SURGICAL SYSTEM COUPLABLE TO A CLAMP CARTRIDGE AND A RADIO FREQUENCY CARTRIDGE AND METHOD OF USE OF

专利摘要:
The present invention relates to a method that includes applying staples from a surgical staple cartridge of a surgical instrument to a first tissue during a first procedure; removing the surgical staple cartridge from the surgical instrument; and applying radiofrequency energy from a radiofrequency cartridge of the surgical instrument to a second tissue during a second procedure.
公开号:BR112019026576A2
申请号:R112019026576-7
申请日:2018-06-12
公开日:2020-06-23
发明作者:D. Messerly Jeffrey；Jeffrey D. Messerly；C. Yates David；David C. Yates；L. Harris Jason；Jason L. Harris；E. Shelton Frederick Iv；Frederick E. Shelton Iv
申请人:Ethicon Llc；
IPC主号:

专利说明:

[0001] [0001] The present invention relates to surgical instruments and, in various circumstances, surgical sealing and cutting instruments, and to RF cartridges and staple cartridges for them, which are designed to seal and cut fabrics. BACKGROUND OF THE INVENTION
[0002] [0002] When using a surgical sealing and stapling instrument, it can be useful to have an interchangeable portion of the surgical instrument, so that the operator can use the most effective technology during various aspects of a surgical procedure. Having a set of interchangeable tools allows the operator, for example, to use one type of end actuator, performing a first function, during a first portion of a procedure, then switch to a second type of end actuator, performing a second function, during a second portion of the procedure. SUMMARY OF THE INVENTION
[0003] [0003] In one aspect, a method includes applying staples from a surgical staple cartridge from a surgical instrument to a first tissue during a first procedure; removing the surgical staple cartridge from the surgical instrument; and supplying radio frequency energy from a radio frequency cartridge of the surgical instrument to a second tissue during a second procedure. In another aspect, a method for using an exchangeable tool set includes using a staple cartridge coupled to the interchangeable tool set to apply staples to seal a first fabric during the first period of time; replace the staple cartridge; use a radio frequency cartridge coupled to the set of interchangeable tools to provide radio frequency energy to seal a second tissue for a second period of time.
[0004] [0004] In another aspect, a method includes sealing a first tissue with staples from a removable staple cartridge from a surgical instrument; sterilize the surgical instrument; and seal a second tissue with radio frequency energy released by a radio frequency cartridge removable from the surgical instrument. FIGURES
[0005] [0005] The innovative features of the aspects described here are presented with particularity in the attached claims. However, these aspects, both in terms of organization and methods of operation, can be better understood by referring to the description below, taken in conjunction with the attached drawings.
[0006] [0006] Figure 1 is a perspective view of a surgical system that includes a handle set attached to an interchangeable surgical tool set that is configured to be used in connection with conventional surgical clip / clamp cartridges and radio frequency (RF) cartridges according to one aspect of the present description.
[0007] [0007] Figure 2 is an exploded perspective view of the surgical system of Figure 1 according to an aspect of this description.
[0008] [0008] Figure 3 is another exploded perspective view of portions of the handle set and the interchangeable surgical tool set of Figures 1 and 2 according to one aspect of this description.
[0009] [0009] Figure 4 is an exploded view of an adjacent portion of the set of interchangeable tools of Figures 1 to 3 according to an aspect of this description.
[0010] [0010] Figure 5 is another exploded view of a distal portion of the interchangeable surgical tool set of Figures 1 to 5 according to an aspect of this description.
[0011] [0011] Figure 6 is a partial cross-sectional view of the end actuator shown in Figures 1 to 5 holding an RF cartridge in it and with tissue clamped between the cartridge and the anvil in accordance with an aspect of the present description .
[0012] [0012] Figure 7 is a partial cross-sectional view of the stove in Figure 6 according to an aspect of the present description.
[0013] [0013] Figure 8 is another exploded view of a portion of the surgical tool set of Figures 1 to 5 according to an aspect of this description.
[0014] [0014] Figure 9 is another exploded view of the interchangeable surgical tool set and the handle set of Figures 1 and 2 according to an aspect of the present description.
[0015] [0015] Figure 10 is a perspective view of an RF cartridge and an elongated channel of the interchangeable surgical tool set of Figures 1 to 5 according to an aspect of this description.
[0016] [0016] Figure 11 is a partial perspective view of portions of the RF cartridge and the elongated channel of Figure 10 with a knife-member aspect in accordance with an aspect of the present description.
[0017] [0017] Figure 12 is another perspective view of the RF cartridge installed in the elongated channel of Figure 10 and which illustrates a portion of a flexible drive shaft circuit arrangement according to an aspect of the present description.
[0018] [0018] Figure 13 is an end view in cross section of the RF cartridge and the elongated channel of Figure 12 taken along lines 13-13 in Figure 12 according to an aspect of the present description.
[0019] [0019] Figure 14 is a top cross-sectional view of a portion of the interchangeable surgical tool set in Figures 1 and 5 with the end actuator thereof in an articulated position in accordance with an aspect of the present description.
[0020] [0020] Figure 15 is a perspective view of an integrated circuit board layout and the RF generator plus configuration according to an aspect of this description.
[0021] [0021] Figures 16A to 16B consist of a block diagram of a control circuit of the surgical instrument of Figure 1 that comprises two drawing sheets according to an aspect of this description.
[0022] [0022] Figure 17 is a block diagram of the control circuit of the surgical instrument of Figure 1 that illustrates interfaces between the handle assembly, the supply assembly and the handle assembly and the drive shaft assembly interchangeable according to one aspect of the present description.
[0023] [0023] Figure 18 is a schematic diagram of a surgical instrument configured to control various functions according to an aspect of the present description.
[0024] [0024] Figure 19 is a side elevation view of the surgical instrument with the casing removed showing a trigger detection set, with the closing trigger being in the unacted position according to one aspect of the present description.
[0025] [0025] Figure 20 is a side elevation view of the surgical instrument with the casing removed showing a trigger detection set, the closing trigger being in the actuated position in accordance with an aspect of the present description.
[0026] [0026] Figure 21 is a perspective view of an end actuator comprising a fabric thickness detection assembly according to an aspect of this description.
[0027] [0027] Figure 22 is a schematic view of a sensor of the tissue thickness detection set according to an aspect of this description.
[0028] [0028] Figure 23 is an exploded perspective view of a position detection set according to an aspect of this description.
[0029] [0029] Figure 24 is a diagram of a circuit and a position sensor of a position detection set according to an aspect of the present description.
[0030] [0030] Figure 25 is a block diagram of an example of a surgical instrument configured to display various situations of the surgical instrument according to an aspect of the present description.
[0031] [0031] Figure 26 is a screen showing information on the RF energy status of the surgical instrument according to one aspect of the present description.
[0032] [0032] Figure 27 is a screen showing information on the RF energy status of the surgical instrument according to one aspect of the present description.
[0033] [0033] Figure 28 is one that shows information on the RF energy status of the surgical instrument according to one aspect of the present description.
[0034] [0034] Figure 29 is a screen showing information on the RF energy status of the surgical instrument according to one aspect of the present description.
[0035] [0035] Figure 30 is a screen that shows temperature information of the surgical instrument according to an aspect of the present description.
[0036] [0036] Figure 31 is a screen showing information on the water content of the tissue of the surgical instrument according to an aspect of the present description.
[0037] [0037] Figure 32 is a screen that shows operational progress information for the surgical instrument according to an aspect of this description.
[0038] [0038] Figure 33 is a screen that shows information on the operational progress of the surgical instrument according to an aspect of this description.
[0039] [0039] Figure 34 is a screen that shows information about the tissue and the operational progress of the surgical instrument according to an aspect of the present description.
[0040] [0040] Figure 35 is a screen showing a warning of the surgical instrument according to an aspect of the present description.
[0041] [0041] Figure 36 is a screen showing a warning of the surgical instrument according to an aspect of the present description.
[0042] [0042] Figure 37 is a screen that shows information about the situation, operational progress and tissue of the surgical instrument according to one aspect of the present description.
[0043] [0043] Figure 38 is a screen showing information on the status of the RF cartridge of the surgical instrument according to an aspect of the present description.
[0044] [0044] Figure 39 is a screen showing information on the status of the RF cartridge of the surgical instrument according to an aspect of the present description.
[0045] [0045] Figure 40 shows a nozzle assembly that constitutes a modular portion of the surgical tool set that can include a drive shaft module circuit uniquely configured to control various functions in the drive shaft assembly while also communicating with the handle set and allows an electrosurgical generator to be controlled from the stapling handle equipped with a motor according to some aspects.
[0046] [0046] Figure 41 illustrates a block diagram of a surgical system programmed to communicate energy and control signals with an end actuator in accordance with an aspect of the present description.
[0047] [0047] Figure 42 is a schematic top view of a gripper on an end actuator according to an aspect of this description.
[0048] [0048] Figure 43 is a graph that represents the voltage applied to the electrodes as a function of time according to an aspect of the present description.
[0049] [0049] Figure 44 is a logic flow diagram that represents a process of a control program or a logical configuration for operating the surgical instrument according to an aspect of this description.
[0050] [0050] Figure 45 is a graph of a tissue impedance curve as a function of time according to an aspect of this description.
[0051] [0051] Figure 46 is a graph that represents an example of the motor voltage curve according to an aspect of the present description.
[0052] [0052] Figure 47 is a logic flow diagram that represents a process of a control program or a logical configuration for operating the surgical instrument according to an aspect of this description.
[0053] [0053] Figure 48 is a graph of a tissue impedance curve as a function of time according to an aspect of this description.
[0054] [0054] Figure 49 is a graph that represents an example of the motor voltage curve according to an aspect of the present description.
[0055] [0055] Figure 50 illustrates a top cross-sectional view of an aspect of a flexible assembly shown in Figure 14 according to an aspect of this description.
[0056] [0056] Figure 51A is a top cross-sectional view of an aspect of the flexible assembly shown in Figure 14 for a knife member arranged in a proximal position as arranged within an aspect of an electrosurgical device according to an aspect of the this description.
[0057] [0057] Figure 51B is a top cross-sectional view of an aspect of the flexible assembly shown in Figure 14 for a knife member disposed in a distal position disposed within an aspect of an electrosurgical device in accordance with an aspect of the present description.
[0058] [0058] Figure 52A is a top cross-sectional view of an aspect of the flexible assembly shown in Figure 14 for a knife member arranged in a proximal position in accordance with an aspect of the present description.
[0059] [0059] Figure 52B is a top cross-sectional view of an aspect of the flexible assembly shown in Figure 14 for a knife member arranged in a distal position according to an aspect of the present description.
[0060] [0060] Figure 53 is a perspective view of various aspects of a surgical system according to one aspect of this description.
[0061] [0061] Figure 54 is a partial cross-sectional view of an end actuator of the surgical system of Figure 53 according to an aspect of this description.
[0062] [0062] Figure 55 is a partial perspective view of a radio frequency cartridge supported by an elongated channel of the end actuator of Figure 54 in accordance with an aspect of the present description.
[0063] [0063] Figure 56 is an exploded perspective view of portions of a handle set and an interchangeable tool set of the surgical system of Figure 53 in accordance with an aspect of the present description.
[0064] [0064] Figure 57 is a cross-sectional view of a claw member comprising an electrosurgical cartridge supported by an elongated channel according to some aspects of the present description.
[0065] [0065] Figure 58 is a diagram that illustrates an operation of a first electrode according to some aspects of the present description.
[0066] [0066] Figure 59 is a diagram that illustrates an operation of a second electrode according to some aspects of the present description.
[0067] [0067] Figure 60 is a logic flow diagram of a process that represents a control program or a logical configuration to supply therapeutic electrosurgical energy according to an aspect of the present description.
[0068] [0068] Figure 61 is a schematic cross-sectional view of an electrosurgical end actuator according to an aspect of the present description.
[0069] [0069] Figure 62 is a perspective view of an end actuator according to an aspect of the present description.
[0070] [0070] Figure 63A is a perspective view of an aspect of an end actuator in an open configuration.
[0071] [0071] Figure 63B is a side cross-sectional view of the aspect of the end actuator shown in Figure 63A.
[0072] [0072] Figure 64 is a diagram of aspects of surface features that can be arranged along a shear electrode as shown in Figure 63A.
[0073] [0073] Figure 65 is a perspective view of a staple cartridge of the interchangeable surgical tool set of Figures 1 to 5 according to an aspect of this description.
[0074] [0074] Figure 66 illustrates a method of using the set of interchangeable tools in Figure 1 according to several aspects. DESCRIPTION
[0075] [0075] The applicant for the present application holds the following patent applications filed simultaneously with the same and which are each incorporated in this document as a reference in their respective totalities: No. of the power of attorney document END8183USNP / 17006A, entitled SYSTEMS AND METHODS OF DISPLAYING SURGICAL INSTRUMENT STATUS, by the inventors Jeffrey D. Messerly et al., Deposited on June 28, 2017.
[0076] [0076] Electrosurgical devices can be used in many surgical operations. Electrosurgical devices can supply electrical energy to the tissue to treat the tissue. An electrosurgical device can comprise an instrument that has a distally mounted end actuator that comprises one or more electrodes. The end actuator can be positioned against the fabric, so that electric current can be introduced into the fabric. Electrosurgical devices can be configured for monopolar or bipolar operation. During monopolar operation, current can be introduced into the tissue by an electrode (or source) active on the end actuator and returned via a return electrode. The return electrode can be a grounding block and can be located separately on a patient's body. During bipolar operation, current can be introduced into the tissue and returned from it through the active and return electrodes, respectively, of the end actuator.
[0077] [0077] The end actuator can include two or more claw members. At least one of the claw members can have at least one electrode. At least one claw may be movable from a position spaced from the opposite claw to receive fabrics to a position in which the space between the claw members is less than that of the first position. This movement of the movable claw can compress the interposed fabric. The heat generated by the current flow through the tissue in combination with the compression achieved by the movement of the claw can form hemostatic seals within the tissue and / or between tissues, and thus can be particularly useful for sealing blood vessels, for example. The end actuator can comprise a cutting member. The cutting member can be movable in relation to the tissue and the electrodes to transpose the tissue.
[0078] [0078] Electrosurgical devices may also include mechanisms for clamping tissue together, such as a stapling device, and / or mechanisms for cutting tissue, such as a tissue knife. An electrosurgical device may include a drive shaft to place the end actuator adjacent to the tissue that is being treated. The drive shaft can be straight or curved, foldable or non-foldable. In an electrosurgical device that includes a straight, foldable drive shaft, the drive shaft may have one or more pivot joints to allow controlled folding of the drive shaft. Such joints may allow a user of the electrosurgical device to place the end actuator in contact with the tissue at an angle to the drive axis when the tissue being treated is not readily accessible using an electrosurgical device that has a straight, non-folding drive shaft.
[0079] [0079] The electrical energy applied by electrosurgical devices can be transmitted to the instrument by a generator in communication with the handle. The electrical energy can be in the form of radio frequency energy ("RF"). RF energy is a form of electrical energy that can be in the frequency range of 200 kilohertz (kHz) to 1 megahertz (MHz). In application, an electrosurgical instrument can transmit RF energy at low frequency through the tissue, which causes friction, or ionic agitation, that is, resistive heating, which, therefore, increases the tissue temperature. Due to the fact that a precise boundary is created between the affected tissue and the surrounding tissue, surgeons can operate with a high level of precision and control, without sacrificing unintended adjacent tissue. Low temperatures
[0080] [0080] RF energy can be in a frequency range described in document EN 60601-2-: 2009 + A11: 2011, Definition
[0081] [0081] Figures 1 and 2 represent a motor-driven surgical system 10 that can be used to perform a variety of different surgical procedures. In the illustrated arrangement, the surgical system 10 comprises an interchangeable surgical tool set 1000 that is operationally coupled to a handle set 500. In another aspect of the surgical system, the interchangeable surgical tool set 1000 also it can be effectively used with a tool drive set from a robotic or automated controlled surgical system. For example,
[0082] [0082] In the illustrated aspect, the grip assembly 500 may comprise a grip housing 502 that includes a pistol grip portion 504 that can be held and handled by the physician. As will be briefly discussed below, the handle set 500 operationally supports a plurality of drive systems that are configured to generate and apply various control movements to the corresponding portions of the interchangeable surgical tool set 1000. As shown in Figure 2 , the handle assembly 500 may further include a handle frame 506 that operationally supports the plurality of drive systems. For example, the 506 grip frame can operationally support a "first" closing drive system or system, designed as 510, that can be used to apply closing and opening movements to the 1000 interchangeable surgical tool set. at least one way, the closing drive system 510 may include an actuator in the form of a closing trigger 512 that is pivotally supported by the grip frame 506. This arrangement allows the closing trigger 512 to be manipulated by a method - tip, so that when the physician grips the pistol grip assembly portion 504 of the grip assembly 500, the closing trigger 512 can be easily rotated from an initial or "not acted" position to an "acted" position and, more particularly-
[0083] [0083] In at least one form, the handle assembly 500 and the handle frame 506 can operationally support another drive system referred to herein as trigger drive system 530 which is configured to apply trigger movements to the corresponding portions of the interchangeable surgical tool set that is attached to it. As described in detail in US Patent Application Publication No.
[0084] [0084] The electric motor 505 is configured to axially drive a longitudinally movable driving member 540 (Figure 3) in the distal and proximal directions depending on the polarity of the motor. For example, when the 505 electric motor is driven in a rotating direction, the longitudinally movable drive member will be axially driven in the distal "DD" direction. When motor 505 is started in the opposite rotating direction, the longitudinally movable drive member 540 will be driven axially in the proximal direction "PD". The handle assembly 500 may include a key 513 that can be configured to reverse the polarity applied to the electric motor 505 by the power source 522 or otherwise control the motor
[0085] [0085] In at least one form, the longitudinally movable drive member 540 may have a tooth rack 542 formed thereon for engagement with a corresponding drive arrangement (not shown) that interacts - face with the engine. See Figure 3. Additional details regarding those features can be found in US Patent Application publication 2015/0272575. In at least one arrangement, however, the longitudinally movable drive member is insulated to protect it from inadvertent RF energy. At least one form also includes a manually actuated "retraction" set, which is configured to allow the physician to manually retract the longitudinally movable drive member in case the 505 engine stops running. The rescue set can include a lever or rescue cable set that is stored inside the cable set 500 under a removable door 550. See Figure 2. The lever is configured to be manually pivoted in ratchet engagement with the teeth on the drive member. In this way, the physician can manually retract drive member 540 using the retract handle assembly to perform the ratchet movement on the drive member in the proximal "PD" direction. US Patent No.
[0086] [0086] In the illustrated aspect, the interchangeable surgical tool set 1000 includes a surgical end actuator 1500 comprising a first jaw 1600 and a second jaw 1800. In one arrangement, the first jaw comprises an elongated channel 1602 which is configured to operationally support a conventional surgical (mechanical) staple / fastener cartridge 1400 (Figure 4) or a 1700 radiofrequency (RF) cartridge (Figures 1 and 2) in it. The second claw 1800 comprises an anvil 1810 which is pivotally supported in relation to the elongated channel 1602. The anvil 1810 can be selectively moved towards and in the opposite direction to a surgical cartridge supported in the elongated channel 1602 between the open and closed by the actuation of the closing drive system 510. In the illustrated arrangement, the anvil 1810 is pivotally supported in a proximal end portion of the elongated channel 1602 for selective pivoting movement around a pivot axis that is transversal to the geometric axis of the drive shaft SA. The actuation of the closing drive system 510 may result in the distal axial movement of a proximal closing member or proximal closing tube 1910 that is attached to a 1920 hinge connector.
[0087] [0087] Returning to Figure 4, the hinge connector 1920 includes the upper and lower lugs 1922, 1924 that project distally from a distal end of the hinge connector 1920 to be movably coupled to an actuation closing sleeve. - distal closure tube segment 1930. See Figure 3. The distal closure tube segment 1930 includes an upper tongue 1932 and a lower tongue (not shown) that project proximally from a proximal end of the same. An upper double pivot connection 1940 includes a proximal pin and a distal pin 1941, 1942 that engage the corresponding holes in the upper tabs 1922, 1932 of the articulation connector 1920 and the distal closing tube segment 1930, respectively. mind. Similarly, a lower double pivot connection 1944 includes the proximal pin and the distal pin 1945, 1946 which engage the corresponding holes in the inner tabs 1924 of the hinge connector 1920 and the distal closing tube segment 1930, respectively. again.
[0088] [0088] Still referring to Figure 4, in the illustrated example, the distal closing tube segment 1930 includes positive claw opening features or flaps 1936, 1938 that correspond to the corresponding portions of the anvil 1810 to apply opening movements to the anvil 1810 as the segment of the distal closing tube 1930 is retracted in the proximal direction PD to an initial position. More details on opening and closing the 1810 anvil can be found in the US patent application entitled SURGICAL INSTRUMENT WITH POSITIVE JAW OPENING FEATURES, power of attorney document number END8208USNP / 170096, filed on the same date as this document, the description of which integral is hereby incorporated by reference.
[0089] [0089] As shown in Figure 5, in at least one arrangement, the interchangeable surgical tool set 1000 includes a tool frame set 1200 comprising a tool frame 1210 that operationally supports a set of nozzle 1240 on the same. As further discussed in detail in the US patent application entitled SURGICAL INSTRUMENT WITH AXI-ALLY MOVABLE CLOSURE MEMBER, power of attorney document END8209USNP / 170097, filed on the same date as this document, which is hereby incorporated by way of reference in its entirety, the tool chassis 1210 and the nozzle arrangement 1240 facilitate the rotation of the surgical end actuator 1500 about a geometric axis of the drive shaft SA in relation to the tool chassis 1210. This rotary displacement is represented by the arrow R in Figure 1. As also shown in Figures 4 and 5, the interchangeable surgical tool set 1000 includes a back column set 1250 that operationally supports the proximal closing tube 1910 and is coupled to the surgical end actuator
[0090] [0090] As shown in Figure 4, the upper dorsal segment 1251 ends in an upper ear mount feature 1260 and the lower dorsal segment 1252 ends in a lower ear mount feature 1270. The upper ear mount feature 1260 is formed with an ear groove 1262 in it which is adapted to sustainably mount an upper mounting connection 1264 therein. Similarly, the lower ear mounting feature 1270 is formed with an ear slot 1272 in it which is adapted to sustainably mount a lower mounting connection 1274 therein. The upper mounting connection 1264 includes a pivot socket 1266 in which it is displaced from the geometric axis of the drive axis SA. The pivot socket 1266 is adapted to pivot a pivot pin 1634 which is formed in a channel cover or an anvil retainer 1630 which is attached to a proximal end portion 1610 of the elongated channel 1602. The mounting connection The lower pivot pin 1274 includes the lower pivot pin 1276 which is adapted to be received within a pivot hole 1611 formed in the proximal end portion 1610 of the elongated channel 1602. The lower pivot pin 1276, as well as the pivot hole 1611, is displaced from the geometric axis of the drive axis SA. The lower pivot pin 1276 is vertically aligned with the pivot socket 1266 to define the AA pivot geometry axis around which the surgical end actuator 1500 can pivot in relation to the geometric axis of the SA drive shaft. See Figure 1. Although the hinge axis AA is transversal to the hinge axis of the drive axis SA, in at least one arrangement, the hinge axis AA is displaced laterally from it and does not cross the hinge axis. drive shaft SA.
[0091] [0091] Returning to Figure 5, a proximal end 1912 of the proximal closing tube 1910 is pivotally coupled to a reciprocating closing element 1914 by a connector 1916 which is seated in an annular groove 1915 in the closing tube segment - proximal ment 1910. The reciprocating closing element 1914 is supported for axial displacement inside the tool chassis 1210 and has a pair of hooks 1917 configured therein to engage the closing drive system 510 when the tool chassis 1210 is coupled to the grip frame 506. The tool frame 1210 additionally holds a locking set 1280 in order to lock the tool frame 1210 reliably into the grip frame 506. More details on the tool frame 1210 and the locking set 1280 can be found in the US patent application entitled SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER, power of attorney document END8209USNP / 170097, deposits on the same date as this document and the full description of which is incorporated herein by reference.
[0092] [0092] The trigger drive system 530 in the handle set 500 is configured to be operationally coupled to a trigger system 1300 that is operationally supported in the interchangeable surgical tool set 1000. The trigger system 1300 can include a portion of the intermediate firing drive axis 1310 which is configured to be axially moved in the distal and proximal directions in response to the corresponding firing movements applied to it by the 530 firing drive system. See Figure 4. As shown in Figure 5, a proximal end 1312 of the intermediate firing shaft portion 1310 has a firing ear shaft 1314 formed therein, which is configured to be seated on a mounting bracket 544 ( Figure 3) which is at the distal end of the longitudinally movable drive member 540 of the trigger drive system 530 within the handle assembly adura 500. This arrangement facilitates the axial movement of the portion of the intermediate firing drive shaft 1310 through the actuation of the triggering drive system 530. In the illustrated example, the portion of the intermediate firing drive shaft 1310 is configured for the attachment to a distal cutting portion or knife bar 1320. As shown in Figure 4, knife bar 1320 is connected to a firing member or knife member 1330. The knife member 1330 comprises a knife body 1332 that supports operationally a 1334 fabric cutting blade in it. The knife body 1332 can additionally include flaps or anvil engaging features 1336 and channel filler features or a shim 1338. Anvil engaging features 1336 can serve to apply additional closing movements to the anvil 1810 as knife member 1330 is advanced distally through end actuator 1500.
[0093] [0093] In the illustrated example, the surgical end actuator 1500 is selectively pivotable around the geometric hinge axis AA by a 1360 hinge system. In one form, the hinge system 1360 includes the proximal hinge driver 1370 that it is pivotally coupled to a hinge connection 1380. As can be seen more particularly in Figure 4, a displacement fixing ear 1373 is formed at a distal end 1372 of the proximal hinge driver 1370. A pivot hole 1374 is strong. - fitted on the displacement fixation ear 1373 and is configured to receive, in a pivotal way, a proximal connecting pin 1382 formed at the proximal end 1381 of the articulation connection
[0094] [0094] In addition to the above, the interchangeable surgical tool set 1000 can include a set of displacer 1100 that can be configured to selectively and releasably couple the proximal articulation driver 1310 to the firing system 1300. As illustrated in 5, for example, in a form, shifter 1100 includes a lock collar or lock sleeve 1110 positioned around the intermediate firing drive shaft portion 1310 of the firing system 1300, the sleeve being locking device 1110 can be rotated between a engaged position, where locking sleeve 1110 operationally couples the proximal articulation driver 1370 to the trigger member 1300 assembly, and a disengaged position in which the proximal articulation driver 1370 is not engaged operates - in relation to the firing member 1300. When the locking sleeve 1110 is in its engaged position, the distal movement of the firing member 1300 can move di stally the proximal articulation actuator 1370 and, correspondingly, the proximal movement of the firing member assembly 1300 can proximally move the proximal articulation actuator 1370. When the locking sleeve 1110 is in its disengaged position, the movement of the the firing member assembly 1300 is not transmitted to the 1370 proximal pivoting trigger and, as a result, the 1300 firing member assembly can move independently of the 1370 proximal pivoting trigger. proximal hinge driver 1370 can be held in position by hinge lock 1390 when the proximal hinge driver 1370 is not being moved proximally or distally by the 1300 firing member assembly.
