JP2021509309A - Surgical instruments with flexible circuits - Google Patents

Abstract

The flexible circuit of a surgical instrument includes a rigid portion and a flexible portion. The rigid portion is configured to mechanically interlock with the components of the surgical instrument, on which at least one of (1) a processing device and (2) a logical element is mounted. The flexible portion is aligned with one of (1) the active bending portion of the shaft assembly of the surgical instrument and (2) the articulated joint of the shaft assembly.

Description

(Cross-reference of related applications)
This application is a U.S. provisional application, filed June 28, 2018, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE," the entire disclosure of which is incorporated herein by reference under Article 119 (e) of the U.S. Patent Act. Claim priority over Patent Application No. 62 / 691,230. This application is incorporated herein by reference in its entirety under Article 119 (e) of the United States Patent Act, "A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICS." Claims priority over US Provisional Patent Application No. 62 / 691,228 filed on 28th May.

This application is filed on March 30, 2018, entitled "SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES", the entire disclosure of which is incorporated herein by reference under Article 119 (e) of the US Patent Act. U.S. Provisional Patent Application No. 62 / 650,887, U.S. Provisional Patent Application No. 62 / 650,877, filing March 30, 2018, entitled "SURGICAL SMOKE EVACUATION SENSING AND CONTROLS" US Provisional Patent Application No. 62 / 650,882 filed on March 30, 2018, and US Provisional Patent Application No. 62 / 650,882, filed on March 30, 2018, entitled "CAPACTIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS" Claim the benefit of the priority of Nos. 62 / 650,898.

This application is further under Article 119 (e) of the United States Patent Act, entitled "TEMPERATURE CONTORL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THE REFOR", the entire disclosure of which is incorporated herein by reference. U.S. Provisional Patent Application No. 62 / 640,417 filed on the 8th, and U.S. Provisional Patent Application No. 62 / 640,415, filed on March 8, 2018, entitled "ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THE REFOR". Claim the interests of the priority of.

This application is also a US provisional patent filed on December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," in which the entire disclosure is incorporated herein by reference under Section 119 (e) of the US Patent Act. Application No. 62 / 611,341, U.S. Provisional Patent Application No. 62 / 611,340, filed December 28, 2017, entitled "CLOUD-BASED MEDICAL ANALYTICS", and December 2017, entitled "ROBOT ASSISTED SURGICAL PLATFORM". Claims the priority benefit of US Provisional Patent Application No. 62 / 611,339 filed on 28th May.

The present application discloses inventions relating to surgical systems, surgical instruments, and flexible circuits in general and in various aspects.

Surgical instruments include components that are required to move in different directions and / or are subject to different forces. For example, the shaft rotates, articulates, experiences different tensions, the jaws open and close, experience unwanted flexion or deformation, and the cutting member moves axially distally and proximally. , Experience different resistance.

Surgical instruments may also include electrodes, sensing devices, processing circuits, motors, and additional components such as wiring and / or wiring traces, some of which are located within various parts of the surgical instrument. obtain. For example, the sensing device and / or processing circuit may be located within the end effector of the surgical instrument, within the shaft assembly of the surgical instrument, and / or within the handle assembly of the surgical instrument. Such additional components may form electrical circuits for surgical instruments, some of such electrical circuits are also required to move in different directions and / or exert different forces. There is a possibility of receiving it.

Often, the jaw electrodes of various surgical instruments are rigid, applying electrosurgical energy to the tissue located between the jaws, collectively occupying almost the entire width of the jaws, bending or bending as the jaws open and close. It is used as a therapeutic electrode that can experience deformation. For surgical instruments that include a knife that traverses a slot defined by a jaw, the first electrode can be positioned on the first side of the slot (eg, the right hand side) and the second electrode is the second electrode of the slot. It can be positioned on the side (eg, the left hand side).

Due to their rigid nature, undesired bending or deformation of the electrodes can lead to premature failure. Also, by collectively occupying almost the entire width of the jaws, the electrodes have a relatively large surface area in contact with the tissue located between the jaws. When the electrode delivers radio frequency (RF) energy to the tissue, the large surface area of the electrode can contribute to unwanted tissue adhesion. In addition, the large surface area of the electrodes leaves little space for the sensing and / or measuring device to come into contact with the tissue located between the jaws.

Traditional electrical circuits within surgical instruments require movement in different directions and / or parts of the electrical circuit that receive different forces disengage or separate from their connection to the surgical instrument. And / or tend to fail at a higher rate than desired.

Flexible circuits for surgical instruments are disclosed. The flexible circuit comprises a rigid portion and a flexible portion. The rigid portion includes an interlock mechanism for mechanically engaging the components of the surgical instrument. At least one of a processing device and a logic element is mounted on the rigid portion. The flexible portion is aligned with one of the active bending portion of the shaft assembly of the surgical instrument and the joint of the shaft assembly.

Flexible circuits for surgical instruments are disclosed. The flexible circuit comprises a rigid portion, a flexible portion, and conductive traces located both on the rigid portion and on the flexible portion. At least one of a processing device and a logic element is mounted on the rigid portion. The flexible portion is aligned with one of the active bending portion of the shaft assembly of the surgical instrument and the joint of the shaft assembly. The height and width of the conductive traces vary with the length of the surgical instrument.

Flexible circuits for surgical instruments are disclosed. The flexible circuit comprises a rigid portion, a flexible portion, a conductive trace, and an electromagnetic shield. The flexible portion is aligned with one of the active bending portion of the shaft assembly of the surgical instrument and the joint of the shaft assembly. Conductive traces are positioned on both rigid and flexible portions, and the height and width of the conductive traces vary along the length of the surgical instrument.

The features of the various aspects are described in detail within the appended claims. However, various aspects of both the mechanism and the method of operation, along with their further objectives and advantages, can be best understood by reference to the following description, in conjunction with the accompanying drawings below.
FIG. 6 is a block diagram of a computer-mounted interactive surgical system according to at least one aspect of the present disclosure. A surgical system used to perform a surgical procedure in an operating room according to at least one aspect of the present disclosure. A surgical hub paired with a visualization system, a robotic system, and an intelligent instrument according to at least one aspect of the present disclosure. FIG. 3 is a partial perspective view of a surgical hub housing and a combination generator module slidably acceptable within the drawer of the surgical hub housing according to at least one aspect of the present disclosure. FIG. 3 is a perspective view of a combination generator module with bipolar, ultrasonic, and unipolar contacts, and smoke exhaust components, according to at least one aspect of the present disclosure. Demonstrates the individual power bus attachments of a plurality of lateral docking ports of a laterally modular housing configured to accept a plurality of modules according to at least one aspect of the present disclosure. Demonstrates a vertically modular housing configured to accept multiple modules according to at least one aspect of the present disclosure. A modular device located in one or more operating rooms of a medical facility, or any room in a medical facility equipped with specialized equipment for surgical procedures, according to at least one aspect of the present disclosure. Shown is a surgical data network with a modular communication hub configured to connect. A computer-mounted interactive surgical system according to at least one aspect of the present disclosure is shown. Demonstrates a surgical hub with a plurality of modules connected to a modular control tower according to at least one aspect of the present disclosure. An aspect of a universal serial bus (USB) network hub device according to at least one aspect of the present disclosure is shown. A logical diagram of a control system for a surgical instrument or tool according to at least one aspect of the present disclosure is shown. Demonstrates a control circuit configured to control aspects of a surgical instrument or tool according to at least one aspect of the present disclosure. Demonstrates a combination logic circuit configured to control aspects of a surgical instrument or tool according to at least one aspect of the present disclosure. Demonstrates an order logic circuit configured to control aspects of a surgical instrument or tool according to at least one aspect of the present disclosure. Demonstrates a surgical instrument or tool with multiple motors that can be activated to perform various functions, according to at least one aspect of the present disclosure. It is a circuit diagram of a robotic surgical instrument configured to operate the surgical tools described herein according to at least one aspect of the present disclosure. FIG. 3 shows a block diagram of a surgical instrument programmed to control the distal translation of a displacement member according to at least one aspect of the present disclosure. It is a circuit diagram of a surgical instrument configured to control various functions according to at least one aspect of the present disclosure. FIG. 6 is a simplified block diagram of a generator configured to provide inductorless tuning, among other advantages, according to at least one aspect of the present disclosure. An embodiment of a generator, which is a form of the generator of FIG. 20, according to at least one aspect of the present disclosure. A surgical instrument according to at least one aspect of the present disclosure is shown. The shaft assembly of the surgical instrument of FIG. 22 according to at least one other aspect of the present disclosure is shown. The flexible circuit of the surgical instrument of FIG. 22 according to at least one aspect of the present disclosure is shown. FIG. 22 shows a channel retainer for a surgical instrument according to at least one aspect of the present disclosure. A cross-sectional view of a flexible circuit along line AA of FIG. 24 according to at least one aspect of the present disclosure is shown. FIG. 6 shows a cross-sectional view of a flexible circuit along line BB of FIG. 24 according to at least one aspect of the present disclosure. FIG. 2 shows an exploded view of the flexible electrode of the surgical instrument of FIG. 22 according to at least one aspect of the present disclosure. FIG. 2 shows a plan view of the flexible electrode of the surgical instrument of FIG. 22 according to at least one aspect of the present disclosure. FIG. 2 shows a plan view of the flexible electrode of the surgical instrument of FIG. 22 according to at least one aspect of the present disclosure. FIG. 2 shows an exploded view of the flexible electrode of the surgical instrument of FIG. 22 according to at least one other aspect of the present disclosure. FIG. 2 shows an end view of a flexible electrode of a surgical instrument of FIG. 22 according to at least one other aspect of the present disclosure. FIG. 2 shows a top perspective view of the flexible electrode of the surgical instrument of FIG. 22 according to at least one other aspect of the present disclosure.

The applicant of the present application owns the following US patent application filed June 29, 2018, the entire disclosure of which is incorporated herein by reference.
-US Patent Application No. ___________, Agent Reference Number END8542USNP / 170755, entitled "CAPATICIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS",
U.S. Patent Application No. ___________, Agent Reference Number END8543USNP / 170760, entitled "CONTROLLING A SURGICAL INSTRUMENT ACCRDING TO SENSED CLOSED CLOUSE PARAMETERS",
-US Patent Application No. ___________, Agent Reference Number END8543USNP1 / 170760-1, entitled "SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATION INFORMATION",
U.S. Patent Application No. ___________, Agent Reference Number END8543USNP2 / 170760-2, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING",
U.S. Patent Application No. ___________, Agent Reference Number END8543USNP3 / 170760-3, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING",
U.S. Patent Application No. ___________, Agent Reference No. END8543USNP4 / 170760-4, entitled "SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES",
-US Patent Application No. ___________, Agent Reference Number END8543USNP5 / 170760-5, entitled "SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE".
-US Patent Application No. ___________, Agent Reference Number END8543USNP6 / 170760-6, entitled "SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLES",
U.S. Patent Application No. ____________, Agent Reference Number END8543USNP7 / 170760-7, entitled "VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY",
U.S. Patent Application No. ___________, Agent Reference Number END8544USNP / 170761, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE",
U.S. Patent Application No. ___________, Agent Reference Number END8544USNP2 / 170761-2, entitled "SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY",
-US Patent Application No. ___________, Agent Reference Number END8544USNP3 / 170761-3, entitled "SURGICAL SYSTEMS WITH PRIORIZED DATA TRANSMISSION CAPABILITIES",
-US Patent Application No. ___________, Agent Reference Number END8545USNP / 170762, entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL",
U.S. Patent Application No. ______________, Agent Reference Number END8545USNP1 / 170762-1, entitled "SURGICAL EVACUATION SENSOR ARRANGEMENTS",
U.S. Patent Application No. ___________, Agent Reference Number END8545USNP2 / 170762-2, entitled "SURGICAL EVACUATION FLOW PATHS",
-US Patent Application No. ___________, Agent Reference Number END8545USNP3 / 170762-3, entitled "SURGICAL EVACUATION SENSING AND GENERATION CONTOR",
U.S. Patent Application No. ___________, Agent Reference Number END8545USNP4 / 170762-4, entitled "SURGICAL EVACUATION SENSING AND DISPLAY",
・ "COMMUNICATION OF SMOKE Evacuation SYSTEM SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODEL FOR FOR INTERACTIVE SURGICAL PLATFORM
U.S. Patent Application No. ___________, US Patent Application No. ________, Agent Reference No. END7856
· "SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE entitled", U.S. Patent Application No. __________ No., Attorney Docket No. END8547USNP / 170764, and - "DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS US Patent Application No. ___________, Agent Reference Number END8548USNP / 170765.

The applicant of the present application owns the following US provisional patent application filed June 28, 2018, the entire disclosure of which is incorporated herein by reference.
-US Provisional Patent Application No. 62 / 691,228, entitled "A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES",
-US Provisional Patent Application No. 62 / 691,227, entitled "CONTROLLING A SURGICAL INSTRUMENT ACCRDING TO SENSED CLOSED CLOSE PARAMETERS",
-US Provisional Patent Application No. 62 / 691,230, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE",
-US Provisional Patent Application No. 62 / 691,219, entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL",
・ US title "COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODEL FOR FOR INTERACTIVE SURGICAL PLATFORM"
・ "SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEEN A FILTER AND A SMOKE EVACUATION DEVILE Provisional Patent Application No. 62 / 691,251.

The applicant of the present application owns the following US patent application filed March 29, 2018, the entire disclosure of which is incorporated herein by reference.
U.S. Patent Application No. 15 / 940, 641, entitled "INTERACTIVE SURGICAL SYSTEMS WITH ENGRYPTED COMMUNICATION CAPABILITIES",
U.S. Patent Application No. 15 / 940,648 entitled "INTERACTIVE SURGICAL SYSTEM SYSTEM WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES",
U.S. Patent Application No. 15 / 940,656, entitled "SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATION ROOM DEVICES",
U.S. Patent Application No. 15 / 940,666 entitled "SPATIAL AWARENSS OF SURGICAL HUBS IN OPERATING ROOMS",
U.S. Patent Application No. 15 / 940,670, entitled "COOPERATION UTILIZETION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS",
U.S. Patent Application No. 15 / 940,677, entitled "SURGICAL HUB CONTOROL ARRANGEMENTS",
-US Patent Application No. 15 / 940, 632, entitled "DATA STRIPPING METHOD TO INTERROGATE PAIENT RECORDS AND CREATE ANONYMIZED RECORD",
・ "COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS US Pat.
US Patent Application No. 15 / 940,645, entitled "SELF DESCRIBING DATA PACKETS GENELATED AT AN ISSUING INSTRUMENT",
U.S. Patent Application No. 15 / 940,649 entitled "DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME",
U.S. Patent Application No. 15 / 940,654, entitled "SURGICAL HUB Situational Awareness",
U.S. Patent Application No. 15 / 940,663, entitled "SURGICAL SYSTEM DISTRIBUTED PROCESSING",
U.S. Patent Application No. 15 / 940,668, entitled "AGGREGATION AND REPORTING OF SURGICAL HUB DATA",
U.S. Patent Application No. 15 / 940, 671, entitled "SURGICAL HUB SPARC AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER",
U.S. Patent Application No. 15 / 940,686 entitled "DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE",
U.S. Patent Application No. 15 / 940,700 entitled "STERILE FIELD INTERACTIVE CONTROLL DISPLAYS",
U.S. Patent Application No. 15 / 940,629 entitled "COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS",
U.S. Patent Application No. 15 / 940,704 entitled "USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT",
U.S. Patent Application Nos. 15 / 940, 722, entitled "CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFACTIVITY", and U.S. Patent Application Nos. 15 / 940, 722, and "DUAL CMOS ARRAY"

The applicant of the present application owns the following US patent application filed March 29, 2018, the entire disclosure of which is incorporated herein by reference.
U.S. Patent Application No. 15 / 940,636 entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES",
U.S. Patent Application No. 15 / 940, 653, entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS",
U.S. Patent Application No. 15 / 940, 660, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZETION AND RECOMMENDATIONS TO A USER",
-US Patent Application No. 15/79, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET"
-US Patent Application No. 15 / 940,694 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION",
U.S. Patent Application No. 15 / 940,634, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES",
U.S. Patent Application Nos. 15 / 940, 706 entitled "DATA HANDLING AND PRIORIZATION IN A CLOUD ANALYTICS NETWORK" and-U.S. Patent Application No. 15 / 940, 706 entitled "CLOUD INTERFACE FOR COUPLED SURGICAL DEVICE".

The applicant of the present application owns the following US patent application filed March 29, 2018, the entire disclosure of which is incorporated herein by reference.
U.S. Patent Application No. 15 / 940,627, entitled "DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS",
U.S. Patent Application No. 15 / 940,637, entitled "COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS",
U.S. Patent Application No. 15 / 940,642, entitled "CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS",
U.S. Patent Application No. 15 / 940,676, entitled "AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS",
U.S. Patent Application No. 15 / 940,680 entitled "CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS",
U.S. Patent Application No. 15 / 940,683, entitled "COOPERATION SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS",
U.S. Patent Application Nos. 15/940, 690 entitled "DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS" and- "SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL

The applicant of the present application owns the following US provisional patent application filed March 28, 2018, the entire disclosure of which is incorporated herein by reference.
US Provisional Patent Application No. 62 / 649,302, entitled "INTERACTIVE SURGICAL SYSTEMS WITH ENGRYPTED COMMUNICATION CAPABILITIES",
-US Provisional Patent Application No. 62 / 649,294 entitled "DATA STRIPPING METHOD TO INTERROGATE PAIENT RECORDS AND CREATE ANONYMIZED RECORD",
-US Provisional Patent Application No. 62 / 649,300, entitled "SURGICAL HUB Situational Awareness",
-US Provisional Patent Application No. 62 / 649,309, entitled "SURGICAL HUB SPARC AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER",
-US Provisional Patent Application No. 62 / 649,310, entitled "COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS",
-US Provisional Patent Application No. 62 / 649,291, entitled "USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT",
-US Provisional Patent Application No. 62 / 649,296 entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES",
-US Provisional Patent Application No. 62 / 649,333, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZETION AND RECOMMENDATIONS TO A USER",
-US Provisional Patent Application No. 62 / 649,327 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES",
-US Provisional Patent Application No. 62 / 649,315 entitled "DATA HANDLING AND PRIORIZATION IN A CLOUD ANALYTICS NETWORK",
-US Provisional Patent Application No. 62 / 649,313, entitled "CLOUD Interface FOR COUPLED SURGICAL DEVICES",
-US Provisional Patent Application No. 62 / 649,320 entitled "DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS",
-US provisional patent application No. 62 / 649,307 entitled "AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS", and- "SENSING ARRANGEMENTS FOR ROBOT-ASSISTED US issue.

The applicant of the present application owns the following US provisional patent application filed on April 19, 2018, of which the entire disclosure is incorporated herein by reference.
-US Provisional Patent Application No. 62 / 659,900 entitled "METHOD OF HUB COMMUNICATION".

The applicant of the present application owns the following US provisional patent application filed on March 30, 2018, the entire disclosure of which is incorporated herein by reference.
US Provisional Patent Application No. 62 / 650,887, entitled "SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES",
-US Provisional Patent Application No. 62 / 650,877, entitled "SURGICAL SMOKE EVACUATION SENSING AND CONTORLS",
-US provisional patent application No. 62 / 650,882 entitled "SMOKE EVACUATION MODEL INTERACTIVE SURGICAL PLATFORM", and- "CAPACITION COUPLED RETURN PATH PAD WITH PAD WITH ..

The applicant of the present application owns the following US provisional patent application filed March 8, 2018, of which the entire disclosure is incorporated herein by reference.
-US provisional patent application No. 62 / 640,417 entitled "TEMPERATURE CONTROLL IN ULTRASONIC DEVICE AND CONTROLL SYSTEM THEREFOR", and- "ESTIMATING STATE OF ULTRASONIC END EFFECT" , 415.

The applicant of the present application owns the following US provisional patent application filed December 28, 2017, for which the entire disclosure is incorporated herein by reference.
-US Provisional Patent Application No. 62 / 611,341, entitled "INTERACTIVE SURGICAL PLATFORM",
-US Provisional Patent Application No. 62 / 611,340 entitled "CLOUD-BASED MEDICAL ANALYTICS" and-US Provisional Patent Application No. 62 / 611,339 entitled "ROBOT ASSISTED SURGICAL PLATFORM".

At least some of the figures and descriptions of the present invention have been simplified to show elements relevant to a clear understanding of the present disclosure, but others understood by those skilled in the art for the purpose of clarification. It should be understood that exclusion of elements may form part of the present invention. However, a description of such elements is not provided herein because such elements are well known in the art and they do not facilitate a better understanding of the invention.

In the "forms for carrying out the invention" below, reference is made to the accompanying drawings that form part of this specification. In the figures, in general, similar symbols and reference symbols indicate similar elements through a plurality of figures unless otherwise indicated by the content. The exemplary embodiments described in "Modes for Carrying Out the Invention," "Drawings," and "Claims" are not intended to be limiting. Other embodiments can be used and other modifications can be made without departing from the scope of the art described herein.

The following description of a particular embodiment of the technique should not be used for the purpose of limiting its scope. Other embodiments, features, embodiments, embodiments, and advantages of the present technology will be apparent to those skilled in the art by the following description, which is, by way of example, one of the best possible embodiments of the present technology. Will be. As will be appreciated, none of the techniques described herein are capable of other different and obvious aspects without departing from that technique. Therefore, drawings and descriptions should be considered of exemplary nature, not of limited nature.

One or more of any one or more of the teachings, expressions, embodiments, embodiments, examples, etc. described herein, the other teachings, expressions, embodiments, embodiments, examples described herein. It is also further understood that it can be combined with any one or more of the above. Therefore, the teachings, expressions, embodiments, embodiments, examples, etc. described below should not be considered separately from each other. Various suitable methods that can be combined with the teachings herein will be readily apparent to those skilled in the art by considering the teachings herein. Such modifications and modifications shall be included within the scope of the "claims".

Prior to elaborating on the various aspects of surgical systems, surgical instruments, flexible circuits, and flexible electrode assemblies, the various aspects disclosed herein are attached in their use or use. It should be noted that the details of the structure and arrangement of the parts exemplified in the drawings and description of the above are not limited. Rather, the disclosed embodiments can be positioned as, or incorporated into, other embodiments, embodiments, variants, and modifications thereof, and may be implemented or performed in a variety of ways. Accordingly, aspects of surgical systems, surgical instruments, flexible circuits, and flexible electrode assemblies disclosed herein are exemplary in nature and limit their scope or use. Not intended. Furthermore, unless otherwise stated, the terms and expressions used herein are selected for the convenience of the reader to illustrate aspects and are not intended to limit their scope. Absent. Further, without limitation, any one or more of the disclosed aspects, representations and / or embodiments thereof, and / or embodiments thereof. It should be understood that it can be combined with any one or more of the above.

Also, in the following description, the terms inner, outer, upward, downward, higher, lower, left, right, inner, outer, etc. should be understood as expedient and limited. It should not be interpreted as a term. The terms used herein are not limited as long as the equipment described herein, or parts thereof, can be installed or used in other orientations. Various aspects will be described in more detail with reference to the drawings.

As described in more detail below, aspects of the invention may be implemented by a computing device and / or a computer program stored on a computer-readable medium. Computer-readable media may include disks, devices, and / or propagated signals.

Referring to FIG. 1, a computer-mounted interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (eg, a cloud 104 that may include a remote server 113 attached to a storage device 105). ,including. Each surgical system 102 includes at least one surgical hub 106 that communicates with a cloud 104 that may include a remote server 113. In one embodiment, as shown in FIG. 1, the surgical system 102 is configured to communicate with each other and / or with the hub 106, a visualization system 108, a robot system 110, and a handheld intelligent surgical instrument 112. And, including. In some embodiments, the surgical system 102 may include M hubs 106, N visualization systems 108, O robot systems 110, and P handheld intelligent surgical instruments 112. , Where M, N, O, and P are integers greater than or equal to 1.

FIG. 3 shows an example of a surgical system 102 used to perform a surgical procedure on a patient lying on an operating table 114 in an operating room 116. The robot system 110 is used as part of the surgical system 102 in the surgical procedure. The robot system 110 includes a surgeon's console 118, a patient-side cart 120 (surgical robot), and a surgical robot hub 122. The patient-side cart 120 can operate at least one detachably coupled surgical tool 117 during a minimally invasive incision in the patient's body while the surgeon views the surgical site through the surgeon's console 118. .. An image of the surgical site can be obtained by the medical imaging device 124, which can be manipulated by the patient-side cart 120 to orient the imaging device 124. The robot hub 122 can be used to process images of the surgical site for subsequent display to the surgeon via the surgeon's console 118.

Other types of robot systems can be easily adapted for use with the surgical system 102. Various examples of robotic systems and surgical tools suitable for use with this disclosure are entitled "ROBOT ASSISTED SURGICAL PLATFORM" filed December 28, 2017, the entire disclosure of which is incorporated herein by reference. It is described in US Provisional Patent Application No. 62 / 611,339.

Various examples of cloud-based analysis performed by Cloud 104 and suitable for use with this disclosure are described in "CLOUD-BASED MEDICAL" filed December 28, 2017, the entire disclosure of which is incorporated herein by reference. It is described in US Provisional Patent Application No. 62 / 611,340 entitled "ANALYTICS".

In various aspects, the imaging device 124 comprises at least one image sensor and one or more optical components. Suitable image sensors include, but are not limited to, charge-coupled device (CCD) sensors and complementary metal oxide semiconductor (CMOS) sensors.

