JP7423540B2 - 石灰化した血管の識別 - Google Patents
石灰化した血管の識別 Download PDFInfo
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- JP7423540B2 JP7423540B2 JP2020546927A JP2020546927A JP7423540B2 JP 7423540 B2 JP7423540 B2 JP 7423540B2 JP 2020546927 A JP2020546927 A JP 2020546927A JP 2020546927 A JP2020546927 A JP 2020546927A JP 7423540 B2 JP7423540 B2 JP 7423540B2
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Description
本願は、その開示全体が参照により本明細書に組み込まれる、2018年9月27日に出願された「CALCIFIED VESSEL IDENTIFICATION」と題する米国特許非仮出願第16/144,460号に対する優先権の利益を主張する。
・「METHODS FOR CONTROLLING TEMPERATURE IN ULTRASONIC DEVICE」と題する米国仮特許出願、代理人整理番号END8560USNP1/180106-1M、
・「ULTRASONIC SEALING ALGORITHM WITH TEMPERATURE CONTROL」と題する米国仮特許出願、代理人整理番号END8560USNP3/180106-3、
・「APPLICATION OF SMART ULTRASONIC BLADE TECHNOLOGY」と題する米国仮特許出願、代理人整理番号END8560USNP4/180106-4、
・「ADAPTIVE ADVANCED TISSUE TREATMENT PAD SAVER MODE」と題する米国仮特許出願、代理人整理番号END8560USNP5/180106-5、
・「SMART BLADE TECHNOLOGY TO CONTROL BLADE INSTABILITY」と題する米国仮特許出願、代理人整理番号END8560USNP6/180106-6、及び
・「START TEMPERATURE OF BLADE」と題する米国仮特許出願、代理人整理番号END8560USNP7/180106-7。
・「METHODS FOR ESTIMATING AND CONTROLLING STATE OF ULTRASONIC END EFFECTOR」と題する米国仮特許出願、代理人整理番号END8536USNP1/180107-1M、
・「IN-THE-JAW CLASSIFIER BASED ON MODEL」と題する米国仮特許出願、代理人整理番号END8536USNP3/180107-3、
・「APPLICATION OF SMART BLADE TECHNOLOGY」と題する米国仮特許出願、代理人整理番号END8536USNP4/180107-4、
・「SMART BLADE AND POWER PULSING」と題する米国仮特許出願、代理人整理番号END8536USNP5/180107-5、
・「ADJUSTMENT OF COMPLEX IMPEDANCE TO COMPENSATE FOR LOST POWER IN AN ARTICULATING ULTRASONIC DEVICE」と題する米国仮特許出願、代理人整理番号END8536USNP6/180107-6、
・「USING SPECTROSCOPY TO DETERMINE DEVICE USE STATE IN COMBO INSTRUMENT」と題する米国仮特許出願、代理人整理番号END8536USNP7/180107-7、
・「VESSEL SENSING FOR ADAPTIVE ADVANCED HEMOSTASIS」と題する米国仮特許出願、代理人整理番号END8536USNP8/180107-8、
・「DETECTION OF LARGE VESSELS DURING PARENCHYMAL DISSECTION USING A SMART BLADE」と題する米国仮特許出願、代理人整理番号END8536USNP10/180107-10、
・「SMART BLADE APPLICATION FOR REUSABLE AND DISPOSABLE DEVICES」と題する米国仮特許出願、代理人整理番号END8536USNP11/180107-11、
・「LIVE TIME TISSUE CLASSIFICATION USING ELECTRICAL PARAMETERS」と題する米国仮特許出願、代理人整理番号END8536USNP12/180107-12、及び
・「FINE DISSECTION MODE FOR TISSUE CLASSIFICATION」と題する米国仮特許出願、代理人整理番号END8536USNP13/180107-13。
・「AUTOMATED DATA SCALING,ALIGNMENT,AND ORGANIZING BASED ON PREDEFINED PARAMETERS WITHIN A SURGICAL NETWORK BEFORE TRANSMISSION」と題する米国仮特許出願第62/729,177号、
・「SENSING THE PATIENT POSITION AND CONTACT UTILIZING THE MONO-POLAR RETURN PAD ELECTRODE TO PROVIDE SITUATIONAL AWARENESS TO THE HUB」と題する米国仮特許出願第62/729,182号、
・「POWERED SURGICAL TOOL WITH A PREDEFINED ADJUSTABLE CONTROL ALGORITHM FOR CONTROLLING AT LEAST ONE END-EFFECTOR PARAMETER AND A MEANS FOR LIMITING THE ADJUSTMENT」と題する米国仮特許出願第62/729,184号、
・「SURGICAL NETWORK RECOMMENDATIONS FROM REAL TIME ANALYSIS OF PROCEDURE VARIABLES AGAINST A BASELINE HIGHLIGHTING DIFFERENCES FROM THE OPTIMAL SOLUTION」と題する米国仮特許出願第62/729,183号、
・「A CONTROL FOR A SURGICAL NETWORK OR SURGICAL NETWORK CONNECTED DEVICE THAT ADJUSTS ITS FUNCTION BASED ON A SENSED SITUATION OR USAGE」と題する米国仮特許出願第62/729,191号、
・「INDIRECT COMMAND AND CONTROL OF A FIRST OPERATING ROOM SYSTEM THROUGH THE USE OF A SECOND OPERATING ROOM SYSTEM WITHIN A STERILE FIELD WHERE THE SECOND OPERATING ROOM SYSTEM HAS PRIMARY AND SECONDARY OPERATING MODES」と題する米国仮特許出願第62/729,176号、
・「WIRELESS PAIRING OF A SURGICAL DEVICE WITH ANOTHER DEVICE WITHIN A STERILE SURGICAL FIELD BASED ON THE USAGE AND SITUATIONAL AWARENESS OF DEVICES」と題する米国仮特許出願第62/729,186号、及び
・「POWERED STAPLING DEVICE THAT IS CAPABLE OF ADJUSTING FORCE,ADVANCEMENT SPEED,AND OVERALL STROKE OF CUTTING MEMBER OF THE DEVICE BASED ON SENSED PARAMETER OF FIRING OR CLAMPING」と題する米国仮特許出願第62/729,185号。
・「ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR」と題する米国特許出願第16/115,214号、
・「TEMPERATURE CONTROL OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR」と題する米国特許出願第16/115,205号、
・「RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS」と題する米国特許出願第16/115,233号、
・「CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION」と題する米国特許出願第16/115,208号、
・「CONTROLLING ACTIVATION OF AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO THE PRESENCE OF TISSUE」と題する米国特許出願第16/115,220号、
・「DETERMINING TISSUE COMPOSITION VIA AN ULTRASONIC SYSTEM」と題する米国特許出願第16/115,232号、
