JP2021514786A - 適応型高度組織治療パッドセーバモード - Google Patents
適応型高度組織治療パッドセーバモード Download PDFInfo
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- JP2021514786A JP2021514786A JP2020546909A JP2020546909A JP2021514786A JP 2021514786 A JP2021514786 A JP 2021514786A JP 2020546909 A JP2020546909 A JP 2020546909A JP 2020546909 A JP2020546909 A JP 2020546909A JP 2021514786 A JP2021514786 A JP 2021514786A
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Abstract
Description
本願は、その開示全体が参照により本明細書に組み込まれる、2018年9月27日に出願された「ADAPTIVE ADVANCED TISSUE TREATMENT PAD SAVER MODE」と題する米国特許非仮出願第16/144,423号に対する優先権の利益を主張する。
・「METHODS FOR CONTROLLING TEMPERATURE IN ULTRASONIC DEVICE」と題する米国特許仮出願、代理人整理番号END8560USNP1/180106−1M、
・「ULTRASONIC SEALING ALGORITHM WITH TEMPERATURE CONTROL」と題する米国特許仮出願、代理人整理番号END8560USNP3/180106−3、
・「APPLICATION OF SMART ULTRASONIC BLADE TECHNOLOGY」と題する米国特許仮出願、代理人整理番号END8560USNP4/180106−4、
・「SMART BLADE TECHNOLOGY TO CONTROL BLADE INSTABILITY」と題する米国特許仮出願、代理人整理番号END8560USNP6/180106−6、及び
・「START TEMPERATURE OF BLADE」と題する米国特許仮出願、代理人整理番号END8560USNP7/180106−7。
・「METHODS FOR ESTIMATING AND CONTROLLING STATE OF ULTRASONIC END EFFECTOR」と題する米国特許仮出願、代理人整理番号END8536USNP1/180107−1M、
・「IN−THE−JAW CLASSIFIER BASED ON MODEL」と題する米国特許仮出願、代理人整理番号END8536USNP3/180107−3、
・「APPLICATION OF SMART BLADE TECHNOLOGY」と題する米国特許仮出願、代理人整理番号END8536USNP4/180107−4、
・「SMART BLADE AND POWER PULSING」と題する米国特許仮出願、代理人整理番号第END8536USNP5/180107−5、
・「ADJUSTMENT OF COMPLEX IMPEDANCE TO COMPENSATE FOR LOST POWER IN AN ARTICULATING ULTRASONIC DEVICE」と題する米国特許仮出願、代理人整理番号END8536USNP6/180107−6、
・「USING SPECTROSCOPY TO DETERMINE DEVICE USE STATE IN COMBO INSTRUMENT」と題する米国特許仮出願、代理人整理番号END8536USNP7/180107−7、
・「VESSEL SENSING FOR ADAPTIVE ADVANCED HEMOSTASIS」と題する米国特許仮出願、代理人整理番号END8536USNP8/180107−8、
・「CALCIFIED VESSEL IDENTIFICATION」と題する米国特許仮出願、代理人整理番号END8536USNP9/180107−9、
・「DETECTION OF LARGE VESSELS DURING PARENCHYMAL DISSECTION USING A SMART BLADE」と題する米国特許仮出願、代理人整理番号END8536USNP10/180107−10、
・「SMART BLADE APPLICATION FOR REUSABLE AND DISPOSABLE DEVICES」と題する米国特許仮出願、代理人整理番号END8536USNP11/180107−11、
・「LIVE TIME TISSUE CLASSIFICATION USING ELECTRICAL PARAMETERS」と題する米国特許仮出願、代理人整理番号END8536USNP12/180107−12、及び
・「FINE DISSECTION MODE FOR TISSUE CLASSIFICATION」と題する米国特許仮出願、代理人整理番号END8536USNP13/180107−13。
・「AUTOMATED DATA SCALING,ALIGNMENT,AND ORGANIZING BASED ON PREDEFINED PARAMETERS WITHIN A SURGICAL NETWORK BEFORE TRANSMISSION」と題する米国特許仮出願第62/729,177号、
・「SENSING THE PATIENT POSITION AND CONTACT UTILIZING THE MONO−POLAR RETURN PAD ELECTRODE TO PROVIDE SITUATIONAL AWARENESS TO THE HUB」と題する米国特許仮出願第62/729,182号、
・「POWERED SURGICAL TOOL WITH A PREDEFINED ADJUSTABLE CONTROL ALGORITHM FOR CONTROLLING AT LEAST ONE END−EFFECTOR PARAMETER AND A MEANS FOR LIMITING THE ADJUSTMENT」と題する米国特許仮出願第62/729,184号、
