JP7330980B2 - Surgical system for presenting information interpreted from external data - Google Patents

Description

(Cross reference to related applications)
This application is the subject of U.S. Provisional Patent Application Serial No. 16/182,230, filed November 6, 2018, entitled "SURGICAL SYSTEM FOR PRESENTING INFORMATION INTERPRETED FROM EXTERNAL DATA," the disclosure of which is hereby incorporated by reference in its entirety. claim the interests of No.

This application, under 35 U.S.C. MISSION" No. 62/729,177, filed September 10, 2018, entitled

This application is further filed under 35 U.S.C. U.S. Provisional Patent Application No. 62/692,747, filed on June 20, 2018; Priority is claimed to U.S. Provisional Patent Application No. 62/692,768, filed June 30, 2018.

119(e), filed April 19, 2018, entitled "METHOD OF HUB COMMUNICATION," the entire disclosure of which is incorporated herein by reference. Claims priority to 62/659,900.

This application is further filed under 35 U.S.C. U.S. Provisional Patent Application No. 62/650,898, filed March 30, 2018, entitled "SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES," U.S. Provisional Patent Application No. 62/650,887, entitled "SMOKE EVACUATION MODULE FOR INTERACT IVE U.S. Provisional Patent Application No. 62/650,882, filed March 30, 2018, entitled "SURGICAL PLATFORM," and U.S. Provisional Patent Application No. 62, filed March 30, 2018, entitled "SURGICAL SMOKE EVACUATION SENSING AND CONTROLS." No./650,877 is claimed.

This application is further filed under 35 U.S.C. U.S. Provisional Application No. 62/640,417 of application and priority to U.S. Provisional Application No. 62/640,415, filed March 8, 2018, entitled "ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR" Claim your rights.

This application is further filed under 35 U.S.C. 62/611,341, U.S. Provisional Patent Application No. 62/611,340, filed December 28, 2017, entitled "CLOUD-BASED MEDICAL ANALYTICS," and December 2017, entitled "ROBOT ASSISTED SURGICAL PLATFORM." Priority benefit of US Provisional Patent Application No. 62/611,339 filed on 28th is claimed.

The present disclosure relates to various surgical systems. Surgical procedures are typically performed, for example, in an operating room or room within a medical facility, such as a hospital. A sterile field is typically formed around the patient. A sterile field may include clean team members in appropriate clothing and all equipment and fixtures within the area. Various surgical devices and systems are utilized in performing surgical procedures.

Additionally, in the digital and information age, medical systems and facilities are implementing systems or procedures that utilize newer and improved technology due to the general desire to maintain patient safety and traditional practices. It is often slower to do. However, in many cases, healthcare systems and facilities may consequently lack communication and shared knowledge with other nearby or similarly situated facilities. It would be desirable to find ways to help interconnect healthcare systems and facilities to improve patient care.

SUMMARY In various embodiments, a surgical instrument is disclosed that includes an end effector, a user interface, and control circuitry. The end effector is configured to deploy staples into tissue grasped by the end effector and sever the grasped tissue during the firing stroke. The control circuitry is configured to cause at least one parameter setting associated with the firing stroke to be displayed on the user interface and to cause interpreted information associated with the firing stroke to be displayed concurrently with the at least one parameter setting on the user interface. The information interpreted and interpreted is based on external data.

SUMMARY In various embodiments, a surgical instrument is disclosed that includes an end effector, a user interface, and control circuitry. The end effector is configured to deploy staples into tissue grasped by the end effector and sever the grasped tissue during the firing stroke. The control circuitry is configured to cause at least one parameter setting associated with the firing stroke to be displayed on the user interface and to cause interpreted information associated with the firing stroke to be displayed concurrently with the at least one parameter setting on the user interface. The interpreted information is based on the imaging data.

SUMMARY In various embodiments, a surgical instrument is disclosed that includes an end effector, a user interface, and control circuitry. The end effector is configured to perform the function of manipulating tissue grasped by the end effector. The control circuitry is configured to cause at least one parameter setting associated with the function to be displayed on the user interface and to cause interpreted information associated with the function to be displayed on the user interface concurrently with the at least one parameter setting. The interpreted information is based on external data.

The various aspects described herein, both as to organization and method of operation, together with further objects and advantages thereof, are best understood by reference to the following description, taken in conjunction with the accompanying drawings in which: can be
1 is a block diagram of a computer-implemented interactive surgical system, according to 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. 122 is a partial perspective view of a surgical hub housing and a combination generator module slidably receivable within a drawer of the surgical hub housing 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 housing configured to receive multiple modules, in accordance with at least one aspect of the present disclosure; 1 illustrates a vertical modular housing configured to receive multiple modules, according to 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 healthcare facility with specialized equipment for surgical procedures, according to at least one aspect of the present disclosure. 1 illustrates a surgical data network with modular communication hubs configured to connect; 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 is a block diagram of a cloud computing system comprising a plurality of smart surgical instruments coupled to a surgical hub that can be connected to cloud components of the cloud computing system, according to at least one aspect of the present disclosure; FIG. 1 is a functional module architecture of a cloud computing system, according to at least one aspect of the present disclosure; 1 is a schematic illustration of a situation-aware surgical system, according to at least one aspect of the present disclosure; 4 is a timeline illustrating surgical hub situational awareness, in accordance with at least one aspect of the present disclosure; 1 illustrates a surgical device including a user interface and a surgical stapling end effector, according to at least one aspect of the present disclosure; 17 is a schematic view of various components of the surgical device of claim 16; FIG. FIG. 3 is a process logic flow diagram illustrating a control program and logic configuration for displaying information interpreted based on external data, in accordance with at least one aspect of the present disclosure; FIG. 3 is a process logic flow diagram illustrating a control program and logic configuration for displaying information interpreted based on external data, in accordance with at least one aspect of the present disclosure; 1 illustrates a surgical device including a user interface and a surgical stapling end effector, according to at least one aspect of the present disclosure; 21 is a logic flow diagram of a process showing a control program or logic configuration for adjusting parameter settings of the surgical device of FIG. 20, in accordance with at least one aspect of the present disclosure; FIG. 21 is a logic flow diagram of a process showing a control program or logic configuration for adjusting parameter settings of the surgical device of FIG. 20, in accordance with at least one aspect of the present disclosure; FIG. 1 illustrates a surgical device including a user interface and a surgical stapling end effector, according to at least one aspect of the present disclosure; 1 is a logic flow diagram of a process illustrating a control program or logic configuration for automatically adjusting the field of view of a medical imaging device with respect to detected structures of interest, in accordance with at least one aspect of the present disclosure; FIG. FIG. 3 is a logic flow diagram of a process illustrating a control program or logic configuration for obtaining user authorization to automatically adjust the field of view of a medical imaging device with respect to critical structures, in accordance with at least one aspect of the present disclosure;

The applicant of this application owns the following US patent applications filed November 6, 2018, the entire disclosures of each of which are incorporated herein by reference:
- U.S. patent application Ser. No. 4,
U.S. Patent Application No. 16/182,233, entitled "MODIFICATION OF SURGICAL SYSTEMS CONTROL PROGRAMS BASED ON MACHINE LEARNING";
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. Patent Application No. 16/182,251, entitled "INTERACTIVE SURGICAL SYSTEM";
- U.S. patent application Ser.
- U.S. Patent Application No. 1 entitled "SENSING THE PATIENT POSITION AND CONTACT UTILIZING THE MONO-POLAR RETURN PAD ELECTRODE TO PROVIDE SITUATIONAL AWARENESS TO A SURGICAL NETWORK" 6/182,267,
- U.S. patent application Ser.
U.S. patent application Ser. No. 16/182,246 entitled "ADJUSTMENTS BASED ON AIRBORNE PARTICLE PROPERTIES";
- U.S. patent application Ser.
・"REAL-TIME ANALYSIS OF COMPREHENSIVE COST OF ALL INSTRUMENTATION USED IN SURGERY UTILIZING DATA FLUIDITY TO TRACK INSTRUMENTS THROUGH STOCKING AND IN-HOUSE PR US patent application Ser. No. 16/182,242 entitled OCESSES;
・"USAGE AND TECHNIQUE ANALYSIS OF SURGEON / STAFF PERFORMANCE AGAINST A BASELINE TO OPTIMIZED DEVICE UTILIZATION AND PERFORMANCE FOR BOTH CURRENT AND FUT U.S. Patent Application Serial No. 16/182,255 entitled URE PROCEDURES;
- U.S. patent application Ser.
・"COMMUNICATION OF DATA WHERE A SURGICAL NETWORK IS USING CONTEXT OF THE DATA AND REQUIREMENTS OF A RECEIVING SYSTEM / USER TO INFLUENCE INCLUSION OR LINKAGE U.S. patent application Ser.
- U.S. patent entitled "SURGICAL NETWORK RECOMMENDATIONS FROM REAL TIME ANALYSIS OF PROCEDURE VARIABLES AGAINST A BASELINE HIGHLIGHTING DIFFERENCES FROM THE OPTIMAL SOLUTION" Application No. 16/182,290,
- U.S. Patent Application No. 16/182,232 entitled "CONTROL OF A SURGICAL SYSTEM THROUGH A SURGICAL BARRIER";
- U.S. patent application Ser.
・ Titled "Wireless Pairing of a Surgical Device With Another Device Without a Sterile Surgical Field Based on the Usage and Situational Awareness of Devices" U.S. patent application Ser. No. 16/182,231;
- U.S. patent application Ser.
- U.S. patent application Ser.
・"POWERED STAPLINING DEVICE CONFIGURED TO ADJUST FORCE, ADVANCEMENT SPEED, AND OVERALL STROKE OF CUTTING MEMBER BASED ON SENSED PARAMETER OF FIRING OR CLAMP U.S. Patent Application Serial No. 16/182,240 entitled "G";
・"VARIATION OF RADIO FREQUENCY AND ULTRASONIC POWER LEVEL IN COOPERATION WITH VARYING CLAMP ARM PRESSURE TO ACHIEVE PREDEFINED HEAT FLUX OR POWER APPLIED TO T ISSUE," U.S. Patent Application Serial No. 16/182,235;
- U.S. patent application Ser. No. 38.

