JP2017000808A - 電気式手術器具 - Google Patents
電気式手術器具 Download PDFInfo
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- JP2017000808A JP2017000808A JP2016172810A JP2016172810A JP2017000808A JP 2017000808 A JP2017000808 A JP 2017000808A JP 2016172810 A JP2016172810 A JP 2016172810A JP 2016172810 A JP2016172810 A JP 2016172810A JP 2017000808 A JP2017000808 A JP 2017000808A
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- surgical instrument
- motor
- staple
- anvil
- switch
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
-
- 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
- A61B90/90—Identification means for patients or instruments, e.g. tags
- A61B90/98—Identification means for patients or instruments, e.g. tags using electromagnetic means, e.g. transponders
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00137—Details of operation mode
- A61B2017/00154—Details of operation mode pulsed
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
- A61B2017/00482—Coupling with a code
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00734—Aspects not otherwise provided for battery operated
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2923—Toothed members, e.g. rack and pinion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2943—Toothed members, e.g. rack and pinion
-
- 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
-
- 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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0803—Counting the number of times an instrument is used
-
- 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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0804—Counting number of instruments used; Instrument detectors
- A61B2090/0806—Instrument detectors with a removable part, e.g. working tip
-
- 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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
-
- 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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
- A61B2090/0811—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
-
- 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
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- H—ELECTRICITY
- H01—ELECTRIC ELEMENTS
- H01M—PROCESSES OR MEANS, e.g. BATTERIES, FOR THE DIRECT CONVERSION OF CHEMICAL ENERGY INTO ELECTRICAL ENERGY
- H01M10/00—Secondary cells; Manufacture thereof
- H01M10/05—Accumulators with non-aqueous electrolyte
- H01M10/052—Li-accumulators
- H01M10/0525—Rocking-chair batteries, i.e. batteries with lithium insertion or intercalation in both electrodes; Lithium-ion batteries
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- H—ELECTRICITY
- H01—ELECTRIC ELEMENTS
- H01M—PROCESSES OR MEANS, e.g. BATTERIES, FOR THE DIRECT CONVERSION OF CHEMICAL ENERGY INTO ELECTRICAL ENERGY
- H01M10/00—Secondary cells; Manufacture thereof
- H01M10/42—Methods or arrangements for servicing or maintenance of secondary cells or secondary half-cells
- H01M10/46—Accumulators structurally combined with charging apparatus
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- H01—ELECTRIC ELEMENTS
- H01M—PROCESSES OR MEANS, e.g. BATTERIES, FOR THE DIRECT CONVERSION OF CHEMICAL ENERGY INTO ELECTRICAL ENERGY
- H01M16/00—Structural combinations of different types of electrochemical generators
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- H—ELECTRICITY
- H01—ELECTRIC ELEMENTS
- H01M—PROCESSES OR MEANS, e.g. BATTERIES, FOR THE DIRECT CONVERSION OF CHEMICAL ENERGY INTO ELECTRICAL ENERGY
- H01M6/00—Primary cells; Manufacture thereof
- H01M6/14—Cells with non-aqueous electrolyte
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02E—REDUCTION OF GREENHOUSE GAS [GHG] EMISSIONS, RELATED TO ENERGY GENERATION, TRANSMISSION OR DISTRIBUTION
- Y02E60/00—Enabling technologies; Technologies with a potential or indirect contribution to GHG emissions mitigation
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Abstract
Description
・電源オン
・ホームポジションを確認し、必要/所望の場合にホームポジションへ移動
・伸長/収縮ボタンをエネイブル(点灯)にし、ステープル射出ボタンをディセーブル(消灯)にする
・ステープル射出ボタンを完全に伸ばした(アンビルが取り去られた)後にのみエネイブルにし、伸長/収縮ボタンをエネイブルにしたままその後収縮させる。
・ステープル射出ボタンの作動時、フォーススイッチが作動するまでアンビルを引き戻す。
・ボタンLEDの点滅により秒読みを開始し、射出サイクルが切迫するごとに点滅速度を速くする。継続的にフォーススイッチを監視し、アンビルを引き戻してフォーススイッチが作動したままとする。
・ステープル射出サイクルの間は、どのボタン押下もステープル射出ルーチンを打ち切る。
・ステープル射出モータの作動前に打ち切りが生じたら、射出サイクルは停止し、アンビルがホームポジションに伸ばされ、ステープル射出ボタンはアクティブのままで再発射可能となる。
・あるいは、射出モータの作動時に打ち切りが生じたら、射出サイクルは停止し、射出モータは引き戻され、アンビルがホームポジションに戻り、射出ボタンは非アクティブとなる。したがって、ステープラ(またはステープルカートリッジ)は使用不可となる。
・射出の秒読みが終了したら、ステープル範囲制限スイッチの位置が確認される。ステープル範囲制限スイッチが作動したら、それはアンビルが良好なステープル射出範囲にあることを意味し、ステープル射出モータが作動して射出サイクルが進められる。ステープル範囲制限スイッチが作動しない場合、射出サイクルは打ち切られ、アンビルはホームポジションに戻り、ステープル射出ボタンはアクティブのままで再発射可能となる。
・ステープル射出が完了したら、アンビルは閉じ位置に維持され、伸長ボタンのみがアクティブのままとなる。アンビルが少なくともホームポジションまで伸びたら、伸長ボタンと収縮ボタンの双方をアクティブにする。ステープル射出ボタンは、ステープル射出が完了したら非アクティブに維持される。
’8−3−06
’Modified program to abort with only fire button, added pbcount variable
’Added PWM ramping
’7−28−06
’final tweaks − stan is now an integer etc.
