JP2021509330A - Surgical discharge sensor mechanism - Google Patents

Abstract

Surgical systems can include a scavenging system for scavenging smoke, fluids, and / or microparticles from the surgical site. Surgical drainage systems may be intelligent and include, for example, one or more sensors for detecting one or more characteristics of a surgical system, drainage system, surgical procedure, surgical site, and / or patient tissue. It may be.

Description

(Cross-reference of related applications)
This application is a U.S. provisional application, filed June 28, 2018, entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTOR", the entire disclosure of which is incorporated herein by reference under Article 119 (e) of the U.S. Patent Act. Claim the priority benefit of Patent Application No. 62 / 691,219.

This application is filed in the United States 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 U.S. Patent Act. Provisional Patent Application No. 62 / 650,887, US Provisional Patent Application No. 62 / 650,877, entitled "SURGICAL SMOKE EVACUATION SENSING AND COUNTROLLS", filed March 30, 2018, "SMOKE EVACUATION MODELRATE MODELATOR" US Provisional Patent Application No. 62 / 650,882, filed March 30, 2018, and US Provisional Patent Application No. 62, filed March 30, 2018, entitled "CAPACTIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS". Claim the benefit of the priority of / 650,898.

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

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 invention relates to a surgical system and its ejector. Surgical smoke evacuators are configured to expel smoke and / or fluids and / or microparticles from the surgical site. For example, smoke may be generated at the surgical site during a surgical procedure involving an energy device.

In various embodiments, the surgical drainage system comprises a pump, a motor operably connected to the pump, a flow path fluidly connected to the pump, and a sensor system. The sensor system includes a first pressure sensor and a second pressure sensor. The first pressure sensor is arranged along the flow path. The second pressure sensor is arranged along the flow path upstream of the first pressure sensor. The surgical drainage system further comprises a control circuit configured to determine the pressure difference between the first pressure sensor and the second pressure sensor. The control circuit is further configured to adjust the operating parameters of the motor based on the pressure difference.

In various embodiments, the surgical drainage system comprises a pump that includes a motor, a flow path fluidly connected to the pump, and a sensor system. The sensor system includes a first pressure sensor and a second pressure sensor. The first pressure sensor is arranged along the flow path to detect the first pressure. The second pressure sensor is arranged along the upstream flow path of the first pressure sensor to detect the second pressure. The surgical drainage system further comprises a control circuit configured to determine the ratio of the second pressure to the first pressure and to determine the operating state of the surgical drainage system based on that ratio.

In various embodiments, non-transitory computer-readable media for storing computer-readable instructions are disclosed. When executed, the command causes the machine to receive a first signal from a first sensor located along the flow path through the surgical drainage system and place it along the flow path through the surgical drainage system. A second signal is received from the second sensor, the operating state of the surgical discharge system is determined based on the first signal and the second signal, and the operating state of the surgical discharge system is determined based on the operating state. Adjust the operating parameters.

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.
It is a perspective view of the discharger housing of the surgical discharge system according to at least one aspect of the present disclosure. FIG. 3 is a perspective view of a surgical exhaust electrosurgical tool according to at least one aspect of the present disclosure. It is an elevational view of a surgical drain tool leasably fixed to an electrosurgical pencil according to at least one aspect of the present disclosure. It is a schematic diagram which shows the internal component in the discharger housing of the surgical discharge system by at least one aspect of this disclosure. FIG. 6 is a schematic representation of an electrosurgical system including a smoke evacuator according to at least one aspect of the present disclosure. FIG. 6 is a schematic representation of a surgical drainage system according to at least one aspect of the present disclosure. FIG. 3 is a perspective view of a surgical system, including a surgical drainage system, according to at least one aspect of the present disclosure. It is a perspective view of the discharger housing of the surgical discharge system of FIG. 7 according to at least one aspect of the present disclosure. It is an elevation sectional view of the socket in the ejector housing of FIG. 8 along the plane shown in FIG. 8 according to at least one aspect of the present disclosure. It is a perspective view of the filter of the discharge system according to at least one aspect of this disclosure. FIG. 10 is a perspective sectional view of the filter of FIG. 10 taken along the central longitudinal plane of the filter according to at least one aspect of the present disclosure. A pump for a surgical drainage system, such as the surgical drainage system of FIG. 7, according to at least one aspect of the present disclosure. FIG. 3 is a perspective view of a portion of a surgical drainage system according to at least one aspect of the present disclosure. FIG. 13 is a front perspective view of the fluid trap of the surgical drainage system of FIG. 13 according to at least one aspect of the present disclosure. FIG. 14 is a rear perspective view of the fluid trap of FIG. 14 according to at least one aspect of the present disclosure. FIG. 14 is an elevation sectional view of the fluid trap of FIG. 14 according to at least one aspect of the present disclosure. FIG. 14 is an elevational cross-sectional view of the fluid trap of FIG. 14 with a portion removed for clarity according to at least one aspect of the present disclosure, the liquid trapped in the fluid trap and the smoke flowing through the fluid trap. Is shown. It is the schematic of the discharger housing of the discharge system according to at least one aspect of this disclosure. It is a schematic diagram of the discharger housing of another discharge system according to at least one aspect of the present disclosure. FIG. 6 is a schematic representation of a photoelectric sensor in a surgical discharge system according to at least one aspect of the present disclosure. FIG. 6 is a schematic representation of another photoelectric sensor in a surgical discharge system according to at least one aspect of the present disclosure. FIG. 6 is a schematic representation of an ionization sensor for a surgical drainage system according to at least one aspect of the present disclosure. According to at least one aspect of the present disclosure, (A) a graph display of the number of particles over time, and (B) a graph display of the motor speed over time of the surgical discharge system. FIG. 5 is a cross-sectional view of a divertor valve in a surgical discharge system showing a divertor valve in a first position according to at least one aspect of the present disclosure. FIG. 2 is a cross-sectional view of the divertor valve of FIG. 24A in a second position according to at least one aspect of the present disclosure. FIG. 6 is a graph representation of (A) airflow fluid content over time and (B) duty cycle over time of a surgical drainage system according to at least one aspect of the present disclosure. It is a flowchart which shows the adjustment algorithm of the surgical discharge system by at least one aspect of this disclosure. It is a flowchart which shows the adjustment algorithm of the surgical discharge system by at least one aspect of this disclosure. It is a flowchart which shows the adjustment algorithm of the surgical discharge system by at least one aspect of this disclosure. It is a flowchart which shows the adjustment algorithm of the surgical system by at least one aspect of this disclosure. FIG. 3 is a perspective view of a surgical system according to at least one aspect of the present disclosure. It is a flowchart which shows the algorithm for displaying the efficiency data of the surgical discharge system by at least one aspect of this disclosure. It is a flowchart which shows the adjustment algorithm of the surgical discharge system by at least one aspect of this disclosure. FIG. 5 is a graph representation of (A) the number of particles over time and (B) the ratio of RF current to voltage over time in a surgical system, according to at least one aspect of the present disclosure. It is a flowchart which shows the adjustment algorithm of the surgical system by at least one aspect of this disclosure. The motor is controlled based on at least one of a first signal received from the first sensor of the discharge system and a second signal received from the second sensor of the discharge system according to at least one aspect of the present disclosure. It is a flowchart for doing. A graphical representation of (A) particles counted over time, (B) generator power and voltage over time, and (C) motor speed over time of an emission system, according to at least one aspect of the present disclosure. .. In a graphical representation of the ratio of the pressure detected by the first sensor to the pressure detected by the second sensor and the pulse width modulation duty cycle of the motor of the discharge system over time, according to at least one aspect of the present disclosure. is there. FIG. 6 is a graph representation of (A) particles counted over time and (C) air flow velocity over time in the discharge system according to at least one aspect of the present disclosure. 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 robot 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. To connect to the cloud 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 in. 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. Shows one aspect of a Universal Serial Bus (USB) network hub device according to at least one aspect of the present disclosure. 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. FIG. 6 is a schematic representation 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. FIG. 6 is a schematic representation 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 example of a generator, which is one form of the generator of FIG. 20, according to at least one aspect of the present disclosure is shown. It is a timeline showing the situational awareness of the surgical hub according to one 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 CLOSEPARAMETERS",
-US Patent Application No. ________, Agent Reference Number, END8543USNP1 / 170760-1, entitled "SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATION INFORMATION",
US Patent Application No. ___________, Agent Reference Number, END8543USNP2 / 170760-2, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING",
US Patent Application No. ___________, Agent Reference Number, END8543USNP3 / 170760-3, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING",
U.S. Patent Application No. ________, Agent Reference Number, 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",
U.S. 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, END8544USNP1 / 170761-1, entitled "SURGICAL INSTRUMENT HAVING A FLEXICBLE CIRCUIT",
U.S. Patent Application No. ________, Agent Reference Number, END8544USNP2 / 170761-2, entitled "SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY",
U.S. Patent Application No. ________, Agent Reference Number, END8544USNP3 / 170761-3, entitled "SURGICAL SYSTEMS WITH PRIORIZED DATA TRANSMISSION CAPABILITIES",
U.S. Patent Application No. ________, Agent Reference Number, END8545USNP / 170762, entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL",
U.S. Patent Application No. ________, Agent Reference Number, END8545USNP2 / 170762-2, entitled "SURGICAL EVACUATION FLOW PATHS",
U.S. Patent Application No. ________, Agent Reference Number, END8545USNP3 / 170762-3, entitled "SURGICAL EVACUATION SENSING AND GENERATION CONTORL",
U.S. Patent Application No. ________, Agent Reference Number, END8545USNP4 / 170762-4, entitled "SURGICAL EVACUATION SENSING AND DISPLAY",
U.S. Pat. No.
U.S. Patent Application No. ________, Agent Reference No. END8576-1170
· "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".

Prior to elaborating on the various aspects of surgical devices and generators, the illustrated examples are not limited in application or application to the details of the structure and arrangement of the parts shown in the accompanying drawings and description. It should be noted. The exemplary examples may be implemented or incorporated in other embodiments, variants, and modifications, and may be implemented or implemented in a variety of ways. Furthermore, unless otherwise stated, the terms and expressions used herein have been selected for the convenience of the reader to illustrate exemplary examples and are not intended to limit them. .. In addition, one or more of the embodiments, embodiments, and / or examples described below, and any one or more of the other embodiments, embodiments, and / or examples described below. Please understand that it can be combined with.

Energy Devices and Smoke Emissions The present disclosure relates to energy devices and intelligent surgical discharge systems for discharging smoke and / or other fluids and / or particles from surgical sites. Smoke is often generated during surgical procedures that utilize one or more energy devices. Energy devices use energy to affect tissues. In an energy device, energy is supplied by a generator. Examples of the energy device include a device having a tissue contact electrode such as an electrosurgical device having one or more radio frequency (RF) electrodes, and a device having a vibrating surface such as an ultrasonic device having an ultrasonic blade. Be done. For electrosurgical devices, the generator is configured to generate an oscillating current to energize the electrodes. With respect to the ultrasonic device, the generator is configured to generate ultrasonic vibrations to energize the ultrasonic blades. The generator will be described further herein.

Ultrasonic energy can be used to coagulate and cleave tissue. Ultrasonic energy coagulates and cuts tissue by vibrating an energy delivery surface (eg, an ultrasonic blade) that comes into contact with the tissue. The ultrasonic blades can be connected to a waveguide that transmits vibrational energy from the ultrasonic transducer, which produces mechanical vibrations and is powered by a generator. By vibrating at high frequencies (eg, 55,500 times per second), the ultrasonic blade denatures proteins between the blade and the tissue, i.e. in the tissue, to form a sticky mass, blade-tissue. Friction and heat are generated at the interface. The pressure exerted on the tissue by the blade surface causes the blood vessels to collapse, allowing the clot to form a hemostatic seal. The accuracy of cutting and coagulation can be controlled, for example, by the skill of the clinician and by adjusting the power level, blade blade, tissue traction, and blade pressure.

Ultrasound surgical instruments have been found to have an increasingly wide range of applications in surgical procedures due to the special performance characteristics of such instruments. Depending on the particular instrument configuration and operating parameters, the ultrasonic surgical instrument can provide hemostasis by cutting and coagulating tissue at substantially the same time, preferably minimizing patient trauma. The cutting action is typically achieved by an end effector or blade tip at the distal end of the ultrasonic instrument. The ultrasonic end effector transfers ultrasonic energy to the tissue in contact with the end effector. Ultrasound instruments of this nature can be configured, for example, for open surgery applications, including robot-assisted surgery, laparoscopic surgery or endoscopic surgery.

Electrical energy can also be utilized for solidification and / or cutting. An electrosurgical device typically includes a handpiece and an instrument with an end effector (eg, one or more electrodes) attached to the distal end. The end effector can be placed relative to and / or adjacent to the tissue so that current is introduced into the tissue. Electrosurgery is widely used and offers many advantages, including the use of a single surgical instrument for both coagulation and amputation.

Electrodes or chips of electrosurgical devices are small at the point of contact with the patient so as to generate a high current with a high current density to produce the surgical effect of coagulating and / or cutting the tissue by cauterization. It has become a thing. The return electrode carries the same high frequency signal back to the electrosurgical generator after passing through the patient, thus providing a return path for the RF signal.

The electrosurgical device can be configured for bipolar or unipolar operation. During bipolar operation, each current is introduced into the tissue by the working electrode of the end effector and returned from the tissue by the return electrode of the end effector. During unipolar operation, the current is introduced into the tissue by the active electrode of the end effector and is returned to the patient's body or via a return electrode (eg, a ground pad) located separately from the body. The heat generated by the current flowing through the tissue may form a hemostatic seal within and / or between the tissues, and thus may be particularly useful, for example, to seal a blood vessel. The end effector of the electrosurgical device may also include a cutting member that is movable relative to the tissue and electrodes for cutting the tissue.

During application, the electrosurgical device can transmit low frequency RF currents through the tissue, which causes ionic agitation or friction (ie, resistance heating), which raises the temperature of the tissue. Boundaries are created between the affected and surrounding tissue, allowing clinicians to operate with a high level of accuracy and control without sacrificing adjacent non-target tissue. The low operating temperature of RF energy is useful for sealing blood vessels while removing, contracting, or shaping soft tissue. RF energy can act particularly well on connective tissue, which is composed primarily of collagen and contracts upon contact with heat. Other electrosurgical instruments include, but are not limited to, irreversible and / or reversible electroporation and / or microwave technology. The techniques disclosed herein apply, among other things, to ultrasound, bipolar and / or unipolar RF (electrosurgical), irreversible and / or reversible electroperforation, and / or microwave-based surgical instruments. It is possible.

The electrical energy applied by the electrosurgical device can be transferred from the generator to the instrument. The generator is configured to convert electricity into a high frequency waveform consisting of an oscillating current transmitted to the electrodes to affect the tissue. The current passes through the tissue and causes the tissue to become agitated (a form of coagulation in which the current arc to the tissue produces tissue charring), drying (direct energy application to expel water from the cells), and / or cleavage (vaporizing the cell fluid). Indirect energy application that causes cell explosion). Tissue response to current is a function of tissue resistance, current density through the tissue, power output, and duration of current application. In certain examples, as further described herein, the current waveform can be adjusted to affect different surgical functions and / or to adapt to tissues of different characteristics. For example, different types of tissue-vascular tissue, nervous tissue, muscle, skin, adipose, and / or bone may react differently to the same waveform.

The electrical energy may be in the form of RF energy which may be within the frequency range described in EN60601-2-2: 2009 + A11: 2011, Definition 2011.3.218-HIGH FREQUENCY. For example, frequencies in unipolar RF applications are typically limited to less than 5 MHz to minimize problems associated with high frequency leakage currents. Frequencies above 200 kHz can typically be used in monopolar applications to avoid unnecessary nerve and muscle irritation resulting from the use of low frequency currents.

In bipolar RF applications, the frequency may be almost any frequency. Lower frequencies can be used for bipolar techniques in certain cases, such as when risk analysis shows that the potential for neuromuscular stimulation has been mitigated to acceptable levels. Generally, 10 mA is recognized as the lower threshold of thermal effect on tissue. In the case of bipolar technology, higher frequencies can also be used.

In certain examples, the generator digitally generates an output waveform and provides it to the surgical device, which allows the surgical device to utilize the waveform for a variety of tissue effects. can do. The generator may be a unipolar generator, a bipolar generator, and / or an ultrasonic generator. For example, a single generator can supply energy to a unipolar device, a bipolar device, an ultrasound device, or a combined electrosurgical / ultrasound device. The generator can promote tissue-specific effects through waveform shaping and / or drive RF and ultrasonic energies simultaneously and / or sequentially into a single surgical instrument or multiple surgical instruments. can do.

In one example, the surgical system may include a generator and various surgical instruments that can be used with it, including ultrasonic surgical instruments, RF electrosurgical instruments, and combined ultrasonic / RF electrosurgical instruments. it can. The generator, which is incorporated herein by reference in its entirety, is "TECHNIQUES FOR OPERATING GENERATION FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INST," US Pat. It may be configurable for use with a variety of surgical instruments, as further described in 279 (now US Patent Application Publication No. 2017/0086914).

As described herein, medical procedures that cut tissue and / or cauterize blood vessels are often generated by the generator and transmitted to the patient's tissue via electrodes that are manipulated by the clinician. It is done by utilizing the RF electrical energy that is produced. The electrodes deliver an electric discharge to the cytoplasm of the patient's body adjacent to the electrodes. This discharge heats the cytoplasm, cutting tissue and / or cauterizing blood vessels.

The high temperatures associated with electrosurgery can cause thermal necrosis of the tissue adjacent to the electrodes. The longer the tissue is exposed to the high temperatures associated with electrosurgery, the more likely it is that the tissue will undergo thermal necrosis. In certain cases, thermal necrosis of tissue slows the rate of cutting tissue and increases the incidence of heat damage to tissue located away from the cut site, as well as postoperative complications, scabs. May increase production and healing time.

The concentration of RF energy discharge affects both the efficiency with which the electrode can cut tissue and the potential for tissue damage away from the cut site. With standard electrode shapes, RF energy tends to be evenly distributed over a relatively large area adjacent to the intended incision site. The generally uniform distribution of RF energy discharges increases the likelihood of foreign charge loss to the surrounding tissue, which can increase the likelihood of unwanted tissue damage in the surrounding tissue.

A typical electrosurgical generator produces RF electrical energy and output power levels at various operating frequencies. The particular operating frequency and power output of the generator will vary based on the particular electrosurgical generator used and the need of the physician during the electrosurgical procedure. Specific operating frequencies and power output levels can be manually adjusted on the generator by the clinician or other operating room personnel. Proper adjustment of these various settings requires a great deal of knowledge, skill, and care of the clinician or other staff. When the clinician makes the desired adjustments to the various settings on the generator, the generator can maintain their output parameters during electrosurgery. Generally, waveform generators used in electrosurgery are such that they generate RF waves with output power in the range of 1-300 W in cutting mode and 1-120 W in coagulation mode, as well as frequencies in the range of 300-600 kHz. It has been adapted. Typical waveform generators are adapted to maintain selected settings during electrosurgery. For example, if the clinician sets the output power level of the generator to 50W and then brings the electrodes into contact with the patient to perform electrosurgery, the power level of the generator rises rapidly and is maintained at 50W. It will be. Setting the power level to a specific setting, such as 50 W, will allow the clinician to cut the patient's tissue, but maintaining such a high power level will result in thermal necrosis of the patient's tissue. Increase the chances of

In some forms, the generator provides sufficient power to effectively perform electrosurgery in connection with electrodes that increase the concentration of RF energy discharges, while at the same time limiting unwanted tissue damage. It is configured to reduce postoperative complications and promote faster healing. For example, the waveform from the generator can be optimized by control circuitry throughout the surgical procedure. However, the subject matter claimed herein is not limited to aspects that eliminate any disadvantage or operate only in an environment such as those described above. Rather, this background technique is presented merely to illustrate an example of the art in which some aspects described herein can be practiced.

As provided herein, an energy device cuts tissue, cauterizes blood vessels, and / or coagulates tissue to treat tissue (eg, in and / or near the target tissue). To deliver mechanical and / or electrical energy to the target tissue. Tissue cutting, cauterization, and / or solidification can result in fluid and / or fine particles being released into the air. Such fluids and / or microparticles released during the surgical procedure may constitute smoke, which may include, for example, carbon particles and / or other particles suspended in the air. In other words, the fluid may contain smoke and / or other fluid material. Approximately 90% of endoscopic and open surgery produces some level of smoke. Smoke can be unpleasant to the olfactory sensation of the clinician (s), assistants (s), and / or the patient (s) and can obscure the clinician (s) of the surgical site. It may block and in certain cases may be unhealthy if inhaled. For example, smoke generated during electrosurgical procedures includes acroleine, acetonitrile, acrylonitrile, acetylene, alkylbenzene, benzene, butadiene, butene, carbon monoxide, cleosol, ethane, ethylene, formaldehyde, free radicals, hydrogen cyanide, isobutene, methane, Contains toxic chemicals, including phenols, polycyclic aromatic hydrocarbons, propene, propylene, pyridene, pyrrole, styrene, toluene, and xylene, as well as dead and living cellular material (including blood fragments), and viruses. I have something to do. Certain substances identified in surgical smoke have been identified as known carcinogens. It is estimated that 1 gram of tissue cauterized during electrosurgical procedures can be comparable to the toxic and carcinogens of 6 unfiltered cigarettes. In addition, exposure to smoke released during electrosurgical procedures has been reported to cause eye and lung inflammation in healthcare professionals.

In addition to the toxicity and odor associated with the substance in the surgical smoke, the size of the particulate matter in the surgical smoke can be determined by the clinician (s), assistant (s), and / or patient (s). Multiple) can be harmful to the respiratory system. In certain examples, the particles can be very small. In certain cases, repeated inhalation of very small particulate matter can lead to acute and chronic respiratory conditions.

Many electrosurgical systems provide surgical discharge systems that capture the smoke resulting from the surgical procedure and direct the captured smoke away from the clinician (s) and / or the patient through filters and exhaust ports. Use. For example, the efflux system can be configured to evacuate smoke generated during an electrosurgical procedure. The reader can refer to such an efflux system as a "smoke efflux system", but understand that such efflux systems can be configured to evacuate more than just smoke from the surgical site. There will be. Throughout this disclosure, the "smoke" emitted by the emission system is not simply limited to smoke. Rather, the smoke exhaust system disclosed herein can be used to exhaust a variety of fluids, including liquids, gases, vapors, smoke, water vapor, or combinations thereof. The fluid may be of biological origin and / or can be introduced into the surgical site from an external source during the procedure. Fluids include, for example, water, saline, lymph, blood, exudate, and / or purulent discharge. In addition, the fluid can contain microparticles or other substances (eg, cytoplasm or debris) that are ejected by the drainage system. For example, such microparticles may float in a fluid.

Discharge systems often include pumps and filters. The pump produces a suction that draws smoke into the filter. For example, suction can be configured to draw smoke from the surgical site to the duct opening, through the drain conduit, and into the drain housing of the drain system. The discharger housing 50018 of the surgical discharge system 50000 is shown in FIG. In one aspect of the disclosure, the pump and filter are located within the ejector housing 50018. Smoke drawn into the ejector housing 50018 travels through the suction conduit 50036 to the filter, and harmful toxic substances and unpleasant odors are filtered from the smoke as it travels through the filter. The suction conduit may also be referred to, for example, a vacuum conduit and / or a drainage conduit and / or a vacuum tube and / or a drainage tube. The filtered air can then exit the surgical effluent system as exhaust. In certain examples, the various drainage systems disclosed herein can also be configured to deliver fluid to a desired location, such as a surgical site.

Here, referring to FIG. 2, the suction conduit 50036 from the ejector housing 50018 (FIG. 1) may be terminated by a handpiece such as a handpiece 50032. The handpiece 50032 comprises an electrosurgical instrument including an electrode tip 50043 and a discharge duct opening near and / or adjacent to the electrode tip 50034. The drain duct opening is configured to capture fluid and / or microparticles released during the surgical procedure. In such an example, the drainage system 50000 is integrated with the electrosurgical instrument 50032. Further referring to FIG. 2, the smoke S is drawn into the suction conduit 50036.

In certain examples, the drainage system 50000 can include a separate surgical tool that has a duct opening and is configured to aspirate smoke within the system. In yet another example, a tool with drainage conduits and openings can be snap-fitted onto an electrosurgical tool as shown in FIG. For example, a portion of the suction conduit 51036 may be placed around (or adjacent to) the electrode tip 51034. In one example, the suction conduit 51036 may be releasably secured to the handpiece 51032 of an electrosurgical tool with an electrode tip 51034 having a clip or other fastener.

The various internal components of the ejector housing 50518 are shown in FIG. In various examples, the internal components of FIG. 4 can also be incorporated into the ejector housing 50018 of FIG. Primarily with reference to FIG. 4, the exhaust system 50500 includes an exhaust housing 50518, a filter 50502, an exhaust mechanism 50520, and a pump 50506. The discharge system 50500 defines a flow path 50504 through a discharger housing 50518 having an inlet port 50522 and an outlet port 50524. The filter 50502, the exhaust mechanism 50520, and the pump 50506 are arranged continuously in line with the flow path 50504 through the exhaust housing 50518 between the inlet port 50522 and the outlet port 50524. The inlet port 50522 can be fluidly connected to a suction duct such as, for example, the suction duct 50036 of FIG. 1, which can include a distal conduit opening that can be placed at the surgical site.

The pump 50506 is configured to generate a pressure difference in the flow path 50504 by mechanical operation. The pressure difference is configured to draw smoke 50508 from the surgical site into the inlet port 50522 and along the flow path 50504. After the smoke 50508 has moved through the filter 50502, the smoke 50508 can be considered to be filtered smoke or air 50510, which continues to travel through the flow path 50504 and exits through the outlet port 50524. Will be done. The flow path 50504 includes a first zone 50514 and a second zone 50516. The first zone 50514 is upstream from pump 50506. The second zone 50516 is downstream from the pump 50506. Pump 50506 is configured to pressurize the fluid in flow path 50504 so that the fluid in the second zone 50516 has a higher pressure than the fluid in the first zone 50514. The motor 50512 drives the pump 50506. Various suitable motors are described further herein. The exhaust mechanism 50520 is a mechanism capable of controlling the velocity, direction, and / or other characteristics of the filtered smoke 50510 exiting the exhaust system 50500 at the outlet port 50524.

The flow path 50504 through the drainage system 50500 may consist of a pipe or other conduit that substantially contains and / or separates the fluid moving through the flow path 50504 from the fluid outside the flow path 50504. it can. For example, the first zone 50514 of the flow path 50504 may include a tube in which the flow path 50504 extends between the filter 50502 and the pump 50506. The second zone 50516 of the flow path 50504 may also include a pipe through which the flow path 50504 extends between the pump 50506 and the exhaust mechanism 50520. The flow path 50504 also extends through the filter 50502, the pump 50506, and the exhaust mechanism 50520 so that the flow path 50504 extends continuously from the inlet port 50522 to the outlet port 50524.

During operation, smoke 50508 can flow into filter 50502 at inlet port 50522 and can be pumped through flow path 50504 by pump 50506 so that smoke 50508 is drawn into filter 50502. The filtered smoke 50510 can then be pumped out through the exhaust mechanism 50520 through the outlet port 50524 of the exhaust system 50500. The filtered smoke 50510 exiting the exhaust system 50500 at the outlet port 50524 is exhaust and can consist of filtered gas that has passed through the exhaust system 50500.

In various examples, the efflux systems disclosed herein (eg, efflux system 50000 and efflux system 50500) are computer-mounted interactive surgical systems, such as, for example, system 100 (FIG. 39) or system 200 (FIG. 47). Can be incorporated into. In one aspect of the disclosure, for example, the computer-mounted surgical system 100 can include at least one hub 106 and a cloud 104. Primarily with reference to FIG. 41, the hub 106 includes a smoke exhaust module 126. The operation of the smoke exhaust module 126 can be controlled by the hub 106 based on its situational awareness and / or feedback from its components and / or information from the cloud 104. Computer-mounted surgical systems 100 and 200, and situational awareness for them, are described further herein.

Situational awareness includes the ability of some aspects of the surgical system to determine or infer information related to a surgical procedure from data received from databases and / or instruments. The information can include the type of procedure being performed, the type of tissue being operated on, or the body cavity being treated. With contextual information associated with the surgical procedure, the surgical system controls, for example, a modular device (eg, a smoke evacuator system) that is connected to it and provides contextualized information or suggestions during the surgical procedure to the clinician. The method can be improved. For situational awareness, further to 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. Has been described.

In various examples, the surgical system and / or drainage system disclosed herein can include a processor. The processor can be programmed to control one or more operating parameters of the surgical system and / or efflux system, for example, based on sensed and / or aggregated data and / or one or more user inputs. .. FIG. 5 is a schematic diagram of an electrosurgical system 50300 including processor 50308. The electrosurgical system 50300 is powered by an AC power source 50302 that provides either 120V or 240V alternating current. The voltage supplied by the AC power source 50302 is directed to the AC / DC converter 50304, which converts 120V or 240V alternating current to 360V direct current. The 360 V direct current is then directed to the power converter 50306 (eg, back converter). The power converter 50306 is a gradual DC / DC converter. The power converter 50306 is adapted to diminish the input 360V to a desired level within the range 0-150V.

Processor 50308 can be programmed to adjust various aspects, functions, and parameters of the electrosurgical system 50300. For example, the processor 50308 determines the desired output power level in the electrode chip 50334, which may be in many respects similar to, for example, the electrode chip 50043 and / or the electrode chip 51034 of FIG. 3, and provides the desired output power. As such, the power converter 50306 can be instructed to diminish the voltage to a specified level. Processor 50308 is coupled to memory 50310 configured to store machine-executable instructions that operate the electrosurgical system 50300 and / or its subsystems.

A digital-to-analog converter (“DAC”) 50312 is connected between the processor 50308 and the power converter 50306. The DAC 50312 is adapted to convert the digital code generated by the processor 50308 into an analog signal (current, voltage, or charge), which controls the voltage diminishing performed by the power converter 50306. .. When the power converter 50306 diminishes 360V to the level determined by the processor 50308, it will provide the desired output power level, and the diminished voltage will be applied to the electrode tip 50334 to achieve electrosurgical treatment of the patient's tissue. It is directed and then directed to the return electrode or ground electrode 50335. The voltage sensor 50314 and the current sensor 50316 are adapted to detect the voltage and current present in the electrosurgical circuit and communicate the detected parameters to the processor 50308, thereby causing the processor 50308 to output power. It is possible to determine whether to adjust the level. As mentioned herein, typical waveform generators are adapted to maintain the selected settings throughout the electrosurgical procedure. In another example, the operating parameters of the generator are one or more to the processor 5308, such as inputs from a surgical hub, cloud, and / or situation recognition module, as further described herein. Based on the input of, it can be optimized during the surgical procedure.

Processor 50308 is coupled to communication device 50318 for communication over the network. The communication device includes a transmitter / receiver 50320 configured to communicate via physical wires or wirelessly. The communication device 50318 may further include one or more additional transmitters and receivers. Transmitters include cellular modems, wireless mesh network transceivers, Wi-Fi® transmitters and receivers, low power wide area (LPWA) transceivers, and / or near field transmitters and receivers. Communications transceiver, NFC), but is not limited to these. The communication device 50318 includes mobile phones, sensor systems (eg, environment, location, movement, etc.) and / or sensor networks (wired and / or wireless), computing systems (eg, servers, workstation computers, desktop computers, laptops). Computers, tablet computers (eg, iPad®, Galaxy Tab®, etc.), ultra-portable computers, ultra-mobile computers, netbook computers, and / or sub-notebook computers, etc. can be included or these. Can be configured to communicate with. In at least one aspect of the present disclosure, one of these devices may be a coordinator node.

The transmitter / receiver 50320 receives serial transmission data from processor 50308 via the corresponding UART, modulates the serial transmission data on an RF carrier, generates a transmission RF signal, and transmits the transmission RF signal via the corresponding antenna. Can be configured to: The transmitter / receiver (s) receive the received RF signal, including the RF carrier wave modulated by the serial received data, through the corresponding antenna, demodulate the received RF signal to extract the serial received data, and send it to the processor. It is further configured to provide serial received data to the corresponding UART for provision. Each RF signal has an associated carrier frequency and associated channel bandwidth. Channel bandwidth is associated with carrier frequency, transmit data, and / or receive data. Each RF carrier frequency and channel bandwidth is related to the operating frequency range (s) of the transmitter / receiver (s) 50320. Each channel bandwidth is further related to radio communication standards and / or protocols to which the transmitter / receiver (s) 50320 may comply. In other words, each transmitter / receiver 50320 is a radio using a selected radio communication standard and / or protocol, such as IEEE802.11a / b / g / n and / or Zigbee routing for Wi-Fi®. It can support the implementation of IEEE 802.115.4 for mesh networks.

