节省和/或优化该钉仓的电力消耗。图25是根据本公开的至少一个方面的算法1140的逻辑流程图,该逻辑流程图描绘了用于钉仓1046的功率节省或优化该钉仓的功率消耗的控制程序或逻辑配置。算法1140包括监测1142可用于钉仓1046的功率消耗的功率电平。算法1140还可包括确定1144用于原始数据(例如,传感器阵列1036的传感器数据)的信号处理的功率要求。
除上述以外,算法1140可包括基于可用功率电平和/或用于本地地处理原始数据的功率要求在原始数据的本地处理与远程处理之间进行选择1146。在某些实例中,选择1146是在使用例如控制电路1049在钉仓1046内本地地执行原始数据的信号处理之间进行,或者在使用例如控制电路1026在钉仓1046外远程地执行原始数据的信号处理之间进行。
除上述以外,监测1142功率电平可以通过使用例如电荷计测量功率电平并且将所测量的功率电平与预定阈值进行比较来完成。附加地或另选地,可通过监测功率消耗来实现监测1142功率电平。然后可以通过从可用于消耗的总功率中减去所消耗的功率值来计算当前功率电平。
除上述以外,例如,可以根据存储在存储器电路1047中的等式、表和/或数据库来确定1146特定原始数据集的信号处理的功率要求。在某些实例中,功率要求可以是原始数据集的大小和/或信号处理的性质或类型的函数。本地信号处理的各种细节在2018年6月12日公布的名称为“SMART SENSORS WITH LOCAL SIGNAL PROCESSING”的美国专利9,993,248中公开,该专利以引用方式全文并入本文。
在各种实例中,在低功率电平的情形下,本地处理单元(例如,控制电路1147)可执行选择性数据处理,而不是将数据处理成批地传输到远程处理单元(例如,控制电路1026)。选择性数据处理可以是基于先前分配的不同数据处理任务和/或数据类型的优先级。在一个示例中,为了减轻低功率电平,控制电路1147可选择维持先前限定的采样速率以用于从传感器阵列1036收集传感器数据,同时放弃或暂停数据加密。在另一示例中,为了减轻低功率电平,控制电路1147可选择维持传感器阵列1036的第一传感器子集的第一采样速率,同时调整传感器阵列1036的第二传感器子集的第二采样速率。
在各种方面,钉仓1046包括本地电荷积聚器(例如,图A5的电荷积聚器1075),该本地电荷积聚器被配置为能够本地地存储由远程电源(例如,图16的电源1043)通过传输系统1045向该本地电荷积聚器供应的电力。本地电荷积聚器11800可被配置为能够向控制电路1049、传感器阵列1036和/或钉仓1046的其他功率消耗部件供应电力。在某些实例中,根据算法1140监测1142功率电平包括监测本地电荷积聚器的充电状态、放电速率和/或充电速率。在至少一个示例中,通过将充电状态、放电速率和/或充电速率的所确定的值分别与预定的充电状态、放电速率和/或充电速率阈值进行比较来完成监测1142。
除上述以外,电力管理电路可基于一个或多个比较来调整钉仓1046的一个或多个操作参数以减轻功率消耗。例如,如果充电状态的所确定的值小于或等于预定充电状态阈值,如果放电速率的所确定的值大于或等于预定放电速率阈值,并且/或者如果充电速率的所确定的值小于或等于预定充电速率阈值,则电力管理电路可调整钉仓1046的一个或多个操作参数。该调整可包括被配置为能够减轻功率消耗的一系列逐渐增加的调整。
除上述以外,调整钉仓1046的操作参数还可包括适配或调整与数据收集、传输和/或处理相关联的一个或多个传感器参数,例如传感器采样速率、采样驱动电流和/或电压、收集速率、传感器数据分辨率、传感器数据传输速率、激活持续时间和/或激活频率。在某些实例中,调整钉仓1046的操作参数还可以是基于例如由外科集线器1024(图16)导出的态势感知数据。
图26是根据本公开的至少一个方面的算法1150的逻辑流程图,该逻辑流程图描绘了用于优化传输系统1045上的无线电力和/或数据信号传输的控制程序或逻辑配置。在所示示例中,算法1150包括检测1151外科器械1022的位置,以及基于外科器械1022的位置来选择1152频带。此外,算法1150可包括从频带中选择1153传输系统1045的初级线圈或驱动线圈的驱动频率。另外,算法1150可包括从频带中选择1154传输系统1045的次级线圈或接收器线圈的接收频率。
在各种方面,算法1150的一个或多个方面可由控制电路实现,该控制电路例如控制电路1026、控制电路1049或传输系统1045的本地处理单元。在某些实例中,检测1151外科器械1022的位置包括检测指示位置的参数,例如经度和纬度读数。控制电路1049可利用读数来识别外科器械1022的位置。在其他实例中,外科器械1022的位置可由使用者通过例如反馈系统1038输入。此外,从频带中选择1153驱动频率和/或选择1154接收频率可以是基于外科器械1022的一个或多个操作参数。
频带选择可以取决于本地规则。在各种方面,存储器电路1032或存储器电路1047可存储列出各种位置和对应可用频带的表或数据库。例如,执行算法1150的控制电路可被配置为能够利用该表或数据库来基于检测1151到的位置处的可用频带来选择1152合适的频带。
参见图8B、图8C和图8D,外科器械1022的自适应控制系统1155的各种部件可位于端部执行器1040的近侧部分内的腔1156中,该端部执行器在许多方面类似于端部执行器10400。自适应控制系统1155被配置为能够管理钉仓1046与外科器械1022之间的无线电力和/或数据信号传输的各个方面。在所示示例中,自适应控制系统1155包括用于优化通过传输系统1045的无线电力和/或数据信号传输的调谐电子器件封装件1157。调谐电子器件封装件1157被定位在腔1156中,紧邻传输系统1045的天线阵列,以实现可本地地调谐的无线电力和/或数据信号传输,包括例如频率使用率、电力传输速率和/或数据传输速率的调整。
除上述以外,自适应控制系统1155可包括专用电力管理电路和专用数据信号管理电路,或者可选地包括公共电力和数据信号管理电路。在本公开中的别处所述的各种算法可由自适应控制系统1155的电路实现,以优化钉仓1046与外科器械1022之间的无线电力和/或数据信号传输的各个方面。自适应控制系统1155可包括各种调谐电路或调谐电路部件,如结合图21至图23更详细地描述,例如可调整串联RLC电路1130和/或可调整并联RLC电路1135。在一个范例中,自适应控制系统1155通过与电力然后数据或者数据然后电力的无线传输相关联的传输参数的多个顺序调整来实现调谐。
在一个具体实现中,自适应控制系统1155包括电容器、电感器、数模转换器(DAC)、电压调整器和/或本地处理单元,例如集成电路(IC)芯片,该IC芯片可被配置为能够调整/滤波传输系统1045的天线阵列的驱动频率和/或调整电容和阻抗中的至少一者以优化钉仓1046与外科器械1022之间的无线电力和/或数据信号传输。在某些实例中,自适应控制系统1155通过调整外科器械1022的一个或多个参数(诸如无线电力和/或数据信号传输参数)来优化无线电力和/或数据信号传输,例如以使信号反射最小化。
为了使等待时间最小化并提高动态平衡的速度,自适应控制系统1155的电子器件封装件1157和被配置为能够由自适应控制系统1155调谐的传输系统1045的天线阵列(例如,天线阵列10530”、10535”)被放置成彼此紧密接近。在某些实例中,如图8C所示,自适应控制系统1155的电子器件封装件1157和传输系统1045的天线阵列10530”、10535”间隔开预定义距离(D)。
图8C描绘了具有分开的电力和数据信号传输的传输系统1045的具体实现1053。然而,传输系统1045的其他具体实现(例如,图6和图7的具体实现1051、1052)可包括类似的布置,其中自适应控制系统1155的电子器件封装件1157与天线阵列之间的间隔被限制为预定义距离(D)。为简洁起见,以下对预定义距离(D)的讨论将集中于图8C所示的示例性具体实现1053,该具体实现包括天线阵列10530”、10535”。
如上所述,电子器件封装件1157在端部执行器1040的近侧部分处存储在腔1156中,该端部执行器在许多方面类似于端部执行器10400。此外,天线阵列10530”、10535”安装在钳口10410的侧壁上。在所示示例中,电子器件封装件1157在钳口10410的近侧部分处驻留在腔1156中,但在关节运动接头10500的远侧。电子器件封装件1157在腔1156内的放置允许电子器件封装件1157与天线阵列10530”、10535”相距预定义距离(D),如图8C所示。
在各种方面,预定义距离(D)选自例如约0.1”至约1.0”的范围、约0.2”至约0.8”的范围、约0.3”至约0.7”的范围、约0.4”至约0.6”的范围或约0.45”至约0.55”的范围。在至少一个示例中,预定义距离(D)是0.50”、0.51”、0.52”、0.49”或0.48”。本公开设想了预定义距离(D)的其他值。
在各种方面,腔1156位于远侧通道保持器1158下方,该远侧通道保持器提供端部执行器10400操作性地联接(安装到)可关节运动接头10500的位置。在所示示例中,腔1156位于销1159下方,该销被配置为能够将远侧通道保持器1158附接到钳口10400。在某些实例中,操作性地联接到马达(例如,马达1042)的击发杆10640在腔1156上方延伸。在钉击发行程期间,击发杆10640由马达1042朝远侧驱动以推动组织切割刀10630穿过钉仓11000”,该钉仓在许多方面类似于钉仓1046。
除上述以外,销1159可固定到钳口10410的侧壁,以防止远侧通道保持器1158相对于钳口10410旋转。销1159的放置在销1159与钳口10410的基座1174之间留有足够的空间,以将电子器件封装件1157容纳在距传感器阵列10530”、10535”足够近的范围内,从而使等待时间最小化并且/或者提高由自适应控制系统1155执行的动态平衡的速度。
在所示示例中,电子器件封装件1157通过柔性电路1175连接到天线阵列10530”、10535”。在其他示例中,电子器件封装件1157被集成到不具有硬电路板的柔性电路1175上。在此类实例中,柔性电路1175可以桥接关节运动接头10500。一个或多个保持特征可以结合到关节运动接头中,以使柔性电路1175与关节运动接头10500内的移动部件之间的相互作用最小化。在某些实例中,柔性电路1175的各部分可联接到偏置构件,该偏置构件确保柔性电路1175被保持远离例如夹紧点和/或钩绊点。
图27是根据本公开的至少一个方面的算法1160的逻辑流程图,该逻辑流程图描绘了用于校准外科器械1022的传感器阵列1036的控制程序或逻辑配置。在所示示例中,算法1160包括执行1161传感器阵列1036的初始校准,以及基于初始校准来确定1162对测量结果的初始调整。另外,算法1160可包括执行1163传感器阵列1036的使用中校准,以及基于使用中校准来修改1164初始调整。例如,初始调整的修改1164可以产生最终调整。
在所示示例中,算法1160由控制电路1049实现或至少部分地实现。在其他示例中,算法1160的各种方面可由其他控制电路(例如,控制电路1026)或任何另一合适的控制电路实现。此外,在所示示例中,在传感器阵列1036的校准中执行算法1160。在其他示例中,算法1160可同样地在外科器械1022的其他传感器或传感器阵列的校准中执行。
如在本公开的别处更详细地讨论,传感器阵列1036的传感器被配置为能够确定与外科器械1022的功能相关联的参数。初始调整和/或最终调整将用于确定参数的传感器读数归一化。在一种形式中,参数是组织参数,例如组织厚度。在另一种形式中,参数是端部执行器1040的操作参数,例如端部执行器1040的闭合状态的参数。
在一种形式中,算法1160可限于执行1161初始校准,并且确定1162初始调整。在另一种形式中,算法1160可限于执行1163使用中校准,并且基于使用中校准在没有初始校准的情况下确定调整。
除上述以外,初始校准可包括在制造设施或测试设施处、在手术室之外和/或在运输到最终使用者之前执行的校准。另一方面,使用中校准可包括由最终使用者在例如手术室或医院中开封之后执行的校准。钉仓1046的传感器阵列1036的使用中校准可由例如来自外科器械1022的唤醒信号或初始化信号触发。例如,可以通过传输系统1045递送唤醒或初始化信号。在某些实例中,执行1161初始校准和/或执行1163使用中校准可由用户输入通过反馈系统1038触发。
在各种方面,算法1160包括对抵靠传感器阵列1036设置的仓保持器执行1161初始校准和/或执行1163使用中校准。钉仓保持器通常用于在例如钉仓在外科器械1022的钳口中的运输和/或安置期间将钉仓的钉保持就位。在某些实例中,仓保持器可以被修改为包括具有已知电阻、电容和/或电感性质的校准特征。可通过使得传感器阵列1036的一个或多个传感器取得对应于其已知电阻、电容和/或电感性质的校准特征的测量结果来执行1161传感器阵列1036的初始校准。然后可以将测量结果与已知电阻、电容和/或电感性质的存储值进行比较。可以基于测量结果和存储值来确定1162对传感器阵列1162测量结果的初始调整。例如,初始校准可包括使用参考值来校正电容泄漏、布线长度的变化以及跨传感器的读取距离的归一化过程。另外,初始校准可包括与已知设计变化的一系列比较以识别校正值。
类似地,例如通过使得传感器阵列1036的一个或多个传感器取得对应于其已知电阻、电容和/或电感性质的仓保持器的校准特征的测量结果,可以在手术室中使用仓保持器来执行1163传感器阵列1036的使用中校准。使用中校准可以作为激活、初始化和/或唤醒序列的一部分自动执行。在一个示例中,可将测量结果与已知电阻、电容和/或电感性质的存储值进行比较,且可基于测量结果和存储值来确定1162对传感器阵列1162测量结果的最终调整。在另一示例中,将使用中校准的测量结果与初始校准的测量结果进行比较,以检测可能进一步影响传感器阵列1036的由于灭菌、包装、运输、保存期限和/或除箱而引起的任何变化。
在某些实例中,导电介质(例如,电动润滑脂)被放置在钉仓与钉仓保持器之间,以确保钉仓保持器的测量特征与传感器阵列1036的对应传感器之间的适当电连接。导电介质消除或至少减少了由传感器阵列1036的传感器取得的仓保持器的特征的测量结果中的基于环境或接触的变化。在其他实例中,可以采用另一校准构件来代替仓保持器,以执行1161初始校准和/或执行1163使用中校准。测量特征可设置到校准构件的平坦或大致平坦的表面上或设置在该表面下方,该校准构件可抵靠传感器阵列1036的传感器放置以执行对该传感器的校准。
在各种方面,算法1160可包括在预定介质(诸如空气、盐水或具有可由传感器阵列1036的传感器测量的已知性质的任何其他合适介质)中执行1161初始校准和/或使用中校准。传感器阵列1036的初始校准可通过使得传感器阵列1036的一个或多个传感器在传感器浸入介质中时取得介质的已知性质中的一个或多个性质的测量结果来执行1161。然后可以将测量结果与已知性质的预定值进行比较。可以基于测量结果和预定值来确定1162对传感器阵列1162测量结果的初始调整。
类似地,传感器阵列1036的使用者校准可通过使得传感器阵列1036的一个或多个传感器在传感器浸入介质中时取得对应于介质的已知性质中的一个或多个性质的测量结果来执行1163。如上所讨论,使用中校准可以作为激活、初始化和/或唤醒序列的一部分自动执行。在一个示例中,可将测量结果与已知性质的存储值进行比较,且可基于测量结果和存储值来确定1162对传感器阵列1162测量结果的最终调整。在另一示例中,将使用中校准的测量结果与初始校准的测量结果进行比较,以检测可能进一步影响传感器阵列1036的由于灭菌、包装、运输、保存期限和/或除箱而引起的任何变化。
在某些实例中,控制电路1026可给出指令以在根据使用中校准取得传感器测量结果之前将端部执行器1040浸入手术室介质(例如,盐水)中。例如,这些指令可以通过反馈系统1038给出。控制电路1026可以请求对浸入的确认。例如,在钉仓安置在端部执行器1040的钳口中之后,指令可在钉仓1046的激活、初始化和/或唤醒序列期间发出。在接收到确认后,随后可如先前所述执行使用中校准。
除上述以外,算法1160还可将初始调整的确定1162值存储在钉仓1046的存储器电路1047中。例如,在钉仓1046的唤醒或初始化序列期间,初始调整的存储值可例如使用例如传输系统1045传达到外科器械1022的主控制电路1026。例如,处理器1030可以在将传感器阵列1036的传感器的读数转换为对应组织参数的值时采用初始调整。另选地,处理器1041可在钉仓1046中本地地执行转换。然后可以使用传输系统1045将转换后的值传达到控制电路1026。