The applicant of this application owns the following US patent applications filed September 10, 2018, the entire disclosures of each of which are incorporated herein by reference:
- U.S. Provisional Patent Application No. entitled "A CONTROL FOR A SURGICAL NETWORK OR SURGICAL NETWORK CONNECTED DEVICE THAT ADJUSTS ITS FUNCTION BASED ON A SENSED SITUATION OR USAGE" 62/729,183,
U.S. Provisional Patent Application No. 62/729,177 entitled "AUTOMATED DATA SCALING, ALIGNMENT, AND ORGANIZING BASED ON PREDEFINED PARAMETERS WITHIN A SURGICAL NETWORK BEFORE TRANSMISSION";
・"INDIRECT COMMAND AND CONTROL OF A FIRST OPERATING ROOM SYSTEM THROUGH THE USE OF A SECOND OPERATING ROOM SYSTEM WITHIN A STERILE FIELD WHERE THE SECOND OPERATING ROOM U.S. Provisional Patent Application No. 62/729,176, entitled "ING ROOM SYSTEM HAS PRIMARY AND SECONDARY OPERATING MODES"issue,
・"POWERED STAPLING DEVICE THAT IS CAPABLE OF ADJUSTING FORCE, ADVANCEMENT SPEED, AND OVERALL STROKE OF CUTTING MEMBER OF THE DEVICE BASED ON SENSED PARAMETERS" U.S. Provisional Patent Application No. 62/729,185 entitled ER OF FIRING OR CLAMPING;
・"POWERED SURGICAL TOOL WITH A PREDEFINED ADJUSTABLE CONTROL ALGORITHM FOR CONTROLLING AT LEAST ONE END EFFECTOR PARAMETER AND A MEANS FOR LIMITING THE AD U.S. Provisional Patent Application No. 62/729,184 entitled JUSTMENT;
U.S. Provisional Patent Application No. 62/729,18, entitled "SENSING THE PATIENT POSITION AND CONTACT UTILIZING THE MONO POLAR RETURN PAD ELECTRODE TO PROVIDE SITUATIONAL AWARENESS TO THE HUB"; No. 2,
・U.S. provisional provision entitled “SURGICAL NETWORK RECOMMENDATIONS FROM REAL TIME ANALYSIS OF PROCEDURE VARIABLES AGAINST A BASELINE HIGHLIGHTING DIFFERENCES FROM THE Patent Application No. 62/729,191,
- U.S. Provisional Patent Application No. 62/729, entitled "ULTRASONIC ENERGY DEVICE WHICH VARIES PRESSURE APPLIED BY CLAMP ARM TO PROVIDE THRESHOLD CONTROL PRESSURE AT A CUT PROGRESSION LOCATION"; 195, and "WIRELESS PAIRING OF A SURGICAL DEVICE WITH ANOTHER DEVICE WITHIN U.S. Provisional Patent Application No. 62/729,186, entitled "A STERILE SURGICAL FIELD BASED ON THE USAGE AND SITUATIONAL AWARENESS OF DEVICES".

The applicant of this application owns the following US patent applications filed Aug. 28, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. Patent Application No. 16/115,214, entitled "ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR"
U.S. Patent Application No. 16/115,205, entitled "TEMPERATURE CONTROL OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR";
- U.S. patent application Ser.
U.S. Patent Application No. 16/115,208 entitled "CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION";
- U.S. patent application Ser.
U.S. patent application Ser. No. 16/115,232 entitled "DETERMINING TISSUE COMPOSITION VIA AN ULTRASONIC SYSTEM";
- U.S. patent application Ser.
U.S. patent application Ser. No. 16/115,247 entitled "DETERMINING THE STATE OF AN ULTRASONIC END EFFECTOR";
U.S. patent application Ser.
- U.S. patent application Ser.
U.S. Patent Application No. 16/115,240, entitled "DETECTION OF END EFFECTOR IMMERSION IN LIQUID";
U.S. patent application Ser. No. 16/115,249 entitled "INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING";
- US patent application Ser.
U.S. Patent Application No. 16/115,223 entitled "BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY"; 6/115,238.

The applicant of this application owns the following US patent applications filed Aug. 23, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. Provisional Patent Application No. 62/721,995 entitled "CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION";
- U.S. Provisional Patent Application No. 62/721,998, entitled "SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS";
U.S. Provisional Patent Application No. 62/721,999 entitled "INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING";
U.S. Provisional Patent Application No. 62/721,994 entitled "BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY"; U.S. Provisional Patent Application Serial No. 62, entitled ELIVERING COMBINED ELECTRICAL SIGNALS 721,996.

The applicant of this application owns the following US patent applications filed June 30, 2018, the entire disclosures of each of which are incorporated herein by reference:
- U.S. Provisional Patent Application No. 62/692,747 entitled "SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE";
• US Provisional Patent Application No. 62/692,748, entitled "SMART ENERGY ARCHITECTURE"; and • US Provisional Patent Application No. 62/692,768, entitled "SMART ENERGY DEVICES."

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. 16/024,090 entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS";
- U.S. patent application Ser.
U.S. patent application Ser.
U.S. Patent Application No. 16/024,075 entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING";
- U.S. Patent Application No. 16/024,083 entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING";
- U.S. Patent Application No. 16/024,094 entitled "SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES";
U.S. patent application Ser.
U.S. Patent Application No. 16/024,150 entitled "SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES";
- U.S. Patent Application No. 16/024,160 entitled "VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY";
- U.S. Patent Application No. 16/024,124 entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE";
- U.S. Patent Application No. 16/024,132 entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT";
- U.S. Patent Application No. 16/024,141 entitled "SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY";
- U.S. Patent Application No. 16/024,162 entitled "SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES";
- U.S. Patent Application No. 16/024,066 entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL";
- U.S. Patent Application No. 16/024,096 entitled "SURGICAL EVACUATION SENSOR ARRANGEMENTS";
- U.S. Patent Application No. 16/024,116 entitled "SURGICAL EVACUATION FLOW PATHS";
U.S. Patent Application No. 16/024,149 entitled "SURGICAL EVACUATION SENSING AND GENERATOR CONTROL";
- U.S. Patent Application No. 16/024,180 entitled "SURGICAL EVACUATION SENSING AND DISPLAY";
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser. L IN-SERIES LARGE AND SMALL DROPLET FILTERS. Application Serial No. 16/024,273.

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 provisional patent applications filed March 30, 2018, the entire disclosures of each of which are incorporated herein by reference:
U.S. Provisional Patent Application No. 62/650,898, filed March 30, 2018, entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS";
U.S. Provisional Patent Application No. 62/650,887 entitled "SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES";
U.S. Provisional Patent Application No. 62/650,882, entitled "SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM," and U.S. Provisional Patent Application No. 62/650, entitled "SURGICAL SMOKE EVACUATION SENSING AND CONTROLS." , 877.

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 Ser.
• US patent application Ser. No. 15/940,742, entitled "DUAL CMOS ARRAY IMAGING."
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";
U.S. Patent Application No. 15/940,675, entitled "CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES";
- 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:
- U.S. Provisional Patent Application No. U.S. 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 embodiments 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 other aspects, implementations of aspects and/or examples described below. It should be understood that any one or more may be combined.

Surgical Hub Referring to FIG. 1, a computer-implemented interactive surgical system 100 may include one or more surgical systems 102 and a cloud-based system (e.g., remote server 113 coupled to storage 105). 104), and 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. 1, surgical system 102 includes visualization system 108, robotic system 110, and handheld intelligent surgical instrument 112 configured to communicate with each other and/or hub 106. and including. 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. , where M, N, O, and P are integers of 1 or greater.

FIG. 2 shows an example of surgical system 102 used to perform a surgical procedure on a patient lying on operating table 114 in 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 removably coupled surgical tool 117 through minimally invasive incisions in the patient's body while the surgeon views the surgical site through the surgeon's console 118. 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 can be found in "ROBOT ASSISTED SURGICAL PLATFORM," filed Dec. 28, 2017, the disclosure of which is incorporated herein by reference in its entirety. US Provisional Patent Application No. 62/611,339 entitled

Various examples of cloud-based analytics performed by the cloud 104 and suitable for use with the present disclosure are described in "CLOUD- US Provisional Patent Application No. 62/611,340 entitled "BASED MEDICAL 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 portions 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 to the human eye (i.e., can be detected by the human eye) and can be referred to as visible light, or simply light. is sometimes called 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, cholangoscopes, 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 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 U.S. Provisional Patent Application No. 62/611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed Dec. 28, 2017, the disclosure of which is incorporated herein by reference in its entirety. Advanced Imaging 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 imaging device 124 and its accessories and components. A sterile field may be considered a specific area, such as in a tray or on a sterile towel, which is considered free of microorganisms, or a sterile field may be considered an area immediately surrounding a patient prepared for a surgical procedure. It will be appreciated that this 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 disclosure of which is hereby incorporated by reference in its entirety. "Advanced Imaging Acquisition Module" in vol.

As shown in FIG. 2, primary display 119 is positioned within the sterile field so as to be visible to the operator of 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 utilizing 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 may route diagnostic input or feedback entered by a non-sterile operator located at the visualization tower 111 to a primary display 119 within the sterile area, which can be viewed by a sterile operator at the operating table. It may also be configured to be visible. In one example, the input may be a modification to a snapshot displayed on non-sterile display 107 or 109 , which can be routed by hub 106 to primary display 119 .

Referring to FIG. 2, surgical instrument 112 is being used in a surgical procedure as part of surgical system 102 . Hub 106 is also configured to coordinate information flow to the display of surgical instrument 112 . For example, information flow coordination is discussed in U.S. Provisional Patent Application No. 62/611,341, filed Dec. 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," the disclosure of which is incorporated herein by reference in its entirety. further explained. Diagnostic input or feedback entered by a non-sterile operator at visualization tower 111 may be routed by hub 106 to surgical instrument display 115 within the sterile field, where diagnostic input or feedback is provided to the operator of surgical instrument 112 . may be viewed by Examples of exemplary surgical instruments suitable for use with surgical system 102 include, for example, the section entitled "Surgical Instrument Hardware," the disclosure of which is incorporated herein by reference in its entirety, and the "INTERACTIVE SURGICAL US Provisional Patent Application No. 62/611,341, filed Dec. 28, 2017, entitled PLATFORM.

Referring now to FIG. 3 , 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 (which may include monopolar generator 142, bipolar generator 144, and/or ultrasonic generator 143), communication module 130, processor module 132, and It includes a storage array 134 . In certain aspects, the hub 106 further includes a smoke evacuation module 126, an aspiration/irrigation module 128, and/or an OR mapping module 133, as shown in FIG.

During a surgical procedure, the application of energy to tissue for sealing and/or cutting generally involves venting smoke, aspirating excess fluid, and/or irrigating the 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 combines 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. include. 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 type of energy 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 different generators and facilitate two-way communication between them. 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 the 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 two-way communication between the modules 140,126,128. As shown in FIG. 5, the generator module 140 is an integrated monopolar, bipolar, and ultra polar generator supported within a single housing unit 139 that is slidably insertable into the hub's modular housing 136 . It may be a generator module comprising an acoustic wave component. As shown in FIG. 5, the generator module 140 can be configured to connect to a monopolar device 146, a bipolar device 147, and an 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. 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. 4 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 a bipolar, ultrasonic, and monopolar module 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 . may include alignment features configured to engage their counterparts therein. For example, as shown in FIG. 4, combination generator module 145 has side brackets configured to slidably engage corresponding brackets 156 of corresponding docking stations 151 of hub modular housing 136 . 155 included. 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, each designed to accommodate a particular module.

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

As shown in FIG. 4, the docking port 150 of one drawer 151 is coupled to the docking port 150 of another drawer 151 via a communication link 157 to accommodate modules contained within the modular housing 136 of the hub. can facilitate two-way communication between Alternatively or additionally, the docking ports 150 of the hub modular housing 136 may 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. 6 illustrates individual power bus attachments 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 housings 160 that contain backplanes for interconnecting modules 161 . As shown in FIG. 6, the modules 161 are laterally arranged within the lateral modular housing 160 . Alternatively, modules 161 may be arranged vertically within a lateral modular housing.