・「DETERMINING THE STATE OF AN ULTRASONIC ELECTROMECHANICAL SYSTEM ACCORDING TO FREQUENCY SHIFT」と題する米国特許出願第16/115,239号、
・「DETERMINING THE STATE OF AN ULTRASONIC END EFFECTOR」と題する米国特許出願第16/115,247号、
・「SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS」と題する米国特許出願第16/115,211号、
・「MECHANISMS FOR CONTROLLING DIFFERENT ELECTROMECHANICAL SYSTEMS OF AN ELECTROSURGICAL INSTRUMENT」と題する米国特許出願第16/115,226号、
・「DETECTION OF END EFFECTOR EMERSION IN LIQUID」と題する米国特許出願第16/115,240号、
・「INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING」と題する米国特許出願第16/115,249号、
・「INCREASING RADIO FREQUENCY TO CREATE PAD-LESS MONOPOLAR LOOP」と題する米国特許出願第16/115,256号、
・「BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY」と題する米国特許出願第16/115,223号、及び
・「ACTIVATION OF ENERGY DEVICES」と題する米国特許出願第16/115,238号。
・「CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION」と題する米国仮特許出願第62/721,995号、
・「SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS」と題する米国仮特許出願第62/721,998号、
・「INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING」と題する米国仮特許出願第62/721,999号、
・「BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY」と題する米国仮特許出願第62/721,994号、及び
・「RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS」と題する米国仮特許出願第62/721,996号。
・「SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE」と題する米国仮特許出願第62/692,747号、
・「SMART ENERGY ARCHITECTURE」と題する米国仮特許出願第62/692,748号、及び
・「SMART ENERGY DEVICES」と題する米国仮特許出願第62/692,768号。
・「CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS」と題する米国特許出願第16/024,090号、
・「CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS」と題する米国特許出願第16/024,057号、
・「SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION」と題する米国特許出願第16/024,067号、
・「SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING」と題する米国特許出願第16/024,075号、
・「SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING」と題する米国特許出願第16/024,083号、
・「SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES」と題する米国特許出願第16/024,094号、
・「SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE」と題する米国特許出願第16/024,138号、
・「SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES」と題する米国特許出願第16/024,150号、
・「VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY」と題する米国特許出願第16/024,160号、
・「SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE」と題する米国特許出願第16/024,124号、
・「SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT」と題する米国特許出願第16/024,132号、
・「SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY」と題する米国特許出願第16/024,141号、
・「SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES」と題する米国特許出願第16/024,162号、
・「SURGICAL EVACUATION SENSING AND MOTOR CONTROL」と題する米国特許出願第16/024,066号、
・「SURGICAL EVACUATION SENSOR ARRANGEMENTS」と題する米国特許出願第16/024,096号、
・「SURGICAL EVACUATION FLOW PATHS」と題する米国特許出願第16/024,116号、
・「SURGICAL EVACUATION SENSING AND GENERATOR CONTROL」と題する米国特許出願第16/024,149号、
・「SURGICAL EVACUATION SENSING AND DISPLAY」と題する米国特許出願第16/024,180号、
・「COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM」と題する米国特許出願第16/024,245号、
・「SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTROL CIRCUIT FOR INTERACTIVE SURGICAL PLATFORM」と題する米国特許出願第16/024,258号、
・「SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE」と題する米国特許出願第16/024,265号、及び
・「DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS」と題する米国特許出願第16/024,273号。
・「A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES」と題する米国仮特許出願第62/691,228号、
・「CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS」と題する米国仮特許出願第62/691,227号、
・「SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE」と題する米国仮特許出願第62/691,230号、
・「SURGICAL EVACUATION SENSING AND MOTOR CONTROL」と題する米国仮特許出願第62/691,219号、
・「COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM」と題する米国仮特許出願第62/691,257号、
・「SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE」と題する米国仮特許出願第62/691,262号、及び
・「DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS」と題する米国仮特許出願第62/691,251号。
・「METHOD OF HUB COMMUNICATION」と題する米国仮特許出願第62/659,900号。
・2018年3月30日に出願された、「CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS」と題する米国仮特許出願第62/650,898号、
・「SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES」と題する米国仮特許出願第62/650,887号、
・「SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM」と題する米国仮特許出願第62/650,882号、及び
・「SURGICAL SMOKE EVACUATION SENSING AND CONTROLS」と題する米国仮特許出願第62/650,877号
・「INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES」と題する米国特許出願第15/940,641号、
・「INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES」と題する米国特許出願第15/940,648号、