’7−17−06 This version written for the 3c board.
’7−14 DEBUGGING VERSION
’Program written for 3c board using the Cubloc 280 chipset
’Note: this program is a modified version of the ones noted below. All changes not related to the addition of the E/R limit switches
’apply. The programs below were written to deal with the ”gray logic” of the 1 cm switch. This version uses
’a limit switch at either end of the extend/retract stage.
’V6.20 Final Version of Gray Logic program as used in prototype 0, serial number 100
’V6.05
’modified the extend to cm 1 and retract to cm 1 routines to make sure that when they are called that they move the motor until the cm
’switch is closed; ie: When the anvil is all the way out and the retract button is pressed, retract the anvil until the cm limit switch
’is closed regardless of whether the retract button is released before the cm switch is closed. Same change for when the anvil is ’extended from the 1 cm position,
’made changes to comments in the extend/retract routines
’V6.02
’added loop requiring the release of both buttons to exit jog routine, and a 1 second delay at the end of jog subroutine before
’going back to main routine
’reformatted datadump labels
’added variables for high and low speed pwm values
’added extend only capability at end of completed fire to prevent crushing stapled tissue
’NOT WORKING− REMOVED added checks To ensure 1 cm switch Is made when extending Or retracting from the 1 cm And fully extended positions respectively
’V6.01
’All prior versions were made for testing the program on the Cubloc development board. All outputs were pulled LOW. The actual device
’requires all the outputs to be pulled high (+5V). This version is set−up to run on the actual device.
’limited the values of the EEPROM data to 255 max
’added delays before changes in motor direction, made program run smoother
’removed pwmoff commands. They were not allowing the motors to stay on when changing subroutines (for some reason)
’V5.27 ’added the recording of jog routine button presses
’added the recording of datadump requests
’V5.26
’added the recording of Extend/Retract button presses
’added serial number field in eeprom
’the datadump routine now keeps running total of data as it is read from eeprom
’V5.25 (circular−staρler−5−25.cul)
’added code to allow storage of data each power on cycle in eeprom
’V5.24 works well, no known bugs (circular−stapler−5−24.cul)
’KMS Medical LLC (c) 2006
’MAP
’P10 Extend Button
’P11 Retract Button
’P12 Fire Button
’P13 Extend Limit
’P14 Retract Limit
’P15 Fire Forward Limit
’Pl6 Fire Back Limit
’P17 1 cm Limit Switch
’P18 Staple Range Limit Switch
’P19 Force Switch
’P20 Extend Button LED
’P21 Retract Button LED
’P22 Fire Button LED
’P23 Force LED (blue)
’P24 Not USED
’P25 Not USED
’P26 Not USED
’P27 Not USED T28 Not USED
’P29 Staple Range LED (green)
Const Device=cb280 ’Comfile Tech. Cubloc CB280 chipset
Dim ver As String*7
ver=”3C−8.03” ’set software version here
Dim extendbutton As Byte
Dim retractbutton As Byte