Processor 50308 is coupled to sensing and intelligent control device 50324 connected to smoke evacuator 50326. The smoke evacuator 50326 can include one or more sensors 50327, and can also include a pump and a pump motor controlled by a motor driver 50328. The motor driver 50328 is communicably connected to the processor 50308 and the pump motor in the smoke evacuator 50326. The sensing and intelligent control device 50324 includes a sensor algorithm 50321 and a communication algorithm 50322 that facilitate communication between the smoke evacuator 50326 and other devices and adapt their control programs. The sensing and intelligent control device 50324 evaluates, for example, fluids, microparticles, and gases extracted via the discharge conduit 50336 to improve smoke extraction efficiency and / or, as further described herein. It is configured to reduce the smoke output of the device. In a particular example, the sensing and intelligent control device 50324 attaches to one or more sensors 50327 in the smoke evacuator 50326, one or more internal sensors 50330, and / or one or more external sensors 50332 in the electrosurgical system 50300. Connected so that they can communicate.

In certain examples, the processor can be located within the ejector housing of the surgical ejection system. For example, referring to FIG. 6, the processor 50408 and the memory 50410 for it are located in the ejector housing 50440 of the surgical ejection system 50400. The processor 50408 signals and communicates with the motor driver 50428, various internal sensors 50430, the display 50442, the memory 50410, and the communication device 50418. The communication device 50418 is in many respects similar to the communication device 50318 described above with respect to FIG. The communication device 50418 can allow the processor 50408 in the surgical discharge system 50400 to communicate with other devices in the surgical system. For example, the communication device 50418 may include one or more external sensors 50432, one or more surgical devices 50444, one or more hubs 50448, one or more clouds 50446, and / or one or more additional surgical systems. / Or wired and / or wireless communication to the tool can be enabled. In a particular example, the reader will readily understand that the surgical drainage system 50400 of FIG. 6 can be incorporated into the electrosurgical system 50300 of FIG. The surgical drainage system 50400 also includes a pump 50450, including its pump motor 50451, a drainage conduit 50436, and an exhaust port 50452. The various pumps, exhaust conduits, and exhaust ports are described further herein. The surgical drainage system 50400 can also include, for example, a sensing and intelligent control device that can be similar in many respects to the sensing and intelligent control device 50324. For example, such a sensing and intelligent controller can signal and communicate with one or more of the processor 50408 and / or the sensor 50430 and / or the external sensor 50432.

The electrosurgical system 50300 (FIG. 5) and / or the surgical drainage system 50400 (FIG. 6) can be programmed to monitor one or more parameters of the surgical system and signal communication with the processors 50308 and / or 50408. Surgical function can be affected based on one or more algorithms stored in the memory. Various exemplary embodiments disclosed herein can be implemented, for example, by such an algorithm.

In one aspect of the disclosure, the processors and sensor systems, such as the processors 50308 and 50408 and the corresponding sensor systems (FIGS. 5 and 6) communicating with them, are, for example, smoke exhaust systems and / or electrosurgical systems, energy devices. And / or are configured to sense the airflow through the vacuum source in order to adjust the parameters of the external device and / or system used in conjunction with a smoke evacuating system such as a generator. In one aspect of the disclosure, the sensor system can include multiple sensors arranged along the airflow path of the surgical discharge system. The sensor can measure the pressure difference in the discharge system to detect the state or condition of the system between the sensors. For example, the system between the two sensors may be a filter, which uses a pressure difference to increase the speed of the pump motor when the flow through the filter is reduced to maintain the flow rate through the system. Can be made to. As another embodiment, the system may be a fluid trap in the discharge system and the pressure difference can be used to determine the airflow path through the discharge system. In yet another embodiment, the system may be the inlet and outlet (or outlet) of the exhaust system and within the exhaust system to use the pressure difference to keep the maximum suction load below the threshold. The maximum suction load can be determined.

In one aspect of the disclosure, the processors and sensor systems, such as the processors 50308 and 50408 and the corresponding sensor systems (FIGS. 5 and 6) that communicate with them, are aerosols or carbide particles in the fluid extracted from the surgical site, ie. It is configured to detect the proportion of smoke. For example, the sensing system may include a sensor that detects the size and / or composition of the particles used to select the airflow path through the discharge system. In such an example, the discharge system can include a first filtration path or first filtration state, and a second filtration path or second filtration state, which can have different properties. In one example, the first pathway comprises only the particulate filter and the second pathway includes both the fluid filter and the particulate filter. In a particular example, the first pathway comprises a particulate filter and the second pathway comprises a particulate filter arranged in series and a finer particulate filter. Additional and / or alternative filtration channels are also envisioned.

In one aspect of the disclosure, processors and sensor systems, such as processors 50308 and 50408 and the corresponding sensor systems communicating with them (FIGS. 5 and 6), chemically analyze particles ejected from the patient's abdominal cavity. Is configured to do. For example, the sensing and intelligent controller 50324 may sense the number and type of particles to adjust the power level of the ultrasonic generator in order to guide the ultrasonic blades to generate less smoke. In another embodiment, the sensor system may include a sensor for detecting the number of particles, temperature, fluid content, and / or percentage of contamination of the discharged fluid to regulate the output of the generator. , The detected characteristics (s) can be communicated to the generator. For example, the smoke evacuator 50326 and / or the sensing and intelligent control device 50324 for it may be configured to adjust the effluent flow rate and / or the motor speed of the pump to a predetermined particle level and is generated by an end effector. Operability may be affected on the output power or waveform of the generator to reduce smoke.

In one aspect of the disclosure, the processor and sensor systems, such as the processors 50308 and 50408 and their corresponding sensor systems (FIGS. 5 and 6), are one or more in ambient air and / or exhaust from the ejector housing. It is configured to assess particle count and contamination in the operating room by assessing properties. Particle number and / or air quality, such as on the ejector housing, to communicate information to the clinician and / or to establish the effectiveness of the flue gas system and its filters (s). It may be displayed on the smoke exhaust system.

In one aspect of the disclosure, for example, a processor such as processor 50308 or processor 50408 (FIGS. 5 and 6) determines correlation and / or speed of revolutions-per-minute (RPM) of the pump. The sample velocity image obtained from the endoscope is configured to be compared to the number of particles in the ejector from the sensing system (eg, sensing and intelligent control device 50324). In one example, the activation of the generator may be communicated to the smoke evacuator, whereby the expected required smoke evacuation rate can be achieved. The activation of the generator may be communicated to the surgical discharge system, for example, via a surgical hub, a cloud communication system, and / or a direct connection.

In one aspect of the disclosure, the sensor system and algorithm of the smoke evacuator system (see, eg, FIGS. 5 and 6) can be configured to control the smoke evacuator and of the surgical field at a given time. Based on the need, its motor parameters can be adapted to adjust the filtration efficiency of the smoke evacuator. In one example, an adaptive airflow pump velocity algorithm is provided for automatically changing the motor pump speed based on the sensed particles entering and / or exiting the evacuator outlet or outlet. Will be done. For example, the sensing and intelligent controller 50324 (FIG. 5) can include, for example, user selectable speeds and automatic mode speeds. At automatic mode speeds, the airflow through the effluent system may be scaleable based on the lack of smoke entering the effluent system and / or filtered particles exiting the effluent system. In certain examples, automatic mode velocities can provide automatic sensing and compensation for laparoscopic mode.

In one aspect of the disclosure, the efflux system is an electrical and communication architecture that provides data collection and communication capabilities to improve interactivity with surgical hubs and clouds (see, eg, FIGS. 5 and 6). Can be included. In one embodiment, the surgical drainage system and / or its processors, such as, for example, processor 50308 (FIG. 5) and processor 50408 (FIG. 6), are used to identify system errors, short circuits, and / or safety checks. Can include segmented control circuits that are energized in a stepwise manner. The segmented control circuit can also be configured to have a portion that is energized and a portion that is not energized until the energized portion performs a first function. The segmented control circuit can include circuit elements for identifying status updates and displaying them to the user of the attached components. The segmented control circuit is also in the first state where the motor is started by the user and in the second state where the motor is not started by the user but the pump is operated quieter and at a slower speed. Includes circuit elements for operating the motor. The segmented control circuit can, for example, allow the smoke evacuator to be energized in stages.

The electrical and communication architecture of the evacuator system (see, eg, FIGS. 5 and 6) also interacts with the smoke evacuator with other components within the surgical hub for interaction and communication of data with the cloud. Connectivity can be provided. Communication of surgical discharge system parameters to the surgical hub and / or cloud can be provided to influence the output or operation of other attached devices. The parameters may be operational or may be perceived. Operating parameters include air flow, pressure difference, and air quality. Detected parameters include particulate concentration, aerosol proportions, and chemical analysis.

In one aspect of the disclosure, a drainage system, such as, for example, the surgical drainage system 50400, may also include a housing, replaceable components, a control unit, and a display. Circuit elements are provided for communicating security identifications (IDs) between such interchangeable components. For example, the communication between the filter and the flue gas electronics is to verify the reliability of the component, the remaining life, to update the parameters in the component, to record the error, and / Alternatively, it can be provided to limit the number and / or types of components that can be identified by the system. In various examples, the communication circuit can authenticate features for enabling and / or disabling configuration parameters. The communication circuit may employ an encryption and / or error handling scheme to manage the security and unique relationships between the components and the flue gas electronics. Disposable / reusable components are included in certain examples.

In one aspect of the disclosure, the discharge system can provide fluid management as well as extraction filters and airflow configurations. For example, a surgical drainage system including a fluid capture mechanism is provided, the fluid capture mechanism having a first and second set of extraction or airflow control mechanisms, which are in series with each other and have large fluid droplets. And each small fluid droplet is extracted. In certain examples, the airflow path can include a recirculation channel or a secondary fluid channel that returns from downstream of the exhaust port of the main fluid management chamber to the primary reservoir.

In one aspect of the disclosure, a high performance pad can be connected to an electrosurgical system. For example, the ground electrode 50335 of the electrosurgical system 50300 (FIG. 5) can include a high performance pad with local sensing integrated into the pad while maintaining capacitive coupling. For example, a capacitive return pathway pad can be used to sense the neural control signal and / or movement of a selected anatomical position to detect the proximity of a unipolar tip to a nerve fascicle. It can have small separable array elements.

The electrosurgical system can include a signal generator, an electrosurgical instrument, a return electrode, and a surgical discharge system. The generator may be an RF wave generator that produces RF electrical energy. Connected to the electrosurgical instrument is a utility conduit. Utility conduits include cables that transfer electrical energy from signal generators to electrosurgical instruments. Utility conduits also include vacuum hoses that carry captured / collected smoke and / or fluid away from the surgical site. Such an exemplary electrosurgical system 50601 is shown in FIG. More specifically, the electrosurgical system 50601 includes a generator 50640, an electrosurgical instrument 50630, a return electrode 50646, and a discharge system 50600. The electrosurgical instrument 50630 includes a handle 50632 and a distal conduit opening 50634 fluidly connected to a suction hose 50636 of the drainage system 50600. The electrosurgical instrument 50630 also includes electrodes powered by a generator 50640. The first electrical connection 50642, for example the wire, extends from the electrosurgical instrument 50630 to the generator 50640. The second electrical connection 50644, for example, the wire, extends from the electrosurgical instrument 50630 to the electrode, i.e. the return electrode 50646. In another example, the electrosurgical instrument 50630 may be a bipolar electrosurgical instrument. The distal conduit opening 50634 on the electrosurgical instrument 50630 is fluidly coupled to a suction hose 50636 extending to the filter end cap 50603 of the filter installed within the discharger housing 50618 of the discharge system 50600.

In another example, the distal duct opening 50634 of the drainage system 50600 may be on a handpiece or tool separate from the electrosurgical instrument 50630. For example, the drainage system 50600 can include surgical tools that are not connected to the generator 50640 and / or do not include a surface that energizes the tissue. In certain examples, the distal duct opening 50634 of the drainage system 50600 may be detachably attached to an electrosurgical tool. For example, the drainage system 50600 can include a clip-on or snap duct that terminates at the distal duct opening, which may be detachably attached to a surgical tool (see, eg, FIG. 3).

The electrosurgical instrument 50630 electrifies the patient's target tissue to cut tissue and / or cauterize blood vessels in and / or near the target tissue, as described herein. It is configured to deliver energy. Specifically, an electric discharge is provided to the patient by the electrode tip to cause heating of the patient's cytoplasm in close contact with or adjacent to the electrode tip. Tissue heating occurs at a reasonably high temperature so that electrosurgery can be performed using the electrosurgical instrument 50630. A return electrode 50646 is applied to the patient (depending on the type of return electrode) or the patient to complete the circuit and provide a return electrical path to the generator 50640 for energy entering the patient's body. Either is placed in close proximity to.

Cauterization of blood vessels to prevent heating of the patient's cytoplasm by electrode tips or bleeding will often result in smoke being emitted where the cauterization occurs, as further described herein. In such an example, the drainage duct opening 50634 is located near the electrode tip, so that the drainage system 50600 is configured to capture smoke emitted during the surgical procedure. Vacuum suction allows smoke to be drawn into the conduit opening 50634 via the electrosurgical instrument 50630 and into the suction hose 50636 towards the discharger housing 50618 of the discharge system 50600.

Here, with reference to FIG. 8, the discharger housing 50618 of the discharge system 50600 (FIG. 7) is shown. The ejector housing 50618 includes a socket 50620 sized and structured to receive the filter. The ejector housing 50618 can completely or partially enclose the internal components of the ejector housing 50618. Socket 50620 includes a first receptacle 50622 and a second receptacle 50624. The transition surface 50626 extends between the first receptacle 50622 and the second receptacle 50624.

Here, mainly referring to FIG. 9, the socket 50620 is drawn along the cross-sectional plane shown in FIG. The socket 50620 includes a first end 50621 that is open to receive the filter and a second end 50623 that communicates with the flow path 50699 through the ejector housing 50618. The filter 50670 (FIGS. 10 and 11) may be detachably arranged with the socket 50620. For example, the filter 50670 may be inserted into and removed from the first end 50621 of the socket 50620. The second receptacle 50624 is configured to receive the connecting nipple of the filter 50670.

Surgical effluent systems often use filters to remove unwanted contaminants from the smoke before it is released as exhaust. In certain examples, the filters may be replaceable. The reader will understand that the filters 50670 shown in FIGS. 10 and 11 can be used in the various emission systems disclosed herein. The filter 50670 may be a replaceable and / or disposable filter.

The filter 50670 includes a front cap 50672, a rear cap 50674, and a filter body 50676 arranged between them. The front cap 50672 includes a filter inlet 50678 configured to receive smoke directly from the suction hose 50636 (FIG. 7) or other smoke source in certain examples. In some aspects of the disclosure, the front cap 50672 directs smoke directly from the smoke source, removes at least a portion of the fluid from it, and then filters body 50676 to further treat the partially treated smoke. It can be replaced by a fluid trap (eg, fluid trap 50760 shown in FIGS. 14-17) that is passed through. For example, the filter inlet 50678 receives smoke through the exhaust port of a fluid trap, such as port 50766 of the fluid trap 50760 (FIGS. 14-17), and transmits the partially processed smoke to the filter 50670. Can be configured in.

Once the smoke enters the filter 50670, the smoke can be filtered by the components contained within the filter body 50676. The filtered smoke can then exit the filter 50670 through the filter exhaust port 50680 defined within the rear cap 50674 of the filter 50670. When the filter 50670 is associated with an exhaust system, the suction generated within the exhaust housing 50618 of the exhaust system 50600 is transmitted to the filter 50670 via the filter exhaust port 50680 to pass the internal filtration components of the filter 50670. Smoke can be drawn in through. Filters often include particulate filters and charcoal filters. The particulate filter can be, for example, a high-efficiency particulate air (HEPA) filter or an ultra-low penetration air (ULPA) filter. ULPA filtration utilizes a depth filter similar to a maze. Particles can be filtered using at least one of the following methods: Direct blocking (particles larger than 1.0 micron are trapped because they are too large to pass through the fibers of the media filter. ), Inertial collision (0.5-1.0 micron particles collide with the fiber and stay there), and diffusion blocking (Brown random thermal motion as the particles "search" the fiber and attach to it. Particles smaller than 0.5 micron are captured by the effect).

The charcoal filter is configured to remove toxic gases and / or odors generated by surgical smoke. In various examples, the charcoal may be "activated", which means that it has been treated in a heating process to expose the active absorption sites. The charcoal may be, for example, from an activated, unused coconut shell.

Here, referring to FIG. 11, the filter 50670 includes a coarse media filter layer 50684 followed by a fine particulate filter layer 50686. In another example, the filter 50670 may consist of a single type of filter. In yet another example, the filter 50670 can include three or more filter layers and / or three or more different types of filter layers. After the particulate matter has been removed by the filter layers 50684 and 50686, the smoke is drawn in through the carbon reservoir 50688 in the filter 50670 to remove gaseous contaminants in the smoke, for example volatile organic compounds. Is done. In various examples, the carbon reservoir 50688 can include a carbon filter. The filtered smoke is here substantially free of particulate matter and gaseous contaminants and is drawn through the filter exhaust port 50680 into the discharge system 50600 for further treatment and / or removal.

The filter 50670 includes a plurality of dams between the components of the filter body 50676. For example, the first dam 50690 is arranged between, for example, the filter inlet 50678 (FIG. 10) and the first particulate filter such as the coarse media filter 50684. The second dam 50692 is arranged between the carbon reservoir 50688 and the second particulate filter, for example, the fine particulate filter 50686. In addition, the third dam 50694 is located between the carbon reservoir 50688 and the filter exhaust port 50680. Dams 50690, 50692, and 50694 can include gaskets or O-rings, which are configured to prevent the movement of components within the filter body 50676. In various examples, the size and shape of the dams 50690, 50692, and 50694 can be selected to prevent expansion of the filter components in the direction of applied suction.

The coarse media filter 50684 can include, for example, low air resistance filter materials such as glass fiber, polyester, and / or pleated filters configured to remove most of the particulate matter larger than 10 μm. In some aspects of the disclosure, it is at least 85% of the particulate matter greater than 10 μm, greater than 90% of the particulate matter greater than 10 μm, greater than 95% of the particulate matter greater than 10 μm, and greater than 10 μm. Includes a filter that removes more than 99% of the material, more than 99.9% of the particulate matter greater than 10 μm, or more than 99.99% of the particulate matter greater than 10 μm.

In addition or instead, the coarse media filter 50684 can include a low air resistance filter that removes most of the particulate matter larger than 1 μm. In some aspects of the disclosure, it is at least 85% of particulate matter greater than 1 μm, greater than 90% of particulate matter greater than 1 μm, greater than 95% of particulate matter greater than 1 μm, and particulate matter greater than 1 μm. Includes a filter that removes more than 99% of the material, more than 99.9% of the particulate matter greater than 1 μm, or more than 99.99% of the particulate matter greater than 1 μm.

The fine particulate filter 50686 can include any filter with higher efficiency than the coarse media filter 50684. This includes, for example, a filter capable of filtering a higher percentage of particles of the same size as the coarse media filter 50684 and / or filtering particles smaller in size than the coarse media filter 50684. In some aspects of the disclosure, the fine particulate filter 50686 can include a HEPA filter or a ULPA filter. In addition or instead, the fine particulate filter 50686 may be pleated to increase its surface area. In some aspects of the disclosure, the coarse media filter 50684 comprises a pleated HEPA filter and the fine particulate filter 50686 comprises a pleated ULPA filter.

After fine particle filtration, smoke enters the downstream portion of the filter 50670 containing the carbon reservoir 50688. The carbon reservoir 50688 is defined by porous partitions 50696 and 50698 located between the intermediate dam 50692 and the terminal dam 50694, respectively. In some aspects of the disclosure, the porous partitions 50696 and 50698 are rigid and / or inflexible, defining a constant spatial volume for the carbon reservoir 50688.

The carbon reservoir 50688 can contain an additional adsorbent that acts cumulatively with or independently of the carbon particles to remove gaseous contaminants. Additional adsorbents may include, for example, adsorbents such as magnesium oxide and / or copper oxide, which may include, for example, gaseous pollutants such as carbon monoxide, ethylene oxide, and / or ozone. It can act to adsorb. In some aspects of the disclosure, the additional adsorbent is dispersed throughout the reservoir 50688 and / or placed in separate layers above, below, or inside the reservoir 50688.

Referring again to FIG. 4, the discharge system 50500 includes a pump 50506 in the discharger housing 50518. Similarly, the discharge system 50600 shown in FIG. 7 can generate a suction that draws smoke from the surgical site through the suction hose 50636 and through the filters 50670 (FIGS. 10 and 11), the ejector housing 50618. Can include pumps located within. During operation, the pump can generate a pressure difference within the ejector housing 50618 that moves smoke into the filter 50670 and exhausts it from an exhaust mechanism (eg, exhaust mechanism 50520 in FIG. 4) at the outlet of the flow path. it can. Filter 50670 is configured to extract harmful, contaminated, or otherwise unwanted particulates from smoke.

The pump may be aligned with the flow path through the ejector housing 50618 so that the gas flowing through the ejector housing 50618 enters the pump at one end and pumps at the other end. Get out. The pump can provide a sealed positive displacement flow path. In various examples, the pump seals by capturing (sealing) a first volume of gas and reducing that volume to a second smaller volume as the gas travels through the pump. A stopped positive displacement flow path can be generated. By reducing the volume of captured gas, the pressure of the gas increases. A second pressurized volume of gas can be expelled from the pump at the pump outlet. For example, the pump may be a compressor. More specifically, the pump may include a hybrid regeneration blower, a claw pump, a lobe compressor, and / or a scroll compressor. The positive displacement compressor can provide improved compression ratios and operating pressures while limiting the vibrations and noise generated by the discharge system 50600. In addition or instead, the discharge system 50600 may include a fan for moving the fluid.

An example of a positive displacement compressor, for example, a scroll compressor pump 50650, is shown in FIG. The scroll compressor pump 50650 includes a stator scroll 50652 and a moving scroll 50654. The stator scroll 50652 can be fixed in place while the moving scroll 50654 is eccentrically orbiting. For example, the moving scroll 50654 can eccentrically orbit around the central longitudinal axis of the stator scroll 50652. As shown in FIG. 12, the central longitudinal axis of the stator scroll 50652 and the moving scroll 50654 extends perpendicular to the visual field plane of the scrolls 50652, 50654. The stator scroll 50652 and the moving scroll 50654 are alternated with each other to form a separate sealed compression chamber 50656.

During use, gas can enter the scroll compressor pump 50650 at inlet 50658. When the moving scroll 50654 orbits with respect to the stator scroll 50652, the inlet gas is first trapped in the compression chamber 50656. The compression chamber 50656 is configured to move a separate volume of gas towards the center of the scroll compressor pump 50650 along the spiral shape of the scrolls 50652 and 50654. The compression chamber 50656 defines an enclosed space in which the gas resides. Further, as the moving scroll 50654 moves the captured gas towards the center of the stator scroll 50652, the compression chamber 50656 is reduced in volume. This reduction in volume increases the pressure of the gas in the compression chamber 50656. The gas in the sealed compression chamber 50656 is trapped during the volume reduction and therefore pressurizes the gas. When the pressurized gas reaches the center of the scroll compressor pump 50650, the pressurized gas is discharged through the outlet 50656.

Here, with reference to FIG. 13, a portion of the discharge system 50700 is shown. The discharge system 50700 may be similar to the discharge system 50600 (FIG. 7) in many respects. For example, the discharge system 50700 includes a discharger housing 50618 and a suction hose 50636. Referring again to FIG. 7, the discharge system 50600 is configured to generate suction, thereby drawing smoke from the distal end of the suction hose 50636 into the discharger housing 50618 for processing. In particular, the suction hose 50636 is not connected to the ejector housing 50618 via the filter end cap 50603 of FIG. Rather, the suction hose 50636 is connected to the ejector housing 50618 via a fluid trap 50760. A filter similar to the filter 50670 can be placed in the socket of the ejector housing 50618 behind the fluid trap 50760.

The fluid trap 50760 is a first treatment that extracts and retains at least a portion of the fluid (eg, liquid) from the smoke before relaying the partially treated smoke for further treatment and filtration to the discharge system 50700. It is a point. The effluent system 50700 processes and filters smoke to reduce or eliminate unpleasant odors or other problems associated with smoke generation in the operating room (or other operating environment), as described herein. , And are configured to be cleaned in another way. In certain examples, the fluid trap 50760 increases the efficiency of the discharge system 50700 and / or with it, among other things, by extracting droplets and / or aerosols from the smoke before further processing by the discharge system 50700. The life of the associated filter can be increased.

Primarily with reference to FIGS. 14-17, the fluid trap 50760 is shown removed from the ejector housing 50618 (FIG. 13). The fluid trap 50760 includes an inlet port 50762 defined on the front cover or surface 50764 of the fluid trap 50760. The inlet port 50762 can be configured to releasably receive the suction hose 50636 (FIG. 13). For example, the end of the suction hose 50636 can be at least partially inserted into the inlet port 50762 and secured by a tight fit between them. In various examples, the tight fit may be a fluid tight and / or airtight fit such that substantially all of the smoke passing through the suction hose 50636 is transferred into the fluid trap 50760. In some cases, for example, a latch-based compression fit, O-ring, suction hose 50636 may be screwed to the inlet port 50762 and / or a suction hose 50636 such as another connecting mechanism may be connected to the inlet port 50762 or Other mechanisms for joining can be used.

In various examples, the fluid tight and / or airtight fit between the suction hose 50636 and the fluid trap 50760 is the fluid and / or other material in the smoke discharged at or near the junction of these components. Is configured to prevent leakage. In some cases, the suction hose 50636 is associated with the inlet port 50762 via, for example, an intermediate coupling device such as an O-ring and / or adapter, and is airtight and / or fluid tight between the suction hose 50636 and the fluid trap 50760. The connection can be made more secure.

As mentioned above, the fluid trap 50760 includes an exhaust port 50766. The exhaust port extends away from the back cover or surface 50768 of the fluid trap 50760. Exhaust port 50766 defines an open channel between the internal chamber 50770 of the fluid trap 50760 and the external environment. In some cases, the exhaust port 50766 is sized and molded to be closely associated with the surgical exhaust system or its components. For example, the exhaust port 50766 is sized and molded to transmit at least partially treated smoke from the fluid trap 50760 to the filter housed in the exhaust housing 50618 (FIG. 13). May be done. In certain examples, the exhaust port 50766 can extend away from the front plate, top surface, or side surface of the fluid trap 50760.

In a particular example, the exhaust port 50766 includes a membrane that separates the exhaust port 50766 from the ejector housing 50618. Such a membrane allows water or other liquid collected in the fluid trap 50760 to pass through the exhaust port 50766, while allowing air, water, and / or steam to enter the discharger housing 50618 freely. It can act to prevent entry into the ejector housing 50618. For example, high flow microporous polytetrafluoroethylene (PTFE) may be placed downstream of exhaust port 50766 and upstream of the pump to protect the pump or other components of the exhaust system 50700 from damage and / or contamination. Can be done.

The fluid trap 50760 is also arranged and sized to assist the user in handling the fluid trap 50760 and / or connecting the fluid trap 50760 to the suction hose 50636 and / or the ejector housing 50618. Includes 50772. The grip area 50772 is drawn to be an elongated recess. However, the reader may include, for example, at least one recess, groove, protrusion, tassel, and / or ring in the grip area 50772, such as corresponding to the user's finger, or otherwise. It will be readily appreciated that it may be sized and molded to provide a gripping surface.

Here, primarily with reference to FIGS. 16 and 17, the internal chamber 50770 of the fluid trap 50760 is shown. The relative arrangement of the inlet port 50762 and the exhaust port 50766 is configured to facilitate the extraction and retention of fluid from the smoke as it enters the fluid trap 50760. In certain examples, the inlet port 50762 can have a notched cylindrical shape, which directs smoke and associated fluid towards the fluid reservoir 50774 of the fluid trap 50760, or otherwise directionally at the exhaust port. It can be turned away from 50766. Examples of such fluid flow are shown by arrows A, B, C, D, and E in FIG.

As shown, smoke enters fluid trap 50760 through inlet port 50762 (indicated by arrow A) and exits fluid trap 50760 through exhaust port 50766 (indicated by arrow E). Smoke entering the inlet port 50762, due at least in part due to the geometry of the inlet port (eg, the longer upper side wall 50761 and the shorter lower side wall 50763), first enters the fluid reservoir 50774 of the fluid trap 50760. Mainly pointed downwards (indicated by arrow B). As the smoke continues to be drawn downwards into the fluid trap 50760 along the arrows A and B, the first downwardly directed smoke rotates downwards and is directed laterally away from its source. Towards the top of the fluid trap 50760, travel out of exhaust port 50766 in a substantially opposite but parallel path (indicated by arrows D and E).

The directional flow of smoke through the fluid trap 50760 can ensure that the liquid in the smoke is extracted and retained in the lower part of the fluid trap 50760 (eg, fluid reservoir 50774). Further, the relative arrangement of the exhaust port 50766 vertically above the inlet port 50762 when the fluid trap 50760 is in the upright position does not substantially impede the flow of fluid in and out of the fluid trap 50760, while at the same time allowing the smoke to flow. It is configured to prevent the fluid from being unintentionally carried through the exhaust port 50766 by the flow. In addition, in certain examples, the configuration of inlet port 50762 and outlet port 50766, and / or the size and shape of the fluid trap 50760 itself, can allow the fluid trap 50760 to be hermetic.

In various examples, the discharge system can include multiple sensors and intelligent controls, for example, as further described herein with respect to FIGS. 5 and 6. In one aspect of the disclosure, the discharge system comprises one or more temperature sensors, one or more fluid detection sensors, one or more pressure sensors, one or more particle sensors, and / or one or more chemical sensors. Can include. The temperature sensor can be arranged to detect the temperature of the fluid at the surgical site as it travels through the surgical drainage system and / or is drained from the surgical drainage system into the operating room. The pressure sensor can be arranged to detect the pressure in the discharge system, such as in the discharger housing. For example, the pressure sensor can be located upstream of the filter, between the filter and the pump, and / or downstream of the pump. In certain examples, the pressure sensor can be arranged to detect pressure in the ambient environment outside the discharge system. Similarly, the particle sensor can be arranged to detect particles in the discharge system, such as in the discharger housing. The particle sensor may be, for example, upstream of the filter, between the filter and the pump, and / or downstream of the pump. In various examples, particle sensors can be arranged to detect particles in the surrounding environment, for example, to determine air quality in the operating room.

The discharger housing 50818 of the discharge system 50800 is schematically shown in FIG. The ejector housing 50818 may be, for example, similar in many respects to the ejector housing 50018 and / or 50618 and / or can be incorporated into the various ejection systems disclosed herein. The ejector housing 50818 includes a number of sensors as further described herein. The reader will understand that the particular ejector housing may not include each of the sensors shown in FIG. 18 and / or may include additional sensors (s). Similar to the ejector housings 50018 and 50618 disclosed herein, the ejector housing 50818 of FIG. 18 includes an inlet 50822 and an outlet 50824. The fluid trap 50860, the filter 50870, and the pump 50806 are continuously aligned along the flow path 50804 through the ejector housing 50818 between the inlet 50822 and the outlet 50824.

The ejector housing can include modular and / or replaceable components as further described herein. For example, the ejector housing can include a socket or receptacle 50871 sized to receive a modular fluid trap and / or a replaceable filter. In a particular example, as shown in FIG. 18, the fluid trap and filter can be integrated into a single replaceable module 50859. More specifically, the fluid trap 50860 and the filter 50870 form a modular and / or replaceable replaceable module 50859 and can be detachably installed in the receptacle 50871 within the ejector housing 50818. .. In another example, the fluid trap 50860 and the filter 50870 can be separate and separate modular components, which can be assembled together and / or installed separately within the ejector housing 50818. Can be done.

Further referring to the ejector housing 50818, the ejector housing 50818 includes a plurality of sensors for detecting various internal parameters and / or ambient environment parameters. In addition or instead, one or more modular components installed within the ejector housing 50818 may include one or more sensors. For example, further referring to FIG. 18, the interchangeable module 50859 includes a plurality of sensors for detecting various parameters inside.