・「SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES」と題する米国特許出願第15/940,656号、
・「SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS」と題する米国特許出願第15/940,666号、
・「COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS」と題する米国特許出願第15/940,670号、
・「SURGICAL HUB CONTROL ARRANGEMENTS」と題する米国特許出願第15/940,677号、
・「DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD」と題する米国特許出願第15/940,632号、
・「COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS」と題する米国特許出願第15/940,640号、
・「SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT」と題する米国特許出願第15/940,645号、
・「DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME」と題する米国特許出願第15/940,649号、
・「SURGICAL HUB SITUATIONAL AWARENESS」と題する米国特許出願第15/940,654号、
・「SURGICAL SYSTEM DISTRIBUTED PROCESSING」と題する米国特許出願第15/940,663号、
・「AGGREGATION AND REPORTING OF SURGICAL HUB DATA」と題する米国特許出願第15/940,668号、
・「SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER」と題する米国特許出願第15/940,671号、
・「DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE」と題する米国特許出願第15/940,686号、
・「STERILE FIELD INTERACTIVE CONTROL DISPLAYS」と題する米国特許出願第15/940,700号、
・「COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS」と題する米国特許出願第15/940,629号、
・「USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT」と題する米国特許出願第15/940,704号、
・「CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY」と題する米国特許出願第15/940,722号、及び
・「DUAL CMOS ARRAY IMAGING」と題する米国特許出願第15/940,742号。
・「ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES」と題する米国特許出願第15/940,636号、
・「ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS」と題する米国特許出願第15/940,653号、
・「CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER」と題する米国特許出願第15/940,660号、
・「CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET」と題する米国特許出願第15/940,679号、
・「CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION」と題する米国特許出願第15/940,694号、
・「CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES」と題する米国特許出願第15/940,634号、
・「DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK」と題する米国特許出願第15/940,706号、及び
・「CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES」と題する米国特許出願第15/940,675号。
・「DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,627号、
・「COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,637号、
・「CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,642号、
・「AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,676号、
・「CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,680号、
・「COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,683号、
・「DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,690号、及び
・「SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国特許出願第15/940,711号。
・「INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES」と題する米国仮特許出願第62/649,302号、
・「DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD」と題する米国仮特許出願第62/649,294号、
・「SURGICAL HUB SITUATIONAL AWARENESS」と題する米国仮特許出願第62/649,300号、
・「SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER」と題する米国仮特許出願第62/649,309号、
・「COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS」と題する米国仮特許出願第62/649,310号、
・「USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT」と題する米国仮特許出願第62/649,291号、
・「ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES」と題する米国仮特許出願第62/649,296号、
・「CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER」と題する米国仮特許出願第62/649,333号、
・「CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES」と題する米国仮特許出願第62/649,327号、
・「DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK」と題する米国仮特許出願第62/649,315号、
・「CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES」と題する米国仮特許出願第62/649,313号、
・「DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国仮特許出願第62/649,320号、
・「AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国仮特許出願第62/649,307号、及び
・「SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国仮特許出願第62/649,323号。
・「INTERACTIVE SURGICAL PLATFORM」と題する米国仮特許出願第62/611,341号、
・「CLOUD-BASED MEDICAL ANALYTICS」と題する米国仮特許出願第62/611,340号、及び
・「ROBOT ASSISTED SURGICAL PLATFORM」と題する米国仮特許出願第62/611,339号。
・「INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES」と題する米国仮特許出願第62/649,302号、
・「DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD」と題する米国仮特許出願第62/649,294号、
・「SURGICAL HUB SITUATIONAL AWARENESS」と題する米国仮特許出願第62/649,300号、
・「SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER」と題する米国仮特許出願第62/649,309号、
・「COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS」と題する米国仮特許出願第62/649,310号、