・「SURGICAL NETWORK RECOMMENDATIONS FROM REAL TIME ANALYSIS OF PROCEDURE VARIABLES AGAINST A BASELINE HIGHLIGHTING DIFFERENCES FROM THE OPTIMAL SOLUTION」と題する米国特許仮出願第62/729,183号、
・「A CONTROL FOR A SURGICAL NETWORK OR SURGICAL NETWORK CONNECTED DEVICE THAT ADJUSTS ITS FUNCTION BASED ON A SENSED SITUATION OR USAGE」と題する米国特許仮出願第62/729,191号、
・「INDIRECT COMMAND AND CONTROL OF A FIRST OPERATING ROOM SYSTEM THROUGH THE USE OF A SECOND OPERATING ROOM SYSTEM WITHIN A STERILE FIELD WHERE THE SECOND OPERATING ROOM SYSTEM HAS PRIMARY AND SECONDARY OPERATING MODES」と題する米国特許仮出願第62/729,176号、
・「WIRELESS PAIRING OF A SURGICAL DEVICE WITH ANOTHER DEVICE WITHIN A STERILE SURGICAL FIELD BASED ON THE USAGE AND SITUATIONAL AWARENESS OF DEVICES」と題する米国特許仮出願第62/729,186号、及び
・「POWERED STAPLING DEVICE THAT IS CAPABLE OF ADJUSTING FORCE,ADVANCEMENT SPEED,AND OVERALL STROKE OF CUTTING MEMBER OF THE DEVICE BASED ON SENSED PARAMETER OF FIRING OR CLAMPING」と題する米国特許仮出願第62/729,185号。
・「ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR」と題する米国特許出願第16/115,214号、
・「TEMPERATURE CONTROL OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR」と題する米国特許出願第16/115,205号、
・「RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS」と題する米国特許出願第16/115,233号、
・「CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION」と題する米国特許出願第16/115,208号、
・「CONTROLLING ACTIVATION OF AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO THE PRESENCE OF TISSUE」と題する米国特許出願第16/115,220号、
・「DETERMINING TISSUE COMPOSITION VIA AN ULTRASONIC SYSTEM」と題する米国特許出願第16/115,232号、
・「DETERMINING THE STATE OF AN ULTRASONIC ELECTROMECHANICAL SYSTEM ACCORDING TO FREQUENCY SHIFT」と題する米国特許出願第16/115,239号、
・「DETERMINING THE STATE OF AN ULTRASONIC END EFFECTOR」と題する米国特許出願第16/115,247号、
・「SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS」と題する米国特許出願第16/115,211号、
・「MECHANISMS FOR CONTROLLING DIFFERENT ELECTROMECHANICAL SYSTEMS OF AN ELECTROSURGICAL INSTRUMENT」と題する米国特許出願第16/115,226号、
・「DETECTION OF END EFFECTOR EMERSION IN LIQUID」と題する米国特許出願第16/115,240号、
・「INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING」と題する米国特許出願第16/115,249号、
・「INCREASING RADIO FREQUENCY TO CREATE PAD−LESS MONOPOLAR LOOP」と題する米国特許出願第16/115,256号、
・「BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY」と題する米国特許出願第16/115,223号、及び
・「ACTIVATION OF ENERGY DEVICES」と題する米国特許出願第16/115,238号。
・「CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION」と題する米国仮特許出願第62/721,995号、
・「SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS」と題する米国仮特許出願第62/721,998号、
・「INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING」と題する米国仮特許出願第62/721,999号、
・「BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY」と題する米国仮特許出願第62/721,994号、及び
・「RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS」と題する米国仮特許出願第62/721,996号。
・「SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE」と題する米国仮特許出願第62/692,747号、
・「SMART ENERGY ARCHITECTURE」と題する米国仮特許出願第62/692,748号、及び
・「SMART ENERGY DEVICES」と題する米国仮特許出願第62/692,768号。