除上述以外,执行1163使用中校准可包括确定一个或多个转换因子,该一个或多个转换因子表示由于诸如灭菌、运输时间、保存期限、先前使用时间、海拔、诸如湿度和/或温度的环境影响、物理损坏、传感器退化和/或漂移的各种影响而引起的变化。这些影响中的每个影响都可能导致可以通过对初始调整的修改1064来补救的偏差。在某些实例中,算法1160基于初始调整和对应于例如灭菌、运输时间、保存期限、先前使用时间、海拔、环境影响(诸如湿度和/或温度)、物理损坏、传感器退化和/或漂移的一个或多个附加转换因子来计算最终调整。
在某些实例中,可以根据存储在存储器电路1047中的等式、表和/或数据库来确定转换因子。例如,关于这些影响的信息可以由用户输入通过反馈系统1038提供。附加地或另选地,可使用内部时钟、时钟、定时器/计数器(例如,定时器/计数器2781)、各种传感器和/或各种形式的信号处理来本地地确定该信息。附加地或另选地,该信息可基于由外科器械1022从例如本地服务器、外科集线器(例如,外科集线器1024)和/或基于云的系统接收的一个或多个信号来确定。
在一个示例中,可基于可存储在存储器电路1047中或由用户输入的制造日期以及激活日期来确定运输时间。在另一示例中,可基于外科器械1022的地理位置来确定海拔。在其他示例中,诸如湿度和/或温度参数的环境参数可由使用者输入或可根据钉仓1046、外包装和/或外科器械1022上的环境传感器确定。在其他示例中,物理损坏和/或传感器劣化可以通过在激活之后检测传感器信号的丢失和/或通过在向传感器阵列1036的传感器传输询问信号之后检测响应信号的缺失来确定。
在任何情况下,控制电路1026可利用所接收的关于一个或多个影响的信息来基于例如存储在存储器电路1032中的一个或多个等式、表和/或数据库而开发用于该影响的各个转换因子。然后,控制电路1026可以基于初始调整和各个影响的一个或多个转换因子来确定最终调整。
图28是根据本公开的至少一个方面的算法1165的逻辑流程图,该逻辑流程图描绘了用于调制外科器械1022的控制参数的控制程序或逻辑配置。在所示示例中,算法1165包括测量1166例如安置在端部执行器1040的钳口中的钉仓1046的物理参数。算法116还包括基于钉仓1046的所测量的物理参数来调整1167外科器械1022的控制参数。
在所示示例中,算法1160由控制电路1026实现或至少部分地实现。在其他示例中,算法1160的各种方面可由其他控制电路(例如,控制电路1049)或任何另一合适的控制电路实现。为简洁起见,以下描述将集中于由控制电路1026执行算法1160的各个方面。
在各种方面,物理参数是组织间隙。在某些范例中,组织间隙是在端部执行器1040的闭合构型下确定的砧座1031与钉仓1046之间的最小间隙(G),如图29所示。在所示示例中,最小间隙(G)由止挡构件1039限定,该止挡构件被配置为能够干扰端部执行器1040的闭合。止挡构件1039从钉仓1046突出,并且在闭合构型时被砧座1031接触。在某些实例中,止挡构件1039定位在端部执行器1040的近侧位置处,例如组织止挡件后面。在其他实例中,止挡构件1039可定位在例如钉仓1046或砧座1031的远侧端部部分处。
图30是描绘了控制程序或逻辑配置的在许多方面类似于算法1165的算法1170的逻辑流程图。类似于算法1165,算法1170的各种方面可由控制电路1026、控制电路1049和/或任何另一合适的控制电路实现或至少部分地实现。算法1165例示了根据算法1165的钉仓1046的物理参数的测量1166的具体执行,其中该物理参数是组织间隙。在所示示例中,算法1170包括基于马达1042的电流消耗来检测1171闭合构型,并且在闭合构型下确定1172砧座1031与钉仓1046之间的最小间隙。在一个示例中,如下文更详细地描述,最小间隙(G)基于在闭合构型下传感器1035的输出信号来确定。
在端部执行器1040的闭合期间,控制电路1026被配置为能够使得马达1042生成闭合运动,该闭合运动促使可纵向移动的移位构件1044将端部执行器1040转变成闭合构型,如图29所示。止挡构件1039被配置为能够在闭合构型下抵抗端部执行器1040的闭合运动。可通过在端部执行器1040闭合期间马达1042的电流消耗增加到大于或等于预定阈值的值来检测电阻,该预定阈值表示达到闭合构型。在各种方面,控制电路1026被配置为能够在马达1042的电流消耗大于或等于预定阈值时确定1173钉仓1046与砧座1031之间的最小间隙(G)。
控制电路1026可进一步基于所确定的最小间隙(G)来调整外科器械1022的一个或多个控制参数。在某些范例中,控制参数可以是可执行算法的参数,以执行外科器械1022的功能。在某些范例中,控制参数例如是阈值或预定算法反应。
仍参见图29和图30,控制电路1026可被配置为能够使用一个或多个传感器1035监测钉仓1046与砧座1031之间的间隙。在所示示例中,传感器1035是磁性传感器,例如霍尔效应传感器。对应的磁体1069被放置在砧座1031上。传感器1035可被配置为能够测量由磁体1069产生的磁场的强度。随着砧座1031与钉仓1046之间的间隙减小,磁场的强度增大。因此,控制电路1026可被配置为能够通过监测传感器1035的输出信号来监测钉仓1046与砧座1031之间的间隙。
本公开设想了用于检测最小间隙(G)的其他传感器。在一个示例中,传感器1035包括应变仪、光电传感器、压力传感器、电感式传感器(诸如电涡流传感器)、电阻传感器、电容传感器、光学传感器和/或任何另一合适的传感器。
在各种实例中,控制电路1026可利用算法确定由马达1042消耗的电流的变化。例如,电流传感器可检测闭合运动期间由马达1042消耗的电流。电流传感器可以连续地检测和/或可以间歇地检测由电动马达1042消耗的电流。在各种实例中,算法可比较最新的电流读数与例如紧接进展的电流读数。除此之外或另选地,算法可比较时间段X内的样品读数X与此前的电流读数。例如,算法可比较样品读数与例如此前的时间段X(诸如紧接进展的时间段X)内的样品读数。在其他实例中,算法可计算由马达1042消耗的电流趋势平均值。算法可计算时间段X期间消耗的平均电流(包括例如最新电流读数),并且可比较消耗的平均电流与例如在紧接进展的时间段X期间消耗的平均电流。
在一个范例中,控制电路1026被配置为能够接收指示在端部执行器1040闭合期间马达1042的电流消耗的第一信号,并且接收指示钉仓1046与砧座1031之间的间隙的第二信号。第一信号可以表示电流传感器的输出,该电流传感器被配置为能够在闭合运动期间监测马达1042的电流消耗,而第二信号可以表示传感器1035的输出。此外,控制电路1026可被配置为能够通过确定在闭合构型下钉仓1046与砧座1031之间的最小间隙(G)来测量钉仓1046的物理参数,该最小间隙由大于或等于预定阈值的马达1042的电流消耗标识。
例如,控制电路1026可被配置为能够将马达1042的电流消耗与存储在存储器电路1032中的预定阈值进行比较。控制电路1026可进一步被配置为能够在马达1042的电流消耗大于或等于预定阈值时存储钉仓1046与砧座1031之间的最小间隙(G)的值。然后可以采用存储值来调制外科器械1022的一个或多个控制参数。
仍参见图30,算法1170可包括基于最小间隙(G)和初始组织厚度来验证由端部执行器1040抓持的组织的组织压缩参数。在某些实例中,算法1170可以验证组织压缩参数是如预期的。在一个示例中,组织压缩参数是当由端部执行器1040抓持的组织有时间进行流体流出时发生的组织压缩蠕变。
组织压缩蠕变取决于最小间隙(G)和初始组织厚度。初始组织厚度可使用一个或多个合适的传感器或传感器布置来测量,诸如在以下者中所述的传感器或传感器布置:2016年5月24日公布的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利9,345,481,该专利以引用方式全文并入本文;2014年9月18日公布的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利申请公布2014/0263552(现为美国专利10,032,719),该专利申请以引用方式全文并入本文;以及2017年6月20日提交的名称为“TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF ASURGICAL STAPLING AND CUTTING INSTRUMENT”的美国专利申请序列号15/628,175(现为美国专利10,881,399),该专利申请以引用方式全文并入本文。在任何情况下,控制电路1026可被配置为能够通过将组织压缩蠕变的期望值(该期望值可以例如被存储在存储器电路1032中)与基于最小间隙(G)和初始组织厚度来确定的组织压缩蠕变的值进行比较,以验证组织压缩蠕变。
在各种方面,如图28所示,算法1165可包括基于钉仓1046的所测量1166的物理参数来验证1168或识别安置在端部执行器1040的钳口中的钉仓1046的类型。在一个示例中,物理参数是组织间隙,或闭合构型下钉仓1046与砧座1031之间的最小间隙(G)。
如上所述,控制电路1026被配置为能够确定闭合构型下钉仓1046与砧座1031之间的组织间隙或最小间隙(G)。不同钉仓类型可包括被配置为能够限定不同组织间隙或最小间隙(G)的不同止挡构件。因此,控制电路1026可利用所确定的最小间隙(G)来验证钉仓1046的类型。在一个示例中,控制电路1026被配置为能够例如通过使用存储钉仓类型和对应的最小间隙(G)值的查找表或数据库来验证1168或识别钉仓1046的类型。
在各种方面,算法1165包括基于验证1168或识别出的钉仓类型来调制外科器械1022的一个或多个控制参数。在一个示例中,控制电路1026被配置为能够取决于识别出的钉仓类型在不同算法之间进行选择。不同算法可以是被配置为能够以不同方式控制传感器阵列1036的不同感测算法。在另一示例中,控制电路1026被配置为能够取决于识别出的钉仓类型在传感器阵列1036的传感器或传感器组的不同操作模式之间进行选择。操作模式可包括空闲模式、非活动模式和/或活动模式。在一个示例中,控制电路1026被配置为能够基于识别出的钉仓类型来调整算法参数。例如,算法参数可以是预定阈值。在一个示例中,控制电路1026被配置为能够基于识别出的钉仓类型来调整一个或多个传感器参数。可调整的传感器参数可包括与数据收集、传输和/或处理相关联的参数,例如传感器采样速率、采样驱动电流和/或电压、收集速率、传感器数据分辨率、传感器数据传输率、激活持续时间和/或激活频率。
图31是根据本公开的至少一个方面的算法1180的逻辑流程图,该逻辑流程图描绘了用于调制传感器阵列1036的传感器参数的控制程序或逻辑配置。在所示示例中,算法1180包括基于马达1042的操作参数来检测1181端部执行器1040的闭合状态。算法1180还包括根据检测到的闭合状态选择性地调制1182传感器阵列1036的传感器的传感器参数。在所示示例中,算法1180由控制电路1026实现或至少部分地实现。在其他示例中,算法1180的各种方面可由其他控制电路(例如,控制电路1049)或任何另一合适的控制电路实现。为简洁起见,以下描述将集中于由控制电路1026执行算法1180的各个方面。
在闭合期间,控制电路1026被配置为能够使得马达1042生成闭合运动,该闭合运动使端部执行器1040从打开构型朝向闭合构型转变,以将组织抓持在端部执行器1040的钳口之间。向闭合构型的转变包括多个闭合状态。例如,第一闭合状态的特征可在于,当砧座1031和钉仓1046两者首先同时与组织接触时实现第一组织接触。在某些实例中,钉仓1046首先被放置成与目标组织接触。然后,砧座1031朝向目标组织移动,以将组织抓持在钉仓1046与砧座1031之间。在此类实例中,当砧座1031与抵靠钉仓1046放置的目标组织进行第一次接触时,检测到第一闭合状态。在其他实例中,首先将砧座1031放置成与目标组织接触,并且然后使钉仓1046朝向目标组织移动。在此类实例中,当钉仓1046与抵靠砧座1031放置的目标组织进行第一次接触时,检测到第一闭合状态。
在任何情况下,由于组织的初始阻力,与组织的初始接触可能在端部执行器闭合期间产生马达1042的电流消耗的增加。在某些实例中,该增加是小幅增加或逐步增加的形式,该小幅增加或逐步增加可由控制电路1026检测为指示达到第一闭合状态。在其他实例中,端部执行器1040的钳口中的一个或两个钳口可包括被配置为能够检测初始组织接触的一个或多个传感器。在一个示例中,当目标组织使位于端部执行器1040的一个或两个钳口的组织接触表面上的组织接触检测电路闭合时,可检测到初始组织接触。例如,当闭合时,组织接触检测电路可以传输指示第一组织接触的信号。控制电路1026可被配置为能够响应于来自组织接触检测电路的信号而检测第二闭合状态。
除上述以外,由马达1042生成的闭合运动还使得端部执行器1040从第一闭合状态转变到第二闭合状态,该第二闭合状态的特征在于例如完全夹紧条件。在第二闭合状态下,施加到组织的闭合力等于或大于预定阈值。因此,控制电路1026可被配置为能够通过监测闭合力来检测第二闭合状态。闭合力可由一个或多个力传感器响应于由马达1042施加的夹紧负荷来测量。在各种示例中,一个或多个力传感器可包括例如力换能器、力矩单元、负荷传感器、应变仪、惠斯通(Wheatstone)电桥或任何另一合适的力传感器。例如,控制电路1026可被配置为能够响应于由一个或多个力传感器生成的传感器信号而检测第二闭合状态,该传感器信号指示闭合力等于或大于预定阈值。
除上述以外,第二闭合状态之后可以是第三闭合状态,该第三闭合状态的特征在于完全稳定的组织蠕变。在目标组织初始夹持在砧座1031与钉仓1046之间期间,可纵向移动的位移构件1044必须向砧座1031传输足够量的轴向闭合力,以将砧座1031枢转到闭合位置并且在整个钉成形过程中将该砧座保持在该位置。使砧座闭合并将砧座保持在闭合位置所需的闭合力的量可在缝合过程中因“组织蠕变”而变化。例如,随着砧座1031压缩目标组织,被夹持的目标组织内的流体可在组织内“蠕变”或迁移,并且甚至流动到相邻的未夹持组织。在完全夹紧条件之后,允许被抓持的组织有时间进行流体流出,直到闭合力稳定。因此,控制电路1026可被配置为能够基于闭合力来检测第三闭合状态。
在检测到第二闭合状态之后,控制电路1026可以监测闭合力的稳态。在某些实例中,控制电路1026被配置为能够响应于来自一个或多个力传感器的传感器信号而检测第三闭合状态,该传感器信号指示在检测到第二闭合状态之后或者在达到大于或等于预定阈值的值之后达到稳定状态。在某些实例中,稳定状态的特征可在于闭合力在预定时间段(t)内的变化小于或等于预定阈值。在其他实例中,稳定状态的特征可在于闭合力在预定时间段(t)内在预定范围内的变化。
除上述以外,选择性地调制1182传感器阵列1036的传感器的传感器参数可包括选择性地调制传感器参数,该传感器参数可包括与数据收集、传输和/或处理相关联的参数,例如传感器采样速率、采样驱动电流和/或电压、收集速率、传感器数据分辨率、传感器数据传输速率、激活持续时间和/或激活频率。在某些实例中,控制电路1026可被配置为能够基于闭合状态选择性地将传感器阵列1036的传感器或传感器子集切换到活动模式、空闲模式或非活动模式,以例如优化数据收集、传输和/或处理。在至少一个示例中,控制电路1026被配置为能够随着检测到每个闭合状态而递增地调整传感器阵列的一个或多个传感器或传感器组的采样速率。
在各种方面,可基于态势感知数据来检测端部执行器1040的一个或多个闭合状态。例如,控制电路1026可基于从外科集线器(例如,外科集线器1024)和/或用于数据聚合和分析的基于云的系统接收到的指示态势感知数据的信号来检测端部执行器1040的闭合状态。
