JP2023508579A - Control program for modular combination energy device - Google Patents

Abstract

A surgical instrument is disclosed that includes a housing, a shaft assembly, a processor, and memory. A shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions which, when executed from the memory, cause the processor to transmit an electrical interrogation signal to the attached shaft assembly; receiving a response signal from the assembly; causing a default function to be performed when the response signal is not received by the attached shaft assembly; and modifying the control program based on the signature of the attached shaft assembly.

Description

(Cross reference to related applications)
This application claims the benefit under 35 U.S.C. and the entire contents of this disclosure are incorporated herein by reference.

The present invention relates to surgical instruments designed to treat tissue, including but not limited to surgical instruments configured to cut and fasten tissue. A surgical instrument may include an electrosurgical instrument powered by a generator to effect tissue dissection, cutting, and/or coagulation during a surgical procedure. Surgical instruments may include instruments configured to cut and staple tissue using surgical staples and/or fasteners. The surgical instrument may be configured for use in open surgical procedures, but has application in other types of surgery, such as laparoscopic, endoscopic, and robotic-assisted procedures, to provide precise control within a patient. An end effector may be included that is articulatable with respect to the shaft portion of the instrument to facilitate positioning.

SUMMARY In various embodiments, a surgical instrument is disclosed that includes a housing, a shaft assembly, a processor, and memory. A shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions which, when executed from the memory, cause the processor to transmit an electrical interrogation signal to the attached shaft assembly; receiving a response signal from the assembly; causing the default function to be performed when the response signal is not received by the attached shaft assembly; and modifying the control program based on the signature of the attached shaft assembly.

SUMMARY In various embodiments, a surgical instrument is disclosed that includes a housing, a shaft assembly, a processor, and memory. A shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions which, when executed from the memory, instruct the processor to send a variable interrogation communication to the attached shaft assembly and to the variable interrogation communication. Based on the response, determine the capability of the installed shaft assembly and modify the control program based on the determined capability of the installed shaft assembly.

SUMMARY In various embodiments, a surgical instrument is disclosed that includes a housing, a shaft assembly, a processor, and memory. A shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions which, when executed from the memory, cause the processor to interrogate a shaft assembly coupled to the housing; receiving a response signal from the shaft assembly, performing a default end effector function when the response signal is not recognized, and performing the default end effector function resulting in a shaft coupled to the housing; Determining an identifying characteristic of the assembly and modifying the control program based on the identifying characteristic of the shaft assembly coupled to the housing are performed.

The novel features of the various aspects are set forth with particularity in the appended claims. The forms described, however, both as to organization and method of operation, may best be understood by reference to the following description taken in conjunction with the accompanying drawings.
1 illustrates an example generator for use with a surgical system, according to at least one aspect of the present disclosure; 1 illustrates one form of surgical system comprising a generator and an electrosurgical instrument usable with the generator, according to at least one aspect of the present disclosure; 1 shows a schematic illustration of a surgical instrument or tool, according to at least one aspect of the present disclosure; FIG. 1 is a perspective view of a surgical system comprising a surgical instrument and a display monitor, the surgical instrument comprising a display screen according to at least one embodiment; FIG. 5 is a schematic diagram of a display screen of the surgical instrument of FIG. 4 and corresponding views of a display monitor in accordance with at least one embodiment; FIG. 5 is a schematic diagram of a display screen of the surgical instrument of FIG. 4 and corresponding views of a display monitor in accordance with at least one embodiment; FIG. 5 is a schematic diagram of a display screen of the surgical instrument of FIG. 4 and corresponding views of a display monitor in accordance with at least one embodiment; FIG. 5 is a schematic diagram of a display screen of the surgical instrument of FIG. 4 and corresponding views of a display monitor in accordance with at least one embodiment; FIG. 5 is a schematic diagram of a display screen of the surgical instrument of FIG. 4 and corresponding views of a display monitor in accordance with at least one embodiment; FIG. 4 is a graphical depiction of the relationship between the total effective energy delivered by one or more generators of a surgical system and the duty cycle of a motor from a smoke evacuator in accordance with at least one embodiment; 1 is a schematic diagram of a surgical system comprising a surgical hub, a combination electrosurgical instrument powered by multiple generators, a smoke evacuation system, and a display in accordance with at least one embodiment; FIG. 4 is a graphical depiction of the relationship between power supplied by one or more generators of a surgical system over time and impedance of treated tissue over time in accordance with at least one embodiment; FIG. 19 is a schematic illustration of a communication path having a surgical system, the surgical system powering a surgical hub, a smoke evacuation device, a surgical instrument, and a first operation of the surgical instrument, in accordance with at least one embodiment; and a second generator configured to power a second operation of the surgical instrument. 1 is a schematic illustration of a surgical system comprising a surgical hub and a plurality of robotic arms configured to receive tools thereon, according to at least one embodiment; FIG. an authentication module configured to approve the tool for attachment to and/or for use with the surgical system. FIG. 12 is a schematic diagram of a surgical system positioned within a treatment room, according to at least one embodiment; 4 is a chart illustrating various operational parameters and/or specifications of a surgical instrument during various stages of a surgical procedure, in accordance with at least one embodiment; 17 is an elevational view of the surgical instrument of FIG. 16 shown at a first time delivering bipolar energy to patient tissue; FIG. 17 is an elevational view of the surgical instrument of FIG. 16 shown at a second time delivering bipolar and monopolar energy to patient tissue; FIG. 17 is an elevational view of the surgical instrument of FIG. 16 shown at a fourth time delivering monopolar energy to patient tissue; FIG. 17 are graphical representations of various operating parameters and/or specifications of the surgical instrument of FIG. 16 at various stages of a surgical procedure; 5 is a graphical representation of measured tissue impedance over the duration of a surgical procedure, according to at least one embodiment; FIG. 100 is a schematic representation of strain calculation, wherein the applied strain is calculated using the gap defined between the jaws of the end effector when the end effector is in the open configuration, according to at least one embodiment; FIG. 23 is a schematic representation of the strain calculation of FIG. 22, wherein the calculated applied strain overestimates the actual applied strain because the patient tissue is positioned without contact between the jaws of the end effector; . FIG. 12 is a schematic diagram representing a tissue impedance calculation, wherein the tissue impedance was defined between the jaws of the end effector when the jaws of the end effector contacted patient tissue positioned therebetween, according to at least one embodiment; Calculated using the gap. 4 is a graphical representation of the relationship between motor current and jaw clearance over time in accordance with at least one embodiment; FIG. 12 is a schematic diagram of a network formed by surgical instruments and cloud-based storage media in accordance with at least one embodiment; 27 is a graphical representation of the relationship between change in jaw clearance and jaw motor clamp current determined from the network of FIG. 26; 27 is a graphical representation of the relationship over time between generator powers determined from the network of FIG. 26; 6 is a graphical representation of the relationship between the activation cycle of a surgical instrument and measured impedance when an end effector of the surgical instrument is in a closed configuration with no patient tissue positioned therebetween, according to at least one embodiment; is. 4 is a graphical representation of the relationship between tissue conductance during a jaw clamping stroke, jaw opening size, and jaw motor force, according to at least one embodiment; 4 is a graphical representation of jaw closing speed based on user input and jaw closing speed based on user input and monitored parameters, in accordance with at least one embodiment;

The applicant of this application owns the following US patent applications filed on even date herewith, each of which is hereby incorporated by reference in their entirety.
・Attorney subject reference number END9234USNP1/190717-1M, title of invention "METHOD FOR AN ELECTROSURGICAL PROCEDURE",
・Attorney Subject Reference No. END9234USNP2/190717-2, Title of Invention “ARTICULATABLE SURGICAL INSTRUMENT”,
・Attorney Subject Reference No. END9234USNP3/190717-3, Title of Invention “SURGICAL INSTRUMENT WITH JAW ALIGNMENT FEATURES”,
・Attorney Subject Reference No. END9234USNP4/190717-4, Title of Invention "SURGICAL INSTRUMENT WITH ROTATABLE AND ARTICULATABLE SURGICAL END EFFECTOR",
・Attorney subject reference number END9234USNP5/190717-5, title of invention "ELECTROSURGICAL INSTRUMENT WITH ASYNCHRONOUS ENERGIZING ELECTRODES",
・Attorney Subject Reference No. END9234USNP6/190717-6, Invention Title "ELECTROSURGICAL INSTRUMENT WITH ELECTRODES BIASING SUPPORT",
・Attorney Subject Reference No. END9234USNP7/190717-7, Invention Title “ELECTROSURGICAL INSTRUMENT WITH FLEXIBLE WIRING ASSEMBLIES”,
・Attorney subject reference number END9234USNP8/190717-8, title of invention "ELECTROSURGICAL INSTRUMENT WITH VARIABLE CONTROL MECHANISMS",
・Attorney Subject Reference No. END9234USNP9/190717-9, Invention Title “ELECTROSURGICAL SYSTEMS WITH INTEGRATED AND EXTERNAL POWER SOURCES”,
・Attorney Subject Reference No. END9234USNP10/190717-10, Invention Title "ELECTROSURGICAL INSTRUMENTS WITH ELECTRODES HAVING ENERGY FOCUSING FEATURES",
・Attorney Subject Reference No. END9234USNP11/190717-11, Invention Title "ELECTROSURGICAL INSTRUMENTS WITH ELECTRODES HAVING VARIABLE ENERGY DENSITIES",
・Attorney subject reference number END9234USNP12/190717-12, title of invention "ELECTROSURGICAL INSTRUMENT WITH MONOPOLAR AND BIPOLAR ENERGY CAPABILITIES",
・Attorney subject reference number END9234USNP13/190717-13, title of invention "ELECTROSURGICAL END EFFECTORS WITH THERMALLY INSULATIVE AND THERMALLY CONDUCTIVE PORTIONS",
・Attorney Subject Reference No. END9234USNP14/190717-14, Title of Invention "ELECTROSURGICAL INSTRUMENT WITH ELECTRODES OPERAABLE IN BIPOLAR AND MONOPOLAR MODES",
・Attorney Subject Reference No. END9234USNP15/190717-15, Invention Title "ELECTROSURGICAL INSTRUMENTS FOR DELIVERING BLENDED ENERGY MODALITIES TO TISSUE",
・Attorney Subject Reference No. END9234USNP16/190717-16, Title of Invention “CONTROL PROGRAM ADAPTITION BASED ON DEVICE STATUS AND USER INPUT”, and ・Attorney Subject Reference No. END9234USNP18/190717-18, Title of Invention “SURGICAL SYSTEM COMMUNICATION PATHWAYS".

The applicant of the present application owns the following US provisional patent applications filed December 30, 2019, the disclosures of each of which are hereby incorporated by reference in their entirety:
U.S. Provisional Patent Application No. 62/955,294 entitled "USER INTERFACE FOR SURGICAL INSTRUMENT WITH COMBINATION ENERGY MODALITY END-EFFECTOR";
US Provisional Patent Application No. 62/955,292, entitled "COMBINATION ENERGY MODALITY END-EFFECTOR," and US Provisional Patent Application No. 62/955,306, entitled "SURGICAL INSTRUMENT SYSTEMS."

The applicant of this application owns the following US patent applications, the disclosures of each of which are incorporated herein by reference in their entireties:
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser.
U.S. patent application Ser. ,
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・米国特許出願第１６／２０９，４３３号、発明の名称「ＭＥＴＨＯＤ ＯＦ ＳＥＮＳＩＮＧ ＰＡＲＴＩＣＵＬＡＴＥ ＦＲＯＭ ＳＭＯＫＥ ＥＶＡＣＵＡＴＥＤ ＦＲＯＭ Ａ ＰＡＴＩＥＮＴ，ＡＤＪＵＳＴＩＮＧ ＴＨＥ ＰＵＭＰ ＳＰＥＥＤ ＢＡＳＥＤ ＯＮ ＴＨＥ ＳＥＮＳＥＤ ＩＮＦＯＲＭＡＴＩＯＮ，ＡＮＤ ＣＯＭＭＵＮＩＣＡＴＩＮＧ ＴＨＥ ＦＵＮＣＴＩＯＮＡＬ ＰＡＲＡＭＥＴＥＲＳ ＯＦ ＴＨＥ ＳＹＳＴＥＭ ＴＯ ＴＨＥ ＨＵＢ」（ Currently, U.S. Patent Application Publication No. 2019/0201594),
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser.
・米国特許出願第１６／２０９，４７８号、発明の名称「ＭＥＴＨＯＤ ＦＯＲ ＳＩＴＵＡＴＩＯＮＡＬ ＡＷＡＲＥＮＥＳＳ ＦＯＲ ＳＵＲＧＩＣＡＬ ＮＥＴＷＯＲＫ ＯＲ ＳＵＲＧＩＣＡＬ ＮＥＴＷＯＲＫ ＣＯＮＮＥＣＴＥＤ ＤＥＶＩＣＥ ＣＡＰＡＢＬＥ ＯＦ ＡＤＪＵＳＴＩＮＧ ＦＵＮＣＴＩＯＮ ＢＡＳＥＤ ＯＮ Ａ ＳＥＮＳＥＤ ＳＩＴＵＡＴＩＯＮ ＯＲ ＵＳＡＧＥ」（現在は、米国特許出願公開第２０１９ /0104919),
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser.
U.S. patent application Ser. No. 16/562,135, entitled "METHOD FOR CONTROLLING AN ENERGY MODULE OUTPUT";
U.S. Patent Application No. 16/562,144, entitled "METHOD FOR CONTROLLING A MODULAR ENERGY SYSTEM USER INTERFACE," and U.S. Patent Application No. 16/562,125, entitled "METHOD FOR COMMUNICATION BETWEEN MODULES AND DEVICES IN A MODULAR SURGICAL SYSTEM".

Before describing various aspects of the electrosurgical system in detail, it is noted that the illustrated embodiments are not limited in application or use to the details of construction and arrangement of parts shown in the accompanying drawings and specification. sea bream. The example embodiments may be practiced or incorporated in other aspects, variations, and modifications, and may be practiced or carried out in various ways. Further, unless otherwise stated, the terms and expressions used herein are chosen for the convenience of the reader, for the purpose of describing example embodiments, and not for purposes of limitation thereof. Additionally, one or more of the aspects, expressions of aspects and/or examples described below may be combined with any of the other aspects, expressions of aspects and/or examples described below. It should be understood that one or more can be combined.

Various aspects are directed to an electrosurgical system that includes an electrosurgical instrument powered by a generator to effect tissue dissection, cutting, and/or coagulation during a surgical procedure. Electrosurgical instruments can be configured for use in open surgical procedures, but also have applications in other types of surgery, such as laparoscopic, endoscopic, and robotic-assisted procedures.

As described in more detail below, electrosurgical instruments generally include a shaft having a distally mounted end effector (eg, one or more electrodes). The end effector can be positioned with respect to tissue such that a current is introduced into the tissue. Electrosurgical instruments can be configured for bipolar or monopolar operation. During bipolar operation, currents are introduced into the tissue by the end effector's active electrode and returned from the tissue by the end effector's return electrode, respectively. During unipolar operation, current is introduced into the tissue by the active electrode of the end effector and returned via a return electrode (eg, ground pad) separately located on the patient's body. Heat generated by current flowing through tissue may form a hemostatic seal within and/or between tissues, and thus may be particularly useful for sealing blood vessels, for example.

FIG. 1 shows an example of a generator 900 configured to deliver multiple energy modalities to a surgical instrument. Generator 900 provides RF and/or ultrasonic signals for delivering energy to the surgical instrument. The generator 900 can transmit multiple energy modalities (e.g., ultrasound energy, bipolar or monopolar RF energy, irreversible and/or reversible electroporation, and/or microwave energy, among others) through a single port. , and these signals can be delivered to the end effector individually or simultaneously to treat tissue. Generator 900 comprises a processor 902 coupled to a waveform generator 904 . Processor 902 and waveform generator 904 are configured to generate various signal waveforms based on information stored in memory coupled to processor 902, not shown for clarity of disclosure. . Digital information associated with the waveform is provided to waveform generator 904, which includes one or more DAC circuits to convert the digital input to analog output. The analog output is provided to amplifier 906 for signal conditioning and amplification. The conditioned and amplified output of amplifier 906 is coupled to power transformer 908 . The signal is coupled across the power transformer 908 to the secondary on the patient-isolated side. A first signal of a first energy modality is provided to the surgical instrument between terminals labeled ENERGY ₁ and RETURN. A second signal of the second energy modality is coupled across capacitor 910 and provided to the surgical instrument between terminals labeled ENERGY ₂ and RETURN. More than two energy modalities can be output, so the subscript "n" can be used to indicate that up to n ENERGY _n- terminals can be provided, where n is a positive integer greater than or equal to 2. One thing is understood. It will also be appreciated that up to 'n' return paths RETURN _n may be provided without departing from the scope of the present disclosure.

A first voltage sensing circuit 912 is coupled across terminals labeled ENERGY ₁ and RETURN paths to measure the output voltage therebetween. A second voltage sensing circuit 924 is coupled across terminals labeled ENERGY ₂ and RETURN paths to measure the output voltage therebetween. A current sensing circuit 914 is arranged in series with the RETURN leg of the secondary side of the power transformer 908 shown to measure the output current of either energy modality. If different return paths are provided for each energy modality, separate current sensing circuitry must be provided for each return leg. The outputs of the first voltage sensing circuit 912 and the second voltage sensing circuit 924 are provided to isolation transformers 928 , 922 respectively, and the output of the current sensing circuit 914 is provided to another isolation transformer 916 . The outputs of isolation transformers 916 , 928 , 922 on the primary side (non-patient isolated side) of power transformer 908 are provided to one or more ADC circuits 926 . The digitized output of ADC circuitry 926 is provided to processor 902 for further processing and calculations. Output voltage and output current feedback information can be used to calculate parameters such as output impedance to adjust the output voltage and current provided to the surgical instrument. Input/output communication between processor 902 and patient isolation circuitry is provided through interface circuitry 920 . Sensors may also be in electrical communication with processor 902 via interface circuitry 920 .