・「CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS」と題する米国特許出願第16/024,090号、
・「CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS」と題する米国特許出願第16/024,057号、
・「SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION」と題する米国特許出願第16/024,067号、
・「SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING」と題する米国特許出願第16/024,075号、
・「SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING」と題する米国特許出願第16/024,083号、
・「SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES」と題する米国特許出願第16/024,094号、
・「SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE」と題する米国特許出願第16/024,138号、
・「SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES」と題する米国特許出願第16/024,150号、
・「VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY」と題する米国特許出願第16/024,160号、
・「SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE」と題する米国特許出願第16/024,124号、
・「SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT」と題する米国特許出願第16/024,132号、
・「SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY」と題する米国特許出願第16/024,141号、
・「SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES」と題する米国特許出願第16/024,162号、
・「SURGICAL EVACUATION SENSING AND MOTOR CONTROL」と題する米国特許出願第16/024,066号、
・「SURGICAL EVACUATION SENSOR ARRANGEMENTS」と題する米国特許出願第16/024,096号、
・「SURGICAL EVACUATION FLOW PATHS」と題する米国特許出願第16/024,116号、
・「SURGICAL EVACUATION SENSING AND GENERATOR CONTROL」と題する米国特許出願第16/024,149号、
・「SURGICAL EVACUATION SENSING AND DISPLAY」と題する米国特許出願第16/024,180号、
・「COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM」と題する米国特許出願第16/024,245号、
・「SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTROL CIRCUIT FOR INTERACTIVE SURGICAL PLATFORM」と題する米国特許出願第16/024,258号、
・「SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE」と題する米国特許出願第16/024,265号、及び
・「DUAL IN−SERIES LARGE AND SMALL DROPLET FILTERS」と題する米国特許出願第16/024,273号。
・「A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES」と題する米国仮特許出願第62/691,228号、
・「CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS」と題する米国仮特許出願第62/691,227号、
・「SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE」と題する米国仮特許出願第62/691,230号、
・「SURGICAL EVACUATION SENSING AND MOTOR CONTROL」と題する米国仮特許出願第62/691,219号、
・「COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM」と題する米国仮特許出願第62/691,257号、
・「SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE」と題する米国仮特許出願第62/691,262号、及び
・「DUAL IN−SERIES LARGE AND SMALL DROPLET FILTERS」と題する米国仮特許出願第62/691,251号。
・「METHOD OF HUB COMMUNICATION」と題する米国仮特許出願第62/659,900号。
・「CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS」と題する2018年3月30日出願の米国仮特許出願第62/650,898号、
・「SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES」と題する米国仮特許出願第62/650,887号、
・「SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM」と題する米国仮特許出願第62/650,882号、及び
・「SURGICAL SMOKE EVACUATION SENSING AND CONTROLS」と題する米国仮特許出願第62/650,877号。
・「INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES」と題する米国特許出願第15/940,641号、
・「INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES」と題する米国特許出願第15/940,648号、