・「USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT」と題する米国仮特許出願第62/649,291号、
・「ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES」と題する米国仮特許出願第62/649,296号、
・「CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER」と題する米国仮特許出願第62/649,333号、
・「CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES」と題する米国仮特許出願第62/649,327号、
・「DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK」と題する米国仮特許出願第62/649,315号、
・「CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES」と題する米国仮特許出願第62/649,313号、
・「DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国仮特許出願第62/649,320号、
・「AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国仮特許出願第62/649,307号、及び
・「SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS」と題する米国仮特許出願第62/649,323号。
・「INTERACTIVE SURGICAL PLATFORM」と題する米国仮特許出願第62/611,341号、
・「CLOUD-BASED MEDICAL ANALYTICS」と題する米国仮特許出願第62/611,340号、及び
・「ROBOT ASSISTED SURGICAL PLATFORM」と題する米国仮特許出願第62/611,339号。
様々な態様では、スマート超音波エネルギー装置は、超音波ブレードの動作を制御するための適応アルゴリズムを含んでもよい。一態様では、超音波ブレード適応制御アルゴリズムは、組織の種類を特定し、装置パラメータを調整するように構成される。一態様では、超音波ブレード制御アルゴリズムは、組織の種類をパラメータ化するように構成される。超音波ブレードの遠位先端の振幅を調整するために組織のコラーゲン/弾性比を検出するためのアルゴリズムが、本開示の以下の項で説明される。スマート超音波エネルギー装置の様々な態様が、例えば図1~図2に関連して本明細書で説明される。したがって、適応型超音波ブレード制御アルゴリズムの以下の説明は、図1~図2及びこれらに関連する説明と併せて読まれるべきである。
図2は、超音波器具と連結するように構成され、かつ、図1に示すモジュール式通信ハブを備える外科用データネットワーク内で適応型超音波ブレード制御アルゴリズムを実行するように更に構成された発生器の一形態である、発生器900の一実施例を示す。発生器900は、複数のエネルギーモダリティを外科用器具に送達するように構成されている。発生器900は、エネルギーを外科用器具に送達するためのRF信号及び超音波信号を単独で又は同時にのいずれかで提供する。RF信号及び超音波信号は、単独で又は組み合わせて提供されてもよく、また同時に提供されてもよい。上述したように、少なくとも1つの発生器出力部は、単一のポートを通して複数のエネルギーモダリティ(例えば、とりわけ超音波、双極若しくは単極RF、不可逆及び/若しくは可逆電気穿孔法並びに/又はマイクロ波エネルギー)を送達することができ、これらの信号は、組織を治療するために個別に又は同時にエンドエフェクタに送達することができる。発生器900は、波形発生器904に連結されたプロセッサ902を備える。プロセッサ902及び波形発生器904は、プロセッサ902に連結されたメモリに記憶された情報(開示を明瞭にするために示されず)に基づいて、様々な信号波形を発生するように構成されている。波形に関連するデジタル情報は、デジタル入力をアナログ出力に変換するために1つ以上のDAC回路を含む波形発生器904に提供される。アナログ出力は、信号調節及び増幅のために、増幅器906に供給される。増幅器906の、調節され増幅された出力は、電力変圧器908に連結されている。信号は、電力変圧器908を横断して患者絶縁側にある二次側に連結されている。第1のエネルギーモダリティの第1の信号は、外科用器具のENERGY1及びRETURNとラベルされた端子間に提供される。第2のエネルギーモダリティの第2の信号は、コンデンサ910を横断して連結され、外科用器具のENERGY2及びRETURNとラベルされた端子間に提供される。2つを超えるエネルギーモダリティが出力されてもよく、したがって添え字「n」は、最大n個のENERGYn端子が提供され得ることを示すために使用することができ、ここでnは、1超の正の整数であることが理解されよう。最大「n」個のリターンパス(RETURNn)が、本開示の範囲から逸脱することなく提供されてもよいことも理解されよう。
φ=2πft+φ0
式中、φは位相角であり、fは周波数であり、tは時間であり、φ0は、t=0における位相である。
超音波エネルギー送達に伴う課題は、超音波音響が誤った材料又は誤った組織に適用されることにより、装置故障、例えば、クランプアームパッドの燃焼又は超音波ブレードの破損が生じ得ることである。また、ジョー内に追加のセンサを追加することなく、超音波装置のエンドエフェクタのジョー内に何が位置するのか、及びジョーの状態を検出することも望ましい。超音波エンドエフェクタのジョー内にセンサを位置決めすることは、信頼性、コスト、及び複雑性の課題を提起する。
各特性パターンに関して、パラメトリックラインは、便宜により決定され得るように、多項式、フーリエ級数、又は任意の他の形態のパラメトリック方程式を使用して、訓練に使用されるデータに適合させることができる。続いて、新しいデータ点が受信され、これを、新たなデータ点から特性パターン訓練データに適合された軌跡までのユークリッド垂直距離を使用することによって分類する。新たなデータ点のそれぞれの軌跡(それぞれの軌跡は異なる状態又は状況を表す)までの垂直距離を使用して、点を状態又は状況に割り当てる。
超音波トランスデューサ/超音波ブレードの作動前、作動中、又は作動後に測定されたデータの分類に基づいて、様々な自動タスク及び安全対策を実装することができる。同様に、エンドエフェクタ内に位置する組織の状態及び超音波ブレードの温度もある程度推定され、超音波装置の状態をユーザによりよく知らせるか、又は重要な構造を保護するためなどに使用することもできる。超音波ブレードの温度制御は、全体が参照により本明細書に組み込まれる、2018年3月8日に出願された共同所有の米国仮特許出願第62/640,417号、発明の名称「TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR」に記載されている。
このシステムは、確率関数及びカルマンフィルタを使用して、このプロセスからのデータを前述のデータと組み合わせることによって、センサ、ユーザ、患者の測定基準、環境要因などによって提供される他の情報と併用することができる。カルマンフィルタは、様々な信頼性の不確かな測定値をふんだんに考慮して、生じる状態又は状況の最大尤度を決定する。この方法により、新たに分類されたデータ点への確率の割り当てが可能となるため、このアルゴリズムの情報は、カルマンフィルタ内の他の測定又は推定を用いて実装することができる。
組織の種類及び状況を含む超音波装置のジョー内に位置する物質を分類することに対する関心は既存である。様々な態様において、高度なデータサンプリング及び精緻なパターン認識を用いると、この分類が可能であることが示され得る。このアプローチは、周波数の関数としてのインピーダンスに基づくものであり、ここでは、大きさ、位相、及び周波数が3Dでプロットされ、パターンは、図19及び図20、並びに図21の論理フロー図に示されるように、リボン様に見える。本開示は、圧電トランスデューサの十分に確立されたモデルに基づく代替的なスマートブレードアルゴリズムのアプローチを提供する。
Co=3.0nF
Cs=8.22pF
Ls=1.0h
Rs=450Ω
r=1.012*103
a=1.013*103
b=-954.585
r2=(x-a)2+(y-b)2
Z2,iは、サセプタンスと称される虚数成分の第2であり、
Z3,iは、アドミッタンスが計算される周波数を表す第3のベクトルである。
Ls=L1=1.1068H
Rs=R1=311.352Ω
Cs=C1=7.43265pF
C0=C0=3.64026nF
図25は、本開示の少なくとも1つの態様による、ジョーが開放しており、負荷がない超音波装置の複素インピーダンス(Z)/アドミッタンス(Y)円プロット132068、132070を示すインピーダンス分析器のグラフ表示132066であり、実線の円プロット132068は複素インピーダンスを示し、破線の円プロット132070は複素アドミッタンスを示す。超音波トランスデューサに印加される発振器電圧は500mVであり、周波数は55kHzから56kHzに掃引される。インピーダンス(Z)スケールは200Ω/divであり、アドミッタンス(Y)スケールは500μS/divである。複素インピーダンス(Z)及びアドミッタンス(Y)円プロット132068、132070を特徴付け得る値の測定は、インピーダンスカーソル132072及びアドミッタンスカーソル132074によって示される円プロット132068、132070上の位置で取得されてもよい。したがって、インピーダンスカーソル132072は、約55.55kHzに等しいインピーダンス円プロット132068の一部分に位置し、アドミッタンスカーソル132074は、約55.29kHzに等しいアドミッタンス円プロット132070の一部分に位置する。図25に示されるように、インピーダンスカーソル132072の位置は、以下の値に対応する。