In one aspect, the impedance is determined by either the first voltage sensing circuit 912 coupled across the terminals labeled ENERGY ₁ /RETURN or the second voltage sensing circuit 924 coupled across the terminals labeled ENERGY ₂ /RETURN. That output may be determined by processor 902 by dividing by the output of current sensing circuit 914 arranged in series with the RETURN leg of the secondary side of power transformer 908 . The outputs of the first voltage sensing circuit 912 and the second voltage sensing circuit 924 are provided to separate isolation transformers 928 , 922 and the output of the current sensing circuit 914 is provided to another isolation transformer 916 . Digitized voltage and current sensing measurements from ADC circuitry 926 are provided to processor 902 for calculating impedance. As an example, the first energy modality ENERGY ₁ may be RF monopolar energy and the second energy modality ENERGY ₂ may be RF bipolar energy. Nevertheless, in addition to bipolar and unipolar RF energy modalities, other energy modalities include ultrasound energy, irreversible and/or reversible electroporation, and/or microwave energy, among others. be done. Also, while the example shown in FIG. 1 illustrates that a single return path RETURN may be provided for two or more energy modalities, in other aspects multiple return paths RETURN _n may be provided. , to each energy modality ENERGY _n .

As shown in FIG. 1, a generator 900 with at least one output port provides power, for example, ultrasound energy, bipolar RF energy or monopolar RF energy, among others, depending on the type of tissue treatment being performed. having a single output for providing to the end effector in the form of one or more energy modalities such as energy, irreversible and/or reversible electroporation, and/or microwave energy; , and may include a power transformer 908 having multiple taps. For example, the generator 900 can deliver high voltage, low current energy to drive an ultrasound transducer, and low voltage, high current energy to drive RF electrodes to seal tissue. Alternatively, energy with a coagulation waveform can be delivered for spot coagulation using either monopolar RF electrosurgical electrodes or bipolar RF electrosurgical electrodes. The output waveform from generator 900 can be induced, switched or filtered to provide frequencies to the end effector of the surgical instrument. In one example, the connection to the output of the RF bipolar electrode generator 900 would preferably be located between the output labeled ENERGY ₂ and RETURN. For unipolar outputs, the preferred connections would be active electrodes (eg, pencil or other probes) to suitable return pads connected to the ENERGY ₂ and RETURN outputs.

Additional details can be found in U.S. Patent Application Publication No. 47/0891, published March 30, 2017, entitled TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS, which is incorporated herein by reference in its entirety. disclosed in No.

FIG. 2 shows one form of surgical system 1000 comprising a generator 1100 and various surgical instruments 1104, 1106, 1108 usable therewith, where surgical instrument 1104 is an ultrasonic surgical instrument. There, surgical instrument 1106 is an RF electrosurgical instrument and multi-function surgical instrument 1108 is a combined ultrasonic/RF electrosurgical instrument. Generator 1100 is configurable for use with various surgical instruments. According to various aspects, the generator 1100 is, for example, an ultrasonic surgical instrument 1104, an RF electrosurgical instrument 1106, and a multi-function surgical instrument that integrates RF and ultrasonic energy simultaneously delivered from the generator 1100. The surgical instrument 1108 may be configurable for use with a variety of different types of surgical devices. In the form of FIG. 2, generator 1100 is shown separate from surgical instruments 1104, 1106, 1108, but in one form, generator 1100 is attached to any of surgical instruments 1104, 1106, 1108. may be integrally formed with it to form an integrated surgical system. The generator 1100 has an input device 1110 located on the front panel of the console of the generator 1100 . Input device 1110 may comprise any suitable device for generating signals suitable for programming the operation of generator 1100 . Generator 1100 may be configured for wired or wireless communication.

Generator 1100 is configured to drive multiple surgical instruments 1104 , 1106 , 1108 . The first surgical instrument is an ultrasonic surgical instrument 1104 , comprising a handpiece (HP) 1105 , an ultrasonic transducer 1120 , a shaft 1126 and an end effector 1122 . End effector 1122 comprises an ultrasonic blade 1128 and a clamp arm 1140 acoustically coupled to ultrasonic transducer 1120 . Handpiece 1105 includes a trigger 1143 to operate clamp arm 1140 and a combination of toggle buttons 1137, 1134b, 1134c to energize and drive ultrasonic blade 1128 or other functions. Toggle buttons 1137 , 1134 b , 1134 c can be configured to energize ultrasound transducer 1120 with generator 1100 .

Generator 1100 is also configured to drive a second surgical instrument 1106 . Second surgical instrument 1106 is an RF electrosurgical instrument and includes handpiece 1107 (HP), shaft 1127 and end effector 1124 . End effector 1124 includes electrodes in clamp arms 1145 , 1142 b and returns through the electrically conductive portion of shaft 1127 . The electrodes are coupled to and energized by a bipolar energy source within generator 1100 . Handpiece 1107 includes a trigger 1145 for operating clamp arms 1145 , 1142 b and an energy button 1135 for activating an energy switch for energizing the electrodes in end effector 1124 . A second surgical instrument 1106 can also be used with a return pad to deliver monopolar energy to tissue.

Generator 1100 is also configured to drive multi-function surgical instrument 1108 . Multi-function surgical instrument 1108 includes handpiece 1109 (HP), shaft 1129 and end effector 1125 . End effector 1125 includes ultrasonic blade 1149 and clamp arm 1146 . Ultrasonic blade 1149 is acoustically coupled with ultrasonic transducer 1120 . Handpiece 1109 includes a trigger 1147 for operating clamp arm 1146 and a combination of toggle buttons 11310, 1137b, 1137c for energizing and driving ultrasonic blade 1149 or other functions. Toggle buttons 11310, 1137b, 1137c energize ultrasonic transducer 1120 with generator 1100 and energize ultrasonic blade 1149 with a bipolar energy source also housed within generator 1100. can be configured to Monopolar energy can be delivered to tissue in combination with bipolar energy or separately from bipolar energy.

Generator 1100 is configurable for use with various surgical instruments. According to various aspects, the generator 1100 is, for example, an ultrasonic surgical instrument 1104, an RF electrosurgical instrument 1106, and a multi-function surgical instrument that integrates RF and ultrasonic energy simultaneously delivered from the generator 1100. It may be configurable for use with different types of different surgical instruments, including surgical instrument 1108 . In the form of FIG. 2, the generator 1100 is shown separate from the surgical instruments 1104, 1106, 1108; It may be integrally formed with either one to form an integrated surgical system. As discussed above, the generator 1100 includes an input device 1110 located on the front panel of the console of the generator 1100 . Input device 1110 may comprise any suitable device for generating signals suitable for programming the operation of generator 1100 . Generator 1100 may also include one or more output devices 1112 . Further aspects of a generator for digitally generating electrical signal waveforms and surgical instruments are described in US Patent Application Publication No. US-2017-0086914-A1, which is incorporated herein by reference in its entirety. It is

FIG. 3 shows a schematic diagram of a surgical instrument or tool 600 that includes multiple motor assemblies that can be activated to perform various functions. In the illustrated example, the closing motor assembly 610 is operable to transition the end effector between the open and closed configurations, and the articulation motor assembly 620 moves the end effector relative to the shaft assembly. operable to articulate; In certain examples, multiple motor assemblies can be individually activated to produce firing, closing, and/or articulating motions in the end effector. Firing motion, closing motion, and/or articulation motion can be transmitted to the end effector via, for example, a shaft assembly.

In certain examples, closure motor assembly 610 includes a closure motor. Closure motor 603 may be configured to transmit a closing motion generated by the motor to the end effector, specifically to displace the closure member and close the end effector to transition to the closed configuration. It may be operatively connected with drive assembly 612 . The closing motion may cause the end effector to transition from an open configuration to a closed configuration to capture tissue, for example. The end effector can be moved to the open position by reversing the direction of the motor.

In certain examples, articulation motor assembly 620 includes an articulation motor operably coupled to articulation drive assembly 622, which may be configured to transmit articulation motion generated by the motor to the end effector. In certain examples, the articulation may, for example, articulate the end effector with respect to the shaft.

One or more of the motors of surgical instrument 600 may include a torque sensor for measuring the output torque on the shaft of the motor. The force on the end effector may be sensed in any conventional manner, such as by a force sensor outside the jaws or by a torque sensor on the motor that actuates the jaws.

In various examples, motor assemblies 610, 620 include one or more motor drivers, which may include one or more H-bridge FETs. The motor driver may modulate the power transferred from power supply 630 to the motor based on, for example, input from microcontroller 640 (“controller”) of control circuit 601 . In certain examples, a microcontroller 640 can be used, for example, to determine the current drawn by the motor.

In particular examples, microcontroller 640 may include a microprocessor 642 (“processor”) and one or more non-transitory computer-readable media or memory units 644 (“memory”). In particular examples, memory 644 may store various program instructions that, when executed, may cause processor 642 to perform a number of functions and/or calculations described herein. can. In particular examples, one or more of memory units 644 may be coupled to processor 642, for example. In various aspects, microcontroller 640 may communicate via wired or wireless channels, or a combination thereof.

In certain examples, power supply 630 may be used to power microcontroller 640, for example. In certain examples, power source 630 may comprise a battery (or “battery pack” or “power pack”) such as, for example, a lithium-ion battery. In certain examples, the battery pack may be configured to be releasably attached to the handle to power surgical instrument 600 . Multiple battery cells connected in series can be used as the power source 630 . In certain examples, power source 630 may be replaceable and/or rechargeable, for example.

In various examples, processor 642 may control motor drivers to control the position, rotational direction, and/or speed of the motors of assemblies 610 , 620 . In certain examples, processor 642 may signal the motor driver to stop and/or disable the motor. The term "processor," as used herein, means any suitable microprocessor, microcontroller, or computer central processing unit (CPU) that combines the functions of a single integrated circuit or up to It should be understood to include other basic computing devices integrated on several integrated circuits. Processor 642 is a general purpose programmable device that accepts digital data as input, processes that data according to instructions stored in memory, and provides the results as output. This is an example of sequential digital logic since it has internal memory. Processors work with numbers and symbols represented in a binary number system.

In one example, processor 642 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex by Texas Instruments. In a particular example, microcontroller 620 may be, for example, the LM 4F230H5QR available from Texas Instruments. In at least one embodiment, Texas Instruments' LM4F230H5QR provides 256 KB of single-cycle flash memory up to 40 MHz or other non-volatile memory on-chip memory, performance up to 40 MHz, among other features readily available in product datasheets. 32 KB single-cycle SRAM, internal ROM with StellarisWare software, 2 KB EEPROM, one or more PWM modules, one or more QEI analog , ARM Cortex-M4F processor cores with one or more 12-bit ADCs with 12 analog input channels. Other microcontrollers can be readily substituted for use with surgical instrument 600 . Accordingly, the present disclosure should not be limited in this context.

In particular examples, memory 644 may contain program instructions for controlling each of the motors of surgical instrument 600 . For example, memory 644 may contain program instructions for controlling the closing motor and the articulation motor. Such program instructions may cause processor 642 to control the closure and articulation functions according to inputs from an algorithm or control program of surgical instrument 600 .

In particular examples, one or more mechanisms and/or sensors, such as sensor 645, may be used to alert processor 642 of program instructions to use in a particular setting. For example, sensor 645 can alert processor 642 to use program instructions associated with end effector closure and articulation. In certain examples, sensor 645 may comprise a position sensor that may be used, for example, to sense the position of a closing actuator. Accordingly, the processor 642 activates the motor of the closure drive assembly 620 using program instructions associated with closing the end effector when the processor 642 receives a signal from the sensor 630 indicating activation of the closure actuator. can.

In some examples, the motor may be a brushless DC electric motor and each motor drive signal may comprise a PWM signal provided to one or more stator windings of the motor. Also, in some examples, the motor driver may be omitted and the control circuit 601 may directly generate the motor drive signal.

It is common during various laparoscopic surgical procedures to access a surgical site located within the patient's abdomen by inserting a surgical end effector portion of a surgical instrument through a trocar placed in the patient's abdominal wall. It is customary. In its simplest form, a trocar has a sharp triangular point at one end typically used within a hollow tube known as a cannula or sleeve to create an opening in the body through which a surgical end effector can be introduced. It is a pen-shaped instrument with Such placement forms an access port within the body cavity through which a surgical end effector can be inserted. The inner diameter of the trocar cannula necessarily limits the size of the end effector and drive support shaft of the surgical instrument that can be inserted through the trocar.

Regardless of the particular type of surgical procedure being performed, once the surgical end effector is inserted into the patient through the trocar cannula, in order to properly position the surgical end effector with respect to the tissue or organ to be treated: It is often necessary to move the surgical end effector relative to the shaft assembly positioned within the trocar cannula. This movement or positioning of the surgical end effector relative to the portion of the shaft that remains within the trocar cannula is often referred to as "articulation" of the surgical end effector. To facilitate such articulation of surgical end effectors, various articulation joints have been developed to attach surgical end effectors to associated shafts. In many surgical procedures, as expected, it is desirable to use surgical end effectors that have the greatest possible range of articulation.

Due to the size constraints imposed by the size of the trocar cannula, the articulation joint components must be sized to be freely insertable through the trocar cannula. These size constraints also operably interface with motors and/or other control systems supported within the housing, which may be handheld or may comprise part of a larger automation system. , limits the size and composition of the various drive members and components. In many cases, these drive members must operably pass through articulation joints to be operably coupled or operably interfaced with the surgical end effector. For example, one such drive member is commonly used to impart articulation control motion to surgical end effectors. In use, the articulation drive member facilitates insertion of the surgical end effector through the trocar and then articulates the surgical end effector to a desired position as the surgical end effector enters the patient. To activate, it can be deactivated so that the surgical end effector is positioned in a non-articulated position.

Accordingly, the aforementioned size constraints provide an articulation system that can achieve the desired range of articulation and also accommodate a variety of different drive systems required to operate various features of the surgical end effector. Forms many challenges to develop. Further, once the surgical end effector is positioned in the desired articulation position, the articulation system and articulation joints hold the surgical end effector in that position upon actuation of the end effector and completion of the surgical procedure. must be able to Such an articulation joint arrangement must also be able to withstand the external forces experienced by the end effector during use.

Various modes of one or more surgical devices are often used throughout a particular surgical procedure. A communication path extending between a surgical device and a centralized surgical hub, for example, can facilitate efficiency and increase the success rate of surgical procedures. In various examples, each surgical device within the surgical system includes a display that communicates the presence and/or operational status of other surgical devices within the surgical system. The surgical hubs use the information received over the communication path to evaluate the suitability of surgical devices for use with each other and to select surgical devices for use during a particular surgical procedure. Suitability can be evaluated and/or operating parameters of the surgical device can be optimized. As described in more detail herein, one or more operating parameters of the surgical device may be, for example, patient demographics, a particular surgical procedure, and/or tissue thickness. It can be optimized based on detected environmental conditions.

A split display system is shown in FIGS. The split display communicates various generator and/or surgical device parameters between the display 27010 of the handheld surgical instrument 27000 and the primary monitor display 27100 . FIG. 4 shows an example of a display 27010 of handheld surgical instrument 27000. As shown in FIG. In various examples, display 27010 includes a touch-sensitive graphic user interface capable of receiving user input. Display 27010 includes various settings and/or modes that allow a user to customize the information and/or images shown on display 27010 at any given time.

Surgical instrument 27000 is in communication with primary display monitor 27100 . A primary display monitor 27100 has a larger screen than the display 27010 of the surgical instrument 27000 . In various examples, primary display monitor 27100 displays the same information and/or images as display 27010 of surgical instrument 27000 . In other examples, primary display monitor 27100 displays different information and/or images than display 27010 of surgical instrument 27000 . In various examples, primary display monitor 27100 includes a touch-sensitive graphical user interface capable of receiving user input. Similar to the display 27010 of the surgical instrument 27000, the primary display monitor 27100 has a variety of features that allow the user to customize the information and/or images shown on the primary display monitor 27100 at any given time. Includes settings and/or modes. As described in more detail herein, a selected mode on primary display monitor 27100 can change the mode of display 27010 on surgical instrument 27000 and vice versa. Stated another way, primary display monitor 27100 and surgical instrument display 27010 cooperate together to most effectively communicate selected operating parameters to the user.

The illustrated handheld surgical instrument 27000 provides combined electrosurgical functionality, and the surgical instrument 27000 includes an end effector with first and second jaws. The first jaw and the second jaw have electrodes disposed thereon. Electrosurgical instrument 27000 includes one or more generators configured to power the electrodes to energize the electrodes. More specifically, energy delivery to patient tissue supported between the first and second jaws may be performed in a monopolar mode, a bipolar mode, and/or a combination mode to deliver energy. Accomplished by supplying energy to configured electrodes. Combination modes are configured to deliver alternating or fused bipolar and monopolar energy. In at least one embodiment, the at least one generator comprises batteries, rechargeable batteries, disposable batteries, and/or combinations thereof. Various details regarding the operation of the first and second generators are set forth in U.S. patent application Ser. MULTIPLE DEVICES”, which is incorporated herein by reference in its entirety.

The display 27010 and primary display monitor 27100 of surgical instrument 27000 include split displays for communicating many operating parameters to the user. The split display is configured to be selectively segmentable. Stated another way, the user can select which operating parameters to display and/or where to display selected operating parameters. Such customization minimizes distractions by eliminating unnecessary and/or unnecessary information while allowing the user to control surgical instrument 27000 and/or Alternatively, it enables efficient observation of necessary and/or desired information for performing a surgical procedure. A display 27010 of surgical instrument 27000 comprises a first portion 27012 in which power levels for a particular mode are displayed. Display 27010 of surgical instrument 27000 further comprises a second portion 27014 in which the current mode of surgical instrument 27000 and/or the type of energy being delivered by surgical instrument 27000 is identified or otherwise. communicated.

Similarly, the primary display monitor 27100 comprises a segmented display, however in various examples the images displayed on the display monitor 27100 can be superimposed on each other. A central portion 27110 of the primary display monitor 27100 streams live and/or still images of the surgical site to the procedure room. Live video and/or images of the surgical site are captured through a suitably positioned camera, such as an endoscope. A menu selection portion 27130 of the primary display monitor 27100 prompts the user to select which mode the primary display monitor 27100 is in and/or what information the user wishes to see on the primary display monitor 27100; /or otherwise allow for such user selection. The device status portion 27120 of the master 27100 communicates display monitor information as well as the first portion 27012 of the surgical instrument display 27010 . In various examples, the device status portion 27120 is further divided into multiple sections. For example, the first portion 27122 is configured to communicate operating parameters that reflect the bipolar mode. Such operating parameters may be specific and/or general. Certain operating parameters may reflect, for example, bipolar mode power levels. A general operating parameter can indicate, for example, whether the bipolar mode is active or inactive. Second portion 27124 is configured to communicate operating parameters that reflect unipolar mode. Such operating parameters may be specific and/or general. Certain operating parameters may reflect, for example, monopolar mode power levels. A general operating parameter can indicate, for example, whether the unipolar mode is active or inactive. A third portion 27126 is configured to communicate operating parameters that reflect the smoke evacuation system. Such operating parameters may be specific and/or general. Certain operating parameters may reflect, for example, the power level of the smoke evacuation system. A general operating parameter may indicate, for example, whether the smoke evacuation system is active or inactive.

