JP7346423B2 - Surgical systems with preferential data transmission capabilities - Google Patents

Description

(Cross reference to related applications)
This application is filed under 35 U.S.C. 119(e) under U.S. Pat. Claims priority to Provisional Application No. 62/691,230. This application is filed under 35 U.S.C. 119(e) with reference to ``A METHOD OF USING REINFORCED FLEX CIRCUITS WITH ELECTROSURGICAL DEVI'', the entire disclosure of which is incorporated herein by reference. 2018 June titled “CES” Claims priority to U.S. Provisional Patent Application No. 62/691,228, filed May 28, 2013.

This application further relates to US Pat. U.S. Provisional Patent Application No. 62/650,887, entitled “SURGICAL SMOKE EVACUATION SENSING AND CONTROLS,” filed March 30, 2018, “SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM ” and U.S. Provisional Patent Application No. 62/650,882, filed March 30, 2018, entitled “CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS.” No. 62/650,898 claims priority.

This application is further filed under 35 U.S.C. 119(e) entitled ``TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR,'' March 8, 2018, each disclosure of which is incorporated herein by reference in its entirety. U.S. Provisional Patent Application No. 62/640,417, filed March 8, 2018, entitled “ESTIMATION STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR” No. 5 Claim the right of priority.

This application further relates to a United States provisional patent filed December 28, 2017 entitled "INTERACTIVE SURGICAL PLATFORM," each disclosure of which is incorporated herein by reference in its entirety under 35 U.S.C. 119(e). Application No. 62/611,341, U.S. Provisional Patent Application No. 62/611,340 filed December 28, 2017, entitled “CLOUD-BASED MEDICAL ANALYTICS” and 2017 entitled “ROBOT ASSISTED SURGICAL PLATFORM” 12 claims priority to U.S. Provisional Patent Application No. 62/611,339, filed May 28, 2009.

TECHNICAL FIELD This disclosure relates to various surgical systems.

A surgical system for use in a surgical procedure is disclosed. The surgical system includes a surgical hub, a powered surgical instrument, and a communication module. The communication module receives first data related to a first surgical activity of the surgical procedure, receives second data related to a second surgical activity of the surgical procedure, and receives first data related to a first surgical activity of the surgical procedure, and receives first data related to a second surgical activity of the surgical procedure. selecting a transmission rate for transmitting the first data and the second data between the powered surgical instrument and the surgical hub based on at least one characteristic of at least one of the surgical activities; The first data and the second data are configured to be transmitted between the powered surgical instrument and the surgical hub at a selected transmission rate.

A surgical system for use in a surgical procedure is disclosed. The surgical system includes a surgical hub, a powered surgical instrument, and a communication module. The communication module receives first data related to a first surgical activity of the surgical procedure, receives second data related to a second surgical activity of the surgical procedure, and receives first data related to a first surgical activity of the surgical procedure, and receives first data related to a second surgical activity of the surgical procedure. adjusting a transmission rate for transmitting the first data and the second data between the powered surgical instrument and the surgical hub based on at least one characteristic of at least one of the surgical activities; It is composed of

A surgical system for use in a surgical procedure is disclosed. The surgical system includes a surgical hub, a powered surgical instrument, and a communication module. The communication module receives first data regarding a first surgical activity of the surgical procedure, receives second data regarding a second surgical activity of the surgical procedure, and transmits the first data and the second data. transmitting between the powered surgical instrument and the surgical hub, detecting an anomaly in the second data, adjusting transmission rates of the first data and the second data, and transmitting the anomaly in the second data; is configured to give priority to

The features of various aspects are set forth in detail in the appended claims. However, various aspects of both the mechanism and the method of operation, together with further objects and advantages thereof, can best be understood by reference to the following description, taken in conjunction with the accompanying drawings, in which: FIG.
1 is a block diagram of a computer-implemented interactive surgical system according to at least one aspect of the present disclosure. FIG. 1 is a surgical system used to perform a surgical procedure within an operating room, according to at least one aspect of the present disclosure. 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. 1 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; FIG. 1 is a perspective view of a combination generator module with bipolar, ultrasonic, and monopolar contacts and smoke evacuation components in accordance with at least one aspect of the present disclosure; FIG. FIG. 6 illustrates individual power bus attachments of a plurality of lateral docking ports of a lateral modular housing configured to receive a plurality of modules in accordance with at least one aspect of the present disclosure. 2 illustrates a vertical modular housing configured to receive a plurality of modules in accordance with at least one aspect of the present disclosure. A modular device located in one or more operating rooms of a medical facility, or any room within a medical facility with specialized equipment for surgical procedures, according to at least one aspect of the present disclosure, can be placed in the cloud. 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. 3 illustrates a surgical hub with multiple modules coupled to a modular control tower in accordance with at least one aspect of the present disclosure; FIG. 1 illustrates one aspect of a Universal Serial Bus (USB) network hub device in accordance with at least one aspect of the present disclosure. 1 illustrates a logic diagram of a surgical instrument or tool control system in accordance with at least one aspect of the present disclosure. 1 illustrates a control circuit configured to control aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure. 2 illustrates a combinational logic circuit configured to control aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure. 3 illustrates a sequential logic circuit configured to control aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure. 1 illustrates a surgical instrument or tool with multiple motors that can be activated to perform various functions, according to at least one aspect of the present disclosure. 1 is a schematic illustration of a robotic surgical instrument configured to manipulate the surgical tools described herein, according to at least one aspect of the present disclosure. FIG. FIG. 3 illustrates a block diagram of a surgical instrument programmed to control distal translation of a displacement member in accordance with at least one aspect of the present disclosure. 1 is a schematic illustration of a surgical instrument configured to control various functions in accordance with at least one aspect of the present disclosure; FIG. 1 is a schematic illustration of a surgical instrument configured to control various functions in accordance with at least one aspect of the present disclosure; FIG. 1 is a perspective view of a surgical instrument having an operably coupled replaceable shaft assembly in accordance with at least one aspect of the present disclosure; FIG. 22 is an exploded view of a portion of the surgical instrument of FIG. 21, in accordance with at least one aspect of the present disclosure. FIG. FIG. 3 is an exploded view of a portion of an interchangeable shaft assembly in accordance with at least one aspect of the present disclosure. 22 is an exploded view of the surgical instrument of FIG. 21 in accordance with at least one aspect of the present disclosure. FIG. 22 is a block diagram of a control circuit for the surgical instrument of FIG. 21 spanning two figures, in accordance with at least one aspect of the present disclosure. FIG. 22 is a block diagram of a control circuit for the surgical instrument of FIG. 21 spanning two figures, in accordance with at least one aspect of the present disclosure. FIG. 22 is a block diagram of a control circuit for the surgical instrument of FIG. 21 illustrating the interface between the handle assembly and the power supply assembly and the replaceable shaft assembly in accordance with at least one aspect of the present disclosure. FIG. FIG. 2 is a logic flow diagram of a process illustrating a control program or logic configuration for marking tissue in accordance with at least one aspect of the present disclosure. 3 illustrates a jaw member of an end effector including a staple cartridge in accordance with at least one aspect of the present disclosure. 3 illustrates a jaw member of an end effector of an ultrasonic surgical instrument in accordance with at least one aspect of the present disclosure. 4 illustrates an end effector of a surgical stapling and cutting instrument in accordance with at least one aspect of the present disclosure. 1 illustrates a surgical instrument control system according to at least one aspect of the present disclosure. 2 illustrates tissue processing applied to tissue to remove cancerous portions of the colon, according to at least one aspect of the present disclosure. The clamping force (FTC) and firing force (FTF) readings of a powered surgical instrument during a surgical procedure and the corresponding communication speed of transmission of the readings to the surgical hub according to at least one aspect of the present disclosure. 2 is a graph showing readings and communication speed plotted against time; 34 illustrates transmission rates for FTC and FTF data at four example points in the graph of FIG. 33, in accordance with at least one aspect of the present disclosure. FIG. FIG. 3 is a logical flow diagram of a process illustrating a control program or logic arrangement for coordinating the transmission of data between a powered surgical instrument and a surgical hub in accordance with at least one aspect of the present disclosure. 34 is a control system for the powered surgical instrument of FIG. 33 in accordance with at least one aspect of the present disclosure. FIG. 3 is a logical flow diagram of a process illustrating a control program or logic arrangement for coordinating the transmission of data between a powered surgical instrument and a surgical hub in accordance with at least one aspect of the present disclosure.

The applicant of this application owns the following United States patent applications filed June 29, 2018, the disclosures of each of which are incorporated herein by reference in their entirety.
- U.S. Patent Application No. _____, entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS"; Attorney Docket No. END8542USNP/170755;
- U.S. Patent Application No. ___________ entitled "CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS"; Attorney Docket No. END8543USNP/170760;
- U.S. Patent Application No. ___________ entitled "SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION"; Attorney Docket No. END8543USNP1/17 0760-1,
- U.S. Patent Application No. ______ entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING"; Attorney Docket No. END8543USNP2/170760-2;
・U.S. Patent Application No. ______ entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING"; Attorney Docket No. END8543USNP3/170760-3;
- U.S. Patent Application No. ``SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES''; Attorney Docket No. END8543USNP4/1707 60-4,
- U.S. Patent Application No. ______ entitled "SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE"; Attorney Docket No. END8543USNP5/170760 -5,
- U.S. Patent Application No. _____, entitled "SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES"; Attorney Docket No. END8543USNP6/170760-6;
- U.S. Patent Application No. ______ entitled "VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY"; Attorney Docket No. END8543USNP7/170760-7;
- U.S. Patent Application No. _____, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE"; Attorney Docket No. END8544USNP/170761;
- United States Patent Application No. _____, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT"; Attorney Docket No. END8544USNP1/170761-1;
- U.S. Patent Application No. ______ entitled "SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY"; Attorney Docket No. END8544USNP2/170761-2;
・U.S. Patent Application No. _____, entitled “SURGICAL EVACUATION SENSING AND MOTOR CONTROL”; Attorney Docket No. END8545USNP/170762;
- United States Patent Application No. _____, entitled "SURGICAL EVACUATION SENSOR ARRANGEMENTS"; Attorney Docket No. END8545USNP1/170762-1;
- United States Patent Application No. _____, entitled "SURGICAL EVACUATION FLOW PATHS"; Attorney Docket No. END8545USNP2/170762-2;
- U.S. Patent Application No. ______ entitled "SURGICAL EVACUATION SENSING AND GENERATOR CONTROL"; Attorney Docket No. END8545USNP3/170762-3;
・U.S. Patent Application No. ＿＿＿＿＿＿＿＿＿＿, entitled “SURGICAL EVACUATION SENSING AND DISPLAY”; Attorney Docket No. END8545USNP4/170762-4;
・“COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL United States Patent Application No. ``PLATFORM''; Attorney Docket No. END8546USNP/170763;
・U.S. Patent Application No. ``SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTROL CIRCUIT FOR INTERACTIVE SURGICAL PLATFORM''; Attorney Docket No. END8546USNP1/170763-1,
・“SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVIC ``DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS ”, United States Patent Application No. ___________; Attorney Docket No. END8548USNP/170765.

The applicant of this application owns the following U.S. provisional patent applications filed June 28, 2018, the disclosures of each of which are incorporated herein by reference in their entirety.
- 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 EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL U.S. Provisional Patent Application No. 62/691,257 entitled ``PLATFORM'';
・“SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVIC U.S. Provisional Patent Application No. 62/691,262 entitled ``DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS''; Provisional Patent Application No. 62/691,251.

The applicant of this application owns the following United States patent applications filed March 29, 2018, the disclosures of each of which are incorporated herein by reference in their entirety.
- U.S. Patent Application No. 15/940,641 entitled "INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES";
- U.S. Patent Application No. 15/940,648 entitled "INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES";
- U.S. Patent Application No. 15/940,656 entitled "SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES";
- U.S. Patent Application No. 15/940,666 entitled "SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS";
- 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 No. 15/940,632 entitled "DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD";
・“COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUDS BAS U.S. Patent Application No. 15/940,640 entitled ``ED ANALYTICS SYSTEMS'';
- 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 LINEAR 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 No. 15/940,704 entitled "USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT";
U.S. Patent Application No. 15/940,722 entitled "CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY," and U.S. Patent Application No. 15/940,742 entitled "DUAL CMOS ARRAY IMAGING."

The applicant of this application owns the following United States patent applications filed March 29, 2018, the disclosures of each of which are incorporated herein by reference in their entirety.
- U.S. Patent Application No. 15/940,636 entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES";
- U.S. Patent Application No. 15/940,653 entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS";
- U.S. Patent Application No. 15/940,660 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER,"
・“CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGE DATA U.S. Patent Application No. 15/940,679 entitled ``SET'';
- U.S. Patent Application No. 15/940, 6 entitled "CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION" No. 94,
- 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 Ser. US patent application Ser. No. 15/940,675 entitled ``ICAL DEVICES''.

The applicant of this application owns the following United States patent applications filed March 29, 2018, the disclosures of each of which are incorporated herein by reference in their entirety.
- U.S. Patent Application No. 15/940,627 entitled "DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- U.S. Patent Application No. 15/940,637 entitled "COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- U.S. Patent Application No. 15/940,642 entitled "CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- U.S. Patent Application No. 15/940,676 entitled "AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- U.S. Patent Application No. 15/940,680 entitled "CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- U.S. Patent Application No. 15/940,683 entitled "COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- U.S. Patent Application No. 15/940,690 entitled "DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS" U.S. Patent Application No. 15/940,711 entitled "ED SURGICAL PLATFORMS".

The applicant of this application owns the following United States provisional patent applications filed March 28, 2018, the disclosures of each of which are incorporated herein by reference in their entirety.
- 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 STRIPPING 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," and - "SENSING ARRANGEMENTS FOR ROBOT - ASSISTED SURGICAL PLATFORMS” U.S. Provisional Patent Application No. 62/649,323 issue.

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

The applicant of this application owns the following U.S. provisional patent applications filed March 30, 2018, the disclosures of each of which are incorporated herein by reference in their entirety.
- U.S. Provisional Patent Application No. 62/650,887 entitled "SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES";
- U.S. Provisional Patent Application No. 62/650,877 entitled "SURGICAL SMOKE EVACUATION SENSING AND CONTROLS";
- U.S. Provisional Patent Application No. 62/650,882 entitled "SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM," and - "CAPACITIVE COUPLED RETURN PATH PAD WI U.S. Provisional Patent Application No. 62/650,898 entitled ``TH SEPARABLE ARRAY ELEMENTS'' .

The applicant of this application owns the following U.S. provisional patent applications filed March 8, 2018, the disclosures of each of which are incorporated herein by reference in their entirety.
・U.S. Provisional Patent Application No. 62/640,417 entitled ``TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR,'' and ・``ESTIMATING STATE OF ULTRAS.'' U.S. Provisional Patent Application No. 62/640 entitled “ONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR” , No. 415.

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

Before describing various aspects of surgical devices and systems in detail, it is noted that the illustrated embodiments are not limited in application or use to the details of construction and arrangement of parts shown in the accompanying drawings and description. Should. The example embodiments may be implemented in or incorporated into other aspects, variations, and modifications and may be practiced or carried out in various ways. Furthermore, unless otherwise stated, the terms and expressions used herein have been selected for the convenience of the reader to describe illustrative embodiments and are not intended to be limiting. . In addition, one or more of the aspects, implementations of the aspects, and/or examples described below may be used as any of the other aspects, implementations of the aspects, and/or examples described below. It should be understood that one or more of the following can be combined.

Aspects of the present disclosure present various surgical instruments utilized in cancer treatment that assess proximity to cancerous tissue and/or allow users to safely move away from the cancerous tissue. Uses various sensors and algorithms to help navigate distance. Surgical instruments can be utilized alone or as components of computer-implemented interactive surgical systems.

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

FIG. 3 illustrates an example of a surgical system 102 used to perform a surgical procedure on a patient lying on an operating table 114 within a surgical operating room 116. One or more of the surgical instruments of the present disclosure can be implemented as a robotic tool for use with a robotic system. 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 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 while the surgeon views the surgical site via the surgeon's console 118 during a minimally invasive dissection of the patient's body. . Images of the surgical site may be obtained by medical imaging device 124, which may be manipulated by patient cart 120 to orient imaging device 124. Robotic hub 122 may be used to process images of the surgical site for subsequent display to the surgeon via surgeon's console 118.

