JP7301843B2 - Smoke Evacuation System Including Segmented Control Circuitry for Interactive Surgical Platforms - Google Patents

Description

(Cross reference to related applications)
This application is filed under 35 U.S.C. §119(e) under 35 U.S.C. L PLATFORM" and No. 62/691,257, filed Jun. 28, 2018, entitled

This application, filed March 30, 2018, under 35 U.S.C. U.S. Provisional Patent Application No. 62/650,877, filed March 30, 2018, entitled "SURGICAL SMOKE EVACUATION SENSING AND CONTROLS," entitled "SMOKE EVACUATION MODULE FOR INTERACTIVE SUR". GICAL PLATFORM” and U.S. Provisional Patent Application No. 62/650,882, filed March 30, 2018, entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS." No./650,898 priority benefit is claimed.

This application is also filed under 35 U.S.C. U.S. Provisional Patent Application No. 62/640,417, filed on May 31, 2018; Claim priority benefits.

This application is also covered under 35 U.S.C. Application No. 62/611,341, U.S. Provisional Patent Application No. 62/611,340, filed Dec. 28, 2017, entitled "CLOUD-BASED MEDICAL ANALYTICS," and U.S. Provisional Patent Application No. 62/611,340, entitled "ROBOT ASSISTED SURGICAL PLATFORM," Dec. 12, 2017. It claims the benefit of priority from US Provisional Patent Application No. 62/611,339, filed May 28.

The present invention relates to a surgical system and its ejector. Surgical smoke evacuators are configured to evacuate smoke and fluids and/or particulates from a surgical site. For example, smoke may be generated at the surgical site during surgical procedures involving energy devices.

The present disclosure provides new and innovative methods and systems for smoke evacuation systems including segmented control circuitry for interactive surgical platforms. An exemplary method includes booting a first segment that includes a main processor and a safety processor. A first segment is caused to perform a first function. The second segment is activated if the second segment includes sensing circuitry and display circuitry. A third segment is activated if the third segment includes the motor control circuit and the motor.

An exemplary system includes a control circuit that includes multiple segments, including a first segment, a second segment, and a third segment. The first segment includes a main processor and a safety processor, the main processor coupled to a memory, the memory executed by the main processor for energizing the first segment before the second and third segments. Storing possible instructions and energizing the second and third segments is after the first segment performs the first function. The second segment contains sensing circuitry and display circuitry, and the third segment contains motor control circuitry and motors.

Additional features and advantages of the disclosed method and system are set forth in, and will be apparent from, the following detailed description and drawings.

Features of various aspects are set forth with particularity in the appended claims. The various aspects, both as to organization and method of operation, however, together with further objects and advantages thereof, may best be understood by reference to the following description, taken in conjunction with the accompanying drawings, which follow.
1 shows a perspective view of an ejector housing for a surgical ejection system, according to at least one aspect of the present disclosure; FIG. 1 is a perspective view of a surgical evacuation electrosurgical tool in accordance with at least one aspect of the present disclosure; FIG. 2 is an elevational view of a surgical ejection tool releasably secured to an electrosurgical pencil in accordance with at least one aspect of the present disclosure; FIG. FIG. 12 is a schematic diagram showing internal components within an ejector housing for a surgical ejection system, in accordance with at least one aspect of the present disclosure; 1 is a schematic illustration of an electrosurgical system including a smoke evacuator, according to at least one aspect of the present disclosure; FIG. 1 is a schematic illustration of a surgical drainage system, according to at least one aspect of the present disclosure; FIG. 1 is a perspective view of a surgical system including a surgical drainage system in accordance with at least one aspect of the present disclosure; FIG. 8 is a perspective view of the ejector housing of the surgical ejection system of FIG. 7 according to at least one aspect of the present disclosure; FIG. 9 is an elevation cross-sectional view of a socket in the ejector housing of FIG. 8 taken along the plane shown in FIG. 8, in accordance with at least one aspect of the present disclosure; FIG. 2 is a perspective view of a filter for an evacuation system, according to at least one aspect of the present disclosure; FIG. 11 is a perspective cross-sectional view of the filter of FIG. 10 taken along the central longitudinal plane of the filter, in accordance with at least one aspect of the present disclosure; FIG. 8 is a pump for a surgical drainage system, such as the surgical drainage system of FIG. 7, according to at least one aspect of the present disclosure; 1 is a perspective view of a portion of a surgical drainage system in accordance with at least one aspect of the present disclosure; FIG. 14 is a front perspective view of a fluid trap of the surgical drainage system of FIG. 13 in accordance with at least one aspect of the present disclosure; FIG. 15 is a rear perspective view of the fluid trap of FIG. 14 in accordance with at least one aspect of the present disclosure; FIG. 15 is an elevated cross-sectional view of the fluid trap of FIG. 14 in accordance with at least one aspect of the present disclosure; FIG. 15 is an elevated cross-sectional view of the fluid trap of FIG. 14 with portions removed for clarity showing liquid trapped within the fluid trap and smoke flowing through the fluid trap in accordance with at least one aspect of the present disclosure; FIG. is. 1 is a schematic illustration of an ejector housing of an ejection system, in accordance with at least one aspect of the present disclosure; FIG. FIG. 12 is a schematic illustration of an ejector housing of another ejection system, in accordance with at least one aspect of the present disclosure; 1 illustrates a smoke evacuation system in communication with various other modules and devices, according to at least one aspect of the present disclosure; 4 illustrates an exemplary flow diagram of interconnectivity between a surgical hub, a cloud, a smoke evacuation module, and/or various other modules A, B, and C, according to at least one aspect of the present disclosure; 1 illustrates a smoke evacuation system in communication with various other modules and devices, according to at least one aspect of the present disclosure; 1 illustrates one aspect of a segmented control circuit, in accordance with at least one aspect of the present disclosure; A method of operating a control circuit portion of a smoke evacuation module to stepwise energize a segmented control circuit is disclosed, according to at least one aspect of the present disclosure. 1 is a block diagram of a computer-implemented interactive surgical system in accordance with at least one aspect of the present disclosure; FIG. A surgical system used to perform a surgical procedure in an operating room, according to at least one aspect of the present disclosure. 1 is a surgical hub paired with a visualization system, a robotic system, and an intelligent instrument according to at least one aspect of the present disclosure; FIG. 18 is a partial perspective view of a surgical hub enclosure and a combination generator module slidably receivable within a drawer of the surgical hub enclosure in accordance with at least one aspect of the present disclosure; 1 is a perspective view of a combination generator module comprising bipolar, ultrasonic, and monopolar contacts and smoke evacuation components in accordance with at least one aspect of the present disclosure; FIG. 4 illustrates individual power bus attachments for multiple lateral docking ports of a lateral modular enclosure configured to receive multiple modules, in accordance with at least one aspect of the present disclosure; 1 illustrates a vertical modular enclosure configured to receive multiple modules, in accordance with at least one aspect of the present disclosure; Cloud modular devices located in one or more operating rooms of a healthcare facility, or any room within a health facility with specialized equipment for surgical procedures, according to at least one aspect of the present disclosure 1 illustrates a surgical data network comprising a modular communication hub configured to connect to; 1 illustrates a computer-implemented interactive surgical system, according to at least one aspect of the present disclosure; 1 illustrates a surgical hub comprising multiple modules coupled to a modular control tower, according to at least one aspect of the present disclosure; 1 illustrates one aspect of a Universal Serial Bus (USB) network hub device, in accordance with at least one aspect of the present disclosure; 1 illustrates a logic diagram of a control system for a surgical instrument or tool, according to at least one aspect of the present disclosure; FIG. 1 illustrates a control circuit configured to control aspects of a surgical instrument or tool, according to at least one aspect of the present disclosure; FIG. 11 illustrates a combinational logic circuit configured to control aspects of a surgical instrument or tool, according to at least one aspect of the present disclosure; FIG. 4 illustrates a sequential logic circuit configured to control aspects of a surgical instrument or tool, according to at least one aspect of the present disclosure; 1 illustrates a surgical instrument or tool comprising multiple motors that can be activated to perform various functions, in accordance with at least one aspect of the present disclosure; 1 is a schematic illustration of a robotic surgical instrument configured to operate a surgical tool described herein, according to at least one aspect of the present disclosure; FIG. FIG. 10 illustrates a block diagram of a surgical instrument programmed to control distal translation of a displacement member, according to at least one aspect of the present disclosure; 1 is a schematic illustration of a surgical instrument configured to control various functions, according to at least one aspect of the present disclosure; FIG. 1 is a simplified block diagram of a generator configured to provide inductive tuning, among other advantages, in accordance with at least one aspect of the present disclosure; FIG. 45 illustrates an example of a generator, one form of the generator of FIG. 44, in accordance with at least one aspect of the present disclosure; 4 is a timeline showing situational awareness of a surgical hub, according to one aspect of the present disclosure;

The applicant of this application owns the following US patent applications filed June 29, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. Patent Application No. ______________, entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS", Attorney Docket No. END8542USNP/170755;
- U.S. Patent Application No. ______________, Attorney Docket No. END8543USNP/170760, entitled "CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS";
U.S. Patent Application No. ____________, Attorney Docket No. END8543USNP1/170760-1, entitled "SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOD PERATIVE INFORMATION";
- U.S. Patent Application No. ____________, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING," Attorney Docket No. END8543USNP2/170760-2;
- U.S. Patent Application No. ____________, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING," Attorney Docket No. END8543USNP3/170760-3;
U.S. Patent Application No. ______________, Attorney Docket No. END8543USNP4/170760-4, entitled "SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES";
U.S. Patent Application No. ______________, Attorney Docket No. END8543USNP5/170760-5, entitled "SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE";
- U.S. Patent Application No. ______________, entitled "SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES," Attorney Docket No. END8543USNP6/170760-6;
- U.S. Patent Application No. ____________, entitled "VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY," Attorney Docket No. END8543USNP7/170760-7;
- U.S. Patent Application No. ____________, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE", Attorney Docket No. END8544USNP/170761;
- U.S. Patent Application No. ____________, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT", Attorney Docket No. END8544USNP1/170761-1;
- U.S. Patent Application No. ____________, entitled "SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY," Attorney Docket No. END8544USNP2/170761-2;
U.S. Patent Application No. ______________, Attorney Docket No. END8544USNP3/170761-3, entitled "SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES";
- U.S. Patent Application No. ______________, entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL," Attorney Docket No. END8545USNP/170762;
- U.S. Patent Application No. ____________, entitled "SURGICAL EVACUATION SENSOR ARRANGEMENTS," Attorney Docket No. END8545USNP1/170762-1;
- U.S. Patent Application No. ____________, entitled "SURGICAL EVACUATION FLOW PATHS," Attorney Docket No. END8545USNP2/170762-2;
- U.S. Patent Application No. ____________, entitled "SURGICAL EVACUATION SENSING AND GENERATOR CONTROL," Attorney Docket No. END8545USNP3/170762-3;
- U.S. Patent Application No. ____________, entitled "SURGICAL EVACUATION SENSING AND DISPLAY," Attorney Docket No. END8545USNP4/170762-4;
- U.S. Patent Application No. ____________, entitled "COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM", Attorney Person Control Number END8546USNP/170763,
U.S. Patent Application No. ______________, Attorney Docket No. EN, entitled "SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION DEVICE" D8547 USNP/170764, and "DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS , Attorney Docket No. END8548USNP/170765.

The applicant of this application owns the following US provisional patent applications, filed June 28, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. Provisional Patent Application No. 62/691,228 entitled "A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES";
- U.S. Provisional Patent Application No. 62/691,227, entitled "CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS";
U.S. Provisional Patent Application No. 62/691,230 entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE";
U.S. Provisional Patent Application No. 62/691,219 entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL";
"Communication OF SMOKE Evacutations to Hub or Cloud IN SMOKE EVACUATION MODULE FORGIVE SURGICAL SURGICAL PLATFORM "US temporary patent application No. 62/691, 257,
U.S. Provisional Patent Application No. 62/691,262 entitled "SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE"; AL IN-SERIES LARGE AND SMALL DROPLET FILTERS Provisional Patent Application No. 62/691,251.

The applicant of this application owns the following US provisional patent applications filed April 19, 2018, the disclosures of each of which are incorporated herein by reference in their entirety:
• US Provisional Patent Application No. 62/659,900, entitled "METHOD OF HUB COMMUNICATION."

The applicant of this application owns the following US patent applications filed March 29, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. Patent Application No. 15/940,641, entitled "INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES";
- U.S. patent application Ser.
U.S. Patent Application No. 15/940,656 entitled "SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES";
- U.S. patent application Ser.
U.S. Patent Application Serial No. 15/940,670 entitled "COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS";
- U.S. Patent Application No. 15/940,677 entitled "SURGICAL HUB CONTROL ARRANGEMENTS";
- U.S. patent application Ser.
- U.S. Patent Application No. entitled "COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS" 15/940,640,
U.S. Patent Application No. 15/940,645, entitled "SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT";
U.S. Patent Application No. 15/940,649, entitled "DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME";
- U.S. Patent Application No. 15/940,654 entitled "SURGICAL HUB SITUATIONAL AWARENESS";
- U.S. Patent Application No. 15/940,663 entitled "SURGICAL SYSTEM DISTRIBUTED PROCESSING";
- U.S. Patent Application No. 15/940,668, entitled "AGGREGATION AND REPORTING OF SURGICAL HUB DATA";
- U.S. Patent Application No. 15/940,671 entitled "SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER"
U.S. Patent Application No. 15/940,686, entitled "DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINE STAPLE LINE";
- U.S. Patent Application No. 15/940,700, entitled "STERILE FIELD INTERACTIVE CONTROL DISPLAYS";
U.S. Patent Application No. 15/940,629 entitled "COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS";
- U.S. patent application Ser.
U.S. Patent Application No. 15/940,722, entitled "CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY," and U.S. Patent Application No. 15/940, entitled "DUAL CMOS ARRAY IMAGING." , 742.

The applicant of this application owns the following US patent applications filed March 29, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. patent application Ser. No. 15/940,636 entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES";
U.S. patent application Ser. No. 15/940,653 entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS";
- U.S. Patent Application No. 15/940,660 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER"
- U.S. patent application Ser.
U.S. patent application Ser.
- U.S. Patent Application No. 15/940,634 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES"
U.S. Patent Application No. 15/940,706, entitled "DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK"; No. 675.

The applicant of this application owns the following US patent applications filed March 29, 2018, the entire disclosures of each of which are incorporated herein by reference:
- US patent application Ser.
- U.S. Patent Application No. 15/940,637, entitled "COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- US patent application Ser.
- US patent application Ser.
- US patent application Ser.
U.S. patent application Ser.
U.S. Patent Application No. 15/940,690, entitled "DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS," and US patent application Ser. No. 15/940,711.

The applicant of this application owns the following US provisional patent applications filed March 28, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. Provisional Patent Application No. 62/649,302 entitled "INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES";
U.S. Provisional Patent Application No. 62/649,294 entitled "DATA STRIPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD";
U.S. Provisional Patent Application No. 62/649,300 entitled "SURGICAL HUB SITUATIONAL AWARENESS";
U.S. Provisional Patent Application No. 62/649,309 entitled "SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER";
U.S. Provisional Patent Application No. 62/649,310 entitled "COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS";
U.S. Provisional Patent Application No. 62/649,291 entitled "USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT";
U.S. Provisional Patent Application No. 62/649,296 entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES";
- U.S. Provisional Patent Application No. 62/649,333 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER";
U.S. Provisional Patent Application No. 62/649,327 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES";
U.S. Provisional Patent Application No. 62/649,315 entitled "DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK";
U.S. Provisional Patent Application No. 62/649,313 entitled "CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES";
U.S. Provisional Patent Application No. 62/649,320, entitled "DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- U.S. Provisional Patent Application No. 62/649,307 entitled "AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT - ASSISTED SURGICAL PLATFORMS"; U.S. Provisional Patent Application No. 62/649,323 entitled "ORMS" issue.

The applicant of this application owns the following US provisional patent application, filed April 19, 2018, the disclosures of which are hereby incorporated by reference in their entireties:
• US Provisional Patent Application No. 62/659,900, entitled "METHOD OF HUB COMMUNICATION."

The applicant of this application owns the following US patent applications filed March 29, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. Patent Application No. 15/940,641, entitled "INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES";
- U.S. patent application Ser.
U.S. Patent Application No. 15/940,656 entitled "SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES";
- U.S. patent application Ser.
U.S. Patent Application No. 15/940,670 entitled "COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS";
- U.S. Patent Application No. 15/940,677 entitled "SURGICAL HUB CONTROL ARRANGEMENTS";
- U.S. patent application Ser.
- U.S. Patent Application No. entitled "COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS" 15/940,640,
U.S. Patent Application No. 15/940,645, entitled "SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT";
U.S. Patent Application No. 15/940,649, entitled "DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME";
- U.S. Patent Application No. 15/940,654 entitled "SURGICAL HUB SITUATIONAL AWARENESS";
- U.S. Patent Application No. 15/940,663 entitled "SURGICAL SYSTEM DISTRIBUTED PROCESSING";
- U.S. Patent Application No. 15/940,668, entitled "AGGREGATION AND REPORTING OF SURGICAL HUB DATA";
- U.S. Patent Application No. 15/940,671 entitled "SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER"
U.S. Patent Application No. 15/940,686, entitled "DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINE STAPLE LINE";
- U.S. Patent Application No. 15/940,700, entitled "STERILE FIELD INTERACTIVE CONTROL DISPLAYS";
U.S. Patent Application No. 15/940,629 entitled "COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS";
- U.S. patent application Ser.
U.S. Patent Application No. 15/940,722, entitled "CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY," and U.S. Patent Application No. 15/940, entitled "DUAL CMOS ARRAY IMAGING." , 742.

The applicant of this application owns the following US patent applications filed March 29, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. patent application Ser. No. 15/940,636 entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES";
U.S. patent application Ser. No. 15/940,653 entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS";
- U.S. Patent Application No. 15/940,660 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER"
- U.S. patent application Ser.
U.S. patent application Ser.
- U.S. Patent Application No. 15/940,634 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES"
U.S. Patent Application No. 15/940,706, entitled "DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK"; No. 675.

The applicant of this application owns the following US patent applications filed March 29, 2018, the entire disclosures of each of which are incorporated herein by reference:
- US patent application Ser.
- U.S. Patent Application No. 15/940,637, entitled "COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- US patent application Ser.
- US patent application Ser.
- US patent application Ser.
U.S. patent application Ser.
U.S. Patent Application No. 15/940,690, entitled "DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS," and US patent application Ser. No. 15/940,711.

The applicant of this application owns the following US provisional patent applications filed March 28, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. Provisional Patent Application No. 62/649,302 entitled "INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES";
U.S. Provisional Patent Application No. 62/649,294 entitled "DATA STRIPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD";
U.S. Provisional Patent Application No. 62/649,300 entitled "SURGICAL HUB SITUATIONAL AWARENESS";
U.S. Provisional Patent Application No. 62/649,309 entitled "SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER";
U.S. Provisional Patent Application No. 62/649,310 entitled "COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS";
U.S. Provisional Patent Application No. 62/649,291 entitled "USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT";
U.S. Provisional Patent Application No. 62/649,296 entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES";
- U.S. Provisional Patent Application No. 62/649,333 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER";
U.S. Provisional Patent Application No. 62/649,327 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES";
U.S. Provisional Patent Application No. 62/649,315 entitled "DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK";
U.S. Provisional Patent Application No. 62/649,313 entitled "CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES";
U.S. Provisional Patent Application No. 62/649,320, entitled "DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- U.S. Provisional Patent Application No. 62/649,307 entitled "AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT - ASSISTED SURGICAL PLATFORMS"; U.S. Provisional Patent Application No. 62/649,323 entitled "ORMS" issue.

The applicant of this application owns the following US provisional patent applications filed March 8, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. Provisional Patent Application No. 62/640,417, entitled "TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR"; and "ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM" U.S. Provisional Patent Application No. 62/640 entitled EM THEREFOR , No. 415.

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

Before describing various aspects of surgical devices and generators in detail, it is noted that the illustrated examples are not limited in application or use to the details of construction and arrangement of parts set forth in the accompanying drawings and description. It should be noted. Example embodiments may be practiced with 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 have been chosen for the convenience of the reader for the purpose of describing the exemplary embodiments and not for purposes of limitation thereof. . Further, one or more of the aspects, implementations of aspects and/or examples described below may be combined with any of the other aspects, implementations of aspects and/or examples described below. It should be understood that one or more can be combined.

Energy Devices and Smoke Evacuation The present disclosure relates to energy devices and intelligent surgical evacuation systems for evacuating smoke and/or other fluids and/or particulates from a surgical site. Smoke is often generated during surgical procedures utilizing one or more energy devices. Energy devices use energy to affect tissue. In energy devices, energy is supplied by a generator. Energy devices include devices with tissue contacting electrodes, such as electrosurgical devices with one or more radio frequency (RF) electrodes, and devices with vibrating surfaces, such as ultrasonic devices with ultrasonic blades. be done. In electrosurgical devices, a generator is configured to generate an oscillating current to energize the electrodes. In the case of ultrasonic devices, the generator is configured to generate ultrasonic vibrations that energize the ultrasonic blade. Generators are further described herein.

Ultrasonic energy can be used to coagulate and cut tissue. Ultrasonic energy coagulates and cuts tissue by vibrating an energy delivery surface (eg, an ultrasonic blade) that contacts the tissue. The ultrasonic blade can be coupled to a waveguide that conducts vibrational energy from the ultrasonic transducer, which generates mechanical vibrations and is powered by a generator. By vibrating at high frequencies (e.g., 55,500 times per second), the ultrasonic blade denatures proteins between the blade and the tissue, i.e., within the tissue, to form a sticky clot, blade-tissue. At the interface, friction and heat are generated between the blade and the tissue. The pressure exerted by the blade surface on the tissue causes the vessel to collapse, allowing the clot to form a hemostatic seal. Accuracy of cutting and coagulation can be controlled, for example, by clinician technique and adjustment of power level, blade edge, tissue traction, and blade pressure.

Ultrasonic surgical instruments are finding increasingly widespread use in surgical procedures due to the special performance characteristics of such instruments. Depending on the particular instrument configuration and operating parameters, ultrasonic surgical instruments can provide tissue cutting and hemostasis by coagulation substantially simultaneously, desirably with minimal trauma to the patient. . The cutting action is typically accomplished by an end effector or blade tip at the distal end of the ultrasonic instrument. An ultrasonic end effector transmits ultrasonic energy to tissue in contact with the end effector. Such ultrasonic surgical instruments can be configured for open surgery, including robotic-assisted surgery, for laparoscopic use, or for endoscopic surgery, for example.

Electrical energy may also be utilized for coagulation and/or cutting. Electrosurgical devices typically include a handpiece and an instrument having an end effector (eg, one or more electrodes) attached to its distal end. The end effector can be positioned against and/or adjacent to tissue such that an electrical current is introduced into the tissue. Electrosurgery is widely used and offers many advantages, including the use of a single surgical instrument for both coagulation and cutting.

The electrodes or tips of the electrosurgical device are points of contact with the patient to generate high frequency currents with high current densities to produce a surgical effect of coagulating and/or cutting tissue by cauterization. is small in The return electrode carries the same RF signal back to the electrosurgical generator after passing through the patient, thus providing a return path for the RF signal.

Electrosurgical devices can be configured for bipolar or monopolar operation. During bipolar operation, current is introduced into the tissue by the end effector's working 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 through a return electrode (eg, ground pad) separately located on or relative to the patient's body. Heat generated by current flowing through tissue may form hemostatic seals within and/or between tissues, and thus may be particularly useful for sealing blood vessels, for example. An end effector of an electrosurgical device may also include a cutting member movable relative to the tissue and the electrode for severing tissue.

During application, the electrosurgical device can transmit low frequency RF current through tissue, which creates ionic stirring or friction, ie resistive heating, thereby increasing the temperature of the tissue. A boundary is created between diseased and surrounding tissue, allowing the clinician to operate with a high level of precision and control without sacrificing adjacent non-target tissue. The low operating temperature of RF energy is useful for removing, shrinking, or shaping soft tissue while simultaneously sealing blood vessels. RF energy can work particularly well on connective tissue, which is composed primarily of collagen and contracts when exposed to heat. Other electrosurgical instruments include, but are not limited to, irreversible and/or reversible electroporation, and/or microwave technology. Accordingly, the techniques disclosed herein are used for ultrasound, bipolar, and/or monopolar RF (electrosurgical), irreversible and/or reversible electroporation, and/or microwave-based surgical techniques, among others. Applicable to instruments.

Electrical energy applied by the electrosurgical device may be transmitted from the generator to the instrument. A generator is configured to convert electricity into a high frequency waveform comprising an oscillating current that is transmitted to the electrodes to affect tissue. An electric current is passed through the tissue to create tissue (a form of coagulation in which an electric current arc over the tissue produces tissue charring), desiccant (direct application of energy that pushes out cellular water), and/or cutting (vaporizes cellular fluids). Indirect energy application) causing cell explosions by causing the tissue to be electrodischarge treated. The response of tissue to electrical current is a function of tissue resistance, current density through the tissue, power output, and duration of current application. In certain examples, the current waveform can be adjusted to affect different surgical functions and/or to accommodate tissue with different characteristics, as described further herein. For example, different types of tissue-vascular tissue, nerve tissue, muscle, skin, fat, and/or bone can respond differently to the same waveform.

The electrical energy may be in the form of RF energy which may be within the frequency range described in EN60601-2-2:2009+A11:2011, Definition 201.3.218-HIGH FREQUENCY. For example, frequencies in monopolar RF applications are typically limited to less than 5 MHz to minimize problems associated with high frequency leakage currents. Frequencies above 200 kHz can typically be used for monopolar applications to avoid unnecessary stimulation of nerves and muscles resulting from the use of low frequency currents.

In bipolar RF applications, the frequency can be almost any frequency. Lower frequencies may be used for bipolar techniques in certain instances, such as when risk analysis indicates that the likelihood of neuromuscular stimulation has been mitigated to an acceptable level. 10 mA is generally recognized as the lower threshold for thermal effects on tissue. Higher frequencies can also be used in the case of bipolar techniques.

In certain examples, the generator is configured to digitally generate and provide an output waveform to a surgical device so that the surgical device can utilize the waveform for various tissue effects. may be The generator can be a monopolar generator, a bipolar generator, and/or an ultrasonic generator. For example, a single generator can energize a monopolar device, a bipolar device, an ultrasonic device, or a combined electrosurgical/ultrasound device. The generator can facilitate tissue-specific effects through corrugation and/or can push RF energy and ultrasonic energy to a single surgical instrument or multiple surgical instruments simultaneously and/or sequentially. .

In one example, the surgical system includes a generator and various surgical instruments that can be used together, including ultrasonic surgical instruments, RF electrosurgical instruments, and combined ultrasonic/RF electrosurgical instruments. can be done. The generator is disclosed in U.S. patent application filed Sep. 14, 2016, entitled "TECHNEQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS," which is incorporated herein by reference in its entirety. 15/265,279 (currently U.S. Patent Application Publication No. 2017/0086914), it may be configurable for use with various surgical instruments.

As described herein, medical procedures for cutting tissue and/or cauterizing blood vessels are often performed by utilizing RF electrical energy, which is generated by a generator. and delivered to the patient's tissue through electrodes operated by the clinician. The electrodes deliver electrical discharges to the cellular matter of the patient's body adjacent to the electrodes. This discharge causes the cytoplasm to heat up, cutting tissue and/or cauterizing blood vessels.

The high temperatures associated with electrosurgery can cause thermal necrosis of tissue adjacent to the electrodes. The longer tissue is exposed to the high temperatures associated with electrosurgery, the more likely it is to undergo thermal necrosis. In certain instances, thermal necrosis of tissue not only reduces the rate at which tissue is cut and increases the incidence of thermal damage to tissue located away from the cut site, but also post-operative complications, May increase eschar formation and healing time.

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

A typical electrosurgical generator produces various operating frequencies of RF electrical energy and output power levels. The specific operating frequency and power output of the generator will vary based on the particular electrosurgical generator being used and the needs of the physician during the electrosurgical procedure. The specific operating frequency and power output level can be manually adjusted on the generator by a clinician or other operating room personnel. Properly adjusting these various settings requires a great deal of knowledge, skill and attention of a clinician or other personnel. As the clinician makes desired adjustments to various settings on the generator, the generator can maintain their output parameters during electrosurgery. Generally, wave generators used in electrosurgery are adapted to produce RF waves having output powers in the range of 1-300 W in cutting mode and 1-120 W in coagulation mode, and frequencies in the range of 300-600 kHz. It is Typical wave generators are adapted to maintain selected settings during electrosurgery. For example, if a clinician sets the output power level of the generator to 50W and then performs electrosurgery with the electrodes in contact with the patient, the power level of the generator rises rapidly and is maintained at 50W. be. Setting the power level to a particular setting, such as 50W, allows the clinician to cut the patient's tissue, and maintaining such a high power level increases the likelihood of thermal necrosis of the patient's tissue. Let

In some forms, the generator is configured to provide sufficient power to effectively perform electrosurgery in conjunction with the electrode to increase the concentration of the RF energy discharge while simultaneously removing unwanted tissue. Designed to limit injury, reduce post-operative complications and promote faster healing. For example, the waveform from the generator can be optimized by the control circuitry throughout the surgical procedure. However, the subject matter claimed herein is not limited to aspects that remedy any disadvantages or operate only in environments such as those described above. Rather, this background is provided merely to illustrate one example of an area of technology in which some aspects described herein may be implemented.

As provided herein, energy devices are used to treat tissue (e.g., to cut tissue, cauterize blood vessels, and/or coagulate tissue in and/or near target tissue). b) delivering mechanical and/or electrical energy to the target tissue; Cutting, cauterizing, and/or coagulating tissue may release fluids and/or particulates into the air. Such fluids and/or particulates emitted during surgical procedures may include, for example, smoke, which may include carbon particles and/or other particles suspended in the air. In other words, the fluid may include smoke and/or other fluid matter. About 90% of endoscopic and open surgical procedures generate some amount of smoke. Smoke can be offensive to the clinician(s), assistant(s), and/or patient(s) olfactory senses, and may obscure the clinician(s)' view of the surgical site, making certain For example, inhaling may be unhealthy. For example, fumes generated during electrosurgical procedures include acrolein, acetonitrile, acrylonitrile, acetylene, alkylbenzenes, benzene, butadiene, butene, carbon monoxide, creosol, ethane, ethylene, formaldehyde, free radicals, hydrogen cyanide, isobutene, methane, Phenol, polycyclic aromatic hydrocarbons, propene, propylene, pyridene, pyrrole, styrene, toluene, and xylene, as well as dead and live cell material (including blood fragments), and viruses. Certain materials identified in surgical smoke have been identified as known carcinogens. It is estimated that one gram of tissue ablated during electrosurgical procedures can be equivalent to six unfiltered cigarettes worth of toxins and carcinogens. Additionally, exposure to smoke emitted during electrosurgical procedures has been reported to cause eye and lung irritation in health care workers.