Referring now to FIGS. 5-9, display 27010 of surgical instrument 27000 is shown alongside corresponding displays on primary display monitor 27100. FIG. As the user changes power levels on handheld surgical instrument 27000 , such power level changes are reflected on primary display monitor 27100 , as described in more detail herein. For example, as shown in FIG. 5, generators operating in bipolar mode are now shown in the device status portion 27120 of primary display monitor 27100 and first portion 27012 and second portion 27014 of surgical instrument display 27010. It is operating at a power level of 80 Watts so that More specifically, a first portion 27012 of the surgical instrument display 27010 represents the output of the generator, while a second portion 27014 of the surgical instrument display 27010 represents the mode and/or type of energy. . Similarly, the device status portion 27120 of the primary display monitor 27100 indicates that the generator is operating in bipolar energy mode at a power level of 80 watts and the generator is operating in unipolar energy mode at a power level of 0 watts. show. Upon receiving a command to increase the power output of the generator to operate the bipolar mode to 100 watts, the surgical instrument display 27010 and primary display monitor 27100 change accordingly as shown in FIG. More specifically, the first portion 27012 of the surgical instrument display 27010 represents a power level of 100 Watts and the device status portion 27120 of the main display monitor 27100 currently indicates that the generator is bipolar at a power level of 100 Watts. Indicates that the mode is operating. The primary display monitor 27100 continues to indicate that the monopolar energy mode is operating at a power level of 0 Watts, but the primary display monitor 27100 also indicates smoke detection within the surgical site and/or increased surgical instrument pressure. Due to the power level, at 27126 the smoke detection system is activated to 20%.

7-9 show the display 27010 and corresponding primary display monitor 27100 of surgical instrument 27000 when a combination of both bipolar and monopolar energy is being delivered to patient tissue. FIG. 7 shows a first portion 27012' of surgical instrument display 27010 in full power mode. As shown on primary display monitor 27100, bipolar energy mode 27122 is operating at a power level of 60 Watts and monopolar energy model 27124 is operating at a power level of 60 Watts. However, a combined power level and/or total power level of 120 Watts is represented on the first portion 27012' of the surgical instrument display 27010. The primary display monitor 27100 also shows that the smoke detection system is activated to 50% at 27126 due to detection of smoke within the surgical site and/or increased power levels of the surgical instruments. As shown in FIG. 8, the user can set the individual power levels for the bipolar and monopolar modes on the first portion 27012'' of the surgical instrument display 27010, and the total power level for the primary display monitor 27100 device. You may want to see it on the status portion 27122'. Stated another way, the information shown on the display of FIG. 8 is reversed from the display shown in FIG. The primary display monitor 27100 further indicates that the smoke detection system is activated to 73% at 27126 due to detection of smoke within the surgical site and/or changes in power levels in bipolar and/or monopolar mode. show. The display pair shown in FIG. 9 is similar in many respects to the display pair shown in FIG. are doing.

As discussed in greater detail herein, surgical instrument display 27010 and/or primary display monitor 27100 can include a touch sensitive graphic user interface. In various examples, the surgical instrument display 27010 is used to control what is displayed on the surgical instrument display 27010 and what is displayed on the primary display monitor 27100. In another example, primary display monitor 27100 is used to control what is displayed on surgical instrument display 27010 and what is displayed on primary display monitor 27100 . In various examples, each display is configured to control what is displayed on its own display. In various examples, each display within the surgical system is configured to cooperatively control what is displayed on other displays within the surgical system.

In various examples, a surgical system includes an electrosurgical device and a smoke evacuation system. As discussed in more detail herein, electrosurgical devices are configured to deliver energy to patient tissue supported between jaws of the end effector by energizing electrodes. . The electrodes are configured to deliver energy in monopolar modes, bipolar modes, and/or combination modes having alternating or fused bipolar and monopolar energies. In various examples, the first generator is configured to control a bipolar energy modality and the second generator is configured to control a unipolar energy modality. A third generator is configured to control the smoke evacuation system. Various details regarding the operation of the first and second generators are set forth in U.S. patent application Ser. MULTIPLE DEVICES”, which is incorporated herein by reference in its entirety.

FIG. 10 is a graphical representation 27200 showing the proportional relationship between smoke evacuation system duty cycle and total effective energy delivered to patient tissue. Time 27210 is represented along the x-axis and power (W) 27220a and smoke evacuation system duty cycle (%) 27220b are represented along the y-axis. The total effective energy is expressed in three phases: (1) bipolar therapy 27230, (2) monopolar therapy 27240, and (3) combined energy 27250. The percentage duty cycle of the smoke evacuator is expressed in two phases: (1) in response to combined energy 27260 and (2) in response to bipolar therapy 27270 alone. For example, at time t ₀ no power is delivered to patient tissue and the smoke evacuation system is inactive. At time t ₁ , bipolar therapy 27230 is delivered at first power level P ₁ . At time _t1 , bipolar therapy 27230 is the only energy delivered to patient tissue. When the power increases to P ₁ during the period t ₀ -t ₁ , the smoke evacuation system is activated. At time _t1 , a first fraction _S1 of the smoke exhaust duty cycle is utilized.

At time _t2 , the power level of bipolar therapy 27230 was increased and monopolar therapy 27240 began to be delivered. At time _t3 , bipolar therapy 27230 decreased while monopolar therapy 27240 increased. Overall, the combination energy 27250 remained substantially the same from t ₂ to t ₃ . At time _t3 , the combined energy 27250 is delivered at a third power level _P3 , which is higher than the first power level _P1 delivered at time _t1 . As the power increased to P ₃ during the period t ₁ -t ₃ , the smoke evacuation system duty cycle percentage also increased. At time _t3 , a third fraction _S3 of the smoke exhaust duty cycle is utilized. The third proportion _S3 is greater than the first proportion _S1 . At time t ₄ , the delivery of bipolar therapy 27230 ceases and the only energy delivered to patient tissue is through monopolar therapy 27240 . Specifically, at time _t4 , monopolar therapy 27240 delivers energy to patient tissue at _P4 , the highest level of monopolar therapy delivered during the entire surgical procedure. Therefore, since the energy _P4 delivered at time _t4 is greater than the energy _P3 delivered at time _t3 , the fraction of the smoke exhaust duty cycle has also increased. At time _t4 , a fourth fraction _S4 of the smoke exhaust duty cycle is utilized. The fourth proportion S4 is greater than the proportion of the third proportion _S3 and the first proportion _S1 .

The graphical representation in FIG. 10 shows bipolar energy 27230 being delivered at varying levels throughout the surgical procedure. Such times may correspond to a tissue sealing cycle in which the surgical hub commands the smoke evacuation system to increase or decrease its operating level in response to the current bipolar power level. After the tissue sealing cycle is completed, monopolar energy can be applied for a defined period of time to cut patient tissue. As patient tissue is cut, the surgical hub can command the smoke evacuation system to increase its operating level based on the increase in energy being applied to cut the tissue, thus For example, an increase in applied energy typically corresponds to an increase in smoke from burning tissue. During a particular surgical procedure, the surgical hub recognizes predefined points in time to change energy delivery and power levels. Predefined time points can vary, for example, based on the type of particular surgical procedure to be performed. The predefined time points can vary, for example, based on patient demographics identified in the surgical hub. Any detected change in the type of energy being applied and/or the level of energy being applied can trigger responses of different components of the surgical system.

Similar to the surgical system described with respect to Figure 10, the surgical system 27700 shown in Figure 11 includes an electrosurgical instrument 27710 in communication with a surgical hub. The electrosurgical instrument 27710 delivers energy to patient tissue supported between jaws of the end effector by electrodes configured to deliver energy in monopolar, bipolar, and/or combination modes. It is configured. Electrosurgical instrument 27710 is configured to apply alternating or fused bipolar and monopolar energy to patient tissue when in a combined mode. Surgical system 27700 further comprises a first generator 27720 configured to control a monopolar energy modality and a second generator 27730 configured to control a bipolar energy modality. The display screen 27750 is positioned at a location within the procedure room within the user's field of view. In various examples, electrosurgical instrument 27710 includes a display positioned thereon. As the second generator 27730 delivers bipolar energy to patient tissue, an instrument display and/or display screen 27750 in the treatment room indicates the level of power being applied. In various examples, the level of smoke evacuation by the smoke evacuation system is indicated on the display(s), and the level of smoke evacuation is based on the level of power and/or type of energy being applied. there is As discussed in more detail herein, the first generator 27720 delivers monopolar energy to patient tissue and/or the second generator 27730 delivers a reduced amount of bipolar energy to the patient. When delivered to tissue, the display(s) are configured to update the displayed or otherwise communicated operating parameter. As the level of power changes during a surgical procedure, such changes are communicated to the surgical hub. In response, the surgical hub automatically or without external prompting changes the level of smoke evacuation to compensate for changes in the level and/or type of energy being applied to the patient tissue. is configured as

At least one of the instrument display and display screen 27750 comprises a touch sensitive graphic user interface configured to receive user input. The user can select what information is displayed, where the selected information is displayed on a particular display, and/or which display within the surgical system displays the desired information. can. In various examples, the surgical system 27700 further comprises one or more cameras positioned within the procedure room. One or more cameras are configured to monitor movement of the user and/or devices of the surgical system. One or more cameras can communicate any detected motion to the surgical hub, which recognizes that the detected motion corresponds to a predetermined command. For example, the camera can detect when the user rocks the arm. A memory within the surgical hub correlates arm rocking with a user request to clear the display of all operating parameters, so that only live video and/or images of the surgical site remain on the display. . Exemplary commands that may be associated with particular user and/or instrument movements include adjusting the position of the display(s), adjusting the view of the display(s), adjusting the view of the display(s), adjusting the information presented on a plurality of); adjusting the location of the displayed information on a particular display; adjusting the size of the displayed information; controlling the power level of the generator; and/or controlling operating parameters of various surgical instruments of the surgical system.

As discussed with respect to surgical system 27700, electrosurgical instrument 27710 comprises combined electrical modalities. The unipolar modality of the electrosurgical instrument is operated by first generator 27720 while the bipolar modality is operated by second generator 27730 . Monopolar energy is delivered to patient tissue to make an incision or otherwise cut the treated tissue. Bipolar energy is delivered to the tissue to seal and/or ablate the target tissue prior to cutting the patient tissue. A graphical representation 27300 of first and second generator power levels (wattage) 27320a versus time (t) 27310 is shown in FIG. Power levels are represented by two phases: (1) first generator 27340 and (2) second generator 27330 . Graphical representation 27300 further illustrates the relationship of tissue impedance (Ω) 27320b to time (t) 27310. Tissue impedance is biphasic (1) in response to delivered monopolar energy 27345 and (2) in response to delivered bipolar energy 27335 .

As the power level of the second generator 27330 increases from 0, bipolar energy is delivered to patient tissue. The patient tissue impedance increases in response to the application of bipolar energy 27335 . In particular, the patient tissue impedance continues to increase over time even after the power level of the second generator 27330 begins to decrease. Stated another way, the impedance of the tissue sealed by the bipolar energy 27335 is such that, in the absence of delivery of monopolar energy to cut patient tissue, the power level of the second generator 27330 is Although reduced and then reduced, tissue impedance in such instances does not necessarily decrease immediately. At time t ₁ , the power level of first generator 27340 is increased, thereby cutting tissue through delivery of monopolar energy to patient tissue. Patient tissue impedance also increases in response to the application of monopolar energy 27345 . In particular, the patient's impedance increases exponentially as tissue is cut and the power level of the first generator 27340 is reduced.

FIG. 13 shows an algorithm 27400 for controlling various components of the surgical system. A surgical system includes surgical instruments configured to perform an intended surgical function. In various examples, the surgical instrument is handheld and includes a handle. A user is configured to operate various modes of the surgical instrument via input elements on the handle. As described in more detail herein, the surgical instrument has a first generator configured to power a unipolar modality and a first generator configured to power a bipolar modality. and a second generator. The surgical system further includes a smoke evacuation system configured to remove smoke and/or other unwanted particulates from the surgical site. The surgical instrument and/or smoke evacuation system is in signal communication with a surgical hub that provides user input to the surgical instrument, smoke evacuation system, and/or another component within the surgical system. In response, it is configured to adjust the appropriate response(s) of the components of the surgical system.

As shown in FIG. 13, control algorithm 27400 begins when the user changes mode 27410 of the surgical instrument. For example, a user may wish to increase the power level of the first generator in order to cut patient tissue. In another example, a user may desire a surgical instrument to seal and/or cut patient tissue. In any event, the surgical instrument then communicates user input to the first and second generators at 27412, 27414, respectively. The surgical instrument further communicates 27415 the user input to the surgical hub. After the surgical hub is notified of the desired increase in monopolar energy at 27420, the surgical hub commands the second generator at 27425 to supply and/or dispense the appropriate power level. is configured to Upon receiving communication from the surgical instrument at 27412, the first generator increases the waveform at 27440 in preparation for cutting patient tissue. Upon receiving the communication from the surgical instrument at 27414 and the command from the surgical hub at 27425, the second generator at 27450 prepares to seal the patient tissue after the cut has been performed. Increase power levels associated with bipolar modalities. The second generator can then communicate its readiness to the first generator at 27455 . The first generator can then begin cutting patient tissue at 27442 . Stated another way, the surgical hub prevents the monopolar electrode from being energized until the bipolar electrode is energized to prevent ablation and/or cutting of unsealed tissue. To prevent. The surgical hub is further configured at 27426 to command the smoke evacuation system to increase the motor speed in response to increasing the power levels of the first and second generators. At 27430, after the smoke evacuation system has increased its motor speed, the smoke evacuation system moves the surgical hub, the surgical instrument, and/or the first and second generators through the duration of the surgical procedure. communication line. For example, the smoke evacuation system is configured at 27435 to continuously communicate the current motor speed to the surgical hub. In such an example, the smoke evacuation system would transmit its current motor speed to the surgical hub every minute or every two minutes, but the smoke evacuation system would transmit its current motor speed at any suitable frequency. can communicate. Once the surgical instrument has completed the desired tissue cut, the user can again provide input on the instrument handle to reduce the power level of the first generator and/or terminate the control algorithm 27400. . In various examples, the control algorithm 27400 is configured to automatically reduce the power level of the first generator after a predetermined period of time corresponding to completion of tissue cutting. Utilizing control algorithms 27400, the surgical hub can, for example, adjust operating parameters of surgical system components to facilitate an efficient and/or effective surgical procedure.

Many surgical devices, tools, and/or replaceable components are often used during a particular surgical procedure. Among other things, its role in streamlining the equipment and/or components stocked in the procedure room for use during a particular procedure, minimizing operator error, and/or minimizing delays during a surgical procedure. Various systems are disclosed herein. The systems described herein use, among other things, artificial intelligence and machine learning developed during the course of one or more surgical procedures to increase the efficiency of surgical procedures.

Various components of an exemplary surgical system 27500 are shown in FIG. During a particular surgical procedure, the patient is on the operating table, or any suitable treatment surface 27510. In various examples, certain procedures are performed at least in part using a surgical robot. A surgical robot includes one or more robotic arms 27520 . Each robotic arm 27520 is configured to receive a tool component 27590. Tool components 27590 are configured to cooperate with each other to assist the performance and/or clinician in performing a particular surgical procedure. Tool components may comprise, for example, surgical stapling and/or tissue cutting tool components, tissue grasping tool components, and/or electrosurgical tool components. Tool components may include other characteristics such as, for example, size, manufacturer, date of manufacture, number of previous uses, and/or expiration date.

Surgical system 27500 further comprises surgical hub 27530 . Various surgical hubs are described in U.S. patent application Ser. incorporated. Surgical hub 27530 includes a memory 27535 that stores various suitable or otherwise suitable combinations of tool components 27590 for use during a particular procedure. Stated another way, the memory 27535 of the surgical hub 27530 comprises a stored bank of information that can be used to indicate which tool components 27590 are suitable for use during selected procedures. .

Prior to performing a desired surgical procedure, a clinician may inform or otherwise communicate details regarding the desired surgical procedure and/or patient to surgical hub 27530 . Such details may include, for example, the identity of the surgical procedure, the identity of the clinician performing the surgical procedure, and/or the biometric profile of the patient. Surgical hub 27530 then utilizes one or more of the communicated details to determine which tool components 27950 are needed to perform the desired surgical procedure and/or or appropriate. In various examples, surgical hub 27530 is configured to assess which mode of each tool component 27950 is appropriate for performing a desired surgical procedure on a particular patient. .

As shown in FIG. 14, four robotic arms 27250 surround or are otherwise attached to an operating table 27510 . The three tool components 27590 are connected to three corresponding robotic arms 27250, leaving one robotic arm free to receive additional tool components. A plurality of unique tool components 27560, 27570, 27580 are shown stored on a mobile stand 27550 within the procedure room. As discussed above, the types and/or functions of tool components 27560, 27570, 27580 may differ. In such an example, surgical hub 27530 evaluates available tool components 27560, 27570, 27580 and identifies appropriate tool components for attachment to the surgical robot. Suitable tool components may be, for example, which tool types and/or functions are still required by the surgical robot and/or which tool components are associated with the desired surgical procedure. The identification is based on one or more factors, such as completing a predetermined pairing. In various examples, a surgical robot includes a memory that stores predetermined tool component pairings based, for example, on a particular surgical procedure and/or particular patient demographics. In such examples, the surgical robot can identify the appropriate tool component for attachment to the surgical robot based on the identification information of the already attached tool components.