In various examples, the ejector housing 50818 and / or the modular components (s) that are compatible with the ejector housing 50818 receive inputs from one or more sensors and / or one or more systems. And / or processors such as processors 50308 and 50408 (FIGS. 5 and 6 respectively) configured to communicate output to the driver can be included. Various processors for use with the ejector housing 50818 are further described herein.

During operation, smoke from the surgical site can be drawn from the inlet 50822 through the fluid trap 50860 into the ejector housing 50818. The flow path 50804 through the ejector housing 50818 of FIG. 18 can include a sealed conduit or pipe 50805 extending between various rows of components. In various examples, smoke can flow through the fluid detection sensor 50830 and the chemical sensor 50832 to the divertor valve 50834 further described herein. A fluid detection sensor such as the sensor 50830 can detect fluid particles in smoke. In one example, the fluid detection sensor 50830 can be a continuity sensor. For example, the fluid detection sensor 50830 can include two isolated electrodes and a sensor for detecting the degree of continuity between them. For example, in the absence of fluid, the continuity can be zero or virtually zero. The chemical sensor 50832 can detect the chemical properties of smoke.

At the divertor valve 50834, the fluid can be directed into the condenser 50835 of the fluid trap 50860 and the smoke can continue to travel towards the filter 50870. The baffle 50864 is placed in the condenser 50835 to facilitate the condensation of fluid droplets from smoke into the reservoir in the fluid trap 50860. The fluid detection sensor 50836 can ensure that any fluid in the ejector housing is completely or at least substantially trapped in the fluid trap 50860.

Further referring to FIG. 18, smoke can then be directed into the filter 50870 of the replaceable module 50859. At the inlet to the filter 50870, smoke can flow through the particle sensor 50838 and the pressure sensor 50840. In one embodiment, the particle sensor 50838 may include a laser particle counter, as further described herein. Smoke can be filtered through a pleated ultra-low particulate air (ULPA) filter 50842 and a charcoal filter 50844, as shown in FIG.

Upon exiting the filter, the filtered smoke can flow through the pressure sensor 50846 and then continue along the flow path 50804 in the discharger housing 50818 towards the pump 50806. As it travels through the pump 50806, the filtered smoke can flow through the outlet particle sensor 50848 and the pressure sensor 50850 to the ejector housing 50818. In one embodiment, the particle sensor 50848 can include a laser particle counter, as further described herein. The ejector housing 50818 of FIG. 18 also includes an air quality particle sensor 50852 and an ambient pressure sensor 50854 to detect various characteristics of the ambient environment, such as the operating room environment. In at least one form, the air quality particle sensor or the external / ambient air particle sensor 50852 can include a laser particle counter. The various sensors shown in FIG. 18 will be further described herein. Moreover, in various examples, alternative sensing means can be utilized in the smoke exhaust system disclosed herein. For example, alternative sensors for counting particles and / or determining the concentration of fine particles in a fluid are further disclosed herein.

In various examples, the fluid trap 50860 shown in FIG. 18 can be configured to prevent the outflow and / or outflow of trapped fluid. For example, the geometry of the fluid trap 50860 may be chosen to prevent the trapped fluid from flowing out and / or leaking out. In certain examples, the fluid trap 50860 can include a splatter screen such as a baffle and / or screen 50862 to prevent the trapped fluid from splashing out of the fluid trap 50860. In one or more examples, the fluid trap 50860 may include a sensor for detecting the volume of fluid in the fluid trap and / or determining if the fluid trap 50860 is filled to capacity. The fluid trap 50860 may include a valve for emptying the fluid from it. The reader will easily understand that various alternative fluid trap configurations and geometry can be used to capture the fluid drawn into the ejector housing 50818.

In certain examples, the filter 50870 can include additional and / or lower filtration levels. For example, the filter 50870 can include one or more filtration layers selected from the group of coarse media filters, fine media filters, and adsorbent-based filters. The coarse media filter may be, for example, a low air resistance filter which can be composed of glass fiber, polyester, and / or a pleated filter. The fine media filter may be a high efficiency fine particle air (HEPA) filter and / or a ULPA filter. The adsorbent-based filter may be, for example, an activated carbon filter. The reader will easily understand that various alternative filter configurations and geometries can be used to filter smoke drawn along the flow path through the discharger housing 50818.

In one or more examples, the pump 50806 shown in FIG. 18 is replaced with and / or combined with another compressor and / or pump, such as a hybrid regenerative blower, claw pump, and / or lobe compressor. Can be used. The reader will easily understand that various alternative pump configurations and geometries can be used to generate suction in the flow path 50804 to draw smoke into the discharger housing 50818. ..

Various sensors in the emission system, such as the sensor shown in FIG. 18, can communicate with the processor. The processor can be integrated into the drainage system and / or may be a component of another surgical instrument and / or surgical hub. The various processors are described further herein. The onboard processor can be configured to adjust one or more operating parameters of the ejector system (eg, the motor for pump 50806) based on the input from the sensor (s). In addition or instead, the onboard processor now adjusts one or more operating parameters of another device, such as an electrosurgical tool and / or an imaging device, based on input from a sensor (s). Can be configured.

Here, with reference to FIG. 19, another ejector housing 50918 of the ejector system 50900 is shown. The ejector housing 50918 of FIG. 19 may be similar in many respects to the ejector housing 50818 of FIG. For example, the ejector housing 50918 defines a flow path 50904 between the inlet 50922 to the ejector housing 50918 and the outlet 50924 of the ejector housing 50918. A fluid trap 50960, a filter 50970, and a pump 50906 are continuously arranged between the inlet 50922 and the outlet 50924. The ejector housing 50918 can include, for example, a socket or receptacle 50971 sized to receive a modular fluid trap and / or a replaceable filter, similar to the receptacle 50871. At the divertor valve 50934, the fluid can be directed into the condenser 50935 of the fluid trap 50960 and the smoke can continue to travel towards the filter 50970. In certain examples, the fluid trap 50960 can include, for example, a baffle such as a baffle 50964 and / or a splatter screen such as a screen 50962 to prevent the trapped fluid from splashing out of the fluid trap 50960. The filter 50970 includes a pleated ultra-low particulate air (ULPA) filter 50942 and a charcoal filter 50944. A sealed conduit or tube 50905 extends between various rows of components. The ejector housing 50918 also includes sensors 50830, 50832, 50836, 50838, 50840, 50846, 50848, 50850, 50852, and 50854, which are further described herein and shown in FIGS. 18 and 19.

Further referring to FIG. 19, the ejector housing 50918 also includes a centrifugal blower configuration 50980 and a recirculation valve 50990. The recirculation valve 50990 can be selectively opened and closed to recirculate the fluid through the fluid trap 50960. For example, if the fluid detection sensor 50836 detects a fluid, the recirculation valve 50990 can be opened so that the fluid is directed away from the filter 50970 and back into the fluid trap 50960. If the fluid detection sensor 50836 does not detect the fluid, the valve 50990 can be closed so that the smoke is directed into the filter 50970. When the fluid is recirculated through the recirculation valve 50990, the fluid may be drawn through the recirculation conduit 50982. The centrifugal blower configuration 50980 engages with the recirculation conduit 50982 to generate a recirculation suction force within the recirculation conduit 50982. More specifically, when the recirculation valve 50990 is opened and the pump 50906 is activated, the suction force generated by the pump 50906 downstream of the filter 50970 causes the rotation of the first centrifugal blower or squirrel-cage 50984. This can be transmitted to a second centrifugal blower or squirrel-cage 50986 that draws the fluid recirculated into the fluid trap 50960 through the recirculation valve 50990.

In various aspects of the disclosure, the control schematics of FIGS. 5 and 6 can be used with the various sensor systems and ejector housings of FIGS. 18 and 19.

Smoke emitted from the surgical site can contain liquids, aerosols, and / or gases, and / or different chemicals and / or physics, such as particulate matter and particles of different sizes and / or densities. It can contain substances with specific properties. Different types of substances ejected from the surgical site can affect the efficiency of the surgical drainage system and its pumps. In addition, certain types of substances may require the pump to draw in excessive power and / or may damage the motor for the pump.

The power delivered to the pump can be modulated to control the flow rate of smoke through the discharge system based on inputs from one or more sensors along the flow path. The output from the sensor is, for example, the state or quality of the smoke exhaust system and / or the type (s) and proportions of the substance (s) and ratio, chemical properties, density, and / or the size of the emitted smoke. It can exhibit one or more properties. In one aspect of the present disclosure, the pressure difference between two pressure sensors in the discharge system can indicate the state of the region between them, for example, the state of the filter, fluid trap, and / or the entire system. .. Based on the sensor input, the operating parameters of the pump motor can be adjusted by changing the current and / or duty cycle supplied to the motor, which is configured to change the motor speed.

In one aspect of the disclosure, the efficiency of the filter can be improved and / or the motor can be protected from burnout by adjusting the flow rate of smoke through the discharge system.

The surgical discharge system can include one or more particle counters or particle sensors for detecting the size and / or concentration of particles in smoke. With reference to FIGS. 18 and 19 again, particle sensors 50838 and 50848 are shown. The reader will easily understand that various particle measuring means are possible. For example, the particle sensor may be an optical sensor, a laser sensor, a photoelectric sensor, an ionization sensor, an electrostatic sensor, and / or a combination thereof. Various particle sensors will be described further herein.

In various examples, the speed of the motor, and therefore the speed of the pump, may be adjusted based on the particle concentration detected by one or more particle sensors in the surgical discharge system. For example, when a particle sensor (s) detects an increase in particle concentration in a flow path that can accommodate an increase in the amount of smoke in the flow path, it increases the speed of the motor and the speed of the pump. And more fluid can be drawn from the surgical site into the smoke evacuated system. Similarly, when a particle sensor (s) detects a decrease in particle concentration in the flow path, which can accommodate a decrease in the amount of smoke in the flow path, it reduces the speed of the motor and reduces the speed of the pump. The speed can be reduced and suction from the surgical site can be reduced. Additional and alternative tuning algorithms for surgical drainage systems are described further herein. Further, in certain examples, based on sensor data from the smoke evacuated system, the generator in the surgical system will adjust the amount of smoke generated at the surgical site, as further described herein. It may be controlled.

In addition to particle sensors placed along the flow path of the surgical drainage system, the system can include one or more sensors for detecting particle concentrations in the perimeter room, eg, the operating room or operating room. .. With reference to FIGS. 18 and 19 again, the air quality particle sensor 50852 is installed on the outer surface of the ejector housing 50818. An alternative location for the air quality particle sensor 50852 is also envisioned.

In at least one example, the particle sensor can be located downstream of the filter, and in certain examples, it can be located at or near the exit of the filter. For example, the particle sensor 50848 is located downstream of the filter 50870 and pump 50806 in the smoke exhaust system 50800 and downstream of the filter 50970 and pump 50906 in the smoke exhaust system 50900. Since the particle sensor 50848 is located downstream of the filters (s) 50870, 50970, the particle sensors should ensure that the filters (s) 50870, 50970 have removed sufficient particulates from the smoke. It is configured. In various examples, such a sensor may be adjacent to the exhaust outlets 50824, 50924, respectively, of the ejector housings 50818, 50918. In one aspect of the present disclosure, an electrostatic particle sensor can be used. For example, the exhaust outlets 50824, 50924 can include electrostatic particle sensors through which the exhaust passes downstream of the filtration system and flows before it is exhausted into the operating room.

The particle concentration detected by one or more sensors in the surgical drainage system may be communicated to the clinician in many different ways. For example, the ejector housings 50818, 50918 and / or the ejector (eg, electrosurgical instrument 50032 in FIG. 2) can include one or more lights and / or indicators such as a display screen. For example, the LEDs on the ejector housings 50818, 50819 can change color (eg, from blue to red) depending on the volume of particles detected by the sensor (s). In another example, the indicator can include, for example, an alarm or warning that may be tactile, auditory, and / or visual. In such an example, when the concentration of fine particles in the ambient air detected by an air quality sensor (eg, particle sensor 50852) exceeds a threshold amount, the clinician in the operating room (s) will indicate the indicator (s). ) Can be notified.

In certain examples, the surgical discharge system may include an optical sensor. The optical sensor can include an electronic sensor that covers light or a change in light into an electronic signal. The optical sensor can utilize a light scattering method that detects and counts the particles in the smoke in order to determine the concentration of the particles in the smoke. In various examples, the light is based on a laser. For example, in one example, the laser light source is configured to illuminate the particles as they move through the detection chamber. As the particles pass through the laser beam, the light source is obscured, redirected, and / or absorbed. The scattered light is recorded by a photodetector and the recorded light is analyzed. For example, the recorded light can be converted into an electrical signal indicating the size and amount of particles corresponding to the concentration of the particles in the smoke. The concentration of fine particles in smoke can be calculated in real time by, for example, a laser optical sensor. In one aspect of the present disclosure, at least one of the particle sensors 50838, 50848, 50852 is a laser optical sensor.

The photoelectric sensor for detecting particles in smoke may be a pass-through type beam sensor, a reflection type sensor, or a diffusion type sensor. The reflective photoelectric sensor 51000 is shown in FIG. Referring to FIG. 20, the reflective photoelectric sensor 51000 is a light scattering sensor in which the light beam 51002 emitted from the light source 51006 through the lens 51012 is offset from the photodetector or photocell 51004. For example, the photodetector 51004 in FIG. 20 is offset 90 degrees from the light source 51006. When the smoke S obscures the light beam 51002 between the light source 51006 and the light catcher 51008, the light is reflected and the reflected light 51010 is scattered towards the lens 51014 and on the photodetector 51004. The photodetector 51004 converts light into an electrical signal (current) corresponding to the concentration of fine particles in the smoke S. The output signal can be provided to processor 51016, which may be similar in many respects to processor 50308 and / or 50408 shown in FIGS. 5 and 6, respectively, with processor 51016 to the electrical signal and the corresponding fine particle concentration. Based on this, the operating parameters of the motor can be influenced. For example, the output signal from the reflective photoelectric sensor 51000 may be an input to a control algorithm for the motor and / or an input to a surgical hub.

The pass-through photoelectric sensor 51100 is shown in FIG. As shown in FIG. 21, a line of sight extends between the light source 51102 and the photodetector 51104. In such an example, the intensity of the light reaching the photodetector 51104 can be converted into an electrical signal (current) corresponding to the concentration of fine particles in the smoke S. The output signal can be provided to processor 51106 coupled to a 24V DC power supply, which may be similar in many respects to processors 50308 and / or 50408 shown in FIGS. 5 and 6. Processor 51106 can influence the operating parameters of the motor based on the electrical signal and the corresponding particle concentration. For example, the output signal from the photoelectric sensor 51100 may be an input to a control algorithm for the motor and / or an input to a surgical hub.

Photoelectric sensors in surgical discharge systems, such as the sensor 51000 in FIG. 20 and / or the sensor 51100 in FIG. 21, adjust the sensor 51000 for a particular type of smoke, ignoring other types of smoke. The wavelength of light can be selected. In certain examples, multiple sensors and / or multiple wavelengths can be used to tune the sensors 51000 to the correct combination (s). Water vapor, and even denser water vapor, absorbs light of a particular wavelength. For example, water vapor absorbs infrared light instead of reflecting it. Due to these absorption properties of water vapor, infrared light can be useful in the presence of water vapor to accurately count particles in a fluid in a surgical discharge system.

In certain examples, ionization sensors can be used to detect particles in smoke. The ionization sensor contains two electrodes and a radioactive material that converts air molecules into cations and negative ions. Cations move toward the negative electrode and negative ions move toward the positive electrode. As the smoke passes between the electrodes, it combines with the ions, which breaks the circuit. The decrease in current through the circuit can be converted into an electrical signal (current) corresponding to the volume of smoke passing between the electrodes.

The ionization sensor 51200 is shown in FIG. The ionization sensor 51200 utilizes americium-241 to ionize air in a closed area. The sensor 51200 includes a small ionization chamber 51202 having two isolated electrodes 51204. The ionization chamber 51202 can be made of, for example, polyvinyl chloride or polystyrene, and the electrodes 51204 can be, for example, about 1 cm apart in the ionization chamber 51202. Americium-241 source 51208 can provide americium-241 to the ionization chamber 51202. About 0.3 μg of americium-241 can be embedded, for example, in a gold leaf matrix sandwiched between a silver backing and a 2 micron thick layer of palladium laminate. Americium-241 has a half-life of 432 years and can be attenuated by emitting alpha rays 51206. The gold leaf matrix is configured to retain radioactive material while still allowing alpha rays 51206 to pass through. In various examples, alpha rays are preferred over beta and gamma waves because they can easily ionize air particles, have low permeability, and easily contain them.

During ionization, electrons are knocked down from oxygen and nitrogen molecules, thereby producing charged ions. The charged ions are attracted to the decharged electrode and thus form an electric current in the chamber. Since the smoke particles 5210 are larger than the air molecules, the ionized particles collide with and bond with the smoke particles. The bound particles act as a recombination center and neutralize the ions, thereby reducing the amount of ionized particles in the ionization chamber 51202 and reducing the overall current. The decrease in current can be converted into an electrical signal corresponding to the volume of smoke passing between the electrodes 51204. The output signal can be provided, for example, to a processor such as processor 50308 and / or processor 50408 shown in FIGS. 5 and 6, respectively, which can affect the operating parameters of the motor. For example, the output signal from the ionization sensor 51200 may be an input to a control algorithm for the motor and / or an input to a surgical hub, as further described herein.

In various examples, a dual ionization chamber can be used. The first chamber, which acts as a sensing chamber, is open to the atmosphere and can be affected by particulate matter, humidity, and atmospheric pressure. The second chamber can be isolated from smoke and particulate matter. The second chamber is located outside the smoke channel, but is still affected by humidity and atmospheric pressure. By using two chambers, the outputs from both chambers are equally affected and cancel each other out, thus minimizing changes in humidity and atmospheric pressure. For example, depending on the type of surgical procedure, the surgical device used (s), and the type of tissue encountered, the humidity and pressure can change significantly during the surgical procedure, so the dual ion chamber is It can be useful in smoke exhaust systems to compensate for pressure and humidity fluctuations.

In certain examples, a combination technique can be used to determine the concentration of particulates in smoke. For example, a plurality of different types of smoke detectors or sensors can be utilized. Such sensors can be arranged in a row in series with the flow path. For example, the plurality of particle sensors can be arranged along the flow path 50804 and / or the flow path 50904 of FIG. Various sensors can provide inputs to pump motor control algorithms, such as the various tuning algorithms described herein.

In certain examples, the surgical discharge system can be configured to adjust sensor parameters for more accurate detection of particulates in smoke. Adjustment of sensor parameters may depend on the type of surgical device, type of surgical procedure, and / or type of tissue. Surgical devices often produce a predictable type of smoke. For example, in certain treatments, the predictable type of smoke can be smoke with a high water vapor content. In such an example, an infrared photoelectric sensor can be used because infrared rays are substantially absorbed by water vapor and are not reflected. In addition or instead, the predictable type of smoke can be smoke with particles of a particular size or concentration. Based on the expected size of the particles, the sensor can be adjusted to more accurately determine the concentration of particles in the smoke.

In certain examples, situational awareness can facilitate the adjustment of sensor parameters. Information related to situational awareness can be provided to the surgical drainage system by a clinician, an intelligent electrosurgical instrument that signals the surgical drainage system, a robotic system, a hub, and / or the cloud. For example, the hub can include a situational awareness module that can aggregate data from various sensor systems and / or input systems, including, for example, smoke exhaust systems. Computer-implemented interactive surgical systems Using sensors and / or inputs throughout the surgical system, for example, determining and / or confirming the surgical device used for the surgical procedure, the type and / or process of the surgical procedure, and / or the type of tissue. be able to. In certain examples, situational awareness can predict the type of smoke that will be produced at a particular time. For example, a situational awareness module can determine the type of surgical procedure and the steps within it to determine what type of smoke is likely to be generated. The sensor can be adjusted based on the type of smoke expected.

In a particular example, one or more of the particle sensors disclosed herein can be fluid detection sensors. For example, the particle sensor can be arranged and configured to determine if the aerosol and / or droplets are present in the emitted smoke. In one aspect of the disclosure, the size and / or concentration of the detected particles may correspond to aerosols, droplets, solids, and / or combinations thereof. In certain examples, situational awareness can determine and / or confirm whether the detected particles are aerosols or solids. For example, a situation recognition module that signals and communicates with a processor (eg, processor 50308 in FIG. 5 and / or processor 50408 in FIG. 6) can notify the identification of particles in a fluid.

Here, referring to FIG. 23, a graph display of the number of particles 51300 and the motor speed 51302 over time of a surgical discharge system such as the surgical discharge system 50400 (FIG. 6) is shown. The target motor speed 51304 is predetermined and may be stored in the memory of the processor signaling the motor (see, eg, FIGS. 5 and 6). In various examples, the processor can be configured to maintain a target motor speed of 51304 under normal operating conditions. For example, the target motor speed 51304 may be stored in memory 50410 (FIG. 6), and the processor 50408 (FIG. 6) can be configured to maintain the target motor speed 51304 under normal operating conditions. In such an example, when the surgical discharge system 50400 (FIG. 6) is activated, the motor 50451 can operate at a target motor speed 51304, one or more conditions are detected and / or processor 50408. Can continue to operate at a target motor speed of 51304 unless communicated with.

In a particular example, the processor 50408 can signal and communicate with a particle sensor configured to detect the concentration of fine particles in the intake smoke in real time. Various examples of particle density sensors, such as laser particle counter sensors, are described herein. In one aspect of the present disclosure, the particle sensors 50838 (FIGS. 18 and 19) located at the inlet to the filter 50870 of FIG. 18 and the inlet to the filter 50970 of FIG. 19 signal communicate with the processor 50408 (FIG. 6). be able to. For example, the laser particle sensor 50838 can correspond to one of the sensors 50430 in FIG.

In various examples, when the particle sensor 50838 (FIGS. 18 and 19) detects that the particle concentration (eg, the percentage of particulate matter in the fluid) drops below the threshold amount 51306, Processor 50408 can instruct motor driver 50428 to reduce the speed of motor 50451. For example, at time _{t 1} in FIG. 23, the number of particles or particle concentration 51300 is lowered below a threshold amount 51306. Since the number of particles 51300 is lower than the threshold amount 51306, the motor speed 51302 may be reduced until it is lower than the target motor speed 51304. Thereafter, if the particle sensor that exceeded the particle number 51300 again a threshold amount 51306 in, for example, time _{t 2} 50 838 (FIGS. 18 and 19) is detected, the processor 50408 includes a target motor speed 51,304 by increasing the speed of the motor 50451 Can be instructed to restart the motor driver 50428. The fine particle concentration can correspond to the size of the particles in the smoke. For example, smoke may contain smaller particles between times t ₁ and time t _2. By reducing the speed of motor 50451, the suction produced by pump 50450 can be reduced, thereby ensuring that smaller particles are not sucked through the filter of the surgical discharge system 50400. For example, by reducing the motor speed or the pressure of the pump, ensure that the filtration system has the appropriate time and capacity to capture the particles, and the fine media filter captures the smaller particles. You can be sure that you can. In other words, the slower rate can improve the filtration efficiency of the surgical drainage system 50400.

In a particular example, the speed of the motor 50451 driving the pump 50450 can be adjusted based on a particle sensor located downstream of the filter. For example, referring again to FIGS. 18 and 19, the particle sensor 50848 is located downstream of the filter 50870 of FIG. 18 and downstream of the filter 50970 of FIG. Since the particle sensor 50848 is located downstream of the filter assembly, the particle sensor 50848 is configured to detect, for example, fine particles in the exhaust from the surgical discharge system 50800 or the discharge system 50900. In other words, such a particle sensor 50848 is configured to detect fine particles that have passed through the ejector housings 50818, 50918 and are ejected into the ambient air. The particle sensor 50848 is arranged adjacent to the outlets 50824 and 50924 of the ejector housings 50818 and 50918, respectively. In one example, when the particle concentration in the exhaust (eg, the particle concentration detected by the particle sensor 50848) exceeds a predetermined threshold amount, the processor 50308 (FIG. 5) and / or the processor 50408 (FIG. 6) adjusts to the pump. Can be carried out. For example, referring again to FIG. 6, the speed of the motor 50451 can be adjusted to improve the filtration efficiency of the surgical discharge system 50400.

The motor speed can be adjusted by limiting the current supplied to the motor and / or changing the duty cycle of the motor. For example, a pulse modulation circuit can adjust the length and / or frequency of a pulse using pulse width modulation and / or pulse frequency modulation.

In addition or instead, if the number of particles in the exhaust exceeds a predetermined threshold amount that can be dangerous or harmful to the operator (s) and clinician (s) in the operating room, the discharged fluid. Can be redirected through one or more filters in the surgical drainage system. For example, if the particle sensor 50838 detects the number of particles in the exhaust that exceeds the threshold amount, the processor 50308 (FIG. 5) and / or the processor 50408 (FIG. 6) can open the valve downstream of the filter. This allows the exhaust gas to be recirculated and the recirculated exhaust gas to be injected into the flow path upstream of the filter. In certain examples, the valve can inject, for example, the recirculated exhaust into an alternative flow path containing one or more additional and / or different filters.

In certain examples, the surgical effluent system can include an override option that keeps the efflux system operating and / or at a predetermined power level even though the set threshold is exceeded. For example, in override mode, the surgical efflux system can continue to operate and evacuate particles even if the particle sensor downstream of the filter detects a particle concentration above the threshold. The operating room operator activates the override function or mode, for example, by activating a switch, toggle, button, or other actuator on the ejector housing and / or by inputting to a surgical hub. Can be done.

Here, with reference to FIG. 27, a flowchart showing the adjustment algorithm 52300 of the surgical drainage system is shown. The various surgical drainage systems disclosed herein can utilize the tuning algorithm 52300 of FIG. Further, the reader will readily understand that in certain examples, the tuning algorithm 52300 can be combined with one or more additional tuning algorithms described herein. Adjustments to the surgical discharge system can be performed by a processor that signals and communicates with the motor of the discharger pump (see, eg, the processor and pump of FIGS. 5 and 6). For example, processor 50408 can implement tuning algorithm 52300. Such processors can also signal and communicate with one or more sensors in the surgical discharge system.

In various examples, the surgical drainage system can initially operate in standby mode 52302, as shown in FIG. 27, in which the motor is placed in block 52310 to sample fluid from the surgical site. Operates at low power as shown. For example, in standby mode 52302, a small amount of fluid sample can be drained from the surgical site by a surgical drainage system. The standby mode 52302 can be the default mode of the discharge system.

If a particle sensor upstream of the filter (eg, particle sensor 50838) detects a particle number or particle concentration greater than the threshold X as shown in block 52312, the surgical discharge system can enter automatic discharge mode 52304. .. In automatic discharge mode 52304, the motor speed can be increased at block 52314 to draw additional smoke from the surgical site. For example, the number of particles or the concentration of fine particles can increase above the threshold amount X when an electrosurgical procedure is initiated or when a particular electrosurgical power level is activated. In certain examples, the speed of the motor can be adjusted during automatic discharge mode 52304 based on the detected particulate concentration. For example, as the particle concentration detected by the particle sensor 50838 increases, the motor speed can increase accordingly. In a particular example, the default motor speed can correspond to a predetermined range of particle concentration detected by the particle sensor 50838.

Further referring to FIG. 27, if a particle sensor downstream of the filter (eg, particle sensor 50848) detects a particle number or particle concentration below the threshold amount Y in block 52316, the motor resumes low power mode in block 52310. And / or can be further adjusted at block 52314 as provided herein. Further, when the downstream particle sensor 50848 detects the number of particles or the concentration of fine particles larger than the threshold amount Y and less than the threshold amount Z in the block 52318, the motor speed is reduced in the block 52320 to improve the efficiency of the filter. be able to. For example, the particle concentration detected by the particle sensor 50848 between the thresholds Y and Z can correspond to the small particles that pass through the filter of the smoke exhaust system.

Further referring to FIG. 27, if the particle sensor 50848 downstream of the filter detects a number of particles greater than the threshold amount Z in block 52318, the motor can be turned off in block 52322 to end the discharge procedure and surgery. The discharge system can be in override mode 52306. For example, the threshold Z can address the air quality risk to the clinician and / or other staff in the operating room. In certain examples, the operator can selectively override the shutdown function, as further provided herein, whereby the motor continues to operate in block 52310. For example, the surgical drainage system can return to standby mode 52302, where a sample of fluid is drained from the surgical site and monitored by the surgical drainage system.

In certain examples, the power level of the pump may be a function of the pressure difference over at least a portion of the surgical discharge system. For example, a surgical drainage system can include at least two pressure sensors. With reference to FIGS. 18 and 19 again, the ambient pressure sensor 50854 is configured to detect the pressure in the ambient chamber. The pressure sensor 50840 detects the pressure in the flow path 50804 between the fluid trap 50860 of FIG. 18 and the filter or filtration system 50870, and the flow path between the fluid trap 50960 and the filter system 50970 of FIG. It is configured to detect the pressure within 50904. In addition, the pressure sensor 50846 is configured to detect the pressure in the intermediate flow path 50804 between the filtration system 50870 and the pump 50806 of FIG. 18 and the intermediate flow path 50904 between the filtration system 50970 and the pump 50906 of FIG. Has been done. Finally, the pressure sensor 50850 is configured to detect the pressure in the channels 50804 and 50904 at the exhaust port or outlets 50824 and 50924, respectively. The reader can easily understand that a particular smoke exhaust system can include less than or more pressure sensors 50840, 50846, 50850, and 50854 shown in FIGS. 18 and 19. There will be. In addition, the pressure sensor can be placed in an alternative location throughout the surgical drainage system. For example, one or more pressure sensors may be included in the smoke evacuator device along a discharge conduit extending between the discharger and the housing, and in different layers upstream of the fluid trap and / or in the middle of the filtration system. It can be placed inside the housing.

Here, with reference to FIG. 28, a flowchart showing the adjustment algorithm 52400 of the surgical drainage system is shown. In various examples, the surgical drainage system disclosed herein can utilize the tuning algorithm of FIG. 28. Further, the reader will readily understand that in certain examples, the adjustment algorithm 52400 of FIG. 28 can be combined with one or more additional adjustment algorithms described herein. Adjustments to the surgical discharge system can be performed by a processor that signals and communicates with the motor of the discharger pump (see, eg, the processor and pump of FIGS. 5 and 6). For example, processor 50408 can implement tuning algorithm 52400. The processor can also signal and communicate with one or more pressure sensors in the surgical discharge system.

In various examples, processor 50408 is configured to obtain the pressure measurement P1 from the first pressure sensor at block 52402 and the second pressure measurement P2 from the second pressure sensor at block 52404. There is. The first and second pressure sensors may be provided, for example, by the sensor 50430 of FIG. Processor 50408 is configured to compare measurements P1 and P2 at block 52406 to determine the pressure difference between the first pressure sensor and the second pressure sensor. In one example, when the pressure difference is less than or equal to the threshold amount X, such as in block 52408, the speed of the pump can be maintained. On the contrary, when the pressure difference is larger than the threshold amount X, such as in the block 52410, the speed of the pump can be adjusted. Adjustments to the operating parameters of the motor are configured to adjust the speed of the pump. The tuning algorithm 52400 can be repeated continuously and / or at regular intervals. In certain examples, the clinician can trigger the implementation of the tuning algorithm 52400.

The flow rate of smoke through the discharge system can be a function of the pressure difference. In one example, if the pressure difference across the discharge system increases significantly, then the flow rate through the system can also increase. The actual flow rate can be predicted based on the pressure difference and the motor speed. Therefore, by monitoring the pressure difference, the flow rate can be determined more accurately.

In addition, blockage in the flow path can accommodate an increase in pressure difference. For example, as the filter captures particles from smoke, the pressure difference across the filter can increase for a given pump speed. The speed of the motor and the speed of the corresponding pump can be increased in response to a predetermined pressure drop across the filter to maintain the flow rate of smoke through the system despite blockage in the filter. For example, referring again to FIGS. 18 and 19, the first pressure sensor (eg, pressure sensor 50840) can be located upstream of the filter and the second pressure sensor (eg, pressure sensor 50846). It can be placed downstream of the filter. The pressure difference between the pressure sensor 50840 and the pressure sensor 50846 can accommodate a pressure drop across the filter. As the filter captures the particles in the smoke, the captured particles can block the flow path, which can increase the pressure difference across the filter. In response to the increase in pressure difference, the processor can adjust the operating parameters of the motor to maintain the flow rate across the system. For example, the speed of the motor and the speed of the corresponding pump can be increased to compensate for the partially blocked filter in the flow path.