[0095] [0095] In the illustrated arrangement, the intermediate firing drive shaft portion 1310 of the firing member assembly 1300 is formed with two opposing flat sides with a driving groove 1316 formed therein. See Figure 5. As can also be seen in Figure 5, locking sleeve 1110 comprises a cylindrical, or at least substantially cylindrical, body that includes a longitudinal opening that is configured to receive the drive shaft portion. 1310 intermediate trip through it. The locking sleeve 1110 may comprise diametrically opposed inwardly locking protuberances which, when the locking sleeve 1110 is in a position, are received in an engaging manner within corresponding portions of the drive notch 1316 in the portion of the drive shaft - intermediate firing drive 1310, and, when in another position, they are not received inside the drive slot 1316 to thus allow the relative axial movement between the lock sleeve 1110 and the intermediate firing drive shaft 1310. As can be seen in Figure 5, the locking sleeve 1110 additionally includes a locking member 1112 which is sized to be movably received within a notch 1375 at a proximal end of the 1370 proximal pivoting actuator. that the locking sleeve 1110 rotates slightly to and from the engagement with the intermediate firing shaft portion 1310 while remaining in the u in engagement with the notch 1375 on the 1370 proximal pivoting actuator. For example, when the locking sleeve 1110 is in its engaged position, the locking protrusions are positioned within the drive notch 1316 in the drive shaft portion of intermediate firing 1310, so that a distal pushing force and / or a proximal pulling force can be transmitted from the firing member assembly 1300 to the locking sleeve 1110. Such an axial pulling or pulling motion is then transmitted from the locking sleeve 1110 to the proximal articulation actuator 1370 to thus articulate the surgical end actuator
[0096] [0096] In the illustrated example, the relative movement of the locking sleeve 1110 between its engaged and disengaged positions can be controlled by the displacer assembly 1100 that interfaces with the 1910 proximal closing tube. Still referring to Figure 5, the displacer assembly 1100 additionally includes a displacer key 1120 which is configured to be slidably received within a key groove formed on the outer perimeter of the locking sleeve 1110. This arrangement allows the displacer key 1120 to move axially. in relation to locking sleeve 1110. As discussed in more detail in the US patent application entitled SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER, power of attorney document number END8209USNP / 170097, filed on the same date as this document, the full description of which is here incorporated by way of reference, a portion of the shifter key 1120 is configured to interact as a cam with a cam opening (n (shown)) in the proximal closing tube portion 1910. In addition, in the example shown, displacer assembly 1100 additionally includes a switching cylinder 1130 which is pivotally received at a proximal end portion of the pipe portion proximal closing 1910. A portion of the shifter key 1120 extends through an axial screw segment in the switching cylinder 1130 and is movably received within an arcuate screw segment in the switching cylinder 1130. A spring switch cylinder torque 1132 is mounted on switch cylinder 1130 and engages a portion of the nozzle assembly 1240 to apply a twist or rotation tilt that serves to rotate the switch cylinder 1130 until the key portion of displacer 1120 reach an end portion of the cam opening in the proximal closing tube portion 1910. When in this position, the switch cylinder 1130 can provide a torsional tilt to the key and displacer 1120, which causes the locking sleeve 1110 to rotate to its engaged position with the intermediate firing drive shaft portion 1310. This position also corresponds to the unacted configuration of the 1910 proximal closing tube ( and the distal closing tube segment 1930).
[0097] [0097] In an arrangement, for example, when the proximal closing tube 1910 is in a non-actuated configuration (the beaker 1810 is in an open position spaced from the cartridge mounted in the elongated channel 1602) the actuation of the portion of the intermediate firing drive axis 1310 will result in axial movement of the proximal pivot actuator 1370 to facilitate pivoting of the 1500 end actuator. When the user has pivoted the 1500 end actuator for a desired orientation, the user then the proximal closing tube portion 1910 can act. The actuation of the proximal closing tube portion 1910 will result in the distal displacement of the distal closing tube segment 1930 to finally apply a closing movement to the anvil 1810 This distal displacement of the proximal closing tube portion 1910 will result in the cam opening therein, which interacts like a cam with a cam portion of the shifter switch 11 20 in order to make the displacement switch 1120 rotate the locking sleeve 1110 in an actuating direction. Such rotation of the locking sleeve 1110 will result in the disengagement of the locking protrusions from the drive notch.
[0098] [0098] As also illustrated in Figures 5 and 15, the interchangeable surgical tool set 1000 can comprise a set of slip ring 1150 that can be configured to conduct electrical energy to and / or from the surgical end actuator 1500 and / or communicate signals to and / or from the surgical end actuator 1500 back to an integrated circuit board 1152, while facilitating the rotary displacement of the drive shaft and end actuator 1500 around the axis geometric axis drive system relative to tool chassis 1210 by rotating nozzle assembly 1240. As shown in Figure 15, in at least one arrangement, integrated circuit board 1152 includes an on-board connector 1154 that is configured to make interface with a housing connector 562 (Figure 9) that communicates with a microprocessor 560 that is supported on the handle assembly 500 or robotic system controller, for example. The 1150 slip ring assembly is configured to interface with a proximal connector
[0099] [0099] An exemplary version of the interchangeable surgical tool set 1000 disclosed in the present invention can be used in connection with a standard 1400 surgical (mechanical) clamp cartridge or a 1700 cartridge that is configured to facilitate cutting the tissue with the knife limb and seal the cut tissue using radio frequency (RF) energy. Again with reference to Figure 4, a conventional or standard mechanical type 1400 cartridge is shown. Such cartridge arrangements are known and may comprise a cartridge body 1402 that is sized and shaped to be removably received and supported in the elongated channel 1602. For example, the cartridge body 1402 can be configured to be retained in a manner removable in snap-fit engagement with elongated channel 1602. Cartridge body 1402 includes an elongated slot 1404 to accommodate axial displacement of knife member 1330 therethrough. The cartridge body 1402 operationally supports a plurality of clip drivers (not shown) that are aligned in rows on each side of the centrally arranged elongated slot 1404.
[0100] [0100] Still with reference to Figure 4, the anvil 1810 in at least one shape, includes an anvil mounting portion 1820 that has a pair of rotating anvil pins 1822 that project laterally from the same to be pivotally received on corresponding rotating supports 1614 formed on the vertical walls 1622 of the proximal end portion 1610 of the elongated channel 1602. The rotating anvil pins 1822 are pivotally retained on their corresponding rotating pin support 1614 by the cover - anvil end or retainer 1630. The anvil mounting portion 1820 is movable or pivotally supported in the elongated channel 1602 for selective pivoting displacement relative to it around a fixed anvil pivot geometric axis that is transverse to the axis geometry of the SA drive shaft. As shown in Figures 6 and 7, in at least one form, the anvil 1810 includes a portion of the body of the anvil 1812 that is manufactured from an electrically conductive metallic material, for example, and has a staple forming subsurface. 1813 which has a series of fastener forming pockets 1814 formed therein on each side of an anvil slit 1815 centrally arranged which is configured to accommodate the knife member 1330 slidingly therein. The anvil slit 1815 opens into an upper opening 1816 that extends longitudinally through the anvil body 1812 to accommodate the anvil engaging features 1336 on the knife member 1330 during firing. When a conventional mechanical surgical clamp / clamp cartridge 1400 is installed in the elongated channel 1602, the clamps / clamps are guided through the T fabric and inward, forming contact with the corresponding clamp forming pockets
[0101] [0101] In the illustrated arrangement, the interchangeable surgical tool set 1000 is configured with a trigger member locking system, generally designed as 1640. See Figure 8. As shown in Figure 8, the elongated channel 1602 includes a surface - bottom part or bottom portion 1620 which has two vertical side walls 1622 projecting from it. A centrally arranged longitudinal channel slot 1624 is formed through bottom portion 1620 to facilitate axial displacement of knife member 1330 therethrough. The channel slot 1624 opens in a longitudinal passage 1626 that accommodates the channel engagement or shim feature 1338 in the knife member 1330. The passage 1626 serves to define two protruding inwardly extending portions 1628 that serve to engage the portions corresponding to the channel hitch or shim 1338 feature. The triggering member locking system 1640 includes proximal openings 1642 located on each side of channel slot 1624 which are each configured to receive corresponding portions of the feature channel hitch or shim 1338 when knife member 1330 is in an initial position. A knife lock spring 1650 is held at the proximal end 1610 of the elongated channel 1602 and serves to propel the knife member 1330 downwards. As shown in Figure 8, knife lock spring 1650 includes two distally terminated spring arms 1652 which are configured to engage engaging features of the corresponding center channel 1337 on knife body 1332. Spring arms 1652 are configured to propel the center channel 1337 engaging features down. In this way, when in the initial (not fired) position, knife member 1330 is prone downward so that the channel engagement or shim 1338 features are received into the corresponding proximal openings 1642 in the elongated channel 1602. When in such a position locked, if attempting to advance knife 1330 distally, the engaging features of central channel 1137 and / or shim 1338 could engage projections 1654 in elongate channel 1602 (Figures 8 and 11), and knife 1330 could not be fired.
[0102] [0102] Still with reference to Figure 8, the locking system of the trigger member 1640 also includes an unlocking set
[0103] [0103] The attachment of the interchangeable surgical tool set 1000 to the handle set 500 will now be described with reference to Figures 3 and 9. To start the coupling process, the doctor can position the tool frame 1210 of the set interchangeable surgical tool 1000 above or adjacent to the distal end of the grip frame 506 so that the tapered clamping portions 1212 formed on the tool chassis 1210 are aligned with the slot slots 507 in the grip frame 506. O The physician can then move the interchangeable surgical tool set 1000 along a geometry axis IA installation that is perpendicular to the geometry axis of the drive shaft SA to seat the tapered clamping portions 1212 in "operational engagement"
[0104] [0104] During a typical surgical procedure, the doctor can insert the surgical end actuator 1500 into the surgical site through a trocar or other opening in the patient to access the target tissue. In doing so, the physician typically axially aligns the surgical end actuator 1500 along the geometric axis of the SA drive shaft (non-articulated state). When the surgical end actuator 1500 has passed through the trocar port, for example, the physician may need to articulate the end actuator 1500 to advantageously position it adjacent to the target tissue. This occurs before the anvil 1810 is closed on the target tissue, so that the closing drive system 510 remains unacted. When in this position, the actuation of the drive system
[0105] [0105] As indicated above, the surgical tool kit 1000 is configured to be used in connection with conventional mechanical surgical clamp / clamp cartridges 1400 as well as with 1700 RF cartridges. In at least one way, the RF cartridge 1700 can facilitate the mechanical cutting of the tissue that is clamped between the anvil 1810 and the RF cartridge 1700 with the knife member 1330 while the electrical coagulation current is released to the tissue in the current path. Alternative arrangements for mechanically cutting and coagulating tissue using electrical current are disclosed, for example, in US Patent Nos. 5,403,312; 7,780,663 and US Patent Application Serial No. 15 / 142,609, entitled ELECTROSURGICAL INS-
[0106] [0106] As shown in Figures 10 to 12, in at least one arrangement, the RF 1700 surgical cartridge includes a 1710 cartridge body that is sized and shaped to be received and removably supported in the elongated channel 1602. For example, the 1710 cartridge body can be configured to be removably retained in a snap fit with the elongated channel 1602. In several arrangements, the 1710 cartridge body can be manufactured from a polymeric material, such as For example, a engineering thermoplastic such as liquid crystal polymer (LCP) VECTRAY, and the elongated channel 1602 can be made from metal. In at least one aspect, the cartridge body 1710 includes an elongated centrally arranged slot 1712 that extends longitudinally through the cartridge body to accommodate the longitudinal displacement of knife 1330 therethrough. As shown in Figures 10 and 11, a pair of locking engagement tails 1714 extends proximally from the body of the 1710 cartridge. Each locking engagement tail 1714 has a locking block 1716 formed on the underside thereof. which is sized to be received within a corresponding proximal opening portion 1642 at the bottom of channel 1620. Thus, when cartridge 1700 is properly installed in elongated channel 1602, locking engagement tails 1714 cover openings 1642 and overhangs 1654 to hold knife 1330 in an unlocked position ready to fire.
[0107] [0107] Now with reference to Figures 10 to 13, in the example shown, the cartridge body 1710 is formed with a centrally arranged high electrode block 1720. As can be seen more particularly in Figure 6, the elongated slot 1712 extends through the center of the electrode block 1720 and serves to divide the block 1720 into a left block segment 1720L and into a right block segment 1720R. A right flexible circuit set 1730R is attached to the right block segment 1720R and a left flexible circuit set 1730L is attached to the left block segment 1720L. In at least one arrangement, for example, the straight flexible circuit 1730R comprises a plurality of 1732R electrical conductors which may include, for example, wider electrical conductors / conductors for RF purposes and thinner electrical conductors for conventional stapling purposes which are supported or fixed or embedded in a 1734R right insulating member / enclosure that is fixed to the 1720R right block. In addition, the 1730R right flexible circuit assembly includes a 1736R "phase one" proximal right electrode and a 1738R "phase two" distal right electrode. Likewise, the left flexible circuit assembly 1730L comprises a plurality of 1732L electrical conductors which may include, for example, wider electrical conductors / conductors for RF purposes and thinner electrical conductors for conventional stapling purposes which are supported or secured or embedded in a 1734L left insulating member / housing that is attached to the left 1720L block. In addition, the 1730L left flexible circuit assembly includes a 1736L proximal "phase one" left electrode and a 1738L distal left "phase two" electrode. The 1732L, 1732R left and right electrical conductors are attached to a 1740 distal microchip mounted on the distal end portion of the 1710 cartridge body. In one arrangement, for example, each of the 1730R, 1730L right and left flexible circuits can have an overall "CW" width of approximately 0.025 inch, and each of the 1736R, 1736L, 1738R, 1738R electrodes has an "EW" width of approximately 0.010 inch, for example. See Figure 13. However, other widths / sizes are contemplated and can be used in alternative aspects.
[0108] [0108] In at least one arrangement, RF energy is supplied to the surgical tool kit 1000 by a conventional RF generator 400 via a supply lead wire 402. In at least one arrangement, the supply lead wire 402 includes a set of male plug 406 that is configured to be plugged into corresponding female connectors 410 that are attached to a segmented RF circuit 1160 on an integrated circuit board 1152. See Figure 15. Such an arrangement facilitates the pivoting displacement of the drive shaft and end actuator 1500 around the geometric axis of the drive shaft SA in relation to the tool frame 1210 by rotating the nozzle assembly 1240 without winding the supply lead 402 from the generator 400. A built-in power on / off switch 420 is held in the locking set 1280 and the tool chassis 1210 to turn the RF generator on and off. When tool set 1000 is operationally coupled to handle set 500 or robotic system, built-in segmented RF circuit 1160 communicates with microprocessor 560 through connectors 1154 and 562. As shown in Figure 1, the set handle 500 can also include a display screen 430 for viewing information about sealing progress, stapling, knife location, cartridge status, fabric, temperature, etc. As can also be seen in Figure 15, the slip ring assembly 1150 interfaces with a distal connector 1162 which includes a strip or flexible drive shaft circuit assembly 1164 that can include a plurality of narrow electrical conductors 1166 for activities related to stapling and wider 1168 electrical conductors used for RF purposes. As shown in Figures 14 and 15, the drive shaft flexible circuit strip 1164 is centrally supported between the laminated plates or bars 1322 that form knife bar 1320. Such an arrangement facilitates sufficient flexing of knife bar 1320 and the drive shaft flexible circuit strip 1164 during articulation of the end actuator 1500 while remaining sufficiently rigid to allow knife member 1330 to be distally advanced through the clamped tissue.
[0109] [0109] Again with reference to Figure 10, in at least one illustrated arrangement, the elongated channel 1602 includes a channel circuit 1670 sustained in a recess 1621 that extends from the proximal end 1610 of the elongated channel 1602 to a distal location 1623 in the lower portion of the elongated channel 1620. The channel circuit 1670 includes a proximal contact portion 1672 that contacts a distal contact portion 1169 of the drive shaft flexible circuit strip 1164 for electrical contact therewith. A distal end 1674 of channel circuit 1670 is received within a corresponding wall recess 1625 formed in one of channel walls 1622 and is folded over and fixed to an upper edge 1627 of the wall of channel 1622. A series of corresponding exposed contacts 1676 are provided at the distal end 1674 of the channel circuit 1670, as shown in Figure 10. As can also be seen in Figure 10, an end 1752 of a flexible cartridge circuit 1750 is attached to the distal microchip 1740 and is attached to the distal end portion of the 1710 cartridge body. Another end
[0110] [0110] Figures 16A and 16B are a block diagram of a control circuit 700 of the surgical instrument 10 of Figure 1 that comprises two drawing sheets, according to one aspect of this description. Referring mainly to Figures 16A and 16B, a handle assembly 702 can include an engine 714, which can be controlled by an engine driver 715 and can be employed by the trigger system of the surgical instrument 10. In various ways, the motor 714 can be a direct current (dc) drive motor with brushes with a maximum rotation speed of approximately 25,000 rpm. In other arrangements, the 714 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable type of electric motor. Motor starter 715 may comprise an H bridge starter that comprises field effect transistors (FETs) 719, for example. The motor 714 can be powered by the supply set 706 releasably mounted to the handle set 500 to supply control power to the surgical instrument 10. The supply set 706 may comprise a battery that may include several battery cells connected in series, which can be used as the power source to energize the surgical instrument 10. In certain circumstances, the battery cells in the 706 power pack can be replaceable and / or rechargeable. In at least one example, the battery cells can be lithium ion batteries that can be separately separable to the 706 power pack.
[0111] [0111] The drive shaft assembly 704 may include a drive shaft assembly controller 722 that can communicate with a safety controller and a power management controller 716 through an interface, while the shaft assembly drive 704 and power supply 706 are coupled to cable assembly 702. For example, the interface may comprise a first portion of interface 725 which may include one or more electrical connectors for coupling coupling with electrical connector connectors. corresponding drive shaft and a second portion of interface 727 which may include one or more connectors for coupling coupling with the corresponding electrical connectors of the power package to enable electrical communication between the controller of the drive shaft assembly 722 and the power management controller 716 while the drive shaft assembly 704 and the power supply 706 are healthy o attached to the cable assembly
[0112] [0112] The interface can facilitate the transmission of one or more communication signals between the power management controller 716 and the drive shaft controller 722 by routing these communication signals through a main controller 717 located in the assembly cable 702, for example. In other circumstances, the interface can facilitate a direct communication line between the power management controller 716 and the drive shaft assembly controller 722 via cable assembly 702, while the drive shaft assembly 704 and the power set 706 are coupled to the cable set 702.
[0113] [0113] The main controller 717 can be any single-core or multi-core processor, such as those known under the trade name of ARM Cortex from Texas Instruments. In one respect, the main controller 717 may be a Core Cor- tex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single cycle flash memory, or other memory non-volatile, up to 40 MHz, a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the program StellarisWareGO, 2 KB electronically programmable and erasable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder (QEI) input analogues, one or more 12-bit analog to digital converters (ADC) with 12 channels of analog input, details of which are available for the product data sheet.
[0114] [0114] The safety controller can be a safety controller platform that comprises two families based on controllers, such as TMS570 and RM4x, known under the trade name of Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[0115] [0115] The power pack 706 may include a power management circuit which may comprise the power management controller 716, a power modulator 738 and a current sensing circuit 736. The management circuit The power supply can be configured to modulate the battery's output power based on the power needs of the drive shaft assembly 704, while the drive shaft assembly 704 and the power supply 706 are coupled to the drive assembly. cable 702. The power management controller 716 can be programmed to control power modulator 738 from the power output of the power supply 706 and current sensor circuit 736 can be employed to monitor the power output of the power supply. power supply 706 to provide feedback to the power management controller 716 about the battery power output so that the power management controller 716 can adjust the output power supply unit 706 to maintain a desired output. The power management controller 716 and / or the drive shaft assembly controller 722 may each comprise one or more processors and / or memory units that can store multiple software modules.
[0116] [0116] Surgical instrument 10 (Figures 1 to 5) can comprise an output device 742 that can include devices to provide sensory feedback to a user. Such devices may comprise, for example, visual feedback devices (for example, a monitor with LCD screen, LED indicators), hearing feedback devices (for example, a speaker, a bell) or devices tactile feedback (eg haptic actuators). In certain circumstances, output device 742 may comprise a screen 743 which may be included in cable assembly 702. The drive shaft assembly controller 722 and / or the power management controller 716 may provide feedback to a user of the surgical instrument 10 via the output device 742. The interface can be configured to connect the drive shaft assembly controller 722 and / or the power management controller 716 to the output device 742. The device output 742 can instead be integrated with the supply set 706. In these circumstances, communication between the output device 742 and the drive shaft set controller 722 can be done via the interface, while the drive shaft assembly 704 is coupled to the cable assembly 702.
[0117] [0117] Control circuit 700 comprises circuit segments configured to control the operations of the powered surgical instrument 10. A safety controller segment (segment 1) comprises a safety controller and the main controller segment 717 (segment 2 ). The safety controller and / or the main controller 717 are configured to interact with one or more additional circuit segments such as an acceleration segment, a display segment, a drive axis segment, a encoder, a motor segment, and a power segment. Each of the circuit segments can be coupled to the safety controller and / or to the main controller 717. The main controller 717 is also coupled to a flash memory. The main controller 717 also comprises a serial communication interface. Main controller 717 comprises a plurality of inputs coupled, for example, to one or more circuit segments, a battery, and / or a plurality of switches. The segmented circuit can be implemented by any suitable circuit, such as, for example, a printed circuit board (PCBA) assembly inside the energized surgical instrument 10. It should be understood that the term processor, as used here, includes any microprocessor, processor, controller, controllers or other basic computing device that incorporates the functions of a central computer processing unit (CPU) in an integrated circuit or at most some integrated circuits. The main controller 717 is a programmable multipurpose device that accepts digital data as input, processes it according to the instructions stored in its memory, and provides results as output. This is an example of sequential digital logic, as it has internal memory. The control circuit 700 can be configured to implement one or more of the processes described herein.
[0118] [0118] The acceleration segment (segment 3) comprises an accelerometer. The accelerometer is configured to detect movement or the acceleration of the energized surgical instrument 10. Input from the accelerometer can be used to transition to and from a suspend mode, identify the orientation of the energized surgical instrument, and / or identify when the surgical instrument is dropped. In some examples, the acceleration segment is coupled to the safety controller and / or the main controller 717.
[0119] [0119] The screen or display segment (segment 4) comprises a screen connector coupled to the main controller 717. The screen connector couples the primary controller 717 to a screen via one or more drivers of the integrated circuits of the screen. The drivers of the integrated circuits of the screen may be integrated with the screen and / or may be located separately from the screen. The display may comprise any suitable display, such as an organic light emitting diode (OLED) display, a liquid crystal display (LCD), and / or any other suitable display. In some examples, the screen segment is coupled to the safety controller.
[0120] [0120] The drive shaft segment (segment 5) comprises controls for an interchangeable drive shaft assembly 500 coupled to surgical instrument 10 (Figures 1 to 5) and / or one or more controls for a 1500 end actuator coupled to the interchangeable drive shaft assembly 500. The drive shaft segment comprises a drive shaft connector configured to couple main controller 717 to a drive shaft PCBA. The drive shaft PCBA comprises a low power microprocessor with a ferroelectric random access memory (FRAM), a toggle switch, a drive shaft release Hall effect switch, and a shaft PCBA EEPROM memory. drive. The drive shaft PCBA EEPROM memory comprises one or more parameters, routines and / or specific programs for the interchangeable drive shaft assembly 500 and / or for the drive shaft PCBA. The drive shaft PCBA can be attached to the interchangeable drive shaft assembly 500 and / or can be integral with the surgical instrument
[0121] [0121] The position encoder segment (segment 6) comprises one or more magnetic encoders of the rotation angle position. The one or more magnetic encoders of the rotation angle position are configured to identify the rotational position of the engine 714, an interchangeable drive shaft assembly 500 and / or an end actuator 1500 of the surgical instrument 10 (Figures 1 to 5 ). In some instances, the magnetic encoders of the rotation angle position can be coupled to the safety controller and / or the main controller 717.
[0122] [0122] The motor circuit segment (segment 7) comprises a motor 714 configured to control the movements of the powered surgical instrument 10 (Figures 1 to 5). The motor 714 is coupled to the main microcontroller processor 717 by an H bridge driver comprising one or more H bridge field effect transistors (FETs) and a motor controller. The H bridge actuator is also coupled to the safety controller. A motor current sensor is coupled in series with the motor to measure the current drain from the motor. The motor current sensor is in signal communication with the main controller 717 and / or with the safety processor. In some instances, the 714 motor is coupled to an electromagnetic interference (EMI) filter on the motor.
[0123] [0123] The motor controller controls a first motor signal and a second motor signal to indicate the status and position of motor 714 to main controller 717. Main controller 717 provides a high pulse width modulation signal (PWM), a low PWM signal, a direction signal, a synchronization signal, and a motor restart signal to the motor controller via a buffer. The supply segment is configured to supply a segment voltage to each of the circuit segments.
[0124] [0124] The power segment (segment 8) comprises a battery coupled to the safety controller, the main controller 717, and additional circuit segments. The battery is coupled to the circuit segmented by a battery connector and a current sensor. The current sensor is configured to measure the total current drain from the segmented circuit. In some examples, one or more voltage converters are configured to provide predetermined voltage values for one or more circuit segments. For example, in some examples, the segmented circuit may comprise 3.3 V voltage converters and / or 5 V voltage converters. A voltage amplification converter is configured to provide a voltage rise to a predetermined amount, such as up to 13 V. The voltage amplifier converter is configured to supply additional voltage and / or current during operations that require a lot of energy and to avoid blackouts or low power conditions.
[0125] [0125] A plurality of keys are coupled to the safety controller and / or the main controller 717. The keys can be configured to control the operations of the surgical instrument 10 (Figures 1 to 5), of the segmented circuit , and / or indicate a state of the surgical instrument 10. An ejection port switch and an ejection Hall switch are configured to indicate the status of an ejection port. A plurality of hinge keys, such as a left hinge key for the left side, a right hinge key for the left side, a central hinge key for the left side, a key from the left pivot side to the right side, a key from the right pivot side to the right side, and a central pivot key to the right side are configured to control the articulation of an interchangeable drive shaft assembly 500 ( Figures 1 and 3) and / or the end actuator 300 (Figures 1 and 4). A reverse key on the left side and a reverse key on the right side are attached to the main controller 717. The keys on the left side which comprise the left-hand pivot switch for the left side, the right-hand pivot key for the left side, the central articulation key for the left side and the reverse key for the left side are coupled to the primary controller 717 by a flexing connector on the left. The keys on the right side that comprise the key on the left pivot side for the right side, the key on the right pivot side for the right side, the central key for the right side, and the reverse key on the right side they are coupled to the main controller 717 by a right flex connector. A trip key, a clamping release key, and a key attached to the drive shaft are coupled to the main controller 717.
[0126] [0126] Any suitable mechanical, electromechanical, or solid state keys can be used to implement the plurality of keys in any combination. For example, the keys can limit the keys operated by the movement of components associated with the surgical instrument 10 (Figures 1 to 5) or the presence of an object. These switches can be used to control various functions associated with the surgical instrument 10. A limit switch is an electromechanical device that consists of an actuator mechanically connected to a set of contacts. When an object comes into contact with the actuator, the device operates the contacts to make or break an electrical connection. Limit switches are used in a variety of applications and environments because of their robustness, ease of installation and reliable operation. They can determine the presence or absence, passage, positioning and end of an object's displacement. In other implementations, the switches can be solid state switches that work under the influence of a magnetic field such as Hall effect devices, magnetic resistive devices (MR), giant magnetoresistive devices (GMR), magnetometers, among others. In other implementations, the switches can be solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, metal oxide semiconductor FET (MOSFET), bipolar, and the like). Other keys may include keys without an electrical conductor, ultrasonic keys, accelerometers, inertia sensors, among others.