In addition to the toxicity and odors associated with materials in surgical smoke, the size of particulate matter in surgical smoke is an important consideration for clinician(s), assistant(s), and/or patient(s). can be harmful to the respiratory system of In certain instances, particulates can be very small. Repeated inhalation of very small particulate matter can lead to acute and chronic respiratory illness in certain instances.

Many electrosurgical systems include a surgical exhaust that captures smoke resulting from a surgical procedure and directs the captured smoke away from the clinician(s) and/or patient(s) through filters and exhaust ports. use the system. For example, an evacuation system may be configured to evacuate smoke generated during an electrosurgical procedure. Although the reader may refer to such evacuation systems as "smoke evacuation systems," such evacuation systems are configured to expel more than just smoke from the surgical site. you will understand that it can be done. Throughout this disclosure, the "smoke" emitted by the emission system is not limited to just smoke. Rather, the smoke evacuation system disclosed herein can be used to evacuate a variety of fluids including liquids, gases, vapor, smoke, steam, or combinations thereof. The fluid may be biological in nature and/or may be introduced to the surgical site from an external source during the procedure. Fluids can include, for example, water, saline, lymph, blood, exudate, and/or purulent discharge. Additionally, the fluid may contain particulates or other material (eg, cellular material or debris) that is expelled by the expulsion system. For example, such microparticles may be suspended in a fluid.

Evacuation systems often include pumps and filters. The pump creates suction that draws the smoke into the filter. For example, suction can be configured to draw smoke from the surgical site through the evacuation conduit to the conduit opening and into the evacuation system's ejector housing. Ejector housing 50018 of surgical ejection system 50000 is shown in FIG. In one aspect of the disclosure, the pump and filter are positioned within the eductor housing 50018 . Smoke drawn into the eductor housing 50018 travels to the filter via the suction conduit 50036, and harmful toxins and unpleasant odors are filtered from the smoke as it travels through the filter. Aspiration conduits may also be referred to as vacuum and/or evacuation conduits and/or tubes, for example. The filtered air may then exit the surgical evacuation system as exhaust. In certain examples, the various drainage systems disclosed herein can also be configured to deliver fluid to a desired location, such as a surgical site.

Referring now to FIG. 2, the aspiration conduit 50036 from the ejector housing 50018 (FIG. 1) may terminate in a handpiece, such as handpiece 50032. Handpiece 50032 comprises an electrosurgical instrument that includes an electrode tip 50034 and a drainage conduit opening near and/or adjacent electrode tip 50034 . The drainage conduit opening is configured to trap fluids and/or particulates released during a surgical procedure. In such an example, evacuation system 50000 is integrated into electrosurgical instrument 50032 . Still referring to FIG. 2, smoke S is drawn into suction conduit 50036 .

In certain examples, the evacuation system 50000 can include a separate surgical tool with conduit openings and configured to draw smoke into the system. In yet another example, a tool with a drainage conduit and openings can be snap fitted onto an electrosurgical tool as shown in FIG. For example, a portion of the suction conduit 51036 can be positioned around (or adjacent to) the electrode tip 51034 . In one example, the suction conduit 51036 can be releasably secured to an electrosurgical tool handpiece 51032 that includes an electrode tip 51034 having a clip or other fastener.

Various internal components of the ejector housing 50518 are shown in FIG. In various examples, the internal components of FIG. 4 can also be incorporated into the ejector housing 50018 of FIG. Referring primarily to FIG. 4, the evacuation system 50500 includes an ejector housing 50518, a filter 50502, an evacuation mechanism 50520, and a pump 50506. Ejection system 50500 defines a flow path 50504 through an ejector housing 50518 having an inlet port 50522 and an outlet port 50524 . Filter 50502 , evacuation mechanism 50520 , and pump 50506 are arranged in series with flow path 50504 through ejector housing 50518 between inlet port 50522 and outlet port 50524 . Entry port 50522 can be fluidly connected to an aspiration conduit, such as, for example, aspiration conduit 50036 of FIG. 1, which can include a distal conduit opening positionable at the surgical site.

Pump 50506 is configured to create a pressure differential within flow path 50504 by mechanical action. The pressure differential is configured to draw smoke 50508 from the surgical site into entry port 50522 and along flow path 50504 . After the smoke 50508 travels through the filter 50502, the smoke 50508 can be considered filtered smoke or air 50510, which can travel through the flow path 50504 and exit port 50524 is extruded. Flow path 50504 includes first zone 50514 and second zone 50516 . A first zone 50514 is upstream of the pump 50506 . A second zone 50516 is downstream of the pump 50506 . The pump 50506 is configured to pressurize the fluid within the flow path 50504 such that the fluid within the second zone 50516 has a higher pressure than the fluid within the first zone 50514 . Motor 50512 drives pump 50506 . Various suitable motors are further described herein. Exhaust mechanism 50520 is a mechanism that can control the velocity, direction, and/or other characteristics of filtered smoke 50510 exiting exhaust system 50500 at exit port 50524 .

The flow path 50504 through the evacuation system 50500 can be constructed of a tube or other conduit that substantially contains and/or isolates fluid traveling through the flow path 50504 from fluid outside the flow path 50504. . For example, the first zone 50514 of the flow path 50504 can comprise a tube through which the flow path 50504 extends between the filter 50502 and the pump 50506. The second zone 50516 of the flow path 50504 can also comprise a tube through which the flow path 50504 extends between the pump 50506 and the exhaust mechanism 50520. The flow path 50504 also extends through the filter 50502 , the pump 50506 and the exhaust mechanism 50520 such that the flow path 50504 extends continuously from the inlet port 50522 to the outlet port 50524 .

During operation, smoke 50508 may enter filter 50502 at inlet port 50522 and may be pumped through flow path 50504 by pump 50506 such that smoke 50508 is drawn into filter 50502 . Filtered smoke 50510 may then be pumped through exhaust mechanism 50520 and out of exit port 50524 of exhaust system 50500 . The filtered smoke 50510 exiting the exhaust system 50500 at the exit port 50524 is exhaust and may consist of filtered gases that have passed through the exhaust system 50500 .

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

Situational awareness encompasses the ability of some aspects of a surgical system to determine or infer information related to a surgical procedure from data received from databases and/or instruments. The information may include the type of procedure being performed, the type of tissue being operated on, or the body cavity being treated. Contextual information related to a surgical procedure may lead surgical systems to include, for example, modular devices (e.g., smoke evacuation systems) that are connected to provide contextual information or suggestions to clinicians during the course of a surgical procedure. You can improve the way you control. Situational Awareness is further described herein and in U.S. Provisional Patent Application No. 62/611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed December 28, 2017, which is hereby incorporated by reference in its entirety. Are listed.

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

Processor 50308 may be programmed to regulate various aspects, functions, and parameters of electrosurgical system 50300 . For example, the processor 50308 determines a desired output power level at the electrode tip 50334, which may be similar in many respects to the electrode tip 50034 of FIG. 2 and/or the electrode tip 51034 of FIG. Power converter 50306 can be instructed to step down the voltage to a specified level to provide power. Processor 50308 is coupled to memory 50310 configured to store machine-executable instructions for operating electrosurgical system 50300 and/or its subsystems.

A digital-to-analog converter (“DAC”) 50312 is connected between processor 50308 and power converter 50306 . DAC 50312 is adapted to convert the digital code generated by processor 50308 into an analog signal (current, voltage, or charge) that governs the voltage step-down performed by power converter 50306. do. Once the power converter 50306 steps down the 360V to a level that the processor 50308 determines provides the desired output power level, the stepped voltage is applied to the electrode tip 50334 to effect electrosurgical treatment of the patient's tissue. directed and then directed to the return or ground electrode 50335 . Voltage sensor 50314 and current sensor 50316 detect voltage and current present in the electrosurgical circuit and communicate the detected parameters to processor 50308 so that processor 50308 can determine whether to adjust the output power level. is adapted to As described herein, typical wave generators are adapted to maintain selected settings throughout the electrosurgical procedure. In other examples, the operating parameters of the generator are one or more to processor 5308, such as, for example, inputs from a surgical hub, cloud, and/or situational awareness module, as further described herein. It can be optimized during a surgical procedure based on two or more inputs.

Processor 50308 is coupled to communication device 50318 for communicating over a network. The communication device includes a transceiver 50320 configured to communicate by physical wire or wireless. Communication device 50318 may further include one or more additional transceivers. The transceiver may include a cellular modem, a wireless mesh network transceiver, a Wi-Fi® transceiver, a low power wide area (LPWA) transceiver, and/or a near field communication transceiver (NFC). but not limited to these. Communication devices 50318 include mobile phones, sensor systems (e.g. environment, location, motion, etc.) and/or sensor networks (wired and/or wireless), computing systems (e.g. servers, workstation computers, desktop computers, laptops top computers, tablet computers (such as iPad® and Galaxy Tab®), ultra-portable computers, ultra-mobile computers, netbook computers, and/or sub-notebook computers, and the like, or In at least one aspect of the disclosure, one of the devices may be a coordinator node.

Transceiver 50320 receives serial transmit data from processor 50308 via respective UARTs, modulates the serial transmit data onto an RF carrier to generate transmit RF signals, and transmits transmit RF signals via respective antennas. may be configured to transmit The transceiver(s) receives, via respective antennas, a received RF signal comprising an RF carrier modulated with serial received data, demodulates the received RF signal to extract serial received data, and performs serial reception. It is further configured to provide data to respective UARTs to the processor. Each RF signal has an associated carrier frequency and an associated channel bandwidth. Channel bandwidth is associated with carrier frequency, transmitted data, and/or received data. Each RF carrier frequency and channel bandwidth is associated with an operating frequency range(s) of transceiver(s) 50320 . Each channel bandwidth is further associated with a wireless communication standard and/or protocol that the transceiver(s) 50320 may comply with. In other words, each transceiver 50320 uses a selected wireless communication standard and/or protocol, eg, IEEE 802.11a/b/g/n and/or Zigbee routing for Wi-Fi. implementation of IEEE 802.15.4 for wireless mesh networks.

Processor 50308 is coupled to sensing and intelligent control device 50324 which is coupled to smoke evacuator 50326 . Smoke evacuator 50326 may include one or more sensors 50327 and may also include a pump motor controlled by pump and motor driver 50328 . A motor driver 50328 is communicatively coupled to the processor 50308 and the pump motor in the smoke evacuator 50326 . Sensing and intelligent control device 50324 includes sensor algorithms 50321 and communication algorithms 50322 that facilitate communication between smoke evacuator 50326 and other devices to adapt their control programs. Sensing and intelligent control device 50324 evaluates fluids, particulates and gases extracted via exhaust conduit 50336 to, for example, improve smoke extraction efficiency as further described herein. and/or configured to reduce user smoke output. In certain examples, the sensing and intelligent control device 50324 includes one or more sensors 50327 within the smoke evacuator 50326, one or more internal sensors 50330 of the electrosurgical system 50300, and/or electrical Communicatively coupled to one or more external sensors 50332 of surgical system 50300 .

In certain examples, the processor can be located within an ejector housing of a surgical ejection system. For example, referring to FIG. 6, processor 50408 and memory 50410 therefor are located within ejector housing 50440 of surgical ejection system 50400 . Processor 50408 is in signal communication with motor driver 50428 , various internal sensors 50430 , display 50442 , memory 50410 and communication device 50418 . Communication device 50418 is similar in many respects to communication device 50318 described above in connection with FIG. A communication device 50418 can allow the processor 50408 within the surgical drainage system 50400 to communicate with other devices within the surgical system. For example, the communication device 50418 may include one or more external sensors 50432, one or more surgical devices 50444, one or more hubs 50448, one or more clouds 50446, and/or enable wired and/or wireless communication to one or more additional surgical systems and/or tools. The reader will readily appreciate that surgical drainage system 50400 of FIG. 6 can be incorporated into electrosurgical system 50300 of FIG. 5 in certain examples. Surgical drainage system 50400 also includes pump 50450 including its pump motor 50451 , drainage conduit 50436 and exhaust port 50452 . Various pumps, exhaust conduits, and vents are further described herein. Surgical drainage system 50400 can also include sensing and intelligent control devices, which can be similar in many respects to sensing and intelligent control device 50324, for example. For example, such sensing and intelligent control devices may be in signal communication with processor 50408 and/or one or more of sensors 50430 and/or external sensors 50432 .

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

In one aspect of the present disclosure, processors and sensor systems, e.g., processors 50308 and 50408, and their respective sensor systems (FIGS. 5 and 6) communicate with, e.g., electrosurgical systems, energy devices, and/or generators. configured to sense airflow through the vacuum source in order to adjust parameters of the smoke evacuation system and/or external devices and/or systems used in series with the smoke evacuation system, such as an appliance. In one aspect of the present disclosure, the sensor system may include a plurality of sensors positioned along the airpath of the surgical evacuation system. The sensors can measure pressure differentials within the evacuation system to detect the state or status of the system between the sensors. For example, the system between the two sensors may be a filter and the pressure difference is used to increase the pump motor speed as the flow through the filter decreases in order to maintain the flow through the system. be able to. As another example, the system can be a fluid trap in the exhaust system and can use the pressure differential to determine the airflow path through the exhaust system. In yet another example, the system may be the inlet and outlet (or exhaust port) of the evacuation system, and the pressure differential is equal to the maximum suction load in the evacuation system to keep the maximum suction load below the threshold. Can be used to determine load.

In one aspect of the present disclosure, a processor and sensor system, e.g., processors 50308 and 50408, and their respective sensor systems (FIGS. 5 and 6) communicate with aerosols or carbonized particulates in fluids extracted from a surgical site, That is, it is configured to detect the smoke ratio. For example, the sensing system may include sensors that detect the size and/or composition of particles used to select airflow paths through the exhaust system. In such examples, the evacuation system can include a first filtration path, or first filtration state, and a second filtration path, or second filtration state, which can have different characteristics. can. In one example, the first path includes only the particulate filter and the second path includes both the fluid filter and the particulate filter. In a particular example, the first path includes a particulate filter and the second path includes a particulate filter and a finer particulate filter arranged in series. Additional and/or alternative filtration paths are also envisioned.

In one aspect of the present disclosure, a processor and sensor system, e.g., processors 50308 and 50408 and respective sensor systems in communication therewith (FIGS. 5 and 6), chemically react to particles expelled from within the patient's abdominal cavity. Configured to perform analytics. For example, the sensing and intelligent control device 50324 may sense particle count and type to adjust the power level of the ultrasonic generator to guide the ultrasonic blade to generate less smoke. . In another embodiment, the sensor system may include sensors for detecting particle count, temperature, fluid content, and/or contamination rate of the discharged fluid, and generate the detected characteristic(s). device to adjust its output. For example, the smoke evacuator 50326 and/or the sensing and intelligent control device 50324 therefor can be configured to adjust the exhaust flow rate and/or the motor speed of the pump such that, at a given particulate level, The output power or waveform of the generator may be operably influenced to reduce smoke.

In one aspect of the present disclosure, a processor and sensor system, e.g., processors 50308 and 50408, and their respective sensor systems (FIGS. 5 and 6) communicate with ambient air and/or exhaust from the ejector housing. It is configured to assess particle counts and contamination in an operating room by assessing one or more properties. Particle counts and/or air quality may be measured, for example, on an evacuator housing, to communicate information to a clinician and/or to establish the effectiveness of its smoke evacuation system and filter(s). May be displayed on the smoke extraction system.

In one aspect of the present disclosure, a processor, e.g., processor 50308 or processor 50408 (FIGS. 5 and 6), for example, determines the correlation and/or adjusts the revolutions per minute (RPM) speed of the pump. To do so, it is configured to compare sample velocity images acquired from the endoscope with ejector particle counts from a sensing system (eg, sensing and intelligent control device 50324). In one example, activation of the generator can be communicated to the smoke evacuator so that the expected required smoke evacuation rate can be implemented. Activation of the generator can be communicated to the surgical drainage system, for example, through a surgical hub, cloud communication system, and/or direct connection.

In one aspect of the present disclosure, the sensor system and algorithms of the smoke evacuation system (see, e.g., FIGS. 5 and 6) can be configured to control the smoke evacuator and Based on the needs, its motor parameters can be adapted to adjust the filtering efficiency of the smoke evacuator. In one example, an adaptive airflow pump speed algorithm to automatically change the motor pump speed based on sensed particulates to the smoke evacuator inlet and/or from the smoke evacuator outlet or exhaust. is provided. For example, sensing and intelligent control device 50324 (FIG. 5) can include, for example, user selectable speed and automatic mode speed. At automatic mode speeds, the airflow through the exhaust system may be expanded based on the lack of smoke into the exhaust system and/or filtered particles from the flue system. Automatic mode speed can provide automatic sensing and compensation for laparoscopic mode in certain instances.

In one aspect of the present disclosure, the evacuation system has an electrical and communication architecture (see, e.g., FIGS. 5 and 6) that provides data collection and communication capabilities for improved interactivity with the surgical hub and cloud. can include In one example, a surgical drainage system and/or processor, e.g., processor 50308 (FIG. 5) and processor 50408 (FIG. 6), e.g. It may include segmented control circuits that are energized in a systematic manner. The segmented control circuit may also be configured to have an energized portion and a non-energized portion until the energized portion performs the first function. The segmented control circuitry can include circuitry for identifying and displaying status updates to users of attached components. The segmented control circuit also includes circuitry for operating the motor in a first state in which the motor is activated by the user, and for operating the pump in a first state in which the motor is not activated by the user, but at a quieter, slower speed. and circuitry for operating the motor in a second state for operating at. A segmented control circuit can, for example, allow the smoke evacuator to be energized in stages.

The electrical and communication architecture of the evacuation system (see, e.g., FIGS. 5 and 6) also includes interconnection of the smoke evacuator with other components within the surgical hub for interaction and data exchange with the cloud. Communication can also be provided. Communication of surgical drainage system parameters to the surgical hub and/or cloud may be provided to affect the output or operation of other attached devices. The parameter can be actionable or sensed. Operating parameters include airflow, pressure differential, and air quality. Sensed parameters include particulate concentration, aerosol rate, and chemical analysis.

In one aspect of the present disclosure, a drainage system, such as surgical drainage system 50400, can include, for example, an enclosure and replaceable components, controls, and a display. Circuitry is provided for communicating security identifiers (IDs) between such interchangeable components. For example, communication between the filter and the smoke evacuation electronics may be used to verify component reliability, remaining life, update parameters within the component, log errors, and/or It can be provided to limit the number and/or types of components that can be identified by the system. In various examples, the communication circuitry can authorize the ability to enable and/or disable configuration parameters. The communication circuitry may employ encryption and/or error handling schemes to manage security and unique relationships between components and smoke evacuation electronics. Disposable/reusable components are included in certain examples.

In one aspect of the present disclosure, an evacuation system can provide fluid management and extraction filters and airflow configurations. For example, a surgical drainage system is provided that includes a fluid capture mechanism, the fluid capture mechanism having first and second sets of extraction or airflow control functions, which are large fluid droplets and small fluid droplets. are arranged in series with each other to extract respectively In certain examples, the air flow path may contain a recirculation or secondary fluid channel from downstream of the exhaust port of the primary fluid management chamber back to the primary reservoir.

In one aspect of the present disclosure, an advancement pad can be coupled to an electrosurgical system. For example, the ground electrode 50335 of the electrosurgical system 50300 (FIG. 5) can include an advancing pad with localized sensing integrated into the pad while maintaining capacitive coupling. For example, capacitively coupled return path pads can be used to sense neural control signals and/or movement of selected anatomical locations to detect the proximity of the monopolar tip to nerve bundles. It can have separable array elements.

An electrosurgical system can include a signal generator, an electrosurgical instrument, a return electrode, and a surgical drainage system. The generator may be an RF wave generator that produces RF electrical energy. Connected to the electrosurgical instrument is a utility conduit. A utility conduit includes a cable that communicates electrical energy from the signal generator to the electrosurgical instrument. Utility conduits also include vacuum hoses that carry trapped and/or collected smoke and/or fluid away from the surgical site. Such an exemplary electrosurgical system 50601 is shown in FIG. More specifically, electrosurgical system 50601 includes a generator 50640, an electrosurgical instrument 50630, a return electrode 50646, and an evacuation system 50600. Electrosurgical instrument 50630 includes a handle 50632 and a distal conduit opening 50634 fluidly coupled to suction hose 50636 of evacuation system 50600 . Electrosurgical instrument 50630 also includes electrodes powered by generator 50640 . A first electrical connection 50642 , eg, a wire, extends from the electrosurgical instrument 50630 to the generator 50640 . A second electrical connection 50644 , eg, a wire, extends from the electrosurgical instrument 50630 to an electrode, return electrode 50646 . In other examples, electrosurgical instrument 50630 may be a bipolar electrosurgical instrument. A distal conduit opening 50634 on the electrosurgical instrument 50630 is fluidly connected to a suction hose 50636 that extends to a filter end cap 50603 of a filter located within the ejector housing 50618 of the ejection system 50600 .

In other examples, the distal conduit opening 50634 of the drainage system 50600 may be on a separate handpiece or tool from the electrosurgical instrument 50630. For example, evacuation system 50600 can include a surgical tool that is not coupled to generator 50640 and/or does not include a tissue-energizing surface. In certain examples, distal conduit opening 50634 of drainage system 50600 can be releasably attached to an electrosurgical tool. For example, the evacuation system 50600 can include a clip-on or snap-on conduit that terminates at the distal conduit opening, which can be releasably attached to a surgical tool (see, eg, FIG. 3).

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

Heating of a patient's cellular material by the electrode tip, or cauterization of a blood vessel to prevent bleeding, results in the release of smoke at the location where the cauterization occurs, as further described herein. often become. In such instances, the evacuation system 50600 is configured to capture smoke emitted during the surgical procedure, as the evacuation conduit opening 50634 is near the electrode tip. Vacuum suction may draw smoke through the electrosurgical instrument 50630 into the conduit opening 50634 and into the vacuum hose 50636 towards the ejector housing 50618 of the smoke evacuation system 50600 .

Referring now to Figure 8, the ejector housing 50618 of the ejection system 50600 (Figure 7) is shown. Ejector housing 50618 includes a socket 50620 sized and structured to receive a filter. The ejector housing 50618 can completely or partially enclose the internal components of the ejector housing 50618 . Socket 50620 includes a first receptacle 50622 and a second receptacle 50624 . Transition surface 50626 extends between first receptacle 50622 and second receptacle 50624 .

Referring now primarily to FIG. 9, socket 50620 is depicted along the cross-sectional plane shown in FIG. Socket 50620 includes a first end 50621 open to receive a filter and a second end 50623 in communication with flow path 50699 through ejector housing 50618 . Filter 50670 ( FIGS. 10 and 11 ) may be removably positioned with socket 50620 . For example, filter 50670 can be inserted into and removed from first end 50621 of socket 50620 . A second receptacle 50624 is configured to receive a connection nipple of filter 50670 .

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

Filter 50670 includes a front cap 50672, a rear cap 50674, and a filter body 50676 disposed therebetween. The front cap 50672, in certain examples, includes a filter inlet 50678 configured to receive smoke directly from a suction hose 50636 (FIG. 7) or other smoke source. In some aspects of the present disclosure, the front cap 50672 directs smoke directly from the smoke source and removes at least a portion of the fluid therefrom before transferring the partially treated smoke for further treatment. It can be replaced by a fluid trap that moves within the filter body 50676 (eg, the fluid trap 50760 shown in FIGS. 14-17). For example, filter inlet 50678 receives smoke through a fluid trap exhaust port, such as port 50766 of fluid trap 50760 (FIGS. 14-17), to transmit the partially treated smoke into filter 50670. can be configured as

As smoke enters the filter 50670 , the smoke may be filtered by components contained within the filter body 50676 . Filtered smoke may then exit the filter 50670 through a filter outlet 50680 defined in the rear cap 50674 of the filter 50670 . When the filter 50670 is associated with the evacuation system, suction generated within the eductor housing 50618 of the evacuation system 50600 is transmitted to the filter 50670 through the filter outlet 50680 to force smoke through the internal filtering components of the filter 50670. can be drawn in. Filters often include particulate filters and charcoal filters. A particulate filter can be, for example, a high efficiency particulate air (HEPA) filter or an ultra-low penetration air (ULPA) filter. ULPA filtering utilizes a maze-like depth filter. Particulates are captured by direct interception (particles larger than 1.0 microns are too large to pass through the fibers of the media filter), inertial impaction (particles between 0.5 and 1.0 microns At least one of impact and stay there, and diffusion intercept (particles smaller than 0.5 microns are trapped by the effects of Brownian random thermal motion such that the particles "seek out" the fiber and adhere to it). can be filtered using

The charcoal filter is configured to remove toxic gases and/or odors generated by surgical smoke. In various examples, the charcoal can be "activated," meaning that it has been treated with a heating process to expose active absorption sites. Charcoal can be obtained, for example, from activated virgin coconut shells.

Referring now to FIG. 11, filter 50670 includes coarse media filter layer 50684 followed by fine particulate filter layer 50686 . In other examples, filter 50670 may consist of a single type of filter. In still other examples, filter 50670 can include more than two filter layers and/or more than two different types of filter layers. After particulate matter is removed by filter layers 50684 and 50686, the smoke is drawn through carbon reservoir 50688 in filter 50670 to remove gaseous contaminants in the smoke such as, for example, volatile organic compounds. In various examples, carbon reservoir 50688 can include a charcoal filter. The filtered smoke is substantially free of particulate matter and gaseous contaminants and is drawn through filter outlet 50680 into exhaust system 50600 for further processing and/or exhaust.

Filter 50670 includes multiple dams between components of filter body 50676 . For example, a first dam 50690 is positioned intermediate the filter inlet 50678 (FIG. 10) and a first particulate filter, eg, coarse media filter 50684 . A second dam 50692 is positioned intermediate a second particulate filter, eg, fine particulate filter 50686 , and carbon reservoir 50688 . Additionally, a third dam 50694 is positioned intermediate the carbon reservoir 50688 and the filter outlet 50680 . Dams 50690 , 50692 , and 50694 may include gaskets or O-rings configured to prevent movement of components within filter body 50676 . In various examples, the size and shape of dams 50690, 50692, and 50694 can be selected to prevent expansion of the filter component in the direction of applied suction.

Coarse media filter 50684 may comprise a low air resistance filter material such as, for example, fiberglass, polyester, and/or pleated filters configured to remove most particulate matter larger than 10 μm. can be done. In some aspects of the present disclosure, this is at least 85% particulate matter greater than 10 μm, at least 90% particulate matter greater than 10 μm, at least 95% specific materials greater than 10 μm, at least 99 % of specified materials greater than 10 μm, at least 99.9% of specified materials greater than 10 μm, or at least 99.99% of specified materials greater than 10 μm .

Additionally or alternatively, coarse media filter 50684 may comprise a low air resistance filter that removes most particulate matter larger than 1 μm. In some aspects of the present disclosure, this is at least 85% particulate matter greater than 1 μm, at least 90% particulate matter greater than 1 μm, at least 95% specific materials greater than 1 μm, at least 99 % of specified material greater than 1 μm, at least 99.9% of specified material greater than 1 μm, or at least 99.99% of specified material greater than 1 μm.

Fine particulate filter 50686 can include any filter with a higher efficiency than coarse media filter 50684 . This includes, for example, filters that can filter a higher percentage of particles of the same size as the coarse media filter 50684, and/or filters that can filter particles that are smaller than the coarse media filter 50684. In some aspects of the present disclosure, fine particulate filter 50686 may include a HEPA filter or a ULPA filter. Additionally or alternatively, fine particulate filter 50686 may be pleated to increase its surface area. In some aspects of the present disclosure, the coarse media filter 50684 comprises a pleated HEPA filter and the fine particulate filter 50686 comprises a pleated ULPA filter.

After particulate filtration, smoke enters the downstream portion of filter 50670 containing carbon reservoir 50688 . Carbon reservoir 50688 is bounded by porous partitions 50696 and 50698 disposed between intermediate and terminal dams 50692 and 50694, respectively. In some aspects of the present disclosure, porous partitions 50696 and 50698 are rigid and/or inflexible and define a constant spatial deposition of carbon reservoirs 50688.

Carbon reservoir 50688 can include additional adsorbents that work with or independently of the carbon particles to remove gaseous contaminants. Additional adsorbents can include, for example, adsorbents such as magnesium oxide and/or copper oxide, which are designed to adsorb gaseous pollutants such as carbon monoxide, ethylene oxide, and/or ozone. can function. In some aspects of the present disclosure, the additional sorbent is dispersed throughout reservoir 50688 and/or positioned in separate layers above, below, or within reservoir 50688 .

Referring again to FIG. 4, the ejection system 50500 includes a pump 50506 within an ejector housing 50518 . Similarly, the evacuation system 50600 shown in FIG. 7 can include a pump located within the ejector housing 50618 that passes through a suction hose 50636 and through a filter 50670 (FIGS. 10 and 11). ) to draw smoke from the surgical site. In operation, the pump creates a pressure differential within the eductor housing 50618 that causes smoke to move into the filter 50670 and exit the exhaust mechanism (eg, exhaust mechanism 50520 in FIG. 4) at the outlet of the flow path. be able to. Filter 50670 is configured to extract harmful, polluting, or otherwise unwanted particulates from smoke.

The pump can be arranged in line with the flow path through the ejector housing 50618 such that gas flowing through the ejector housing 50618 enters the pump on one end and exits the pump on the other end. . The pump can provide a sealed positive displacement flow path. In various examples, the pump captures (seales) a first volume of gas as it travels through the pump, and reduces the volume to a second, smaller volume, thus sealing the gas. A closed positive displacement flow path can be created. By decreasing the volume of trapped gas, the pressure of the gas increases. A second pressurized volume of gas may be discharged from the pump at the pump outlet. For example, the pump can be a compressor. More specifically, the pump can comprise a hybrid regenerative blower, claw pump, lobe compressor, and/or scroll compressor. Positive displacement compressors can provide improved compression ratios and operating pressures while limiting the vibration and noise generated by the exhaust system 50600. Additionally or alternatively, the evacuation system 50600 can include a fan for moving fluid therethrough.

An example of a positive displacement compressor, such as a scroll compressor pump 50650 is shown in FIG. Scroll compressor pump 50650 includes stator scroll 50652 and moving scroll 50654 . The stator scroll 50652 can be fixed in place while the moving scroll 50654 orbits eccentrically. For example, the moving scroll 50654 can orbit eccentrically to rotate about the central longitudinal axis of the stator scroll 50652 . As shown in FIG. 12, the central longitudinal axis of the stator scroll 50652 and the moving scroll 50654 extend perpendicular to the viewing planes of the scrolls 50652,50654. The stator scrolls 50652 and moving scrolls 50654 alternate with each other to form separate sealed compression chambers 50656 .