FIG. 7 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 housings 164 that contain backplanes for interconnecting modules 165 . Although the drawers 167 of the vertical modular housing 164 are vertically oriented, in certain cases the vertical modular housing 164 may include laterally oriented drawers. Additionally, modules 165 may interact with each other via docking ports in vertical modular housing 164 . In the embodiment of FIG. 7, a display 177 is provided for displaying data related to the operation of module 165 . Additionally, vertical modular housing 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 containing 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, imaging module 138 can be configured to integrate images from different imaging devices.

Various image processors and imagers 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, each of which is incorporated herein by reference in its entirety.

FIG. 8 illustrates a cloud-based system (e.g., storage) of modular devices located in one or more operating rooms of a medical facility, or any room within a medical facility with specialized equipment for surgical procedures. 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 devices 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 data conduit, allowing data to go from one device (or segment) to another and to cloud computing resources. The intelligent surgical data network includes additional features 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, the surgical data network 201 comprises a combination of network hub(s), network switch(es), and network router(s) that connect the 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. The term "cloud" may be used as a metaphor for "Internet," but 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 at the surgical site (e.g., fixed, mobile, temporary, or on-site operating room or space), and via the Internet to modular communication hub 203 and /or delivered to a device connected to computer 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 devices.

By applying cloud computer data processing techniques to the data collected by the devices 1a-1n/2a-2m, the surgical data network will lead to improved surgical outcomes, reduced costs, and improved patient satisfaction. I will provide a. At least some of the devices 1a-1n/2a-2m can be used to monitor tissue condition to assess leakage or perfusion of the sealed tissue after the tissue sealing and cutting procedure. . At least some of the devices 1a-1n/2a-2m using cloud-based computing to examine data including images of body tissue samples for diagnostic purposes to identify medical conditions such as disease effects. can be used. This includes confirmation of tissue and phenotypic localization and margins. 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 on top of the physical layer of the Open System 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/Internet Protocol, IP) for transferring device data. Only one of the devices 1a-1n can transmit data through the 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. 9) 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. A network switch 209 is a multicast device for connecting the devices 2a to 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 2 a - 2 m can transmit data simultaneously through network switch 209 . 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. may be used. 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 a 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 (long-term evolution). term evolution, LTE) and Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT and their Ethernet derivatives, as well as 3G, 4G, 5G and beyond designations. Communicate with modular communication hub 203 via a number of wireless or wired communication standards or protocols including, but not limited to, any other wireless and wired protocols supported. 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 the 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 the 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 stand-alone 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. 9 shows a computer-implemented interactive surgical system 200 . 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 comprises a modular control tower 236 connected to multiple operating room devices such as, for example, intelligent surgical instruments, robots, and other computerized devices located within the operating room. . As shown in FIG. 10, modular control tower 236 comprises modular communication hub 203 coupled to computer system 210 . As illustrated in the embodiment of FIG. 9, modular control tower 236 includes imaging module 238 coupled to endoscope 239, generator module 240 coupled to energy device 241, smoke evacuator module 226, aspiration/ Coupled to an irrigation module 228 , a communications module 230 , a processor module 232 , a storage array 234 , a smart device/instrument 235 optionally coupled to a display 237 , and a contactless sensor module 242 . Operating room equipment is 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. 10 shows surgical hub 206 comprising multiple modules coupled to modular control tower 236 . Modular control tower 236 includes a modular communication hub 203, eg, a network connection device, and a computer system 210, eg, for providing local processing, visualization, and imaging. As shown in FIG. 10, 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. may be transferred to computer system 210, cloud computing resources, or both. As shown in FIG. 10, 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 field 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," which is hereby incorporated by reference in its entirety. 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, as described in Section 1. 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 device 248, memory 249, non-volatile memory 250, and input/output interface 251 through a system bus. The system bus is a 9-bit bus, Industrial Standard Architecture (ISA), Micro-Chearmel Architecture (MSA), Extended ISA (EISA), Intelligent Drive Electronics (IDE). ), VESA Local Bus (VLB), Peripheral Component Interconnect (PCI), USB, Advanced Graphics Port (AGP), Personal Computer Memory Card International Association Bus (Personal Computer Memory Card International Association bus, PCMCIA), Small Computer Systems Interface (SCSI), or any other proprietary bus, using any of a variety of bus architectures; 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.

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. Prefetch buffer, 32 KB single-cycle serial random access memory (SRAM), internal read-only memory (ROM) with StellarisWare® software, 2 KB electrical erase erasable programmable read-only memory (EEPROM) and/or one or more pulse width modulation (PWM) modules, one or more quadrature encoder inputs ( quadrature encoder input (QEI) analog, LM4F230H5QR available from Texas Instruments including one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels It may be an ARM Cortex-M4F processor core.

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 are specifically configured for IEC 61508 and ISO 26262 safety-critical applications to provide advanced integrated safety functionality while offering scalable performance, connectivity, and memory options. may

System memory includes both volatile and non-volatile memory. A basic input/output system (BIOS), containing the basic routines to transfer information between elements within a 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 includes random-access memory (RAM), which acts as external cache memory. Furthermore, RAM includes SRAM, dynamic RAM (dynamic RAM, DRAM), synchronous DRAM (synchronous DRAM, SDRAM), double data rate SDRAM (double data rate, DDR SDRAM), enhanced SDRAM (enhanced SDRAM, ESDRAM), sync link It is available in many forms such as DRAM (Synchlink DRAM, SLDRAM) and direct Rambus RAM (DRRAM).

Computer system 210 also includes removable/non-removable, volatile/non-volatile computer storage media, such as disk storage devices. Disk storage devices include, but are 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 be used to store storage media independently or as a compact disc ROM device (compact disc ROM, CD-ROM), a compact disc recordable drive (CD-R Drive), a compact disc Other storage media including, but not limited to, a compact disc rewritable drive (CD-RW Drive) or an optical disc drive such as a digital versatile disc ROM drive (DVD-ROM). can be included in any combination of 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 the disk storage device, 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 devices. 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 touchpads, 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 the 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 the 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, etc. be done. WAN technologies include 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). are not limited to these.

In various aspects, the computer system 210 of FIG. 10, the imaging module 238 of FIGS. 9-10, and/or the visualization system 208, and/or the processor module 232 are image processors, image processing engines, media processors, or digital image processors. may include any dedicated digital signal processor (DSP) used to process the Image processors can increase speed and efficiency using parallel computing using single instruction multiple data (SIMD) or multiple instruction multiple data (MIMD) techniques. 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. 11 illustrates a functional block diagram of one aspect of a USB network hub 300 device, in accordance with at least 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 (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 and receive ports 304, 306, 308 support both high 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 for managing 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 invert (NRZI) data Encoding/decoding and bit stuffing, CRC generation and checking (tokens and data), packet ID (PID) generation and checking/decoding, and/or serial-parallel-parallel-serial conversion may be mentioned. 310 receives a clock input 314 and via port logic 320 , 322 , 324 suspend/suspend to control communication between the upstream USB transmit/receive port 302 and the downstream USB transmit/receive ports 304 , 306 , 308 . It is coupled to resume logic and frame timer 316 circuitry and hub repeater circuitry 318 . SIE 310 is coupled to command decoder 326 via interface logic 328 to control 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.

Additional details regarding the structure and function of surgical hubs and/or networks of surgical hubs are provided in the U.S. patent entitled "METHOD OF HUB COMMUNICATION," filed April 19, 2018, which is incorporated herein by reference in its entirety. It can be found in Provisional Application No. 62/659,900.

Cloud System Hardware and Functional Modules FIG. 12 is a block diagram of a computer-implemented interactive surgical system, according to at least one aspect of the present disclosure. In one aspect, the computer-implemented interactive surgical system is configured to monitor and analyze data regarding the operation of various surgical systems including surgical hubs, surgical instruments, robotic devices, and operating rooms or medical facilities. be. Computer-implemented interactive surgical systems include cloud-based analysis systems. The cloud-based analysis system is described as a surgical system, but is not necessarily so limited and may be a cloud-based medical system. As shown in FIG. 12, the cloud-based analysis system includes a plurality of surgical instruments 7012 (which may be the same or similar to instrument 112) and a plurality of surgical instruments 7012 (which may be the same or similar to hub 106). Surgical hub 7006 and surgical data network 7001 (which may be the same or similar to network 201) couple surgical hub 7006 to cloud 7004 (which may be the same or similar to cloud 204). do. Each of the plurality of surgical hubs 7006 are communicatively coupled to one or more surgical instruments 7012 . Hub 7006 is also communicatively coupled via network 7001 to cloud 7004 of computer-implemented interactive surgical systems. Cloud 7004 is a remote, centralized source of hardware and software for storing, manipulating, and communicating data generated based on the operation of various surgical systems. As shown in Figure 12, access to cloud 7004 is achieved via network 7001, which may be the Internet or some other suitable computer network. Surgical hub 7006 coupled to cloud 7004 can be considered the client side of the cloud computing system (ie, cloud-based analysis system). Surgical instrument 7012 is paired with surgical hub 7006 for controlling and performing various surgical procedures or actions described herein.

Additionally, surgical instrument 7012 may include a transceiver for data transmission to and from a corresponding surgical hub 7006 (which may also include a transceiver). The combination of surgical instrument 7012 and corresponding hub 7006 may point to a particular location, such as an operating room within a medical facility (eg, hospital) for providing medical surgery. For example, the memory of surgical hub 7006 may store position data. As shown in FIG. 12, cloud 7004 includes central server 7013 (which may be the same or similar to remote server 113 of FIG. 1 and/or remote server 213 of FIG. 9), hub application server 7002, data analytics module 7034 and input/output (“I/O”) interface 7007 . A central server 7013 of cloud 7004 collectively manages the cloud computing system, including monitoring requests by client modules 7006 and managing the processing power of cloud 7004 to execute the requests. Each of the central servers 7013 has one or more processors coupled to a suitable memory device 7010, which can include volatile memory such as random access memory (RAM) and non-volatile memory such as magnetic storage. 7008. Memory device 7010 contains machine-executable instructions that, when executed, cause processor 7008 to execute data analysis module 7034 for cloud-based data analysis, operations, recommendations, and other operations described below. It's okay. Further, processor 7008 can execute data analysis module 7034 independently of, or in conjunction with, hub applications independently executed by hub 7006 . Central server 7013 also includes an aggregated medical data database 2212 that may reside within memory 2210 .

Based on its connection to various surgical hubs 7006 via network 7001, cloud 7004 can aggregate data from specific data generated by various surgical instruments 7012 and their corresponding hubs 7006. can. Such aggregated data may be stored in aggregated medical database 7011 in cloud 7004 . Specifically, cloud 7004 may advantageously perform data analysis and operations on aggregated data to provide functionality that individual hubs 7006 cannot accomplish on their own. To this end, as shown in FIG. 12, cloud 7004 and surgical hub 7006 are communicatively coupled to send and receive information. I/O interface 7007 is connected to multiple surgical hubs 7006 via network 7001 . In this manner, I/O interface 7007 may be configured to transfer information between surgical hub 7006 and aggregated medical data database 7011 . Accordingly, the I/O interface 7007 can facilitate read/write operations of the cloud-based analytics system. Such read/write operations may be performed in response to requests from hub 7006 . These requests may be sent to hub 7006 via the hub application. I/O interfaces 7007 may include one or more Universal Serial Bus (USB) ports, IEEE 1394 ports, and Wi-Fi and Bluetooth I/O interfaces for connecting cloud 7004 to hub 7006. A high speed data port may also be included. Hub application server 7002 of cloud 7004 is configured to host and provide shared functionality to software applications (eg, hub applications) executed by surgical hub 7006 . For example, hub application server 7002 may manage requests made by hub applications through hub 7006 to control access to centralized medical data database 7011 and perform load balancing. Data analysis module 7034 is described in more detail with reference to FIG.