[0127] [0127] Figure 17 is another block diagram of the control circuit 700 of the surgical instrument of Figure 1 that illustrates the interfaces between the grip set 702 and the feed set 706 and between the grip set 702 and the interchangeable drive shaft assembly 704, according to one aspect of this description. The cable assembly 702 may comprise a main controller 717, a drive shaft assembly connector 726 and a power assembly connector 730. The power assembly 706 may include a power assembly connector 732, a power management circuit 734 which can comprise the power management controller 716, a power modulator 738, and a current sensor circuit 736. The drive shaft assembly connectors 730, 732 form an interface 727. The power circuit power management 734 can be configured to modulate battery output energy 707 based on the power needs of the interchangeable drive shaft assembly 704 while the interchangeable drive shaft assembly 704 and the power supply 706 are coupled to cable assembly 702. Power management controller 716 can be programmed to control power modulator 738 from the power output of the assembly power supply 706 and current sensor circuit 736 can be employed to monitor the power output of the power supply 706 to provide feedback to the power management controller 716 about the battery power output 707 so that the controller management system 716 can adjust the power output of the power supply 706 to maintain a desired output. The drive shaft assembly 704 comprises a drive shaft processor 719 coupled to a non-volatile memory 721 and a drive shaft assembly connector 728 for electrically coupling the drive shaft assembly 704 to the handle assembly
[0128] [0128] Surgical instrument 10 (Figures 1 to 5) can comprise an output device 742 for sensory feedback to a user. Such devices may comprise visual feedback devices (for example, a monitor with an LCD screen, LED indicators), hearing feedback devices (for example, a speaker, a bell) or tactile feedback devices (for example , haptic actuators). In certain circumstances, output device 742 may comprise a screen 743 that may be included in cable assembly 702. The drive shaft assembly controller 722 and / or the power management controller 716 can provide feedback to a surgical instrument 10 user via output device 742. Interface 727 can be configured to connect the drive shaft
[0129] [0129] Figure 18 is a schematic diagram of a surgical instrument 600 configured to control various functions in accordance with an aspect of the present description. In one aspect, the surgical instrument 600 is programmed to control the distal translation of a displacement member, such as the beam with an i-profile 614. The surgical instrument 600 comprises an end actuator 602 that can comprise a anvil 616, an i-profile beam 614 and a removable staple cartridge 618 that can be exchanged for an RF 609 cartridge (shown in dashed line). The end actuator 602, the anvil 616, the i-profile beam 614, the staple cartridge 618 and the RF cartridge 609 can be configured as described here, for example, in relation to Figures 1 to 15. For brevity and clarity of the description, various aspects of the present description can be described with reference to Figure 18. It will be recognized that the components shown schematically in Figure 18, such as control circuit 610, sensors 638, position sensor 634, end actuator - 602, the i-profile beam 614, the staple cartridge 618, the RF cartridge 609, the anvil 616, are described in connection with Figures 1 to 17 of the present description.
[0130] [0130] Consequently, the components represented schematically in Figure 18 can be readily replaced by the equivalent physical and functional components described in connection with Figures 1 to 17. For example, in one aspect, the control circuit 610 can be implemented as the control circuit 700 shown and described in connection with Figures 16 to 17. In one aspect, sensors 638 can be implemented as a limit switch, an electromechanical device, solid state switches, Hall effect devices , magnetoresistive devices (MR), giant magnetorresistive devices (GMR), magnetometers, among others.
[0131] [0131] The position, movement, displacement and / or translation of a linear displacement member, such as the beam with emi 614 profile, can be measured by an absolute positioning system, sensor arrangement and a sensor of position represented as the 634 position sensor. Since the i-beam beam 614 is coupled to a longitudinally movable drive member 540, the i-beam beam position 614 can be determined by measuring the position of the drive member longitudinally movable 540 that employs the position sensor 634. Consequently, in the description below, the position, displacement and / or translation of the beam with i 614 profile can be obtained by the position sensor 634, as described in the present invention. A control circuit 610, like the control circuit 700 described in Figures 16A and 16B, can be programmed to control the translation of the displacement member, such as the i-profile beam 614, as described in this document. The control circuit 610, in some examples, may comprise one or more microcontrollers, microprocessors or other suitable processors to execute the instructions that cause the processor or processors to control the displacement member, for example, the beam with i 614 profile, as described. In one aspect, a timer / counter circuit 631 provides an output signal, such as elapsed time or a digital count, to control circuit 610 to correlate beam position with i 614 profile, as determined by the sensor. position 634, with the timer / counter circuit 631 leaving so that the control circuit 610 can determine the position of the beam with i-profile 614 at a specific time (t) in relation to an initial position. The timer / counter circuit 631 can be configured to measure elapsed time, count external events or time external events.
[0132] [0132] Control circuit 610 can generate a 622 motor setpoint signal. The 622 motor setpoint signal can be supplied to a 608 motor controller. The 608 motor controller can comprise one or more circuits configured to provide a motor 624 drive signal to motor 604 to drive motor 604, as described in the present invention. In some examples, motor 604 may be a DC (direct current) electric motor with brushes, such as motor 505 shown in Figure 1. For example, the speed of motor 604 may be proportional to the drive signal of motor 624 In some instances, the 604 motor may be a brushless DC (direct current) electric motor and the 624 motor drive signal may comprise a pulse-width modulated (PWM) signal provided to one or more windings of the motor stator 604. In addition, in some examples, the motor controller 608 can be omitted, and the control circuit 610 can generate the drive signal of motor 624 directly.
[0133] [0133] The 604 motor can receive power from a power source
[0134] [0134] The control circuit 610 can be in communication with one or more sensors 638. The sensors 638 can be positioned on the end actuator 602 and be adapted to work with the surgical instrument 600 to measure the various derived parameters, such as the distance of the gap in relation to time, the compression of the tissue in relation to time and the tension of the anvil in relation to time. The 638 sensors can comprise, for example, a magnetic sensor, a magnetic field sensor, a voltage meter, a pressure sensor, a force sensor, an inductive sensor such as a current sensor parasite, a resistive sensor, a capacitive sensor, an optical sensor and / or any other sensor suitable for measuring one or more parameters of the end actuator 602. The 638 sensors may include one or more sensors.
[0135] [0135] The one or more 638 sensors may comprise a strain gauge, such as a microtension gauge, configured to measure the magnitude of the strain on the anvil 616 during a tight condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The 638 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 616 and the staple cartridge 618. The sensors 638 can be configured to detect the impedance of a section of tissue located between the bi - gorna 616 and the staple cartridge 618 which is indicative of the thickness and / or completeness of the fabric located between them.
[0136] [0136] The 638 sensors can be configured to measure the forces exerted on the anvil 616 by the closing drive system. For example, one or more sensors 638 may be at an interaction point between the closing tube 1910 (Figures 1a4) and the anvil 616 to detect the closing forces applied by the closing tube 1910 to the anvil 616. The forces exerted on the anvil 616 can be representative of the tissue compression experienced by the section of tissue captured between the anvil 616 and the staple cartridge 618. The one or more sensors 638 can be positioned at various points of interaction throughout the closing drive system for detect the closing forces applied to the anvil 616 by the closing drive system. The one or more sensors 638 can be sampled in real time during a gripping operation by a processor as described in Figures 16A and 16B. The control circuit 610 receives sample measurements in real time to provide and analyze information based on time and evaluate, in real time, the closing forces applied to the anvil 616.
[0137] [0137] A current sensor 636 can be used to measure the current drained by the 604 motor. The force required to advance the beam with i 614 profile corresponds to the current drained by the 604 motor. The measured force is converted into a signal digital and supplied to the 610 control circuit.
[0138] [0138] An RF 400 power source is coupled to end actuator 602 and is applied to RF 609 cartridge when RF 609 cartridge is loaded on end actuator 602 in place of clamp cartridge 618. The circuit Control Panel 610 controls the release of RF energy into the 609 RF cartridge.
[0139] [0139] SYSTEMS AND METHODS FOR VIEWING THE SITUATION OF THE SURGICAL INSTRUMENT In a surgical sealing and stapling instrument, it can be useful to display a variety of information captured by the surgical instrument's sensors to the operator, so that the operator can ensure that the instrument is working
[0140] [0140] In several respects, the surgical instrument may include one or more sensors that are configured to measure a variety of different parameters associated with the operation of the surgical instrument. Such parameters may include the situation of the RF energy applied by the surgical instrument, the temperature of the tissue being seen by the surgical instrument, the temperature of the tissue being sealed by the surgical instrument, the water content of the tissue, the situation surgical instrument and the thickness of the clamped tissue. The surgical instrument can be configured to monitor these various parameters and present information associated with them to the instrument operator through, for example, screen 430 (Figure 1). In several aspects, the screen 430 can present the parameters monitored to the operator through a graphical display.
[0141] [0141] In some aspects, the surgical instrument may include a sensor or sensor set configured to detect the position of the closing trigger, that is, if the closing trigger is activated. One of these aspects is represented in Figures 19 to 20, which are seen in lateral elevation of the surgical instrument 2000 with the casing removed, in which the closing trigger 2002 is alternately in the actuated and not actuated positions, according to one or more aspects of this description. As described in more detail above, the non-actuated position of the closing trigger 2002 is associated with an open or unpinned position for the end actuator 1500 (Figure 1) in which the fabric can be positioned between the claws 1600 , 1800, and the actuated position of the closing trigger 2002 is associated with a closed or clamped position for the end actuator 1500 in which the fabric can be clamped between the claws 1600, 1800. The closing trigger 2002 can comprise an arm 2004 which is connected directly or indirectly to it by means of a mechanical connection, so that the arm 2004 rotates through the actuation of the closing trigger 2002. In one aspect, a trigger detection set 2005 comprises a magnetic element 2006 , as a permanent magnet, disposed at a distal end of the arm 2004 and a sensor 2008 that is configured to detect the movement of the magnetic element 2006. The sensor 2008 can comprise, for example, an effect sensor ito Hall configured to detect changes in a magnetic field surrounding the Hall effect sensor caused by the movement of the magnetic element 2006. Since the 2008 sensor can detect the movement of the magnetic element 2006 and the movement of the magnetic element 2006 corresponds to the position of the closing trigger 2002 in a known way, the trigger detection set 2005 can detect, therefore, if the closing trigger 2002 is in the actuated position, in the not acted position or in another position between them.
[0142] [0142] In another aspect, the trigger detection set 2005 comprises a sensor or a switch that is activated when the closing trigger system 510 (Figure 1) locks the closing trigger 2002 in the fully pressed or fully actuated position. In this respect, the key can generate a signal that indicates that the lock is engaged and, therefore, that the closing trigger 2002 is fully depressed.
[0143] [0143] In another aspect described in US Patent Application Publication No. 2014/0296874, entitled ROBOTICALLY-CON- TROLLED END EFFECTOR, which is incorporated herein by reference in its entirety, the trigger detection set 2005 comprises a force sensor positioned between the closing trigger 2002 and the pivot pin 2003 around which the closing trigger
[0144] [0144] The trigger detection set 2005 can be in signal communication with a 2102 controller (Figure 25) through a wired or wireless connection, so that any signal generated by the trigger detection set 2005 is relayed to controller 2102. The trigger detection set 2005 can be configured to continuously monitor the position of the closing trigger 2002 throughout the operation of the instrument by sampling the detected parameter (or parameters detected) or transmission a feedback signal indicating the detected parameter (or detected parameters) with a minimum delay. In several respects, the trigger detection set 2005 may comprise an analog sensor configured to generate a signal corresponding to the degree of force exerted on the closing trigger 2002 and / or a specific position of the closing trigger 2002. In such aspects, a analog-digital converter can be positioned between trigger detection set 2005 and controller 2102. In several other aspects, trigger detection set 2005 can comprise a digital sensor configured to generate an indicative signal only the possibility of the closing trigger 2002 being activated or not activated.
[0145] [0145] In some aspects, the surgical instrument may include a sensor or sensor set that is configured to detect the thickness of the tissue clamped by the end actuator. One of these aspects is represented in Figures 21 to 22, which are a perspective view of an end actuator 2020 comprising a fabric thickness detection set 2022 and a schematic view of a sensor 2024 of the detection set fabric thickness 2022, according to one or more aspects of the present description. The tissue thickness detection assembly 2022 may comprise a sensor 2024 disposed in a first claw 2034, or RF cartridge 2042, and a magnetic element 2032, such as a permanent magnet, disposed in a second claw 2036 of the end actuator 2020. In one aspect, the sensor 2024 is disposed at or adjacent to the distal end 2038 of the first claw 2034, so that it is positioned distally with respect to the electrodes of the RF cartridge, and the magnetic element 2032 is correspondingly disposed at or adjacent to the distal end 2040 of the second claw 2036. The sensor 2024 can comprise a magnetic field detection element 2026 that is configured to detect the movement of the magnetic element 2006, such as a Hall effect sensor configured to detect changes in a magnetic field surrounding the Hall effect sensor caused by the movement of the magnetic element 2032. When the operator closes the end actuator 2020, the magnetic element 20 32 rotates downwards closer to the magnetic field detection element 2026, thus varying the magnetic field detected by the magnetic field detection element 2026 as the claw or claws rotate to the closed (or clamped) position. The strength of the magnetic field from the magnetic element 2032 detected by the magnetic field detection element 2026 is indicative of the distance between the first claw 2034 and the second claw 2036, which, in turn, is indicative of the thickness of the clamped tissue between them. For example, a greater distance between the first claw 2034 and the second claw 2036, and therefore a weaker magnetic field detected by the magnetic field detection element 2026, may indicate that a special tissue is present between the first claw 2034 and the second claw
[0146] [0146] In another aspect, the fabric thickness detection set 2022 may comprise a displacement sensor that is arranged in the pivot joint between the first claw 2034 and the second claw
[0147] [0147] In other respects, the fabric thickness detection set 2022 may additionally comprise a reed switch sensor, a displacement sensor, an optical sensor, a magneto-inductive sensor, a force sensor, a pressure sensor pressure, a piezoresistive film sensor, an ultrasonic sensor, a parasitic current sensor, an accelerometer, a pulse oximeter sensor, a temperature sensor, a sensor configured to detect an electrical characteristic of a tissue path (such as capacitance or resistance) or any combination thereof. In one of these aspects, the fabric thickness detection set 2022 may comprise a first electrical sensor disposed on the first claw 2034 and a second corresponding electrical sensor disposed on the second claw 2036, the first sensor being configured to transmit a current electrical that is detected by the second sensor through the tissue captured by the end actuator 2020. The detected current can be used by the tissue thickness detection set 2022 to determine the thickness of the pinched tissue since the resistivity of the tissue is a function thickness (and the type of fabric, among a variety of other factors).
[0148] [0148] The fabric thickness detection set 2022 can be in signal communication with a controller 2102 through a wired or wireless connection, so that any signal generated by the fabric thickness detection set 2022 is retransmitted to the controller 2102. For example, the fabric thickness detection set 2022 may comprise a transmitter 2028 configured to transmit the signals generated by the magnetic field detection element 2026 through a wired or wireless connection to a receiver, which, in turn, is communicably coupled to controller 2102. The fabric thickness detection set 2022 can be configured to continuously monitor the thickness of the clamped tissue throughout the instrument's operation by sampling the detected parameter (or detected parameters) or by transmitting a feedback signal indicative of the detected parameter (or detected parameters) with a minimum delay. In several respects, the tissue thickness detection set 2022 may comprise an analog sensor configured to generate a signal that corresponds to the relative or absolute thickness of the pinched tissue and / or a specific position of the first jaw 2034 or the second jaw 2036. In such aspects, an analog-to-digital converter can be positioned between the fabric thickness detection set 2022 and the controller 2102. In several other aspects, the fabric thickness detection set 2022 may comprise a digital sensor configured to generate a signal indicative only of the possibility that the claws 2034, 2036 are open or closed.
[0149] [0149] In some respects, the fabric thickness detection set 2022 may additionally comprise a power source 2030 operationally connected to the magnetic field detection element 2026. The power source 2030 can be separated from any other source of energy associated with the surgical instrument. Alternatively, the tissue thickness detection set 2022 can be interconnected with one or more energy sources associated with the surgical instrument.
[0150] [0150] In some aspects, the surgical instrument may include a sensor or a sensor set configured to detect the position of the longitudinally movable drive member 540 (Figure 3), knife bar 1320 (Figure 4), knife member 1330 ( Figure 4), cutting blade 1334 (Figure 4) and / or other components of the trigger drive system 530 (Figure 3). In many respects, the 2050 position sensing set can be configured to track the linear displacement of the 530 trigger drive system component using sensors configured to track the rotation of a 2054 gear arrangement attached to the drive system. trigger drive 530. For example, Figure 23 is an exploded perspective view of a position detection set 2050 configured to detect and track the linear position of the longitudinally movable drive member 540. In the aspect illustrated in Figure 23, the ins - surgical instrument comprises a 2058 drive gear that is operationally driven through a 2056 drive shaft by the 505 electric motor (Figure 1). Drive gear 2058 engages gear rack 542 (Figure 3) of longitudinally movable drive member 540 in gear, thus allowing motor 505 to drive displacement | i longitudinally movable drive 540. Rotation of the drive gear 2058 in a first direction causes the longitudinally movable drive member 540 to move in a distal direction and rotation of the drive gear 2058 in a second direction causes the longitudinally movable drive member 540 retracts in a proximal direction P. In many respects, the 2054 gear arrangement of the 2050 position sensing assembly may be positioned on or adjacent to the 2058 drive gear attached to the longitudinally movable actuating member 540, as shown in Figure
[0151] [0151] In the illustrated aspect, the gear arrangement 2054 of the position detection assembly 2050 comprises a first gear 2052 that rotates about the drive shaft 2056 according to the rotation of the drive gear 2058. Thus, the The rotation of the first gear 2052 around the actuation axis 2056 corresponds to the longitudinal translation of the longitudinally movable drive member 540 as driven by the drive gear 2058. The position detection set 2050 additionally comprises a magnet 2064 that rotates a way that corresponds to the rotation of the first gear 2052. In one aspect, the magnet 2064 is disposed in the first gear 2052. In that respect, a revolution of the first gear 2052 and, thus, of the magnet 2064, corresponds to a revolution of the gear of drive 2058. In another aspect, the 2054 gear arrangement is configured to serve as a gear There is an alternative ratio between the number of revolutions of the drive gear 2058 and the magnet 2064. In such an aspect illustrated in Figure 23, the gear arrangement 2054 comprises a second gear 2060, which is engaged in engagement with the first gear. gear 2052. In this respect, magnet 2064 is disposed on second gear 2060. The gear ratio connection between first gear 2052 and second gear 2060 can be configured so that a single revolution of magnet 2064 corresponds to a displacement linear adjustment of the longitudinally movable drive member 540. For example, the gear ratio connection between first gear 2052 and second gear 2060 can be configured so that a single revolution of magnet 2064 can correspond to a full stroke of the longitudinally movable drive member 540. Thus, a full stroke of the longitudinally movable drive member 540, either in the distant direction al, either proximal, corresponds to a single rotation of the second gear 2060. Since the magnet 2064 is coupled to the second gear 260, the magnet 2064, therefore performs a complete rotation with each complete stroke of the longitudinally movable drive member 540.
[0152] [0152] The 2050 position detection assembly further comprises a 2070 position sensor operationally connected to a 2072 circuit. The 2070 position sensor comprises one or more magnetic detection elements, such as Hall effect sensors, and is positioned next to magnet 2064. Since magnet 2064 rotates, the magnetic sensing elements of the position sensor 2070 determine the absolute angular position of the magnet 2064 during a revolution. In aspects of the surgical instrument in which a revolution of the magnet 2064 corresponds to a full stroke of the longitudinally movable actuating member 540, the specific angular position of the magnet 2064 then corresponds to a specific linear position of the longitudinally movable actuating member 540 In one aspect, the position detection set 2050 is configured to provide a unique position signal that corresponds to the location of the longitudinally movable actuating member 540 according to the exact angle position of the magnet 2064 as detected by the sensor of position
[0153] [0153] The 2070 position sensor can comprise any number of magnetic detection elements, such as magnetic sensors classified according to the possibility of measuring the total magnetic field or the vector components of the magnetic field. A series of n keys, where n is an integer greater than one, can be used alone or in combination with a gear reduction to provide a single position signal for more than one revolution of the 2064 magnet The state of the switches can be fed back to a controller 2080 that applies logic to determine a single position signal that corresponds to the linear displacement of the longitudinally movable drive member 540.
[0154] [0154] In one aspect, the position sensor 2070 is supported by a position sensor holder 2066 that defines an opening 2068 configured to hold position sensor 270 in precise alignment with the magnet 2064 that rotates below. The magnet 2064 can be coupled to a structural element 2062, such as a bracket, which supports the gear arrangement 2054, and to the circuit 2072.
[0155] [0155] Figure 24 is a diagram of a 2072 circuit and a 2070 position sensor from a 2050 position detection assembly, according to one or more aspects of the present description. The 2070 position sensor can be implemented as an ASSOSSEQFT single chip magnetic rotary position sensor, available from Austria Microsystems, AG. The 2070 position sensor interfaces with a 2080 controller, such as a microcontroller, to provide a system that is able to detect the absolute positioning of the longitudinally movable drive member 540 and / or other components of the control system. trigger drive 530. In one aspect, the 2070 position sensor is a low-voltage, low-consumption component and includes four Hall effect elements 2078A, 2078B, 2078C, 2078D in an area 2076 of the 2070 position sensor that is located above the 2064 magnet. A 2082 high-resolution ADC and an intelligent 2084 power management controller are also provided on the chip. A CORDIC processor ("Coordinate Rotation Digital Computer", or digital computer of coordinated rotation) 2086, also known as digit by digit method and Volder algorithm, is provided to implement a simple and efficient algorithm for calculating hyperbolic functions and trigonometrics that require only addition, subtraction, bit shift and lookup table operations. The angle position, alarm bits and magnetic field information are transmitted via a standard serial communication interface, such as a SPI 2088 interface, to the 2080 controller. The 2070 position sensor provides 12 or 14 resolution bits. The 2070 position sensor can be an AS5055 chip supplied in a small package
[0156] [0156] Although the 2070 position sensor is shown in Figure 24 as including four Hall effect elements, in other aspects of the surgical instrument, the number of Hall effect elements included in the 2070 position sensor may vary. In general, the number of Hall effect elements will correspond to the desired resolution degree for the 2070 position sensor, since a greater number of Hall effect elements would allow the 2070 position sensor to detect finer limb movements longitudinally movable drive
[0157] [0157] In other respects, knife bar 1320, knife member
[0158] [0158] In other respects, the 2050 position detection set comprises linear displacement sensors with or without contact configured to track the linear displacement of the triggering system 530. Linear displacement sensors can comprise linear transformers variable differential (LVDT), variable reluctance differential transducers (DVRT), a potentiometer, a magnetic detection system comprising a moving magnet and a series of linearly arranged Hall effect sensors, a magnetic detection system comprising a magnet fixed and a series of linearly arranged mobile Hall effect sensors, an optical detection system comprising a mobile light source and a series of linearly arranged photodiodes or photodetectors, or an optical detection system comprising a fixed light source and a series of photodiodes or mobile photodetectors arranged linearly, or any combination thereof.
[0159] [0159] Figure 25 is a block diagram of an example of a 2100 surgical instrument programmed to display various situations of the 2100 surgical instrument, according to one or more aspects of this description. The surgical instrument 2100 comprises a controller 2102 that is operationally connected to one or more sensors 2104, 2106 and a screen 2108, which can be arranged in the outer casing of the surgical instrument 2100. Controller 2102 incorporates or executes a logic that controls the operation of the surgical instrument 2100 according to a variety of inputs, such as signals received from one or more sensors 2104, 2106 with which controller 2102 is in signal communication. In many respects, controller 2102 comprises a processor, such as a CPU, operationally connected to a memory 2110 that stores program instructions that, when executed by the processor, cause controller 2102 and / or the surgical instrument 2100 perform a process directed by the program instructions. In other respects, controller 2102 comprises a control circuit that is configured to execute a process according to digital or analog signal actions. The control circuit can comprise an ASIC, an FPGA or any other circuit that is fabricable or programmable to execute logic.
[0160] [0160] Controller 2102 is configured to display various situations associated with the use of surgical instrument 2100 on screen 2108 according to the action received from a variety of sensors. One of these sensors includes the position sensor 2104, which can include the position detection set 2050 (Figure 23), as described above. Other 2106 sensors from which controller 2102 relates
[0161] [0161] The surgical instrument 2100 additionally includes a motor 2116, such as an electric motor, which drives a rotary drive shaft 224, which makes operational interface with a gear set 2122 that is mounted in gear engaged with a set , or rack, of driving teeth, as in a pinion and rack arrangement, in a displacement member 2118. In position detection set 2050, displacement member 2118 may include, for example, the driving member longitudinally movable 540 of the trigger drive system 530. A sensor element or magnet 2120 can be operationally coupled to a gear assembly 2122 so that a single revolution of the magnet 2120 corresponds to a certain linear longitudinal translation of the displacement member 2118. O position sensor 2104 can then additionally include a plurality of magnetic sensing elements configured to detect the angular position of magnet 2120, which corresponds to the linear position of the displacement member 2118 and thus allows the position sensor 2104 to detect the absolute or relative position of the displacement member 2118. The position sensor 2104 can also be configured to relay a signal from feedback to controller 2102 that is indicative of the position of displacement member 2118. A driver 2114 is operationally connected to motor 2116 and configured to provide a drive signal while adjusting the speed at which motor 2116 is driven, current drawn by the 2116 motor, the voltage at which the 2116 motor is adjusted, or a variety of other characteristics of the 2116 motor. The 2112 power source provides power to all or any one of the 2114 driver, the 2116 motor, the controller 2102, screen 2108, sensors 2104, 2106 or other components of surgical instrument 2100.
[0162] [0162] In some respects, the 2100 surgical instrument may include a detection set that is configured to detect the progress or advance of the closing mechanism. In many ways, the detection mechanism of the closing mechanism can comprise the trigger detection set 2005 described above. When the closing trigger 512 is used to actuate the closing drive system 510, which in turn causes the reciprocating closing element 1914 (Figure 5) to advance, the actuation or position of the closing trigger 512 can therefore be detected as a substitute for progress or advancement of the closing mechanism.
[0163] [0163] In other respects, the closing mechanism detection set may be similar to the position detection set 2050 described above with respect to trigger trigger system 530 and illustrated in Figures 23 to 24. The mecha detection set - closing mechanism of the surgical instrument 2100 may include the position sensor 2104, which can be supplied in addition to or in place of the position sensor described in relation to the position detection set 2050. In these aspects, the displacement member 2118 may include one or more components of the closing mechanism, such as the reciprocating closing element 1914, the proximal closing tube 1910 and / or the distal closing tube 1930, which comprise the rack of the driving teeth which are in engaged gear with a corresponding gear set 2122 that supports a magnet 2120 in it. As displacement member 2118 of the closing mechanism advances distally or proximally, magnet 2120 is induced to rotate in a first or second direction. The 2104 position sensor additionally includes a plurality of magnetic sensing elements, such as Hall effect elements, which are positioned close to the magnet 2120. Since the magnet 2120 rotates, the magnetic sensing elements of the 2104 position sensor determine the absolute angular position of the magnet 2120 during a revolution. Since the angular position of the magnet 2120 corresponds to the position of the displacement member 2118 of the closing mechanism with which the gear set 2122 is engaged, the closing tube detection set can thus detect the absolute position of the component closing mechanism. Additional details regarding these aspects of the detection mechanism of the closing mechanism are described above in relation to the position detection set 2050.
[0164] [0164] The speed at which the knife bar 1320 is being moved by the firing drive system 530 and / or the end actuator 1500 is being closed by the closing mechanism can be determined in several respects using a sensor position 2104 to track the position of a displacement member 2118 in combination with a timer or timing circuit. As displacement member 2118 is being transported, position sensor 2104 can determine its position ds, d>, ... dn over a series of different time intervals or timestamps t1, ta, ... th provided by the timer. The timer can include a timer that runs continuously, that is, a clock or a timer that is started by activating any of the trigger or closing mechanisms. In one aspect, for each distinct position measurement taken by position sensor 2104, controller 2102 accesses the timer to retrieve a timestamp according to the time of receiving the position measurement. Controller 2102 can then calculate the speed of displacement member 2118 over a set period of time according to the change in its displacement position over time. As the speed of the displacement member 2118 corresponds, in a known manner, both to the speed at which the knife bar 1320 is translated and to the speed at which the end actuator 1500 is closed, controller 2102 can then stop - undermine the closing or firing speed of the 2100 surgical instrument.