In other examples, the tool components 27560, 27570, 27580 comprise the same type and/or functionality, but the tool components 27560, 27570, 27580 are different, for example, in size, manufacturer, expiration date, and/or ever at least one other trait, such as the number of uses of Surgical hub 27530 evaluates the profile of each available tool component 27560, 27570, 27580 to ensure that its properties are compatible with the profile of other selected and/or attached tool components 27590. Identify appropriate tool components based on

As shown in FIG. 14, each tool component 27560, 27570, 27580 has a QR code 27565, 27575, 27585 positioned at any suitable location thereon, each QR code Contains a profile of information representing the linked tool components. The user scans and/or reads the QR codes 27565, 27575, 27585 using any suitable scan tool 27540. Scan tool 27540 then communicates the QR code and/or information contained within the QR code to surgical hub 27530 . In examples where the QR code itself is communicated by the scan tool 27540 to the surgical hub 27530, the processor of the surgical hub 27530 is configured to decode the profile of information contained by the received QR code. Although the illustrated embodiment comprises a QR code, the tool component can comprise any suitable memory device such as barcodes, RFID tags, and/or memory chips, for example.

Surgical hub 27530 is configured to alert the user when a tool component is unacceptable and/or undesirable for use during a surgical procedure. Such alerts may be communicated via various forms of feedback including, for example, haptic feedback, auditory feedback, and/or visual feedback. In at least one example, the feedback includes audio feedback, and the surgical system 27500 can include a speaker that emits sounds, eg, beeps, when an error is detected. In certain examples, the feedback includes visual feedback, and the tool components can each include, for example, a light emitting diode (LED) that flashes when an error is detected. In certain examples, visual feedback can be communicated to the user through alerts presented on a display monitor within the clinician's field of view. In various examples, the feedback includes haptic feedback, and the surgical system 27500 components can include electric motors with eccentric elements that vibrate when an error is detected. Warnings may be specific or general. For example, the warning may specifically state that the QR code on the tool component cannot be detected, or the warning may indicate that the QR code is non-compliant and/or malfunctioning tool component. It can be specifically stated that it contains information that represents.

For example, a user attempts to attach a first tool component 27560 to an available robotic arm 27590 of a surgical robot. Prior to attaching first tool component 27560 to robotic arm 27590 , scan tool 27540 scans QR code 27565 displayed on first tool component 27560 . Scan tool 27540 communicates QR code 27565 and/or information contained within QR code 27565 to surgical hub 27530 . The Surgical Hub 27530 converts the information contained within the QR Code 27565 into a stored list of acceptable tool components associated with a particular surgical procedure and/or tools currently attached to the surgical robot. Compare to a stored list of acceptable tool components that are compatible with the component. In this case, surgical hub 27530 is unable to recognize and/or locate first tool component 27560 within its memory 27535 . Accordingly, the first tool component 27560 is not recommended and/or suitable for use with surgical robots. As discussed above, the surgical hub 27530 is configured to alert the clinician of incompatibility between the first tool component 27560 and the surgical robot and/or certain surgical procedures. In various examples, the surgical system 27500 can prevent the first tool component 27560 from being attached thereto, eg, by mechanical and/or electrical lockouts. Such an attachment lockout prevents clinicians from overlooking and/or simply ignoring warnings issued by the surgical system 27500 . Stated another way, attachment lockout requires the clinician to take positive steps in overriding errors communicated by the surgical system 27500 . In such an example, an override can be activated to allow the clinician to override any system lockout and take advantage of the operational features of the first tool component 27560. Various examples prevent clinicians from utilizing the functionality of the first tool component 27560 while the first tool component 27560 has been identified as unsuitable for use with a surgical robot. No overrides are available to do this.

Similarly, the user attempts to attach a second tool component 27570 to an available robotic arm 27590 of the surgical robot. Prior to attaching second tool component 27570 to robotic arm 27590 , scan tool 27540 scans QR code 27575 displayed on second tool component 27570 . Scan tool 27540 communicates QR code 27575 and/or information contained within QR code 27575 to surgical hub 27530 . The Surgical Hub 27530 converts the information contained within the QR Code 27575 into a stored list of acceptable tool components associated with a particular surgical procedure and/or tools currently attached to the surgical robot. Compare to a stored list of acceptable tool components that are compatible with the component. In this case, surgical hub 27530 is unable to recognize and/or locate second tool component 27570 within its memory 27535 . Therefore, the second tool component 27570 is not recommended and/or suitable for use with surgical robots. As discussed above, the surgical hub 27530 is configured to alert the clinician of incompatibility of the second tool component 27570 with the surgical robot and/or certain surgical procedures. In various examples, the surgical system 27500 can prevent the second tool component 27570 from being attached thereto. Such an attachment lockout prevents clinicians from overlooking and/or simply ignoring warnings issued by the surgical system 27500 . Stated another way, attachment lockout requires the clinician to take positive steps in overriding errors communicated by surgical system 27500 . In such an example, an override can be activated to allow the clinician to override any system lockout and take advantage of the operational features of the second tool component 27570. Various examples prevent clinicians from utilizing the functionality of the second tool component 27570 while the second tool component 27570 has been identified as unsuitable for use with a surgical robot. Therefore, no override is available.

The user attempts to attach the third tool component 27580 to the available robotic arm 27590 of the surgical robot. Prior to attaching the third tool component 27580 to the robot arm 27590, the scan tool 27540 scans the QR code 27585 displayed on the third tool component 27580. Scan tool 27540 communicates QR code 27585 and/or information contained within QR code 27585 to surgical hub 27530 . The Surgical Hub 27530 converts the information contained within the QR Code 27585 into a stored list of acceptable tool components associated with a particular surgical procedure and/or tools currently attached to the surgical robot. Compare to a stored list of acceptable tool components that are compatible with the component. In this case, surgical hub 27530 successfully recognizes and/or locates third tool component 27580 within its memory 27535 . A third tool component 27580 is then determined to be suitable for use with a surgical robot and/or with other attached tool components during a particular surgical procedure. In various examples, the surgical hub 27530 is configured to alert the clinician of the compatibility of the third tool component 27580 with the surgical robot. In other examples, surgical system 27500 does not simply prevent attachment of third tool component 27580 to available robotic arm 27590 .

In various examples, memory 27535 of surgical hub 27530 is configured to store QR codes associated with each tool component used during a particular surgical procedure. Surgical hub 27530 may then analyze the collected information to make observations and recommendations regarding factors such as the efficiency and/or effectiveness of a particular tool component and/or multiple tool components during a surgical procedure, for example. /or conclusions can be formed. These observations and/or conclusions can then be used by surgical hub 27530 in selecting and/or recommending which tool components to utilize during future surgical procedures.

FIG. 15 illustrates a surgical system 27600 comprising one or more cameras configured to assist clinicians in performing efficient and/or successful surgical procedures. Similar to surgical system 27500, surgical system 27600 comprises an operating table 27610, or any suitable treatment surface. Surgical system 27600 further comprises surgical hub 27650 and device tower 27660 . Various surgical hubs are described in U.S. patent application Ser. incorporated.

Surgical system 27600 further comprises a camera system including one or more cameras 27640 positioned at various locations throughout the procedure room. In the illustrated embodiment, the two cameras 27640 are positioned at opposite corners of the procedure room, but the cameras 27640 are capable of cooperatively capturing the procedure room in an unobstructed manner. It can be positioned and/or oriented in any suitable location possible. Artificial intelligence protocols detect and/or identify various devices, equipment, and/or personnel and their corresponding locations and/or orientations within the procedure room.

Camera system camera 27640 is in communication with surgical hub 27650 . Stated another way, live video from camera 27640 can be transmitted to surgical hub 27650 for processing and analysis. Through analysis of images collected by camera 27640, surgical hub 27650 may maintain a real-time inventory of devices, equipment, and/or personnel in the procedure room and/or interaction between can be monitored and/or controlled. Using the images and/or data collected by the camera system, the surgical hub 27650 is informed as to the identity of the detected device, alerts the clinician as to suitability for the detected device, and/or It is configured to control various components of the surgical system 27600 based on the detected presence and/or motion of the device. Surgical Hub 27650 compares any detected devices to determine compatibility between devices and/or during a particular surgical procedure, and to facilitate cooperation between two devices intended to work together. and/or facilitate cooperation of the two devices to establish motion sensed and/or controlled by each other.

As shown in FIG. 15, an anesthesia cart 27670 and preparation table 27620 are positioned within the procedure room. Preparation table 27620 is configured to support various surgical tools and/or surgical devices such that they are easily accessible for use during a surgical procedure. Such surgical tools and/or surgical devices may include, for example, variable sized interchangeable staple cartridges, or shaft assemblies with variable sized and/or functional end effectors. In the illustrated embodiment, preparation table 27620 supports first device 27630a, second device 27630b, and third device 27630c.

Camera 27640 is configured to detect identifying information regarding devices, equipment, and/or personnel located within the procedure room. For example, camera 27640 can capture a serial number printed on a visible portion of each device 27630a, 27630b, 27630c, such as, for example, on the packaging of the device. In various examples, the package includes a QR code printed thereon, the QR code containing information about the device contained therein. The QR code is captured by camera 27640 and communicated to surgical hub 27650 for staple cartridge analysis and identification.

Such an identification system may be useful, for example, during a surgical procedure in which a surgical stapling instrument includes an end effector and a 60 mm staple cartridge is configured to seat within the end effector. A camera 27640 within the procedure room is configured to capture the presence of the surgical stapling instrument, eg, in the form of live video and/or still images. Camera 27640 then communicates the captured image(s) to surgical hub 27650 . Surgical hub 27650 is configured to identify a surgical stapling instrument based on image(s) received from camera 27640 . In instances where surgical hub 27650 is aware of the surgical procedure to be performed, surgical hub 27650 can alert the clinician as to whether the identified surgical stapling instrument is appropriate. For example, knowing that a 45mm staple cartridge is associated with a particular surgical procedure, the surgical hub 27650 will cause the end effector of the detected surgical stapling instrument to receive a 60mm staple cartridge. As configured, the clinician can be alerted to the inappropriateness of the detected surgical stapling instrument.

Surgical hub 27650 includes memory 27655 that stores technical requirements and/or specifications associated with various devices therein. For example, memory 27655 of surgical hub 27650 recognizes that the surgical stapling instrument described above is configured to receive a 60mm staple cartridge. In various examples, the memory 27655 can also recognize specific brands of 60 mm staple cartridges compatible with surgical stapling instruments. In various examples, camera 27640 can capture the presence of replaceable staple cartridges, eg, in the form of live video and/or still images. Camera 27640 then communicates the captured image(s) to surgical hub 27650 . Surgical hub 27650 is configured to identify characteristics of the replaceable staple cartridge based on image(s) received from camera 27640 . Such characteristics include, for example, size, brand, and/or manufacturing lot. As discussed in more detail herein, warnings may be specific or general. In the example where the camera 27640 captures the presence of a package containing replaceable 45 mm staple cartridges, the surgical hub 27650 alerts the clinician that the chamber is incorrectly stocked with non-compliant staple cartridges. It is configured. Such warnings can, for example, prevent surgical instrument failure, patient injury, and/or loss of valuable time during a surgical procedure.

As discussed above, the camera system is configured to facilitate surgical hub 27650 in adjusting the detected device within the procedure room. In various examples, the combination energy device and smoke evacuation system are detected by a camera system. The combination energy device is configured to apply bipolar energy and monopolar energy to patient tissue. When the camera system and/or surgical hub 27650 detects the activation of the combined energy device, the presence of the combined energy device located near the patient, and/or the presence of smoke within the procedure room, the surgical hub 27650 may, for example, , configured to instruct the generator to activate the smoke evacuation system.

Surgical instruments utilize measurable or otherwise detectable properties of the end effector to identify particular stages of a surgical procedure and/or control various operational parameters of the surgical instrument. be able to. Such characteristics can include, for example, the distance between the jaws of the end effector. The memory of the surgical instrument and/or surgical hub includes stored information that associates a particular jaw gap distance with a particular stage of the surgical procedure. For example, the surgical instrument and/or surgical hub confirms that the end effector delivers bipolar energy to patient tissue when a distance between the jaws of 0.030 inches to 0.500 inches is measured. In another example, when a distance between the jaws of 0.030 inches to 0.500 inches is measured, the surgical instrument and/or surgical hub activates the generator, thereby delivering bipolar force to patient tissue. Start delivering energy. Stated another way, the detection of characteristics of the surgical instrument and/or the contacted patient tissue is used by the surgical instrument and/or the surgical hub to identify and/or adapt the operation of the surgical instrument. be able to.

FIG. 16 includes charts showing various operating parameters and/or specifications of surgical instruments corresponding to various stages of a surgical procedure. Similar to the surgical instruments described in more detail herein, surgical instrument 27000 shown in FIGS. An end effector with a second jaw 27820 is included. At least one of the first jaw 27810 and the second jaw 27820 are movable relative to each other, and the end effector is configurable between an open configuration and a closed configuration. First jaw 27810 comprises a first tissue-supporting and/or tissue-contacting surface 27815 and second jaw 27820 comprises a second tissue-supporting and/or tissue-contacting surface 27825 . The first jaw 27810 and the second jaw 27810 have electrodes disposed thereon. Electrosurgical instrument 27000 includes one or more generators configured to power the electrodes to energize the electrodes. More specifically, energy delivery to patient tissue supported between the first and second jaws may be performed in a monopolar mode, a bipolar mode, and/or a combination mode to deliver energy. This is achieved by structured electrodes. Alternating or fused bipolar and monopolar energy are configured to be delivered in a combined mode. In at least one embodiment, the at least one generator comprises batteries, rechargeable batteries, disposable batteries, and/or combinations thereof.

End effector 27800 is used to perform various end effector functions during a surgical procedure. At original time _t0 , end effector 27800 is not in contact with patient tissue _Tt0 . Therefore, the electrodes of the end effector 27800 are not delivering any energy. At the original time _t0 , the patient tissue _Tt0 is in a relaxed, uncompressed state. End effector 27800 is shown in an open configuration. In the open configuration, the distance d ₀ ranges anywhere from 0.500 inches to 0.700 inches between the first tissue support surface 27815 and the second tissue support surface 27825. Stated another way, the tissue support surfaces 27815, 27825 are separated from each other by a maximum distance d ₀ of 0.500 inches to 0.700 inches when the end effector 27800 is in the open configuration.

At a first time _t1 , jaws 27810, 27820 of end effector 27800 contact patient tissue _Tt1 . At least a portion of patient tissue _Tt1 is positioned between jaws 27810, 27820 of end effector 27800 as end effector 27800 moves from the open configuration toward the closed configuration. As jaws 27810, 27820 are moved toward the closed configuration, tissue _Tt1 is compressed between them. At time _t1 , end effector 27800 is configured to deliver bipolar energy to patient tissue _Tt1 . Application of bipolar energy can cause the end effector 27800 to feather through parenchymal cells, for example. End effector 27800 is in a partially closed configuration at time _T1 . The first distance d ₁ ranges anywhere from 0.030 inches to 0.500 inches between the first tissue support surface 27815 and the second tissue support surface 27825 at time t ₁ . Stated another way, the tissue support surfaces 27815, 27825 have a first thickness of 0.030 inches to 0.500 inches when the end effector is delivering bipolar energy to patient tissue T _t1 at time _t1 . separated by a maximum distance d ₁ . A detailed depiction of jaws 27810, 27820 of end effector 27800 delivering bipolar energy to patient tissue _Tt1 at a first time _t1 is shown in FIG.

At a second time _t2 , jaws 27810, 27820 of end effector 27800 maintain contact with patient tissue _Tt2 . At least a portion of patient tissue T _t2 is positioned between jaws 27810 , 27820 of end effector 27800 . At time _t2 , end effector 27800 is configured to deliver a combination of bipolar and monopolar energy to patient tissue _Tt2 . The application of bipolar and monopolar energy allows the end effector 27800 to warm patient tissue _Tt2 . Although the end effector 27800 is in the partially closed configuration at time _t2 , the end effector 27800 is closer to the fully closed configuration at time _t2 than the end effector 27800 at time t1 _. More specifically, the second distance d ₂ is between 0.010 inches and 0.030 inches between the first tissue support surface 27815 and the second tissue support surface 27825 at time t ₂ . up to Stated another way, tissue support surfaces 27815, 27825 are between 0.010 inches and 0.030 inches when the end effector is delivering bipolar and monopolar energy to patient tissue T _t2 at time _t2. are separated by a second maximum distance d ₂ . A detailed depiction of jaws 27810, 27820 of end effector 27800 delivering bipolar and monopolar energy to patient tissue _Tt2 at a second time _t2 is shown in FIG.

At a third time _t3 , jaws 27810, 27820 of end effector 27800 maintain contact with patient tissue _Tt3 . At least a portion of patient tissue T _t3 is positioned between jaws 27810 , 27820 of end effector 27800 . At time _t3 , end effector 27800 is configured to continue to deliver a combination of bipolar and monopolar energy to patient tissue _Tt3 . With continued application of bipolar energy and monopolar energy, the end effector 27800 can seal _t3 of patient tissue T. FIG. The end effector 27800 is in a partially closed configuration and/or a fully closed configuration at time _t3 . Stated another way, the end effector 27800 is in a fully closed configuration and/or closer to a fully closed configuration at time _t3 than the end effector 27800 at time _t2 . More specifically, the third distance d ₃ is between 0.003 inches and 0.010 inches between the first tissue support surface 27815 and the second tissue support surface 27825 at time t ₃ up to Stated another way, tissue support surfaces 27815, 27825 are between 0.003 inches and 0.100 inches when the end effector is delivering bipolar and monopolar energy to patient tissue T _t3 at time _t3 . are separated by a third maximum distance _d3 . A detailed depiction of jaws 27810, 27820 of end effector 27800 delivering bipolar and monopolar energy to patient tissue at a third time _t3 is shown in FIG.

At a fourth time _t4 , jaws 27810, 27820 of end effector 27800 maintain contact with patient tissue _Tt4 . At least a portion of patient tissue T _t4 is positioned as end effector 27800 between jaws 27810 , 27820 of end effector 27800 . At time _t4 , end effector 27800 is configured to deliver monopolar energy to patient tissue _Tt4 . Application of monopolar energy allows the end effector 27800 to cut patient tissue _Tt4 . End effector 27800 is in the partially closed configuration and/or fully closed configuration at time _t4 . Stated another way, the end effector 27800 is in a fully closed configuration and/or closer to a fully closed configuration at time _t4 than the end effector 27800 at time _t2 . More specifically, fourth distance d ₄ is between 0.003 inches and 0.010 inches between first tissue support surface 27815 and second tissue support surface 27825 at time t ₄ up to Stated another way, the tissue support surfaces 27815, 27825 are 0.003 inches to 0.010 inches in the fourth direction when the end effector is delivering monopolar energy to patient tissue T _t4 at time _t4 . are separated by a maximum distance _d4 . A detailed depiction of jaws 27810, 27820 of end effector 27800 delivering monopolar energy to patient tissue _Tt4 at a fourth time _t4 is shown in FIG.