The configuration of the particular cloud computing system described in this disclosure specifically raises various issues in the context of medical operations and procedures performed using medical devices such as surgical instruments 7012, 112. designed to deal with In particular, surgical instrument 7012 may be a digital surgical device configured to interact with cloud 7004 to implement techniques to improve surgical outcomes. Various surgical instruments 7012 and/or surgical hubs 7006 include touch-controlled user interfaces so that the clinician may control aspects of the interaction between the surgical instruments 7012 and the cloud 7004. It's okay. Other suitable user interfaces for control may also be used, such as an audibly controlled user interface.

FIG. 13 is a block diagram illustrating the functional architecture of a computer-implemented interactive surgical system, according to at least one aspect of the present disclosure; The cloud-based analysis system includes a plurality of data analysis modules 7034 that can be executed by processors 7008 of cloud 7004 to provide data analysis solutions to problems that arise specifically in the medical field. As shown in FIG. 13, the functionality of the cloud-based data analysis module 7034 may be supported via a hub application 7014 hosted by a hub application server 7002 that may be accessed on the surgical hub 7006. Cloud processor 7008 and hub application 7014 may work in conjunction to perform data analysis module 7034 . Application program interface (API) 7016 defines a set of protocols and routines corresponding to hub application 7014 . In addition, API 7016 manages the storage and retrieval of data in and out of aggregated medical data database 7011 for the operation of application 7014 . Cache 7018 also stores data (eg, temporarily) and is coupled to API 7016 for more efficient retrieval of data used by application 7014 . The data analysis module 7034 of FIG. Contains modules. Other suitable data analysis modules may also be implemented by cloud 7004, according to some aspects. In one aspect, the data analysis module is used to make specific recommendations based on analysis of trends, outcomes, and other data.

For example, the data collection and aggregation module 7022 can identify salient features or configurations (e.g., trends), manage redundant data sets, and group by surgery, but not necessarily on the actual surgical date and surgeon. It may be used to generate self-describing data (eg, metadata), including storing data in unmatched paired datasets. In particular, paired data sets generated from the operation of surgical instrument 7012 may include applying binary classification, such as bleeding or non-bleeding events. More generally, a binary classification may be characterized as either a desirable event (eg, a successful surgical procedure) or an undesirable event (eg, misfiring or misused surgical instrument 7012). Aggregated self-describing data may correspond to individual data received from various groups or subgroups of surgical hub 7006 . Accordingly, data collection and aggregation module 7022 can generate aggregated metadata or other organized data based on raw data received from surgical hub 7006 . To this end, processor 7008 can be operatively coupled to hub application 7014 and aggregated medical data database 7011 to execute data analysis module 7034 . Data collection and aggregation module 7022 may store the aggregated organized data in aggregated medical data database 2212 .

A resource optimization module 7020 can be configured to analyze this aggregated data to determine the optimal use of resources for a particular medical facility or group of medical facilities. For example, the resource optimization module 7020 may determine optimal ordering points for surgical staplers 7012 for a group of medical facilities based on the corresponding predicted demand for such instruments 7012 . The resource optimization module 7020 may also evaluate resource usage or other operating configurations of various medical facilities to determine if resource usage can be improved. Similarly, recommendation module 7030 can be configured to analyze organized data aggregated from data collection and aggregation module 7022 to provide recommendations. For example, the recommendation module 7030 may indicate that a particular surgical instrument 7012 should be upgraded to an improved version based, for example, on a higher than expected error rate. health care providers). In addition, recommendation module 7030 and/or resource optimization module 7020 may recommend better supply chain parameters, such as product reorder points, for different surgical instruments 7012, their use, or procedural steps to improve surgical outcomes. It may also be possible to provide recommendations such as Medical facilities can receive such recommendations via corresponding surgical hubs 7006 . More specific recommendations regarding various surgical instrument 7012 parameters or configurations may also be provided. Hub 7006 and/or surgical instrument 7012 may each have a display screen for displaying data or recommendations provided by cloud 7004 .

Patient outcome analysis module 7028 can analyze surgical results associated with currently used operating parameters of surgical instrument 7012 . Patient outcome analysis module 7028 may also analyze and evaluate other potential operating parameters. In this connection, the recommendation module 7030 may use these other potential operating parameters to make recommendations based on yielding better surgical outcomes, such as better sealing or less bleeding. Sometimes you can. For example, recommendation module 7030 can send recommendations to surgical hub 7006 regarding when to use a particular cartridge in a corresponding stapling surgical instrument 7012 . Cloud-based analysis systems can therefore analyze large collections of raw data, across multiple medical facilities (advantageously, decisions based on aggregated data) while controlling for common variables. ) may be configured to provide focused recommendations. For example, a cloud-based analysis system can identify which providers/facilities use similar types of instruments, types of practices, types of patients, patient can be analyzed, evaluated, and/or aggregated for the number of medical providers, geographic similarities among healthcare providers.

The control program update module 7026 may also be configurable to implement various surgical instrument 7012 recommendations when the corresponding control program is updated. For example, patient outcome analysis module 7028 may be able to identify correlations linking successful (or unsuccessful) outcomes with particular control parameters. Such correlations may be addressed when an updated control program is sent to surgical instrument 7012 via control program update module 7026 . Updates to instruments 7012 sent via corresponding hubs 7006 may incorporate aggregated performance data collected and analyzed by data collection and aggregation module 7022 of cloud 7004 . Additionally, patient outcome analysis module 7028 and recommendation module 7030 can identify improved methods of using instrument 7012 based on aggregated performance data.

A cloud-based analytics system may include security features implemented by the cloud 7004 . These security features may be managed by authorization and security module 7024 . Each surgical hub 7006 can have associated unique credentials such as a username, password, and other suitable security credentials. These credentials may be stored in memory 7010 and associated with permitted cloud access levels. For example, based on providing correct credentials, surgical hub 7006 may be granted access to communicate with the cloud to a predetermined extent (e.g., transmission of certain defined types of information). or receive). To this end, the aggregated medical data database 7011 of cloud 7004 may include a credential database for verifying the accuracy of provided credentials. Different credentials may be associated with different levels of authorization for interaction with cloud 7004 , such as a predetermined access level for receiving data analytics generated by cloud 7004 .

Additionally, for security purposes, the cloud may be able to maintain a database of hubs 7006, appliances 7012, and other devices that may include a "blacklist" of prohibited devices. Specifically, a blacklisted surgical hub 7006 may not be allowed to interact with the cloud, while a blacklisted surgical instrument 7012 may not be allowed to interact with the corresponding hub. 7006 and/or may be prevented from being fully functional when paired with a corresponding hub 7006. Additionally or alternatively, cloud 7004 may flag instruments 7012 based on non-compliance or other specified criteria. In this manner, unauthorized medical devices and inappropriate reuse of such devices can be identified and addressed across cloud-based analysis systems.

Surgical instruments 7012 may, for example, use wireless transceivers to transmit wireless signals that may represent authorization credentials for access to corresponding hub 7006 and cloud 7004 . A wired transceiver may also be used to transmit the signal. Such authorization credentials can be stored in the respective memory device of surgical instrument 7012 . Authorization and security module 7024 can determine whether authorization credentials are correct or incorrect. Authorization and security module 7024 can also dynamically generate authorization credentials for enhanced security. Credentials can also be encrypted, such as by using hash-based encryption. Upon sending the appropriate authorization, the surgical instrument 7012 signals the corresponding hub 7006 and ultimately the cloud 7004 to indicate that the instrument 7012 is ready to acquire and transmit medical data. may In response, cloud 7004 may transition to a state capable of receiving medical data for storage in aggregated medical data database 7011 . This readiness for data transmission may be indicated by a light indicator on the instrument 7012, for example. Cloud 7004 can also send signals to surgical instruments 7012 to update their associated control programs. Cloud 7004 can transmit signals directed to specific classes of surgical instruments 7012 (e.g., electrosurgical instruments) so that only those surgical instruments 7012 that are appropriate for updating the software controlling the program. sent. Additionally, cloud 7004 may also be used to implement system-wide solutions to address local or global issues based on selective data transmission and authorization credentials. For example, if a group of surgical instruments 7012 is identified as having a common manufacturing defect, cloud 7004 may modify the authorization credentials corresponding to this group to enforce operational lockout for this group. good.

A cloud-based analytics system monitors multiple medical facilities (e.g., medical facilities such as hospitals), determines improved practices, and recommends changes accordingly (e.g., via recommendation module 2030). may Accordingly, processor 7008 of cloud 7004 can analyze data associated with individual medical facilities to identify the facilities and aggregate that data with other data associated with other medical facilities. Groups may be defined based on similar operational practices or geographic locations, for example. In this manner, cloud 7004 may provide analysis and recommendations across medical facility groups. Cloud-based analytics systems may also be used for enhanced situational awareness. For example, the processor 7008 may predictively model the effects of cost and effectiveness recommendations for a particular facility (over overall operations and/or various medical procedures). The costs and effectiveness associated with that particular facility can also be compared to corresponding local areas of other facilities or any other comparable facility.

The data classification and prioritization module 7032 may prioritize and classify data based on severity (eg, severity of medical event associated with the data, surprise, suspiciousness). This categorization and prioritization may be used in conjunction with other data analysis module 7034 functions described above to improve the cloud-based analysis and operations described herein. For example, data classification and prioritization module 7032 can assign priorities to data analysis performed by data collection and aggregation module 7022 and patient outcome analysis module 7028 . Different priority levels can be used to send messages from cloud 7004 (corresponding to levels of urgency), such as escalation for expedited response, special handling, exclusion from aggregated medical data database 7011, or other suitable response. can provide a specific response. Additionally, if desired, cloud 7004 can send requests (eg, push messages) through hub application servers for additional data from corresponding surgical instruments 7012 . A push message can result in a notification to request support or additional data displayed on the corresponding hub 7006 . This push message may be required in situations where the cloud detects significant irregularities or outliers and the cloud cannot determine the cause of the irregularities. The central server 7013 is configured to trigger this push message in certain critical situations, such as when data is determined to differ from expected values by more than a predetermined threshold, or when security appears to have been involved. may be programmed to

Further details regarding cloud analytics systems can be found in U.S. Provisional Patent Application No. 62/659,900, entitled "METHOD OF HUB COMMUNICATION," filed April 19, 2018, which is incorporated herein by reference in its entirety. can be issued.