・「SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES」と題する米国特許出願第15/940,656号、
・「SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS」と題する米国特許出願第15/940,666号、
・「COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS」と題する米国特許出願第15/940,670号、
・「SURGICAL HUB CONTROL ARRANGEMENTS」と題する米国特許出願第15/940,677号、
・「DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD」と題する米国特許出願第15/940,632号、
・「COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS」と題する米国特許出願第15/940,640号、
・「SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT」と題する米国特許出願第15/940,645号、
・「DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME」と題する米国特許出願第15/940,649号、
・「SURGICAL HUB SITUATIONAL AWARENESS」と題する米国特許出願第15/940,654号、
・「SURGICAL SYSTEM DISTRIBUTED PROCESSING」と題する米国特許出願第15/940,663号、
・「AGGREGATION AND REPORTING OF SURGICAL HUB DATA」と題する米国特許出願第15/940,668号、
・「SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER」と題する米国特許出願第15/940,671号、
・「DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE」と題する米国特許出願第15/940,686号、
・「STERILE FIELD INTERACTIVE CONTROL DISPLAYS」と題する米国特許出願第15/940,700号、
・「COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS」と題する米国特許出願第15/940,629号、
・「USE OF LASER LIGHT AND RED−GREEN−BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT」と題する米国特許出願第15/940,704号、
・「CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO−CHROMATIC LIGHT REFRACTIVITY」と題する米国特許出願第15/940,722号、及び
・「DUAL CMOS ARRAY IMAGING」と題する米国特許出願第15/940,742号。
・「ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES」と題する米国特許出願第15/940,636号、
・「ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS」と題する米国特許出願第15/940,653号、
・「CLOUD−BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER」と題する米国特許出願第15/940,660号、
・「CLOUD−BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET」と題する米国特許出願第15/940,679号、
・「CLOUD−BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION」と題する米国特許出願第15/940,694号、
・「CLOUD−BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES」と題する米国特許出願第15/940,634号、
・「DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK」と題する米国特許出願第15/940,706号、及び
・「CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES」と題する米国特許出願第15/940,675号。
・「DRIVE ARRANGEMENTS FOR ROBOT−ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,627号、
・「COMMUNICATION ARRANGEMENTS FOR ROBOT−ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,637号、
・「CONTROLS FOR ROBOT−ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,642号、
・「AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT−ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,676号、
・「CONTROLLERS FOR ROBOT−ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,680号、
・「COOPERATIVE SURGICAL ACTIONS FOR ROBOT−ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,683号、
・「DISPLAY ARRANGEMENTS FOR ROBOT−ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,690号、及び
・「SENSING ARRANGEMENTS FOR ROBOT−ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,711号。