In another example, the default pressure drop can accommodate a blockage in the drainage conduit. In one embodiment, for example, the speed of the motor and the speed of the corresponding pump can be reduced to avoid tissue damage when the drainage duct is occluded with tissue. Reducing the speed of the pump in such an example can be configured to avoid potential tissue trauma.

In another example, the first pressure sensor can be located upstream of the fluid trap and the second pressure sensor can be located downstream of the fluid trap (eg, pressure sensor 50840). The pressure difference between the sensors can correspond to the pressure drop across the fluid trap, which can correspond to the flow rate and / or the flow path through the fluid trap. The pressure difference across the fluid trap can also be estimated by other sensors in the fluid discharge system. In certain examples, it is desirable to reduce the flow rate through the fluid trap to ensure sufficient removal of the liquid from the smoke before it enters the downstream filters (s) and pumps. In such an example, the pressure difference may be reduced by reducing the speed of the motor and the speed of the corresponding pump.

In yet another example, the first pressure sensor may be located at the inlet to the surgical drainage system or its drainer housing and the second pressure sensor may be located at the outlet of the surgical drainage system. Yes (eg, pressure sensor 50850). The pressure difference between the sensors can accommodate the pressure drop across the surgical drainage system. In certain examples, the maximum suction load of the system can be maintained below the threshold by monitoring the pressure drop over the system. When the pressure drop exceeds the threshold amount, the processor can adjust the operating parameters of the motor (eg, slow down the motor) to reduce the pressure difference.

In one example, the chemical sensor 50832 can detect the pH of a substance that is in physical contact with the sensor, such as a fluid splattered on the sensor 50832. In one aspect of the present disclosure, the chemical sensor 50832 can detect glucose and / or oxygen content in a fluid. In certain examples, the chemical sensor 50382 can be configured to detect cancerous by-products. If cancerous by-products are detected, the parameters of the drainage system can be adjusted to reduce the likelihood of such by-products entering the operating room. In one example, the pump speed can be reduced, for example, to improve the efficiency of the filter in the discharge system. In another example, the discharge system can be turned off to ensure that cancerous by-products are not discharged into the operating room.

The fluid extracted from the surgical site by the surgical drainage system may contain liquids and various microparticles. The combination of substances of different types and / or states in the evacuated fluid can make it difficult to filter the evacuated fluid. In addition or instead, substances of a particular type and / or condition can be harmful to a particular filter. For example, the presence of droplets in smoke can damage certain filters, and the presence of larger particulates in smoke can block certain fine particulate filters.

The sensor can be configured to detect the parameters of the fluid moving through the drainage system. Based on the parameters detected by the sensor (s), the surgical drainage system can direct the drained fluid along the appropriate flow path. For example, a fluid containing a proportion of droplets above a particular threshold parameter can be directed through a fluid trap. As another embodiment, a fluid containing fine particles above the threshold size can be directed through a coarse media filter, and a fluid containing fine particles below the threshold size bypasses the coarse media filter and is a fine media filter. Can be turned to.

By providing an alternative flow path through the surgical drainage system, the surgical drainage system and its filters (s) can operate more efficiently and are less susceptible to damage and / or obstruction. it can. The usable life of the filter can also be extended. As provided herein, the filter can include one or more filtration layers, and in certain examples, the filtration system can include one or more filters.

The divertor valve 52934 of the surgical drainage system is shown in detail in FIGS. 24A and 24B. In one aspect of the disclosure, the divertor valves 50834 and 50934 shown in the surgical drainage systems 50800 and 50900, respectively, of FIGS. 18 and 19, may include a divertor valve 52934. The divertor valve 52934 includes a ball valve 52396 configured to direct fluid along either the first path 52940 or the second path 52938 from the inlet path 52942. In various examples, the ball valve 52396 may be an electrically actuated ball valve with a controller. For example, a processor in a surgical discharge system, such as processor 50408 (FIG. 6), can signal a ball valve controller to initiate rotation of the ball valve 52396 to change the smoke flow path. When the divertor valve 52934 is in the first position (FIG. 24A), smoke intake through the divertor valve 52934 is directed along the first path 52940. When the divertor valve 52934 is in the second position (FIG. 24B), smoke intake through the divertor valve 52934 is directed along the second path 52938.

The first path 52940 can correspond to a flow path when no liquid is detected in the smoke, or when the detected liquid-gas ratio or aerosol ratio is less than the threshold value. The second path 52938 can correspond to a flow path when a liquid, for example, an aerosol, is detected in the smoke, or when the detected liquid-gas ratio or aerosol ratio is greater than or equal to the threshold. In certain aspects of the disclosure, the first path 52940 can bypass the fluid trap and the second path 52938 smoke to capture the fluid from the smoke before it is directed into the filter. Can be directed through a fluid trap. By selecting the flow path based on the proportion of aerosol, the efficiency of the surgical drainage system can be improved.

In another example, the divertor valve 52934 can include three or more fluid path outlets. In addition, the fluid path is different, including bypassing / recirculating the fluid to the fluid trap and / or different configurations of the fluid trap, condenser, and / or particulate filter, depending on the detected parameters of the fluid. Smoke can be directed along the filtration path.

With reference to FIGS. 18 and 19 again, the fluid detection sensor 50830 is configured to detect the presence of aerosols or the liquid-to-gas ratio in smoke. For example, the fluid detection sensor 50830 of FIG. 18 is located at the inlet 50822 of the ejector housing 50818. In another example, the fluid detection sensor 50830 may be located near the inlet 50822 and / or upstream of the socket for receiving the filter 50870 and / or the filter 50870. Examples of fluid detection sensors will be further described herein. For example, the fluid detection sensor 50830 may include one or more of the particle sensors further disclosed herein. In addition or instead, in one aspect of the present disclosure, the fluid detection sensor 50830 includes a continuity sensor.

In one example, if the fluid detection sensor 50830 detects a liquid-to-gas ratio above a threshold, the intake air can be diverted to the condenser before entering the particulate filter. The condenser can be configured to condense small droplets in the flow path. In various examples, the condenser can include a honeycomb structure. The condenser can include multiple baffles or other structures that are configured to condense the liquid. As the smoke flows through the condenser, the liquid can condense on the internal baffle and direct it to drip downward into the fluid reservoir.

Primarily with reference to FIG. 18, the internal divertor valve 50834 is arranged to direct smoke intake so as to bypass the condenser 50835 so that the smoke flows directly to the filter 50870. When bypassing the condenser 50835, the surgical discharge system 50800 may require less power from the motor driving the pump (see, eg, motor 50451 and pump 50450 in FIG. 6). With reference to FIG. 19, the divertor valve 50934 is arranged to direct the smoke into the condenser 50935 in the fluid trap 50960 before the smoke flows into the filter 50970. Conversely, if the fluid detection sensor 50830 detects a liquid-to-gas ratio below the threshold, the intake air can bypass the condenser 50935 and direct directly to the filter 50970.

In various examples, the fluid detection sensor 50830 can detect the presence of smoke in the flow path. For example, the fluid detection sensor 50830 may include a particle sensor. Detection of particles, or detection of fine particle concentrations above a threshold, can indicate the presence of smoke in the flow path. In certain examples, the fluid detection sensor may not distinguish between solid particles (eg, carbon) and aerosol particles. In another example, the fluid detection sensor 50830 can also detect the presence of aerosols. For example, the fluid detection sensor can include, for example, a continuity sensor as described herein, which can determine if the detected particles are aerosols.

In various examples, the surgical drainage system can include additional or alternative channels. For example, a surgical drainage system can include a high particle channel and a low particle channel. For example, when a particle sensor such as the particle sensor 50838 (FIGS. 18 and 19) detects a fine particle concentration equal to or higher than the threshold valve, the intake smoke can be diverted to the fine particle filter. Conversely, if the laser particle sensor detects a particulate concentration below the threshold, the inspiratory smoke can bypass the particulate filter. Similarly, different channels can accommodate different sizes and / or types of particles. For example, if the particle sensor 50838 detects larger particles, the smoke can be directed along a different path than if smaller particles were detected. For example, a surgical discharge system can include different types of particulate filters (eg, large media filters and fine media filters), direct blocking, inertial collisions based on the detected size (or size range) of the particles. , And different filtration methods such as diffusion blocking can be utilized. Different channels can be selected to optimize smoke fluid extraction and / or particulate filtration while minimizing power draw and / or stress to the motor. In certain examples, the default flow path can be a more direct flow path, and if a fluid parameter above the threshold limit is detected, the fluid can be diverted to a less direct flow path. Less direct channels may require more power.

In various examples, the motor of the surgical exhaust system may be adjusted based on the characteristics of the intake smoke and / or the filter installed within the surgical exhaust system. With reference to the schematic diagram shown in FIG. 6 again, the processor 50408 signals and communicates with the motor driver 50428 coupled to the motor 50451 for the pump 50450. Processor 50408 can be configured to adjust motor 50451 based on the characteristics of smoke and / or installed filters. In one example, processor 50408 corresponds to the volume of aerosol suspended in smoke and / or in a flow path containing the volume of droplets in contact with or resting on the piping of a surgical discharge system. The input corresponding to the liquid volume can be received. For example, various sensors for detecting the fluid density of intake smoke, such as a continuity sensor, will be further described herein.

The liquid-to-gas ratio of smoke can affect the efficiency of the flue gas pump. For example, the liquid in smoke (s) may be less compressible than the gas in smoke, which can affect the efficiency of the pump. In addition, different types of pumps can operate differently in the presence of aerosols. In certain examples, the pump speed can be accelerated, and in other examples, the pump speed can be decelerated. To optimize the efficiency of the pump for each liquid-to-gas ratio, the processor can be configured to tune the motor that drives the pump. In other words, the motor control program can operably adjust the pump speed based on the detected liquid-to-gas ratio in the flow path.

Certain pumps can efficiently process fluids with high liquid-to-gas ratios, either as the efficiency of the pump remains the same or increases. For example, certain scroll pumps can process aerosols in the smoke path. In such an example, an incompressible (or less compressible) fluid may be used to reduce the rotational speed of the pump and increase vacuum air treatment. Other pumps may be more sensitive to fluids with high liquid-to-gas ratios and can therefore be decelerated to limit the pressure difference through the fluid trap.

In various examples, the sensor can be configured to detect the flow rate through the surgical drainage system. For example, an optical sensor can be configured to measure the flow rate of particles in a surgical discharge system. In certain examples, the detected flow rate through the surgical discharge system can be used to control the suction rate of the compressor. The algorithm can determine the appropriate suction rate based on the flow rate and / or one or more detected parameters of smoke (eg, particle concentration, liquid-to-gas ratio, etc.). For example, when smoke with a high liquid-to-gas ratio enters a surgical discharge system, its fluid trap allows the motor speed to be reduced so that more liquid can be extracted from the smoke before it enters the pump. It is possible to reduce the flow rate through the surgical discharge system including. Liquids can damage certain pumps. For example, lobe pumps and regeneration blowers can be damaged if liquids in smoke can enter.

FIG. 25 shows a graphical representation of the airflow fluid content and duty cycle of a surgical drainage system such as the surgical drainage system 50800 (FIG. 18) and / or 50900 (FIG. 19) over time. The fluid content can include aerosols and droplets in the discharge system and can be detected by, for example, fluid detection sensors 50830 and 50836 (FIGS. 18 and 19). Referring again to FIG. 25, at the beginning of the procedure, the fluid detection sensors 50830 and 50836 detect the same or substantially the same content in smoke. In other words, the fluid content upstream of the fluid traps 50860, 50960, respectively, is the same as or substantially the same as the fluid content downstream of the fluid traps 50860, 50960, respectively. The fluid content detected by both sensors 50830 and 50836 continues to increase as the procedure continues.

At time _{t 1,} the fluid content detected by both sensors 50830 and 50836 is above the fluid content threshold _(C T) 52102, smoke, in order to prevent damage to the filtration system, the fluid trap 50 860 and / Or turned through a fluid trap such as 50960. Fluid content threshold C _T 52102 may correspond to the ratio of the volume or fluid and / or aerosol becomes detrimental to the filtration system. Primarily with reference to the discharge system 50900 of FIG. 19, the recirculation valve 50990 can be turned back into the condenser 50935 of the fluid trap 50960 before the fluid enters the filter 50970 (see FIG. 19). Can be opened (as shown). By recirculating the fluid, additional droplets can be removed from the fluid. As a result, referring again to FIG. 25, the fluid content which is detected by the fluid sensor 50836 located upstream of the filter 50970 can be reduced to below the fluid content threshold C _T 52,102. In various examples, by the air flow path through the ejector housing is adjusted at time t _1, as shown in FIG. 25, it is possible to maintain the duty cycle of the motor.

Further referring to the graph representation of FIG. 25, when the smoke is recirculated through a fluid trap that captures a portion of the aerosol and / or droplet, the downstream fluid detection sensor 50836 has a lower liquid content in the smoke. Start to detect. However, the upstream fluid detection sensor 50830 continues to detect an increase in the amount of liquid in the smoke. Further, at time _{t 2,} downstream of the fluid sensor 50836 again detects fluid content above the fluid content threshold _C T 52,102. Duty cycle of pump motor so that more liquid can be extracted from smoke before it enters the pump to cope with the increasing fluid content despite the recirculation of smoke through the fluid trap. It is reduced at time t _2, thereby reducing the speed of the pump. When the pump is adjusted to a reduced duty cycle, the fluid trap can more effectively capture aerosols and / or droplets in smoke, and the fluid content detected by the fluid detection sensor 50836 is final. It begins to decrease to below the fluid content threshold _C T 52,102 in manner.

In certain examples, the volume of fluid in the fluid trap and / or the levelness of the housing is used to reach a threshold limit that can accommodate reaching the outlet port of the fluid trap to the outflow prevention baffle and / or particulate filter. It is possible to determine whether the internal fluid level is approaching. The liquid may damage the particulate filter and / or reduce its efficiency, as further described herein. To prevent the liquid from entering the particulate filter, the processor can adjust the motor to minimize the possibility of drawing the liquid into the particulate filter. For example, when a predetermined volume of liquid enters a fluid trap and / or when the liquid in the trap reaches a set marker or level in the housing above a predetermined safety level, the processor will slow down. Can be instructed to the motor.

In various examples, the motor control program is further affected by using the pressure difference between the pressure sensors in the drainage system, such as the pressure sensors 50840 and 50846 (FIG. 19) in the surgical drainage system 50900. There is. For example, based on the pressure difference across the filter 50970 and the speed of the motor of the pump 50906, the processor of the surgical discharge system 50900 can be configured to predict the actual flow rate through the filter 50970. In addition, the flow rate can be adjusted (eg, by adjusting the motor speed) to limit the flow rate and reduce the likelihood that fluid will be drawn into the filter 50970 from the reservoir in the fluid trap 50960.

As described herein, a surgical effluent system is composed of one or more sensors configured to detect the presence of aerosols in smoke (eg, liquid-to-gas ratio) and particulates in smoke. It can include one or more sensors configured to detect the presence (eg, a fractional measure). By determining whether the extracted fluid is predominantly steam, predominantly smoke, and / or corresponding proportions of each, the surgical effluent system is a clinician, intelligent electrosurgical instrument, robotic system, hub. , And / or can provide useful information to the cloud. For example, the ratio of steam to smoke can indicate the degree of tissue welding and / or collagen ablation. In various examples, the energy algorithms of electrosurgical instruments and their generators can be adjusted based on the ratio of steam to smoke.

In one aspect of the disclosure, if the extracted fluid is predominantly vapor or has a high aerosol proportion, the processor adjusts the amplitude and / or power of an ultrasonic generator such as Generator 800 (FIG. 58). can do. For example, the processor of the smoke exhaust system can be communicatively coupled to the generator 800. In one example, if the power is too high for a particular surgical scenario, excess vapor or aerosol may be produced. In such an example, the power level of the generator can be reduced to reduce the generation of steam / aerosol by the energy tool. In another example, the processor can adjust the power level of the generator for higher particle ratios. For example, the power level can be reduced for particle ratios above the threshold. In certain examples, the voltage can be adjusted to reduce the particulates produced by the energy tool.

Here, with reference to FIG. 26, the tuning algorithm 52200 for the surgical drainage system is shown. The various surgical drainage systems disclosed herein can utilize the tuning algorithm 52200. Further, the reader will readily understand that in certain examples, the tuning algorithm 52200 can be combined with one or more additional tuning algorithms described herein. Adjustments to the surgical discharge system can be performed by a processor that signals and communicates with the motor of the discharger pump (see, eg, the processor and pump of FIGS. 5 and 6). For example, the tuning algorithm 52200 can be implemented by a processor 50408 that signals and communicates with the motor driver 50428 and / or the controller for the divertor valve, as further described herein. The processor is configured to use various sensors to monitor the characteristics of the emitted smoke. In one aspect of the disclosure, with reference to FIG. 26, the processor is configured to determine if the inspiratory smoke contains above-threshold particles and aerosols.

At the beginning of the tuning algorithm 52200, at block 52202, a standard flow rate can be initiated and at block 52204, one or more characteristics of the intake smoke can be monitored. At block 52206, the sensor can be configured to identify particles in the fluid. At block 52202, standard flow and / or power levels can be maintained if no particles are detected by the sensor. In one example, the standard flow rate may be a minimum flow rate or an idle flow rate, as described further herein. If particles are detected in block 52206 and it is determined in block 52208 that the particles are not aerosol particles, then block 52210 can make a first adjustment to the flow rate and / or power level. For example, the flow rate and power level can be increased to increase the emission of particles, or smoke, from the surgical site. In a particular example, if block 52208 determines that the particles are aerosol particles, or if some of the particles are aerosol particles, a second adjustment can be made.

In one aspect of the disclosure, the second adjustment may depend on the proportion of aerosol in the smoke. For example, if the proportion of aerosol is determined to be greater than a first threshold amount, such as X% of block 52212 in FIG. 26, block 52214 can direct smoke to the fluid trap. Conversely, at block 52216, the smoke can be directed to bypass the fluid trap if the aerosol concentration in the smoke is less than or equal to the threshold amount X%. Conduit and valves for directing the flow of fluid in the flue gas system are described further herein. In certain examples, the flow rate and / or power level can be adjusted to adequately draw the fluid along the selected flow path, for example towards and / or around the fluid trap. In one aspect of the disclosure, additional power and / or suction may be required to draw the fluid into the fluid trap.

Further referring to FIG. 26, when exiting the fluid trap, additional aerosol particles are detected in the smoke at block 52218, and at block 52220 the aerosol concentration is greater than a second threshold, such as Y% in FIG. , Block 52224 can reduce the flow rate to ensure proper extraction of aerosols from smoke. On the contrary, when the aerosol concentration downstream of the fluid trap is equal to or less than the second threshold amount Y%, the flow rate can be maintained at the block 52222. As shown in FIG. 26, when the flow path is redirected and / or the flow rate is adjusted and / or maintained by the adjustment algorithm 52200, the adjustment algorithm returns to block 52204 to set one or more parameters of the smoke exhaust system. You can keep an eye on it. In a particular example, the tuning algorithm 52200 can be cycled continuously so that the smoke characteristics are continuously monitored and / or transmitted to the processor in real time or near real time. In another example, the tuning algorithm 52200 can repeat a predetermined time and / or interval.

In certain examples, the surgical drainage system can further include a chemical sensor such as the chemical sensor 50832 (FIGS. 18 and 19). The chemical sensor 50832 is located near the entrance 50822 of the surgical discharge system 50800 and near the entrance 50922 of the surgical discharge system 50900. The chemical sensor 50832 is configured to detect the chemical properties of the particles ejected by the surgical ejection system. For example, the chemical sensor 50832 can identify the chemical composition of particles in smoke emitted from a patient's abdominal cavity during an electrosurgical procedure. Different types of chemical sensors can be used to determine the type of material extracted by the surgical discharge system. In certain examples, the flue gas system may be controlled based on what is being extracted from the surgical site, such as by what is detected by the chemical sensor 50832.

Chemical analysis of the extracted fluid and / or particles can be used to tailor generator functions, such as those of generator 800 (FIG. 58). For example, generator function can be adjusted based on the detection of cancerous material by the chemical sensor 50832. In certain examples, if the chemical sensor 50832 no longer detects the cancerous substance, the clinician can be warned that all the cancerous substance has been removed, and / or the generator operates the energy device. Can be stopped. Alternatively, if the chemical sensor 50832 detects a cancerous substance, the clinician can be warned and the generator can optimize the operation of the energy device to remove the cancerous substance.

In certain examples, generator function may be adjusted based on the tissue characteristics detected by the surgical system. Primarily with reference to FIG. 29, a flowchart showing the adjustment algorithm 52500 of the surgical system is shown. The various surgical systems disclosed herein can utilize the tuning algorithm 52500. Further, the reader will readily understand that in certain examples, the tuning algorithm 52500 can be combined with one or more additional tuning algorithms described herein. Adjustments to the surgical system can be performed by a processor (see, eg, processor 50308 in FIG. 5). In various aspects of the disclosure, processor 50308 (FIG. 5) can be configured to receive information from multiple sources in order to determine the type of tissue.

Further referring to FIG. 29, one or more sensors 52502 in the surgical discharge system can provide information to processor 50308 (FIG. 5). Further, with reference primarily to FIG. 28, for example, the particle sensor (s) 52502a, chemical sensor (s) 52502b of the surgical discharge system, which may be similar to the sensors shown in FIGS. 18 and 19. And / or the fluid detection sensor (s) 52502c can provide data indicating the type of tissue to processor 50308. In addition, the external sensor (s) 52504 can provide information to processor 50308. The external sensor 52504 may be remote to the surgical drainage system, but may be located on other surgical devices involved in the surgical procedure. For example, one or more external sensors (s) 52504 can be placed on surgical instruments, robot tools, and / or endoscopes. In certain examples, the internal sensor 52502 and the external sensor 52504 can provide information to the situational awareness module or surgical hub, which can provide situational awareness 52506 to various sensors 52502, 52504. Further, the situational awareness 52506 can notify the processor 50308 with respect to various sensor data. Based on data from situational awareness 52506 and sensors 52502, 52504, at block 52510, processor 50308 (FIG. 5) can determine the type of tissue.

In certain examples, the ratio of elastin to collagen in the extracted material can be determined from the type of tissue. For example, elastin can correspond to a first melting temperature and collagen can correspond to a second melting temperature that is higher than the first melting temperature. When the external sensor 52504 is configured to detect the parameters of the electric motor corresponding to the speed of the clamp arm and / or the clamp speed, the external sensor 52504 indicates the melting temperature of the tissue and thus the ratio of elastin to collagen. be able to. Elastin and collagen also define different indices of refraction and absorption. In certain examples, an infrared spectrometer and / or a refracting camera sensor can be used to determine and / or confirm the type of tissue.

In certain examples, energy modality can be adjusted based on the type of tissue detected (elastin, collagen, and / or the ratio of elastin to collagen). For example, certain energy devices are more efficient at dissolving collagen than elastin, but can be adjusted to better dissolve elastin by adjusting the energy modality. In other examples, it may be desirable to dissolve collagen and retain elastin. In addition or instead, the ratio of elastin to collagen can indicate the type of physical structure such as veins or arteries, which can be notified to the system situational awareness 52506. For example, if collagen is detected in block 52510, energy modality A can be performed in block 52512. In another example, if elastin is detected in block 52510, energy modality C can be performed in block 52516. In yet another example, if a combination of collagen and elasticity is detected in block 52510, energy modality B can be performed in block 52514. The reader will easily understand that additional and / or alternative energy modality is envisioned. For example, different modality can be utilized depending on the particular ratio of elastin to collagen and / or based on the surgical procedure and / or the process being performed.

In various surgical procedures that use energy devices to treat tissue, fluids and / or particles are released, thereby allowing the air in and / or around the surgical site, as further described herein. May be contaminated. To improve the visibility of the atmosphere at the surgical site, for example, contaminants can be drawn into the flue gas system. In addition, when contaminants are directed along the airflow path within the flue gas system, suspended fluids and / or particles can be filtered to improve air quality. Depending on the efficiency of the smoke evasion system and / or the amount of smoke and / or contaminants generated after activation of the electrosurgical instrument, smoke may accumulate in and / or in the surrounding air at the surgical site. Accumulation of such contaminants can, for example, prevent clinicians from seeing the surgical site.

In one aspect of the disclosure, the surgical system can include a smoke evacuating system that includes a particle sensor, an electrosurgical instrument, and a generator. Such a flue gas system can monitor the concentration of particulates as the electrosurgical instrument applies energy to the tissue during the surgical procedure. For example, when a clinician requests that an electrosurgical instrument be powered, the generator is configured to deliver the requested power. The processor in the surgical system is configured to analyze the monitored particle concentration and the power required by the clinician to the generator. The processor can prevent the generator from supplying the required power if it produces contaminants that cause the clinician-requested power to reach a particulate concentration above a predetermined threshold. Alternatively, in such an example, the generator can be powered at a level that returns the particle concentration below a predetermined threshold.

In such cases, the clinician (s) and / or assistants (s) do not need to monitor the particle concentration individually and adjust the energy modality accordingly. Instead, the instruments and devices of the surgical system communicate between themselves and instruct the generator to deliver a particular power level in a particular situation based on inputs from sensors in the smoke evacuation system. be able to. The reader will easily understand that situational awareness can further inform the generator's decision-making process. The various algorithms that carry out the monitoring process and / or coordination described above are further disclosed herein.

The surgical system can include an electrosurgical device, a generator configured to power the electrosurgical device, and a flue gas system. The smoke exhaust system can include a sensor system configured to monitor the size and / or concentration of particulates in the smoke and / or intake exhaust conduit. With reference to FIGS. 18 and 19 again, the particle sensor 50838 is shown. The particle sensor 50838 is an internal sensor located at a position along the flow path 50804 (FIG. 18) and the flow path 50904 (FIG. 19). In various examples, the particle sensor 50838 is located at a point on the flow paths 50804, 50904 before filtration by the filter systems 50870, 50970, respectively. However, the internal particle sensor 50838 can be placed at any suitable location along the channels 50804, 50904 to monitor the contaminated air flowing in from the surgical site. In various examples, the smoke exhaust system 50800 and / or 50900 may include two or more internal particle sensors 50838 located at various locations along the flow paths 50804 and / or 50904, respectively. The reader will easily understand that various particle measuring means are possible. For example, the fine particle concentration sensor may be an optical sensor, a laser sensor, a photoelectric sensor, an ionization sensor, an electrostatic sensor, and / or any suitable combination thereof. The various sensors will be described further herein.

The electrosurgical generator is a major component in the electrosurgical circuit because it produces the electrosurgical waveform. The generator is configured to convert electricity into a high frequency waveform to generate a voltage for the flow of electrosurgical current. In various examples, the generator is configured to produce different waveforms, each of which has a different effect on the tissue. A "cutting current" cuts tissue but provides little hemostasis. The "coagulation current" provides coagulation with a limited tissue incision and increases the depth of heating. The "blend current" is an intermediate current between the cutting current and the coagulation current, but the blending current is generally not a combination of the cutting current and the coagulation current. Rather, the blend current may be a cutting current in which the actual flow time of the current is reduced from 100 percent to about 50 percent. In various examples, the generator automatically monitors the tissue impedance and adjusts the power output to the energy device to reduce tissue damage, resulting in efficient and accurate disconnection in the lowest possible settings. Can have an effect.

An additional mode of electrosurgical amputation, known as the Advanced Cutting Effect (ACE), provides the clinician with a female amputation effect with little to no thermal necrosis and no hemostasis. When the generator is placed in ACE mode, a constant voltage is maintained at the tips of the electrodes on the end effector. An active electrode on the end of the end effector delivers RF current from the generator to the surgical site. By utilizing ACE mode, clinicians can use electrosurgical devices on the skin, often causing wounds and / or punctures on surgical scalpels, needles, and / or patients. Has the ability to achieve comparable wound healing results without the use of specific surgical instruments, such as any surgical instrument, and / or without any personnel handling them.

In various aspects of the disclosure, the electrosurgical device comprises an ACE cutting system.

Pollutants and / or smoke may be generated throughout the duration of the surgical procedure. If the air in and / or around the surgical site is not efficiently filtered by the flue gas system, pollutants will aggregate in the air, making it difficult for clinicians and / or assistants to see the surgical site. Further concerns about smoke in the operating room are further disclosed herein. In various examples, a processor in a surgical system stores information specific to the amount of smoke and / or contaminants produced when a clinician uses a particular surgical instrument for a particular duration. Can be remembered. Such information can be stored directly in the memory of the processor in the centralized hub and / or in the cloud. In various examples, such information can be stored using the processors and memories shown in FIGS. 5 and 6.

In various examples, a communication path is established between the smoke evacuator system and the generator to control the power delivered to the electrosurgical instrument. Such power can effectively guide electrosurgical instruments to produce less smoke and / or release less contaminants, as well as to efficiently filter the surgical site. Controlled to do. In various examples, the components of the surgical system can communicate directly with each other. In various examples, the components of the surgical system communicate with each other via a centralized hub, for example, as further described herein with respect to FIGS. 39-60. The reader will easily understand that any suitable communication path can be used.

When the surgical procedure begins and the electrosurgical instrument is activated, the sensors in the flue gas system are configured to monitor parameters related to air quality. Such parameters can include, for example, the number and / or concentration of particles, temperature, fluid content, and / or percentage of contamination. The sensor is configured to communicate the monitored parameters to the processor. In various examples, the sensor automatically communicates the parameters monitored after detection. In various examples, the sensor communicates the monitored parameters to the processor after the sensor has been queried. However, the reader will understand that any suitable method of communicating monitored information can be used. In various examples, the sensor continuously communicates the monitored information to the processor. However, the reader will understand that any suitable sample rate can be used. The monitored information can be communicated in real time or near real time, for example.

In various examples, the processor stores information about a given threshold. The predetermined threshold varies based on the parameters monitored by the sensors of the smoke exhaust system. For example, when a sensor is monitoring particle count and / or concentration, such thresholds effectively and / or unsafely obstruct the clinician's field of view within the surgical site, of the particles in the surgical site's atmosphere. Can indicate the level. In another example, the threshold can correspond to the filtration system in the ejector housing and the ability of the filtration system to properly filter the particles. For example, if the particle concentration exceeds a certain threshold, filtration may not be sufficient to filter the particles from the smoke, and toxic substances may pass through the discharge system and / or block the filter and / or. Or it may be clogged. When the processor receives information about the monitored parameters from the smoke exhaust system's sensors (s), the processor compares the monitored parameters (s) to a predetermined threshold (s). It is configured to ensure that it did not exceed (singular or plural).

In various examples, the processor can control various motor functions of the flue gas system if it recognizes that it has exceeded and / or is approaching a predetermined threshold. The processor can regulate the flow rate of the flue gas system by increasing or decreasing the speed of the motor to more efficiently filter contaminants from the surgical site. For example, if the sensor communicates information to the processor that suggests that the particle threshold has been reached, the processor will increase the speed of the motor to filter more fluid and possibly more contaminants from the surgical site. Therefore, it can be pulled into the smoke exhaust system.

In various examples, when the processor recognizes that it has exceeded and / or is approaching a predetermined threshold, the processor will vary the power supplied by the generator to the electrosurgical instrument. Can be done. For example, if the sensor communicates information to the processor that suggests that the particle threshold has been reached, the processor prevents the generator from supplying any additional requested power to the handheld electrosurgical instrument. become. Once the flue gas system has filtered contaminants from the air to levels below the particle threshold, the processor can then allow the generator to supply the required power to the handheld electrosurgical instrument. ..

FIG. 33 is a graphical representation of the correlation between the number of detected particles and the power level over a period of time during the surgical procedure. The upper graph 53300 shows the number and / or fine particles detected by the internal particle sensor 50838 (FIGS. 18 and 19) as the particles and contaminants are filtered from the surgical site into the smoke exhaust system 50800 and / or 50900. Represents the concentration. Particle concentration C _T represents the predetermined number of particles and / or concentration threshold in the volume of the discharged fluid. Bottom graph 53302 arrived during the surgical procedure, including the power requested by the clinician via the handheld electrosurgical instrument (broken line) and the power actually supplied by the generator of the surgical system (solid line). Represents the power level (s). The power level (s) is defined as the ratio of RF current to voltage in an electrosurgical system.

Prior to the start of the surgical procedure at time t <t _{1, a baseline particle concentration 53304 is detected.} When the clinician and / or passenger activates the electrosurgical instrument at time t _1, the clinician and / or assistants, in order to perform a specific function, is required to provide a particular power level. Such functions include incising and / or cutting tissue within the surgical site. The application of power to the tissue produces, for example, smoke and / or contaminants that can be directed into the smoke evacuated system to improve visibility within the surgical site. At time t _1, the generator supplies the requested power. The detected particle concentration is less than the threshold C _T. However, the internal particle sensor 50838 begins to detect the increase in the particle concentration in time t ₂ after activation of the electrosurgical instrument at time t _1.