Situational Awareness "Intelligent" devices, including control algorithms responsive to sensed data, are an improvement over "dumb" devices that operate without considering sensed data, but some Any sensed data may be incomplete or indeterminate when considered alone, i.e., without the context of the type of surgical procedure being performed or the type of tissue being operated on. . Without knowledge of the treatment context (e.g., the type of tissue being operated on or the type of procedure being performed), the control algorithm could, given sensory data containing no specific context, operate the modular device. It can be controlled imprecisely or sub-optimally. For example, the optimal method of control algorithm for controlling a surgical instrument in response to a particular sensed parameter may differ according to the particular tissue type being operated on. This is due to the fact that different tissue types have different properties (eg, resistance to tearing) and thus respond differently to motion taken by a surgical instrument. Therefore, it may be desirable for the surgical instrument to take different actions even when the same measurement is sensed for a particular parameter. As one specific example, the optimal method of controlling surgical stapling and severing instruments in response to the instrument sensing an unexpectedly high force to close its end effector is to determine whether the tissue type is torn. depending on whether it is susceptible or resistant to For tissue susceptible to tearing, such as lung tissue, the instrument's control algorithm optimally ramps down the motor in response to the unexpectedly high closing force to avoid tearing the tissue. For tissue that is resistant to tearing, such as stomach tissue, the instrument's control algorithm responds to an unexpectedly high closing force to ensure that the end effector is properly clamped to the tissue. Allows the motor to ramp up optimally. Without knowing whether lung tissue is clamped or stomach tissue is clamped, the control algorithm may make sub-optimal decisions.

One solution includes a surgical procedure that includes a system configured to derive information about a surgical procedure to be performed based on data received from various data sources, and then control paired modular devices accordingly. Use a hub for In other words, the surgical hub infers information about the surgical procedure from the received data and then controls the modular devices paired with the surgical hub based on the inferred context of the surgical procedure. Configured. FIG. 14 shows a diagram of a situation-aware surgical system 5100 according to at least one aspect of the present disclosure. In some examples, data sources 5126 may include, for example, modular device 5102 (which may include sensors configured to detect parameters associated with the patient and/or the modular device itself), database 5122 ( EMR database containing patient records), and patient monitoring devices 5124 (eg, blood pressure (BP) monitors and electrocardiogram (EKG) monitors).

Surgical hub 5104 can be similar in many respects to hub 106, for example, based on a particular combination of received data or a particular order in which data is received from data sources 5126, to determine whether data can be translated into a surgical procedure. may be configured to derive contextual information about the Contextual information inferred from the received data may include, for example, the type of surgical procedure being performed, the specific steps in the surgical procedure being performed by the surgeon, the type of tissue being operated on, or the body cavity being treated. can be done. This ability by some aspects of the surgical hub 5104 to derive or infer surgical procedure-related information from the received data may be referred to as "situational awareness." In one illustration, surgical hub 5104 can incorporate a situational awareness system, which is hardware and/or programming associated with surgical hub 5104 that derives contextual information related to a surgical procedure from received data.

The situational awareness system of surgical hub 5104 may be configured to derive contextual information from data received from data sources 5126 in a variety of different ways. In one example, the situational awareness system is trained to correlate various inputs (eg, data from database 5122, patient monitoring device 5124, and/or modular device 5102) with corresponding contextual information about surgical procedures. Including pattern recognition systems trained on data, or machine learning systems (eg, artificial neural networks). In other words, a machine learning system can be trained to accurately derive contextual information about a surgical procedure from the input provided. In another illustrative example, the situation awareness system stores pre-characterized contextual information about a surgical procedure in association with one or more inputs (or ranges of inputs) corresponding to the contextual information. It can contain a lookup table that In response to interrogation by one or more inputs, the lookup table can return corresponding contextual information for the situational awareness system to control the modular device 5102 . In one illustration, contextual information received by the situational awareness system of surgical hub 5104 is associated with a particular control adjustment or set of control adjustments for one or more modular devices 5102 . In another illustration, the situational awareness system is a further machine that generates or obtains one or more control adjustments for one or more modular devices 5102 when contextual information is provided as input. Including learning systems, lookup tables, or other such systems.

Surgical hub 5104 incorporating a situational awareness system provides surgical system 5100 with many benefits. One benefit includes improved interpretation of sensed and collected data, which improves processing accuracy and/or use of data during the course of a surgical procedure. To return to the previous example, the context-aware surgical hub 5104 can determine what type of tissue is being operated on, and thus an unexpectedly high force is required to close the end effector of the surgical instrument. Once detected, the context-aware surgical hub 5104 can properly ramp up or ramp down the motor of the surgical instrument for the tissue type.

As another example, the type of tissue being operated on can affect adjustments made to the compression rate and load threshold of the surgical stapling and cutting instrument for a particular tissue gap measurement. The context-aware surgical hub 5104 can deduce whether the surgical procedure being performed is a thoracic procedure or an abdominal procedure, which allows the context-aware surgical hub 5104 to use surgical stapling and severing instruments. It can be determined whether the tissue being clamped by the end effector is the lung (for thoracic surgery) or the stomach (for abdominal surgery). Surgical hub 5104 can then adjust the compression rate and load threshold of the surgical stapling and severing instrument appropriately for the tissue type.

As yet another example, the type of body cavity being operated on during an insufflation procedure can affect smoke evacuator function. The context-aware surgical hub 5104 can determine if the surgical site is under pressure (by determining that the surgical procedure utilizes insufflation) and determine the procedure type. Because the procedure type is typically performed within a specific body cavity, the surgical hub 5104 can control the motor speed of the smoke evacuator appropriately for the body cavity being operated on. Accordingly, the context-aware surgical hub 5104 can provide a consistent amount of smoke evacuation for both thoracic and abdominal surgery.

As yet another example, the type of procedure being performed can affect the optimal energy level at which an ultrasonic surgical instrument or radio frequency (RF) electrosurgical instrument operates. Arthroscopic procedures, for example, require higher energy levels because the end effectors of ultrasonic surgical instruments or RF electrosurgical instruments are immersed in fluid. The context-aware surgical hub 5104 can determine if the surgical procedure is an arthroscopic procedure. The surgical hub 5104 can then adjust the generator's RF power level or ultrasound amplitude (ie, “energy level”) to compensate for the fluid-filled environment. Relatedly, the type of tissue being operated on can affect the optimal energy level at which an ultrasonic or RF electrosurgical instrument operates. The situational awareness surgical hub 5104 determines which type of surgical procedure is being performed according to the expected tissue profile of the surgical procedure, and then adjusts the energy level of the ultrasonic surgical instrument or the RF electrosurgical instrument, respectively. Can be customized. Additionally, the context-aware surgical hub 5104 may be configured to adjust the energy levels of ultrasonic or RF electrosurgical instruments over the course of a surgical procedure, not just on a procedure basis. The context-aware surgical hub 5104 determines which step of the surgical procedure is being performed or is to be performed and then activates the generator and/or ultrasonic or RF electrosurgical instrument control algorithms. It can be updated to set the energy level to a value appropriate for the expected tissue type according to the surgical procedure step.

As yet another example, data can be drawn from additional data sources 5126 to improve the conclusions surgical hub 5104 draws from one data source 5126 . Situational Awareness Surgical Hub 5104 can augment the data received from modular device 5102 with contextual information built about surgical procedures from other data sources 5126 . For example, the context-aware surgical hub 5104 is configured to determine whether hemostasis has occurred (i.e., whether bleeding has stopped at the surgical site) according to video or image data received from a medical imaging device. can be However, in some cases the video or image data may be indeterminate. Thus, in one illustration, the surgical hub 5104 can communicate physiological measurements (eg, blood pressure sensed by a BP monitor communicatively connected to the surgical hub 5104) to the surgical hub 5104 (eg, It may be further configured to compare to visual or image data of hemostasis (from a medical imaging device 124 (FIG. 2) coupled to the device) to make determinations about staple line integration or tissue welding. In other words, the situational awareness system of surgical hub 5104 can consider physiological measurement data to provide additional context in analyzing visualization data. Additional context may be useful when visualization data may be indeterminate or incomplete on their own.

Another benefit is the identification of the surgical procedure being performed to reduce the number of times medical personnel are required to interact with or control the surgical system 5100 during the course of the surgical procedure. involves proactively and automatically controlling the modular devices 5102 to be paired. For example, the context-aware surgical hub 5104 can proactively activate a generator to which an RF electrosurgical instrument is connected if it determines that a subsequent step in the procedure requires use of the instrument. . By proactively activating the energy source, the instrument can be ready for use as soon as the preceding steps of the procedure are completed.

As another example, the context-aware surgical hub 5104 anticipates that the surgeon will need to see if current or subsequent steps in the surgical procedure require different views or degrees of magnification on the display. can be determined according to the characteristic(s) at the surgical site. Surgical hub 5104 can then proactively change the displayed field of view (eg, provided by the medical imaging device for visualization system 108) accordingly, so that the display remains stable throughout the surgical procedure. to automatically adjust.

As yet another example, the context-aware surgical hub 5104 can determine which step of the surgical procedure is being performed or will be performed after it, and what particular data or comparisons between data are required for that step of the surgical procedure. can determine whether or not Surgical hub 5104 may be configured to automatically invoke data screens based on the steps of the surgical procedure being performed without waiting for the surgeon to ask for specific information.

Another benefit includes checking for errors during surgical setup or during the course of a surgical procedure. For example, the context-aware surgical hub 5104 can determine whether the operating room is properly or optimally set up for the surgical procedure to be performed. Surgical hub 5104 determines the type of surgical procedure being performed, retrieves (eg, from memory) the corresponding checklists, product locations, or setup needs, and then maps the current operating room layout to the surgical The surgical hub 5104 may be configured to compare to a standard layout for the type of surgical procedure determined to be performed. In one example, surgical hub 5104 stores a list of items for processing scanned by, for example, a suitable scanner and/or a list of devices paired with surgical hub 5104 for a given surgical procedure. It may be configured to compare against recommended or expected manifests of items and/or devices. If there is any discontinuity between the listings, surgical hub 5104 will issue a warning indicating that a particular modular device 5102, patient monitor device 5124, and/or other surgical item is missing. can be configured to provide In one illustration, surgical hub 5104 can be configured to determine the relative distance or position of modular device 5102 and patient monitor device 5124 by, for example, proximity sensors. Surgical hub 5104 can compare the relative positions of the devices to the recommended or anticipated layout for a particular surgical procedure. If a discontinuity exists between layouts, surgical hub 5104 may be configured to provide a warning indicating that the current layout of the surgical procedure deviates from the recommended layout.

As another example, the situational awareness surgical hub 5104 may indicate that the surgeon (or other medical personnel) has made a mistake or otherwise deviated from the expected course of action during the course of a surgical procedure. can determine whether there is For example, the surgical hub 5104 determines the type of surgical procedure to be performed, retrieves (eg, from memory) the corresponding list of steps or instrument use sequences, and then performs the procedure during the course of the surgical procedure. It may be configured to compare steps or instruments being used with expected steps or instruments for the type of surgical procedure that surgical hub 5104 has determined is being performed. In one example, surgical hub 5104 is configured to provide a warning indicating that an unexpected action has been taken or an unexpected device has been utilized at a particular step in a surgical procedure. obtain.

Overall, the situational awareness system for surgical hub 5104 tailors surgical instruments (and other modular devices 5102) for the specific context of each surgical procedure (e.g., adapts to different tissue types, etc.). ), improving surgical outcomes by validating actions during the surgical procedure. The situational awareness system also assists surgical procedures by automatically suggesting next steps, providing data, and coordinating displays and other modular devices 5102 in the operating room according to the specific context of the procedure. improve the efficiency of the surgeon in performing

Referring now to FIG. 15, a timeline 5200 illustrating situational awareness of a hub such as, for example, surgical hub 106 or 206 (FIGS. 1-11) is shown. The timeline 5200 is an exemplary surgical procedure and contextual information that the surgical hubs 106, 206 can derive from the data received from the 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, starting with setting up the operating room and ending with transferring the patient to the post-operative recovery room. shows the typical steps that might be taken.