・「INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES」と題する米国仮特許出願第62/649,302号、
・「DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD」と題する米国仮特許出願第62/649,294号、
・「SURGICAL HUB SITUATIONAL AWARENESS」と題する米国仮特許出願第62/649,300号、
・「SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER」と題する米国仮特許出願第62/649,309号、
・「COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS」と題する米国仮特許出願第62/649,310号、
・「USE OF LASER LIGHT AND RED−GREEN−BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT」と題する米国仮特許出願第62/649,291号、
・「ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES」と題する米国仮特許出願第62/649,296号、
・「CLOUD−BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER」と題する米国仮特許出願第62/649,333号、
・「CLOUD−BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES」と題する米国仮特許出願第62/649,327号、
・「DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK」と題する米国仮特許出願第62/649,315号、
・「CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES」と題する米国仮特許出願第62/649,313号、
・「DRIVE ARRANGEMENTS FOR ROBOT−ASSISTED SURGICAL PLATFORMS」と題する米国仮特許出願第62/649,320号、
・「AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT−ASSISTED SURGICAL PLATFORMS」と題する米国仮特許出願第62/649,307号、及び
・「SENSING ARRANGEMENTS FOR ROBOT−ASSISTED SURGICAL PLATFORMS」と題する米国仮特許出願第62/649,323号。
・「INTERACTIVE SURGICAL PLATFORM」と題する米国仮特許出願第62/611,341号、
・「CLOUD−BASED MEDICAL ANALYTICS」と題する米国仮特許出願第62/611,340号、及び
・「ROBOT ASSISTED SURGICAL PLATFORM」と題する米国仮特許出願第62/611,339号。
様々な態様では、スマート超音波エネルギー装置は、超音波ブレードの動作を制御するための適応アルゴリズムを含んでもよい。一態様では、超音波ブレード適応制御アルゴリズムは、組織の種類を特定し、装置パラメータを調節するように構成されている。一態様では、超音波ブレード制御アルゴリズムは、組織の種類をパラメータ化するように構成されている。超音波ブレードの遠位先端の振幅を調整するために組織のコラーゲン/エラスチン比を検出するためのアルゴリズムが、本開示の以下の項で説明される。スマート超音波エネルギー装置の様々な態様が、例えば図1〜図2に関連して本明細書で説明される。したがって、適応型超音波ブレード制御アルゴリズムの以下の説明は、図1〜図2及びこれらに関連する説明と併せて読まれるべきである。
図2は、超音波器具と連結するように構成され、かつ、図1に示すモジュール式通信ハブを備える外科用データネットワーク内で適応型超音波ブレード制御アルゴリズムを実行するように更に構成された発生器の一形態である、発生器900の一実施例を示す。発生器900は、複数のエネルギーモダリティを外科用器具に送達するように構成されている。発生器900は、エネルギーを外科用器具に送達するためのRF信号及び超音波信号を単独で又は同時に、そのいずれかで提供する。RF信号及び超音波信号は、単独で又は組み合わせて提供されてもよく、また同時に提供されてもよい。上述したように、少なくとも1つの発生器出力部は、単一のポートを通して複数のエネルギーモダリティ(例えば、とりわけ超音波、双極若しくは単極RF、不可逆及び/若しくは可逆電気穿孔法並びに/又はマイクロ波エネルギー)を送達することができ、これらの信号は、組織を治療するために個別に又は同時にエンドエフェクタに送達することができる。発生器900は、波形発生器904に連結されたプロセッサ902を備える。プロセッサ902及び波形発生器904は、プロセッサ902に連結されたメモリに記憶された情報(開示を明瞭にするために示されず)に基づいて、様々な信号波形を発生するように構成されている。波形に関連するデジタル情報は、デジタル入力をアナログ出力に変換するために1つ以上のDAC回路を含む波形発生器904に提供される。アナログ出力は、信号調節及び増幅のために、増幅器906に供給される。増幅器906の、調節され増幅された出力は、電力変圧器908に連結されている。信号は、電力変圧器908を横断して患者絶縁側にある二次側に連結されている。第1のエネルギーモダリティの第1の信号は、外科用器具のENERGY1及びRETURNとラベルされた端子間に提供される。第2のエネルギーモダリティの第2の信号は、コンデンサ910を横断して連結され、外科用器具のENERGY2及びRETURNとラベルされた端子間に提供される。2つを超えるエネルギーモダリティが出力されてもよく、したがって添え字「n」は、最大n個のENERGYn端子が提供され得ることを示すために使用することができ、ここでnは、1超の正の整数であることが理解されよう。最大「n」個のリターンパス(RETURNn)が、本開示の範囲から逸脱することなく提供されてもよいことも理解されよう。
φ=2πft+φ0
式中、φは位相角であり、fは周波数であり、tは時間であり、φ0は、t=0における位相である。