在各种方面,根据算法1180选择性地调制1182传感器参数包括将不同优先级分配给不同传感器数据。例如,所分配的优先级可以规定数据收集、传输和/或处理的各个方面。控制电路1026可被配置为能够基于闭合状态向来自不同传感器或传感器组的传感器数据选择性地分配优先级。在一个示例中,仓识别数据可以在打开构型中被分配较高优先级,并且在第一、第二和/或第三闭合状态下被分配较低优先级。在另一示例中,来自组织接触传感器的传感器数据可以直到第一闭合状态和/或在第一闭合状态下被分配较高优先级,并且在第二和/或第三闭合状态下被分配较低优先级。在又一示例中,组织询问数据可以在第一、第二和/或第三闭合状态下被分配较高优先级,并且在第三闭合状态之后被分配较低优先级。较高优先级和/或较低优先级可由电路1026通过调整数据收集、传输和/或处理的各个方面来实现,如先前更详细描述。
图32是根据本公开的至少一个方面的算法1190的逻辑流程图,该逻辑流程图描绘了用于调制传感器阵列1036的传感器参数的控制程序或逻辑配置。在所示示例中,算法1190包括检测1191钉仓1046的组织接触状态。算法1190还包括根据检测到的组织接触状态选择性地调制1182传感器阵列1036的一个或多个传感器的传感器参数。在所示示例中,算法1190由控制电路1026实现或至少部分地实现。在其他示例中,算法1190的各种方面可由其他控制电路(例如,控制电路1049)或任何另一合适的控制电路实现。为简洁起见,以下描述将集中于由控制电路1026执行算法1190的各个方面。
在各种方面,检测1191钉仓1046的组织接触状态是在多个闭合状态中的每个闭合状态下执行的。当端部执行器1040开始闭合时,与钉仓1046的传感器阵列1036接触的组织的尺寸和/或位置可能改变。为了优化传感器数据收集、传输和/或处理,控制电路1026可被配置为能够基于在不同闭合状态下是否检测到组织接触来调整传感器阵列1036的一个或多个传感器或传感器组的一个或多个传感器参数。
在某些范例中,如图33所示,传感器阵列1036沿着钉仓1046的长度L设置。然而,由端部执行器1040抓持的组织可覆盖仅沿长度L的一部分延伸(例如,沿长度L1延伸)的区域1193。在此类实例中,可向来自区域1193外的传感器的传感器数据分配比来自区域1193内的传感器的传感器数据低的优先级。例如,控制电路1026可被配置为能够基于传感器相对于区域1193的位置来确定传感器阵列1036的传感器的优先级水平。此外,例如,控制电路1026可被配置为能够将传感器阵列1036的在区域1193内的传感器切换到活动模式1083并且/或者将传感器阵列1136的在区域1193外的传感器切换到空闲模式1084(参见图15)。
在各种方面,组织接触检测可由组织接触电路2830完成,如在本公开的别处更详细描述。组织接触电路2830处于没有组织抵靠传感器2788a、2788b定位的开路模式。组织接触回路2830通过组织2820转变为闭路模式。传感器2788a、2788b由电压源V供电,并且传感器电路2790测量由传感器2788a、2788b生成的信号。在一些方面,传感器2788a、2788b可包括一对相对的电极板以与组织2820电接触。
本文所公开的传感器2788a、2788b中的任一者可包括但不限于放置在钳口的内表面上的电接触件,该钳口在与组织接触时使原本断开的感测电路闭合。接触传感器还可包括力敏换能器,该力敏换能器检测被夹持的组织何时首先抵抗压缩。力传感器可包括但不限于压电元件、压阻元件、金属膜或半导体应变仪、电感式压力传感器、电容压力传感器和电阻传感器。
除上述以外,控制电路1026例如可接收来自传感器电路2790和/或传感器2788a、2788b的指示沿钉仓1046的长度L的一个或多个区域的组织接触状态的一个或多个信号。响应于调整一个或多个传感器或传感器组的一个或多个传感器参数,控制电路1026可被配置为能够基于组织接触状态来调整一个或多个区域中的传感器阵列1036的一个或多个传感器的传感器参数。
在2020年3月24日公布的名称为“SYSTEMS FOR ADJUSTING END EFFECTORPARAMETERS BASED ON PERIOPERATIVE INFORMATION”的美国专利10,595,887、2017年8月8日公布的名称为“ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUECOMPRESSION”的美国专利9,724,094以及2017年11月7日公布的名称为“METHOD OFOPERATING A POWERED SURGICAL INSTRUMENT”的美国专利9,808,246中公开了另外的细节,这些专利的全部公开内容以引用方式并入本文。
在一个一般方面,本公开提供了随时间监测多个传感器以检测位于端部执行器的钳口中的组织的移动特性的方法。在一个方面,端部执行器包括仓。多于一个传感器可位于仓上以感测组织从一个传感器朝向相邻传感器的运动。在缝合仓中,多个传感器可位于缝合仓上以通过监测组织的性质来感测组织的移动。在一个方面,组织性质可以是组织的电性质,诸如阻抗或电容。在另一方面,从一个时间点到下一时间点监测组织的阻抗可以允许系统检测组织从一个传感器朝向下一传感器的运动。
在一个方面,一种随时间监测多个传感器以检测组织的移动特性的方法包括随时间监测多个传感器以检测相对于至少两个感测位置的组织移动。该方法通过随时间监测感测到的组织性质来提供实时组织流动感测。
现在转到图34,其示出了根据本公开的至少一个方面的包括器械外壳2800和端部执行器2752的外科器械2750的图,该端部执行器经由实现无线电力和数据通信系统的一组线圈2818电感地耦合到器械外壳2800。器械外壳2800包括电感地耦合到端部执行器2752的能量源2762和控制电路2760。来自能量源2762的电力从针对位于器械外壳2800中的电力而调谐的初级线圈2802到针对位于端部执行器2752中的电力而调谐的次级线圈2804电感地耦合到端部执行器2752。数据在控制电路2760与端部执行器传感器电路2790之间在针对位于器械外壳2800中的数据而调谐的初级线圈2816与针对位于端部执行器2752中的数据而调谐的次级线圈2814之间传输。
图34示出了用于电力和数据的无线传输的传输系统1045的一个具体实现。在图34所示的具体实现中,电力和数据被单独传输。在其他具体实现中,如上所述,相继地或同时地传输电力和数据。为简洁起见,以下描述集中于被配置为能够单独地传输电力和数据的传输系统1045的具体实现。然而,应理解,可同样利用传输系统1045的其他具体实现。
在各种方面,端部执行器2752包括仓2768和枢转地联接到仓2768的砧座2766。多个传感器2788(详细视图参见图40)可设置在仓2768、砧座2766或两者中。如上所述,端部执行器2752包括次级线圈2804、2814,以从器械外壳2800接收电力并且分别在端部执行器2752电路与器械外壳2800电路之间通信。来自次级线圈2804的电力由整流器电路2806和滤波电容器2808整流,并且经由模拟多路复用器2810或另一模拟切换电路提供到多个传感器2788。来自传感器2788的信号通过模拟多路复用器2810传输,耦合到近场通信(NFC)标签2812,并从位于端部执行器2752中的次级线圈2814和位于器械外壳2800中的初级线圈2816耦合到控制电路2760。NFC标签2812被配置为能够传输来自仓2768的数据。传感器2788可被配置为能够测量组织阻抗、组织温度、组织电容、组织电感、实耗时间以及在以下描述中解释的其他组织参数。
在其他方面,端部执行器2752的仓2768部分可包括电极以接收电外科能量,从而帮助或增强组织封闭过程。在此类方面,多个传感器2788中的一些或全部传感器可充当电极以将电外科能量递送穿过夹紧在砧座2766与仓2768之间的组织。在此类方面,多个传感器2788可被配置为能够测量组织参数,诸如阻抗、电容以及在以下描述中解释的其他组织参数。
在其他方面,端部执行器2752可包括夹持臂组件和超声刀(用于切割和密封夹持在夹持臂组件与超声刀之间的组织),而不是如图34的示例中所示的砧座2766和仓2768。在此类方面包括夹持臂组件和超声刀的情况下,多个传感器2788可设置在夹持臂组件中,并且可通过导电超声刀提供电返回路径。多个传感器788可被配置为能够测量组织参数,诸如阻抗、电容以及在以下描述中解释的其他组织参数。
在其他方面,端部执行器2752可包括一对钳口(构造有电极以递送电外科能量来密封夹持在钳口之间的组织),而不是如图34的示例中所示的砧座2766和仓2768。钳口中的一个钳口可构造有用于在密封之后切穿组织的刀狭槽。在此类方面,多个传感器2788可设置在任一钳口或两个钳口中。多个传感器2788可被配置为能够测量组织参数,诸如阻抗、电容以及在以下描述中解释的其他组织参数。
在其他方面,端部执行器2752可包括夹持臂组件和超声刀,而不是如图34的示例中所示的砧座2766和仓2768。在此类方面,夹持臂组件构造有用于接收电外科能量以密封位于夹持臂组件与超声刀之间的组织的电极。通过导电超声刀提供用于电外科能量的电返回路径。在此类方面,超声刀用于切割夹紧在夹持臂组件与超声刀之间的密封组织。多个传感器2788可被配置为能够测量组织参数,诸如阻抗、电容以及在以下描述中解释的其他组织参数。
在某些实例中,如在本公开的别处更详细描述,器械外壳2800与端部执行器2752之间的无线电力和/或数据传输包括外科器械2750与钉仓2768之间的无线电力和/或数据传输。例如,初级线圈2802、2816可设置在端部执行器2752的仓通道上,并且次级线圈2804、2814可设置在钉仓2768上,使得当钉仓2768安置在仓通道中时,初级线圈2802、2816和次级线圈2804、2814对准以进行无线连接。在此类实例中,器械外壳2800可涵盖包括能量源2762和控制电路2760的近侧外壳、从近侧外壳朝远侧延伸的轴,以及仓通道。
图35示出根据本公开的至少一个方面的图34所示的包括器械外壳2800和端部执行器2752的外科器械2750的框图,该端部执行器经由实现无线电力和数据通信系统的一组线圈2818电感地耦合到器械外壳2800。在一个方面,外科器械2750被配置或编程为控制位移构件(诸如I形梁2764)的远侧平移。外科器械2750包括端部执行器2752,该端部执行器可包括砧座2766、I形梁2764(包括锋利切割刃)和可移除仓2768。端部执行器2752包括传感器2788和联接到传感器2788的传感器电路2790。电力经由近场通信通过线圈2802、2804电感地耦合到传感器电路2790和传感器2788。来自传感器2788的信号(例如、电压、电流、电阻、阻抗、电容、电感、频率、相位等)由传感器电路2790调节。信号或对应于信号的数据经由线圈2814、2816之间的近场通信电感耦合在端部执行器2752中的传感器电路2790与器械外壳2800中的控制电路2760之间通信。
应当理解,传感器2788可位于端部执行器2752中的任何合适的位置。在一个方面,传感器2788以阵列布置在仓2768中。在另一方面,传感器2788以阵列布置在砧座2766中。在各种方面,传感器2788以阵列布置在仓2768和砧座2766中。控制电路2760可被配置为能够随时间监测传感器2788以检测位于端部执行器2752的钳口中的组织的运动特性。在一个方面,端部执行器2752的钳口可由例如砧座2766和仓2768构成。
线性位移构件(诸如I形梁2764)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2784来测量。控制电路2760可以被配置或编程为控制位移构件(诸如I形梁2764)的平移。在一些示例中,控制电路2760可包括用于执行使得一个或多个处理器控制位移构件(例如,I形梁2764)的指令的一个或多个微控制器、微处理器或其他合适的处理器。在其他方面,控制电路2760可包括模拟或数字电路,例如可编程逻辑装置(PLD)、场可编程门阵列(FPGA)、离散逻辑或其他硬件电路、软件和/或固件,或其他机器可执行指令,以执行以下描述中解释的功能。
在一个方面,控制电路2760可被配置或编程为独立地感测端部执行器2752内的多个纵向和横向位置,并且使用具有本地预定返回路径的这些不同的感测位置来感测在砧座2766与仓2768之间抓持的组织在横向和纵向两者上的变化,从而能够通过对至少两个互连会话组合进行三角剖分来检测任何特定组织中厚度量度。例如,传感器2788可包括沿缝合器钳口(即,钉仓2768和砧座2766)的长度横向和纵向分布的阻抗传感器阵列。当钳口正在闭合时,控制电路2760可基于来自定时器/计数器2781的读数或使用软件定时技术在每个传感器的钳口闭合过程期间随时间跟踪本地阻抗。此时间历史可用于推断异质阻抗值的区域(如果存在的话),其中存在标记特定位置的不同变化或异常。当启动击发时,记录并跟踪这些基线位置。一旦启动,这些位置的位置历史就被跟踪并用于击发过程的反馈控制。在另一示例中,控制电路可被配置或编程为修改外科器械2750的功能以在I形梁2764的击发期间改变组织流动,包括改变击发速度、击发暂停(完全停止)、闭合力以及其他参数。
在其他方面,控制电路2760可被配置或编程为通过监测传感器2788来预测发生在端部执行器2752的钳口中的组织流动。从态势感知和/或其他装置感测的量度(例如,闭合期间闭合负荷的变化率、闭合完成之后闭合负荷的变化率等)获知组织类型可由控制电路2760用来预测组织流动。因此,在一个方面,控制电路2760被配置或编程为通过将钳口闭合期间的组织流动与砧座2766闭合系统的力反馈组合来确定组织类型或状况。
在另一示例中,可通过使用传感器2788来测量组织阻抗以及其他参数、检测钳口中的刚性或外来物体、测量组织阻抗的量值、测量钳口闭合期间的组织流动等来进一步细化预测。在另一示例中,控制电路2760可执行钳口闭合算法以感测闭合期间的组织移动,作为I形梁2764的击发期间的每个变化的潜在影响的指标。例如,在第一闭合速率下,控制电路2760估计组织流动的量值/方向,调整钳口的闭合速率,并且观察或记录钳口内组织流动的变化。在另一示例中,控制电路2760可被配置或编程为通过在击发之前利用闭合流动结合闭合力反馈来预测击发后组织位置,以向外科医生提供反馈,并且允许重新定位端部执行器2752的机会,以确保组织被完全捕获在端部执行器2752的切割线中(对于切割线的示例,参见图40中的狭槽2822、2824)。
在其他方面,控制电路2760可被配置或编程为接收用于传感器2788的各种配置的数据以监测和询问组织。这可包括监测组织阻抗,以及跨沿着仓2788的长度配置的单个电极或分段电极组跟踪组织的阻抗。控制电路2760可被配置或编程为通过利用不同频率的扫描并监测组织对功率和频率的阻抗以确定组织的生理组成、监测组织的电容以及确定组织特性和钳口的间隙关系以确定存在于钳口内的组织的量来监测光谱阻抗。在另一方面,控制电路2760可被配置或编程为测量光透射率、反射率或多普勒(Doppler)效应以确定组织特性。可以采用本地光反射率分析来确定组织的表面状况,以监测在钳口之间捕获的组织内的不规则性。控制电路2760可被配置或编程为使用光的多普勒效应频率分析来监测组织的本地移动颗粒。
在一个方面,定时器/计数器2781向控制电路2760提供输出信号,诸如实耗时间或数字计数,以将如由位置传感器2784确定的I形梁2764的位置与定时器/计数器2781的输出相关联,使得控制电路2760可确定I形梁2764在特定时间(t)相对于起始位置的位置。定时器/计数器2781可被配置为能够测量实耗时间、对外部事件计数或对外部事件计时。在其他方面,定时器/计数器2781可用于测量实耗时间以随时间监测传感器2788,以检测位于端部执行器2752的钳口中的组织的移动特性。
控制电路2760可生成马达设定点信号2772。马达设定点信号2772可被提供给马达控制器2758。马达控制器2758可包括一个或多个电路,该一个或多个电路被配置为能够向马达2754提供马达驱动信号2774,以驱动马达2754,如本文所述。在一些示例中,马达2754可为有刷直流电动马达。例如,马达2754的速度可与马达驱动信号2774成比例。在一些示例中,马达2754可为无刷直流电动马达,并且马达驱动信号2774可包括提供给马达2754的一个或多个定子绕组的PWM信号。另外,在一些示例中,可省略马达控制器2758,并且控制电路2760可直接生成马达驱动信号2774。