Dim firebutton As Byte
Dim firstout As Byte
Dim firstback As Byte Dim cmstatus As Byte ’lcm limit switch status
Dim srstatus As Byte ’staplerange limit switch status
Dim x As Integer
Dim powerons As Byte ’store in eeprom address 2
Dim cycnumf?res As Byte ’store in eeprom (powerons* 5)
Dim cycabortfires As Byte ’store in eeprom (powerons*5)+l
Dim cycers As Byte ’store in eeprom, number of cycle extend/retract presses
Dim cycjogs As Byte
Dim arm As Byte
Dim completefire As Byte Dim staplerangestatus As Byte
Dim bail As Byte
Dim ds As Integer ’eeprom data start location for individual cycle data writing
Dim fast As Integer
Dim slow As Integer Dim extendonly As Byte
Dim extlimit As Byte
Dim retlimit As Byte
Dim speed As Integer
Dim dracula As Byte
’initalize outputs
Out 20,0 ’extend button LED
Out 21,0 ’retract button led
Out 22,0 ’fire button led
Out 23,0 ’force led
Out 29,0 ’staple range led
’initialize variables
firstout=0
firstback=0
completefire=0
arm=0
bail=0
cycnumfires=0
cycabortfires=0
cycers=0
cycjogs=0
extendonly=0
’CHANGE PWM VALUES HERE
fast=60000 ’highspeed pwm value
slow=60000 ’lowspeed pwm value
speed=0
Output 5 ’turns on pwm output for PINCH
Output 6 ’turns on pwm output for FIRE
’read totals from eeprom
powerons=Eeread(2, 1 )
Incr powerons ’increment total power on number
If powerons>=255 Then powerons=255 limit number of recorded powerons to an integer of one byte max
Eewrite 2,powerons,l ’write total power on number to eeprom
ds=powerons*5
’JOG and DATADUMP Check
’push any button within 2 (or so) seconds to go to jog routine
’hold all three buttons on at startup to dump the data
For x=l To 50
If Keyin(10,20)−0 And Keyin(l l,20)=0 And Keyin(12,20)=0 Then datadump ’write all stored data to the debug screen
Exit For
Elseif Keyin(10,20)=0 Or Keyin(l 1,2O)=O Or Keyin(12,20)=0 Then ’either e/r button or the fire button pressed
jog
Exit For
End If
Delay 20
Next
’ホーミングシーケンス
cmstatus=Keyin(17,20) ’read the status of the lcm limit switch
If cmstatus=0 Then
homeretract
Elseif cm status=l Then
homeextend
End If
’Return fire motor to back position
homefire ’this returns the fire motor to the full retracted condition (P6 limit switch)
**********
’メインループ
**********
Do
’Debug ”Main Loop”,Cr
’Delay 1000
cmstatus=Keyin( 17,20) ’read the 1 cm switch
’staplerangestatus=Keyin(5,20) ’read the staplerange limit switch
extendbutton=Keyin( 10,20)
retractbutton=Keyin(l 1 ,20)
firebutton=Keyin(12,20)
If cmstatus=0 And Keyin(13,20)<>0 Then
Out 20,1 ’turn extend led on
Out 21,1 ’turn retract led on
Elseif cmstatus=0 And Keyin(l 3,2O)=O Then
Out 20,0 ’turn off extend led because extend limit met
Out 21,1 ’turn on retract limit
Elseif cmstatus=l Then
Out 20,1
Out 21,0
End If
’check firebutton led status
If firstout=l And firstback=l And arm=l And completef?re<>l And cmstatus<>0 Then
Out 22,1 ’turn on fire button led
Else
Out 22,0 ’turn off fire led
End If
’check for extend retract button press
If extendbutton=0 And cmstatus=0 Then
extend
Elseif cmstatus=l And extendbutton=0 Then