The graphical representation of FIG. 33, the clinician does not require additional power to the time t _3. The "off" time 53306 between t ₁ and t ₃ can allow, for example, to cool the tissue to cause some degree of hemostasis. As can be seen in FIG. 33, the detected particulate concentration and power level decrease between _{time t 2} and time t _3. At time t _3, clinician, causes an increase in particle concentration on the time supplied t ₄ by the generator, require high power levels. Finally, the clinician may request a power level that causes particle concentration which rises at time t ₅ in the vicinity of a predetermined threshold value C _T. In some cases, it exceeds the threshold C _T is the accumulation of contaminants and / or particles, inefficient flue system, and / or by inoperable smoke system, the low visibility of the surgical site May be shown.

In response to the particle concentration at time t ₅ exceeds the particles threshold C _T, the processor of the surgical system, to return the particle concentration below the particle threshold C _T, is configured to adjust the power supplied generators ing. As shown in FIG. 33, the power supplied by the generator is the power requested by the handpiece when the particle threshold _CT is reached and / or exceeded due to the high power required by the handpiece. Is different. Such as at time t _6, return particulate concentration threshold C _T, and / or the drops below the threshold C _T, is the generator supplies power level as required by the handheld electrosurgical instrument again. Further, when the power handpiece requests after time t ₆ is reduced, also reduces particulate concentration detected by the particle sensor 50838.

FIG. 34 shows a representation of instruction 53400 stored in the memory of a surgical system, such as the memory of FIGS. 5 and 6. In various examples, the surgical system disclosed herein can utilize instruction 53400. For example, instruction 53400 can include a tuning algorithm for the surgical system. Further, the reader will readily understand that in certain examples, instruction 53400 can be combined with one or more additional algorithms and / or instructions described herein. The instruction 53400 can be executed by a processor such as the processor 50308 of FIG.

At block 53402 of instruction 53400, the processor can receive a request from the electrosurgical instrument for power. For example, electrosurgical instruments can include handheld devices and / or robotic tools. The requested power may be provided by the user, for example, via a control unit and / or a control console. As mentioned above, the sensor is configured to monitor the parameters associated with the fluid passing through the discharge system. Such parameters can include, for example, particle size, temperature, fluid content, and / or percentage of contamination. The processor is configured to receive the monitored parameters from the sensor. In various examples, the processor receives such information in response to querying the sensor, as shown in block 53404. In various examples, the sensor automatically communicates information upon detection. The processor then determines in block 53406 whether the received information exceeds a predetermined threshold. If the threshold is exceeded and / or is approaching to exceed, the processor is to prevent the generator from supplying any or all of the required power to the electrosurgical instrument at block 53408. It is configured in. In another example, the genital waveform can be adjusted at block 53410 to reduce the smoke produced by the surgical device, as further described herein.

In various examples, the generator can be powered at a level that does not exceed the threshold. If the threshold is not exceeded, the processor is configured at block 53410 to allow the generator to supply the required power to the electrosurgical instrument. In various examples, the processor may receive information from the sensors of the flue gas system over the duration of the surgical procedure, or at least as long as the processor receives a request from the electrosurgical instrument for the delivery of power. It is configured.

In various surgical procedures, radio frequency (RF) power can be used to cut tissue and coagulate bleeding. When RF power is used to treat tissue, fluids and / or microparticles are released, which can contaminate the air in and / or around the surgical site. To improve visibility of the surgical site for the clinician, for example, contaminated air inside the surgical site can be drawn into the flue gas system. When the polluted air is directed along the air flow path, floating fluids and / or fine particles can be filtered from the polluted air. The filtered air eventually exits the discharge system through the outlet port and is released into the atmosphere of the operating room. Depending on the efficiency and / or effectiveness of the flue gas system, the filtered air may still contain fluids and / or particulates when released into the operating room atmosphere. The remaining contaminants may be unpleasant to the olfactory sense of, for example, clinicians (s), assistants (s), and / or patients (s), and contaminants may be unpleasant in certain cases. Inhalation may be unhealthy.

The flue gas system was configured to monitor the detected size and / or concentration of particulates in the air at various points along the airflow path, including locations outside the effluent system and inside the effluent system. It can be equipped with a sensor system. In one aspect of the disclosure, the flue gas system is efficient of the effluent system based on comparing the particulate concentration outside the efflux system and inside the efflux system and / or by monitoring the particulate concentration over time. Can be determined. In addition, the flue gas system can alert clinicians (s) of contaminated air in the operating room via a display.

The clinician (s) can recognize the levels of contaminants such as fluids and / or microparticles suspended in the atmosphere of the operating room. Indications of pollutants in the air indicate air quality in the operating room and inform clinicians (s) and / or assistants (s) that the flue gas system requires adjustment and / or maintenance. Can warn you.

The flue gas system can include a sensor system configured to monitor the size and / or concentration of particles in the air. With reference to FIGS. 18 and 19 again, particle sensors 50838 and 50852 are shown. The particle sensor 50838 is an internal sensor located at a position along the flow path. In various examples, the particle sensor 50838 is located at a point on the flow path 50804 (FIG. 18), 50904 (FIG. 19) before filtration. However, the internal particle sensor 50838 can be placed at any suitable location along the respective channels 50804, 50904 to monitor the contaminated air flowing in from the surgical site. In various examples, the smoke exhaust system 50800, 50900 can include two or more internal particle sensors 50838 located at various positions along the flow paths 50804, 50904, respectively.

The particle sensor 50852 is an external sensor arranged on the outer surface of the smoke exhaust systems 50800 (FIG. 18) and 50900 (FIG. 19). In various examples, the smoke exhaust systems 50800, 50900 can include two or more external particle sensors 50852. In various examples, the external particle sensor 50852 is located in the recess of the housing of the smoke exhaust systems 50800, 50900. However, the external particle sensor 50852 can be placed on any suitable surface to detect air quality in the operating room. In various examples, the external particle sensor 50852, to ensure that unfiltered air does not leak from the surgical site into the atmosphere of the operating room, the inlet 50822 of the smoke exhaust system 50800, 50900 (FIG. 18), 50922 (Fig. 19) Located near each. In various examples, the external particle sensor 50852 is located near the outlet ports 50824 (18) and 50924 (19) of the smoke systems 50800 and 50900 to analyze the air flowing out of the smoke systems 50800 and 50900, respectively. Located in.

The reader will easily understand that the external particle sensor (s) 50852 can be located in any suitable position for proper monitoring of the operating room atmosphere. In addition, the reader will easily understand that various particle measuring means are possible. For example, the particle sensor 50852 may be any suitable particle concentration sensor such as an optical sensor, a laser sensor, a photoelectric sensor, an ionization sensor, an electrostatic sensor, and / or any suitable combination thereof. The various sensors will be described further herein.

In various examples, the sensor system of the flue gas system is configured to assess the particle size and / or concentration of contamination in the operating room and display the detected air quality. The display of such information can, for example, communicate the effectiveness of the smoke exhaust system. In various examples, the information communicated includes detailed information about the filters (s) in the smoke exhaust system, preventing contaminated air and / or smoke from accumulating in the operating room air. be able to. The flue gas system senses, for example, particulate concentration, temperature, fluid content, and / or percentage of contamination and communicates it to the generator to adjust its output, as further described herein. Can be configured to: In one aspect of the disclosure, the smoke evacuator system adjusts its flow rate and / or motor speed to reduce the amount of smoke produced by the end effector at a predetermined particle level output power or waveform of the generator. Can be configured to affect operability.

In various examples, the sensor systems described herein are used to properly and efficiently remove contaminants and / or smoke in the air by filters (s) within the smoke exhaust system. It is possible to detect whether or not it is present. By detecting the operating room air quality level (s), the flue gas system is configured to prevent high levels of pollution from accumulating in the operating room air. Parameters monitored by the sensor system can be used to notify the clinician whether the smoke evacuation system is functioning and / or performing its intended purpose. In various examples, the monitored parameters can be used by the clinician and / or assistant to determine that the filter in the flue gas system needs to be repaired and / or replaced. For example, if the external sensor 50852 (FIGS. 18 and 19) detects a particle size and / or concentration of contaminants above a predetermined threshold and / or acceptable threshold, the clinician will filter the filter in the flue gas system. You will be instructed to see if it needs to be repaired and / or replaced.

In various examples, as described above, the processor in the flue gas system compares the parameters detected by the external sensor with the parameters detected by the internal sensor. In various examples, the smoke exhaust system comprises a plurality of internal sensors located at various points along the flow path, for example after each individual filter. The reader will understand that the internal sensor can be placed at any point throughout the flow path to provide a meaningful comparison of filter efficiency. Using this detected information, the clinician can determine that the filter at a particular location is not able to effectively remove contaminants and / or smoke from the air. In such cases, the clinician is instructed on the exact location of the filter (or filtration layer) that requires attention for repair and / or replacement.

In various examples, the sensor system is configured to assess the dilution of contaminants and / or particles in the operating room air. As described herein, the internal sensor (s) can be located at any suitable location along the flow path. If the internal sensor is located near the outlet port of the flue gas system and downstream of the filter (s), the internal sensor effectively measures the size and / or concentration of particles released into the atmosphere of the operating system. ing. In other words, the internal sensor is configured to detect particles and / or contaminants that were not captured during the filtration process. External sensors are configured to monitor the concentration and / or size of diluted particles throughout the operating room atmosphere. The difference between the readings of the internal and external sensors can be important in determining the air quality of a particular operating room.

The size and / or concentration of particles released into the atmosphere can have various effects on operating room air quality, for example, based on parameters such as operating room size and / or operating room ventilation. In one example, the size and / or concentration of the emitted particles is air quality when released in a smaller operating room than when particles of the same size and / or concentration are released into a larger operating room. May have more harmful effects. In various examples, the presence and / or efficiency of the ventilation system in the operating room can affect how air quality fluctuates in response to the release of particles from the flue gas system. For example, in an operating room without a ventilation system or with an inefficient ventilation system, particles released from the flue gas system accumulate more quickly to potentially harmful levels in the operating room. May make the air quality unsatisfactory.

In various examples, the information detected by the sensor system can be used to control one or more motor functions of the smoke exhaust system. Prior to the start of the surgical procedure, an external sensor can detect the initial air quality level. Air quality can be continuously monitored throughout the surgical procedure. However, the reader will understand that air quality can be monitored at any suitable speed. The external sensor communicates the detected information to the processor of the smoke exhaust system (eg, the processors 50308 and 50408 of FIGS. 5 and 6, respectively). The processor uses the initial air quality level as a baseline and compares it to continuously detected air quality levels. If the processor determines that the air quality level (s) detected by the external sensor 50852 indicates signs of higher pollutant particle size and / or concentration in the operating room air, the processor is higher. Instruct the motor to operate at the level. As the motor operates at increased speed, more polluted air and / or smoke is drawn from the surgical site into the smoke exhaust system 50800, 50900 for filtration. In various examples, the processor is contaminated during the procedure when the internal sensor 50838 determines that a smoke-producing ablation device and / or other electrosurgical device is active. Memorize commands to increase the flow of air and / or smoke produced. By detecting the activation of the surgical device that produces smoke, the smoke exhaust systems 50800, 50900 prevent high levels of contamination from accumulating in the operating room air via the motor controls.

In various examples, the motor speed level is automatically controlled when the processor determines that the operating room air has an unacceptable air quality level. In various examples, the motor speed level is automatically controlled when the processor determines that a smoke-producing surgical device has been activated. For example, when the external sensor 50852 detects an operating room air pollution level above a predetermined threshold, the processor can automatically instruct the motor to operate at a higher speed. The processor then automatically reduces the speed of the motor when the external sensor 50852 detects a contamination level that drops below a predetermined threshold. In various examples, the motor speed level is manually controlled after the clinician has been notified of an unacceptable air quality level. In various examples, the motor speed level is manually controlled after the clinician has activated a surgical device that produces smoke. The reader will understand that any suitable combination of automatic and / or manual control can be implemented and / or incorporated into the control algorithms of the smoke exhaust systems 50800, 50900.

In various examples, the processor of the flue gas system can recognize when the external sensor 50852 detects an unacceptable and / or increased pollution level in the operating room atmosphere. Such detection indicates that the smoke exhaust systems 50800, 50900 are inefficient. The detected inefficiencies can indicate that one or more filters are not functioning and / or need to be replaced. When the clinician is notified of a non-functional filter, the clinician can ensure that the replacement filter is in stock for future maintenance and prevent delays (s).

In various examples, a smoke evacuator system can be used in combination with a camerascope during a surgical procedure to efficiently control contaminant and / or smoke emissions from the surgical site. For example, the smoke exhaust systems 50800 and 50900 can be used in combination with the imaging module 238 and the endoscope 239 (FIG. 47). In one aspect of the disclosure, a surgical hub, such as the hub 206 (FIG. 48), may coordinate communication between, for example, an imaging module 238 and a surgical exhaust system, such as a smoke evacuator 226 (FIG. 48). it can. Camerascopes are configured to monitor visual blockages in the air by capturing a series of images at a particular sample rate. The collected images are transmitted to a processor (eg, processors 50308 and 50408 of FIGS. 5 and 6 respectively) for evaluation. In various examples, the processor is also configured to receive monitored data from a sensor system that may include an internal sensor 50838 and / or an external sensor 50852, as described herein. The processor compares the image received from the camera scope with the number and / or density of particles received from the sensor system to determine the correlation (s) and smoke from the surgical site and / or the atmosphere of the operating room. / Or configured to improve the emission efficiency of pollution.

In such an example, in order to reconcile the particle count readings to the motor speed of the smoke exhaust system, the visual blockage determined by the camerascope and the particle number and / or concentration determined by the sensor system , Will be compared. Comparing the data collected from the sensor system and camera scope, the processor can perform any of a number of steps. For example, based on comparison, the processor turns on the smoke evacuator system, increases the motor speed of the flue gas system, decreases the motor speed of the flue gas system, and / or turns off the flue gas system. You can decide to do it. In various examples, the comparison is automatic. However, the reader will understand that such comparisons can be made after manual launch.

In various examples, the image captured by the camera scope, as well as the number and / or density of particles detected by the sensor system, can be stored in memory for baseline comparison. In future surgical procedures, clinicians and / or assistants can use the images collected by the camerascope alone to determine the density of smoke and / or contaminants. In such an example, the visual obstruction detected by the camera scope is associated with a particular particle number and / or concentration. After the processor analyzes the air, the processor can perform any of a number of steps. For example, taking into account the stored baseline comparison, based on the analyzed image captured by the camera scope, the processor turns on the smoke evacuator system, increases the motor speed of the flue gas system, It can be decided to reduce the motor speed of the smoke exhaust system and / or turn off the smoke exhaust system.

In various examples, situational awareness can further inform the decision-making process described herein. For example, an image from a scope can be meaningful in the context of a particular surgical procedure and / or its process, which is constructed and / or determined based on situational awareness of the smoke evacuating system and / or the hub communicating with it. be able to. For example, more smoke can be expected during a particular surgical procedure and / or that particular step, and / or when treating a particular type of tissue.

In various examples, the flue gas system wirelessly communicates with other surgical devices and / or hubs located in the operating room to improve the efficiency of flue gas during the surgical procedure. For example, the activation of the generator of a surgical device may be communicated to a centralized hub that transfers information to the smoke evacuator system. The centralized hub can detect the current through the surgical energy device and / or the change in the power draw of the generator for communication to the smoke evacuated system. In various examples, the centralized hub can store information related to the surgical procedure and / or the activated surgical device. Such information may include, for example, the expected amount of smoke generated during a particular surgical procedure and may use information related to a particular surgical device and / or a particular patient's tissue composition. The expected amount can be determined. Receiving such information can allow the smoke evacuator system to predict a particular flue gas rate and move smoke and / or contaminants from the surgical site more efficiently. The reader will understand that various surgical devices can communicate information directly to and / or indirectly through a centralized hub to the flue gas system. The centralized hub may be, for example, a surgical hub such as the surgical hub 206 (FIG. 48).

In various examples, the flue gas system communicates by wire with other surgical devices and / or hubs located in the operating room to improve the efficiency of flue gas during the surgical procedure. Such wired communication can be established via a cable interconnect between the generator and the smoke evacuated system for communication in the activation of the generator. For example, a activation indication signal cable may be connected between the generator of the surgical device and the smoke evacuated system. The smoke exhaust system is automatically activated when the generator is activated and the signal is received over the wired connection.

Radio and / or wired communication between the generator and / or centralized hub and / or smoke evacuation system of the surgical device can include information about the activated surgical device. Such information may include, for example, information about the current mode of operation of the surgical device and / or the intensity of a particular energy setting and / or delivery. In various examples, when such information is communicated from the surgical device, the memory of the centralized hub and / or smoke evacuator system is configured to store such information for future use. .. For example, a centralized hub can store information about surgical devices used during a particular procedure, as well as the average number and / or concentration of smoke and / or contaminants. In future surgical procedures, when the same (or similar) surgical device is activated with the same (or similar) surgical procedure that treats the same (or similar) type of tissue, the centralized hub will smoke and / or Such information can be communicated to the flue gas system prior to the accumulation of pollutants.

In various examples, the flue gas system is configured to notify the clinician of the detected levels of contamination in the operating room air. The smoke evacuator system can utilize the sensor system to monitor the difference between the particle size and / or concentration of the particles detected by the first internal sensor and the second external sensor. In various examples, if the detected contamination level exceeds a predetermined threshold, the monitored parameters of the sensor system can be used to warn the clinician and / or assistant.

In various examples, the processor instructs the display to indicate the parameters monitored by the sensor system. In various examples, the display is located outside the housing of the smoke exhaust system. The processor can also communicate the monitored parameters with other surgical instruments and / or hubs located in the operating room to assist in situational awareness of the interactive surgical system. In this way, other surgical instruments and / or hubs can be used together more efficiently. In situations where monitored parameters are communicated throughout the operating room, clinicians and / or assistants can see contamination warnings from various displays around the operating room. The monitored parameters can be displayed on multiple monitors in the operating room in addition to the display on the smoke exhaust system. The reader will understand that any suitable combination of displays can be used to communicate the detected air quality in the operating room.

FIG. 30 is configured to monitor the air quality of the operating room air and warn the clinician if the detected air quality exceeds a predetermined threshold and / or is potentially harmful. The smoke system 53000 is shown. The smoke exhaust system 53000 is similar to the smoke exhaust system 50600 (FIG. 7) in many respects. For example, the smoke exhaust system 53000 includes a generator 50640, a first electrical connection 50642, a surgical instrument 50630, and a suction hose 50636. As shown in FIG. 30, in various examples, the smoke exhaust system 53000 comprises a display or an air quality indicator screen 53002. The air quality indicator screen 53002 is a sensor further described herein and comprising one or more of the sensors 50830, 50832, 50836, 50838, 50840, 50846, 50848, 50850, 50852 shown in FIGS. 18 and 19. It is configured to display information detected by a sensor system such as a system. Processors such as the processor 50308 and / or 50408 (FIGS. 5 and 6) can signal and communicate with the sensor system and the air quality indicator screen 53002. In various examples, the air quality indicator screen 53002 displays the number of pollutant particles monitored by the external sensor 50852 to verify that the pollutants are not circulated into the operating room air at harmful levels. It is configured as follows.

In various examples, the smoke evacuator system 53000 comprises a latch door 53004 accessible to the clinician to replace and / or replace the filter housed within the flue gas exhaust system 53000's evacuator housing. For example, by monitoring the concentration of particulates through the flue gas system 53000, the processor is substantially occluded by one or more filters and is nearing the end of their useful life and therefore needs to be replaced. It can be determined that there is. In such an example, the clinician can open the latch door 53004 and replace one or more filters. As further described herein, specific filters and / or filters (s) that need to be replaced can be identified based on the relative placement of internal sensors within the smoke exhaust system 53000.

In various examples, processors such as processor 50308 and / or 50408 (FIGS. 5 and 6) are configured to communicate smoke parameters such as detected particle size and / or concentration to display 53002. The display 53002 is configured to display such detected information in any suitable manner. For example, the display 53002 can show the contamination levels detected by the internal and external sensors throughout the sensor system. In various examples, the display 53002 is configured to display information only if the air quality does not meet a predetermined threshold. In various examples, the display 53002 includes a touch screen that allows the clinician to determine what information to display and / or where to display that information.

In various examples, the display 53002 includes a graphical interface, an LCD screen, and / or a touch screen. The reader will understand that any suitable means of displaying the detected information and / or combinations thereof can be used in the flue gas system 53000. For example, LED light can be used as the display 53002. If the processors 50308 and / or 50408 (FIGS. 5 and 6) determine that unacceptable air quality is present in the operating room, the processors 50308 and / or 50408 are configured to activate the LED light.

FIG. 31 shows a representation of instruction 53100 stored by the memory of a surgical discharge system, such as the memories 50310 and 50410 of FIGS. 5 and 6. In various examples, the surgical drainage system disclosed herein can utilize instruction 53100 of FIG. Further, the reader will readily understand that in certain examples, instruction 53100 of FIG. 31 can be combined with one or more additional algorithms and / or instructions described herein. The instruction 53100 stored in the memory can be executed by a processor such as the processors 50308 and / or 50408 of FIGS. 5 and 6.

Further referring to FIG. 31, as described above, internal sensors such as the sensor 50838 (FIGS. 18 and 19) are configured to monitor internal parameters such as fluid particle size and / or concentration. As the fluid flows through the flow path, particles and / or contaminants are filtered before the fluid exits the surgical drainage system. External sensors, such as the sensor 50852 (FIGS. 18 and 19), located on the outer housing of the surgical drainage system, are configured to monitor external parameters as the filtered fluid exits the surgical drainage system. .. Such external parameters include, for example, particle size and / or concentration of particles in the atmosphere of the operating room.

At block 53102 of instruction 53100, the processor is configured to query the internal and external sensors for the detected internal and external parameters, respectively. In various examples, the processor continuously queries internal and external sensors for this information. However, any suitable sample rate can be used. The processor is then configured in block 53104 to analyze the information received from the internal and external sensors to determine the efficiency level of the surgical efflux system. After determining the efficiency level of the surgical drainage system, the processor is configured in block 53106 to display the determined efficiency level on the display. Such indications may include raw information received from internal and external sensors, a processor-determined efficiency level, and / or a warning to the clinician if the efficiency level is below a predetermined threshold. Below a predetermined threshold can indicate, for example, that the filter needs to be replaced and / or that the particles are not efficiently filtered and accumulate in the operating room atmosphere. ..

FIG. 32 shows a representation of instruction 53200 stored in the memory of the surgical discharge system, similar to that shown in FIG. In various examples, the surgical drainage system disclosed herein can utilize the instructions of FIG. Further, the reader will readily understand that in certain examples, the instructions in FIG. 32 can be combined with one or more additional algorithms and / or instructions described herein. Instructions can be stored in memory and executed by the processor, for example, in memory 50310 and / or 50410 and / or processor 50308 and / or 50408 of FIGS. 5 and 6.

Further referring to FIG. 32, at block 53202, the processor is configured to query an external sensor such as sensor 50852 (FIGS. 18 and 19) for baseline air quality parameters prior to the initiation of the surgical procedure. The baseline air quality parameter indicates the air quality of the operating room before the surgical procedure. At block 53204, the processor is configured to continuously query internal sensors to recognize that a surgical procedure is in progress. After the processor determines that a surgical procedure is being performed, the processor continuously queries the external sensor at block 53206. If the processor determines that the air quality detected by an external sensor has deteriorated, for example at block 53208, the processor increases the speed of the motor at block 53210 to expel more fluid into the surgical drainage system. It is configured to face inward. If the detected air quality is the same as the baseline air quality, such as at block 53212, the processor is configured to maintain the speed of the motor at block 53214. If the detected air quality is improved from the baseline air quality, for example at block 53216, the processor is configured at block 53218 to maintain or reduce the speed of the motor. In various examples, the processor continuously queries internal and external sensors for information. However, any suitable sample rate can be used.

Smoke evasion systems play an important role in electrosurgical systems by removing harmful toxic substances and / or unpleasant odors from the operating room. However, the control and adjustment functions of certain smoke exhaust systems may be lacking, which can result in, for example, reduced motor life and / or reduced filter life.

In one aspect of the disclosure, the sensor can be arranged and configured to detect the presence of particles in the fluid moving through various points in the flow path of the discharge system. In some aspects of the disclosure, control circuits can be utilized to change the speed of the motor driving the pump of the discharge system based on the detected particulate concentration at various points along the flow path. .. In addition or instead, control circuits can be utilized to change the speed of the motor based on the detected pressure at various points in the flow path.

Efficient adjustment of the motor speed of the discharge system can increase the life of the motor and / or increase the life of the filter. Further benefits include, for example, potential energy savings and reduced noise in the operating room.

As described herein, electrosurgical instruments deliver energy to a patient's target tissue to cut tissue and / or cauterize blood vessels in and / or in the vicinity of the target tissue. .. Cutting and cauterization can result in smoke being released into the air. In various examples, smoke can be unpleasant, obstruct the practitioner's vision, and unhealthy when inhaled, as further described herein. An electrosurgical system can use an efflux system that captures the resulting smoke and directs the captured smoke through one or more filters to expel the filtered smoke. More specifically, smoke can travel through the discharge system via vacuum tubes. Hazardous toxic substances and unpleasant odors can be filtered from the smoke as it travels through one or more of the filters in the emission system. The filtered air can then exit the exhaust system as exhaust through the exhaust port.

In various aspects of the disclosure, the discharge system comprises a filter receptacle or socket. The filter receptacle is configured to accept the filter. The drainage system also includes a pump with a sealed positive displacement flow path and a motor that drives the pump. The sealed positive displacement flow path of the pump can include one or more circulation paths of fluid in the pump. In one aspect of the present disclosure, the pump has a first working pressure and a second working pressure. In certain examples, the pump can compress the inflow fluid to create a pressure difference along the flow path, as further described herein.

As shown in FIG. 4, the discharge system 50500 includes a pump 50506 connected to and driven by the motor 50512. As described herein, the pump 50506 may be, for example, a positive displacement pump such as a positive displacement reciprocating pump, a positive displacement rotary pump, or a positive displacement linear pump. In various examples, the pump 50506 may be, for example, a hybrid regeneration blower, a claw pump, a lobe compressor, or a scroll compressor. In one aspect of the present disclosure, the motor 50512 may be a permanent magnet direct current (DC) motor. Some embodiments may include a brushless DC motor.

According to aspects of the present disclosure, the motor 50512 may, for example, maintain flow rate, increase motor efficiency, increase motor life, increase pump life, increase filter life, and / or save energy. It can be adjusted and / or controlled for a variety of reasons, including. When the control circuit of the discharge system (see, eg, control schematics of FIGS. 5 and 6) recognizes certain conditions such as blockage in the flow path, undesired pressure, and / or undesired number of particles, The control circuit can adjust the motor 50512 to adjust or maintain the flow rate, thereby increasing the motor efficiency, increasing the motor life, increasing the pump life, increasing the filter life, for example. And / or energy can be saved.

In one aspect of the present disclosure, referring to FIG. 6, the processor may be inside the emission system. For example, the processor 50408 may be inside the ejector housing 50618 of FIG. In another aspect of the disclosure, the processor may be near the outside of the emission system 50600. For example, the external processor 50308 is shown in FIG. The external processor may be a surgical hub processor. In yet another aspect, the internal and external processors can communicate to coordinately control the motor 50512.

According to one aspect of the present disclosure, the motor 50512 may be tuned by a control circuit to increase motor efficiency. For example, with reference to the discharge systems of FIGS. 18 and 19, the fluid detection sensor 50830 is located upstream of the filter (s) and filter receptacle. In various examples, the fluid detection sensor 50830 is configured to detect fluid upstream of the filter (s). For example, the fluid detection sensor 50830 is configured to detect whether an aerosol or droplet is present in the emitted smoke. Based on the output from the fluid detection sensor 50830, the control circuit can adjust the control parameters of the smoke exhaust system, for example adjusting the power to the valves and / or motors.

In certain examples, the effluent system can detect whether a fluid (eg, smoke) is present in the flow path. In a particular example, when a clinician initiates treatment of a patient tissue using an electrosurgical instrument, for example, when the electrosurgical instrument 50630 (FIG. 7) is activated by a generator 50640 (FIG. 7), The fluid detection sensor 50830 can automatically scan for fluids or certain types of fluids. Alternatively, or in combination with the fluid detection sensor 50830, a separate sensor, such as an end effector or imaging device for surgical instruments, can be configured to detect fluid (s) at the surgical site. .. In one example, a separate sensor may be located near the tip of the electrosurgical instrument 50630. When the fluid detected by one or more of the fluid detection sensors (s) is below the threshold, the control circuit motors the pump to a level sufficient to monitor the presence of the fluid or a particular type of fluid. The speed can be adjusted. The motor speed in such an example may be the minimum motor speed or idle motor speed that allows accurate reading by the fluid detection sensor (s). Alternatively, the motor speed can be reduced to zero and periodically increased to the minimum motor speed or idle motor speed to monitor the presence of fluid or certain types of fluid.

When the fluid detection sensor detects fluid, or a fluid level above the threshold, the control circuit can adjust the speed of the motor 50512 to a level sufficient to completely drain the fluid from the surgical site. In one embodiment, clouds such as Cloud 104 (FIG. 39) and / or Cloud 204 (FIG. 46) have been established to be sufficient to efficiently drain fluid for the same or similar surgical procedure. The motor speed level can be tracked and / or stored. In such an embodiment, the control circuit can access and / or refer to the historical motor speed level stored in the cloud when setting the appropriate motor speed level for the surgical procedure.

In addition or instead, the speed of the motor can be adjusted based on the particle concentration detected along the flow path. For example, referring again to FIGS. 18 and 19, the emission systems 50800 and 50900 include laser particle sensors 50838 and 50884 along the respective channels 50804 and 50904, respectively. The particle sensor 50838 is located upstream of the filters 50842, 50844, and receptacle 50871 in the surgical discharge system 50800, and upstream of the filters 50942, 50944, and receptacle 50971 in the surgical discharge system 50900. The particle sensor 50838 is configured to detect and / or count particles upstream of the filter (s). The particle sensor 50848 is located downstream of the filters (s) 50842, 50844 and receptacles 50871 in the surgical discharge system 50800, and the filters (s) 50942, 50944, and receptacles 50971 in the surgical discharge system 50900. It is located downstream of. The particle sensor 50848 is configured to detect and / or count particles downstream of the filter (s).

In such an example, the discharge systems 50800, 50900 can detect the presence of fluid (eg, smoke containing particulate matter) (eg, via a laser particle counter sensor). For example, a sensor (s) can detect the concentration of fine particles in smoke. In certain examples, the laser particle counter sensor (s) are used by the practitioner to treat patient tissue with an electrosurgical instrument, for example, when the electrosurgical instrument 50630 is activated by a generator 50640. Particles can be automatically scanned and counted when starting.

When the particle concentration detected by the particle sensor 50838 is below the threshold, the control circuit can adjust the motor speed to a level sufficient to sample the particle concentration in the flow path. For example, the motor speed can be set to a minimum or idle motor speed that allows accurate reading on the sensor. In an alternative embodiment, the motor speed is reduced to zero and periodically increased to a minimum or idle motor speed level sufficient to monitor the presence of fluid (eg, the concentration of particulates in smoke above the threshold). Can be done. In such an embodiment, when a particle concentration above the threshold is detected, the control circuit speeds the motor 50512 (FIG. 4) to a level sufficient to completely exhaust the smoke and filter the particles from the surgical site. Can be adjusted. Again, the cloud tracks the motor speed level established to be sufficient to efficiently drain the fluid for the same or similar surgical procedure, based on the particle concentration detected by the sensor. And / or can be memorized. In such an embodiment, the control circuit can access and / or refer to such historical motor speed levels when setting the appropriate motor speed levels for the surgical procedure.

In one aspect of the present disclosure, the motor 50512 is either off (ie, zero motor speed) or operating at a predetermined minimum or idle speed unless fluid and / or threshold particle concentration is detected. It is more efficient because it will be. In such cases, energy can be saved and noise in the operating room can be minimized. Furthermore, if fluid and / or threshold particle concentration is detected, the motor 50512 is established to be sufficient for efficient motor speed, i.e., sufficient to efficiently expel fluid and / or particles based on historical data. It can be operated at the specified motor speed. It sets the motor speed level based on a subjective assessment (eg, the experience of a particular clinician) and / or simply a visual and / or olfactory queue (eg, seeing smoke and / or smoke). It is an improvement over other manual methods of adjusting the discharge system and / or increasing the motor speed level based on (sniffing).