Graph 27900 shown in FIG. 20 illustrates the relationship between various operating parameters and/or specifications of the surgical instrument of FIGS. 16-19 over time. A surgical instrument and/or a surgical hub may utilize the illustrated relationships to confirm proper functioning of the surgical instrument during a surgical procedure and/or may be subject to one or more measurements. Various functions of the surgical instrument can be operated and/or adjusted in response to the parameters. The graphs show (1) change 27930 in power (W) 27920a of a generator controlling a bipolar modality of a surgical instrument at time 27910, and (2) power of a generator controlling a unipolar modality of a surgical instrument over time 27910. (3) change in distance between jaws of end effector 27920b over time 27910 27940; (4) change in jaw motor force (F) 27920c over time 27910 27950; ) shows change 27960 in jaw motor velocity (V) 27920d over time 27910. FIG.

At time t ₀ , the end effector electrodes have not delivered energy to the patient tissue and the end effector has not yet made contact with the patient tissue. The distance 27920b between the end effector jaws is maximum at time _t0 due to the end effector being in the open configuration. From time t ₀ to time t ₁ the force 27950 clamping the jaws is minimal as the end effector experiences little or no resistance from patient tissue as it moves from the open configuration toward the closed configuration. The end effector jaws continue to close around the patient tissue from time _t1 to time _t2 , during which time the end effector begins to deliver bipolar energy 27930. The distance between the jaws of the end effector is less at time _t1 than at time _t0 . From time _t1 to time _t2 , the jaw motor speed 27960 begins to slow down as the end effector jaw clamping force 27950 begins to increase.

As described with respect to FIGS. 16-29, a combination of monopolar energy 27935 and bipolar energy 27930 is delivered to patient tissue from time t ₂ to time t ₃ . The end effector jaws remain closed around the patient tissue during this period. The distance between the jaws of the end effector is less at time _t2 than at time _t1 . A certain distance between the end effector jaws at time _t2 has been reached for the tissue warming phase of the surgical procedure and a combination of monopolar and bipolar energy should be delivered to the patient tissue. , and/or being delivered to patient tissue. From time _t2 to time _t3 , the jaw motor speed continues to decrease and is lower than the jaw motor speed at _t1 . The force required to clamp the jaws increases sharply between time _t2 and time _t3 , thereby indicating that a combination of monopolar and bipolar energy is being delivered to the patient tissue; Check with surgical instruments and/or surgical hubs.

Monopolar and bipolar energy continue to be delivered to the patient tissue and the patient tissue is sealed from time _t3 to time _t4 . When the end effector reaches its fully closed configuration at time _t3 , the force clamping the jaws also reaches a maximum, but the force clamping the jaws remains stable between time _t3 and time _t4 . The power level of the generator delivering monopolar energy increases between time _t3 and time _t4 , while the power level of the generator delivering bipolar energy increases between time _t3 and time _t4 . decrease between Finally, between times _t4 and _t5 , monopolar energy is the only energy being delivered to cut patient tissue. While patient tissue is being cut, the force clamping the jaws of the end effector may vary. In Example 27952, where the force clamping the jaws decreases from its steady state level maintained between times _t3 and _t4 , efficient and/or effective tissue cutting is recognized by the hub. In example 27954, where the force clamping the jaws is increased from its steady state level maintained between times _t3 and _t4 , inefficient and/or ineffective tissue cutting may result in surgical instrument and/or Or recognized by the surgical hub. In such instances, the error can be communicated to the user.

In various examples, the clamping action of the jaws of the end effector can be adjusted based on detected characteristics of contacted patient tissue. In various examples, the detected characteristic includes tissue thickness and/or tissue type. For example, the range of gap distances between the jaws during the jaw closing stroke, the load threshold, the speed of jaw closing, the current limit applied during the jaw closing stroke, and/or the waiting time between the jaw closing stroke and the delivery of energy. etc. can be adjusted based on the detected thickness of the patient tissue. In various examples, detected properties of contacted patient tissue can be used to adjust tissue welding parameters. More specifically, the detected characteristics may be adjusted, for example, for multi-frequency sweeps of impedance sensing, balance and/or sequencing of energy modalities, energy delivery levels, impedance block levels, and/or waiting times between energy level adjustments. can be used to

As discussed in more detail above, surgical instruments and/or surgical hubs can utilize measured tissue properties to control and/or adjust operational parameters of the surgical instrument. For example, tissue impedance can be detected when patient tissue is positioned between the jaws of the end effector. Detection of tissue impedance alerts the surgical instrument and/or surgical hub that the jaws of the end effector are in contact with and/or near patient tissue. Referring now to FIG. 21, graph 28000 shows calculated tissue impedance 28020 over time 28010 . When the end effector jaws are not in contact with patient tissue, the tissue impedance 28030a is infinite. When the jaws of the end effector are clamped around patient tissue positioned therebetween, the patient tissue contacts both jaws. In such examples, tissue impedance 28030b can be measured. The ability to measure tissue impedance indicates to the surgical instrument and/or surgical hub that patient tissue is properly positioned between the jaws of the end effector. The surgical instrument and/or surgical hub may then begin operation, such as, for example, applying bipolar and/or monopolar energy to patient tissue.

In various examples, the surgical instrument and/or surgical hub can utilize the sensed tissue impedance magnitude to determine the stage of the surgical procedure. For example, as shown in FIG. 21, tissue impedance 28030b is measured at a first level during initial contact between the jaws of the end effector and patient tissue. The surgical instrument can then begin delivering bipolar energy to patient tissue. The surgical instrument warms patient tissue and/or forms a seal when the detected tissue impedance 28030b increases to and/or exceeds a first predetermined level. To do so, begin delivering a combination of bipolar and monopolar energy to patient tissue. As the detected tissue impedance 28030b continues to increase, the tissue impedance 28030b reaches and/or exceeds a second predetermined level, at which point the surgical instrument releases monopolar energy. is continued to be delivered while the delivery of bipolar energy is stopped in order to cut patient tissue. Eventually, tissue impedance reaches an infinite level because patient tissue is no longer positioned between the jaws of the end effector at the completion of cutting. In such instances, the surgical instrument and/or surgical hub can cease delivering monopolar energy.

In various examples, strain can be a metric used to adjust operating parameters of a surgical instrument such as, for example, a clamping mechanism. However, contact between the end effector jaws and patient tissue is desirable for accurate estimation of compressive strain. As discussed in more detail with reference to FIG. 21, the surgical instrument and/or surgical hub determines that contact exists between the end effector jaws and patient tissue by the detected tissue impedance. can be done. FIG. 22 shows an end effector 28100 with a first jaw 28110 and a second jaw 28120, the end effector in an open configuration. gap

は、開放構成における第１のジョー２８１１０と第２のジョー２８１２０との間に画定される。エンドエフェクタ２８１００のジョー２８１１０、２８１２０は、それらの間に患者組織を受容するように構成されている。初期時間ｔ_０において、患者組織Ｔ_Ａ，０は、第１のジョー２８１１０と第２のジョー２８１２０との間に位置付けられる。特に、患者組織Ｔ_Ａ，０は、第１のジョー２８１１０及び第２のジョー２８１２０の両方と接触している。別の言い方をすれば、患者組織Ｔ_Ａ，０の厚さは、間隙

is defined between the first jaw 28110 and the second jaw 28120 in the open configuration. Jaws 28110, 28120 of end effector 28100 are configured to receive patient tissue therebetween. At initial time t ₀ , patient tissue T _A,0 is positioned between first jaw 28110 and second jaw 28120 . In particular, patient tissue T _A,0 is in contact with both first jaw 28110 and second jaw 28120 . Stated another way, the thickness of the patient tissue T _A,0 is the gap

以上である。第１のジョー２８１１０及び第２のジョー２８１２０のうちの少なくとも１つは、互いに向かって移動し、患者組織が圧縮し、第１のジョー２８１１０と第２のジョー２８１２０との間に画定された間隙

That's it. At least one of the first jaw 28110 and the second jaw 28120 move toward one another and the patient tissue compresses to create a gap defined between the first jaw 28110 and the second jaw 28120.

が減少する。患者組織Ｔ_Ａ，１は、時間ｔ_１において、第１のジョー２８１１０と第２のジョー２８１２０との間で圧縮されて示されている。圧縮ひずみは、図２２に示される等式を使用して計算することができる。患者組織Ｔ_Ａ，０が時間ｔ_０においてエンドエフェクタ２８１００のジョー２８１１０、２８１２０と接触していたので、印加されたひずみが正確に計算される。

decreases. Patient tissue T _A,1 is shown compressed between first jaw 28110 and second jaw 28120 at time t ₁ . Compressive strain can be calculated using the equation shown in FIG. Since patient tissue T _A,0 was in contact with jaws 28110, 28120 of end effector 28100 at time t ₀ , the applied strain is accurately calculated.

FIG. 23 shows the end effector 28100 of FIG. 22 in an open configuration. gap

は、開放構成における第１のジョー２８１１０と第２のジョー２８１２０との間に画定される。エンドエフェクタ２８１００のジョー２８１１０、２８１２０は、それらの間に患者組織を受容するように構成されている。初期時間ｔ_０において、患者組織Ｔ_Ｂ，０は、第１のジョー２８１１０と第２のジョー２８１２０との間に位置付けられる。しかしながら、患者組織Ｔ_Ａ，０とは異なり、患者組織Ｔ_Ｂ，０は、第１のジョー２８１１０及び第２のジョー２８１２０の両方には接触していない。別の言い方をすれば、患者組織Ｔ_Ｂ，０の厚さは、間隙

is defined between the first jaw 28110 and the second jaw 28120 in the open configuration. Jaws 28110, 28120 of end effector 28100 are configured to receive patient tissue therebetween. At initial time t ₀ , patient tissue T _B,0 is positioned between first jaw 28110 and second jaw 28120 . However, unlike patient tissue T _A,0 , patient tissue T _B,0 does not contact both first jaw 28110 and second jaw 28120 . Stated another way, the thickness of the patient tissue T _B,0 is the gap

以下である。第１のジョー２８１１０及び第２のジョー２８１２０のうちの少なくとも１つは、互いに向かって移動し、第１のジョー２８１１０と第２のジョー２８１２０との間に画定された間隙

It is below. At least one of the first jaw 28110 and the second jaw 28120 move toward each other and the gap defined between the first jaw 28110 and the second jaw 28120

が減少する。患者組織Ｔ_Ｂ，１は、時間ｔ_１において、第１のジョー２８１１０及び第２のジョー２８１２０との間で圧縮されている、かつ／又はそれらと接触して示されている。圧縮ひずみは、図２３に示される等式を使用して計算することができるが、計算された圧縮ひずみは、患者組織Ｔ_Ｂ，０が、時間ｔ_０において、エンドエフェクタ２８１００のジョー２８１１０、２８１２０と接触していなかったので、過大評価される。

decreases. Patient tissue T _B,1 is shown compressed between and/or in contact with first jaw 28110 and second jaw 28120 at time t ₁ . Compressive strain can be calculated using the equations shown in FIG. 23, where the calculated compressive strain is that the patient tissue T _B,0 , at time t ₀ , jaws 28110, 28120 of end effector 28100 Overestimated because it was not in contact with.

As described above, calculating the compressive strain by utilizing the gap defined between the first and second jaws of the end effector when the end effector is in the open configuration is useful for patient tissue. yields accurate calculations only when is in contact with both jaws of the end effector at the initial time _t0 . Therefore, it is undesirable to use the standard gap defined between the first and second jaws of the end effector when the end effector is in the open configuration. Instead, the gap defined between the first and second jaws of the end effector when the patient tissue first contacts both jaws should be used when calculating the compressive strain. is. The end effector is shown in an open configuration 28150 in FIG. In particular, patient tissue is not in contact with both jaws 28110, 28120 of the end effector. Therefore, the dimensions and/or specifications of the end effector in this configuration 28150 should not be used in calculating compressive strain. As at least one of the first jaw 28110 and the second jaw 28120 continue to move toward each other, the gap

は、第１のジョー２８１１０と第２のジョー２８１２０との間に画定される。初期時間ｔ_０において、患者組織Ｔ_Ｃ，０は、第１のジョー２８１１０と第２のジョー２８１２０との間に位置付けられる。特に、患者組織Ｔ_Ｃ，０は、ここで、第１のジョー２８１１０及び第２のジョー２８１２０の両方と接触している。別の言い方をすれば、患者組織Ｔ_Ｃ，０の厚さは、間隙

is defined between the first jaw 28110 and the second jaw 28120 . At initial time t ₀ , patient tissue T _C,0 is positioned between first jaw 28110 and second jaw 28120 . In particular, patient tissue T _C,0 is now in contact with both first jaw 28110 and second jaw 28120 . Stated another way, the thickness of the patient tissue T _C,0 is the gap

以上である。第１のジョー２８１１０及び第２のジョー２８１２０のうちの少なくとも１つが互いに向かって移動し続けると、患者組織が圧縮し、第１のジョー２８１１０と第２のジョー２８１２０との間に画定された間隙

That's it. As at least one of the first jaw 28110 and the second jaw 28120 continue to move toward each other, the patient tissue compresses and the gap defined between the first jaw 28110 and the second jaw 28120 increases.

が減少する。患者組織Ｔ_Ｃ，１は、時間ｔ_１において、第１のジョー２８１１０と第２のジョー２８１２０との間で圧縮されて示されている。圧縮ひずみは、図２４に示される等式を使用して計算することができる。患者組織Ｔ_Ｃ，０が、時間ｔ_０においてエンドエフェクタ２８１００のジョー２８１１０、２８１２０と接触し、初期組織接触点において第１のジョー２８１１０と第２のジョー２８１２０との間に画定された間隙

decreases. Patient tissue T _C,1 is shown compressed between first jaw 28110 and second jaw 28120 at time t ₁ . Compressive strain can be calculated using the equation shown in FIG. The patient tissue T _C,0 contacts the jaws 28110, 28120 of the end effector 28100 at time t ₀ and the gap defined between the first jaw 28110 and the second jaw 28120 at the initial tissue contact point.

が実現されたので、印加されたひずみは、正確に計算される。

has been realized, the applied strain can be calculated accurately.

A motor control program for a combination electrosurgical instrument can utilize the detected tissue stability as an input. The surgical instrument can detect compression velocity and/or measure creep of patient tissue compressed between jaws of the end effector to determine tissue stability. The control program adjusts the wait time between end effector functions, defines when additional tissue stability determinations should be made, and/or adjusts the speed of the jaw clamp based on the determined tissue stability. can be modified to

As shown in FIG. 25, the end effector 28250 comprises a first jaw 28254 and a second jaw 28256, at least one of the first jaw 28254 and the second jaw 28256 moving towards each other. and patient tissue T is configured to be positioned therebetween. FIG. 25 provides schematic views of various positions of first jaw 28254 and second jaw 28256 relative to patient tissue T during a jaw clamping stroke. The gap 28220a defined between the end effector jaws and the motor current 28220b required to clamp the end effector jaws vary over time 28210 due, at least in part, to tissue stability measurements. The initial slope _S0 corresponds to the change in jaw gap 28230 from when the jaws are fully open to when initial contact is made between the jaws and patient tissue T. The resulting motor current 28240 remains low during the absence of tissue contact until the end effector jaws contact patient tissue T. The surgical system is configured to monitor the current 28220b over time 28210 to identify when the slope of the current plateaus, ie when the tissue stabilizes. When the current slope plateaus, the surgical system is configured to take the difference between the peak current at the time the end effector makes initial contact with the tissue and the point at which the current plateaus. Stated another way, the jaws can continue to clamp the tissue positioned between them when the waiting time has expired, the waiting time being defined by the time it takes for the tissue compression to stabilize. . Motor current creep drives the next step motor current and speed to the desired jaw gap or level of tissue compression. The creep measurement is repeated to drive the next stage of motor current and speed until the final jaw cap or tissue compression level is achieved.

In addition to sensing parameters associated with jaw clamp stroke, the surgical system can monitor additional functions for adjusting and/or improving operational parameters of the surgical instrument. For example, the surgical system may determine the orientation of the surgical instrument relative to the user and/or patient, the impedance of tissue positioned between the jaws of the end effector to determine tissue position and/or tissue composition, grounding to the patient. and/or leakage current can be monitored. Leakage currents can be monitored to determine secondary leakage from other devices and/or capacitive coupling to create parasitic generated energy outputs.

In various examples, surgical instruments are configured to use local unsupervised machine learning to modify instrument and/or generator settings and/or control programs. In such examples, the surgical instrument updates and/or modifies local functional behavior based on summaries and/or aggregations of data from various surgical procedures performed with the same surgical instrument. can be adjusted. Such functional behavior can be adjusted based on historical usage and/or particular user and/or hospital preferences. In such instances, the surgical instrument control program recognizes the same user and automatically modifies the default program with the identified user preferences. The surgical instrument can be updated by receiving regional and/or global updates and/or improvements to the digitally enabled control program and/or displayed information through interaction with a non-local server. .

In various examples, the surgical instrument is configured to use a global set of instrument operating parameters and/or surgical procedure results to modify instrument and/or generator settings and/or control programs. It is The global surgical system collects data regarding relevant and/or contributing instrument parameters such as, for example, outcome, complications, comorbidities, cost of surgical instruments, instrument utilization, procedure time, procedure data, and/or patient data. is configured to The global surgical system is further configured to collect data regarding generator operational data such as, for example, impedance curves, power levels, energy modalities, event annotations, and/or adverse events. The Global Surgical System, for example, provides data on operating parameters of intelligent devices such as clamp time, tissue pressure, hold time, number of uses, patient on table time, battery level, motor current, and/or working stroke. further configured to collect. The global surgical system is configured to adapt default control programs and/or update existing control programs based on sensed operating parameters. In this manner, each surgical instrument within the global surgical system can perform the most effective and/or efficient surgical procedure possible.