extend
End If
If retractbutton=0 And cmstatus=0 Then ’And extendonly=0
retract
End If
’check for firebutton press
If firebutton=0 And firstout=l And firstback=l And arm=l And completefire<>l And cmstatus<>0 Then initialfire
Loop ’keep looping til powerdown
End ’End of program
************
サブルーチン
************
’ホーム:cmスイッチまで引き戻す=押下なし
Sub homeretract() ’retract until 1 cm switch is open
’Debug ”Homeretract”,Cr
’Delay 1000
Pwm 0,slow,60000
Do Until Keyin(17,20)=l ’retract until 1 cm switch is open
Out 31,1 ’ER motor reverse
Loop
Out 31,0 ’er motor off
Out 21 ,0 ’turn retract led Off
Out 20,1 ’turn extend led On
Pwmoff 0 ’turn pwm off
End Sub
’
’ホーム:cmスイッチまで伸長=押下あり
Sub homeextend() ’extend until 1 cm switch is closed
’Debug ’Ηomextend”,Cr
’Delay 1000
Pwm 0,slow,60000
If Keyin(17,20)=l Then
Do Until Keyin(17,20)=0 ’now the 1 cm switch is pressed
Out 30, l ’ER motor forward DDD
Loop
End If
Out 30,0 1DDD
Pwmoff O Delay 300
homeretract ’once the switch is made, call homeretract
End Sub
’射出モータホーミングルーチン
Sub homefire()
’Debug ”Homefire”,Cr
’Delay 1000
Pwm l,slow,60000
Do Until Keyin(16,20)=0 ’retract firing stage until back switch is closed
Out 33,1
Loop
Out 33,0 Pwmoff 1
End Sub
’JOG ルーチン ’
Sub jog()
Out 20,1
Out 21,1
Do
Delay 25
If Keyin(10,20)=0 And Keyin(l 1,2O)=O Then Exit Do ’if both buttons pressed, exit jog routine and start homing routine after 1 second delay
If Keyin(10,20)=0 And Keyin(l 1 ,20)<>0 And Keyin(12,20)<>0 Then
Pwm 0,slow,60000
Out 30,1 ’extend motor forward
Do Until Keyin(10,20)<>0 Or Keyin(13,20)=0
Out 30,1 ’extend motor on forward DDD
Loop
Out 30,0 ’extend motor off forward DDD
Pwmoff 0
Incr cycjogs
If cycjogs>=255 Then cycjogs=255
Eewrite ds+3,cycjogs,l
End If
If Keyin(l 1,2O)=O And Keyin(10,20)<>0 And Keyin(12,20)<>0 Then
Pwm 0,slow,60000
Do Until Keyin(l l,20)<>0 Or Keyin(14,20)=0
Out 31,1 ’extend motor reverse
Loop
Out 31,0 ’extend motor off reverse
Pwmoff0
Incr cycjogs
If cycjogs>=255 Then cycjogs=255 Eewrite ds+3,cycjogs,l
End If
If Keyin(12,20)=0 And Keyin(10,20)=0 Then ’jog the fire motor forward
Pwm l,slow,60000
Do Until Keyin(l 0,20)<>0 Or Keyin(12,20)<>0 Or Keyin(15,20)=0
Out 32,1 ’fire motor forward
Loop
Out 32,0 ’fire motor off forward
Pwmoff 1
Incr cycjogs
If cycjogs>=255 Then cycjogs=255
Eewrite ds+3,cycjogs,l
End If
If Keyin(12,20)=0 And Keyin(l 1,2O)=O Then ’jog the fire motor reverse
Pwm l,slow,60000
Do Until Keyin(l l,20)<>0 Or Keyin(12,20)<>0 Or Keyin(16,20)=0
Out 33,1 ’fire motor reverse Loop
Out 33,0 ’fire motor off reverse
Pwmoff 1
Incr cycjogs
If cycjogs>=255 Then cycjogs=255
Eewrite ds+3,cycjogs,l
End If
Loop
Do Until Keyin(l 0,2O)=I And Keyin(l 1 ,2O)=I ’let off both buttons before exiting jog routine
Delay 10
Loop
Out 20,0 ’turn on e/r button leds
Out 21,0
Delay 1000
End Sub
’伸長制限を満たすまで伸長する
Sub extend()
Out 22,0 ’turn off fire button led while extending
Out 21,0 ’turn off retract button led while extending
Pwm 0,fast,60000
Do Until Keyin(l0,20)=1 Or Keyin(l3,20)=0 ’extend until either the extend limit is closed or the extend button is released