The optical components of the imaging device 124 may include one or more illumination sources and / or one or more lenses. One or more illumination sources may be oriented to illuminate part of the surgical field. One or more image sensors may receive reflected or refracted light from the surgical field, including light reflected or refracted from tissues and / or surgical instruments.

One or more illumination sources may be configured to radiate electromagnetic energy within the visible and invisible spectra. The visible spectrum, sometimes referred to as the optical spectrum or emission spectrum, is a portion of the electromagnetic spectrum visible to the human eye (ie, detectable by the human eye) and is sometimes referred to as visible light, or simply light. The typical human eye responds to wavelengths in the air from about 380 nm to about 750 nm.

The invisible spectrum (ie, the non-emissive spectrum) is a portion of the electromagnetic spectrum located below and above the visible spectrum (ie, wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths above about 750 nm are longer than the red visible spectrum, which results in invisible infrared (IR), microwave, and radioelectromagnetic radiation. Wavelengths below about 380 nm are shorter than the violet spectrum, which results in invisible UV, X-ray, and gamma-ray electromagnetic radiation.

In various aspects, the imaging device 124 is configured for use in minimally invasive surgery. Examples of imaging devices suitable for use with the present disclosure include arthroscopy, angioscope, bronchoscope, biliary tract, colonoscope, cytoscope, duodenalscope, endoscopy, esophagogastroduodenalscope (gastroscope) , Endoscope, laryngoscope, nasopharyngo-neproscope, sigmoid colonoscope, thoracoscope, and cystoscope, but not limited to these.

In one aspect, the imaging device uses multispectral monitoring to distinguish between topography and underlayer structure. A multispectral image captures image data within a specific wavelength range over an electromagnetic spectrum. Wavelengths can be separated by filters or by using devices that are sensitive to light from frequencies beyond the visible light range, such as IR and ultraviolet light. Spectral imaging can allow the extraction of additional information that the human eye cannot capture with its red, green, and blue receptors. The use of multispectral imaging is the "Advanced Imaging" of US Provisional Patent Application No. 62 / 611,341 entitled "INTERACTIVE SURGICAL PLATFORM" filed December 28, 2017, the entire disclosure of which is incorporated herein by reference. It is explained in detail in the section "Acquisition Module". Multispectral monitoring can be a useful tool for rearranging surgical fields to perform one or more of the above tests on treated tissue after one surgical operation has been completed.

It is self-evident that any surgical procedure requires strict sterilization of the operating room and surgical instruments. The "surgical theater", that is, the strict hygiene and sterilization conditions required for operating rooms or treatment rooms, require the highest degree of sterilization of all medical devices and equipment. Part of the sterilization process is the need to sterilize anything that comes into contact with the patient or invades the sterilization field, including the imaging device 124 and its accessories and components. The sterile field can be considered as a specific area considered to be free of microorganisms, such as in a tray or on a sterile towel, or the sterile field is seen as the area immediately surrounding the patient prepared for the surgical procedure. It will be understood that it can be done. The sterile field may include washed team members wearing appropriate clothing, as well as all fixtures and fixtures within the area.

In various aspects, the visualization system 108 comprises one or more imaging sensors strategically placed relative to the sterile field and one or more image processing units, as shown in FIG. And one or more storage arrays and one or more displays. In one aspect, the visualization system 108 includes HL7, PACS, and EMR interfaces. For the various components of the visualization system 108, US Provisional Patent Application No. 62 / 611,341, entitled "INTERACTIVE SURGICAL PLATFORM", filed December 28, 2017, the entire disclosure of which is incorporated herein by reference. It is described in the section "Advanced Imaging Application Module".

As shown in FIG. 2, the primary display 119 is arranged in the sterile field so that it is visible to the operator located on the operating table 114. In addition, the visualization tower 111 is located outside the sterile field. The visualization tower 111 includes a first non-sterile display 107 and a second non-sterile display 109 facing away from each other. The visualization system 108 guided by the surgical hub 106 utilizes displays 107, 109, and 119 to coordinate the flow of information to operators inside and outside the sterile field. For example, the surgical hub 106 displays a snapshot of the surgical site recorded by the imaging device 124 on the non-sterile display 107 or 109 while allowing the visualization system 108 to maintain a live image of the surgical site on the primary display 119. Can be made to. Snapshots on the non-sterile display 107 or 109 can allow, for example, a non-sterile operator to perform surgical steps related to the surgical procedure.

In one aspect, the surgical hub 106 sends diagnostic input or feedback input by a non-sterile operator located at the visualization tower 111 to the primary display 119 in the sterile area within the sterile field, which is located on the operating table. It is also configured to be visible to the sterilizer operator. In one embodiment, the input may be in the form of a modification to the snapshot displayed on the non-sterile display 107 or 109, which can be sent to the primary display 119 by the surgical hub 106.

With reference to FIG. 2, the surgical instrument 112 is used as part of the surgical system 102 in the surgical procedure. The surgical hub 106 is also configured to coordinate the flow of information to the display of the surgical instrument 112. See, for example, US Provisional Patent Application No. 62 / 611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM", the entire disclosure of which is incorporated herein by reference. Diagnostic input or feedback entered by the non-sterile operator at the location of the visualization tower 111 can be sent to the surgical instrument display 115 by the surgical hub 106 in the sterile field, where the operator of the surgical instrument 112 is the diagnostic input. Or you can see the feedback. For exemplary surgical instruments suitable for use with the surgical system 102, for example, the section "Surgical Instrument Hardware", the entire disclosure of which is incorporated herein by reference, and the year 2017 entitled "INTERACTIVE SURGICAL PLATFORM". It is described in US Provisional Patent Application No. 62 / 611,341 filed December 28.

With reference to FIG. 3, the surgical hub 106 is shown communicating with the visualization system 108, the robot system 110, and the handheld intelligent surgical instrument 112. The surgical hub 106 includes a surgical hub display 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132, and a storage array 134. In a particular aspect, as shown in FIG. 3, the surgical hub 106 further comprises a smoke evacuating module 126 and / or a suction / irrigation module 128.

During the surgical procedure, applying energy to the tissue for sealing and / or cutting generally involves flue gas, aspiration of excess fluid, and / or irrigation of the tissue. Fluids, power, and / or data lines from different sources are often entangled during the surgical procedure. Addressing this issue during a surgical procedure can result in the loss of valuable time. Untangling the lines may require pulling the lines out of their corresponding modules, which may require resetting the modules. The modular housing 136 of the surgical hub provides a unified environment for managing power, data, and fluid lines, reducing the frequency of such line entanglements.

Aspects of the present disclosure present a surgical hub for use in surgical procedures involving application of energy to tissue at a surgical site. The surgical hub includes a surgical hub housing and a combination generator module that is slidably acceptable within the docking station of the surgical hub housing. The docking station includes data and power contacts. The combination generator module includes two or more of an ultrasonic energy generator component, a bipolar RF energy generator component, and a unipolar RF energy generator component housed in a single unit. In one aspect, the combination generator module also includes a smoke exhaust component, at least one energy delivery cable for connecting the combination generator module to a surgical instrument, and smoke generated by the application of therapeutic energy to the tissue. Includes at least one flue gas component configured to expel fluid and / or particulates and a fluid line extending from the remote surgery site to the flue gas component.

In one aspect, the fluid line is the first fluid line and the second fluid line extends from the remote surgery site to the suction and irrigation module that is slidably received within the surgical hub housing. In one aspect, the surgical hub housing comprises a fluid interface.

Certain surgical procedures may require the application of more than one energy type to the tissue. One energy type can be more beneficial for cutting tissue, while another different energy type can be more beneficial for sealing tissue. For example, a bipolar generator can be used to seal the tissue, while an ultrasonic generator can be used to cut the sealed tissue. Aspects of the present disclosure present a solution in which a modular enclosure 136 of a surgical hub is configured to accommodate various generators and facilitate two-way communication between them. One of the advantages of the modular housing 136 of the surgical hub is that it allows for rapid removal and / or replacement of various modules.

Aspects of the present disclosure present a modular surgical enclosure for use in surgical procedures involving the application of energy to tissue. The modular surgical enclosure comprises a first energy generator module configured to generate a first energy to be applied to the tissue and a first docking port containing first data and power contacts. A first docking station, including, the first energy generator module is slidably movable to electrically engage with power and data contacts, and the first energy generator module is: It is slidable and movable so as to disengage from the electrical engagement with the first power and data contacts.

In addition to the above, the modular surgical enclosure has a second energy generator module configured to generate a second energy to be applied to the tissue, which is different from the first energy, and a second. A second docking station with a second docking port containing the data and power contacts of the second energy generator module is slidably moved to electrically engage the power and data contacts. It is possible and the second energy generator module is slidably movable so as to disengage from the electrical engagement with the second power and data contacts.

In addition, the modular surgical enclosure is configured to facilitate communication between the first energy generator module and the second energy generator module, with a first docking port and a second docking. It also includes a communication bus to and from the port.

Referring to FIGS. 3-7, aspects of the present disclosure relating to a modular enclosure 136 of a surgical hub that allows modular integration of a generator module 140, a smoke exhaust module 126, and a suction / irrigation module 128. Is presented. The modular housing 136 of the surgical hub further facilitates bidirectional communication between the modules 140, 126, 128. As shown in FIG. 5, the generator module 140 is an integrated unipolar, bipolar, supported within a single housing unit 139 that is slidably insertable into the modular housing 136 of the surgical hub. And may be a generator module with ultrasonic components. As shown in FIG. 5, the generator module 140 may be configured to connect to a unipolar device 146, a bipolar device 147, and an ultrasonic device 148. Alternatively, the generator module 140 may include a series of unipolar, bipolar, and / or ultrasonic generator modules that interact through the modular housing 136 of the surgical hub. The modular housing 136 of the surgical hub allows multiple generators to be inserted and docked to the modular housing 136 of the surgical hub so that multiple generators function as a single generator. It may be configured to facilitate two-way communication between.

In one aspect, the modular housing 136 of the surgical hub is modular with external and wireless communication headers to allow removable attachment of modules 140, 126, 128 and bidirectional communication between them. Includes power and communication backplane 149.

In one aspect, the modular housing 136 of the surgical hub includes a docking station or drawer 151, also referred to herein as a drawer, configured to slidably receive modules 140, 126, 128. .. FIG. 4 shows a partial perspective view of the surgical hub housing 136 and the combination generator module 145 slidably acceptable to the docking station 151 of the surgical hub housing 136. A docking port 152 having power and data contacts on the rear side of the combination generator module 145 slides the combination generator module 145 into a position within the corresponding docking station 151 of the modular housing 136 of the surgical hub. And the corresponding docking port 150 is configured to engage the power and data contacts of the corresponding docking station 151 of the modular housing 136 of the hub. In one aspect, the combination generator module 145 includes a bipolar, ultrasonic, and unipolar module and a smoke exhaust module integrated with a single housing unit 139, as shown in FIG.

In various aspects, the smoke exhaust module 126 includes a fluid line 154 that transports captured / recovered smoke and / or fluid away from the surgical site, eg, to the smoke exhaust module 126. The vacuum suction generated from the smoke exhaust module 126 can draw smoke into the opening of the utility conduit at the surgical site. The utility conduit connected to the fluid line may be in the form of a flexible tube terminated by a smoke exhaust module 126. Utility conduits and fluid lines define a fluid path extending towards the smoke exhaust module 126 received within the surgical hub housing 136.

In various aspects, the suction / irrigation module 128 is coupled to a surgical tool that includes an aspiration fluid line and a suction fluid line. In one embodiment, the suction and suction fluid line is in the form of a flexible tube extending from the surgical site towards the suction / irrigation module 128. One or more drive systems may be configured to cause fluid irrigation and inhalation into and from the surgical site.

In one aspect, the surgical tool comprises a shaft having an end effector at its distal end, at least one energy treatment section associated with the end effector, a suction tube, and an irrigation tube. The suction tube can have an inlet port at its distal end, and the suction tube extends through the shaft. Similarly, the irrigation tube can extend through the shaft and can have an inlet port in close proximity to the energy delivery device. The energy delivery device is configured to deliver ultrasonic and / or RF energy to the surgical site and is first connected to the generator module 140 by a cable that extends through the shaft.

The irrigation pipe can communicate with the fluid source, and the suction pipe can communicate with the vacuum source. The fluid source and / or vacuum source may be housed in the suction / irrigation module 128. In one embodiment, the fluid source and / or vacuum source may be housed in the surgical hub housing 136 separately from the suction / irrigation module 128. In such an embodiment, the fluid interface may be configured to connect the suction / irrigation module 128 to a fluid source and / or a vacuum source.

In one aspect, their corresponding docking stations on modules 140, 126, 128 and / or the modular housing 136 of the surgical hub align the docking ports of the modules and the modular housing of the surgical hub Alignment mechanisms configured to engage these corresponding components within the 136 docking station may be included. For example, as shown in FIG. 4, the combination generator module 145 is configured to slidably engage the corresponding bracket 156 of the corresponding docking station 151 of the modular housing 136 of the surgical hub. Includes section bracket 155. The brackets work together to guide the docking port contacts of the combination generator module 145 into electrical engagement with the docking port contacts of the modular housing 136 of the surgical hub.

In some embodiments, the drawer 151 of the modular housing 136 of the surgical hub is the same or substantially the same size, and the module is adjusted to a size that is acceptable within the drawer 151. For example, the side brackets 155 and / or 156 may be larger or smaller depending on the size of the module. In another aspect, the drawer 151 is of different size and is designed to accommodate a particular module.

In addition, the contacts of a particular module may be locked to engage the contacts of a particular drawer to avoid inserting the module into a drawer with incompatible contacts.

As shown in FIG. 4, the docking port 150 of one drawer 151 is connected to the docking port 150 of another drawer 151 via a communication link 157 and housed in the modular housing 136 of the surgical hub. Bidirectional communication between modules can be facilitated. Alternatively, or further, the docking port 150 of the modular housing 136 of the surgical hub may facilitate wireless bidirectional communication between the modules housed within the modular housing 136 of the surgical hub. For example, any suitable wireless communication such as Air Titan-Bluetooth may be used.

FIG. 6 shows the individual power bus attachments of the plurality of lateral docking ports of the laterally modular housing 160 configured to receive the plurality of modules of the surgical hub 206. The laterally modular housing 160 is configured to laterally receive and interconnect the modules 161. The module 161 is slidably inserted into the docking station 162 of the lateral modular housing 160, which includes a backplane for interconnecting the modules 161. As shown in FIG. 6, the module 161 is arranged laterally within the laterally modular housing 160. Alternatively, the module 161 may be arranged vertically within the vertically modular housing.

FIG. 7 shows a vertical modular housing 164 configured to receive multiple modules 165 of the surgical hub 106. The module 165 is slidably inserted into the docking station or drawer 167 of the vertical modular housing 164 including the backplane for interconnecting the modules 165. Although the drawer 167 of the vertical modular housing 164 is arranged vertically, in certain cases the vertical modular housing 164 may include a drawer arranged laterally. Further, the modules 165 can interact with each other via the docking port of the vertical modular housing 164. In the embodiment of FIG. 7, a display 177 for displaying data related to the operation of module 165 is provided. In addition, the vertical modular housing 164 includes a master module 178 that houses a plurality of submodules that are slidably received within the master module 178.

In various aspects, the imaging module 138 comprises a built-in video processor and modular light source and is adapted for use with a variety of imaging devices. In one aspect, the imaging device comprises a modular housing that can be assembled with a light source module and a camera module. The housing may be a disposable housing. In at least one embodiment, the disposable housing is detachably coupled with a reusable controller, light source module, and camera module. The light source module and / or the camera module can be selectively selected according to the type of surgical procedure. In one aspect, the camera module includes a CCD sensor. In another aspect, the camera module comprises a CMOS sensor. In another aspect, the camera module is configured for imaging the scanned beam. Similarly, the light source module can be configured to deliver white light or different light depending on the surgical procedure.

During the surgical procedure, it may be inefficient to remove the surgical device from the surgical field and replace it with another surgical device containing a different camera or different light source. Temporary loss of field of view in the surgical field can have undesired consequences. The modular imaging device of the present disclosure is configured to allow replacement of a light source module or camera module intermediate (midstream) during a surgical procedure without the need to remove the imaging device from the surgical field.

In one aspect, the imaging device comprises a tubular housing that includes a plurality of channels. The first channel is configured to slidably accept a camera module that may be configured to snap fit and engage with the first channel. The second channel is configured to slidably accept a light source module that may be configured to snap fit and engage with the second channel. In another embodiment, the camera module and / or light source module can be rotated to its final position within these corresponding channels. Screw engagement may be employed instead of snap fit engagement.

In various embodiments, multiple imaging devices are positioned at different locations within the surgical field to provide multiple fields of view. The imaging module 138 can be configured to switch between imaging devices to provide an optimal field of view. In various aspects, the imaging module 138 can be configured to integrate images from different imaging devices.

Various image processors and imaging devices suitable for use with the present disclosure are US Pat. Nos. 6, 2011, entitled "COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR," which are incorporated herein by reference in their entirety. It is described in No. 7,995,045. In addition, US Pat. No. 7,982,776, issued July 19, 2011, entitled "SBI MOTION ARTIFACT REMOVAL APPARATUS AND METHOD," which is incorporated herein by reference in its entirety, removes motion artifacts from image data. Describes various systems for doing so. Such a system can be integrated with the imaging module 138. In addition, the US Patent Application Publication No. 2011/0306840 published on December 15, 2011, entitled "CONTROLLABLE MAGNETIC SOURCE TO FIXTURE TO FIXTURE INTRACORPORTAL APPARATUS", and "SYSTEM FOR PERFORMING A MEMRAL 2014" Published US Patent Application Publication No. 2014/0243597, the entire disclosure of which is incorporated herein by reference in its entirety.

FIG. 8 shows a cloud-based system (eg, storage) of modular equipment located in one or more operating rooms of a medical facility, or in any room within a medical facility equipped with specialized equipment for surgical procedures. FIG. 6 shows a surgical data network 201 with a modular communication hub 203 configured to connect to a cloud 204 (FIG. 9) that may include a remote server 213 coupled to device 205. In one aspect, the modular communication hub 203 comprises a network hub 207 and / or a network switch 209 that communicates with a network router. The modular communication hub 203 can also be coupled to the local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 may be configured as passive, intelligent, or switchable. Passive surgical data networks act as conduits for data, allowing data to travel from one device (or segment) to another (or segment) and to cloud computing resources. The intelligent surgical data network allows traffic to pass through the monitored surgical data network and includes additional mechanisms that make up each port within the network hub 207 or network switch 209. Intelligent surgical data networks can be referred to as manageable hubs or switches. The switching hub reads the destination address of each packet and then forwards the packet to the correct port.

The modular devices 1a to 1n arranged in the operating room may be connected to the modular communication hub 203. The network hub 207 and / or the network switch 209 can be connected to the network router 211 to connect the devices 1a to 1n to the cloud 204 or the local computer system 210. The data associated with the devices 1a-1n may be transferred to a cloud-based computer via a router for remote data processing and operation. The data associated with the devices 1a-1n may also be transferred to the local computer system 210 for local data processing and operation. Modular devices 2a-2m located in the same operating room may also be connected to the network switch 209. The network switch 209 can be connected to the network hub 207 and / or the network router 211 to connect the devices 2a to 2m to the cloud 204. The data associated with the devices 2a-2m may be transferred to the cloud 204 via the network router 211 for data processing and operation. The data associated with the devices 2a-2m may also be transferred to the local computer system 210 for local data processing and operation.

It will be appreciated that the surgical data network 201 can be extended by interconnecting the plurality of network hubs 207 and / or the plurality of network switches 209 with the plurality of network routers 211. The modular communication hub 203 may be housed in a modular control tower configured to receive a plurality of devices 1a-1n / 2a-2m. The local computer system 210 may also be housed in a modular control tower. The modular communication hub 203 is connected to the display 212 to display images acquired by some of the devices 1a-1n / 2a-2m, for example during a surgical procedure. In various aspects, the devices 1a-1n / 2a-2m are among the modular devices that can be connected to the modular communication hub 203 of the surgical data network 201, for example, the imaging module 138 connected to an endoscope. , Generator module 140 connected to energy-based surgical equipment, smoke exhaust module 126, suction / irrigation module 128, communication module 130, processor module 132, storage array 134, surgical equipment connected to display, and / Alternatively, various modules such as non-contact sensor modules may be mentioned.

In one aspect, the surgical data network 201 combines a network hub (s), a network switch (s), and a network router (s) that connect the devices 1a-1n / 2a-2m to the cloud. It may be included. Any one or all of the devices 1a-1n / 2a-2m connected to the network hub or network switch can collect data in real time and transfer the data to a cloud computer for data processing and operation. .. It will be appreciated that cloud computing relies on shared computing resources rather than having local servers or personal devices to handle software applications. The term "cloud" can be used as a metaphor for the "Internet," but the term is not so limited. Therefore, the term "cloud computing" can be used herein to refer to "a type of Internet-based computing," in which various services such as servers, storage, and applications are referred to as surgical sites. Modular communication hub 203 and / or computer system 210 located (eg, fixed, mobile, temporary, or field operating room or space) and / or modular communication hub 203 and / or computer via the Internet. Delivered to a device connected to system 210. The cloud infrastructure can be maintained by the cloud service provider. In this context, a cloud service provider can be an entity that coordinates the use and control of devices 1a-1n / 2a-2m located in one or more operating rooms. Cloud computing services can perform a number of calculations based on data collected by smart surgical instruments, robots, and other computerized devices located in the operating room. Surgical hub hardware allows multiple devices or connections to connect to computers that communicate with cloud computing resources and storage.

By applying cloud computer data processing technology to the data collected by the devices 1a-1n / 2a-2m, the surgical data network provides improved surgical outcomes, reduced costs, and improved patient satisfaction. After the tissue sealing and cutting procedure, at least some of the devices 1a-1n / 2a-2m can be used to observe the condition of the tissue and assess leakage or perfusion of the sealed tissue. .. At least one of the devices 1a-1n / 2a-2m to use cloud-based computing to examine data containing images of body tissue samples for diagnostic purposes to identify medical conditions such as the effects of disease. Some can be used. This includes tissue and phenotypic localization and margin confirmation. Devices 1a-1n / 2a to identify the anatomical structure of the body using techniques such as overlaying images captured by multiple imaging devices and various sensors integrated with the imaging device. At least some of ~ 2 m can be used. Data collected by devices 1a-1n / 2a-2m, including image data, may be transferred to cloud 204 and / or local computer system 210 for data processing and operation, including image processing and operation. .. The data of surgical procedures by determining whether further treatments such as endoscopic interventions for tissue-specific sites and conditions, emerging technologies, targeted radiation, targeted interventions, and the application of precision robots can be performed. It can be analyzed to improve the results. Such data analysis may further employ prognostic processing, and whether using a standardized approach confirms surgical treatment and surgeon behavior or suggests modifications to surgical treatment and surgeon behavior. Can provide useful feedback for any of the above.

In one implementation, the operating room devices 1a-1n may be connected to the modular communication hub 203 via a wired or wireless channel, depending on the configuration of the devices 1a-1n with respect to the network hub. In one aspect, the network hub 207 may be implemented as a local network broadcaster acting on the physical layer of the Open Systems Interconnection (OSI) model. The network hub provides connectivity to devices 1a-1n located within the same operating room network. Network hub 207 collects data in packet form and sends them to the router in half-duplex mode. The network hub 207 does not store any medium access control / internet protocol (MAC / IP) for transferring device data. Only one of the devices 1a-1n can transmit data at a time via the network hub 207. The network hub 207 does not have a routing table or intelligence regarding the destination of information, and broadcasts all network data to the entire connection and to the remote server 213 (FIG. 9) on the cloud 204. The network hub 207 can detect basic network errors such as collisions, but broadcasting all the information to a plurality of ports poses a security risk and may cause a bottleneck.

In another implementation, the operating room devices 2a-2m may be connected to the network switch 209 via a wired or wireless channel. The network switch 209 functions within the data link layer of the OSI model. The network switch 209 is a multicast device for connecting devices 2a to 2m located in the same operating room to the network. The network switch 209 transmits data in the form of a frame to the network router 211 and functions in full-duplex mode. The plurality of devices 2a to 2m can simultaneously transmit data via the network switch 209. The network switch 209 stores and uses the MAC addresses of the devices 2a to 2m to transfer data.

The network hub 207 and / or network switch 209 is connected to the network router 211 to connect to the cloud 204. The network router 211 functions within the network layer of the OSI model. The network router 211 cloud the data packets received from the network hub 207 and / or the network switch 211 in order to further process and manipulate the data collected by any one or all of the devices 1a-1n / 2a-2m. Create a route to send to the base computer resource. The network router 211 is used to connect two or more different networks located at different locations, for example, different operating rooms in the same medical facility or different networks located in different operating rooms in different medical facilities. May be good. The network router 211 transmits packet form data to the cloud 204 and functions in full-duplex mode. Multiple devices can transmit data at the same time. The network router 211 uses an IP address to transfer data.

In one embodiment, the network hub 207 may be implemented as a USB hub that allows a plurality of USB devices to be connected to a host computer. A USB hub can extend a single USB port into several layers so that more ports are available to connect the device to the host system computer. The network hub 207 may include a wired or wireless capability for receiving information via a wired or wireless channel. In one aspect, a wireless USB short-range, high-bandwidth wireless communication protocol may be used for communication between devices 1a-1n and devices 2a-2m located in the operating room.