马达2754可从能量源2762处接收电力。能量源2762可为或包括电池、超级电容器或任何其他合适的能量源。马达2754可经由传输装置2756机械地耦接到I形梁2764。传输装置2756可包括用于将马达2754耦接到I形梁2764的一个或多个齿轮或其他连杆部件。位置传感器2784可感测I形梁2764的位置。位置传感器2784可为或包括能够生成指示I形梁2764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2784可包括编码器,该编码器被配置为能够在I形梁2764朝远侧和朝近侧平移时向控制电路2760提供一系列脉冲。控制电路2760可跟踪脉冲以确定I形梁2764的位置。可使用其他合适的位置传感器,包括例如接近传感器。其他类型的位置传感器可提供指示I形梁2764的动作的其他信号。另外,在一些示例中,可省略位置传感器2784。在马达2754是步进马达的情况下,控制电路2760可通过聚合马达2754已被指示执行的步骤的数量和方向来跟踪I形梁2764的位置。位置传感器2784可位于端部执行器2752中或器械的任何另一部分处。
控制电路2760可与位于端部执行器2752中的一个或多个传感器2788连通。传感器2788可定位在端部执行器2752中并适于与外科器械2750一起操作以测量各种导出的参数,诸如间隙距离对时间、组织压缩对时间、砧座应变对时间、组织移动对时间、组织阻抗、组织电容、光谱阻抗、光透射率、反射率或多普勒效应,以及其他参数。传感器2788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)、电阻传感器、电容传感器、光学传感器和/或用于测量端部执行器2752的一个或多个参数的任何其他合适的传感器。传感器2788可包括一个或多个传感器。
一个或多个传感器2788可包括应变仪(诸如微应变仪),该应变仪被配置为能够在夹紧条件期间测量砧座2766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2788可包括压力传感器,该压力传感器被配置为能够检测由砧座2766与仓2768之间的压缩组织的存在所生成的压力。传感器2788可被配置为能够检测位于砧座2766与仓2768之间的组织区段的阻抗,该阻抗指示位于两者间的组织的厚度和/或完全性。
传感器2788可被配置为能够测量由闭合驱动系统施加在砧座2766上的力。例如,一个或多个传感器2788可位于闭合管与砧座2766之间的交互点处,以检测由闭合管施加到砧座2766的闭合力。施加在砧座2766上的力可表示在砧座2766与仓2768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2788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2766的闭合力。一个或多个传感器2788可在夹持操作期间由控制电路2760的处理器实时取样。控制电路2760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2766的闭合力。
可采用电流传感器2786测量由马达2754消耗的电流。推进I形梁2764所需的力对应于由马达2754消耗的电流。将力转换成数字信号并提供给控制电路2760。
外科器械2750的驱动系统被配置为能够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2764。另一示例是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2754。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。此类外部影响可以被称为与电动马达2754相反地作用的曳力。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2750,该外科器械包括带有马达驱动的外科缝合和切割工具的端部执行器2752。例如,马达2754可沿端部执行器2752的纵向轴线朝远侧和朝近侧驱动位移构件。端部执行器2752可包括可枢转砧座2766,并且当被配置为能够用于使用时,仓2768被定位成与砧座2766相对。临床医生可抓持砧座2766与仓2768之间的组织,如本文所述。当准备好使用器械2750时,临床医生可例如通过按下器械2750的触发器来提供击发信号。响应于击发信号,马达2754可沿端部执行器2752的纵向轴线将位移构件从近侧行程开始位置朝远侧驱动到行程开始位置远侧的行程结束位置。当位移构件朝远侧平移时,带有定位在远侧端部处的切割元件的I形梁2764可切割仓2768与砧座2766之间的组织。
在各种示例中,控制电路2760可被配置或编程为基于一个或多个组织状况来控制位移构件(诸如I形梁2764)的远侧平移。控制电路2760可被配置或编程为直接或间接地感测组织状况,诸如厚度、流动、阻抗、电容、光透射率,如本文所述。控制电路2760可被配置或编程为基于组织状况来选择击发控制程序。击发控制程序可描述位移构件的远侧运动。可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2760可被配置或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2760可被配置或编程为以较高的速度和/或以较高的功率平移位移构件。
图36示出了根据本公开的至少一个方面的图34和图35所示的外科器械2750的端部执行器2752的透视图。端部执行器2752包括砧座2766和仓2768,该砧座和仓形成一对钳口以将组织2820抓持在该对钳口之间,如图37所示。多个传感器2788可设置在砧座2766、仓2768或两者中。
图37描绘了根据本公开的至少一个方面的端部执行器2752的示例,其中组织2820被压缩在由砧座2766和仓2768形成的钳口中。砧座2766限定第一纵向狭槽2822,该第一纵向狭槽被配置为能够可滑动地接收I形梁部分以用于闭合砧座2766以便抓持组织2820。仓2768限定第二纵向狭槽2824,该第二纵向狭槽被配置为能够接收切割元件,用于切断被抓持在砧座2766与仓2768之间的组织2820。纵向狭槽2822、2824限定端部执行器2752的切割线。(参见图40中的狭槽2822、2824)。
现在参见图36至图37,传感器2788可定位在砧座2766和仓2768中,位于抓持在该砧座与该仓之间的组织2820的相对两侧上。如上所述,多个传感器2788可被配置为能够测量各种导出的参数,诸如间隙距离对时间、组织压缩对时间、砧座应变对时间、组织移动对时间、组织阻抗、组织电容、光谱阻抗、光透射率、反射率或多普勒效应,以及其他参数。
图38A和图38B是根据本公开的至少一个方面的组织接触电路2830的示意图。图38A中的组织接触电路2830以开路模式示出,其中在分别夹紧在砧座2766与仓2768(图34至图37所述)之间之前没有组织位于传感器2788a、2788b之间。图38B所示的组织接触回路2830以闭路模式示出,示出了当传感器2788a、2788b与在砧座2766与仓2768之间夹紧之后的组织2820接触时电路的接通。传感器2788a、2788b由电压源V供电,并且传感器电路2790测量由传感器2788a、2788b生成的信号,并与钳口中的组织2829接触。在一些方面,传感器2788a、2788b可包括一对相对的电极板以与组织2820电接触。
本文所公开的传感器2788a、2788b中的任一者可包括但不限于放置在钳口的内表面上的电接触件,该钳口在与组织接触时使原本断开的感测电路闭合。接触传感器还可包括力敏换能器,该力敏换能器检测被夹持的组织何时首先抵抗压缩。力传感器可包括但不限于压电元件、压阻元件、金属膜或半导体应变仪、电感式压力传感器、电容压力传感器和电阻传感器。
在一个方面,前述外科器械中的任一个可包括一个或多个压电元件以检测在钳口构件上发生的压力变化。压电元件是将应力转换成电势的双向换能器。元件可由金属化石英或陶瓷组成。在操作中,当向晶体施加应力时,材料的电荷分布发生变化,从而导致整个材料上生成电压。压电元件可用于指示钳口构件(例如,砧座2766、仓2768)中的任一者或两者何时与组织2820接触以及在建立接触之后施加在组织2820上的压力的量。
在一方面,传感器2788a、2788b可包括一个或多个金属应变仪,该一个或多个金属应变仪放置在该传感器的主体的一部分内或该部分上。金属应变仪的工作原理是材料的电阻取决于长度、宽度和厚度。因此,当金属应变仪的材料经历应变时,材料的电阻改变。因此,由这种材料制成的电阻器结合到电路中,将使应变转换为电信号的变化。有利地,应变仪可放置在外科器械上,使得施加到组织的压力影响该应变仪。
另选地,在另一方面,传感器2788a、2788b可包括一个或多个半导体应变仪,该一个或多个半导体应变仪可以与上述金属应变仪类似的方式使用,但换能模式不同。在操作中,当半导体应变仪的晶格结构由于所施加的应力而变形时,材料的电阻改变。该现象被称为压阻效应。
在又一方面,传感器2788a、2788b可包括一个或多个电感式压力传感器,以将压力或力转换成感应元件相对于彼此的运动。感应元件相对于彼此的这种运动改变了总体电感或电感耦合。电容式压力换能器类似地将压力或力转换成电容元件相对于彼此的运动,从而改变总电容。
在再一方面,传感器2788a、2788b可包括一个或多个电容式压力换能器,以将压力或力转换成电容元件相对于彼此的运动,从而改变总电容。
在一个方面,传感器2788a、2788b可包括一个或多个机械压力换能器以将压力或力转换成运动。在使用中,机械元件的运动用于使计量器上的指针或刻度盘偏转。指针或刻度盘的这种移动可表示施加到组织2820的压力或力。以举例的方式,机械元件可与其它测量和/或感测元件诸如电位计压力换能器联接。在该示例中,机械元件与可变电阻器上的弧刷联接。在使用中,压力或力可转换成机械运动,该机械运动使电位计上的弧刷件偏转,从而改变电阻以反映所施加的压力或力。
在另一方面,组织2820阻抗Z可由传感器电路2790通过在传感器2788a、2788b两端施加电压差V、传导电流I穿过组织2820并且测量电压和电流(V,I)以确定阻抗Z来测量。在另一方面,传感器2788a、2788b之间的组织2820的电容C可由传感器电路2790基于组织阻抗Z根据下式来测量:C=1/2πfZ,其中f是交流电压和电流的频率,并且C是组织2820的电容。
在一个方面,传感器电路2790通常可为测量传感器2788a、2788b的导电板的电容的集成电路。在一些方面,传感器电路2790可测量供应电压V和电流I、测量外部电压和/或测量温度。组织电容传感器电路2790系统向组织2820施加电场信号以确定电容信号。传感器电路2790生成一个或多个电信号以在组织2820中生成电场信号,从而驱动由传感器2788a的导电板限定的电容节点以在组织2820中发射电场。在一些示例中,电容节点包括使用组织2820作为电介质的单板电容器。在许多示例中,电场信号可以是调制电信号。
在一个方面,传感器电路2790可在组织2820附近施加电场,这可包括施加电场信号而不使电容节点的任何电容器板部分接触组织2820。在其他示例中,电容节点的任何相关联的电容器板部分被定位成接触组织2820。在图38B中示出接触示例。电场信号可包括由传感器电路2790产生并由电压源V施加的调制信号。
传感器电路2790可检测施加到组织2820的电场信号的变化以识别电容信号。电场信号的这些变化可以由传感器电路2790测量和检测。当电场信号被施加到组织2820时,可以监测电容的变化,并且电容信号可以反映电容的变化。在各种方面,电场信号可包括调制信号,诸如正弦波信号。用于产生电场信号的调制电路可包括形成电容节点的传感器2788a的导电板的电容器部分。用于将电场信号施加到组织2820的电容器的电容值的变化可由传感器电路2790检测为调制频率的变化或电容器或相关联的调制电路的电力消耗的变化,以及其他检测方法。电场信号的这些变化还可以通过监测噪声水平、电流消耗或由传感器电路2790检测到的电场信号的其他特性的变化来测量。传感器电路2790可包括电容-数字转换器电路。可以与其他生理参数监测同时监测电容信号,如在以下描述中所解释。
图39是根据本公开的至少一个方面的结合图34和图35所述的包括传感器监测和处理电路2400的外科器械2750的示意图。传感器监测和处理电路2400包含在器械外壳2800内,并且通过用于电力的近场通信线圈2802/2804和用于数据的线圈2814/2816以无线方式耦合到端部执行器2752。
在一个方面,传感器监测和处理电路2400包括组织阻抗模块2442。在一个方面,组织阻抗模块2442可被配置为能够测量组织阻抗Z和电容。组织阻抗模块2442还可以用于监测其他组织参数。在一个方面,组织阻抗模块2442可包括RF振荡器2446、电压感测电路2448和电流感测电路2450。电压感测电路2448和电流感测电路2450响应于施加到设置在端部执行器2752中的电极或传感器2788的RF电压Vrf和传导通过传感器2788的电极、组织和端部执行器2752的其他传导部分的RF电流irf。来自电流感测电路2430和电压感测电路2432的感测到的电流Irf和感测到的电压Vrf经由模拟多路复用器2434由模拟-数字转换器2436(ADC)转换为数字形式。控制电路2760接收ADC 2436的数字化输出2438,并且结合通过线圈2814/2816耦合的传感器数据来处理信号,以确定各种组织参数,包括测量组织阻抗、组织温度、组织电容、组织电感、实耗时间以及在以下描述中解释的其他组织参数。在一个方面,组织阻抗Z和/或组织电容可由控制电路2760通过计算由电压感测电路2448和电流感测电路2450测量的RF电压Vrf与电流Irf的比率或通过独立地处理从传感器电路2790接收的数据来计算。
在一种形式中,控制电路2760可被配置为能够生成数字电流信号2420和数字频率信号2422。这些信号2420、2422被施加到直接数字合成器(DDS)电路2424,以调整去往设置在端部执行器2752中的传感器2788的电流输出信号2404的振幅和频率(f)。DDS电路2424的输出被施加到放大器2426,该放大器的输出可被施加到变压器2428。变压器2428的输出通过线圈2802/2804电感地耦合到端部执行器2752中的电源模块2805。电源模块2805可包括整流器、滤波器和其他元件,以向传感器2788和传感器电路2790供应电力。
在一种形式中,施加到端部执行器2752电极的RF电压Vrf和传导通过由端部执行器2752夹持的组织的RF电流Irf适于血管密封和/或解剖。因此,传感器监测和处理电路2400的RF功率输出可以被选择用于诸如密封和解剖的治疗功能,以及诸如测量组织阻抗、电容和其他组织参数的非治疗功能。应当理解,在本公开的上下文中,超声和RF电外科能量可单独地或同时地供应到端部执行器2752,以实现治疗或非治疗功能。
在一个方面,去往传感器监测和处理电路2400的输入2412可包括可施加到控制电路2760以控制传感器监测和处理电路2400的操作的任何合适的输入信号2414。在各种形式中,输入2412可经由用户界面被预编程、上传和/或输入,该用户界面诸如按钮、开关、指轮、键盘、小键盘、触摸屏显示器、指点装置、到通用或专用计算机的远程连接。在其他形式中,输入2412可包括合适的用户界面。因此,以举例的方式,输入2412可由使用者设定或输入以对电流(I)、电压(V)、频率(f)和/或周期(T)进行编程,以用于对传感器监测和处理电路2400的功能输出进行编程。控制电路2760可显示选定输入2412。
在一种形式中,包括计算机可读指令的各种可执行模块(例如,算法2410)可由传感器监测和处理电路2400的控制电路2760部分执行。在各种形式中,相对于技术所述的操作可被实现为一个或多个软件部件,例如程序、子例程、逻辑;一个或多个硬件部件,例如处理器、DSP、PLD、ASIC、电路、寄存器;和/或软件与硬件的组合。在一种形式中,用以执行技术的可执行指令可存储在存储器中。当被执行时,指令使得控制电路2760确定如本文所述的组织参数。根据此类可执行指令,控制电路2760监测并评估可从传感器监测和处理电路2400获得的电压、电流和/或频率信号样本,并且根据对此类信号样本的评估来确定组织参数。如在以下描述中进一步解释,组织参数、状态或状况的变化可以基于处理此类信号来确定。