Out 30,1 ’ER motor forward DDD
Loop
Out 30,0 ’DDD
If firstout=0 Then ’this will keep the extend motor going on the first extension until the anvil is all the way out
Do Until Keyin(l3,20)=0
Out 30,l ’DDD
Loop
End If
Out 30,0 ’DDD
Pwmoff 0
Incr cycers
If cycers>=255 Then cycers=255
Eewrite ds+2, cycers, 1
If Keyin(l3,20)=0 Then firstout=l ’set the firstout flag to enable fire button
Out 20,0 ’turn off extend led
End If
End Sub
’cmスイッチが開になるまで収縮
Sub retract()
Out 22,0 ’turn off fire button led while retracting
Out 20,0 ’turn off extend button led while retracting
Pwm 0,fast,60000
Do Until Keyin(l1,20)=1 Or Keyin(17,20)=l ’retract until either the lcm switch goes open or the extend button is released
Out 31,1 ’ER motor reverse
Loop
Out 31,0
Pwmoff 0
Incr cycers
If cycers>=255 Then cycers=255
Eewrite ds+2, cycers, 1
If Keyin(17,20)=l Then
firstback=l
Out 21,0 ’turn retract led off
End If
If firstout=l And firstback=l Then arm=l ’set the arm flag to arm the fire button
End Sub
’DATADUMP ルーチン
Sub datadump()
Dim chef As Byte
Dim tf As Byte ’total fires
Dim ta As Byte ’total aborts
Dim ers As Integer
Dim tj As Byte
Dim tdd As Byte
Dim stan As Integer
Dim kyle As Byte
Dim token As Byte
Dim ike As Byte
Dim kenny As Byte
Dim sn As Byte
tf=0
ta=0
ers=0
tj=0
tdd=0
Eewrite ds+4,1,1 ’write 1 to the ds+4 eeprom register denoting that datadump was accessed
Delay 1000 sn=Eeread(0,l)
Debug ”Circular Stapler Stored Data”,Cr
Debug ”Version ”,ver,Cr
Debug ”KMS Medical LLC5Cr
Debug ”−−−−−−−−−−−−−−−−−−−−−−−”;Cr
Debug Cr
Debug ”Serial Number: ”,Dec sn,Cr
powerons=Eeread(2, 1 )
If powerons>=255 Then powerons=255
Debug ”Total Cycles: ”,Dec powerons,Cr
Debug Cr
Debug ”−−−−−−−−−−−−−−−−−−−−−−−−−−−−”,Cr
Debug Cr
For stan=5 To (powerons*5) Step 5
Debug ”Cycle ”,Dec (stan/5),Cr
Debug ”−−−−−−−−−−−−−−−−−−−−−−−−−−−−−”,Cr
chef=Eeread(stan, 1 )
tf=chef+tf
Debug ”Completed Fires: ”,Dec chef,Cr
kyle=Eeread(stan+ 1,1)
ta=kyle+ta
Debug ”Aborted Fires: ”,Dec kyle,Cr
token=Eeread(stan+2 , 1 )
ers=token+ers
Debug Ε/Rs: ”,Dec token,Cr
ike=Eeread(stan+3 , 1 )
tj=ike+tj
Debug ”Jogs: ”,Dec ike,Cr
kenny=Eeread(stan+4, 1 )
tdd=kenny+tdd
Debug ”Datadumps: ”,Dec kenny,Cr
Debug Cr
Next ’stan
Debug ”−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−”,Cr
Debug ”Cycle Totals”,Cr
Debug Cr
Debug ”Completed Fires: ”,Dec tf,Cr
Debug ”Aborted Fires: ”,Dec ta,Cr
Debug ”E/R Presses: ”,Dec ers,Cr
Debug ”Jog Presses: ”,Dec tj,Cr
Debug ”Datadumps: ”,Dec tdd,Cr
Debug Cr
Delay 1000
For x=l To tfblink the number of completed firing cycles
Out 22,1
Delay 500
Out 22,0
Delay 500
Next ’x
Do Until Adin(0)>800 And Keyin(3,20)=l ’wait until datadump buttons are released
Loop
End Sub
’最初の射出
Sub initialfire()
Dim f As Integer
Dim p As Integer
Dim t As Integer
Dim y As Integer
Dim z As Integer
Dim q As Integer
Dim timmy As Integer
Dim butter As Integer
Dim numblinks As Integer
Dim fbcount As Integer
Debug clr,Cr
’turn off extend and retract buttons to show that they are not active for abort?