図19A〜図19Bは、本開示の少なくとも1つの態様による、低温(室温)及び高温の超音波ブレードを備える、同じ超音波装置の複合インピーダンススペクトルのグラフ図133000、図133010である。本明細書で使用するとき、低温超音波ブレードは、室温の超音波ブレードを指し、高温超音波ブレードは、使用中に摩擦により加熱された後の超音波ブレードを指す。図19Aは、低温及び高温の超音波ブレードを備える同じ超音波装置の共振周波数foの関数としてのインピーダンス位相角φのグラフ図133000であり、図19Bは、低温及び高温超音波ブレードを備える同じ超音波装置の共振周波数foの関数としてのインピーダンスの大きさ|Z|のグラフ図133010である。インピーダンス位相角φ及びインピーダンスの大きさ|Z|は、共振周波数foにおいて最小である。
超音波ブレードの温度を推定又は推測する1つの態様は、3つの工程を含み得る。第1に、時間及びエネルギー依存性の温度及び周波数の状態空間モデルを定義する。周波数成分の関数として温度をモデル化するために、一組の非線形状態空間方程式を使用して、電気機械的共振周波数と超音波ブレードの温度との間の関係をモデル化する。第2に、経時的に温度推定器及び状態空間モデルの精度を改善するためにカルマンフィルタを適用する。第3に、超音波トランスデューサ、及びひいては超音波ブレードに印加する電力を制御して超音波ブレードの温度を調節するために、カルマンフィルタのフィードバックループに状態推定器が設けられる。3つの工程を以下に記載する。
第1の工程は、時間及びエネルギー依存性の温度及び周波数の状態空間モデルを定義することである。周波数成分の関数として温度をモデル化するために、一組の非線形状態空間方程式を使用して、電気機械的共振周波数と超音波ブレードの温度との間の関係をモデル化する。一態様では、状態空間モデルは、以下の式によって定義される。
第2の工程は、温度推定器及び状態空間モデルを改善するためにカルマンフィルタを適用することである。図20は、等式:
第3の工程は、超音波トランスデューサ、及びひいては超音波ブレードに印加される電力を制御して超音波ブレードの温度を調節するために、カルマンフィルタ133020のフィードバックループ133032内の状態推定器133026を使用する。
(状態推定器及びカルマンフィルタによって推定される)温度が制御されることを確実にするために、電力入力が低減される。
一態様では、本開示は、フィードバック制御を用いて温度を調節するための制御された熱管理(CTM)アルゴリズムを提供する。フィードバック制御の出力は、超音波外科用器具にとって望ましい効果ではない超音波エンドエフェクタのクランプアームパッドの溶落ちを防止するために使用され得る。上述したように、一般に、パッドの溶落ちは、エンドエフェクタ内に把持された組織が横切開された後で、パッドと接触する超音波ブレードに超音波エネルギーを連続的に印加することによって引き起こされる。
図27は、本開示の少なくとも1つの態様による、血管発射中の、時間の関数としての超音波ブレード温度のグラフ図133110である。超音波ブレード温度のプロット133112は、水平軸に沿った時間の関数として垂直軸に沿ってグラフ化される。周波数−温度フィードバック制御アルゴリズムは、超音波ブレードフィードバック制御の温度をジョー感知能力と組み合わせる。周波数−温度フィードバック制御アルゴリズムは、装置の耐久性とのバランスがとれた最適な止血を提供し、クランプアームパッドを保護しながら、最良の封止のためにエネルギーをインテリジェントに送達することができる。
実施例1.2つの温度設定値間で超音波ブレードの温度を制御する方法であって、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加することと、
超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視することと、
超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φに基づいて、超音波ブレードの温度を推定することと、
横切開プロセスが完了していると判定することと、
超音波ブレード温度を第2の標的温度T2に設定するために、超音波トランスデューサに第2の電力レベルを印加することと、
を含む方法。
クランプアームパッドと、
超音波トランスデューサに電力を供給するように構成された発生器であって、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加し、
超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視し、
超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φに基づいて、超音波ブレードの温度を推定し、
横切開プロセスが完了していると判定し、
超音波ブレード温度を第2の標的温度T2に設定するために、超音波トランスデューサに第2の電力レベルを印加する、
ように構成された制御回路を備える発生器と、
を備える超音波外科用器具。
制御回路であって、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加し、
超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視し、
超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φに基づいて、超音波ブレードの温度を推定し、
横切開プロセスが完了していると判定し、
超音波ブレード温度を第2の標的温度T2に設定するために、超音波トランスデューサに第2の電力レベルを印加する、
ように構成された制御回路を備える、発生器。
非一過性メモリが、プロセッサによって実行されると、プロセッサに、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加させ、
超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視させ、
超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φに基づいて、超音波ブレードの温度を推定させ、
横切開プロセスが完了していると判定させ、
超音波ブレード温度を第2の標的温度T2に設定するために、超音波トランスデューサに第2の電力レベルを印加させる、