图40是根据本公开的至少一个方面的包括砧座2766和仓2768的端部执行器2752的一部分的示意图,以示出设置在该砧座和仓中的传感器阵列2788a、2788b。第一传感器阵列2788a可沿I形梁狭槽2822纵向地设置在砧座2766中,并且在I形梁狭槽2822的任一侧上横向地设置在该砧座中。第二传感器阵列2788b可沿刀狭槽2824纵向地设置在仓2768中,并且在刀狭槽2824的任一侧上横向地设置在该仓中。在各种其他方面,传感器2788可位于砧座2766中,或仓2768中,或砧座2766和仓2768两者中。此外,在一些方面,设置在砧座2766中的传感器阵列2788a可纵向地、横向地或既纵向又横向地布置,如图40所示。在其他方面,设置在砧座2766中的传感器阵列2788b可纵向地、横向地或既纵向又横向地布置,如图40所示。传感器2788可以布置成包括单行或多行或单个传感器的阵列。此外,任一传感器阵列2788a、2788b中的传感器2788可由控制电路2760单独地寻址、供电和读取。在其他方面,砧座2766中的传感器阵列2788a可作为与仓2768中的传感器阵列2788b分开的组而由控制电路2760寻址、供电和读取。在其他方面,仓2768中的传感器阵列2788b可作为与砧座2766中的传感器阵列2788a分开的组而由控制电路2760寻址、供电和读取。在其他方面,砧座2766中的传感器阵列2788a和仓2768中的传感器阵列2788b可作为一个组而由控制电路2760寻址、供电和读取。
图41是根据本公开的至少一个方面的包括多个可独立寻址传感器2788(S1-Sn)的仓2768的局部剖面图。为了寻址和读取单独地标记为S1-Sn的多个传感器2788中的每一者,传感器电路2790包括多路复用器2840和逻辑电路2842,以控制各个传感器2788的选择和读取。传感器2788的输出被路由到多路复用器2840的输入2844。可由逻辑电路2842通过经由多路复用器输入选择2846线单独地寻址传感器来选择各个传感器S1-Sn。选定传感器S1-Sn的输出2848被提供给逻辑电路2842并通过线圈2814、2816耦合到控制电路2760,例如用于进一步处理以跟踪组织的性质并执行用于跟踪组织跨多个传感器S1-Sn的运动的算法。如图41所示,在一个方面,传感器S1-Sn耦合到共同返回路径。类似的构造可在端部执行器2752的砧座2766部分中提供(图40)。
传感器S1-Sn的位置被映射到仓2768,使得控制电路2760知道仓2768上的每个传感器S1-Sn的位置。通过监测每个传感器S1-Sn的输出,控制电路2760可以基于所监测的传感器S1-Sn的输出来确定组织是否正占据传感器S1-Sn的位置。例如,如果组织2820的所监测的性质是阻抗Z,则控制电路2760可以基于从每个传感器S1-Sn读取的阻抗输出来映射组织2820的位置,以基于阻抗读数来推断存在组织2820并且基于无阻抗读数(例如,开路)来推断不存在组织。
现在描述转向如附图42至图45所示的各种方法2900、2910、2930、2950。方法2900、2910、2930、2950中的每一者可以被实现为存储在传感器监测和处理电路2400的程序存储器中的算法2410,该算法可以由控制2760执行,如结合图39所解释。在一个方面,算法2410(例如,方法2900、2910、2930、2950)可被存储为控制电路2760经编程以执行的一系列机器可执行指令。在其他方面,算法2410(例如,方法2900、2910、2930、2950)可由实现于硬件中的控制电路2760执行,其中控制电路2760被配置为能够执行算法2410。
现在参见图34至图42,在一个一般方面,图42示出了根据本公开的至少一个方面的随时间监测位于端部执行器2752的钳口中的多个传感器2788以检测抓持在端部执行器2752的钳口中的组织2820的特性的方法2900的流程图。在一个方面,外科器械2750包括端部执行器2752,该端部执行器包括一对钳口,该对钳口用于将组织2820抓持在其间。在一个方面,端部执行器2752包括砧座2766和仓2768。例如,多个传感器2788可位于钉仓2768上以感测被抓持在砧座2766与仓2768之间的组织2820从一个传感器S1朝向相邻传感器S2的运动。如上文所解释,控制电路2760可被配置为能够执行实现为传感器监测和处理电路2400中的算法2410的方法2900。
在一个方面,控制电路2760被配置为能够独立地选择设置在端部执行器2752中的传感器S1-Sn中的任一者或多者。一个或多个传感器S1-Sn被配置为能够感测2902设置在外科器械2750的端部执行器2752中的组织2820的性质。控制电路2760被配置为能够随时间监测2904设置在外科器械2750的端部执行器2752中的感测到的组织2820的性质。在缝合仓中,多个传感器2788设置在缝合仓2768上并且可被独立地监测以感测组织2820相对于每个传感器2788的移动,如图41中所述。在一个方面,控制电路2760将命令发送到逻辑电路2842以通过多路复用器2840选择各个传感器S1-Sn。每个传感器S1-Sn在连续循环中被相继地寻址和监测。通过监测2904选定传感器S1-Sn中的每一者的输出2848,控制电路2760可被配置为能够基于组织2820的所监测的性质感测2906组织2820从一个传感器S1相对于相邻传感器S2的移动。在一个方面,由控制电路2760监测的组织性质可以是组织2820的电性质,诸如阻抗Z或电容C。在另一方面,从一个时间点到下一个时间点监测组织2820的阻抗Z或电容C可允许控制电路2760检测组织2820从一个传感器朝向下一个传感器的运动。控制电路2760可被配置为能够基于组织2820的感测到的移动来选择2908外科器械2750的功能。控制电路2760可基于组织2820的所监测的性质来检测组织2820上的位置。在各种其他方面,所监测2902的性质可以是在组织2820上的端部执行器2752的闭合期间的闭合负荷的变化率、在组织2820上的端部执行器2752的闭合完成之后的闭合负荷的变化率、施加到组织2820的力、阻抗Z谱、光透射率、光反射率或多普勒效应以确定组织特性,以及可由传感器S1-Sn监测的其他性质。
现在参见图34至图41和图43,在一个一般方面,图43示出了根据本公开的至少一个方面的随时间监测位于端部执行器2752的钳口中的多个传感器2788以检测抓持在端部执行器2752的钳口中的组织2820的特性或性质的方法2910的流程图。在一个方面,方法2910包括随时间监测多个传感器S1-Sn以检测组织2820的运动特性,检测组织2820相对于至少两个感测位置的移动,并且通过在一段时间内监测一个或多于一个感测到的组织性质来提供实时组织流动感测。如上文所解释,控制电路2760可被配置为能够执行实现为传感器监测和处理电路2400中的算法2410的方法2910。
在一个方面,控制电路2760被配置为能够通过监测端部执行器2752中的多个纵向和横向设置的传感器S1-Sn位置来独立地感测组织2820的性质。控制电路2760可被配置为能够采用具有本地预定返回路径的感测技术来感测性质在横向和纵向两者上的变化。在各种方面,组织性质可以是阻抗Z、阻抗Z谱、电容C、施加在端部执行器2752上的力、施加到组织2820的力、光透射率、光反射率或多普勒效应以确定组织特性,以及可由传感器S1-Sn监测的其他组织性质。
光反射率、光折射等。使用这些感测技术,控制电路2760可使用众所周知的三角剖分算法技术来检测位于传感器2788的阵列中的至少两个互连传感器组合(例如,S1-S2或S1-S4)之间的组织2820的特定中厚度量度。
更具体地,根据方法2910的一个方面,控制电路2760可被配置为能够独立地监测2912纵向和横向传感器阵列S1-Sn并且测量组织2820的性质。例如,控制电路2760可监测组织2820的阻抗Z、电容C、施加在端部执行器2752上的力、光反射、光折射等,以确定传感器S1-S2的个体或组是否与组织2820接触。控制电路2760可被配置为能够确定2914组织2820的所监测的性质在横向和纵向两者上的任何变化,并且这些变化可以在闭合期间、闭合完成之后、击发期间或击发完成之后发生的一段时间内被跟踪。控制电路2760可被配置为能够使用众所周知的三角剖分算法技术对至少两个互连传感器组合(例如,S1-S2或S1-S4)进行三角剖分2916,以检测2918位于两个S1-S2或S1-S4之间的组织2820的中厚度量度,例如,并且基于组织2820的检测到的中厚度来选择2920外科器械2750的功能。
控制电路2760可以采用多种众所周知的三角剖分算法来检测组织2820的中厚度。这些算法包括例如德洛内(Delaunay)三角剖分算法、“A New Voronoi-Based SurfaceReconstruction Algorithm”(Amenta等人,SIGGRAPH 1998)和“Poisson SurfaceReconstruction”(Kazhdan等人,Symposium on Geometry Processing 2006),这些中的每一者通过引用并入本文。
德洛内三角剖分算法能够基于来自一组顶点的顶点之间的空间几何关系来生成顶点之间的边,从而构造一组三角面并且因此构造目标网格模型。顶点可以由感测组织2820的存在的传感器S1-Sn位置来确定。具体地,德洛内三角剖分算法可以通过尝试使每个三角形面的三个内角中的最小内角的值最大化来推测性地计算出其间应当存在连接线的顶点。在大多数情况下,德洛内三角剖分算法将避免生成形状太窄和太长的三角形(例如,内角中的至少一个内角小于10度的三角形)。从许多文献中公开的实验结果可以知道,在大量顶点的情况下,德洛内三角剖分算法可以对顶点之间的边进行相对准确的猜测。
参见图34至图41和图44,在一个一般方面,图44示出了根据本公开的至少一个方面的监测沿端部执行器2752钳口(例如,仓2768和砧座2766)的长度横向和纵向分布的传感器阵列S1-Sn以确定抓持在端部执行器2752的钳口中的组织2820的异质组织阻抗区域的位置的方法2930。如上文所解释,控制电路2760可被配置为能够执行实现为传感器监测和处理电路2400中的算法2410的方法2930。
在一个方面,控制电路2760被配置为能够监测2932端部执行器2752的钳口在组织2820上闭合(例如,砧座2766朝向仓2768枢转地旋转以将组织抓持在该砧座与该仓之间)。控制电路2760可被配置为能够在钳口闭合时段期间监测2934位于钳口的砧座2766和/或钉仓2768上的每个传感器S1-Sn的组织性质。在各种方面,组织性质可以是阻抗Z、阻抗Z谱、电容C、施加在端部执行器2752上的力、施加到组织2820的力、光透射率、光反射率或多普勒效应以确定组织特性,以及可由传感器S1-Sn监测的其他组织性质。控制电路2760可以跟踪和记录在钳口闭合时段期间每个传感器S1-Sn的感测到的组织性质。控制电路2760可以使用在钳口闭合时段期间感测到的组织性质的这种时间历史来确定2936所监测的组织性质的异质区域(如果存在的话),其中该异质区域限定了标记特定基线位置的不同变化或异常。控制电路2760可被配置为能够在刀/I形梁2764的击发被启动时跟踪2938这些基线位置。一旦启动了刀/I形梁2764的击发,控制电路2760就被配置为能够跟踪2940这些基线位置的位置历史并且将该位置历史用于击发过程的反馈控制。控制电路2760被配置为能够修改2942外科器械2750的功能,以在刀/I形梁2764击发过程期间改变组织流动。可被修改以在击发过程期间改变组织流动的装置功能包括改变击发速度、暂停(完全停止)击发过程、闭合力等。
参见图34至图41和图45,在一个一般方面,图45示出了根据本公开的至少一个方面的监测在端部执行器2752(例如,仓2768和砧座2766)中横向和纵向分布的传感器阵列S1-Sn以预测端部执行器2752的钳口中的组织2820流动的方法2950。如上文所解释,控制电路2760可被配置为能够执行实现为传感器监测和处理电路2400中的算法2410的方法2950。
为了预测端部执行器2752的钳口中的组织2820流动的量,根据方法2950,控制电路2760可被配置为能够独立地监测2952纵向和横向传感器阵列S1-Sn并且测量组织2820的性质。在各种方面,组织性质可以是阻抗Z、阻抗Z谱、电容C、施加在端部执行器2752上的力、施加到组织2820的力、光透射率、光反射率或多普勒效应以确定组织特性,以及可由传感器S1-Sn监测的其他组织性质。在监测阶段2952期间,控制电路2760可被配置为能够确定2954组织2820的所监测的性质在纵向和横向两者上的变化,并且基于所确定2954的变化,控制电路2760可被配置为能够在钳口闭合时段期间感测2956组织流动。一旦感测2956到组织流动,控制电路2760就可被配置为能够在完成钳口闭合之后确定2958至少一个装置参数。至少一个装置参数可包括装置感测参数,例如闭合期间的闭合负荷的变化率、闭合完成之后的闭合负荷的变化率等。控制电路2760可被配置为能够基于钳口闭合期间的组织流动结合在钳口闭合完成之后确定2960的至少一个装置参数来确定2958组织类型或组织状况。控制电路2760可被进一步配置为能够基于组织类型来修改2962外科器械的功能。
在一个方面,感测2956组织流动可以是基于从态势感知和/或其他装置感测量度(例如,闭合期间的闭合负荷的变化率、闭合完成之后的闭合负荷的变化率等)获知组织类型。组织类型或组织状况可通过将钳口闭合期间的组织流动与闭合系统的力反馈组合来确定组织类型。可以通过确定组织阻抗来进一步细化组织流动。该过程可用于检测端部执行器2752的钳口内的刚性或外来物体。
在另一方面,控制电路2760可被配置为能够监测和记录组织阻抗Z的量值,同时在钳口闭合期间测量组织流动。钳口闭合算法可用于感测闭合期间的组织移动,作为刀/I形梁2764的击发期间的每个变化的潜在效果的指标。例如,在第一闭合速率下,可以估计组织流动的量值/方向,然后可以调整闭合速率,并且组织流动的变化由控制电路2760跟踪并记录在存储器中。在一个方面,控制电路2760可被配置为能够通过在击发之前利用闭合组织流动和闭合力反馈来预测击发后组织位置,以向外科医生提供反馈,从而允许重新定位的机会以确保组织被完全捕获在端部执行器2752的切割线2824中。
在各种其他方面,传感器监测和处理电路2400的控制电路2760可被配置或编程为执行算法2410以基于端部执行器2752中的多种传感器配置来监测和询问组织。
在一个方面,控制电路2760可被配置或编程为随时间监测组织阻抗Z并且跟踪沿着仓2768的长度配置的传感器阵列S1-Sn的单个电极或分段电极两端的组织阻抗Z。
在其他方面,控制电路2760可被配置或编程为监测组织阻抗Z谱。这可通过利用不同频率的扫描并监测组织对功率和频率的阻抗Z以确定组织2820的组成来实现。
在其他方面,控制电路2760可被配置或编程为监测组织电容C。钳口的组织特性和间隙关系可用于确定存在于端部执行器2752的钳口中的组织2820的量。
在其他方面,端部执行器2752的钳口可包括纵向和横向地设置在砧座2766和/或仓2768中的光学传感器。控制电路2760可被配置为能够监测光透射率、反射率或多普勒效应以确定组织特性。该方法可包括分析本地光反射率以确定组织2820的表面状况,从而监测在钳口之间捕获的组织内的不规则性。该方法还可包括分析光的多普勒效应频率以监测端部执行器2752的钳口中的组织的本地移动颗粒。
在一个一般方面,本公开提供能够监测至少两个内部仓部件位置以确定仓的状态或操作的传感器和电子电路。本公开还提供传感器和电子电路,用于监测仓内的部件的内部功能或运动,以确定耦合击发致动器的状态、操作或当前行程位置。在一个方面,传感器和电子电路向使用者提供从感测参数导出的信息。在另一方面,电子电路可基于感测到的状态来改变装置的功能状态(例如,安全闭锁)。
在各种方面,仓传感器和电子电路被配置为能够监测仓元件的操作,包括用于检测钉驱动器和钉的部署以监测钉部署的状态和操作的传感器和电子电路。在另一方面,仓传感器和电子电路被配置为能够监测和询问在端部执行器的钳口中捕获的组织。最后,在另一方面,仓传感器和电子电路被配置为能够采用数据聚合的组合,该组合可被用来创建冗余的安全措施。在以下结合附图的描述中更详细地解释这些方面。
图46示出了外科缝合系统的端部执行器4000的分解图。端部执行器4000包括框架4002、仓钳口4004和砧座4006。仓钳口4004从框架4002固定地延伸。砧座4006能够相对于仓钳口4004在打开或松开位置与闭合或夹紧位置之间移动。在另选方面,仓钳口4004能够相对于砧座4006在打开或松开位置与闭合或夹紧位置之间移动。在至少一个此类实施方案中,砧座4006从框架4002固定地延伸。