Out 20,0 ’extend button
Out 21,0 ’retract button
bail=0
t=15 ’total blink time
p=3 ’number of blink periods
Pwm 0,fast,60000
’start blink and adjust pinch motor to force
f=(t*1000)/p
fbcount=0
If Keyin(12,20)=l Then fbcount=l
For y=l To p
numblinks= (t*y)/p
For z=l To numblinks
timmy=f/numblinks
butter=timmy/50 ’calibrate this to seconds
If timmy=0 Then timmy=l
If Keyin(12,20)=0 And fbcount=l Then
bail=l ’set abortfire flag
Exit For
End If
If Keyin(12,20)=l Then fbcount=l
Do Until Keyin(19,20)=0 Or Keyin(14,20)=0 ’retract until force switch met or retract limit met
Out 31,1
If Keyin(12,20)=0 And fbcount= 1 Then
bail=l ’set abortfire flag
Exit Do
End If
If Keyin(12,20)=l Then fbcount=l
Loop
If baiM Then Exit For
Out 31,0
Out 23,1 ’force led
Out 22,1 ’fire button led
For q=0 To butter
Delay 10
If Keyin(12,20)=0 And fbcount=l Then
bail=l ’set abortfire flag
Exit For
End If
If Keyin(12,20)=l Then fbcount=l
If Keyin(19,20)=l Then Out 23,0
Next ’q
If bail=l Then Exit For
Do Until Keyin(19,20)=0 Or Keyin(14,20)−0 ’retract until force switch met
Out 31,1
If Keyin(12,20)=0 And fbcount=l Then
bail=l ’set abortfire flag
Exit Do
End If
IfKeyin(12,20)=l Then fbcount=l
Loop
Out 31,0
Out 23,1
If Keyin(12,20)=0 And fbcount=l Then
bail=l ’set abortfire flag
Exit For
End If
If Keyin( 12,20)= 1 Then fbcount= 1
Out 22,0
For q=0 To butter
Delay 10
If Keyin(12,20)=0 And fbcount=l Then
bail=l ’set abortfire flag
Exit For
End If
If Keyin(12,20)=l Then fbcount=l
If Keyin(l9,20)=1 Then Out 23,0
Next ’q
If bail=l Then Exit For
Next ’z
’Debug Dec? fbcount,Cr
If bail=l Then Exit For
Next ’y
Pwmoff 0
If bail=l Then
abortfire
Else
’staplerangecheck
finalfire
End If
End Sub
’ステープル範囲確認ルーチン
Sub staplerangecheck()
srstatus=Keyin(29,20) ’read the staplerange limit switch
If srstatus=0 Then
finalfire
Else
abortfire
End If
End Sub
’最終射出ルーチン
Sub finalfire()
Out 23,0 ’turn force led off
Out 20,0 ’turn extend led off
Out 21,0 ’turn retract led off
Out 22,1 ’Turn on fire led to signify final fire abort ready
Pwmoff 1
’Pwm l,fast,60000
’Out 32,1 ’fire motor forward DDD
completefire=l
Do Until Keyin( 15,20)^0 ’fire forward until forward limit is met
If speed>=60000 Then speed=60000
If speed<60000 Then
speed=speed+10000
End If
Pwm l,speed,60000
Out 32,1
Delay 50
If Keyin(12,20)=0 Then Or Keyin(10,20)=0 Or Keyin(l1,20)=0
bail=l
Exit Do
End If
Loop
Out 32,0 ’fire motor fwd off DDD
speed=0
Delay 250
Do Until Keyin(16,20)=0 ’retract fire motor
If speed>=60000 Then speed=60000
If speed<60000 Then
speed=speed+10000
End If
Pwm l,speed,60000
Out 33,1
Delay 50
Loop
speed=0
Out 33,0
Pwmoff l
Out 22,0 ’turn fire led off
Out 21,0 ’turn off retract led
extendonly=l
Incr cycnumfires
If cycnumfires>=255 Then cycnumfires=255