According to various aspects of the disclosure, motor parameters, such as motor speed, can be adapted to adjust (eg, increase) the efficiency of the drainage system and its filters based on the need at the surgical site. Is. As described herein, it can be inefficient for the effluent system to unnecessarily filter the volume of air if the smoke detected at the surgical site is below the threshold. In such an example, the motor speed can be reduced, reduced to zero, or maintained at zero, thereby reducing, reducing, or reducing the volume of air filtered by the discharge box to zero, respectively. Maintained at zero. Efficient use of the drainage system ultimately extends the useful life of the drainage system and / or its components (eg, fluid traps, filters, motors, pumps, etc.) and of the drainage system and / or its components. Reduce related repair and / or replacement costs. Stresses and wear caused by running the motor at all times above full speed or sufficient speed are avoided. In addition, the motor driving the pump within the discharge system can generate varying levels of operational and / or vibration noise. In the operating room and / or environment, such operating noise and / or vibration noise may, for example, impede communication between surgical staff and / or irritate and / or distract surgical staff. It may not be desirable.

In certain cases, reducing the motor speed to zero may not be desirable. For example, an electric motor such as a permanent magnet synchronous DC motor may require a large starting torque from a completely stopped state for use with the various pumps described herein. Here again with reference to FIG. 4, pump 50506 creates a pressure difference between the fluid entering pump 50506 and the fluid exiting pump 50506. This pressure difference or compression ratio of pump 50506 may result in a high starting torque of motor 50512 in order to start motor 50512 and rotate pump 50506. In one embodiment, the pump 50506 can include a blower (eg, a hybrid regeneration blower). In such an embodiment, the blower operates at, for example, a compression ratio of about 1.1 to 1.2 and at an operating pressure of about 1.5 psig to 1.72 psig (eg, relative to a fan or compressor). A larger volume of fluid can be delivered. In another embodiment, the pump 50506 can include a compressor (eg, the scroll compressor pump 50650 of FIG. 12). In such an embodiment, the compressor operates, for example, at a compression ratio greater than about 2, and delivers a smaller volume of fluid (eg, with respect to a fan or blower) at an operating pressure greater than about 2.72 psig. be able to.

Aspects of the present disclosure are directed to systems and methods for improving filter assembly life. The filter assembly can include multiple filtration layers. For example, referring again to FIG. 11, the filter assembly includes a coarse media filter 50684, a fine particulate filter 50686, and a carbon reservoir 50688.

According to various aspects of the present disclosure, the first pressure sensor (eg, the pressure sensor 50840 in FIGS. 18 and 19) can be located upstream of the filter receptacle in the flow path and is a second pressure sensor. (For example, the pressure sensor 50846 in FIGS. 18 and 19) can be placed downstream of the filter receptacle in the flow path. In such an example, the first pressure sensor is configured to detect the first pressure and transmit a signal indicating the first pressure to the control circuit. Similarly, the second pressure sensor is configured to detect the second pressure and transmit a signal indicating the second pressure to the control circuit. Further, the control circuit that receives the signal indicating the first pressure and the signal indicating the second pressure is configured to calculate the pressure difference between the first pressure sensor and the second pressure sensor. .. The control circuit can utilize the calculated pressure difference in various ways. In the first example, the control circuit can adjust the motor speed based on the pressure difference. In the second example, the control circuit can indicate that maintenance is required based on the pressure difference. For example, the indicator may be displayed on the drainage system interface and / or the surgical hub interface. The control circuit can calculate the pressure difference continuously, in real time, periodically, or when system computational resources are available.

Seeing FIG. 4 again, in certain examples, particles entering flow path 50504 of discharge system 50500 can cause internal blockage. For example, particles can clog and / or block a portion of channel 50504 at least partially. In one example, the filter 50502 may be blocked by particles. Occlusion can occur rapidly or over time as the drainage system operates. Occlusion in the discharge system 50500 creates a pressure difference in the flow path 50504 and may increase as the flow is obstructed. The pump 50506 and / or the motor 50512 may require more power and / or speed increase to maintain the desired flow rate and compensate for the blockage. However, increased speed and / or power may reduce the efficiency of motor 50512 and / or pump 50506. In addition, operating the motors 50512 and / or pumps 50506 at increased speeds to compensate for blockages may reduce their lifetime. In another example, to compensate for the blockage, the control circuit can adjust the motor 50512 as further described herein.

In one aspect of the present disclosure, the control circuit can transmit a drive signal to supply the tuned current to the motor 50512. The desired current supply can be achieved by varying the duty cycle of pulse width modulation of the electrical input to the motor 50512. In such an embodiment, the motor speed can be increased by increasing the duty cycle of the current input to the motor, and the motor speed can be reduced by decreasing the duty cycle of the current input to the motor. it can.

In one aspect of the present disclosure, the discharge system may include a relief valve in the flow path to relieve excessive resistance pressure in the discharge system. The relief valve can, for example, communicate fluidly with the surrounding environment. The release of excess resistance pressure by such a relief valve can prevent the motor 50512 from having to compensate for the excess resistance pressure or attempting to compensate. In various aspects of the disclosure, such relief valves are configured to operate (eg, open and / or close) upon receiving a signal from the control circuit.

In various aspects of the disclosure, the control circuit can recognize blockages based on sensors located within the discharge system. For example, referring again to FIGS. 18 and 19, the pressure sensor 50840 is arranged and configured to detect the pressure upstream of one or more filters (s) and the pressure sensor 50846 is one. It is arranged and configured to detect the pressure downstream of the above filters (s). The pressure sensor 50840 is further configured to transmit a signal indicating the detected pressure to the control circuit. Similarly, the pressure sensor 50846 is configured to transmit a signal indicating the detected pressure to the control circuit. In such an example, the control circuit determines that a portion of the filter assembly is at least partially blocked based on the pressure detected at 50846 and / or the calculated pressure difference between 50840 and 50846. can do. In various aspects of the disclosure, the control circuit was calculated between (B) the pressure sensor 50840 and the pressure sensor 50846, for example, if the pressure detected by the pressure sensor 50846 exceeds a particular threshold. When the pressure difference exceeds a specific threshold, (C) the pressure detected by the pressure sensor 50846 exceeds the specific threshold established for the filter (s) and / or (D) the pressure sensor 50840. If the calculated pressure difference between and the pressure sensor 50846 exceeds a certain threshold established for the filter (s), it can be determined that the filter assembly is blocked. In one example, the control circuit is at the expected pressure on the filter (s) based on historical data stored in the cloud, such as cloud 104 (FIG. 39) and / or cloud 204 (FIG. 46). It is configured to be accessed and / or referenced.

With reference to FIGS. 18 and 19 again, the pressure sensor 50850 is arranged and configured to detect pressure at or near the outlet of the discharge system. In addition, the pressure sensor 50850 is configured to transmit a signal indicating the pressure detected at or near the outlet to the control circuit. In such an example, the control circuit is downstream of the filter (s) based on the pressure detected by the pressure sensor 50846 and / or the calculated pressure difference between the pressure sensor 50846 and the pressure sensor 50850. It can be determined that the flow path through the discharge system is at least partially blocked. In various aspects of the disclosure, the control circuit may include, for example, when the pressure detected by the pressure sensor 50846 exceeds a particular threshold and / or the pressure difference between the pressure sensor 50846 and the pressure sensor 50850 is a particular threshold. If it exceeds, it can be determined that the flow path is blocked. When comparing the pressure difference between the pressure sensor 50846 and the pressure sensor 50850, the pressure difference generated by the pump can be taken into account. In one example, the control circuit accesses and / or accesses the predicted pressure on the flow path based on historical data stored in the cloud, such as cloud 104 (FIG. 39) and / or cloud 204 (FIG. 46). You can refer to it.

The speed of the motor 50512 can correspond to the current supplied to the motor 50512. In one aspect of the present disclosure, the control circuit can reduce the duty cycle of pulse width modulation (PWM) of the current input to the motor 50512 to reduce the rotational speed of the pump 50506 and /. Alternatively, the PWM duty cycle of the current input to the motor 50512 can be increased to increase the rotational speed of the pump 50506. As described herein, adjustments to the PWM duty cycle measure the flow rate in the range of inlet pressure (eg, measured by pressure sensor 50840) and / or outlet pressure (eg, measured by pressure sensor 50850). ) Can be configured to remain substantially constant over the range of).

Here, referring to FIG. 37, the control circuit tracks the ratio of the pressure detected by the upstream pressure sensor 50840 to the pressure detected by the downstream pressure sensor 50846 (pressure ratio between upstream and downstream) over time. And / or can be plotted. For example, a control circuit (FIGS. 5 and 6) that includes processors 50308 and / or 50408 can determine the pressure ratio and make various adjustments to the surgical discharge system based on the pressure ratio.

In one example, referring to graph display 54200 in FIG. 37, the pressure difference between the upstream pressure sensor 50840 and the downstream pressure sensor 50846 can increase as the filter is closed. In one aspect of the present disclosure, the pressure ratio may increase as the downstream pressure measured by the pressure sensor 50846 decreases and / or the upstream pressure measured by the pressure sensor 50840 increases. The pressure at the pressure sensor 50840 may be equal to or substantially equal to the pressure at the surgical site (eg, in the patient's body). The pressure in the pressure sensor 50846 can be the pressure drawn by the pump. Increasing the pressure ratio can accommodate blockages between the downstream pressure sensor 50846 and the upstream pressure sensor 50840, such as blockages in the filter (s). For example, as the filter is occluded, the pressure at the pressure sensor 50840 can remain the same or substantially the same (pressure at the surgical site) and the pressure at the pressure sensor 50846 decreases as the pump continues to evacuate. obtain.

The ratio of pressure upstream to downstream can indicate filter life. For example, a low ratio can indicate that the filter does not need to be replaced, and a high ratio can indicate that the filter needs to be replaced.

New at time t _0, and a filter which is not closed, progression to filter almost closed at time t ₂ is shown in Figure 37. As shown in FIG. 37, the ratio of the upstream and downstream pressures (the pressure at the upstream pressure sensor 50840 to the pressure at the downstream pressure sensor 50846) starts at a non-zero ratio, which is the filter component and material. It may be due to the baseline pressure difference from the airflow through. The ratio remains relatively constant _{from time t 0} to just before time t _1. At time t _1, the pressure ratio between the upstream and downstream, until the pressure ratio between the upstream and downstream reaches the exchange ratio R '', increased at a relatively constant rate with a gradient of alpha. When the replacement ratio R'' is reached and / or exceeded, the filter is considered to be substantially blocked and should be replaced, for example, to avoid damage to the motor and / or pump. .. In one example, the control circuit can access and / or reference the exchange ratio R'' for a given filter installed or placed in the filter receptacle of the emission system via the cloud. For example, the exchange ratio R ″ may be stored in memory 50410 accessible to processor 50408 in FIG. Alternatively, the exchange ratio R'' may be user-defined and / or based on the history of local and / or global pressure data in the cloud. In various aspects of the disclosure, the control circuit utilizes traced and / or plotted ratios to provide a filter lifetime metric (eg, 40%) on the drain system and / or surgical hub user interface. (Remaining) can be displayed.

Further referring to FIG. 37, the control circuit can further track and / or plot the duty cycle of the pulse width modulation (PWM) of the motor of the discharge system over time. For example, if the filter (s) is _{considered relatively new after time t 0} until just before time t ₁ , the PWM duty cycle of the motor is set to a relatively low constant duty cycle or percentage. .. _{At time t 1} corresponding to the partial occlusion ratio R', the control circuit is configured to increase the PWM duty cycle of the motor at a relatively constant speed with a gradient of ^{α 1.} The increased duty cycle can be selected to compensate for filter blockage. As the blockage in the filter continues to accumulate during use, the duty cycle can be increased accordingly to compensate for the filter blockage. In various examples, the gradient α ¹ can track the gradient α, as shown in FIG. 37. The control circuit accesses and / or the partial blockage ratio associated with a given filter installed within the filter receptacle of the emission system via a cloud such as cloud 104 (FIG. 39) and / or cloud 204 (FIG. 46). / Or can be referred to. Alternatively, the partial blockage ratio may be user-defined and / or based on the history of local and / or global pressure data in the cloud.

In one aspect of the disclosure, by increasing the duty cycle of the motor, the pump speed can be increased so that the pump draws more air through the exhaust system. In other words, the increase in pressure difference across the filter can trigger a corresponding increase in the PWM duty cycle of the motor for the pump.

The pump of the drainage system is configured to transfer or influence the movement of the fluid along the flow path by mechanical operation. During operation, the pump can increase the pressure of the fluid as it moves. The pump can have more than one operating pressure. In one aspect of the present disclosure, the pump can operate at a first operating pressure that results in a first flow rate of fluid through the flow path, and the pump results in a second flow rate of fluid through the flow path. It can operate at an operating pressure of 2. The first and second flow rates of the fluid through the flow path may be the same or substantially the same regardless of the difference between the first operating pressure and the second operating pressure of the pump. In one example, as the blockage accumulates in the flow path, the pump can operate at higher operating pressures to maintain a constant flow rate.

Further referring to the graph display 54200 of FIG. 37, the control circuit can increase the PWM duty cycle of the motor to increase the current supplied to the motor and increase the operating pressure of the pump. The control circuit can adjust the duty cycle, for example, based on the detected pressure (s), pressure difference (s), and / or the ratio of the detected pressures. The increased operating pressure, while maintaining a constant flow rate of fluid through the flow path may be configured to compensate for occlusion, such as clogging in the filter which begins near time t ₁ in FIG. 37. In such an example, the control circuit can control the load on the pump, for example, as the filter is blocked with particles.

In various aspects of the disclosure, the control circuit can increase the current delivered to the motor to an established motor current threshold. In one aspect, the control circuit can increase the established motor current threshold to achieve the pressure difference required to maintain the desired flow rate. For example, the pressure difference and the desired flow rate can be maintained despite the blockage in the flow path.

In another aspect of the present disclosure, the control circuit can reduce the established motor current threshold for a variety of reasons. For example, the control circuit can reduce the established motor current threshold to prevent inadvertent tissue damage at the surgical site. For example, when the surgical port is blocked by the patient tissue, the control circuit can reduce the motor current to reduce the pressure in the system and the suction force applied to the tissue. In one example, the control circuit can access and / or reference an established motor current threshold via a cloud such as cloud 104 (FIG. 39) and / or cloud 204 (FIG. 46). Alternatively, the established motor current threshold may be user-defined and / or based on the history of local and / or global data in the cloud.

In various aspects of the disclosure, the control circuit can provide increased power and / or motor speed for a limited period of time based on feedback from the pressure sensor. During this time, pressure (s) and / or occlusion indications may be communicated to the user, for example, via an interface in the operating room. In one example, the clinician can address the obstruction by removing the obstruction and / or modifying one or more filters (s) within the filter receptacle. The limited period can be determined based on data stored in the cloud, such as historical data on the period of operation at increased power levels and / or speeds prior to motor and / or pump failure. After a limited period of time, power and / or speed can be reduced, as further described herein, until the blockage is properly addressed.

According to various aspects of the present disclosure, the control circuit of the discharge system sends a drive signal to supply an increased or decreased current to the motor of the discharge system in order to adjust the speed of the motor and / or the speed of the pump. Can be sent. In one example, the control circuit can transmit drive signals to achieve burst speeds at startup and / or transitions between power levels of the discharge system. For example, the burst rate can be configured to pull the discharge system to a specified level at the beginning of active discharge mode. The specified level can correspond to, for example, a specified flow rate and / or a specified pressure. In various examples, the burst rate can efficiently pull the emission system to a specified level in an energy-efficient manner.

In one example, the burst speed set by the control circuit is different from the constant operating speed set by the control circuit. For example, after the initial startup of the discharge system and / or when the increased power level of the discharge system is set, the control circuit sends a drive signal to supply the increased current to the motor and the motor speed for a short period of time. Can be increased to burst speed. The burst speed may be, for example, a motor speed that is at least 20% higher than the constant motor speed required to achieve the desired flow rate. In one aspect of the disclosure, the burst speed is at least 50% or at least 100% higher than the constant motor speed required to achieve the desired flow rate.

Here, referring to the graph display 54300 of FIG. 38, the air flow velocity and the number of particles over time of the surgical discharge system are shown. The control circuits of the surgical drainage systems 50800 and 50900 (FIGS. 18 and 19) can adjust the air flow velocity, for example, as shown graphically in FIG. 38. More specifically, the air flow velocity includes burst velocities 54302 and 54304 for the motor of the surgical discharge system. For example, the burst speed may be the motor speed required to achieve an air flow velocity higher than the desired air flow velocity over a short period of time. As shown in FIG. 38, the desired air between the burst rate 54302 is over a portion of the period between time _{t 1} and time _{t 2} (e.g., 1/5), and the time _{t 1} and time _{t 2} It may be the motor speed required to achieve an air velocity that is at least 20% higher than the flow velocity V _1. For example, similarly, the burst velocity 54304 is the period between _{time t 2} and time t _3. The motor speed required to achieve an air velocity that is at least 20% higher than the desired air velocity V _{2 between time t 2} and time t ₃ over a portion (eg, 1/4) of. You may. In various examples, the air flow velocity may depend on the number of particles in the discharge system, as further described herein.

According to various aspects of the present disclosure, the transition of the discharge system from the first air flow rate to the second air flow rate is immediately before or after the transition and before the adjustment to the second air flow rate. Can be accompanied by an increase in. For example, the first air flow rate and the second air flow rate can correspond to a constant or substantially constant motor speed and a correspondingly constant or substantially constant air flow velocity. Referring to the graphical representation of FIG. 38 again, the air flow rate, with the exception of the burst rate 54,302 and 54,304 immediately after each time _{t 1} and time _{t 2,} between time _{t 1} and time _{t 2,} and again the time _{t 2} it is substantially constant between the time t _3. The substantially constant air flow velocity shown in FIG. 38 can correspond to the corresponding constant motor speed in the corresponding mode of operation of the discharge system.

Further referring to FIG. 38, at time t ₀ , the air flow velocity may be a non-zero value of _{V 0 to} V ₁ , which can correspond to the motor speed of the "quiet" mode 54310. In "quiet" mode 54310, the drainage system can be configured to sample fluid from the surgical site. The sampled fluid can be used to determine, for example, the operating state of another component of a smoke evacuating system, an energy device, and / or a surgical system. At time _{t 1,} the discharge system can be "active" mode 54312. In certain examples, the "active" mode 54312 can be triggered by one or more sensors in the discharge system, as further described herein. An increase in air velocity to velocity V _{1 at} time t ₁ and / or to velocity V _{2 at time t 2} can be accompanied by a further increase in air flow velocity immediately after the transition or start of a new velocity level. .. More specifically, the air flow rate, prior to further adjustments in and time t ₂ after the time t ₁ in FIG. 38, rapidly increases. In addition, air flow rate, when the air flow in a second "active" mode 54314 transits from the velocity v ₁ to the speed v _2, spikes immediately after the time t _2.

In addition or instead, the reduction of the power level of the discharge system from the first air flow velocity to the second air flow velocity can be accompanied by an initial increase in the air flow velocity immediately prior to the reduction. For example, when reducing the air flow velocity from a first constant or substantially constant level to a second constant or substantially constant level, the air flow velocity encounters an air flow velocity spike similar to that shown in FIG. 38. can do. In one example, the control circuit can affect the air flow velocity spike just before returning to a constant "quiet mode" motor speed from "active mode". In various examples, the burst velocity before silent mode can, for example, shed smoke from a surgical system and / or an efflux system.

According to aspects of the present disclosure, various particle sensors, such as the particle sensors 50838 and 50848 of FIGS. 18 and 19, count the particles flowing through and / or through the emission systems 50800 and 50900. Can be arranged and configured in. Similarly, air quality particle sensors, such as the particle sensors 50852 in FIGS. 18 and 19, are arranged and configured to count particles in the ambient air around the discharge systems 50800 and 50900 and / or in the operating room. be able to. Various particle sensors (eg, particle sensors 50838, 50848, 50852, etc.) can be further configured to send a signal indicating particle concentration to the control circuit, for example, to adjust the air flow velocity.

With reference to FIG. 38 again, the motor of the discharge system can operate at a constant "quiet" mode 54310 speed between _{time t 0} and time t _1. Between time t ₀ and time t ₁ , at least one particle sensor (eg, particle sensor 50838 and / or 50848) can actively count particles flowing through the discharge system. In a particular example, at least one particle sensor (eg, particle sensor 50852) can actively count particles in the ambient air. In at least one example, the control circuit can compare the particles counted by the particle sensor 50838 and / or the particle sensor 50848 with the particles counted by the particle sensor 50852. The control circuit can determine, for example, that the particle concentration detected by the particle sensor 50838 and / or the particle sensor 50848 exceeds a first threshold such as _{threshold C 1 in FIG.} The threshold C ₁ can correspond, for example, to the particle concentration levels and / or ratios of the particles counted by various sensors along the flow path. Depending on the concentration of particles above a first threshold value C _1, the control circuit, at time t _1, the speed of the "silence" mode 54310 associated with the first non-zero air flow rate, the second motor speed, or The motor speed can be increased to the "active" mode 54312 associated with a second air flow velocity (eg V _1). As mentioned above, the increase in air flow rate, may be accompanied by air flow velocity spikes or bursts 54,302 immediately after the time t _1.

Still referring to FIG. 38, the control circuit until the time _{t 2} from time _{t 1,} while maintaining the motor speed associated with the air velocity _{V 1,} at least one of the particle sensor 50838,50848, and / or 50,852 It is possible to continue to detect the fine particle concentration. At time _{t 2,} the control circuit includes at least particle concentration detected by one and / or the ratio of the particle sensor 50838,50848, and / or 50852 are the second threshold value, such as threshold _{C 2} in FIG. 38 It can be determined that it exceeds. The threshold C ₂ can correspond to a particle concentration level and / or ratio of particles counted by various sensors along the flow path, which is larger than the first threshold C _1. At time t ₂ in response to exceeding the second threshold value C _2, the control circuit, the air flow velocity V ₂ or the increased from the motor speed associated with the air velocity V ₁ or the first of the "active" mode 54314 It is configured to increase the motor speed up to the motor speed associated with the "active" mode 54314 of 2. Again, the increase _{from air flow velocity V 1} to air flow velocity V ₂ may be accompanied by an air flow velocity spike or burst 54304 immediately after _{time t 2.}

In various examples, control circuit, for example, while maintaining the motor speed associated with the air flow velocity _{V 2,} particulates by particle sensor 50838,50848, and / or 50852 concentration between time _{t 2} and time _{t 3} Can continue to receive input indicating. At time _{t 3,} the control circuit determines that at least particle concentration detected by one and / or the ratio of the particle sensor 50838,50848, and / or 50852 was reduced to below the first threshold value _{C 1} can do. Accordingly, the control circuit _{can reduce the motor speed by returning from the motor speed associated with the air flow rate V 2} to the "quiet" mode speed associated with the first non-zero air flow rate. As described above, in certain instances, reduced back from the air flow rate V ₂ to the non-zero air flow rate, it can be accompanied by air flow velocity spikes immediately after time t _3. Control circuitry, for example, can be time while maintaining a "silent" mode velocity after _{t 3,} continues to detect and / or comparing the particle concentration detected by the particle sensor 50838,50848, and / or 50852.

In various aspects of the disclosure, the motor may be a variable speed motor. For example, the motor 50512 (FIG. 4) may be a variable speed motor. In such an example, the speed of the motor may be controlled based on parameters measured externally. For example, the speed of a variable speed motor may be increased, decreased, or maintained based on parameters measured outside the discharge system.

According to aspects of the present disclosure, the motor 50512 (FIG. 4) can be adjusted by varying the supply of current to the motor 50512. For example, a first amount of current can be supplied to the motor 50512 to operate the motor 50512 at the first operating level. Alternatively, a second amount of current can be supplied to the motor 50512 to operate the motor 50512 at the second operating level. More specifically, changing the current supply may be achieved by varying the duty cycle of pulse width modulation (PWM) of the electrical input to the motor 50512. In other embodiments, the current can be varied by adjusting the frequency of the current delivered to the motor. In various aspects of the disclosure, the motor 50512 reduces the rotational speed of the pump 50506 by reducing the duty cycle or frequency of the current input to the motor 50512 (eg, the present specification). It is connected to a compressor, blower, etc. as described in the book. Similarly, the rotational speed of pump 50506 can be increased by increasing the duty cycle or frequency of the current input to the motor 50512.

In various aspects of the disclosure, a lower operating level of motor 50512 turns motor 50512 completely off when drainage and / or suction is not required, and then switches motor 50512 on when suction is required. Can be more advantageous than returning. For example, clinicians may need to use suction only intermittently during long-term surgery. In such an embodiment, turning on the motor 50512 from a completely off state requires a high starting torque to overcome the static inertia of the motor 50512. Repeatedly turning on the motor 50512 from a completely off mode in this way is inefficient and may reduce the life of the motor 50512. Alternatively, by adopting a lower operating level, it is possible to keep the motor 50512 on during intermittent use of the drainage system during surgery and require higher torque to overcome the static inertia of the motor. Allows adjustments to higher operating levels (eg, when additional suction is required).

In various aspects of the disclosure, the range of variation can be established or predetermined with respect to the motor parameters. In one embodiment, the motor speed range can be predetermined for variable speed motors. In various aspects, the control circuit as described above can determine that a particular flow rate or an increase or decrease in the flow rate is required at the surgical site based on feedback from one or more sensors. For example, processors 50308 and / or 50408 in the control circuit are configured to receive inputs from one or more sensors and make adjustments to the flow rate based at least in part on the sensor inputs (s). be able to. Adjustments can be determined in real time or near real time.

In one aspect, the control circuit detects a fluid (eg, fluid detection sensor 50830 in FIGS. 18 and 19) and / or particles in the fluid (eg, particle sensor 50838 and / or 50848 in FIGS. 18 and 19). Within the surgical system, such as at least one sensor arranged and configured such as, and / or a separate sensor on an electrosurgical instrument (eg, electrosurgical instrument 50630 of FIG. 7) that can be located at or near the surgical site. The need for adjustment to the motor can be determined based on the measured values detected by the sensor of. Depending on the determined need, the control circuit can send a drive signal to supply the drive current to the motor 50512 (FIG. 4) and adjust its speed to the adjusted motor speed. This adjusted motor speed can correspond to the desired specific flow rate.

Alternatively, depending on the determined need, the control circuit may send a drive signal to supply the drive current to the motor 50512 to increase or decrease the motor speed to a speed within a predetermined motor speed range. it can. In such an example, the control circuit limits the speed increase or decrease of the variable speed motor within a predetermined motor speed range. This adjusted motor speed may or may not correspond to the desired adjusted flow rate. For example, due to a predetermined motor speed range, the control circuit may not be able to adjust the motor speed to achieve the desired flow rate.

In another aspect of the disclosure, the motor speed may be selected by the clinician in the operating room, such as when the motor is operating in manual mode. For example, the clinician can manually change the variable speed motor to the desired motor speed via the user interface. The user interface may be, for example, on the housing and / or surgical hub interface of the drainage system. In various aspects, the user interface can display externally measured parameters (eg, the amount of smoke and / or particles measured via a sensor at or near the surgical site) to the clinician, clinically. The physician can manually set the motor speed based on parameters measured externally. In such an embodiment, the user interface can send a drive signal to supply the drive current to the motor to set, increase or decrease the motor speed to the selected motor speed.

In one aspect of the present disclosure, the control circuit can change the first drive signal to a second drive signal based on the pressure conditions detected and / or measured in the discharge system. For example, referring again to FIGS. 18 and 19, the pressure sensors 50840, 50846, 50850, and 50854 can transmit their corresponding pressures to the control circuit, which controls the detected pressures. Based on one or more, the first drive signal can be changed to the second drive signal. In particular, in such an embodiment, the actual motor speed may not be equal to the motor speed selected by the user via the user interface. For example, if the pressure measured in the discharge system exceeds the threshold pressure, damage the motor and / or other components of the discharge system by allowing the increased motor speed associated with the motor speed selected by the user. I have something to do. Therefore, the control circuit can override the motor speed of the user's choice to prevent damage to the discharge system and its components.

In another aspect of the present disclosure, the motor speed may be automatically selected by the control circuit, such as when the motor is operating in automatic mode. In such an embodiment, the control circuit draws a drive current to the motor based on externally measured parameters (s) (eg, the amount of smoke and / or particles measured at or near the surgical site). A drive signal can be transmitted to supply and the motor speed can be set, increased or decreased to the appropriate motor speed. In an alternative embodiment, the control circuit supplies the drive current to the motor based on parameters measured within the discharge system, including at least one of the pressure and fine particle concentrations detected by various internal sensors. The drive signal can be transmitted in such a way that the motor speed can be set, increased or decreased. In one embodiment, the pressure sensors 50840, 50846, 50850, and 50854 can transmit their corresponding detected and / or measured pressures to the control circuit. In addition or instead, the particle sensors 50838, 50848, and 50852 can transmit their corresponding detected and / or measured particle numbers to the control circuit.

With reference to FIG. 35, the tuning algorithm 54000 for the surgical drainage system is shown. The various surgical drainage systems disclosed herein can utilize the tuning algorithm 54000 of FIG. Further, the reader will readily understand that in certain examples, the tuning algorithm 54000 can be combined with one or more additional tuning algorithms described herein. Adjustments to the surgical discharge system can be performed by a processor that signals and communicates with the motor of the discharger pump (see, eg, the processor and pump of FIGS. 5 and 6). For example, processor 50408 can implement the tuning algorithm 54000. Such processors can also signal and communicate with one or more sensors in the surgical discharge system.

In one example, the control circuit 54008 may be similar to the particle sensor 50838 of FIGS. 18 and 19 and may transmit a first signal containing the number of particles detected and / or measured in block 54002. It may be communicably connected to the first fine particle sensor 54010. In addition, the control circuit 54008 may be similar in many respects to the particle sensor 50848 of FIGS. 18 and 19 and provides a second signal containing the number of particles detected and / or measured in block 54004. It can be connected to a second particle sensor 54012 that can be transmitted to the control circuit. The control circuit 54008 can then transmit a drive signal at block 54006 to apply the determined drive current at block 54016 to the motor of the discharge system. For example, the control circuit 54008 may be similar in many respects to the control schematics of FIGS. 5 and 6 and may include a processor communicatively coupled to memory. In yet another embodiment, any combination of sensors 50840, 50846, 50850, 50854, 50838, 50848, and 50852 (FIGS. 18 and 19) controls their corresponding detected and / or measured parameters. Can be sent to. In such an alternative aspect, the control circuit can determine the appropriate motor speed based on internally measured parameters. In each case, in various examples, the user interface can display the current motor speed.

In various aspects of the disclosure, the appropriate motor speed is determined based on historical data stored in the cloud, such as cloud 104 (FIG. 39) and / or cloud 204 (FIG. 46). It may be. The ideal motor speed may be, for example, the most efficient speed given the measured external and / or internal parameters (s). In another aspect, the appropriate motor speed may be an ideal motor speed determined so that all measured pressures are below the threshold pressure. In other words, it is to avoid damage to the discharge system components and to minimize the particle concentration, such as the concentration measured by the particle sensor 50848. In a further aspect, the motor speed automatically selected by the control circuit can be adjusted manually. In such a manual override mode, the user can select a desired motor speed that is different from the automatically selected motor speed. In such an embodiment, the user interface can display the selected motor speed. In a further aspect of the disclosure, the user interface is determined by the control circuit to notify the user that the motor speed and / or flow rate is set lower (or higher) than the ideal motor speed and / or flow rate is selected. The ideal motor speed can be displayed.

In yet another aspect of the present disclosure, the externally measured parameters supplied to the control circuit are the electricity supplied to the electrosurgical instrument by the generator, such as to the electrosurgical instrument 50630 by the generator 50640 of FIG. The power level of the surgical signal can be included. In such an embodiment, the control circuit can increase the motor speed in proportion to the increase in power level. For example, various increases in power levels can be correlated with increases in smoke levels in a cloud database. Similarly, the control circuit can reduce the motor speed in proportion to the decrease in power level. Here, in an alternative embodiment, the motor speed can be set in the discharge system (eg, automatically and / or manually as described herein). Further, in such an embodiment, the power level set by the generator 50640 can affect the set motor speed. In one aspect, the manually set motor speed can be changed based on the power level set by the generator 50640. In another aspect, the automatically set motor speed can be changed based on the power level set by the generator 50640.