In another embodiment, operating room devices 1a-1n / 2a-2m exchange data over short distances from fixed and mobile devices (using short wavelength UHF radio waves in the ISM band 2.4-2.485 GHz). ), And can communicate with the modular communication hub 203 via the Bluetooth radio technology standard to build a personal area network (PAN). In another aspect, the operating room devices 1a-1n / 2a-2m are Wi-Fi (IEEE802.11 family), WiMAX (IEEE802.16 family), IEEE802.20, Long Term Evolution (LTE), and Ev. -DO, HSPA +, HSDPA +, HSUPA +, LTE, GSM, GPRS, CDMA, TDMA, DECT, and their Ethernet derivatives, as well as any other radio designated as 3G, 4G, 5G, and beyond. It is possible to communicate with the modular communication hub 203 via a number of wireless or wired communication standards or protocols, including but not limited to wired protocols. The computing module may include a plurality of communication modules. For example, the first communication module may be dedicated to short-range wireless communication such as Wi-Fi and Bluetooth, and the second communication module may be GPS, EDGE, GPRS, CDMA, WiMAX, LTE, Ev-DO, etc. May be dedicated to long-range wireless communication.

The modular communication hub 203 can function as a central connection for one or all of the operating room devices 1a-1n / 2a-2m and handles a data type known as a frame. The frame carries the data generated by the devices 1a-1n / 2a-2m. When the frame is received by the modular communication hub 203, the frame is amplified and transmitted to the network router 211, which uses a number of wireless or wired communication standards or protocols described herein. Transfer this data to your cloud computing resources.

The modular communication hub 203 may be used as a stand-alone device or may be connected to compatible network hubs and network switches to form a larger network. The modular communication hub 203 is generally easy to install, configure, and maintain, making the modular communication hub 203 a good choice for networking operating room devices 1a-1n / 2a-2m.

FIG. 9 shows a computer-mounted interactive surgical system 200. The computer-mounted interactive surgical system 200 is, in many respects, similar to the computer-mounted interactive surgical system 100. For example, the computer-mounted interactive surgical system 200 includes one or more surgical systems 202 that are similar in many respects to the surgical system 102. Each surgical system 202 includes at least one surgical hub 206 that communicates with a cloud 204 that may include a remote server 213. In one aspect, the computer-mounted interactive surgical system 200 comprises a modular control tower 236 connected to multiple operating room devices, such as, for example, intelligent surgical instruments, robots, and other computerized devices located in the operating room. .. As shown in FIG. 10, the modular control tower 236 includes a modular communication hub 203 connected to the computer system 210. As illustrated in the examples of FIG. 9, the modular control tower 236 includes an imaging module 238 connected to an endoscope 239, a generator module 240 connected to an energy device 241, a smoke exhaust module 226, and suction / irrigation. It is coupled to module 228, communication module 230, processor module 232, storage array 234, smart device / appliance 235 optionally coupled to display 237, and non-contact sensor module 242. The operating room equipment is connected to cloud computing resources and data storage via a modular control tower 236. Robot hub 222 may also be connected to modular control tower 236 and cloud computing resources. Above all, the device / appliance 235, visualization system 208 may be connected to the modular control tower 236 via a wired or wireless communication standard or protocol described herein. Modular control tower 236 is coupled to a surgical hub display 215 (eg, monitor, screen) to display and overlay images received from imaging modules, device / instrument displays, and / or other visualization systems 208. May be good. The surgical hub display may also display data received from a device connected to the modular control tower along with images and overlay images.

FIG. 10 shows a surgical hub 206 with a plurality of modules connected to a modular control tower 236. The modular control tower 236 includes, for example, a modular communication hub 203 such as a network connection device and a computer system 210 for providing, for example, local processing, visualization, and imaging. As shown in FIG. 10, the modular communication hub 203 is connected in a hierarchical configuration in order to expand the number of modules (for example, devices) that can be connected to the modular communication hub 203, and the data associated with the modules is displayed. It can be transferred to computer system 210, cloud computing resources, or both. As shown in FIG. 10, each of the network hubs / switches in the modular communication hub 203 includes three downstream ports and one upstream port. Upstream network hubs / switches are connected to processors to provide communication connections to cloud computing resources and local displays 217. Communication to the cloud 204 can be done via either a wired or wireless communication channel.

The surgical hub 206 uses the non-contact sensor module 242 to measure the dimensions of the operating room and uses either an ultrasonic or laser non-contact measuring device to generate a map of the surgical site. "Surgical Hub Spatial Awarens With Operating Room" in US Provisional Patent Application No. 62 / 611,341 filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM", which is incorporated herein by reference in its entirety. As described in the section, the ultrasound-based non-contact sensor module scans the operating room by transmitting a burst of ultrasound and receiving an echo as the burst of ultrasound reflects off the outer wall of the operating room. Here, the sensor module is configured to determine the size of the operating room and adjust the distance limit of the Bluetooth pairing. A laser-based non-contact sensor module, for example, transmits a laser light pulse, receives a laser light pulse reflected on the outer wall of the operating room, and compares the phase of the transmitted pulse to the received pulse in the operating room. The operating room is scanned by determining the size and adjusting the Pulsetooth pairing distance limit.

The computer system 210 includes a processor 244 and a network interface 245. The processor 244 is connected to the communication module 247, the storage 248, the memory 249, the non-volatile memory 250, and the input / output interface 251 via the system bus. The system bus is a 9-bit bus, industry standard architecture (ISA), microchannel architecture (MSA), extended ISA (EISA), intelligent drive electronics (IDE), VESA local bus (VLB), peripheral device interconnection (PCI), Any, but not limited to, USB, Advanced Graphics Port (AGP), Personal Computer Memory Card International Association Bus (PCMCIA), Small Computer System Interface (SCSI), or any other proprietary bus. It may be any of several types of bus structures (s), including memory buses or memory controllers, peripheral or external buses, and / or local buses that use different bus architectures.

The processor 244 may be any single-core or multi-core processor, such as that known by the Texas Instruments ARM Cortex trade name. In one aspect, the processor, for example, on-chip memory of up to 40 MHz 256 KB single cycle flash memory or other non-volatile memory, the details of which are available in the product data sheet, for improving performance above 40 MHz. Prefetch buffer, 32KB single-cycle serial random access memory (SRAM), internal read-only memory with StaticrisWare® software (ROM), 2KB electrically erasable programmable read-only memory (EEPROM), and / or One or more pulse width modulation (PWM) modules, one or more orthogonal encoder input (QEI) analogs, one or more 12-bit analog-to-digital with 12 analog input channels It may be an LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, including a converter (ADC).

In one aspect, the processor 244 may include a safety controller that includes two controller families such as the TMS570 and RM4x, also known by the Texas Instruments Hercules ARM Cortex R4 trade name. The safety controller may be configured specifically for IEC 61508 and ISO 26262 safety limit applications to provide a highly integrated safety mechanism while providing scalable performance, connectivity, and memory options. Good.

Examples of the system memory include volatile memory and non-volatile memory. A basic input / output system (BIOS) that includes a basic routine for transferring information between elements in a computer system, such as during startup, is stored in non-volatile memory. For example, the non-volatile memory may include a ROM, a programmable ROM (PROM), an electrically programmable ROM (EPROM), an EEPROM, or a flash memory. Examples of the volatile memory include a random access memory (RAM) that functions as an external cache memory. Further, the RAM includes SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESRAM), synclink DRAM (SLRAM), direct rambus RAM (DRRAM), and the like. It is available in many forms of.

The computer system 210 also includes removable / non-removable volatile / non-volatile computer storage media such as disk storage. Disk storage includes, but is not limited to, devices such as magnetic disk drives, floppy disk drives, tape drives, Jaz drives, Zip drives, LS-60 drives, flash memory cards, or memory sticks. In addition, the disk storage can be a storage medium independently, or a compact disc ROM device (CD-ROM), a compact disc recordable drive (CD-R drive), a compact disc rewritable drive (CD-RW drive), and the like. Alternatively, an optical disk drive such as a digital versatile disk ROM drive (DVD-ROM) can be mentioned, but the present invention can be included in combination with other storage media not limited thereto. A removable or non-removable interface may be used to facilitate the connection of the disk storage device to the system bus.

It should be understood that the computer system 210 includes software that acts as an intermediary between the user and the basic computer resources described in the preferred operating environment. Examples of such software include operating systems. An operating system that can be stored on disk storage functions to control and allocate resources for the computer system. System applications take advantage of resource management by the operating system via program modules and program data stored either in system memory or on disk storage. It should be understood that the various components described herein can be implemented in different operating systems or combinations of operating systems.

The user inputs a command or information to the computer system 210 via an input device (s) connected to the I / O interface 251. Input devices include pointing devices such as mice, trackballs, stylus, and touchpads, keyboards, microphones, joysticks, gamepads, satellite dishes, scanners, TV tuner cards, digital cameras, digital video cameras, and webcams. However, it is not limited to these. These and other input devices connect to the processor through the system bus via the interface port (s). Examples of the interface port (s) include a serial port, a parallel port, a game port, and USB. The output device (s) use some of the same types of ports as the input device (s). Thus, for example, the USB port may be used to provide input to the computer system and output information from the computer system to the output device. Output adapters are provided to indicate the presence of some output devices, such as monitors, displays, speakers, and printers, among other output devices that require special adapters. Output adapters include, for example, but not limited to, video and sound cards that provide a means of connection between the output device and the system bus. Note that other devices and / or systems of devices, such as remote computers (s), provide both input and output functions.

The computer system 210 can operate in a networked environment that uses a logical connection to one or more remote computers or local computers, such as a cloud computer (s). The remote cloud computer (s) can be a personal computer, server, router, network PC, workstation, microprocessor-based device, peer device, or other common network node, typically a computer. Contains many or all of the elements described for the system. For brevity, only the memory storage device is shown along with the remote computer (s). The remote computer (s) are logically connected to the computer system via a network interface and then physically connected via a communication connection. Network interfaces include communication networks such as local area networks (LANs) and wide area networks (WANs). Examples of LAN technology include an optical fiber distributed data interface (FDDI), a copper wire distributed data interface (CDDI), Ethernet / IEEE802.3, Token Ring / IEEE802.5, and the like. WAN technology includes, but is not limited to, point-to-point links, integrated services digital networks (ISDN) and circuit switching networks such as and variants thereof, packet switching networks, and digital subscriber lines (DSL).

In various embodiments, the computer system 210 of FIG. 10, the imaging module 238 of FIGS. 9-10, and / or the visualization system 208, and / or the processor module 232 are image processors, image processing engines, media processors, or digital images. It may include any dedicated digital signal processor (DSP) used in the processing of. Image processors can increase speed and efficiency by using single instruction multiple data (SIMD) or parallel computing using multiple instruction multiple data (MIMD) technology. Digital image processing engines can perform a variety of tasks. The image processor may be a system on a chip with a multi-core processor architecture.

Communication connection (s) refers to the hardware / software used to connect the network interface to the bus. The communication connection is shown inside the computer system for the sake of illustration clarity, but the communication connection may be outside the computer system 210. For illustrative purposes only, the hardware / software required to connect to a network interface includes conventional telephone grade modems, cable modems, modems including DSL modems, ISDN adapters, and internal and external technologies such as Ethernet cards. Can be mentioned.

FIG. 11 shows a functional block diagram of one aspect of the USB network hub 300 device according to at least one aspect of the present disclosure. In the illustrated embodiment, the USB network hub device 300 employs a Texas Instruments TUSB2036 integrated circuit hub. The USB network hub 300 is a CMOS device that provides upstream USB transmission / reception ports 302 and up to three downstream USB transmission / reception ports 304, 306, and 308 that comply with the USB 2.0 standard. The upstream USB transmit / receive port 302 is a differential root data port that includes a differential data plus (DP0) input and a paired differential data minus (DM0) input. The three downstream USB transmit / receive ports 304, 306, 308 are differential data ports each containing a differential data plus (DP1 to DP3) output paired with a differential data minus (DM1 to DM3) output.

The USB network hub 300 device is implemented with a digital state machine instead of a microcontroller and does not require firmware programming. A fully compliant USB transmitter / receiver is integrated into the circuits of the upstream USB transmit / receive port 302 and all downstream USB transmit / receive ports 304, 306, 308. Downstream USB transmit and receive ports 304, 306, 308 support both maximum and slow speed devices by automatically setting the slew rate according to the speed of the device attached to the port. The USB network hub 300 device may be configured in either bus-powered mode or self-powered mode and includes a surgical hub-powered logic 312 for managing power.

The USB network hub 300 device includes a serial interface engine 310 (SIE). The SIE310 is the front end of the USB network hub 300 hardware and handles most of the protocols described in Chapter 8 of the USB specification. The SIE310 typically understands signaling down to the transaction level. Functions covered by this include packet recognition, transaction reordering, SOP, EOP, SETET, and RESTUME signal detection / generation, clock / data separation, non-return-to-zero reversal (NRZI) data coding / decoding and bit stuffing, CRC Generation and check (tokens and data), packet ID (PID) generation, and check / decryption, and / or serial parallel / parallel serial conversion can be mentioned. The SIE 310 receives the clock input 314 and suspend / resume logic to control communication between the upstream USB transmit / receive ports 302 and the downstream USB transmit / receive ports 304, 306, 308 via the port logic circuits 320, 322, 324. It is connected to the frame timer 316 circuit and the surgical hub repeater circuit 318. The SIE 310 is connected to the command decoder 326 via an interface logic for controlling commands from the serial EEPROM via the serial EEPROM interface 330.

In various aspects, the USB network hub 300 can connect 127 functions configured in up to 6 logical layers (hierarchies) to a single computer. In addition, the USB network hub 300 can be connected to all peripherals using four standardized wire cables that provide both communication and power distribution. The power configuration is a bus-powered mode and a self-powered mode. The USB network hub 300 is a bus power hub having either individual port power management or interlocking port power management, and a self-powered hub having either individual port power management or interlocking port power management. It may be configured to support one mode. In one aspect, using a USB cable, a USB network hub 300, the upstream USB transmit / receive port 302 is plugged into a USB host controller, and the downstream USB transmit / receive ports 304, 306, 308 connect a USB compatible device. It is exposed because of it.

FIG. 12 shows a logical diagram of a surgical instrument or tool control system 470 according to one or more aspects of the present disclosure. System 470 includes a control circuit. The control circuit includes a microprocessor 461 with a processor 462 and a memory 468. For example, one or more of the sensors 472, 474, and 476 provide real-time feedback to the processor 462. The motor 482, driven by the motor driver 492, operably connects displacement members that are movable in the longitudinal direction to drive the I-beam knife element. The tracking system 480 is configured to determine the position of a displacement member that is movable in the longitudinal direction. Positional information is provided to a processor 462 that may be programmed or configured to determine the location of drive members that are longitudinally movable, as well as the location of launch members, launch bars, and I-beam knife elements. Additional motors may be provided in the tool driver interface to control I-beam launch, closed tube movement, shaft rotation, and joint movement. The display 473 may display various operating conditions of the appliance and may include a touch screen function for data entry. The information displayed on the display 473 can be overlaid with the image acquired via the endoscopic imaging module.

In one aspect, the microcontroller 461 may be any single-core or multi-core processor, such as that known by the Texas Instruments ARM Cortex trade name. In one aspect, the main microcontroller 461 improves performance to over 40 MHz, for example, on-chip memory of 256 KB single cycle flash memory up to 40 MHz or other non-volatile memory, the details of which are available in the product datasheet. Prefetch buffer for, 32KB single cycle SRAM, internal ROM with NonvolatilesWare® software, 2KB EEPROM, one or more PWM modules, one or more QEI analogs, and / Alternatively, it may be an LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, including one or more 12-bit ADCs with 12 analog input channels.

In one aspect, the microcontroller 461 may include a safety controller that includes two controller families such as the TMS570 and RM4x, also known by the Texas Instruments Hercules ARM Cortex R4 trade name. The safety controller may be configured specifically for IEC 61508 and ISO 26262 safety limit applications to provide a highly integrated safety mechanism while providing scalable performance, connectivity, and memory options. Good.

The microcontroller 461 may be programmed to perform a variety of functions, such as precise control over the speed and position of the knife and joint movement system. In one aspect, the microcontroller 461 includes a processor 462 and memory 468. The electric motor 482 may be a brushed direct current (DC) motor with a gearbox and a mechanical connection to a joint movement or knife system. In one aspect, the motor drive 492 may be A3941 available from Allegro Microsystems, Inc. Other motor drives can be easily replaced for use in the tracking system 480 with an absolute positioning system. A detailed description of the absolute positioning system, which is incorporated herein by reference in its entirety, is entitled "SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT" published October 19, 2017 in the United States Patent Application Publication No. 2017/2017. 0296213.

The microcontroller 461 may be programmed to provide precise control over the speed and position of the displacement member and joint movement system. Microcontroller 461 may be configured to calculate the response within the software of microcontroller 461. The calculated response is compared to the measured response of the actual system to give an "observed" response, which is used to determine the actual feedback. The observed response is a suitable adjusted value that balances the smooth and continuous nature of the simulated response with the measured response, which can detect external effects on the system.

In one aspect, the motor 482 may be controlled by a motor drive 492 and may be used by a surgical instrument or tool launch system. In various forms, the motor 482 may be, for example, a brushed DC drive motor having a maximum rotational speed of about 25,000 RPM. In other configurations, the motor 482 may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor drive 492 may include, for example, an H-bridge drive that includes a field effect transistor (FET). The motor 482 may be powered by a power assembly that is detachably mounted on the handle assembly or tool housing to supply control power to the surgical instrument or tool. The power assembly may include a battery that may include a large number of battery cells connected in series, which can be used as a power source to power a surgical instrument or tool. Under certain circumstances, the battery cells in the power assembly may be replaceable and / or rechargeable. In at least one example, the battery cell can be a lithium ion battery that can be coupled to and separable from the power assembly.

The motor drive 492 may be A3941 available from Allegro Microsystems, Inc. The A3941 motor 492 is a full bridge controller for use with an external N-channel power metal oxide semiconductor field effect transistor (MOSFET) specifically designed for inductive loads such as brushed DC motors. The drive 492 is equipped with a unique charge pump regulator, which provides full (> 10V) gate drive for battery voltages up to 7V, allowing the A3941 to operate with reduced gate drive up to 5.5V. To do. A bootstrap capacitor may be used to provide the above-mentioned battery supply voltage required for the N-channel MOSFET. The internal charge pump for high-side drive enables DC (100% duty cycle) operation. The full bridge can be driven in fast or slow decay mode using diodes or synchronous rectification. In slow decay mode, current recirculation is possible with both high-side and low-side FETs. The power FET is protected from shoot-through by a register-adjustable dead time. The integrated diagnostics indicate low voltage, overtemperature, and power bridge anomalies and can be configured to protect the power MOSFET under most short circuit conditions. Other motor drives can be easily replaced for use in the tracking system 480 with an absolute positioning system.

The tracking system 480 comprises a controlled motor drive circuit configuration with a position sensor 472 according to one aspect of the present disclosure. The position sensor 472 for the absolute positioning system provides a unique position signal corresponding to the position of the displacement member. In one aspect, the displacement member represents a longitudinally movable drive member comprising a rack of drive teeth for meshing and engaging with the corresponding drive gear of the gear reducer assembly. In another aspect, the displacement member represents a launching member that can be adapted and configured to include a rack of drive teeth. In yet another aspect, the displacement member represents a firing bar or I-beam, each of which may be adapted and configured to include a rack of driving teeth. Accordingly, as used herein, the term displacement member refers to any movable member of a surgical instrument, such as a drive member, launch member, launch bar, I-beam, or any element that can be displaced. Used to refer as a whole. In one aspect, longitudinally movable drive members are coupled to launch members, launch bars, and I-beams. Therefore, the absolute positioning system can actually track the linear displacement of the I-beam by tracking the linear displacement of the drive member that is movable in the longitudinal direction. In various other aspects, the displacement member may be coupled to any position sensor 472 suitable for measuring linear displacement. Thus, longitudinally movable drive members, launch members, launch bars, or I-beams, or combinations thereof, may be coupled to any suitable displacement sensor. The linear displacement sensor may include a contact or non-contact displacement sensor. Linear displacement sensors include linear variable differential transformers (LVDTs), differential variable reluctance transducers (DVRTs), slide potentiometers, movable magnets and a series of straight lines. A reluctance system including an arranged Hall effect sensor, a magnetosensing system including a fixed magnet and a Hall effect sensor arranged on a series of movable straight lines, a movable light source and arranged on a series of linear lines. An optical detection system including a reluctance or photodetector, an optical detection system including a fixed light source and a series of reluctant linearly arranged magnetos and photodetectors, or any combination thereof may be included. ..

The electric motor 482 may include a rotary shaft operably linked to a gear assembly mounted in mesh engagement with a set of drive teeth on the displacement member or rack. The sensor element may be operably coupled to the gear assembly such that one rotation of the position sensor 472 element corresponds to some linear longitudinal translation of the displacement member. Gearing and sensor mechanisms can be connected to linear actuators by rack and pinion mechanisms, or to rotary actuators by spur gears or other connections. The power supply powers the absolute positioning system and the output indicator can display the output of the absolute positioning system. The displacement member represents a longitudinally movable drive member with a rack of drive teeth formed on it to mesh and engage with the corresponding drive gear of the gear reducer assembly. Displacement members represent longitudinally movable launch members, launch bars, I-beams, or combinations thereof.

One rotation of the sensor element attached to the position sensor 472 corresponds to a linear displacement d1 in the longitudinal direction of the displacement member. In d1, the displacement member moves from the point "a" after one rotation of the sensor element connected to the displacement member. It is a linear distance in the longitudinal direction to move to the point "b". The sensor mechanism may be connected via gear deceleration resulting in the position sensor 472 completing one or more rotations for the full stroke of the displacement member. The position sensor 472 can complete a plurality of rotations with respect to the full stroke of the displacement member.

A series of switches (where n is an integer greater than 1), even when used alone, in combination with gear deceleration to provide a unique position signal for two or more rotations of the position sensor 472. May be used in. The state of the switch is fed back to the microcontroller 461, and the microcontroller 461 applies logic to linear displacement d1 + d2 + of the displacement member in the longitudinal direction. .. .. Determine the unique position signal corresponding to dn. The output of the position sensor 472 is provided to the microcontroller 461. The position sensor 472 of the sensor mechanism may include an analog rotation sensor such as a magnetic sensor, a potential difference meter, or an array of analog Hall effect elements that output a unique combination of position signals or values.

The position sensor 472 may include any number of magnetic sensing elements, such as magnetic sensors that are classified based on whether or not they measure the total magnetic field or vector component of the magnetic field. The technology used to produce both types of magnetic sensors involves many aspects of physics and electronics. Techniques used for magnetic field sensing include, among other things, probe coils, flux gates, optical pumping, nuclear precession, SQUID, Hall effect, anisotropic magnetic resistance, giant magnetic resistance, magnetic tunnel junctions, giant magnetic impedance. , Magnetic strain / piezoelectric composites, magnetic diodes, magnetic transistors, optical fibers, magnetic optics, and magnetic sensors based on microelectromechanical systems.

In one aspect, the position sensor 472 of the tracking system 480 with the absolute positioning system comprises a magnetic rotation absolute positioning system. The position sensor 472 may be implemented as an AS5055 EQFT single-chip gyromagnetic position sensor available from Austria Microsystems, AG. The position sensor 472 cooperates with the microcontroller 461 to provide an absolute positioning system. The position sensor 472 is a low voltage, low power component and includes four Hall effect elements in the region of the position sensor 472 located above the magnet. In addition, a high resolution ADC and smart power management controller are provided on the chip. Digit-by-digit method and boulder to implement a concise and efficient algorithm for computing hyperbolic and trigonometric functions that requires only addition, subtraction, bitshift, and table reference operations. A coordinate rotation digital computer (CORDIC) processor, also known as a Volder's algorithm, is provided. The angular position, alarm bits, and magnetic field information are transmitted to the microcontroller 461 via a standard serial communication interface such as a serial peripheral interface (SPI) interface. The position sensor 472 provides a 12-bit or 14-bit resolution. The position sensor 472 may be an AS5055 chip provided in a small QFN 16-pin 4 x 4 x 0.85 mm package.

The tracking system 480 with an absolute positioning system may include and / or may be programmed to implement a feedback controller such as a PID, state feedback, and adaptive controller. The power supply converts the signal from the feedback controller into a physical input to the system, in this case a voltage. Other examples include voltage, current, and force PWM. In addition to the position measured by the position sensor 472, other sensors (plurality) may be provided to measure the physical parameters of the physical system. In some embodiments, as the other sensor (s), the US Pat. No. 9, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM," which is incorporated herein by reference in its entirety. , 345, 481, the United States Patent Application Publication No. 2014/0263552, published September 18, 2014, entitled "STAPLE CARTRIDGE TISSUE TISSUE TISSUE SENSOR SYSTEM," which is incorporated herein by reference in its entirety, and in its entirety. U.S. Patent Application No. 17/28 A sensor configuration such as a thing can be mentioned. In a digital signal processing system, the absolute positioning system is coupled to a digital data acquisition system, where the output of the absolute positioning system has a finite resolution and sampling frequency. Absolute positioning systems use algorithms such as weighted averages and theoretical control loops that drive the calculated response towards the measured response to combine the calculated response with the measured response. Can be equipped. In order to predict what the state and output of the physical system will be by knowing the inputs, the calculated response of the physical system takes into account properties such as mass, inertia, viscous friction, and induced resistance.