Eewrite ds,cycnumfires,l ’write the current cycle number of fires to the eeprom
Delay 200
End Sub ’return to the main routine
’射出打ち切り
Sub abortfire()
’Debug ”Fire aborted before firing! !”,Cr
Out 31 ,0 ’turn retract motor off
Out 32,0 ’turn fire forward off DDD
Out 23,0 ’turn force led off
Pwm l,fast,60000
Delay 250
Do Until Keyin(l 6,2O)=O ’retract fire motor
Out 33,1
Loop
Out 33,0
Pwmoff 1 Out 22,0 ’turn fire led off
Incr cycabortfires
If cycabortfires>=255 Then cycabortfires=255
Eewrite ds+1, cycabortfires, 1 ’write the current cycle abortfires to the eeprom
Delay 200
homeextend ’extend to lcm
End Sub
1)約3秒以内で約60mm(〜2.4”)のストロークに約54.5kg(120ポンド)をかける、
2)約8秒以内で約60mm(〜2.4”)のストロークに約82kg(180ポンド)をかけるものである。
本発明の電気駆動式ハンドヘルド型手術用線形ステープル装置は、後述するように新規な方法で最適化され、これらの要求を満たすことができる。
・セル内の電解質の種類
・電解質の濃度および化学組成
・陽極と陰極がどうやって作られているか(化学的あるいは機械的構造の両方)
・PTC(抵抗の正温度係数)装置の種類と構造
これらの特性の1またはそれ以上を試験すると、ステープル装置への使用に最も望ましい電池を選択するのに価値ある情報を与えてくれる。最後の特性、すなわちPTC装置の動作の試験により、望む作業を行う電池種類の最適化が実現する。
・4x1電池パックでは、約2.5アンペア、約8ボルトで、負荷を約0.6IPSで駆動した。
・6x1電池パックでは、約2.5アンペア、約13ボルトで、負荷を約0.9IPSで駆動した。
・3x2電池パックでは、約2.5アンペア、約6ボルトで、負荷を約0.4IPSで駆動した。
180#負荷について、
・4x1電池パックでは、約4アンペア、約7.5ボルトで、負荷を約0.65IPSで駆動した。
・6x1電池パックでは、約4アンペア、約12ボルトで、負荷を約0.9IPSで駆動した。
・3x2電池パックでは、約4アンペア、約7ボルトで、負荷を約0.4IPSで駆動した。
(60rpm−>1回転/秒(rps);1rps@0.8IPR−>0.8インチ/秒)
このような理想化されたケースでは、速度に対してIPRをプロットすると、真っ直ぐな線が出来上がる。固定の距離に対する速度は、さらに射出時間まで低減することができる。したがって、IPRに対する射出時間のプロットもこの理想的なケースでは真っ直ぐな線となる。しかしながら、モータの出力(rpm)と、それ故ギアボックスの出力は、負荷によって変化するため一定ではない。負荷の程度により、モータが出力しうる出力量が決定される。負荷が増えると、rmpが減り効率が変化する。負荷を変化させた効率試験によると、効率のピークは丁度60%以上と判明している。しかしながら、このピーク効率における対応する電圧とアンペアは、出力のピーク時点と同じではない。負荷が増大するのに伴い、電力の増加速度より効率の定価が早くなるまで電力は増え続ける。IPRが増大すると、速度が増加することが見込まれるが、IPRの増加に対応して機械的利益は低くなり、したがって負荷が増大する。この負荷が増大すると、段々増える高い負荷に応じて効率が落ちることは、IPRが大きくなってもラックからの出力速度が大きくならなくなる点が存在することを意味する。この性質は、IPRに対する射出時間(秒)のプロットにおける予測される真っ直ぐな線からの偏向として反映される。本発明のシステムの実験は、不要な機械的利益と不十分な機械的利益が約0.4IPRで生じることを示している。
。この構成により、ステープラの動作は前進リミットまでの一度のストロークと、後進リミットまでの一度の引き戻しに限定される。両方が起こった場合、モータMは2つのスイッチ1320がリセットされるまで使用不能となる。
Claims (20)
- 手術器具であって、
互換部品を脱着可能に受けうる受け部を有し、前記受け部が通信接続部を有する手術用エンドエフェクタと、
前記手術用エンドエフェクタに接続され、制御部を有し、当該制御部は前記通信接続部と電気的に接続され、電源を有する、ハンドルと、
前記受け部に脱着可能に連結されるよう形成され、前記通信接続部に電気的に脱着可能に連結された暗号化装置を有し、前記受け部にあるときに前記電源から電力供給される、互換部品と、
を具えることを特徴とする手術器具。 - 請求項1に記載の手術器具において、前記ハンドルは、前記エンドエフェクタを作動可能であることを特徴とする手術器具。
- 請求項1に記載の手術器具において、前記暗号化装置は、前記互換部品が前記受け部にあるときに当該互換部品を認証するようプログラムされていることを特徴とする手術器具。
- 請求項3に記載の手術器具において、前記制御部は、前記互換部品を認証可能であることを特徴とする手術器具。
- 請求項1に記載の手術器具において、前記暗号化装置が、マイクロプロセッサを具えることを特徴とする手術器具。
- 請求項5に記載の手術器具において、
1本の配線が、前記通信接続部と前記制御部との間の電気接続を構成し、
前記暗号化装置が1配線装置であり、当該1配線によって前記電源から電力供給され、前記1配線を通して前記制御部とデータを送受信することを特徴とする手術器具。 - 請求項6に記載の手術器具において、前記暗号化装置と前記制御部がアースを共用することを特徴とする手術器具。
- 請求項6に記載の手術器具において、前記制御部が、前記マイクロプロセッサと前記1配線を通して接続された第2のマイクロプロセッサを有する回路基板を具えることを特徴とする手術器具。