Other types of robotic systems can be easily adapted for use with surgical system 102. Various examples of robotic systems and surgical tools suitable for use with the present disclosure are disclosed in the application entitled "ROBOT ASSISTED SURGICAL PLATFORM," filed December 28, 2017, the entire disclosure of which is incorporated herein by reference. No. 62/611,339.

Various examples of cloud-based analytics performed by cloud 104 and suitable for use with this disclosure are described in “CLOUD-BASED MEDICAL,” filed December 28, 2017, the entire disclosure of which is incorporated herein by reference. No. 62/611,340 entitled ``ANALYTICS''.

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

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

The one or more illumination sources may be configured to emit electromagnetic energy within the visible and invisible spectrum. 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., detectable by the human eye) and is sometimes referred to as visible light, or simply light. The typical human eye is sensitive to wavelengths from about 380 nm to about 750 nm in air.

The invisible spectrum (ie, the non-emissive spectrum) is the portion of the electromagnetic spectrum that lies below and above the visible spectrum (ie, wavelengths less than about 380 nm and greater than about 750 nm). 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 wireless electromagnetic radiation. Wavelengths less than about 380 nm are shorter than the violet spectrum, and these constitute invisible ultraviolet, X-ray, and gamma electromagnetic radiation.

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

In one aspect, the imaging device uses multispectral monitoring to distinguish between topography and underlying structure. Multispectral images capture image data within specific wavelength ranges across the electromagnetic spectrum. Wavelengths can be separated by filters or by using instruments sensitive to light from specific wavelengths, including frequencies beyond the visible light range, such as IR and ultraviolet light. Spectral imaging can enable the extraction of additional information that the human eye cannot capture with its red, green, and blue receptors. The use of multispectral imaging techniques is described in "Advanced Imaging" in U.S. Provisional Patent Application No. 62/611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed December 28, 2017, the entire disclosure of which is incorporated herein by reference. Acquisition Module” section. Multispectral monitoring can be a useful tool to reposition 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 a "surgical theater", ie, operating room or treatment room, require maximum sterility of all medical devices and equipment. Part of that sterilization process is the need to sterilize anything that comes into contact with the patient or enters the sterile field, including the imaging device 124 and its accessories and components. A sterile field may be considered a specific area that is considered free of microorganisms, such as in a tray or on a sterile towel, or a sterile field may be considered the area immediately surrounding a patient prepared for a surgical procedure. It will be understood that what can be done. A sterile field may include cleaned team members wearing appropriate clothing and all equipment and fixtures within the area.

In various aspects, visualization system 108 includes one or more imaging sensors strategically positioned 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, visualization system 108 includes HL7, PACS, and EMR interfaces. Various components of visualization system 108 are described in U.S. Provisional Patent Application No. 62/611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed December 28, 2017, the entire disclosure of which is incorporated herein by reference. It is explained in the section "Advanced Imaging Acquisition Module".

As shown in FIG. 2, primary display 119 is positioned within the sterile field so that it is visible to an operator positioned at operating table 114. Additionally, visualization tower 111 is located outside the sterile field. 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 the hub 106 is configured to use displays 107, 109, and 119 to coordinate the flow of information to operators inside and outside the sterile field. For example, 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 live video of the surgical site on primary display 119. I can do it. Snapshots on non-sterile display 107 or 109 may, for example, allow a non-sterile operator to perform diagnostic steps associated with a surgical procedure.

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

Referring to FIG. 2, surgical instrument 112 is used as part of surgical system 102 in a surgical procedure. Hub 106 is also configured to coordinate the flow of information to the display of surgical instrument 112. For example, in U.S. Provisional Patent Application No. 62/611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," the entire disclosure of which is incorporated herein by reference. Diagnostic input or feedback entered by a non-sterile operator at the visualization tower 111 location may be sent by the hub 106 within the sterile field to the surgical instrument display 115, where the diagnostic input or feedback is input to the surgical instrument 112. May be viewed by the operator. For exemplary surgical instruments suitable for use with surgical system 102, see, for example, the section entitled "Surgical Instrument Hardware" and the 2017 article entitled "INTERACTIVE SURGICAL PLATFORM," the entire disclosure of which is incorporated herein by reference. It is described in US Provisional Patent Application No. 62/611,341, filed December 28, 2013.

Referring now to FIG. 3, hub 106 is shown in communication with visualization system 108, robotic system 110, and hand-held intelligent surgical instrument 112. Hub 106 includes a hub display 135, an imaging module 138, a generator module 140, a communications module 130, a processor module 132, and a storage array 134. In certain aspects, as shown in FIG. 3, the hub 106 further includes a smoke evacuation module 126 and/or an aspiration/irrigation module 128.

During surgical procedures, applying energy to tissue for sealing and/or cutting typically involves evacuation of smoke, aspiration of excess fluid, and/or irrigation of the tissue. Fluid, power, and/or data lines from different sources often become intertwined during surgical procedures. Valuable time may be lost addressing this problem during the surgical procedure. Disentangling the lines may require removing the lines from their corresponding modules, which may require resetting the modules. The hub's modular enclosure 136 provides a unified environment for managing power, data, and fluid lines and reduces 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 includes data and power contacts. A combination generator module includes two or more of an ultrasonic energy generator component, a bipolar radio frequency (RF) energy generator component, and a monopolar RF energy generator component housed within a single unit. include. In one aspect, the combination generator module further includes a smoke evacuation component, at least one energy supply cable for connecting the combination generator module to a surgical instrument, and a smoke evacuation component and at least one energy delivery cable for connecting the combination generator module to a surgical instrument and for generating smoke generated by application of therapeutic energy to tissue. , fluid, 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 the second fluid line extends from the remote surgical site to an aspiration and irrigation module slidably received within the hub housing. In one aspect, the hub housing includes a fluidic interface.

Certain surgical procedures may require the application of more than one energy type to tissue. One energy type may be more beneficial for cutting tissue, while another different energy type may be more beneficial for sealing tissue. For example, a bipolar generator can be used to seal tissue, while an ultrasound generator can be used to cut the sealed tissue. Aspects of the present disclosure present a solution in which the hub's modular enclosure 136 is configured to house various generators and facilitate bi-directional communication therebetween. One of the advantages 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. The modular surgical housing includes a first energy generator module configured to generate a first energy for application to tissue and a first docking port that includes a first data and power contact. a first docking station comprising: a first energy generator module slidably movable into electrical engagement with the power and data contacts; and a first energy generator module comprising: The first power and data contact is slidably movable out of electrical engagement with the first power and data contact.

In addition to the above, the modular surgical housing includes a second energy generator module configured to generate a second energy for applying to tissue that is different than the first energy; a second docking station with a second docking port including data and power contacts of the second energy generator module, the second energy generator module being slidably moved into electrical engagement with the power and data contacts. and the second energy generator module is slidably movable out of electrical engagement with the second power and data contacts.

Additionally, the modular surgical housing 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. It further includes a communication bus to and from the port.

3-7, aspects of the present disclosure are presented relating to a modular housing 136 of a hub that allows for modular integration of a generator module 140, a smoke evacuation module 126, and a suction/irrigation module 128. be done. The hub's modular housing 136 further facilitates bi-directional communication between the modules 140, 126, 128. As shown in FIG. 5, the generator module 140 is an integrated monopolar, bipolar, and super It may also be a generator module comprising a sonic component. As shown in FIG. 5, generator module 140 may be configured to connect to monopolar device 146, bipolar device 147, and ultrasound device 148. Alternatively, the generator module 140 may include a series of monopolar, bipolar, and/or ultrasonic generator modules that interact through the hub's modular housing 136. The hub's modular housing 136 allows for insertion of multiple generators and bi-directional communication between generators docked in the hub's modular housing 136 so that the multiple generators function as a single generator. The communication may be configured to facilitate communication.

As described in more detail below, one or more of monopolar device 146, bipolar device 147, and ultrasound device 148 may assess proximity to cancerous tissue and/or may be equipped with sensors and algorithms to assist the patient in navigating a safe distance away from cancerous tissue.

In one aspect, the hub's modular housing 136 includes a modular power and A communication 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. FIG. A docking port 152 with power and data contacts on the rear side of the combination generator module 145 allows the combination generator module 145 to be slid into position within the corresponding docking station 151 of the hub's modular housing 136. A corresponding docking port 150 is configured to engage power and data contacts of a corresponding docking station 151 of the hub's modular housing 136. In one aspect, the combination generator module 145 includes bipolar, ultrasonic, and monopolar modules and a smoke evacuation module integrated with a single housing unit 139, as shown in FIG.

In various aspects, the smoke evacuation module 126 includes a fluid line 154 that conveys captured/recovered smoke and/or fluid away from the surgical site, e.g., to the smoke evacuation module 126. The vacuum suction generated from the smoke evacuation module 126 can draw smoke into the utility conduit opening at the surgical site. The utility conduit connected to the fluid line may be in the form of a flexible tube that terminates in the smoke evacuation module 126. The utility conduits and fluid lines define a fluid path extending toward the smoke evacuation module 126 received within the hub housing 136.

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

In one aspect, a surgical tool includes a shaft having an end effector at a distal end thereof, at least one energy treatment portion associated with the end effector, a suction tube, and an irrigation tube. The suction tube can have an inlet port at its distal end, and the suction tube extends through the shaft. Similarly, an irrigation tube can extend through the shaft and have an entry port proximate to the energy delivery device. The energy delivery instrument is configured to deliver ultrasound and/or RF energy to the surgical site and is initially coupled to the 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 source and/or vacuum source may be housed within the hub housing 136 separate from the aspiration/irrigation module 128. In such embodiments, the fluidic interface may be configured to connect the suction/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's modular housing 136 align the docking ports of the modules with the docking stations of the hub's modular housing 136. may include an alignment mechanism configured to engage these mating parts within. For example, as shown in FIG. 4, the combination generator module 145 includes a side bracket configured to slidably engage a corresponding bracket 156 of a corresponding docking station 151 of the hub's modular housing 136. Contains 155. The brackets cooperate to direct the docking port contacts of the combination generator module 145 into electrical engagement with the docking port contacts of the hub's 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, the drawers 151 are of different sizes, each designed to accommodate a particular module.

Further, the contacts of a particular module may be keyed to engage the contacts of a particular drawer to avoid inserting the 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 housed within the modular housing 136 of the hub. Two-way communication between users can be facilitated. Alternatively or additionally, the docking port 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 Air Titan-Bluetooth.

FIG. 6 illustrates individual power bus attachments of a plurality of lateral docking ports of a lateral modular housing 160 configured to receive a plurality of modules of a surgical hub 206. Lateral modular housing 160 is configured to laterally receive and interconnect modules 161. The modules 161 are slidably inserted into a docking station 162 of a lateral modular housing 160 that includes a backplane for interconnecting the modules 161. As shown in FIG. 6, modules 161 are laterally arranged within lateral modular housing 160. As shown in FIG. Alternatively, modules 161 may be arranged vertically within a laterally modular housing.

FIG. 7 shows a vertical modular housing 164 configured to receive multiple modules 165 of surgical hub 106. FIG. The modules 165 are slidably inserted into a docking station or drawer 167 of a vertical modular housing 164 that includes a backplane for interconnecting the modules 165. Although the drawer 167 of the vertical modular housing 164 is vertically oriented, in certain cases the vertical modular housing 164 may include a laterally oriented drawer. Additionally, modules 165 may interact with each other through 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. In addition, vertical modular housing 164 includes a master module 178 that houses a plurality of submodules that are slidably received within master module 178.

In various aspects, the imaging module 138 includes a built-in video processor and a modular light source, and is adapted for use with a variety of imaging devices. In one aspect, the imaging device is constructed with 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 to a 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 scanned beam imaging. Similarly, the light source module can be configured to deliver white light or different lights 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 a different light source. Temporary loss of vision of the surgical field can have undesirable consequences. The modular imaging device of the present disclosure is configured to allow replacement of the light source module or camera module midstream during a surgical procedure without the need to remove the imaging device from the surgical field.

In one aspect, an imaging device includes a tubular housing that includes a plurality of channels. The first channel is configured to slidably receive a camera module that can be configured for snap-fit engagement with the first channel. The second channel is configured to slidably receive a light source module that can be configured to snap-fit into engagement with the second channel. In another example, the camera module and/or the light source module can be rotated to a final position 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 can be configured to switch between imaging devices to provide optimal viewing. In various aspects, imaging module 138 can be configured to integrate images from different imaging devices.

Various image processors and imaging devices suitable for use with the present disclosure are described in U.S. Pat. No. 7,995,045. Additionally, 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, provides a method for removing motion artifacts from image data. It describes various systems for doing so. Such a system may be integrated with imaging module 138. Additionally, U.S. Patent Application Publication No. 2011/0306840, published December 15, 2011, entitled "CONTROLLABLE MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPARATUS" and "SYSTEM FOR PERFO August 28, 2014 titled “RMING A MINIMALLY INVASIVE SURGICAL PROCEDURE” Published US Patent Application Publication No. 2014/0243597, each disclosure of which is incorporated herein by reference in its entirety.

FIG. 8 shows how a cloud-based system (e.g. storage A surgical data network 201 is shown comprising a modular communication hub 203 configured to connect to a cloud 204 ), which may include a remote server 213 coupled to a device 205 . In one aspect, modular communications hub 203 includes a network hub 207 and/or a network switch 209 that communicates with a network router. Modular communication hub 203 may further be coupled to local computer system 210 to provide local computer processing and data manipulation. Surgical data network 201 may be configured as passive, intelligent, or switched. A passive surgical data network acts as a conduit for data, allowing data to go from one device (or segment) to another device (or segment) and to cloud computing resources. The intelligent surgical data network includes additional mechanisms that allow traffic to pass through the monitored surgical data network and configure each port within the 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 1a-1n located in the operating room may be coupled to a modular communication hub 203. Network hub 207 and/or network switch 209 may be coupled to network router 211 to connect devices 1a-1n to cloud 204 or local computer system 210. Data associated with devices 1a-1n may be transferred via a router to a cloud-based computer 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 2a-2m located in the same operating room may also be coupled to network switch 209. Network switch 209 can 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 communications hub 203 may be housed within a modular control tower configured to receive a plurality of devices 1a-1n/2a-2m. Local computer system 210 may also be housed in the modular control tower. The modular communications hub 203 is connected to a display 212 to display images acquired by some of the devices 1a-1n/2a-2m, eg, during a surgical procedure. In various aspects, the devices 1a-1n/2a-2m include, for example, an imaging module 138 coupled to an endoscope, among other modular devices that may be connected to the modular communications hub 203 of the surgical data network 201. , 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 Alternatively, various modules such as a non-contact sensor module may be mentioned.

In one aspect, surgical data network 201 includes a combination of network hub(s), network switch(es), and network router(s) that connect devices 1a-1n/2a-2m to the cloud. May include. 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 a local server or personal device. Although the term "cloud" may be used as a metaphor for "Internet," the term is not so limited. Accordingly, the term "cloud computing" may be used herein to refer to "a type of Internet-based computing" in which various services such as servers, storage, and applications are provided at the surgical site. (e.g., a fixed, mobile, temporary, or on-site operating room or space) and via the Internet to a modular communication hub 203 and/or computer system 210 located in a fixed, mobile, temporary, or on-site operating room or space. and delivered to devices connected to system 210. 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 within 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 within the operating room. Hub hardware allows multiple devices or connections to connect to a computer that communicates with cloud computing resources and storage.

By applying cloud computer data processing techniques to the data collected by the devices 1a-1n/2a-2m, the surgical data network provides improved surgical outcomes, reduced costs, and improved patient satisfaction. After the tissue sealing and cutting procedure, at least some of the devices 1a-1n/2a-2m can be used to observe the state of the tissue and assess leakage or perfusion of the sealed tissue. . At least one of the devices 1a-1n/2a-2m is configured to use cloud-based computing to examine data including images of samples of body tissue for diagnostic purposes to identify medical conditions such as disease effects. Several can be used. This includes tissue and phenotypic localization and margin confirmation. Devices 1a-1n/2a for identifying body anatomy using various sensors integrated with the imaging device and techniques such as overlaying images captured by multiple imaging devices. ~2m 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. . Data can be used to improve surgical procedures by determining whether further treatments can be performed, such as endoscopic interventions, emerging technologies, targeted radiation, targeted interventions, and the application of precision robotics to tissue-specific sites and conditions. Results can be analyzed to improve. Such data analysis may further employ prognostic analysis processing, using a standardized approach to confirm surgical treatment and surgeon behavior or suggest modifications to surgical treatment and surgeon behavior. You can provide helpful feedback for any of them.