FIG. 36 shows a graph display 54100 of particle number, power, voltage, and motor speed of surgical discharge systems such as, for example, discharge systems 50800 and 50900. The control circuit of the discharge system is configured to adjust the motor speed based on the parameters measured from the outside and the parameters measured internally. In one aspect of the present disclosure, the control circuits of FIGS. 5 and 6 can perform the illustrated motor speed adjustment. In FIG. 36, externally measured parameters are the power of the electrosurgical signal supplied to the electrosurgical instrument by the generator used in the surgical procedure (eg, the electrosurgical instrument 50630 by the generator 50640 in FIG. 7). It is a level. The parameter measured internally is the number of particles detected by an emission system such as, for example, the laser particle number counter 50838 of FIGS. 18 and 19. The reader will easily understand that in certain cases the motor speed can be adjusted based on one of the parameters measured externally or internally. In certain examples, additional internal or external parameters can be utilized to adjust the motor speed.

At time t _0, the motor speed is zero, the power level supplied to the electrosurgical instrument is zero, the number of particles detected by the particle sensor 50838 is zero. At time t _1, the first power level is supplied to the electrosurgical instrument by the generator. In one embodiment, the first power level can correspond to a solidification mode. In parallel with the increase in power level at time t _1, or immediately thereafter, the control circuit sends a drive signal to supply the starting current to the motor. The starting current _{results in a burst of motor speed 54102 between t 1} and t ₂ before the motor sets to baseline (eg idle) motor speed 54104. The baseline motor speed 54104 can correspond to, for example, the minimum torque required to rotate the pump. For example, as time _{approaches t 2} , the motor speed can correspond to sleep mode or silent mode, and the smoke evacuator is powered in anticipation of smoke generation. At time _{t 1,} the particle sensor 50 838 does not affect the motor speed.

At time _{t 2,} the particle sensor 50 838 increases the number of particles exceeds a minimum threshold 54110 corresponding to "active" mode for flue gas, detecting a first spike 54,106 of particle concentration. In response to the first spike 54 106, immediately after the time t _2, the control circuit, for example, by sending a second driving signal to supply a current increased to the motor, "active from the" silent "mode Increase the flow rate through the discharge system to mode. According to an increase of the flow rate, particle concentration, which is counted by the particle sensor 50838 starts to decrease between times t ₂ and time t _3. The control circuit actively monitors the output from the particle sensor 50838 and supplies the reduced current to the motor 50512 in proportion to the decreasing particle concentration detected by the particle sensor 50838 as the particle concentration decreases. The third drive signal is transmitted as described above. In other words, _{the motor speed between time t 2} and time t ₃ is proportional to the particle concentration detected by the particle sensor 50838.

At time _{t 3,} the first power level supplied by a the generator 50640 remains relatively constant between times _{t 1} and _{t 3} from the first power level 54,112 second power level 54114 Will be increased to. In one embodiment, the second power level 54114 can accommodate a disconnect mode. In accordance with an increase in the power level of the generator, immediately after the time t _3, the control circuit sends a third driving signal to supply a current increased motor, the flow through the exhaust system also again increase. For example, the motor speed may be changed in response to changes in the waveform at time t _3. In addition, due to the increased power level, the particle sensor 50838 detects a second spike 54108 of the counted particles. The third drive signal can cope with the increased particle concentration in the smoke. According to an increase in the motor speed, the particles counted by the particle sensor 50838 is reduced by between times t ₃ and t _4. Again, the control circuit actively monitors the particle sensor 50838 and drives the motor to supply a reduced current in proportion to the decrease in particle concentration detected by the particle sensor 50838. Send a signal.

At time t _4, a constant speed between the second power level 54114 supplied by a relatively constant while the was the generator, and the time t ₄ and t ₅ between times t ₃ and t ₄ Decreases with. Accordingly, after time t _4, also reduces particulate concentration detected by the particle sensor 50838. In fact, particle concentration is slightly below the minimum threshold 54,110 between times _{t 4} and time _{t 5,} and decreases to a level above the stop threshold value 54118, a relatively constant at around stop threshold value 54118 to the time _{t 5} Remains. In one example, this can accommodate the emission of residual smoke from the surgical site. The control circuit continues to monitor the particle sensor 50838 between times t ₄ and t _5, with the reduction in particle concentration between times t ₄ and time t _5, so as to reduce the current to the motor The subsequent drive signal is transmitted to.

At time _{t 5,} it is possible to detect the third spike 54,116 particulate concentration to increase the number of particles exceeds a minimum threshold 54,110 again by the particle sensor 50838. In one example, the additional smoke generated during the surgical procedure and detected by the particle sensor 50838 may be the result of tissue condition. For example, if the tissue dries during the procedure, additional smoke may be generated. According to an increase in the smoke at time t _5, the generator waveform is automatically adjusted to minimize smoke. For example, a generator can provide a third power level. Further, the voltage remained relatively constant first level between times t ₁ and time t _5, after a time t _5, decreases to a relatively constant second level until the time t ₆ .. In a particular example, the waveform adjusting 54122 at time t ₅ that power decreases increased voltage can be configured to generate less smoke.

According to the adjustment of the power level to the generator at time t _5, particle concentration detected by the particle sensor 50838 is steadily decreases between times t ₅ and t _6. At time t _6, the power level and the voltage of the generator, for example, it is reduced to zero, corresponding to the power-off state, such as at the completion of surgery process. Furthermore, particle concentration detected by the particle sensor 50838 is lowered below the stop threshold value 54118 at time _{t 6.} In response, the control circuit sends a drive signal to supply the motor with reduced current, reducing the motor speed to sleep or silent mode 54120.

In various examples, the drainage system can automatically detect and compensate for the use of the laparoscope. For example, the drainage system can automatically detect the laparoscopic mode of the surgical system. In laparoscopic surgery, gas (eg, carbon dioxide) is blown into the patient's body cavity to inflate the body cavity and create a working space and / or visual field space for the practitioner during the surgical procedure. By expanding the body cavity, it creates a pressurized cavity. In such an example, the discharge system disclosed herein senses a pressurized cavity and adjusts the parameters of the discharge system parameters, such as motor speed, according to the parameters of the pressurized cavity. Can be configured to:

For example, referring again to FIGS. 18 and 19, the pressure sensor 50840 can detect a pressure above a particular threshold pressure that can correspond to the pressure conventionally used in the insufflation. In such an example, the control circuit can first determine if the surgical procedure being performed is laparoscopic surgery. In a particular example, the control circuitry of the flue gas system (eg, processors 50308 and / or 50408 in FIGS. 5 and 6) queries a communicably connected surgical hub and / or cloud to perform laparoscopic surgery. It can be determined whether or not it has been implemented. For example, situational awareness can determine and / or confirm whether a laparoscopic procedure is being performed, as further described herein.

In a particular example, an external control circuit, such as a control circuit associated with a surgical hub, can query a communicably connected cloud. In another aspect, the drain system user interface can receive input from the practitioner. The control circuit can receive a signal from the user interface indicating that the surgical procedure being performed is laparoscopic surgery. If not laparoscopic surgery, the control circuit can determine if the filter is clogged and / or partially clogged as described herein. In the case of laparoscopic surgery, the control circuit can adjust the pressure detected by the pressure sensor 50840 by a predetermined amount to realize the pressure adjusted by the laparoscopic method with the sensor 50840. This laparoscopically adjusted pressure on the sensor 50840 can be utilized in various embodiments described herein in place of the actual pressure detected on the sensor 50840. In such an embodiment, this can avoid inappropriate and / or premature indication that the filter is clogged and / or partially clogged. Further, the above-mentioned adjustment can avoid unnecessary motor speed adjustment.

According to various aspects, the drainage system further senses such pressurized cavities, depending on the determination that the surgical procedure being performed is laparoscopic surgery, and drainage system parameters (eg, motors). Speed) can be adjusted. In such an embodiment, after a pressure sensor, such as the pressure sensor 50840, detects that the discharge system is being used in a pressurized environment, the control circuit laparoscopically sets one or more operating parameters of the motor. A drive signal can be transmitted to change to an effective discharge rate for laparoscopic treatment. In one embodiment, compensating for the applied pressure supplied by the pressurized cavity (eg, see FIG. 7, via the distal conduit opening 50634 near the tip of the surgical instrument 50630 and the suction hose 50636). To do so, the baseline (eg idle) motor speed and / or the upper limit motor speed can be adjusted and lowered. In such an example, after a pressure sensor, such as the pressure sensor 50840, detects that the discharge system is being used in a pressurized environment, the control circuit will respond to the pressure loss in the pressure sensor. The secondary threshold can be set and / or the established secondary threshold can be monitored.

If the pressure detected by the pressure sensor 50840 drops below such a secondary threshold, the drainage system can adversely affect the air supply at the surgical site. For example, adjustments to the motor speed may reduce the pressure at the pressure sensor 50840 to below the secondary threshold. In certain examples, a separate pressure sensor is placed on the electrosurgical instrument (ie, laparoscope) to first detect the pressurized cavity during laparoscopic surgery and / or monitor the pressure in the body cavity. It can be placed (as it is in the body cavity during the procedure). In such an embodiment, such a pressure sensor will send a signal to the control circuit to properly adjust the discharge system parameters (eg, motor speed) as described herein. ..

The reader will readily understand that the various surgical drainage systems and components described herein can be incorporated into computer-mounted interactive surgical systems, surgical hubs, and / or robotic systems. For example, a surgical drainage system can communicate data to a surgical hub, robotic system, and / or computer-mounted interactive surgical system and / or a surgical hub, robotic system, and / or computer-mounted interactive surgery. You can receive data from the system. Various examples of computer-mounted interactive surgical systems, robotic systems, and surgical hubs are further described below.

Computer Mounted Interactive Surgical System With reference to FIG. 39, the computer mounted interactive surgical system 100 may include one or more surgical systems 102 and a cloud-based system (eg, a remote server 113 coupled to a storage device 105). Cloud 104) and. 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. 39, 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. 40 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 includes 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 imaging 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 strict hygiene and sterilization conditions required for an "surgical theater," or operating room or treatment room, require the highest degree of sterilization of all medical equipment and devices. And. 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 with respect to the sterile field, one or more image processing units, and one or more storages, as shown in FIG. Includes an array 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. 40, the primary display 119 is placed 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 hub 106 is configured to use displays 107, 109, and 119 to coordinate the flow of information to operators inside and outside the sterile field. For example, the hub 106 causes the visualization system 108 to display a snapshot of the surgical site recorded by the imaging device 124 on the non-sterile display 107 or 109 while maintaining a live image of the surgical site on the primary display 119. Can be done. A snapshot 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 hub 106 sends diagnostic input or feedback input by a non-sterile operator located at the visualization tower 111 to the primary display 119 within the sterilization area in the sterilization field, which is a sterilization operation located on the operating table. It is also configured so that one can see it. 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 by the hub 106 to the primary display 119.

With reference to FIG. 40, the surgical instrument 112 is used as part of the surgical system 102 in the surgical procedure. The hub 106 is also configured to coordinate the flow of information to the display of the surgical instrument 112. For example, in 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 input by the non-sterile operator at the location of the visualization tower 111 may be sent by the hub 106 to the surgical instrument display 115 in the sterile field, where the diagnostic input or feedback is on the surgical instrument 112. It may be seen by the operator. 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. 41, the hub 106 is shown communicating with the visualization system 108, the robot system 110, and the handheld intelligent surgical instrument 112. The hub 106 includes a 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 embodiment, as shown in FIG. 41, the hub 106 further includes a smoke exhaust 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 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 hub housing and a combination generator module that is slidably acceptable within the docking station of the 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 further comprises a smoke exhaust component, at least one energy supply 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 a suction and irrigation module that is slidably received within the hub housing. In one aspect, the 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 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 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 a first docking station, 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. 41-45, an aspect of the present disclosure relating to a modular housing 136 of a hub that allows modular integration of a generator module 140, a smoke exhaust module 126, and a suction / irrigation module 128 is presented. Will be done. The modular housing 136 of the hub further facilitates bidirectional communication between the modules 140, 126, 128. As shown in FIG. 43, the generator module 140 is an integrated unipolar, bipolar, and integrated unipolar, bipolar, and supported within a single housing unit 139 that is slidably insertable into the modular housing 136 of the hub. It may be a generator module with ultrasonic components. As shown in FIG. 42, the generator module 140 can be configured to be connected 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 via the modular housing 136 of the hub. The modular housing 136 of the hub allows multiple generators to be inserted and bidirectional between the generators docked in the modular housing 136 of the hub so that the multiple generators function as a single generator. It may be configured to facilitate communication.

In one aspect, the modular enclosure 136 of the hub comprises modular power and with external and wireless communication headers to allow removable mounting of modules 140, 126, 128 and bidirectional communication between them. A communication backplane 149 is provided.

In one aspect, the modular housing 136 of the hub includes a docking station or drawer 151, also referred to herein as a drawer, configured to slidably receive modules 140, 126, 128. FIG. 43 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. The docking port 152, which has power and data contacts on the rear side of the combination generator module 145, is configured when the combination generator module 145 is slid into a position within the corresponding docking station 151 of the modular housing 136 of the hub. The corresponding docking port 150 is configured to engage the power and data contacts of the corresponding docking station 151 of the modular enclosure 136 of the hub. In one aspect, the combination generator module 145 comprises a bipolar, ultrasonic, and unipolar module and a smoke evacuator module integrated together within 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. The utility conduit and fluid line define a fluid path extending towards the smoke exhaust module 126 received within the 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 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 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 hub align the docking ports of the modules to the docking stations of the modular housing 136 of the hub. It may include an alignment mechanism configured to engage these corresponding components within. For example, as shown in FIG. 42, 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 hub. Includes 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 hub.

In some embodiments, the drawer 151 of the modular housing 136 of the 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. 43, 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 is housed in the modular housing 136 of the hub. Two-way communication can be facilitated. Alternatively, or further, the docking port 150 of the modular housing 136 of the hub may facilitate wireless bidirectional communication between the modules housed in the modular housing 136 of the hub. For example, any suitable wireless communication such as Air Titan-Bluetooth may be used.

FIG. 44 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. 44, the modules 161 are arranged laterally within the laterally modular housing 160. Alternatively, the module 161 may be arranged vertically within the laterally modular housing.

FIG. 45 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. 45, 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 placed 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, each of which is incorporated herein by reference in its entirety.

FIG. 46 shows modular devices 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, into a cloud-based system (eg, storage device 205). FIG. 6 shows a surgical data network 201 with a modular communication hub 203 configured to connect to a cloud 204) that may include a concatenated remote server 213. 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-2n 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 includes network hubs (s), network switches (s), and network routers (s) that connect devices 1a-1n / 2a-2m to the cloud. May include a combination of. 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 case various services such as servers, storage, and applications are used in the operating room. 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. 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. 47) 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. 47 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. 48, the modular control tower 236 includes a modular communication hub 203 connected to the computer system 210. As illustrated in the embodiment of FIG. 47, 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 evacuator module 226, and suction / It is coupled to an irrigation module 228, a communication module 230, a processor module 232, a storage array 234, a smart device / appliance 235 optionally coupled to a display 237, and a contactless 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. The modular control tower 236 may be coupled to a hub display 215 (eg, monitor, screen) to display and overlay images received from the imaging module, device / instrument display, and / or other visualization system 208. .. The hub display may also display data received from a device connected to the modular control tower along with images and overlay images.

FIG. 48 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. 48, the modular communication hub 203 is connected in a hierarchical configuration to expand the number of modules (eg, 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. 48, 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 operating room. "Surgical Hub Spatial Awarens With Operating Ro" in 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. As described in the section, the ultrasound-based non-contact sensor module transmits a burst of ultrasound and receives an echo as the burst of ultrasound reflects off the outer wall of the operating room. 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 Bluetooth 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 variety including, 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, using a flexible bus architecture.

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 is, for example, on-chip memory of 256 KB single cycle flash memory or other non-volatile memory up to 40 MHz, 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 StellarisWare® software (ROM), 2KB electrically erasable programmable read-only memory (EEPROM), and / or Texas, including one or more pulse width modulation (PWM) modules, one or more orthogonal encoder input (QEI) analogs, and one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels. It may be the LM4F230H5QR ARM Cortex-M4F processor core available from Instruments.

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 interface ports (s). Interface ports (s) include, for example, serial ports, parallel ports, game ports, and USB. The output device (s) uses 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 cloud computers (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, and typically Includes many or all of the elements described for computer systems. For brevity, only memory storage devices are shown along with remote computers (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. 48, the imaging module 238 and / or the visualization system 208 of FIG. 48, and / or the processor module 232 of FIGS. 47 and 48 are image processors, image processing engines, media processors, or Any dedicated digital signal processor (DSP) used to process digital images may be included. 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 a network interface to a 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. 49 shows a functional block diagram of one aspect of the USB network hub 300 device according to 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 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. 310 receives clock input 314 and suspend / resume logic as well to control communication between upstream USB transmit / receive ports 302 and downstream USB transmit / receive ports 304, 306, 308 via port logic circuits 320, 322, 324. It is connected to the frame timer 316 circuit and the 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.

Hardware for Surgical Instruments Figure 50 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 can be programmed or configured to determine the position of drive members that are longitudinally movable, as well as the positions 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, 256 KB single cycle flash memory up to 40 MHz or other non-volatile memory on-chip memory whose details are available in the product datasheet. Prefetch buffer for It may be an LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, which includes one or more 12-bit ADCs with 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 driver 492 may be A3941 available from Allegro Microsystems, Inc. Other motor drivers 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 driver 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 another configuration, the motor 482 may include a brushless motor, a cordless motor, a synchronous motor, a stepped motor, or any other suitable electric motor. The motor driver 492 may include, for example, an H-bridge driver 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 embodiment, the battery cell can be a lithium ion battery that can be coupled to and separable from the power assembly.

The motor driver 492 may be A3941 available from Allegro Microsystems, Inc. The A3941 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 driver 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. .. 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 drivers 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 members represent firing bars or I-beams, each of which may be adapted and configured to include a rack of drive teeth. Thus, as used herein, the term displacement member generally refers to any movement of a surgical instrument or tool, such as a drive member, launch member, launch bar, I-beam, or any element that can be displaced. Used to refer to a member. 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 linear 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. Magnetic sensing system with placed Hall effect sensors, magnetic sensing system with fixed magnets and Hall effect sensors placed on a series of movable straight lines, movable light sources and placed on a series of straight lines It may include an optical detection system with a magneto or photodetector, an optical detection system with a fixed light source and a reluctance or photodetector arranged on a series of movable straight lines, or any combination thereof. ..

The electric motor 482 may include a rotary shaft that operably interfaces with a gear assembly mounted in mesh engagement with a set or rack of drive teeth on the displacement member. 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 associated with the position sensor 472 corresponds to the longitudinal linear displacement d1 of the displacement member, where d1 is the displacement member from point "a" after one rotation of the sensor element connected to the displacement member. It is a linear distance in the longitudinal direction that moves 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, which applies logic to the longitudinal displacement d1 + d2 + of the displacement member. .. .. 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 to 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 (s) may be provided to measure the physical parameters of the physical system. In some embodiments, the other sensor (s), which is incorporated herein by reference in its entirety, is entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", US Pat. No. US Patent Application Publication No. 9,345,481, which is incorporated herein by reference in its entirety, entitled "STAPLE CARTRIDGE TISSUE TISSUE SENSOR SYSTEM", published September 18, 2014, and all inclusive U.S. Patent Application No. 25, June 20, 2017, U.S. A sensor mechanism such as a patent mechanism 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 members, 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 retracting or advancing to the zero or home) position.

A sensor 474, such as a strain gauge or microstrain gauge, can provide one or more parameters of the end effector, such as the amplitude of strain exerted on the anvil during clamping, which can indicate the closing force applied to the anvil. It is configured to measure. 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 drawn by the motor 482. The force required to advance the launching member can correspond to, for example, the current drawn by the electric 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 includes, for example, a strain gauge sensor 474, such as a micro strain gauge configured to measure one or more parameters of the end effector. In one aspect, the strain gauge sensor 474 can measure the amplitude or magnitude of strain exerted on the end effector jaw member during the gripping 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 FIG.

FIG. 51 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 can 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 processor 502, cause 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 can 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. 52 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 can 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. 53 shows a sequence logic circuit 520 configured to control aspects of a surgical instrument or tool according to an 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. 51) 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. 52) and a sequence logic circuit 520.

FIG. 54 shows a surgical instrument or tool with a plurality of 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 operably coupled to a launch motor drive assembly 604, which can be configured to transmit the launch motion generated by the motor 602 to the end effector, specifically to displace the I-beam element. May be done. In certain examples, the firing motion generated by the 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 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 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 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 may be activated independently or separately to perform one or more functions while the other motors remain stationary. Can be done. 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 embodiment, the common control module 610 is 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. It can be switched selectively. In at least one embodiment, as shown in FIG. 54, 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, separate common control modules 610 may be electrically connected to launch motors 602, closure motors 603, and joint motion motors 606a, 606b at the same time. 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. 54, the common control module 610 may include a motor driver 626 that may include one or more H-bridge FETs. The motor driver 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-temporary computer-readable media or memory units 624 (“memory”). In a particular example, memory 624 can store various program instructions that, when executed, can 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, the 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 driver 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 driver 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 features on-chip memory of up to 40 MHz 256 KB single-cycle flash memory or other non-volatile memory, with 40 MHz performance, among other characteristics readily available in the product datasheet. Prefetch buffer for super-improvement, 32KB single cycle SRAM, internal ROM with Non-volatile memory® software, 2KB EEPROM, 1 or more PWM modules, 1 or more QEI analogs, 12 analog inputs An ARM Cortex-M4F processor core containing one or more 12-bit ADCs with channels. 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 sensor 630, can be used to warn 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. Can use the program instructions associated with the closure of the anvil, for example, when it detects that the switch 614 is in the second position 617 via the sensor 630, 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. 55 is a schematic view 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 can be programmed or configured to individually control a launching member, a closing member, a shaft member, or one or more joint motion members. The surgical instrument 700 includes a control circuit 710 configured to control a motor-driven launching member, closing member, shaft member, 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 can 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 may include one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause the processor or multiple processors to perform one or more tasks. .. 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 determines 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. Can be done. The timer / counter 731 can be configured to measure elapsed time, count external events, or measure the time of 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 can generate a motor setpoint signal. Motor setpoint signals may be provided to various motor controllers 708a-708e. Motor controllers 708a-708e may include one or more circuits configured to provide motor drive signals to motors 704a-704e to drive motors 704a-704e, as described herein. .. 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, and each motor drive signal includes a PWM signal provided to one or more stator windings of the motors 704a-704e. But it may be. 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 742a, and joint motion 742b via their respective transmission mechanisms 706a-706e. May be good. Transmission mechanisms 706a-706e may include one or more gears or other connecting components for connecting motors 704a-704e to movable 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 embodiments, 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 can 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 step 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 can 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 a transmission mechanism 706a connected to the I beam 714. The transmission mechanism 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 can 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 setting point 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 a transmission mechanism 706b connected to the anvil 716. The transmission mechanism 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 setting point 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 a transmission mechanism 706c connected to the shaft 740. The transmission mechanism 706c includes movable mechanical elements such as rotating elements 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 mechanism 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 setting point 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 mechanism 706d connected to the joint movement member 742a. The transmission mechanism 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 708d, 708e. 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, the 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 embodiment 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 can cooperate with the control circuit 710 to provide an absolute positioning system. 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. Sensor 738 is placed 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. Any other suitable sensor for measuring the above parameters may be provided. The sensor 738 can include one or more sensors. The sensor 738 may be placed on the deck of the staple cartridge 718 to determine the position of the tissue using the divided 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 during the gripped 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 may be implemented as one or more limit switches, electromechanical devices, solid switches, Hall effect devices, magnetoresistive (MR) devices, giant magnetoresistive (GMR) devices, magnetometers, among others. Good. 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 can 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 can be placed at various points of interaction along the closure drive system to detect the closure force applied to the anvil 716 by the closure drive system. 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 can 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. 56 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 cutting edge), and an end effector 752 capable of containing a removable staple cartridge 768.

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, sensor mechanism, and position sensor 784. Since the I-beam 764 is connected to a drive member that can move in the longitudinal direction, the position of the I-beam 764 is determined by measuring the position of the drive member that can move in the longitudinal direction using the position sensor 784. be able to. 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 executes instructions to control a displacement member, eg, an I-beam 764, in a manner described by one or more microcontrollers, microprocessors, or processors or multiple processors. Other suitable processors may be provided. 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 specific 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 a motor setpoint signal 772. The motor set point 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 can 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 mechanism 756. The transmission mechanism 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 detect 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 embodiments, 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 can 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 step 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 can be located within the end effector 752 or at any other part of the instrument.

The control circuit 760 can communicate with one or more sensors 788. The sensor 788 is placed 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. Sensor 788 measures one or more parameters 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 may be provided for this purpose. The sensor 788 can include one or more sensors.

The 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 during 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 can be configured to measure the force exerted on the anvil 766 by the 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 by the closure tube on the anvil 766. 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 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 can 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 embodiment 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 obstacles 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 opposite the anvil 766. The clinician may grip the tissue between the anvil 766 and the staple cartridge 768 as described herein. When the instrument 750 is ready for use, 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. Can be done. 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 may include a control circuit 760 programmed to control the distal translation of a displacement member, eg, an I-beam 764, based on one or more tissue conditions. Good. 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. 57 is a schematic view of a surgical instrument 790 configured to control various functions according to 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 can 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 comprising 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 can cooperate with the control circuit 760 to provide an absolute positioning system. 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 with a knife body operably supporting the tissue cutting blade on top of the anvil engagement tab or feature and channel engagement 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 mechanisms, are incorporated herein by reference in their entirety, filed June 20, 2017, in US Patent Application No. 15 / 628,175 of the same applicant (titled "TECHNIQUES FOR ADAPTIVE". CONTOROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT ”).

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 mechanism, and a position sensor represented as a position sensor 784. Since the I-beam 764 is connected to a drive member that can move in the longitudinal direction, the position of the I-beam 764 is determined by measuring the position of the drive member that can move in the longitudinal direction using the position sensor 784. be able to. 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, as described herein. In some embodiments, the control circuit 760 executes instructions to control a displacement member, eg, an I-beam 764, in a manner described by one or more microcontrollers, microprocessors, or processors or multiple processors. Other suitable processors may be provided. 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 specific 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 a motor setpoint signal 772. The motor set point 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 embodiments, 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 can 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 mechanism 756. The transmission mechanism 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 detect 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 embodiments, 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 can 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 step 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 can be located within the end effector 792 or at any other part of the instrument.

The control circuit 760 can communicate with one or more sensors 788. The sensor 788 is placed on the end effector 792 and is 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. May be good. Sensor 788 measures one or more parameters 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 may be provided for this purpose. The sensor 788 can include one or more sensors.

The 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 during 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 can 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 by the closure tube on the anvil 766. 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 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 clamping operation by the processor portion 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 added 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.

Generator Hardware FIG. 58 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, filed June 23, 2015, entitled "SURGICAL GENERATION FOR ULTRASONIC AND ELECTROSURGICAL DEVICES", which is in its entirety. Incorporated herein by reference. 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. Provided with 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. Can be done. 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. The drive signal output units 810b and 810c 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. You may.

In certain forms, ultrasonic and electrosurgical drive signals are multifunctional surgical instruments capable of delivering both ultrasonic and electrosurgical energy to separate surgical instruments and / or tissues. May be supplied 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 incise tissue, while electrosurgical RF energy may be used to seal blood vessels.

The non-insulated stage 804 can 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 stage 804 is a logic for supplying a digital output to a digital-to-analog converter (DAC) circuit 818 that supplies a corresponding analog signal following the input of the power amplifier 812. Device 816 may be further included. In a particular form, the logic device 816 may include, for example, a programmable gate array (PGA), an FPGA, 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, 810c. Any of (amplitude) can be controlled. In certain embodiments, and as described below, the logical device 816, along with the processor (eg, the DSP described below), implements a number of DSP-based and / or other control algorithms to generate the generator 800. It is possible to control the parameters of the drive signal output by.

Power may be supplied to the power rails of the power amplifier 812 by a switch mode regulator 820, for example 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, which in one form is, for example, an Analog Devices ADSP-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 regulator 820 (eg, via a 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, implements a digital compositing circuit, such as a direct digital synthesizer control scheme, to produce the waveform shape, frequency, and / or amplitude of the drive signal output by the generator 800. You may control it. In one form, for example, the logical device 816 by calling a waveform sample stored in a dynamically updated look-up table (LUT), such as a RAM LUT that may be embedded in the FPGA. , DDS control algorithm 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 clear 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. The waveform shape of the drive signal output by the generator 800 is based on the drive signal because it is affected by various sources of distortion present in the output drive circuit (eg, power transformer 806, power amplifier 812). Voltage and current feedback data can be input to algorithms such as the error control algorithm performed by the DSP processor 822, which allows the waveform stored in the LUT dynamically and continuously (eg, in real time). Distortion is compensated by optionally pre-distorting or modifying the sample. 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 ADC circuit connected to the output section of the power transformer 806 via the insulated transformers 830 and 832 in order to sample the voltage and current of the drive signal output by the generator 800, respectively. 826 and a second ADC circuit 828 may be further provided. In certain embodiments, the ADC circuits 826, 828 are configured to sample at high speeds (eg, mega samples per second, MSPS) to allow oversampling of drive signals. Can be done. In one embodiment, 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 is, among other things, the calculation of complex currents flowing through the operating branch, which is used in certain forms to perform the DDS-based waveform shape control described above. It may be possible), accurate digital filtering of the sampled signal, and highly accurate calculation of actual power consumption. The voltage and current feedback data output by the ADC circuits 826, 828 can be received and processed by the logical device 816 (eg, first-in-first-out (FIFO) buffer, multiplexer). For example, it may be stored in the data memory for subsequent reading by the DSP processor 822. 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 logical device 816 when a voltage and current feedback data pair is obtained. It may be necessary for voltage and current feedback data pairs 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 may then be controlled to minimize or reduce the difference between the determined impedance phase and the impedance phase set point (eg 0 °), thus minimizing the effect of harmonic distortion. The impedance phase measurement accuracy is 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 logical 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, control of the current amplitude may be performed by a control algorithm, such as a proportional-integral-derivative (PID) control algorithm within the DSP processor 822. Variables controlled by the control algorithm in order to suitably control the current amplitude of the drive signal 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 USB interface), communication with footswitches, and input devices (eg, touch). Communication with a screen display) and communication with an output device (for example, a speaker) can be mentioned. The UI processor 836 can communicate with the DSP processor 822 and the logical device 816 (eg, via the SPI bus). The UI processor 836 may primarily support UI functions, but in certain embodiments, it may also work with the DSP processor 822 to mitigate the hazard. 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. If 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 performed 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 presented 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 to 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 verify that the requested transition is valid. If the UI processor 836 determines that the transition between the requested states is 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). it can. In certain embodiments, the controller 838 may include at least one processor and / or other 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). Can 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 (via a line from the generator 800's power supply, such as, for example, power supply 854 described below). You may. In this way, the controller 838 can continue to monitor the input device for turning the generator 800 on and off (eg, a 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 can power up if a user's activation of the "on / off" input device is detected (eg, one or more DCs of power supply 854). Enable the operation of the / DC voltage converter 856). As a result, the controller 838 can 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 for transitioning the generator 800 to the power off state. Can be done. In certain embodiments, for example, the controller 838 can report the activation of the "on / off" input device to the UI processor 836, resulting in the process sequence required to transition the generator 800 to the power off state. To carry out. In such a form, the controller 838 may not have the separate ability 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 for a surgical instrument (eg, a control circuit that includes a handpiece switch) and a non-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 with the components of insulation step 804. The instrument interface circuit 840 configures 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. Information can be exchanged with elements. 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 can 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 can be configured to receive a periodic signal (eg, a 2 kHz square wave) from the logic circuit 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, by 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. May be done. The control circuit may include a large number of switches, resistors, and / or diodes, and is one of the calling signals so that the state or configuration of the control circuit can be individually identified based on one or more characteristics. The above characteristics (for example, amplitude, rectification) may be modified. In one form, for example, the signal conditioning circuit 844 can include an ADC circuit for generating 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 a component of the 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 846 and is disposed in a surgical instrument or otherwise with a logic circuit 842 (or other element of the instrument interface circuit 840). Information may be exchanged with and from the associated first data circuit. In certain embodiments, for example, the first data circuit is in a cable integrally attached to the surgical instrument handpiece to interface with a particular surgical instrument type or model having a generator 800, or It may be located in the adapter. 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 includes suitable circuits (eg, separate logic devices, processors), the logic circuit 842 and the first. Communication with the data circuit may be enabled. 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 presented to the user via the output device and / or for controlling 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 communicated 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 removed from the handpiece). It may be 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 can 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 can 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 instead, any kind of information may be communicated to the second data circuit for internal storage via the second data circuit interface 848 (eg, logic circuit 842 is used). hand). 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, instrument-based temperature sensors). In certain embodiments, the second data circuit receives data from the generator 800 and provides the user with an indication (eg, a light emitting diode indication or other visible indication) based on the received data. May be good.