例如,仓钳口4004包括通道或载体4022,该通道或载体被构造成能够接纳钉仓,诸如钉仓4008。参见图58,钉仓4008包括仓体4010。仓体4010包括被构造成能够支撑患者组织的平台4012、纵向狭槽4014、以及限定在其中的六个纵向排钉腔4016。每个钉腔4016被构造成能够在其中接纳并以可移除方式存储钉。钉仓4008还包括被配置为能够驱动钉离开钉腔4016的钉驱动器4028。还设想了具有钉腔、平台和/或钉的各种其他布置的其他钉仓,以与端部执行器4000一起使用。
除上述以外,钉仓4008还包括滑动件4018,该滑动件被配置为能够接合钉驱动器4028。更具体地,滑动件4018包括斜坡4020,该斜坡被配置为能够接合限定在钉驱动器4028上的凸轮,并且能够在滑动件4018朝远侧移动通过钉仓4008时,提升钉驱动器4028以及钉腔4016内的钉。击发构件被构造成能够在钉击发行程期间使滑动件4018从近侧、未击发或起始位置朝远侧移动到远侧、击发或结束位置。
钉由仓体4010中的钉驱动器4028支撑。钉驱动器4028能够在第一或未击发位置与第二或击发位置之间移动,以将钉从钉腔4016射出。钉驱动器4028通过盘或保持器4030保留在仓体4010中,该保持器围绕仓体4010的底部延伸并且包括被配置为能够抓持仓体4010以及将保持器4030保持到仓体4010的弹性构件4031。钉驱动器4028能够通过滑动件4018在该钉驱动器的未击发位置与该钉驱动器的击发位置之间移动。滑动件4018能够在近侧位置与远侧位置之间移动。滑动件4018包括多个斜坡表面4020,该多个斜坡表面被配置为能够在钉驱动器4028下方滑动并且将钉驱动器4028以及支撑在该钉驱动器上的钉朝向砧座4006提升。
在各种示例中,钉仓4008包括一个或多个保持构件,该一个或多个保持构件被配置为能够确保未击发钉仓4008与仓通道或载体4022之间的紧密附接。保持构件可在钉仓4008的击发期间移动或以其他方式修改,以产生已击发钉仓4008与仓通道或载体4022之间的减少的附接。此类减少的附接允许使用者容易地从仓通道或载体4022移除已击发钉仓4008。
在图46所示的示例中,钉仓4008以可移除方式安置在仓通道或载体4022中。钉仓4008包括在钉仓4008的相对两侧上的两个保持构件4037。保持构件4037被配置为能够保持或帮助保持钉仓4008与仓通道或载体4022之间的紧密附接。保持构件4037可从保持器4030的基座4019延伸。在各种示例中,保持构件4037与保持器4030的壁4039间隔开,以允许保持构件4037相对于壁4039挠曲。
每个保持构件4037为弹性构件的形式,该弹性构件能够在未击发钉仓4008中的偏置构型与已击发钉仓4008中的未偏置或较少偏置的构型之间移动。在未击发钉仓4008中,保持构件4037被偏置成与仓通道或载体4022接合,以保持或帮助保持预击发仓移除负荷。需要大于或等于预击发仓移除负荷的负荷以将未击发钉仓4008与仓通道或载体4022分开。
每个保持构件4037包括第一弯曲部分4044,该第一弯曲部分限定可接纳在限定于仓通道或载体4022的侧壁4009中的凹陷或沟槽中的第一保持特征部或制动件。在保持构件4037处于偏置构型的同时,第一弯曲部分4044保持在沟槽中。每个保持构件4037还包括第二弯曲部分4047,该第二弯曲部分限定第二保持特征部制动件,该第二保持特征部制动件被配置为能够在保持构件4037处于偏置构型的同时抵靠至少一个钉驱动器4028。在各种示例中,每个保持构件4037限定横切基座4019的平面,其中第一弯曲部分4044在平面的第一侧上限定第一制动件,并且其中第二弯曲部分4047在平面的第二侧上限定第二制动件。
在一个方面,盘或保持器4030包括以第一阵列布置的第一多个传感器4050,该第一多个传感器纵向地设置在形成于保持器4030的基座4019中的纵向狭槽4054的两侧上。以第二阵列布置的第二多个传感器4052设置在纵向狭槽4054的一侧上。然而,应当理解,第二传感器阵列4052也可以设置在纵向狭槽4054的两侧上。在一个一般方面,第一传感器阵列4050被配置为能够检测可移动钉驱动器4028的运动,并且更具体地,第一传感器阵列4050被配置为能够感测钉驱动器4028的推进状态以驱动钉离开钉腔4016。在一个方面,第二传感器阵列4052被配置为能够在滑动件4018沿纵向狭槽4054移动并致动钉驱动器4028时感测该滑动件的运动。
在一个方面,滑动件4018和/或钉驱动器4028可由铁磁材料形成或嵌入有铁磁颗粒。第一传感器阵列4050和第二传感器阵列4052可定位在仓基座4019的盘或保持器4030中。滑动件4018和/或钉驱动器4028的移动在钉驱动器4028下方的第一传感器阵列4050和/或第二传感器阵列4052中感应出电流(信号),以产生可由电子电路4074检测到的信号,如图47所述。滑动件4018和钉驱动器4028以及第一传感器阵列4050和第二传感器阵列4052的这种构造使得电子电路4074能够确定钉驱动器4028的位置和速度和/或滑动件4018的位置和速度。
参见图46和图47,钉仓4008包括仓电路4044。仓电路4024包括:存储介质4026;仓连接器区域4017,其包括多个外部电接触件4028;以及仓状态电路部分4032,其包括迹线元件4034。存储介质4026可以是存储关于钉仓4008的信息(诸如钉仓4008的各种特性,包括击发状态、钉类型、钉尺寸、仓批号和/或仓颜色)的存储器。
图47是根据本公开的至少一个方面的定位在仓基座4019的盘或保持器4030中的第一传感器阵列4050和第二传感器阵列4052的示意图,第一传感器阵列4050和第二传感器阵列4052示出为耦合到电子电路4074。如图所示,第一传感器阵列4050纵向设置在限定于盘或保持器4030中的狭槽4054的两侧上。第二传感器阵列4052沿狭槽4054的一侧纵向设置,但在其他方面,第二传感器阵列4052可类似于第一传感器阵列4050而设置在狭槽4054的两侧上。
现在参见图46和图47,在一个方面,第一传感器阵列4050包括多个元件,该多个元件被配置为能够在钉驱动器4028通过滑动件4018在该钉驱动器的未击发位置与该钉驱动器的击发位置之间移动时检测该钉驱动器的移动。如上所讨论,钉驱动器4028可由铁磁材料制成或可嵌入有由第一传感器阵列4050中的元件检测到的铁磁材料。在一个方面,钉驱动器4028的移动在位于钉驱动器4028下方的第一阵列传感器4050中感应出电流(信号)。因此,第一传感器阵列4050可检测钉驱动器4028的位置和速度。在一个方面,第一传感器阵列4050可包括由半导体条构造的多个霍尔单元。在其他方面,第一传感器阵列4050可包括多个霍尔传感器元件。在其他方面,第一传感器阵列4050可包括被配置为能够检测通过移动仓4008中的铁磁元件生成的磁场的其他传感器元件。
仍参见图46和图47,在一个方面,第二传感器阵列4052包括多个元件,该多个元件被配置为能够检测滑动件4018或组织切割刀的移动,并且该滑动件或组织切割刀沿着钉仓4008的狭槽4014移动。如上所讨论,滑动件4018或组织切割刀可由铁磁材料制成或可嵌入有由第二传感器阵列4052中的元件检测到的铁磁材料。在一个方面,滑动件4018或切割刀的移动在第二阵列传感器4052沿槽4054行进时在该第二阵列传感器中感应出电流(信号)。因此,第二传感器阵列4052可以检测滑动件4018或切割刀的位置和速度。在一个方面,传感器阵列4052可包括由半导体条构造的多个霍尔单元。在其他方面,第二传感器阵列4052可包括多个霍尔传感器元件。在其他方面,第二传感器阵列4052可包括被配置为能够检测通过移动仓4008中的铁磁元件生成的磁场的其他传感器元件。
仍参见图46和图47,第一传感器阵列4050耦合到控制电路4062,用于处理由钉驱动器4028的运动生成的信号4058。由第一传感器阵列4050生成的信号4058可包括电压、电流、电阻、阻抗、电容、电感、频率、相位等。第一传感器阵列4050的各个传感器元件由多路复用器4056通过控制电路4062选择,并且由逻辑/模拟-数字转换器(ADC)电路4060经由选择线4066选择。选定传感器元件的输出信号4058被路由到多路复用器4056的输出4068,到达逻辑/ADC电路4060的ADC部分。控制电路4062通过数据线4064读取第一传感器阵列4050中的选定传感器元件的输出信号4058的数字输出值。该值可被存储在联接到控制电路4062的存储器4066中。
第二传感器阵列4052耦合到控制电路4062,用于处理由滑动件4018或组织切割刀的运动生成的信号4070。由第二传感器阵列4052生成的信号4070可包括电压、电流、电阻、阻抗、电容、电感、频率、相位等。第二传感器阵列4052的各个传感器元件由多路复用器4056通过控制电路4062选择,并且由逻辑/ADC电路4060经由选择线4066选择。选定传感器元件的输出信号4070被路由到多路复用器4056的输出4068,到达逻辑/ADC电路4060的ADC部分。控制电路4062通过数据线4064读取第二传感器阵列4052中的选定传感器元件的输出信号4070的数字输出值。该值可被存储在联接到控制电路4062的存储器4066中。
在各种方面,控制电路4062可包括一个或多个微控制器、微处理器或用于执行使得一个或多个处理器处理从第一传感器阵列4050和第二传感器阵列4052接收的信号的指令的其他合适处理器。在其他方面,控制电路4062可包括模拟或数字电路(诸如可编程逻辑装置(PLD)、场可编程门阵列(FPGA)、离散逻辑,或其他硬件电路、软件和/或固件,或其他机器可执行指令)以执行在以下描述中解释的功能。控制电路4062联接到用于存储数据和/或机器可执行指令的存储器4066。在各种方面,控制电路4062和存储器4066可位于仓4008中。在其他方面,控制电路4062和存储器4066可以位于仓4008外,并且经由有线或无线通信技术联接到电子电路4074的其他部件。在其他方面,存储器4066可以位于仓4008中,并且控制电路4062可以位于仓4008外并且经由有线或无线连接技术联接到电子电路4074。
仍参见图46和图47,对于组织切割刀容纳在仓4008内而不是集成到I形梁的构造,刀可用作铁磁材料。相同的原理可应用于钉盘或保持器4030、I形梁和砧座4006。在一些方面,钉可由钛或钛合金制成。然而,如果钉由铁磁材料制成,则相同的原理也可应用于钉。
如果所测量的部件(例如,钉驱动器4028和滑动件4018)的运动偏离所期望的不当装置状态,则可能发生不良钉成形等,这可能导致并发症,诸如流血、渗漏等。因此,控制电路4062可以被编程或配置为能够基于从第一传感器阵列4050和第二传感器阵列4052获得的读数来检测与适当操作的偏离,并且在操作的下一步骤已经开始之前干预装置的功能以改善装置的操作。例如,如果钉驱动器4028不移动预期距离,则钉成形可能受到损害。如果滑动件4018不移动预期距离,则钉线可能不完整。因此,控制电路4062可以处理从第一传感器阵列4050和第二传感器阵列4052获得的测量信号4058、4070以认证仓4008并确保该仓不是(次优)副本。另外,控制电路4062可处理从第一传感器阵列4050和第二传感器阵列4052获得的测量信号4058、4070,以确定装置状态,包括仓4008是否被适当地装载、钉盘或保持器4030是否已被移除、仓4008是否已被击发等。下面参见图48和图49解释的附加电路可由控制电路4062采用以确定诸如当钉腿不接触钉凹坑时是否可能发生不良钉成形,该不良钉成形可能增加该区中泄漏的可能性。可由控制电路4062监测的其他状况包括例如在击发滑动件4018和组织切割刀之前确定砧座4006是否完全闭合。
现在主要转到图48和图49并返回参见图46和图47,根据本公开的一个或多个方面,砧座4006包括钉成形凹坑4310,该钉成形凹坑包括导电电路元件4314。图49示出了根据本公开的一个或多个方面的在钉腿的适当成形期间导电电路元件4314已经被钉腿切断之后的图48的钉成形凹坑4310的透视图。
如图48所示,钉成形凹坑4310包括与组织接触表面4308在外边缘4326处相交的凹表面4324。导电电路元件4314可定位在适当成形钉的路径中的凹表面4324上。侧壁4328以及凹表面4324限定用于钉腿的成形导轨3325。凹表面4324包括第一接触部分4330、深部分4332和端部部分4334。第一接触部分4330被配置为能够当钉腿进入钉成形凹坑4310时进行与钉腿的端部第一次接触。然后,钉腿在其沿着凹表面4324的深部分4332和端部部分4334跟随成形导轨4325穿过时卷曲。端部部分4334导引钉腿朝向钉的基座。
如图48所示,导电电路元件4314可以定位在成形导轨4325上。由于与第一接触部分4330的成功接触増加了钉腿的适当成形的可能性,因此将导电电路元件4314放置在第一接触部分4330之外的位置处的成形导轨4325上提高了检测适当或不适当钉成形的准确性。
在至少一个示例中,将导电电路元件4314放置在第一接触部分4330与深部分4332之间的成形导轨4325上。在至少一个示例中,将导电电路元件4314放置在深部分4332与端部部分4334之间的成形导轨4325上。在至少一个示例中,将导电电路元件4314放置在深部分4332的成形导轨4325上。在至少一个示例中,将导电电路元件4314放置在深部分4332的中心处的或基本上位于深部分的中心处的成形导轨4325上。在至少一个示例中,将导电电路元件4314放置在成形导轨4325的最深部分处的成形导轨4325上。在至少一个示例中,将导电电路元件4314定位到相比端部部分4334更靠近第一接触部分4330的凹表面4324。在至少一个示例中,将导电电路元件4314定位到相比第一接触部分4330更靠近侧端部部部分4334的凹表面4324。
在某些实例中,电路可定位在适当成形钉的路径中并且可联接到电子电路4074(图47)。电子电路4074被配置为能够检测导电电路元件4314的连续性,以确定钉是否适当成形在钉成形凹坑4310中。在此类实例中,电气电路的中断可由电子电路4074理解为钉适当成形的指示,而电气电路的电气连续性的连续性可由电子电路4074理解为钉不适当成形的指示。在其它情况下,电气电路可以定位在不适当成形钉的可能路径中。在其他实例中,电气电路的电气连续性的中断可以被理解为钉不适当成形的指示,而电气电路的电气连续性的连续性可由电子电路4074理解为钉适当成形的指示。
参见图48,电气电路可包括一个或多个导电电路元件4314,当在成形钉腿时由该钉腿切断时,这些导电电路元件导致电气电路的中断。电气电路的导电电路元件4314可以定位在适当成形的钉腿的路径中。如图49所示,导电电路元件4314的切断可以被理解为钉适当成形的指示。在其他实例中,电气电路的导电电路元件4314可以定位在不适当成形的钉的可能路径中。在此类实例中,导电电路元件4314的切断可由电子电路4074理解为钉不适当成形的指示。
参见图46至图49,在一个方面,控制电路4062可以被编程或配置为能够监测和询问组织。在一个方面,控制电路4062可被编程或配置为能够通过读取位于端部执行器4000中的钉仓4008的盘或保持器4030部分中的第一传感器阵列4050和第二传感器阵列4052的输出信号4058、4070来监测磁场。第一传感器阵列4050和第二传感器阵列4052可设置在盘或保持器4030部分中以监测位于仓4008的边界内的磁性结构或监测仓4008外部的空气磁场。控制电路4062可进一步被编程或配置为能够检测接触钉成形凹坑4310的钉腿,如相关描述在图48和图49中所解释。控制电路4062可结合从第一传感器阵列4050和第二传感器阵列4052接收的信号4058、4070来考虑对接触钉成形凹坑4310的钉腿的检测,以确定仓4008的状态,例如确定仓4008是否被适当地装载、钉盘或保持器4030是否已被移除、仓4008是否已被击发、钉是否适当成形、钉驱动器4028的位置和速度,和/或滑动件4018的位置和速度等。在名称为“STAPLE FORMATION DETECTION MECHANISMS”的美国专利10,456,137中描述了用于检测钉成形的附加技术,该专利以引用方式全文并入本文。