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 to the network hub. Network hub 207, in one aspect, may be implemented as a local network broadcast device that functions on the physical layer of the Open Systems Interconnection (OSI) model. A network hub provides connectivity to devices 1a-1n located within the same operating room network. Network hub 207 collects data in the form of packets and sends them in half-duplex mode to the router. Network hub 207 does not store any Media Access Control/Internet Protocol (MAC/IP) for transferring device data. Only one of the devices 1a-1n can transmit data via network hub 207 at a time. Network hub 207 has no routing table or intelligence as to where to send the information and broadcasts all network data across each connection and to remote server 213 (FIG. 9) on cloud 204. Although network hub 207 can detect basic network errors such as collisions, broadcasting all information to multiple ports can be a security risk and cause bottlenecks.

In another implementation, operating room devices 2a-2m may be connected to network switch 209 via wired or wireless channels. Network switch 209 functions within the data link layer of the OSI model. The network switch 209 is a multicast device for connecting devices 2a to 2m located in the same operating room to a network. Network switch 209 sends data in the form of frames to network router 211 and functions in full duplex mode. Multiple devices 2a-2m can transmit data simultaneously via 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. The network router 211 sends data packets received from the network hub 207 and/or network switch 211 to the cloud for further processing and manipulation of the data collected by any one or all of the devices 1a-1n/2a-2m. Create a route for transmission to the base computer resource. Network router 211 is used to connect two or more different networks located at different locations, such as, for example, different networks located in different operating rooms of the same medical facility or different operating rooms of different medical facilities. Good too. Network router 211 sends data in the form of packets to cloud 204 and functions in full duplex mode. Multiple devices can transmit data at the same time. Network router 211 uses 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 extend a single USB port into several tiers so that more ports are available for connecting the device to a host system computer. Network hub 207 may include wired or wireless capabilities for receiving information via wired or wireless channels. In one aspect, a wireless USB short range high bandwidth wireless communication protocol may be used for communication between devices 1a-1n and devices 2a-2m located within the operating room.

In other embodiments, the operating room devices 1a-1n/2a-2m exchange data over short distances from fixed and mobile devices (using short wavelength UHF radio waves in the ISM band of 2.4-2.485 GHz). ), and can communicate with the modular communication hub 203 via the Bluetooth wireless technology standard to create a personal area network (PAN). In other aspects, the operating room equipment 1a-1n/2a-2m supports Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, Long Term Evolution (LTE), and Ev - DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and their Ethernet derivatives, as well as any other wireless and Communication with modular communication hub 203 may be via a number of wireless or wired communications standards or protocols, including but not limited to wired protocols. A computing module may include multiple communication modules. For example, the first communication module may be dedicated to short-range wireless communications such as Wi-Fi and Bluetooth, and the second communication module may be dedicated to short-range wireless communications such as Wi-Fi and Bluetooth, and the second communication module may be dedicated to short-range wireless communications such as It may also be used exclusively for long-distance wireless communications.

The modular communication hub 203 can serve as a central connection for one or all of the operating room devices 1a-1n/2a-2m and handles a data type known as a frame. The frames carry data generated by devices 1a-1n/2a-2m. Once the frame is received by modular communication hub 203, the frame is amplified and sent to network router 211, which can transmit the frame to network router 211 using any of the numerous wireless or wired communication standards or protocols described herein. Transfer this data to cloud computing resources.

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

FIG. 9 shows a computer-implemented interactive surgical system 200. Computer-implemented interactive surgical system 200 is similar to computer-implemented interactive surgical system 100 in many respects. For example, computer-implemented interactive surgical system 200 includes one or more surgical systems 202 that are similar to surgical system 102 in many respects. Each surgical system 202 includes at least one surgical hub 206 that communicates with a cloud 204 that may include remote servers 213. In one aspect, computer-implemented interactive surgical system 200 includes a modular control tower 236 connected to multiple operating room equipment, such as, for example, intelligent surgical instruments, robots, and other computerized equipment located within the operating room. Be prepared. As shown in FIG. 10, modular control tower 236 includes modular communication hub 203 coupled to computer system 210. As shown in FIG. As illustrated in the embodiment of FIG. 9, the modular control tower 236 includes an imaging module 238 coupled to an endoscope 239, a generator module 240 coupled to an energy device 241, a smoke evacuator module 226, a suction/ Coupled to irrigation module 228 , communication module 230 , processor module 232 , storage array 234 , smart device/appliance 235 optionally coupled to display 237 , and non-contact sensor module 242 . Operating room equipment is coupled to cloud computing resources and data storage via a modular control tower 236. Robot hub 222 may also be connected to a modular control tower 236 and cloud computing resources. Among others, devices/appliances 235, visualization system 208 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 with multiple modules coupled to modular control tower 236. FIG. Modular control tower 236 includes a modular communication hub 203, such as a network connection device, and a computer system 210, for example, to provide local processing, visualization, and imaging. As shown in FIG. 10, the modular communications hubs 203 are connected in a layered configuration to expand the number of modules (e.g., devices) that can be connected to the modular communications hubs 203 to transmit data associated with the modules. The information 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 connectivity to cloud computing resources and local display 217. Communication to cloud 204 can occur via either wired or wireless communication channels.

Surgical hub 206 uses non-contact sensor modules 242 to measure dimensions of the operating room and generates a map of the surgical site using either ultrasound or laser-type non-contact measurement devices. ``Surgical Hub Spatial Awareness Within an Operator'' in U.S. Provisional Application No. 62/611,341, filed December 28, 2017, entitled ``INTERACTIVE SURGICAL PLATFORM,'' which is incorporated herein by reference in its entirety. 'ating Room' The ultrasound-based non-contact sensor module scans the operating room by transmitting bursts of ultrasound waves and receiving echoes when the bursts of ultrasound reflect off the exterior walls of the operating room, as described in section where the sensor module is configured to determine the size of the operating room and adjust distance limits for Bluetooth pairing. A laser-based non-contact sensor module, for example, transmits laser light pulses, receives laser light pulses that reflect off the exterior walls of an operating room, and compares the phase of the transmitted pulses with the received pulses to determine the location of the operating room. Scan the operating room by determining size and adjusting Bluetooth pairing distance limits.

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

Processor 244 may be any single-core or multi-core processor, such as that known under the trade name ARM Cortex from Texas Instruments. In one aspect, the processor includes 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 data sheet, to improve performance above 40 MHz. a prefetch buffer, 32 KB of single-cycle serial random access memory (SRAM), internal read-only memory (ROM) with StellarisWare® software, 2 KB of electrically erasable programmable read-only memory (EEPROM), and/or one or more pulse width modulation (PWM) modules, one or more quadrature encoder input (QEI) analog, one or more 12-bit analog-to-digital with 12 analog input channels LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, including a converter (ADC).

In one aspect, processor 244 may include a safety controller that includes two controller family families, such as the TMS570 and RM4x, also known by the Hercules ARM Cortex R4 trade names from Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety limit applications, among other things, to provide advanced integrated safety mechanisms while offering scalable performance, connectivity, and memory options. good.

System memory includes volatile memory and non-volatile memory. The basic input/output system (BIOS), containing the basic routines for transferring information between elements within a computer system, such as during startup, is stored in non-volatile 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 functions as external cache memory. Furthermore, RAM includes SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), sink link DRAM (SLDRAM), and direct RAM bus RAM (DRRAM). is available in many forms.

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

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

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

Computer system 210 can operate in a networked environment using logical connections to one or more remote or local computers, such as cloud computer(s). The remote cloud computer(s) may be a personal computer, server, router, network PC, workstation, microprocessor-based device, peer device, or other common network node, and typically includes a computer Contains many or all of the elements described with respect to the system. For simplicity, only the memory storage device is shown along with the remote computer(s). The remote computer(s) are logically connected to the computer system via a network interface and then physically connected via a communication connection. Network interfaces encompass communication networks such as local area networks (LANs) and wide area networks (WANs). LAN technologies include fiber optic distributed data interface (FDDI), copper wire distributed data interface (CDDI), Ethernet/IEEE802.3, Token Ring/IEEE802.5, and the like. WAN technologies include, but are not limited to, point-to-point links, circuit-switched networks such as Integrated Services Digital Network (ISDN) and its variants, packet-switched networks, and digital subscriber lines (DSL).

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

Communication connection(s) refers to the hardware/software used to connect the network interface to the bus. Although the communication connections are shown internal to the computer system for clarity of illustration, the communication connections may be external to the computer system 210. For illustrative purposes only, the hardware/software required to connect to a 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. Can be 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 Texas Instruments TUSB2036 integrated circuit hub. The USB network hub 300 is a CMOS device that provides an upstream USB transceiver port 302 and up to three downstream USB transceiver ports 304, 306, 308, compliant with the USB 2.0 standard. The upstream USB transmit/receive port 302 is a differential root data port that includes a differential data minus (DM0) input paired with a differential data plus (DP0) input. The three downstream USB transmit and receive ports 304, 306, 308 are differential data ports, each port including a differential data plus (DP1-DP3) output paired with a differential data minus (DM1-DM3) output.

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

The USB network hub 300 device includes a serial interface engine (SIE) 310. SIE 310 is the front end for 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, SOP, EOP, RESET, and RESUME signal detection/generation, clock/data separation, non-return-to-zero inversion (NRZI) data encoding/decoding and bit stuffing, CRC Generation and checking (tokens and data), packet ID (PID) generation and checking/decoding, and/or serial-to-parallel/parallel-to-serial conversion may be mentioned. The SIE 310 receives a clock input 314 and provides suspend/resume logic as well as to control communication between the upstream USB transceiver port 302 and the downstream USB transceiver port 304, 306, 308 via port logic 320, 322, 324. It is coupled to a frame timer 316 circuit and a hub repeater circuit 318. SIE 310 is coupled to command decoder 326 via interface logic for controlling commands from the serial EEPROM via serial EEPROM interface 330.

In various aspects, USB network hub 300 can connect up to 127 functions organized in six logical layers to a single computer. Additionally, the USB network hub 300 can be connected 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. The USB network hub 300 has four types of power management: bus-powered hubs with either individual port power management or ganged port power management; and self-powered hubs with either individual port power management or ganged port power management. may be configured to support two modes. In one aspect, using a USB cable, a USB network hub 300, the upstream USB transceiver port 302 is plugged into a USB host controller and the downstream USB transceiver ports 304, 306, 308 connect USB compatible devices. In other words, they are exposed for the sake of others.

Surgical Instrument Hardware FIG. 12 depicts a logic diagram of a surgical instrument or tool control system 470 in accordance with one or more aspects of the present disclosure. Control system 470 includes a microcontroller 461 with a processor 462 and memory 468. For example, one or more of sensors 472, 474, 476 provide real-time feedback to processor 462. A motor 482 driven by a motor driver 492 operably couples the longitudinally movable displacement member to drive the I-beam knife member. Tracking system 480 is configured to determine the position of the longitudinally movable displacement member. The position information is provided to a processor 462 that may be programmed or configured to determine the position of the longitudinally movable drive member, as well as the position of the firing member, firing bar, and I-beam knife element. Additional motors may be provided at the tool driver interface to control I-beam firing, closure tube movement, shaft rotation, and articulation. Display 473 displays various operating conditions of the instrument and may include touch screen functionality for data entry. Information displayed on display 473 may be overlaid with images acquired via the endoscopic imaging module.

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

In one aspect, microcontroller 461 may include a safety controller that includes two controller family families, such as TMS570 and RM4x, also known by the Hercules ARM Cortex R4 trade names from Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety limit applications, among other things, to provide advanced integrated safety features while offering scalable performance, connectivity, and memory options. good.

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

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

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

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

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

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

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

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

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

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

Tracking system 480 with an absolute positioning system may include and/or be programmed to implement feedback controllers such as PID, state feedback, and adaptive controllers. A power supply converts the signal from the feedback controller into a physical input to the system, in this case voltage. Other examples include voltage, current, and force PWM. In addition to the position measured by position sensor 472, other sensor(s) may be provided to measure physical parameters of the physical system. In some aspects, the other sensor(s) include U.S. Pat. , 345,481, and U.S. Patent Application Publication No. 2014/0263552, published September 18, 2014, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM," which is incorporated herein by reference in its entirety. TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, filed June 20, 2017, incorporated herein by reference. As described in U.S. Patent Application No. 15/628,175 Examples include sensor mechanisms such as objects. In a digital signal processing system, an absolute positioning system is coupled to a digital data acquisition system, where the output of the absolute positioning system has a finite resolution and sampling frequency. Absolute positioning systems use comparison and combination circuits to combine the calculated response with the measured response, using algorithms such as weighted averaging and theoretical control loops to drive the calculated response towards the measured response. can be provided. The calculated response of a physical system takes into account properties such as mass, inertia, viscous friction, induced drag, etc. in order to predict what the state and output of the physical system will be by knowing the inputs.

Absolute positioning systems do not reset the displacement member (as may be required with conventional rotary encoders where the motor 482 simply counts the number of steps forward or backward that it has taken to estimate the position of a device actuator, drive bar, knife, etc.). Provides the absolute position of the displacement member upon power-up of the instrument without retracting or advancing to a zero or home) position.

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

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

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

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

FIG. 13 illustrates a control circuit 500 configured to control aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure. Control circuit 500 may be configured to implement various processes described herein. Control circuit 500 can include a microcontroller that includes one or more processors 502 (eg, microprocessors, microcontrollers) coupled to at least one memory circuit 504. Memory circuit 504 stores machine-executable instructions that, when executed by processor 502, cause processor 502 to perform machine instructions to implement the various processes described herein. Processor 502 may be any one of a number of single or multi-core processors known in the art. Memory circuit 504 may include volatile and non-volatile storage media. Processor 502 may include an instruction processing unit 506 and a computing unit 508. The instruction processing unit may be configured to receive instructions from the memory circuit 504 of the present disclosure.

FIG. 14 illustrates a combinational logic circuit 510 configured to control aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure. Combinatorial logic circuit 510 can be configured to implement various processes described herein. Combinatorial logic circuit 510 is a finite state machine that includes combinational logic 512 configured to receive data associated with a surgical instrument or tool at input 514, process the data through combinational logic 512, and provide output 516. may include.

FIG. 15 illustrates a sequential logic circuit 520 configured to control aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure. Sequential logic circuit 520 or combinatorial logic 522 may be configured to implement various processes described herein. Sequential logic circuit 520 may include a finite state machine. Sequential logic circuit 520 may include, for example, combinational logic 522, at least one memory circuit 524, and a clock 529. At least one memory circuit 524 can store the current state of the finite state machine. In particular examples, sequential logic circuit 520 may be synchronous or asynchronous. Combinational logic 522 is configured to receive data associated with a surgical instrument or tool from input 526, process the data through combinational logic 522, and provide output 528. In other aspects, a circuit may include a combination of a processor (eg, processor 502 of FIG. 13) and a finite state machine that implements various processes herein. In other aspects, the finite state machine may include a combination of combinational logic circuits (eg, combinational logic circuit 510 of FIG. 14) and sequential logic circuit 520.

FIG. 16 shows a surgical instrument or tool with multiple motors that can be activated to perform various functions. In particular examples, a first motor can be activated to perform a first function, a second motor can be activated to perform a second function, and a third motor can be activated to perform a second function. A fourth motor can be activated to perform a third function, a fourth motor can be activated to perform a fourth function, and so on. In certain examples, multiple motors of robotic surgical instrument 600 may be individually activated to produce firing, closing, and/or articulating motions at the end effector. The firing motion, closing motion, and/or articulation motion can be transmitted to the end effector via the shaft assembly, for example.

In certain examples, a surgical instrument system or tool may include a firing motor 602. Firing motor 602 is operably coupled to firing motor drive assembly 604, which can be configured to transmit firing motion generated by motor 602 to an end effector, specifically to displace the I-beam element. may be done. In certain examples, the firing motion generated by motor 602 may, for example, deploy staples from a staple cartridge into tissue captured by an end effector and/or advance a cutting edge of an I-beam element. The captured tissue may be cut. The I-beam element may be retracted by reversing the direction of motor 602.