[0165] [0165] The other 2106 sensors may additionally include a cartridge sensor. In one aspect, the cartridge sensor includes channel circuit 1670 (Figure 10), which can be configured to detect the presence and / or status of a 1700 RF cartridge through exposed contacts 1676 positioned to make electrical contact with the corresponding exposed contacts 1756 of the RF 1700 cartridge. In another aspect, the cartridge sensor includes a sensor, such as the cartridge presence sensor and / or the cartridge condition sensor disclosed in US Patent Application Publication No. 2014/0296874, which is positioned with the elongated channel 1602 which comprises electrical contacts that emit a logical zero when the circuit is opened and a logical one when the circuit is closed, that is, the 1700 RF cartridge is correctly positioned inside of the elongated channel 1602.
[0166] [0166] The other 2106 sensors may additionally include a temperature sensor that is configured to detect the temperature of the fabric that is sealed by RF energy. In one aspect, the temperature sensor includes a temperature detection circuit disclosed as described in US Patent No. 8,888,776, entitled ELECTRO-SURGICAL INSTRUMENT EMPLOYING AN ELECTRODE, which is incorporated herein by reference in its entirety. In this regard, the temperature detection circuit can be configured to apply a voltage that is a function of the temperature detected by the temperature detection circuit. The temperature detection circuit can be configured to apply a first voltage to the switching terminal when it detects a first temperature, a second voltage when it detects a second temperature and a third voltage when it detects a third temperature, and so on. onwards. In many ways, the temperature detection circuit can decrease the voltage applied to the switching terminal as the electrode temperature increases. For example, the temperature detection circuit can be configured to apply a first voltage to the switching terminal when a first temperature is detected by the temperature detection circuit, and in addition, a second voltage, which is lower than the first voltage, when the temperature detection circuit detects a second temperature that is higher than the first temperature. Correspondingly, the temperature detection circuit can increase the voltage applied to the switch terminal as the electrode temperature decreases. The change in voltage generated by the temperature detection circuit can be detected, for example, by means of a circuit to generate a feedback signal indicative of the temperature experienced or detected by the circuit which is then transmitted to controller 2102. The temperature detection circuit can be included with the first claw 1600 (Figure 3), with the second claw 1800 (Figure 3) and / or with the cartridge 1700 (Figure 2). In aspects where the cartridge 1700 includes the temperature detection circuit, the feedback signal generated by the temperature detection circuit can be transmitted to the channel circuit 1670 through the electrical connection between the corresponding exposed contacts 1676, 1756. Channel circuit 1670 can then transmit the feedback signal to controller 2102.
[0167] [0167] The other 2106 sensors can additionally include sensors
[0168] [0168] In total, the various sensors or sets of sensors disclosed herein can be used by the surgical instrument 2100 to monitor the position of the closing trigger 512, the advancement of the closing drive system 510 and / or components of the closing mechanism. closing, the thickness of the clamped tissue, the position of the knife bar 1320 and / or other components of the triggering system 530, the presence of the RF 1700 cartridge, the situation of the RF 1700 cartridge, the closing speed of the end actuator 1500 and various other operational situations of the surgical instrument 2100. These states, parameters, positions or other information associated with the operation of the surgical instrument 2100 can be tracked by controller 2102 through feedback signals transmitted to from the various detection sets. Controller 2102 can then cause screen 2108 to display one or more monitored variables associated with the operation of the 2100 surgical instrument in a graph format for viewing by the 2100 surgical instrument operators.
[0169] [0169] Figures 26 to 39 are views that represent various situations, parameters or other information associated with the operation of the surgical instrument according to one or more aspects of the present description. In various aspects represented in Figures 26 to 29, the screen 2200 of the surgical instrument can be configured to graphically represent the situation of the RF energy that is supplied to the tissue engaged by the end actuator 1500 (Figure 1). The situation of the supplied RF energy can be represented in the form of a graph 2202, a numerical value 2204, a disk 2206 or a bar graph 2208. The RF energy released to the tissue corresponds to the importance of the tissue 2210 measured, for example, by a tissue impedance sensor, as described above. In addition, the tissue impedance 2210 varies as a function of time 2212 because the properties of the engaged tissue change due to the application of mechanical force from the claws of the end actuator 1500 and the RF energy. One such change in the properties of the engaged tissue is the water leaving the tissue. Another such change in the properties of the engaged tissue is the change in the conductance of the fibers in the tissue as the RF energy is applied. Therefore, in some respects, screen 2200 can be configured to represent the change in tissue impedance 2210 over time 2212, for example, a curve 2216 on a graph 2202 or a series of bars 2224 that indicate impedance measurements of the fabric 2210 at distinct time intervals on a bar graph 2208. The screen 2200 can be additionally configured to represent an expected curve 2217 of impedance 2210 over time 2212 which is calculated by controller 2102 according to an executed algorithm by the same. In other respects, the screen 2200 can represent the impedance of the fabric 2210 as a numeral 2218. The numeral 2218 can represent the absolute value of the impedance measured in, for example, ohms. Alternatively, the number 2218 can represent the relative value or the ratio of the impedance measured between the maximum and minimum impedance values. In addition, the size that the numeral 2218 has on the screen 2200 may correspond to the relative size of the value. The disk format 2206 of the screen 2200 can similarly represent the fabric impedance measured in relation to a maximum impedance 2222 and a minimum impedance 2220.
[0170] [0170] Screen 2200 can also be configured to represent one or more alerts 2214 or situations 2226 according to the operation of the surgical instrument 2100. Alerts 2214 may include warnings that the tissue impedance has exceeded a maximum tissue impedance, which the electrodes lost energy, that the measured tissue impedance is deviating from an expected tissue impedance, as calculated by controller 2102 or stored in memory 2110, and that the RF power supply time has exceeded a maximum or expected time . Situations 2226 may include the current or stage or subsequent step in the process of using the 2100 surgical instrument.
[0171] [0171] In addition to displaying the RF energy that is supplied to the tissue, the 2200 screen can also be configured to represent a variety of other parameters, situations or other information as determined by the detection sets in communication with the controller 2102. In one aspect, the screen 2200 can be configured to represent a temperature situation 2228 of the fabric to which the RF energy is applied. The temperature can be determined, for example, by means of a temperature detection circuit, as described above. In several respects, the temperature situation 2228 can be represented as an absolute value of the measured temperature or a relative value of the temperature measured between a minimum and a maximum temperature. In one aspect, temperature situation 2228 can be represented as a curve 2239 of absolute or relative temperature 2236 as a function of time 2238. Screen 2200 can be further configured to represent an expected temperature curve 2240 2236 over time 2238 which is calculated by controller 2102 according to an algorithm performed by it.
[0172] [0172] In another aspect, the screen 2200 can be configured to represent the situation of the water content 2230 of the fabric. The water content of the tissue can be determined, for example, as a function of the change in the impedance of the tissue during the RF gripping and sealing operations performed by the 2100 surgical instrument. When the change in the mechanical properties of a tissue type specific over time is experimentally known and the change in tissue importance as a result of the change in the mechanical properties of tissue is likewise experimentally known, controller 2102 can isolate these effects from the measured change in im- fabric over time, calculate the change in the water content of the fabric and then make the 2200 fabric represent the situation of the calculated water content 2230. As described above in relation to other fabric parameters or of the surgical instrument, the screen 2200 can represent the situation of the water content of the 2230 tissue in the form of a graph, a numeral, a disc or any other graphic representation like these. In one aspect, fabric 2200 can represent the change in water content of fabric 2242 over time 2244 as a curve 2246. Fabric 2200 can be additionally configured to represent an expected curve 2248 of water content 2242 over of time 2244 which is calculated by controller 2102 according to an algorithm performed by it.
[0173] [0173] In other respects, the screen 2200 can be configured to represent the seal completion situation 2232 or completion situation 2234 according to the operation of the surgical instrument
[0174] [0174] In various aspects shown in Figures 34 to 37, the screen 2200 can be configured to display the thickness of the fabric engaged by the end actuator 1500, the advance of a displacement member, such as knife bar 1320 and several situations associated with tissue thickness and / or displacement limb. The thickness of the fabric engaged by the end actuator 1500 can be detected, for example, by a fabric thickness detection set 2022 in communication with the controller 2102, as described above. In many respects, controller 2102 can cause screen 2200 to represent tissue thickness according to the feedback signal generated by tissue thickness detection set 2202 as an absolute or relative value in a variety of graphic formats - different features, such as a series of distinct zones 2264 in the thin to thick range, such as a 2266 graphic or a 2268 disc, among others.
[0175] [0175] Screen 2200 can additionally comprise alerts to provide graphic warnings to users that the fabric is too thick or too thin for a specific operation. For example, an alert may comprise a 2274 icon, such as an "X", as shown in Figure 35, which is superimposed on screen 2200 to indicate to the operator that the 2100 surgical instrument is or will be operating outside the desired conditions. . In other respects, the 2274 icon may or may not be superimposed on the various graphic formats 2264, 2266, 2268 that indicate the thickness of the fabric. Various other graphic notices can be used, including icons for different designs, changes in color or textual notices. As another example, an alert may comprise a graphical representation that a curve 2276 of tissue thickness, the speed of the displacement limb, or another parameter measured or calculated from the various detection sets is deviating from an expected curve 2278 In such aspects, several other additional alerts can accompany the represented alert, such as textual alerts, icons, changes in color and the like.
[0176] [0176] In one aspect, the 2200 screen can be further configured to represent the position of the knife bar 1320. The position of the knife bar 1320 can be detected, for example, by means of a position detection set 2050 in communication with controller 2102, as described above. In several respects, controller 2102 can cause the screen 2200 to represent the displacement of the knife bar 1320 according to the feedback signal generated by the position detection set 2050, for example, a linear position measured 2270 of the bar of knife 1320 in relation to a maximum position 2272 thereof. The maximum position 2272 can include a maximum desired incision length for a specific surgical operation or an absolute maximum length over which the knife bar 1320 can translate.
[0177] [0177] In another aspect, the 2200 screen can be additionally configured to show the advance or status of the closing mechanism. The advance of the closing mechanism can be detected, for example, by a closing trigger detection set 2005 in communication with controller 2102, as discussed above, or a position detection set 2050 configured to detect a position of a member displacement 2118 of the closing mechanism, as described above in relation to Figure 25. In several aspects, controller 2102 can cause screen 2200 to show the advance of the closing mechanism according to the feedback signal generated by the set trigger detection 2005 or the position detection set 2050, such as, for example, a detected position of the reciprocating closing element 1914 in relation to its maximum position.
[0178] [0178] In some respects, controller 2102 can be configured to fill screen 2200 with a variety of icons when certain events or situations occur. For example, a first icon 2280 may indicate that the RF energy is present or has been applied correctly to the tissue. A second icon 2282 may indicate that knife bar 1320 is present or has been triggered correctly. A third icon 2284 may indicate that an error has occurred at some point during instrument operation. A fourth 2286 icon may indicate that all steps in the instrument's operation have been completed successfully. A fifth 2288 icon may indicate that an error has occurred with an instrument-specific component, such as knife bar 1320. Screen 2200 can be additionally configured to display any other type of Icon such as that indicating that a step or process complete or that an event has occurred, such as an error. The various icons can be configured to illuminate, become visible or change color when the situation is active or the event has occurred.
[0179] [0179] In some respects, screen 2200 can be configured to indicate whether a correct or incorrect type of cartridge has been loaded in end actuator 1500, that is, inserted into the elongated channel 1602 (Figure 10). The 1670 channel circuit can be configured to read or detect the type of cartridge that is received by the end actuator 1500 via a sensor or by an electrical communication between the 1670 channel circuit and the cartridge. In one aspect, the cartridges comprise a memory that stores an identifier or indicative value of the type of cartridge that is transmitted to the 1670 channel circuit by inserting the cartridge into the elongated channel 1602 of the end actuator 1500. The channel circuit 1670, which is communicably coupled to controller 2102, is configured to then transmit the cartridge type identifier or value to controller 2102. The logic executed by controller 2102 can then compare the type of cartridge with the type of cartridge expected. If the cartridge type and expected cartridge type are not compatible, then controller 2102 can cause screen 2200 to display a first 2290 icon. If the cartridge type and expected cartridge type are compatible, then , controller 2102 can cause screen 2200 to display a second icon 2292. In the aspect shown in Figures 38 to 39, the first icon 2290 corresponds to a staple cartridge that is inserted when an RF cartridge is expected and the second icon 2292 corresponds to an RF cartridge that is inserted when an RF cartridge is expected.
[0180] [0180] The various aspects of screen 2200 represented in Figures 26 to 39 can represent individual representations of a screen displayed to an operator or portions of a screen displayed to an operator. In several respects, operators can switch between the various screens through user action or the 2102 controller can automatically adjust the 2200 screen according to the operation of the 2100 surgical instrument. In several respects, the 2200 screen can include a graphical user interface that can be manipulated using, for example, a capacitive touchscreen.
[0181] [0181] Screen 2200 as described in the present invention can include one or more screens arranged on or connected with the surgical instrument to graphically display information captured by the various detection sets. In one aspect, the screen 2200 comprises a single screen positioned in the outer casing of the surgical instrument, as shown in Figure 1. In aspects that use multiple screens, the screens can be positioned adjacent to each other or separated from each other . The screen 2200 can be positioned directly on the surgical instrument, it can be removably connected to the surgical instrument, so that the screen 2200 is placed in signal communication with the controller when connected to the surgical instrument, or it can be otherwise, associated with the surgical instrument.
[0182] [0182] The monitoring functions or processes of the various situations of the surgical instrument through the various detection sets described here can be performed by any of the processing circuits, individually or in combination, described here, such as the plate integrated circuit 1152 described in connection with Figures 5 and 15, the channel circuit 1670 described in connection with Figure 10, the flexible circuit assemblies 1730L, 1730R described in connection with Figures 10 to 13, the controller 2080 described in connection with Figure 24 and controller 2102 described in connection with Figure 25.
[0183] [0183] Various aspects of the subject described in this document are defined in the following examples: Example 1. A surgical instrument comprising: a circuit configured to supply RF energy to a cartridge arranged in an end actuator configured to receive the cartridge; a closing mechanism configured to transition the end actuator between an open position and a closed position; a monitor; and a control circuit operationally coupled to the screen, the control circuit being configured to: determine an amount of RF energy released to a tissue through the cartridge; display the amount of RF energy on the screen; determine a position of the closing mechanism; and display the position of the closing mechanism on the screen.
[0184] [0184] In a surgical sealing and stapling system, it may be useful to employ a modular design that allows a single handle set to be attached to multiple nozzle sets, and that a nozzle set to be attached to multiple handle sets . Since the nozzle assembly would include the various surgical instruments on the end actuator, a special circuit on the nozzle may be required to allow instrumentation in a handle assembly to control the various functions on the end actuator of the modular nozzle assembly. In addition, it may be necessary to supply power to the end actuator, which may or may not originate from the handle assembly. For example, the handle assembly can be battery powered to control the functions of the handle assembly, but it may not have enough power to control the end actuator.
[0185] [0185] In some respects, an exclusive circuit system is included in the nozzle set that allows a user of the modular surgical instruments described here to manipulate the end actuator directly from the instrumentation contained in the handle set. The nozzle assembly can include an integrated circuit board that allows an electrosurgical generator to attach directly to the nozzle assembly and provide radio frequency (RF) energy to the end actuator, while also interfacing with the processor or circuit control of the handle set. In some respects, the exclusive nozzle assembly circuit also allows the drive shaft to rotate while still providing adequate power and functionality to the end actuator.
[0186] [0186] In one aspect, the connection of the surgical instrument to a generator allows certain functions of the drive shaft. For example, the fixation of RF conductive wires to the generator allows the integrated circuit board of the surgical instrument to isolate a part of the elongated drive shaft integral circuit wiring for applying RF to an interchangeable RF cartridge with stapling cartridges. The integrated circuit board is a segmented circuit configured to isolate the generator inputs (for example, RF energy, etc.) from the handle's electronic devices where appropriate. A flexible circuit contains electrical conductors with different geometries to accommodate the transfer of RF energy.
[0187] [0187] Referring to Figure 40, in some respects, the nozzle assembly 1240 that constitutes a modular portion of the surgical tool set 1000 may include a drive shaft module circuit uniquely configured to control various functions in the drive shaft assembly while also communicating with the handle set 500 and allows the RF generator 400 to be controlled from the powered staple handle. In Figure 40, the circuit of Figure 15 is shown in the context of an exemplary nozzle assembly 1240. The circuit according to some aspects of the present description includes integrated circuit board 1152 with several connectors. The female connectors 410 are electrically coupled to the 1152 circuit board, which allows connection to the male plug set 406 that mates with the generator 400, not shown.
[0188] [0188] In addition, the built-in power on / off switch 420 is electrically coupled to circuit board 1152 and positioned so that it is pressed when the nozzle assembly 1240 is attached to the handle assembly 500, according to some aspects . For example, when the nozzle assembly is locked in place (see, for example, Figure 9), the power on / off switch 420 can be positioned so that it faces proximally to the handle assembly. hard and can be pressed as the nozzle assembly slides into the handle assembly slot through the 514 lock connection (see Figure 9). In other cases, the power switch 420 is exposed so that it can be manually pressed by an operator of the surgical tool set 1000.
[0189] [0189] The circuit board 1152 includes the integrated connector 1154 configured to interface with the connector of the housing 562 (see Figure 9) in communication with the microprocessor 560 contained in the handle set 500. Thus, the set of handle 500 is able to control circuit board 1152 which controls various functions in the 1240 nozzle assembly. The circuit design in the 1240 nozzle assembly allows an operator to perform a variety of functions from the various controls of the assembly handgrip 500, as well as through the various controls and screen consoles available in the handgrip 500.
[0190] [0190] The 1152 circuit board also includes the 1153 proximal connector which is configured to interface with the 1150 slip ring assembly. Power can be supplied to the end actuator even while the drive shaft rotates due to the energy that the entire slip ring assembly 1150 is provided and the distal connector 1162 is in constant contact with the slip ring assembly as the 1164 drive shaft flexible circuit strip rotates within the 1910 proximal closing tube. 1164 drive shaft circuit can include several electrical conductors, such as the narrow electrical conductors 1166 for stapling-related activities, and the wider electrical conductors 1168 for RF purposes (see Figure 15).
[0191] [0191] Based on the various components described in the nozzle assembly 1240, circuit 1152 can be configured to control the RF generator 400 from the powered handle set 500, allowing communication with the various functions and interfaces of the - with handle 500, and allowing the operation of RF functions and stapling of the end actuator of the handle set 500. Other functions may include controlling a type of algorithm to perform various surgical procedures and energy applications on the end actuator , allowing the alert functionality visible in the 500 handle set of any part of the 1240 nozzle set, and vary the energy modulation from the RF generator
[0192] [0192] In some respects, the integrated circuit includes the segmented RF circuit 1160, which can allow RF energy from generator 400 to be supplied to the drive shaft flexible circuit strip through the slip ring assembly (see , for example, Figure 15). The RF generator can be coupled to the integrated circuit board 1152 via the segmented RF circuit 1160. The power on / off switch 420 can be similarly connected to the segmented RF circuit 1160.
[0193] [0193] Figure 41 illustrates a block diagram of a 3200 surgical system programmed to communicate energy and control signals with a 3250 end actuator in accordance with an aspect of the present description. In an exemplary aspect, the 3200 surgical system may include a 3210 control circuit (for example, microprocessor 560, segmented RF circuit 1160 or distal microchip 1740) that has an electrosurgical energy control segment (or a control segment 3220 drive shaft and a 3230 drive shaft control segment (for example, drive shaft segment (segment 5), motor circuit segment (segment 7) or power segment (segment 8)) . The 3210 control circuit can be programmed to supply electrosurgical energy (for example, RF energy) to the electrodes on the 3250 end actuator (for example, the 1500 end actuator). The 3200 surgical system may include one or more 3260 electrical conductors (for example, 1168 electrical conductors) used to supply electrosurgical energy,
[0194] [0194] The 3220 electrosurgical energy control segment can be programmed to supply electrosurgical energy to the electrodes via one or more 3260 electrical conductors. In an exemplary aspect, the 3230 drive shaft control segment can be programmed to provide and / or receive a control signal to / from the end actuator 3250 (and / or the surgical tool set 1000, the drive shaft set 704) via one or more 3260 electrical conductors. , the one or more 3260 electrical conductors can be used not only to supply electrosurgical energy to the 3250 end actuator, but also to communicate control signals with the 3250 end actuator. In an exemplary aspect, at least some portions of the segment electrosurgical energy control device 3220 and the 3230 drive shaft control segment can be electrically isolated from each other.
[0195] [0195] In an exemplary aspect, the 3220 electrosurgical energy control segment can electrically isolate one or more 3260 electrical conductors from the 3230 drive shaft control segment, for example, by supplying electrosurgical energy to the electrodes on the 3250 end actuator via one or more 3260 electrical conductors. In an exemplary aspect, the 3220 electrosurgical energy control segment can control a 3270 switch located between the one or more 3260 electrical conductors and the axis control segment 3230 drive by providing a signal via a 3280 control line to electrically isolate one or more 3260 electrical conductors from the 3230 drive shaft control segment. The 3270 switch can be configured to switch between an open state and a closed state. The control segment of the drive shaft 3230 and the one or more electrical conductors 3260 can be electrically isolated when the switch 3270 is in the open state and can be in electrical communication when the switch 3270 is in the closed state. In another exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate one or more electrical conductors 3260 from the control segment of the drive shaft 3230 in any other suitable manner. Other configurations of the 3270 switch may allow the electrical isolation of one or more 3260 electrical conductors from the 3230 drive shaft control segment by closing the 3270 switch.
[0196] [0196] In an exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate one or more electrical conductors 3260 from the control segment of the drive shaft 3230 when the 3210 control circuit detects that the electrosurgical energy generator 3240 is connected to the 3265 connector (for example, female connectors 410), for example, by continuously checking the 3265 connector or detecting the application of electrosurgical energy. For example, when the male plug set 406 is plugged into the female connectors 410, the electrosurgical energy control segment 3220 can isolate the electrical conductors 3260 from the control segment of the drive shaft 3230. In another exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate the one or more electrical conductors 3260 from the control segment of the drive shaft 3230 when electrosurgical energy is supplied to the 3250 end actuator or at any other suitable time.
[0197] [0197] In an exemplary aspect, the surgical system can include one or more 3290 electrical conductors (for example, 1166 electrical conductors) used to operate the 3250 end actuator (and / or the surgical tool set 1000, the set drive shaft 704). In an exemplary aspect, the one or more 3290 electrical conductors may not be used to release electrosurgical energy to the 3250 end actuator. The 3230 drive shaft control segment can be programmed to provide and / or receive an control to / from 3250 end actuator via one or more 3290 electrical conductors. In an exemplary aspect, the 3230 drive shaft control segment can use one or more 3290 electrical conductors to supply and / or receive the control signal to / from the 3250 end actuator while the 3270 switch is in an open state (for example, while the 3220 electrosurgical power control segment is supplying the electrosurgical power to the 3250 end actuator via one or more 3260 electrical conductors). In an exemplary aspect, the 3230 drive shaft control segment can also use one or more 3290 electrical conductors to supply and / or to receive the control signal to / from the 3250 end actuator while the 3270 switch is in a closed state.
[0198] [0198] The 3270 switch can be a transistor switch, a mechanical switch or any other suitable switch. In an exemplary aspect, the control signals communicated between the 3210 control circuit and the 3250 end actuator (and / or the surgical tool set 1000, the drive shaft set 704) through the 3260 electrical conductors , 3290 include, but are not limited to, signals to drive the 3250 end actuator (and / or the surgical tool set 1000, the drive shaft set 704) in cutting and / or coagulation operating modes, measuring the electrical characteristics of the 3200 surgical system and / or the tissue clamped on the 3250 end actuator, providing feedback for use, communication of sensor signals and identification of certain characteristics of the 3250 end actuator (for example, situation used / not used).
[0199] [0199] Consequently, aspects of the present description can advantageously reduce the number of electrical conductors required to communicate control signals between the 3210 control circuit and the 3250 end actuator (and / or the 1000 surgical tool set , the drive shaft assembly 704) through the use of some of the electrical conductors (for example, electrical conductors 3260) used to supply electrosurgical energy to communicate control signals when these electrical conductors are not used for electrosurgical energy. In addition, by isolating the electrical conductors from other circuit segments (for example, the 3230 drive shaft control segment) by supplying electrosurgical energy through these electrical conductors, aspects of this description can prevent electrosurgical energy flow into the other circuit segments and / or electrical conductors (for example, 3290 electrical conductors) connected to those circuit segments, preventing damage to those circuit segments and / or electrical conductors.
[0200] [0200] Various aspects of the subject described in this document are defined in the following examples: Example 1. A control circuit for a surgical instrument, the control circuit comprising: a drive shaft control segment; an electrosurgical energy control segment; and a connector coupled to the electrosurgical energy control segment configured to be coupled to an electrosurgical generator; the drive shaft control segment being configured to communicate with a handle portion of the surgical instrument; and receive user action controls; the electrosurgical energy control segment is configured to: detect the connection of the electrosurgical generator with the connector; communicate with the electrosurgical generator; electrically isolate the grip control segment from the electrosurgical energy control segment when the connection of the electrosurgical generator to the connector is detected; and supplying electrosurgical energy from the electrosurgical generator to a portion of the end actuator of the surgical instrument through a first set of electrical conductors.
[0201] [0201] In several open, endoscopic and / or laparoscopic surgeries, for example, it may be desirable to clot, seal and / or fuse the tissue. A method of sealing tissue relies on the supply of energy, such as electrical energy, for example, to tissue captured or pinned within an end actuator or end actuator set of a surgical instrument to cause thermal effects within the tissue. . Several surgical instruments and monopolar and bipolar radiofrequency (RF) surgical techniques have been developed for such purposes. In general, the supply of RF energy to the captured tissue can raise the temperature of the tissue and, as a result, the energy can at least partially denature the proteins within the tissue. Such proteins, such as collagen, for example, can be denatured into a proteinaceous amalgam that mixes and fuses, or seals, together as the proteins renature. As the treated region heals over time, this biological seal can be reabsorbed by the body's wound healing process.
[0202] [0202] In certain provisions of a bipolar radio frequency (RF) surgical instrument, the surgical instrument may comprise an opposing first and second jaw, each jaw may comprise an electrode. In use, the fabric can be captured between the claws, so that energy can flow between the electrodes on the opposite claws and through the fabric positioned between them. Such instruments may need to seal many types of tissue, such as anatomical structures that have walls with thick or irregular fibrous content, clusters of uneven anatomical structures and / or substantially thick or thin anatomical structures.
[0203] [0203] In general, it is difficult to supply electrosurgical energy to the low impedance fabric continuously until the welding of the fabric is substantially completed. For example, when supplying electrosurgical energy to low impedance tissue, there is a point at which the impedance of the tissue becomes too low, acting as a short circuit, so that the tissue merely absorbs a lot of current while supplying little or no electrosurgical energy to the tissue. This can result in a number of undesirable consequences, including, for example, incomplete welding of the tissue, excessive heating of the electrodes, a delay in surgery, inconvenience or frustration by the doctor, etc.
[0204] [0204] Aspects of this description can address the weakness noted above by controlling control circuits for an independent power supply across segmented sections.
[0205] [0205] In this way, the aspects of the present description can allow the surgical instrument to supply electrosurgical energy to the tissue that has low impedance until the welding of the low impedance tissue is substantially completed. In addition, aspects of the present description can advantageously use the microchip in the first claw or a processor in the body of the surgical instrument to alternate the electrosurgical energy between the two sets of electrodes using the RF energy from an energy generator. Conventional RF.