In use, gas can enter scroll compressor pump 50650 at inlet 50658 . As moving scroll 50654 orbits relative to stator scroll 50652, inlet gas is first trapped in compression chamber 50656. Compression chambers 50656 are configured to move discrete volumes of gas toward the center of scroll compressor pump 50650 along the helical contours of scrolls 50652 and 50654 . Compression chamber 50656 defines a sealed space in which gas resides. Also, as moving scroll 50654 moves trapped gas toward the center of stator scroll 50652, the volume of compression chamber 50656 decreases. This reduction in volume increases the pressure of the gas inside compression chamber 50656 . Gas within the sealed compression chamber 50656 is trapped during the volume reduction, thereby pressurizing the gas. When the pressurized gas reaches the center of scroll compressor pump 50650, the pressurized gas is discharged through outlet 50659.

Referring now to Figure 13, a portion of the evacuation system 50700 is shown. Ejection system 50700 may be similar in many respects to ejection system 50600 (FIG. 7). For example, the ejection system 50700 includes an ejector housing 50618 and a suction hose 50636. Referring again to FIG. 7, the evacuation system 50600 is configured to create suction, thereby drawing smoke from the distal end of the suction hose 50636 into the ejector housing 50618 for disposal. In particular, the suction hose 50636 is not connected to the ejector housing 50618 through the filter end cap 50603 of FIG. Rather, suction hose 50636 is connected to ejector housing 50618 through fluid trap 50760 . A filter similar to filter 50670 may be positioned in a socket of ejector housing 50618 behind fluid trap 50760 .

Fluid trap 50760 is a first fluid trap 50760 that extracts and retains at least a portion of the fluid (e.g., liquid) from the partially processed smoke before relaying it to exhaust system 50700 for further processing and filtering. is the processing point of The evacuation system 50700 treats smoke, as described herein, to reduce or eliminate unpleasant odors or other problems associated with smoke generation in an operating room (or other surgical environment). It is configured to filter and otherwise wash. By extracting liquid droplets and/or aerosols from the smoke before being further processed by the evacuation system 50700, the fluid trap 50760 may, in certain examples, among other things, increase the efficiency of the evacuation system 50700 and/or The life of filters associated with system 50700 can be extended.

Referring primarily to FIGS. 14-17, fluid trap 50760 is shown removed from ejector housing 50618 (FIG. 13). Fluid trap 50760 includes inlet port 50762 defined in front cover or surface 50764 of fluid trap 50760 . Inlet port 50762 may be configured to releasably receive suction hose 50636 (FIG. 13). For example, the end of the suction hose 50636 can be inserted at least partially into the inlet port 50762 and secured with an interference fit therebetween. In various examples, the interference fit can be a fluid tight and/or airtight fit such that substantially all of the smoke passing through the suction hose 50636 is transferred into the fluid trap 50760. In some examples, other mechanisms for connecting or joining the suction hose 50636 to the inlet port 50762, such as latch-based compression fittings, o-rings, threaded connections of the suction hose 50636 to the inlet port 50762, and /or other coupling mechanisms may be used.

In various examples, a fluid-tight and/or air-tight fit between the suction hose 50636 and the fluid trap 50760 may provide fluid and/or other fluid in the exhaled smoke at or near the junction of these components. It is configured to prevent material from leaking out. In some examples, for example, the suction hose 50636 has intermediate coupling devices such as O-rings and/or adapters to further ensure an airtight and/or liquid tight connection between the suction hose 50636 and the fluid trap 50760. can be associated with inlet port 50762 through .

As mentioned above, fluid trap 50760 includes exhaust port 50766 . The exhaust port extends away from the back cover or surface 50768 of the fluid trap 50760 . Exhaust port 50766 defines an open channel between interior chamber 50770 of fluid trap 50760 and the outside environment. In some examples, the exhaust port 50766 is sized and shaped to be closely associated with a surgical drainage system or component thereof. For example, exhaust port 50766 is sized and configured to communicate with at least partially treated smoke from fluid trap 50760 and a filter ( FIG. 13 ) housed within ejector housing 50618 . can be shaped. In certain examples, exhaust port 50766 may extend away from the front plate, top surface, or sides of fluid trap 50760 .

In certain examples, exhaust port 50766 includes a membrane that spaces exhaust port 50766 from ejector housing 50618 . Such a membrane allows air, water, and/or vapor to pass freely through eductor housing 50618 while water or other liquid collected in fluid trap 50760 is released through exhaust port 50766 . It can function to prevent passage into the ejector housing 50618. For example, high flow microporous polytetrafluoroethylene (PTFE) may be positioned downstream of the exhaust port 50766 and upstream of the pump to protect the pump or other components of the exhaust system 50700 from damage and/or contamination. can be done.

The fluid trap 50760 is also positioned to assist the user in handling the fluid trap 50760 and/or to assist in connecting the fluid trap 50760 with the suction hose 50636 and/or the ejector housing 50618. Includes a dimensioned gripping area 50772 . Gripping area 50772 is shown to be an elongated recess. However, the reader will appreciate that gripping area 50772 may include, for example, at least one recess, groove, protrusion, slack, and/or ring, which are sized and shaped to accommodate a user's finger. It will be readily appreciated that the gripping surface may be provided in a similar manner or in another manner.

16 and 17, interior chamber 50770 of fluid trap 50760 is shown. The relative positioning of inlet port 50762 and exhaust port 50766 are configured to facilitate extraction and retention of fluid from smoke as it passes through fluid trap 50760 . In certain examples, the inlet port 50762 may comprise a notched cylindrical shape, which directs smoke and associated fluid toward the fluid reservoir 50774 of the fluid trap 50760 or otherwise exhausts it. It can be unidirectionally directed away from port 50766 . One example of such fluid flow is indicated by arrows A, B, C, D, and E in FIG.

As shown, smoke enters fluid trap 50760 through inlet port 50762 (indicated by arrow A) and exits fluid trap 50760 through exhaust port 50766 (indicated by arrow E). Due, at least in part, to the shape of the inlet port (e.g., longer upper sidewall 50761 and shorter lower sidewall 50763), smoke entering inlet port 50762 first flows into fluid reservoir 50774 of fluid trap 50760. and mainly directed downward (indicated by arrow B). As the smoke continues to be drawn downward into the fluid trap 50760 along arrows A and B, the initially downward directed smoke rotates downward toward the upper portion of the fluid trap 50760 and into the exhaust port. 50766 (indicated by arrows D and E) are oriented laterally away from the smoke source so as to travel in substantially opposite but parallel paths.

The unidirectional flow of smoke through the fluid trap 50760 can ensure that liquid in the smoke is extracted and retained within the lower portion of the fluid trap 50760 (eg, fluid reservoir 50774). Furthermore, the relative positioning of the exhaust port 50766 vertically above the inlet port 50762 when the fluid trap 50760 is in an upright position does not substantially impede the flow of fluid into or out of the fluid trap 50760, It is configured to inhibit liquid from being inadvertently transported through the exhaust port 50766 by the smoke stream. Further, in certain examples, the configuration of inlet port 50762 and outlet port 50766 and/or the size and shape of fluid trap 50760 itself may enable fluid trap 50760 to be spill resistant.

In various examples, the evacuation system can include multiple sensors and intelligent controls, for example, as further described herein with respect to FIGS. In one aspect of the present disclosure, the evacuation system comprises one or more temperature sensors, one or more fluid detection sensors, one or more pressure sensors, one or more particle sensors and/or one or more chemical sensors. A temperature sensor may be positioned to detect the temperature of fluid at the surgical site that travels through the surgical drainage system and/or is exhausted from the surgical drainage system into the operating room. A pressure sensor may be positioned to detect pressure within the evacuation system, such as within the ejector housing. For example, pressure sensors can be positioned upstream of the filter, between the filter and the pump, and/or downstream of the pump. In certain examples, a pressure sensor can be positioned to detect pressure in the ambient environment outside the evacuation system. Similarly, a particle sensor can be positioned to detect particles within an ejection system, such as within an ejector housing. A particle sensor can be positioned, for example, upstream of the filter, between the filter and the pump, and/or downstream of the pump. In various examples, a particle sensor can be positioned to detect particles in the ambient environment, eg, to determine air quality in an operating room.

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

The ejector housing can include modular and/or replaceable components, as further described herein. For example, the ejector housing can include sockets or receptacles 50871 sized to receive modular fluid traps and/or replaceable filters. In certain examples, a fluid trap and filter can be incorporated into a single interchangeable module 50859, as shown in FIG. More specifically, fluid trap 50860 and filter 50870 form an interchangeable module 50859 that may be modular and/or replaceable and removably installs within receptacle 50871 within ejector housing 50818. be able to. In other examples, the fluid trap 50860 and filter 50870 can be separate and distinct modular components, which can be assembled together and/or separately installed within the ejector housing 50818. .

With further reference to the ejector housing 50818, the ejector housing 50818 includes multiple sensors for sensing various internal parameters and/or parameters of the surrounding environment. Additionally or alternatively, one or more modular components installed within the ejector housing 50818 can include one or more sensors. For example, still referring to FIG. 18, interchangeable module 50859 includes multiple sensors for sensing various parameters therein.

In various examples, ejector housing 50818 and/or modular component(s) compatible with ejector housing 50818 include processors such as processors 50308 and 50408 (FIGS. 5 and 6, respectively). , which is configured to receive input from one or more sensors and/or communicate output to one or more systems and/or drivers . Various processors for use with ejector housing 50818 are further described herein.

During operation, smoke from the surgical site can be drawn into inlet 50822 through fluid trap 50860 and into ejector housing 50818 . The flow path 50804 through the ejector housing 50818 of FIG. 18 can comprise sealed conduits or tubes 50805 extending between the various series of components. In various examples, smoke can flow through fluid detection sensor 50830 and chemical sensor 50832 to divergent valve 50834, which is further described herein. A fluid detection sensor, such as sensor 50830, can detect fluid particles in smoke. In one example, the fluid detection sensor 50830 can be a continuity sensor. For example, the fluid detection sensor 50830 can include two spaced apart electrodes and a sensor for detecting the degree of continuity therebetween. In the absence of fluid, continuity can be, for example, zero or substantially zero. A chemical sensor 50832 can detect chemical properties of smoke.

At diverter valve 50834 , fluid may be directed into condenser 50835 of fluid trap 50860 and smoke may travel toward filter 50870 . A baffle 50864 is positioned within the condenser 50835 to facilitate condensation of fluid droplets within the fluid trap 50860 from the smoke into a reservoir. Fluid detection sensor 50836 can ensure that any fluid within ejector housing is completely or at least substantially trapped within fluid trap 50860 .

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

Upon exiting the filter, filtered smoke may flow past pressure sensor 50846 and then along flow path 50804 within ejector housing 50818 toward pump 50806 . Moving through pump 50806 , the filtered smoke can flow past particle sensor 50848 and outlet pressure sensor 50850 to ejector housing 50818 . In one form, particle sensor 50848 can include a laser particle counter, as further described herein. The ejector housing 50818 of FIG. 18 also includes an air quality particle sensor 50852 and an ambient pressure sensor 50854 to detect various characteristics of the ambient environment, such as the environment within the operating room. The air quality particle sensor, or external/ambient air particle sensor 50852, may comprise at least one form of laser particle counter. The various sensors shown in Figure 18 are described further herein. Further, in various examples, alternative sensing means may be utilized in the smoke evacuation systems disclosed herein. For example, alternative sensors for counting particles and/or determining particle concentrations in fluids are further disclosed herein.

In various examples, the fluid trap 50860 shown in FIG. 18 can be configured to prevent spillage and/or leakage of trapped fluid. For example, the shape of the fluid trap 50860 can be selected to prevent trapped fluid from spilling and/or leaking. In certain examples, the fluid trap 50860 may include baffles and/or splatter screens, such as screen 50862, to prevent trapped fluid from splattering out of the fluid trap 50860. In one or more examples, the fluid trap 50860 can include a sensor for detecting the volume of fluid within the fluid trap and/or determining whether the fluid trap 50860 is filled to capacity. can. Fluid trap 50860 may include a valve for evacuating fluid therefrom. The reader will readily appreciate that a variety of alternative fluid trap arrangements and shapes can be used to trap fluid drawn into the ejector housing 50818.

In certain examples, filter 50870 may include additional and/or less levels of filtration. For example, filter 50870 can include one or more filtration layers selected from the following groups of filters: coarse media filters, fine media filters, and adsorbent-based filters. The course media filter can be, for example, a low air resistance filter that can be constructed of fiberglass, polyester, and/or pleated filters. The fine media filters can be high efficiency particulate air (HEPA) filters and/or ULPA filters. The sorbent-based filter can be, for example, an activated carbon filter. The reader will readily appreciate that a variety of alternative filter arrangements and shapes may be used to filter smoke entrained along the flow path through the ejector housing 50818.

In one or more examples, the pump 50806 shown in FIG. 18 is replaced with another compressor and/or pump such as, for example, a hybrid regenerative blower, a claw pump, and/or a lobe compressor, and / or can be used in combination with these. The reader will readily appreciate that various alternative pump arrangements and shapes can be used to create suction within flow path 50804 and draw smoke into ejector housing 50818.

Various sensors within the evacuation system, such as the sensors shown in FIG. 18, can communicate with the processor. The processor may be incorporated into the evacuation system and/or may be a component of another surgical instrument and/or surgical hub. Various processors are further described herein. The on-board processor can be configured to adjust one or more operating parameters of the ejector system (eg, motor for pump 50806) based on input from sensor(s). . Additionally or alternatively, the on-board processor determines one or more operating parameters of another device, such as an electrosurgical tool and/or an imaging device, based on input from the sensor(s). can be configured to adjust.

Referring now to Figure 19, another ejector housing 50918 for the ejection system 50900 is shown. The ejector housing 50918 of FIG. 19 can be similar in many respects to the ejector housing 50818 of FIG. For example, the ejector housing 50918 defines a flow path 50904 between an inlet 50922 to the ejector housing 50918 and an outlet 50924 to the ejector housing 50918 . Intermediate inlet 50922 and outlet 50924 are positioned sequentially fluid trap 50960, filter 50970 and pump 50906. FIG. Ejector housing 50918 can include, for example, sockets or receptacles 50971 similar to receptacles 50871 sized to receive modular fluid traps and/or replaceable filters. At diverter valve 50934 , fluid may be directed into condenser 50935 of fluid trap 50960 and smoke may proceed toward filter 50970 . In certain examples, the fluid trap 50960 can include baffles 50964 such as screens 50962 and/or baffles such as splatter screens to prevent trapped fluid from splattering out of the fluid trap 50960 . Filters 50970 include pleated ultra-low permeation air (ULPA) filters 50942 and charcoal filters 50944 . Sealed conduits or tubes 50905 extend between the various series of components. Ejector housing 50918 also includes sensors 50830, 50832, 50836, 50838, 50840, 50846, 50848, 50850, 50852, and 50854, which are further described herein and shown in FIGS.

Still referring to FIG. 19, the ejector housing 50918 also includes a centrifugal blower mechanism 50980 and a recirculation valve 50990. Recirculation valve 50990 can be selectively opened and closed to recirculate fluid through fluid trap 50960 . For example, when the fluid detection sensor 50836 detects fluid, the recirculation valve 50990 can open such that fluid is directed away from the filter 50970 and back into the fluid trap 50960 . If the fluid detection sensor 50836 does not detect fluid, the valve 50990 can be closed such that smoke is directed into the filter 50970 . When fluid is recirculated through recirculation valve 50990 , fluid may be drawn through recirculation conduit 50982 . A centrifugal blower mechanism 50980 engages the recirculation conduit 50982 to create a recirculation suction force within the recirculation conduit 50982 . More specifically, when the recirculation valve 50990 is opened and the pump 50906 is activated, the suction force generated by the pump 50906 downstream of the filter 50970 causes rotation of the first centrifugal blower, or tumbling basket 50984. which can be transferred into a second centrifugal blower or tumbling basket 50986 that draws recirculating fluid through a recirculating valve 50990 and into a fluid trap 50960 .

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

Communication Of Smoke Evacuation System Parameters to Surgical Hub Or Cloud To Effect The Output Or Operation Of Other Attached Devices END8546USN P (M-1/164469)
During the course of surgical procedures in which electrosurgical instruments are used, parameters such as particle type, particle concentration, and particle size in surgical smoke have not been previously monitored. This lack of smoke monitoring during a surgical procedure requires that smoke emissions present at the surgical site be monitored to compensate for changing parameters during the course of the surgical procedure (e.g., higher particle concentrations in the exhaled smoke). It suggests that the device was unable to adjust its behavior to expel the smoke more carefully.

20-22 and 25-35, an exemplary smart smoke evacuation system 56100 as described herein may transmit detected or sensed parameters to the surgical hub 206 or cloud analysis computer. and communication environment 204 (hereinafter cloud 204 ) to affect the output and operation of surgical hub 206 or other devices communicating with cloud 204 . For example, if different particle concentrations are detected, the different parameters are communicated to surgical hub 206 or cloud 204, and surgical hub 206 or cloud 204 may use the electrosurgical instrument to compensate for the different parameters. The operation of other components within the smart smoke evacuation system 56100 may be adjusted, such as the power level applied to the .

Due to the parameters detected by the smart smoke evacuation system, the smoke generated by the operation of the electrosurgical instrument is more effectively removed by automatically adjusting the operation of the other device and during the surgical procedure. Reduced risk to physicians and other personnel present in the

FIG. 20 illustrates a smoke evacuation system 56100 with various modules and devices communicating with each other, according to at least one aspect of the present disclosure. Communication between modules and devices identified in smoke evacuation system 56100 may occur directly or indirectly via connections through surgical hub 204 and/or cloud 204 . Smoke evacuation system 56100 may be actively coupled to surgical hub 206 and/or cloud 204, eg, as described in FIGS. 25-35. In this manner, parameters sensed or detected by smoke evacuation module 226 may affect the functioning of other modules, devices, or components within a computer-implemented surgical system such as those shown in FIGS. can affect FIG. 20, for example, shows a computer-implemented smoke evacuation system 56100 comprising cloud 204, surgical hub 206, smoke evacuation module 226, module A 56108, module B 56106, and module C 56104. FIG. Modules A 56108 , B 56106 , and C 56104 may be any modules or devices that communicate with or are part of surgical hub 206 . For example, modules A 56108, B 56106, and C 56104 are components of visualization system 208, components of robotic system 222, intelligent instrument 235, imaging module 238, generator module 240, suction/irrigation module 228, and communication module 230. , processor module 232, storage array 234, operating room mapping module 242, and the like. Examples and descriptions of these various types of modules and components can be found, for example, in the descriptions of Figures 25-35.

Smoke evacuation module 226 includes at least one sensor. The sensor can be any type of sensor including, for example, sensors that detect operating parameters such as ambient pressure sensors, air quality particle sensors, and the like. Additionally, the sensor can be an internal sensor such as, for example, a pressure sensor, a fluid detection sensor, a chemical sensor, a laser particle counter, and the like. Additionally, more than one pressure sensor may be included in the smoke evacuation module 226 to determine pressure differentials across various portions of the smoke evacuation module 226 . A description of sensors used in the context of smoke evacuation system 56100 can be found, for example, in connection with FIGS.

In various aspects, smoke evacuation module 226 and modules A 56108, B 56106, and C 56104 may communicate directly or indirectly with surgical hub 206 and/or cloud 204, for example. Referring again to FIG. 20, smoke evacuation module 206 and modules A 56108, B 56106, and C 56104 are shown engaging surgical hub 206 in two-way communication. This two-way communication is indicated by double-headed arrows, such as arrow 56112 . This two-way communication can be accomplished, in one example, by connecting the modular enclosures or modules A 56108, B 56106, and C 56104 of the smoke extraction module 226 to a modular backplane that includes an internal connector console. The modular backplane is configured to laterally or vertically connect to the smoke evacuation module 226 with the surgical hub 206 or the modular housing of modules A 56108, B 56106, and C 56104. An example of this is shown in FIGS. 27-31. In an alternative embodiment, the smoke evacuation module 226 housing or modules A 56108, B 56106, and C 56104 are stand-alone housings having wired attachments on the back of the device to allow interfacing with the surgical hub 206. Two-way communication may be established by being a body. Alternatively, in another embodiment, smoke extraction module 226 and modules A 56108, B 56106, and C 56104 may be directly connected to each other. In yet another embodiment, smoke evacuation module 226 and modules A 56108, B 56106, and C 56104 include wireless communication modules for communicating directly or indirectly with surgical hub 206 and/or cloud 204. may In the example illustrated in FIG. 20, surgical hub 206 is shown in two-way communication with cloud 204 . Alternatively, in another embodiment, smoke evacuation module 226 as indicated by dashed line 56110 and any one or all of modules A 56108, B 56106, and C 56104 pass through surgical hub 206. may communicate directly with the cloud 204 to receive instructions or information directly from the cloud.

FIG. 21 is an illustration of interconnections between surgical hub 206, cloud 204, smoke evacuation module 226, and/or various other modules A 56108, B 56106, and C 56104, according to at least one aspect of the present disclosure 56200 of a generic method. An exemplary method 56200 is described with reference to the flow diagram shown in FIG. 21, but it will be appreciated that many other methods of performing the operations associated with this method may also be used. For example, the order of some of the blocks may be changed, certain blocks may be combined with other blocks, and some of the blocks described are optional.

Referring also to FIGS. 25-35, parameters are first obtained by smoke evacuation module 226 (56202). For example, a sensor component of smoke evacuation module 226, such as an air quality particle sensor, will detect the parameter. This parameter may be, for example, any parameter related to the ambient environment of the operating room, such as the air quality of the operating room. In this example, there is only one sensed parameter, but the disclosure should not be limited in such manner. In alternate embodiments, there may be many parameters sensed by any number of different sensors. How often the parameters are sensed and how often the smoke evacuation module 226 is activated depends on the amount of smoke being evacuated. For example, when little smoke is being expelled, the smoke evacuation module 226 may operate more slowly and/or sense parameters less frequently. Alternatively, if the smoke evacuation module 226 is actively acting to evacuate rapidly emerging smoke, the smoke evacuation module 226 may be It may be useful for the to operate at higher speeds and/or sensing parameters. This can provide a safe environment for all surgeons, personnel and medical equipment present in the operating room. Other parameters that can be sensed include, for example, those sensed by internal sensors such as particulate concentration, aerosol rate, or chemical analysis. Alternatively, operating parameters sensed by sensors on the housing of the smoke evacuation module 226 include, for example, airflow, pressure differential, or air quality. A description of sensors used in the context of smoke evacuation system 56100 can be found, for example, in FIGS.

Smoke evacuation module 226 then transmits the obtained parameter values to surgical hub 206 or cloud 204 (56204). For example, if an operating room air quality value is obtained, the value may be sent to surgical hub 206 by smoke evacuation module 226 . Surgical hub 206 may process the parameters and/or communicate received air quality parameters to cloud 204 . This may be accomplished via network router 211, network hub 207, network switch 209, or any combination thereof. In alternative embodiments, smoke extraction module 226 may communicate air quality parameters directly to cloud 204 using wired or wireless communication technology.

The parameter values are then processed (56206) to determine if the parameter values affect the way the surgical drainage system 56100 or another modular device should operate (56208). This process can occur at surgical hub 206 within cloud 204 or a combination of surgical hub 206 and cloud 204 . The processing performed on the sensed parameters is automatic operation of the smoke evacuation module 226 or any of modules A 56108, B 56106, and C 56104 to compensate for the values of the sensed parameters. and using the values of the sensed parameters in various algorithms and learning software to determine whether to adjust to . The value of the parameter is the smoke evacuation variable. Algorithms and learning software may be stored in cloud 204 (storage 105) or surgical hub 206 (storage 248) prior to processing and may be updated remotely as needed.

For example, if the sensed air quality parameter value indicates a large amount of smoke particles in the air, the cloud 204 may use the air quality parameter value to improve the air quality around the operating room by generating exhaust gas. A software algorithm may be included to determine how the operation of the smoke module or modules A 56108, B 56106, and C 56104 may be altered. In this example, cloud 204 may determine that the operation of intelligent fixture 235 should be modified, which is optimized by adjusting the output of the generator to supply intelligent fixture 235 . adjusted. Generator module 240 converts the electricity into a high frequency waveform consisting of an oscillating current that is transmitted to the electrodes to affect tissue. In an alternate embodiment, cloud 204 may determine that all of modules A 56108, B 56106, and C 56104 should be adjusted, but the operation of smoke evacuation module 226 should be adjusted. In this alternative embodiment, cloud 204 determines that smoke evacuation module 226 is safer if the value of the air quality parameter adjusts the operation of smoke evacuation module 226 to expel smoke from the operating room more quickly. It may be judged that it indicates that there is a possibility of providing a

Instructions are then sent 56210 to the surgical drainage system 56100 or modular device to adjust its operation. For example, cloud 204 may determine that the operation of intelligent fixtures 235 should be adjusted based on the values of sensed air quality parameters. This was previously determined by cloud 204 to be most effective, in this example, by modifying the output of generator module 240 . Accordingly, at step 56210 of this example, cloud 204 sends instructions to generator module 240 (eg, module A 56108). In an embodiment, instructions are sent to the generator module 240 directing it to modify the output of the generator module 240 in order to alter the operation of the intelligent appliance 235 .

Finally, operation of the surgical drainage system 56100 or modular device is adjusted 56212 based on the instructions. For example, generator module 240 changes the shape of the waveform output to intelligent appliance 235 according to instructions received from cloud 204 . This adjustment causes intelligent instrument 235 to affect tissue in a desired manner. In one example, the instructions for the various modules are pre-stored in cloud 204 or surgical hub 206, but may be updated remotely as needed. Alternatively, these instructions are generated dynamically by cloud 204 or surgical hub 206 as needed.

FIG. 22 illustrates a smoke evacuation system 56300 in communication with various other modules and devices, according to at least one aspect of the disclosure. The embodiment illustrated in FIG. 22 discloses an alternative embodiment of the computer-implemented surgical system shown in FIG. With continued reference to FIGS. 25-35 and 22, cloud 204 and surgical hub 206 are shown. Although the illustrated embodiment shows one cloud 204 and one surgical hub 206 in an alternative embodiment, more than one cloud 204 and/or surgical hub 206 may be used within a computer-implemented surgical system. may exist.

22, surgical hub 206 may include various modules such as aspiration/irrigation module 228, smoke evacuation module 226, and generator module 240. In FIG. Smoke evacuation module 226 may include a first sensor 56302 and a second sensor 56304 that detect different parameters. For example, the first sensor 56302 may be a chemical sensor that performs a chemical analysis on the smoke being discharged from the operating room, and the second sensor 56304 measures the particle concentration of the smoke being discharged from the operating room. It may be a laser particle counter to determine. In alternate embodiments, there may be more than one sensor within smoke evacuation module 226 .

In an embodiment, a first sensor 56302 senses a first parameter 56306, eg, pH of smoke being expelled from an operating room. A second sensor 56304 senses a second parameter 56308, eg, number of particles (parts per million) of smoke being expelled from the operating room. Smoke evacuation module 226 may be connected to surgical hub 206 or may be part of surgical hub 206, and thus first parameter 56306 and second parameter 56308 are measured after being sensed. It may be automatically provided to surgical hub 206 . In an alternate embodiment, surgical hub 206 may periodically request any sensed parameter from smoke evacuation module 226 or by user request for sensed parameter information, which smoke evacuation module 226 may , will provide the values of the sensed parameters upon request. Alternatively, smoke evacuation module 226 may periodically provide sensed values to surgical hub 206 without being requested.

In one example, surgical hub 206 processes, modifies, or manipulates first parameter 56306 and second parameter 56308 to generate first processed parameter 56306' and second processed parameter 56308'. ' can be. In an alternate embodiment, surgical hub 206 may not perform any processing of first parameter 56306 and second parameter 56308 . Surgical hub 206 uses first processed parameter 56306' and second processed parameter 56306' to determine whether the operation of the various modules should be adjusted based on the values of the sensed parameters. Parameters 56308' may be sent to cloud 204 for further processing. The cloud 204 may run various algorithms to determine the values of the first processed parameter 56306' and the second processed parameter 56308' by any of the other modules and devices, including the smoke extraction module 226, A determination can be made as to whether the motion should be adjusted to create a more ideal surgical environment within the operating room. Cloud 204, in this example, determines whether the values of first processed parameter 56306' and second processed parameter 56308' are above or below acceptable thresholds and, therefore, other modules' It can be determined that the operation should be adjusted to compensate for the sensed/detected values of the first processed parameter 56306' and the second processed parameter 56308'.

In the example shown in FIG. 22, cloud 204 may determine that the display of visualization system 208 should be adjusted to accurately depict the surgical site. In this case, cloud 204 may send command A 56312 to visualization system 208 to adjust the display of that surgical site. A visualization system 208 is communicatively coupled to surgical hub 206 .

Further, in an embodiment, after cloud 204 executes various algorithms, operation of aspiration/irrigation module 228 is also based on the value of either first processing parameter 56306' or second processing parameter 56308'. It may be determined that it should be adjusted. In an embodiment, Order B 56310 may be sent from cloud 204 to surgical hub 206 . Surgical hub 206 may send command B 56310 to aspiration/irrigation module 228 . In an alternative embodiment, surgical hub 206 may have processor 244 located within surgical hub 206 regulate operation of aspiration/irrigation module 228 . In another alternative embodiment, cloud 204 may send instruction B 56310 directly to aspiration/irrigation module 228 without first sending instruction B 56310 through surgical hub 206 .

Cloud 204, after executing various algorithms, indicates that generator module 240 may not benefit from on-the-fly adjustments, or that sensed parameters may not benefit from on-the-fly adjustments of generator module 240. It may determine that it may not be affected. Accordingly, in the example illustrated in FIG. 22 , cloud 204 may not send instructions to generator module 240 . Alternatively, cloud 204 may send an indication to generator module 240 that no modification of operation is required.

Smoke Evacuation System Containing a Segmented Control Circuit Where the Circuit is Energized in a Staged Method to Check for Errors, Shorts, and Safet Y Checks of the System END8546USNP1 (M-7/162220)
If no faults in the smoke evacuation system are detected, the smoke evacuation system may be unknowingly operated in a surgical context when the smoke evacuation system is not functioning properly. This can lead to an unsafe operating environment where hazardous or carcinogenic fumes are not adequately filtered from the operating room. Alternatively, portions of the smoke evacuation system may function properly while other portions may not. This can make smoke evacuation systems generally unsafe to energize and operate.

For example, as described with reference to FIGS. 20-22, a smoke evacuation system 56100, 56300 comprising a smoke evacuation module 226 coupled to surgical hub 206 and/or cloud 204 may be configured with reference to FIG. A segmented control circuit 57100 may also be included as described. The segmented control circuit 57100 is energized in stages to check for faults, errors, shorts, and perform various safety checks while powering up the smoke evacuation module 226 to ensure that the smoke evacuation module 226 is It can help determine if it is safe to operate.