The situational awareness surgical hub 106, 206 sources data throughout the course of a surgical procedure, including data generated each time a medical practitioner utilizes a modular device paired with the surgical hub 106, 206. receive from The surgical hubs 106, 206 retrieve this data from paired modular devices and other data sources, and new data is received such as which steps of the procedure are being performed at any given time. , an inference (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 a procedure to generate a report, verify steps being taken by medical personnel, collect data that may be relevant to a particular procedure step, or Provide prompts (e.g., via a display screen), adjust modular devices based on context (e.g., activate a monitor, adjust the field of view (FOV) of a medical imaging device, or perform ultrasound 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 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. Additionally, the surgical hub 106, 206 can also determine that the procedure is not a wedge procedure (the incoming product does not include the specific product required for a thoracic wedge procedure or otherwise either not compatible with 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 auxiliary devices 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 equipment. Upon activation, an auxiliary instrument that is a modular device can automatically pair with surgical hubs 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 that the surgical procedure is a VATS procedure based on this particular combination of paired modular devices. Based on a combination of data from the patient's EMR, the list of medical supplies used in the surgery, and the type of modular device that connects to the hub, the surgical hub 106, 206 can determine the specific procedure to be performed by the surgical team. can be roughly estimated. Once the surgical hub 106, 206 knows what particular procedure is being performed, then the surgical hub 106, 206 retrieves the steps of that procedure from memory or from the cloud and then connects. Data subsequently received from different data sources (eg, modular devices and patient monitors) can be cross-referenced to deduce which step of the surgical procedure the surgical team is performing.

In a fifth step 5210, personnel attach EKG electrodes and other patient monitoring equipment 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 monitor, the surgical hub 106, 206 confirms that the patient is in the operating room.

In a sixth step 5212, medical personnel anesthetize the patient. The surgical hub 106, 206 determines that the patient is under anesthesia based on data from the modular device and/or patient monitor device 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 undergoing surgery 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 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 ignored by the surgical hubs 106, 206). Data from medical imaging device 124 (FIG. 2) can be used to determine contextual information about the type of procedure being performed in many different ways, many of which include Determining the angle of the medical imaging device oriented with respect to visualization of the structure, the number or medical imaging devices in use (i.e., activated and paired with the surgical hub 106, 206) and the type of visualization device being used. 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 utilizes 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 utilized in VATS lobectomy. By tracking any or all of this data from the medical imaging device, the surgical hub 106, 206 can be used for the particular type of surgical procedure being performed and/or the type of surgical procedure being performed. technology can be determined.

In 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 instrument is being fired, and therefore assumes that the surgeon is in the process of making an incision to move the patient's lungs. be able to. The surgical hub 106, 206 cross-references the received data with the retrieved steps of the surgical procedure to determine what is being fired at this point in the process (i.e., after the previously-discussed steps of the procedure have been completed). It can be determined that the energy device present corresponds to the lancing step. In certain examples, the energy instrument can be an energy tool attached to a robotic arm of a robotic surgical system.

In 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 steps in the read 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 type of staple fired is 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 utilized after the parenchyma has been transected correspond to the knototomy step by which the surgical hub 106, 206 makes this estimate. 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 monitors 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 the patient monitor. 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 U.S. Provisional Patent Application No. 62/659,900, filed April 19, 2018, entitled "METHOD OF HUB COMMUNICATION," which is hereby incorporated by reference in its entirety. . In certain examples, 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 from cloud 104. can be controlled by the hub 106, 206 based on the information of

Automatic Correlation/Integration of Data Streams In various aspects, a computer system (e.g., cloud analysis system, surgical hub, and/or data warehouse system) has focus areas of data that can be additionally accessed or overlaid. It can be programmed to perform automatic correlation and/or integration of multiple data streams into a single interface. In one aspect, real-time interpreted information may be displayed on the device for the user, the interpretation being based on data from at least one function of the device and data from a second, different source.

In one aspect, the interpreted information may be displayed to the user based on at least one capability of the device, including at least one data source not originating within the device. In another aspect, the at least one additional source automatically updates aspects of the measurement device and the secondary information on the display of the device capable of determining relevant parameters of the patient with respect to the functioning of the device, and and the ability to update it in real time. In one aspect, real-time updating is accomplished by allowing the surgical instrument to iteratively calculate new data within a user-defined selection form.

Referring to FIG. 16, a modular device in the form of a handheld surgical device 205001 includes a handle 205002 having a user interface 205004 in the form of, for example, a display or screen. Surgical device 205001 includes an end effector 205006 configured to resect a blood vessel. In the example of FIG. 16, end effector 205006 comprises staple cartridge 205008 . Staples 205003 are deployed from staple cartridge 205008 into tissue (T) grasped by end effector 205006 such that the cutting member advances distally to tissue (T) during the firing stroke of surgical device 205001. disconnect. In other examples, the surgical device 205001 can utilize energy (eg, RF energy and/or ultrasonic energy) to seal, coagulate, and/or cut tissue.

Referring to the upper left of FIG. 16, the field of view 205007 of the imager is shown. Field of view 205007 may be displayed on any suitable monitor or display within and/or outside the sterile field. Field of view 205007 shows end effector 205006 about to staple and cut around a vessel. Another vessel that was previously stapled and cut also appears within field of view 205007 . A magnified view of the lower left field of view 205007 of FIG. 16 shows a leak (L) in a previously stapled and cut vessel. As noted above, leakage (L) may be detected by one or more of the automatic image interpretation techniques described herein.

In the embodiment of FIG. 16, surgical device 205001 is shown as a handheld surgical instrument similar in many respects to handheld surgical instruments 112 (FIG. 2), 235 (FIG. 9). User interface 205004 may be device/instrument display 237, for example. In other examples, however, surgical device 205001 may be adapted for use as surgical tool 117 of robotic system 110 . In such examples, the user interface 205004 and/or the controls of the surgical device 205001 may be located, for example, on the surgeon's console 118 (FIG. 2). Alternatively, user interface 205004 may be any suitable display (eg, 107, 109, 119, 135, 210, 217).

Referring to FIG. 17, a schematic diagram of surgical device 205001 is shown. Control circuitry 205012 is in electrical communication with a motor driver 205013 that controls a motor 205014 that propels firing member 205010 to deploy staples 205003 and cut members during the firing stroke of surgical device 205001. is configured to advance the

As shown in the bottom right of FIG. 16, the user interface 205004 relates to the firing stroke of the surgical device 205001, including speed settings 205005 of the firing member 205010 movable to deploy the staples 205003 and advance the cutting member. display the various parameters that User interface 205004 also displays a latency graph 205018 that presents recommended latency times for two separate functions of surgical device 205001, the first function of which is to grasp tissue; The second function is to deploy staples 205003 and advance the cutting member. In various examples, the user interface 205004 allows the user to select and/or adjust the velocity and/or amount of latency of the firing member 205010.

User interface 205004 is configured to display information interpreted based on at least one feature of surgical device 205001 . In the example of FIG. 16, the at least one function is firing stroke and the interpreted information relates to tissue hemostasis. Specifically, the interpreted information relates to hemostasis of tissue treated in previous firings of surgical device 205001 . The user interface 205004 may display information interpreted concurrently with setting at least one parameter of the firing stroke, such as rate of fire or latency, as described in more detail below. Additionally, tissue hemostasis may be monitored separately, and tissue hemostasis data and/or interpreted information may be transmitted to surgical device 205001 via a suitable communication link.

In another example, for example, interpreted information related to the blood pressure of blood vessels within the tissue being grasped may be displayed concurrently with the firing rate and/or latency parameters of the firing stroke. In various examples, blood pressure may be monitored separately and blood pressure data, or information interpreted from the blood pressure data, may be transmitted to surgical device 205001 via a suitable communication link.

In another example, at least one function may be grasping tissue. Tissue compression or pressure may be parameters of tissue grasping that may be displayed on user interface 205004 and/or modified by user input through user interface 205004 . Further, for example, interpreted information related to blood pressure of blood vessels within the tissue being grasped may be displayed simultaneously with tissue compression or pressure settings.

In at least one example, the interpreted information is based on at least one data source not originating within surgical device 205001 . In various aspects, the data source is a separate device different from surgical device 205001 . Data from data sources may be interpreted into information related to the functions performed by surgical device 205001 .

Data interpretation may be performed locally at surgical device 205001 . Alternatively, data interpretation may be performed locally at the data source, with the interpreted information routed to the surgical device 205001, e.g., directly or indirectly through a surgical hub (e.g., 106, 206). can be Alternatively, data interpretation may be performed locally at the processing unit of the surgical hub (eg, 106, 206) and the interpreted information may then be routed to surgical device 205001, for example. Alternatively, data interpretation may be performed in cloud system 104, which may be configured to route interpreted information to surgical device 205001 either directly or indirectly through a surgical hub (eg, 106, 206), for example. may be broken.

Routing data and/or information to and from surgical device 205001, data sources, and/or surgical hubs (eg, 106, 206) is accomplished using any suitable wired or wireless communication link. can be For example, modular communication hub 203 may be used to route information and/or data.

In various examples, the data source can be a sensor on another modular device. In various examples, the data source is an imaging device. In at least one example, the data sources may be one or more components of visualization system 108 (FIG. 1). 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 disclosure of which is hereby incorporated by reference in its entirety. "Advanced Imaging Acquisition Module" in vol.

In various examples, the imaging device can be configured to record and/or process imaging data related to functions performed by surgical device 205001 . Automated image interpretation may then be performed locally at the imaging device, locally at the surgical device 205001 , locally at the surgical hub (eg 106 , 206 ), and/or remotely at the cloud system 104 . User interface 25004 may then be configured to display the image interpretation concurrently or concurrently with setting one or more parameters associated with the function.

In various examples, the interpreted information is displayed by the user interface 205004 in real time or near real time. Real-time updates are accomplished, for example, by iteratively interpreting new data in a user-defined selected form. Interpreted information may be updated at a default refresh rate that may be selected by the user of surgical device 205001 .

17 and 18, control circuitry 205012 is configured to implement process 205020. FIG. In various examples, control circuitry 205012 includes a processor and memory that stores program instructions that, when executed by the processor, cause the processor to perform process 205020 . As shown in FIG. 18, process 205020 includes receiving 205022 input from an external data source representing interpreted information associated with the firing stroke, as described above. Process 205020 further causes the interpreted information to be displayed on user interface 205004 along with at least one parameter setting associated with the firing stroke (205023). In one embodiment, the interpreted information is displayed concurrently or co-timed with at least one parameter setting to aid in user selection. In at least one example, the parameter setting is the velocity setting 205005 of the firing member 205010, as shown in FIG. In at least one example, the parameter setting is a wait time setting before beginning a firing stroke.

17 and 19, control circuitry 205012 is configured to implement process 205030. FIG. In various examples, control circuitry 205012 includes a processor and memory that stores program instructions that, when executed by the processor, cause the processor to perform process 205030 . As shown in FIG. 19, process 205030 includes receiving (205032) input from an external data source representing interpreted information related to tissue treatment functions of surgical device 205001, as described above. Process 205030 further causes the interpreted information to be displayed along with at least one parameter setting associated with the tissue treatment function of user interface 205004 (205033). In one embodiment, the interpreted information is displayed concurrently or co-timed with at least one parameter setting to aid in user selection.