The absolute positioning system resets the displacement member, which may be required in conventional rotary encoders where the motor 482 simply counts the number of steps taken forward or backward to estimate the position of device actuators, drive bars, knives, etc. Provides the absolute position of the displacement member when the appliance is powered on, without retreating or advancing to (zero or home).

A sensor 474, such as a strain gauge or microstrain gauge, can indicate, for example, one or more end effectors such as the amplitude of strain exerted on the anvil during clamping operation, which can indicate the closing force applied to the anvil. It is configured to measure the parameters of. The measured distortion is converted into a digital signal and provided to the processor 462. Instead of, or in addition to, the sensor 474, a sensor 476, such as a load sensor, can measure the closure force applied to the anvil by the closure drive system. For example, a sensor 476, such as a load sensor, can measure the firing force applied to the I-beam during the firing stroke of a surgical instrument or tool. The I-beam is configured to engage the wedge-shaped thread, which cams the staple driver upwards to push the staples into deformed contact with the anvil. The I-beam also includes a sharp cutting edge that can be used to cut tissue as the I-beam is advanced distally by the firing bar. Alternatively, a current sensor 478 can be used to measure the current draw by the motor 482. The force required to advance the launching member may correspond, for example, to the current drawn by the motor 482. The measured force is converted into a digital signal and provided to the processor 462.

In one form, the strain gauge sensor 474 can be used to measure the force applied to the tissue by the end effector. A strain gauge can be attached to the end effector to measure the force of the end effector on the tissue to be treated. The system for measuring the force applied to the tissue gripped by the end effector is, for example, a strain gauge sensor 474, such as a micro strain gauge configured to measure one or more parameters of the end effector. To be equipped. In one aspect, the strain gauge sensor 474 can measure the amplitude or magnitude of strain exerted on the end effector jaw member during clamping operation, which can indicate tissue compression. The measured distortion is converted into a digital signal and provided to the processor 462 of the microcontroller 461. The load sensor 476 can measure the force used to manipulate the knife element, for example, to cut the tissue trapped between the anvil and the staple cartridge. Magnetic field sensors can be used to measure the thickness of captured tissue. The magnetic field sensor measurements can also be converted to digital signals and provided to the processor 462.

Measures of tissue compression, tissue thickness, and / or force required to close the end effector on the tissue, measured by sensors 474 and 476, respectively, are the selected position of the launching member and /. Alternatively, it can be used by the microcontroller 461 to characterize the corresponding value of the velocity of the launching member. In one example, memory 468 can store techniques, equations and / or look-up tables that can be used by microcontroller 461 during evaluation.

The surgical instrument or tool control system 470 may also include a wired or wireless communication circuit for communicating with a modular communication hub as shown in FIGS. 8-11.

FIG. 13 shows a control circuit 500 configured to control aspects of a surgical instrument or tool according to one aspect of the present disclosure. The control circuit 500 may be configured to implement the various processes described herein. The control circuit 500 can include a microcontroller having one or more processors 502 (eg, microprocessor, microcontroller) coupled to at least one memory circuit 504. The memory circuit 504 stores machine executable instructions that, when executed by the processor 502, cause the processor 502 to execute machine instructions for implementing the various processes described herein. The processor 502 may be any one of a number of single or multi-core processors known in the art. The memory circuit 504 may include volatile and non-volatile storage media. Processor 502 may include instruction processing unit 506 and arithmetic unit 508. The instruction processing unit may be configured to receive instructions from the memory circuit 504 of the present disclosure.

FIG. 14 shows a combination logic circuit 510 configured to control aspects of a surgical instrument or tool according to one aspect of the present disclosure. The combination logic circuit 510 may be configured to implement the various processes described herein. The combination logic circuit 510 is a finite state machine containing the combination logic 512 configured to receive data associated with a surgical instrument or tool at input 514, process the data by combination logic 512, and provide output 516. May include.

FIG. 15 shows a sequence logic circuit 520 configured to control aspects of a surgical instrument or tool according to one aspect of the present disclosure. The sequential logic circuit 520 or combinational logic 522 can be configured to implement the various processes described herein. The order logic circuit 520 may include a finite state machine. The sequential logic circuit 520 may include, for example, a combinatorial logic 522, at least one memory circuit 524, and a clock 529. At least one memory circuit 524 can store the current state of the finite state machine. In a particular example, the order logic circuit 520 may be synchronous or asynchronous. Combination logic 522 is configured to receive data associated with a surgical instrument or tool from input 526, process the data by combination logic 522, and provide output 528. In another aspect, the circuit may include a combination of a processor (eg, processor 502 in FIG. 13) and a finite state machine that implements the various processes herein. In another aspect, the finite state machine can include a combination of a combination logic circuit (eg, combination logic circuit 510 in FIG. 14) and a sequence logic circuit 520.

FIG. 16 shows a surgical instrument or tool with multiple motors that can be activated to perform various functions. In a particular example, the first motor can be started to perform the first function, the second motor can be started to perform the second function, and the third motor can be started. The third function can be executed, the fourth motor can be started to execute the fourth function, and so on. In certain examples, multiple motors of the robotic surgical instrument 600 can be individually activated to produce launching, closing, and / or jointing motions in the end effector. Launching motion, closing motion, and / or joint motion can be transmitted to the end effector, for example, via a shaft assembly.

In certain examples, the surgical instrument system or tool may include a launch motor 602. The launch motor 602 is operational to the launch motor drive assembly 604, which can be configured to transmit the launch motion generated by the launch motor 602 to the end effector, specifically to displace the I-beam element. It may be concatenated. In certain examples, the firing motion generated by the firing motor 602, for example, deploys the staples from the staple cartridge into the tissue captured by the end effector and / or advances the cutting edge of the I-beam element. , The captured tissue may be cut. The I-beam element can be retracted by reversing the direction of the launch motor 602.

In certain examples, the surgical instrument or tool may include a closure motor 603. The closing motor 603 specifically displaces the closing tube to close the anvil and transmits the closing motion generated by the motor 603 to the end effector to compress the tissue between the anvil and the staple cartridge. It may be operably coupled with a closed motor drive assembly 605 that may be configured. The closing motion allows, for example, the end effector to transition from an open configuration to an approaching configuration to capture tissue. The end effector can be transitioned to the open position by reversing the direction of the motor 603.

In certain examples, the surgical instrument or tool may include, for example, one or more joint motion motors 606a, 606b. The joint motion motors 606a, 606b may be operably coupled to the corresponding joint motion motor drive assemblies 608a, 608b, which may be configured to transmit the joint motion generated by the joint motion motors 606a, 606b to the end effector. In certain examples, articulation allows, for example, end effectors to articulate with respect to the shaft.

As mentioned above, a surgical instrument or tool may include multiple motors that may be configured to perform a variety of independent functions. In certain examples, multiple motors of a surgical instrument or tool can be activated independently or separately to perform one or more functions while the other motors remain stationary. Can be carried out. For example, the joint movement motors 606a and 606b can be activated to jointly move the end effector while the launch motor 602 is maintained in a stopped state. Alternatively, the launch motor 602 can be activated to launch multiple staples and / or advance the cutting edge while the joint motion motor 606 is stopped. Further, the closure motor 603 may be activated at the same time as the launch motor 602 to advance the closure tube and the I-beam element distally, as described in more detail below.

In certain examples, the surgical instrument or tool may include a common control module 610 that can be used with multiple motors of the surgical instrument or tool. In a particular example, the common control module 610 can accommodate one of a plurality of motors at a time. For example, the common control module 610 may be individually connectable and detachable to multiple motors of a robotic surgical instrument. In certain examples, multiple motors of a surgical instrument or tool may share one or more common control modules, such as the common control module 610. In certain examples, multiple motors of a surgical instrument or tool can be independently and selectively engaged with a common control module 610. In a particular example, the common control module 610 selectively works from one of the multiple motors of the surgical instrument or tool to the other of the multiple motors of the surgical instrument or tool. You can switch.

In at least one example, the common control module 610 selects between an operable engagement with the joint motion motors 606a, 606b and an operable engagement with either the launch motor 602 or the closure motor 603. Can be switched. In at least one embodiment, as shown in FIG. 16, switch 614 can move or transition between multiple positions and / or states. For example, at the first position 616, the switch 614 may electrically connect the common control module 610 to the launch motor 602, and at the second position 617, the switch 614 closes the common control module 610. It may be electrically connected to the motor 603, and at the third position 618a, the switch 614 may electrically connect the common control module 610 to the first joint motion motor 606a, at the fourth position. At 618b, the switch 614 may electrically connect the common control module 610 to the second joint motion motor 606b. In certain examples, at the same time, separate common control modules 610 may be electrically connected to launch motors 602, closure motors 603, and joint motion motors 606a, 606b. In a particular example, the switch 614 may be a mechanical switch, an electromechanical switch, a solid state switch, or any suitable switching mechanism.

Each of the motors 602, 603, 606a, 606b may be provided with a torque sensor for measuring the output torque on the shaft of the motor. The force on the end effector may be sensed by any conventional method, such as by a force sensor on the outside of the jaw, or by a torque sensor on the motor that actuates the jaw.

In various examples, as shown in FIG. 16, the common control module 610 may include a motor drive 626, which may include one or more H-bridge FETs. The motor drive 626 may modulate the power transmitted from the power supply 628 to the motor connected to the common control module 610, for example, based on the input from the microcontroller 620 (“controller”). In a particular example, as described above, for example, a microcontroller 620 can be used while the motor is connected to a common control module 610 to determine the current drawn by the motor.

In certain examples, the microcontroller 620 may include a microprocessor 622 (“processor”) and one or more non-transitory computer-readable media or memory units 624 (“memory”). In a particular example, memory 624 may store various program instructions that, when executed, may cause processor 622 to perform multiple functions and / or calculations described herein. it can. In a particular example, one or more of the memory units 624 may be attached to, for example, processor 622.

In certain examples, the power supply 628 may be used to power, for example, the microcontroller 620. In certain examples, the power supply 628 may include a battery (or "battery pack" or "power pack"), such as a lithium ion battery. In certain examples, the battery pack may be configured to be detachably attached to the handle to power the surgical instrument 600. A large number of battery cells connected in series may be used as the power source 628. In certain examples, the power supply 628 may be, for example, replaceable and / or rechargeable.

In various examples, the processor 622 can control the motor drive 626 to control the position, direction of rotation, and / or speed of the motor coupled to the common control module 610. In a particular example, the processor 622 can signal the motor drive 626 to stop and / or disable the motor coupled to the common control module 610. The term "processor", as used herein, is the function of any suitable microprocessor, microcontroller, or computer central processing unit (CPU) in one integrated circuit or up to several integrated circuits. It should be understood to include other basic computing devices integrated above. A processor is a versatile programmable device that accepts digital data as input, processes the data according to instructions stored in memory, and provides the results as output. This is an example of sequential digital logic because it has internal memory. The processor operates on numbers and symbols represented in binary notation.

In one example, the processor 622 may be any single-core or multi-core processor, such as that known by the Texas Instruments ARM Cortex trade name. In a particular example, the microcontroller 620 may be, for example, the LM 4F230H5QR available from Texas Instruments. In at least one embodiment, the Texas Instruments LM4F230H5QR delivers 256KB single-cycle flash memory up to 40MHz or other NVM on-chip memory, performance above 40MHz, among other characteristics readily available in the product datasheet. Prefetch buffer for improvement, 32KB single cycle SRAM, internal ROM with Non-volatilesWare® software, 2KB EEPROM, one or more PWM modules, one or more QEI analogs, 12 An ARM Cortex-M4F processor core containing one or more 12-bit ADCs with one analog input channel. Other microcontrollers may be readily substituted for use with the module 4410. Therefore, this disclosure should not be limited to this context.

In a particular example, the memory 624 may include program instructions for controlling each motor of a surgical instrument 600 that can be connected to a common control module 610. For example, the memory 624 may include program instructions for controlling the launch motor 602, the closure motor 603, and the joint motion motors 606a, 606b. Such program instructions can cause the processor 622 to control firing, closing, and joint motor functions according to input from an algorithm or control program of a surgical instrument or tool.

In certain examples, one or more mechanisms and / or sensors, such as the sensor 630, can be used to warn the processor 622 of program instructions to be used in a particular setting. For example, sensor 630 can warn processor 622 to use program instructions related to end effector firing, closing, and joint movement. In certain examples, the sensor 630 may include, for example, a position sensor that can be used to sense the position of the switch 614. Thus, if the processor 622 detects, for example, through the sensor 630 that the switch 614 is in the first position 616, it can use the program instructions associated with the emission of the I-beam of the end effector, the processor 622. For example, if it detects that the switch 614 is in the second position 617 via the sensor 630, it can use the program instructions associated with the closure of the anvil, and the processor 622 can use, for example, via the sensor 630. When the switch 614 is detected at the third position 618a or the fourth position 618b, the program instruction associated with the joint movement of the end effector can be used.

FIG. 17 is a circuit diagram of a robotic surgical instrument 700 configured to operate the surgical tools described herein according to an aspect of the present disclosure. The robotic surgical instrument 700 uses either a single or multiple joint motion drive joints to provide distal / proximal translation of displacement members, distal / proximal displacement of closed tubes, shaft rotation, and joints. It may be programmed or configured to control movement. In one aspect, the surgical instrument 700 may be programmed or configured to individually control a launching member, a closing member, a shaft member, and / or one or more joint motion members. The surgical instrument 700 includes a control circuit 710 configured to control motor-driven launching members, closing members, shaft members, and / or one or more joint motion members.

In one aspect, the robotic surgical instrument 700 has an anvil 716 and an I-beam 714 (including a sharp cutting edge) portion of the end effector 702, a removable staple cartridge 718, a shaft 740, via a plurality of motors 704a-704e. In addition, a control circuit 710 configured to control one or more joint movement members 742a, 742b is provided. The position sensor 734 may be configured to provide position feedback for the I-beam 714 to the control circuit 710. The other sensor 738 may be configured to provide feedback to the control circuit 710. The timer / counter 731 provides timing and count information to the control circuit 710. An energy source 712 may be provided to operate the motors 704a-704e, and the current sensor 736 provides motor current feedback to the control circuit 710. The motors 704a-704e can be individually operated by the control circuit 710 in open-loop or closed-loop feedback control.

In one aspect, the control circuit 710 is one or more microcontrollers, microprocessors, or other suitable for executing instructions that cause the processor or multiple processors to perform one or more tasks. It may be equipped with a processor. In one aspect, the timer / counter 731 provides an output signal such as elapsed time or digital count to the control circuit 710 to correlate the position of the I-beam 714 determined by the position sensor 734 with the output of the timer / counter 731. As a result, the control circuit 710 can determine the position of the I-beam 714 at a specific time (t) with respect to the start position or time (t) when the I-beam 714 is at a specific position with respect to the start position. it can. The timer / counter 731 may be configured to measure elapsed time, count external events, or measure time for external events.

In one aspect, the control circuit 710 may be programmed to control the function of the end effector 702 based on one or more tissue states. The control circuit 710 may be programmed to sense tissue conditions such as thickness, either directly or indirectly, as described herein. The control circuit 710 may be programmed to select a launch control program or a closure control program based on tissue conditions. The launch control program can describe the distal motion of the displacement member. Various launch control programs can be selected to better handle different tissue conditions. For example, in the presence of thicker tissue, the control circuit 710 may be programmed to translate the displacement member at a slower speed and / or at a lower power. In the presence of thinner tissue, the control circuit 710 may be programmed to translate the displacement member faster and / or at higher power. The closure control program can control the closure force applied to the tissue by the anvil 716. Other control programs control the rotation of the shaft 740 and the joint motion members 742a, 742b.

In one aspect, the control circuit 710 may generate a motor set value signal. Motor set value signals may be provided to various motor controllers 708a-708e. Motor controllers 708a-708e include one or more circuits configured to provide motor drive signals to motors 704a-704e to drive motors 704a-704e, as described herein. You may. In some embodiments, the motors 704a-704e may be brushed DC electric motors. For example, the speeds of the motors 704a to 704e may be proportional to the respective motor drive signals. In some embodiments, the motors 704a-704e may be brushless DC electric motors, the respective motor drive signal being PWM provided to one or more stator windings of the motors 704a-704e. It may include a signal. Further, in some embodiments, the motor controllers 708a to 708e may be omitted, and the control circuit 710 may directly generate a motor drive signal.

In one aspect, the control circuit 710 may first operate each of the motors 704a-704e in an open-loop configuration at the first open-loop portion of the displacement member stroke. Based on the response of the robotic surgical instrument 700 during the open loop portion of the stroke, the control circuit 710 may select a launch control program with a closed loop configuration. The response of the instrument is the translational distance of the displacement member between the open loop portions, the time elapsed between the open loop portions, the energy provided to one of the motors 704a-704e during the open loop portions, the motor. The total pulse width of the drive signal may be mentioned. After the open loop portion, the control circuit 710 may implement the selected launch control program for the second portion of the displacement member stroke. For example, during the closed-loop portion of the stroke, the control circuit 710 modulates one of the motors 704a-704e in a closed-loop fashion based on translational data describing the position of the displacement member to translate the displacement member at a constant speed. You may let me.

In one aspect, the motors 704a-704e can receive power from the energy source 712. The energy source 712 may be a main AC power source, a battery, a supercapacitor, or a DC power source driven by any other suitable energy source. Motors 704a-704e are mechanically coupled to individual movable mechanical elements such as I-beam 714, anvil 716, shaft 740, joint motion section 742a, and joint motion section 742b via corresponding transmission devices 706a-706e. May be done. Transmission devices 706a-706e may include one or more gears or other connecting components for connecting motors 704a-704e to mobile mechanical elements. The position sensor 734 can sense the position of the I-beam 714. The position sensor 734 may be any type of sensor capable of generating position data indicating the position of the I-beam 714, or may include it. In some examples, the position sensor 734 may include an encoder configured to provide a series of pulses to the control circuit 710 as the I-beam 714 translates distally and proximally. The control circuit 710 may track the pulse to determine the position of the I-beam 714. Other suitable position sensors, including, for example, proximity sensors may be used. Other types of position sensors may provide other signals indicating the motion of the I-beam 714. Also, in some embodiments, the position sensor 734 may be omitted. If any of the motors 704a-704e is a stepper motor, the control circuit 710 may track the position of the I-beam 714 by summing the number and directions of steps instructed by the motor 704 to perform. it can. The position sensor 734 may be located within the end effector 702 or at any other part of the instrument. Each output of the motors 704a-704e includes torque sensors 744a-744e for sensing force and has an encoder that senses the rotation of the drive shaft.

In one aspect, the control circuit 710 is configured to drive a launching member, such as the I-beam 714 portion of the end effector 702. The control circuit 710 provides the motor control unit 708a with a motor set value, and the motor control unit 708a provides a drive signal to the motor 704a. The output shaft of the motor 704a is connected to the torque sensor 744a. The torque sensor 744a is connected to the transmission device 706a connected to the I beam 714. The transmission device 706a includes movable mechanical elements such as a rotating element and a launching member for controlling the movement of the I-beam 714 in the distal and proximal directions along the longitudinal axis of the end effector 702. In one aspect, the motor 704a may be coupled to a knife gear assembly that includes a knife gear reduction set that includes a first knife drive gear and a second knife drive gear. The torque sensor 744a provides a firing force feedback signal to the control circuit 710. The launch force signal represents the force required to launch or displace the I-beam 714. The position sensor 734 may be configured to provide the position of the I-beam 714 or the position of the firing member along the firing stroke to the control circuit 710 as a feedback signal. The end effector 702 may include an additional sensor 738 configured to provide a feedback signal to the control circuit 710. When ready for use, the control circuit 710 can provide a firing signal to the motor control unit 708a. In response to the launch signal, the motor 704a drives the launch member distally along the longitudinal axis of the end effector 702 from the proximal stroke start position to the stroke end position distal to the stroke start position. be able to. As the launching member translates distally, the I-beam 714 with the cutting element located at the distal end advances distally and cuts the tissue located between the staple cartridge 718 and the anvil 716. ..

In one aspect, the control circuit 710 is configured to drive a closing member such as an anvil 716 portion of the end effector 702. The control circuit 710 provides a motor set value to the motor control unit 708b that provides a drive signal to the motor 704b. The output shaft of the motor 704b is connected to the torque sensor 744b. The torque sensor 744b is connected to the transmission device 706b connected to the anvil 716. The transmission device 706b includes movable mechanical elements such as rotating elements and closing members for controlling the movement of the anvil 716 from the open and closed positions. In one aspect, the motor 704b is coupled to a closed gear assembly that includes a closed reduction gear set that is meshed with and supported by the closed spur gear. The torque sensor 744b provides a closing force feedback signal to the control circuit 710. The closing force feedback signal represents the closing force applied to the anvil 716. The position sensor 734 may be configured to provide the position of the closing member as a feedback signal to the control circuit 710. An additional sensor 738 in the end effector 702 can provide a closing force feedback signal to the control circuit 710. The pivotable anvil 716 is located on the opposite side of the staple cartridge 718. When ready for use, the control circuit 710 can provide a closure signal to the motor control unit 708b. In response to the closure signal, the motor 704b advances the closure member to grip the tissue between the anvil 716 and the staple cartridge 718.

In one aspect, the control circuit 710 is configured to rotate a shaft member, such as a shaft 740, to rotate the end effector 702. The control circuit 710 provides a motor set value to the motor control unit 708c that provides a drive signal to the motor 704c. The output shaft of the motor 704c is connected to the torque sensor 744c. The torque sensor 744c is connected to the transmission device 706c connected to the shaft 740. The transmission device 706c includes a movable mechanical element such as a rotating element to control the clockwise or counterclockwise rotation of the shaft 740 up to and beyond 360 degrees. In one aspect, the motor 704c is formed (or to) on the proximal end of the proximal closure tube so that it is operably engaged by a rotating gear assembly operably supported on a tool mounting plate. It is connected to a rotation transmission assembly that includes a tubular gear segment (attached). The torque sensor 744c provides a rotational force feedback signal to the control circuit 710. The rotational force feedback signal represents the rotational force applied to the shaft 740. The position sensor 734 may be configured to provide the position of the closing member as a feedback signal to the control circuit 710. An additional sensor 738, such as a shaft encoder, may provide the rotation position of the shaft 740 to the control circuit 710.

In one aspect, the control circuit 710 is configured to jointly move the end effector 702. The control circuit 710 provides a motor set value to the motor control unit 708d that provides a drive signal to the motor 704d. The output shaft of the motor 704d is connected to the torque sensor 744d. The torque sensor 744d is connected to a transmission device 706d connected to the joint movement member 742a. The transmission device 706d includes a movable mechanical element such as a joint movement element for controlling the ± 65 ° joint movement of the end effector 702. In one aspect, the motor 704d is connected to a joint motion nut, which is rotatably pivoted on the proximal end portion of the distal spine portion and joints on the proximal end portion of the distal spine portion. It is rotatably driven by the kinetic gear assembly. The torque sensor 744d provides a joint kinetic force feedback signal to the control circuit 710. The joint kinetic force feedback signal represents the joint kinetic force applied to the end effector 702. A sensor 738, such as a joint motion encoder, may provide the joint motion position of the end effector 702 to the control circuit 710.

In another aspect, the joint motor function of the robotic surgical system 700 may include two joint motor members, or joints 742a, 742b. These joint motion members 742a, 742b are driven by separate discs on a robot interface (rack) driven by two motors 704d, 704e. A separate launch motor 704a is provided to provide resistance holding motion and load to the head when the head is not in motion, and to provide joint motion when the head is in joint motion. Each of the joint motion connecting portions 742a and 742b can be driven antagonistically with respect to the other connecting portions. The joint movement members 742a and 742b are attached to the head with a fixed radius when the head rotates. Therefore, as the head rotates, the mechanical efficiency of the push-pull connection changes. This change in mechanical efficiency can be more pronounced in the drive system of other joint motion connections.

In one aspect, one or more motors 704a-704e may include a gearbox and a brushed DC motor with a mechanical connection to a launching member, closing member, or articulating member. Another example includes electric motors 704a-704e that operate movable mechanical elements such as displacement members, joint motion connections, closure tubes, and shafts. External effects are unmeasured and unpredictable effects, such as friction on tissues, surrounding bodies, and physical systems. Such external influences are sometimes referred to as drags that act against one of the electric motors 704a-704e. External influences, such as failures, can deviate the behavior of the physical system from the desired behavior of the physical system.

In one aspect, the position sensor 734 may be implemented as an absolute positioning system. In one aspect, the position sensor 734 may include a gyromagnetic absolute positioning system implemented as an AS5055 EQFT single-chip gyromagnetic position sensor available from Austria Microsystems, AG. The position sensor 734 may provide an absolute positioning system in conjunction with the control circuit 710. The position is located above the magnet and is provided to implement a concise and efficient algorithm for computing hyperbolic and trigonometric functions that requires only addition, subtraction, bitshift, and table reference operations. It may include multiple Hall effect elements coupled to a CORDIC processor, also known as the digit-by-digit method and the boulder algorithm.