By starting the smoke evacuation module 226 in a phased manner, faults and errors can be identified before attempting to operate the smoke evacuation module 226 . This can improve the overall safety of the surgical procedure as the smoke evacuation system may be repaired or replaced with a replacement smoke evacuation module as needed.

In one aspect, the smoke evacuation module 226 described in FIGS. 20-22 includes segmented control circuitry, where the circuitry checks for errors, shorts, and performs safety checks of the system. It may be energized in a stepwise manner. FIG. 23 illustrates one aspect of a segmented control circuit 57100, according to at least one aspect of the present disclosure. Note that although certain features, modules, processors, motors, etc. are grouped into various segments shown in FIG. 23, the present disclosure should not be limited to this example. In alternate embodiments, the segments may include more, fewer, or different components than those disclosed in FIG. Furthermore, in other alternative embodiments, the number of segments in the segmented circuit example may be greater or less than three segments.

23, the segmented control circuit 57100 includes a first segment 57102, a second segment 57104 and a third segment 57106. In the example of FIG. In one embodiment, first segment 57102 includes main processor 57108 and safety processor 57110 . The main processor 57108 may be wired directly to a power button or switch 57120 . Thus, in this example, first segment 57102 , and specifically main processor 57108 , activates first segment 57102 and component 57108 .

The safety processor 57110 and/or main processor 57108 may include one or two processors, such as a second segment 57104, which may include sensing circuitry 57112 and display circuitry 57114, and a third segment 57106, which may include motor control circuitry 57116 and motor 57118. It may be configured to interact with one or more additional circuit segments and their components. Each of the circuit segments and their components may be coupled to or in communication with the safety processor 57110 and/or the main processor 57108. Main processor 57108 and/or safety processor 57110 may also be coupled to or include internal memory. Main processor 57108 and/or safety processor 57110 may also be coupled to or wired or wirelessly with a communication device that would enable communication over a network, such as surgical hub 206 and/or cloud 204. may communicate.

The main processor 57108 may have multiple inputs coupled, for example, to one or more circuit segments, a battery, and/or multiple switches. Segmented control circuitry 57100 may be implemented by any suitable circuitry, such as, for example, a printed circuit board assembly (PCBA) within smoke extraction module 226 . The term processor, as used herein, means any microprocessor, processor, controller or controllers, or central processing unit (CPU) of a computer that combines the functions of a single integrated circuit or It should be understood to include other basic computing devices incorporated on several integrated circuits in . Main processor 57108 and safety processor 57110 are general purpose programmable devices that accept digital data as input, process that data according to instructions stored in their memory, and provide results as output. This is an example of sequential digital logic since it has internal memory. The safety processor 57110 may be specifically configured for safety marginal applications, among other things, to provide advanced integrated safety features while offering scalable performance, connectivity and memory options. .

In the example shown in FIG. 23, the second segment 57104 may comprise sensing circuitry 57112 and display circuitry 57114 coupled together or in signal communication with the main processor 57108 . The sensing circuit 57112 of the smoke evacuation module 226 generally described herein includes various sensors, some internal to the smoke evacuation module 226 and some external to the smoke evacuation module 226. located on the housing. These sensors include various pressure sensors, fluid sensors, chemical sensors, laser particle counters or other laser sensors, and air quality sensors. A description of sensors used in the context of smoke evacuation system 56100 can be found, for example, in FIGS.

In an alternative aspect, the sensing circuit 57112 communicates with the sensing circuit 57112, the main processor 57108 and/or the safety processor 57102 via a communication device through a number of sensors located on the exterior housing of the smoke extraction module 226. may include communication and/or connection of Display circuitry 57114 includes a screen or other display capable of displaying text, images, graphs, charts, etc. acquired by smoke evacuation module 226 or another device in communication with smoke evacuation module 226 or surgical hub 206. It's okay. For example, display circuitry 57114 can display and overlay images or data received from imaging module 238, device/instrument 235, and/or other visualization system 208 (e.g., displays 210, 217 or monitors). 135). This display or screen may present to the user the status of each segment within the segmented control circuit 57100, or the status of each component within each segment. The status of each segment, or the status of each component of each segment, is determined by identifying each component or segment, receiving or determining the status of each component or segment, and providing the status of each component or segment to a user. may be identified by the segmented control circuit 57100 by displaying . Components or segments may be identified using, for example, unique data packet formats, authentication information, encryption, ID numbers, passwords, signaling, flags, and the like. The status of a component or segment may be determined using flags, indications, sensed parameter values, measurements, and the like.

These functions (identification, determination, and indication) may be implemented using, for example, Wi-Fi, wired connectivity, signaling, Thread, Bluetooth, RFID, or NFC. For example, the segmented control circuit 57100 components may include a communication device for communicating over a network, or may be coupled to an external communication device that enables communication over the network. A communication device may include a transceiver configured to communicate over a physical wire or wirelessly. The device may further include one or more additional transceivers. The transceiver may include a cellular modem, a wireless mesh network transceiver, a Wi-Fi® transceiver, a low power wide area (LPWA) transceiver, and/or a near field communication transceiver (NFC). but not limited to these. The communication device may include or be configured to communicate with main processor 57108, safety processor 57110, display circuitry 57114, surgical hub 206, or cloud 204, which may be configured to communicate with components and their Associated status identities may be verified or their identities may be received. The transceivers receive serial transmit data from the processor via respective UARTs, modulate the serial transmit data onto an RF carrier to generate transmit RF signals, and transmit the RF signals via respective antennas. It may be configured as Each transceiver is connected to a selected wireless communication standard and/or protocol, such as IEEE 802.11a/b/g/n for Wi-Fi and/or as described herein. An implementation of IEEE 802.15.4 for wireless mesh networks using Zigbee routing may be supported. In alternative embodiments, the display circuitry may include a small speaker or small lights/indicators that audibly signal to indicate smoke detector status, on/off operation, remaining filter life, and the like. Identification of each component and their status is optionally provided by each component and may send or transmit such information at regular or irregular time intervals. An example of irregular time intervals may be, for example, when a user indicates information to be sent. In alternate embodiments, identification and status information for each component or segment may be requested at regular or irregular time intervals. For example, the identification and status of the motor control circuit 57116 may be requested every 1 minute, 20 minutes, 40 minutes, 1 hour, 3 hours, 24 hours, and so on.

In another aspect, the segmented control circuit 57100 enables energization of a status circuit that allows the smoke evacuation module 226 to query or poll all attached components. The status circuit may be located in any of the segments, but this embodiment may be located in the first segment 57102. FIG. This status circuit includes a first segment 57102, a second segment 57104, a third segment 57106, and any other additional components such as those depicted in FIGS. It may be possible to query/poll the component. Polling/querying of the installed component determines compatibility, i.e. the component or segment may be compatible with the smoke evacuation system or hub, reliability, i.e. the component or segment may be the correct component. , reliability, used status, or status of any segment or component that has a life based on use, such as a filter, and correctly inserting a filter before energizing a motor and a pump connected to the motor, etc. This may be done to verify correct insertion of segments or components. In one embodiment, intelligent fixtures, such as intelligent fixture 235, know that the appropriate fixture is being used and that the smoke evacuator system can or does work with the polled/queried intelligent fixture. It may be further queried/polled to confirm that For example, the polled or interrogated intelligent instrument 235 may be a Zip Pen®. Knowing that a Zip Pen® is being used can help determine how the smoke evacuation system works. If an unidentified intelligent appliance is being used, the smoke evacuation system may determine that the motor is improperly energized or unsafe, and an error may be indicated by the display circuitry 57114. This may be done for any component of the smart surgical environment, not just the intelligent instrument 235 . Alternatively, if an unverified intelligent appliance is being used, the smoke evacuation system may determine that the device can be used in a universally safe mode of operation.

As noted above, energizing the status circuitry that allows the smoke evacuation module 226 to query/poll other components also provides unique identification, authentication, and validation for the queried/polled component. A status text string can be provided. This allows for controlled identification of the smoke evacuation module 226 and its sub-components to prevent mimicking devices from fooling security devices. For example, an exemplary attempt to trick a security device is by constructing a "skimmer" to make unique connections. To prevent the system from being tricked, actions can be taken to authenticate each component. Each component attached to the smoke evacuation system may be authenticated based on stored data, security encryption, authentication, parameters, or some combination thereof. Data stored may include identification numbers or other identifiers, product names and types, unique device identifiers, corporate trademarks, serial numbers, and/or other manufacturing data, configuration parameters, usage information, activation or deactivation. may include algorithms/instructions on how to use the integrated features or attached components.

In the example shown in FIG. 23, third segment 57106 may include motor control circuitry 57116 and motor 57118 . Motor control circuitry 57116 and/or motor 57118 may be coupled to or in signal communication with main processor 57108 and/or safety processor 57110 . Main processor 57108 may direct motor control circuitry 57116 to decrease or increase the speed of motor 57118 . In alternate embodiments, the motor control circuit 57116 and motor 57118 may be coupled to or in signal communication with the safety processor 57110 . The motor 57118 may be coupled to a pump within the smoke evacuation module 226 (see FIGS. 4 and 6-19), and operation of the motor 57118 may cause the pump to function. Specifically, in one embodiment, motor 57118 may operate in two different states. A first state may be when motor 57118 is activated by a user. In this first state, the motor 57118 may operate at a higher speed than in the second state. In a second state, the motor 57118, motor control circuit 57116, main processor 57108, or safety processor 57110 may sense a lack of user activity, or the main processor 57108, safety processor 57110, surgical hub 204, cloud 206, or another module (eg, processor module 232) located within surgical hub 206, to slow the speed of operation of motor 57118.

The number of different states in which motor 57118 may operate is not limited to two. Motor 57118 may change or select its operating state based on various measurements of parameters. In another aspect, the motor 57118 may determine or set its operating state based on user activity levels entering, above, or below certain thresholds. Additionally, these thresholds may relate to or correlate with thresholds of other modules or components of smoke evacuation module 226 .

In an alternate embodiment, the motor 57118 may have a mode arbitrarily called sleep mode. In this example, a sleep mode may be activated, or the motor 57118 may be shut down to a sleep mode (considerable mode, or low power mode) when not used for a predetermined amount of time. The threshold amount of time of activity before entering sleep mode may vary depending on a number of factors, including the type of surgical procedure, the particular surgeon performing the procedure, or other factors. Accordingly, the predetermined amount of time may be preset, but may be easily adjusted. For example, an exemplary active-to-sleep-mode threshold may be 10 minutes. In this example, if intelligent instrument 235 is not used by the surgeon for more than 10 minutes, motor control circuit 5716 or motor 5718 may receive an instruction to enter sleep mode. In an alternative embodiment, intelligent instrument 235 may automatically activate sleep mode by decelerating motor 57118 to a sleep mode state when intelligent instrument 235 is not used by the surgeon for more than 10 minutes. Additionally, when smoke evacuation module 226 or intelligent appliance 235 is used again or senses user interaction, smoke evacuation module 226 may undergo a wake-up sequence that reenergizes segmented circuit 57100. . This wake-up sequence may be the same as the start-up sequence used to energize the segmented circuit 57100 while checking for errors or faults. Alternatively, the wakeup sequence may be a shortened version of the startup sequence for quickly reenergizing segmented circuit 57100 when user interaction is sensed.

The example shown in FIG. 24 discloses a method 57200 of operating the control circuit portion of the smoke extraction module 226 to stepwise energize the segmented control circuit 57100 according to at least one aspect of the present disclosure. ing. In this way, various parts of the control circuit can perform safety checks before energizing subsequent segments, providing a safe electrical start circuit method. Although the exemplary method 57200 is described with reference to the flow diagram shown in FIG. 24, it will be appreciated that many other methods of performing the operations associated with this method may also be used. For example, the order of some of the blocks may be changed, certain blocks may be combined with other blocks, and some of the blocks described are optional.

According to method 57200, control circuit 57100 first activates (57202) first segment 57102 . For example, the first segment 57102 may include a main processor 57108 and a safety processor 57110, as previously described in FIG. In alternate embodiments, other components may also be included in the first segment 57102, or the first segment 57102 may not include the main processor 57108 and/or the safety processor 57110.

First segment 57102 then performs first function 57204 . This first function may relate to verifying the safety of the control circuit 57100 and/or the smoke evacuation module 226, for example. For example, main processor 57108 or safety processor 57110 may check each segment or component of the segment for short circuits and other errors before engaging the high power portion of segmented control circuit 57100. . Main processor 57108 and/or safety processor 57110 may perform safety checks on each component or each segment to determine that they are functioning properly. Additionally, in another embodiment, main processor 57108 or safety processor 57110 may perform verification functions to ensure that the components within smoke evacuation module 226 are the correct components. For example, the main processor 57108 or the safety processor 57110 may include a Trusted Platform Module (TPM), or the TPM may be a segmented module to ensure that the components of the smoke evacuator system 56100, 56300 are the correct components. It may also be a separate component within integrated control circuit 57100 . This verification can be done in various ways. For example, one exemplary method is to store the key for each component or segment within the TPM. Connected components are compared and if the key for each component or segment is not found in the TPM, smoke evacuation module 226 may not enable or power those modules. In a further example, the described keys may incorporate encryption, or alternatively may require authentication by components of smoke evacuation module 226 such as main processor 57108 or security processor 57110 .

Further, for example, the main processor 57108 and/or the safety processor 57110 may store in memory a set of instructions to prevent the segmented control circuit 57100 from activating portions of the circuit if certain safety conditions are not met. may include switched logic. For example, there may be various conditions stored within the safety processor 57118 associated with a logic switch or multiple logic switches. For example, if the protective enclosure is not fully closed, if the filter module is not fully or properly inserted, if the fluid reservoir is not fully or properly inserted, if the hose is not properly or fully inserted. If not inserted, and if the fluid reservoir is not sufficiently filled, a logic switch may be triggered and the associated portion of the segmented control circuit 57100 or smoke evacuation module 226 may not be activated.

In an alternative embodiment, a separate control is provided to ensure that the enclosure is completely and properly closed before allowing the smoke extraction module 226 or one of the various segments to be activated or operated. enclosure circuits may be present. For example, the circuit may not be complete if the enclosure is not completely closed. Accordingly, the remaining segments or components of segmented control circuit 57100 may not be activated. This enclosure circuit concept may be used in tampered circuits to prevent unauthorized maintenance. For example, the tampering circuitry may include verification circuitry. If a housing that should not be opened is opened, the verification circuit may be permanently destroyed, either electrically or mechanically. This breakable verification circuit has an internal connection strip capable of bridging two rigidly fixed electrical connection blocks, one block may be located on the shell of the enclosure and the other The block may be located on the base frame of the enclosure. The internal connections have rigid insertable electrical connectors that can be locked to respective connection blocks, the electrical connectors having latching mechanisms on each of the shell and base frame. When destroyed, it may become apparent that the enclosure has been opened or tampered with. Once destroyed, the electrical connector can be easily released and replaced when the housing is opened for replacement. Alternatively, the blocks and latching mechanisms may be located in different portions and each segment may include separate blocking and latching mechanisms. For example, first segment 57102, second segment 57104, and third segment 57106 may each have separate verification circuitry. If the first segment 57102 is tampered with or opened, the verification circuitry may be broken by the rigid interconnect strip and thus identified as tampered with and/or the verification circuitry replaced. good too. By having separate verification circuitry, it may be readily detectable whether any of the various segments or components of segmented control circuitry 57100 have been tampered with.

Alternatively, the enclosure circuit may be used as a segmented security device. For example, if a portion of the system requires maintenance, the enclosure circuitry may allow the portion of the system to be opened for maintenance, while an unauthorized separate portion of the segmented control circuit 57100 is opened. The use of a segmented control circuit 57100 or smoke evacuation module 226 after it has been removed, dismantled, or modified can be prevented. For example, if the segmented control circuit 57100 of the smoke evacuation system 226 is to be serviced, but only the display circuit 57114 needs to be serviced, a service technician or other personnel may Or there may be no reason to maintain the first segment 57102 . Accordingly, the third segment 57106 and the first segment 57102 may include separate enclosure circuits containing digital versions of single use fuses or other mechanical/electromechanical devices or the like. When the third segment 57106 and first segment 57102 are opened, modified, or disassembled, the fuse may be blown preventing power from reaching the third segment 57106 and first segment 57102 .

If an error, short, fault, or other problem is detected, the segmented control circuit 57100 operates at least one segment of the segmented control circuit 57100 while not operating other segments. may To ensure the safety of the segmented control circuit 57100, portions of the segmented control circuit 57100 and the connections between them may physically be switches, fuses, or circuit breakers. This allows switches, fuses, and circuit breakers to trip and prevent energization if an unsafe condition exists. Multiple switches may be implemented using any suitable mechanical, electromechanical, or solid state switches. For example, there may be single use fuses, resettable fuses, or solid state switching devices residing between main processor 57108 and motor control circuitry 57116 . Generally, fuses are electrical safety devices that operate to provide overcurrent protection for electrical circuits. A fuse may include a metal wire or strip that melts when too much current flows through it, thereby interrupting the current. Generally, resettable fuses are polymer positive temperature coefficient (PPTC) devices, which are passive electronic components used to protect against overcurrent faults in electronic circuits. Devices are also sometimes known as polyfuses or polyswitches. In general, solid-state switches may be solid-state switches that operate under the influence of a magnetic field, such as Hall effect devices, magnetoresistive (MR) devices, giant magnetoresistive (GMR) devices, magnetometers, among others. . In other implementations, the switches may be solid-state switches that operate under the influence of light, such as light sensors, infrared sensors, and ultraviolet sensors, among others. Further, the switch may be a solid state device such as a transistor (eg, FET, junction FET, metal oxide semiconductor FET (MOSFET), bipolar, etc.). Other switches may include wireless switches, ultrasonic switches, accelerometers, and inertial sensors, among others.

A second segment may then be activated (57206). For example, a second segment 57104 including sensing circuitry 57112 and display circuitry 57114 may be energized. A third segment may then be activated (57208). For example, a third segment 57106 that includes a motor control circuit 57116 and a motor 57118 may be energized. Although this exemplary aspect discloses firing the first segment 57102 before the second segment 57102 and firing the second segment 57104 before the third segment 57106, the segments The boot order may be modified if deemed appropriate. Further, in alternate embodiments, various error checks, verifications, etc. may be performed while energizing the second segment 57104 and the third segment 57106. FIG.

The reader will readily appreciate that the various surgical drainage systems and components described herein can be incorporated into computer-implemented interactive surgical systems, surgical hubs, and/or robotic systems. . For example, the surgical evacuation system can communicate data to the surgical hub, robotic system, and/or computer-implemented interactive surgical system and/or the surgical hub, robotic system, and/or computer-implemented interactive surgical system. Data can be received from the surgical system. Various examples of computer-implemented interactive surgical systems, robotic systems, and surgical hubs are further described below.

Computer-implemented Interactive Surgical System Referring to FIG. 25, a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (e.g., a remote server coupled to a storage device 105). cloud 104), which may include 113; Each surgical system 102 includes at least one surgical hub 106 that communicates with cloud 104 that may include remote servers 113 . In one example, as shown in FIG. 25, the surgical system 102 includes a visualization system 108, a robotic system 110, and a handheld intelligent surgical device configured to communicate with each other and/or with the hub 106. and an instrument 112 . In some aspects, the surgical system 102 may include M hubs 106, N visualization systems 108, O robotic systems 110, and P handheld intelligent surgical instruments 112. Well, where M, N, O, and P are integers of 1 or greater.

FIG. 27 illustrates one embodiment of surgical system 102 used to perform a surgical procedure on a patient lying on operating table 114 within surgical operating room 116 . Robotic system 110 is used as part of surgical system 102 in a surgical procedure. Robotic system 110 includes a surgeon's console 118 , a patient-side cart 120 (surgical robot), and a surgical robot hub 122 . The patient-side cart 120 is capable of manipulating at least one releasably coupled surgical tool 117 while the surgeon views the surgical site via the surgeon's console 118 during minimally invasive incisions in the patient's body. . Images of the surgical site may be obtained by a medical imaging device 124 , which may be manipulated by the patient-side cart 120 to orient the imaging device 124 . The robotic hub 122 can be used to process images of the surgical site for subsequent display to the surgeon via the surgeon's console 118 .

Other types of robotic systems can be readily adapted for use with surgical system 102 . Various examples of robotic systems and surgical tools suitable for use with the present disclosure are entitled "ROBOT ASSISTED SURGICAL PLATFORM," filed Dec. 28, 2017, the disclosure of which is incorporated herein by reference in its entirety. See US Provisional Patent Application No. 62/611,339.

Various examples of cloud-based analytics performed by the cloud 104 and suitable for use with the present disclosure are described in "CLOUD-BASED MEDICAL US Provisional Patent Application No. 62/611,340 entitled ANALYTICS.

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

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

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

The invisible spectrum (ie, non-emissive spectrum) is the portion of the electromagnetic spectrum that lies below and above the visible spectrum (ie, wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths above about 750 nm are longer than the red visible spectrum and these become invisible infrared (IR), microwave and radio electromagnetic radiation. Wavelengths less than about 380 nm are shorter than the violet spectrum and become invisible ultraviolet, X-ray, and gamma-ray electromagnetic radiation.

In various aspects, imaging device 124 is configured for use in minimally invasive surgery. Examples of imaging devices suitable for use with the present disclosure include arthroscopes, angioscopes, bronchoscopes, cholangioscopes, colonoscopes, cytoscopes, duodenoscopes, enteroscopes, esophagogastroduodenoscopes (gastroscopes) , endoscopes, laryngoscopes, nasopharyngo-neproscopes, sigmoidoscopes, thoracoscopes, and ureteroscopes.

In one aspect, the imaging device uses multispectral monitoring to distinguish between topography and underlying structure. Multispectral imaging captures image data within specific wavelength ranges across the electromagnetic spectrum. Wavelengths can be separated by filters or by using instruments that are sensitive to light from specific wavelengths, including frequencies above the visible light range, such as IR and ultraviolet light. Spectral imaging can allow the extraction of additional information that the human eye cannot capture with its red, green, and blue receptors. The use of multispectral imaging is described in US Provisional Patent Application No. 62/611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed Dec. 28, 2017, the entire disclosure of which is incorporated herein by reference. Acquisition Module" section. Multispectral monitoring can be a useful tool for repositioning the surgical field to perform one or more of the above-described tests on the treated tissue after one surgical task is completed.

It is self-evident that any surgical procedure requires rigorous sterilization of the operating room and surgical instruments. The stringent hygiene and sterilization conditions required in the "surgical theater", ie operating room or procedure room, require maximum sterility of all medical devices and equipment. Part of that sterilization process is the need to sterilize anything that comes in contact with the patient or enters the sterile field, including the imaging device 124 and its accessories and components. A sterile field may be considered a specific area considered free of microorganisms, such as in a tray or on a sterile towel, or a sterile field may be considered an area immediately surrounding a patient prepared for a surgical procedure. It will be appreciated what can be done. A sterile field may include clean team members in appropriate clothing and all equipment and fixtures within the area.

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

As shown in FIG. 26, primary display 119 is positioned within the sterile field so as to be visible to an operator positioned at operating table 114 . Additionally, the visualization tower 111 is positioned outside the sterile field. The visualization tower 111 includes a first non-sterile display 107 and a second non-sterile display 109 facing away from each other. A visualization system 108 guided by hub 106 is configured to coordinate information flow to operators inside and outside the sterile field using displays 107, 109, and 119. FIG. For example, hub 106 may cause visualization system 108 to display a snapshot of the surgical site recorded by imaging device 124 on non-sterile display 107 or 109 while maintaining a live image of the surgical site on primary display 119. can be done. A snapshot on a non-sterile display 107 or 109 can, for example, allow a non-sterile operator to perform diagnostic steps related to a surgical procedure.

In one aspect, the hub 106 transmits diagnostic input or feedback entered by a non-sterile operator located at the visualization tower 111 within the sterile field to the primary display 119 within the sterile field, which directs it to the sterile operator located at the operating table. It is also configured so that it can be viewed by In one example, the input may be in the form of modifications to the snapshot displayed on non-sterile display 107 or 109 that can be sent by hub 106 to primary display 119 .

Referring to FIG. 26, surgical instrument 112 is being used as part of surgical system 102 in a surgical procedure. Hub 106 is also configured to coordinate information flow to the display of surgical instrument 112 . For example, in US Provisional Patent Application No. 62/611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," the entire disclosure of which is incorporated herein by reference. Diagnostic input or feedback entered by a non-sterile operator at visualization tower 111 may be sent by hub 106 to surgical instrument display 115 within the sterile field, where the diagnostic input or feedback is input to surgical instrument 112 . It may be viewed by an operator. Exemplary surgical instruments suitable for use with surgical system 102 are described, for example, in the "Surgical Instrument Hardware" section and 2017 entitled "INTERACTIVE SURGICAL PLATFORM", the entire disclosures of which are incorporated herein by reference. No. 62/611,341, filed Dec. 28, 2003.

Referring now to FIG. 27, hub 106 is shown in communication with visualization system 108 , robotic system 110 and handheld intelligent surgical instrument 112 . Hub 106 includes hub display 135 , imaging module 138 , generator module 140 , communication module 130 , processor module 132 and storage array 134 . In certain aspects, the hub 106 further includes a smoke evacuation module 126 and/or an aspiration/irrigation module 128, as shown in FIG.

During surgical procedures, the application of energy to tissue for sealing and/or cutting is generally accompanied by evacuation of smoke, aspiration of excess fluid, and/or irrigation of tissue. Fluid, power, and/or data lines from different sources often become entangled during surgical procedures. Valuable time may be lost in addressing this issue during a surgical procedure. Untangling the lines may require uncoupling the lines from their corresponding modules, which may require the modules to be reset. The hub's modular housing 136 provides a unified environment for managing power, data, and fluid lines, reducing the frequency of tangling between such lines.

Aspects of the present disclosure present a surgical hub for use in surgical procedures involving the application of energy to tissue at a surgical site. The surgical hub includes a hub housing and a combination generator module slidably receivable within a docking station of the hub housing. The docking station contains data and power contacts. A combination generator module includes two or more of an ultrasonic energy generator component, a bipolar RF energy generator component, and a unipolar RF energy generator component housed within a single unit. In one aspect, the combination generator module further comprises a smoke evacuation component, at least one energy delivery cable for connecting the combination generator module to a surgical instrument, and smoke generated by application of therapeutic energy to tissue. , at least one smoke evacuation component configured to evacuate fluids and/or particulates, and a fluid line extending from the remote surgical site to the smoke evacuation component.

In one aspect, the fluid line is a first fluid line and a second fluid line extends from a remote surgical site to an aspiration and irrigation module slidably received within the hub housing. In one aspect, the hub housing includes a fluidic interface.

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

Aspects of the present disclosure present a modular surgical housing for use in surgical procedures involving the application of energy to tissue. A modular surgical housing includes a first energy generator module configured to generate a first energy for application to tissue and a first docking port including first data and power contacts. a first docking station comprising: a first energy generator module slidably moveable into electrical engagement with the power and data contacts; and the first energy generator module comprising: Slidably moveable out of electrical engagement with the first power and data contact.

Further to the above, the modular surgical enclosure includes a second energy generator module configured to generate a second energy for application to tissue, different from the first energy; a second docking station comprising a second docking port including data and power contacts of the second energy generator module slidably moved into electrical engagement with the power and data contacts; Yes, and the second energy generator module is slidably moveable out of electrical engagement with the second power and data contacts.

Additionally, the modular surgical enclosure includes a first docking port and a second docking port configured to facilitate communication between the first energy generator module and the second energy generator module. Further includes a communication bus to and from the port.

Referring to FIGS. 3-7, aspects of the present disclosure are presented for a hub modular housing 136 that allows for modular integration of the generator module 140, the smoke evacuation module 126, and the aspiration/irrigation module 128. be done. The modular housing 136 of the hub further facilitates bi-directional communication between the modules 140,126,128. As shown in FIG. 29, the generator module 140 is an integrated monopolar, bipolar housing unit 139 supported within a single housing unit 139 slidably insertable into the hub's modular housing 136 . , and a generator module comprising an ultrasound component. As shown in FIG. 29, generator module 140 may be configured to connect to monopolar device 146, bipolar device 147, and ultrasound device 148. FIG. Alternatively, the generator module 140 may comprise a series of monopolar, bipolar and/or ultrasonic generator modules interacting through the hub modular housing 136 . The modular housing 136 of the hub provides bi-directional switching between insertion of multiple generators and generators docked to the modular housing 136 of the hub so that the generators function as a single generator. and may be configured to facilitate communication.

In one aspect, the hub modular housing 136 is a modular power and A communications backplane 149 is provided.

In one aspect, the hub modular housing 136 includes a docking station or drawer 151, also referred to herein as a drawer, configured to slidably receive the modules 140,126,128. FIG. 28 shows a partial perspective view of surgical hub housing 136 and combination generator module 145 slidably receivable in docking station 151 of surgical hub housing 136 . A docking port 152 with power and data contacts on the rear side of the combination generator module 145 is slid into position within the corresponding docking station 151 of the hub modular housing 136. Corresponding docking ports 150 are configured to engage power and data contacts of corresponding docking stations 151 of hub modular housing 136 . In one aspect, the combination generator module 145 includes bipolar, ultrasonic, and monopolar modules and a smoke evacuation module integrated with a single housing unit 139, as shown in FIG.

In various aspects, the smoke evacuation module 126 includes a fluid line 154 that carries captured/collected smoke and/or fluid away from the surgical site, eg, to the smoke evacuation module 126 . The vacuum suction generated by the smoke evacuation module 126 can draw smoke into the openings of utility conduits at the surgical site. A utility conduit coupled to the fluid line may be in the form of flexible tubing that terminates in the smoke evacuation module 126 . The utility conduits and fluid lines define fluid pathways that extend toward the smoke extraction module 126 received within the hub housing 136 .

In various aspects, aspiration/irrigation module 128 is coupled to a surgical tool including an aspiration fluid line and a suction fluid line. In one example, the aspiration and aspiration fluid lines are in the form of flexible tubing that extends from the surgical site toward aspiration/irrigation module 128 . One or more drive systems may be configured to cause irrigation and aspiration of fluid to and from the surgical site.

In one aspect, a surgical tool includes a shaft having an end effector at its distal end, at least one energy treatment portion associated with the end effector, a suction tube, and an irrigation tube. A suction tube can have an inlet port at its distal end and the suction tube extends through the shaft. Similarly, an irrigation tube can extend through the shaft and have an inlet port proximate to the energy delivery device. The energy delivery instrument is configured to deliver ultrasonic and/or RF energy to the surgical site and is initially connected to generator module 140 by a cable extending through the shaft.