[0206] [0206] Figure 42 shows a schematic top view of a claw 3000 in an end actuator (for example, end actuator 1500) of a surgical instrument (for example, surgical system 10 or surgical tool set 1000) of according to one aspect of the present description. The claw 3000 may include a cartridge 3010, a flexible circuit 3020 that has flexible circuit contacts 3025 (for example, exposed contacts 1756) and an elongated slot 3030, within which a cutting member (for example, the knife 1330) is received in a sliding way to cut the clamped fabric within the end actuator along a cut line 3035. The elongated slit can extend from an adjacent end of the claw 3000. In an exemplary aspect, the flexible circuit 3020 can also include a microchip (for example, a distal 1740 microchip), and then the 3010 cartridge can be called a smart cartridge. The claw 3000 can also include a first set of electrodes 3040L, 3040R in a first zone 3060 and a second set of electrodes 3050L, 3050R in a second zone 3065. In an exemplary aspect, the first zone 3060 can be located in an adjacent portion of the claw 3000 and the second zone 3065 can be located in a distal portion of the claw 3000. In another exemplary aspect, the first zone 3060 and the second zone 3065 can be located in any other suitable locations of the claw 3000.
[0207] [0207] The first and second sets of electrodes 3040L, 3040R, 3050L, 3050R can be in communication with and / or deposited on the flexible circuit 3020. In one example, the elongated slot 3030 can be arranged in the central part of the claw 3000. In another example, the elongated slot 3000 can be arranged in any other suitable locations on the claw 3000. As seen in Figure 16, electrodes 3040L and 3050L can be located on the left side of elongated slot 3030 and electrodes 3040R and 3050R can be located on the right side of the elongated slot 3030. In an exemplary aspect, a control circuit (for example, the microprocessor 560, the segmented RF circuit 1160 or the distal microchip 1740) can be configured to supply electrosurgical energy to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R.
[0208] [0208] Electrosurgical energy may be in the form of radio frequency (RF) energy. RF energy is a form of electrical energy that can be in the frequency range of 200 kilohertz (kKHz) to 1 megahertz (MHz). In application, an electrosurgical device can transmit RF energy at low frequency through the tissue, which causes friction, or ionic agitation, that is, resistive heating, which, therefore, increases the temperature of the tissue. The low operating temperatures of the RF energy are useful for removing, shrinking or sculpting soft tissues while simultaneously cauterizing blood vessels. RF energy works particularly well in connective tissue, which mainly comprises collagen and shrinks when it comes in contact with heat. The first set of electrodes
[0209] [0209] In an exemplary aspect, the length 3070 of the first set of electrodes 3040L, 3040R can be in the range of about 10 mm to about 100 mm, preferably in the range of about 20 mm to about 50 mm, more preferably, in the range of about 25 mm to about 35 mm. Similarly, in an exemplary aspect, the length 3075 of the second set of electrodes 3050L, 3050R can be in the range of about 10 mm to about 100 mm and, preferably, in the range of about 20 mm to about 50 mm and, more preferably, in the range of about 25 mm to about 35 mm. In another exemplary aspect, the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can have any other suitable length. In an exemplary aspect, a gap between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be very small, so that the clamped tissue can be welded from the first zone 3060 to the second zone 3065 continuously without the fabrics located between the two zones 3060 and 3065 being sealed / welded. In an exemplary aspect, the length 3072 of the gap between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be in the range of about 0.1 mm to about 20 mm and, preferably, in the range from about 0.5 mm to about 5 mm and, more preferably, in the range from about 1 mm to about 3 mm. In another exemplary aspect, the length 3072 of the gap between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be any other suitable length. The total length 3080 of the first set of electrodes 3040L, 3040R, the second set of electrodes 3050L, 3050R and the span can be in the range of about 20 mm to about 210 mm and, preferably, in the range of about 60 mm to about 100 mm, more preferably, in the range of about 50 mm to about 70 mm.
[0210] [0210] In an exemplary aspect, the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be electrically coupled to the wider electrical conductors 1168 from which the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can receive electrosurgical energy (for example, RF energy). The first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be electronically coupled to a plurality of electrical conductors (for example, electrical conductors 1732L and 1732R) in the flexible circuit 3020 through which the electrical conductors are broad 1168 can provide RF energy for the 3040L, 3040R, 3050L, 3050R electrodes. In an exemplary aspect, each of the electrodes 3040L, 3040R, 3050L, 3050R can be connected separately to the control circuit (for example, microchip 1740) through a different electrical conductor. For example, a first electrical conductor for the left 1722L electrical conductors can be connected to the 3040L electrode and a second electrical conductor for the 1732L left electrical conductors can be connected to the 3050L electrode. Similarly, a first electrical conductor for the 1732R straight electrical conductors can be connected to the 3040R electrode and a second electrical conductor for the 1732R straight electrical conductors can be connected to the 3050R electrode.
[0211] [0211] In an exemplary aspect, the 3000 jaw can include a multiplexer to address the 3040L, 3040R, 3050L, 3050R electrodes individually. The multiplexer can be included in the control circuit (for example, microprocessor 560, segmented RF circuit 1160 or distal microchip 1740) or located between the control circuit and electrodes 3040L, 3040R, 3050L, 3050R. The multiplexer can distribute the electrosurgical energy to the 3040L, 3040R, 3050L, 3050R electrodes under the control of the control circuit. In an exemplary aspect, the multiplexer can be configured to detect a short circuit of the 3040L, 3040R, 3050L, 3050R electrodes, for example, caused by a metal clamp line or another electrically conductive object left in the tissue from a previous instrument trigger or surgical procedure, and electrosurgical energy can be modulated appropriately for the short circuit. In an exemplary aspect, electrical conductors 1168, 1732L, 1732R can be isolated to protect components (for example, a 1740 microchip, a back column assembly 1250, laminated plates 1322, a flexible circuit 3020) adjacent to the conductors electrical 1168, 1732L, 1732R from inadvertent RF energy. In an exemplary aspect, the 3010 cartridge can be interchangeable. When the cartridge is changed, the narrow and wider electrical conductors 1166, 1168 in the surgical instrument can be connected to the new electrical conductors and electrodes in the new cartridge.
[0212] [0212] In an exemplary aspect, the cutting member (for example, knife member 1330) can be coupled directly or indirectly to a motor (for example, the 505 motor). When the control circuit supplies voltage to the motor, the cutting member can be advanced to the first zone 3060 or to the second zone 3065 to cut the fabric in the first and second zones 3060, 3065.
[0213] [0213] Figure 43 shows a graph 3100 that represents the voltage applied to the electrodes 3040L, 3040R, 3050L, 3050R as a function of time according to a non-limiting aspect. Pulses 3110 can represent the voltage applied to electrodes 3040L, 3040R in the first zone 3060. Pulses 3120 can represent the voltage applied to electrodes 3050L, 3050R in the second zone 3065. When the voltage is connected to the first zone 3060 , electrosurgical energy can be applied to the tissue adjacent to the first set of 3040L, 3040R electrodes to form a welding / coagulation line in it. Similarly, when the voltage is connected to the second zone 3065, electrosurgical energy can be applied to the tissue adjacent to the second set of electrodes 3050L, 3050R to form a welding / coagulation line in it. As shown in Figure 43, in an exemplary aspect, the control circuit can apply an alternatively established voltage across all alternation cycles. Then, the power / energy applied to the tissue can be changed as the tissue's importance changes. In another exemplary aspect, the control circuit or generator 400 can change the voltage applied to the electrodes (for example, 30 volts during the first 5 cycles, 50 volts during the next 5 cycles, 80 volts during the next 5 cycles ). In another exemplary aspect, the control circuit or generator 400 can alter the voltage applied to the electrodes to provide constant power to the tissue. In that case, the voltage can be changed as the tissue impedance changes.
[0214] [0214] In an exemplary aspect, electrosurgical energy can alternate repeatedly between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R in a predetermined time interval. For example, electrosurgical energy can be supplied to the first set of 3040L, 3040R electrodes for a first period of time (for example, 0.25 seconds) and then to the second set of 3050L, 3050R electrodes for a second period - time mode (for example, 0.25 seconds). It can then be switched back to the first set of electrodes 3040L, 3040R and the alternation of electrosurgical energy between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be repeated, for example, up to that the impedance of the clamped tissue reaches a predetermined impedance value. In an exemplary aspect, the predetermined time interval can be in the range of about 0.05 seconds to about 0.5 seconds, preferably in the range of about 0.1 seconds to about 0.4 seconds, more preferably, in the range of about 0.2 second to about 0.3 second. In another exemplary aspect, the predetermined time interval can have any other suitable period of time. In an exemplary aspect, the predetermined time interval for the alternation of electrosurgical energy may be fast enough that the supply of electrosurgical energy to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R simultaneously.
[0215] [0215] In an exemplary aspect, the alternation of electrosurgical energy can be initiated when the on / off switch for the built-in energy 420 is turned on and the alternation can continue without an input from a user of the electrosurgical device until the | turn on / off the built-in power 420 is switched off. The power on / off switch 420 can be automatically turned off when the measured fabric impedance reaches a predetermined impedance value (for example, an impedance value that indicates that the fixed fabric is completely sealed). The number of cycles (for example, n times) of alternating electrosurgical energy that are required to achieve the predetermined impedance value can vary depending on several parameters, including the type of tissue, the thickness of the tissue, how much moisture is in the fabric, etc.
[0216] [0216] In an exemplary aspect, as shown in Figure 43, the time interval for the first set of electrodes 3040L, 3040R can be the same as the time interval for the second set of electrodes 3050L, 3050R. In another exemplary aspect, the time interval for the first set of electrodes 3040L, 3040R may be different from the time interval for the second set of electrodes 3050L, 3050R. For example, the time interval for the first set of electrodes 3040L, 3040R can be 0.3 seconds, while the time interval for the second set of electrodes 3050L, 3050R can be 0.2 seconds. That is, in this case, the electrosurgical energy can be supplied to the first set of electrodes 3040L, 3040R for 0.3 seconds, then, for the second set of electrodes 3050L, 3050R for 0.2 seconds, then this repeat is repeated alternation. In an exemplary aspect, the predetermined time interval may decrease over time. For example, the predetermined time interval can be 0.3 seconds at the beginning (for example, for a couple of cycles), 0.2 seconds afterwards (for the next cycles), 0.1 seconds afterwards ( for the next cycles before the fabric begins to complete the weld or be welded). In another exemplary aspect, the predetermined time interval may increase over time.
[0217] [0217] Figure 41 illustrates a block diagram of a 3200 surgical system programmed to communicate energy and control signals with a 3250 end actuator in accordance with an aspect of the present description. In an exemplary aspect, the 3200 surgical system may include a 3210 control circuit (for example, microprocessor 560, segmented RF circuit 1160 or distal microchip 1740) that has an electrosurgical energy control segment (or a control segment 3220 drive shaft and a 3230 drive shaft control segment (for example, drive shaft segment (segment 5), motor circuit segment (segment 7) or power segment (segment 8)) . The 3210 control circuit can be configured to deliver electrosurgical energy (for example, RF energy) to the electrodes (for example, 3040L, 3040R, 3050L, 3050R electrodes) on the 3250 end actuator (for example, the 1500 end actuator) . The 3200 surgical system can include one or more 3260 electrical conductors (for example, 1168 electrical conductors) used to supply electrosurgical energy from a 3240 electrosurgical energy generator (for example, the RF 400 generator), while actuator 3250. The one or more 3260 electrical conductors can be electrically connected between the 3250 end actuator and the 3210 control circuit (for example, the 3220 electrosurgical power control segment and the drive shaft control segment 3230). The 3230 drive shaft control segment can store control programs in a memory and control sensors and outputs, for example.
[0218] [0218] The 3220 electrosurgical energy control segment can be configured to supply electrosurgical energy to the electrodes through one or more 3260 electrical conductors. In an exemplary aspect, the 3230 drive shaft control segment can be configured to provide and / or receive a control signal to / from the end actuator 3250 (and / or the surgical tool set 1000, the drive shaft set 704) through one or more electrical conductors 3260. That is, the one or more 3260 electrical conductors can be used not only to supply electrosurgical energy to the 3250 end actuator, but also to communicate control signals with the 3250 end actuator. In an exemplary aspect, at least some portions of the segment electrosurgical energy control device 3220 and the 3230 drive shaft control segment can be electrically isolated from each other.
[0219] [0219] In an exemplary aspect, the 3220 electrosurgical energy control segment can electrically isolate one or more 3260 electrical conductors from the 3230 drive shaft control segment, for example, by supplying electrosurgical energy to the electrodes on the 3250 end actuator via one or more 3260 electrical conductors. In an exemplary aspect, the 3220 electrosurgical energy control segment can control a 3270 switch located between the one or more 3260 electrical conductors and the axis control segment 3230 drive by providing a signal via a 3280 control line to electrically isolate one or more 3260 electrical conductors from the 3230 drive shaft control segment. The 3270 switch can be configured to switch between an open state and a closed state. The control segment of the drive shaft 3230 and the one or more electrical conductors 3260 can be electrically isolated when the switch 3270 is in the open state and can be in electrical communication when the switch 3270 is in the closed state. In another exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate one or more electrical conductors 3260 from the control segment of the drive shaft 3230 in any other suitable manner. Other configurations of the 3270 switch may allow the electrical isolation of one or more 3260 electrical conductors from the 3230 drive shaft control segment by closing the 3270 switch.
[0220] [0220] In an exemplary aspect, the 3220 electrosurgical energy control segment can electrically isolate one or more 3260 electrical conductors from the 3230 drive shaft control segment when the 3210 control circuit detects that the electrosurgical energy generator 3240 is connected to the 3265 connector (for example, female connectors 410), for example, by continuously checking the 3265 connector or detecting the application of electrosurgical energy. For example, when the male plug set 406 is plugged into the female connectors 410, the electrosurgical energy control segment 3220 can isolate the electrical conductors 3260 from the control segment of the drive shaft 3230. In another exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate the one or more electrical conductors 3260 from the control segment of the drive shaft 3230 when electrosurgical energy is supplied to the 3250 end actuator or at any other suitable time.
[0221] [0221] In an exemplary aspect, the surgical system can include one or more 3290 electrical conductors (for example, 1166 electrical conductors) used to operate the 3250 end actuator (and / or the surgical tool set 1000, the set drive shaft 704). In an exemplary aspect, the one or more 3290 electrical conductors may not be used to release electrosurgical energy to the 3250 end actuator. The 3230 drive shaft control segment can be programmed to provide and / or receive an control to / from 3250 end actuator via one or more 3290 electrical conductors. In an exemplary aspect, the 3230 drive shaft control segment can use one or more 3290 electrical conductors to supply and / or receive the control signal to / from the 3250 end actuator while the 3270 switch is in an open state (for example, while the 3220 electrosurgical power control segment is supplying the electrosurgical power to the 3250 end actuator via one or more 3260 electrical conductors). In an exemplary aspect, the 3230 drive shaft control segment can also use one or more 3290 electrical conductors to supply and / or to receive the control signal to / from the 3250 end actuator while the 3270 switch is in a closed state.
[0222] [0222] The 3270 switch can be a transistor switch, a mechanical switch, an electromechanical switch, a relay or any other suitable switch. In an exemplary aspect, the control signals communicated between the control circuit 3210 and the end actuator 3250 (and / or the surgical tool set 1000, the drive shaft set 704) through electrical conductors 3260, 3290 include, but are not limited to, signals to drive the 3250 end actuator (and / or the surgical tool set 1000, the drive shaft set 704) in cutting and / or coagulating operating modes measurement, measuring the electrical characteristics of the 3200 surgical system and / or the tissue clamped on the 3250 end actuator, providing re-information for use, communicating sensor signals and identifying certain characteristics of the 3250 end actuator (for example , used / unused situation).
[0223] [0223] Consequently, aspects of the present description can advantageously reduce the number of electrical conductors needed to communicate control signals between the 3210 control circuit and the 3250 end actuator (and / or the 1000 surgical tool set , the drive shaft assembly 704) through the use of some of the electrical conductors (for example, electrical conductors 3260) used to supply electrosurgical energy to communicate control signals when these electrical conductors are not used for electrosurgical energy. In addition, by isolating the electrical conductors from other circuit segments (for example, the 3230 drive shaft control segment) by supplying electrosurgical energy through these electrical conductors, aspects of this description can prevent electrosurgical energy flow into the other circuit segments and / or electrical conductors (for example, 3290 electrical conductors) connected to those circuit segments, preventing damage to those circuit segments and / or electrical conductors.
[0224] [0224] In an exemplary aspect, the control circuit can include two modes of operation, Mode | and Mode Il. In Mode |, the control circuit can cut the fabric when or after fabric welding is completed. In Mode 2, the control circuit can cut the fabric while fabric welding is in progress. Examples of such modes are described in more detail below and as shown in Figures 44 to 49.
[0225] [0225] Figure 44 is a logic flow diagram representing a 4500 process from a control program or a logical configuration for operating the surgical instrument according to Mode | Although the 4500 example process is described with reference to the logical flowchart illustrated in Figure 44, it will be understood that many other methods for performing the acts associated with the method can be used. For example, the order of some of the blocks can be changed, certain blocks can be combined with other blocks and some of the described blocks are optional.
[0226] [0226] In the example illustrated and with reference also to Figure 18, a control circuit 610 (Figure 18) can receive 4510 information about tissue impedance. For example, the control circuit 610 may include an impedance feedback circuit and measure the impingance of the clamped tissue on the end actuator 602 (for example, the end actuator 1500), such as, for example, the tissue adjacent to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R. In an exemplary aspect, control circuit 610 can measure tissue impedance periodically (for example, every 0.1 second, every 0.5 second or every second). In another exemplary aspect, the control circuit
[0227] [0227] Then, at some points, the control circuit 610 can determine 4530 that the tissue impedance reaches a predetermined impedance value. For example, the predetermined impedance value may be a value that indicates that the tissue adjacent to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R is substantially or completely welded or coagulated. Control circuit 610 can determine that fabric welding is substantially complete by comparing the measured fabric impedance with the predetermined termination impedance value. Then, the control circuit 610 can interrupt 4540 the supply of electrosurgical energy to the first set of electrodes and the second set of electrodes. Then, the control circuit 610 can advance a cutting member 4550, such as the i-profile beam 614, to cut the fabric. In an exemplary aspect, the control circuit 610 can advance the cutting member (for example, i-profile beam 614) to the first zone 3060 to cut the fabric in the first zone 3060 and then to the second zone 3065 to cutting the fabric in the second zone 3065. In another exemplary aspect, the control circuit 610 can cut the fabric in the first zone 3060 and in the second zone 3065 at the same time.
[0228] [0228] Figure 45 shows a 4600 plot of a 4605 tissue impedance curve as a function of time. The tissue impedance curve 4605 can represent a change in the impedance of the tissue clamped on the end actuator 1500 when the control circuit 610 (Figure 18) is operating in Mode |. As shown in Figure 45, tissue impedance tends to follow a common "bath" pattern, decreasing at the start of the power switch for a first time 4625 (for example, 0.3 to 1.5 seconds) , reaching a minimum impedance value (Zvm) in the first time (t1) 4615 and then increasing during a second time period 4630 (for example, 0.3 to 1.5 seconds) as the clamped fabric is being welded. Then, the tissue impedance can reach a point 4610 in a second time (t2) 4620, and the impedance of the fabric at point 4610 is equal to a predetermined termination impedance (Z71).
[0229] [0229] In the first time period 4625, the tissue impedance drops from an initial value and decreases, for example, it has a negative slope, until it reaches the minimum impedance value (Zw) since, after the energy is applied to the fabric for a certain period, the moisture content of the fabric evaporates, causing the fabric to dry out and causing the impedance of the fabric to start to increase, for example, the positive slope then in the second time period 4630, until the fabric impedance reaches the predetermined terminating impedance Z71, at which point in time, the power to the end actuator can be turned off. In an exemplary aspect, the impedance of the tissue can maintain the minimum impedance Zm for a certain period of time (for example, 0.5 to 5 seconds), with the impedance curve of the 4605 tissue almost aligning during that period of time. If electrosurgical energy (for example, RF energy) is applied continuously instead of being turned off at the 4610 terminating impedance point, the tissue impedance may increase by continuously passing the point
[0230] [0230] In an exemplary aspect, the predetermined termination impedance (Z7) can correspond to a point where the tissue adjacent to the 3040L, 3040R, 3050L, 3050R electrodes can be substantial or completely welded in order to cut the tissue ( for example, blood vessel) without bleeding. The predetermined terminating impedance can be stored in a surgical instrument memory device (for example, surgical system 10 or surgical tool set 1000).
[0231] [0231] When the tissue impedance reaches the predetermined termination impedance, the control circuit can interrupt the supply of electrosurgical energy for the first set of electrodes 3040L, 3040R and for the second set of electrodes 3050L, 3050R, resulting in a sudden drop in tissue impedance at t2
[0232] [0232] Figure 47 is a logic flow diagram representing a 4700 process from a control program or a logical configuration for operating the surgical instrument according to Mode Il. Although the 4700 example process is described with reference to the logic flow diagram shown in Figure 47, it will be understood that many other methods for performing the acts associated with the method can be used. For example, the order of some of the blocks can be changed, certain blocks can be combined with other blocks and some of the blocks described are optional.
[0233] [0233] In the illustrated example and with reference also to Figure 18, a control circuit 610 can receive 4710 information about the importance of the fabric. For example, control circuit 610 can measure the impedance of the clamped tissue on end actuator 602 (for example, end actuator 1500). In an exemplary aspect, the 610 control circuit can measure the tissue impedance periodically (for example, every 0.1 second, every 0.5 second or every second). In another exemplary aspect, control circuit 610 can measure tissue impedance at random or in any other suitable way. The 610 control circuit can supply 4720 electrosurgical energy to a first set of electrodes in an adjacent portion of a claw and a second set of electrodes in a distal portion of the claw, the supply of electrosurgical energy alternating between the first set of electrodes and the second set of electrodes in a predetermined time interval. For example, the 610 control circuit can supply electrosurgical energy to the first set of 3040L, 3040R electrodes and the second set of 3050L, 3050R electrodes
[0234] [0234] Then, at some points, the control circuit 610 may determine 4730 that the tissue impedance reaches a predetermined impedance value. For example, the predetermined impedance value can be a value that indicates that the welding of the tissue adjacent to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R begins to be completed. Then, the control circuit 610 can advance the cutting member 4740, such as the i-profile beam 614, to cut the tissue in the adjacent portion while supplying electrosurgical energy to the first set of electrodes and the second set of electrodes. After cutting the tissue in the adjacent portion of the jaw, control circuit 610 can advance the cutting member 4740 (for example, the i-profile beam 614) to cut the tissue in the distal portion while supplying electrosurgical energy to the second set of electrodes.
[0235] [0235] In an exemplary aspect, the control circuit 610 can advance the cutting member 4750 (for example, the beam with i-profile 614) to cut the tissue in the distal portion while supplying electrosurgical energy to both the first set electrodes 3040L, 3040R as for the second set of electrodes 3050L, 3050R. In another exemplary aspect, the 610 control circuit can interrupt the supply of electrosurgical energy to the first set of electrodes after cutting the tissue in the adjacent portion and supply electrosurgical energy only to the second set of electrodes while cutting the tissue in the portion distal. In this case, the supply of electrosurgical energy to the second set of electrodes 3050L, 3050R can still be discontinuous. For example, electrosurgical energy can be supplied to the second set of electrodes 3050L, 3050R for a given
[0236] [0236] In another exemplary aspect, the 610 control circuit can interrupt the supply of electrosurgical energy to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R after cutting the tissue in the first zone. In this case, no electrosurgical energy can be supplied to the tissue while cutting the tissue in the second zone 3065. In an exemplary aspect, the 610 control circuit can interrupt the supply of electrosurgical energy to the first set of electrodes 3040L, 3040R and to the second set of electrodes 3050L, 3050R when the impedance of the tissue reaches a predetermined value of termination impedance while cutting the tissue in the first zone 3060 and / or the second zone 3065.
[0237] [0237] Figure 48 shows a 4800 plot of an 4805 tissue impedance curve as a function of time. The tissue impedance curve 4805 can represent a change in the impedance of the tissue clamped on the end actuator 1500 when the control circuit is operating in Mode Il. As seen in Figure 45, the impedance of the fabric here also tends to follow a common "bathtub" pattern, decreasing at the beginning of the power switch (for example, between the first set of 3040L, 3040R electrodes and the second electrodes 3050L, 3050R) for a first period of time
[0238] [0238] In an exemplifying aspect, when the fabric impedance reaches the minimum impedance value (Zvm), an impedance change rate (for example, decrease) can become approximately zero, as shown in Figure 45 Welding of the clamped fabric can begin to be completed at this point. In an exemplary aspect, in Mode Il, the control circuit can begin to advance the cutting member when the tissue impedance reaches the minimum impedance value (Zm). For example, the control circuit can determine that the tissue impedance reaches the minimum impedance value (Zm) when the impedance change rate (for example, decrease) becomes approximately zero. In another exemplary aspect, in Mode Il, the control circuit can begin to advance the cutting member at any other suitable time before the clamped tissue is completely welded. If the tissue impedance maintains the minimum impedance over a period of time (for example, 0.5 to 5 seconds), the control circuit can begin to advance the cutting member at any suitable time during that period. time (for example, at the beginning / middle / end of the flat curve).
[0239] [0239] As shown in Figure 49, and with reference also to Figure 18, control circuit 610 can supply voltage 4860 to motor 604 (for example, motor 505) to cut the fabric in the first zone 3060 when or after impedance of fabric reaches the minimum impedance value (Zvm) before fabric welding is completed. The termination impedance Zr1: can represent the fabric impedance at the conclusion of the cut in a second time (t2) 4825. Then, the control circuit can supply voltage 4870 to motor 604 (for example, motor 505) to cut the fabric in the second zone 3065 after cutting the fabric in the first zone 3060. The termination impedance Zr2 can represent the impedance of the fabric at the conclusion of the cut in a third time (ta) 4830. The impedance curve 4805 can suffer a drop near the second time 4825 just after cutting the tissue in the first zone 3060, because the pinched tissue may be wet with some fluids (eg blood or any other body fluids) that are produced when cutting the tissue in the first zone 3060. Thus, although the measured impedance value 4805 may appear to drop after cutting the tissue in the first zone 3060, the actual tissue impedance may not drop, but may be similar to or greater than Z11 throughoutthe third time period 4845. As the moisture content of the tissue evaporates causing the tissue to dry out due to the electrosurgical energy applied to the clamped tissue during the third time period 4845, the measured impedance value can also increase rapidly to reflect the impedance of the actual tissue.
[0240] [0240] In an exemplary aspect, the control circuit 610 can consider the amount of time required to cut the pinched fabric on the end actuator 602 in determining when to start advancing the cutting member, such as the beam with profile in i 614. For example, if it takes 1 second to cut the fabric in the first zone 3060, the control circuit 610 can start advancing the cutting member (for example, the beam with i 614 profile) around 1 second before the fabric impedance reaches a predetermined termination impedance value (the fabric welding is normally completed around this time) so that the soldering of the fabric is substantially completed the moment the cutting of the fabric is completed. fabric in the first zone 3060 is completed. In another example, the cutting speed can be adjusted so that the welding of the fabric is substantially completed by the end of the cut. For example, if it takes 0.5 seconds from the moment that the fabric impedance reaches the minimum impedance until the moment that it reaches the termination impedance (for example, when the fabric welding is completed), the speed cutting edge can be adjusted so that it takes 0.5 seconds to cut the fabric in the first and second zones 3060, 3065.
[0241] [0241] As explained above, in an exemplary aspect, the 610 control circuit can provide electrosurgical energy for both the first set of 3040L, 3040R electrodes and the second set of 3050L, 3050R electrodes while cutting the tissue in se - second zone 3065 during the third time period 4845. In this case, since the pinched tissue received additional electrosurgical energy for the third time period 4845, the termination impedance Zr2 in the third time 4830 may be higher than the termination impedance Zr1 in the second half 4825, as seen in Figure 48.