FIG. 26 shows a network 28300 of surgical instruments 28310 communicating with a cloud-based storage medium 28320. FIG. Cloud-based storage medium 28320 is configured to receive data regarding operational parameters from surgical instrument 28310 collected over many surgical procedures. Data is used by cloud-based storage media 28320 to optimize control programs to achieve efficient and/or desired results. Cloud-based storage medium 28320 is further configured to analyze all of the collected data in random batches 28340. The results of analysis from Random Batch 28340 can be further used in redefining the control program. For example, data collected within Batch A may represent a significantly different wear profile. It can then be concluded from this data that it may suggest that instruments that regulate power rather than clamp current, for example, deteriorate faster. Cloud-based storage medium 28320 is configured to communicate the findings and/or conclusions to the surgical instrument. The surgical instrument can then maximize instrument life by adjusting clamp current instead of power and/or the surgical system can alert the clinician of this finding.

FIG. 26 shows a network 28300 of surgical instruments 28310 communicating with a cloud-based storage medium 28320. FIG. Cloud-based storage medium 28320 is configured to receive data regarding operational parameters from surgical instrument 28310 collected over many surgical procedures. Data is used by cloud-based storage media 28320 to optimize control programs to achieve efficient and/or desired results. Cloud-based storage medium 28320 is further configured to analyze all of the collected data in random batches 28340. The results of analysis from Random Batch 28340 can be further used in redefining the control program. For example, data collected within Batch A may represent a significantly different wear profile. It can then be concluded from this data that it may suggest that instruments that regulate power rather than clamp current, for example, deteriorate faster. Cloud-based storage medium 28320 is configured to communicate the findings and/or conclusions to the surgical instrument. The surgical instrument can then maximize instrument life by adjusting clamp current instead of power and/or the surgical system can alert the clinician of this finding.

Information gathered from network 28300 of surgical instruments 28310 by cloud-based storage medium 28320 is presented in graphical form in FIGS. More specifically, the relationship between the gap 28430 defined between the end effector jaws and the initial tissue contact point is shown in FIG. changes over time. The number of times a particular end effector reaches full clamping during a jaw clamping stroke affects the amount of force required to clamp tissue of the same thickness. For example, the end effector jaws can clamp to a greater extent with less current for an instrument 28430a fully clamped 1-10 times than for an instrument 28430a fully clamped 10-15 times than for an instrument 28430b fully clamped 10-15 times. Further, the end effector jaws can clamp to a greater extent with less current with instrument 28430b fully clamped 10-15 times than with instrument 28430c fully clamped 16-20 times. . Ultimately, as the surgical instrument continues to be used, more power, and therefore current, is required to clamp the same thickness of tissue into the same perfectly clamped gap. The control program can be modified using information gathered from the surgical instrument 28310 and the cloud-based storage medium 28320 to perform more efficient and/or time efficient jaw clamp strokes.

By achieving the same fully clamped gap between the end effector jaws, the current required to clamp tissue of the same thickness is used to set the motor current threshold of the generator. . As shown in FIG. 28, the motor current threshold is lower for end effectors that have reached full clamp less than 10 times because less current is required to achieve full clamp. Therefore, the control program sets a lower threshold generator power for the new end effector than the threshold generator power for the old end effector. If the same generator power is used in an older end effector than that used in a new end effector, the tissue may not be sufficiently clamped and/or compressed between the jaws of the end effector. If the same generator power is used in a new end effector than that used in an old end effector, the tissue and/or instrument may be damaged as the tissue may be overcompressed by the jaws of the end effector. There is

In various examples, a surgical system comprises modular components. For example, a surgical system includes a surgical robot with a robotic arm configured to receive tools of different capabilities thereon. The surgical system's control program is modified based on the modular attachment, eg, the type of tool connected to the surgical robotic arm. In another example, a surgical system includes a handheld surgical instrument configured to receive different and/or interchangeable end effectors thereon. Prior to performing an intended surgical function, the handheld surgical instrument is configured to identify the attached end effector and modify the control program based on the determined identity of the end effector. there is

Surgical systems are configured to identify installed modular components using adaptive and/or intelligent interrogation technology. In various examples, the surgical system uses a combination of electrical interrogations in combination with mechanical actuation interrogations to determine the capacity and/or capability of the installed component. The response to the interrogation can be recorded and/or compared to information stored within the memory of the surgical system to establish baseline operating parameters associated with the identified modular attachment. . In various examples, the established baseline parameters are stored within the surgical system's memory for use when the same or similar modular attachments are identified in the future.

In various examples, an electrical interrogation signal is transmitted from the handle of the surgical instrument to the attached modular component, and the electrical interrogation signal includes the attached modular component's identity, operating parameters, and information. /or sent in an attempt to determine status. The attached modular component is configured to transmit a response signal with the identifying information. In various examples, no response is received in the interrogation signal and/or the response signal includes unidentifiable information. In such instances, the surgical instrument can implement default functions to assess the capabilities of the attached modular components. Default functions are defined by legacy operating parameters. Stated another way, the default operating parameters used during performance of the default function avoid injury to the surgical instrument and/or attached modular components, the patient, and/or the user. defined at a specific level so that The surgical instrument is configured to utilize the results of default functions to set a specific operating program for the attached modular components.

For example, the surgical instrument can perform a tissue cutting stroke, with the cutting member traversing through the attached end effector from a proximal position to a distal position. In instances where the surgical instrument cannot identify the attached end effector, the surgical instrument is configured to perform tissue cutting strokes using default operating parameters. By utilizing the position of the cutting member within the end effector at the end of the tissue cutting stroke, the surgical instrument is associated with and/or suitable for completion with the attached end effector. , the length of the tissue cutting stroke can be determined. The surgical instrument is configured to record the most distal position of the cutting member to set additional operating parameters associated with the attached end effector. Such additional operating parameters include, for example, cutting element velocity and/or end effector length during a tissue cutting stroke.

Default functions may also be used to determine the current state and/or status of installed modular components. For example, a default function may be implemented to determine whether the attached end effector is articulating and/or how much the attached end effector is articulating. The surgical instrument is then configured to adjust the control program accordingly. The length of the cutting stroke changes as the end effector articulates through a range of articulation angles. Stated another way, the length of the cutting stroke is different when the end effector is articulated compared to when the end effector is unarticulated. The surgical instrument is configured to update the control program to implement a cutting stroke spanning the length associated with the last detected complete stroke. The surgical instrument uses the length of the last completed cutting stroke when the end effector is not articulated compared to when the end effector is articulated so that the total length of the cutting stroke is equal to the current. It is further configured to determine whether it is achieved and/or completed using the control program.

In various examples, surgical systems can perform intelligent evaluations of the properties of attached components. Such characteristics include, for example, tissue pad wear, attachment usage, and/or attachment operating conditions. Stated another way, the surgical system is configured to assess the function and/or condition of the attached component. Upon sensing the characteristics of the installed modular components, the control program used to operate the surgical system is adjusted accordingly.

The surgical instrument includes one or more tissue pads positioned on the jaws of the end effector. It is generally well known that tissue pads tend to degrade and wear over time due, for example, to frictional engagement with the blades when tissue is not present between them. Surgical instruments are configured to determine the extent of tissue pad wear, for example, by analyzing the thickness and/or stiffness of the remaining tissue pad. Utilizing the determined status of the tissue pad(s), the surgical instrument adjusts its control program accordingly. For example, the control program may change the applied pressure and/or power level of the surgical instrument based on the determined status of the tissue pad(s). In various examples, the power level of the surgical instrument can be automatically reduced by a processor of the surgical instrument in response to the detected thickness of the tissue pad(s) being below a threshold thickness. can.

A surgical instrument provides combined electrosurgical functionality, the surgical instrument including an end effector having a first jaw and a second jaw. At least one of the first jaw and the second jaw are configured to move toward each other to transition the end effector between the open configuration and the closed configuration. The first jaw and the second jaw have electrodes disposed thereon. An electrosurgical instrument includes one or more generators configured to power the electrodes to energize the electrodes. The surgical instrument detects charring and/or tissue contamination on one or more of the jaws of the end effector by measuring impedance when the end effector is in a closed configuration with no patient tissue positioned therebetween. can be evaluated. A predetermined impedance can be stored in the memory of the surgical instrument, and if the impedance exceeds a predetermined threshold, the jaws contain undesirable levels of char and/or tissue contamination thereon. As discussed in more detail herein, upon detection of an undesirable level of char, a warning can be issued to the user. In various examples, the operating parameters can be automatically adjusted by a processor of the surgical instrument and/or surgical hub in response to the detected closed jaw impedance. Such operating parameters include, for example, power levels, applied pressure levels, and/or advanced tissue cutting parameters.

As shown in FIG. 29, graphical representation 28500 shows relationship 28530 between measured impedance 28250 and multiple activation cycles 28510 . Baseline impedance is measured and recorded in memory prior to any energy activation (n=0 activation). As discussed above, impedance is measured when the end effectors of the surgical instrument are in the closed configuration and no patient tissue is positioned between them. The surgical instrument and/or surgical hub prompts the user to transition the end effector to the closed configuration to measure closed jaw impedance. Such prompts can be delivered at predefined activation intervals, eg, n=5, 10, 15, and so on. As char and/or tissue contamination accumulates on the jaws of the end effector, the impedance increases. At and/or beyond the first predetermined level 28540, the surgical instrument and/or surgical hub warns the user of such char build-up and advises the user to clean the end effector. is configured to At and/or beyond a second predetermined level 28550, the surgical instrument and/or the surgical hub is maintained at a level that allows the user to utilize various operational features of the surgical instrument until the end effector has been cleaned. can be prevented. The operational lockout can be released upon cleaning the end effector, assuming the measured impedance has been reduced to an acceptable level.

As discussed above, the surgical hub and/or surgical instrument are configured to alert the user when a predetermined impedance is met and/or exceeded. Such alerts may be communicated via various forms of feedback including, for example, haptic feedback, auditory feedback, and/or visual feedback. In at least one example, the feedback includes audio feedback, and the surgical instrument can include a speaker that emits a sound, eg, a beep, when an error is detected. In certain examples, the feedback includes visual feedback, and the surgical instrument can include, for example, light emitting diodes (LEDs) that flash when an error is detected. In certain examples, visual feedback may be communicated to the user through alerts presented on a display monitor within the user's field of view. In various examples, the feedback includes tactile feedback and the surgical instrument can include an electric motor with an eccentric element that vibrates when an error is detected. Warnings may be specific or general. For example, the warning may specifically state that the closed jaw impedance has exceeded a predetermined level, or the warning may also state the measured impedance.

In various examples, the surgical instrument and/or surgical hub is designed to detect parameters such as integral shaft stretch, damage, and/or tolerance build-up to compensate for functional parametric behavior of the electric actuator. is configured to The surgical instrument alerts the user when sensed parameters of the attached end effector and/or shaft are near and/or outside the desired operating range specific to the attached component. It is configured. In addition to alerting the user, various examples prevent operation of the surgical instrument when it is detected that the surgical instrument cannot operate within a predefined envelope of adjustment. Surgical instruments and/or surgical hubs are provided with overrides that allow the user to override the lockout under certain predefined conditions. Such predefined conditions include emergencies, during surgical procedures where the inability to use the surgical instrument would harm the patient, the surgical instrument is currently in use, and may be determined at the discretion of the user. includes a disposable override to allow for one additional use of the surgical instrument in the . In various examples, overrides are also available to allow the user to implement secondary end effector functions that are independent of the primary end effector function. For example, if the surgical instrument prevents the jaws of the end effector from articulating, the user may activate an override to allow the surgical instrument to articulate the end effector.

The surgical system can adapt a control program configured to operate the surgical instrument in response to sensed instrument actuation parameters, energy generator parameters, and/or user input. The determined status of the surgical instrument is used in combination with user input to adapt the control program. The determined status of the surgical instrument can include, for example, whether the end effector is in its open configuration, whether the end effector is in its closed configuration, and/or whether tissue impedance is detectable. can. The determined status of the surgical instrument can include two or more detected characteristics. For example, the determined status of a surgical instrument may use a combination of two or more measures, an ordered sequence of actions, and/or an interpretation of familiar user input based on its contextual use. can be evaluated as The control program is configured to adjust various functions of the surgical instrument such as, for example, power levels, gradual step-ups or step-downs, and/or various motor control parameters.

A surgical system includes a surgical instrument including combined electrosurgical functionality, the surgical instrument including an end effector having first and second jaws having electrodes disposed thereon. . An electrosurgical instrument includes one or more generators configured to power the electrodes to energize the electrodes. More specifically, energy delivery to patient tissue supported between the first and second jaws can be in monopolar mode, bipolar mode, and/or alternating or fused bipolar energy and unipolar energy. Accomplished by electrodes configured to deliver energy in a combination mode with polar energy. As described in more detail herein, the surgical system adapts the level of energy power activation of one or more generators based on various monitored parameters of the surgical instrument. can be made

The surgical system is configured to adapt energy power activation based on monitored parameters of the instrument. In various examples, the surgical system can monitor the sequence in which various surgical instrument functions are activated. The surgical system can then automatically adjust various operating parameters based on the activation of surgical instrument functions. For example, the surgical system monitors rotational activation and/or articulation controls to prevent the ability of surgical instruments to deliver energy to patient tissue while such secondary unclamping controls are in use. be able to.

In various examples, the surgical system can adapt instrument power levels to compensate for detected operating parameters, such as, for example, insufficient battery and/or motor drive power levels. Detection of insufficient battery and/or motor drive power levels can, for example, affect and/or compromise the clamping strength of the end effector, thereby undesirably controlling patient tissue positioned therebetween. The surgical system can be shown to provide

Surgical systems can record operational parameters of surgical instruments during periods of use associated with specific intended functions. The surgical system then uses the recorded operating parameters to, for example, reduce energy power levels and/or surgical instrument pressure when the surgical system identifies that a particular intended function is being performed. mode can be adapted. Stated another way, the surgical system automatically adjusts the mode of the surgical instrument in which the energy power level and/or preferred operating parameters are stored when the desired function of the surgical instrument is identified. and/or the surgical instrument may adjust energy power levels and/or modes of the surgical instrument to try to support and complement the desired function. For example, surgical systems have detected lateral loads on the shaft with application of monopolar power, since the detected lateral load on the shaft is often due to abrasive anatomy with the end effector in its closed configuration. Lateral loads can be supplemented. The surgical system decides to apply monopolar power because the surgical system provides improved anatomy through previous procedures and/or through information stored in memory. rice field. In various examples, the surgical system is configured to apply monopolar power in proportion to an increase in detected lateral load.

The surgical system can adapt a control program configured to operate the surgical instrument in response to the sensed end effector parameters. As shown in FIG. 30, the surgical instrument can utilize the measured tissue conductance to automatically modify the gap clamp control program. Tissue conductance is measured at two frequencies, eg, 50 kHz and 5 MHz. Low frequency conductance (GE) is driven by extracellular fluid, while high frequency conductance (GI) is driven by intracellular fluid. Intracellular fluid levels change, for example, when cells are damaged. The end effector is configurable in open and closed configurations. Thus, when moving the end effector from its open configuration toward its closed configuration, the jaws of the end effector compress tissue positioned therebetween. Changes in conductance between the two frequencies can be detected and/or recorded during tissue compression. The surgical system is configured to adapt the control program to control end effector clamp compression based on the ratio of low frequency conductance (GE) to high frequency conductance (GI). The surgical system adapts the control program to a discrete predetermined point and/or approaching an inflection point, whereby the predetermined point and/or inflection point indicates that cell damage may be nearby. .

More specifically, FIG. 30 shows measured tissue conductance 29100, low frequency to high frequency conductance ratio 29200, jaw opening dimensions 29300, and jaw motor force 29400 over the duration 29010 of the jaw clamp stroke. is a graphical representation 29000 of the relationship between . At the beginning of the jaw clamping stroke, the measured tissue conductance is at its lowest as the end effector jaws first contact the patient tissue, and the jaw opening 29300 is at its maximum when the end effector is in its open configuration. It is in. The jaw motor force is low at the beginning of the jaw clamp stroke due, at least in part, to the low resistance provided to the jaws from tissue positioned between the jaws. Before compression, but after contact between the patient tissue and the jaws of the end effector, the low frequency conductance 29110 increases to indicate the presence of extracellular fluid within the captured tissue. Similarly, before compression, but after contact between the patient tissue and the jaws of the end effector, the high energy conductance 29120 increases indicating the presence of intracellular fluid.

As the end effector begins to move toward its closed configuration, the jaws of the end effector begin to clamp tissue positioned between them, and thus jaw opening 29300 continues to decrease. Tissue begins to be compressed by the jaws, but the patient tissue is undesirably sealed by the surgical instrument until fluid begins to drain from the compressed tissue. Jaw motor force continues to increase during the jaw clamping stroke as increased resistance is exerted against the end effector jaws by captured tissue.

After the initial ejection of extracellular fluid causes the low frequency conductance (GE) 29110 to decrease, the low frequency conductance (GE) 29110 remains relatively constant during the jaw clamp stroke. High frequency conductance (GI) 29120 remains relatively constant during the jaw clamp stroke until after patient tissue is sealed. If the tissue continues to compress after sealing is complete, intracellular tissue damage will occur and intracellular fluid will be expelled. At such point, the high frequency conductance 29120 decreases causing a spike in the ratio 29210 of the low frequency conductance to the high frequency conductance. Tissue damage threshold 29220 to alert the user to modify operating parameters when a spike in the ratio of low frequency conductance to high frequency conductance 29210 reaches and/or exceeds tissue damage threshold 29220 , and/or is predetermined to automatically prompt the surgical system. At such point, the surgical system may stop moving the end effector jaws toward the end effector closed configuration and/or move the end effector jaws back toward the end effector open configuration. It is configured to modify the control program to initiate movement. In various examples, the surgical system is configured to modify the control program to reduce jaw clamp force. Such adaptation of the control program prevents additional tissue damage.