The irrigation tube can be in fluid communication with a fluid source and the suction tube can be in fluid communication with a vacuum source. A fluid source and/or a vacuum source may be housed within the aspiration/irrigation module 128 . In one example, the fluid and/or vacuum source may be housed within hub housing 136 separately from aspiration/irrigation module 128 . In such examples, the fluid interface may be configured to connect the aspiration/irrigation module 128 to a fluid source and/or a vacuum source.

In one aspect, the modules 140, 126, 128 and/or their corresponding docking stations on the hub modular housing 136 align the docking ports of the modules to the docking stations of the hub modular housing 136. Alignment features configured to engage their counterparts therein may be included. For example, as shown in FIG. 28, combination generator modules 145 have side portions configured to slidably engage corresponding brackets 156 of corresponding docking stations 151 of hub modular housing 136 . Includes bracket 155 . The brackets cooperate to guide the docking port contacts of the combination generator module 145 into electrical engagement with the docking port contacts of the hub modular housing 136 .

In some aspects, the drawers 151 of the hub modular housing 136 are the same or substantially the same size, and the modules are sized to be received within the drawers 151 . For example, side brackets 155 and/or 156 may be larger or smaller depending on the size of the module. In other aspects, drawers 151 vary in size and are each designed to accommodate a particular module.

Additionally, the contacts of a particular module may be keyed to mate with the contacts of a particular drawer to avoid inserting a module into a drawer with incompatible contacts.

As shown in FIG. 28, the docking port 150 of one drawer 151 is coupled via a communication link 157 to the docking port 150 of another drawer 151 for modules housed within the hub's modular housing 136. can facilitate two-way communication between The docking ports 150 of the hub modular housing 136 may alternatively or additionally facilitate wireless two-way communication between modules housed within the hub modular housing 136 . Any suitable wireless communication may be used, such as, for example, Air Titan-Bluetooth.

FIG. 30 illustrates individual power bus attachment of multiple lateral docking ports of lateral modular housing 160 configured to receive multiple modules of surgical hub 206 . Lateral modular housing 160 is configured to laterally receive and interconnect modules 161 . Modules 161 are slidably inserted into docking stations 162 of lateral modular enclosures 160 that contain backplanes for interconnecting modules 161 . As shown in FIG. 30, the modules 161 are arranged laterally within the lateral modular housing 160 . Alternatively, modules 161 may be arranged vertically within a lateral modular housing.

FIG. 31 shows a vertical modular housing 164 configured to receive multiple modules 165 of surgical hub 106 . Modules 165 are slidably inserted into docking stations or drawers 167 of vertical modular enclosures 164 that contain backplanes for interconnecting modules 165 . Although the drawers 167 of the vertical modular enclosure 164 are vertically oriented, in certain cases the vertical modular enclosure 164 may include laterally oriented drawers. Additionally, modules 165 may interact with each other via docking ports on vertical modular housing 164 . In the embodiment of FIG. 31, a display 177 is provided for displaying data relating to the operation of module 165 . Additionally, vertical modular enclosure 164 includes master module 178 that houses a plurality of sub-modules that are slidably received within master module 178 .

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

During a surgical procedure, it can be inefficient to remove a surgical device from the surgical field and replace it with another surgical device that includes a different camera or different light source. Temporary loss of vision in the surgical field can have undesirable consequences. The modular imaging device of the present disclosure is configured to allow replacement of a light source module or camera module midstream during a surgical procedure without having to remove the imaging device from the surgical field.

In one aspect, an imaging device comprises a tubular housing that includes a plurality of channels. The first channel is configured to slidably receive a camera module that may be configured for snap fit engagement with the first channel. The second channel is configured to slidably receive a light source module that may be configured for snap fit engagement with the second channel. In another example, the camera modules and/or light source modules can be rotated to their final positions within their corresponding channels. A threaded engagement may be employed instead of a snap-fit engagement.

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

Various image processors and imaging devices suitable for use with the present disclosure are described in U.S. Patent No. 1, issued Aug. 9, 2011, entitled "COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR," which is incorporated herein by reference in its entirety. 7,995,045. Further, U.S. Patent No. 7,982,776, issued July 19, 2011, entitled "SBI MOTION ARTIFACT REMOVAL APPARATUS AND METHOD," which is incorporated herein by reference in its entirety, removes motion artifacts from image data. Various systems for doing so are described. Such systems may be integrated with imaging module 138 . See also U.S. Patent Application Publication No. 2011/0306840, published Dec. 15, 2011, entitled "CONTROLLABLE MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPARATUS" and "SYSTEM FOR PERFORMING A MINIMALLY INVASIVE August 28, 2014 entitled "SURGICAL PROCEDURE" Published US Patent Application Publication No. 2014/0243597 is each incorporated herein by reference in its entirety.

FIG. 32 illustrates a cloud-based system (e.g., A surgical data network 201 is shown comprising a modular communication hub 203 configured to connect to a cloud 204 ), which may include a remote server 213 coupled to a storage device 205 . In one aspect, modular communication hub 203 comprises network hub 207 and/or network switch 209 that communicate with network routers. Modular communication hub 203 can also be coupled to local computer system 210 to provide local computer processing and data manipulation. Surgical data network 201 may be configured as passive, intelligent, or switched. A passive surgical data network acts as a conduit for data, allowing data to go from one device (or segment) to another device (or segment) and to cloud computing resources. The intelligent surgical data network includes additional mechanisms that allow traffic to pass through the monitored surgical data network and configure each port within network hub 207 or network switch 209 . An intelligent surgical data network may be referred to as a manageable hub or switch. The switching hub reads the destination address of each packet and then forwards the packet to the correct port.

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

It will be appreciated that surgical data network 201 may be expanded by interconnecting multiple network hubs 207 and/or multiple network switches 209 with multiple network routers 211 . Modular communication hub 203 may be housed in a modular control tower configured to receive multiple devices 1a-1n/2a-2m. A local computer system 210 may also be housed in the modular control tower. Modular communication hub 203 is connected to display 212 to display images acquired by some of devices 1a-1n/2a-2m, eg, during a surgical procedure. In various aspects, the devices 1a-1n/2a-2m include, among other modular devices that can be connected to the modular communication hub 203 of the surgical data network 201, an imaging module 138 coupled to, for example, an endoscope. , a generator module 140 coupled to an energy-based surgical device, a smoke evacuation module 126, an aspiration/irrigation module 128, a communication module 130, a processor module 132, a storage array 134, a surgical device coupled to a display, and/or Or various modules such as a non-contact sensor module.

In one aspect, surgical data network 201 comprises a combination of network hub(s), network switch(es), and network router(s) that connect devices 1a-1n/2a-2m to the cloud. may contain. Any one or all of the devices 1a-1n/2a-2m coupled to a network hub or network switch can collect data in real time and transfer the data to a cloud computer for data processing and manipulation. . It will be appreciated that cloud computing relies on shared computing resources to handle software applications rather than having local servers or personal devices. Although the term "cloud" can be used as a metaphor for "Internet," the term is not so limited. Accordingly, the term “cloud computing” can be used herein to refer to “a type of internet-based computing” in which various services such as servers, storage, and applications are to modular communication hub 203 and/or computer system 210 located (e.g., fixed, mobile, temporary, or on-site operating room or space) and via the Internet to modular communication hub 203 and/or computer Delivered to devices connected to system 210 . A cloud infrastructure may be maintained by a cloud service provider. In this context, a cloud service provider may be an entity that coordinates the use and control of devices 1a-1n/2a-2m located in one or more operating rooms. Cloud computing services can perform numerous calculations based on data collected by smart surgical instruments, robots, and other computerized devices located in the operating room. Hub hardware allows multiple devices or connections to connect to a computer that communicates with cloud computing resources and storage.

By applying cloud computer data processing techniques to data collected by devices 1a-1n/2a-2m, surgical data networks provide improved surgical outcomes, reduced costs, and improved patient satisfaction. At least some of the devices 1a-1n/2a-2m can be used to observe the condition of the tissue after the tissue sealing and cutting procedure to assess leakage or perfusion of the sealed tissue. . At least one of the devices 1a-1n/2a-2m for diagnostic examination of data comprising images of body tissue samples to identify medical conditions such as disease effects using cloud-based computing Several can be used. This includes tissue and phenotype localization and margin confirmation. Devices 1a-1n/2a for identifying body anatomy using various sensors integrated with imaging devices and techniques such as overlaying images captured by multiple imaging devices. At least some of ~2 m can be used. Data collected by devices 1a-1n/2a-2m, including image data, may be transferred to cloud 204 or local computer system 210, or both, for data processing and manipulation, including image processing and manipulation. . The data will help guide surgical interventions by determining whether additional therapies such as endoscopic interventions, emerging technologies, targeted radiation, targeted interventions, and precision robotic applications for tissue-specific sites and conditions can be performed. Can be analyzed to improve results. Such data analysis may further employ prognostic analysis processing, using a standardized approach to confirm surgical intervention and surgeon behavior, or suggest modifications to surgical intervention and surgeon behavior. can provide useful feedback for any of the

In one implementation, the operating room devices 1a-1n may be connected to the modular communication hub 203 via wired or wireless channels, depending on the configuration of the devices 1a-1n relative to the network hub. Network hub 207 may, in one aspect, be implemented as a local network broadcast device that functions above the physical layer of the Open Systems Interconnection (OSI) model. A network hub provides connectivity to devices 1a-1n located within the same operating room network. Network hub 207 collects the data in packet form and sends them to the router in half-duplex mode. Network hub 207 does not store any Media Access Control/Internet Protocol (MAC/IP) for transferring device data. Only one of devices 1a-1n can transmit data through network hub 207 at a time. Network hub 207 does not have routing tables or intelligence about where to send information, it broadcasts all network data across each connection and to remote server 213 (FIG. 33) on cloud 204 . Although the network hub 207 can detect basic network errors such as collisions, broadcasting all information to multiple ports can be a security risk and create bottlenecks.

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

Network hub 207 and/or network switch 209 are coupled to network router 211 to connect to cloud 204 . Network router 211 functions within the network layer of the OSI model. Network router 211 may cloud data packets received from network hub 207 and/or network switch 211 for further processing and manipulation of data collected by any one or all of devices 1a-1n/2a-2m. Create a route to send to the base computer resource. Network router 211 is used to connect two or more different networks located at different locations, such as different operating rooms in the same medical facility, or different networks located in different operating rooms in different medical facilities. good too. Network router 211 transmits data in packet form to cloud 204 and functions in full-duplex mode. Multiple devices can transmit data simultaneously. Network routers 211 use IP addresses to transfer data.

In one embodiment, network hub 207 may be implemented as a USB hub that allows multiple USB devices to be connected to a host computer. A USB hub can expand a single USB port into several layers so that there are many ports available for connecting devices to the host system computer. Network hub 207 may include wired or wireless capabilities for receiving information over wired or wireless channels. In one aspect, a wireless USB short range high band wireless communication protocol may be used for communication between devices 1a-1n and devices 2a-2m located in the operating room.

In another embodiment, operating room devices 1a-1n/2a-2m exchange data from fixed and mobile devices over short distances (using short wavelength UHF radio waves in the 2.4-2.485 GHz ISM band). ), and can communicate with the modular communication hub 203 via the Bluetooth wireless technology standard to build a personal area network (PAN). In other aspects, the operating room devices 1a-1n/2a-2m support Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, Long Term Evolution (LTE), and Ev - DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT and their Ethernet derivatives, as well as any other radio designated 3G, 4G, 5G and beyond, and It is possible to communicate with modular communication hub 203 via numerous wireless or wired communication standards or protocols, including but not limited to wired protocols. A computing module may include multiple communication modules. For example, a first communication module may be dedicated to short-range wireless communication such as Wi-Fi and Bluetooth, and a second communication module may be dedicated to GPS, EDGE, GPRS, CDMA, WiMAX, LTE, Ev-DO, etc. may be dedicated to long-range wireless communication.

The modular communication hub 203 can serve as a central connection for one or all of the operating room devices 1a-1n/2a-2m and handles data types known as frames. The frames carry data generated by devices 1a-1n/2a-2m. As frames are received by modular communication hub 203, the frames are amplified and transmitted to network router 211, which uses a number of wireless or wired communication standards or protocols described herein to transmit the frames. Transfer this data to cloud computing resources.

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

FIG. 33 shows a computer-implemented interactive surgical system 200. As shown in FIG. Computer-implemented interactive surgical system 200 is similar in many respects to computer-implemented interactive surgical system 100 . For example, computer-implemented interactive surgical system 200 includes one or more surgical systems 202 that are similar in many respects to surgical system 102 . Each surgical system 202 includes at least one surgical hub 206 that communicates with cloud 204 that may include remote servers 213 . In one aspect, the computer-implemented interactive surgical system 200 includes a modular control tower 236 connected to multiple operating room devices such as, for example, intelligent surgical instruments, robots, and other computerized devices located in the operating room. Prepare. As shown in FIG. 34, modular control tower 236 comprises modular communication hub 203 coupled to computer system 210 . As shown in the embodiment of FIG. 33, the modular control tower 236 includes an imaging module 238 coupled to an endoscope 239, a generator module 240 coupled to an energy device 241, a smoke evacuator module 226, an aspiration/ Coupled to irrigation module 228 , communications module 230 , processor module 232 , storage array 234 , smart device/instrument 235 optionally coupled to display 237 , and contactless sensor module 242 . Operating room devices are coupled to cloud computing resources and data storage via modular control towers 236 . Robot hub 222 may also be connected to modular control tower 236 and cloud computing resources. Devices/instruments 235, visualization system 208, among others, may be coupled to modular control tower 236 via wired or wireless communication standards or protocols described herein. Modular control tower 236 may be coupled to hub display 215 (e.g., monitor, screen) for displaying and overlaying images received from imaging modules, device/instrument displays, and/or other visualization systems 208. . The hub display may also display data received from devices connected to the modular control tower along with images and overlay images.

FIG. 34 shows surgical hub 206 with multiple modules coupled to modular control tower 236 . Modular control tower 236 comprises a modular communication hub 203, eg, a networked device, and a computer system 210, eg, for providing local processing, visualization, and imaging. As shown in FIG. 34, modular communication hubs 203 are connected in a hierarchical configuration to expand the number of modules (e.g., devices) that can be connected to modular communication hub 203 to store data associated with the modules. can be transferred to computer system 210, cloud computing resources, or both. As shown in FIG. 34, each of the network hubs/switches within modular communication hub 203 includes three downstream ports and one upstream port. An upstream network hub/switch is connected to the processor to provide communication connections to cloud computing resources and local displays 217 . Communication to cloud 204 can be via either wired or wireless communication channels.

Surgical hub 206 uses non-contact sensor module 242 to measure the dimensions of the operating room, and to generate a map of the surgical site using either ultrasonic or laser-based non-contact measurement devices. "Surgical Hub Spatial Awareness Within an Operating Room," in U.S. Provisional Patent Application No. 62/611,341, filed Dec. 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," the entire disclosure of which is incorporated herein by reference. The ultrasonic-based non-contact sensor module scans the operating room by transmitting bursts of ultrasonic waves and receiving echoes when the bursts of ultrasonic waves reflect off the outer walls of the operating room. and where the sensor module is configured to determine the size of the operating room and adjust the distance limit of the Bluetooth pairing. A laser-based non-contact sensor module, for example, transmits a laser light pulse, receives a laser light pulse that reflects off the outer wall of an operating room, compares the phase of the transmitted pulse with the received pulse, and compares the phase of the operating room. Scan the operating room by determining the size and adjusting the Bluetooth pairing distance limit.

Computer system 210 includes processor 244 and network interface 245 . Processor 244 is coupled to communication module 247, storage 248, memory 249, nonvolatile memory 250, and input/output interface 251 via a system bus. The system bus includes a 9-bit bus, Industry Standard Architecture (ISA), Micro Channel Architecture (MSA), Enhanced ISA (EISA), Intelligent Drive Electronics (IDE), VESA Local Bus (VLB), Peripheral Device Interconnect (PCI), Any, including but not limited to USB, Advanced Graphics Port (AGP), Personal Computer Memory Card International Association Bus (PCMCIA), Small Computer Systems Interface (SCSI), or any other proprietary bus. It may be any of several types of bus structure(s) including a memory bus or memory controller, a peripheral or external bus, and/or a local bus using various bus architectures.

Processor 244 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex manufactured by Texas Instruments. In one aspect, the processor has on-chip memory, e.g., 256 KB of single-cycle flash memory or other non-volatile memory at up to 40 MHz, details of which are available in the product datasheet, to improve performance beyond 40 MHz. a prefetch buffer, 32 KB of single-cycle serial random access memory (SRAM), internal read-only memory (ROM) with StellarisWare® software, 2 KB of electrically erasable programmable read-only memory (EEPROM), and/or One or more pulse width modulation (PWM) modules, one or more quadrature encoder input (QEI) analog, one or more 12-bit analog-to-digital with 12 analog input channels It may be an LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, including a converter (ADC).

In one aspect, the processor 244 may include a safety controller that includes two controller family families, such as the TMS570 and RM4x, also known by the trade designation Hercules ARM Cortex R4, also manufactured by Texas Instruments. Safety controllers may be configured specifically for IEC61508 and ISO26262 safety limit applications to provide advanced integrated safety mechanisms while offering scalable performance, connectivity, and memory options. good.

System memory includes both volatile and non-volatile memory. The basic input/output system (BIOS), containing the basic routines to transfer information between elements within the computer system, such as during start-up, is stored in nonvolatile memory. For example, non-volatile memory may include ROM, programmable ROM (PROM), electrically programmable ROM (EPROM), EEPROM, or flash memory. Volatile memory can include random access memory (RAM), which acts as external cache memory. Further, RAM includes SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), sync link DRAM (SLDRAM), and direct RAM bus RAM (DRRAM). available in many forms.

Computer system 210 also includes removable/non-removable, volatile/non-volatile computer storage media such as disk storage. Disk storage includes, but is not limited to, devices such as magnetic disk drives, floppy disk drives, tape drives, Jaz drives, Zip drives, LS-60 drives, flash memory cards, or memory sticks. In addition, disc storage may refer to a storage medium, either independently or as a compact disc ROM device (CD-ROM), a compact disc recordable drive (CD-R drive), a compact disc rewritable drive (CD-RW drive), Or it may be included in combination with other storage media including, but not limited to, an optical disk drive such as a Digital Versatile Disk ROM Drive (DVD-ROM). A removable or non-removable interface may be used to facilitate connection of the disk storage device to the system bus.

It should be appreciated that computer system 210 includes software that acts as an intermediary between users and basic computer resources as described in the preferred operating environment. Such software includes an operating system. An operating system, which may be stored on disk storage, functions to control and allocate the computer system's resources. System applications take advantage of resource management by the operating system through program modules and program data stored either in system memory or on disk storage. It should be appreciated that the various components described herein can be implemented on various operating systems or combinations of operating systems.

A user enters commands or information into computer system 210 through input device(s) coupled to I/O interface 251 . Input devices include pointing devices such as mice, trackballs, styluses, and touch pads, keyboards, microphones, joysticks, gamepads, satellite dishes, scanners, TV tuner cards, digital cameras, digital video cameras, and webcams. include but are not limited to: These and other input devices connect to the processor through the system bus via interface port(s). Interface port(s) include, for example, serial port, parallel port, game port, and USB. Output device(s) use some of the same types of ports as input device(s). Thus, for example, a USB port may be used to provide input to the computer system and output information from the computer system to an output device. Output adapters are provided to illustrate that there are some output devices such as monitors, displays, speakers, and printers, among other output devices that require special adapters. Output adapters include, by way of example and not limitation, video and sound cards that provide a means of connection between output devices and a system bus. Note that other devices and/or systems of devices, such as remote computer(s), provide both input and output functionality.

Computer system 210 can operate in a networked environment using logical connections to one or more remote or local computers, such as cloud computer(s). The remote cloud computer(s) may be personal computers, servers, routers, network PCs, workstations, microprocessor-based appliances, peer devices, or other general network nodes, etc., and are typically computers Includes many or all of the elements described for the system. For simplicity, only the memory storage device is shown along with the remote computer(s). Remote computer(s) are logically connected to the computer system through a network interface and then physically connected via a communications connection. The network interface encompasses communication networks such as local area networks (LAN) and wide area networks (WAN). LAN technologies include Fiber Distributed Data Interface (FDDI), Copper Distributed Data Interface (CDDI), Ethernet/IEEE 802.3, Token Ring/IEEE 802.5, and the like. WAN technologies include, but are not limited to, point-to-point links, circuit-switched networks such as Integrated Services Digital Networks (ISDN) and variations thereof, packet-switched networks, and Digital Subscriber Lines (DSL).

In various aspects, computer system 210 of FIG. 34, imaging module 238 of FIGS. 9-10, and/or visualization system 208, and/or processor module 232 may be an image processor, an image processing engine, a media processor, or a digital image processor. may include any dedicated digital signal processor (DSP) used to process the Image processors can use parallel computing with single instruction multiple data (SIMD) or multiple instruction multiple data (MIMD) techniques to increase speed and efficiency. A digital image processing engine can perform a variety of tasks. The image processor may be a system on chip with a multi-core processor architecture.

Communication connection(s) refers to hardware/software used to connect a network interface to a bus. Although communication connections are shown internal to the computer system for clarity of illustration, the communication connections may be external to computer system 210 . By way of example only, the hardware/software required to connect to the network interface includes internal and external technologies such as modems, including regular telephone grade modems, cable modems, and DSL modems, ISDN adapters, and Ethernet cards. mentioned.

FIG. 35 illustrates a functional block diagram of one aspect of a USB network hub 300 device, according to one aspect of the present disclosure. In the illustrated embodiment, USB network hub device 300 employs a TUSB2036 integrated circuit hub manufactured by Texas Instruments. The USB network hub 300 is a CMOS device that provides an upstream USB transmit/receive port 302 and up to three downstream USB transmit/receive ports 304, 306, 308 conforming to the USB 2.0 standard. The upstream USB transmit/receive port 302 is a differential root data port that includes a differential data minus (DM0) input paired with a differential data plus (DP0) input. The three downstream USB transmit/receive ports 304, 306, 308 are differential data ports, each port including differential data plus (DP1-DP3) outputs paired with differential data minus (DM1-DM3) outputs.

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

The USB network hub 300 device includes a serial interface engine 310 (SIE). The SIE 310 is the front end of the USB network hub 300 hardware and handles most of the protocols described in Chapter 8 of the USB specification. SIE 310 typically understands signaling down to the transaction level. The functions it handles include packet recognition, transaction reordering, detection/generation of SOP, EOP, RESET, and RESUME signals, clock/data separation, non-return-to-zero inversion (NRZI) data encoding/decoding and bit stuffing; CRC generation and checking (token and data), packet ID (PID) generation and checking/decoding, and/or serial-parallel-parallel-serial conversion may be included. 310 receives a clock input 314 and suspend/resume logic to control communication between the upstream USB transmit/receive port 302 and the downstream USB transmit/receive ports 304 , 306 , 308 via port logic circuits 320 , 322 , 324 . It is coupled to frame timer 316 circuitry and hub repeater circuitry 318 . SIE 310 is coupled to command decoder 326 via interface logic for controlling commands from the serial EEPROM via serial EEPROM interface 330 .

In various aspects, the USB network hub 300 can connect 127 functions organized in up to 6 logical layers (hierarchies) to a single computer. Additionally, the USB network hub 300 can connect to all peripherals using a standardized four wire cable that provides both communication and power distribution. The power configurations are bus power mode and self power mode. USB network hub 300 has four power management capabilities: a bus-powered hub with either individual port power management or ganged port power management, and a self-powered hub with either individual port power management or ganged port power management. It may be configured to support two modes. In one aspect, using a USB cable, USB network hub 300, the upstream USB transmit/receive port 302 plugs into a USB host controller and the downstream USB transmit/receive ports 304, 306, 308 connect USB compatible devices. and so on.

Surgical Instrument Hardware FIG. 36 illustrates a logic diagram of a surgical instrument or tool control system 470, in accordance with one or more aspects of the present disclosure. System 470 includes control circuitry. The control circuitry includes a microcontroller 461 with a processor 462 and memory 468 . For example, one or more of sensors 472 , 474 , 476 provide real-time feedback to processor 462 . A motor 482 driven by a motor driver 492 operatively couples the longitudinally movable displacement member to drive the I-beam knife element. Tracking system 480 is configured to determine the position of the longitudinally moveable displacement member. The positional information is provided to processor 462, which may be programmed or configured to determine the position of the longitudinally movable drive member, as well as the positions of the firing member, firing bar, and I-beam knife elements. Additional motors may be provided in the tool driver interface to control I-beam firing, obturator tube movement, shaft rotation, and articulation. The display 473 displays various operating conditions of the instrument and may include touch screen functionality for data entry. Information displayed on display 473 can be overlaid with images acquired via the endoscopic imaging module.

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

In one aspect, the microcontroller 461 may include a safety controller that includes two controller family families, such as the TMS570 and RM4x, also known by the trade designation Hercules ARM Cortex R4, also manufactured by Texas Instruments. Safety controllers may be configured specifically for IEC61508 and ISO26262 safety limit applications to provide advanced integrated safety mechanisms while offering scalable performance, connectivity, and memory options. good.

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

Microcontroller 461 may be programmed to provide precise control over the velocity and position of the displacement members and articulation system. The microcontroller 461 may be configured to calculate the response within the microcontroller 461 software. The calculated response is compared with the measured response of the actual system to obtain the "observed" response, which is used to determine the actual feedback. The observed response is a well-tuned value that balances the smooth, continuous nature of the simulated response with the measured response, which can detect external influences on the system.

In one aspect, the motor 482 may be controlled by a motor driver 492 and used by the firing system of a surgical instrument or tool. In various forms, motor 482 may be, for example, a brushed DC drive motor having a maximum rotational speed of approximately 25,000 RPM. In alternative configurations, motor 482 may include a brushless motor, cordless motor, synchronous motor, stepper motor, or any other suitable electric motor. Motor driver 492 may comprise, for example, an H-bridge driver including field effect transistors (FETs). Motor 482 may be powered by a power assembly releasably attached to the handle assembly or tool housing to provide control power to the surgical instrument or tool. The power assembly may include a battery that may include multiple battery cells connected in series that may be used as a power source to power a surgical instrument or tool. Under certain circumstances, the battery cells of the power assembly may be replaceable and/or rechargeable. In at least one example, the battery cells may be lithium ion batteries that may be connectable to and separable from the power assembly.

Motor driver 492 may be an A3941 available from Allegro Microsystems, Inc. The A3941 492 is a full-bridge controller for use with external N-channel power metal oxide semiconductor field effect transistors (MOSFETs) specifically designed for inductive loads such as brushed DC motors. Driver 492 includes an inherent charge pump regulator that provides full (>10V) gate drive for battery voltages up to 7V and allows the A3941 to operate with reduced gate drive down to 5.5V. . Bootstrap capacitors may be used to provide the necessary battery supply voltages for the N-channel MOSFETs. An internal charge pump for the high side drive allows DC (100% duty cycle) operation. The full bridge can be driven in fast or slow decay mode using diodes or synchronous rectification. In slow decay mode, current recirculation is possible through either the high-side FETs or the low-side FETs. The power FETs are protected from shoot-through by a resistor adjustable dead time. Integrated diagnostics indicate undervoltage, overtemperature, and power bridge faults and can be configured to protect power MOSFETs under most short circuit conditions. Other motor drivers can be easily substituted for use in tracking system 480 with an absolute positioning system.

Tracking system 480 comprises controlled motor drive circuitry comprising position sensor 472 according to one aspect of the present disclosure. A position sensor 472 for the absolute positioning system provides a unique position signal corresponding to the position of the displacement member. In one aspect, the displacement member represents a longitudinally movable drive member comprising a rack of drive teeth for meshing engagement with a corresponding drive gear of the gear reducer assembly. In other aspects, the displacement member represents a firing member that may be adapted and configured to include a rack of drive teeth. In yet another aspect, the displacement member represents a firing bar or I-beam, each of which may be adapted and configured to include a rack of drive teeth. Accordingly, as used herein, the term displacement member refers to any movable member of a surgical instrument or tool, such as a drive member, firing member, firing bar, I-beam, or any element that can be displaced. used to refer generically to any member. In one aspect, a longitudinally movable drive member is coupled to the firing member, firing bar, and I-beam. Thus, the absolute positioning system can actually track the linear displacement of the I-beam by tracking the linear displacement of the longitudinally movable drive member. In various other aspects, the displacement member may be coupled to any position sensor 472 suitable for measuring linear displacement. Accordingly, a longitudinally movable drive member, firing member, firing bar, or I-beam, or combinations thereof, may be coupled to any suitable linear displacement sensor. Linear displacement sensors may include contact or non-contact displacement sensors. Linear displacement sensors include linear variable differential transformers (LVDTs), differential variable reluctance transducers (DVRTs), sliding potentiometers, movable magnets and a series of linear A magnetic sensing system comprising an arranged Hall effect sensor, a magnetic sensing system comprising a fixed magnet and Hall effect sensors arranged in a series of movable lines, a movable light source and a series of linearly arranged magnetic sensing systems It may comprise an optical detection system comprising a photodiode or photodetector, an optical detection system comprising a fixed light source and a series of movable linearly arranged photodiodes or photodetectors, or any combination thereof. .

The electric motor 482 may include a rotatable shaft that operably interfaces with a gear assembly that is mounted in meshing engagement with a set or rack of drive teeth on the displacement member. The sensor element may be operably coupled to the gear assembly such that one rotation of the position sensor 472 element corresponds to some linear longitudinal translation of the displacement member. The gearing and sensor mechanism can be connected to the linear actuator by a rack and pinion mechanism or to the rotary actuator by spur gears or other connections. A power supply can power the absolute positioning system and an output indicator can display the output of the absolute positioning system. The displacement member represents a longitudinally movable drive member having a rack of drive teeth formed thereon for meshing engagement with a corresponding drive gear of the gear reducer assembly. The displacement member represents a longitudinally movable firing member, firing bar, I-beam, or a combination thereof.

One rotation of the sensor element associated with the position sensor 472 corresponds to a longitudinal linear displacement d1 of the displacement member, which is after one rotation of the sensor element coupled to the displacement member after the displacement member reaches point "a". is the linear longitudinal distance traveled from to point "b". The sensor mechanism may be connected via a gear reduction that results in the position sensor 472 completing one or more revolutions for a full stroke of the displacement member. The position sensor 472 can complete multiple revolutions for a full stroke of the displacement member.

A series of switches (where n is an integer greater than 1) may be used alone or in combination with gear reduction to provide a unique position signal for two or more revolutions of the position sensor 472. may be used in The state of the switch is fed back to the microcontroller 461, which applies logic to determine the longitudinal linear displacement of the displacement member d1+d2+ . . . Determine the unique location signal corresponding to dn. The output of position sensor 472 is provided to microcontroller 461 . The position sensor 472 of the sensor mechanism may comprise a magnetic sensor, an analog rotary sensor such as a potentiometer, or an array of analog Hall effect elements that output a unique combination of position signals or values.