[0242] [0242] In an exemplary aspect, the 610 control circuit can interrupt the supply of electrosurgical energy to the first set of electrodes after cutting the tissue in the first zone 3060 and supply the electrosurgical energy only to the second set of electrodes. electrodes while cutting the tissue in the second zone 3065. In that case, the termination impedance of the tissue in the second zone 3065 may be greater than the termination impedance of the tissue in the first zone 3060 since the tissue in the second zone 3065 received more electrosurgical energy for the third time period 4845 than the tissue in the first zone 3060, assuming that the predetermined time intervals for the two sets of electrodes are equal.
[0243] [0243] The functions or processes 4500, 4700 described herein can be performed by any of the processing circuits described here, such as control circuit 700 described in connection with Figures 16 to 17, control circuit 610 described in connection with Figure 18.
[0244] [0244] Various aspects of the subject described in this document are defined in the following examples: Example 1. A surgical instrument comprising: an end actuator comprising: a first jaw comprising a distal portion and an adjacent portion; a second claw that is movable in relation to the first claw; and at least one electrode in the first claw; a control circuit configured to supply electrosurgical energy to at least one electrode, the control circuit comprising a drive shaft control segment and an electrosurgical energy control segment; and a first electrical conductor electrically connected between the end actuator and the control circuit; the drive shaft control segment being configured to provide a control signal to operate the end actuator for the end actuator through the first electrical conductor; the electrosurgical energy control segment being configured to supply electrosurgical energy to at least one electrode through the first electrical conductor.
[0245] [0245] In some respects, an electrosurgical device may have a pivotable drive shaft to allow a user to adjust an angle of an end actuator with respect to a handle assembly to access tissues in any orientation with respect to the user . The electrical signals exchanged between the end actuator and the handle assembly must be clear, regardless of the type or extent of the drive shaft joint.
[0246] [0246] Typical electrical wires that pass between the handle assembly and an end actuator can become entangled and potentially cut over time due to repeated flexing of the articulated drive shaft. Therefore, the present description provides a flexible circuit element that can withstand repeated articulation of the drive shaft and any other mechanical movements necessary to operate the electrosurgical device end actuator.
[0247] [0247] As shown in Figure 14, the 1164 drive shaft flexible circuit strip may be arranged in part within the proximal closing tube 1910 and extend through the 1920 connector into the surgical end actuator 1500 Similarly, knife bar 1320 can also be arranged in part within the proximal closing tube 1910 and extends through the hinge connector 1920 into the surgical end actuator 1500. The flexible shaft strip of drive shaft 1164 can be centrally supported between the laminated plates or bars 1322 that form knife bar 1320. Such an arrangement facilitates sufficient flexing of knife bar 1320 and the flexible circuit strip of drive shaft 1164 during articulation of end actuator 1500 while remaining sufficiently rigid to allow the knife member 1330 to be advanced distally through the clamped fabric. Together, the drive shaft flexible circuit strip 1164 and the laminated plates or bars 1322 that form knife bar 1320 can comprise a flexible assembly to allow knife bar 1320 to reciprocate while the hinge connector 1920 is flexed .
[0248] [0248] Figure 50 represents, in more detail, an aspect of a flexible set 3500. In the aspect of flexible set 3500 represented in Figure 50, knife bar 1320 is composed of two pairs of laminated plates 1322, with a pair of laminated plates 1322 is arranged along a first side of the flexible shaft strip 1164 and a second pair of laminated plates 1322 is arranged along a second side of the flexible shaft strip 1164 Although knife bar 1320 is revealed to have two pairs of laminated plates 1322, it can be recognized that knife bar 1320 can consist of any even number of laminated plates 1322, with a first half of the even number of laminated plates 1322 is arranged along a first side of the drive shaft flexible circuit strip 1164 and a second half of the even number of laminated plates 1322 is arranged along a second side of the strip d and flexible drive shaft circuit 1164.
[0249] [0249] As shown in Figure 10, the drive shaft flexible circuit strip 1164 includes a distal contact portion 1169 that can be in electrical communication with a contact portion 1672 of a 1670 channel circuit disposed within a wall recess 1625 formed in one of the channel walls 1622 of the elongated channel 1602. In this way, the distal end of the flexible shaft strip of drive shaft 1164 can be in a fixed position in relation to the elongated channel 1602 of the surgical end actuator 1500. As shown in Figure 15, a proximal end of the drive shaft flexible circuit strip 1164 may be in electrical communication with a distal connector 1162 of a slip ring assembly 1150 disposed in the assembly tool frame
[0250] [0250] Knife bar 1320 can similarly pass through the hinge connector 1920 from a connection proximal to the portion of the intermediate firing drive shaft 1310 disposed in the nozzle assembly 1240 relative to a distal connection on knife member 1330, as shown in Figure 3. Knife bar 1320 can therefore be configured to reciprocate in order to activate knife member 1330 while it is flexible enough to be flexed when the hinge connector 1920 articulates.
[0251] [0251] It can be recognized that the reciprocating action of knife bar 1320 along the sides of the 1164 drive shaft flexible circuit strip can cause friction and / or abrasion of any electrical traces or wires disposed on the strip. flexible drive shaft circuit
[0252] [0252] As shown in Figure 50, this protection can be provided by one or more leaf springs 3505 arranged on opposite sides of the 1164 drive shaft flexible circuit strip. Each leaf spring 3505 can be arranged between one side of the strip drive shaft flexible circuit 1164 and an inner side of a laminated plate 1322. Leaf springs 3505 can remain fixed in relation to drive shaft flexible circuit strip 1164, and can therefore protect each side of the strip 1164 drive shaft flexible circuit against wear from knife bar 1320 during positioning of knife member 1330. Each blade spring 3505 can also provide physical support for the 1164 drive shaft flexible strip In addition, each leaf spring 3505 can provide a restoring force to the 1164 drive shaft flexible circuit strip to return the drive shaft flexible circuit strip 1164 for essentially longitudinal (or non-flexed) geometry when the end actuator 1500 is returned to a position coaxial with the drive axis of the electrosurgical device. It can be recognized that, in some aspects, the flexible assembly 3500 may also include one or more of such leaf springs 3505 in addition to the drive shaft flexible circuit strip 1164 and the plurality of laminated plates 1322.
[0253] [0253] Figure 51A represents the flexible assembly 3500 disposed within an electrosurgical device, in which the knife member 1330 is disposed in a proximal knife position 3530. Figure 51A represents the flexible assembly 3500 disposed within the electro device - surgical, in which knife member 1330 is disposed in a distal knife position 3531. Although the articulation of the drive shaft of the electrosurgical device is shown in a right direction (from the perspective of using the device) in Figures 51A and 51B, it must be recognized that the articulation of a drive axis of the electrosurgical device can also be in a left direction (from the perspective of using the device), with the components of the flexible set 3500 flexed properly in the left direction.
[0254] [0254] Figure 51A is similar to Figure 14 and also highlights additional details. For example, a proximal end of the flexible assembly 3500 can be stabilized within the back column assembly 1250 disposed within the proximal closing tube (1910, see Figure 14). The distal end of the flexible assembly 2500 can be stabilized within the proximal end portion 1610 of the elongated channel (1602, see Figure 4). The distal contact portion 1169 of the drive shaft flexible circuit strip 1164 can be either electrically or physically coupled to the proximal contact portion 1672 of the channel circuit (1670, see Figure 10).
[0255] [0255] As shown in Figure 51A, the knife member can be located in a 3530 proximal knife position. In a non-limiting aspect, the 3530 proximal knife position of the knife member can have a proximal knife distance (PKD, "proximal knife distance"), for example, measured from a proximal end of the knife member to a distal end of the distal contact portion 1169 of the drive shaft flexible circuit strip 1164. Figure 51B depicts the knife member located in a distal knife position
[0256] [0256] As revealed above, the distal end of the 1164 drive shaft flexible circuit strip can be in a fixed position relative to the surgical end actuator 1500, and the proximal end of the 1164 drive shaft flexible circuit strip can be be in a fixed position in relation to the tool frame assembly 1200. In addition, the leaf springs 3505 can remain in a fixed position in relation to the 1164 drive shaft flexible strip. In a non-limiting aspect , a first leaf spring 3505 can be arranged adjacent or against a first side of the 1164 drive shaft flexible circuit strip, and a second leaf spring 3505 can be arranged adjacent or against a second side or opposite side of the strip drive shaft flexible circuit 1164. As knife bar 1320 moves knife member 1330 to distal knife position 3531 or proximal knife position 3530, laminated plates 1322 from knife bar 1320 slide in a longitudinal direction with respect to the fixed position of the 1164 drive shaft flexible circuit strip and the 3505 leaf springs.
[0257] [0257] While knife bar 1320 is in a proximal aspect and knife member 1330 is in the proximal knife position 3530, a portion of the first pair of laminated plates 1322 may be located in a first proximal position 1322a over a external side of a first leaf spring 3505, and a portion of the second pair of laminated plates 1322 may be located in a second proximal position 3522b along an external side of a second leaf spring 3505. In this configuration, in the portion of the strip with flexible circuit of drive shaft 1164 and a portion of the leaf springs 3505 separate those portions of the laminated plates 1322 located in the first proximal position 3522a and in the second proximal position 3522b. When knife bar 1320 is moved distally, so that knife member 1330 is in distal knife position 3531, the portion of the first pair of laminated plates 1322 located in the first proximal position 3522a can traverse in the distal direction up to a first distal position 3522c. Similarly, when knife bar 1320 is moved distally, so that knife member 1330 is in distal knife position 3531, the portion of the second pair of laminated plates 1322 located in the second proximal position 3522b can pass through in the distal direction to a second 3522d distal position. In this way, at least some portion of the laminated plates 1322 moves slidingly in relation to the leaf springs 3505.
[0258] [0258] As a result of the movement of knife bar 1320 in the distal direction, the portion of the first pair of laminated plates in the first distal position 3522c and the portion of the second pair of laminated plates in the second distal position 3522d are no longer separated by drive shaft flexible circuit strip 1164 and leaf springs 3505. In this way, an internal surface of the portion of the first pair of laminated plates in the first distal position 3522c can come in contact with an internal surface of the portion of the second pair of laminated plates in the second distal position 3522d when knife bar 1320 is moved in the distal direction.
[0259] [0259] Similarly, it can be understood that when knife bar 1320 is moved in a proximal direction, thus moving knife member 1330 from distal knife position 3531 to proximal knife position 3530, the portion of the first pair of laminated plates 1322 located in the first distal position 3522c can traverse in the proximal direction to the first proximal position 3522a. Similarly, when knife bar 1320 is moved in a proximal direction, the portion of the second pair of laminated plates 1322 located in the second distal position 3522d can traverse in the proximal direction to the second proximal position 3522b. As a result of the movement of the knife bar 1320 in the proximal direction, the portion of the first pair of laminated plates in the first proximal position 3522a and the portion of the second pair of laminated plates in the second proximal position 3522b can be separated by the leaf springs 3505 and a 1164 drive shaft flexible circuit strip.
[0260] [0260] Figures 52A and 52B represent the flexible set 3500 of Figures 51A and 51B independent of structures that can accommodate the flexible set 3500 in an electrosurgical device. In particular, Figure 52A represents a flexible, non-articulated assembly 3501 (dotted line) and a flexible, articulated assembly 3502 after a joint to the right RA. Figure 52B represents the effect of movement of knife bar 1320 in a distal direction DD, thus moving knife member 1330 from proximal knife position 3530 to distal knife position 3531. Figure 52B further represents the effect of a movement of knife bar 1320 in a proximal direction PD, thus moving knife member 1330 from distal knife position 3531 to proximal knife position 3530.
[0261] [0261] As shown above with reference to Figures 51 and 52A, B, a flexible assembly 3500 may include a flexible circuit strip of drive shaft 1164 disposed between a pair of leaf springs 3505 and a knife bar 1320 comprising two pairs of laminated plates 1322, a pair of laminated plates 1322 being arranged along an outer surface of each of the leaf springs 3505. Such leaf springs 3505 can provide protection for the flexible strip strip surfaces drive shaft 1164 against abrasion and wear caused by reciprocating movement of laminated plates 1322. In an alternative aspect, flexible assembly 3500 can be removed from the pair of leaf springs 3505, and laminated plates 1322 can be arranged directly against the sides of the 1164 drive shaft flexible circuit strip. The movement of the 1322 laminated plates against the sides of the 1164 drive shaft flexible circuit strip can include such movements as revealed above in detail with respect to Figures 52A, B. Such an alternate aspect of a 3500 flexible assembly without leaf springs 3505 can be used for a flexible 3500 assembly in which the drive shaft flexible circuit strip 1164 includes a protective coating on its sides, thus removing the need for 3505 protective leaf springs.
[0262] [0262] It may be further recognized that the 3500 flexible assembly disclosed above may be useful in an electrosurgical device that includes an end actuator configured to include a surgical clamp / clamp cartridge, a radio frequency (RF) cartridge or to accept in a manner a surgical staple / clamp cartridge or a radio frequency (RF) cartridge is releasable.
[0263] [0263] Aspects of a flexible set configured for use within an electrosurgical system that comprises an articulable drive shaft are presented above. The flexible assembly can comprise a hinge connector and include a flexible drive shaft circuit strip configured to be flexed according to the hinge connector bending. The flexible shaft strip of the drive shaft can be configured to allow the communication of electrical signals from a handle assembly at a proximal end of the drive shaft pivotable to an end actuator at a distal end of the drive shaft articulable. The flexible assembly can also include one or more components configured to move transversely along a longitudinal geometric axis of the pivotable drive axis to control one or more end actuator operations. The flexible assembly may also include additional components configured to support or protect the flexible drive strip of the drive shaft and / or the components configured to move in a transverse manner along the longitudinal geometric axis of the drive shaft .
[0264] [0264] Although a flexible set is described in relation to a motor-driven surgical system, as shown in Figures 1 to 15 and as revealed above, it can be recognized that a flexible set may not be limited to a surgical system that has the specific functions or components of such a motor-operated surgical system. Such a flexible assembly can be incorporated into any surgical system that comprises at least one drive shaft articulated with a body or handle assembly at a proximal end of the drive shaft and an end actuator at a distal end of the drive shaft articulable.
[0265] [0265] In this way, a flexible circuit strip of the drive shaft of a flexible assembly can be configured to conduct any one or more electrical signals including electrical DC signals (DC current), electrical AC signals (alternating current), digital electrical signals, analog electrical signals, electrical RF signals or any combination or combinations of such electrical signals. The drive shaft flexible circuit strip can comprise any non-conductive material on which or in which any number, type or size of conductive wires or traces are arranged. The drive shaft flexible circuit strip can comprise any number of layers. The drive shaft flexible circuit strip can additionally comprise any one or more electronic components, such as separate circuits (for example, resistors, capacitors and inductors) or integrated circuits. The drive shaft flexible circuit strip may additionally include protective layers to cover the one or more conductive wires or traces and / or electronic components. The flexible assembly may include one or more springs, such as leaf springs, arranged on one or more sides of the drive shaft flexible circuit strip to provide a restoring force after the surgical system is returned from an articulated position . Alternatively, the drive shaft flexible strip can incorporate such leaf springs into the body of the drive shaft flexible strip.
[0266] [0266] Components configured to move in a transverse manner along the longitudinal geometry axis of the pivotable drive shaft may include any number or type of component or components capable of both a transverse movement and a bending movement flexible. Non-limiting examples of such components may include flexible wires, bands, plates and shafts. One or more of these components configured to move transversely can be included in the flexible assembly. Multiple components can move in a harmonized way or can move independently. Multiple components can be arranged along a single side of the drive shaft flexible circuit strip. Alternatively, some of the multiple components can be arranged along a first side of the drive shaft flexible strip, while a different number of the multiple components can be arranged along a second side of the flexible shaft strip drive. The components configured to move in a transverse way can be operationally coupled to any moving components at a proximal end or a distal end of the articulated drive shaft, without limitation on the functions of such moving components.
[0267] [0267] The flexible assembly may also include any number or type of components configured to protect or support the drive shaft flexible circuit strip and / or the components configured to move across. For example, additional components can include any number or type of component configured to protect one or more surfaces of the drive shaft flexible circuit strip, including, for example, protective sheets or sheaths. Additional components may include a frame to support the drive shaft flexible circuit strip. The additional components can also include protective housings for the configured components to move in a transverse way like cannulas.
[0268] [0268] Various aspects of the subject described in this document are defined in the following numbered examples: Example 1. A surgical system powered by an engine comprising: a handle assembly; and a set of interchangeable surgical tools, operationally coupled to the handle set, which comprises: a mouthpiece set; a proximal closing tube that has a proximal end operatively coupled to a distal end of the nozzle assembly; a hinge connector that has a proximal end operatively coupled to a distal end of the proximal closing tube; a surgical end actuator comprising a first claw and a second claw and having a proximally coupled end operatively attached to a distal end of the hinge connector; a flexible shaft strip of drive shaft disposed within at least a portion of the proximal closing tube, at least a portion of the hinge connector and at least a portion of the surgical end actuator; a knife member slidably disposed within the surgical end actuator; and a knife bar operatively connected to a proximal end of the knife member, the knife bar comprising a first laminated plate disposed on a first side of the drive shaft flexible circuit strip and a second laminated plate disposed on a second side of the flexible axis strip of drive shaft, and the knife bar is configured to reciprocate along a longitudinal geometric axis of the proximal closing tube.
[0269] [0269] In some respects, an electrosurgical device can be configured to induce a hemostatic seal in a tissue and / or between tissues. The hemostatic seal can be created by a combination of a compressive force applied to the tissue and a supply of electrical energy to the tissue. In some aspects of an electrosurgical device, the compression force can be provided by compressing the tissue between sets of jaws. In addition, electrical energy can be supplied by one or more electrodes arranged inside or on some components of the claw sets. The amount of electrical energy sufficient to effect hemostatic sealing may depend, in part, on the thickness, density and / or quality of the tissue to be sealed.
[0270] [0270] It can be understood that an excessive supply of electrical energy to a fabric can result in burning or marking of the fabric. However, insufficient electrical supply to a tissue can result in an ineffective hemostatic seal. Thus, it may be necessary for a user of the electrosurgical device to adjust the amount of electrical energy released to the tissue compressed between the device's clamp sets based on the thickness, density and quality of the tissue. If a compressed tissue between the clamp assemblies is essentially homogeneous, the user of the electrosurgical device can use simple controls to adjust the amount of electrical energy supplied to the tissue. However, it can be recognized that some fabrics for hemostatic sealing are not homogeneous in any one or more of their thickness, density and / or quality. As a result, a single control over the amount of electrical energy supplied to the compressed tissue between the claw assemblies can result in burnt portions and insufficiently sealed portions of the tissue. Consequently, it is desirable to have an electrosurgical device that can be configured to apply a variety of electrical energies to a piece of compressed tissue between the claw assemblies.
[0271] [0271] Electrosurgical instruments apply electrosurgical energy to seal the tissue. However, at times, the fabric can be sealed with staples applied by a staple cartridge, and at other times, the fabric can be sealed by supplying electro-
[0272] [0272] Figure 53 is a perspective view of the surgical system
[0273] [0273] As shown in Figure 53, surgical system 4000 includes a handle set 4006 and an exchangeable tool set 4008 that can be attached to the handle set 4006. The handle set 4006 is similar or identical to the handle set -
[0274] [0274] Figure 54 is a partial cross section of the end actuator 4010 of the surgical system 4000 according to various aspects, and shows the interface between the radio frequency cartridge 4002 and the anvil 4018 when the end actuator 4010 is in a completely closed position. For clarity purposes, the elongated channel 4016 is not shown in Figure 54. The radio frequency cartridge 4002 is similar to the radio frequency cartridge 1700, however, it is different in the sense that the radio frequency cartridge 4002 includes a platform surface of cartridge 4020 which defines at least two protrusions 4022. Although only one of protrusions 4022 is shown in the cross section of Figure 54, it will be understood that a first one of protrusions 4022 is positioned on one side of an elongated slot centrally arranged 4024 of the radio frequency cartridge 4002 to a second protrusion 4022 is positioned on the opposite side of the elongated centrally arranged slot
[0275] [0275] The radio frequency cartridge 4002 is also different from the radio frequency cartridge 1700, in the sense that the radio frequency cartridge 4002 includes insulating shell members 4026 that define, respectively, the 4028 protrusions that are associated with the 4022 protrusions Although only one of the insulating enclosure members 4026 and one of the protuberances 4028 are shown in the cross section of Figure 54, it will be understood that a first of the insulating enclosure members 4026 and a first of the protuberances 4028 are positioned in one side of the elongated slot centrally arranged 4024 of the radio frequency cartridge 4002, and a second of the insulating housing members 4026 and a second of the protrusions 4028 are positioned on the opposite side of the elongated slot centrally arranged from the radio frequency cartridge 4002 ( see, for example, Figure 55). The protrusions 4028 are positioned between the protrusions 4022 of the cartridge platform surface 4020 and the anvil 4018 of the interchangeable tool set 4008.
[0276] [0276] The radio frequency cartridge 4002 is also different from the radio frequency cartridge 1700 in that the radio frequency cartridge 4002 additionally includes flexible circuit assemblies 4030 that respectively define the 4032 protrusions that are associated with the 4022 protrusions and the protrusions 4028. Although only one of the 4030 flexible circuit assemblies and one of the 4032 protrusions are shown in the cross section of Figure 54, it will be understood that a first of the 4030 flexible circuit assemblies and a first of the 4032 protrusions are positioned in one side of the elongated slot centrally arranged 4024 of the
[0277] [0277] When the T fabric (Figure 6) is positioned between the radio frequency cartridge 4002 and the anvil 4018, the anvil 4018 is moved towards the radio frequency cartridge 4002 to clamp the fabric positioned between the radio frequency cartridge 4002 and the anvil 4018, the minimum span or the distance d, between the anvil 4018 and the radio frequency staple cartridge 4002 adjacent to the distal end of the end actuator 4010 are made when the insulating material 1819 positioned in the segments facing the fabric 1817 of the anvil forming surface 1813 of the anvil 4018 is placed in physical contact with the protrusions 4032. Once this physical contact between the insulating material 1819 and the protrusions 4032 is established, the protrusions 4032 physically prevent ( 1) that the anvil 4018 is brought closer to the radiofrequency cartridge 4002 and (2) that the tissue is additionally compressed. The establishment of this minimum span or distance d1 also operates to help prevent the formation of an electrical short circuit between the radio frequency cartridge 4002 and the anvil 4018.
[0278] [0278] An example of an RF cartridge that routes RF energy through tissue from an electrode to an internal surface of a staple pocket is shown in Figures 6 and 7. Consequently, briefly returning to Figures 6 and 7, a partial cross-sectional view of the end actuator 1500 shown in Figures 1 to 5 is shown, which supports an RF cartridge 1700 (Figures 12), 4002 (Figures 53 and 55) in it and with the fabric T clamped between cartridge 1400 (Figure 4) and anvil 1810 and a partial cross-sectional view of anvil 1810. In the example shown in Figures 6 and 7, anvil 1810 comprises a non-conductive masking, except in pockets 1814, so that all surfaces that are not for the formation of staples are masked and coated with an electrically non-conductive insulating material 1819, creating a surface of variable return path containing cavities and an extension that minimizes the scorching and adhesion of the you experienced by opposing flat electrodes.
[0279] [0279] Figure 55 is a partial perspective view of the radio frequency cartridge 4002 supported by the elongated channel 4016 according to several aspects. As described above, the radio frequency cartridge 4002 includes flexible circuit assemblies 4030 and protrusions 4032 on each side of the centrally arranged elongated slot 4024. For clarity purposes, the insulating enclosure members 4026 are not shown in Figure 55. Additionally, it should be considered that the protrusions 4022, 4028 are hidden from view in Figure 55.
[0280] [0280] Figure 56 is an exploded perspective view of portions of the handle set 4006 and the set of interchangeable tools 4008 according to various aspects. The handle set 4006 is similar or identical to the handle set 500. The set of interchangeable tools 4008 is similar to the set of interchangeable tools 1000, but is different in that the portion of the firing system 4004 associated with the the interchangeable tool set 4008 is different from the portion of the firing system 1300 associated with the interchangeable tool system 1000. The portion of the firing system 4004 associated with the grip set 4006 is similar or identical to the portion of the firing system 1300 associated with the handle assembly 500. The portion of the trigger system 4004 associated with the handle assembly 4006 includes a trigger system 4034 that includes a longitudinal drive member 4036. The longitudinal drive member 4036 has a tooth rack 4038 formed on it and has a 4040 fixing support at its distal end. The trigger drive system 4034, the longitudinal drive member 4036, the tooth rack 4038 and the fixing bracket 4040 are similar or identical to the trigger drive system 530, the longitudinal drive member 540, the tooth rack. parts 542 and the coupling support 544 of the firing system 1300.
[0281] [0281] The firing system portion 4004 associated with the interchangeable tool set 4008 includes a nozzle assembly 4042, a portion of the intermediate firing drive shaft 4044, an ear fixing the firing drive shaft 4046, a bar knife 4048, a firing member / knife member 4050 and a proximal closing tube 4054 which are similar or identical to the nozzle assembly 1240, to the portion of the intermediate firing drive shaft 1310, to the ear fixing shaft of firing drive 1314, knife bar 1320, firing member / knife member 1330 and proximal closing tube 1910. However, the firing system portion 4004 associated with the interchangeable tool set 4008 is different from the firing portion trigger 1300 associated with the interchangeable tool set 1000 in the sense that the portion of the trigger system 4004 associated with the interchangeable tool set 4008 additionally includes u m electrically insulating material 4056 (an electrically non-conductive conductive material) that works to prevent radio frequency energy from inadvertently passing from the portion of the trigger system 4004 associated with the set of interchangeable tools 4008 to the handle set
[0282] [0282] According to various aspects, the electrically insulating material 4056 is a coating that covers the ear of the 4046 firing drive shaft. When the ear of the 4046 firing drive shaft is seated on the fixation 4040 within the handle set 4006, the electrically insulating material 4056 operates to electrically isolate the longitudinal drive member 4036 from the trigger drive system 4034 and the handle set 4006 from the interchangeable tool set 4008. In other words, the longitudinal drive member 4036 and the handle set 4006 are protected against the inadvertent receipt of radio frequency energy from the set of interchangeable tools 4008. According to other aspects, the electrically insulating material 4056 it can also cover other portions of the 4004 firing system to electrically isolate the 4036 longitudinal drive member and handle 4006 of the interchangeable tool set 4008. For example, the electrically insulating material 4056 can also cover other portions of a proximal end 4058 of the 4044 intermediate drive shaft portion. several portions of the 4004 firing system associated with the set of 4008 interchangeable tools with the electrically insulating material
[0283] [0283] Various aspects of the subject described in this document are defined in the following numbered examples: Example 1. A set of interchangeable tools comprising: a first claw configured to hold a staple cartridge for a first period of time and a cartridge radio frequency for a second period of time; a second claw coupled to the first claw, with a surface of the second claw defining a plurality of staple forming pockets configured to form staples driven from the staple cartridge; and an electrically insulating material that covers segments of the second claw surface in addition to the staple forming pockets, with the staple forming pockets defining at least one return path for the radio frequency energy released by the radio frequency cartridge.
[0284] [0284] In several open, endoscopic and / or laparoscopic surgeries, for example, it may be desirable to clot, seal and / or fuse the tissue. A method of sealing tissue relies on the supply of energy, such as electrical energy, for example, to tissue captured or pinned within an end actuator or end actuator set of a surgical instrument to cause thermal effects within the tissue. . Several surgical instruments and monopolar and bipolar radiofrequency (RF) surgical techniques have been developed for such purposes. In general, the supply of RF energy to the captured tissue can raise the temperature of the tissue and, as a result, the energy can at least partially denature the proteins within the tissue. Such proteins, such as collagen, for example, can be denatured into a proteinaceous amalgam that mixes and fuses, or seals, together as the proteins renature. As the treated region heals over time, this biological seal can be reabsorbed by the body's wound healing process.