In one aspect, the control circuit 710 may communicate with one or more sensors 738. The sensor 738 is positioned on the end effector 702 and is adapted to work with the robotic surgical instrument 700 to measure various derived parameters such as clearance distance vs. time, tissue compression vs. time, and anvil strain vs. time. You may. The sensor 738 is one of a magnetic sensor, a magnetic field sensor, a strain gauge, a load cell, a pressure sensor, a force sensor, a torque sensor, an induction sensor such as a vortex current sensor, a resistance sensor, a capacitance sensor, an optical sensor, and / or an end effector 702. Alternatively, any other suitable sensor for measuring two or more parameters may be provided. Sensor 738 may include one or more sensors. The sensor 738 may be located on the deck of the staple cartridge 718 to locate the tissue using segmented electrodes. Torque sensors 744a-744e may be configured to sense, among other things, forces such as firing force, closing force, and / or joint kinetic force. Therefore, the control circuit 710 has (1) the closure load experienced by the distal closure tube and its location, (2) the launcher and its location in the rack, and (3) which part of the staple cartridge 718 is tissue on it. And (4) can sense the load and position on both staples.

In one aspect, the one or more sensors 738 may include a strain gauge, such as a micro strain gauge, configured to measure the magnitude of strain in the anvil 716 in the clamped state. The strain gauge provides an electrical signal whose amplitude fluctuates with the magnitude of the strain. The sensor 738 may include a pressure sensor configured to detect the pressure generated by the presence of compressed tissue between the anvil 716 and the staple cartridge 718. The sensor 738 may be configured to detect the impedance of the tissue portion located between the anvil 716 and the staple cartridge 718, which impedance is the thickness and / or fullness of the tissue located between them. Is shown.

In one aspect, the sensor 738 is mounted as, among other things, one or more limit switches, electromechanical devices, solid switches, Hall effect devices, magnetoresistive (MR) devices, giant magnetoresistive (GMR) devices, magnetometers. May be done. In other embodiments, the sensor 738 may be mounted as a solid-state switch that operates under the influence of light, such as light sensors, IR sensors, and UV sensors, among others. Further, the switch may be a solid-state device such as a transistor (eg, FET, junction FET, MOSFET, bipolar, etc.). In other implementations, the sensor 738 may include, among other things, a conductor-free switch, an ultrasonic switch, an accelerometer, and an inertial sensor.

In one aspect, the sensor 738 may be configured to measure the force exerted on the anvil 716 by the closed drive system. For example, one or more sensors 738 may be located at the point of interaction between the closure tube and the anvil 716 to detect the closing force exerted on the anvil 716 by the closure tube. The force exerted on the anvil 716 may represent the tissue compression experienced by the tissue portion captured between the anvil 716 and the staple cartridge 718. One or more sensors 738 may be positioned at various points of interaction along the closed drive system to detect the closing force exerted by the closed drive system on the anvil 716. One or more sensors 738 may be sampled in real time during the clamping operation by the processor of control circuit 710. The control circuit 710 receives real-time sample measurements, provides and analyzes time-based information, and evaluates the closing force applied to the anvil 716 in real time.

In one aspect, the current sensor 736 can be used to measure the current drawn by each of the motors 704a-704e. The force required to advance any of the movable mechanical elements, such as the I-beam 714, corresponds to the current drawn by one of the motors 704a-704e. The force is converted into a digital signal and provided to the control circuit 710. The control circuit 710 may be configured to simulate the response of the actual system of the instrument with the software of the controller. The displacement member can be actuated to move the I-beam 714 in the end effector 702 at or near the target velocity. The robotic surgical instrument 700 can include a feedback controller, the feedback controller being any feedback controller including, but not limited to, PID, state feedback, linear quadratic (LQR), and / or adaptive controllers. It may be any one of them. The robotic surgical instrument 700 can include a power source for converting signals from the feedback controller into physical inputs such as case voltage, PWM voltage, frequency modulation voltage, current, torque, and / or force. .. Further details are disclosed in US Patent Application No. 15 / 636,829 entitled "CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT", filed June 29, 2017, which is incorporated herein by reference in its entirety. Has been done.

FIG. 18 shows a block diagram of a surgical instrument 750 programmed to control the distal translation of a displacement member according to one aspect of the present disclosure. In one aspect, the surgical instrument 750 is programmed to control the distal translation of the displacement member, such as the I-beam 764. The surgical instrument 750 comprises an anvil 766, an I-beam 764 (including a sharp cut edge), and an end effector 752 that may include a removable staple cartridge 768.

The position, movement, displacement, and / or translation of a linear displacement member, such as the closing member 764, can be measured by an absolute positioning system, sensor configuration, and position sensor 784. Since the I-beam 764 is connected to a longitudinally movable drive member, the position of the I-beam 764 can be determined by measuring the position of the longitudinally movable drive member using a position sensor 784. Therefore, in the following description, the position, displacement, and / or translation of the I-beam 764 can be achieved by the position sensor 784 described herein. The control circuit 760 may be programmed to control the translation of the displacement member, such as the I-beam 764. In some embodiments, the control circuit 760 commands one or more microcontrollers, microprocessors, or processors or multiple processors to control a displacement member, such as the I-beam 764, in the manner described. Other suitable processors to run may be included. In one aspect, the timer / counter 781 provides an output signal such as elapsed time or digital count to the control circuit 760 to correlate the position of the I-beam 764 determined by the position sensor 784 with the output of the timer / counter 781. As a result, the control circuit 760 can determine the position of the I-beam 764 at a particular time (t) with respect to the starting position. The timer / counter 781 may be configured to measure elapsed time, count external events, or measure the time of external events.

The control circuit 760 may generate the motor set value signal 772. The motor set value signal 772 may be provided to the motor controller 758. The motor controller 758 may include one or more circuits configured to provide the motor 754 with a motor drive signal 774 to drive the motor 754, as described herein. In some embodiments, the motor 754 may be a brushed DC electric motor. For example, the speed of the motor 754 may be proportional to the motor drive signal 774. In some examples, the motor 754 may be a brushless DC electric motor and the motor drive signal 774 may include PWM signals provided to one or more stator windings of the motor 754. Also, in some embodiments, the motor controller 758 may be omitted and the control circuit 760 may directly generate the motor drive signal 774.

The motor 754 may receive power from the energy source 762. The energy source 762 may be a battery, a supercapacitor, or any other suitable energy source, or may include it. The motor 754 may be mechanically coupled to the I-beam 764 via a transmission device 756. The transmission device 756 may include one or more gears or other connecting components for connecting the motor 754 to the I-beam 764. The position sensor 784 can sense the position of the I-beam 764. The position sensor 784 may be any type of sensor capable of generating position data indicating the position of the I-beam 764, or may include it. In some examples, the position sensor 784 may include an encoder configured to provide a series of pulses to the control circuit 760 as the I-beam 764 translates distally and proximally. The control circuit 760 may track the pulse to determine the position of the I-beam 764. Other suitable position sensors, including, for example, proximity sensors may be used. Other types of position sensors may provide other signals indicating the motion of the I-beam 764. Also, in some embodiments, the position sensor 784 may be omitted. If the motor 754 is a stepper motor, the control circuit 760 can track the position of the I-beam 764 by summing the number and directions of steps instructed by the motor 754 to perform. The position sensor 784 may be located within the end effector 752 or at any other part of the instrument.

The control circuit 760 may communicate with one or more sensors 788. The sensor 788 is positioned on the end effector 752 and is adapted to work with the surgical instrument 750 to measure various derived parameters such as clearance distance vs. time, tissue compression vs. time, and anvil strain vs. time. May be good. The sensor 788 is one or more of induction sensors such as magnetic sensors, magnetic field sensors, strain gauges, pressure sensors, force sensors, eddy current sensors, resistance sensors, capacitance sensors, optical sensors, and / or end effectors 752. Any other suitable sensor for measuring parameters may be included. Sensor 788 may include one or more sensors.

One or more sensors 788 may include a strain gauge, such as a micro strain gauge, configured to measure the magnitude of strain in the anvil 766 in the clamped state. The strain gauge provides an electrical signal whose amplitude fluctuates with the magnitude of the strain. The sensor 788 may include a pressure sensor configured to detect the pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The sensor 788 may be configured to detect the impedance of the tissue portion located between the anvil 766 and the staple cartridge 768, which impedance is the thickness and / or fullness of the tissue located between them. Is shown.

The sensor 788 may be configured to measure the force exerted on the anvil 766 by a closed drive system. For example, one or more sensors 788 may be located at the point of interaction between the closure tube and the anvil 766 to detect the closing force exerted on the anvil 766 by the closure tube. The force exerted on the anvil 766 may represent the tissue compression experienced by the tissue portion captured between the anvil 766 and the staple cartridge 768. One or more sensors 788 may be positioned at various points of interaction along the closed drive system to detect the closing force exerted by the closed drive system on the anvil 766. One or more sensors 788 may be sampled in real time during the clamping operation by the processor of control circuit 760. The control circuit 760 receives real-time sample measurements, provides and analyzes time-based information, and evaluates the closing force applied to the anvil 766 in real time.

A current sensor 786 can be used to measure the current drawn by the motor 754. The force required to advance the I-beam 764 corresponds to the current drawn by the motor 754. The force is converted into a digital signal and provided to the control circuit 760.

The control circuit 760 may be configured to simulate the response of the actual system of the instrument with the software of the controller. The displacement member can be actuated to move the I-beam 764 in the end effector 752 at or near the target velocity. The surgical instrument 750 can include a feedback controller, the feedback controller being any one of any feedback controllers including, but not limited to, for example, PID, state feedback, LQR, and / or adaptive controllers. It may be one. The surgical instrument 750 can include a power source for converting signals from the feedback controller into physical inputs such as case voltage, PWM voltage, frequency modulation voltage, current, torque, and / or force.

The actual drive system for the surgical instrument 750 is such that the displacement member, cutting member, or I-beam 764 is driven by a brushed DC motor with a gearbox and a mechanical connection to the joint movement and / or knife system. It is configured in. Another example is an electric motor 754 that operates an interchangeable shaft assembly, eg, a displacement member and a joint motion driver. External effects are unmeasured and unpredictable effects, such as friction on tissues, surrounding bodies, and physical systems. Such external influences are sometimes referred to as failures acting against the electric motor 754. External influences, such as failures, can deviate the behavior of the physical system from the desired behavior of the physical system.

Various exemplary embodiments are directed to a surgical instrument 750 with an end effector 752 having motor-driven surgical staple fastening and cutting means. For example, the motor 754 may drive the displacement members distally and proximally along the longitudinal axis of the end effector 752. The end effector 752 may include a pivotable anvil 766 and, if configured for use, a staple cartridge 768 located on the opposite side of the anvil 766. The clinician may grip the tissue between the anvil 766 and the staple cartridge 768 as described herein. When ready to use the instrument 750, the clinician can provide a firing signal, for example by pressing the trigger on the instrument 750. In response to the firing signal, the motor 754 drives the displacement member distally along the longitudinal axis of the end effector 752 from the proximal stroke start position to the stroke end position distal to the stroke start position. You may. As the displacement member translates distally, the I-beam 764 with the cutting element located at the distal end can cut the tissue between the staple cartridge 768 and the anvil 766.

In various embodiments, the surgical instrument 750 provides a control circuit 760 programmed to control the distal translation of a displacement member, such as an I-beam 764, based on one or more tissue conditions. You may prepare. The control circuit 760 may be programmed to sense tissue conditions such as thickness, either directly or indirectly, as described herein. The control circuit 760 may be programmed to select a launch control program based on tissue conditions. The launch control program can describe the distal motion of the displacement member. Various launch control programs can be selected to better handle different tissue conditions. For example, in the presence of thicker tissue, the control circuit 760 may be programmed to translate the displacement member at a slower speed and / or at a lower power. In the presence of thinner tissue, the control circuit 760 may be programmed to translate the displacement member faster and / or at higher power.

In some embodiments, the control circuit 760 may first operate the motor 754 in an open loop configuration with respect to the first open loop portion of the displacement member stroke. Based on the response of the instrument 750 during the open loop portion of the stroke, the control circuit 760 may select a launch control program. The response of the instrument is the sum of the translational distance of the displacement member between the open loop portions, the time elapsed between the open loop portions, the energy provided to the motor 754 during the open loop portions, and the pulse width of the motor drive signal. And so on. After the open loop portion, the control circuit 760 may implement the selected launch control program for the second portion of the displacement member stroke. For example, during the closed loop portion of the stroke, the control circuit 760 may modulate the motor 754 in a closed loop manner based on translational data describing the position of the displacement member to translate the displacement member at a constant speed. Further details are incorporated herein by reference in its entirety, US Patent Application No. 15 / 720,852, entitled "SYSTEM AND METHODS FOR CONTOROLRING A DISPLAY OF A SURGICAL INSTRUMENT", filed September 29, 2017. It is disclosed in.

FIG. 19 is a schematic representation of a surgical instrument 790 configured to control various functions according to at least one aspect of the present disclosure. In one aspect, the surgical instrument 790 is programmed to control the distal translation of the displacement member, such as the I-beam 764. The surgical instrument 790 includes an end effector 792 that may include an anvil 766, an I-beam 764, and a removable staple cartridge 768 that can be replaced with an RF cartridge 796 (shown by a dashed line).

In one aspect, the sensor 788 may be implemented, among other things, as a limit switch, electromechanical device, solid switch, Hall effect device, MR device, GMR device, magnetometer. In other embodiments, the sensor 638 may be a solid-state switch that operates under the influence of light, especially light sensors, IR sensors, UV sensors, and the like. Further, the switch may be a solid-state device such as a transistor (eg, FET, junction FET, MOSFET, bipolar, etc.). In other implementations, the sensor 788 may include, among other things, a conductor-free switch, an ultrasonic switch, an accelerometer, and an inertial sensor.

In one aspect, the position sensor 784 may be implemented as an absolute positioning system including a magnetic rotation absolute positioning system implemented as an AS5055EQFT single chip magnetic rotation position sensor available from Austria Microsystems, AG. The position sensor 784 may provide an absolute positioning system in conjunction with the control circuit 760. The position is located above the magnet and is provided to implement a concise and efficient algorithm for computing hyperbolic and trigonometric functions that requires only addition, subtraction, bitshift, and table reference operations. It may include multiple Hall effect elements coupled to a CORDIC processor, also known as the digit-by-digit method and the boulder algorithm.

In one aspect, the I-beam 764 may be mounted as a knife member that includes a knife body operably supporting the tissue cutting blade on top of the anvil engaging tab or feature and passage engaging feature or foot. Further may be included. In one aspect, the staple cartridge 768 may be implemented as a standard (mechanical) surgical fastener cartridge. In one aspect, the RF cartridge 796 may be mounted as an RF cartridge. These, and other sensor configurations, are the same as the "TECHNIQUES FOR ADAPTIVE CONTOROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTUL" filed June 20, 2017, which is incorporated herein by reference in its entirety. It is described in the owner's US Patent Application No. 15 / 628,175.

The position, movement, displacement, and / or translation of a linear displacement member such as the I-beam 764 can be measured by an absolute positioning system, a sensor configuration, and a position sensor represented as a position sensor 784. Since the I-beam 764 is connected to a longitudinally movable drive member, the position of the I-beam 764 can be determined by measuring the position of the longitudinally movable drive member using a position sensor 784. Therefore, in the following description, the position, displacement, and / or translation of the I-beam 764 can be achieved by the position sensor 784 described herein. As described herein, the control circuit 760 may be programmed to control the translation of displacement members such as the I-beam 764. In some embodiments, the control circuit 760 commands one or more microcontrollers, microprocessors, or processors or multiple processors to control a displacement member, such as the I-beam 764, in the manner described. Other suitable processors to run may be included. In one aspect, the timer / counter 781 provides an output signal such as elapsed time or digital count to the control circuit 760 to correlate the position of the I-beam 764 determined by the position sensor 784 with the output of the timer / counter 781. As a result, the control circuit 760 can determine the position of the I-beam 764 at a particular time (t) with respect to the starting position. The timer / counter 781 may be configured to measure elapsed time, count external events, or measure the time of external events.

The control circuit 760 may generate the motor set value signal 772. The motor set value signal 772 may be provided to the motor controller 758. The motor controller 758 may include one or more circuits configured to provide the motor 754 with a motor drive signal 774 to drive the motor 754, as described herein. In some embodiments, the motor 754 may be a brushed DC electric motor. For example, the speed of the motor 754 may be proportional to the motor drive signal 774. In some examples, the motor 754 may be a brushless DC electric motor and the motor drive signal 774 may include PWM signals provided to one or more stator windings of the motor 754. Also, in some embodiments, the motor controller 758 may be omitted and the control circuit 760 may directly generate the motor drive signal 774.

The motor 754 may receive power from the energy source 762. The energy source 762 may be a battery, a supercapacitor, or any other suitable energy source, or may include it. The motor 754 may be mechanically coupled to the I-beam 764 via a transmission device 756. The transmission device 756 may include one or more gears or other connecting components for connecting the motor 754 to the I-beam 764. The position sensor 784 can sense the position of the I-beam 764. The position sensor 784 may be any type of sensor capable of generating position data indicating the position of the I-beam 764, or may include it. In some examples, the position sensor 784 may include an encoder configured to provide a series of pulses to the control circuit 760 as the I-beam 764 translates distally and proximally. The control circuit 760 may track the pulse to determine the position of the I-beam 764. Other suitable position sensors, including, for example, proximity sensors may be used. Other types of position sensors may provide other signals indicating the motion of the I-beam 764. Also, in some embodiments, the position sensor 784 may be omitted. If the motor 754 is a stepper motor, the control circuit 760 can track the position of the I-beam 764 by summing the number and directions of steps instructed by the motor to perform. The position sensor 784 may be located within the end effector 792 or at any other part of the instrument.

The control circuit 760 may communicate with one or more sensors 788. The sensor 788 is positioned on the end effector 792 and may be adapted to work with the surgical instrument 790 to measure various derived parameters such as clearance distance vs. time, tissue compression vs. time, and anvil strain vs. time. .. The sensor 788 is one or more of induction sensors such as magnetic sensors, magnetic field sensors, strain gauges, pressure sensors, force sensors, eddy current sensors, resistance sensors, capacitance sensors, optical sensors, and / or end effectors 792. Any other suitable sensor for measuring parameters may be included. Sensor 788 may include one or more sensors.

One or more sensors 788 may include a strain gauge, such as a micro strain gauge, configured to measure the magnitude of strain in the anvil 766 in the clamped state. The strain gauge provides an electrical signal whose amplitude fluctuates with the magnitude of the strain. The sensor 788 may include a pressure sensor configured to detect the pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The sensor 788 may be configured to detect the impedance of the tissue portion located between the anvil 766 and the staple cartridge 768, which impedance is the thickness and / or fullness of the tissue located between them. Is shown.

The sensor 788 may be configured to measure the force exerted on the anvil 766 by a closed drive system. For example, one or more sensors 788 may be located at the point of interaction between the closure tube and the anvil 766 to detect the closing force exerted on the anvil 766 by the closure tube. The force exerted on the anvil 766 may represent the tissue compression experienced by the tissue portion captured between the anvil 766 and the staple cartridge 768. One or more sensors 788 can be placed at various points of interaction along the closure drive system to detect the closure force applied to the anvil 766 by the closure drive system. One or more sensors 788 may be sampled in real time during the clamping operation by the processor of control circuit 760. The control circuit 760 receives real-time sample measurements, provides and analyzes time-based information, and evaluates the closing force applied to the anvil 766 in real time.

A current sensor 786 can be used to measure the current drawn by the motor 754. The force required to advance the I-beam 764 corresponds to the current drawn by the motor 754. The force is converted into a digital signal and provided to the control circuit 760.

The RF energy source 794 is coupled to the end effector 792 and is applied to the RF cartridge 796 when the RF cartridge 796 is loaded into the end effector 792 instead of the staple cartridge 768. The control circuit 760 controls the delivery of RF energy to the RF cartridge 796.

Further details are incorporated herein by reference in their entirety, "SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING US Pat. / 636,096.

FIG. 20 is a simplified block diagram of the generator 800 configured to provide inductorless tuning, among other advantages. Additional details of the generator 800 can be found in US Pat. No. 9,060,775, issued June 23, 2015, entitled "SURGICAL GENERALTOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES," which is incorporated herein by reference in its entirety. Has been described. The generator 800 may include a patient isolation stage 802 that communicates with the non-insulation stage 804 via the power transformer 806. The secondary winding 808 of the power transformer 806 is housed within the insulation stage 802 and includes, for example, ultrasonic surgical instruments, RF electrosurgical instruments, and ultrasonic and RF energy modes that can be delivered independently or simultaneously. A tap configuration (eg, center tap or non-center tap configuration) for defining drive signal output units 810a, 810b, 810c to deliver drive signals to various surgical instruments such as functional surgical instruments may be included. Good. Specifically, the drive signal output units 810a and 810c may output an ultrasonic drive signal (for example, a 420 V root mean square (RMS) drive signal) to an ultrasonic surgical instrument, and the drive signal output unit 810b may be used. , 810c may output an RF electrosurgical drive signal (for example, a 100 V RMS drive signal) to the RF electrosurgical instrument by the drive signal output unit 810b corresponding to the center tap of the power transformer 806.

In certain forms, ultrasonic and electrosurgical drive signals are multifunctional surgical instruments capable of delivering to separate surgical instruments and / or both ultrasonic energy and electrosurgical energy to tissues. May be provided simultaneously to a single surgical instrument such as. The electrosurgical signal provided to either the dedicated electrosurgical instrument and / or the combined multifunctional ultrasound / electrosurgical instrument is either a therapeutic or sub-therapeutic level signal for treatment. It will be appreciated that sub-quantity signals can be used, for example, to monitor tissue or instrument status and provide feedback to the generator. For example, ultrasound and RF signals can be delivered separately or simultaneously from a generator with a single output port to provide the desired output signal to the surgical instrument, as discussed in more detail below. .. Therefore, the generator can combine ultrasonic energy and RF energy for electrosurgery to deliver the combined energy to the multifunctional ultrasonic / electrosurgical instrument. The bipolar electrode can be placed on one or both jaws of the end effector. One jaw may be driven by ultrasonic energy in addition to the co-working RF energy for electrosurgery. Ultrasound energy may be used to make an incision in the tissue, and electrosurgical RF energy may be used to seal the blood vessel.

The non-insulated step 804 may include a power amplifier 812 with an output section connected to the primary winding 814 of the power transformer 806. In certain embodiments, the power amplifier 812 may include a push-pull amplifier. For example, the non-isolated step 804 may further include a logic device 816 for supplying digital output to the digital-to-analog converter (DAC) circuit 818, which the digital-to-analog converter (DAC) circuit 818 then corresponds to. An analog signal is supplied to the input of the power amplifier 812. In certain embodiments, the logic device 816 may include, for example, a programmable gate array (PGA), a field programmable gate array (FPGA), and a programmable logic device (PLD), among other logic circuits. Therefore, the logic device 816 controls the input of the power amplifier 812 via the DAC circuit 818 to control many parameters (for example, frequency, waveform, waveform) of the drive signal appearing in the drive signal output units 810a, 810b, and 810c. Any of (amplitude) can be controlled. In a particular embodiment, as described below, the logical unit 816, along with the processor (eg, the DSP described below), implements many DSP-based and / or other control algorithms by the generator 800. The parameters of the output drive signal can be controlled.

Power may be supplied to the power rails of the power amplifier 812 by a switch mode regulator 820, such as a power converter. In certain embodiments, the switch mode regulator 820 may include, for example, an adjustable back regulator. The non-isolated stage 804 may further include a first processor 822, the first processor 822 in one form, for example, such as Analog Devices ADCS-21469 SHARC DSP available from Analog Devices (Norwood, MA). A DSP processor may be included, but in various forms any suitable processor may be used. In certain embodiments, the DSP processor 822 may control the operation of the switch-mode regulator 820 in response to voltage feedback data received by the DSP processor 822 from the power amplifier 812 via the ADC circuit 824. In one embodiment, for example, the DSP processor 822 may receive the waveform envelope of the signal (eg, RF signal) amplified by the power amplifier 812 as an input via the ADC circuit 824. The DSP processor 822 may then control the switch-mode controller 820 (eg, PWM output) so that the rail voltage supplied to the power amplifier 812 tracks the waveform envelope of the amplified signal. By dynamically modulating the rail voltage of the power amplifier 812 based on the waveform envelope, the efficiency of the power amplifier 812 can be significantly improved relative to the fixed rail voltage amplifier scheme.

In certain embodiments, the logic device 816, along with the DSP processor 822, directly implements a digital synthesis circuit such as a digital synthesizer control scheme to control the waveform shape, frequency and / or amplitude of the drive signal output by the generator 800. You may. In one form, for example, the logic device 816 implements a DDS control algorithm by calling a waveform sample stored in a dynamically updated look-up table (LUT), such as a RAM LUT that can be embedded in an FPGA. It may be implemented. This control algorithm is particularly useful in ultrasonic applications where an ultrasonic converter, such as an ultrasonic converter, can be driven by a distinct sinusoidal current at its resonant frequency. Minimization or reduction of the total distortion of the operating branch current can correspondingly minimize or reduce the undesired resonance effect, as other frequencies can excite the parasitic resonance. Since the waveform of the drive signal output by the generator 800 is affected by various distortion sources existing in the output drive circuit (eg, power transformer 806, power amplifier 812), voltage and current feedback based on the drive signal The data may be input to an algorithm such as the error control algorithm implemented by the DSP processor 822, which is a dynamic, progress-based (eg, real-time), suitable waveform sample stored in the LUT. Compensate for distortion by pre-distorting or correcting. In one form, the amount or degree of pre-strain applied to the LUT sample may be based on the error between the calculated operating branch current and the desired current waveform, the error being determined on a sample-by-sample basis. In this way, the pre-distorted LUT sample, when processed by the drive circuit, provides an operating branch drive signal with the desired waveform shape (eg, sinusoidal) in order to optimally drive the ultrasonic transducer. Can occur. In such a form, the LUT waveform sample is therefore necessary to finally generate the desired waveform of the motion branch drive signal, taking into account the distortion effect, rather than representing the desired waveform of the drive signal. Waveform.