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

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

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

In certain examples, a surgical instrument or tool may include a common control module 610 that can be used with multiple motors of the surgical instrument or tool. In certain examples, the common control module 610 can serve one of multiple motors at a time. For example, a common control module 610 may be individually connectable and disconnectable to multiple motors of a robotic surgical instrument. In certain examples, multiple motors of a surgical instrument or tool may share one or more common control modules, such as common control module 610. In certain examples, multiple motors of a surgical instrument or tool can independently and selectively engage a common control module 610. In certain examples, the common control module 610 selectively switches from cooperating with one of the plurality of motors of the surgical instrument or tool to cooperating with another of the plurality of motors of the surgical instrument or tool. Can be switched.

In at least one example, common control module 610 selects between operative engagement with articulation motors 606a, 606b and operative engagement with either firing motor 602 or closure motor 603. can be switched. In at least one embodiment, as shown in FIG. 16, switch 614 can be moved or transitioned between multiple positions and/or states. For example, in a first position 616, the switch 614 may electrically couple the common control module 610 with the firing motor 602, and in a second position 617, the switch 614 may close the common control module 610. The switch 614 may electrically couple the common control module 610 with the first articulation motor 606a, and in the third position 618a, the switch 614 may electrically couple the common control module 610 with the first articulation motor 606a, and in the fourth position 618a. At 618b, switch 614 may electrically couple common control module 610 with second articulation motor 606b. In certain examples, a separate and common control module 610 may be electrically coupled to firing motor 602, closure motor 603, and articulation motors 606a, 606b at the same time. In particular examples, switch 614 may be a mechanical switch, an electromechanical switch, a solid state switch, or any suitable switching mechanism.

Each of the motors 602, 603, 606a, 606b may include a torque sensor to measure the output torque on the motor's shaft. The force on the end effector may be sensed in any conventional manner, such as by a force sensor outside the jaw or by a torque sensor on the motor actuating the jaw.

In various examples, as shown in FIG. 16, the common control module 610 may include a motor driver 626 that may include one or more H-bridge FETs. Motor driver 626 may modulate the power transferred from power supply 628 to motors coupled to common control module 610, for example, based on input from microcontroller 620 (the “controller”). In certain examples, the microcontroller 620 can be used to determine the current drawn by the motors, for example, while the motors are coupled to a common control module 610, as described above.

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

In certain examples, power supply 628 may be used to power microcontroller 620, for example. In certain examples, power source 628 may include a battery (or "battery pack" or "power pack"), such as, for example, a LI battery. In certain examples, the battery pack may be configured to be releasably attached to the handle to power the surgical instrument 600. A number of battery cells connected in series may be used as the power source 628. In certain examples, power source 628 may be replaceable and/or rechargeable, for example.

In various examples, processor 622 can control motor driver 626 to control the position, direction of rotation, and/or speed of motors coupled to common control module 610. In certain examples, processor 622 may signal motor driver 626 to stop and/or disable motors coupled to common control module 610. The term "processor" as used herein refers to any suitable microprocessor, microcontroller, or computer central processing unit (CPU) that combines the functionality of one or up to several integrated circuits. It should be understood to include other basic computing devices integrated above. A processor is a versatile programmable device that accepts digital data as input, processes that data according to instructions stored in memory, and provides results as output. This is an example of sequential digital logic since it has internal memory. Processors operate with numbers and symbols that are represented in a binary system.

In one example, processor 622 may be any single-core or multi-core processor, such as that known under the trade name ARM Cortex from Texas Instruments. In a particular example, microcontroller 620 may be a LM 4F230H5QR available from Texas Instruments, for example. In at least one embodiment, the Texas Instruments LM4F230H5QR has on-chip memory, performance of up to 40 MHz of 256 KB of single-cycle flash memory or other non-volatile memory, among other characteristics readily available in the product data sheet. Prefetch buffer for super-improvement, 32KB single-cycle SRAM, internal ROM with StellarisWare® software, 2KB EEPROM, one or more PWM modules, one or more QEI analogs , an ARM Cortex-M4F processor core that includes one or more 12-bit ADCs with 12 analog input channels. Other microcontrollers may be easily substituted for use with module 4410. Therefore, the present disclosure should not be limited to this context.

In certain examples, memory 624 may include program instructions for controlling each motor of surgical instrument 600 that is connectable to common control module 610. For example, memory 624 may include program instructions for controlling firing motor 602, closure motor 603, and articulation motors 606a, 606b. Such program instructions may cause processor 622 to control firing, closure, and articulation functions in accordance with input from a surgical instrument or tool algorithm or control program.

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

FIG. 17 is a schematic illustration of a robotic surgical instrument 700 configured to manipulate the surgical tools described herein, in accordance with at least one aspect of the present disclosure. Robotic surgical instrument 700 uses either single or multiple articulation drive connections to achieve distal/proximal translation of the displacement member, distal/proximal displacement of the obturator canal, rotation of the shaft, and articulation. It may be programmed or configured to control movement. In one aspect, surgical instrument 700 may be programmed or configured to individually control the firing member, closure member, shaft member, or one or more articulating members. Surgical instrument 700 includes a control circuit 710 configured to control a motor-driven firing member, a closure member, a shaft member, and/or one or more articulation members.

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

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

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

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

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

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

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

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

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

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

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

In one aspect, the one or more motors 704a-704e may include a brushed DC motor with a gearbox and a mechanical connection to a firing member, closure member, or articulation member. Another example includes electric motors 704a-704e that operate movable mechanical elements such as displacement members, articulation connections, closure tubes, and shafts. External influences are unmeasured and unpredictable influences such as friction on tissues, surrounding bodies, and physical systems. Such an external influence may be referred to as a disturbance acting against one of the electric motors 704a-704e. External influences, such as disturbances, can cause the behavior of a physical system to deviate from its desired behavior.

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

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

In one aspect, the one or more sensors 738 may include a strain gauge, such as a microstrain gauge, configured to measure the amount of strain in the anvil 716 during the grasping condition. Strain gauges provide electrical signals whose amplitude varies with the magnitude of strain. Sensor 738 may include a pressure sensor configured to detect pressure generated by the presence of compressed tissue between anvil 716 and staple cartridge 718. Sensor 738 may be configured to detect the impedance of a portion of tissue located between anvil 716 and staple cartridge 718, which impedance may be determined by the thickness and/or fullness of tissue located therebetween. shows.

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

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

In one aspect, current sensor 736 can be used to measure the current drawn by each of motors 704a-704e. The force required to advance any of the movable mechanical elements, such as I-beam 714, corresponds to the current drawn by one of the motors 704a-704e. The force is converted to a digital signal and provided to control circuit 710. Control circuit 710 may be configured to simulate the instrument's actual system response in the controller's software. The displacement member can be actuated to move the I-beam 714 within the end effector 702 at or near a target velocity. Robotic surgical instrument 700 may include a feedback controller, including any feedback controller, including, but not limited to, PID, state feedback, linear quadratic (LQR), and/or adaptive controllers. It may be any one of the following. Robotic surgical instrument 700 can include a power source for converting signals from a feedback controller into physical inputs such as, for example, case voltages, PWM voltages, frequency modulated voltages, currents, torques, and/or forces. . Further details may be found in U.S. patent application Ser. disclosure has been done.

FIG. 18 illustrates a block diagram of a surgical instrument 750 programmed to control distal translation of a displacement member, according to at least one aspect of the present disclosure. In one aspect, surgical instrument 750 is programmed to control distal translation of a displacement member, such as I-beam 764. Surgical instrument 750 includes an anvil 766, an I-beam 764 (including a sharp cutting edge), and an end effector 752 that may include a removable staple cartridge 768.

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

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

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

Control circuit 760 can communicate with one or more sensors 788. Sensor 788 may be positioned on end effector 752 and adapted to operate with surgical instrument 750 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. . The sensor 788 may be a magnetic sensor, a magnetic field sensor, an inductive sensor such as a strain gauge, a pressure sensor, a force sensor, an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor, and/or one or more of the end effectors 752. Any other suitable sensor for measuring one or more parameters may be included. Sensor 788 may include one or more sensors.

One or more sensors 788 may include strain gauges, such as microstrain gauges, configured to measure the amount of strain in anvil 766 during the clamped condition. Strain gauges provide electrical signals whose amplitude varies with the magnitude of strain. Sensor 788 may include a pressure sensor configured to detect pressure generated by the presence of compressed tissue between anvil 766 and staple cartridge 768. Sensor 788 may be configured to detect the impedance of a portion of tissue located between anvil 766 and staple cartridge 768, which impedance may be determined by the thickness and/or fullness of the tissue located therebetween. shows.

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

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

Control circuit 760 may be configured to simulate the instrument's actual system response in the controller's software. The displacement member can be actuated to move the I-beam 764 within the end effector 752 at or near a target velocity. Surgical instrument 750 can include a feedback controller, for example, any one of any feedback controllers including, but not limited to, PID, status feedback, LQR, and/or adaptive controllers. It may be one. Surgical instrument 750 can include a power source for converting signals from the feedback controller into physical inputs such as, for example, case voltages, PWM voltages, frequency modulated voltages, currents, torques, and/or forces.

The actual drive system for the surgical instrument 750 is a brushed DC motor with a gearbox and a mechanical connection to the articulation and/or knife system to drive the displacement member, cutting member, or I-beam 764. It is composed of Another example is an electric motor 754 that operates an exchangeable shaft assembly, such as a displacement member and an articulation driver. External influences are unmeasured and unpredictable influences such as friction on tissues, surrounding bodies, and physical systems. Such external influences may be referred to as disturbances acting against the electric motor 754. External influences, such as disturbances, can cause the behavior of a physical system to deviate from its desired behavior.

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

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

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

FIG. 19 is a schematic illustration of a surgical instrument 790 configured to control various functions in accordance with at least one aspect of the present disclosure. In one aspect, surgical instrument 790 is programmed to control distal translation of a displacement member, such as I-beam 764. Surgical instrument 790 includes an end effector 792 that may include an anvil 766, an I-beam 764, and a removable staple cartridge 768 that can be replaced with an RF cartridge 796 (shown in phantom).

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

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

In one aspect, the I-beam 764 may be implemented as a knife member with a knife body operably supporting a tissue cutting blade thereon, an anvil-engaging tab or feature and a passageway-engaging feature or foot. It may further contain. In one aspect, staple cartridge 768 may be implemented as a standard (mechanical) surgical fastener cartridge. In one aspect, RF cartridge 796 may be implemented as an RF cartridge. These and other sensor configurations are described in commonly owned U.S. patent application Ser. No. 15/628,175, filed June 20, 2017, entitled "TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT”.

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

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

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

Control circuit 760 can communicate with one or more sensors 788. Sensor 788 may be positioned on end effector 792 and adapted to operate with surgical instrument 790 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. . The sensor 788 may be a magnetic sensor, a magnetic field sensor, an inductive sensor such as a strain gauge, a pressure sensor, a force sensor, an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor, and/or one or two of the end effectors 792. Any other suitable sensor for measuring one or more parameters may be included. Sensor 788 may include one or more sensors.

One or more sensors 788 may include strain gauges, such as microstrain gauges, configured to measure the amount of strain in anvil 766 during the clamped condition. Strain gauges provide electrical signals whose amplitude varies with the magnitude of strain. Sensor 788 may include a pressure sensor configured to detect pressure generated by the presence of compressed tissue between anvil 766 and staple cartridge 768. Sensor 788 may be configured to detect the impedance of a portion of tissue located between anvil 766 and staple cartridge 768, which impedance may be determined by the thickness and/or fullness of the tissue located therebetween. shows.

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

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

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

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

FIG. 20 is a schematic illustration of a surgical instrument 791 that is similar to surgical instrument 790 in many respects. Surgical instrument 791 includes an end effector 769 that includes a first jaw 765 and a second jaw 767. End effector 769 is configured to transition from an open configuration to a closed configuration. The first jaw 765 and the second jaw 767 are close together in the closed configuration. In one aspect, tissue grasped by end effector 769 in the closed configuration is treated by ultrasound energy generated by energy source 795. In another aspect, tissue grasped by end effector 769 in the closed configuration is treated with RF energy generated by energy source 795 or a separate RF energy source.

In one aspect, closure tube 773 (shown in phantom) can transition end effector 769 to a closed configuration. Motor 754 may be mechanically coupled to closure tube 773 via transmission device 756 to transmit closure motion to end effector 769. Alternatively, closure tube 773 can be manually moved to transition end effector 769 between open and closed configurations. In one aspect, an I-beam 771 (shown in dashed line), similar to I-beam 764, can transition end effector 769 to a closed configuration. Motor 754 may be mechanically coupled to I-beam 771 via transmission 756 to transmit closing motion to end effector 769. Alternatively, I-beam 771 can be manually moved to transition end effector 769 between open and closed configurations. Position sensor 784 may sense the position of I-beam 771 and/or closure tube 773.

21-24 illustrate a motor-driven cutting and fastening surgical instrument 150010 that may or may not be reused. In the illustrated example, surgical instrument 150010 includes a housing 150012 with a handle assembly 150014 configured to be grasped, manipulated, and actuated by a clinician. The housing 150012 is configured to be operably attached to a replaceable shaft assembly 150200 to which an end effector 150300 configured to perform one or more surgical tasks or procedures is operably coupled. ing. According to the present disclosure, various forms of interchangeable shaft assemblies may be effectively used in conjunction with robotically controlled surgical systems. Accordingly, the term "housing" includes housing or operably supporting at least one drive system configured to generate and apply at least one control motion available for actuating the replaceable shaft assembly. It can include a housing or similar part of a robotic system. The term "frame" may refer to a portion of a hand-held surgical instrument. The term "frame" may also refer to a portion of a robotically controlled surgical instrument and/or a portion of a robotic system that may be used to operably control a surgical instrument. Replaceable shaft assemblies can be used in various robots as disclosed in U.S. Pat. It may be used with systems, devices, components, and methods.

FIG. 21 is a perspective view of a surgical instrument 150010 having a replaceable shaft assembly 150200 operably coupled thereto, in accordance with at least one aspect of the present disclosure. Housing 150012 includes an end effector 150300 that includes a surgical cutting and fastening device therein configured to operably support surgical staple cartridge 150304. The housing 150012 may be configured for use in conjunction with a replaceable shaft assembly, the replaceable shaft assembly including an end effector adapted to support staple cartridges of various sizes and types; With various shaft lengths, sizes and types. The housing 150012 may be used with a variety of interchangeable shaft assemblies that provide RF energy, and an assembly configured to apply ultrasound energy and/or other forms of motion and energy, such as motion. The end effector, shaft assembly, handle, surgical instrument, and/or surgical instrument system may utilize any suitable fasteners for fastening tissue. For example, a fastener cartridge having a plurality of fasteners removably stored therein may be removably inserted and/or attached to an end effector of a shaft assembly.

Handle assembly 150014 may include a pair of interconnectable handle housing segments 150016, 150018 that may be interconnected with screws, snap mechanisms, adhesives, or the like. Handle housing segments 150016, 150018 cooperate to form a pistol grip portion 150019 that can be grasped and manipulated by a clinician. The handle assembly 150014 operably supports a plurality of drive systems, the drive systems configured to generate and apply controlled motion to corresponding portions of an interchangeable shaft assembly operably attached to the handle assembly. . The display may be provided below the cover 150045.

FIG. 22 is an exploded view of a portion of surgical instrument 150010 of FIG. 21 in accordance with at least one aspect of the present disclosure. Handle assembly 150014 may include a frame 150020 that operably supports multiple drive systems. The frame 150020 can operably support a "first" or closure drive system 150030, which can apply closing and opening movements to the replaceable shaft assembly 150200. Closure drive system 150030 may include an actuator such as a closure trigger 150032 that is pivotally supported by frame 150020. Closure trigger 150032 is pivotally coupled to handle assembly 150014 by pivot pin 150033 to enable closure trigger 150032 to be operated by a clinician. When a clinician grasps the pistol grip portion 150019 of the handle assembly 150014, the closure trigger 150032 moves from a starting or "unactuated" position to an "actuated" position, and more specifically to a fully compressed or fully activated position. can pivot.