[0285] [0285] In certain provisions of a bipolar radio frequency (RF) surgical instrument, the surgical instrument may comprise an opposing first and second jaw, each jaw may comprise an electrode. In use, the fabric can be captured between the claws, so that energy can flow between the electrodes on the opposite claws and through the fabric positioned between them. Such instruments may need to seal many types of tissue, such as anatomical structures that have walls with thick or irregular fibrous content, clusters of uneven anatomical structures and / or substantially thick or thin anatomical structures.
[0286] [0286] In general, it is difficult to supply electrosurgical energy to the low impedance fabric continuously until the welding of the fabric is substantially completed. For example, when supplying electrosurgical energy to low impedance tissue, there is a point at which the impedance of the tissue becomes too low, acting as a short circuit, so that the tissue merely absorbs a lot of current while supplying little or no electrosurgical energy to the tissue. This can result in several undesirable consequences including, for example, incomplete welding of the tissue, excessive heating of the electrodes, a delay in surgery, inconvenience or frustration by the doctor, etc.
[0287] [0287] Aspects of the present description can address the weakness noted above by controlling control circuits for an independent power supply across segmented sections. In an exemplary aspect, a surgical instrument can include an end actuator that has a first jaw with a distal portion and an adjacent portion, a second jaw that is movable in relation to the first jaw, a first set of electrodes located in the distal portion of the first claw and a second set of electrodes located in the portion close to the first claw. The surgical instrument may also include a control circuit programmed to deliver electrosurgical energy (eg, RF energy) to the first set of electrodes and the second set of electrodes. The electrosurgical energy supplied to the first set of electrodes and the second set of electrodes can be alternated repeatedly between the first set of electrodes and the second set of electrodes in a predetermined time interval. For example, electrosurgical energy can be supplied to the first set of electrodes for a first period of time (for example, 0.25 seconds), to the second set of electrodes for a second period of time (for example, 0.25 second) after the first period of time and then to the first set of electrodes for a third period of time (0.25 seconds), and so on. The alternation of electrosurgical energy between the first set of electrodes and the second set of electrodes can be repeated, for example, until the welding of the fabric begins to be completed or is substantially completed. Alternating electrosurgical energy in a very short period of time (for example, 0.25 seconds) between the first set of electrodes and the second set of electrodes can facilitate the complete welding of low impedance tissue without excessive heating of the electrodes or a delay in surgery. In one example, this alternation of electrosurgical energy can be performed by a microchip in the first claw or a processor in the body of the surgical instrument using the RF energy supplied from a conventional RF energy generator.
[0288] [0288] In this way, the aspects of this description can allow the surgical instrument to supply electrosurgical energy to the fabric that has low impedance until the welding of the low impedance tissue is substantially completed. In addition, aspects of the present description can advantageously use the microchip in the first claw or a processor in the body of the surgical instrument to alternate the electrosurgical energy between the two sets of electrodes using the RF energy from an energy generator. Conventional RF.
[0289] [0289] Figure 42 shows a schematic top view of a 3000 claw on an end actuator (for example, 1500 end actuator) of a surgical instrument (for example, surgical system 10 or surgical tool set 1000) according to one aspect of the present description. The claw 3000 may include a cartridge 3010, a flexible circuit 3020 that has flexible circuit contacts 3025 (for example, exposed contacts 1756) and an elongated slot 3030, within which a cutting member (for example, the knife 1330) is received in a sliding way to cut the clamped fabric within the end actuator along a cut line 3035. The elongated slit can extend from an adjacent end of the claw 3000. In an exemplary aspect, the flexible circuit 3020 can also include a microchip (for example, a distal 1740 microchip), and then the 3010 cartridge can be called a smart cartridge. The claw 3000 can also include a first set of electrodes 3040L, 3040R in a first zone 3060 and a second set of electrodes 3050L, 3050R in a second zone 3065. In an exemplary aspect, the first zone 3060 can be located in an adjacent portion of the claw 3000 and the second zone 3065 can be located in a distal portion of the claw 3000. In another exemplary aspect, the first zone 3060 and the second zone 3065 can be located in any other suitable locations of the claw 3000.
[0290] [0290] The first and second sets of electrodes 3040L, 3040R, 3050L, 3050R can be in communication with and / or deposited on the flexible circuit 3020. In one example, the elongated slot 3030 can be arranged in the central part of the claw 3000. In another example, the elongated slot 3000 can be arranged in any other suitable locations on the claw 3000. As seen in Figure 42, electrodes 3040L and 3050L can be located on the left side of elongated slot 3030, and electrodes 3040R and 3050R can be located on the right side of the elongated slot 3030. In an exemplary aspect, a control circuit (for example, the microprocessor 560, the segmented RF circuit 1160 or the distal microchip 1740) can be configured to supply electrosurgical energy to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R.
[0291] [0291] Electrosurgical energy may be in the form of radio frequency (RF) energy. RF energy is a form of electrical energy that can be in the frequency range of 200 kilohertz (kKHz) to 1 megahertz (MHz). In application, an electrosurgical device can transmit RF energy at low frequency through the tissue, which causes friction, or ionic agitation, that is, resistive heating, which, therefore, increases the temperature of the tissue. The low operating temperatures of the RF energy are useful for removing, shrinking or sculpting soft tissues while simultaneously cauterizing blood vessels. RF energy works particularly well in connective tissue, which mainly comprises collagen and shrinks when it comes in contact with heat. The first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be electronically connected to the control circuit via flexible circuit 3020. The first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be configured to emit RF energy to form a hemostatic line (or a coagulation) in the tissue adjacent to the 3040L, 3040R, 3050L, 3050R electrodes along the 3035 cut line.
[0292] [0292] In an exemplary aspect, the length 3070 of the first set of electrodes 3040L, 3040R can be in the range of about 10 mm to about 100 mm, preferably in the range of about 20 mm to about 50 mm, more preferably, in the range of about 25 mm to about 35 mm. Similarly, in an exemplary aspect, the length 3075 of the second set of electrodes 3050L, 3050R can be in the range of about 10 mm to about 100 mm and, preferably, in the range of about 20 mm to about 50 mm and, more preferably, in the range of about 25 mm to about 35 mm. In another exemplary aspect, the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can have any other suitable length. In an exemplary aspect, a gap between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be very small, so that the clamped tissue can be welded from the first zone 3060 to the second zone 3065 continuously without the fabrics located between the two zones 3060 and 3065 being sealed / welded. In an exemplary aspect, the length 3072 of the gap between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be in the range of about 0.1 mm to about 20 mm and, preferably, in the range from about 0.5 mm to about 5 mm and, more preferably, in the range from about 1 mm to about 3 mm. In another exemplary aspect, the length 3072 of the gap between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be any other suitable length. The total length 3080 of the first set of electrodes 3040L, 3040R, the second set of electrodes 3050L, 3050R and the span can be in the range of about 20 mm to about 210 mm and, preferably, in the range of about 60 mm to about 100 mm, more preferably, in the range of about 50 mm to about 70 mm.
[0293] [0293] In an exemplary aspect, the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be electrically coupled to the wider wires 1168 from which the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can receive electrosurgical energy (for example, RF energy). The first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be electronically coupled to a plurality of wires (for example, wires 1732L and 1732R) in flexible circuit 3020 through which the wider wires 1168 can supply the RF energy to the 3040L, 3040R, 3050L, 3050R electrodes. In an exemplary aspect, wires 1168, 1732L, 1732R can be isolated to protect components (for example, a 1740 microchip, a back column assembly 1250, laminated plates 1322, a flexible circuit 3020) adjacent to wires 1168, 1732L, 1732R against inadvertent RF energy. In an exemplary aspect, the 3010 cartridge can be interchangeable. When the cartridge is changed, the narrow and wider wires 1166, 1168 in the surgical instrument can be connected to the new wires and electrodes in the new cartridge.
[0294] [0294] In an exemplary aspect, the cutting member (for example, knife member 1330) can be coupled directly or indirectly to a motor (for example, the 505 motor). When the control circuit supplies voltage to the motor, the cutting member can be advanced to the first zone 3060 or to the second zone 3065 to cut the fabric in the first and second zones 3060, 3065.
[0295] [0295] Figure 43 shows a 3100 graph representing the voltage applied to the 3040L, 3040R, 3050L, 3050R electrodes as a function of time according to a non-limiting aspect. Pulses 3110 can represent the voltage applied to electrodes 3040L, 3040R in the first zone 3060. Pulses 3120 can represent the voltage applied to electrodes 3050L, 3050R in the second zone 3065. When the voltage is connected to the first zone 3060 , electrosurgical energy can be applied to the tissue adjacent to the first set of 3040L, 3040R electrodes to form a welding / coagulation line in it. Similarly, when the voltage is connected to the second zone 3065, electrosurgical energy can be applied to the tissue adjacent to the second set of electrodes 3050L, 3050R to form a welding / coagulation line in it. As shown in Figure 43, in an exemplary aspect, the control circuit can apply an alternatively established voltage across all alternation cycles. Then, the power / energy applied to the tissue can be changed as the tissue's importance changes. In another exemplary aspect, the control circuit or generator 400 can change the voltage applied to the electrodes (for example, 30 volts during the first 5 cycles, 50 volts during the next 5 cycles, 80 volts during the next 5 cycles ). In another exemplary aspect, the control circuit or generator 400 can alter the voltage applied to the electrodes to provide constant power to the tissue. In that case, the voltage can be changed as the tissue impedance changes.
[0296] [0296] In an exemplifying aspect, electrosurgical energy can alternate repeatedly between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R in a predetermined time interval. For example, electrosurgical energy can be supplied to the first set of 3040L, 3040R electrodes for a first period of time (for example, 0.25 seconds) and then to the second set of 3050L, 3050R electrodes for a second period - time mode (for example, 0.25 seconds). It can then be switched back to the first set of electrodes 3040L, 3040R and the alternation of electrosurgical energy between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be repeated, for example, up to that the impedance of the clamped tissue reaches a predetermined impedance value. In an exemplary aspect, the predetermined time interval can be in the range of about 0.05 seconds to about 0.5 seconds, preferably in the range of about 0.1 seconds to about 0.4 seconds, more preferably, in the range of about 0.2 second to about 0.3 second. In another exemplary aspect, the predetermined time interval can have any other suitable period of time. In one
[0297] [0297] In an exemplary aspect, the alternation of electrosurgical energy can be initiated when the built-in power on / off switch 420 is turned on and the switch can continue without input from a user of the electrosurgical device until the | turn on / off the built-in power 420 is switched off. The power on / off switch 420 can be automatically turned off when the measured fabric impedance reaches a predetermined impedance value (for example, an impedance value that indicates that the fixed fabric is completely sealed). The number of cycles (for example, n times) of alternating electrosurgical energy that are required to achieve the predetermined impedance value can vary depending on several parameters, including the type of tissue, the thickness of the tissue, how much moisture is in the fabric, etc.
[0298] [0298] In an exemplary aspect, as shown in Figure 43, the time interval for the first set of electrodes 3040L, 3040R can be the same as the time interval for the second set of electrodes 3050L, 3050R. In another exemplary aspect, the time interval for the first set of electrodes 3040L, 3040R may be different from the time interval for the second set of electrodes 3050L, 3050R. For example, the time interval for the first set of electrodes 3040L, 3040R can be 0.3 seconds, while the time interval for the second set of electrodes 3050L, 3050R can be 0.2 seconds. That is, in this case, the electrosurgical energy can be supplied for the first set of 3040L, 3040R electrodes for 0.3 seconds, then, for the second set of 3050L, 3050R electrodes for 0.2 seconds, then repeat this alternation. In an exemplary aspect, the predetermined time interval may decrease over time. For example, the predetermined time interval can be 0.3 seconds at the beginning (for example, for a couple of cycles), 0.2 seconds afterwards (for the next cycles), 0.1 seconds afterwards ( for the next cycles before the fabric begins to complete the weld or be welded). In another exemplary aspect, the predetermined time interval may increase over time.
[0299] [0299] In an exemplary aspect, the control circuit can include two modes of operation, Mode | and Mode Il. In Mode |, the control circuit can cut the fabric when or after fabric welding is completed. In Mode 2, the control circuit can cut the fabric while fabric welding is in progress. Examples of such modes are described in more detail below and as shown in Figures 44 to 49.
[0300] [0300] Figure 41 illustrates a block diagram of a 3200 surgical system programmed to communicate energy and control signals with a 3250 end actuator in accordance with an aspect of the present description. In an exemplary aspect, the 3200 surgical system may include a 3210 control circuit (for example, microprocessor 560, segmented RF circuit 1160 or distal microchip 1740) that has an electrosurgical energy control segment (or a control segment 3220 drive shaft and a 3230 drive shaft control segment (for example, drive shaft segment (segment 5), motor circuit segment (segment 7) or power segment (segment 8)) . The 3210 control circuit can be programmed to supply electrosurgical energy (for example, RF energy) to the electrodes on the 3250 end actuator
[0301] [0301] The 3220 electrosurgical energy control segment can be programmed to supply electrosurgical energy to the electrodes via one or more 3260 electrical conductors. In an exemplary aspect, the 3230 drive shaft control segment can be programmed to provide and / or receive a control signal to / from the end actuator 3250 (and / or the surgical tool set 1000, the drive shaft set 704) via one or more 3260 electrical conductors. , the one or more 3260 electrical conductors can be used not only to supply electrosurgical energy to the 3250 end actuator, but also to communicate control signals with the 3250 end actuator. In an exemplary aspect, at least some portions of the segment electrosurgical energy control device 3220 and the 3230 drive shaft control segment can be electrically isolated from each other.
[0302] [0302] In an exemplary aspect, the 3220 electrosurgical energy control segment can electrically isolate one or more 3260 electrical conductors from the 3230 drive shaft control segment, for example, by supplying electrosurgical energy to the electrodes on the 3250 end actuator via one or more 3260 electrical conductors. In an exemplary aspect, the 3220 electrosurgical energy control segment can control a 3270 switch located between the one or more 3260 electrical conductors and the axis control segment 3230 drive by providing a signal via a 3280 control line to electrically isolate one or more 3260 electrical conductors from the 3230 drive shaft control segment. The 3270 switch can be configured to switch between an open state and a closed state. The control segment of the drive shaft 3230 and the one or more electrical conductors 3260 can be electrically isolated when the switch 3270 is in the open state and can be in electrical communication when the switch 3270 is in the closed state. In another exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate one or more electrical conductors 3260 from the control segment of the drive shaft 3230 in any other suitable manner. Other configurations of the 3270 switch may allow the electrical isolation of one or more 3260 electrical conductors from the 3230 drive shaft control segment by closing the 3270 switch.
[0303] [0303] In an exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate one or more electrical conductors 3260 from the control segment of the drive shaft 3230 when the 3210 control circuit detects that the electrosurgical energy generator 3240 is connected to the 3265 connector (for example, female connectors 410), for example, by continuously checking the 3265 connector or detecting the application of electrosurgical energy. For example, when the male plug set 406 is plugged into the female connectors 410, the electrosurgical energy control segment 3220 can isolate the electrical conductors 3260 from the control segment of the drive shaft 3230. In another exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate the one or more electrical conductors 3260 from the control segment of the drive shaft 3230 when electrosurgical energy is supplied to the 3250 end actuator or at any other suitable time.
[0304] [0304] In an exemplary aspect, the surgical system may include one or more 3290 electrical conductors (for example, 1166 electrical conductors) used to operate the 3250 end actuator (and / or the surgical tool set 1000, the set drive shaft 704). In an exemplary aspect, the one or more 3290 electrical conductors may not be used to release electrosurgical energy to the 3250 end actuator. The 3230 drive shaft control segment can be programmed to provide and / or receive an control to / from 3250 end actuator via one or more 3290 electrical conductors. In an exemplary aspect, the 3230 drive shaft control segment can use one or more 3290 electrical conductors to supply and / or receive the control signal to / from the 3250 end actuator while the 3270 switch is in an open state (for example, while the 3220 electrosurgical power control segment is supplying the electrosurgical power to the 3250 end actuator via one or more 3260 electrical conductors). In an exemplary aspect, the 3230 drive shaft control segment can also use one or more 3290 electrical conductors to supply and / or receive the control signal to / from the 3250 end actuator while the 3270 switch is in a closed state.
[0305] [0305] The 3270 switch can be a transistor switch, a mechanical switch or any other suitable switch. In an exemplary aspect, the control signals communicated between the 3210 control circuit and the 3250 end actuator (and / or the surgical tool set 1000, the drive shaft set 704) through the 3260 electrical conductors , 3290 include, but are not limited to, signals to drive the 3250 end actuator (and / or the surgical tool set 1000, the drive shaft set 704) in cutting and / or coagulation operating modes, measuring the electrical characteristics of the 3200 surgical system and / or the tissue clamped on the 3250 end actuator, providing feedback for use, communication of sensor signals and identification of certain characteristics of the 3250 end actuator (for example, situation used / not used).
[0306] [0306] Consequently, aspects of the present description can advantageously reduce the number of electrical conductors needed to communicate control signals between the 3210 control circuit and the 3250 end actuator (and / or the 1000 surgical tool set , the drive shaft assembly 704) through the use of some of the electrical conductors (for example, electrical conductors 3260) used to supply electrosurgical energy to communicate control signals when these electrical conductors are not used for electrosurgical energy. In addition, by isolating the electrical conductors from other circuit segments (for example, the 3230 drive shaft control segment) by supplying electrosurgical energy through these electrical conductors, aspects of this description can prevent electrosurgical energy flow into the other circuit segments and / or electrical conductors (for example, 3290 electrical conductors) connected to those circuit segments, preventing damage to those circuit segments and / or electrical conductors.
[0307] [0307] Figure 44 is a logic flow diagram representing a 4500 process from a control program or a logical configuration for operating the surgical instrument according to Mode | Although the 4500 example process is described with reference to the logical flowchart illustrated in Figure 44, it will be understood that many other methods for performing the acts associated with the method can be used. For example, the order of some of the blocks can be changed, certain blocks can be combined with other blocks and some of the described blocks are optional.
[0308] [0308] In the example illustrated and with reference also to Figure 18, a control circuit 610 (Figure 18) can receive 4510 information about the tissue impedance. For example, the control circuit 610 may include an impedance feedback circuit and measure the impingance of the clamped tissue on the end actuator 602 (for example, the end actuator 1500), such as, for example, the tissue adjacent to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R. In an exemplary aspect, control circuit 610 can measure tissue impedance periodically (for example, every 0.1 second, every 0.5 second or every second). In another exemplary aspect, control circuit 610 can measure tissue impedance at random or in any other suitable way. The 610 control circuit can supply 4520 electrosurgical energy to a first set of electrodes and a second set of electrodes, the supply of electrosurgical energy alternating repeatedly between the first set of electrodes and the second set of electrodes in a predetermined time interval. For example, control circuit 610 can supply electrosurgical energy to the first set of electrodes 3040L, 3040R and a second set of electrodes 3050L, 3050R alternatively at a predetermined time interval, as described above in relation to Figure 43.
[0309] [0309] Then, at some points, the control circuit 610 may determine 4530 that the tissue impedance reaches a predetermined impedance value. For example, the predetermined impedance value may be a value that indicates that the tissue adjacent to the first set of 3040L, 3040R electrodes and the second set of electrodes
[0310] [0310] Figure 45 shows a 4600 plot of a 4605 tissue impedance curve as a function of time. The tissue impedance curve 4605 can represent a change in the impedance of the tissue clamped on the end actuator 1500 when the control circuit 610 (Figure 18) is operating in Mode |. As shown in Figure 45, tissue impedance tends to follow a common "bath" pattern, decreasing at the start of the power switch for a first time 4625 (for example, 0.3 to 1.5 seconds) , reaching a minimum impedance value (Zvm) in the first time (t1) 4615 and then increasing during a second time period 4630 (for example, 0.3 to 1.5 seconds) as the clamped fabric is being welded. Then, the tissue impedance can reach a point 4610 in a second time (t2) 4620, and the impedance of the fabric at point 4610 is equal to a predetermined termination impedance (Z71).
[0311] [0311] In the first time period 4625, the tissue impedance falls from an initial value and decreases, for example, it has a negative slope, until it reaches the minimum impedance value (Zw) since, after the energy is applied to the fabric for a certain period, the moisture content of the fabric evaporates, causing the fabric to dry out and causing the impedance of the fabric to start to increase, for example, the positive slope then in the second time period 4630, until the fabric impedance reaches the predetermined terminating impedance Z71, at which point in time, the power to the end actuator can be turned off. In an exemplary aspect, the impedance of the tissue can maintain the minimum impedance Zm for a certain period of time (for example, 0.5 to 5 seconds), with the impedance curve of the 4605 tissue almost aligning during that period of time. If electrosurgical energy (for example, RF energy) is applied continuously instead of being turned off at the 4610 terminating impedance point, the tissue impedance may increase by continuously passing the point
[0312] [0312] In an exemplary aspect, the predetermined termination impedance (Z7) can correspond to a point where the tissue adjacent to the 3040L, 3040R, 3050L, 3050R electrodes can be substantial or completely welded in order to cut the tissue ( for example, blood vessel) without bleeding. The predetermined terminating impedance can be stored in a surgical instrument memory device (for example, surgical system 10 or surgical tool set 1000).
[0313] [0313] When the tissue impedance reaches the predetermined termination impedance, the control circuit can interrupt the supply of electrosurgical energy for the first set of electrodes 3040L, 3040R and for the second set of electrodes 3050L,
[0314] [0314] Figure 47 is a logic flow diagram representing a 4700 process from a control program or a logical configuration for operating the surgical instrument according to Mode Il. Although the 4700 example process is described with reference to the logic flow diagram shown in Figure 47, it will be understood that many other methods for performing the acts associated with the method can be used. For example, the order of some of the blocks can be changed, certain blocks can be combined with other blocks and some of the blocks described are optional.
[0315] [0315] In the example illustrated and with reference also to Figure 18, a control circuit 610 can receive 4710 information about the importance of the fabric. For example, control circuit 610 can measure the impedance of the clamped tissue on end actuator 602 (for example, end actuator 1500). In an exemplary aspect
[0316] [0316] Then, at some points, the control circuit 610 can determine 4730 that the tissue impedance reaches a predetermined impedance value. For example, the predetermined impedance value can be a value that indicates that the welding of the tissue adjacent to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R begins to be completed. Then, the control circuit 610 can advance the cutting member 4740, such as the i-profile beam 614, to cut the tissue in the adjacent portion while supplying electrosurgical energy to the first set of electrodes and the second set of electrodes. After cutting the tissue in the adjacent portion of the jaw, control circuit 610 can advance the cutting member 4740 (for example, the i-profile beam 614) to cut the tissue in the distal portion while supplying electrosurgical energy to the second set of electrodes.
[0317] [0317] In an exemplary aspect, control circuit 610 can advance 4750 the cutting member (for example, the beam with i-profile 614) to cut the tissue in the distal portion while supplying electrosurgical energy to both the first set electrodes 3040L, 3040R as for the second set of electrodes 3050L, 3050R. In another exemplary aspect, the 610 control circuit can interrupt the supply of electrosurgical energy to the first set of electrodes after cutting the tissue in the adjacent portion and supply electrosurgical energy only to the second set of electrodes while cutting the tissue in the portion distal. In this case, the supply of electrosurgical energy to the second set of electrodes 3050L, 3050R can still be discontinuous. For example, electrosurgical energy can be supplied to the second set of electrodes 3050L, 3050R for a certain period of time (eg 0.25 seconds) and then no electrosurgical energy can be supplied to the second electrode set 3050L, 3050R for the next set period of time (eg 0.25 second), and then electrosurgical energy can be supplied to the second set of electrodes 3050L, 3050R for the next period of time set (for example, 0.25 seconds). This process can be repeated while cutting the tissue in the distal portion of the claw (for example, the second zone 3065).
[0318] [0318] In another exemplary aspect, the control circuit 610 can interrupt the supply of electrosurgical energy to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R after cutting the tissue in the first zone. In this case, no electrosurgical energy can be supplied to the tissue while cutting the tissue in the second zone 3065. In an exemplary aspect, the 610 control circuit can interrupt the supply of electrosurgical energy to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R when the impedance
[0319] [0319] Figure 48 shows a 4800 plot of an 4805 tissue impedance curve as a function of time. The tissue impedance curve 4805 can represent a change in the impedance of the tissue clamped on the end actuator 1500 when the control circuit is operating in Mode Il. As seen in Figure 48, the fabric impedance here also tends to follow a common "bathtub" pattern, decreasing at the beginning of the power switch (for example, between the first set of electrodes 3040L, 3040R and the second with electrodes 3050L, 3050R) for a first period of time 4835 (for example, 0.3 to 1.5 seconds), reaching a minimum impedance value (Zu) in the first period (t1) 4820 and, then, increasing over a 4840 second time period (for example, 0.3 to 1.5 seconds). As explained above, in the first period of time 4835, the impedance of the tissue falls from an initial value and decreases, for example, it has a negative slope, until it reaches the minimum impedance value (Zwm) since , after the energy is applied to the fabric for a certain period, the moisture content of the fabric evaporates, causing the fabric to dry out and causing the importance of the fabric to start to increase, for example, the coefficient an - positive turn, then, in the second time period 4840, until the tissue impedance reaches the termination impedance Zr1. In an exemplary aspect, the impedance of the tissue can maintain the minimum impedance over a period of time (for example, 0.5 to 5 seconds), where the impedance curve of the 4805 tissue almost aligns during that period of time.
[0320] [0320] In an exemplary aspect, when the fabric impedance reaches the minimum impedance value (Zvm), an impedance change rate (for example, decrease) can become approximately zero as shown in Figure 48. The welding of the pinched fabric can begin to be completed at this point. In an exemplary aspect, in Mode Il, the control circuit can begin to advance the cutting member when the tissue impedance reaches the minimum impedance value (Zm). For example, the control circuit can determine that the tissue impedance reaches the minimum impedance value (Zm) when the impedance change rate (for example, decrease) becomes approximately zero. In another exemplary aspect, in Mode Il, the control circuit can begin to advance the cutting member at any other suitable time before the clamped tissue is completely welded. If the tissue impedance maintains the minimum impedance over a period of time (for example, 0.5 to 5 seconds), the control circuit can begin to advance the cutting member at any appropriate time during that period. time (for example, at the beginning / middle / end of the flat curve).
[0321] [0321] As shown in Figure 49, and with reference also to Figure 18, control circuit 610 can supply voltage 4860 to motor 604 (for example, motor 505) to cut the fabric in the first zone 3060 when or after the impedance of fabric reaches the minimum impedance value (Zvm) before fabric welding is completed. The termination impedance Zr1: can represent the fabric impedance at the conclusion of the cut in a second time (t2) 4825. Then, the control circuit can supply voltage 4870 to motor 604 (for example, motor 505) to cut the fabric in the second zone 3065 after cutting the fabric in the first zone 3060. The termination impedance Zr2 can represent the impedance of the fabric at the conclusion of the cut in a third time (ta) 4830. The impedance curve 4805 can suffer a drop near the second half 4825 just after cutting the fabric in the first zone 3060, because the pinched fabric may be wet with some fluids
[0322] [0322] In an exemplary aspect, the control circuit 610 can consider the amount of time needed to cut the pinched fabric on the end actuator 602 in determining when to start advancing the cutting member, such as the beam with profile in i 614. For example, if it takes 1 second to cut the fabric in the first zone 3060, the control circuit 610 can start advancing the cutting member (for example, the beam with i 614 profile) around 1 second before the fabric impedance reaches a predetermined termination impedance value (the fabric welding is normally completed around this time) so that the soldering of the fabric is substantially completed the moment the cutting of the fabric is completed. fabric in the first zone 3060 is completed. In another example, the cutting speed can be adjusted so that the welding of the fabric is substantially completed by the end of the cut. For example, if it takes 0.5 seconds from the moment that the fabric impedance reaches the minimum impedance until the moment that it reaches the termination impedance (for example, when the fabric welding is completed), the speed cutting edge can be adjusted so that it takes 0.5 seconds to cut the fabric in the first and second zones 3060, 3065.