The non-isolated stage 804 is a first connected to the output section of the power transformer 806 via the corresponding insulated transformers 830 and 832 in order to sample the voltage and current of the drive signal output by the generator 800, respectively. The ADC circuit 826 and the second ADC circuit 828 may be further included. In certain embodiments, the ADC circuits 826, 828 may be configured to sample at high speeds (eg, 80 megasamples per second (MSPS)) to allow oversampling of drive signals. In one form, for example, the sampling rate of the ADC circuits 826, 828 may allow oversampling of the drive signal by approximately 200x (depending on frequency). In certain embodiments, the sampling operation of the ADC circuits 826, 828 may be performed by a single ADC circuit that receives the input voltage and current signals via a bidirectional multiplexer. The use of fast sampling in the form of the generator 800, among other things, can be used in certain forms to implement the calculation of complex currents flowing through the operating branch, which is the DDS-based waveform shape control described above. ), Accurate digital filtering of the sampled signal, and highly accurate calculation of actual power consumption may be possible. The voltage and current feedback data output by the ADC circuits 826, 828 may be received and processed by the logic device 816 (eg, first-come-first-served basis (FIFO) buffer, multiplexer, etc.), eg, by the DSP processor 822 thereafter. It may be stored in the data memory for reading. As mentioned above, the voltage and current feedback data can be used as input to the algorithm to pre-distort or modify the LUT waveform sample on a dynamic and progressive basis. In certain embodiments, this is stored based on or in connection with the corresponding LUT sample output by the logic device 816 when a voltage and current feedback data pair is obtained, respectively. Voltage and current feedback data pairs may need to be indexed. The synchronization of the LUT sample with the voltage and current feedback data in this way contributes to the accurate timing and stability of the pre-distortion algorithm.

In certain embodiments, voltage and current feedback data may be used to control the frequency and / or amplitude (eg, current amplitude) of the drive signal. For example, in one form, voltage and current feedback data may be used to determine the impedance phase. The frequency of the drive signal is then controlled to minimize or reduce the difference between the determined impedance phase and the impedance phase set value (eg 0 °), thereby minimizing the effect of harmonic distortion. Alternatively, it can be reduced and the impedance phase measurement accuracy can be improved accordingly. The determination of the phase impedance and the frequency control signal may be implemented, for example, in the DSP processor 822, and the frequency control signal is supplied as an input to the DDS control algorithm implemented by the logic device 816.

In another embodiment, for example, current feedback data may be monitored to maintain the current amplitude of the drive signal at the current amplitude set point. The current amplitude set value may be directly specified, or may be indirectly determined based on the specified voltage amplitude and power set value. In certain embodiments, current amplitude control can be implemented by a control algorithm, such as a proportional-integral-differential (PID) control algorithm within a DSP processor 822. In order to suitably control the current amplitude of the drive signal, the variables controlled by the control algorithm include, for example, scaling of the LUT waveform sample stored in the logic device 816 and / or DAC circuit 818 via DAC circuit 834. The full scale output voltage (which supplies the input to the power amplifier 812) can be mentioned.

The non-isolated stage 804 may further include a second processor 836, especially to provide user interface (UI) functionality. In one embodiment, the UI processor 836 may include, for example, an Atmel AT91SAM9263 processor with an ARM 926EJ-S core, available from Atmel Corporation (San Jose, California). Examples of UI features supported by the UI processor 836 include auditory and visual user feedback, communication with peripherals (eg, via a universal serial bus (USB) interface), communication with footswitches, and input. Communication with a device (eg, a touch screen display) as well as communication with an output device (eg, a speaker) can be mentioned. The UI processor 836 may communicate with the DSP processor 822 and the logic device 816 (eg, SPI bus). The UI processor 836 may primarily support UI functionality, but in certain embodiments, the UI processor 836 may also work with the DSP processor 822 to achieve risk mitigation. For example, the UI processor 836 may be programmed to monitor various aspects of user input and / or other inputs (eg, touch screen input, footswitch input, temperature sensor input), and may be misstated. When detected, the drive output of the generator 800 may be disabled.

In certain embodiments, both the DSP processor 822 and the UI processor 836 may, for example, determine and monitor the operating state of the generator 800. With respect to the DSP processor 822, the operating state of the generator 800 may represent, for example, which control and / or diagnostic process is implemented by the DSP processor 822. With respect to the UI processor 836, the operating state of the generator 800 may represent, for example, which element of the UI (eg, display screen, sound) is provided to the user. The DSP processor 822 and the UI processor 836 may each maintain the current operating state of the generator 800 separately and recognize and evaluate possible transitions from the current operating state. The DSP processor 822 may act as a master in this relationship and determine when transitions between operating states occur. The UI processor 836 may recognize valid transitions between operating states and may confirm that a particular transition is appropriate. For example, when the DSP processor 822 instructs the UI processor 836 to make a transition to a specific state, the UI processor 836 may confirm that the requested transition is valid. If the transition between the requested states is determined by the UI processor 836 to be invalid, the UI processor 836 may put the generator 800 into failure mode.

The non-insulated step 804 may further include a controller 838 for monitoring the input device (eg, a capacitive touch sensor used to turn the generator 800 on and off, a capacitive touch screen). .. In certain embodiments, the controller 838 may include at least one processor and / or another controller device that communicates with the UI processor 836. In one embodiment, for example, the controller 838 is a processor configured to monitor user input provided via one or more capacitive touch sensors (eg, a Meg168 8-bit controller available from Atmel). ) May be included. In one form, the controller 838 may include a touch screen controller (eg, a QT5480 touch screen controller available from Atmel) for controlling and managing the acquisition of touch data from a capacitive touch screen.

In certain embodiments, when the generator 800 is in the "power off" state, the controller 838 continues to receive operating power (eg, via a line from the generator 800's power supply, such as power supply 854 described below). You may. In this way, the controller 838 may continue to monitor the input device for turning the generator 800 on and off (eg, the capacitive touch sensor located on the front panel of the generator 800). When the generator 800 is in the power off state, the controller 838 may activate the power supply (eg, one or two of the power sources 854) when the user's activation of the "on / off" input device is detected. Enable the operation of one or more DC / DC voltage transformers 856). Therefore, the controller 838 may initiate a sequence for transitioning the generator 800 to the "power on" state. Conversely, if activation of the "on / off" input device is detected while the generator 800 is in the power on state, the controller 838 initiates a sequence to transition the generator 800 to the power off state. May be good. For example, in certain embodiments, the controller 838 may report the activation of the "on / off" input device to the UI processor 836, which in turn causes the generator 800 to transition to the power off state. Implement the required process sequence. In such an embodiment, the controller 838 may not have an independent capability to remove power from the generator 800 after the power-on state of the generator 800 has been established.

In certain embodiments, the controller 838 may cause the generator 800 to provide audible or other sensory feedback to warn the user that a power-on or power-off sequence has begun. Such warnings may be provided at the beginning of a power-on or power-off sequence, and before the start of other processes associated with the sequence.

In certain embodiments, the insulation step 802 is, for example, a control circuit of a surgical instrument (eg, a control circuit including a handpiece switch) and a non-isolated step such as, for example, a logic device 816, a DSP processor 822 and / or a UI processor 836. An instrument interface circuit 840 may be included to provide a communication interface to and from the components of the 804. The instrument interface circuit 840 is a component of the non-insulated stage 804 via a communication link that maintains a suitable degree of electrical insulation between the insulated stage 802 and the non-insulated stage 804, such as an IR-based communication link. Can exchange information with. For example, a low dropout voltage regulator powered by an insulated transformer driven from non-isolated stage 804 can be used to power the appliance interface circuit 840.

In one form, the instrument interface circuit 840 may include a logic circuit 842 (eg, logic circuit, programmable logic circuit, PGA, FPGA, PLD) communicating with the signal conditioning circuit 844. The signal conditioning circuit 844 may be configured to receive a periodic signal (eg, a 2 kHz square wave) from the logic device 842 in order to generate a bipolar call signal having the same frequency. The call signal can be generated using, for example, a bipolar current source supplied by a differential amplifier. The call signal is communicated to the surgical instrument control circuit (eg, using a conductive pair in a cable connecting the generator 800 to the surgical instrument) and monitored to determine the state or configuration of the control circuit. You may. The control circuit may include a large number of switches, resistors, and / or diodes so that the state or configuration of the control circuit can be individually identified based on one or more characteristics. One or more characteristics of (eg, amplitude, rectification) may be modified. For example, in one form, the signal conditioning circuit 844 may include an ADC circuit to generate a sample of the voltage signal that appears over the input of the control circuit resulting from the path through which the call signal passes. The logic circuit 842 (or component of non-insulated step 804) can then determine the state or configuration of the control circuit based on the ADC circuit sample.

In one form, the instrument interface circuit 840 includes a first data circuit interface (DCI) 846 and is disposed within a surgical instrument with a logic circuit 842 (or other element of the instrument interface circuit 840). Alternatively, information can be exchanged with a first data circuit associated in another way. In certain embodiments, for example, the first data circuit is in a cable or adapter integrally attached to the surgical instrument handpiece to link a particular surgical instrument type or model with the generator 800. It may be arranged in. The first data circuit may be implemented in any suitable manner, eg, communicating with the generator according to any suitable protocol, including those described herein for the first data circuit. May be good. In certain embodiments, the first data circuit may include a non-volatile storage device, such as an EEPROM device. In certain embodiments, the first data circuit interface 846 may be implemented separately from the logic circuit 842 and also includes suitable circuits (eg, separate logic devices, processors), the logic circuit 842 and the first. It may enable communication with the data circuit of. In other embodiments, the first data circuit interface 846 may be integrated with the logic circuit 842.

In certain embodiments, the first data circuit may store information about the particular surgical instrument with which the first data circuit is associated. Such information can include, for example, model numbers, serial numbers, number of movements in which surgical instruments have been used, and / or any other type of information. This information is read by the instrument interface circuit 840 (eg, by the logic circuit 842) and is not provided to the user via the output device and / or to control the function or operation of the generator 800. It may be transmitted to the components of isolation step 804 (eg, logic device 816, DSP processor 822, and / or UI processor 836). In addition, any kind of information may be transmitted to the first data circuit (eg, using logic circuit 842) for internal storage via the first data circuit interface 846. Such information may include, for example, the latest number of surgeries in which the surgical instrument was used and / or the date and / or time of its use.

As mentioned above, surgical instruments may be removable from the handpiece to facilitate instrument compatibility and / or disposability (eg, multifunctional surgical instruments are removable from the handpiece. possible). In such cases, conventional generators may have limited ability to recognize the particular instrument configuration used and to optimize control and diagnostic processes accordingly. However, adding readable data circuits to surgical instruments to address this issue is problematic from a compatibility standpoint. For example, designing surgical instruments to be backwards compatible with generators that lack the required data reading functionality may not be practical, for example due to different signal schemes, design complexity and cost. is there. The instrument forms discussed herein are designed to economically use data circuits that may be implemented in existing surgical instruments and to maintain compatibility between the surgical instrument and modern generator platforms. Address these concerns by minimizing changes.

In addition, the form of the generator 800 may allow communication with instrument-based data circuits. For example, the generator 800 may be configured to communicate with a second data circuit housed within an instrument (eg, a multifunctional surgical instrument). In some embodiments, the second data circuit may be implemented in many similar to those of the first data circuit described herein. The instrument interface circuit 840 may include a second data circuit interface 848 that enables this communication. In one form, the second data circuit interface 848 may include a tristate digital interface, but other interfaces may also be used. In certain embodiments, the second data circuit may generally be any circuit for transmitting and / or receiving data. In one form, for example, the second data circuit may store information about the particular surgical instrument with which the second data circuit is associated. Such information can include, for example, model numbers, serial numbers, number of movements in which surgical instruments have been used, and / or any other type of information.

In some embodiments, the second data circuit may store information about the electrical and / or ultrasonic properties of the associated ultrasonic transducer, end effector, or ultrasonic drive system. For example, the first data circuit may exhibit a burn-in frequency slope as described herein. In addition, or alternative, any kind of information is transmitted to the second data circuit (eg, using logic circuit 842) for internal storage via the second data circuit interface 848. May be done. Such information may include, for example, the latest number of movements in which the instrument has been used, and / or the date and / or time of its use. In certain embodiments, the second data circuit may transmit data acquired by one or more sensors (eg, appliance-based temperature sensors). In certain embodiments, the second data circuit may receive data from the generator 800 and provide the user with an index (eg, a light emitting diode index or other visible index) based on the received data.

In certain embodiments, the second data circuit and the second data circuit interface 848 allow communication between the logic circuit 842 and the second data circuit to be an additional conductor for this purpose (eg, a handpiece). May be configured so that it can be provided without the need to provide a dedicated conductor of the cable that connects the generator 800. In one form, a one-wire bus communication scheme implemented over existing cabling, for example, one of the conductors used sends a call signal from the signal conditioning circuit 844 to the control circuit in the handpiece. Can be used to transfer information to and from a second data circuit. In this way, design changes or modifications to surgical instruments that may be originally required are minimized or reduced. In addition, the presence of a second data circuit is "invisible" to generators that do not have the required data reading capabilities, as different types of communications performed on common physical channels can be frequency band separated. And therefore, it allows for backward compatibility of surgical instruments.

In certain embodiments, the isolation step 802 may include at least one blocking capacitor 850-1 connected to the drive signal output section 810b to prevent DC current from passing through the patient. A single blocking capacitor may be required to comply with, for example, medical regulations or standards. Although failures in single-capacitor designs are relatively rare, such failures can nevertheless have negative consequences. In one embodiment, the second blocking capacitor 850-2 may be provided in series with the blocking capacitor 850-1, and leakage from a point between the blocking capacitors 850-1 and 850-2 may be, for example, leakage. It is monitored by the ADC circuit 852 to sample the voltage induced by the current. The sample may be received, for example, by logic circuit 842. The generator 800 can determine when at least one of the blocking capacitors 850-1, 850-2 has failed, based on the change in leakage current (as shown by the voltage sample), in doing so. Benefits over a single capacitor design with a single fault point.

In certain embodiments, the non-insulated step 804 may include a power source 854 for delivering DC power at suitable voltages and currents. The power supply may include, for example, a 400 W power supply for delivering a 48 VDC system voltage. The power supply 854 comprises one or more DC / DC voltage converters 856 for receiving the power supply output and producing a DC output at the voltage and current required by the various components of the generator 800. Further may be included. As mentioned above in connection with the controller 838, one or more of the DC / DC voltage converters 856 are controllers when the controller 838 detects the activation of the "on / off" input device by the user. Inputs may be received from 838 to enable the operation or activation of the DC / DC voltage converter 856.

FIG. 21 shows an example of the generator 900, which is a form of the generator 800 (FIG. 20). The generator 900 is configured to deliver multiple energy modality to the surgical instrument. The generator 900 provides RF and ultrasonic signals, either alone or simultaneously, to deliver energy to the surgical instrument. The RF signal and the ultrasonic signal may be provided alone or in combination, or may be provided at the same time. As mentioned above, at least one generator output unit has multiple energy modalities (eg, ultrasound, bipolar or unipolar RF, irreversible and / or reversible electroporation, and / or microwaves, among others, through a single port. Energy) can be delivered and these signals can be delivered to the end effector individually or simultaneously to treat the tissue.

The generator 900 includes a processor 902 coupled to a waveform generator 904. The processor 902 and the waveform generator 904 are configured to generate various signal waveforms based on information stored in a memory connected to the processor 902 (not shown for clarity of disclosure). The digital information associated with the waveform is provided to the waveform generator 904, which includes one or more DAC circuits to convert the digital input to an analog output. The analog output is supplied to amplifier 1106 for signal conditioning and amplification. The regulated and amplified output of the amplifier 906 is coupled to the power transformer 908. The signal is coupled across the power transformer 908 to the secondary side on the patient isolated side. The first signal of the first energy modality is provided between the terminals labeled _{ENERGY 1 and RETURN of the surgical instrument.} The second signal of the second energy modality is coupled over the capacitor 910 and provided between the terminals labeled _{ENERGY 2 and RETURN of the surgical instrument.} More than two energy modality may be output, so the subscript "n" can be used to indicate that up to n ENERGYn terminals can be provided, where n is greater than or equal to 1. It will be understood that it is a positive integer. It will also be appreciated that a maximum of "n" return paths (RETURNn) may be provided without departing from the scope of the present disclosure.

The first voltage sensing circuit 912 is _{connected over the terminals labeled ENERGY 1} and RETURN path and measures the output voltage between them. A second voltage sensing circuit 924 is _{connected over the terminals labeled ENERGY 2} and RETURN paths and measures the output voltage between them. The current sensing circuit 914 is arranged in series with the RETURN section on the secondary side of the illustrated power transformer 908 to measure the output current of either energy modality. If different return paths are provided for each energy modality, a separate current sensing circuit must be provided for each return interval. The output of the first voltage sensing circuit 912 and the second voltage sensing circuit 924 is provided to the corresponding insulated transformers 916, 922, and the output of the current sensing circuit 914 is provided to another insulated transformer 918. The output of the insulated transformers 916, 928, 922 on the primary side (non-patient isolated side) of the power transformer 908 is provided to one or more ADC circuits 926. The digitized output of the ADC circuit 926 is provided to processor 902 for further processing and computation. The output voltage and output feedback information can be used to adjust the output voltage and current provided to the surgical instrument and to calculate the output impedance among several parameters. Input / output communication between the processor 902 and the patient isolation circuit is provided through the interface circuit 920. The sensor may also telecommunications with the processor 902 via the interface circuit 920.

In one aspect, the impedance is either a first voltage sensing circuit 912 coupled over a terminal labeled _{ENERGY 1} / RETURN or a second voltage sensing circuit 924 coupled over a terminal labeled _{ENERGY 2 / RETURN.} The output can be determined by the processor 902 by dividing the output by the output of the current sensing circuit 914 arranged in series with the RETURN section on the secondary side of the power transformer 908. The output of the first voltage sensing circuit 912 and the second voltage sensing circuit 924 is provided to the separate insulated transformers 916, 922, and the output of the current sensing circuit 914 is provided to another insulated transformer 916. The digitized voltage and current sense measurements from the ADC circuit 926 are provided to processor 902 to calculate the impedance. As an example, the first energy modality ENERGY ₁ may be ultrasonic energy and the second energy modality ENERGY ₂ may be RF energy. Nevertheless, in addition to ultrasonic energy modality and bipolar or unipolar RF energy modality, other energy modality includes irreversible and / or reversible electropiercing and / or radiofrequency energy, among others. Also, the example illustrated in FIG. 21 shows that a single return path RETURN can be provided to more than one energy modality, but in other embodiments, multiple return paths RETURNn have their respective energies. It may be provided to the modality ENERGYn. Therefore, as described herein, the impedance of the ultrasonic converter may be measured by dividing the output of the first voltage sensing circuit 912 by the current sensing circuit 914, and the tissue impedance is the first. It may be measured by dividing the output of the voltage sensing circuit 924 of 2 by the current sensing circuit 914.

As shown in FIG. 21, a generator 900 containing at least one output port can power, for example, ultrasound, bipolar or unipolar RF, irreversible and /, depending on the type of tissue treatment performed. Or a power transformer having a single output and having multiple taps to provide to the end effector in the form of one or more energy modalities such as reversible electropiercing and / or microwave energy. A vessel 908 can be included. For example, the generator 900 uses either unipolar or bipolar RF electrosurgical electrodes to drive the RF electrodes for tissue encapsulation at high voltage and low current to drive the ultrasonic converter. Therefore, energy can be delivered at low voltage and high current, or with a solidification waveform for spot solidification. The output waveform from the generator 900 can be guided, switched, or filtered to provide frequency to the end effector of the surgical instrument. The connection of the ultrasonic transducer to the generator 900 output will preferably be located between the output labeled _{ENERGY 1 and RETURN as shown in FIG.} In one embodiment, the connection of the RF bipolar electrode to the output of the generator 900 would preferably be located between the output labeled _{ENERGY 2 and RETURN.} For unipolar outputs, a preferred connection would be an active electrode (eg, pencil type or other probe) to a suitable return pad connected to the _{ENERGY 2 output and the RETURN output.}

Further details are incorporated herein by reference in their entirety, entitled "TECHNIQUES FOR OPERATING GENERATIONOR FOR DIGITALLY GENERATION ELECTRIC SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS 2017 U.S.A. It is disclosed in the issue.

FIG. 22 shows a surgical instrument 29000 according to at least one aspect of the present disclosure. In the embodiment shown in FIG. 22, the surgical instruments include a handle 29002, a bendable shaft assembly 29004, an end effector 29006, a motor (not visible through the outer surface of the handle 29002), and a flexible circuit 29008. including. Although FIG. 22 shows the surgical instrument 29000 as having a bendable shaft assembly 29004, according to another aspect, the surgical instrument 29000 has a joint instead of a bendable portion. It will be appreciated that the shaft assembly may be included.

FIG. 23 shows the shaft assembly 29005 of the surgical instrument 29000 according to at least one other aspect of the present disclosure. As shown in FIG. 23, the shaft assembly 29005 includes a joint 29010 and is connected to an end effector 29006 including a first jaw 29012 and a second jaw 29014, the first and second jaws 29012, At least one of the 29014 is configured to pivot between the open and closed positions to clamp tissue between the first jaw 29012 and the second jaw 29014. Although the end effector 29006 is shown to include a staple cartridge 29016, it will be appreciated that according to other embodiments, the end effector 29006 may include electrodes in place of or in addition to the staple cartridge 29016.

FIG. 24 shows the flexible circuit 29008 of the surgical instrument 29000 of FIG. The flexible circuit 2900 resides within the handle 29002, the shaft assembly 29004/29005, and the end effector 29006 and includes a processing device 29018, a logic element 29020, a conductive trace 29022, and a conductive pad 29024. Although only one processor 29018 and one logic element 29020 are shown in FIG. 23, it will be appreciated that the flexible circuit 29008 may include any number of processors 29018 and / or logic element 29020. .. The conductive pad 29024 is another surgical instrument 29000 such as a sensing device, a motor (see conductive pads A and B in FIG. 24), and a slip ring (see conductive pads C and D in FIG. 24) as described above. It is configured to connect to a component. The conductive trace 29022 carries a signal from the sensor, a signal to and from the processing device 29018, a signal to and from the logic element 29020, a signal to and from the control circuit, a signal to the motor, and the like. Although not shown for brevity, the flexible circuit 29008 may also include a substrate, one or more insulating layers, and an overlay. The processing apparatus 29018, the logic element 90020, etc. can be mounted on the substrate, and the conductive traces 29022 and the conductive pads 90024 can be patterned on / across the substrate. One or more insulating layers electrically insulate the conductive traces from each other. The overlay covers the insulating layer and / or the processing device 29018, the logic element 29020, the conductive trace 29022, and the conductive pad 29024. The flexible circuit 29008 may be single-sided, double-sided, or multi-layered, as shown in FIG. The conductive trace 29022 and the conductive pad 29024 may include copper, gold, tin, and / or other suitable conductive materials.

According to various aspects, in order to insulate the conductive trace 29022 from the high frequency energy delivered by the surgical instrument 29000, the flexible circuit 29008 blocks high frequency electromagnetic radiation and / or between the various conductive traces 29022. Includes an electromagnetic shield (eg, guard trace or guard ring) that minimizes signal crosstalk. The electromagnetic shield need not be included in the entire flexible circuit 20008. For example, according to various aspects, the electromagnetic shield is positioned only at selected locations in the flexible circuit 29008 and is a conductive trace so that it is not subject to unwanted effects or signals caused by external high frequency generators or magnets. 29022 can be protected. For brevity, the electromagnetic shield is not shown in FIG.

The flexible circuit 29008 includes both a rigid (registered) portion 29026 and a flexible (flex) portion 29028. Therefore, the flexible circuit 29008 is sometimes referred to as a rigid flex circuit. The rigid portion 29026 may be reinforced and is configured not to bend / bend to any significant degree. The rigid portion 29026 includes a portion of the conductive trace 29022 and also includes, for example, one or more processing devices 29018, one or more integrated circuits, one or two as shown in FIG. The above logic element 29020 and / or conductive pad 90024 may be included. The actual positioning of devices such as non-chip gates and other logic elements 29020 allows low-level decision making (eg, distributed processing) locally to the actuator of the surgical instrument 29000.

According to various aspects, the first rigid portion 29026 of the flexible circuit 29008 proximal to the joint 29010 of the shaft assembly 29005 snaps into the recess 29032 defined by the first channel cage 29034. The second rigid portion 29026 of the flexible circuit 29008 distal to the joint 29010 of the shaft assembly 29005 includes a second rigid portion 29026, including an interlock mechanism 29030 configured to be fitted (see FIG. 25). Includes an interlock mechanism configured to snap into a recess defined by a channel cage. The interlock mechanism of the second rigid portion, the second channel cage, and its recess are not shown in FIG. 24 for brevity, except for positioning (proximal vs. distal with respect to the joint). Further, the interlock mechanism of the second rigid portion may be similar to or the same as the interlock mechanism 29030 of the first rigid portion 29026, and the second channel cage may be similar to or the same as the first channel cage 29034. It will be appreciated that the recesses of the second channel cage may be similar or identical and may be similar or identical to the recesses 29032 of the first channel cage 29034. The first and second channel holders 29034 are fixed within the surgical instrument 29000 and do not move relative to the surgical instrument 29000. The snap-fit connection between the rigid portion 29026 and the channel cage 29034 allows the flexible circuit 29008 to be attached to the surgical instrument 29000, when the surgical instrument 29000 needs to be moved in different directions. And / or prevent the flexible circuit 29008 from "disengaging" from position when it receives various forces.