The handle assembly 150014 and frame 150020 may operably support a firing drive system 150080 configured to apply a firing motion to a corresponding portion of an interchangeable shaft assembly attached thereto. may have been done. Firing drive system 150080 may utilize an electric motor 150082 located in pistol grip portion 150019 of handle assembly 150014. Electric motor 150082 may be, for example, a brushed DC motor with a maximum rotational speed of about 25,000 RPM. In other configurations, the motor may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. Electric motor 150082 may be powered by a power source 150090 that may include a removable power pack 150092. Removable power pack 150092 may include a proximal housing portion 150094 configured to attach to distal housing portion 150096. Proximal housing portion 150094 and distal housing portion 150096 are configured to operably support a plurality of batteries 150098 therein. Each of the batteries 150098 may include, for example, a LI or other suitable battery. Distal housing portion 150096 is configured to be removably and operably attached to control circuit board 150100, which is operably coupled to electric motor 150082. Several batteries 150098 connected in series can power the surgical instrument 150010. Power source 150090 may be replaceable and/or rechargeable. Display 150043 located below cover 150045 is electrically coupled to control circuit board 150100. Cover 150045 may be removed to expose display 150043.

The electric motor 150082 is mounted on a rotary shaft (see FIG. (not shown). A longitudinally movable drive member 150120 has a rack of drive teeth 150122 formed thereon for mating engagement with a corresponding drive gear 150086 of a gear reducer assembly 150084.

In use, the voltage polarity provided by the power source 150090 may cause the electric motor 150082 to operate in a clockwise direction, while the voltage polarity applied to the electric motor by the battery may cause the electric motor 150082 to operate in a counterclockwise direction. can be reversed. When the electric motor 150082 is rotated in one direction, the longitudinally movable drive member 150120 will be axially driven in the distal direction "DD". When the electric motor 150082 is driven in the opposite rotational direction, the longitudinally movable drive member 150120 will be axially driven in the proximal direction "PD". Handle assembly 150014 can include a switch that can be configured to reverse the polarity applied to electric motor 150082 by power source 150090. Handle assembly 150014 may include a sensor configured to detect the position of longitudinally movable drive member 150120 and/or the direction in which longitudinally movable drive member 150120 is being moved.

Actuation of electric motor 150082 may be controlled by firing trigger 150130 pivotally supported on handle assembly 150014. Firing trigger 150130 may pivot between an inactive position and an activated position.

Returning to FIG. 21, the replaceable shaft assembly 150200 includes an end effector 150300 having an elongated channel 150302 configured to operably support a surgical staple cartridge 150304 therein. End effector 150300 may include an anvil 150306 pivotally supported relative to elongate channel 150302. Replaceable shaft assembly 150200 may include an articulation joint 150270. The construction and operation of end effector 150300 and articulation joint 150270 are described in U.S. Patent Application Publication No. 2014/0263541, entitled “ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION,” which is incorporated herein by reference in its entirety. LOCK”. . Replaceable shaft assembly 150200 may include a proximal housing or nozzle 150201 comprised of nozzle portions 150202, 150203. The replaceable shaft assembly 150200 may include a closure tube 150260 extending along the shaft axis SA, and the closure tube 150260 may be utilized to close and/or open the anvil 150306 of the end effector 150300.

Also shown in FIG. 21 is a closure tube 150260 in a distal direction (direction “DD ”) and the anvil 150306 is closed. Anvil 150306 is opened by proximally translating closure tube 150260. In the anvil open position, closure tube 150260 is moved to its proximal position.

FIG. 23 is another exploded view of a portion of replaceable shaft assembly 150200 in accordance with at least one aspect of the present disclosure. Replaceable shaft assembly 150200 may include a firing member 150220 supported for axial movement within spine 150210. Firing member 150220 includes an intermediate firing shaft 150222 configured to attach to a distal cutting portion or knife bar 150280. Firing member 150220 may also be referred to as a "second shaft" or "second shaft assembly." The intermediate firing shaft 150222 may include a longitudinal slot 150223 at its distal end configured to receive a tab 150284 at the proximal end 150282 of the knife bar 150280. Longitudinal slot 150223 and proximal end 150282 may be configured to allow relative movement therebetween and may include a slip joint 150286. Slip joint 150286 may allow intermediate firing shaft 150222 of firing member 150220 to articulate end effector 150300 about articulation joint 150270 without moving knife bar 150280, or at least substantially without moving. Once the end effector 150300 is properly oriented, intermediate firing shaft 150222 is advanced distally until the proximal sidewall of longitudinal slot 150223 contacts tab 150284 to advance knife bar 150280 and into channel 150302. The staple cartridge located thereon can be fired. Spine 150210 has an elongated opening or window 150213 therein to facilitate assembly and insertion of intermediate firing shaft 150222 into spine 150210. Once intermediate firing shaft 150222 is inserted, top frame segment 150215 may be engaged with shaft frame 150212 to enclose intermediate firing shaft 150222 and knife bar 150280 therein. The operation of firing member 150220 can be found in US Patent Application Publication No. 2014/0263541. The spine 150210 may be configured to slidably support a firing member 150220 and a closure tube 150260 extending around the spine 150210. Spine 150210 may slidably support articulation driver 150230.

Replaceable shaft assembly 150200 may include a clutch assembly 150400 configured to selectively and removably couple articulation driver 150230 to firing member 150220. The clutch assembly 150400 includes a locking collar or locking sleeve 150402 positioned about a firing member 150220, the locking sleeve 150402 having an engaged position where the locking sleeve 150402 couples an articulating driver 150230 to the firing member 150220 and an articulating driver. 150230 may be rotated to and from a disengaged position in which the firing member 150230 is not operably coupled to the firing member 150220. When locking sleeve 150402 is in its engaged position, distal movement of firing member 150220 can cause articulation driver 150230 to move distally, and correspondingly, proximal movement of firing member 150220. allows articulation driver 150230 to be moved proximally. When locking sleeve 150402 is in its disengaged position, movement of firing member 150220 is not transferred to articulating driver 150230, so that firing member 150220 can be moved independently of articulating driver 150230. Nozzle 150201 can be used to operably engage and disengage the articulation drive system and the firing drive system in a variety of ways as described in US Patent Application Publication No. 2014/0263541.

The replaceable shaft assembly 150200 can include a slip ring assembly 150600 that, for example, transfers power to and/or from the end effector 150300 and/or transmits power to and/or from the end effector 150300. Alternatively, it can be configured to communicate signals from the end effector 150300. The slip ring assembly 150600 may include a proximal connector flange 150604 and a distal connector flange 150601 disposed within slots defined within the nozzle portions 150202, 150203. The proximal connector flange 150604 can include a first surface, and the distal connector flange 150601 can include a second surface disposed adjacent to the first surface and movable relative to the first surface. You can prepare. Distal connector flange 150601 can rotate relative to proximal connector flange 150604 about shaft axis SA-SA (FIG. 21). The proximal connector flange 150604 can include a plurality of concentric, or at least substantially concentric, conductors 150602 defined on a first surface thereof. Connector 150607 can be mounted proximal to distal connector flange 150601 and can have multiple contacts, each contact corresponding to and in electrical contact with one of conductors 150602. are doing. Such a configuration allows proximal connector flange 150604 and distal connector flange 150601 to rotate relative to each other while maintaining electrical contact therebetween. Proximal connector flange 150604 can include, for example, an electrical connector 150606 that can place conductor 150602 in signal communication with a shaft circuit board. In at least one instance, a wiring harness including multiple conductors may extend between the electrical connector 150606 and the shaft circuit board. The electrical connector 150606 may extend proximally through a connector opening defined in the chassis mounting flange. US Patent Application Publication No. 2014/0263551, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM," is incorporated herein by reference in its entirety. US Patent Application Publication No. 2014/0263552, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM," is incorporated herein by reference in its entirety. Further details regarding slip ring assembly 150600 can be found in US Patent Application Publication No. 2014/0263541.

Interchangeable shaft assembly 150200 may include a proximal portion that is fixedly attached to handle assembly 150014 and a distal portion that is rotatable about a longitudinal axis. The rotatable distal shaft portion can be rotated relative to the proximal portion about the slip ring assembly 150600. A distal connector flange 150601 of slip ring assembly 150600 can be positioned within the rotatable distal shaft portion.

FIG. 24 is an exploded view of one aspect of the end effector 150300 of the surgical instrument 150010 of FIG. 21, in accordance with at least one aspect of the present disclosure. End effector 150300 may include an anvil 150306 and a surgical staple cartridge 150304. Anvil 150306 may be coupled to elongated channel 150302. An aperture 150199 can be defined within the elongated channel 150302 to receive a pin 150152 extending from the anvil 150306 to pivot the anvil 150306 from an open position to a closed position relative to the elongated channel 150302 and the surgical staple cartridge 150304. can be done. Firing bar 150172 is configured to longitudinally translate into end effector 150300. Firing bar 150172 may be constructed from one solid section or may include a laminated material including a stack of steel plates. Firing bar 150172 includes an I-beam 150178 and a cutting edge 150182 at its distal end. The distally projecting end of firing bar 150172 can be attached to I-beam 150178 and spaced apart from surgical staple cartridge 150304 disposed within elongated channel 150302 when anvil 150306 is in the closed position. Clearance may be provided to assist in positioning anvil 150306. The I-beam 150178 may include a sharp cutting edge 150182 for cutting tissue while the I-beam 150178 is advanced distally by the firing bar 150172. In operation, I-beam 150178 may fire surgical staple cartridge 150304. The surgical staple cartridge 150304 can include a shaped cartridge body 150194 that retains a plurality of staples 150191 mounted on a staple driver 150192 within a corresponding upwardly open staple cavity 150195. Wedge-shaped sled 150190 is driven distally by I-beam 150178 and slides over cartridge tray 150196 of surgical staple cartridge 150304. While cutting edge 150182 of I-beam 150178 cuts the clamped tissue, wedge-shaped sled 150190 cams staple driver 150192 upward to drive and deform staple 150191 into contact with anvil 150306.

I-beam 150178 can include a top pin 150180 that engages anvil 150306 during firing. The I-beam 150178 may include a central pin 150184 and a bottom foot 150186 for engaging the cartridge body 150194, the cartridge tray 150196, and a portion of the elongated channel 150302. When the surgical staple cartridge 150304 is placed within the elongated channel 150302, the slot 150193 defined within the cartridge body 150194 is combined with the longitudinal slot 150197 defined within the cartridge tray 150196 and the longitudinal slot 150197 defined within the elongated channel 150302. It can be aligned with slot 150189. In use, the I-beam 150178 can slide through aligned longitudinal slots 150193, 150197, and 150189, and the bottom foot 150186 of the I-beam 150178 can slide through the slots, as shown in FIG. 150189 is capable of engaging a groove passing along the bottom surface of the elongate channel 150302, and the central pin 150184 is capable of engaging the top surface of the cartridge tray 150196 along the length of the longitudinal slot 150197. The upper pin 150180 can engage the anvil 150306. The I Beam 150178 can space or limit relative movement between anvil 150306 and surgical staple cartridge 150304. Firing bar 150172 and I-beam 150178 are retracted proximally, thereby opening anvil 150306 and allowing release of the two stapled and cut tissue sections.

25A and 25B are block diagrams of control circuitry 150700 of surgical instrument 150010 of FIG. 21 spanning two figures, in accordance with at least one aspect of the present disclosure. Referring primarily to FIGS. 25A and 25B, the handle assembly 150702 may include a motor 150714 that may be controlled by a motor driver 150715 and used by the firing system of the surgical instrument 150010. In various forms, motor 150714 may be a brushed DC drive motor with a maximum rotational speed of approximately 25,000 RPM. In other configurations, motor 150714 may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. Motor driver 150715 may include, for example, an H-bridge driver including FET 150719. Motor 150714 may be powered by power supply assembly 150706 releasably attached to handle assembly 150200 to provide control power to surgical instrument 150010. Power supply assembly 150706 may include a battery that may include multiple battery cells connected in series that may be used as a power source to power surgical instrument 150010. Under certain circumstances, the battery cells of power supply assembly 150706 may be replaceable and/or rechargeable. In at least one example, the battery cells may be LI batteries that may be separately connectable to power supply assembly 150706.

Shaft assembly 150704 can include a shaft assembly controller 150722 that is in communication with a safety controller and power management controller 150716 via an interface while shaft assembly 150704 and power supply assembly 150706 are coupled to handle assembly 150702. . For example, the interface may include a corresponding shaft assembly electrical a first interface portion 150725 that may include one or more electrical connectors for mating engagement with a connector, and one or more for mating engagement with a corresponding power supply assembly electrical connector; A second interface portion 150727 may be included that may include an electrical connector. One or more communication signals can be transmitted through the interface to transmit one or more power requirements of the installed replaceable shaft assembly 150704 to the power management controller 150716. Accordingly, the power management controller may modulate the power output of the battery of the power supply assembly 150706 according to the power requirements of the attached shaft assembly 150704, as described in further detail below. The connector may be activated after mechanical coupling engagement of the handle assembly 150702 to the shaft assembly 150704 and/or power supply assembly 150706 to enable electrical communication between the shaft assembly controller 150722 and the power management controller 150716. A switch that can be used can be provided.

The interface communicates one or more such communication signals between the power management controller 150716 and the shaft assembly controller 150722 by, for example, routing the communication signals through a main controller 150717 housed in the handle assembly 150702. communication can be facilitated. Under other circumstances, while shaft assembly 150704 and power supply assembly 150706 are coupled to handle assembly 150702, the interface is a direct line of communication between power management controller 150716 and shaft assembly controller 150722 through handle assembly 150702. can be facilitated.

Main controller 150717 may be any single-core or multi-core processor, such as that known by the trade name ARM Cortex from Texas Instruments. In one aspect, the main controller 150717 includes on-chip memory, e.g., 256 KB of single-cycle flash memory or other non-volatile memory up to 40 MHz, the details of which are available in the product data sheet, improving performance above 40 MHz. prefetch buffer, 32 KB single-cycle SRAM, internal ROM with StellarisWare® software, 2 KB EEPROM, one or more PWM modules, one or more QEI analog, or 12 The LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments may include one or more 12-bit ADCs with analog input channels.

The safety controller may be a safety controller platform comprising two controller base families, such as the TMS570 and RM4x, also known by the trade name Hercules ARM Cortex R4 from Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety limit applications, among other things, to provide advanced integrated safety features while offering scalable performance, connectivity, and memory options. good.

Power supply assembly 150706 may include power management circuitry, which may include a power management controller 150716, a power modulator 150738, and a current sensor circuit 150736. While the shaft assembly 150704 and power supply assembly 150706 are coupled to the handle assembly 150702, the power management circuit may be configured to modulate the power output of the battery based on the power requirements of the shaft assembly 150704. For example, the power management controller 150716 may be programmed to control a power modulator 150738 of the power output of the power supply assembly 150706, and the current sensor circuit 150736 provides feedback to the power management controller 150716 regarding the power output of the battery. The power management controller 150716 can be used to monitor the power output of the power supply assembly 150706 so that the power management controller 150716 can adjust the power output of the power supply assembly 150706 to maintain a desired output. Power management controller 150716 and/or shaft assembly controller 150722 may each include one or more processors and/or memory units capable of storing a number of software modules.

Surgical instrument 150010 (FIGS. 21-24) can include an output device 150742, which can include a device for providing sensory feedback to a user. Such devices include, for example, visual feedback devices (e.g., liquid crystal display (LCD) display screens, LED indicators), audible feedback devices (e.g., speakers, buzzers), or tactile feedback devices (e.g., tactile activation devices). But that's fine. Under certain circumstances, output device 150742 may include a display 150743 that may be included in handle assembly 150702. Shaft assembly controller 150722 and/or power management controller 150716 may provide feedback to a user of surgical instrument 150010 via output device 150742. The interface can be configured to connect shaft assembly controller 150722 and/or power management controller 150716 to output device 150742. Output device 150742 may alternatively be integrated with power supply assembly 150706. Under such circumstances, while shaft assembly 150704 is coupled to handle assembly 150702, communication between output device 150742 and shaft assembly controller 150722 may be accomplished via the interface.

Control circuit 150700 comprises circuit segments configured to control operation of powered surgical instrument 150010. The safety controller segment (segment 1) includes a safety controller and a main controller 150717 segment (segment 2). The safety controller and/or main controller 150717 is configured to interact with one or more additional circuit segments, such as an acceleration segment, a display segment, a shaft segment, an encoder segment, a motor segment, and a power segment. There is. Each of the circuit segments may be coupled to a safety controller and/or main controller 150717. Main controller 150717 is also coupled to flash memory. Main controller 150717 also includes a serial communication interface. Main controller 150717 includes multiple inputs coupled to, for example, one or more circuit segments, a battery, and/or multiple switches. The segmentation circuit may be implemented by any suitable circuit, such as, for example, a printed circuit board assembly (PCBA) within the powered surgical instrument 150010. The term processor, as used herein, refers to any microprocessor, processor, controller or controllers, or devices that incorporate the functionality of a computer's CPU on one integrated circuit or up to several integrated circuits. should be understood to include other basic computing devices. Main controller 150717 is a general purpose programmable device that accepts digital data as input, processes that data according to instructions stored in memory, and provides results as output. This is an example of sequential digital logic since it has internal memory. Control circuit 150700 may be configured to implement one or more of the processes described herein.