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 as an additional conductor (eg, a handpiece) for this purpose. Can be configured so that it can be provided without the need to provide a dedicated conductor of the cable connecting to the generator 800). In one form, a one-wire bus communication scheme implemented on existing cabling, for example, one of the conductors used transmits a call signal from the signal conditioning circuit 844 to the control circuit in the handpiece. Can be used to communicate information with 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 direct 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 current leakage from a point between the blocking capacitors 850-1 and 850-2 may occur, for example. It is monitored by the ADC circuit 852 to sample the voltage induced by the leakage current. The sample may be received, for example, by logic circuit 842. Based on the change in leakage current (as shown by the voltage sample), the generator 800 determines when at least one of the blocking capacitors 850-1, 850-2 fails and is therefore single. It can provide advantages over single capacitor designs with fault points.

In certain embodiments, the non-insulated step 804 can 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 further 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. Can be done. As mentioned above in connection with the controller 838, one or more of the DC / DC voltage converters 856 are input from the controller 838 when the controller 838 detects the activation of the "on / off" input device by the user. Can be received to enable the operation of the DC / DC voltage converter 856 or activate it.

FIG. 59 shows an example of the generator 900, which is a form of the generator 800 (FIG. 58). 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 to the surgical instrument between the terminals labeled ENERGY1 and RETURN. The second signal of the second energy modality is coupled over the capacitor 910 and provided to the surgical instrument between the terminals labeled ENERGY2 and RETURN. Three or more 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 two or more. It will be understood that it is a positive integer. It will also be appreciated that up to "n" return paths (RETURNn) may be provided without departing from the scope of this disclosure.

The first voltage sensing circuit 912 is connected over the terminals labeled ENERGY1 and RETURN paths and measures the output voltage between them. A second voltage sensing circuit 924 is connected over the terminals labeled ENERGY2 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 via 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 the first voltage sensing circuit 912 coupled over the terminals labeled ENERGY1 / RETURN or the second voltage sensing circuit 924 coupled over the terminals labeled ENERGY2 / RETURN. The output may 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 ENERGY1 may be ultrasonic energy and the second energy modality ENERGY2 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. 59 shows that a single return path RETURN may be provided for more than one energy modality, but in other embodiments, multiple return path RETURNn may be provided, respectively. It may be provided to the energy 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. 59, the generator 900, which includes at least one output port, powers, for example, ultrasound, bipolar or unipolar RF, irreversible and /, depending on the type of tissue treatment performed. Alternatively, a power transformer 908 having a single output and having multiple taps to provide to the end effector in the form of a reversible electropiercing method and / or one or more energy modalities such as microwave energy. Can include. 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 to the output of the generator 900 of the ultrasonic transducer will preferably be located between the output labeled ENERGY1 and the output labeled RETURN shown in FIG. 59. 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 ENERGY2 and the output labeled RETURN. For unipolar outputs, the preferred connection would be an active electrode (eg, pencil type or other probe) to a suitable return pad connected to the ENERGY2 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.

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, Long Term Evolution (LTE), Ev-DO, HSPA +, HSDPA +, HSUPA +, EDGE, GSM, GPRS. , CDMA, TDMA, DECT, Bluetooth, their Ethernet derivatives, as well as any other radio and wired protocols designated as 3G, 4G, 5G, and beyond, but not limited to many radios. Alternatively, either a wired communication standard or a protocol 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 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 a system-on-chip (SoC)) that combines many dedicated "processors".

As used herein, a system or system-on-chip (SoC or SOC) on a chip is also known as an integrated circuit (also known as an "IC" or "chip") that integrates all components of a computer or other electronic system. Is). 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, 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), one or more Available from Texas Instruments, including pulse width modulation (PWM) modules, one or more orthogonal encoder input (QEI) analogs, and one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels. LM4F230H5QR ARM Cortex-M4F processor core may be used.

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.

The modular device connects to a module that is acceptable within the surgical hub (eg, described in connection with FIGS. 41 and 48) and to various modules to connect or pair with the corresponding surgical hub. Includes surgical devices or instruments that can. 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 pressure) or the modular device itself (eg, forward knife speed, motor current, or 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.

Situational awareness Situational awareness is the ability of some aspects of a surgical system to determine or infer information related to a surgical procedure from data received from databases and / or instruments. The information can include the type of procedure being performed, the type of tissue being operated on, or the body cavity being treated. With contextual information related to the surgical procedure, the surgical system is connected to, for example, a modular device (eg, a robot arm and / or for robotic surgery) that provides the surgeon with contextualized information or suggestions during the surgical procedure. The method of controlling the tool) can be improved.

Here, with reference to FIG. 60, a timeline 5200 showing situational awareness of a hub, such as a surgical hub 106 or 206, is shown. Timeline 5200 is an exemplary surgical procedure and contextual information that the surgical hubs 106, 206 can derive from data received from a data source at each step of the surgical procedure. Timeline 5200 is taken by nurses, surgeons, and other healthcare professionals in the process of lung segment resection surgery, which begins with the establishment of an operating room and ends with the transfer of the patient to the postoperative recovery room. Here is a typical process that would be.

Situation Aware Surgical Hubs 106, 206 are data sources that include data generated each time a healthcare professional uses a modular device paired with Surgical Hubs 106, 206 throughout the surgical procedure. Receive from. Surgical hubs 106, 206 receive this data from paired modular devices and other data sources to receive new data such as which step of the procedure is being performed at any given time. Once done, estimates (ie, contextual information) about ongoing treatment can be continuously derived. The situation-aware system of surgical hubs 106, 206, for example, records data about the procedure to generate a report, validates the steps taken by healthcare professionals, data that may be relevant to a particular procedure step, or Providing a prompt (eg, via a display screen), adjusting a modular device based on context (eg, activating a monitor, adjusting the visibility (FOV) of a medical imaging device, or for ultrasound surgery It is possible to perform any of the above operations, such as changing the energy level of the instrument or RF electrosurgical instrument).

As a first step 5202 in this exemplary procedure, the hospital staff reads the patient's Electronic Medical Record (EMR) from the hospital's EMR database. Based on selected patient data in the EMR, surgical hubs 106, 206 determine that the procedure performed is a thoracic procedure.

In the second step 5204, the staff scans incoming medical supplies for treatment. Surgical hubs 106, 206 cross-reference the scanned supplies with a list of supplies used in various types of procedures to ensure that the mix of supplies corresponds to the thoracic procedure. In addition, the surgical hubs 106, 206 can also determine that the procedure is not a wedge-shaped procedure (the incoming supplies do not contain the specific supplies required for the thoracic wedge-shaped procedure, or otherwise the thoracic Either because it does not support wedge-shaped treatment).

In step 5206, the healthcare professional scans the patient's band via a scanner communicatively connected to the surgical hubs 106, 206. Subsequently, the surgical hubs 106, 206 can confirm the patient's identification information based on the scanned data.

In step 4 5208, the medical staff turns on the assistive device. Auxiliary devices utilized may vary depending on the type of surgical procedure and the technique used by the surgeon, but in this exemplary case, these include smoke evacuators, inhalers, and medical imaging devices. Upon activation, the modular device, the auxiliary device, can be automatically paired with surgical hubs 106, 206 located within a particular neighborhood of the modular device as part of its initialization process. .. The surgical hubs 106, 206 can then derive contextual information about the surgical procedure by detecting the type of modular device paired with it before or during this initialization phase. In this particular embodiment, surgical hubs 106, 206 determine that the surgical procedure is VATS surgery based on this particular combination of paired modular devices. Based on a combination of data from the patient's EMR, a list of medical supplies used in surgery, and the type of modular device connected to the hub, the surgical hubs 106, 206 generally perform specific procedures performed by the surgical team. Can be estimated. When the surgical hubs 106, 206 know what specific procedure is being performed, the surgical hubs 106, 206 are subsequently connected, reading the procedure steps from memory or from the cloud. Data subsequently received from other data sources (eg, modular and patient monitoring devices) can be cross-referenced to estimate which step of the surgical procedure is being performed by the surgical team.

In the fifth step 5210, the staff attaches the EKG electrode and other patient monitoring device to the patient. EKG electrodes and other patient monitoring devices can be paired with surgical hubs 106, 206. When the surgical hubs 106, 206 start receiving data from the patient monitoring device, the surgical hubs 106, 206 confirm that the patient is in the operating room.

In step 5212, the healthcare professional induces anesthesia in the patient. Surgical hubs 106, 206 indicate that the patient is under anesthesia, based on data from modular and / or patient monitoring devices, including, for example, EKG data, blood pressure data, ventilator data, or a combination thereof. Can be estimated. When the sixth step 5212 is completed, the preoperative part of the lung segment resection surgery is completed and the surgical part is started.

In step 5214, the operated patient's lungs are collapsed (while ventilation is switched to the contralateral lungs). Surgical hubs 106, 206 can, for example, estimate from ventilator data that the patient's lungs have collapsed. Surgical hubs 106, 206 can compare the detection of collapse of the patient's lungs with the expected steps of the procedure (which can be pre-accessed or read) so that the surgical portion of the procedure It can be presumed that it has begun, thereby collapsing the lungs, which can be determined to be the first surgical step in this particular procedure.

In the eighth step 5216, a medical imaging device (eg, a scope) is inserted and a video image from the medical imaging device is started. Surgical hubs 106, 206 receive medical imaging device data (ie, video or image data) through a connection to a medical imaging device. Upon receiving the medical imaging device data, the surgical hubs 106, 206 can determine that the laparoscopic portion of the surgical procedure has begun. In addition, surgical hubs 106, 206 can determine that the particular procedure being performed is a segmental resection as opposed to a lobectomy (in the data received in the second step 5204 of the procedure). Note that the wedge procedure has already been discounted by the surgical hubs 106, 206). The data from the medical imaging device 124 (FIG. 40) has been used (ie, activated) by determining the angle of the medical imaging device that is oriented with respect to the visualization of the patient's anatomy. Of many different methods, including by monitoring the number or medical imaging device (paired with surgical hubs 106, 206) and by monitoring the type of visualization device used. It may be used to determine contextual information about the type of action being taken from. For example, one technique for performing a VATS lobectomy is to place the camera above the diaphragm in the anterior inferior corner of the patient's chest cavity, while one technique for performing a VATS segmental resection is a camera. Is placed at the anterior intercostal position with respect to the segmental fissure. For example, using pattern recognition or machine learning techniques, a situation recognition system can be trained to recognize the location of a medical imaging device based on a visualization of the patient's anatomical structure. As another example, one technique for performing VATS lobectomy utilizes a single medical imaging device, while another technique for performing VATS segmental resection utilizes multiple cameras. .. As yet another embodiment, one technique for performing VATS segmental resection uses an infrared light source (which can be communicatively linked to a surgical hub as part of a visualization system) to visualize segmental fissures. However, it is not used in VATS lobectomy. By tracking any or all of this data from a medical imaging device, surgical hubs 106, 206 are used for a particular type of surgical procedure in progress and / or a particular type of surgical procedure. You can determine which technology you have.

In step 5218, the surgical team initiates the procedure incision step. The surgical hubs 106, 206 are presumed to be in the process of the surgeon incising and separating the patient's lungs to receive data from the RF or ultrasound generator indicating that the energy device is being fired. Can be done. Surgical hubs 106, 206 cross-reference the received data with the read process of the surgical procedure and the energy fired at this point in the process (ie, after the procedure of the procedure described above is complete). It can be determined that the instrument is compatible with the incision process. In certain examples, the energy instrument can be an energy tool attached to the robot arm of a robotic surgical system.

In step 10 5220, the surgical team proceeds to the procedure ligation step. Since the surgical hubs 106, 206 receive data from surgical staples and cutting instruments indicating that the instrument is being fired, it can be presumed that the surgeon is ligating the arteries and veins. Similar to the previous step, surgical hubs 106, 206 can derive this estimate by cross-referencing the reception of data from surgical staples and cutting instruments with the steps in the read process. .. In certain examples, the surgical instrument can be a surgical tool attached to the robot arm of a robotic surgical system.

In step 5222, a segmental excision portion of the procedure is performed. Surgical hubs 106, 206 can be presumed that the surgeon is making a transverse incision in parenchymal tissue based on data from surgical staples and cutting instruments, including data from the cartridge. The data in the cartridge can correspond, for example, to the size or type of staple fired by the instrument. Since different types of staples are utilized for different types of tissue, the cartridge data can indicate the type of tissue that is stapled and / or traversed. In this case, the type of staple fired is used for parenchymal tissue (or other similar tissue type), thereby presuming that surgical hubs 106, 206 are performing a segmental resection of the procedure. Can be done.

Subsequently, in the twelfth step 5224, a nodule incision step is performed. Surgical hubs 106, 206 are presumed to have a surgical team incising a nodule and performing a leak test based on data received from a generator indicating that an RF or ultrasonic instrument is being fired. Can be done. For this particular procedure, the RF or ultrasound instrument used after the parenchymal tissue has been transversely incised corresponds to a nodular incision process that allows the surgical hubs 106, 206 to make this estimate. It will be possible. Surgeons regularly staple / cut instruments and surgical energy (ie, RF or ultrasound), depending on the particular step during the procedure, because different instruments better fit to a particular task. ) Note that it alternates between the instrument and the device. Thus, the particular sequence in which stapled / cutting instruments and surgical energy instruments are used can indicate which step of the procedure the surgeon is performing. Further, in certain examples, robotic tools can be used for one or more steps during a surgical procedure and / or handheld surgical instruments can be used for one or more steps during a surgical procedure. The surgeon (s) can, for example, alternate between robotic tools and handheld surgical instruments in sequence and / or, for example, the devices can be used simultaneously. Upon completion of the twelfth step 5224, the incision is closed and the postoperative portion of the procedure begins.

In step 5226, the patient's anesthesia is reversed. Surgical hubs 106, 206 can be estimated, for example, based on ventilator data (ie, the patient's respiratory rate begins to increase) that the patient is awakening from anesthesia.

Finally, the fourteenth step 5228 is for the healthcare professional to remove various patient monitoring devices from the patient. Therefore, surgical hubs 106, 206 can presume that the patient is being transferred to the recovery room when the hub loses other data from the EKG, BP, and patient monitoring device. As can be seen from the description of this exemplary procedure, the surgical hubs 106, 206 are given a given surgical procedure, based on data received from various data sources communicatively linked to the surgical hubs 106, 206. It is possible to determine or estimate when each step of is occurring.

Situational awareness is further described 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. ing. In certain examples, the operation of a robotic surgical system, including, for example, the various robotic surgical systems disclosed herein, is based on its situational awareness and / or feedback from its components and / or from the cloud 104. It may be controlled by hubs 106 and 206 based on the information in.

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

Example 1-A surgical drainage system comprising a pump, a motor operably connected to the pump, a flow path fluidly connected to the pump, and a sensor system. The sensor system includes a first pressure sensor and a second pressure sensor. The first pressure sensor is arranged along the flow path. The second pressure sensor is arranged along the flow path upstream of the first pressure sensor. The surgical drainage system further comprises a control circuit configured to determine the pressure difference between the first pressure sensor and the second pressure sensor. The control circuit is further configured to adjust the operating parameters of the motor based on the pressure difference.

Example 2-The surgical discharge system according to Example 1, further comprising a receptacle and a filter installed within the receptacle. The first pressure sensor is located downstream of the filter and the second pressure sensor is located upstream of the filter.

Example 3-The surgical discharge system according to Example 1 or 2, wherein the control circuit is configured to increase the speed of the motor as the pressure difference increases above a threshold amount.

Example 4-A fluid trap is further provided, the first pressure sensor is located downstream of the fluid trap, and the second pressure sensor is located upstream of the fluid trap. Or the surgical drain system according to 3.

Example 5-The surgical drain system according to Example 4, wherein the pressure difference indicates the flow path to the fluid trap.

Example 6-A housing including an inlet and an outlet is further provided, a flow path extends between the inlet and the outlet, a first pressure sensor is located adjacent to the outlet, and a second pressure sensor. , The surgical drainage system according to Example 1, 2, 3, 4, or 5, which is located adjacent to the entrance.

Example 7-The surgical drain system according to Example 1, 2, 3, 4, 5, or 6, wherein the control circuit is configured to maintain a suction load on the pump below the maximum suction load.

Example 8-The surgical discharge system according to Example 1, 2, 3, 4, 5, 6, or 7, wherein the control circuit comprises a processor communicatively coupled to the sensor system. The control circuit further comprises a memory communicatively attached to the processor, which stores instructions that can be executed by the processor.

Example 9-A surgical drainage system comprising a pump comprising a motor, a flow path fluidly connected to the pump, and a sensor system. The sensor system includes a first pressure sensor and a second pressure sensor. The first pressure sensor is arranged along the flow path to detect the first pressure. The second pressure sensor is arranged along the upstream flow path of the first pressure sensor to detect the second pressure. The surgical drainage system further comprises a control circuit configured to determine the ratio of the second pressure to the first pressure and to determine the operating state of the surgical drainage system based on that ratio.

Example 10-The surgical discharge system according to Example 9, wherein the control circuit is further configured to adjust the operating parameters of the motor based on the operating state of the surgical discharge system.

Example 11-The surgical drainage system according to Example 9 or 10, further comprising a receptacle and a filter installed within the receptacle. The first pressure sensor is located downstream of the filter. The second pressure sensor is located upstream of the filter.

Example 12-The surgery according to Example 9, 10, or 11, wherein the control circuit is further configured to increase the speed of the motor in proportion to the ratio of the second pressure to the first pressure. Discharge system for.

Example 13-A fluid trap is further provided, the first pressure sensor is located downstream of the fluid trap, the second pressure sensor is located upstream of the fluid trap, and the operating state is the fluid trap. The surgical drain system according to Example 9, 10, 11, or 12, which corresponds to the flow path for.

Example 14-A housing including an inlet and an outlet is further provided, a flow path extends between the inlet and the outlet, a first pressure sensor is located adjacent to the outlet, and a second pressure. The sensor is located adjacent to the inlet and the control circuit is further configured to maintain the suction load on the pump below the maximum suction load, Examples 9, 10, 11, 12, or 13. The surgical drainage system described in.

Example 15-The surgical discharge system according to Example 9, 10, 11, 12, 13, or 14, wherein the control circuit comprises a processor communicatively coupled to the sensor system. The control circuit further comprises a memory communicatively attached to the processor, which stores instructions that can be executed by the processor.

Example 16-A non-temporary computer-readable medium that stores computer-readable instructions, the computer-readable instructions, when executed, are first placed on the machine along a flow path through a surgical discharge system. The first signal is received from the sensor, the second signal is received from the second sensor arranged along the flow path through the surgical discharge system, and based on the first signal and the second signal, A non-temporary computer-readable medium that allows the operating status of a surgical drainage system to be determined and the operating parameters of the surgical drainage system adjusted based on the operating status.

Example 17-The non-transitory computer-readable medium of Example 16, wherein the first sensor comprises a first pressure sensor and the second sensor comprises a second pressure sensor.

Example 18-The non-transitory computer-readable medium according to Example 16 or 17, wherein the operating state corresponds to the state of the filtration system of the surgical drainage system.

Example 19-In Example 18, when a computer-readable instruction is executed, the machine increases the speed of the pump motor of the surgical discharge system when the state of the filtration system has a partially blocked condition. The non-temporary computer-readable medium described.

20-The non-transitory computer-readable medium according to Example 16, 17, 18, or 19, wherein the computer-readable instruction, when executed, causes the machine to redirect the flow path through the surgical discharge system.

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, such block diagrams, flowcharts, and / or embodiments should be understood by those skilled in the art. Each feature and / or operation included 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 are as one or more computer programs running on one or more computers (eg, one or more). As one or more programs running on a computer system), as one or more programs running on one or more processors (eg, as one or more programs running on one or more microprocessors). It can be equivalently implemented on an integrated circuit as firmware, or in virtually any combination thereof, and designing the circuit and / or writing software and / or firmware code is a task. In view of the disclosure, it will be understood that it is included within the skill of those skilled in the art. Further, as will be appreciated by those skilled in the art, the mechanisms of the subject matter described herein can be distributed in a variety of forms as one or more program products, and the subject matter described herein. The specific form of is used regardless of the particular type of signal carrier used to actually carry out the distribution.

Instructions used to program logic to perform various disclosed aspects can be stored in in-system memory such as dynamic random access memory (DRAM), cache, flash memory, or other storage. In addition, instructions can be distributed over the network or by other computer-readable media. Therefore, the machine-readable medium may include any mechanism for storing or transmitting information in a form readable by a machine (for example, a computer), such as a floppy diskette, an optical disk, a compact disk, or a read-only memory (CD). -ROM), as well as magnetic optical disks, read-only memory (ROM), random access memory (RAM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), magnetic or optical cards, Tangible machine readable used to transmit information over the Internet via flash memory or electrical, optical, acoustic, or other forms of propagating signals (eg, carriers, infrared signals, digital signals, etc.) Not limited to storage. 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 in any aspect of the specification, the term "control circuit" refers to, for example, a hard-wired circuit, a programmable circuit (eg, a computer processor, a processing unit, a processor, including one or more individual instruction processing cores). Executed by a microcontroller, a microcontroller unit, a controller, a digital signal processor (DSP), a programmable logic device (PLD), a programmable logic array (PLA), or a field programmable gate array (FPGA)), a state machine circuit, a programmable circuit. It can refer to a firmware that stores instructions, and any combination thereof. 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 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 includes an Ethernet communication protocol that can enable communication using a transmission control protocol / Internet Protocol (TCP / IP). The Ethernet protocol conforms to or is compatible with the title "IEEE802.3 Standard" published by the Institute of Electrical and Electronics Engineers (IEEE) in December 2008, and / or later versions of the Ethernet standard. There can be. 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 may conform to or be compatible with the ATM standard published in August 2001 under the title "ATM-MPLS Network Interworking 2.0" by the ATM Forum and / or later versions of this standard. .. Not surprisingly, connection-oriented network communication protocols developed differently and / or later are equally contemplated herein.

Unless otherwise specified, as is clear from the above disclosure, "process", "calculate", "calculate", "determine", "display" through the entire above disclosure. Discussions that use terms such as computer system registers and data expressed as physical (electronic) quantities in memory, computer system memory or registers or other such information storage, transmission, or display devices. It will be understood that it refers to the operation and processing of a computer system or similar electronic computing device that manipulates and transforms into other data that is similarly expressed as physical quantity within.

One or more components are "configured to", "configurable to", and "operable / behave" herein. "Compatible / cooperative to", "adapted / adaptive to", "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, it will be further understood that spatial terms such as "vertical", "horizontal", "top", and "bottom" can be used with respect to the drawings herein. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limited and / or absolute.

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, whether in the specification, unless the context requires other meanings. It should be understood that it is intended to include one of those terms, any of those terms, or both, whether within the claims or in the drawings. Those skilled in the art will understand that there is. 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. Further, although the flow charts of various operations are shown in a sequence (s), the various operations may be performed in an order other than those illustrated, or may be performed at the same time. Should be understood. 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. Absent. 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 of one or more forms is presented for purposes of illustration and description. 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 illustrate the principles and practical applications, thereby making different forms available to those skilled in the art as suitable for the particular application conceived, along with various modifications. It has been selected and described. The claims presented with this specification are intended to define the overall scope.

[Implementation mode]
(1) With a pump
With a motor operably connected to the pump,
A flow path fluidly connected to the pump and
It ’s a sensor system,
A first pressure sensor arranged along the flow path and
A second pressure sensor arranged along the flow path upstream of the first pressure sensor,
Including sensor system and
It ’s a control circuit,
The pressure difference between the first pressure sensor and the second pressure sensor is determined, and the pressure difference is determined.
Adjusting the operating parameters of the motor based on the pressure difference,
The control circuit, which is configured as
Surgical drainage system.
(2) Receptacle and
With the filter installed in the receptacle,
The first pressure sensor is arranged downstream of the filter, and the second pressure sensor is arranged upstream of the filter.
The surgical drainage system according to embodiment 1.
(3) The surgical discharge system according to embodiment 2, wherein the control circuit is configured to increase the speed of the motor when the pressure difference increases above a threshold amount.
(4) The first embodiment is further provided with a fluid trap, the first pressure sensor is arranged downstream of the fluid trap, and the second pressure sensor is arranged upstream of the fluid trap. The surgical drainage system described in.
(5) The surgical drainage system according to embodiment 4, wherein the pressure difference indicates the flow path to the fluid trap.

(6) A housing including an inlet and an outlet is further provided, the flow path extends between the inlet and the outlet, and the first pressure sensor is arranged adjacent to the outlet. The surgical discharge system according to embodiment 1, wherein the pressure sensor of 2 is arranged adjacent to the inlet.
(7) The surgical discharge system according to embodiment 6, wherein the control circuit is configured to maintain a suction load on the pump below the maximum suction load.
(8) The control circuit is
With a processor communicatively connected to the sensor system,
A memory that is communicatively connected to the processor and
The memory stores instructions that can be executed by the processor.
The surgical drainage system according to embodiment 1.
(9) Surgical drainage system
With a pump including a motor,
A flow path fluidly connected to the pump and
It ’s a sensor system,
A first pressure sensor arranged along the flow path to detect the first pressure,
A second pressure sensor arranged along the flow path upstream of the first pressure sensor to detect the second pressure, and a second pressure sensor.
Including sensor system and
It ’s a control circuit,
The ratio of the second pressure to the first pressure is determined and
The operating state of the surgical drainage system is determined based on the ratio.
With the control circuit configured as
Surgical drainage system.
(10) The surgical discharge system according to embodiment 9, wherein the control circuit is further configured to adjust operating parameters of the motor based on the operating state of the surgical discharge system.

(11) With the receptacle
With the filter installed in the receptacle,
The first pressure sensor is arranged downstream of the filter, and the second pressure sensor is arranged upstream of the filter.
The surgical drainage system according to embodiment 10.
(12) The surgical discharge system according to embodiment 11, wherein the control circuit is further configured to increase the speed of the motor in proportion to the ratio.
(13) Further including a fluid trap, the first pressure sensor is arranged downstream of the fluid trap, and the second pressure sensor is arranged upstream of the fluid trap, and the operating state. 9 is the surgical drainage system according to embodiment 9, which corresponds to the flow path for the fluid trap.
(14) A housing including an inlet and an outlet is further provided, the flow path extends between the inlet and the outlet, and the first pressure sensor is arranged adjacent to the outlet. In embodiment 9, the second pressure sensor is disposed adjacent to the inlet and the control circuit is further configured to maintain a suction load on the pump below the maximum suction load. The surgical drainage system described.
(15) The control circuit is
With a processor communicatively connected to the sensor system,
A memory that is communicatively connected to the processor and
The memory stores instructions that can be executed by the processor.
The surgical drainage system according to embodiment 9.

(16) A non-temporary computer-readable medium that stores computer-readable instructions, and when the computer-readable instructions are executed, the machine receives the computer-readable instructions.
A first signal is received from a first sensor located along a flow path through the surgical drainage system.
A second signal is received from a second sensor located along the flow path through the surgical drainage system.
Based on the first signal and the second signal, the operating state of the surgical discharge system is determined.
The operating parameters of the surgical drainage system are adjusted based on the operating condition.
Non-temporary computer-readable medium.
(17) The non-transitory computer-readable medium according to embodiment 16, wherein the first sensor includes a first pressure sensor, and the second sensor includes a second pressure sensor.
(18) The non-transitory computer-readable medium according to embodiment 16, wherein the operating state corresponds to the state of the filtration system of the surgical discharge system.
(19) When executed, the computer-readable instruction increases the speed of the pump motor of the surgical discharge system when the machine has a state in which the state of the filtration system is partially blocked. The non-transitory computer-readable medium according to embodiment 18.
(20) The non-transitory computer-readable medium of embodiment 16, wherein the computer-readable instruction, when executed, causes the machine to redirect the flow path through the surgical discharge system.

Claims (20)

With a pump
With a motor operably connected to the pump,
A flow path fluidly connected to the pump and
It ’s a sensor system,
A first pressure sensor arranged along the flow path and
A second pressure sensor arranged along the flow path upstream of the first pressure sensor,
Including sensor system and
It ’s a control circuit,
The pressure difference between the first pressure sensor and the second pressure sensor is determined, and the pressure difference is determined.
Adjusting the operating parameters of the motor based on the pressure difference,
The control circuit, which is configured as
Surgical drainage system. Receptacle and
With the filter installed in the receptacle,
The first pressure sensor is arranged downstream of the filter, and the second pressure sensor is arranged upstream of the filter.
The surgical drainage system according to claim 1. The surgical discharge system according to claim 2, wherein the control circuit is configured to increase the speed of the motor when the pressure difference increases above a threshold amount. The first aspect of claim 1, further comprising a fluid trap, wherein the first pressure sensor is located downstream of the fluid trap and the second pressure sensor is located upstream of the fluid trap. Surgical drainage system. The surgical drainage system of claim 4, wherein the pressure difference indicates the flow path to the fluid trap. A housing including an inlet and an outlet is further provided, the flow path extends between the inlet and the outlet, the first pressure sensor is located adjacent to the outlet, and the second pressure. The surgical discharge system according to claim 1, wherein the sensor is arranged adjacent to the entrance. The surgical drainage system of claim 6, wherein the control circuit is configured to maintain a suction load on the pump below the maximum suction load. The control circuit
With a processor communicatively connected to the sensor system,
A memory that is communicatively connected to the processor and
The memory stores instructions that can be executed by the processor.
The surgical drainage system according to claim 1. Surgical drainage system
With a pump including a motor,
A flow path fluidly connected to the pump and
It ’s a sensor system,
A first pressure sensor arranged along the flow path to detect the first pressure,
A second pressure sensor arranged along the flow path upstream of the first pressure sensor to detect the second pressure, and a second pressure sensor.
Including sensor system and
It ’s a control circuit,
The ratio of the second pressure to the first pressure is determined and
The operating state of the surgical drainage system is determined based on the ratio.
With the control circuit configured as
Surgical drainage system. The surgical discharge system according to claim 9, wherein the control circuit is further configured to adjust operating parameters of the motor based on the operating state of the surgical discharge system. Receptacle and
With the filter installed in the receptacle,
The first pressure sensor is arranged downstream of the filter, and the second pressure sensor is arranged upstream of the filter.
The surgical drainage system according to claim 10. The surgical discharge system according to claim 11, wherein the control circuit is further configured to increase the speed of the motor in proportion to the ratio. A fluid trap is further provided, the first pressure sensor is arranged downstream of the fluid trap, the second pressure sensor is arranged upstream of the fluid trap, and the operating state is the said. The surgical drainage system according to claim 9, which corresponds to the flow path for a fluid trap. A housing including an inlet and an outlet is further provided, the flow path extends between the inlet and the outlet, the first pressure sensor is arranged adjacent to the outlet, and the second. 9. The surgery according to claim 9, wherein the pressure sensor is located adjacent to the inlet and the control circuit is further configured to maintain a suction load on the pump below the maximum suction load. Discharge system for. The control circuit
With a processor communicatively connected to the sensor system,
A memory that is communicatively connected to the processor and
The memory stores instructions that can be executed by the processor.
The surgical drainage system according to claim 9. A non-transitory computer-readable medium that stores computer-readable instructions, said computer-readable instructions to the machine when executed.
A first signal is received from a first sensor located along a flow path through the surgical drainage system.
A second signal is received from a second sensor located along the flow path through the surgical drainage system.
Based on the first signal and the second signal, the operating state of the surgical discharge system is determined.
The operating parameters of the surgical drainage system are adjusted based on the operating condition.
Non-temporary computer-readable medium. The non-temporary computer-readable medium according to claim 16, wherein the first sensor includes a first pressure sensor, and the second sensor includes a second pressure sensor. The non-transitory computer-readable medium according to claim 16, wherein the operating state corresponds to the state of the filtration system of the surgical drainage system. The computer-readable instruction, when executed, increases the speed of the pump motor of the surgical discharge system when the machine has a state in which the state of the filtration system is partially blocked. Non-temporary computer-readable medium described in. The non-transitory computer-readable medium of claim 16, wherein the computer-readable instruction, when executed, causes the machine to redirect the flow path through the surgical discharge system.

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