The flexible portion 29028 is configured to bend and bend as needed. For example, in the case of a flexible portion 29028 aligned with the active bending portion of the shaft assembly 20004 of the surgical instrument 29000 or the articulating portion of the shaft assembly 29005, the flexible portion 29028 is also added to the flexible portion 29028. It also needs to be bendable to prevent unwanted stress and / or failure of the flexible portion 29028. Similarly, if the flexible portion 29028 needs to be stepped across the mechanical components of the surgical instrument 29000 (eg, the articulating rod of the surgical instrument), the flexible portion of the flexible circuit 29008. 29028 makes this feasible (see, eg, FIG. 23). When a force, twist, or deformation is applied to the flexible circuit 29008, the flexible portion 29028 allows the flexible circuit 29008 to bend in one direction more than in the other direction, thereby loading. Prevents damage to the flexible circuit 29008 due to.

The flexible portion 29028 includes a portion of the conductive trace 29022 and can be stepped across one or more mechanical components as described above and / or maneuverability, strength, and /. Alternatively, it folds in certain potentially high stress areas to increase resistance to failure (eg, within the active bend portion of shaft assembly 29004 as shown in FIG. 22, or within the articulation joint 29010 of shaft assembly 29005). It can be.

According to various aspects, each cross section of the conductive trace 29022 can vary throughout the flexible circuit 29008, even though the conductive trace 29022 still has the same or substantially similar current carrying capacities. The height (h) or thickness of each of the conductive traces 29022 can be changed, and / or the width (w) of each of the conductive traces 29022 can also be changed. For example, in the case of a given conductive trace 29022 present in both the rigid portion 29026 and the flexible portion 29028, the height (h) of the conductive trace 29022 may be greater in the rigid portion 29026 than in the flexible portion 29028. Often, the width (W) of the conductive trace 29022 may be larger at the flexible portion 29028 than at the rigid portion 29026. The combination of lower height and larger width in the flexible portion 29028 allows the conductive trace 29022 to increase resistance to high stresses introduced by movements such as joint movements and / or jaw closing movements. .. The length L shown in FIG. 24 represents the length of the articulated portion of the shaft assembly 29005 with respect to the conductive trace 29022 aligned with the articulated joint 29010.

FIG. 26 shows a cross-sectional view of the flexible circuit 29008 along line AA of FIG. 24 according to at least one aspect of the present disclosure. The portion of the flexible circuit 29008 along line AA is distal to the bent portion of the shaft assembly 29004 / joint joint 29010 of the shaft assembly 29005 and can be considered as the rigid portion 29026. As shown in FIGS. 24 and 26, the flexible circuit 29008 is not separated along the line A-A, the corresponding conductive traces 29022 in this portion of the flexible circuit 29008 is and the height _{h a} It has a width _{W a.}

FIG. 27 shows a cross section of the flexible circuit 29008 along line BB of FIG. 24 according to at least one aspect of the present disclosure. The portion of the flexible circuit 29008 along line BB is proximal to the bent portion of the shaft assembly 29004 / joint joint 29010 of the shaft assembly 29005 and can be considered as the flexible portion 29028. As shown in FIGS. 24 and 27, the flexible circuit 29008 defines a separator or opening 29036 along line BB, and the corresponding conductive trace 29022 in this portion of the flexible circuit 29008 Has a height h _b and a width W _b .

By comparing FIGS. 26 and 27, the height of the portion of the corresponding conductive traces 29022 along line A-A (conductive portions of the traces 29022 in the rigid portion 29026) _{(h a),} the line B-B It is clear that it is larger than _{the height (h b} ) of the corresponding conductive trace 29022 portion (the portion of the conductive trace 29022 in the flexible portion 29028) along. Similarly, the corresponding along line A-A width of a portion of the conductive traces 29022 (conductive portions of the traces 29022 in the rigid portion 29026) _{(W a)} is the corresponding along line B-B conductive traces 29022 It is also clear that it is smaller than _{the width (W b} ) of the portion (the portion of the conductive trace 29022 in the flexible portion 29028). In other words, as shown in FIG. _26, a _h a> h _b and _W a _{<W b.}

In aspects of the surgical instrument 29000 including the joint 29010 within the shaft assembly 29005, the corresponding portion of the flexible circuit 29008 passing through the joint 29010 (flexible portion 29028 of the flexible circuit 29008). The portion of the conductive trace 29022 is shorter / thinner and wider than the portion of the corresponding conductive trace 29022 in the rigid portion 29026 distally adjacent to the flexible portion 29028. Conventional wires in this region typically have to be augmented with strain relief, but the conductive traces 29022 of the flexible circuit 29008 in this region have the conductive traces 29022 of this flexible portion 29028. It is made shorter / thinner and wider so that it can have the same current carrying capacity as those in the rigid portion 29026 while increasing their flexibility. Considering the above, the flexible portion 29028 of the flexible circuit 29008 may be aligned with the pivot axis of the articulation joint 29010 of the shaft assembly 29005, whereby the flexible circuit 29008 may be aligned with the shaft assembly 29005. And / or it will be appreciated that the surgical instrument 29000 can be bent up to 90 ° (or more) with respect to the longitudinal axis 29038. Similar functionality may be achieved for the pivotal joint of the end effector 29006 and / or part of the flexible circuit 29008 that passes through the first and / or second jaws 29012 and 29014 of the surgical instrument 29000. .. Thus, the flexible circuit 29008 has a variable cross section that is aligned with the joint of the surgical instrument 29000 (eg, the articulation joint 29010 of the shaft assembly 29005 and / or the pivot joint of the end effector 29006). It can be understood to include elements (eg, conductive traces 29022).

As shown in FIG. 22, due to the portion of the flexible circuit 29008 that passes through the bendable portion of the shaft assembly 29004 (or through the articulation joint 29010 of the shaft assembly 29005), the flexible circuit 29008 Similar to the method shown in FIG. 22, it may be folded on each side of the separator or opening 29040. Folding on each side of the separation or opening 29040, and the flexibility of the conductive trace 29022, the wider portion of the conductive trace 29022 of the flexible portion 29028 is available within the joint 29010 of the shaft assembly 29005. Allows you to fit within the restricted area.

According to various aspects, the flexible circuit 29008 may include a twist or strain relief portion 29042 built into the flexible circuit 29008. As shown in FIG. 22, according to various aspects, the twist or strain relief portion 29042 includes a rigid portion 29026 including an interlock mechanism 29030 and a flexible portion 29028 that passes through the articulated joint 29010 of the shaft assembly 29005. Can be positioned between. The twist or strain relief portion 29042 first attaches the flexible circuit 29008 to the first channel cage 29034 (along the first plane along the length of the shaft assembly 29005 proximal to the joint 29010. And then twist about 90 ° with respect to the first plane to allow joint movement around an axis perpendicular to the first plane. The twist or strain relief portion 29042 is configured to safely relax the strain imposed on the flexible circuit 29008.

By incorporating both the rigid portion 29026 and the flexible portion 29028 into the flexible circuit 29008 of the surgical instrument 29000, the flexible circuit 29008 remains properly positioned within the surgical instrument 29000 and the surgical instrument. It may reflect the movement of the active bend portion of the shaft assembly 29004 of the 29000 or the articulation joint 29010 of the shaft assembly 29005. Such a combination provides a flexible circuit 29008 that is more resistant to failure than those typically associated with the surgical instrument 29000.

FIG. 28 shows an exploded view of the flexible electrode 29100 of the surgical instrument 29000 of FIG. 22 according to at least one aspect of the present disclosure. According to various aspects, the flexible electrode 29100 can be incorporated into the flexible circuit 29008 of FIG. 22 or at least electrically connected to the flexible circuit 29008. Although not shown for clarity, the flexible electrode 29100 can be coupled to an electrosurgical generator and can receive electrosurgical energy (RF level alternating current) supplied by the electrosurgical generator. Will be understood.

The flexible electrode 29100 may be positioned on the first or second jaws 29012, 29014 of the end effector 29006 of the surgical instrument 29000 and includes a therapeutic electrode 29102 and a sensing electrode 29104. The therapeutic electrode 29102 and the sensing electrode 29104 may include copper, gold, tin, or any other suitable material for conducting electricity.

The therapeutic electrode 29102 may have a rectangular shape and is configured to deliver RF energy to the tissue located between the first jaw 29012 and the second jaw 29014 of the surgical instrument 29000. According to various aspects, the therapeutic electrode 29102 may have a thickness in the range of about 0.003 inches.

The sensing electrode 29104 is configured to help determine one or more parameters associated with the tissue located between the first jaw 29012 and the second jaw 29014 of the surgical instrument 29000. Has been done. For example, the sensing electrode 29104 may be configured to help determine the impedance of the tissue located between the first jaw 29012 and the second jaw 29014 of the surgical instrument 29000. By sensing the amplitude, frequency, phase shift, etc. of the current passing through the tissue, the sensing electrode 29104 can pass the sensed "value" to the processing circuit of the surgical instrument 29000, which is then surgical. The impedance of the tissue located between the first jaw 29012 and the second jaw 29014 of the instrument 29000 can be determined. An example of such a sensing electrode is the United States of the same owner entitled "IMPEDANCE FEEDBACK MONITOR WITH QUERY ELECTRODE FOR ELECTROSURGICAL INSTRUMENT" published October 6, 1998, the entire contents of which are incorporated herein by reference. It is described in Pat. No. 5,817,093. The sensing electrode 29104 can be continuously sensed even when RF energy is delivered to the tissue by the therapeutic electrode 29102 to weld the tissue. According to various aspects, the sensing electrode 29104 may have a thickness similar to or the same as that of the therapeutic electrode 29102 (eg, within a range of about 0.003 inches).

According to various aspects, the sensing electrode 29104 may also be configured to help determine tissue contraction and / or temperature transition points within the tissue. For example, by sensing the amplitude, frequency, phase shift, etc. of the current passing through the tissue, the sensing electrode 29104 can pass the sensed "value" to the processing circuit of the surgical instrument 29000, which in turn The sensed "value" can be used to determine the electrical continuity of the tissue located between the first jaw 29012 and the second jaw 29014 of the surgical instrument 29000. The processing circuit can then utilize the determined electrical continuity of the tissue to help determine tissue contraction. When used in connection with the therapeutic electrode 29102, the sensing electrode 29104 detects the approach to the transition temperature point associated with tissue welding because the sensing electrode 29104 is at a higher pressure than the therapeutic electrode 29102. Can make it possible. By utilizing the sensing ability of the sensing electrode 29104, the sensed "value" can be passed to the processing circuit of the surgical instrument 29000, which in turn utilizes the sensed "value" of the tissue. Impedance events can be identified before temperature transitions / inflection points occur in the low pressure zone.

The sensing electrode 29104 has a pattern shape, overlaps the therapeutic electrode 29102, and may have the same overall length and width as the therapeutic electrode 29102, but the pattern shape does not completely cover the therapeutic electrode 29102. As shown in FIG. 28, according to various aspects, the sensing electrode 29104 can be patterned as a modified "E-shape" with a plurality of rectangular fingers 29106. When the sensing electrode 29104 overlaps the therapeutic electrode 29102, the space 29108 between the modified E-shaped rectangular fingers 29106 of the sensing electrode 29104 remains uncovered. Is aligned with. According to another aspect, the pattern shape of the sensing electrode 29104 can be a modified E-shape with a plurality of triangular fingers or fingers of other shapes.

The flexible electrode 29100 also includes a first insulating layer 29110 located between the therapeutic electrode 29102 and the sensing electrode 29104. The first insulating layer 29110 can be patterned in the same manner as the sensing electrode 29104 (eg, a modified E-shape with a plurality of rectangular fingers 29112) and is aligned with the sensing electrode 29104. The 29104 is electrically insulated from the therapeutic electrode 29102. According to various aspects, the first insulating layer 29110 coincides with the sensing electrode 29104. According to various aspects, when the first insulating layer 29110 overlaps the therapeutic electrode 29102, the space 29114 between the plurality of rectangular fingers 29112 of the modified E-shaped first insulating layer 29110 is covered. It is aligned with the portion of the therapeutic electrode 29102 that remains absent and is aligned with the space 29108 between the plurality of rectangular fingers 29106 of the modified E-shaped sensing electrode 29104. According to another aspect, the plurality of rectangular fingers 29112 of the modified E-shaped first insulating layer 29110 is slightly larger than the plurality of rectangular fingers 29106 of the modified E-shaped sensing electrode 29104. It can be wide (see FIGS. 29 and 30), so that space 29114 can be slightly narrower than space 29108. According to various aspects, the first insulating layer 29110 has a thickness in the range of about 0.001 inch to 0.0003 inch. The first insulating layer 29110 may contain any suitable non-conductive material and may have higher flexibility than either the therapeutic electrical 29102 or the sensing electrode 29104.

The flexible electrode 29100 was also positioned to cover the surface of the therapeutic electrode 29102, which is opposite to the surface of the therapeutic electrode 29102, which is partially covered by the first insulating layer 29110 and the sensing electrode 29104. A second insulating layer 29116 is included. The second insulating layer 29116 may have a rectangular shape having the same overall length and width as the therapeutic electrode 29102. According to various aspects, the second insulating layer 29116 can have a thickness in the range of about 0.0001 inches to 0.003 inches. The second insulating layer 29116 may contain any suitable non-conductive material and may have higher flexibility than either the therapeutic electrical 29102 or the sensing electrode 29104.

For clarity, only one flexible electrode 29100 is shown in FIG. 28, but the surgical instrument 29000 is at least two of the flexible electrodes 29100 (eg, the end of the surgical instrument 29000). It is understood that the effector 29006 may include one on the left side of the knife slot and one on the right side of the knife slot). In addition, it will be appreciated that when the flexible electrode 29100 comprises multiple components and multiple layers, the flexible electrode 29100 can be considered as a flexible electrode assembly and / or a multilayer flexible electrode. ..

29 and 30 show a plan view of the flexible electrode assembly 29200 according to at least one aspect of the present disclosure. The flexible electrode assembly 29200 includes two of the flexible electrodes 29100 of FIG. 28, the first electrode 29100a of the flexible electrodes being the knife slot 29202 of the end effector 29006 of the surgical instrument 29000. The second electrode 29100b of the flexible electrodes is located on the left side of the knife slot 29202. With respect to the plan views shown in FIGS. 29 and 30, the sensing electrodes 29104a and 29104b are positioned on and partially cover the therapeutic electrodes 29102a and 29102b.

The surfaces of the corresponding sensing electrodes 29104a, 29104b that may come into direct contact with the tissue located between the first jaw 29012 and the second jaw 29014 of the surgical instrument 29000 are shown in dark color in FIG. The dark surface of FIG. 29 can be considered as a sensing electrode pattern. As mentioned above, the sensing electrode 29104 can help determine the impedance of the tissue located between the first jaw 29012 and the second jaw 29014 of the surgical instrument 29000. When used in connection with the therapeutic electrode 29102, the sensing electrode 29104 detects the approach to the transition temperature point associated with tissue welding because the sensing electrode 29104 is at a higher pressure than the therapeutic electrode 29102. Can make it possible. By utilizing the measuring capability of the sensing electrode 29104, impedance events can be identified before inflection points occur in the low pressure zone of the tissue. In addition, sensing electrodes 29014 may also allow measurement of tissue contraction if electrical continuity is measured by them. By using the sensing electrode 29104 to measure continuity rather than impedance, the measured parameters may indicate tissue contraction rather than water drained from the tissue. In addition, the sensing electrode 29104 can be used to measure both tissue impedance and continuity. According to various aspects, the sensing electrode 29104 can also be used as a conductive gap spacer to control the minimum gap between the first jaw 29012 and the second jaw 29014 of the surgical instrument 29000.

The concave, discontinuous portion of the surface of the corresponding therapeutic electrodes 29102a, 29102b that may come into direct contact with the tissue located between the jaws of the surgical instrument 29000 is shown in dark color in FIG. The dark surface of FIG. 30 can be considered as a therapeutic electrode pattern. Due to the concave, split, discontinuous nature of the surface of the therapeutic electrodes 29102a, 29102b, which may come into direct contact with the tissue located between the first jaw 29012 and the second jaw 29014 of the surgical instrument 29000. , The therapeutic electrode 29102 may reduce any unwanted tissue adhesion when the therapeutic electrode 29102 is energized. According to various aspects, a given concave discontinuity of the therapeutic electrode 29102 between two adjacent rectangular fingers 29106 of the sensing electrode 29104 is one of the rectangular fingers 29106. It can be greater than one "length" by a range of about 0.005 "to 0.0008" in the longitudinal direction. In other words, the surface area of a given concave discontinuity of the therapeutic electrode 29102 between two adjacent rectangular fingers 29106 of the sensing electrode 29104 is the surface area of the rectangular finger 29106 of the sensing electrode 29104. It can be larger than the surface area of one of them. According to various aspects, at least one of the concave, split, discontinuous portions of the surface of the therapeutic electrode 29102 can be positioned in an offset or opposed electrode configuration and is coupled to a current return path. Obtained, from which it can be connected to an electrosurgical generator.

Considering the above, the flexible electrode assembly 29200 is a multi-level flexible electrode and has one or more parameters associated with the surgical instrument 29000 and / or the first jaw of the surgical instrument 29000. It will be appreciated that the tissue located between 29012 and the second jaw 29014 can be measured and the tissue can be cauterized.

FIG. 31 shows an exploded view of the flexible electrode 29300 of the surgical instrument 29000 of FIG. 22 according to at least one other aspect of the present disclosure. The flexible electrode 29300 of FIG. 31 is similar to the flexible electrode 29100 of FIG. 28, but of the sensing electrode 29104 in which the flexible electrode 29300 of FIG. 31 is covered by a first insulating layer 29110. It differs in that it further includes a third insulating layer 29302 positioned to partially cover the surface of the sensing electrode 29104 on the opposite side of the surface. The third insulating layer 29302 has the same overall length as the sensing electrode 29104, the first insulating layer 29110, and / or the therapeutic electrode 29102, but the sensing electrode 29104, the first insulating layer 29110, the therapeutic electrode 29102, and / Or may have a rectangular shape having a width smaller than the width of the second insulating layer 29116. For example, according to various aspects, the third insulating layer 29302 may have a width that covers all sensing electrodes 29104 except the rectangular finger 29106. According to another aspect, the third insulating layer 29302 may have a width that does not cover the rectangular finger portion 29106 but partially covers only the remaining portion of the sensing electrode 29104. According to various aspects, the third insulating layer 29302 may have a thickness in the range of about 0.0001 inches to 0.003 inches. The third insulating layer 29302 may contain any suitable non-conductive material and may have higher flexibility than either the therapeutic electrical 29102 or the sensing electrode 29104.

FIG. 32 shows an end view of the flexible electrode 29400 of the surgical instrument 29000 of FIG. 22 according to at least one other aspect of the present disclosure. The flexible electrode 29400 of FIG. 32 is similar to, but different from, the flexible electrode of FIG. In the flexible electrode 29400 of FIG. 32, the first insulating layer 29110 extends beyond the left and right sides of the sensing electrode 29104 (relative to FIG. 32) and the second insulating layer 29116 is a therapeutic electrode. Extending beyond the left and right sides of 29102, the third insulating layer 29302 extends beyond one of the sides of the sensing electrode 29104. In addition, the flexible electrode 29400 of FIG. 32 also covers one of the sides of the therapeutic electrode 29102 and one of the sides of the sensing electrode 29102 for first, second, and third insulation. Includes insulating material 29402, which connects layers 29110, 29116, and 29302 together. The insulating material 29402 may be similar or identical to the material of the first, second, and / or third insulating layers 29110, 29116, 29302 and is higher than either the therapeutic electrode 29102 or the sensing electrode 29104. Can have flexibility. In addition, the flexible electrode 29400 of FIG. 32 allows a plurality of portions of the sensing electrode 29104 and / or the therapeutic electrode 29102 to come into contact with tissue located between the jaws of the surgical instrument 29000. It can be a layered composite structure that includes a portion of the sensing electrode 29104 and / or the therapeutic electrode 29102 embedded in the structure.

FIG. 33 shows a top perspective view of the flexible electrode 29500 of the surgical instrument 29000 of FIG. 22 according to at least one other aspect of the present disclosure. As shown in FIG. 33, the flexible electrode 29500 further comprises an additional insulating material 29504 that covers the side of the sensing electrode 29104 that is opposite to the side covered by the insulating material 29402. The additional insulating material 29504 may be similar or identical to the material of the insulating material 29402 and the materials of the first, second, and / or third insulating layers 29110, 29116, 29302. The additional insulating material 29504 may have higher flexibility than either the therapeutic electrode 29102 or the sensing electrode 29104. As shown in FIG. 33, the long, thin portion 29506 of the therapeutic electrode 29104 is uncovered and is in direct contact with the tissue located between the first jaw 29012 and the second jaw 29014 of the surgical instrument 29000. Can be done. The limited surface area of the long, thin, uncovered portion 29506 of the therapeutic electrode 29104 can reduce any unwanted tissue adhesion. Similarly, the discontinuous portion of the therapeutic electrode 29102 not covered by the first insulating member 29110 and / or the sensing electrode 29104 is also between the first jaw 29012 and the second jaw 29014 of the surgical instrument 29000. It may come into direct contact with the tissue located in, and may also reduce any unwanted tissue adhesion.

As described above, one or more of the flexible electrodes 29100, 29200, 29300, 29400, 29500 may form part of the flexible circuit 29008 of the surgical instrument 29000. According to various aspects, the termination contact configuration may allow the flexible circuit 29008 to be easily attached or connected to other connections and / or circuits within the surgical instrument 29000. The terminating contact configuration can provide strain relief to the flexible circuit 29008, which can reduce damage to a portion of the flexible circuit 29008 adjacent to the connection. Termination contact configurations can also keep the connection watertight. According to various aspects, the termination contact configuration can be a zero insertion force (ZIF) connector that electrically connects the flexible circuit 29008 to other connections and / or circuits within the surgical instrument 29000. Such a ZIF connector may include a self-sealing connection to the fluid and may provide strain relief for a portion of the flexible circuit 29008 adjacent to the ZIF connector.

By incorporating the therapeutic electrode 29102 and the sensing electrode 29104 into the flexible electrode, the flexible electrode is RF to the tissue located between the first jaw 29012 and the second jaw 29014 of the surgical instrument 29000. While energy can be applied, parameters associated with tissue and / or surgical instrument 29000 can also be measured. In the above configuration, the sensing electrode 29104 can continuously sense the parameters even when the therapeutic electrode 29102 applies RF energy to the tissue for welding. In addition, due to the partial overlap of the "contact surface" of the therapeutic electrode 29102 with the sensing electrode 29104 and / or the first insulating layer 29110, the therapeutic electrode 29102 has a small surface area in contact with the tissue and is therefore desirable. Not likely to contribute to tissue adhesion. Moreover, due to the inherent flexibility of the flexible electrode, the therapeutic electrode 29102 may experience earlier failure due to undesired bending or deformation than the electrode typically associated with surgical instruments. Is low.

Various aspects of the subject matter described herein are described in the numbered examples below.

Example 1-A flexible circuit of a surgical instrument is disclosed. The flexible circuit comprises a rigid portion and a flexible portion. The rigid portion includes an interlock mechanism for mechanically engaging the components of the surgical instrument. At least one of a processing device and a logic element is mounted on the rigid portion. The flexible portion is aligned with one of the active bending portion of the shaft assembly of the surgical instrument and the joint of the shaft assembly.

Example 2-The flexible circuit according to Example 1, wherein the flexible portion is configured to bend laterally with respect to the longitudinal axis of the shaft assembly.

Example 3-The flexible circuit according to any one of Examples 1 and 2, wherein the component comprises a channel cage, the channel cage comprising a recess configured to receive a rigid portion.

Example 4-The flexible circuit according to any one of Examples 1 to 3, further comprising a conductive trace.

Example 5-The flexible circuit according to Example 4, wherein the height of the conductive trace varies along the length of the conductive trace.

Example 6-The flexible circuit according to any one of Examples 4 and 5, wherein the width of the conductive trace varies along the length of the conductive trace.

Example 7-The flexible according to any one of Examples 4 to 6, wherein the conductive trace changes in height along the length of the conductive trace and changes in width along the length of the conductive trace. Sex circuit.

Example 8-The height of the first portion of the conductive trace located on the flexible portion is smaller than the height of the second portion of the conductive trace located on the rigid portion, Examples 4-7. The flexible circuit according to any one of.

Example 9-In Examples 4-8, the width of the first portion of the conductive trace located on the flexible portion is smaller than the width of the second portion of the conductive trace located on the rigid portion. The flexible circuit according to any one.

Example 10-The height of the first portion of the conductive trace located on the flexible portion is smaller than the height of the second portion of the conductive trace located on the rigid portion, the first of the conductive traces. The flexible circuit according to any one of Examples 4 to 9, wherein the width of the portion is larger than the width of the second portion of the conductive trace.

Example 11-The flexible circuit according to any one of Examples 1 to 10, wherein the flexible circuit includes a strain relief portion.

Example 12-The flexible circuit according to any one of Examples 1 to 11, further comprising a conductive pad.

Example 13-The flexible circuit according to any one of Examples 1 to 12, further comprising an electromagnetic shield.