R=1.66026Ω
X=-697.309Ω
式中、Rは抵抗(実数値)であり、Xはリアクタンス(虚数値)である。同様に、アドミッタンスカーソル132074の位置は、以下の値に対応する。
G=64.0322μS
B=1.63007mS
式中、Gはコンダクタンス(実数値)であり、Bはサセプタンス(虚数値)である。
図26は、本開示の少なくとも1つの態様による、エンドエフェクタのジョーが乾燥したセーム上にクランプされている超音波装置の複素インピーダンス(Z)/アドミッタンス(Y)円プロット132078、132080を示すインピーダンス分析器のグラフ表示132076であり、インピーダンス円プロット132078は実線で示され、アドミッタンス円プロット132080は破線で示されている。超音波トランスデューサに印加される電圧は500mVであり、周波数は55kHzから56kHzに掃引される。インピーダンス(Z)スケールは200Ω/divであり、アドミッタンス(Y)スケールは500μS/divである。
R=434.577Ω
X=-758.772Ω
式中、Rは抵抗(実数値)であり、Xはリアクタンス(虚数値)である。
G=85.1712μS
B=1.49569mS
式中、Gはコンダクタンス(実数値)であり、Bはサセプタンス(虚数値)である。
図27は、本開示の少なくとも1つの態様による、ジョーの先端が湿ったセーム上にクランプされている超音波装置の複素インピーダンス(Z)/アドミッタンス(Y)円プロット132098、132090を示すインピーダンス分析器のグラフ表示132086であり、インピーダンス円プロット132088は実線で示され、アドミッタンス円プロット132090は破線で示されている。超音波トランスデューサに印加される電圧は500mVであり、周波数は55kHzから56kHzに掃引される。インピーダンス(Z)スケールは200Ω/divであり、アドミッタンス(Y)スケールは500μS/divである。
R=445.259Ω
X=-750.082Ω
式中、Rは抵抗(実数値)であり、Xはリアクタンス(虚数値)である。同様に、アドミッタンスカーソル132094は、以下の値に対応する。
G=96.2179μS
B=1.50236mS
式中、Gはコンダクタンス(実数値)であり、Bはサセプタンス(虚数値)である。
図28は、本開示の少なくとも1つの態様による、ジョーが湿ったセーム上に完全にクランプされている超音波装置の複素インピーダンス(Z)/アドミッタンス(Y)円プロット132098、132100を示すインピーダンス分析器のグラフ表示132096であり、インピーダンス円プロット132098は実線で示され、アドミッタンス円プロット132100は破線で示されている。超音波トランスデューサに印加される電圧は500mVであり、周波数は55kHzから56kHzに掃引される。インピーダンス(Z)スケールは200Ω/divであり、アドミッタンス(Y)スケールは500μS/divである。
G=137.272μS
B=1.48481mS
式中、Gはコンダクタンス(実数値)であり、Bはサセプタンス(虚数値)である。
図29は、本開示の少なくとも1つの態様による、インピーダンス(Z)/アドミッタンス(Y)円プロットを示すインピーダンス分析器のグラフ表示132106であり、周波数は、ジョーが開放しており、負荷がない超音波装置の複数の共振を捕捉するために、48kHzから62kHzに掃引され、破線で示される矩形132108によって指定された領域は、実線で示されるインピーダンス円プロット132110a、132110b、132110c、及びアドミッタンス円プロット132112a、132112b、132112cを見やすくするためのものである。超音波トランスデューサに印加される電圧は500mVであり、周波数は48kHzから62kHzに掃引される。インピーダンス(Z)スケールは500Ω/divであり、アドミッタンス(Y)スケールは500μS/divである。
R=1.86163kΩ
X=-536.229Ω
式中、Rは抵抗(実数値)であり、Xはリアクタンス(虚数値)である。同様に、アドミッタンスカーソル132116は、以下の値に対応する。
G=649.956μS
B=2.51975mS
式中、Gはコンダクタンス(実数値)であり、Bはサセプタンス(虚数値)である。
Ls=L1=1.1068H
Rs=R1=311.352Ω
Cs=C1=7.43265pF及び
C0=C0=3.64026nF
様々な態様において、本開示は、石灰化した血管を封止する際の止血を改善するための、また、石灰化した血管を封止する際の課題に対処するための様々な技術を提供する。一態様では、超音波器具は、石灰化した血管の封止の、知的(with intelligence)管理を行うように構成される。一態様では、関連する米国特許仮出願第62/640,417号(Nottら、発明の名称「TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR」、当該出願はその全体が参照により本明細書に組み込まれる)において、「ESTIMATING THE STATE OF THE JAW(PAD BURN THROUGH,STAPLES,BROKEN BLADE,BONE IN JAW,TISSUE IN JAW」という見出しの下に図19~図21と関連して、かつ/又は、「STATE OF JAW CLASSIFIER BASED ON MODEL」という見出しの下に図22~図30と関連して、かつ/又は、超音波ブレードの温度を推定するための技術に関連して記載されている、超音波装置のジョーの状態を推定又は分類するためのスマートブレードアルゴリズム技術を用いて、ジョーの内容物を識別してもよい。したがって、超音波器具のジョーに石灰化した血管がクランプされた場合、これらの技術を用いて、その石灰化した血管を識別することができる。
実施例1.超音波装置にエネルギーを送達する方法であって、超音波装置は、所定の共振周波数によって定義される電気機械的超音波システムを備え、電気機械的超音波システムは、超音波ブレードに連結された超音波トランスデューサを更に備え、方法は、
プロセッサ又は制御回路が、超音波トランスデューサに連結された超音波ブレードと接触する血管を感知することと、
プロセッサ又は制御回路が、血管が石灰化していることを識別することと、
プロセッサ又は制御回路が、血管が石灰化しているという警告を発することと、
プロセッサ又は制御回路が、所定の圧迫期間Tにわたって、石灰化した血管を圧迫するよう、ユーザに対してメッセージを発することと、
プロセッサ又は制御回路が、所定の圧迫期間中に超音波ブレードの作動機能を無効化することと、
プロセッサ又は制御回路が、所定の圧迫期間終了後に、超音波ブレードの作動機能を有効化することと、を含む、方法。
プロセッサ又は制御回路が、超音波ブレードの作動を可能にすることと、を更に含む、実施例1に記載の方法。
プロセッサ又は制御回路が、超音波トランスデューサに連結された超音波ブレードと接触する血管を感知することと、
プロセッサ又は制御回路が、血管が石灰化していることを識別することと、
プロセッサ又は制御回路が、血管が石灰化しているという警告を発することと、
プロセッサ又は制御回路が、超音波ブレードの1つ以上の作動機能を無効化することと、を含む、方法。
プロセッサ又は制御回路が、超音波ブレードの作動を可能にすることと、を更に含む、実施例3に記載の方法。
プロセッサ又は制御回路が、超音波トランスデューサの複素インピーダンスを測定することであって、複素インピーダンスは、
プロセッサ又は制御回路が、複素インピーダンス測定データ点を受信することと、
プロセッサ又は制御回路が、複素インピーダンス測定データ点を基準複素インピーダンス特性パターン内のデータ点と比較することと、
プロセッサ又は制御回路が、比較分析の結果に基づいて、複素インピーダンス測定データ点を分類することと、
プロセッサ又は制御回路が、比較分析の結果に基づいて、超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する血管が石灰化した血管であると判定することと、を含む、実施例1~4のいずれか1つ以上に記載の方法。
駆動回路が、超音波トランスデューサに駆動信号を印加することであって、駆動信号は、大きさ及び周波数によって定義される周期信号である、ことと、
プロセッサ又は制御回路が、駆動信号の周波数を電気機械的超音波システムの共振未満から共振超に掃引することと、
プロセッサ又は制御回路が、インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを測定及び記録することと、
プロセッサ又は制御回路が、測定されたインピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを、基準インピーダンス/アドミッタンス円変数Rref、Gref、Xref、及びBrefと比較することと、
プロセッサ又は制御回路が、比較分析の結果に基づいて、超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する血管が石灰化した血管であると判定することと、を含む、実施例1~4のいずれか1つ以上に記載の方法。
プロセッサ又は制御回路が、超音波トランスデューサに連結された超音波ブレードと接触する血管を感知することと、
プロセッサ又は制御回路が、血管が石灰化していることを識別することと、