图50示出了根据本公开的至少一个方面的包括电子电路4074的远侧传感器插头4816,该电子电路被配置为能够监测和处理来自第一传感器阵列4050和第二传感器阵列4052的信号4058、4070。远侧传感器插头4816包括存储传感器4810和电子电路4074。远侧传感器插头4816还包括挠性板4814。传感器4810和电子电路4074操作性地联接到挠性板4814,使得该传感器和该电子电路能够连通。在名称为“SMART SENSORS WITH LOCALSIGNAL PROCESSING”的美国专利9,993,248中描述了附加智能仓技术,该专利以引用方式全文并入本文。
参见图46至图50,在一个方面,钉驱动器4028、滑动件4018和用于监测仓4008的操作的其他元件的仓4008特征感测可与其他数据聚合组合地使用,以创建冗余的安全措施。因此,传输到仓4008的数据和在仓4008上本地感测到的数据的组合或混合可由控制电路4062处理以用于安全上下文解析。
在一个方面,可通过控制电路4062从机械导出的数据源和器械闭锁件数据源获得聚合数据的组合。数据的组合可由控制电路4062处理以确定仓4008或其他端部执行器4000部件的真实性、安全性和数据值。例如,机械闭锁件充当用于力检测的安全系统。在一个方面,如本文所解释,可在仓4008中提供力特征以识别未击发重新装载的存在以及装载在端部执行器4000中的仓4008的类型的某种级别的识别。机械闭锁件结合地存在以确保数字检测的失败仍然允许装置的安全操作。例如,这可以作为同一系统的一部分或作为单独系统。
在另一方面,聚合数据的组合可由控制电路4062从位于不同数据通道上的多个射频识别(RFID)标签或1线存储器获得。这种数据的组合可由控制电路4062处理以确定仓4008或其他端部执行器4000部件的真实性、安全性和数据值。为了安全,仓4008的真实性可以通过多个RFID或1线存储器源的组合来确定。可以通过在仓4008中采用多个数据通道以确保系统中的冗余来实现安全性。在一个方面,除非成功地减轻了所有系统故障/挑战,否则不应建立读数。
在又一方面,可由控制电路4062从至少一个RFID标签或1线存储器结合机械闭锁件数据获得聚合数据的组合。这种数据的组合可由控制电路4062处理以确定仓4008或其他端部执行器4000部件的真实性、安全性和数据值。可通过对存储器装置进行加密和将力特征嵌入仓4008机械闭锁件中来确定真实性,如上文所解释。此外,机械闭锁件充当存储器装置的安全系统。
在又一方面,可由控制电路4062从至少一个RFID标签或1线存储器结合力检测数据获得聚合数据的组合。这种数据的组合可由控制电路4062处理以确定仓4008或其他端部执行器4000部件的真实性、安全性和数据值。可通过存储器装置的加密和力检测特征的存在来确定真实性。可通过适当系统功能的力检测确认来实现安全性。仅需要在所有系统故障/挑战被成功地减轻的情况下起作用。
在又一方面,可由控制电路4062从多个RFID标签结合机械闭锁件数据获得聚合数据的组合。这种数据的组合可由控制电路4062处理以确定仓4008或其他端部执行器4000部件的真实性、安全性和数据值。可通过采用用于安全装置的多个存储器源和机械闭锁件的存在来确定真实性。机械闭锁件充当存储器装置的安全系统。
在又一方面,可由控制电路4062从存储器访问受限制的存储器源和力检测数据获得聚合数据的组合。存储器源数据用于解锁存储器源和力检测。可采用调谐电路来解锁存储器访问力检测数据。力检测数据可用作认证存储器读取的输入值。
聚合数据的每个上述处理可以是基于基于硬件的可编程逻辑风险减轻策略,该策略包括数字逻辑,包括例如FPGA和ASIC(专用集成电路)。
图51是根据本公开的至少一个方面的监测钉仓4000的内部系统以检测和跟踪仓部件的运动状态的方法4100。已经描述了一种传感器系统,该传感器系统被配置为能够监测至少两个内部仓4008部件位置以确定仓4008的状态或操作,从而确定所联接的击发致动器的状态、操作或当前冲程位置,向使用者提供从感测参数导出的信息,并且基于感测到的状态来改变装置的功能状态(例如,安全闭锁),现在描述转向如图51所示的监测仓4008内的部件的内部功能或运动的方法4100。方法4100可以由如参考图46至图50并且更具体地在图47中描述的电子电路4074的控制电路4062来实现。
根据该方法,控制电路4062被编程或配置为能够接收4102来自第一传感器阵列4050的数字化信号4058样本,该第一传感器阵列被配置为能够监测位于外科器械的钉仓4008内的部件的第一内部功能或运动。第一传感器阵列4050设置在仓4008中以感测位于仓4008中的第一部件的位置或运动。以举例的方式,如上所讨论,第一传感器阵列4050设置在仓4008的盘或保持器4030上,并且被配置为能够感测钉驱动器4028的位置或运动。除了钉驱动器4028和滑动件4018信息之外,控制电路4062还可接收来自钉成形凹坑4310的导电电路元件4314的信号以确定钉腿的适当成形。
根据方法4100,控制电路4062被编程或配置为能够接收4104来自第二传感器阵列4052的数字化信号4070样本,该第二传感器阵列被配置为能够监测位于钉仓4008内的部件的第二内部功能或运动。第二传感器阵列也设置在仓4008中以感测位于仓4008中的第二部件的位置或运动。以举例的方式,第二传感器阵列4052设置在仓4008的盘或保持器4030中,并且被配置为能够感测滑动件4018的位置或运动。如贯穿本公开所讨论,击发致动器联接到滑动件4018和组织切割刀。因此,由第二传感器阵列4052感测到的滑动件4018的位置和速度可由控制电路4062处理以确定击发致动器和/或组织切割刀的状态、操作或当前行程位置。
根据方法4100,控制电路4062被编程或配置为能够处理4106从第一传感器阵列4050和第二传感器阵列4052接收4102、4104的信号4058、4070样本以确定钉仓4008的状态。控制电路4062被编程或配置为能够将从经处理的信号样本导出的信息提供4108给外科器械的使用者。根据方法4100,控制电路4062被编程或配置为能够基于所处理的信号样本基于仓4008的感测到的状态来改变4110外科器械的功能状态(例如,安全闭锁)。
另外,以举例的方式,如上所讨论,控制电路4062可从多个源接收数据(该多个源包括但不限于机械闭锁特征部、力测量结果、RFID标签、1线或其他存储器装置)以确定与仓4008相关联的真实性、安全性和数据值。
已结合钉的部署和变形描述了本文所述的外科器械系统;然而,本文所述的实施方案不限于此。例如,设想了部署除钉之外的紧固件诸如夹具或大头钉的各种实施方案。此外,还设想了利用用于密封组织的任何合适装置的各种实施方案。例如,根据各种实施方案的端部执行器可包括被配置成能够加热和密封组织的电极。另外,例如,根据某些实施方案的端部执行器可施加振动能量来密封组织。
下述专利的全部公开内容据此以引用方式并入本文:
-公布于1995年4月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312;
-公布于2006年2月21日的名称为“SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利7,000,818;
-公布于2008年9月9日的名称为“MOTOR-DRIVEN SURGICAL CUTTING ANDFASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK”的美国专利7,422,139;
-公布于2008年12月16日的名称为“ELECTRO-MECHANICAL SURGICAL INSTRUMENTWITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”的美国专利7,464,849;
-公布于2010年3月2日的名称为“SURGICAL INSTRUMENT HAVING ANARTICULATING END EFFECTOR”的美国专利7,670,334;
-公布于2010年7月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245;
-公布于2013年3月12日的名称为“SELECTIVELY ORIENTABLE IMPLANTABLEFASTENER CARTRIDGE”的美国专利8,393,514;
-名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利申请序列号11/343,803,现为美国专利7,845,537;
-提交于2008年2月14日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT HAVING RF ELECTRODES”的美国专利申请序列号12/031,573;
-提交于2008年2月15日的名称为“END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT”的美国专利申请序列号12/031,873,现为美国专利7,980,443;
-名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”的美国专利申请序列号12/235,782,现为美国专利8,210,411;
-名称为“MOTORIZED SURGICAL INSTRUMENT”的美国专利申请序列号12/235972,现为美国专利9050083。
-名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117,现为美国专利8,608,045;
-提交于2009年12月24日的名称为“MOTOR-DRIVEN SURGICAL CUTTINGINSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY”的美国专利申请序列号12/647,100,现为美国专利8,220,688;
-提交于2012年9月29日的名称为“STAPLE CARTRIDGE”的美国专利申请序列号12/893,461,现为美国专利8,733,613;
-提交于2011年2月28日的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号13/036,647,现为美国专利8,561,870;
-名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241,现为美国专利9,072,535;
-提交于2012年6月15日的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING A FIRING DRIVE”的美国专利申请序列号13/524,049,现为美国专利9,101,358;
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,025,现为美国专利9,345,481;
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,067,现为美国专利申请公布2014/0263552;
-提交于2006年1月31日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM”的美国专利申请公布2007/0175955;和
-提交于2010年4月22日的名称为“SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”的美国专利申请公布2010/0264194,现为美国专利8,308,040。
虽然本文已结合某些实施方案描述了各种装置,但也可实施对这些实施方案的许多修改和变型。在一个或多个实施方案中,具体特征、结构或特性可以任何合适的方式进行组合。因此,在无限制的情况下,结合一个实施方案示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其他实施方案的特征、结构或特性组合。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。此外,根据多种实施方案,单个部件可被替换为多个部件,并且多个部件也可被替换为单个部件,以执行给定的一种或多种功能。上述具体实施方式和下述权利要求旨在涵盖所有此类修改和变型。
本文所公开的装置可被设计成在单次使用之后废弃,或者其可被设计成多次使用。然而无论是哪种情况,该装置都可在至少使用一次后经过修整再行使用。修整可包括以下步骤的任意组合,这些步骤包括但不限于拆卸装置、之后进行装置具体部件的清洁或更换、以及随后重新组装装置。具体地,修整设施和/或外科团队可拆卸装置,并且在清洁和/或更换装置的特定部件之后,可重新组装装置以供后续使用。本领域的技术人员将理解,对装置进行修整可利用各种技术来进行拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修复装置均在本申请的范围内。
本文所公开的装置可在手术之前进行处理。首先,可获得新的或用过的器械,并且根据需要进行清洁。然后,可对器械进行消毒。在一种消毒技术中,将该器械放置在密闭且密封的容器(诸如,塑料或TYVEK袋)中。然后可将容器和器械置于可穿透容器的辐射场,诸如γ辐射、X射线和/或高能电子。辐射可杀死器械上和容器中的细菌。经消毒的器械随后可被存储在无菌容器中。密封容器可将器械保持为无菌的,直至在医疗设施中将该容器打开。还可使用本领域已知的任何其他技术对装置进行消毒,所述技术包括但不限于β辐射、γ辐射、环氧乙烷、等离子过氧化物和/或蒸汽。
尽管本发明已被描述为具有示例性设计,但可在本公开的实质和范围内进一步修改本发明。因此,本申请旨在涵盖使用本发明的一般原理的本发明的任何变型、用途或改型。
上述具体实施方式已经由使用框图、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(例如,作为在一个或多个计算机系统上运行的一个或多个程序),作为在一个或多个处理器上运行的一个或多个程序(例如,作为在一个或多个微处理器上运行的一个或多个程序),作为固件,或作为实际上它们的任何组合全部或部分地在集成电路中等效地实现,并且根据本公开,设计电路和/或编写软件和/或硬件的代码将在本领域技术人员的技术范围内。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例示性形式适用,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中的存储器内,诸如动态随机存取存储器(DRAM)、高速缓存、闪存存储器或其他存储器。此外,指令可经由网络或通过其他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传输以机器(例如,计算机)可读形式的信息的任何机构,但不限于软盘、光学盘、光盘只读存储器(CD-ROM)、和磁光盘、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、声学信号或其他形式的传播信号(例如,载波、红外信号、数字信号等)在因特网上传输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)可读的形式存储或传输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、可编程电路(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、存储由可编程电路执行的指令的固件、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,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)、形成存储器装置(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。