指示を含む、超音波外科用システム。
(1) 2つの温度設定値間で超音波ブレードの温度を制御する方法であって、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して前記超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加することと、
前記超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視することと、
前記超音波トランスデューサに印加される前記電圧Vg(t)信号と前記電流Ig(t)信号との間の前記位相角φに基づいて、前記超音波ブレードの前記温度を推定することと、
横切開プロセスが完了していると判定することと、
超音波ブレード温度を第2の標的温度T2に設定するために、前記超音波トランスデューサに第2の電力レベルを印加することと、
を含む方法。
(2) 超音波ブレード温度を第1の標的温度T1に設定するために、超音波トランスデューサに第1の電力レベルを印加することが、前記超音波ブレード温度を前記第2の標的温度T2よりも高い第1の標的温度T1に設定するために、超音波トランスデューサに第1の電力レベルを印加することを含む、実施態様1に記載の方法。
(3) 超音波ブレード温度を第1の標的温度T1に設定するために、超音波トランスデューサに第1の電力レベルを印加することが、前記超音波ブレード温度を血管封止のために最適化された第1の標的温度に設定するために、超音波トランスデューサに第1の電力レベルを印加することを含む、実施態様1に記載の方法。
(4) 超音波ブレード温度を第2の標的温度T2に設定するために、前記超音波トランスデューサに第2の電力レベルを印加することが、超音波ブレード温度をクランプアームパッドの耐用期間のために最適化された第2の標的温度に設定するために、前記超音波トランスデューサに第2の電力レベルを印加することを含む、実施態様1に記載の方法。
(5) 超音波ブレード温度をクランプアームパッドの耐用期間のために最適化された第2の標的温度に設定するために、前記超音波トランスデューサに第2の電力レベルを印加することが、超音波ブレード温度を325℃に設定するために、前記超音波トランスデューサに第2の電力レベルを印加することを含む、実施態様4に記載の方法。
(7) 超音波導波管を介して超音波ブレードに連結された超音波トランスデューサを備える超音波電気機械システムと、
クランプアームパッドと、
前記超音波トランスデューサに電力を供給するように構成された発生器であって、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して前記超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加し、
前記超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視し、
前記超音波トランスデューサに印加される前記電圧Vg(t)信号と前記電流Ig(t)信号との間の前記位相角φに基づいて、前記超音波ブレードの前記温度を推定し、
横切開プロセスが完了していると判定し、
超音波ブレード温度を第2の標的温度T2に設定するために、前記超音波トランスデューサに第2の電力レベルを印加する、
ように構成された制御回路を備える発生器と、
を備える超音波外科用器具。
(8) 前記第1の標的温度T1が、前記第2の標的温度T2よりも高い、実施態様7に記載の超音波外科用器具。
(9) 前記第1の標的温度T1が、血管封止のために最適化される、実施態様7に記載の超音波外科用器具。
(10) 前記第2の標的温度T2が、クランプアームパッドの耐用期間のために最適化される、実施態様7に記載の超音波外科用器具。
(12) 横切開プロセスが完了していると判定するように構成された前記制御回路は、前記超音波ブレードが前記クランプアームパッドと接触していると判定するための制御回路を含む、実施態様7に記載の超音波外科用器具。
(13) 超音波外科用器具用の発生器であって、
制御回路であって、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して前記超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加し、
前記超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視し、
前記超音波トランスデューサに印加される前記電圧Vg(t)信号と前記電流Ig(t)信号との間の前記位相角φに基づいて、前記超音波ブレードの前記温度を推定し、
横切開プロセスが完了していると判定し、
超音波ブレード温度を第2の標的温度T2に設定するために、前記超音波トランスデューサに第2の電力レベルを印加する、
ように構成された制御回路を備える、発生器。
(14) 前記第1の標的温度T1が、前記第2の標的温度T2よりも高い、実施態様13に記載の発生器。
(15) 前記第1の標的温度T1が、血管封止のために最適化される、実施態様13に記載の発生器。
(17) 前記第2の標的温度が325℃である、実施態様16に記載の発生器。
(18) 横切開プロセスが完了していると判定するように構成された前記制御回路は、前記超音波ブレードが前記クランプアームパッドと接触していると判定するための制御回路を含む、実施態様13に記載の発生器。
(19) プロセッサ及び非一過性メモリを備え、
前記非一過性メモリが、前記プロセッサによって実行されると、前記プロセッサに、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して前記超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加させ、
前記超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視させ、
前記超音波トランスデューサに印加される前記電圧Vg(t)信号と前記電流Ig(t)信号との間の前記位相角φに基づいて、前記超音波ブレードの前記温度を推定させ、
横切開プロセスが完了していると判定させ、
超音波ブレード温度を第2の標的温度T2に設定するために、前記超音波トランスデューサに第2の電力レベルを印加させる、
指示を含む、超音波外科用システム。
Claims (19)