プロセッサ又は制御回路が、血管が石灰化しているという警告を発することと、
プロセッサ又は制御回路が、モータを作動させ、クランプアームを超音波ブレードに向かって駆動して、石灰化した血管を圧迫することによって、石灰化した血管に圧迫クランプ力を加えることと、
プロセッサ又は制御回路が、クランプアームが組織を圧迫している間、超音波ブレードの作動機能を無効化することと、
プロセッサ又は制御回路が、圧迫クランプ力を調整した後、超音波ブレードの作動機能を有効化することと、を含む、方法。
プロセッサ又は制御回路が、超音波ブレードの作動を可能にすることと、を更に含む、実施例7に記載の方法。
プロセッサ又は制御回路が、所定の圧迫期間Tの終了後に、超音波ブレードの作動を可能にすることと、を更に含む、実施例7に記載の方法。
プロセッサ又は制御回路が、超音波トランスデューサの複素インピーダンスを測定することであって、複素インピーダンスは、
プロセッサ又は制御回路が、複素インピーダンス測定データ点を受信することと、
プロセッサ又は制御回路が、複素インピーダンス測定データ点を基準複素インピーダンス特性パターン内のデータ点と比較することと、
プロセッサ又は制御回路が、比較分析の結果に基づいて、複素インピーダンス測定データ点を分類することと、
プロセッサ又は制御回路が、比較分析の結果に基づいて、超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する血管が石灰化した血管であると判定することと、を含む、実施例7~9のいずれか1つ以上に記載の方法。
駆動回路が、超音波トランスデューサに駆動信号を印加することであって、駆動信号は、大きさ及び周波数によって定義される周期信号である、ことと、
プロセッサ又は制御回路が、駆動信号の周波数を電気機械的超音波システムの共振未満から共振超に掃引することと、
プロセッサ又は制御回路が、インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを測定及び記録することと、
プロセッサ又は制御回路が、測定されたインピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを、基準インピーダンス/アドミッタンス円変数Rref、Gref、Xref、及びBrefと比較することと、
プロセッサ又は制御回路が、比較分析の結果に基づいて、超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する血管が石灰化した血管であると判定することと、を含む、実施例7~9のいずれか1つ以上に記載の方法。
超音波導波管を介して超音波ブレードに連結された超音波トランスデューサを備える超音波電気機械システムと、
超音波トランスデューサにパワーを供給するように構成された発生器であって、発生器は、
超音波トランスデューサに連結された超音波ブレードと接触する血管を感知することと、
血管が石灰化していることを識別することと、
血管が石灰化しているという警告を発することと、
所定の圧迫期間Tにわたって、石灰化した血管を圧迫するよう、ユーザに対してメッセージを発することと、
所定の圧迫期間中に超音波ブレードの1つ以上の作動機能を無効化することと、
所定の圧迫期間の終了後に、超音波ブレードの1つ以上の作動機能を有効化することと、を行うように構成された制御回路を含む、発生器と、を備える、超音波外科用器具。
血管が正常であることを識別することと、
超音波ブレードの作動を可能にすることと、を行うように更に構成されている、実施例12に記載の超音波外科用器具。
超音波導波管を介して超音波ブレードに連結された超音波トランスデューサを備える超音波電気機械システムと、
超音波トランスデューサにパワーを供給するように構成された発生器であって、発生器は、
超音波トランスデューサに連結された超音波ブレードと接触する血管を感知することと、
血管が石灰化していることを識別することと、
血管が石灰化しているという警告を発することと、
超音波ブレードの1つ以上の作動機能を無効化することと、を行うように構成された制御回路を含む、発生器と、を備える、超音波外科用器具。
血管が正常であることを識別することと、
超音波ブレードの作動を可能にすることと、を行うように更に構成されている、実施例12~14のいずれか1つ以上に記載の超音波外科用器具。
超音波トランスデューサの複素インピーダンスを測定することであって、複素インピーダンスは、
複素インピーダンス測定データ点を受信することと、
複素インピーダンス測定データ点を基準複素インピーダンス特性パターン内のデータ点と比較することと、
比較分析の結果に基づいて、複素インピーダンス測定データ点を分類することと、
比較分析の結果に基づいて、超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する血管が石灰化した血管であると判定することと、を行うように更に構成されている、実施例12~15のいずれか1つ以上に記載の超音波外科用器具。
駆動回路に、駆動信号を超音波トランスデューサに印加させることであって、駆動信号は、大きさ及び周波数によって定義される周期信号である、ことと、
駆動信号の周波数を電気機械的超音波システムの共振未満から共振超に掃引することと、
インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを測定及び記録することと、
測定されたインピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを、基準インピーダンス/アドミッタンス円変数Rref、Gref、Xref、及びBrefと比較することと、
比較分析の結果に基づいて、超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する血管が石灰化した血管であると判定することと、を行うように更に構成されている、実施例12~16のいずれか1つ以上に記載の超音波外科用器具。
超音波導波管を介して超音波ブレードに連結された超音波トランスデューサを備える超音波電気機械システムと、
超音波トランスデューサにパワーを供給するように構成された発生器であって、発生器は、
超音波トランスデューサに連結された超音波ブレードと接触する血管を感知することと、
血管が石灰化していることを識別することと、
血管が石灰化しているという警告を発することと、
モータを作動させ、クランプアームを超音波ブレードに向かって駆動して、石灰化した血管を圧迫することによって、石灰化した血管に圧迫クランプ力を加えることと、
クランプアームが組織を圧迫している間、超音波ブレードの作動機能を無効化することと、
圧迫クランプ力を調整した後に、超音波ブレードの作動機能を有効化することと、を行うように構成された制御回路を含む、発生器と、を備える、超音波外科用器具。
血管が正常であることを識別することと、
超音波ブレードの作動を可能にすることと、を行うように更に構成されている、実施例18に記載の超音波外科用器具。
石灰化した血管に、所定の圧迫期間Tにわたって、圧迫クランプ力を加えることと、
所定の圧迫期間Tの終了後に、超音波ブレードの作動を可能にすることと、を行うように更に構成されている、実施例18~19のいずれか1つ以上に記載の超音波外科用器具。
超音波トランスデューサの複素インピーダンスを測定することであって、複素インピーダンスは、
複素インピーダンス測定データ点を受信することと、
複素インピーダンス測定データ点を基準複素インピーダンス特性パターン内のデータ点と比較することと、
比較分析の結果に基づいて、複素インピーダンス測定データ点を分類することと、
比較分析の結果に基づいて、超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する血管が石灰化した血管であると判定することと、を行うように更に構成されている、実施例18~20のいずれか1つ以上に記載の超音波外科用器具。
駆動回路に、駆動信号を超音波トランスデューサに印加させることであって、駆動信号は、大きさ及び周波数によって定義される周期信号である、ことと、
駆動信号の周波数を電気機械的超音波システムの共振未満から共振超に掃引することと、
インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを測定及び記録することと、
測定されたインピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを、基準インピーダンス/アドミッタンス円変数Rref、Gref、Xref、及びBrefと比較することと、
比較分析の結果に基づいて、超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する血管が石灰化した血管であると判定することと、を行うように更に構成されている、実施例18~21のいずれか1つ以上に記載の超音波外科用器具。
(1) 超音波装置にエネルギーを送達する方法であって、前記超音波装置は、所定の共振周波数によって定義される電気機械的超音波システムを備え、前記電気機械的超音波システムは、超音波ブレードに連結された超音波トランスデューサを更に備え、前記方法は、
プロセッサ又は制御回路が、超音波トランスデューサに連結された前記超音波ブレードと接触する血管を感知することと、
前記プロセッサ又は前記制御回路が、前記血管が石灰化していることを識別することと、
前記プロセッサ又は前記制御回路が、前記血管が石灰化しているという警告を発することと、
前記プロセッサ又は前記制御回路が、所定の圧迫期間Tにわたって、石灰化した前記血管を圧迫するよう、ユーザに対してメッセージを発することと、