如在本公开的一个或多个方面中所使用,微控制器通常可包括存储器和操作地联接到存储器的微处理器(“处理器”)。处理器可控制马达驱动器电路,该马达驱动器电路通常用于控制例如马达的位置和速率。在某些实例中,处理器可发信号通知马达驱动器,以例如停止和/或禁用马达。在某些实例中,微控制器可为例如可从Texas Instruments购得的LM 4F230H5QR。在至少一个示例中,Texas Instruments LM4F230H5QR是ARM Cortex-M4F处理器内核包括高达40MHz的256KB单周期闪速存储器或其他非易失性存储器的芯片上存储器、40MHz以上的用于提高性能的预取缓冲区、32KB单周期串行随机存取存储器(SRAM)、加载有Stellaris软件的内置只读存储器(ROM)、2KB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、一个或多个具有12个模拟输入通道的12位模拟-数字转换器(ADC),以及随时可用于产品数据表的其他特征结构。
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,或者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另一基础计算装置。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,所以是时序数字逻辑的示例。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。在至少一个实例中,处理器可为任何单核或多核处理器,诸如已知的由Texas Instruments生产的商品名为ARMCortex的那些处理器。然而,可不受限制地采用微控制器和安全处理器的其它合适的替代物。
如本文的任何方面所用,术语“逻辑”可指被配置成能够执行前述操作中的任一者的应用程序、软件、固件和/或电路。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。固件可体现为在存储器装置中硬编码(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“部件”、“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”是指导致所期望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(但不一定)采用能被存储、转移、组合、比较和以其他方式操纵的电或磁信号的形式。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能够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月发布的标题为“IEEE 802.3Standard”的以太网标准和/或本标准的更高版本。另选地或附加地,通信装置可能够使用X.25通信协议彼此通信。X.25通信协议可符合或兼容由国际电信联盟电信标准化部门(ITU-T)发布的标准。另选地或附加地,通信装置可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兼容由国际电报电话咨询委员会(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 Network Interworking 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。
如本文的任何方面所使用,可通过包括一个或多个收发器的装置来实现无线传输(例如,数据信号的无线通信或无线传输)。收发器可包括但不限于蜂窝调制解调器、无线网状网络收发器、收发器、低功率广域(LPWA)收发器和/或近场通信收发器(NFC)。装置可包括移动电话、传感器系统(例如,环境、位置、运动等)和/或传感器网络(有线和/或无线)、计算系统(例如,服务器、工作站计算机、台式计算机、膝上型计算机、平板电脑(例如,等)、超便携式计算机、超移动计算机、上网本计算机和/或小型笔记本计算机等或者可被配置为能够与这些装置通信;在本公开的至少一个方面,装置中的一个装置可以是协调器节点。
收发器可被配置为能够经由相应的通用异步收发两用机(UART)从处理器接收串行传输数据,以将串行传输数据调制到RF载波上以产生传输RF信号并经由相应的天线来传输该传输RF信号。该收发器可被进一步配置为能够经由相应天线来接收接收RF信号(接收RF信号包括利用串行接收数据调制的RF载波),将接收RF信号解调以提取串行接收数据,以及将串行接收数据提供给相应UART以提供给处理器。每个RF信号具有相关联的载波频率和相关联的信道带宽。信道带宽与载波频率、传输数据和/或接收数据相关联。每个RF载波频率和信道带宽与收发器的操作频率范围相关。每个信道带宽进一步与收发器可遵守的无线通信标准和/或协议相关。换句话讲,每个收发器可对应于所选择的无线通信标准和/或协议的具体实施,例如用于的IEEE 802.11a/b/g/n和/或用于使用Zigbee路由的无线网状网络的IEEE 802.15.4。
如本文所述,一个或多个驱动系统或驱动组件采用一个或多个电动马达。在各种形式中,电动马达可以是例如直流有刷驱动马达。在其他布置结构中,马达可包括无刷马达、无绳马达、同步马达、步进马达、或任何其他合适的电动马达。电动马达可由电源供电,在一种形式中,该电源可包括可移除电源组。电池可各自包括例如锂离子(“LI”)或另一合适的电池。电动马达可包括例如与齿轮减速器组件可操作地接合的可旋转轴。在某些实例中,电源所提供的电压极性可沿顺时针方向操作电动马达,其中由电池施加到电动马达的电压极性可被反转,以便沿逆时针方向操作电动马达。在各种方面,微控制器经由脉宽调制控制信号通过马达驱动器控制电动马达。马达驱动器可被配置为能够沿顺时针方向或逆时针方向调整电动马达的速度。马达驱动器还被配置为能够在多种操作模式之间切换,该多种操作模式包括电子马达制动模式、恒速模式、电子离合模式和受控电流激活模式。在电子制动模式下,驱动马达200的两个端子被短路,并且所生成的反EMF抵消电动马达的旋转,从而允许更快的停止和更大的位置精度。
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装置的动作和进程,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相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、传输或显示装置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“被配置成能够”、“可配置成能够”、“可操作/可操作地”、“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“被配置成能够”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。
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表述的具体数目为预期的,则此类意图将在权利要求中明确表述,并且在不存在此类叙述的情况下,不存在此类意图。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,在没有其他修饰语的情况下,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,此类构造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,此类构造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各种操作流程图,但应当理解,可以不同于所示顺序的其他顺序执行各种操作,或者可同时执行所述各种操作。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”这样的术语或其他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部、结构或特征包括在至少一个方面中。因此,在整个说明书的各种位置出现的短语“在一个方面”、“在一方面”、“在一范例中”、“在一个范例中”不一定都指同一方面。此外,具体特征部、结构或特征可在一个或多个方面中以任何合适的方式组合。
在本说明书中,除非另有说明,否则如本公开中所使用的术语“约”或“大约”是指如本领域普通技术人员所确定的特定值的可接受误差,这部分地取决于如何测量或确定值。在某些实施方案中,术语“约”或“大约”是指在1、2、3或4标准偏差内。在某些实施方案中,术语“约”或“大约”是指在给定值或范围的50%、20%、15%、10%、9%、8%、7%、6%、5%、4%、3%、2%、1%、0.5%或0.05%内。
在本说明书中,除非另外指明,否则所有的数值参数在所有情况下均应理解为以术语“约”作引语或者受术语“约”修饰,其中数值参数具有用于确定参数数值的基础测量技术的固有差异性特征。在最低程度上且不试图将等同原则的应用限制到权利要求的保护范围的前提下,至少应当根据所报告的数值的有效数位并通过应用惯常的四舍五入法来解释本文描述的每一个数值参数。
本文列出的任何数值范围包括涵盖在所列范围内的所有子范围。例如,范围“1至10”包括列出的最小值1与列出的最大值10之间(包括1和10)的所有子范围,也就是说,具有等于或大于1的最小值和等于或小于10的最大值。此外,本文所列的所有范围包括所列范围的端点。例如,“1至10”的范围包括端点1和10。本说明书中列出的任何上限值旨在包括涵盖在其中的所有较小限值,并且本说明书中列出的任何下限值旨在包括涵盖在其中的所有较大限值。因此,申请人保留修正本说明书(包括权利要求)的权利,以明确地列出涵盖在明确列出的范围内的任何子范围。所有此类范围在本说明书中被固有地描述。
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,非专利公布或其他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各种形式和各种修改。与此一同提交的权利要求书旨在限定完整范围。
Claims (19)
1.一种用于与外科器械一起使用的钉仓,包括:
仓体,所述仓体包括近侧端部、远侧端部和钉腔;
钉,所述钉以可移除方式储存在所述钉腔中;
滑动件,所述滑动件能够在钉击发行程期间朝向所述远侧端部移动,以将所述钉从所述钉腔射出;
传感器,所述传感器被配置为能够检测所述滑动件的位置;和
至少一个存储器装置,所述至少一个存储器装置与所述传感器连通,其中所述至少一个存储器装置被配置为能够存储:
指示所述钉击发行程是否已被执行的至少一个数据;
关于执行所述钉击发行程的时间和日期的至少一个数据;
关于用于击发所述钉仓的所述外科器械的至少一个数据;和
关于何时所述至少一个存储器装置已被所述外科器械外部的装置访问的至少一个数据。
2.根据权利要求1所述的钉仓,还包括安装到所述仓体的电触头,其中,所述电触头与所述至少一个存储器装置连通。
3.根据权利要求1所述的钉仓,还包括处理器,其中,所述处理器被配置为能够对存储在所述至少一个存储器装置中的所述至少一个数据进行加密。
4.根据权利要求3所述的钉仓,其中,所述处理器被配置为能够在所述处理器设置有解密密钥时解密所述至少一个数据。
5.根据权利要求4所述的钉仓,其中,所述处理器被配置为能够在所述解密密钥不正确的情况下锁定对所述加密的至少一个数据的访问,其中所述处理器被配置为能够在所述处理器设置有解锁密钥时解锁对所述加密的至少一个数据的访问,并且其中所述解锁密钥不同于解密密钥。
6.一种缝合系统,包括:
缝合器械;
钉仓,所述钉仓用于与所述缝合器械一起使用,所述钉仓包括:
仓体,所述仓体包括近侧端部、远侧端部和钉腔;
钉,所述钉以可移除方式储存在所述钉腔中;
滑动件,所述滑动件能够在钉击发行程期间朝向所述远侧端部移动,以将所述钉从所述钉腔射出;
传感器,所述传感器被配置为能够检测所述滑动件的位置;和
至少一个存储器装置,所述至少一个存储器装置与所述传感器连通,其中所述至少一个存储器装置被配置为能够存储:
指示所述钉击发行程是否已被执行的至少一个数据;
关于执行所述钉击发行程的时间和日期的至少一个数据;
关于用于击发所述钉仓的所述外科器械的至少一个数据;和
关于何时所述至少一个存储器装置已被所述外科器械外部的装置访问的至少一个数据。
7.根据权利要求6所述的缝合系统,还包括安装到所述仓体的电触头,其中,所述电触头与所述至少一个存储器装置连通。
8.根据权利要求6所述的缝合系统,还包括处理器,其中,所述处理器被配置为能够对存储在所述至少一个存储器装置中的所述至少一个数据进行加密。
9.根据权利要求8所述的缝合系统,其中,所述处理器被配置为能够在所述处理器设置有解密密钥时解密所述至少一个数据。
10.根据权利要求9所述的缝合系统,其中,所述处理器被配置为能够在所述解密密钥不正确的情况下锁定对所述加密的至少一个数据的访问,其中所述处理器被配置为能够在所述处理器设置有解锁密钥时解锁对所述加密的至少一个数据的访问,并且其中所述解锁密钥不同于解密密钥。
11.根据权利要求9所述的缝合系统,其中,所述缝合器械包括钉击发驱动装置,所述钉击发驱动装置包括能够操作以生成所述钉击发行程的电动马达,并且其中所述解密密钥是在所述钉击发行程期间从所述电动马达的操作导出的。
12.根据权利要求9所述的缝合系统,其中,所述解密密钥是从所述钉击发行程结束时所述滑动件的位置导出的。
13.根据权利要求9所述的缝合系统,其中,所述解密密钥是静态的。
14.根据权利要求9所述的缝合系统,其中,所述解密密钥是动态的。
15.一种用于与外科器械一起使用的钉仓,包括:
仓体,所述仓体包括近侧端部、远侧端部和钉腔;
钉,所述钉以可移除方式储存在所述钉腔中;
滑动件,所述滑动件能够在钉击发行程期间朝向所述远侧端部移动,以将所述钉从所述钉腔射出;
传感器,所述传感器被配置为能够检测所述滑动件的位置;和
至少一个存储器装置,所述至少一个存储器装置与所述传感器连通,其中所述至少一个存储器装置被配置为能够存储数据;和
处理器,所述处理器被配置为能够加密存储在所述至少一个存储器装置中的所述数据,其中所述处理器被配置为能够在所述处理器设置有解密密钥时解密所述数据。
16.根据权利要求15所述的钉仓,其中,所述解密密钥是从所述钉击发行程结束时所述滑动件的位置导出的。
17.根据权利要求15所述的钉仓,其中,所述解密密钥是动态的。
18.根据权利要求15所述的钉仓,其中,所述解密密钥是从用于生成所述钉击发行程的电动马达的性能数据导出的。
19.根据权利要求15所述的钉仓,还包括组织传感器,所述组织传感器被配置为能够检测在所述钉击发行程期间被缝合的患者组织的性质,其中所述组织传感器与所述处理器连通,并且其中所述解密密钥是从来自所述组织传感器的数据导出的。
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PCT/IB2022/051593 WO2022180541A2 (en) | 2021-02-26 | 2022-02-23 | Staple cartridge comprising an information access control system |
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-
2021
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- 2022-02-23 WO PCT/IB2022/051593 patent/WO2022180541A2/en active Application Filing
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US11950777B2 (en) | 2024-04-09 |
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US20220273304A1 (en) | 2022-09-01 |
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