Position sensor 472 may comprise any number of magnetic sensing elements, such as, for example, magnetic sensors classified based on whether they measure the total magnetic field or vector component of the magnetic field. The techniques used to produce both types of magnetic sensors involve many aspects of physics and electronics. Techniques used for sensing magnetic fields include, inter alia, searcher coils, fluxgates, optical pumping, nuclear precession, SQUIDs, Hall effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance. , magnetostrictive/piezoelectric composites, magnetic diodes, magnetic transistors, optical fibers, magneto-optics, and micro-electromechanical systems-based magnetic sensors.

In one aspect, position sensor 472 of tracking system 480 comprising an absolute positioning system comprises a gyromagnetic absolute positioning system. Position sensor 472 may be implemented as an AS5055EQFT single-chip gyromagnetic position sensor available from Austria Microsystems, AG. Position sensor 472 cooperates with microcontroller 461 to provide an absolute positioning system. The position sensor 472 is a low voltage, low power component and includes four Hall effect elements in the area of the position sensor 472 located above the magnets. Additionally, a high resolution ADC and a smart power management controller are provided on-chip. To implement simple and efficient algorithms for computing hyperbolic and trigonometric functions, requiring only addition, subtraction, bit shift, and table lookup operations, digit-by-digit method and boulder A coordinate rotation digital computer (CORDIC) processor, also known as Volder's algorithm, is provided. Angular position, alarm bits, and magnetic field information are transmitted to microcontroller 461 via a standard serial communication interface, such as a serial peripheral interface (SPI) interface. Position sensor 472 provides 12-bit or 14-bit resolution. The position sensor 472 may be an AS5055 chip provided in a small QFN 16-pin 4x4x0.85mm package.

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

The absolute positioning system resets the displacement member, such as might be required with a conventional rotary encoder that simply counts the number of steps forward or backward the motor 482 has taken to estimate the position of a device actuator, drive bar, knife, etc. It provides the absolute position of the displacement member at power up of the instrument without retraction or advancement to the zero (or home) position.

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

In one form, a strain gauge sensor 474 can be used to measure the force exerted on tissue by the end effector. A strain gauge can be coupled to the end effector to measure the force exerted by the end effector on the tissue being treated. A system for measuring the force applied to the tissue grasped by the end effector includes a strain gauge sensor 474, such as a microstrain gauge configured to measure one or more parameters of the end effector. Prepare. In one aspect, the strain gauge sensor 474 can measure the amplitude or magnitude of strain exerted on the jaw members of the end effector during a clamping operation, which can be indicative of tissue compression. The measured strain is converted to a digital signal and provided to processor 462 of microcontroller 461 . Load sensor 476 can measure the force used to operate the knife element, for example, to cut tissue captured between the anvil and the staple cartridge. A magnetic field sensor can be used to measure the thickness of the captured tissue. Magnetic field sensor measurements may also be converted to digital signals and provided to processor 462 .

Measurements of tissue compression, tissue thickness, and/or force required to close the end effector on tissue, as measured by sensors 474, 476, respectively, are determined by the selected position of the firing member, and/or Or it can be used by the microcontroller 461 to characterize the corresponding value of the velocity of the firing member. In one example, memory 468 can store techniques, equations and/or lookup tables that can be used by microcontroller 461 in evaluation.

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

FIG. 37 illustrates a control circuit 500 configured to control aspects of a surgical instrument or tool, according to one aspect of the present disclosure. Control circuit 500 may be configured to implement various processes described herein. Control circuitry 500 may comprise a microcontroller comprising one or more processors 502 (eg, microprocessors, microcontrollers) coupled to at least one memory circuit 504 . Memory circuitry 504 stores machine-executable instructions that, when executed by processor 502, cause processor 502 to execute machine instructions to implement various processes described herein. Processor 502 may be any one of numerous single or multi-core processors known in the art. Memory circuit 504 may include volatile and non-volatile storage media. Processor 502 may include an instruction processing unit 506 and an arithmetic unit 508 . The instruction processing unit may be configured to receive instructions from the memory circuit 504 of the present disclosure.

FIG. 38 illustrates combinatorial logic 510 configured to control aspects of a surgical instrument or tool, according to one aspect of the present disclosure. Combinatorial logic 510 may be configured to implement various processes described herein. Combinatorial logic 510 is a finite state machine including combinatorial logic 512 configured to receive data associated with a surgical instrument or tool at input 514 , process the data through combinatorial logic 512 , and provide output 516 . can include

FIG. 39 illustrates a sequential logic circuit 520 configured to control aspects of a surgical instrument or tool, according to one aspect of the present disclosure. Sequential logic 520 or combinatorial logic 522 may be configured to implement various processes described herein. Sequential logic 520 may include a finite state machine. Sequential logic 520 may include, for example, combinatorial logic 522 , at least one memory circuit 524 , and clock 529 . At least one memory circuit 524 can store the current state of the finite state machine. In particular examples, sequential logic 520 may be synchronous or asynchronous. Combinatorial logic 522 is configured to receive data associated with a surgical instrument or tool from input 526 , process the data by combinatorial logic 522 , and provide output 528 . In other aspects, a circuit may include a combination of a processor (eg, processor 502 of FIG. 37) and a finite state machine implementing various processes herein. In other aspects, the finite state machine may include a combination of combinatorial logic (eg, combinatorial logic 510 of FIG. 38) and sequential logic 520 .

FIG. 40 shows a surgical instrument or tool with multiple motors that can be activated to perform various functions. In certain examples, a first motor can be activated to perform a first function, a second motor can be activated to perform a second function, and a third motor can be activated. A third motor can be activated to perform a third function, a fourth motor can be activated to perform a fourth function, and so on. In certain examples, multiple motors of robotic surgical instrument 600 can be individually activated to produce firing motion, closing motion, and/or articulation motion at 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, a surgical instrument system or tool may include firing motor 602 . Firing motor 602 is operably coupled to firing motor drive assembly 604, which can be configured to transmit firing motion generated by motor 602 to the end effector, specifically to displace the I-beam elements. may In certain examples, the firing motion generated by motor 602, for example, deploys staples from a staple cartridge into tissue captured by an end effector and/or advances a cutting edge of an I-beam element for capturing. The tissue that has been cut may be cut. The I-beam elements can be retracted by reversing the direction of motor 602 .

In certain examples, a surgical instrument or tool may include a closure motor 603. Closure motor 603 is configured to transmit the closing motion generated by motor 603 to the end effector to specifically displace the closure tube to close the anvil and compress tissue between the anvil and staple cartridge. It may be operatively connected with a closure motor drive assembly 605, which may be configured. The closing motion can cause the end effector to transition from an open configuration to an approximated configuration to capture tissue, for example. The end effector can be transitioned to the open position by reversing the direction of motor 603 .

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

As noted above, a surgical instrument or tool may include multiple motors that may be configured to perform various independent functions. In certain examples, multiple motors of a surgical instrument or tool are activated independently or separately to perform one or more functions while other motors remain deactivated. can be implemented. For example, articulation motors 606a, 606b can be activated to articulate the end effector while firing motor 602 remains stopped. Alternatively, firing motor 602 can be activated to fire multiple staples and/or advance the cutting edge while articulation motor 606 is deactivated. Additionally, closure motor 603 may be activated simultaneously with firing motor 602 to distally advance the closure tube and I-beam elements, as described in more detail herein below.

In certain examples, a surgical instrument or tool may include a common control module 610 that can be used with multiple motors of the surgical instrument or tool. In certain examples, a common control module 610 can serve one of multiple motors at a time. For example, a common control module 610 may be individually connectable and disconnectable to multiple motors of the robotic surgical instrument. In certain examples, multiple motors of a surgical instrument or tool may share one or more common control modules, such as common control module 610 . In certain examples, multiple motors of a surgical instrument or tool can independently and selectively engage a common control module 610 . In certain examples, the common control module 610 is configured to selectively communicate with one of the motors of the surgical instrument or tool to the other of the motors of the surgical instrument or tool. You can switch.

In at least one example, common control module 610 selects between operable engagement with articulation motors 606a, 606b and operable engagement with either firing motor 602 or closing motor 603. can be switched. In at least one embodiment, as shown in FIG. 40, switch 614 can move or transition between multiple positions and/or states. For example, in a first position 616 the switch 614 may electrically couple the common control module 610 with the firing motor 602, and in a second position 617 the switch 614 may close the common control module 610. In a third position 618a the switch 614 may electrically couple the common control module 610 with the first articulation motor 606a and in a fourth position the switch 614 may be in electrical communication with the motor 603. At 618b, a switch 614 may electrically couple the common control module 610 with the second articulation motor 606b. In certain examples, a separate common control module 610 may be electrically coupled to firing motor 602, closing motor 603, and articulation motors 606a, 606b at the same time. In particular examples, switch 614 may be a mechanical switch, an electromechanical switch, a solid state switch, or any suitable switching mechanism.

Each of the motors 602, 603, 606a, 606b may 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, as shown in FIG. 40, common control module 610 may include motor driver 626, which may include one or more H-bridge FETs. Motor drivers 626 may modulate power transferred from power supply 628 to motors coupled to common control module 610 based on, for example, input from microcontroller 620 (“controller”). In a particular example, as described above, the current drawn by the motors can be determined using, for example, the microcontroller 620 while the motors are coupled to the common control module 610 .

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

In particular examples, power supply 628 may be used to power microcontroller 620, for example. In certain examples, power source 628 may include a battery (or “battery pack” or “power pack”), such as a lithium-ion battery. In certain examples, the battery pack may be configured to be releasably attached to the handle to power surgical instrument 600 . Multiple battery cells connected in series may be used as power source 628 . In certain examples, power source 628 may be replaceable and/or rechargeable, for example.

In various examples, processor 622 can control motor drivers 626 to control the position, direction of rotation, and/or speed of motors coupled to common control module 610 . In certain examples, processor 622 may signal motor drivers 626 to stop and/or disable motors coupled to common control module 610 . The term "processor," as used herein, means any suitable microprocessor, microcontroller, or computer central processing device (CPU) function integrated into one integrated circuit or up to several integrated circuits. It should be understood to include other basic computing devices integrated above. A processor is a 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 622 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex manufactured 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 or other non-volatile memory on-chip memory up to 40 MHz, 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 containing one or more 12-bit ADCs with 12 analog input channels. Other microcontrollers may be readily substituted for use with module 4410 . Accordingly, the present disclosure should not be limited in this context.

In particular examples, memory 624 may contain program instructions for controlling each of the motors of surgical instrument 600 coupleable to a common control module 610 . For example, memory 624 may contain program instructions for controlling firing motor 602, closing motor 603, and articulation motors 606a, 606b. Such program instructions may cause processor 622 to control the firing, closing, and articulating functions according to inputs from an algorithm or control program of the surgical instrument or tool.

In particular examples, one or more mechanisms and/or sensors, such as sensor 630, may be used to alert processor 622 of program instructions to use in a particular setting. For example, sensor 630 can alert processor 622 to use program instructions related to end effector firing, closing, and articulation. In particular examples, sensor 630 may comprise a position sensor that may be used to sense the position of switch 614, for example. Thus, when processor 622 detects, for example, via sensor 630 that switch 614 is in first position 616, processor 622 can use program instructions associated with firing the end effector I-beam, causing processor 622 to can use program instructions associated with closing the anvil upon detecting, for example, via sensor 630 that switch 614 is in second position 617, processor 622, for example, via sensor 630, Upon detecting that the switch 614 is in the third position 618a or the fourth position 618b, program instructions associated with end effector articulation can be used.

FIG. 41 is a schematic illustration of a robotic surgical instrument 700 configured to manipulate the surgical tools described herein, according to one aspect of the present disclosure. Robotic surgical instrument 700 uses either single or multiple articulation drive connections to perform distal/proximal translation of the displacement member, distal/proximal displacement of the obturator tube, rotation of the shaft, and articulation. It may be programmed or configured to control movement. In one aspect, surgical instrument 700 may be programmed or configured to individually control the firing member, closure member, shaft member, or one or more articulation members. Surgical instrument 700 includes a control circuit 710 configured to control a motorized firing member, closure member, shaft member, or one or more articulation members.

In one aspect, the robotic surgical instrument 700, via a plurality of motors 704a-704e, controls the anvil 716 and I-beam 714 (including sharp cutting edges) portions of the end effector 702, removable staple cartridge 718, shaft 740, and a control circuit 710 configured to control one or more articulation members 742a, 742b. Position sensor 734 may be configured to provide position feedback of I-beam 714 to control circuit 710 . Other sensors 738 may be configured to provide feedback to control circuit 710 . Timer/counter 731 provides timing and counting information to control circuit 710 . An energy source 712 may be provided to operate the motors 704 a - 704 e , and a current sensor 736 provides motor current feedback to the control circuit 710 . Motors 704a-704e can be individually operated by control circuit 710 in open-loop or closed-loop feedback control.

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

In one aspect, control circuit 710 may be programmed to control the function of end effector 702 based on one or more tissue conditions. Control circuitry 710 may be programmed to sense tissue conditions, such as thickness, either directly or indirectly, as described herein. Control circuit 710 may be programmed to select a firing control program or a closing control program based on tissue condition. A firing control program can describe the distal movement of the displacement member. Different firing control programs can be selected to better treat different tissue conditions. For example, if thicker tissue is present, control circuitry 710 may be programmed to translate the displacement member at a slower speed and/or with less power. If thinner tissue is present, the control circuit 710 may be programmed to translate the displacement member at a higher speed and/or with a higher power. A closure control program may control the closure force applied to tissue by anvil 716 . Another control program controls the rotation of shaft 740 and articulation members 742a, 742b.

In one aspect, the control circuit 710 can generate a motor setpoint signal. Motor setpoint signals may be provided to various motor controllers 708a-708e. The motor controllers 708a-708e comprise one or more circuits configured to provide motor drive signals to the motors 704a-704e to drive the motors 704a-704e, as described herein. may In some embodiments, motors 704a-704e may be brushed DC electric motors. For example, the speed of motors 704a-704e may be proportional to their respective motor drive signals. In some embodiments, the motors 704a-704e may be brushless DC electric motors, with respective motor drive signals provided to one or more stator windings of the motors 704a-704e using PWM may include a signal. Also, in some embodiments, the motor controllers 708a-708e may be omitted and the control circuit 710 may directly generate the motor drive signals.

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

In one aspect, the motors 704a-704e may receive power from the energy source 712. Energy source 712 may be a DC power source powered by mains AC power, batteries, supercapacitors, or any other suitable energy source. Motors 704a-704e are mechanically coupled to respective movable mechanical elements such as I-beam 714, anvil 716, shaft 740, articulation 742a, and articulation 742b via respective transmissions 706a-706e. may be The transmissions 706a-706e may include one or more gears or other coupling components for coupling the motors 704a-704e to the movable mechanical elements. Position sensor 734 may sense the position of I-beam 714 . Position sensor 734 may be or include any type of sensor capable of generating position data indicative of the position of I-beam 714 . In some embodiments, position sensor 734 may include an encoder configured to provide a series of pulses to control circuit 710 as I-beam 714 translates distally and proximally. Control circuit 710 may track the pulses to determine the position of I-beam 714 . Other suitable position sensors may be used including, for example, proximity sensors. Other types of position sensors can provide other signals indicative of I-beam 714 movement. Also, in some embodiments, position sensor 734 may be omitted. If any of motors 704a-704e are stepper motors, control circuit 710 can track the position of I-beam 714 by summing the number and direction of steps motors 704 are instructed to perform. can. The position sensor 734 can be located within the end effector 702 or any other portion of the instrument. Each output of the motors 704a-704e includes a torque sensor 744a-744e for sensing force and has an encoder for sensing rotation of the drive shaft.

In one aspect, control circuitry 710 is configured to drive a firing member, such as the I-beam 714 portion of end effector 702 . Control circuit 710 provides motor settings to motor control 708a, and motor control 708a provides drive signals to motor 704a. The output shaft of motor 704a is coupled to torque sensor 744a. Torque sensor 744 a is coupled to transmission 706 a which is coupled to I-beam 714 . Transmission device 706a includes moveable mechanical elements such as rotating and firing members for controlling the distal and proximal movement of I-beam 714 along the longitudinal axis of end effector 702 . In one aspect, motor 704a may be coupled to a knife gear assembly that includes a knife gear reduction set that includes a first knife drive gear and a second knife drive gear. Torque sensor 744 a provides a firing force feedback signal to control circuit 710 . The firing force signal represents the force required to fire or displace I-beam 714 . Position sensor 734 may be configured to provide the position of I-beam 714 or the position of the firing member along the firing stroke as a feedback signal to control circuit 710 . End effector 702 may include additional sensors 738 configured to provide feedback signals to control circuitry 710 . When ready for use, control circuit 710 can provide a fire signal to motor control 708a. In response to the firing signal, motor 704a drives the firing member distally along the longitudinal axis of end effector 702 from a proximal stroke start position to a stroke end position distal to the stroke start position. be able to. As the firing member translates distally, I-beam 714 , which has a cutting element positioned at its distal end, advances distally to cut tissue located between staple cartridge 718 and anvil 716 .

In one aspect, control circuit 710 is configured to drive a closure member, such as anvil 716 portion of end effector 702 . Control circuit 710 provides motor setpoints to motor control 708b, which provides drive signals to motor 704b. The output shaft of motor 704b is coupled to torque sensor 744b. Torque sensor 744b is coupled to transmission device 706b which is coupled to anvil 716 . Transmission device 706b includes moveable mechanical elements such as rotating elements and closing members for controlling movement of anvil 716 from open and closed positions. In one aspect, the motor 704b is coupled to a closure gear assembly that includes a closure reduction gear set supported in meshing engagement with a closure spur gear. Torque sensor 744 b provides a closing force feedback signal to control circuit 710 . The closing force feedback signal represents the closing force applied to anvil 716 . Position sensor 734 may be configured to provide the position of the closure member as a feedback signal to control circuit 710 . An additional sensor 738 in end effector 702 can provide a closure force feedback signal to control circuit 710 . A pivotable anvil 716 is positioned opposite staple cartridge 718 . When ready for use, control circuit 710 can provide a close signal to motor control 708b. In response to the closure signal, motor 704 b advances closure member to grasp tissue between anvil 716 and staple cartridge 718 .

In one aspect, control circuit 710 is configured to rotate a shaft member, such as shaft 740 , to rotate end effector 702 . Control circuit 710 provides motor setpoints to motor control 708c, which provides drive signals to motor 704c. The output shaft of motor 704c is coupled to torque sensor 744c. Torque sensor 744 c is coupled to transmission 706 c which is coupled to shaft 740 . Transmission device 706c comprises a moveable mechanical element, such as a rotating element, to control clockwise or counterclockwise rotation of shaft 740 up to 360 degrees and beyond. In one aspect, the motor 704c was formed on (or attached to) the proximal end of the proximal closure tube to be operably engaged by a rotating gear assembly operably supported on the tool mounting plate. attached) to a rotary transmission assembly including a tubular gear segment. Torque sensor 744 c provides a rotational force feedback signal to control circuit 710 . The rotational force feedback signal is representative of the rotational force applied to shaft 740 . Position sensor 734 may be configured to provide the position of the closure member as a feedback signal to control circuit 710 . Additional sensors 738 , such as shaft encoders, may provide the rotational position of shaft 740 to control circuit 710 .

In one aspect, control circuit 710 is configured to articulate end effector 702 . Control circuit 710 provides motor setpoints to motor control 708d, which provides drive signals to motor 704d. The output shaft of motor 704d is coupled to torque sensor 744d. Torque sensor 744d is coupled to transmission 706d that is coupled to articulation member 742a. Transmission device 706d comprises a moveable mechanical element, such as an articulation element for controlling ±65° articulation of end effector 702 . In one aspect, the motor 704d is coupled to an articulation nut that is rotatably journalled on the proximal end portion of the distal spine portion and articulated on the proximal end portion of the distal spine portion. It is rotatably driven by a motion gear assembly. Torque sensor 744 d provides an articulation force feedback signal to control circuit 710 . The articulation force feedback signal represents the articulation force applied to the end effector 702 . A sensor 738 , such as an articulation encoder, may provide the articulation position of end effector 702 to control circuit 710 .

In another aspect, the articulation features of the robotic surgical system 700 may include two articulation members or connections 742a, 742b. These articulation members 742a, 742b are driven by separate discs on a robot interface (rack) driven by two motors 708d, 708e. When separate firing motors 704a are provided, to provide resistive holding motion and load to the head when the head is not moving, and to provide articulation when the head is articulating: Each of the articulation links 742a, 742b can be driven antagonistically with respect to the other link. Articulation members 742a, 742b are attached to the head at a fixed radius as the head rotates. Therefore, as the head rotates, the mechanical efficiency of the push-pull connection changes. This change in mechanical efficiency may be more pronounced in other articulating joint drive systems.

In one aspect, one or more of the motors 704a-704e may comprise brushed DC motors with gearboxes and mechanical connections to the firing, closing, or articulating members. Another example includes electric motors 704a-704e that operate movable mechanical elements such as displacement members, articulation connections, closed tubes, and shafts. External influences are unmeasured and unpredictable influences such as friction on tissues, surroundings, and physical systems. Such an external influence is sometimes referred to as a drag acting against one of the electric motors 704a-704e. External influences, such as disturbances, can cause the behavior of a physical system to deviate from the desired behavior of the physical system.

In one aspect, position sensor 734 may be implemented as an absolute positioning system. In one aspect, the position sensor 734 may comprise a gyromagnetic absolute positioning system implemented as an AS5055EQFT single-chip gyromagnetic position sensor available from Austria Microsystems, AG. A position sensor 734 may cooperate with the control circuit 710 to provide an absolute positioning system. The position is located above the magnet and provided to implement simple and efficient algorithms for computing hyperbolic and trigonometric functions, requiring only addition, subtraction, bit-shifting, and table lookup operations. It may include multiple Hall effect elements coupled to the CORDIC processor, also known as the digit-by-digit method and the Boulder algorithm.

In one aspect, control circuitry 710 may communicate with one or more sensors 738 . Sensors 738 are positioned on end effector 702 and adapted to operate with robotic surgical instrument 700 to measure various derived parameters such as gap distance vs. time, tissue compression vs. time, and anvil strain vs. time. may Sensors 738 may be magnetic sensors, magnetic field sensors, strain gauges, load cells, pressure sensors, force sensors, torque sensors, inductive sensors such as eddy current sensors, resistive sensors, capacitive sensors, optical sensors, and/or one of end effector 702. or any other suitable sensor for measuring two or more parameters. Sensor 738 may include one or more sensors. A sensor 738 may be located on the deck of the staple cartridge 718 for determining tissue location using segmented electrodes. Torque sensors 744a-744e may be configured to sense forces such as firing forces, closing forces, and/or articulation forces, among others. Thus, the control circuit 710 determines (1) the closure load experienced by the distal obturator tube and its position, (2) the firing member in the rack and its position, and (3) which portion of the staple cartridge 718 has tissue thereon. and (4) can sense load and position on both articulation rods.

In one aspect, the one or more sensors 738 may comprise strain gauges, such as micro strain gauges, configured to measure the amount of strain in the anvil 716 during gripping conditions. A strain gauge provides an electrical signal whose amplitude varies with the amount of strain. Sensor 738 may comprise a pressure sensor configured to detect pressure generated by the presence of compressed tissue between anvil 716 and staple cartridge 718 . Sensor 738 may be configured to detect the impedance of a portion of tissue located between anvil 716 and staple cartridge 718, which may indicate the thickness and/or fullness of tissue located therebetween. indicate.

In one aspect, sensor 738 is implemented as one or more limit switches, electromechanical devices, solid state switches, Hall effect devices, magnetoresistive (MR) devices, giant magnetoresistive (GMR) devices, magnetometers, among others. may be In other implementations, sensor 738 may be implemented as a solid-state switch that operates under the influence of light, such as an optical sensor, an IR sensor, an ultraviolet sensor, among others. Additionally, the switch may be a solid state device such as a transistor (eg, FET, junction FET, MOSFET, bipolar, etc.). In other implementations, sensors 738 may include conductorless switches, ultrasonic switches, accelerometers, and inertial sensors, among others.

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

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

FIG. 42 shows a block diagram of a surgical instrument 750 programmed to control distal translation of a displacement member, according to one aspect of the present disclosure. In one aspect, surgical instrument 750 is programmed to control distal translation of a displacement member such as I-beam 764 . Surgical instrument 750 includes an anvil 766 , an I-beam 764 (including sharp cutting edges), and an end effector 752 that may include a removable staple cartridge 768 .

The position, movement, displacement and/or translation of a linear displacement member such as I-beam 764 can be measured by absolute positioning system, sensor mechanism and position sensor 784 . Since I-beam 764 is coupled to a longitudinally movable drive member, the position of I-beam 764 can be determined by measuring the position of the longitudinally movable drive member using position sensor 784 . can. Accordingly, in the discussion below, position, displacement, and/or translation of I-beam 764 may be accomplished by position sensor 784 as described herein. Control circuitry 760 may be programmed to control translation of a displacement member such as I-beam 764 . In some embodiments, the control circuit 760 commands one or more microcontrollers, microprocessors, or processors or processors to control the displacement member, e.g., I-beam 764, in the manner described. Other suitable processors may be provided for execution. In one aspect, timer/counter 781 provides an output signal, such as elapsed time or a digital count, to control circuit 760 to correlate the position of I-beam 764 as determined by position sensor 784 with the output of timer/counter 781. , so that control circuit 760 can determine the position of I-beam 764 at a particular time (t) relative to the starting position. Timer/counter 781 may be configured to measure elapsed time, count external events, or time external events.

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

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

Control circuitry 760 may communicate with one or more sensors 788 . A sensor 788 may be positioned on the end effector 752 and adapted to work with the surgical instrument 750 to measure various derived parameters such as gap distance vs. time, tissue compression vs. time, and anvil strain vs. time. . Sensor 788 may include one or more of magnetic sensors, magnetic field sensors, strain gauges, pressure sensors, force sensors, inductive sensors such as eddy current sensors, resistive sensors, capacitive sensors, optical sensors, and/or end effector 752 . Any other suitable sensor for measuring parameters may be provided. Sensor 788 may include one or more sensors.

The one or more sensors 788 may comprise strain gauges, such as micro strain gauges, configured to measure the amount of strain in the anvil 766 during clamping conditions. A strain gauge provides an electrical signal whose amplitude varies with the amount of strain. Sensor 788 may comprise a pressure sensor configured to detect pressure generated by the presence of compressed tissue between anvil 766 and staple cartridge 768 . Sensor 788 may be configured to detect the impedance of a portion of tissue located between anvil 766 and staple cartridge 768, which may indicate the thickness and/or fullness of tissue located therebetween. indicate.

Sensor 788 may be configured to measure the force exerted on anvil 766 by the closing drive system. For example, one or more sensors 788 may be located at the point of interaction between the closure tube and the anvil 766 to detect the closure force applied to the anvil 766 by the closure tube. The force exerted against anvil 766 may be representative of tissue compression experienced by tissue portions captured between anvil 766 and staple cartridge 768 . One or more sensors 788 may be positioned at various interaction points along the closure drive system to detect the closing force applied to anvil 766 by the closure drive system. One or more sensors 788 may be sampled in real-time during clamping operations by the processor of control circuit 760 . The control circuit 760 receives real-time sample measurements to provide and analyze time-based information to evaluate the closing force applied to the anvil 766 in real-time.

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

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

The actual drive system of surgical instrument 750 is such that the displacement member, cutting member, or I-beam 764 is driven by a gearbox and brushed DC motor with mechanical linkage to the articulation and/or knife system. It is configured. Another example is an electric motor 754 that operates an interchangeable shaft assembly, such as a displacement member and an articulation driver. External influences are unmeasured and unpredictable influences such as friction on tissues, surroundings, and physical systems. Such external influences are sometimes referred to as disturbances that act against the electric motor 754 . External influences, such as disturbances, can cause the behavior of a physical system to deviate from the desired behavior of the physical system.

Various exemplary aspects are directed to a surgical instrument 750 that includes an end effector 752 having a motorized surgical stapling and cutting instrument. For example, motor 754 may drive displacement members distally and proximally along the longitudinal axis of end effector 752 . The end effector 752 may comprise a pivotable anvil 766 and a staple cartridge 768 positioned opposite the anvil 766 when configured for use. A clinician may grasp tissue between anvil 766 and staple cartridge 768 as described herein. When instrument 750 is ready for use, the clinician may provide a firing signal, for example, by pressing the trigger of instrument 750 . In response to the firing signal, motor 754 drives the displacement member distally along the longitudinal axis of end effector 752 from a proximal stroke start position to a stroke end position distal to the stroke start position. can be done. As the displacement member is translated distally, an I-beam 764 having a cutting element positioned at its distal end can cut tissue between staple cartridge 768 and anvil 766 .

In various embodiments, surgical instrument 750 has control circuitry 760 programmed to control distal translation of a displacement member, eg, I-beam 764, based on one or more tissue conditions. You may prepare. Control circuitry 760 may be programmed to sense tissue conditions, such as thickness, either directly or indirectly, as described herein. Control circuit 760 may be programmed to select a firing control program based on tissue condition. A firing control program can describe the distal movement of the displacement member. Different firing control programs can be selected to better treat different tissue conditions. For example, if thicker tissue is present, control circuitry 760 may be programmed to translate the displacement member at a slower speed and/or with less power. If thinner tissue is present, the control circuit 760 may be programmed to translate the displacement member at a higher speed and/or with a higher power.

In some embodiments, control circuit 760 may initially operate motor 754 in an open loop configuration for a first open loop portion of the stroke of the displacement member. Based on the response of instrument 750 during the open-loop portion of the stroke, control circuit 760 may select a firing control program. The response of the instrument includes the translational distance of the displacement member during the open loop portion, the time elapsed during the open loop portion, the energy provided to the motor 754 during the open loop portion, and the total pulse width of the motor drive signal. etc. can be mentioned. After the open loop portion, control circuit 760 may implement the selected firing control program for the second portion of the displacement member stroke. For example, during the closed-loop portion of the stroke, control circuit 760 may closed-loop modulate motor 754 based on translation data describing the position of the displacement member to translate the displacement member at a constant velocity. Further details can be found in U.S. patent application Ser. disclosed in

FIG. 43 is a schematic illustration of a surgical instrument 790 configured to control various functions, according to one aspect of the present disclosure. In one aspect, surgical instrument 790 is programmed to control distal translation of a displacement member such as I-beam 764 . Surgical instrument 790 includes an end effector 792 that can include an anvil 766, an I-beam 764, and a removable staple cartridge 768 that can be replaced with an RF cartridge 796 (shown in dashed lines).