The acceleration segment (segment 3) comprises an accelerometer. The accelerometer is configured to detect movement or acceleration of the powered surgical instrument 150010. Input from the accelerometer may be used to transition to and from sleep mode, identify the orientation of the powered surgical instrument, and/or identify when the surgical instrument has been dropped. In some examples, the acceleration segment is coupled to the safety controller and/or main controller 150717.

The display segment (segment 4) includes a display connector coupled to the main controller 150717. A display connector couples the main controller 150717 to the display through one or more integrated circuit drivers for the display. The display's integrated circuit driver may be integrated with the display and/or may be located separately from the display. The display may include any suitable display, such as, for example, an organic light emitting diode (OLED) display, an LCD, and/or any other suitable display. In some examples, the display segment is coupled to a safety controller.

The shaft segment (segment 5) is a control for a replaceable shaft assembly 150200 (FIGS. 21 and 23) coupled to a surgical instrument 150010 (FIGS. 21-24) and/or a replaceable shaft assembly. one or more controls for an end effector 150300 coupled to 150200; The shaft segment includes a shaft connector configured to couple the main controller 150717 to the shaft PCBA. The shaft PCBA includes a low power microcontroller with ferroelectric random access memory (FRAM), articulation switches, shaft release Hall effect switches, and shaft PCBA EEPROM. The shaft PCBA EEPROM contains one or more parameters, routines, and/or programs specific to the replaceable shaft assembly 150200 and/or the shaft PCBA. Shaft PCBA may be coupled to replaceable shaft assembly 150200 and/or may be integral with surgical instrument 150010. In some examples, the shaft segment includes a second shaft EEPROM. The second shaft EEPROM stores a plurality of algorithms, routines, parameters, and/or other data corresponding to one or more shaft assemblies 150200 and/or end effectors 150300 that may be associated with the powered surgical instrument 150010. include.

The position encoder segment (segment 6) comprises one or more magnetic angular rotary position encoders. The one or more magnetic angular rotational position encoders may rotate the motor 150714 of the surgical instrument 150010 (FIGS. 21-24), the replaceable shaft assembly 150200 (FIGS. 21 and 23), and/or the end effector 150300. configured to identify the location. In some examples, the magnetic angular rotational position encoder may be coupled to the safety controller and/or main controller 150717.

Motor circuit segment (segment 7) includes a motor 150714 configured to control movement of powered surgical instrument 150010 (FIGS. 21-24). Motor 150714 is coupled to main microcontroller processor 150717 by an H-bridge driver that includes one or more H-bridge FETs and a motor controller. The H-bridge driver is also coupled to the safety controller. A motor current sensor is coupled in series with the motor to measure the motor's current draw. The motor current sensor is in signal communication with the main controller 150717 and/or the safety controller. In some examples, motor 150714 is coupled to a motor electromagnetic interference (EMI) filter.

The motor controller controls a first motor flag and a second motor flag to indicate the status and position of motor 150714 to main controller 150717. The main controller 150717 provides a PWM high signal, a PWM low signal, a direction signal, a synchronization signal, and a motor reset signal to the motor controller via a buffer. The power segments are configured to provide segment voltages to each of the circuit segments.

The power segment (segment 8) includes a safety controller, a main controller 150717, and a battery coupled to additional circuit segments. The battery is coupled to the segmentation circuit by a battery connector and a current sensor. The current sensor is configured to measure the total current draw of the segmented circuit. In some examples, one or more voltage converters are configured to provide a predetermined voltage value to one or more circuit segments. For example, in some examples, the segmentation circuit may include a 3.3V voltage converter and/or a 5V voltage converter. The boost converter is configured to provide a boost voltage up to a predetermined amount, for example up to 13V. The boost converter is configured to provide additional voltage and/or current during power intensive operations to prevent brownout or low power conditions.

The plurality of switches are coupled to a safety controller and/or main controller 150717. The switch may be configured to control the operation of the surgical instrument 150010 (FIGS. 21-24) and/or indicate the status of the surgical instrument 150010 of the segmentation circuit. The emergency exit door switch and the emergency exit Hall effect switch are configured to indicate the status of the emergency exit door. Multiple articulation switches, such as left articulation left switch, left articulation right switch, left articulation center switch, right articulation left switch, right articulation right switch, and right articulation center switch, have interchangeable shafts. The assembly is configured to control articulation of assembly 150200 (FIGS. 21 and 23) and/or end effector 150300 (FIGS. 21-24). The left reversing switch and the right reversing switch are coupled to the main controller 150717. The left side switches, comprising a left side articulation left switch, a left side articulation right switch, a left side articulation center switch, and a left side reversal switch, are coupled to the main controller 150717 by a left side flexible connector. The right side switches, comprising a right side articulation left switch, a right side articulation right switch, a right side articulation center switch, and a right side reversal switch, are coupled to the main controller 150717 by a right side flexible connector. The firing switch, clamp release switch, and shaft engagement switch are coupled to the main controller 150717.

The multiple switches may be implemented using any suitable mechanical, electromechanical, or solid state switch and in any combination. For example, the switch may be a limit switch operated by movement of a component associated with the presence of a surgical instrument 150010 (FIGS. 21-24) or a subject. Such switches can be used to control various functions associated with surgical instrument 150010. A limit switch is an electromechanical device consisting of a set of contacts and an actuator in mechanical communication. When the object makes contact with the actuator, the device manipulates the contact to create or break an electrical connection. Due to their ruggedness, ease of installation, and reliability of operation, limit switches are used in a variety of applications and environments. The restriction switch can determine the presence, passage, placement, and termination of movement of the object. In other implementations, the switch may be a solid state switch that operates under the influence of a magnetic field, such as a Hall effect device, MR device, GMR device, and magnetometer, among others. In other implementations, the switch may be a solid state switch that operates under the influence of light, such as a light sensor, an IR sensor, and an ultraviolet sensor, among others. Additionally, the switch may be a solid state device such as a transistor (eg, FET, junction FET, MOSFET, bipolar, etc.). Other switches may include wireless switches, ultrasonic switches, accelerometers, and inertial sensors, among others.

FIG. 26 shows the surgical instrument of FIG. 21 illustrating an interface between handle assembly 150702 and power supply assembly 150706 and an interface between handle assembly 150702 and replaceable shaft assembly 150704, in accordance with at least one aspect of the present disclosure. 15 is another block diagram of the control circuit 150700 of FIG. The handle assembly 150702 can include a main controller 150717, a shaft assembly connector 150726, and a power supply assembly connector 150730. The power supply assembly 150706 may include a power supply assembly connector 150732, a power management circuit 150734, and the power management circuit may include a power management controller 150716, a power modulator 150738, and a current sensor circuit 150736. Shaft assembly connectors 150730, 150732 form interface 150727. While the replaceable shaft assembly 150704 and power supply assembly 150706 are coupled to the handle assembly 150702, the power management circuit 150734 may be configured to modulate the power output of the battery 150707 based on the power requirements of the replaceable shaft assembly 150704. . For example, the power management controller 150716 may be programmed to control a power modulator 150738 of the power output of the power supply assembly 150706, and the current sensor circuit 150736 to provide feedback regarding the power output of the battery 150707 to the power management controller 150716. , may be used to monitor the power output of power supply assembly 150706 so that power management controller 150716 can adjust the power output of power supply assembly 150706 to maintain a desired output. Shaft assembly 150704 includes a shaft processor 150720 coupled to non-volatile memory 150721 and shaft assembly connector 150728 to electrically couple shaft assembly 150704 to handle assembly 150702. Shaft assembly connectors 150726, 150728 form interface 150725. Main controller 150717, shaft processor 150720, and/or power management controller 150716 may be configured to implement one or more of the processes described herein.

Surgical instrument 150010 (FIGS. 21-24) can include an output device 150742 that provides sensory feedback to the user. Such devices may include visual feedback devices (eg, LCD display screen, LED indicators), audible feedback devices (eg, speakers, buzzers), or tactile feedback devices (eg, tactile activation devices). Under certain circumstances, output device 150742 may include a display 150743 that may be included in handle assembly 150702. Shaft assembly controller 150722 and/or power management controller 150716 may provide feedback to a user of surgical instrument 150010 via output device 150742. Interface 150727 may be configured to connect shaft assembly controller 150722 and/or power management controller 150716 to output device 150742. Output device 150742 may be integrated with power supply assembly 150706. Communication between output device 150742 and shaft assembly controller 150722 may be accomplished via interface 150725 while replaceable shaft assembly 150704 is coupled to handle assembly 150702.

Tissue Marking In various surgical procedures, surgical instruments seal tissue by applying energy or deploying staples within the tissue. The surgical instrument may also cut or cut the sealed tissue. In surgical procedures, one or more surgical instruments are applied to several separate sections of the tissue being treated when the tissue size is larger than the maximum tissue size that can be handled by the surgical instrument in one application. Can be applied to tissue parts. If a leak occurs in one of the treated tissue sections, it can be difficult to identify the associated surgical instrument or component thereof, such as a staple cartridge. Without such identification, it becomes difficult to determine the cause of the leak.

Aspects of the present disclosure present a surgical instrument that includes an end effector configured to apply a tissue treatment to tissue. The end effector includes a first jaw, a second jaw movable relative to the first jaw to grasp tissue therebetween, and a grasping mechanism between the first and second jaws. a tissue processing mechanism configured to apply tissue processing to the tissue. In addition, the surgical instrument includes a marking assembly configured to apply distinct markings to the tissue that are specific to each tissue processing application, and the distinct markings make the tissue processing application unique to the surgical instrument or other surgical instrument. differentiated from other tissue processing applications performed by mechanical instruments.

In various embodiments, the tissue processing mechanism includes a staple cartridge configured to apply tissue processing applications by deploying staples into tissue grasped by an end effector. In other aspects, the tissue processing mechanism includes an energy device configured to apply tissue processing applications by delivering therapeutic energy to tissue grasped by an end effector. The energy delivered by the energy device can be in the form of RF energy or ultrasound energy, for example.

In various embodiments, the tissue processing mechanism includes a transverse cutting member movable to apply a tissue processing application by cutting the grasped tissue. One or both of the jaws of the end effector may include a longitudinal slot configured to receive a transverse cutting member. The transverse cutting member may include a cutting edge at its distal portion.

FIG. 27 depicts a logic flow diagram of a process 31010 illustrating a control program or logic configuration for marking tissue processed by an end effector of a surgical instrument, in accordance with at least one aspect of the present disclosure. In one aspect, process 31010 is performed by control circuit 500 (FIG. 13), as described in more detail below. In another aspect, process 31010 may be performed by combinational logic circuit 510 (FIG. 14). In yet another aspect, process 31010 may be performed by sequential logic circuit 520 (FIG. 15).

In the example of FIGS. 28-31, tissue is manipulated by end effector 31000 of surgical stapling and cutting instrument 31006 and marked by marking assembly 31020 of control system 31470.

Surgical instrument 31006 is similar to surgical instrument 150010 in a number of ways. For example, end effector 31000 and control system 31470 are similar in many respects to end effector 150300 and control circuit 470 (FIG. 12), respectively. Components of surgical instrument 31006 that are similar to the above-described components of surgical instrument 150010 are not repeated herein for the sake of brevity.

End effector 31000 includes a first jaw 31001 and a second jaw 31002 extending from replaceable shaft assembly 150200. End effector 31000 further includes an anvil defined within first jaw 31001 and a staple cartridge 31005 defined within second jaw 31002. At least one of the first jaw 31001 and the second jaw 31002 is configured to transition the end effector 26000 between an open configuration and a closed configuration to grasp tissue between the anvil and the staple cartridge 31005. are movable relative to each other. In operation, tissue processing by surgical instrument 31006 involves deploying staples from staple cartridge 26005 into grasped tissue by firing member. The deployed staple is deformed by the anvil. In various embodiments, the tissue is also processed by cutting using a cutting member movable relative to a longitudinal slot 31007 defined in at least one of the first jaw 31001 and the second jaw 31002. can be done.

In various aspects, surgical instruments according to the present disclosure may include an end effector that processes tissue by applying RF or ultrasound energy to the tissue. In various embodiments, surgical instrument 26010 can be a hand-held surgical instrument. Alternatively, surgical instrument 26010 can be incorporated into a robotic system as a component of a robotic arm. This application is disclosed in U.S. Provisional Application No. 62/611,339, filed December 28, 2017, which is incorporated herein by reference in its entirety.

Referring again to FIG. 27, process 31010 includes receiving a 31011 sensor signal indicative of a tissue processing application. If a tissue treatment has been or is being applied to the tissue as determined based on the received sensor signal (31012), a distinct marking is applied to the tissue (31013). The distinct markings are unique to the tissue processing application and can be utilized to distinguish the tissue processing application from other tissue processing applications.

Referring to FIG. 31 in various aspects, process 31010 may be performed by control system 31470 of surgical instrument 31006. Control system 31470 is similar in many respects to control system 470 (FIG. 12). For example, control system 31470 includes control circuitry with microcontroller 470. A number of sensors 472, 474, 476, 31473 provide various sensor signals to microcontroller 470. One or more of such sensor signals may be used alone or in combination with other sensor signals to determine whether tissue processing has been or is being applied to the tissue. can be analyzed. Control system 31470 further includes a marking assembly 31020 in communication with microcontroller 470. After determining that tissue processing is or has been applied to the tissue, microcontroller 470 causes marking assembly 31020 to mark the tissue.

In various examples, marking of tissue by marking assembly 31020 may be triggered by input from an operator of surgical instrument 31006, which may be delivered via a user interface, such as display 473, for example. Alternatively, or in addition, tissue marking may be triggered by one or more sensor signals.

In one example, readings from strain gauge sensor 474, which can be used to measure force applied to tissue grasped by end effector 31000, can trigger tissue marking. Microcontroller 461 may cause marking assembly 31020 to mark tissue upon receiving a sensor signal from sensor 474 indicating that tissue is being grasped by end effector 31000 above a predetermined threshold.

In one example, a reading from activation sensor 31473, which can be used to detect staple deployment or application of energy to tissue, can trigger tissue marking. Upon receiving a sensor signal from sensor 31473 above a predetermined threshold, microcontroller 461 may instruct marking assembly 31020 to mark tissue.

In the example of FIGS. 28 and 30, marking assembly 31020 includes two marking applicators 31021, 31022 disposed on second jaw 31002. In the example of FIGS. More specifically, applicator 31021 is placed on proximal portion 31008 of staple cartridge 31005 assembled with second jaw 31002 while applicator 31022 is placed on distal portion 31009 of staple cartridge 31005. will be placed in In other configurations, more or less than two applicators may be placed on one or more jaws of the end effector to apply markings to tissue treated by the end effector.

Each of the applicators 31021, 31022 includes markers 31023 arranged in a predetermined pattern. As shown in FIG. 31, the markers 31023 of the applicators 31021 and 31022 are arranged in three rows. Applicators 31021, 31022 also include the same number and arrangement of markers 31023. However, in certain instances, the markers on the applicator may be arranged in any suitable arrangement. Different applicators may contain the same or different marker sequences. In certain instances, all of the applicator's markers are activated to produce tissue markings. In other examples, only some of the applicator's markers are activated to produce tissue markings. Activation of markers can be controlled by microcontroller 461 to obtain predetermined markings.

In various examples, markers 31023 may be configured to make their individual marks with the same intensity. Alternatively, the markers 31023 may be configured to make their individual marks at different intensities. The intensity of the mark can be controlled by the microcontroller 461 to obtain a predetermined marking.

In various examples, as shown in FIG. 28, applicators 31021, 31022 are positioned on the proximal portion 31008 and distal portion 31009 of the second jaw 31002, respectively. This configuration allows the applicators 31021, 31022 to make their markings proximal and distal to tissue processing, which can assist in identifying the beginning and end of tissue processing. .