- 2つの温度設定値間で超音波ブレードの温度を制御する方法であって、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して前記超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加することと、
前記超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視することと、
前記超音波トランスデューサに印加される前記電圧Vg(t)信号と前記電流Ig(t)信号との間の前記位相角φに基づいて、前記超音波ブレードの前記温度を推定することと、
横切開プロセスが完了していると判定することと、
超音波ブレード温度を第2の標的温度T2に設定するために、前記超音波トランスデューサに第2の電力レベルを印加することと、
を含む方法。 - 超音波ブレード温度を第1の標的温度T1に設定するために、超音波トランスデューサに第1の電力レベルを印加することが、前記超音波ブレード温度を前記第2の標的温度T2よりも高い第1の標的温度T1に設定するために、超音波トランスデューサに第1の電力レベルを印加することを含む、請求項1に記載の方法。
- 超音波ブレード温度を第1の標的温度T1に設定するために、超音波トランスデューサに第1の電力レベルを印加することが、前記超音波ブレード温度を血管封止のために最適化された第1の標的温度に設定するために、超音波トランスデューサに第1の電力レベルを印加することを含む、請求項1に記載の方法。
- 超音波ブレード温度を第2の標的温度T2に設定するために、前記超音波トランスデューサに第2の電力レベルを印加することが、超音波ブレード温度をクランプアームパッドの耐用期間のために最適化された第2の標的温度に設定するために、前記超音波トランスデューサに第2の電力レベルを印加することを含む、請求項1に記載の方法。
- 超音波ブレード温度をクランプアームパッドの耐用期間のために最適化された第2の標的温度に設定するために、前記超音波トランスデューサに第2の電力レベルを印加することが、超音波ブレード温度を325℃に設定するために、前記超音波トランスデューサに第2の電力レベルを印加することを含む、請求項4に記載の方法。
- 横切開プロセスが完了していると判定することは、前記超音波ブレードがクランプアームパッドと接触していると判定することを含む、請求項1に記載の方法。
- 超音波導波管を介して超音波ブレードに連結された超音波トランスデューサを備える超音波電気機械システムと、
クランプアームパッドと、
前記超音波トランスデューサに電力を供給するように構成された発生器であって、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して前記超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加し、
前記超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視し、
前記超音波トランスデューサに印加される前記電圧Vg(t)信号と前記電流Ig(t)信号との間の前記位相角φに基づいて、前記超音波ブレードの前記温度を推定し、
横切開プロセスが完了していると判定し、
超音波ブレード温度を第2の標的温度T2に設定するために、前記超音波トランスデューサに第2の電力レベルを印加する、
ように構成された制御回路を備える発生器と、
を備える超音波外科用器具。 - 前記第1の標的温度T1が、前記第2の標的温度T2よりも高い、請求項7に記載の超音波外科用器具。
- 前記第1の標的温度T1が、血管封止のために最適化される、請求項7に記載の超音波外科用器具。
- 前記第2の標的温度T2が、クランプアームパッドの耐用期間のために最適化される、請求項7に記載の超音波外科用器具。
- 前記第2の標的温度が、325℃である、請求項10に記載の超音波外科用器具。
- 横切開プロセスが完了していると判定するように構成された前記制御回路は、前記超音波ブレードが前記クランプアームパッドと接触していると判定するための制御回路を含む、請求項7に記載の超音波外科用器具。
- 超音波外科用器具用の発生器であって、
制御回路であって、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して前記超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加し、
前記超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視し、
前記超音波トランスデューサに印加される前記電圧Vg(t)信号と前記電流Ig(t)信号との間の前記位相角φに基づいて、前記超音波ブレードの前記温度を推定し、
横切開プロセスが完了していると判定し、
超音波ブレード温度を第2の標的温度T2に設定するために、前記超音波トランスデューサに第2の電力レベルを印加する、
ように構成された制御回路を備える、発生器。 - 前記第1の標的温度T1が、前記第2の標的温度T2よりも高い、請求項13に記載の発生器。
- 前記第1の標的温度T1が、血管封止のために最適化される、請求項13に記載の発生器。
- 前記第2の標的温度T2が、クランプアームパッドの耐用期間のために最適化される、請求項13に記載の発生器。
- 前記第2の標的温度が325℃である、請求項16に記載の発生器。
- 横切開プロセスが完了していると判定するように構成された前記制御回路は、前記超音波ブレードが前記クランプアームパッドと接触していると判定するための制御回路を含む、請求項13に記載の発生器。
- プロセッサ及び非一過性メモリを備え、
前記非一過性メモリが、前記プロセッサによって実行されると、前記プロセッサに、
超音波ブレード温度を第1の標的温度T1に設定するために、超音波導波管を介して前記超音波ブレードに連結される超音波トランスデューサに、第1の電力レベルを印加させ、
前記超音波トランスデューサに印加される電圧Vg(t)信号と電流Ig(t)信号との間の位相角φを監視させ、
前記超音波トランスデューサに印加される前記電圧Vg(t)信号と前記電流Ig(t)信号との間の前記位相角φに基づいて、前記超音波ブレードの前記温度を推定させ、
横切開プロセスが完了していると判定させ、
超音波ブレード温度を第2の標的温度T2に設定するために、前記超音波トランスデューサに第2の電力レベルを印加させる、
指示を含む、超音波外科用システム。
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