前記プロセッサ又は前記制御回路が、前記所定の圧迫期間中に前記超音波ブレードの作動機能を無効化することと、
前記プロセッサ又は前記制御回路が、前記所定の圧迫期間終了後に、前記超音波ブレードの作動機能を有効化することと、を含む、方法。
(2) 前記プロセッサ又は前記制御回路が、前記血管が正常であることを識別することと、
前記プロセッサ又は前記制御回路が、前記超音波ブレードの作動を可能にすることと、を更に含む、実施態様1に記載の方法。
(3) 超音波トランスデューサに連結された超音波ブレードにパワーを送達する方法であって、
プロセッサ又は制御回路が、前記超音波トランスデューサに連結された前記超音波ブレードと接触する血管を感知することと、
前記プロセッサ又は前記制御回路が、前記血管が石灰化していることを識別することと、
前記プロセッサ又は前記制御回路が、前記血管が石灰化しているという警告を発することと、
前記プロセッサ又は前記制御回路が、前記超音波ブレードの1つ以上の作動機能を無効化することと、を含む、方法。
(4) 前記プロセッサ又は前記制御回路が、前記血管が正常であることを識別することと、
前記プロセッサ又は前記制御回路が、前記超音波ブレードの作動を可能にすることと、を更に含む、実施態様3に記載の方法。
(5) 前記血管が石灰化していることを識別することは、
前記プロセッサ又は前記制御回路が、前記超音波トランスデューサの複素インピーダンスを測定することであって、前記複素インピーダンスは、
前記プロセッサ又は前記制御回路が、複素インピーダンス測定データ点を受信することと、
前記プロセッサ又は前記制御回路が、前記複素インピーダンス測定データ点を基準複素インピーダンス特性パターン内のデータ点と比較することと、
前記プロセッサ又は前記制御回路が、前記比較分析の結果に基づいて、前記複素インピーダンス測定データ点を分類することと、
前記プロセッサ又は前記制御回路が、前記比較分析の前記結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を含む、実施態様1に記載の方法。
駆動回路が、前記超音波トランスデューサに駆動信号を印加することであって、前記駆動信号は、大きさ及び周波数によって定義される周期信号である、ことと、
前記プロセッサ又は前記制御回路が、前記駆動信号の前記周波数を前記電気機械的超音波システムの共振未満から共振超に掃引することと、
前記プロセッサ又は前記制御回路が、インピーダンス/アドミッタンス円変数(impedance/admittance circle variables)Re、Ge、Xe、及びBeを測定及び記録することと、
前記プロセッサ又は前記制御回路が、測定された前記インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを、基準インピーダンス/アドミッタンス円変数Rref、Gref、Xref、及びBrefと比較することと、
前記プロセッサ又は前記制御回路が、前記比較分析の前記結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を含む、実施態様1に記載の方法。
(7) 超音波装置にエネルギーを送達する方法であって、前記超音波装置は、所定の共振周波数によって定義される電気機械的超音波システムを備え、前記電気機械的超音波システムは、超音波ブレードに連結された超音波トランスデューサを更に備え、前記方法は、
プロセッサ又は制御回路が、前記超音波トランスデューサに連結された前記超音波ブレードと接触する血管を感知することと、
前記プロセッサ又は前記制御回路が、前記血管が石灰化していることを識別することと、
前記プロセッサ又は前記制御回路が、前記血管が石灰化しているという警告を発することと、
前記プロセッサ又は前記制御回路が、モータを作動させ、クランプアームを前記超音波ブレードに向かって駆動して、石灰化した前記血管を圧迫することによって、前記石灰化した血管に圧迫クランプ力を加えることと、
前記プロセッサ又は前記制御回路が、前記クランプアームが前記組織を圧迫している間、前記超音波ブレードの作動機能を無効化することと、
前記プロセッサ又は前記制御回路が、前記圧迫クランプ力を調整した後、前記超音波ブレードの前記作動機能を有効化することと、を含む、方法。
(8) 前記プロセッサ又は前記制御回路が、前記血管が正常であることを識別することと、
前記プロセッサ又は前記制御回路が、前記超音波ブレードの作動を可能にすることと、を更に含む、実施態様7に記載の方法。
(9) 前記プロセッサ又は前記制御回路が、前記石灰化した血管に所定の圧迫期間Tにわたって、前記圧迫クランプ力を加えることと、
前記プロセッサ又は前記制御回路が、前記所定の圧迫期間Tの終了後に、前記超音波ブレードの作動を可能にすることと、を更に含む、実施態様7に記載の方法。
(10) 前記血管が石灰化していることを識別することは、
前記プロセッサ又は前記制御回路が、前記超音波トランスデューサの複素インピーダンスを測定することであって、前記複素インピーダンスは、
前記プロセッサ又は前記制御回路が、複素インピーダンス測定データ点を受信することと、
前記プロセッサ又は前記制御回路が、前記複素インピーダンス測定データ点を基準複素インピーダンス特性パターン内のデータ点と比較することと、
前記プロセッサ又は前記制御回路が、前記比較分析の結果に基づいて、前記複素インピーダンス測定データ点を分類することと、
前記プロセッサ又は前記制御回路が、前記比較分析の前記結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を含む、実施態様9に記載の方法。
駆動回路が、前記超音波トランスデューサに駆動信号を印加することであって、前記駆動信号は、大きさ及び周波数によって定義される周期信号である、ことと、
プロセッサ又は制御回路が、前記駆動信号の前記周波数を前記電気機械的超音波システムの共振未満から共振超に掃引することと、
前記プロセッサ又は前記制御回路が、インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを測定及び記録することと、
前記プロセッサ又は前記制御回路が、測定されたインピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを、基準インピーダンス/アドミッタンス円変数Rref、Gref、Xref、及びBrefと比較することと、
前記プロセッサ又は前記制御回路が、前記比較分析の前記結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を含む、実施態様7に記載の方法。
(12) 超音波外科用器具であって、
超音波導波管を介して超音波ブレードに連結された超音波トランスデューサを備える超音波電気機械システムと、
前記超音波トランスデューサにパワーを供給するように構成された発生器であって、前記発生器は、
超音波トランスデューサに連結された前記超音波ブレードと接触する血管を感知することと、
前記血管が石灰化していることを識別することと、
前記血管が石灰化しているという警告を発することと、
所定の圧迫期間Tにわたって、石灰化した前記血管を圧迫するよう、ユーザに対してメッセージを発することと、
前記所定の圧迫期間中に前記超音波ブレードの1つ以上の作動機能を無効化することと、
前記所定の圧迫期間の終了後に、前記超音波ブレードの前記1つ以上の作動機能を有効化することと、を行うように構成された制御回路を含む、発生器と、を備える、超音波外科用器具。
(13) 前記制御回路は、
前記血管が正常であることを識別することと、
前記超音波ブレードの作動を可能にすることと、を行うように更に構成されている、実施態様12に記載の超音波外科用器具。
(14) 超音波外科用器具であって、
超音波導波管を介して超音波ブレードに連結された超音波トランスデューサを備える超音波電気機械システムと、
前記超音波トランスデューサにパワーを供給するように構成された発生器であって、前記発生器は、
前記超音波トランスデューサに連結された前記超音波ブレードと接触する血管を感知することと、
前記血管が石灰化していることを識別することと、
前記血管が石灰化しているという警告を発することと、
前記超音波ブレードの1つ以上の作動機能を無効化することと、を行うように構成された制御回路を含む、発生器と、を備える、超音波外科用器具。
(15) 前記制御回路は、
前記血管が正常であることを識別することと、
前記超音波ブレードの作動を可能にすることと、を行うように更に構成されている、実施態様14に記載の超音波外科用器具。
前記超音波トランスデューサの複素インピーダンスを測定することであって、前記複素インピーダンスは、
複素インピーダンス測定データ点を受信することと、
前記複素インピーダンス測定データ点を基準複素インピーダンス特性パターン内のデータ点と比較することと、
前記比較分析の結果に基づいて、前記複素インピーダンス測定データ点を分類することと、
前記比較分析の前記結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を行うように更に構成されている、実施態様12に記載の超音波外科用器具。
(17) 前記制御回路は、
駆動回路に、駆動信号を前記超音波トランスデューサに印加させることであって、前記駆動信号は、大きさ及び周波数によって定義される周期信号である、ことと、
前記駆動信号の前記周波数を前記電気機械的超音波システムの共振未満から共振超に掃引することと、
インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを測定及び記録することと、