The surgical system is configured to modify the control program based on the cooperative dual inputs. More specifically, the surgical system can vary the motor actuation speed based on user input and predefined settings. For example, the more force the user applies to the handle control, the faster the motor for triggering the system is activated. In various examples, the handle control can be used to communicate different commands to the surgical system depending on its contextual use. More specifically, the surgical system can monitor and/or record certain user inputs. A particular user input can be analyzed for its length, duration, and/or any suitable characteristic that can be used to distinguish the input. For example, a handle of a surgical instrument can include a trigger configured to control shaft rotation. In various examples, faster actuation of the trigger corresponds to an increase in the speed at which the shaft rotates, while the motor's maximum force (current) threshold remains constant. In other examples, faster actuation of the trigger corresponds to increased force applied while the rotational speed threshold remains the same. Such control can be further differentiated by having force based on the speed at which the trigger is actuated, while shaft rotational speed increases based on the duration that the user actuates the trigger.

In various examples, motor actuation control is based on a combination of predefined settings and sensing of instrument operating parameters and/or user control parameters. FIG. 31 is a graphical representation 29500 of the relationship between actual jaw closing speed 29520 and trigger speed indicated by user input 29510. FIG. Jaw closing speed 29520 resulting from corresponding user input 29510 alone is represented by first line 29530 . As the user input trigger speed 29510 increases, the jaw closing speed 29520 also increases. Such relationship 29530 is determined without considering any additional parameters. A jaw closure velocity 29520 resulting from corresponding user input 29510 and determination of thick tissue positioned between the jaws of the end effector is represented by a second line 29540 . As the user input trigger speed 29510 increases, the jaw closing speed 29520 also increases, but the jaw closing speed 29520 is less than if only the user input trigger speed was considered. An additional consideration of tissue thickness, for example, slows jaw closure speed to prevent damage to patient tissue and/or surgical instruments.

A surgical system comprises many components. For example, surgical systems include many handheld surgical instruments, surgical hubs, and surgical robots. In various examples, each component of the surgical system communicates with other components and issues commands and/or control programs based on at least one monitored parameter and/or user input. can be changed. The surgical system includes means for determining which system is in charge and which system will make part of the motion decision. This designation can change based on situational awareness, occurrence of predetermined events, and/or threshold crossings. In various examples, a command protocol is established within the surgical system to provide commands that each component can issue and/or to components within the surgical system that the issuing component can direct commands to. can indicate the type of

The command protocol can use predefined thresholds to determine when a control handoff is warranted. For example, a surgical system includes a generator and a handheld surgical instrument containing various controls therein. At the beginning of the surgical procedure, the generator is first controlled to adjust power based on the detected impedance. The generator uses the sensed impedance and/or current power level to command the pressure control in the handle of the surgical instrument to follow specific pressure needs. At some point during the surgical procedure, a lower impedance threshold is exceeded indicating that the generator algorithm has detected an electrical short. The generator passes control to the pressure control in the handle by instructing the pressure control to determine if tissue is still positioned between the jaws of the end effector. The pressure controller can then determine the appropriate tissue compression and communicate which power level and/or energy modality is most appropriate for the detected tissue.

A control protocol can be determined based on a consensus achieved by multiple components within the surgical system. For example, three components within the surgical system detect a first value for the monitored parameter while two components within the surgical system detect a second value for the same monitored parameter. A value is detected and is different from the first value and the second value. Groups of three components comprise more components than groups of two components and thus the first value of the monitored parameter is controlled. Each component within the surgical system can be assigned a position positioned within the hierarchy. Tiers can be established based on the reliability of particular components and/or the capabilities of particular components. A first component detects a first value for the monitored parameter, a second component detects a second value for the same monitored parameter, the first value Different from the value of 2. The second component is "superior" to the first component in the hierarchy of the surgical system, and thus the second value of the monitored parameter detected by the second component controls. be done.

Various aspects of the subject matter described herein are illustrated in the following examples.

Example set 1
Example 1 - A surgical instrument comprising a surgical instrument, a generator configured to power an end effector, and a processor configured to execute a control program to operate a surgical system system for. A surgical instrument includes an end effector including a first jaw and a second jaw. At least one of the first jaw and the second jaw are moved relative to each other between an open position and a closed position. The tissue is configured to be positioned between the first jaw and the second jaw. The processor detects a first parameter of the surgical system, detects at least one user input, and modifies the control program in response to the detected first parameter and the at least one user input. is configured to do and

[0043] Example 2 - The surgical system of Example 1, wherein the control program is configured to control the power level of the generator.

Example 3 - As in Example 1 or 2, wherein the control program is configured to control a motor, and the motor is configured to move the end effector between an open configuration and a closed configuration surgical system.

Example 4 - A control program is configured to control the motor via a motor control parameter, the control program responsive to the sensed first parameter and the sensed user input to determine the motor control parameter The surgical system of Example 3, wherein the surgical system is configured to adjust the .

Example 5 - The surgical system of Example 1, 2, 3, or 4, wherein the first parameter comprises an instrument actuation parameter.

Example 6 - The surgical system of Example 1, 2, 3, 4, or 5, wherein the first parameter comprises a generator operating parameter.

Example 7 - The surgical system of Example 1, 2, 3, 4, 5, or 6, wherein the first parameter comprises end effector status.

Example 8 - The surgical system of Example 1, 2, 3, 4, 5, 6, or 7, wherein the first parameter indicates whether the end effector is in an open configuration or a closed configuration .

Example 9 - to Example 1, 2, 3, 4, 5, 6, or 7, wherein the first parameter indicates whether the tissue is positioned between the first jaw and the second jaw The described surgical system.

Example 10 - According to Example 1, 2, 3, 4, 5, 6, 7, 8, or 9, wherein the surgical instrument is motion controlled and the generator is the slave control system by default surgical system.

Example 11 - A control program is configured to operationally control the generator and slave the surgical instrument to a detected first parameter and a detected user input in response to the detected first parameter , Example 1, 2, 3, 4, 5, 6, 7, 8, or 9.

Example 12 - The surgical system of Example 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11, wherein the first parameter comprises a combination of two scales.

Example 13 - The surgical system further comprises a trigger configured to receive user input, the processor configured to interpret a plurality of user inputs received by the trigger, each user input comprising: 13. The surgical system of Example 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12, including different purposes based on contextual use.

Example 14 - A surgical instrument, a generator configured to power the surgical instrument, and a processor configured to execute a control program to operate the surgical system, surgical system. The processor detects a status of the surgical instrument, detects at least one user input, and adapts the control program in response to the detected status of the surgical instrument and the at least one user input. and is configured to

Example 15 - A surgical instrument includes an end effector, the end effector is configurable in an open configuration and a closed configuration, and the status of the surgical instrument is that the end effector is in the open configuration or in the closed configuration 15. The surgical system of Example 14, corresponding to:

Example 16 - A surgical instrument includes an end effector, the end effector is configurable in an open configuration and a closed configuration, and the status of the surgical instrument indicates that patient tissue is between the first jaw and the second jaw. 16. The surgical system of example 14 or 15, corresponding to whether positioned therebetween.

Embodiment 17 - The surgical system further comprises an input member configured to receive user input, the processor configured to interpret a plurality of user inputs received by the input member, each receiving 17. The surgical system of Example 14, 15, or 16, wherein the provided user input includes different objectives based on contextual use of the surgical system.

Example 18 - A surgical instrument comprising a surgical instrument, a generator configured to power an end effector, and a processor configured to execute a control program to operate a surgical system system for. A surgical instrument includes an end effector including a first jaw and a second jaw. At least one of the first jaw and the second jaw are moved relative to each other between an open position and a closed position. The tissue is configured to be positioned between the first jaw and the second jaw. The processor detects a first parameter of the surgical instrument, detects a second parameter of the generator, detects at least one user input, detects the first parameter, detects modifying the control program in response to the set second parameter and the at least one user input.

Example 19 - A first parameter of the surgical instrument is whether the end effector is in the open or closed configuration and the patient tissue is positioned between the first and second jaws. 19. The surgical system of Example 18, corresponding to whether or not there is.

Embodiment 20 - The surgical instrument further comprises an input member configured to receive user input, the processor configured to interpret a plurality of user inputs received by the input member, each receiving 20. The surgical system of Example 18 or 19, wherein the provided user input includes different purposes based on contextual use of surgical instruments within the surgical system.

Example set 2
Example 1 - A surgical instrument comprising a housing, a shaft assembly, a processor, and memory. A shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions which, when executed from the memory, cause the processor to transmit an electrical interrogation signal to the attached shaft assembly; receiving a response signal from the assembly; causing a default function to be performed when the response signal is not received by the attached shaft assembly; and modifying the control program based on the signature of the attached shaft assembly.

Example 2 - The surgical instrument of Example 1, wherein the distinguishing characteristic comprises the remaining volume of the attached shaft assembly.

Example 3 - The surgical instrument of Examples 1 or 2, wherein the distinguishing characteristic comprises the performance level of the attached shaft assembly.

Example 4 - The surgical instrument of Examples 1, 2, or 3, wherein the distinguishing characteristic varies with attached shaft assemblies of different capacities.

Example 5 - The memory includes a lookup table containing operating parameters corresponding to a particular shaft assembly, and the processor utilizes the received response signal to identify the installed shaft assembly in the lookup table. The surgical instrument of Examples 1, 2, 3, or 4, wherein the identified and control program is modified using the stored operating parameters corresponding to the identified shaft assembly.

Example 6 - According to example 1, 2, 3, 4, or 5, wherein the memory further comprises program instructions that, upon execution of the program instructions, cause the processor to store the modified control program in the memory. surgical instruments.

Example 7 - A surgical instrument comprising a housing, a shaft assembly, a processor, and memory. A shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions which, when executed from the memory, instruct the processor to send a variable interrogation communication to the attached shaft assembly and to the variable interrogation communication. Based on the response, determine the capability of the installed shaft assembly and modify the control program based on the determined capability of the installed shaft assembly.

Example 8 - The surgical instrument of Example 7, wherein the variable interrogation communication comprises an electrical interrogation signal and physical actuation of the surgical instrument.

Example 9 - The surgical instrument of Examples 7 or 8, wherein the physical actuation of the surgical instrument is monitored to determine the functional capabilities of the attached shaft assembly.

Example 10 - The surgical instrument of Examples 7, 8, or 9, wherein the determined capacity is related to the remaining volume of the shaft assembly.

Example 11 - The surgical instrument of Examples 7, 8, 9, or 10, wherein the determined capability is related to the performance level of the shaft assembly.

Example 12 - The surgical instrument of Example 7, 8, 9, 10, or 11, wherein the determined capacities differ based on the connected shaft assembly.

Example 13 - The memory further comprises program instructions which, when executed, cause the processor to store in the memory the modified control program and the determined shaft assembly capabilities, Examples 7, 8, 13. The surgical instrument of 9, 10, 11 or 12.

Example 14 - A surgical instrument comprising a housing, a shaft assembly, a processor, and memory. A shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions which, when executed from the memory, cause the processor to interrogate a shaft assembly coupled to the housing; receiving a response signal from the shaft assembly, performing a default end effector function when the response signal is not recognized, and performing the default end effector function resulting in a shaft coupled to the housing; Determining an identifying characteristic of the assembly and modifying the control program based on the identifying characteristic of the shaft assembly coupled to the housing are caused.

Example 15 - The surgical instrument of example 14, wherein the response signal is not recognized by the processor because the response signal is not received by the processor.

Example 16 - The surgical instrument of Examples 14 or 15, wherein the distinguishing characteristic comprises the remaining volume of the shaft assembly coupled to the housing.

Example 17 - The surgical instrument of Examples 14, 15, or 16, wherein the distinguishing characteristic comprises a performance level of a shaft assembly coupled to the housing.

Example 18 - The surgical instrument of Example 14, 15, 16, or 17, wherein the determined characteristic may differ based on the shaft assembly interchangeably coupled to the housing.

Example 19 - The memory includes a lookup table containing operating parameters corresponding to a particular shaft assembly, and the processor utilizes the received response signal to identify the shaft assembly coupled to the housing in the lookup table. 19. The surgical instrument of example 14, 15, 16, 17, or 18, wherein the volume is identified and the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.

Embodiment 20 - to embodiment 14, 15, 16, 17, 18, or 19, wherein the memory further comprises program instructions, and upon execution of the program instructions, causes the processor to store the modified control program in the memory A surgical instrument as described.

Example set 3
Example 1 - A surgical system comprises a surgical hub, a surgical instrument, a generator configured to energize an end effector, and a smoke evacuation system configured to remove smoke from a surgical site And prepare. A surgical instrument includes an end effector. Control commands are passed directly from the surgical hub to the surgical instrument. The surgical instrument is configured to daisy-chain control commands received from the surgical hub to the generator and smoke evacuation system.

[0033] Example 2 - The surgical system of Example 1, wherein the surgical instrument is configured to use parameters sensed by the surgical instrument to modify the control command.

[0043] Example 3 - The surgical system of Example 2, wherein the surgical instrument is configured to pass modified control commands to the generator.

Example 4 - The surgical system of Examples 2 or 3, wherein the operating parameters of the generator are controlled by modified control commands.

Example 5 - The surgical application of Example 2, 3, or 4, wherein the generator is configured to use a second parameter detected by the generator to alter the modified control command system.

Example 6 - An implementation wherein the surgical instrument is configured to pass modified control commands to a surgical hub, and the surgical hub is configured to pass modified control commands to the generator The surgical system of Examples 2, 3, 4, or 5.

Example 7 - A surgical instrument detects a first parameter of the surgical instrument, the surgical instrument is configured to communicate the detected first parameter to a generator, the generator comprising: Example 1. The surgical system of Example 1, configured to modify the control command using the first parameter.

Example 8 - A surgical instrument detects a first parameter of the surgical instrument, the surgical instrument is configured to communicate the detected first parameter to a generator, the generator comprising: 2. The surgical system of Example 1, wherein the second parameter is detected and the generator is configured to modify the control command using the first parameter and the second parameter.

Example 9 - Example 1, 2, 3, 4, 5, 6, 7, or, further comprising a display screen configured to display a live image of the surgical site and the first operating parameter of the surgical instrument 9. The surgical system according to 8.

Example 10 - An implementation wherein the surgical instrument further comprises an instrument display configured to display a second operating parameter of the surgical instrument, the first operating parameter being the same as the second operating parameter A surgical system according to Example 9.

Example 11 - An embodiment wherein the surgical instrument further comprises an instrument display configured to display a second operating parameter of the surgical instrument, the first operating parameter being different than the second operating parameter 10. The surgical system according to 9.

[00130] Example 12 - The surgical system of Example 9, 10, or 11, wherein the display screen is further configured to display operating parameters of the generator.

Example 13 - A surgical hub, a surgical instrument, a generator configured to provide energy to an end effector, and a smoke evacuation system configured to remove smoke from a surgical site, surgical system. A surgical instrument includes an end effector. Control commands are passed directly from the surgical hub to the surgical instrument. The surgical instrument is configured to pass control commands received from the surgical hub to the generator and smoke evacuation system.

[00130] Example 14 - The surgical system of Example 13, wherein the surgical instrument is configured to daisy-chain control commands received from the surgical hub to the generator and smoke evacuation system.

Example 15 - A surgical hub, a first surgical instrument, a first generator configured to energize a first end effector, and a second surgical instrument, surgical system. A first surgical instrument includes a first end effector. Control commands are passed directly from the surgical hub to the first surgical instrument. The first surgical instrument is configured to daisy-chain control commands received from the surgical hub to the first generator and the second surgical instrument.

Example 16 - The surgical procedure of Example 15, wherein the first surgical instrument is configured to modify the control command using the first parameter sensed by the first surgical instrument system.

[00130] Example 17 - The surgical system of Example 16, wherein the first surgical instrument is configured to pass modified control commands to the second surgical instrument.

Example 18 - A second surgical instrument is configured to use a second parameter sensed by the second surgical instrument to alter the modified control command; 18. The surgical system of Example 17, wherein the instrument is configured to pass the modified control command to the first surgical instrument.

Example 19 - A first surgical instrument configured to detect a first parameter, a second surgical instrument configured to detect a second parameter, and a second is configured to communicate the detected second parameter to the first surgical instrument, the first surgical instrument being the first parameter detected by the first surgical instrument; 16. The surgical system of Example 15, configured to modify the control command using the parameter of and the second parameter detected by the second surgical instrument.

Example 20 - The surgical system of Example 15, 16, 17, 18, or 19, wherein the second surgical instrument includes a smoke evacuation system configured to remove smoke from the surgical site.

Although several forms have been shown and described, it is not the applicant's intention to limit or limit the scope of the appended claims to such details. Many modifications, variations, alterations, permutations, combinations and equivalents of these forms can be implemented and will occur to those skilled in the art without departing from the scope of this disclosure. Further, the structure of each element associated with the described form can be alternatively described as a means for providing the function performed by that element. Also, although materials are disclosed for particular components, other materials may be used. Accordingly, the above description and appended claims are intended to cover all such modifications, combinations, and variations as included within the scope of the disclosed forms. Please understand. The appended claims are intended to cover all such modifications, variations, alterations, substitutions, modifications and equivalents.

The foregoing detailed description has described various aspects of apparatus and/or processes using block diagrams, flow diagrams and/or examples. To the extent such block diagrams, flow diagrams and/or embodiments include one or more functions and/or actions, it should be understood by those skilled in the art that such block diagrams, flow diagrams and/or Each function and/or operation included in the embodiments may be implemented individually and/or collectively by various hardware, software, firmware, or virtually any combination thereof. Those skilled in the art will appreciate that all or part of some aspects of the forms disclosed herein can be implemented as one or more computer programs running on one or more computers ( For example, as one or more programs running on one or more computer systems), As one or more programs running on one or more processors (for example, can be equivalently implemented on an integrated circuit as one or more programs running on one or more microprocessors), as firmware, or substantially any combination thereof; and/or writing software and/or firmware code is within the skill of one of ordinary skill in the art in view of this disclosure. Additionally, those skilled in the art will appreciate that the subject matter described herein may be distributed as one or more program products in a variety of forms, and may be distributed as one or more program products herein. Embodiments of the subject matter described in apply regardless of the particular type of signal-bearing medium used to actually carry out the distribution.