- 請求項4に記載の手術器具において、
前記互換部品は、前記受け部への着座位置と、前記受け部に対する非着座位置とを有し、
前記互換部品が前記着座位置にあるときにのみ前記暗号化装置と前記通信接続部の間の電気接続が生じて前記互換部品の認証が可能となることを特徴とする手術器具。 - 手術器具であって、
互換部品を脱着可能に受けうる受け部を有し、前記受け部が通信接続部を有する手術用エンドエフェクタと、
前記手術用エンドエフェクタに接続され、制御部を有し、当該制御部は前記通信接続部と電気的に接続され、電源を有する、ハンドルと、
前記受け部に脱着可能に接続されるよう形成された互換部品であって、前記通信接続部に脱着可能に接続された1配線の暗号化装置を有し、前記受け部にあるときに前記電源から電力供給される互換部品と、
を具えることを特徴とする手術器具。 - 請求項10に記載の手術器具において、前記ハンドルは、前記エンドエフェクタを作動可能であることを特徴とする手術器具。
- 請求項10に記載の手術器具において、前記1配線の暗号化装置は、前記互換部品が前記着座位置にあるときに前記互換部品を認証するようプログラムされていることを特徴とする手術器具。
- 請求項12に記載の手術器具において、前記制御部は、前記互換部品を認証可能であることを特徴とする手術器具。
- 請求項10に記載の手術器具において、前記1配線の暗号化装置が、マイクロプロセッサを具えることを特徴とする手術器具。
- 請求項14に記載の手術器具において、
1本の配線が、前記通信接続部と前記制御部との間の電気接続を構成し、
前記1配線の暗号化装置が、前記1本の配線によって前記電源から電力供給され、前記1本の配線を通して前記制御部とデータを送受信することを特徴とする手術器具。 - 請求項15に記載の手術器具において、前記1配線の暗号化装置と前記制御部とがアースを共用することを特徴とする手術器具。
- 請求項16に記載の手術器具において、前記制御部が、前記マイクロプロセッサと前記1本の配線を通して接続された第2のマイクロプロセッサを有する回路基板を具えることを特徴とする手術器具。
- 請求項13に記載の手術器具において、
前記互換部品は、前記受け部への着座位置と、前記受け部に対する非着座位置とを有し、
前記互換部品が前記着座位置にあるときにのみ前記1配線の暗号化装置と前記通信接続部の間の電気接続が生じて前記互換部品の認証が可能となることを特徴とする手術器具。 - 手術器具であって、
互換部品を脱着可能に受けうる受け部を有し、前記受け部が通信接続部を有する手術用エンドエフェクタと、
前記手術用エンドエフェクタに接続され、電源と制御部とを有し、当該制御部は前記通信接続部と電気的に接続される第1のマイクロプロセッサを有する、ハンドルと、
前記受け部に脱着可能に連結されるよう形成された互換部品であって、前記通信接続部に電気的に脱着可能に連結された暗号化装置を有し、当該暗号化装置は前記互換部品が前記受け部にあるときに前記第1のマイクロプロセッサと前記互換部品を暗号方式で認証するようプログラムされた第2のマイクロプロセッサを具える、互換部品と、
を具えることを特徴とする手術器具。 - 請求項19に記載の手術器具において、
1本の配線が、前記通信接続部と前記第1のマイクロプロセッサとの間の電気接続を構成し、
前記暗号化装置が1配線装置であり、当該1配線によって前記電源から電力供給され、前記1配線を通して前記制御部とデータを送受信することを特徴とする手術器具。
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US60/858,112 | 2006-11-09 | ||
US11/705,246 US8028885B2 (en) | 2006-05-19 | 2007-02-12 | Electric surgical instrument with optimized power supply and drive |
US11/705,334 US8573462B2 (en) | 2006-05-19 | 2007-02-12 | Electrical surgical instrument with optimized power supply and drive |
US11/705,246 | 2007-02-12 | ||
US11/705,381 US8038046B2 (en) | 2006-05-19 | 2007-02-12 | Electrical surgical instrument with optimized power supply and drive |
US11/705,381 | 2007-02-12 | ||
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US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
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JP7291667B2 (ja) | 2023-06-15 |
EP3192463A1 (en) | 2017-07-19 |
JP2017070759A (ja) | 2017-04-13 |
JP6045048B2 (ja) | 2016-12-14 |
EP2842500B1 (en) | 2020-09-09 |
EP2842500A1 (en) | 2015-03-04 |
JP6231174B2 (ja) | 2017-11-15 |
JP2020179176A (ja) | 2020-11-05 |
JP2018033980A (ja) | 2018-03-08 |
JP2015178018A (ja) | 2015-10-08 |
EP3181063A1 (en) | 2017-06-21 |
JP6798857B2 (ja) | 2020-12-09 |
JP6676024B2 (ja) | 2020-04-08 |
EP3181063B1 (en) | 2019-09-11 |
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