Example 14-Flexible circuits for surgical instruments are disclosed. The flexible circuit comprises a rigid portion, a flexible portion, and conductive traces located both on the rigid portion and on the flexible portion. At least one of a processing device and a logic element is mounted on the rigid portion. The flexible portion is aligned with one of the active bending portion of the shaft assembly of the surgical instrument and the joint of the shaft assembly. The height and width of the conductive traces vary with the length of the surgical instrument.

Example 15-The flexible circuit of Example 14, wherein the rigid portion is configured to mechanically interlock with a component of the surgical instrument.

Example 16-The flexible circuit of Example 15, wherein the component comprises a channel retainer, the channel retainer comprising a recess configured to receive a rigid portion.

Example 17-The flexible circuit according to any one of Examples 14-16, wherein the flexible portion is configured to bend laterally with respect to the longitudinal axis of the shaft assembly.

Example 18-The height of the first portion of the conductive trace located on the flexible portion is smaller than the height of the second portion of the conductive trace located on the rigid portion, the first of the conductive traces. The flexible circuit according to any one of Examples 14 to 17, wherein the width of the portion is larger than the width of the second portion of the conductive trace.

Example 19-Flexible circuits for surgical instruments are disclosed. The flexible circuit comprises a rigid portion, a flexible portion, a conductive trace, and an electromagnetic shield. The flexible portion is aligned with one of the active bending portion of the shaft assembly of the surgical instrument and the joint of the shaft assembly. Conductive traces are positioned on both rigid and flexible portions, and the height and width of the conductive traces vary along the length of the surgical instrument.

Example 20-The height of the first portion of the conductive trace located on the flexible portion is smaller than the height of the second portion of the conductive trace located on the rigid portion, the first of the conductive traces. 19. The flexible circuit according to Example 19, wherein the width of the portion is larger than the width of the second portion of the conductive trace.

Although several forms have been exemplified and described, it is not the applicant's intent to limit or limit the accompanying "claims" to such details. A number of modifications, modifications, changes, substitutions, combinations and equivalents of these forms can be implemented and will be conceived by those skilled in the art without departing from the scope of the present disclosure. Further, the structure of each element associated with the form described can be described alternative as a means for providing the functionality performed by that element. Also, although the material is disclosed for a particular component, other materials may be used. Therefore, the above description and the appended claims are intended to cover all such modifications, combinations, and modifications as included within the scope of the disclosed form. I want you to understand. The appended claims are intended to cover all such modifications, modifications, changes, substitutions, modifications, and equivalents.

The above detailed description has described various forms of equipment and / or processes using block diagrams, flowcharts, and / or examples. As long as such block diagrams, flowcharts, and / or embodiments include one or more functions and / or operations, the respective functions and / or embodiments contained in such block diagrams, flowcharts, and / or embodiments. Those skilled in the art will appreciate that / or operation can be implemented individually and / or collectively by a variety of hardware, software, firmware, or virtually any combination thereof. To those skilled in the art, all or part of some of the embodiments disclosed herein may be as one or more computer programs running on one or more computers (eg, 1). As one or more programs running on one or more computer systems (as one or more programs running on one or more computer systems) (eg, as one or more programs running on one or more processors) Can be equivalently implemented on an integrated circuit as one or more programs running on a microprocessor, as firmware, or as virtually any combination thereof, and designing the circuit. And / or writing code for software and / or firmware will be understood to be within the skill of those skilled in the art in light of the present disclosure. Further, as will be appreciated by those skilled in the art, the mechanisms of subject matter described herein can be distributed in a variety of forms as one or more program products, which are described herein. The specific forms of the described subject matter are used regardless of the particular type of signal carrier used in the actual distribution.

Instructions used to program logic to perform various disclosed aspects can be stored in in-system memory such as DRAM, cache, flash memory, or other storage. In addition, instructions can be distributed over the network or by other computer-readable media. Thus, machine-readable media can include any mechanism for storing or transmitting information in a form readable by a machine (eg, a computer), including floppy disks, optical disks, CD-ROMs, and magnetic optical disks. , ROM, RAM, EPROM, EEPROM, magnetic or optical card, flash memory, or via electrical, optical, acoustic, or other forms of propagating signals (eg, carriers, IR signals, digital signals, etc.) It is not limited to tangible machine-readable storage used to transmit information over the Internet. Thus, non-transitory computer-readable media include any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a form readable by a machine (eg, a computer).

As used throughout this description, the term "radio" and its derivatives describe circuits, devices, systems, methods, techniques, communication channels, etc. that can communicate data through the use of modulated electromagnetic radiation over non-solid media. May be used for. The term does not mean that the devices involved do not include any wires, but in some embodiments they may not exist. Communication modules include Wi-Fi (IEEE802.11 family), WiMAX (IEEE802.16 family), IEEE802.20, LTE, Ev-DO, HSPA +, HSDPA +, HSUPA +, EDGE, GSM, GPRS, CDMA, TDMA, DECT, Bluetooth, these Ethernet derivatives, as well as any other wireless and wired protocols designated as 3G, 4G, 5G, and beyond, but not limited to a number of wireless or wired communication standards or protocols. One of them may be implemented. The computing module may include a plurality of communication modules. For example, the first communication module may be dedicated to short-range wireless communication such as Wi-Fi and Bluetooth, and the second communication module may be GPS, EDGE, GPRS, CDMA, WiMAX, LTE, Ev-DO, etc. May be dedicated to long-range wireless communication.

As used in any aspect of the specification, the term "control circuit" refers to, for example, a hardwired circuit, a programmable circuit (eg, a computer processor containing one or more individual instruction processing cores, a processing unit). , Processors, microcontrollers, microcontroller units, controllers, DSPs, PLDs, programmable logic arrays (PLAs), or FPGAs), state machine circuits, firmware that stores instructions executed by programmable circuits, and any combination thereof. Can be pointed to. Control circuits can be collectively or individually, for example, integrated circuits (ICs), application-specific integrated circuits (ASICs), system-on-chip (SoC), desktop computers, laptop computers, tablet computers, servers, smartphones, etc. , Can be embodied as a circuit that forms part of a larger system. Therefore, as used herein, the "control circuit" is an electric circuit having at least one individual electric circuit, an electric circuit having at least one integrated circuit, and an electric circuit having at least one integrated circuit for a specific application. A circuit, a general-purpose computing device composed of a computer program (for example, a general-purpose computer composed of a computer program that executes at least a part of the process and / or the device described in the present specification, or a process described in the present specification. And / or electrical circuits that form a computer program that at least partially executes the device, electrical circuits that form a memory device (eg, in the form of a random access memory), and / or a communication device (eg, a communication device). Examples include, but are not limited to, electrical circuits that form modems, communication switches, or optical-electrical equipment. Those skilled in the art will recognize that the subjects described herein may be realized in analog or digital forms or some combination thereof.

As used herein, a processor or processing unit is an electronic circuit that performs operations on some external data source, usually memory or some other data stream. The term is used herein to refer to a central processor (central processing unit) within a system or computer system (particularly SoC) that combines many dedicated "processors".

As used herein, a SoC or system-on-chip (SOC) is an IC that integrates all the components of a computer or other electronic system. It can include digital, analog, mixed signals, and often high frequency features, all on a single substrate. The SoC integrates a microcontroller (or microprocessor) with modern peripherals such as graphics processing units (GPUs), Wi-Fi modules, or coprocessors. The SoC may or may not include a built-in memory.

As used herein, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuits and memory. The microcontroller (or MCU of the microcontroller unit) may be implemented as a small computer on a single integrated circuit. This may be similar to the SoC, which may include a microcontroller as one of its components. The microcontroller can accommodate memory and programmable input / output peripherals along with one or more core processing units (CPUs). Program memory in the form of ferroelectric RAM, NOR flash, or OTP ROM, and small amounts of RAM are also often included on the chip. Microcontrollers can be employed for embedded applications, as opposed to personal computers or other general purpose microprocessors composed of various individual chips.

As used herein, the term controller or microcontroller may be a stand-alone IC or chip device that interfaces with peripheral devices. This may be a connection between two parts of a computer or controller on an external device that controls the operation of the device (and its connection to the device).

Any of the processors or microcontrollers described herein may be any single-core or multi-core processor, such as those known by the Texas Instruments ARM Cortex trade name. In one aspect, the processor is, for example, a 256 KB single cycle flash memory or other NVM up to 40 MHz, a prefetch buffer for improving performance above 40 MHz, a 32 KB single, the details of which are available in the product datasheet. It has an internal ROM with cycle SRAM, NonvolatilesWare® software, 2KB electrical EEPROM, one or more PWM modules, one or more QEI analogs, or twelve analog input channels. It may be an LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, including one or more 12-bit ADCs.

In one aspect, the processor may include a safety controller that includes two controller family families, such as the TMS570 and RM4x, also known by the Texas Instruments Hercules ARM Cortex R4 trade name. The safety controller may be configured specifically for IEC 61508 and ISO 26262 safety limit applications to provide a highly integrated safety mechanism while providing scalable performance, connectivity, and memory options. Good.

As used in any aspect of the specification, the term "logic" may refer to an application, software, firmware, and / or circuit configured to perform any of the aforementioned operations. The software may be embodied as software packages, codes, instructions, instruction sets, and / or data recorded on non-temporary computer-readable storage media. Firmware may be embodied as code, instructions, or instruction sets in a memory device, and / or as hard-coded (eg, non-volatile) data.

As used in any aspect of the specification, the terms "component", "system", "module", etc. are either hardware, a combination of hardware and software, software, or running software. Can point to a computer-related entity.

As used in any aspect of the specification, an "algorithm" refers to a self-consistent sequence of steps that leads to a desired result, and a "step" is, but is not necessarily necessary, a memory, transfer, combination, Refers to the manipulation of physical quantities and / or logical states that can be in the form of electrical or magnetic signals that can be compared and manipulated differently. It is common practice to refer to these signals as bits, values, elements, symbols, letters, terms, numbers, and so on. These and similar terms may be associated with appropriate physical quantities and are simply convenient labels that apply to these quantities and / or conditions.

The network may include a packet switching network. Communication devices can communicate with each other using selected packet-switched network communication protocols. One exemplary communication protocol may include an Ethernet communication protocol that can enable communication using a transmission control protocol / Internet Protocol (TCP / IP). The Ethernet protocol conforms to the title "IEEE 802.3 Standard" published by the Institute of Electrical and Electronics Engineers (IEEE) in December 2008, and / or a later version of the Ethernet standard. Can be compatible. Alternatively or additionally, the communication device is X.I. Twenty-five communication protocols can be used to communicate with each other. X. The 25 communication protocols may conform to or be compatible with the standards promulgated by the International Telecommunication Union-Telecommunication Standardization Detector (ITU-T). Alternatively or additionally, the communication devices can communicate with each other using the Frame Relay communication protocol. The Frame Relay communication protocol conforms to or is compatible with standards promulgated by the Consultative Committee for International Telegraph and Telephone (CCITT) and / or the American National Standards Institute (ANSI). Alternatively or additionally, the transmitters and receivers may be able to communicate with each other using the Asynchronous Transfer Mode (ATM) communication protocol. The ATM communication protocol conforms to or is compatible with the ATM standard published in August 2001 by the ATM Forum under the title "ATM-MPLS Network Interworking 2.0" and / or later versions of this standard. obtain. Not surprisingly, connection-oriented network communication protocols developed differently and / or later are equally contemplated herein.

Unless otherwise stated, as is clear from the above disclosure, throughout the above disclosure, "process," "calculate," "calculate," "determine," "display," etc. Discussions that use the term refer to data expressed as a physical (electronic) quantity in a computer system's memory or memory as a physical quantity in the computer system's memory or register or such information storage, transmission, or display device. It will be appreciated that it refers to the operation and processing of a computer system or similar electronic computing device that manipulates and transforms into other similarly represented data.

One or more components are "configured to", "configurable to", and "operable / as" herein. "Operaable / operative to", "adapted / adaptive", "able to", "conformable / conformable" to) ”and so on. Those skilled in the art will generally appreciate that "configured as" is an active component and / or an inactive component and / or a standby component, unless the context should be interpreted in other ways. You will understand that it can contain elements.

The terms "proximal" and "distal" are used herein with reference to the clinician operating the handle portion of the surgical instrument. The term "proximal" refers to the part closest to the clinician, and the term "distal" refers to the part located away from the clinician. For convenience and clarity, spatial terms such as "vertical," "horizontal," "top," "bottom," "left," and "right" may be used herein with respect to drawings. Will be further understood. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limited and / or absolute.

The modular device is connected to a module that is acceptable within the surgical hub (eg, described in connection with FIGS. 3 and 9) and to various modules to connect or pair with the corresponding surgical hub. Includes surgical equipment or instruments to obtain. Modular devices include, for example, intelligent surgical instruments, medical imaging devices, suction / irrigation devices, smoke evacuators, energy generators, ventilators, inhalers, and displays. The modular devices described herein can be controlled by control algorithms. The control algorithm is on the modular device itself, on the surgical hub to which a particular modular device is paired, or on both the modular device and the surgical hub (eg, via a distributed computing architecture). ), Can be executed. In some examples, the control algorithm of a modular device is to the data sensed by the modular device itself (ie, by a sensor in the modular device, on the modular device, or by a sensor connected to the modular device). Control the device based on. This data may be related to the patient undergoing surgery (eg, tissue characteristics or injection pressure) or the modular device itself (eg, the speed of the knife moving forward, the motor current, or the energy level). For example, a surgical staple fastening and cutting instrument control algorithm can control the speed at which the instrument motor penetrates tissue and drives the knife based on the resistance the knife encounters as the knife advances.

Those skilled in the art generally intend that the terms used herein, and in particular in the appended claims (eg, the text of the appended claims), are generally "open" terms. The term "including" should be interpreted as "including but not limited to" and the term "having". Should be interpreted as "having at least" and the term "includes" should be interpreted as "includes but is not limited to" You will understand that it should be done, etc.). In addition, if a particular number is intended in the introduced claim recitation, such intent is clearly stated in the claim, and in the absence of such intent, such intent does not exist. However, those skilled in the art will understand. For example, as an aid to understanding, the following claims introduce the introductory phrases "at least one" and "one or more" and the claims. May be included to do. However, the use of such a phrase is an introductory phrase such as "one or more" or "at least one" in the same claim, even if the claim description is introduced by the indefinite definite article "a" or "an". And any particular claim, including such an introduced claim statement, is limited to a claim that includes only one such claim, even if it contains the indefinite definite "a" or "an". Should not be construed as suggesting (eg, "a" and / or "an" should usually be construed as meaning "at least one" or "one or more". ). The same is true when introducing claims using definite articles.

Moreover, even if a particular number is specified in the introduced claims, such statement should typically be construed to mean at least the number stated. , Will be recognized by those skilled in the art (eg, if there is a mere "two entries" with no other modifiers, then generally at least two entries, or two or more statements. Means matter). Further, when a notation similar to "at least one of A, B, C, etc." is used, such syntax is generally intended in the sense that one of ordinary skill in the art will understand the notation (eg, for example. , "A system having at least one of A, B, and C", but is not limited to, A only, B only, C only, both A and B, both A and C, B and Includes systems with both C and / or all of A, B and C, etc.). When a notation similar to "at least one of A, B, C, etc." is used, such syntax is generally intended to mean that one of ordinary skill in the art will understand the notation (eg, "" A system having at least one of A, B, or C "is, but is not limited to, A only, B only, C only, both A and B, both A and C, B and C. Includes systems with both and / or all of A, B and C, etc.). Moreover, typically any selective word and / or phrase representing two or more selective terms is used in the specification unless the context requires other meanings. It is understood that it is intended to include one of those terms, any of those terms, or both, whether in the claims, in the claims, or in the drawings. Those skilled in the art will understand that it should be. For example, the phrase "A or B" will typically be understood to include the possibility of "A" or "B" or "A and B".

With respect to the appended claims, one of ordinary skill in the art will appreciate that the actions cited herein can generally be performed in any order. In addition, although the flow charts of various operations are shown in a sequence (s), it is understood that the various operations may be performed in an order other than those illustrated, or may be performed at the same time. It should be. Examples of such alternative ordering are duplicates, alternations, interrupts, reordering, incremental, preliminary, additional, simultaneous, reverse, or other different ordering, unless the context requires other meanings. May include. In addition, terms such as "responding to", "related to", or other past tense adjectives may generally exclude such variants unless they should be interpreted in other ways in the context. Not intended.

Any reference to "one aspect", "aspect", "exemplification", "one example", etc. includes a particular mechanism, structure, or property described in connection with that aspect in at least one aspect. It is worth noting that it means. Thus, the terms "in one aspect", "in an embodiment", "in an example", and "in an example" found in various places throughout the specification do not necessarily all refer to the same aspect. Moreover, certain features, structures, or properties can be combined in any suitable manner in one or more embodiments.

Any patent application, patent, non-patent publication, or other disclosed material referenced herein and / or listed in any application datasheet is to the extent that the material incorporated is consistent with this specification. , Incorporated herein by reference. As such, and to the extent necessary, the disclosures expressly set forth herein shall supersede any contradictory statements incorporated herein by reference. Any content that conflicts with current definitions, views, or other disclosures described herein, or parts thereof, shall be incorporated herein by reference, but with reference and current disclosure. It shall be referred to only to the extent that there is no contradiction with.

In summary, many benefits have been described as a result of using the concepts described herein. The above description in one or more forms is presented for purposes of illustration and explanation. It is not intended to be inclusive or limited to the exact form disclosed. In view of the above teachings, modifications or modifications are possible. One or more forms exemplify the principles and practical applications, thereby making various forms available to those skilled in the art as suitable for the particular application conceived, along with various modifications. Therefore, it has been selected and described. The claims presented with this specification are intended to define the overall scope.

[Implementation mode]
(1) A flexible circuit for a surgical instrument, wherein the flexible circuit is
A rigid portion, said rigid portion comprising an interlock mechanism for mechanically engaging a component of the surgical instrument, said rigid portion.
Processing equipment and
A logic element, and a rigid portion on which at least one of them is mounted.
It is a flexible portion, and the flexible portion is
The active bending portion of the shaft assembly of the surgical instrument and
A flexible circuit comprising a joint of the shaft assembly and a flexible portion aligned with one of the joints.
(2) The flexible circuit according to the first embodiment, wherein the flexible portion is configured to bend laterally with respect to the longitudinal axis of the shaft assembly.
(3) The flexible circuit according to the first embodiment, wherein the component includes a channel cage, and the channel cage includes a recess configured to receive the rigid portion.
(4) The flexible circuit according to the first embodiment, further comprising a conductive trace.
(5) The flexible circuit according to the fourth embodiment, wherein the height of the conductive trace changes along the length of the conductive trace.

(6) The flexible circuit according to the fourth embodiment, wherein the width of the conductive trace changes along the length of the conductive trace.
(7) The conductive trace is
The flexible circuit according to embodiment 4, wherein the height changes along the length of the conductive trace and the width changes along the length of the conductive trace.
(8) An embodiment in which the height of the first portion of the conductive trace positioned on the flexible portion is smaller than the height of the second portion of the conductive trace positioned on the rigid portion. 4. The flexible circuit according to 4.
(9) The fourth embodiment in which the width of the first portion of the conductive trace positioned on the flexible portion is larger than the width of the second portion of the conductive trace positioned on the rigid portion. The flexible circuit according to.
(10) The height of the first portion of the conductive trace positioned on the flexible portion is smaller than the height of the second portion of the conductive trace positioned on the rigid portion.
The flexible circuit according to embodiment 4, wherein the width of the first portion of the conductive trace is larger than the width of the second portion of the conductive trace.

(11) The flexible circuit according to the first embodiment, wherein the flexible circuit further includes a strain relaxation portion.
(12) The flexible circuit according to the first embodiment, further comprising a conductive pad.
(13) The flexible circuit according to the first embodiment, further comprising an electromagnetic shield.
(14) A flexible circuit for a surgical instrument, wherein the flexible circuit is
It is a rigid portion, and the rigid portion is
Processing equipment and
A logic element, and a rigid portion on which at least one of them is mounted.
It is a flexible portion, and the flexible portion is
The active bending portion of the shaft assembly of the surgical instrument and
A flexible portion that is aligned with one of the joints of the shaft assembly.
A conductive trace located on both the rigid portion and the flexible portion, wherein the height and width of the conductive trace vary along the length of the surgical instrument. A flexible circuit.
(15) The flexible circuit according to embodiment 14, wherein the rigid portion is configured to mechanically interlock with a component of the surgical instrument.

(16) The flexible circuit of embodiment 15, wherein the component comprises a channel retainer, the channel retainer comprising a recess configured to receive the rigid portion.
(17) The flexible circuit according to embodiment 14, wherein the flexible portion is configured to bend laterally with respect to the longitudinal axis of the shaft assembly.
(18) The height of the first portion of the conductive trace positioned on the flexible portion is smaller than the height of the second portion of the conductive trace positioned on the rigid portion.
The flexible circuit according to embodiment 14, wherein the width of the first portion of the conductive trace is larger than the width of the second portion of the conductive trace.
(19) A flexible circuit for a surgical instrument, wherein the flexible circuit is
Rigid part and
It is a flexible portion, and the flexible portion is
The active bending portion of the shaft assembly of the surgical instrument and
A flexible portion that is aligned with one of the joints of the shaft assembly.
A conductive trace located on both the rigid portion and the flexible portion, wherein the height and width of the conductive trace vary along the length of the surgical instrument.
A flexible circuit, including an electromagnetic shield.
(20) The height of the first portion of the conductive trace positioned on the flexible portion is smaller than the height of the second portion of the conductive trace positioned on the rigid portion.
The flexible circuit according to embodiment 19, wherein the width of the first portion of the conductive trace is larger than the width of the second portion of the conductive trace.

Claims (20)

A flexible circuit for a surgical instrument, wherein the flexible circuit is
A rigid portion, said rigid portion comprising an interlock mechanism for mechanically engaging a component of the surgical instrument, said rigid portion.
Processing equipment and
A logic element, and a rigid portion on which at least one of them is mounted.
It is a flexible portion, and the flexible portion is
The active bending portion of the shaft assembly of the surgical instrument and
A flexible circuit comprising a joint of the shaft assembly and a flexible portion aligned with one of the joints. The flexible circuit according to claim 1, wherein the flexible portion is configured to bend laterally with respect to the longitudinal axis of the shaft assembly. The flexible circuit of claim 1, wherein the component comprises a channel retainer, the channel retainer comprising a recess configured to receive the rigid portion. The flexible circuit according to claim 1, further comprising a conductive trace. The flexible circuit according to claim 4, wherein the height of the conductive trace changes along the length of the conductive trace. The flexible circuit according to claim 4, wherein the width of the conductive trace changes along the length of the conductive trace. The conductive trace is
The flexible circuit according to claim 4, wherein the height changes along the length of the conductive trace and the width changes along the length of the conductive trace. 4. The fourth aspect of the present invention, wherein the height of the first portion of the conductive trace positioned on the flexible portion is smaller than the height of the second portion of the conductive trace positioned on the rigid portion. Flexible circuit. The fourth aspect of the present invention, wherein the width of the first portion of the conductive trace positioned on the flexible portion is larger than the width of the second portion of the conductive trace positioned on the rigid portion. Flexible circuit. The height of the first portion of the conductive trace positioned on the flexible portion is smaller than the height of the second portion of the conductive trace positioned on the rigid portion.
The flexible circuit according to claim 4, wherein the width of the first portion of the conductive trace is larger than the width of the second portion of the conductive trace. The flexible circuit according to claim 1, wherein the flexible circuit further includes a strain relaxation portion. The flexible circuit according to claim 1, further comprising a conductive pad. The flexible circuit according to claim 1, further comprising an electromagnetic shield. A flexible circuit for a surgical instrument, wherein the flexible circuit is
It is a rigid portion, and the rigid portion is
Processing equipment and
A logic element, and a rigid portion on which at least one of them is mounted.
It is a flexible portion, and the flexible portion is
The active bending portion of the shaft assembly of the surgical instrument and
A flexible portion that is aligned with one of the joints of the shaft assembly.
A conductive trace located on both the rigid portion and the flexible portion, wherein the height and width of the conductive trace vary along the length of the surgical instrument. A flexible circuit. 14. The flexible circuit of claim 14, wherein the rigid portion is configured to mechanically interlock with a component of the surgical instrument. 15. The flexible circuit of claim 15, wherein the component comprises a channel retainer, the channel retainer comprising a recess configured to receive the rigid portion. 14. The flexible circuit of claim 14, wherein the flexible portion is configured to bend laterally with respect to the longitudinal axis of the shaft assembly. The height of the first portion of the conductive trace positioned on the flexible portion is smaller than the height of the second portion of the conductive trace positioned on the rigid portion.
The flexible circuit according to claim 14, wherein the width of the first portion of the conductive trace is larger than the width of the second portion of the conductive trace. A flexible circuit for a surgical instrument, wherein the flexible circuit is
Rigid part and
It is a flexible portion, and the flexible portion is
The active bending portion of the shaft assembly of the surgical instrument and
A flexible portion that is aligned with one of the joints of the shaft assembly.
A conductive trace located on both the rigid portion and the flexible portion, wherein the height and width of the conductive trace vary along the length of the surgical instrument.
A flexible circuit, including an electromagnetic shield. The height of the first portion of the conductive trace positioned on the flexible portion is smaller than the height of the second portion of the conductive trace positioned on the rigid portion.
The flexible circuit according to claim 19, wherein the width of the first portion of the conductive trace is larger than the width of the second portion of the conductive trace.

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