In one aspect, sensor 788 may be implemented as a limit switch, electromechanical device, solid state switch, Hall effect device, MR device, GMR device, magnetometer, among others. In other implementations, sensor 638 may be a solid state switch that operates under the influence of light, such as a light sensor, IR sensor, UV sensor, among others. Additionally, the switch may be a solid state device such as a transistor (eg, FET, junction FET, MOSFET, bipolar, etc.). In other implementations, sensors 788 may include conductorless switches, ultrasonic switches, accelerometers, and inertial sensors, among others.

In one aspect, the position sensor 784 may be implemented as an absolute positioning system comprising a gyromagnetic absolute positioning system implemented as an AS5055EQFT single-chip gyromagnetic position sensor available from Austria Microsystems, AG. Position sensor 784 may cooperate with control circuitry 760 to provide an absolute positioning system. The position is located above the magnet and provided to implement simple and efficient algorithms for computing hyperbolic and trigonometric functions, requiring only addition, subtraction, bit-shifting, and table lookup operations. It may include multiple Hall effect elements coupled to the CORDIC processor, also known as the digit-by-digit method and the Boulder algorithm.

In one aspect, the I-beam 764 may be implemented as a knife member comprising a knife body operably supporting a tissue cutting blade thereon and having an anvil engaging tab or feature and a channel engaging feature or foot. may further include: In one aspect, staple cartridge 768 may be implemented as a standard (mechanical) surgical fastener cartridge. In one aspect, RF cartridge 796 may be implemented as an RF cartridge. These, and other sensor mechanisms, are part of the same application filed June 20, 2017, entitled "TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT," which is hereby incorporated by reference in its entirety. It is described in US patent application Ser. No. 15/628,175.

The position, movement, displacement, and/or translation of a linear displacement member such as I-beam 764 can be measured by an absolute positioning system, sensor mechanism, and position sensor represented as position sensor 784 . Since I-beam 764 is coupled to a longitudinally movable drive member, the position of I-beam 764 can be determined by measuring the position of the longitudinally movable drive member using position sensor 784 . can. Accordingly, in the discussion below, position, displacement, and/or translation of I-beam 764 may be accomplished by position sensor 784 as described herein. Control circuitry 760 may be programmed to control translation of a displacement member, such as closure member 764, as described herein. In some embodiments, the control circuit 760 commands one or more microcontrollers, microprocessors, or processors or processors to control the displacement member, e.g., I-beam 764, in the manner described. Other suitable processors may be provided for execution. In one aspect, timer/counter 781 provides an output signal, such as elapsed time or a digital count, to control circuit 760 to correlate the position of I-beam 764 as determined by position sensor 784 with the output of timer/counter 781. , so that control circuit 760 can determine the position of I-beam 764 at a particular time (t) relative to the starting position. Timer/counter 781 may be configured to measure elapsed time, count external events, or time external events.

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

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

Control circuitry 760 may communicate with one or more sensors 788 . A sensor 788 may be positioned on the end effector 792 and adapted to work with the surgical instrument 790 to measure various derived parameters such as gap distance vs. time, tissue compression vs. time, and anvil strain vs. time. . Sensors 788 may include one or more of magnetic sensors, magnetic field sensors, strain gauges, pressure sensors, force sensors, inductive sensors such as eddy current sensors, resistive sensors, capacitive sensors, optical sensors, and/or end effectors 792 . Any other suitable sensor for measuring parameters may be provided. Sensor 788 may include one or more sensors.

The one or more sensors 788 may comprise strain gauges, such as micro strain gauges, configured to measure the amount of strain in the anvil 766 during clamping conditions. A strain gauge provides an electrical signal whose amplitude varies with the amount of strain. Sensor 788 may comprise a pressure sensor configured to detect pressure generated by the presence of compressed tissue between anvil 766 and staple cartridge 768 . Sensor 788 may be configured to detect the impedance of a portion of tissue located between anvil 766 and staple cartridge 768, which may indicate the thickness and/or fullness of tissue located therebetween. indicates

Sensor 788 may be configured to measure the force exerted on anvil 766 by the closing drive system. For example, one or more sensors 788 may be located at the point of interaction between the closure tube and the anvil 766 to detect the closure force applied to the anvil 766 by the closure tube. The force exerted against anvil 766 may be representative of tissue compression experienced by tissue portions captured between anvil 766 and staple cartridge 768 . One or more sensors 788 may be positioned at various interaction points along the closure drive system to detect the closing force applied to anvil 766 by the closure drive system. One or more sensors 788 may be sampled in real-time during clamping operations by the processor portion of control circuit 760 . The control circuit 760 receives real-time sample measurements to provide and analyze time-based information to evaluate the closing force applied to the clamp arm 766 in real-time.

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

RF energy source 794 is coupled to end effector 792 and applied to RF cartridge 796 when RF cartridge 796 is loaded into end effector 792 in place of staple cartridge 768 . Control circuitry 760 controls the delivery of RF energy to RF cartridge 796 .

Further details can be found in U.S. Patent Application No. 15, entitled "SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME," filed June 28, 2017, which is incorporated herein by reference in its entirety. /636,096.

Generator Hardware FIG. 44 is a simplified block diagram of a generator 800 configured to provide, among other advantages, inductor tuning. Additional details of generator 800 are provided in US Pat. 775. Generator 800 may comprise patient isolation stage 802 communicating with non-isolation stage 804 via power transformer 806 . A secondary winding 808 of the power transformer 806 is housed within the isolation stage 802 and is used for multiple applications including, for example, ultrasonic surgical instruments, RF electrosurgical instruments, and ultrasonic and RF energy modes that can be delivered singly or simultaneously. Tap configurations (eg, center-tap or non-center-tap configurations) may be provided to define drive signal outputs 810a, 810b, 810C for delivering drive signals to different surgical instruments, such as functional surgical instruments. Specifically, the drive signal outputs 810a, 810C may output an ultrasonic drive signal (eg, a root-mean-square (RMS) drive signal of 420V) to the ultrasonic surgical instrument. , drive signal outputs 810b, 810C output RF electrosurgical drive signals (eg, 100V RMS drive signals) to the RF electrosurgical instrument with drive output 810b corresponding to the center tap of power transformer 806. may

In certain forms, ultrasonic and electrosurgical drive signals are provided to separate surgical instruments, and/or multi-function surgical instruments, etc. that have the ability to deliver both ultrasonic and electrosurgical energy to tissue. may be provided simultaneously on a single surgical instrument. Electrosurgical signals provided to either dedicated electrosurgical instruments and/or combined multifunction ultrasound/electrosurgical instruments are either therapeutic or sub-therapeutic level signals and It will be appreciated that subquantitative signals can be used, for example, to monitor tissue or instrument conditions and provide feedback to the generator. For example, ultrasound and RF signals can be delivered separately or simultaneously from a generator having a single output port to provide the desired output signal to the surgical instrument, as discussed in more detail below. . Thus, the generator can combine ultrasonic energy and electrosurgical RF energy to deliver combined energy to a multi-function ultrasonic/electrosurgical instrument. Bipolar electrodes can be placed on one or both jaws of the end effector. One jaw may be driven by ultrasonic energy in addition to electrosurgical RF energy, acting simultaneously. Electrosurgical RF energy may be used for vessel sealing, while ultrasonic energy may be used to dissect tissue.

Non-isolated stage 804 may comprise a power amplifier 812 having an output connected to a primary winding 814 of power transformer 806 . In one particular form, power amplifier 812 may comprise a push-pull amplifier. For example, the non-isolating stage 804 provides logic for providing a digital output to a digital-to-analog converter (DAC) circuit 818 that subsequently provides a corresponding analog signal to the input of power amplifier 812. A device 816 may also be included. In particular forms, logic device 816 may comprise, for example, a programmable gate array (PGA), an FPGA, a programmable logic device (PLD), among other logic circuits. Therefore, the logic device 816 controls many parameters (e.g., frequency, waveform, waveform) of the drive signals appearing at the drive signal outputs 810a, 810b, 810C by controlling the input of the power amplifier 812 via the DAC circuit 818. amplitude) can be controlled. In particular forms, and as described below, logic device 816 implements a number of DSP-based and/or other control algorithms in conjunction with a processor (e.g., a DSP described below) to Parameters of the drive signal output by 800 can be controlled.

Power may be supplied to the power rail of power amplifier 812 by a switch mode regulator 820, such as a power converter. In one particular form, switch mode regulator 820 may comprise, for example, an adjustable buck regulator. The non-isolated stage 804 may further comprise a first processor 822, which in one form may be, for example, an Analog Devices ADSP-21469 SHARC DSP available from Analog Devices (Norwood, Mass.). DSP processor, but in various aspects any suitable processor may be used. In particular forms, DSP processor 822 may control operation of switch-mode regulator 820 in response to voltage feedback data that DSP processor 822 receives via ADC circuitry 824 from power amplifier 812 . In one form, for example, DSP processor 822 may receive as an input via ADC circuitry 824 a waveform envelope of a signal (eg, an RF signal) amplified by power amplifier 812 . DSP processor 822 may then control switch-mode regulator 820 (eg, PWM output) such that the rail voltage supplied to power amplifier 812 tracks the waveform envelope of the amplified signal. By dynamically modulating the rail voltage of power amplifier 812 based on the waveform envelope, the efficiency of power amplifier 812 can be significantly improved over fixed rail voltage amplifier schemes.

In particular forms, logic device 816 implements a digital synthesis circuit, such as a direct digital synthesizer control scheme, in conjunction with DSP processor 822 to control the waveform shape, frequency and/or amplitude of the drive signal output by generator 800. You may In one form, for example, logic device 816 implements DDS control by calling waveform samples stored in a dynamically updated lookup table (LUT), such as a RAM LUT that may be embedded within an FPGA. Algorithms may be implemented. This control algorithm is particularly useful in ultrasonic applications where an ultrasonic transducer, such as an ultrasonic transducer, can be driven by a distinct sinusoidal current at its resonant frequency. Since other frequencies can excite parasitic resonances, minimizing or reducing the total distortion of the operating branch currents can correspondingly minimize or reduce undesirable resonance effects. Since the waveform of the drive signal output by generator 800 is affected by various distortion sources present in the output drive circuit (e.g., power transformer 806, power amplifier 812), voltage and current feedback based on the drive signal The data can be input to an algorithm, such as an error control algorithm executed by the DSP processor 822, which, on a dynamic, progressive basis (eg, real-time), converts the waveform samples stored in the LUT. Distortion is compensated by suitable pre-distortion or modification. In one form, the amount or degree of predistortion applied to the LUT samples may be based on the error between the calculated operating branch current and the desired current waveform, where the error is determined on a sample-by-sample basis. In this way, the pre-distorted LUT samples, when processed by the drive circuit, produce an operating branch drive signal having a desired waveform shape (e.g., sinusoidal) to optimally drive the ultrasonic transducer. can occur. In such a form, the LUT waveform samples are therefore not representative of the desired waveform of the drive signal, but rather the desired waveform of the operational branch drive signal when distortion effects are taken into account. waveform.

The non-isolated stage 804 is coupled to the output of the power transformer 806 via respective isolation transformers 830, 832 for sampling the voltage and current, respectively, of the drive signal output by the generator 800. ADC circuitry 826 and a second ADC circuitry 828 may further be provided. In certain forms, the ADC circuits 826, 828 may be configured to sample at a high speed (eg, 80 megasamples per second (MSPS)) to allow oversampling of the drive signal. In one form, for example, the sampling rate of the ADC circuits 826, 828 may allow approximately 200x (depending on frequency) oversampling of the drive signal. In certain forms, the sampling operations of ADC circuits 826, 828 may be performed by a single ADC circuit that receives input voltage and current signals via bi-directional multiplexers. The use of high-speed sampling in the form of generator 800, among other things, is used to calculate the complex currents flowing through the operating branches, which can be used in certain forms to implement the DDS-based waveform shape control described above. ), which may enable accurate digital filtering of the sampled signal and calculation of real power consumption with high precision. Voltage and current feedback data output by ADC circuits 826, 828 may be received and processed by logic device 816 (eg, first-come, first-served (FIFO) buffers, multiplexers, etc.) for subsequent processing by DSP processor 822, for example. It may be stored in a data memory for reading. As noted above, voltage and current feedback data can be used as inputs to algorithms to pre-distort or modify LUT waveform samples on a dynamic and progressive basis. In certain forms, this is based on, or otherwise related to, the corresponding LUT samples output by the logic device 816 when the voltage and current feedback data pairs are obtained. Voltage and current feedback data pairs may need to be indexed. Synchronization of LUT samples with voltage and current feedback data in this manner contributes to the precise timing and stability of the predistortion algorithm.

In certain forms, voltage and current feedback data may be used to control the frequency and/or amplitude (eg, current amplitude) of the drive signal. For example, in one form, voltage and current feedback data may be used to determine the impedance phase. Subsequently, the frequency of the drive signal is controlled to minimize or reduce the difference between the determined impedance phase and the impedance phase setting (e.g., 0°), thereby minimizing the effects of harmonic distortion. or reduced, with a corresponding improvement in impedance phase measurement accuracy. The phase impedance and frequency control signal determination may be implemented, for example, in DSP processor 822 and the frequency control signal is provided as an input to the DDS control algorithm implemented by logic device 816 .

In another form, for example, current feedback data may be monitored to maintain the current amplitude of the drive signal at the current amplitude set point. The current amplitude setting may be specified directly or indirectly determined based on the specified voltage amplitude and power settings. In certain forms, control of current amplitude may be performed by a control algorithm, such as, for example, a proportional-integral-derivative (PID) control algorithm within DSP processor 822 . Variables controlled by the control algorithm include, for example, the scaling of the LUT waveform samples stored in logic device 816 and/or the DAC circuit 818 via DAC circuit 834 to preferably control the current amplitude of the drive signal. (which feeds the input to power amplifier 812).

The unisolated stage 804 may further include a second processor 836 to provide user interface (UI) functionality, among other things. In one form, the UI processor 836 may include, for example, an Atmel AT91SAM9263 processor with an ARM 926EJ-S core, available from Atmel Corporation (San Jose, Calif.). Examples of UI features supported by processor 836 include audible and visual user feedback, communication with peripheral devices (e.g., via a USB interface), communication with footswitches, input devices (e.g., touch screen displays), as well as communication with output devices (eg, speakers). UI processor 836 may communicate with DSP processor 822 and logic device 816 (eg, SPI bus). UI processor 836 may primarily support UI functionality, but in certain forms UI processor 836 may also cooperate with DSP processor 822 to provide risk mitigation. For example, the UI processor 836 may be programmed to monitor various aspects of user input and/or other input (eg, touchscreen input, footswitch input, temperature sensor input), and erroneous conditions When detected, the drive output of generator 800 can be disabled.

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

The non-isolated stage 804 may further include a controller 838 for monitoring input devices (eg, capacitive touch sensors used to turn generator 800 on and off, capacitive touch screens). In particular forms, controller 838 may include at least one processor and/or other controller device in communication with UI processor 836 . In one form, for example, controller 838 is a processor (eg, Meg168 8-bit controller available from Atmel) configured to monitor user input provided via one or more capacitive touch sensors. can include In one form, the controller 838 may include a touchscreen controller (eg, QT5480 touchscreen controller available from Atmel) for controlling and managing acquisition of touch data from the capacitive touchscreen.

In certain forms, when the generator 800 is in a “power off” state, the controller 838 continues to receive operating power (eg, via a line from the power supply of the generator 800, such as the power supply 854 described below). may In this manner, controller 838 can continue to monitor input devices (eg, capacitive touch sensors located on the front panel of generator 800) for turning generator 800 on and off. When the generator 800 is in the power off state, the controller 838 can activate the power supply (e.g., one or two of the power supplies 854) if activation of an "on/off" input device by the user is detected. enabling the operation of the DC/DC voltage converter 856 above). As a result, the controller 838 can initiate a sequence to transition the generator 800 to the "power on" state. Conversely, if activation of an "on/off" input device is detected while generator 800 is in the power-on state, controller 838 may initiate a sequence to transition generator 800 to the power-off state. can. For example, in certain forms, the controller 838 may report activation of an “on/off” input device to the UI processor 836, which in turn is necessary for the transition of the generator 800 to the power off state. process sequence. In this form, the controller 838 may not have a separate ability to remove power from the generator 800 after the power-on state of the generator 800 has been established.

In certain forms, controller 838 may cause generator 800 to provide audible or other sensory feedback to alert the user that a power-on or power-off sequence has been initiated. Such warnings may be provided at the start of a power-on or power-off sequence and prior to the start of other processes associated with the sequence.

In certain forms, the isolation stage 802 includes, for example, surgical instrument control circuitry (eg, control circuitry including handpiece switches) and non-isolation stages such as, for example, logic device 816, DSP processor 822, and/or UI processor 836. An instrument interface circuit 840 may be included to provide a communication interface between the components of 804 . Instrument interface circuitry 840 exchanges information with the components of non-isolated stage 804 via a communication link that maintains a suitable degree of electrical isolation between stages 802 and 804, such as, for example, an IR-based communication link. can. For example, a low dropout voltage regulator powered by an isolation transformer driven from the non-isolation stage 804 can be used to power the instrument interface circuit 840 .

In one form, instrument interface circuitry 840 may include logic device 842 (eg, logic circuitry, programmable logic circuitry, PGA, FPGA, PLD) in communication with signal conditioning circuitry 844 . Signal conditioning circuitry 844 may be configured to receive a periodic signal (eg, a 2 kHz square wave) from logic circuitry 842 to generate a bipolar interrogation signal having the same frequency. The interrogation signal can be generated using, for example, a bipolar current source fed by a differential amplifier. The interrogation signal is communicated to the surgical instrument control circuitry (eg, using conductive pairs in the cable connecting the generator 800 to the surgical instrument) and monitored to determine the state or configuration of the control circuitry. may The control circuit may comprise a number of switches, resistors, and/or diodes, and interrogation signals such that the state or configuration of the control circuit is individually identifiable based on one or more characteristics. may modify one or more properties of (eg, amplitude, rectification). For example, in one form, the signal conditioning circuit 844 may comprise an ADC circuit to generate samples of the voltage signal appearing across the input of the control circuit resulting from the path traversed by the interrogation signal. Logic circuitry 842 (or a component of non-isolation stage 804) may then determine the state or configuration of the control circuitry based on the ADC circuitry samples.

In one form, the instrument interface circuit 840 includes a first data circuit interface 846 and a logic circuit 842 (or other element of the instrument interface circuit 840) disposed within the surgical instrument or separately. Information may be exchanged between the first data circuit associated in a manner. In certain forms, for example, the first data circuit is in a cable integrally attached to the surgical instrument handpiece for interfacing with a particular surgical instrument type or model having the generator 800, or It may be disposed within the adapter. The first data circuit may be implemented in any suitable manner, for example communicating with the generator according to any suitable protocol, including those described herein with respect to the first data circuit. good too. In certain forms, the first data circuit may include a non-volatile storage device, such as an EEPROM device. In certain forms, the first data circuit interface 846 may be implemented separately from the logic circuit 842 and may comprise suitable circuitry (eg, separate logic devices, processors) to interface the logic circuit 842 and the first data circuit interface 846 together. may enable communication between the data circuits of the Alternatively, first data circuit interface 846 may be integral with logic circuit 842 .

In certain forms, the first data circuit may store information regarding the particular surgical instrument with which the first data circuit is associated. Such information may include, for example, model number, serial number, number of operations in which the surgical instrument was used, and/or any other type of information. This information is read by instrument interface circuitry 840 (e.g., by logic circuitry 842) for presentation to a user via an output device and/or for controlling the function or operation of generator 800. It may be forwarded to the components of stage 804 (eg, logic device 816, DSP processor 822, and/or UI processor 836). Additionally, any type of information may be communicated to the first data circuit (eg, using logic circuit 842) for internal storage via first data circuit interface 846. FIG. Such information may include, for example, the number of most recent surgeries in which the surgical instrument was used and/or the date and/or time of its use.

As previously mentioned, the surgical instrument may be removable from the handpiece to facilitate interchangeability and/or disposability of the instrument (e.g., multi-function surgical instruments may be removable from the handpiece). could be). In such cases, conventional generators may be limited in their ability to recognize the particular instrument configuration being used and correspondingly optimize the control and diagnostic processes. However, adding a readable data circuit to the surgical instrument to address this issue is problematic from a compatibility standpoint. For example, it may not be practical to design a surgical instrument to be backward compatible with generators that lack the necessary data reading functionality, due to, for example, different signaling schemes, design complexity and cost. be. The instrument configurations discussed herein are designed to economically use data circuitry that may be implemented in existing surgical instruments and to maintain compatibility between surgical instruments and modern generator platforms. Address these concerns by minimizing changes.

Further, the configuration of generator 800 may allow communication with instrument-based data circuits. For example, generator 800 can be configured to communicate with a second data circuit contained within an instrument (eg, a multi-function surgical instrument). In some forms, the second data circuit is implemented in many similarities to those of the first data circuit described herein. Instrument interface circuitry 840 may include a second data circuitry interface 848 to facilitate this communication. In one form, the second data circuit interface 848 may include a tri-state digital interface, although other interfaces may also be used. In one particular form, the second data circuit may generally be any circuit for transmitting and/or receiving data. In one form, for example, the second data circuit may store information regarding the particular surgical instrument with which the second data circuit is associated. Such information may include, for example, model number, serial number, number of operations in which the surgical instrument was used, and/or any other type of information.

In some forms, the second data circuit may store information regarding electrical and/or ultrasonic properties of an associated ultrasonic transducer, end effector, or ultrasonic drive system. For example, a first data circuit may indicate a burn-in frequency slope as described herein. Additionally or alternatively, any type of information may be communicated to the second data circuit for internal storage via the second data circuit interface 848 (eg, using logic circuit 842). do). Such information may include, for example, the number of most recent operations in which the device was used and/or the date and/or time of its use. In one particular form, the second data circuit may transmit data acquired by one or more sensors (eg, instrument-based temperature sensors). In certain forms, the second data circuit may receive data from generator 800 and provide an indicator (eg, a light emitting diode indicator or other visible indicator) to the user based on the received data.

In a particular form, the second data circuit and second data circuit interface 848 are such that communication between the logic circuit 842 and the second data circuit requires additional conductors for this purpose (e.g., a hand piece). can be provided without the need to provide a dedicated conductor of the cable connecting the to the generator 800 . In one form, for example, one of the conductors used carries an interrogation signal from the signal conditioning circuit 844 to the control circuit in the handpiece, a one-wire bus communication scheme implemented over existing cabling. can be used to communicate information to and from the second data circuit. In this manner, design changes or modifications to the surgical instrument that may otherwise be required are minimized or reduced. Furthermore, the presence of the second data circuit is "invisible" to generators that do not have the necessary data reading capabilities, as different types of communications carried out over a common physical channel can be frequency band separated. , thus allowing backward compatibility of surgical instruments.

In certain forms, isolation stage 802 may include at least one blocking capacitor 850-1 connected to drive signal output 810b to prevent DC current from passing through the patient. A single blocking capacitor may, for example, be required to comply with medical regulations or standards. Although failures in single-capacitor designs are relatively rare, such failures can nonetheless have negative consequences. In one form, a second blocking capacitor 850-2 may be provided in series with blocking capacitor 850-1, such that, for example, current leakage from a point between blocking capacitors 850-1 and 850-2 is monitored by an ADC circuit 852 to sample the voltage induced by . The samples may be received by logic circuitry 842, for example. Based on changes in leakage current (as indicated by voltage samples), generator 800 may determine when at least one of blocking capacitors 850-1, 850-2 has failed, thus simply It provides an advantage over single capacitor designs with one point of failure.

In particular forms, the non-isolated stage 804 may include a power supply 854 for delivering DC power at a suitable voltage and current. The power supply may include, for example, a 400W power supply to deliver a 48VDC system voltage. Power supply 854 includes one or more DC/DC voltage converters 856 for receiving the output of the power supply and producing DC outputs at voltages and currents required by the various components of generator 800 . You can prepare more. As described above in connection with controller 838, one or more of DC/DC voltage converters 856 are switched on when controller 838 detects activation of an "on/off" input device by the user. Input may be received from controller 838 to enable operation or activation of DC/DC voltage converter 856 .

FIG. 45 shows an example of generator 900, which is a form of generator 800 (FIG. 44). Generator 900 is configured to deliver multiple energy modalities to a surgical instrument. Generator 900 either singly or simultaneously provides RF and ultrasound signals for delivering energy to the surgical instrument. RF and ultrasound signals may be provided alone, in combination, or may be provided simultaneously. As noted above, at least one generator output may transmit multiple energy modalities (e.g., ultrasound, bipolar or monopolar RF, irreversible and/or reversible electroporation, and/or microwave, among others) through a single port. energy) can be delivered, and these signals can be delivered to the end effector individually or simultaneously to treat the tissue.

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 (not shown for clarity of disclosure) stored in memory coupled to processor 902. 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 1106 for signal conditioning and amplification. The conditioned and amplified output of amplifier 906 is coupled to power transformer 908 . The signal is coupled across 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 ENERGY1 and RETURN. A second signal of the second energy modality is coupled across capacitor 910 and provided to the surgical instrument between terminals labeled ENERGY2 and RETURN. More than two energy modalities may be output, so the subscript "n" can be used to denote that up to n ENERGYn terminals can be provided, where n is greater than one. It will be understood to be a positive integer. It will also be appreciated that up to 'n' return paths (RETURNn) may be provided without departing from the scope of the present disclosure.

A first voltage sensing circuit 912 is coupled across terminals labeled ENERGY1 and RETURN paths to measure the output voltage therebetween. A second voltage sensing circuit 924 is coupled across terminals labeled ENERGY2 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 illustrated power transformer 908 to measure the output current of either energy modality. If different return paths are provided for each energy modality, separate current sensing circuits 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 corresponding isolation transformers 916 , 922 and the output of the current sensing circuit 914 is provided to another isolation transformer 918 . 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 adjust the output voltage and current provided to the surgical instrument and to calculate the output impedance, among other parameters. 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 coupled across the first voltage sensing circuit 912 coupled across the terminals labeled ENERGY1/RETURN or the second voltage sensing circuit 924 coupled across the terminals labeled ENERGY2/RETURN to the power transformer. may be determined by processor 902 by dividing by the output of a current sensing circuit 914 arranged in series with the RETURN leg of the secondary side of unit 908 . The outputs of the first voltage sensing circuit 912 and the second voltage sensing circuit 924 are provided to separate isolation transformers 916 , 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 ENERGY1 may be ultrasonic energy and the second energy modality ENERGY2 may be RF energy. Yet, in addition to ultrasound energy modalities and bipolar or monopolar RF energy modalities, other energy modalities include irreversible and/or reversible electroporation and/or microwave energy, among others. Also, while the example illustrated in FIG. 45 shows that a single return path (RETURN) may be provided to more than one energy modality, in other aspects multiple return paths RETURNn may be provided for each It may be provided to the energy modality ENERGYn. Thus, as described herein, the impedance of the ultrasound transducer may be measured by dividing the output of the first voltage sensing circuit 912 by the current sensing circuit 914, and the tissue impedance is the second It may be measured by dividing the voltage sensing circuit 924 output by 2 by the current sensing circuit 914 .

As shown in FIG. 45, the generator 900, including at least one output port, provides power, e.g., ultrasound, bipolar or monopolar RF, irreversible and Power with a single output and multiple taps for delivery to the end effector in the form of one or more energy modalities such as reversible electroporation and/or microwave energy. A transformer 908 may be provided. For example, the generator 900 drives RF electrodes for tissue sealing using either monopolar or bipolar RF electrosurgical electrodes with high voltage and low current to drive the ultrasonic transducer. Energy can be delivered at low voltage and high current for spot coagulation, or in a coagulation waveform for spot coagulation. The output waveform from generator 900 may be induced, switched, or filtered to provide frequencies to the end effector of the surgical instrument. The connection to the output of the ultrasonic transducer generator 900 will preferably be located between the outputs labeled ENERGY1 and RETURN shown in FIG. In one embodiment, the connection to the output of the RF bipolar electrode generator 900 will preferably be located between the outputs labeled ENERGY2 and RETURN. For unipolar outputs, the preferred connections would be active electrodes (eg, pencil or other probes) to suitable return pads connected to the ENERGY2 and RETURN outputs.

Further details can be found in the U.S. Patent, published Mar. 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. Application Publication No. 2017/0086914 disclosed in No.

As used throughout this description, the term "wireless" and its derivatives describe circuits, devices, systems, methods, techniques, communication channels, etc. that can communicate data through the use of modulated electromagnetic radiation over non-solid media. may be used for This term does not imply that the associated device does not include any wires, although in some aspects they may not be present. Communication modules include Wi-Fi (IEEE802.11 family), WiMAX (IEEE802.16 family), IEEE802.20, Long Term Evolution (LTE), Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS , CDMA, TDMA, DECT, Bluetooth, their Ethernet derivatives, as well as any other wireless and wired protocols designated 3G, 4G, 5G, and beyond. Or it may implement any of the wired communication standards or protocols. A computing module may include multiple communication modules. For example, a first communication module may be dedicated to short-range wireless communication such as Wi-Fi and Bluetooth, and a second communication module may be dedicated to GPS, EDGE, GPRS, CDMA, WiMAX, LTE, Ev-DO, etc. may be dedicated to long-range wireless communication.

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

As used herein, a system-on-a-chip or system-on-chip (SoC or SOC) is an integrated circuit (also known as an "IC" or "chip" that integrates all the components of a computer or other electronic system). is available). It can include digital, analog, mixed signal, and often high frequency functions all on a single substrate. SoCs integrate microcontrollers (or microprocessors) with modern peripheral devices such as graphics processing units (GPUs), Wi-Fi modules, or co-processors. The SoC may or may not include embedded memory.

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

As used herein, the term controller or microcontroller may be a standalone IC or chip device that interfaces with peripheral devices. This may be the link between the two parts of the computer or controller on the external device that manages the operation of that device (and the connection with the device).

Any processor or microcontroller described herein may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex manufactured by Texas Instruments. In one aspect, the processor has on-chip memory, e.g., 256 KB of single-cycle flash memory or other non-volatile memory at up to 40 MHz, details of which are available in the product datasheet, to improve performance beyond 40 MHz. 1 or 2 prefetch buffers, 32 KB single-cycle serial random access memory (SRAM), internal read-only memory (ROM) with StellarisWare® software, 2 KB electrically erasable programmable read-only memory (EEPROM) One or more pulse width modulation (PWM) modules, one or more quadrature encoder input (QEI) analog, one or more 12-bit analog-to-digital converters (ADC) with 12 analog input channels ), including the LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments.

In one aspect, the processor may include a safety controller that includes two controller family families, such as the TMS570 and RM4x, also known by the trade name Hercules ARM Cortex R4, also manufactured by Texas Instruments. Safety controllers may be configured specifically for IEC61508 and ISO26262 safety limit applications to provide advanced integrated safety mechanisms while offering scalable performance, connectivity, and memory options. good.