Automatic Image Interpretation In various aspects, a surgical hub (or surgical instrument or other system) can be configured, for example, to reduce a captured image into a representation of a resection result. In one aspect, the surgical hub (e.g., 106, 206) or its imaging module (e.g., 138, 238) is configured to capture pixels of an image (e.g., an image captured by a scope) as shown in the bottom left of FIG. and determine the color difference between the tissue and the end effector and/or leak (e.g., air bubbles, dye, or blood) to determine the presence, amount, and location of any leak (L) or end effector. may include an algorithm that performs the calculations to determine For example, an algorithm can be programmed to compare the weights of pixels and sub-pixels from the resulting image with the mathematical values of the pixels. Detected leaks in previously treated tissue may then be presented to the user of surgical device 205001, along with, for example, one or more recommended settings for parameters of the next firing stroke.

In one aspect, the surgical hub (eg, 106, 206) or its imaging module (eg, 138, 238) distinguishes (classifies) end effectors, bleeding, bubbles, and other events from other classes of tissue in the image. may include a classification algorithm for performing digital image processing on the images (eg, images captured by the scope) in order to do). For example, an algorithm can be programmed to perform comparative pixelation where the image is reduced to a limited grid pattern and each element of the grid is reduced to 256 color designations for the pixel. In the first scan, all pixels from the analysis that do not give the correct coloring of the class sought (eg, bleeding) can be removed. Potential bleeding regions are then compared to either adjacent regions or one frame behind to identify bloodshed in the image.

In one aspect, the surgical hub (e.g., 106, 206) or its imaging module (e.g., 138, 238) reduces the number of random variables into groups of similar variables from the nearly infinite variations of each aspect. It may include an algorithm for performing feature extraction image processing that reduces the image into zones formed by: For example, a user can select a tissue type or anatomical feature, and the imaging system will simplify the characteristic variation in the image to a uniform average aspect of the selected feature. can do. This allows the user to discover, for example, tissue surfaces, boundaries of various organs, or limits of tissue surfaces destroyed by infection or cancer.

In one aspect, the surgical hub (eg, 106, 206) or its imaging module (eg, 138, 238) may include pattern recognition algorithms for identifying target features. Various such techniques are described in Artificial Intelligence-Assisted Polyp Detection for Colonoscopy: Initial Experience, Misawa, Masashi et al. , Gastroenterology, Volume 154, Issue 8, 202-2029. e3, which is available at www. gastrojournal. org/article/S0016-5085(18)30415-3/pdf.

In various examples, control circuitry 205012 may receive interpreted information related to hemostasis of tissue previously treated by surgical device 205001 . The interpreted information may be based on image data processed by one or more of the algorithms described above. As shown in the bottom right of FIG. 16, the interpreted information is shown in graph 205019 representing the second through last and last firings of surgical device 205001 .

Image Manipulation In various aspects, algorithms may be programmed to manipulate one image feed to fit another feed to enable visualization of static images on top of dynamic images. In one aspect, the ability to define the elasticity of the overlay shape on the landmarks and primary feed can be utilized by the algorithm to distort the image and conform to the moving lower anchor. This allows, for example, during surgery, to overlay a pre-surgical CT scan of a tumor or surgical site on top of the live feed from the scope. This may be used, for example, to extrapolate a pre-surgical image landscape or complex from a portion of the scan that is open for visualization, where the surgeon can see the current occluded area from the visible view on the user display. It is possible to see the organization or structure that is being processed.

User-Selectable Data Sets In various aspects, the surgical hub (eg, 106, 206) or its imaging module (eg, 138, 238) converts various data numerically, graphically, or as another image. It may be configured to receive user-selectable, highlightable, or flaggable data sets for display as highlightable regions on the feed.

User-selectable data sets may be utilized in a variety of surgical situations. For example, a selection of blood pressure monitors for selected vessels or capillaries may be selected as they are to be resected, and the surgeon may choose to monitor the proximity of the incision to vessels or adjacent nerves. Alternatively, as a means of determining the length to coagulate a particular region prior to ablation, we would like to continuously monitor the calculated pressure in that region. As another example, the surgeon may want the surgical hub system to continually update the visualization feed of the blood volume traveling through the series of vessels while the series of vessels is skeletonized, dissected, and then individually excised. , may select a set of vessels. In this example, the laser Doppler visualization system can show the magnitude of the blood flow measurements in a large area superimposed on the visible image, and the variation of the blood flow during the dissection step interactively with the blood flow area. . Such interpreted information may be displayed on user interface 205004 along with one or more parameters of the function of surgical device 205001, such as firing stroke, for example.

In various aspects, the user can interact with the information displayed on the user interface 205004 and select specific sources of additional information beyond the displayed information derived from the measured data. The user can then select the form and frequency of refreshed data. The internal processor of the surgical hub (e.g., 106, 206) then continuously updates shading, digital data points, etc., and moves the selected area across the display as it moves across the display. This allows the user to move and refocus the camera or imaging system and the data selected and highlighted will still measure and display the information desired for user selection.

FIG. 20 is a diagram illustrating a surgical device 205001 presenting unprompted recommendations to a user in response to contextual cues, in accordance with at least one aspect of the present disclosure. In various aspects, unprompted recommendations may be presented to the user based on previous behavior and intraoperative outcome assessment.

In at least one example, highlighting based on hyperspectral imaging (i.e., processing images to visualize specific types of structures) is performed when a user requests specific imaging associated with an alert. Failure to do so may still trigger a warning indicator if the processed image indicates something that the user should be aware of. For example, if a critical structure is detected but not visible under direct visualization, the surgical hub (e.g., 106, 206) and/or device 205001 may automatically may trigger an alert on

In at least one example, as shown in FIG. 20, a non-prompted adjustment 205009 to a parameter setting (fire rate setting 205005) based on information interpreted from external data received from an external data source is displayed on the user interface 205004. recommended through

17 and 21, control circuitry 205012 is configured to implement process 205040. FIG. In various examples, control circuitry 205012 includes a processor and memory that stores program instructions that, when executed by the processor, cause the processor to perform process 205040 . As shown in FIG. 21, process 205020 includes receiving 205042 input from an external data source representing interpreted information related to the firing stroke of firing member 205010, as described above. Process 205040 further causes the interpreted information to be displayed on user interface 205004 along with at least one parameter setting associated with the firing stroke (205043). In one embodiment, the interpreted information is displayed concurrently or co-timed with at least one parameter setting to aid in user selection. In at least one example, the parameter setting is the velocity setting 205005 of the firing member 205010, as shown in FIG. In at least one example, the parameter setting is a wait time setting before beginning a firing stroke.

17 and 22, control circuitry 205012 is configured to implement process 205050. FIG. In various examples, control circuitry 205012 includes a processor and memory that stores program instructions that, when executed by the processor, cause the processor to perform process 205050 . As shown in FIG. 22, process 205050 includes receiving 205052 input from an external data source representing interpreted information related to tissue treatment functions of surgical device 205001 . Process 205050 further causes the interpreted information to be displayed along with at least one parameter setting associated with the tissue treatment function of user interface 205004 (205053). In one embodiment, the interpreted information is displayed concurrently or co-timed with at least one parameter setting to aid in user selection. Additionally, process 205050 further includes recommending 205054 adjustments to parameter settings based on the interpreted information. In various aspects, recommendations 205044 and 205054 may be non-prompted recommendations.

FIG. 23 illustrates a surgical device 205001 including a user interface 205004 that receives input from a user to automatically adjust the field of view of the medical imaging device in response to contextual cues, in accordance with at least one aspect of the present disclosure is. The field of view of the medical imaging device can be displayed, for example, on monitor 205011, which can be outside the sterile field.

In various embodiments, automatic adjustment of the field of view of the medical imaging device can include automatic focusing and/or centering based on the position of critical structures, such as the end effector of surgical device 205001, for example. In other examples, the critical structure may be the anatomy or the location of the surgical site. In at least one example, the center of the area visualized on monitor 205011 can be automatically adjusted based on user actions or device position.

FIG. 24 is a logic flow diagram of process 205100 showing a control program or logic configuration for automatically adjusting the field of view of a medical imaging device with respect to detected critical structures. Process 205100 includes detecting (205102) a structure of interest and evaluating (205104) its position relative to the field of view of the imager.

Various suitable image interpretation techniques, such as those described above, may be used by an imaging module (e.g., 138) to detect (205100) structures of interest and/or assess (205104) their position relative to the imager's field of view. , 238). In one example, the surgical hub (e.g., 106, 206) or its imaging module (e.g., 138, 238) resolves pixels of an image (e.g., an image captured by a scope) to provide an image between the structures of interest and the surrounding environment. may include an algorithm for performing calculations to determine the color difference of . The determined color difference is utilized to detect (205100) the structure of interest and/or to estimate (205104) its position relative to the field of view of the imager. In another aspect, the surgical hub (eg, 106, 206) or its imaging module (eg, 138, 238) performs digital image processing on the images (eg, images captured by the scope) to A classification algorithm may be included to detect (205100) the structures of interest (classification) and/or to assess (205104) their position relative to the imaging device.

If it is determined 205106 that the critical structure is at the edge of the imaging device's current field of view and the medical imaging device is capable of adjusting the field of view to the position of the critical structure (e.g., end effector), the monitor 205011 or a surgical field input device (eg, user interface 205004) can optionally provide feedback by prompting the user (205108) that the field of view can be automatically adjusted to the structures of interest. What is automatically adjusted can be a one-time adjustment or a continuous adjustment.

In at least one example, the visualization system (e.g., visualization system 108, 208) instructs, e.g., through user interface 205004, that the system tracks the central focal region of the imager's field of view and adjusts over the location of the structure of interest. , may determine whether the user likes it or not. If the user selects the auto-track option, as shown in FIG. 23, the visualization system can then control the display accordingly.

If the critical structure is an end effector of a surgical device, the end effector can be articulated to a new position in the center of the field of view, for example, according to instructions from the surgical hub. Alternatively, the imager can be moved to reposition the field of view with respect to the structure of interest.

FIG. 25 is a logic flow diagram of process 205200 showing a control program or logic configuration for automatically adjusting the field of view of a medical imaging device with respect to detected critical structures. Process 205100 receives input from the surgical hub (eg, 106, 206) indicating the location of the critical structure relative to the current field of view of the medical imaging device as determined by the visualization or imaging module (eg, 138, 238). including. The process 205200 further includes having the user interface 205004 recommend adjustments that change the position of the structures of interest relative to the field of view of the medical image based on the received input.

In various examples, a medical imaging device comprises a camera aimed at an end effector 205006 of a surgical device 205001 at a surgical site within a patient's cavity. In a particular example, the end effector 205006 is not centered with respect to the field of view 205007 of the medical imaging device, as shown in the upper left of FIG. As described above, the imaging module (eg, 138, 238) of the surgical hub (eg, 106, 206) may detect that the end effector 205006 is not centered with respect to the field of view 205007. Accordingly, the surgical hub (eg, 106, 206) provides the user interface 205004 with permission to automatically center the end effector 205006 with respect to the field of view 205007, as shown in the lower left corner of FIG. A user of device 205001 may be prompted. For example, communication module 130 may wirelessly transmit instructions to a wireless receiver of surgical device 205001 to prompt user authorization to automatically center end effector 205006 .