In various examples, one or more of the markings are detectable through stimulation with at least one of a light source, a radiation source, and an illumination source. In certain examples, the marker 31023 is configured to apply one or more fluorescent materials to the tissue to make the marking visible only in the presence of a light source outside the visible spectrum. In other words, the marking fluoresces under an applied light source outside the visible spectrum.

In a particular example, marker 31023 is configured to use an IR readable ink formulation in producing the marking. Ink formulations can be based on absorption and reflection of light in the IR. As shown in FIG. 32, markers 31023 can be configured to produce unique IR ink markings 31035, 31037.

In a particular example, marker 31023 is in the form of an electrode that can be selectively activated by microcontroller 461 to produce a marking. Microcontroller 461 can control the intensity of each mark by controlling the activation time of the electrodes. The longer the electrode is activated, the greater the intensity of the mark. Divisions can be introduced within the electrodes to leave distinctive markings. In a particular example, marker 31023 may comprise an RF electrode that includes a series of microelectrodes configured to weld discrete, optically distinguishable markings for each tissue processing application.

Referring to FIGS. 29 and 32, eight tissue sections underwent eight treatments performed by end effector 31030 of surgical instrument 31036. FIG. 3 shows jaws 31002 of end effector 31030. In each of the eight treatments, the end effector 31030 grasped the tissue section, sealed the tissue section, and cut the tissue section. As shown in Figure 32, treatments were applied in a specific order to separate the cancerous portion of the colon from the adjacent tissue T. Marking assembly 31033, including applicators 31031, 31032, applied separate tissue markings to each tissue section for each treatment.

Surgical instrument 31036 is similar to surgical instruments 31006, 150010 in a number of ways. For example, end effector 31000 is similar to end effectors 31000, 150300 in many respects. Components of surgical instrument 31036 that are similar to those described above of surgical instruments 31006, 150010 are not repeated herein for the sake of brevity.

In the example of FIG. 29, applicators 31031, 31032 are positioned in the proximal portion 31009 of the second jaw 31034 on either side 31038, 31039 of the transverse path defined by the longitudinal slot 31007 along the longitudinal axis LA. Ru. In this configuration, each side of the transected tissue receives a separate marking.

In various examples, markings may be made in an order such that a series of marks from one use to the next provides a distinct marking for successive series of treatments, as shown in FIG. 32. . This allows for unique markings during a series of treatments in addition to markings associated with individual treatments. In other words, markings associated with related processes may include a common identifier in addition to their unique identifiers. Treatments may be associated in a surgical procedure or by being fired sequentially by a single surgical instrument.

In various aspects, surgical instruments of the present disclosure, such as, for example, surgical instruments 26010, 31006, 310036, can be connected to a surgical hub (e.g., surgical hub 106 (FIG. 2, FIG. 3), 206 (FIG. 10)). Data collected by such surgical instruments can be transmitted to a surgical hub 106, 206, which transmits the data to a cloud-based system (e.g., cloud-based system 104) for further analysis. , 204).

In addition to the above, visualization systems (e.g., visualization systems 108 (FIG. 3), 208 (FIG. 9)) may be used to mark tissue frames for subsequent identification after surgical instruments have been removed from the surgical site. can be recorded. Data from the surgical instruments and frames recorded by the visualization system may be transmitted to the surgical hub, which timestamps and/or timestamps the data received from both sources. data can be correlated. Data may also be transferred to a cloud-based system for additional analysis.

This process can be useful in analyzing failures. For example, as shown in FIG. 32, a leak 31039 occurs in the seventh tissue treatment. Distinct markings in the seventh tissue process recorded by the visualization system serve to identify the surgical instrument performing the seventh process. Accordingly, the operational data 31040 for the seventh process can be examined and compared to operational data 31042 for the same surgical instrument in the same environment that resulted in successful application of a similar process. As mentioned above, markings of a single surgical procedure or markings produced by a single surgical instrument may include a common identifier that allows for quick comparison of operational data 31040 and operational data 31042.

In the example of FIG. 32, operational data for a first tissue processing application that resulted in a successful seal is compared to operational data for a seventh tissue processing application that resulted in a leak. Comparing the two data sets reveals that leakage is caused by an abnormal decrease in clamping force, which can be addressed with subsequent tissue processing using the same or similar surgical instruments. In other examples, surgical instrument operating data related to failures is compared to preset criteria.

In certain examples, the failure analysis described above may be performed by the surgical hub in real time during the surgical procedure. Leak detection and tissue marking decoding can be performed by various image processing techniques. Surgeons can be guided back to the surgical site using the surgical hub by using dot-by-dot analysis techniques to identify anatomical landmarks and unique variable shading in the tissue. . In certain instances, landmarks can be identified and obtained by observing hot spots within the tissue after energy application.

Data Transmission Prioritization Various data may be collected and/or generated by powered surgical instruments during surgical procedures. For example, powered surgical stapling and cutting instruments can collect clamping force (FTC) readings and firing force (FTF) readings, among other things, and the readings can be cloud-based for further processing. and a surgical hub for further transmission to the system. The communication path between the powered surgical instrument and the surgical hub has a predetermined bandwidth. Similarly, the communication path between the surgical hub and the cloud-based system also has a predetermined bandwidth. In certain cases, various environmental interferences may further limit such bandwidth. Additionally, various data sources may compete for limited bandwidth.

During a surgical procedure, the surgical hub can react to received data by adjusting various parameters in its control in real time. Depending on the surgical process being performed, certain data sources and/or surgical activities will be more important than others. Transmitting data without considering its significance can interfere with the operation of the surgical hub and its ability to make timely decisions. Similarly, data transmission delays due to bandwidth limitations can interfere with the operation of the surgical hub and its ability to make timely decisions.

In various aspects, surgical system 32002 is used in a surgical procedure. The surgical system 32002 includes a surgical hub (e.g., surgical hub 106 (Figs. 3, 4, 36), surgical hub 206 (Fig. 10)), a powered surgical instrument (e.g., device/instrument 235 (Fig. 9), surgical instrument 32235 (FIG. 36)), and communication module 32004 (FIG. 36). Communication module 32004 includes a shift/register 32005 and a transceiver 32007.

FIG. 35 illustrates a powered surgical instrument 32235 and a surgical hub (e.g., surgical hub 106 (FIGS. 3, 4, 36), surgical hub 206 (FIG. 10)) in accordance with at least one aspect of the present disclosure. 32 shows a logic flow diagram of a process 32000 showing a control program or logic structure for coordinating the transmission of data during. The process 32000 includes receiving first data regarding a first surgical activity of the surgical procedure (32006) and receiving second data regarding a second surgical activity of the surgical procedure (32008). The first data and the second data are transmitted between the powered surgical instrument 32235 and the surgical hub 106 based on at least one characteristic of at least one of the first surgical activity and the second surgical activity. (32010) and transmitting the first data and the second data between the powered surgical instrument and the surgical hub at the selected transmission rate (32012). and, including.

In at least one example, the process 32000 connects the powered surgical instrument 32235 and the surgical select or adjust the transmission speed for transmitting the first data and the second data to and from the hub 106; Communication module 32004 may determine the available bandwidth, which may change over time based on various factors such as, for example, interference and other environmental factors.

FIG. 36 shows a control system 32470 for surgical instrument 32235 that may be used to perform the process of FIG. Control system 32470 is similar in many respects to control system 470 (FIG. 12). In various aspects, the process 32000 may be performed by a communication module 32004 of a surgical instrument 32235 that includes a microcontroller 461 coupled to sensors 472, 474, 476, as shown in FIG.

In various aspects, the first data can be received from a first source and the second data can be received from a second source that is different than the first source. The first source and/or the second source may be any of the sensors 472, 474, 476, for example.

In various aspects, surgical instrument 32235 is similar in many respects to surgical instrument 235 (FIG. 9), 150010 (FIG. 25). For example, similar to surgical instrument 150010, surgical instrument 32235 includes an end effector 150300 that is transitionable from an open configuration to a closed configuration as shown in FIG. 25 for grasping tissue in a first surgical operation. . A motor 482 (FIG. 36) may drive the transition of the end effector 150300 between open and closed configurations. In a particular example, the first data represents the force required for FTC of the end effector 150300 over time, as shown in FIG. 33.

In various aspects, the surgical instrument 32235 includes a movable displacement member (e.g., drive member 150120 of FIG. 26) in a second surgical operation to deploy staples into tissue grasped by the end effector 150300. / fire. In a particular example, the second data represents the FTF of the end effector 150300 over time, as shown in FIG. 33.

FIG. 33 is a graph showing FTC and FTF readings of powered surgical instrument 32235 during a surgical procedure plotted against time (t). The corresponding transmission rates of FTC and FTF readings to surgical hub 106 are also plotted versus time (t). In the example of FIGS. 33 and 34, sensors 472, 474, 476 include an ideal sampling rate of 30 samples per second. Sampling rate is the rate at which readings are taken.

The communication channel between the powered surgical instrument 32235 and the surgical hub 106 includes a first bandwidth capable of transmitting up to 25 megabits per second, which corresponds to a maximum of 62 samples transmitted per second. The first bandwidth is reduced to a second bandwidth at time t= _t2 due to environmental interference within the operating room. The second bandwidth is capable of transmitting up to 20 megabits per second, corresponding to up to 48 samples per second. FIG. 34 also lists actual FTC and FTF samples transmitted every second at four exemplary time points (t ₁ , t ₂ , t ₃ , t ₄ ) selected for illustration purposes.

Referring again to FIGS. 33 and 34, the first surgical activity represented by FTC data begins at time t=0, while the second surgical activity represented by FTF data begins at time t=t It starts with ₃ . The first surgical activity also reaches a maximum FTC at t=t ₁ , which defines an important characteristic of the first surgical activity. It is therefore desirable to prioritize the transmission of FTC data related to the first surgical activity over FTF data related to the second surgical activity until time t= _t3 . As shown at t=t ₁ , which corresponds to the maximum FTC value, FTC data is transmitted at an optimal transmission rate corresponding to 30 samples per second, but no FTF data is transmitted during this initial stage.

In addition to the above, a negative change in bandwidth or maximum available transmission rate occurs at t= _ta and is sensed by communication module 32004. In response, the transmission rate of FTC data is reduced to a transmission rate corresponding to 26 samples per second, as denoted by t= _t2 , in order to adapt to the negative changes caused by environmental interference. In various examples, the first data and the second data are transmitted via a communication channel established between the powered surgical instrument 32235 and the surgical hub 106, and the communication module 32004 The transmission rate of at least one of the first data and the second data is adjusted in accordance with the change in width.

In the embodiments of FIGS. 34 and 35, since the FTF data rate is already 0 samples per second, only the FTC data rate is reduced from 30 samples per second to 26 samples per second. In other examples, as described in more detail below, the ongoing prioritization scheme is established based on characteristics of at least one of the first surgical activity and the second surgical activity. The effect of a negative change in bandwidth on the transmission rate of the first data and/or the second data may be influenced.

At t=t ₃ , the FTF and FTC data become equally relevant. However, due to reduced bandwidth or maximum available transmission rate, only 48 samples can be transmitted per second. Therefore, the transmission rate of FTC data and FTF data is adjusted to be the same at 24 samples per second. In other words, the transmission rates of FTC and FTF data are adjusted to accommodate the increased relevance of FTF data and negative changes in bandwidth or maximum available transmission rate.

In addition to the above, as the FTF data slopes upward and the FTC data becomes smaller and smaller, the FTF data may be prioritized over the FTC data. Accordingly, the transmission rate of FTF data can be increased and the transmission rate of FTC data can be decreased for the remainder of the second surgical activity. In other words, the communication module 32004 communicates first data between the powered surgical instrument and the surgical hub based on certain characteristics of at least one of the first surgical activity and the second surgical activity. and the transmission speed for transmitting the second data may be adjusted.

At t= _t4 , an abnormal FTF is detected when the FTF exceeds a predetermined threshold. To investigate the abnormal FTF, communication module 32004 responds by increasing the FTF data transmission rate to 40 samples per second while decreasing the FTC transmission rate to 8 samples per second. In other words, the communication module 32004 responds to sensed anomalous FTF data by adjusting the transmission rate to prioritize the transmission of FTF data over FTC data.

FIG. 37 illustrates a powered surgical instrument 32235 and a surgical hub (e.g., surgical hub 106 (FIGS. 3, 4, 36), surgical hub 206 (FIG. 10)) in accordance with at least one aspect of the present disclosure. 32100 depicts a logic flow diagram of a process 32100 showing a control program or logic structure for coordinating the transmission of data during. The process 32100 includes receiving first data regarding a first surgical activity of the surgical procedure (32106) and receiving second data regarding a second surgical activity of the surgical procedure (32108). transmitting first data and second data between the powered surgical instrument 32235 and the surgical hub 106 (32112).

In addition to the above, if an anomaly is detected (32109), the process 32100 transmits first data between the powered surgical instrument 32235 and the surgical hub 106 to prioritize transmission of data containing the anomaly. and adjusting the transmission speed for transmitting the second data (32110). As mentioned above, an anomaly according to process 32109 may be exceeding a predetermined threshold.

In various aspects, the communication module 32004 allows low-speed data flows and high-speed connections while still allowing prioritization of low-speed bandwidth data where the prioritization of low-speed bandwidth data is a higher priority. Establish preferred or preferential communication process configurations to ensure.

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

Example 1 - A surgical system for use in a surgical procedure is disclosed. The surgical system includes a surgical hub, a powered surgical instrument, and a communication module. The communication module receives first data related to a first surgical activity of the surgical procedure, receives second data related to a second surgical activity of the surgical procedure, and receives first data related to a first surgical activity of the surgical procedure, and receives first data related to a second surgical activity of the surgical procedure. selecting a transmission rate for transmitting the first data and the second data between the powered surgical instrument and the surgical hub based on at least one characteristic of at least one of the surgical activities; The first data and the second data are configured to be transmitted between the powered surgical instrument and the surgical hub at a selected transmission rate.

Example 2 - The surgical system of Example 1, wherein the surgical instrument includes an end effector transitionable between an open configuration and a closed configuration for grasping tissue.

Example 3 - The surgical system of Example 2, wherein the first data represents a force that transitions the end effector to the closed configuration over time.

Example 4 - The surgical system of any one of Examples 2 and 3, wherein the surgical instrument includes a translatable member for positioning staples within tissue grasped by the end effector.

Example 5 - The surgical system of Example 4, wherein the second data represents a force that moves the translatable member over time.

Example 6 - According to any one of Examples 1-5, the first data and the second data are transmitted via a communication channel established between the powered surgical instrument and the surgical hub. Surgical system described.

Example 7 - Example 6, wherein the communication module is further configured to adjust the transmission rate of at least one of the first data and the second data in response to a change in the bandwidth of the communication channel. The surgical system described in.

Example 8 - A surgical system for use in a surgical procedure is disclosed. The surgical system includes a surgical hub, a powered surgical instrument, and a communication module. The communication module receives first data related to a first surgical activity of the surgical procedure, receives second data related to a second surgical activity of the surgical procedure, and receives first data related to a first surgical activity of the surgical procedure, and receives first data related to a second surgical activity of the surgical procedure. adjusting a transmission rate for transmitting the first data and the second data between the powered surgical instrument and the surgical hub based on at least one characteristic of at least one of the surgical activities; It is composed of

Example 9 - The surgical system of Example 8, wherein the surgical instrument includes an end effector transitionable between an open configuration and a closed configuration for grasping tissue.

Example 10 - The surgical system of Example 9, wherein the first data represents a force that transitions the end effector to the closed configuration over time.

Example 11 - The surgical system of any one of Examples 9 and 10, wherein the surgical instrument includes a translatable member movable to place staples within tissue grasped by the end effector.

Example 12 - The surgical system of Example 11, wherein the second data represents a force that moves the translatable member over time.

Example 13 - The surgical system of Example 12, wherein the first data and the second data are transmitted via a communication channel established between the powered surgical instrument and the surgical hub.

Example 14 - Example 13, wherein the communication module is further configured to adjust the transmission rate of at least one of the first data and the second data in response to a change in the bandwidth of the communication channel. The surgical system described in.

Example 15 - A surgical system for use in a surgical procedure is disclosed. The surgical system includes a surgical hub, a powered surgical instrument, and a communication module. The communication module receives first data regarding a first surgical activity of the surgical procedure, receives second data regarding a second surgical activity of the surgical procedure, and transmits the first data and the second data. transmitting between the powered surgical instrument and the surgical hub, detecting an anomaly in the second data, adjusting transmission rates of the first data and the second data, and transmitting the anomaly in the second data; is configured to give priority to

Example 16 - The surgical system of Example 15, wherein the surgical instrument includes an end effector transitionable between an open configuration and a closed configuration for grasping tissue.