Modular devices are connected to various modules for connection or pairing with corresponding surgical hubs (e.g., described in connection with FIGS. 3 and 9) receivable within a surgical hub. a surgical device or instrument to obtain. Modular devices include, for example, intelligent surgical instruments, medical imaging devices, suction/irrigation devices, smoke evacuators, energy generators, ventilators, inhalers, and displays. The modular devices described herein can be controlled by control algorithms. Control algorithms may be implemented on the modular device itself, on the surgical hub with which the particular modular device is paired, or on both the modular device and the surgical hub (e.g., via a distributed computing architecture). ), can be executed. In some examples, the control algorithm for the modular device is based on data sensed by the modular device itself (i.e., by sensors within, on, or connected to the modular device). control the device based on This data may relate to the patient during surgery (eg, tissue properties or injection pressure) or the modular device itself (eg, advancing knife speed, motor current, or energy level). For example, a control algorithm for a surgical stapling and severing instrument can control the speed at which the instrument's motor drives the knife through tissue based on the resistance encountered by the knife as it advances.

Situational Awareness Situational awareness is the ability of some aspects of a surgical system to determine or infer information related to a surgical procedure from data received from a database and/or instruments. The information may include the type of procedure being performed, the type of tissue being operated on, or the body cavity being treated. With contextual information relevant to a surgical procedure, the surgical system may, for example, be a modular device (e.g., a robotic arm and/or robotic arm) to which it is connected to provide contextual information or suggestions to the surgeon during the course of the surgical procedure. (surgical tools) can be improved.

Referring now to FIG. 46, a timeline 5200 illustrating situational awareness of a hub, such as surgical hub 106 or 206, is shown. Timeline 5200 is an exemplary surgical procedure and contextual information that surgical hubs 106, 206 can derive from data received from data sources at each step of the surgical procedure. Timeline 5200 is taken by nurses, surgeons, and other medical personnel during the course of a segmentectomy surgery, beginning with setting up the operating room and ending with transferring the patient to the post-operative recovery room. A typical process that might be followed is shown.

The situational awareness surgical hub 106, 206 sources data throughout the course of a surgical procedure, including data generated each time a modular device paired with the surgical hub 106, 206 is used. receive from The surgical hubs 106, 206 receive this data from paired modular devices and other data sources to receive new data such as what steps of the procedure are being performed at any given time. Once done, inferences (ie, contextual information) about the ongoing procedure can be continuously derived. The situational awareness system of the surgical hub 106, 206 may, for example, record data regarding procedures to generate reports, verify steps being taken by medical personnel, collect data that may be relevant to specific procedure steps, or provide a prompt (e.g., via a display screen), adjust the modular device based on context (e.g., wake up a monitor, adjust the field of view (FOV) of a medical imaging device, or ultrasonic surgical changing the energy level of the instrument or RF electrosurgical instrument), and any other such actions described above.

As a first step 5202 in this exemplary procedure, hospital personnel retrieve the patient's EMR from the hospital's Electronic Medical Record (EMR) database. Based on selected patient data in the EMR, surgical hub 106, 206 determines that the procedure to be performed is a thoracic procedure.

In a second step 5204, personnel scan incoming medical supplies for treatment. The surgical hub 106, 206 cross-references the scanned supplies with lists of supplies utilized in various types of procedures to confirm that the mix of supplies corresponds to the thoracic procedure. In addition, the surgical hub 106, 206 can also determine that the procedure is not a wedge procedure (either the incoming product does not include the specific product required for a thoracic wedge procedure or the otherwise thoracic (because it is either not compatible with the wedge treatment).

In a third step 5206, medical personnel scan the patient's band via a scanner communicatively connected to the surgical hub 106,206. The surgical hub 106, 206 can then verify the patient's identity based on the scanned data.

In a fourth step 5208, the medical staff turns on the assistive device. The ancillary instruments utilized may vary according to the type of surgical procedure and the technique used by the surgeon, but in this exemplary case they include smoke evacuators, inhalers, and medical imaging devices. Upon activation, an auxiliary instrument that is a modular device can automatically pair with a surgical hub 106, 206 located within a particular proximity of the modular device as part of its initialization process. . The surgical hub 106, 206 can then derive contextual information about the surgical procedure by detecting the type of modular device paired with it during this preoperative or initialization phase. In this particular example, surgical hubs 106, 206 determine the surgical procedure to be a VATS procedure based on this particular combination of paired modular devices. Based on the combination of data from the patient's EMR, the list of medical supplies used in the surgery, and the types of modular devices that connect to the hub, the surgical hubs 106, 206 approximate the specific procedure to be performed by the surgical team. can be estimated. Once the surgical hub 106, 206 knows what particular procedure is being performed, then the surgical hub 106, 206 retrieves the procedures for that procedure from memory or from the cloud and then connects. Data subsequently received from multiple data sources (eg, modular devices and patient monitoring devices) can be cross-referenced to deduce which steps of the surgical procedure the surgical team is performing.

In a fifth step 5210, personnel attach EKG electrodes and other patient monitoring devices to the patient. EKG electrodes and other patient monitoring devices can be paired with the surgical hub 106,206. Once the surgical hub 106, 206 begins receiving data from the patient monitoring device, the surgical hub 106, 206 confirms that the patient is in the operating room.

In a sixth step 5212, medical personnel induce anesthesia in the patient. The surgical hub 106, 206 determines that the patient is under anesthesia based on data from modular devices and/or patient monitoring devices including, for example, EKG data, blood pressure data, ventilator data, or combinations thereof. can be estimated. Completion of the sixth step 5212 completes the preoperative portion of the segmentectomy surgery and begins the surgical portion.

In a seventh step 5214, the lung of the patient being manipulated is collapsed (while ventilation is switched to the contralateral lung). The surgical hub 106, 206 can, for example, deduce from the ventilator data that the patient's lung has collapsed. The surgical hub 106, 206 can compare the detection of the patient's lung collapse to the expected steps of the procedure (which can be accessed or read out in advance) so that the surgical portion of the procedure is Assuming it has started, it can be determined that collapsing the lung is the first surgical step in this particular procedure.

In an eighth step 5216, a medical imaging device (eg, scope) is inserted and video footage from the medical imaging device is initiated. Surgical hubs 106, 206 receive medical imaging device data (ie, video or image data) through connections to medical imaging devices. Upon receiving the medical imaging device data, the surgical hub 106, 206 can determine that the laparoscopic portion of the surgical procedure has begun. Additionally, the surgical hub 106, 206 can determine that the particular procedure being performed is a segmentectomy as opposed to a lobectomy (based on the data received in the second step 5204 of the procedure). Note that the wedge procedure is already discounted by the surgical hubs 106, 206). Data from the medical imaging device 124 (FIG. 26) is utilized (i.e., activated) by determining the angle of the medical imaging device oriented with respect to visualization of the patient's anatomy. , by monitoring the number or medical imaging devices paired with the surgical hub 106, 206), and by monitoring the type of visualization device being utilized. can be utilized to determine contextual information regarding the type of treatment being performed from. For example, one technique for performing a VATS lobectomy places the camera above the diaphragm in the anterior inferior corner of the patient's thoracic cavity, while one technique for performing a VATS segmentectomy is to place the camera above the diaphragm. is placed in the anterior intercostal position relative to the segmental cleft. For example, using pattern recognition or machine learning techniques, a situational awareness system can be trained to recognize the location of medical imaging devices based on visualizations of patient anatomy. As another example, one technique for performing VATS lobectomy utilizes a single medical imaging device, while another technique for performing VATS segmentectomy utilizes multiple cameras. As yet another example, one technique for performing a VATS segmentectomy uses an infrared light source (which may be communicatively coupled to the surgical hub as part of the visualization system) to visualize the segmental cleft. , which is not used in VATS lobectomy. By tracking any or all of this data from the medical imaging device, the surgical hub 106, 206 may be used for the particular type of surgical procedure being performed and/or the type of surgical procedure being performed. technology can be determined.

At a ninth step 5218, the surgical team begins the incision step of the procedure. The surgical hub 106, 206 receives data from the RF or ultrasound generator indicating that the energy device is being fired, so presuming that the surgeon is in the process of cutting and separating the patient's lungs. can be done. The surgical hub 106, 206 cross-references the received data with the readout steps of the surgical procedure to determine the energy being delivered at this point in the process (i.e., after the steps of the procedure described above have been completed). It can be determined that the instrument is compatible with the lancing process. In certain examples, the energy instrument can be an energy tool attached to a robotic arm of a robotic surgical system.

At a tenth step 5220, the surgical team proceeds to the ligation step of the procedure. The surgical hub 106, 206 receives data from the surgical stapling and severing instrument indicating that the instrument has been fired, so it can be inferred that the surgeon is ligating the artery and vein. Similar to the previous step, the surgical hub 106, 206 can derive this estimate by cross-referencing the receipt of data from the surgical stapling and severing instrument with the read out steps in the process. . In certain examples, the surgical instrument may be a surgical tool attached to a robotic arm of a robotic surgical system.

In an eleventh step 5222, the segmental excision portion of the treatment is performed. The surgical hub 106, 206 can infer that the surgeon is transsecting parenchyma based on data from the surgical stapling and cutting instrument, including data from its cartridge. The cartridge data can correspond, for example, to the size or type of staples fired by the instrument. Since different types of staples are utilized on different types of tissue, the cartridge data can indicate the type of tissue being stapled and/or transected. In this case, the types of staples fired are applied to parenchymal tissue (or other similar tissue types) so that the surgical hub 106, 206 assumes that the segmentectomy portion of the procedure is being performed. can be done.

Subsequently, in a twelfth step 5224, a knot dissection step is performed. The surgical hub 106, 206 infers that the surgical team is incising the nodule and performing a leak test based on data received from the generator indicating RF or ultrasonic instruments are being fired. can be done. For this particular procedure, the RF or ultrasonic instruments used after the parenchymal tissue is transected correspond to the knototomy process that allows the surgical hub 106, 206 to make this estimate. It becomes possible. Surgeons routinely combine surgical stapling/cutting instruments and surgical energy (i.e., RF or ultrasonic) depending on the particular step in the procedure, as different instruments are better suited to specific tasks. ) instruments. Thus, the particular sequence in which stapling/cutting instruments and surgical energy instruments are used can indicate which step of the procedure the surgeon is performing. Additionally, in certain instances, robotic tools may be used for one or more steps during a surgical procedure and/or hand-held surgical instruments may be used for one or more steps during a surgical procedure. can be used. The surgeon(s) may, for example, alternate between robotic tools and handheld surgical instruments and/or may use the devices simultaneously, for example. Upon completion of the twelfth step 5224, the incision is closed and the post-operative portion of the procedure begins.

In a thirteenth step 5226, the patient's anesthesia is reversed. The surgical hub 106, 206 can deduce that the patient is emerging from anesthesia, for example, based on ventilator data (ie, the patient's breathing rate begins to increase).

Finally, a fourteenth step 5228 is for medical personnel to remove various patient monitoring devices from the patient. Therefore, the surgical hub 106, 206 can assume that the patient is being transported to the recovery room when the hub loses EKG, BP, and other data from patient monitoring devices. As can be seen from this exemplary procedure description, surgical hubs 106, 206 may perform a given surgical procedure based on data received from various data sources communicatively coupled with surgical hubs 106, 206. can be determined or estimated when each step of is occurring.

Situational awareness is further described in US Provisional Patent Application No. 62/611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," the entire disclosure of which is incorporated herein by reference. In certain examples, the operation of a robotic surgical system, including, for example, various robotic surgical systems disclosed herein, is based on its situational awareness and/or feedback from its components and/or the cloud. It can be controlled by hubs 106 , 206 based on information from 104 .

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

Example 1. A surgical hub comprising a control circuit comprising a control circuit including a plurality of segments, the plurality of segments including a first segment, a second segment and a third segment, the first segment includes a main processor and a safety processor, the main processor being coupled to a memory, the memory energizing the first segment before the second and third segments, the first segment energizing the first segment; and storing instructions executable by the main processor to energize the second and third segments after performing the functions of a. A segment includes a motor control circuit and a motor, a surgical hub.

Example 2. The surgical hub of example 1, wherein the first function is to check the first, second, and third segments for at least one of shorts and errors.

Example 3. A surgical hub according to example 1 or 2, wherein the first function is to perform safety checks on the first, second and third segments.

Example 4. The surgical hub of any one of Examples 1-3, wherein the first function is to verify that the sensing circuitry, display circuitry, motor control circuitry, and motor are the correct components.

Example 5. A control circuit identifies the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor, and on the display device identifies the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor. The surgical hub of any one of Examples 1-4, wherein the surgical hub displays the status of the.

Example 6. A control circuit identifies the first segment, the second segment, and the third segment and displays the status of the first segment, the second segment, and the third segment to the user on the display device. The surgical hub of any one of Examples 1-5, wherein:

Example 7. The surgical hub of any one of Examples 1-6, further comprising a pump coupled to the motor.

Example 8. The surgical hub of any one of Examples 1-7, wherein the motor operates in a first state or a second state.

Example 9. The surgical hub of any one of Examples 1-8, wherein the first state is user activated and the motor operates the pump at a first speed.

Example 10. The surgical hub of any one of Examples 1-9, wherein the motor operates the pump at a second speed in the second state.

Example 11. A method of operating a segmented control circuit within a surgical drainage system comprising activating a first segment, the first segment including a main processor and a safety processor. , causing the first segment to perform a first function; activating a second segment, the second segment including the sensing circuit and the display circuit; activating a segment, wherein the third segment includes the motor control circuit and the motor.

Example 12. Operating the segmented control circuit of Example 11, wherein the first function is to check the first, second and third segments for at least one of shorts and errors. Method.

Example 13. 13. A method of operating a segmented control circuit as in example 11 or 12, wherein the first function is to perform safety checks on the first, second and third segments.

Example 14. 14. The segmented control of any one of Examples 11-13, wherein the first function is to verify that the sensing circuit, the display circuit, the motor control circuit, and the motor are the correct components. How to make the circuit work.

Example 15. identifying the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor by the control circuit; and displaying the status of the motor.

Example 16. identifying the first segment, the second segment, and the third segment, and displaying the status of the first segment, the second segment, and the third segment on the display device by the control circuit; A method of operating a segmented control circuit according to any one of embodiments 11-15, further comprising:

Example 17. 17. A method of operating a segmented control circuit as in any one of embodiments 11-16, further comprising operating the motor in the first state or the second state.

Example 18. 18. A method of operating a segmented control circuit according to any one of Examples 11-17, wherein the first state is activated by the user and the motor operates the pump at a first speed.

Example 19. 19. A method of operating a segmented control circuit as in any one of embodiments 11-18, wherein the motor operates the pump at a second speed in the second state.

Example 20. A non-transitory computer-readable medium storing computer-readable instructions, the computer-readable instructions, when executed, invoking a first segment in a machine, the first segment being a main processor and a safety processor; causing a first segment to perform a first function; and activating a second segment, wherein the second segment activates the sensing circuit and the display circuit. A non-transitory computer-readable medium causing the following: activating; and activating a third segment, wherein the third segment includes a motor control circuit and a motor.

Example 21. A surgical drainage system comprising a control circuit, the control circuit including a plurality of segments, the plurality of segments including a first segment, a second segment and a third segment, the first segment includes a main processor and a safety processor, the main processor coupled to a memory, the memory having instructions executable by the main processor for energizing the first segment before the second and third segments; The storing and energizing of the second and third segments is after the first segment performs a first function, the second segment includes sensing circuitry and display circuitry, and the third segment includes sensing and display circuitry. segment includes a motor control circuit and a motor.

Example 22. 22. The surgical drainage system of Example 21, wherein the first function is to check the first, second, and third segments for at least one of shorts and errors.

Example 23. 23. A surgical drainage system according to example 21 or 22, wherein the first function is to perform safety checks on the first, second and third segments.

Example 24. The surgical drainage system of any one of Examples 21-23, wherein the first function is to verify that the sensing circuitry, display circuitry, motor control circuitry, and motor are the correct components.

Example 25. A control circuit identifies the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor, and on the display device identifies the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor. 25. The surgical drainage system of any one of Examples 21-24, wherein the surgical drainage system displays the status of the.

Example 26. A control circuit identifies the first segment, the second segment, and the third segment and displays the status of the first segment, the second segment, and the third segment to the user on the display device. The surgical drainage system of any one of Examples 21-25.

Example 27. 27. The surgical drainage system of any one of Examples 21-26, further comprising a pump coupled to the motor.

Example 28. 28. The surgical drainage system of any one of Examples 21-27, wherein the motor operates in a first state or a second state.

Example 29. 29. The surgical drainage system of Example 28, wherein the first state is user activated and the motor operates the pump at a rapid speed.

Example 30. 30. The surgical drainage of embodiment 28 or 29, wherein the second state is the slow state and the motor operates the pump at a slower speed.

Example 31. A method of operating a segmented control circuit within a surgical drainage system comprising activating a first segment, the first segment including a main processor and a safety processor. , causing the first segment to perform a first function; activating a second segment, the second segment including the sensing circuit and the display circuit; activating a segment, wherein the third segment includes the motor control circuit and the motor.

Example 32. Operating the segmented control circuit of Example 31, wherein the first function is to check the first, second and third segments for at least one of shorts and errors Method.

Example 33. 33. A method of operating a segmented control circuit as in embodiment 31 or 32, wherein the first function is to perform safety checks on the first, second and third segments.

Example 34. 34. The segmented control of any one of Examples 31-33, wherein the first function is to verify that the sensing circuit, the display circuit, the motor control circuit, and the motor are the correct components. How to make the circuit work.

Example 35. identifying the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor by the control circuit; and displaying the status of the motor.

Example 36. identifying the first segment, the second segment, and the third segment, and displaying the status of the first segment, the second segment, and the third segment on the display device by the control circuit; 36. A method of operating a segmented control circuit as in any one of embodiments 31-35, further comprising:

Example 37. 37. A method of operating a segmented control circuit as in any one of embodiments 31-36, wherein the pump is coupled to a motor.

Example 38. 38. A method of operating a segmented control circuit as recited in example 37, further comprising operating the motor in the first state or the second state.

Example 39. 39. The method of operating the segmented control circuit of example 38, wherein the first state is user activated and the motor operates the pump at a rapid speed.

Example 40. 40. The method of operating the segmented control circuit of embodiment 38 or 39, wherein the second state is the slow state and the motor operates the pump at a slower speed.

Example 41. A surgical hub comprising a processor and a memory coupled to the processor, the memory storing instructions executable by the processor to perform the method of any one of Examples 31-40. There is a surgical hub.

Example 42. A non-transitory computer-readable medium storing computer-readable instructions that, when executed, cause a machine to perform the method of any one of Examples 31-40. readable medium.

Example 43. 39. The method of operating the segmented control circuit of example 38, wherein the first state is activated by the user and the motor operates the pump at a first speed.

Example 44. 39. The method of operating the segmented control circuit of embodiment 38, wherein the motor operates the pump at a second speed in the second state.

Example 45. A non-transitory computer-readable medium storing computer-readable instructions, the instructions, when executed, causing a first segment to be activated in a machine, the first segment being a main processor and a security activating a processor, causing a first segment to perform a first function, and activating a second segment, the second segment including a sensing circuit and a display circuit; A non-transitory computer-readable medium causing the activating and activating of a third segment, the third segment including a motor control circuit and a motor. Although several forms have been illustrated and described, it is not the applicant's intention to limit or limit the appended claims to such recitations. Numerous modifications, variations, changes, 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, variations, substitutions, modifications and equivalents.

The foregoing detailed description has described various aspects of devices and/or processes using block diagrams, flowcharts, and/or examples. To the extent such block diagrams, flowcharts, and/or embodiments include one or more functions and/or operations, it should be understood by those skilled in the art that such block diagrams, flowcharts, and/or examples 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 understood as one or more computer programs (e.g., one or more computer programs) running on one or more computers. as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., one or more as one or more programs running on a microprocessor), as firmware, or substantially any combination thereof, equivalently embodied on an integrated circuit; , and/or writing software and/or firmware code is within the skill of one of ordinary skill in the art in view of the present disclosure. Moreover, those skilled in the art will appreciate that the subject matter described herein may be distributed in a variety of forms as one or more program products, and is incorporated herein by reference. The specific forms of subject matter described are used regardless of the particular type of signal-bearing medium used to implement the distribution.

Instructions used to program logic to perform various disclosed aspects may be stored in system memory such as dynamic random access memory (DRAM), cache, flash memory, or other storage. 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 memories (CDs), -ROM), as well as magneto-optical disks, read-only memory (ROM), random-access memory (RAM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), magnetic or optical cards, Any tangible, machine-readable material used to transmit information over the Internet via flash memory or electrical, optical, acoustic, or other form of propagated signal (e.g., carrier wave, infrared signal, digital signal, etc.) Not limited to storage. Accordingly, non-transitory computer-readable media include any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a form readable by a machine (eg, a computer).

As used in any aspect 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 units , processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic unit (PLD), programmable logic array (PLA), or field programmable gate array (FPGA)), state machine circuit, programmable circuit It can refer to firmware that stores instructions to be executed, and any combination thereof. Control circuits, collectively or individually, can be, for example, integrated circuits (ICs), application-specific integrated circuits (ASICs), systems-on-chips (SoCs), desktop computers, laptop computers, tablet computers, servers, smart phones, etc. , may be embodied as circuits forming part of a larger system. Thus, as used herein, the term “control circuit” includes 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 device described herein, or a process described herein) and/or a microprocessor configured by a computer program that at least partially executes the device); an electrical circuit forming a memory device (e.g., in the form of a random access memory); (modems, communications switches, or opto-electrical devices). Those skilled in the art will recognize that the subject matter described herein may 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. may be implemented in either hardware, a combination of hardware and software, software, or software in execution. It can refer to some computer-related entity.

As used in any aspect herein, "algorithm" refers to a self-consistent sequence of steps leading to a desired result; Refers to the 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 the appropriate physical quantities and are merely convenient labels applied to these quantities and/or states.

The network may include packet switched networks. 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 use Transmission Control Protocol/Internet Protocol (TCP/IP) to enable communication. The Ethernet protocol may conform to or be 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. can be. 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, communication devices may 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 may conform to or be compatible with the ATM standard published in August 2001 by the ATM Forum under the title "ATM-MPLS Network Interworking 2.0" and/or later versions of this standard. . Of course, different and/or later developed connection-oriented network communication protocols are equally contemplated herein.

Unless expressly specified otherwise, terms such as "process", "calculate", "calculate", "determine", "display", etc. are used throughout the foregoing disclosure as is apparent from the foregoing disclosure. Discussions using the term refer to data represented as physical (electronic) quantities within the registers and memory of a computer system as physical quantities within the memory or registers of a computer system or any such information storage, transmission, or display device. It will be understood to refer to the operations and processes of a computer system or similar electronic computing device that manipulate and transform other data that may be similarly represented.

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 configurations, unless the context requires otherwise. It will be understood that it may contain elements.

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 further be 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 clearly set forth in the claim; 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 the claim recitations are introduced 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 being 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.

Moreover, even if a specific number is specified in the introduced claim statement, such statement should typically be construed to mean at least the stated number. , as will be recognized by those skilled in the art (e.g., where there is simply a statement "two statements" without other modifiers, generally there are at least two statements, or two or more statements matter). 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 system having at least one of A, B, or C" includes, but is not limited to, A only, B only, C only, both A and B, both A and C, B and C (including systems having both, and/or all of A and B and C, etc.). Further, 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. Additionally, while the flow diagrams of various acts are depicted in sequence(s), it is understood that the various acts may occur in orders other than those illustrated, or may occur simultaneously. It should be. Examples of such alternative orderings include overlapping, interleaving, interrupting, reordering, incremental, preliminary, additional, simultaneous, reverse, or other different orderings, unless the context requires otherwise. may include 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., includes in at least one aspect the particular feature, structure, or property described in connection with that aspect. It is worth noting that it means 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 do not necessarily all refer to the same aspect. Moreover, the particular features, structures or characteristics may be combined in any suitable manner in one or more aspects.

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 content, or portion thereof, that is inconsistent with the current definitions, opinions, or other disclosures set forth herein, is hereby incorporated by reference, but the reference content and the current disclosure are hereby incorporated by reference. References shall be made only to the extent that there is no inconsistency between

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 embodiments illustrate principles and practical applications, thereby making the various forms, with various modifications, available to those skilled in the art as suitable for the particular use envisioned. It is selected and described for the purpose. It is intended that the claims presented herewith define the overall scope.

[Mode of implementation]
(1) A surgical hub comprising:
a control circuit comprising a control circuit including a plurality of segments;
the plurality of segments includes a first segment, a second segment, and a third segment;
wherein the first segment includes a main processor and a safety processor, the main processor is coupled to a memory, the memory is adapted to the first segment before the second and third segments; storing instructions executable by the main processor to energize and energize the second and third segments after the first segment performs a first function;
the second segment includes sensing circuitry and display circuitry;
A surgical hub, wherein the third segment includes a motor control circuit and a motor.
Clause 2. The surgical hub of clause 1, wherein the first function is to check the first, second, and third segments for at least one of shorts and errors.
Clause 3. The surgical hub of clause 1, wherein the first function is to perform safety checks on the first, second and third segments.
Clause 4. The surgical hub of clause 1, wherein the first function is to verify that the sensing circuit, the display circuit, the motor control circuit, and the motor are the correct components.
(5) the control circuit identifies the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor, and displays on a display device the main processor, the safety processor, Clause 1. The surgical hub of clause 1, displaying status of the sensing circuit, the display circuit, the motor control circuit, and the motor.

(6) said control circuit identifies said first segment, said second segment, and said third segment, and displays to a user on a display device said first segment, said second segment, and a status of the third segment.
Clause 7. The surgical hub of clause 1, further comprising a pump coupled to said motor.
Clause 8. The surgical hub of clause 1, wherein the motor operates in a first state or a second state.
Clause 9. The surgical hub of clause 8, wherein the first state is user activated and the motor operates the pump at a first speed.
Clause 10. The surgical hub of clause 8, wherein the motor operates the pump at a second speed in the second state.

(11) A method of operating a segmented control circuit within a surgical drainage system comprising:
activating a first segment, said first segment including a main processor and a safety processor;
causing the first segment to perform a first function;
activating a second segment, said second segment including sensing circuitry and display circuitry;
activating a third segment, said third segment including a motor control circuit and a motor.
12. The segmented segmented segment of claim 11, wherein said first function is to check said first, second and third segments for at least one of shorts and errors. A method of operating a control circuit.
13. The method of operating a segmented control circuit of claim 11, wherein said first function is to perform safety checks on said first, second and third segments. .
14. The segmented segmented sensor of claim 11, wherein the first function is to verify that the sensing circuit, the display circuit, the motor control circuit, and the motor are the correct components. A method of operating a control circuit.
(15) identifying, by the control circuit, the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor;
12. The segmented system of embodiment 11, further comprising displaying the status of the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor on a display device. method of operating the control circuit.

(16) identifying, by the control circuitry, the first segment, the second segment, and the third segment;
12. Operating the segmented control circuit of embodiment 11, further comprising displaying the status of the first segment, the second segment, and the third segment on a display device. Method.
17. The method of operating a segmented control circuit of claim 16, further comprising operating the motor in a first state or a second state.
18. The method of operating a segmented control circuit of claim 17, wherein said first state is user activated and said motor operates said pump at a first speed.
19. The method of operating a segmented control circuit of claim 17, wherein the motor operates the pump at a second speed in the second state.
(20) A non-transitory computer-readable medium storing computer-readable instructions which, when executed, causes a machine to:
activating a first segment, said first segment including a main processor and a safety processor;
causing the first segment to perform a first function;
activating a second segment, said second segment including sensing circuitry and display circuitry;
activating a third segment, said third segment including a motor control circuit and a motor.

Claims (14)

A surgical system comprising:
a control circuit comprising a control circuit including a plurality of segments;
the plurality of segments includes a first segment, a second segment, and a third segment;
wherein the first segment includes a main processor and a safety processor, the main processor is coupled to a memory, the memory prior to the second segment and the third segment; storing instructions executable by said main processor for energizing a segment and energizing said second segment and said third segment after said first segment performs a first function; ,
the second segment includes sensing circuitry and display circuitry;
the third segment includes a motor control circuit and a motor;
The first function is
checking the first, second and third segments for at least one of shorts and errors;
performing safety checks on the first, second, and third segments; and
verifying that the sensing circuit, the display circuit, the motor control circuit, and the motor are the correct components;
is at least one of
The control circuit identifies the first segment, the second segment, and the third segment, and indicates to a user on a display device the first segment, the second segment, and the third segment. A surgical system that displays the status of three segments . wherein said surgical system is a surgical evacuation system comprising a smoke evacuation module containing said control circuit;
The surgical system of claim 1, wherein the sensing circuit includes a sensor for sensing particles in surgical smoke. The surgical system of claim 2, wherein the motor control circuit is configured to adjust the speed of the motor based on the particles sensed. The control circuit identifies the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor, and displays on a display device the main processor, the safety processor, the sensing circuit. , the display circuit, the motor control circuit, and the motor . The surgical system of any one of the preceding claims, further comprising a pump coupled to the motor. The surgical system of claim 5, wherein the motor operates in a first state or a second state, wherein in the first state the motor operates at a higher speed than in the second state. . The surgical system of claim 6 , wherein the first state is user activated and the motor operates the pump at a first speed . The surgical system of claim 6, wherein the motor, in the second state , operates the pump at a second speed different from the first speed . A method of operating a segmented control circuit within a surgical drainage system comprising:
activating a first segment, said first segment including a main processor and a safety processor;
causing the first segment to perform a first function;
activating a second segment, said second segment including sensing circuitry and display circuitry;
activating a third segment, said third segment including a motor control circuit and a motor;
identifying, by the control circuitry, the first segment, the second segment, and the third segment;
displaying the status of the first segment, the second segment, and the third segment on a display device ;
The first function is
checking the first, second and third segments for at least one of shorts and errors;
performing safety checks on the first, second and third segments;
verifying that the sensing circuit, the display circuit, the motor control circuit, and the motor are the correct components;
A method that is at least one of identifying, by the control circuit, the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor;
10. The segmented segment of claim 9 , further comprising displaying the status of the main processor, the safety processor, the sensing circuit, the display circuit, the motor control circuit, and the motor on a display device. method of operating the control circuit. 10. The method of claim 9, further comprising operating the motor in a first state or a second state, wherein in the first state the motor operates at a higher speed than in the second state. method of operating the segmented control circuit of 12. The method of operating a segmented control circuit of claim 11 , wherein the first state is user activated and the motor operates a pump coupled to the motor at a first speed. 13. The method of operating a segmented control circuit of claim 12 , wherein said motor, in said second state , operates said pump at a second speed different from said first speed . A non-transitory computer readable medium storing computer readable instructions which, when executed, causes a machine comprising the surgical system of claim 1 to :
activating the first segment;
causing the first segment to perform the first function;
activating the second segment;
activating the third segment; and

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