測定された前記インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを、基準インピーダンス/アドミッタンス円変数Rref、Gref、Xref、及びBrefと比較することと、
前記比較分析の前記結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を行うように更に構成されている、実施態様12に記載の超音波外科用器具。
(18) 超音波外科用器具であって、
超音波導波管を介して超音波ブレードに連結された超音波トランスデューサを備える超音波電気機械システムと、
前記超音波トランスデューサにパワーを供給するように構成された発生器であって、前記発生器は、
前記超音波トランスデューサに連結された前記超音波ブレードと接触する血管を感知することと、
前記血管が石灰化していることを識別することと、
前記血管が石灰化しているという警告を発することと、
モータを作動させ、クランプアームを前記超音波ブレードに向かって駆動して、石灰化した前記血管を圧迫することによって、前記石灰化した血管に圧迫クランプ力を加えることと、
前記クランプアームが前記組織を圧迫している間、前記超音波ブレードの作動機能を無効化することと、
前記圧迫クランプ力を調整した後に、前記超音波ブレードの前記作動機能を有効化することと、を行うように構成された制御回路を含む、発生器と、を備える、超音波外科用器具。
(19) 前記制御回路は、
前記血管が正常であることを識別することと、
前記超音波ブレードの作動を可能にすることと、を行うように更に構成されている、実施態様18に記載の超音波外科用器具。
(20) 前記制御回路は、
前記石灰化した血管に、所定の圧迫期間Tにわたって、前記圧迫クランプ力を加えることと、
前記所定の圧迫期間Tの終了後に、前記超音波ブレードの作動を可能にすることと、を行うように更に構成されている、実施態様18に記載の超音波外科用器具。
前記超音波トランスデューサの複素インピーダンスを測定することであって、前記複素インピーダンスは、
複素インピーダンス測定データ点を受信することと、
前記複素インピーダンス測定データ点を基準複素インピーダンス特性パターン内のデータ点と比較することと、
前記比較分析の結果に基づいて、前記複素インピーダンス測定データ点を分類することと、
前記比較分析の前記結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を行うように更に構成されている、実施態様20に記載の超音波外科用器具。
(22) 前記制御回路は、
駆動回路に、駆動信号を前記超音波トランスデューサに印加させることであって、前記駆動信号は、大きさ及び周波数によって定義される周期信号である、ことと、
前記駆動信号の前記周波数を前記電気機械的超音波システムの共振未満から共振超に掃引することと、
インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを測定及び記録することと、
測定されたインピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを、基準インピーダンス/アドミッタンス円変数Rref、Gref、Xref、及びBrefと比較することと、
前記比較分析の前記結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を行うように更に構成されている、実施態様18に記載の超音波外科用器具。
Claims (9)
- 超音波外科用器具であって、
超音波導波管を介して超音波ブレードに連結された超音波トランスデューサを備える超音波電気機械システムと、
前記超音波トランスデューサにパワーを供給するように構成された発生器であって、前記発生器は、
前記超音波トランスデューサに連結された前記超音波ブレードと接触する血管を感知することと、
前記超音波トランスデューサの電気インピーダンスを測定することと、
前記電気インピーダンスに基づいて、前記血管が石灰化していることを識別することと、
前記血管が石灰化していると識別したことに応答して、前記血管が石灰化しているという警告を発することと、
前記血管が石灰化していると識別したことに応答して、所定の圧迫期間Tにわたって、石灰化した前記血管を圧迫するよう、ユーザに対してメッセージを発することと、
前記所定の圧迫期間中に前記超音波ブレードの1つ以上の作動機能を無効化することと、
前記所定の圧迫期間の終了後に、前記超音波ブレードの前記1つ以上の作動機能を有効化することと、を行うように構成された制御回路を含む、発生器と、を備える、超音波外科用器具。 - 前記制御回路は、
前記電気インピーダンスに基づいて、前記血管が石灰化していないことを識別することと、
前記血管が石灰化していないと識別したことに応答して、前記超音波ブレードの作動を可能にすることと、を行うように更に構成されている、請求項1に記載の超音波外科用器具。 - 前記制御回路は、
電気インピーダンス測定データ点を受信することと、
前記電気インピーダンス測定データ点を基準電気インピーダンス特性パターン内のデータ点と比較することと、
前記比較の結果に基づいて、前記電気インピーダンス測定データ点を分類することと、
前記比較の前記結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を行うように更に構成されている、請求項1に記載の超音波外科用器具。 - 前記制御回路は、
駆動回路に、駆動信号を前記超音波トランスデューサに印加させることであって、前記駆動信号は、大きさ及び周波数によって定義される周期信号である、ことと、
前記駆動信号の前記周波数を前記超音波電気機械システムの共振未満から共振超に掃引することと、
インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを測定及び記録することと、
測定された前記インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを、基準インピーダンス/アドミッタンス円変数Rref、Gref、Xref、及びBrefと比較することと、
前記比較の結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を行うように更に構成されている、請求項1に記載の超音波外科用器具。 - 超音波外科用器具であって、
超音波導波管を介して超音波ブレードに連結された超音波トランスデューサを備える超音波電気機械システムと、
前記超音波トランスデューサにパワーを供給するように構成された発生器であって、前記発生器は、
前記超音波トランスデューサに連結された前記超音波ブレードと接触する血管を感知することと、
前記超音波トランスデューサの電気インピーダンスを測定することと、
前記電気インピーダンスに基づいて、前記血管が石灰化していることを識別することと、
前記血管が石灰化していると識別したことに応答して、前記血管が石灰化しているという警告を発することと、
前記血管が石灰化していると識別したことに応答して、モータを作動させ、クランプアームを前記超音波ブレードに向かって駆動して、石灰化した前記血管を圧迫することによって、前記石灰化した血管に圧迫クランプ力を加えることと、
前記クランプアームが前記血管を圧迫している間、前記超音波ブレードの作動機能を無効化することと、
前記圧迫クランプ力を調整した後に、前記超音波ブレードの前記作動機能を有効化することと、を行うように構成された制御回路を含む、発生器と、を備える、超音波外科用器具。 - 前記制御回路は、
前記電気インピーダンスに基づいて、前記血管が石灰化していないことを識別することと、
前記血管が石灰化していないと識別したことに応答して、前記超音波ブレードの作動を可能にすることと、を行うように更に構成されている、請求項5に記載の超音波外科用器具。 - 前記制御回路は、
前記血管が石灰化していると識別したことに応答して、前記石灰化した血管に、所定の圧迫期間Tにわたって、前記圧迫クランプ力を加えることと、
前記所定の圧迫期間Tの終了後に、前記超音波ブレードの作動を可能にすることと、を行うように更に構成されている、請求項5に記載の超音波外科用器具。 - 前記制御回路は、
電気インピーダンス測定データ点を受信することと、
前記電気インピーダンス測定データ点を基準電気インピーダンス特性パターン内のデータ点と比較することと、
前記比較の結果に基づいて、前記電気インピーダンス測定データ点を分類することと、
前記比較の前記結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を行うように更に構成されている、請求項7に記載の超音波外科用器具。 - 前記制御回路は、
駆動回路に、駆動信号を前記超音波トランスデューサに印加させることであって、前記駆動信号は、大きさ及び周波数によって定義される周期信号である、ことと、
前記駆動信号の前記周波数を前記超音波電気機械システムの共振未満から共振超に掃引することと、
インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを測定及び記録することと、
測定された前記インピーダンス/アドミッタンス円変数Re、Ge、Xe、及びBeを、基準インピーダンス/アドミッタンス円変数Rref、Gref、Xref、及びBrefと比較することと、
前記比較の結果に基づいて、前記超音波トランスデューサと電気的に連通しているエンドエフェクタと接触する前記血管が石灰化した血管であると判定することと、を行うように更に構成されている、請求項5に記載の超音波外科用器具。
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