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

Example 1 - A surgical instrument comprising an end effector configured to deploy staples into and sever tissue grasped by the end effector during a firing stroke. The surgical instrument further includes a user interface and control circuitry. The control circuitry is configured to cause at least one parameter setting associated with the firing stroke to be displayed on the user interface and to cause interpreted information associated with the firing stroke to be displayed concurrently with the at least one parameter setting on the user interface. The interpreted information is based on external data.

Example 2 - The surgical instrument of Example 1, wherein the external data comes from a measurement device separate from the surgical instrument.

Example 3 - The surgical instrument of Examples 1 or 2, wherein the external data is transmitted to the surgical instrument by a wireless communication link.

Example 4 - The surgical instrument of any one of Examples 1-3, wherein the interpreted information is updated in real time.

Example 5 - The surgical instrument of any one of Examples 1-3, wherein the interpreted information is updated at a predetermined update rate.

Example 6 - The surgical instrument of any one of Examples 1-5, wherein the interpreted information relates to tissue hemostasis.

Example 7 - The surgical instrument of any one of Examples 1-6, wherein the interpreted information relates to hemostasis of tissue previously treated with the end effector.

Example 8 - The surgical instrument of any one of Examples 1-7, wherein the interpreted information relates to blood pressure in a selected vessel.

Example 9 - The surgical instrument of any one of Examples 1-8, wherein the at least one parameter setting comprises a firing stroke velocity setting.

Example 10 - The surgical instrument of any one of Examples 1-9, wherein the at least one parameter setting comprises a wait time setting before beginning a firing stroke.

Example 11 - A surgical instrument comprising an end effector configured to deploy staples into and sever tissue grasped by the end effector during a firing stroke. The surgical instrument further includes a user interface and control circuitry. The control circuitry is configured to cause at least one parameter setting associated with the firing stroke to be displayed on the user interface and to cause interpreted information associated with the firing stroke to be displayed concurrently with the at least one parameter setting on the user interface. The interpreted information is based on the imaging data.

Example 12 - The surgical instrument of Example 11, wherein the interpreted information is updated in real time.

Example 13 - The surgical instrument of Example 11, wherein the interpreted information is updated at a predetermined update rate.

Example 14 - The surgical instrument of any one of Examples 11-13, wherein the interpreted information relates to tissue hemostasis.

Example 15 - The surgical instrument of any one of Examples 11-14, wherein the interpreted information relates to hemostasis of tissue previously treated with the end effector.

Example 16 - The surgical instrument of any one of Examples 11-15, wherein the interpreted information relates to blood pressure in a selected vessel.

Example 17 - The surgical instrument of any one of Examples 11-16, wherein the at least one parameter setting comprises a firing stroke velocity setting.

Example 18 - The surgical instrument of any one of Examples 11-17, wherein at least one parameter setting is a wait time setting before beginning a firing stroke.

Example 19 - A surgical instrument comprising an end effector configured to perform the function of manipulating tissue grasped by the end effector. The surgical instrument further includes a user interface and control circuitry. The control circuitry is configured to cause at least one parameter setting associated with the function to be displayed on the user interface and to cause interpreted information associated with the function to be displayed on the user interface concurrently with the at least one parameter setting. The interpreted information is based on external data.

Example 20 - The surgical instrument of Example 19, wherein the external data comes from a measurement device separate from the surgical instrument.

While several forms have been illustrated and described, it is not the intention of the applicant to limit or limit the scope of 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 set forth various aspects of apparatus and/or processes through 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 implemented as 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., as one or more programs running on one or more microprocessors), as firmware, or substantially any combination thereof, and can be equivalently implemented on an integrated circuit; , designing circuits, and/or writing software and/or firmware code are within the skill of one of ordinary skill in the art in view of the present disclosure. Moreover, the features of the subject matter described herein may be distributed in a variety of forms as one or more program products, an illustrative form of the subject matter described herein being: Those skilled in the art will appreciate that this applies regardless of the particular type of signal-bearing medium used to actually effect 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 devices. . 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.) It is not limited to storage devices. 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 by unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (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 circuitry, collectively or individually, can be, for example, an integrated circuit (IC), an application specific integrated circuit (IC), an application -specific integrated circuit, ASIC), system-on-chip (SoC), desktop computer, laptop computer, tablet computer, server, smart phone, etc. As used herein, the term "control circuit" refers to an electrical circuit having at least one discrete electrical circuit, an electrical circuit having at least one integrated circuit, an electrical circuit having at least one application specific integrated circuit, a computer A general-purpose computing device configured with a program (e.g., a general-purpose computer configured with a computer program that executes, at least in part, the processes and/or apparatus described herein, or a process and/or apparatus described herein). 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), and/or a communication device (e.g., a modem) , communication switches, or opto-electrical devices), those skilled in the art will appreciate that the subject matter described herein may be in analog or digital form or some combination thereof. It will be appreciated that it may be implemented in

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

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

As used in any aspect herein, "algorithm" refers to a self-consistent sequence of steps leading to a desired result, "steps" being, but not necessarily, storing, transferring, combining, 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 appropriate physical quantities and are merely convenient labels applied to these quantities and/or states.

The network may include packet switched networks. The communication devices can communicate with each other using a selected packet-switched network communication protocol. One exemplary communication protocol may include the Ethernet communication protocol, which may enable communication using Transmission Control Protocol/Internet Protocol (TCP/IP). The Ethernet protocol conforms to or is compatible with the Ethernet standard entitled "IEEE 802.3 Standard" published December 2008 by the Institute of Electrical and Electronics Engineers (IEEE) and/or later versions of this standard. possible. Alternatively or additionally, the communication device may V.25 communication protocol can be used to communicate with each other. X. The V.25 communication protocol may conform to or be compatible with standards promulgated by the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, the communication devices can communicate with each other using a frame relay communication protocol. The frame relay communication protocol may conform to or be compatible with standards promulgated by the Consultative Committee for International Telegraph and Telephone (CCITT) and/or the American National Standards Institute (ANSI). Alternatively or additionally, the transceivers may be able to communicate with each other using the Asynchronous Transfer Mode (ATM) communication protocol. The ATM communication protocol 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", "compute", "determine", "display", etc. are used throughout the foregoing disclosure as is apparent from the foregoing disclosure. Discussion using the term may refer to data represented as physical (electronic) quantities in computer system registers and memory as physical quantities in computer system memory or registers or in 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 manipulates and transforms data into other data that may similarly be represented as .

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" "includes but is not limited to" 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 introducing claim recitations by the indefinite article "a" or "an". and the indefinite article "a" or "an", any particular claim containing such an introduced claim recitation shall be subject to claims containing only one such recitation. should not be construed as to imply a limitation in scope (e.g., "a" and/or "an" generally mean "at least one" or "one or more should be construed as ). 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 a statement simply "two statements" without other modifiers, generally there are at least two statements, or two or three (meaning the above mentioned items). Further, where notations like "at least one of A, B, and C, etc." are used, such syntax is generally intended in the sense that a person skilled in the art would understand the notation ( For example, "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 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 should be done. 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 function, structure, or property described in connection with that aspect. It is worth noting that it means Thus, the phrases "in one aspect," "in an aspect," "in an example," and "in an example" appearing 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 instrument comprising:
an end effector configured to deploy staples into tissue grasped by the end effector and sever the grasped tissue during a firing stroke;
a user interface;
A control circuit,
causing at least one parameter setting associated with the firing stroke to be displayed on the user interface; and displaying interpreted information associated with the firing stroke on the user interface concurrently with the at least one parameter setting. and a control circuit configured to cause the interpreted information to be based on external data.
(2) The surgical instrument of claim 1, wherein the external data comes from a measurement device separate from the surgical instrument.
Clause 3. The surgical instrument of Clause 1, wherein the external data is transmitted to the surgical instrument over a wireless communication link.
(4) The surgical instrument of Clause 1, wherein the interpreted information is updated in real time.
(5) The surgical instrument of Clause 1, wherein the interpreted information is updated at a predetermined update rate.

6. The surgical instrument of claim 1, wherein the interpreted information relates to tissue hemostasis.
Clause 7. The surgical instrument of clause 1, wherein the interpreted information relates to hemostasis of tissue previously treated with the end effector.
Clause 8. The surgical instrument of Clause 1, wherein the interpreted information relates to blood pressure of a selected vessel.
Clause 9. The surgical instrument of clause 1, wherein the at least one parameter includes a velocity setting for the firing stroke.
Clause 10. The surgical instrument of clause 1, wherein the at least one parameter is a wait time setting before initiating the firing stroke.

(11) A surgical instrument comprising:
an end effector configured to deploy staples into tissue grasped by the end effector and sever the grasped tissue during a firing stroke;
a user interface;
A control circuit,
causing at least one parameter setting associated with the firing stroke to be displayed on the user interface; and displaying interpreted information associated with the firing stroke on the user interface concurrently with the at least one parameter setting. and a control circuit configured to cause the interpreted information to be based on imaging data.
Clause 12. The surgical instrument of Clause 11, wherein the interpreted information is updated in real time.
(13) The surgical instrument of Clause 11, wherein the interpreted information is updated at a predetermined update rate.
14. The surgical instrument of claim 11, wherein the interpreted information relates to tissue hemostasis.
Clause 15. The surgical instrument of Clause 11, wherein the interpreted information relates to hemostasis of tissue previously treated with the end effector.

Clause 16. The surgical instrument of Clause 11, wherein the interpreted information relates to blood pressure of a selected blood vessel.
Clause 17. The surgical instrument of Clause 11, wherein the at least one parameter setting includes a velocity setting for the firing stroke.
Clause 18. The surgical instrument of clause 11, wherein the at least one parameter setting is a wait time setting before beginning the firing stroke.
(19) A surgical instrument comprising:
an end effector configured to perform the function of manipulating tissue grasped by the end effector;
a user interface;
A control circuit,
causing at least one parameter setting associated with the function to be displayed on the user interface; and causing interpreted information associated with the function to be displayed on the user interface concurrently with the at least one parameter setting. and wherein the interpreted information is based on external data.
20. The surgical instrument of claim 19, wherein said external data is derived from a measurement device separate from said surgical instrument.

Claims (4)

A surgical instrument,
An end effector configured to move a firing member during a firing stroke to deploy staples into tissue grasped by the end effector and cut the grasped tissue. and,
a user interface;
A control circuit,
to display on the user interface a parameter setting for the speed of movement of the firing member or the waiting time before initiating the firing stroke ; and
Hemostasis data of tissue treated in previous firings of the surgical instrument and a recommended value for the travel speed of the firing member or the waiting time before beginning the firing stroke are combined with the travel speed of the firing member . or a control circuit configured to be displayed on the user interface concurrently with the parameter setting of the waiting time before beginning the firing stroke, wherein the hemostasis data is measured by a measuring device . Surgical instruments provided. The surgical instrument of Claim 1, wherein the hemostasis data measured by the measuring device is transmitted to the surgical instrument over a wireless communication link. The surgical instrument of claim 1, wherein the hemostasis data is updated in real time. The surgical instrument of Claim 1, wherein the hemostasis data is updated at a predetermined update rate.

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