The instructions used to program the logic to implement the various disclosed aspects are stored in system memory such as dynamic random access memory (DRAM), cache, flash memory, or other storage. can be stored in Additionally, the instructions may be distributed over a network or by other computer-readable media. Thus, a machine-readable medium can include any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), including floppy diskettes, optical discs, compact discs, read only memory (read -only memory, CD-ROM), as well as magneto-optical discs, 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, flash memory or any electrical, optical, acoustic or other form of propagating signal ( For example, but not limited to tangible machine-readable storage used to transmit information over the Internet via carrier waves, infrared signals, digital signals, etc.). Non-transitory computer-readable media thus includes 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 herein, the term "control circuitry" includes, for example, hardwired circuits, programmable circuits (e.g., computer processors including one or more individual instruction processing cores, processing Unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic array (PLA), or field programmable gate It can refer to arrays (field programmable gate arrays, FPGAs), state machine circuits, firmware that stores instructions to be executed by programmable circuits, and any combination thereof. Control circuits may, collectively or individually, be, for example, integrated circuits (ICs), application-specific integrated circuits (ASICs), system on-chips (SoCs), desktop It can be embodied as a circuit forming part of a larger system such as a computer, laptop computer, tablet computer, server, smart phone, or the like. Thus, as used herein, “control circuit” refers to an electrical circuit having at least one discrete electrical circuit, an electrical circuit having at least one integrated circuit, an electrical circuit having at least one application specific integrated circuit, A circuit, a general-purpose computing device configured with a computer program (e.g., a general-purpose computer configured with a computer program that executes, at least in part, a process and/or apparatus described herein, or a process described herein) and/or a microprocessor configured by a computer program that at least partially executes the device); , communication switches, or opto-electrical equipment). Those skilled in the art will recognize that the subject matter described herein can be implemented in analog or digital form, or some combination thereof.

As used in any aspect herein, the term "logic" may refer to applications, software, firmware, and/or circuitry configured to perform any of the operations described above. Software may be embodied as software packages, code, instructions, instruction sets, and/or data recorded on a non-transitory computer-readable storage medium. Firmware may be embodied as code, instructions, or sets of instructions in a memory device and/or hard-coded (eg, non-volatile) data.

As used in any aspect of this specification, the terms “component,” “system,” “module,” etc. refer to hardware, a combination of hardware and software, software, or software in execution. can refer to a computer-related entity that is

As used in any aspect herein, "algorithm" refers to a self-consistent sequence of steps leading to a desired result; , comparison, and manipulation of physical quantities and/or logical states, which may take the form of electrical or magnetic signals capable of being otherwise manipulated. It is common practice to refer to these signals as bits, values, elements, symbols, characters, terms, numbers, or the like. These and similar terms may be associated with appropriate physical quantities and are merely convenient labels applied to these quantities and/or states.

The network may include packet switched networks. The communication devices can communicate with each other using a selected packet-switched network communication protocol. One exemplary communication protocol may include the Ethernet communication protocol, which may enable communication using Transmission Control Protocol/Internet Protocol (TCP/IP). The Ethernet protocol conforms to or is compatible with the Ethernet standard entitled "IEEE 802.3 Standard" published December 2008 by the Institute of Electrical and Electronics Engineers (IEEE) and/or later versions of this standard. possible. Alternatively or additionally, the communication device may V.25 communication protocol can be used to communicate with each other. X. The V.25 communication protocol may conform to or be compatible with standards promulgated by the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, the communication devices can communicate with each other using a frame relay communication protocol. The frame relay communication protocol may conform to or be 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 transceivers may be able to communicate with each other using the Asynchronous Transfer Mode (ATM) communication protocol. The ATM communication protocol conforms to or is compatible with the ATM standard and/or later versions of this standard published in August 2001 by the ATM Forum under the title "ATM-MPLS Network Interworking 2.0". obtain. Of course, different and/or later developed connection-oriented network communication protocols are equally contemplated herein.

Unless expressly specified otherwise, the terms "processing," "computing," and "calculating" are used throughout the foregoing disclosure as is apparent from the foregoing disclosure. , "determining," "displaying," and the like refer to data represented as physical (electronic) quantities in the registers and memory of a computer system. refers to the actions and processing of a computer system or similar electronic computing device that manipulates and transforms the memory or registers of or other such information into other data that are similarly represented as physical quantities in a storage, transmission, or display. It should be understood that

As used herein, one or more components are “configured to,” “configurable to,” “operable/to operable/operative to, adapted/adaptable, capable to, conformable/conformed to)”, etc. Those skilled in the art will understand that "configured to" generally refers to active components and/or inactive components and/or standby components, unless the context requires otherwise. will recognize that it may include

The terms "proximal" and "distal" are used herein with reference to the clinician manipulating the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the clinician and the term "distal" refers to the portion located farther from the clinician. It will be further appreciated that for convenience and clarity, spatial terms such as "vertical," "horizontal," "above," and "below" may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

Those skilled in the art will appreciate that the terms used herein generally, and particularly in the appended claims (e.g., the appended claim text), are generally intended as "open" terms. (e.g., the term "including" is to be interpreted as "including but not limited to"; the term "having" is to be interpreted as "including but not limited to"); should be interpreted as "having at least" and the term "includes" should be interpreted as "includes but is not limited to" should be done, etc.). Moreover, where a particular number is intended in an introduced claim recitation, such intent is expressly recited in the claim; and in the absence of such a statement, such intent does not exist. will be understood by those skilled in the art. For example, as an aid to understanding, the appended claims that follow use the introductory phrases "at least one" and "one or more" to refer to May be included to introduce description. However, use of such phrases may be used to refer to "one or more" or "at least one" even within the same claim when introducing claim recitations by the indefinite article "a" or "an". and the indefinite article "a" or "an", any particular claim containing such an introduced claim recitation shall be subject to claims containing only one such recitation. should not be construed as to be implied as limiting (e.g., "a" and/or "an" are generally taken to mean "at least one" or "one or more"). should be interpreted). the same holds true where the definite article is used to introduce claim recitations.

In addition, even where a specific number is specified in an introduced claim statement, such statement should typically be construed to mean at least the stated number. but will be recognized by those skilled in the art (e.g., where there is a statement simply "two statements" without other modifiers, generally there are at least two statements, or two or three (meaning one or more entries). Further, where notations like "at least one of A, B and C, etc." are used, such syntax is generally intended in the sense that one skilled in the art would understand the notation (e.g. , "a system having at least one of A, B and C" includes, but is not limited to, A only, B only, C only, both A and B, both A and C, B and C and/or all of A and B and C, etc.). Where notations like "at least one of A, B or C, etc." are used, such syntax is generally intended in the sense that one skilled in the art would understand the notation (e.g., "A , B, or C" includes, but is not limited to, A only, B only, C only, both A and B, both A and C, both B and C and/or systems having all of A and B and C, etc.). Moreover, typically any disjunctive word and/or phrase representing two or more alternative terms is used in the specification unless the context requires otherwise. It is understood to be intended to include one of the terms, either of the terms, or both terms, whether in the claims, or in the drawings. Those skilled in the art will understand that it should. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "A and B."

With regard to the appended claims, those skilled in the art will understand that the operations recited herein can generally be performed in any order. Also, while the flow diagrams of various acts are shown in sequence(s), it should be understood that the various acts can be performed in an order other than that shown, or can be performed simultaneously. is. Examples of such alternative orderings include overlapping, interleaving, interrupting, reordering, incremental, preliminary, additional, simultaneous, reverse or other different orderings, unless the context requires otherwise. can contain. Further, terms such as "response to", "related to", or other past tense adjectives generally exclude such variations unless the context dictates otherwise. not intended.

Any reference to “an aspect,” “an aspect,” “exemplary,” “an example,” etc. means that at least one aspect includes the particular feature, structure or property described in connection with that aspect. The implications deserve special mention. Thus, the appearances of the phrases "in one aspect," "in an aspect," "in an example," and "in an example" in various places throughout this specification are not necessarily all referring to the same aspect. Moreover, the particular features, structures or characteristics may be combined in any suitable manner in one or more aspects.

As used herein, unless otherwise indicated, the term "about" or "approximately" as used in this disclosure means a tolerance to a particular value determined by one of ordinary skill in the art, unless otherwise specified. depends in part on how the value is measured or determined. In certain embodiments, the term "about" or "approximately" means 1, 2, 3, or 4 standard deviations. In certain embodiments, the term "about" or "approximately" refers to 50%, 20%, 15%, 10%, 9%, 8%, 7%, 6%, 5% of a given value or range. , 4%, 3%, 2%, 1%, 0.5%, or 0.05%.

In this specification, unless otherwise indicated, all numerical parameters are to be understood as being preceded and modified in all instances by the term "about," and such numerical parameters refer to the numerical value of the parameter. It has variability inherent in the underlying measurement used to determine it. At a minimum, no attempt should be made to limit the application of the doctrine of equivalents to the scope of the claims, and each numerical parameter set forth herein takes into account the number of significant digits reported, should be interpreted at least by applying the usual rounding technique.

Any numerical range recited herein includes all subranges subsumed within the stated range. For example, the range "1 to 10" includes all subranges between (and inclusive) the minimum recited value of 1 and the maximum recited value of 10, namely: All subranges with a minimum value greater than or equal to 1 and a maximum value less than or equal to 10 are included. Also, all ranges recited herein are inclusive of the recited range endpoints. For example, a range of "1-10" includes endpoints 1 and 10. It is intended that every maximum numerical limit given herein includes every lower numerical limit, and every minimum numerical limit given herein is intended to be inclusive thereof. is intended to include all higher numerical limits. Accordingly, Applicant reserves the right to amend the specification, including the claims, to include any expressly recited subranges subsumed within the expressly recited range. All such ranges are inherently disclosed herein.

Any patent applications, patents, non-patent publications, or other disclosure material referenced herein and/or listed in any application data sheet is, to the extent the material incorporated herein, is not inconsistent with this specification. , incorporated herein by reference. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting statements incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated herein by reference but that conflicts with the current definitions, opinions, or other disclosure content set forth herein, is deemed and to the extent not inconsistent with the current disclosure.

In summary, a number of benefits have been described that result from using the concepts described herein. The foregoing description of one or more aspects has been presented for the purposes of illustration and description. It is not intended to be exhaustive or to be limited to the precise forms disclosed. Modifications or variations are possible in light of the above teachings. One or more of the forms illustrate principles and practical applications, thereby enabling those skilled in the art to utilize the various forms, with various modifications, as appropriate for the particular application envisioned. have been selected and described so as to It is intended that the claims presented herewith define the overall scope.

[Mode of implementation]
(1) A surgical instrument comprising:
a housing;
a shaft assembly interchangeably connected to the housing, the shaft assembly including an end effector;
a processor;
A memory configured to store program instructions, the program instructions being executed from the memory to cause the processor to:
transmitting an electrical interrogation signal to the attached shaft assembly;
receiving a response signal from the attached shaft assembly;
causing a default function to be performed when a response signal is not received by the attached shaft assembly;
determining an identifying characteristic of the attached shaft assembly as a result of the implementation of the default function;
modifying a control program based on the identifying characteristic of the attached shaft assembly;
a memory causing the
A surgical instrument comprising:
Clause 2. The surgical instrument of Clause 1, wherein the identifying characteristic includes remaining volume of the attached shaft assembly.
Clause 3. The surgical instrument of Clause 1, wherein the identifying characteristic includes a performance level of the attached shaft assembly.
Clause 4. The surgical instrument of Clause 1, wherein the distinguishing characteristic is different for attached shaft assemblies of different capacities.
(5) the memory includes a lookup table containing operating parameters corresponding to a particular shaft assembly, and the processor utilizes the received response signal to direct the installed Clause 2. The surgical instrument of clause 1, wherein a shaft assembly is identified and the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.

Clause 6. The surgical instrument of clause 1, wherein the memory further includes program instructions, and wherein execution of the program instructions causes the processor to store the modified control program in the memory.
(7) A surgical instrument comprising:
a housing;
a shaft assembly interchangeably connected to the housing, the shaft assembly including an end effector;
a processor;
A memory configured to store program instructions, the program instructions being executed from the memory to cause the processor to:
transmitting a variable interrogation communication to the attached shaft assembly;
determining capabilities of the attached shaft assembly based on responses to the variable interrogation communication;
modifying a control program based on the determined capability of the attached shaft assembly;
a memory causing the
A surgical instrument comprising:
Clause 8. The surgical instrument of clause 7, wherein the variable interrogation communication includes electrical interrogation signals and physical actuation of the surgical instrument.
Clause 9. The surgical instrument of Clause 7, wherein the physical actuation of the surgical instrument is monitored to determine functional capability of the attached shaft assembly.
Clause 10. The surgical instrument of Clause 7, wherein the determined capacity is related to the remaining capacity of the shaft assembly.

Clause 11. The surgical instrument of Clause 7, wherein the determined capability is related to a performance level of the shaft assembly.
(12) The surgical instrument of Clause 7, wherein the determined capabilities differ based on the connected shaft assemblies.
(13) Implementation wherein the memory further comprises program instructions, and execution of the program instructions causes the processor to store the modified control program and the determined shaft assembly capabilities in the memory. A surgical instrument according to aspect 7.
(14) A surgical instrument comprising:
a housing;
a shaft assembly interchangeably coupled to the housing, the shaft assembly including an end effector;
a processor;
A memory configured to store program instructions, the program instructions being executed from the memory to cause the processor to:
transmitting an interrogation signal to the shaft assembly coupled to the housing;
receiving a response signal from the shaft assembly coupled to the housing;
causing default end effector functions to be performed when the response signal is not recognized;
determining an identifying characteristic of the shaft assembly coupled to the housing as a result of the implementation of the default end effector function;
modifying a control program based on the identifying characteristic of the shaft assembly coupled to the housing;
a memory causing the
A surgical instrument comprising:
Clause 15. The surgical instrument of Clause 14, wherein the response signal is not recognized by the processor because the response signal is not received by the processor.

Clause 16. The surgical instrument of Clause 14, wherein the identifying characteristic includes a remaining volume of the shaft assembly coupled to the housing.
Clause 17. The surgical instrument of Clause 14, wherein the identifying characteristic includes a performance level of the shaft assembly coupled to the housing.
Clause 18. The surgical instrument of clause 14, wherein the determined characteristic can vary based on the shaft assembly interchangeably coupled to the housing.
(19) said memory includes a lookup table containing operating parameters corresponding to a particular shaft assembly, and said processor utilizes said received response signal to link said housing in said lookup table; 15. The surgical instrument of embodiment 14, wherein the shaft assembly identified is identified and the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.
Clause 20. The surgical instrument of clause 14, wherein the memory further comprises program instructions, and wherein execution of the program instructions causes the processor to store the modified control program in the memory.

Claims (20)

A surgical instrument,
a housing;
a shaft assembly interchangeably connected to the housing, the shaft assembly including an end effector;
a processor;
A memory configured to store program instructions, the program instructions being executed from the memory to cause the processor to:
transmitting an electrical interrogation signal to the attached shaft assembly;
receiving a response signal from the attached shaft assembly;
causing a default function to be performed when a response signal is not received by the attached shaft assembly;
determining an identifying characteristic of the attached shaft assembly as a result of the implementation of the default function;
modifying a control program based on the identifying characteristic of the attached shaft assembly;
a memory causing the
A surgical instrument comprising: The surgical instrument according to any one of the preceding claims, wherein the distinguishing characteristic includes remaining volume of the attached shaft assembly. The surgical instrument of any one of the preceding claims, wherein the distinguishing characteristic comprises a performance level of the attached shaft assembly. The surgical instrument of any one of the preceding claims, wherein the distinguishing characteristic differs for attached shaft assemblies of different capabilities. The memory includes a lookup table containing operating parameters corresponding to a particular shaft assembly, and the processor utilizes the received response signal to identify the installed shaft assembly in the lookup table. and the control program is modified using the stored operating parameters corresponding to the identified shaft assembly. The surgical instrument of any one of the preceding claims, wherein the memory further comprises program instructions that, upon execution of the program instructions, cause the processor to store the modified control program in the memory. A surgical instrument,
a housing;
a shaft assembly interchangeably connected to the housing, the shaft assembly including an end effector;
a processor;
A memory configured to store program instructions, the program instructions being executed from the memory to cause the processor to:
transmitting a variable interrogation communication to the attached shaft assembly;
determining capabilities of the attached shaft assembly based on responses to the variable interrogation communication;
modifying a control program based on the determined capability of the attached shaft assembly;
a memory causing the
A surgical instrument comprising: The surgical instrument of claim 7, wherein the variable interrogation communications include electrical interrogation signals and physical actuation of the surgical instrument. The surgical instrument of claim 7, wherein the physical actuation of the surgical instrument is monitored to determine functional capabilities of the attached shaft assembly. The surgical instrument of claim 7, wherein the determined capacity is related to remaining capacity of the shaft assembly. The surgical instrument of claim 7, wherein the determined capability is related to the performance level of the shaft assembly. The surgical instrument of claim 7, wherein the determined capabilities differ based on the connected shaft assemblies. 8. The memory of claim 7, further comprising program instructions, wherein execution of the program instructions causes the processor to store the modified control program and the determined shaft assembly capabilities in the memory. A surgical instrument as described. A surgical instrument,
a housing;
a shaft assembly interchangeably coupled to the housing, the shaft assembly including an end effector;
a processor;
A memory configured to store program instructions, the program instructions being executed from the memory to cause the processor to:
transmitting an interrogation signal to the shaft assembly coupled to the housing;
receiving a response signal from the shaft assembly coupled to the housing;
causing default end effector functions to be performed when the response signal is not recognized;
determining an identifying characteristic of the shaft assembly coupled to the housing as a result of the implementation of the default end effector function;
modifying a control program based on the identifying characteristic of the shaft assembly coupled to the housing;
a memory causing the
A surgical instrument comprising: The surgical instrument of Claim 14, wherein the response signal is not recognized by the processor because the response signal is not received by the processor. 15. The surgical instrument of claim 14, wherein the identifying characteristic includes remaining volume of the shaft assembly coupled to the housing. The surgical instrument of Claim 14, wherein the identifying characteristic includes a performance level of the shaft assembly coupled to the housing. The surgical instrument of claim 14, wherein the determined characteristic can differ based on the shaft assembly interchangeably coupled to the housing. The memory includes a lookup table containing operating parameters corresponding to a particular shaft assembly, and the processor utilizes the received response signal to direct the housing coupled to the lookup table. The surgical instrument of Claim 14, wherein a shaft assembly is identified and the control program is modified using the stored operating parameters corresponding to the identified shaft assembly. 15. The surgical instrument of claim 14, wherein the memory further comprises program instructions that, upon execution of the program instructions, cause the processor to store the modified control program in the memory.

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