Example 17 - The surgical system of Example 16, wherein the first data represents a force that transitions the end effector to the closed configuration over time.

Example 18 - The surgical system of any one of Examples 16 and 17, wherein the surgical instrument includes a translatable member movable to place staples within tissue grasped by the end effector.

Example 19 - The surgical system of Example 18, wherein the second data represents a force that moves the translatable member over time.

Example 20 - The surgical system of any one of Examples 12-19, wherein the second data anomaly exceeds a predetermined threshold. In various aspects, the communication channel established by the communication module between the surgical hub and the powered surgical instrument is a wireless communication channel. Examples of suitable wireless communications between surgical instruments and surgical hubs are described elsewhere in this disclosure. In other examples, the communication channel established by the communication module between the surgical hub and the powered surgical instrument is a wired communication channel. In various aspects, as described above, communication through such communication channel(s) is prioritized by the importance of the data being communicated rather than by overall bandwidth.

In various aspects, communication between the surgical hub and the powered surgical instrument prevents interception or modification of data within the system as the system activates, assigns identification numbers, or communicates within the system itself. This is an encrypted communication.

The detailed description above has described various forms of apparatus and/or processes using block diagrams, flowcharts, and/or example embodiments. To the extent that such block diagrams, flowcharts, and/or implementations include one or more features and/or operations, those skilled in the art will appreciate that such block diagrams, flowcharts, and/or implementations include one or more features and/or operations. Each feature and/or operation included in an embodiment may be implemented individually and/or collectively by a variety of hardware, software, firmware, or virtually any combination thereof. Those skilled in the art will appreciate that all or a portion of some aspects of the forms disclosed herein can be implemented as one or more computer programs running on one or more computers (e.g., one 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 a microprocessor), as firmware, or on an integrated circuit as virtually any combination thereof; , and/or software and/or firmware code is within the skill of those skilled in the art in light of this disclosure. Additionally, those skilled in the art will appreciate that the features of the subject matter described herein can be distributed as one or more program products in a variety of formats; The specific forms of the subject matter described are employed without regard to the particular type of signal-bearing medium used to actually effectuate the distribution.

The instructions used to program the logic to perform the various disclosed aspects may be stored in memory within the system, such as DRAM, cache, flash memory, or other storage. Additionally, the instructions may be distributed over a network or by other computer-readable media. Thus, a machine-readable medium may include any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), including floppy diskettes, optical disks, CD-ROMs, and magneto-optical disks. , ROM, RAM, EPROM, EEPROM, magnetic or optical card, flash memory, or the Internet via electrical, optical, acoustic, or other forms of propagating signals (e.g., carrier waves, IR signals, digital signals) is not limited to tangible machine-readable storage used to transmit information via. Thus, non-transitory computer-readable media includes any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a form readable by a machine (eg, a computer).

As used in any aspect herein, the term "control circuit" refers to, for example, hard-wired circuits, programmable circuits (e.g., computer processors containing one or more individual instruction processing cores, processing units, , processor, microcontroller, microcontroller unit, controller, DSP, programmable logic device (PLD), programmable logic array (PLA), or field programmable gate array (FPGA)), state machine circuit, programmable circuit. It can refer to stored firmware, and any combination thereof. The control circuits may collectively or individually form part of a larger system, such as an integrated circuit, an application specific integrated circuit (ASIC), an SoC, a desktop computer, a laptop computer, a tablet computer, a server, or a smartphone. It may also be embodied as a circuit. Thus, as used herein, "control circuit" refers to an electrical circuit having at least one individual electrical circuit, an electrical circuit having at least one integrated circuit, an electrical circuit having at least one ASIC, a computer program a general-purpose computing device (e.g., a general-purpose computer configured with a computer program that at least partially executes the processes and/or devices described herein; or electrical circuits forming memory devices (e.g. in the form of RAM); and/or communication devices (e.g. modems, communication switches); , or optical and electrical equipment). Those skilled in the art will recognize that the subject matter described herein may be implemented in analog or digital form or some combination thereof.

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

As used in any aspect herein, the terms "component," "system," "module," etc. refer to either hardware, a combination of hardware and software, software, or running software. Can refer to some computer-related entity.

As used in any aspect herein, an "algorithm" refers to a self-consistent sequence of steps leading to a desired result; a "step" may include, but does not require, storage, transfer, combination, Refers to the manipulation of physical quantities and/or logical states, which can take the form of electrical or magnetic signals, which can be compared and otherwise manipulated. It is common practice to refer to these signals as bits, values, elements, symbols, characters, terms, numbers, or the like. These and similar terms may be associated with the appropriate physical quantities or are simply convenient labels applied to these quantities and/or conditions.

The network may include a packet switched network. The communication devices can communicate with each other using a selected packet-switched network communication protocol. One example 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 published by the Institute of Electrical and Electronics Engineers (IEEE) entitled "IEEE 802.3 Standard" published December 2008, and/or any later version of this standard. It can be sexual. Alternatively or additionally, the communication device is configured to support X. can communicate with each other using the X.25 communication protocol. X. The T.25 communication protocols 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 may communicate with each other using a frame relay communication protocol. The Frame Relay communication protocol is a protocol developed by the Consultative Committee for International Telegraph and Telephone (CCITT) and/or the American National Standards Institute ( may conform to or be compatible with standards promulgated by ANSI). Alternatively or additionally, the transceivers may be capable of communicating with each other using an asynchronous transfer mode (ATM) communication protocol. The ATM communications protocol shall comply with or be compatible with the ATM standard published by the ATM Forum in August 2001 under the title "ATM-MPLS Network Interworking 2.0" and/or with later versions of this standard. obtain. Of course, different and/or later developed connection-oriented network communication protocols are equally contemplated herein.

Unless explicitly stated otherwise, it is clear from the foregoing disclosure that throughout the foregoing disclosure, terms such as "process", "calculate", "calculate", "determine", "display", etc. Discussion of the use of the term refers to data that is represented as a physical (electronic) quantity in the registers and memory of a computer system, and It will be understood to refer to the operations and processes of a computer system or similar electronic computing device that manipulate and convert other data into similarly represented data.

One or more components are herein defined as "configured to," "configurable to," "operable/as such." "operable/operative to", "adapted/adaptable", "able to", "conformable/conformed" may be referred to as "to)". Those skilled in the art will understand that "configured to" generally refers to components in an active state and/or components in an inactive state and/or components in a standby state, unless the context requires otherwise. It will be understood that elements can be included.

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 part closest to the clinician, and the term "distal" refers to the part located away from the clinician. It is further understood that for convenience and clarity, spatial terms such as "vertical," "horizontal," "above," and "below" may be used herein with respect to the drawings. Will. However, surgical instruments may be used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

Those skilled in the art will generally understand that the terms used herein, and specifically in the accompanying claims (e.g., the text of the accompanying claims), are generally "open" terms. (For example, the term "including" should be interpreted as "including but not limited to," and "having )" should be interpreted as "having at least" and the term "includes" should be interpreted as "includes but is not limited to". )” should be interpreted as “ Further, if a specific number is intended in an introduced claim recitation, such intent will be clearly stated in the claim, and if no such statement is present, no such intent exists. will be understood by those skilled in the art. For example, as an aid to understanding, the following appended claims incorporate the introductory phrases "at least one" and "one or more" into claim statements. may be included in order to However, the use of such phrases does not apply when the claim is introduced by the indefinite article "a" or "an," even if the introductory phrase "one or more" or "at least one" appears within the same claim. and the indefinite article "a" or "an," any particular claim containing such an introduced claim statement is limited to a claim containing only one such statement. (e.g., "a" and/or "an" should generally be interpreted to mean "at least one" or "one or more") ). The same applies when introducing claim statements using definite articles.

Furthermore, even if a particular number is specified in an introduced claim statement, such statement is typically to be construed to mean at least the recited number. As will be recognized by those skilled in the art (e.g., a mere statement of "two entries" without any other modifiers generally means at least two entries, or two or three entries). (means the items stated above). Further, when a notation similar to "at least one of A, B, and C, etc." is used, such construction is generally intended in the sense that a person skilled in the art would understand the notation (e.g. , "a system having at least one of A, B, and C" includes, but is not limited to, A only, B only, C only, both A and B, both A and C, B and C) and/or all of A, B, and C). When a notation similar to "at least one of A, B, or C, etc." is used, such construction is generally intended in the sense that a person skilled in the art would understand the notation (e.g., " A system having at least one of A, B, or C includes, but is not limited to, A only, B only, C only, both A and B, both A and C, B and C. (including systems having both and/or all of A, B, and C). Further, typically any disjunctive words and/or phrases representing two or more alternative terms are used in the specification unless the context requires otherwise. It is understood that the possibility is intended to include one, either, or both of these terms, whether in the claims or in the drawings. Those skilled in the art will understand that this should be the case. For example, the phrase "A or B" will typically be understood to include the possibilities "A" or "B" or "A and B."

With reference to the appended claims, those skilled in the art will appreciate that the acts recited herein may generally be performed in any order. Additionally, while flow diagrams of various operations are shown in sequence(s), it is understood that the various operations may be performed in an order other than that illustrated, or may be performed simultaneously. It should be. Examples of such alternative orderings include overlapping, interleaving, interpolating, reordering, incremental, preliminary, additional, simultaneous, reverse, or other different orderings, unless the context requires otherwise. May include. Additionally, terms such as "responsive to," "relating to," or other past tense adjectives generally exclude such variations unless the context requires otherwise. It's not intended.

Any reference to "an aspect," "an aspect," "an example," "an example," etc. refers to the fact that the particular feature, structure, or characteristic described in connection with that aspect is included in at least one aspect. The meaning of this is worth noting. Thus, the phrases "in one aspect," "in an aspect," "in an example," and "in one 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 one or more aspects in any suitable manner.

Any patent application, patent, non-patent publication, or other disclosure material referenced herein and/or listed in any application data sheet is incorporated by reference herein to the extent that the incorporated material is not inconsistent with this specification. , incorporated herein by reference. As such, and to the extent necessary, disclosure expressly set forth herein shall supersede any conflicting disclosure herein incorporated by reference. Any content, or portion thereof, that is inconsistent with current definitions, views, or other disclosures set forth herein shall be incorporated herein by reference, but the references and current disclosures shall be incorporated herein by reference. shall be referred to only to the extent that there is no conflict between them.

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

[Mode of implementation]
(1) A surgical system for use in a surgical procedure, the surgical system comprising:
a surgical hub;
a powered surgical instrument;
A communication module,
receiving first data regarding a first surgical activity of the surgical procedure;
receiving second data regarding a second surgical activity of the surgical procedure;
transmitting the first data and data between the powered surgical instrument and the surgical hub based on at least one characteristic of at least one of the first surgical activity and the second surgical activity; selecting a transmission speed for transmitting the second data;
a communication module configured to transmit the first data and the second data between the powered surgical instrument and the surgical hub at the selected transmission rate. system.
2. The surgical system of embodiment 1, wherein the surgical instrument includes an end effector transitionable between an open configuration and a closed configuration for grasping tissue.
3. The surgical system of embodiment 2, wherein the first data represents a force that transitions the end effector to the closed configuration over time.
4. The surgical system of embodiment 3, wherein the surgical instrument includes a translatable member movable to place staples within the tissue grasped by the end effector.
5. The surgical system of embodiment 4, wherein the second data represents a force that moves the translatable member over time.

(6) The surgical device of embodiment 1, wherein the first data and the second data are transmitted via a communication channel established between the powered surgical instrument and the surgical hub. system.
(7) The communication module is further configured to adjust the transmission rate of at least one of the first data and the second data in response to a change in the bandwidth of the communication channel. , the surgical system of embodiment 6.
(8) A surgical system for use in a surgical procedure, the surgical system comprising:
a surgical hub;
a powered surgical instrument;
A communication module,
receiving first data regarding a first surgical activity of the surgical procedure;
receiving second data regarding a second surgical activity of the surgical procedure;
transmitting the first data and data between the powered surgical instrument and the surgical hub based on at least one characteristic of at least one of the first surgical activity and the second surgical activity; a communication module configured to adjust a transmission rate for transmitting the second data.
9. The surgical system of embodiment 8, wherein the surgical instrument includes an end effector transitionable between an open configuration and a closed configuration for grasping tissue.
10. The surgical system of embodiment 9, wherein the first data represents a force that transitions the end effector to the closed configuration over time.

11. The surgical system of embodiment 10, wherein the surgical instrument includes a translatable member movable to place staples within the tissue grasped by the end effector.
12. The surgical system of embodiment 11, wherein the second data represents a force that moves the translatable member over time.
13. The surgical device of claim 12, wherein the first data and the second data are transmitted via a communication channel established between the powered surgical instrument and the surgical hub. system.
(14) The communication module is further configured to adjust the transmission rate of at least one of the first data and the second data in response to a change in the bandwidth of the communication channel. , the surgical system of embodiment 13.
(15) A surgical system for use in a surgical procedure, the surgical system comprising:
a surgical hub;
a powered surgical instrument;
A communication module,
receiving first data regarding a first surgical activity of the surgical procedure;
receiving second data regarding a second surgical activity of the surgical procedure;
transmitting first data and second data between the powered surgical instrument and the surgical hub;
detecting an abnormality in the second data;
a communication module configured to adjust transmission rates of the first data and the second data to prioritize transmission of the anomaly in the second data.

16. The surgical system of embodiment 15, wherein the surgical instrument includes an end effector transitionable between an open configuration and a closed configuration for grasping tissue.
17. The surgical system of embodiment 16, wherein the first data represents a force that transitions the end effector to the closed configuration over time.
18. The surgical system of embodiment 17, wherein the surgical instrument includes a translatable member movable to place staples within the tissue grasped by the end effector.
19. The surgical system of embodiment 18, wherein the second data represents a force that moves the translatable member over time.
(20) The surgical system according to embodiment 15, wherein the abnormality of the second data exceeds a predetermined threshold.

Claims (8)

A surgical system for use in a surgical procedure, the surgical system comprising:
a surgical hub;
a powered surgical instrument comprising a first sensor and a second sensor ;
A communication module comprising a control circuit ,
receiving first data regarding a first surgical activity of the surgical procedure from the first sensor ;
receiving second data related to a second surgical activity of the surgical procedure from the second sensor ; configured to transmit to the module,
simultaneously transmitting the first data and the second data from the powered surgical instrument to the surgical hub, each of the first data and the second data having a first transmission rate and a second transmission rate; transmitted at the transmission speed,
the first transmission rate and the second transmission rate for transmitting the first data and the second data between the powered surgical instrument and the surgical hub based on a priority scheme; , adjusted by the communication module , the priority scheme is based on at least one characteristic of the second surgical activity, and during the first surgical activity, the first transmission rate is adjusted by the second surgical activity. during the second surgical activity, the second transmission rate is greater than the first transmission rate;
the first data and the second data can be simultaneously transmitted between the powered surgical instrument and the surgical hub at the adjusted first transmission rate and the second transmission rate; a communication module configured;
When the surgical system detects an abnormality regarding the second data, the surgical system controls the first transmission rate so that the sum of the first transmission rate and the second transmission rate does not exceed the maximum available transmission rate. configured to reduce transmission speed,
the powered surgical instrument includes an end effector transitionable between an open configuration and a closed configuration for grasping tissue;
the first data represents a force that causes the end effector to transition to the closed configuration over time;
the powered surgical instrument includes a translatable member movable to place staples within the tissue grasped by the end effector;
The surgical system , wherein the second data represents a force that moves the translatable member over time . The surgical system of claim 1, wherein the first sensor is a position sensor. The surgical system of claim 2, wherein the second sensor is a strain gauge sensor. The surgical system of claim 3, wherein the first data is a force clamp (FTC) reading. The surgical system of claim 4, wherein the second data is a firing force (FTF) reading. When the first data and the second data are transmitted simultaneously, the maximum available transmission rate is reduced compared to when only the first data or only the second data is transmitted. The surgical system according to any one of items 1 to 5. 7. The first data and the second data are transmitted via a communication channel established between the powered surgical instrument and the surgical hub. Surgical system described. 7. The communication module is further configured to adjust at least one of the first transmission rate and the second transmission rate in response to a change in the bandwidth of the communication channel. The surgical system described in.

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