[0323] [0323] As explained above, in an exemplary aspect, the 610 control circuit can provide electrosurgical energy for both the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R while cutting the tissue in se - second zone 3065 during the third time period 4845. In this case, since the pinched tissue received additional electrosurgical energy for the third time period 4845, the termination impedance Zr2 in the third time 4830 may be greater than the termination impedance Zr1 in the second time 4825, as seen in Figure 48.
[0324] [0324] In an exemplary aspect, the 610 control circuit can interrupt the supply of electrosurgical energy to the first set of electrodes after cutting the tissue in the first zone 3060 and supply the electrosurgical energy only to the second set of electrodes. electrodes while cutting the tissue in the second zone 3065. In that case, the termination impedance of the tissue in the second zone 3065 may be greater than the termination impedance of the tissue in the first zone 3060 since the tissue in the second zone 3065 received more electrosurgical energy for the third time period 4845 than the tissue in the first zone 3060, assuming that the predetermined time intervals for the two sets of electrodes are equal.
[0325] [0325] The functions or processes 4500, 4700 described here can be performed by any of the processing circuits described here, such as control circuit 700 described in connection with Figures 16 to 17, control circuit 610 described in connection with Figure 18.
[0326] [0326] Various aspects of the matter described in this document are defined in the following numbered examples: Example 1. A surgical instrument comprising: an end actuator comprising: a first jaw and a second jaw, the first jaw including a portion adjacent and a distal portion and the second claw is movable in relation to the first claw; a first set of electrodes and a second set of electrodes, the first set of electrodes being located in an adjacent portion of the first claw and the second set of electrodes is located in a distal portion of the first claw; and a defined gap between the first set of electrodes and the second set of electrodes; a cutting member configured to reciprocate within the slot; and a control circuit configured to: receive information about the impedance of the tissue located between the first jaw and the second jaw of the end actuator; supplying electrosurgical energy to the first set of electrodes and the second set of electrodes and repeatedly alternating the electrosurgical energy between the first set of electrodes and the second set of electrodes in a predetermined time interval; and advance the cutting member.
[0327] [0327] In some respects, an electrosurgical device can be configured to induce a hemostatic seal in a tissue and / or between tissues. The hemostatic seal can be created by a combination of a compressive force applied to the tissue and a supply of electrical energy to the tissue. In some aspects of an electrosurgical device, the compression force can be provided by compressing the tissue between sets of jaws. In addition, electrical energy can be supplied by one or more electrodes arranged inside or on some components of the claw sets. The amount of electrical energy sufficient to effect hemostatic sealing may depend, in part, on the thickness, density and / or quality of the tissue to be sealed.
[0328] [0328] It can be understood that an excessive supply of electrical energy to a fabric can result in burning or marking of the fabric. However, applying insufficient electrical energy to a tissue can result in an ineffective hemostatic seal. Thus, it may be necessary for a user of the electrosurgical device to adjust the amount of electrical energy released to the tissue compressed between the device's clamp sets based on the thickness, density and quality of the tissue. If a compressed tissue between the clamp assemblies is essentially homogeneous, the user of the electrosurgical device can use simple controls to adjust the amount of electrical energy supplied to the tissue. However, it can be recognized that some fabrics for hemostatic sealing are not homogeneous in any one or more of their thickness, density and / or quality. As a result, a single control over the amount of electrical energy supplied to the compressed tissue between the claw assemblies can result in burnt portions and insufficiently sealed portions of the tissue. Consequently, it is desirable to have an electrosurgical device that can be configured to apply a variety of electrical energies to a piece of compressed tissue between the claw assemblies.
[0329] [0329] Electrosurgical instruments apply electrosurgical energy to seal the tissue. However, the supply of electrosurgical energy is not optimized for all types of tissue. Some types of tissue require the supply of electrosurgical energy in one way and other types of tissue require the supply of electrosurgical energy in another way. Therefore, it would be desirable to treat different types of tissue by applying electrosurgical energy in one way during a gripping procedure to cut and separate the tissue, and after the gripping process, by applying electrosurgical energy in another way to seal the fabric before advancing a knife to cut the fabric. Therefore, the present description provides an electrosurgical cartridge that is configured to energize different electrode configurations for different periods of time to combine or coordinate each of the different functions of the end actuator jaws, such as closing the jaws on the fabric, supply electrosurgical energy to seal the fabric and fire the cutting element to cut the fabric.
[0330] [0330] Figure 57 is a cross-sectional view of a claw member 5000 comprising an electrosurgical cartridge, such as a radio frequency (RF) cartridge 5002 supported by an elongated channel 5004, in accordance with some aspects of the present description. The RF 5002 cartridge may comprise an elongated slot 5014 that extends through the RF 5002 cartridge.
[0331] [0331] Figure 58 is a 5100 diagram that illustrates an operation of the first electrode according to some aspects of the present description. The horizontal geometric axis represents time t, and the vertical geometric axis represents a force to close (FTC, "force to close"). An end actuator comprising two claws, one of which is the claw member 5000, for example, can be inserted into an organ, for example, the liver, with the claws open. Then, the end actuator begins to hold. For example, the claw member 5000 shown in Figure 57 approaches another claw member and applies a force to a fabric between them. During grip, RF energy is delivered to the first electrode 5006, 5008, as indicated by the shaded region 5104. RF energy delivered to the first electrode 5006, 5008, for example, cuts and separates the parenchyma. As shown in Figure 58, FTC 5102 initially increases and then gradually decreases. The RF energy supplied to the first electrode 5006, 5008 can be interrupted at a first point in time t1, which can be determined as the time when FTC 5102 falls below a threshold. The first point in time t1 can also be determined as a point in time when a gap of suitable fabric, for example, 0.0005 inch to 0.1 inch, is formed.
[0332] [0332] Figure 59 is a diagram 5200 that illustrates an operation of the second electrode according to some aspects of the present description. The horizontal geometric axis represents time t, and the vertical geometric axis represents a force to fire (FTF, from "force to fire"). As shown in Figure 59, the RF energy is switched to the second electrode 5010, 5012 after the first time t1, as indicated by the shaded area 5204. Although the two shaded areas 5104 and 5204 are shown to be the same height, the RF energy delivered to the first electrode 5006, 5008 may be different from the RF energy delivered to the second electrode 5010, 5012. The RF energy delivered to the second electrode 5010, 5012, for example, seals one or more vessels. At a second point in time t2 after the first point in time t1, a cutting member, for example a knife, can begin to advance or fire, as indicated by an FTF 5202 curve. At a third time point t3 after the at the second point in time t2, the RF energy supplied to the second electrode 5010, 5012, for example, can be interrupted. In some aspects of the present description, the beginning of the RF energy delivered to the second electrode 5010, 5012 may not immediately follow the end of the RF energy delivered to the first electrode 5006, 5008.
[0333] [0333] Figure 60 is a logic flow diagram of a 5300 process that represents a control program or a logical configuration to deliver therapeutic electrosurgical energy in accordance with an aspect of the present description. In one respect, electrosurgical energy is RF energy, for example. Therapeutic electrosurgical energy can be applied to prepare for cutting and coagulation of a surgical site, such as a liver, for example. Electrosurgical energy can be applied by segmented lateral electrodes for use in tissue welding during closing or gripping (including displaying feedback on fabric welding progress). A secondary energy switch can be used to allow automated application of electrosurgical energy concomitant with closing or gripping. A secondary set of electrodes with a thinner span for vessel welding after welding parenchyma tissue can also be supplied.
[0334] [0334] Process 5300 can be implemented with surgical instrument 600 shown in Figure 18 and controlled by control circuit 610. Consequently, control circuit 610 is configured to supply 5302 electrosurgical energy through the RF 400 energy source. for the RF cartridge 609 of the end actuator 602 in a first period of time as measured by the timer / counter circuit 631. In one aspect, the RF cartridge 609 is removably attachable to an elongated channel of a first end actuator claw 602 of surgical instrument 600. Anvil 616 is then closed over RF cartridge 609 to apply 5304 a force to the tissue located between anvil 616 and RF cartridge 609 for at least a portion of the first period of time as determined by the timer / counter circuit 631. The control circuit 610 then supplies 5306 electrosurgical energy to a second electrode of the RF cartridge 609 of the at end user 602 in a second time period as determined by timer / counter circuit 631 after the end of the first time period. Control circuit 610 is configured to operate motor 608 to advance a knife, such as the i-profile beam 614, through the fabric for at least part of the second period of time.
[0335] [0335] Various aspects of the subject described in this document are defined in the following numbered examples: Example 1. An end actuator for a surgical instrument comprising: a first claw; and a second claw, at least one of the first and second claws being configured to move from a first position separate from the other between the first and second claws to a second position in which the space between the the first and the second claws are smaller than those in the first position, the second claw comprising: an elongated channel and a cartridge removably coupled to the elongated channel, which comprises a first electrode configured to supply electrosurgical energy to a tissue and a second electrode configured to supply electrosurgical energy to the tissue, and in the second position, a distance between the first electrode and the first claw is greater than a distance between the second electrode and the first claw.
[0336] [0336] In several open, endoscopic and / or laparoscopic surgeries, for example, it may be desirable to clot, seal and / or fuse the tissue. A method of sealing tissue relies on the supply of energy, such as electrical energy, for example, to tissue captured or pinned within an end actuator or end actuator set of a surgical instrument to cause thermal effects within the tissue. . Several surgical instruments and monopolar and bipolar radiofrequency (RF) surgical techniques have been developed for such purposes. In general, the supply of RF energy to the captured tissue can raise the temperature of the tissue and, as a result, the energy can at least partially denature the proteins within the tissue. Such proteins, such as collagen, for example, can be denatured into a proteinaceous amalgam that mixes and fuses, or seals, together as the proteins renature. As the treated region heals over time, this biological seal can be reabsorbed by the body's wound healing process.
[0337] [0337] In certain provisions of a bipolar RF surgical instrument, the surgical instrument may comprise an opposing first and second jaw, each jaw may comprise an electrode. In use, the fabric can be captured between the claws, so that energy can flow between the electrodes on the opposite claws and through the fabric positioned between them. Such instruments may need to seal many types of tissues, such as anatomical structures that have walls with thick or irregular fibrous content, clusters of uneven anatomical structures and / or substantially thick or thin anatomical structures.
[0338] [0338] In general, when electrosurgical energy is applied, through electrodes, to a target tissue clamped on an electrosurgical end actuator of a surgical device, the heat supplied to the target tissue in the zone- target (for example, next to the electrodes) can be transferred laterally, damaging the tissue outside the target zone and increasing the zone of laterally coagulated tissue from the target zone. Excessive lateral propagation of the coagulation zone can be harmful for patients who are submitted to surgical procedures, since more tissue is damaged, and this may require more recovery time. In addition, the electrodes used to transmit electrosurgical energy can typically be placed in an electrical and thermally insulating material, and this can lead to overheating of the tissue, which can cause more lateral thermal propagation to the tissue outside the zone- collateral damage and tissue damage.
[0339] [0339] Aspects of the present description can solve the problems mentioned above. In an exemplary aspect, an end actuator can include a first claw (for example, a cartridge and a groove) and a second claw (for example, anvil), a hot zone in a central portion of the end actuator and zones side portions of the end actuator. The first jaw and the second jaw can define an elongated slot between them, and a cutting member is slidably receivable within the elongated slot to cut the fabric located between the first jaw and the second jaw. The first claw can include electrically and thermally non-conductive insulating layers on each side of the centrally arranged elongated slot, and electrode layers configured to transmit electrosurgical energy can be placed on the insulating layers in the hot zone. The first jaw can also include thermally conductive and electrically insulating heat dissipation layers on the side portions of the first jaw in cold areas. The heat dissipation layers can include fabric contact surfaces that can be in direct contact with the fabric when the fabric is pinched on the end actuator. The heat dissipation layers can be configured to cool the fabric in the cold areas by transferring the heat in the fabric in the cold areas to the outside to minimize the damage caused by the transfer of heat from the target fabric in the hot area to the fabric. immediately outside the hot zone.
[0340] [0340] In an exemplary aspect, the first claw can include raised blocks on each side of the elongated slot under the electrode layers. The raised blocks can allow the electrode layers to be elevated compared to the tissue contact surfaces of the heat dissipating layers, so that more pressure, and ultimately more heat, can be applied only to the fabric. target more precisely, while reducing thermal propagation to the lateral tissue. The raised blocks, in combination with the heat dissipation layers that cool the tissue immediately outside the target zone (eg, hot zone) can significantly reduce the temperature of the tissue immediately outside the target zone, and thus allow a physician to perform a more accurate sealing of the tissue without excess lateral thermal propagation.
[0341] [0341] In an exemplary aspect, the insulating layers may include an edge defined by a first surface facing the electrode layers and a second surface facing the elongated slit, and that edge can be chamfered to allow steam to escape through the elongated slit to avoid burning or overheating the fabric, preventing lateral thermal propagation that can be caused by excessive heat from overheating.
[0342] [0342] Figure 61 shows a schematic cross-sectional view of a 5500 end actuator according to an aspect of the present description. The end actuator 5500 may include a first jaw 5505 and a second jaw 5610. In an exemplary aspect, the first jaw 5505 may include an elongated channel 5530 (e.g., elongated channel 1602) that is configured to operationally support a cartridge (for example, a 5700 cartridge) in it. In an exemplary aspect, the first claw 5505 and the second claw 5610 can define a gap between them. A cutting member (for example, a blade or a 1330 knife member) can be received slidingly into the slot to cut the clamped tissue inside the 5500 end actuator. The slot in the first claw 5505 is a elongated slot 5560 (for example, long slot 1712). The elongated slot 5560 can extend from a proximal end of the first jaw 5505. The slot in the second jaw 5610 is an anvil slot 5630 (for example, anvil slot 1815). In one example, slots 5560, 5630 can be arranged in the central part of the first and second jaws 5505, 5610. In another example, slots 5560, 5630 can be arranged in any other suitable places in the first and second jaws 5505, 5610.
[0343] [0343] In an exemplary aspect, the first claw 5505 can include a first insulating layer 5510L and a second insulating layer 5510R. The first insulating layer 5510L can be on the left side of the elongated slot 5560 and the second insulating layer 5510R can be on the right side of the elongated slot 5560. In the example shown, the first insulating layer 5510L, the second insulating layer and the elongated slot 5560 are arranged in a central portion of the first claw 5505. In an exemplary aspect, the central portion of the claws 5505, 5610 can cover about 1/3 to 1/2 of all portions of the claws 5505, 5610 and can be located in the center. In an exemplary aspect, the first insulating layer 5510L and the second insulating layer 5510R can comprise a thermally and electrically non-conductive material, such as molded plastic.
[0344] [0344] In an exemplary aspect, the first claw 5505 can also include a first layer of electrode 5540L in the first insulating layer 5510L and a second layer of electrode 5540R in the second insulating layer 5510R. The first 5540L electrode layer and the second 5540R electrode layer can be configured for direct application of electrosurgical energy (for example, RF energy) to the tissue (T) to form a hemostatic line (coagulation or caution) in the adjacent tissue to the electrode layers 5540L, 5540R along the elongated slot 5560. The first electrode layer 5540L and the second electrode layer 5540R can be located in the central portion of the first claw 5505. In an exemplary aspect, the first electrode layer 5540L and the second electrode layer 5540R may include a direct contact metal electrode. In an exemplary aspect, each of the first 5540L electrode layer and the second 5540R electrode layer can additionally include a flexible circuit. In this case, the direct contact metal electrode can be deposited in the flexible circuit. In an exemplary aspect, the first electrode layer 5540L and the second electrode layer 5540R can define a hot zone 5650 close to the first and second electrode layers 5540L, 5540R. As illustrated in Figure 61, the hot zone 5650 can be in the central portion of the end actuator 5500 (and in the first and second jaws 5505, 5610).
[0345] [0345] In an exemplary aspect, the first claw 5505 can include a first layer of heat dissipation 5520L in a left side portion of the first claw 5505 and a second layer of heat dissipation 5520R in a right side portion of the first claw 5505. The first 5520L heat dissipation layer can include a first 5525L fabric contact surface, and the second 5520R heat dissipation layer can include a second 5525R fabric contact surface. The 5525L, 5525R fabric contact surfaces can be in direct contact with the fabric (T) when the fabric (T) is clamped on the 5500 end actuator. In an exemplary aspect, the first 5520L heat dissipation layer can define a first cold zone 5660 on the left side of the 5500 end actuator (or the first claw 5505) and the second heat dissipation layer 5520R can define a second cold zone 5670 on the right side of the 5500 end actuator (or the first claw 5505). The first heat dissipation layer 5520L and the second heat dissipation layer 5520R can be configured to cool the fabric (T) in the first and second cold zones 5560, 5570 to minimize heat transfer from the fabric in the hot zone 5650 for the fabric outside the hot zone 5560, preventing damage to the fabric immediately outside the hot zone 5560 (and, finally, immediately outside the 5500 end actuator). In an exemplary aspect, the first and second heat dissipation layers 5520L, 5520R can be made of an electrically insulating and thermally conductive material, such as a ceramic material (for example, aluminum nitride) to dissipate the heat from the fabric adjacent to the heat dissipation layers 5520L, 5520R.
[0346] [0346] In an exemplary aspect, the first and second insulating layers 5510L, 5510R can have around 0.01 to 0.10 inches in the opposite direction to a center line C of the 5500 end actuator In an exemplary aspect, the horizontal distance 5555 between the electrode layer 5540L / 5540R and the center line C can be in the range of about 0.01 inch to 0.10 inch. In an exemplary aspect, the first and second layers of heat dissipation 5520L, 5520R can be around 0.03 to 0.20 inches in the opposite direction to the center line C.
[0347] [0347] In an exemplary aspect, the first layers of electrode 5540L and the first layers of heat dissipation 5520L can define a first horizontal distance 5545L between the first layers of electrode 5540L and the first layers of heat dissipation 5520L. Similarly, the second layer of electrode 5540R and the second layers of heat dissipation 5520R can define a second horizontal distance 5545R between the second layers of electrode 5540R and the second layers of heat dissipation 5520R. The first and second horizontal distances 5545L, 5545R can
[0348] [0348] In an exemplary aspect, the first claw 5505 may include a feature that is configured to apply pressure to the fabric by the first electrode layer 5540L and the second electrode layer 5540R in the hot zone 5650 which is greater than a pressure applied to the fabric (T) by the surfaces of contact with the fabric 5525L, 5525R of the first and second layers of heat dissipation 5520L, 5520R. In an exemplary aspect, this feature may comprise a first 5550L raised block and a second 5550R raised block. The first raised block 5550L and the second raised block 5550R can allow the first electrode layer 5540L and the second electrode layer 5540R to be elevated compared to the 5525L, 5525R tissue contact surfaces, so that greater pressure, and finally more heat, can be applied only to a target tissue (for example, the tissue in the hot zone 5650 adjacent to the electrode layers 5540L, 5540R) more precisely with less lateral thermal propagation.
[0349] [0349] In general, the thickness of typical electrodes themselves may be too thin to provide significant pressure to compress the target tissue, so that energy and heat can be centralized in the target tissue with less lateral thermal propagation. In an exemplary aspect, the raised blocks 5550L, 5550R may not include the electrode layers 5540L, 5540R. The raised blocks 5550L, 5550R can comprise the insulating layers 5510L, 5510R or a combination of the insulating layers 5510L, 5510R and the heat dissipating layers 5520L, 5520R. In another exemplary aspect, the raised blocks 5550L, 5550R can also include electrode layers 5540L, 5540R in addition to insulating layers 5510L, 5510R and / or heat dissipation layers 5520L, 5520R. In an exemplary aspect, the thickness of the raised blocks 5550L, 5550R (for example, the vertical distance between the electrode layers 5540L, 5540R and the tissue contact surfaces 5525L, 5525R) can be at least three to five times the thickness of the 5540L, 5540R electrode layers. In an exemplary aspect, the thickness of the raised blocks 5550L, 5550R can be in the range of about 0.05 inch to 0.10 inch. In another exemplary aspect, the raised blocks 5550L, 5550R can have any suitable thickness that is sufficient to reduce the lateral thermal propagation.
[0350] [0350] In an exemplary aspect, the first insulating layer 5510L may include a first surface 5512L facing the first layer of electrode 5540L and a second surface 5514L facing the elongated slot 5560. The first surface 5512L and a - the second surface 5514L of the first insulating layer 5510L can define a first edge 5570L. Similarly, the second insulating layer 5510R may include a first surface 5512R facing the first electrode layer 5540R and a second surface 5514R facing the elongated slot 5560. The first surface 5512R and the second surface 5514R of the second insulating layer 5510R can define a second 5570R edge. In an exemplary aspect, the first and second edges 55740L, 5570R can be chamfered to allow steam to escape through the elongated slit 5560 to prevent burning or overheating of the fabric which can lead to collateral damage to the fabric.
[0351] [0351] The elongated channel 5530 can be formed under insulating layers 5510L, 5510R and heat dissipation layers 5520L, 5520R. In an exemplary aspect, the elongated channel 5530 may comprise a thermally conductive metallic material in direct contact with the first and second heat dissipation layers 5520L, 5520R to facilitate the cooling of the fabric in the first and second cold zones 5660 , 5670. For example, the heat in the heat dissipation layers 5520L, 5520R transferred from the fabric can still be transferred to the metal channel 5530 and this can help reduce the temperature of the fabric in the cold zones 5660, 5670 more quickly.
[0352] [0352] In an exemplary aspect, during coagulation or cutting, the average temperature of the tissue in the cold zones 5660, 5670 can be much lower than the average temperature of the tissue in the hot zone
[0353] [0353] In an exemplary aspect, the second claw 5610 can comprise an anvil that is pivotally supported in relation to the elongated channel 5530. The second claw 5610 can be selectively moved towards and in the opposite direction to a sustained surgical cartridge in the elongated channel 5630 between the open and closed positions by means of a closing drive system (for example, the closing drive system 510). In Figure 61, the end actuator 5500 is in a closed position with the fabric (T) clamped between the first claw 5505 and the second claw 5610. The anvil slot 5630 can open in an upper opening 5640 that is wider than the anvil slot 5630 as shown in
[0354] [0354] Figure 62 shows a perspective view of the 5500 end actuator according to an aspect of the present description. In Figure 62, the 5500 end actuator is in an open position. The second jaw 5610 can be movable with respect to the first jaw 5505; The first claw 5505 can include a 5700 cartridge that is sized and shaped to be received removably and sustained in the elongated channel 5530. In an exemplary aspect, the 5700 cartridge can include the insulating layers 5510L, 5510R, the dissipation layers heat exchanger 5520L, 5520R and the electrode layers 5540L, 5540R. In an exemplary aspect, a distal end of the first 5540L electrode layer can be connected to a distal end of the second 5540R electrode layer as shown in Figure 62, and the elongated slot 5560 can extend through the center of the electrodes 5540L, 5540R. In another exemplary aspect, the first 5540L electrode layer can be separated from the second 5540R electrode layer. The first 5525L fabric contact surface of the first 5520L heat dissipation layer can be arranged on the left side of the first 5540L electrode layer, and the second 5525R fabric contact surface of the second 5520R heat dissipation layer. may be arranged on the right side of the second layer of electrode 5540R.
[0355] [0355] The first 5505 jaw can include a 5710 microchip in the distal portion of the first 5505 jaw. The 5710 microchip can be configured to control the 5540L, 5540R electrode layers (for example, providing electrosurgical power). The 5710 microchip can be connected to a 5720 flexible cartridge circuit (for example, the 1750 flexible cartridge circuit), which can in turn be connected to a channel circuit (for example, the 1670 channel circuit ). The first 5505 claw can also include a 5730 dissecting electrode at a 5740 distal end. The 5730 dissecting electrode can be connected to an electrical power source (for example, the RF 400 generator) and configured to transmit electrosurgical energy (energy RF) to the tissue to dissect the tissue and / or clot the blood. The dissecting electrode 5730 can be isolated and operated separately from the electrode layers 5540L, 5540R.
[0356] [0356] Various aspects of the matter described in this document are defined in the following numbered examples: Example 1. A surgical instrument comprising: an end actuator comprising: a first jaw; a second claw that is movable in relation to the first claw; a hot zone in a central portion of the end actuator; a first cold zone on a left side portion of the end actuator; and a second cold zone on a right side portion of the end actuator; and an elongated slit defined between the first jaw and the second jaw, the elongated slit being configured to receive a sliding member inside the elongated slit to cut the fabric located between the first jaw and the second jaw, the elongated slot being located in the central portion of the end actuator; the first claw comprising: a first insulating layer in the hot zone, the first insulating layer being on the left side of the elongated crack; a second insulating layer in the hot zone, the second insulating layer being on the right side of the elongated crack; a first electrode layer on the first insulating layer; a second electrode layer in the second insulating layer, the first electrode layer and the second electrode layer being configured for direct application of electrosurgical energy to the tissue in the hot zone; a first layer of heat dissipation in the first cold zone; and a second heat dissipation layer in the second cold zone, the first heat dissipation layer and the second heat dissipation layer being configured to cool the fabric in the first and second cold zones to minimize lateral thermal propagation.
[0357] [0357] In an electrosurgical instrument, the density of the tissue located between the claws of an end actuator varies along the length of the end actuator. The high density fabric can be located in an adjacent portion of the end actuator, the medium density fabric can be located in an intermediate portion of the end actuator and the low density fabric can be located in a distal portion of the actuator end point. A malleable claw can be used to apply variable compression to the fabric of varying density. A constant energy density may not be effective for sealing fabric with variable density along the length of a malleable claw to apply variable compression. Therefore, the present description provides an electrosurgical cartridge that is configured to provide variable energy density along the length of the malleable jaw for varying compression to provide adequate sealing of the variable density fabric.
[0358] [0358] As disclosed above, with reference to Figures 10 to 12, an electrosurgical device may include an end actuator 1500 that includes a removable electrosurgical cartridge, such as, for example, a 1700 radio frequency (RF) surgical cartridge disposed within a elongated channel 1602 of a first claw set 1600. In some respects, the electrosurgical device can be electrically connected to an RF generator designed to supply RF energy to the surgical RF cartridge and its components. Figure 10 particularly represents an aspect of the RF 1700 surgical cartridge that has a 1712 cartridge body formed with a centrally arranged high electrode block 1720. As can be seen more particularly in Figure 6, the elongated slot 1712 is extends through the center of the electrode block 1720 and serves to divide the block 1720 into a left block segment 1720L and into a right block segment 1720R. Returning to Figure 10, a right flexible circuit assembly 1730R is attached to the right block segment 1720R and a left flexible circuit assembly 1730L is attached to the left block segment 1720L. In addition, the 1730R right flexible circuit assembly includes a 1736R "phase one" proximal right electrode and a 1738R "phase two" distal right electrode. In addition, the 1730L left flexible circuit assembly includes a 1736L proximal "phase one" left electrode and a 1738L distal left "phase two" electrode.
[0359] [0359] Figures 63A and 63B represent an alternative aspect of a 1500 end actuator that has a replaceable electrosurgical cartridge, such as an RF 1700 surgical cartridge. Figure 63A shows the end actuator 1500 in one configuration open, and Figure 63B shows the end actuator 1500 in a closed configuration. In the closed configuration, a first jaw set 1600 and a second jaw set 1800 of the end actuator 1500 can be spaced adjacent to each other by a distance that can result in a piece of fabric 6070 placed between them being subjected to a gripping pressure. In the open configuration, the first claw set 1600 and the second claw set can be spaced further apart. The open or closed configuration of the end actuator 1500 can be determined by the position and operational action of a 1910 proximal closing tube.
[0360] [0360] As shown in Figure 63A, end actuator 1500 includes a first claw set 1600 that can include an elongated channel for receiving the replaceable RF surgical cartridge 1700. The surgical RF cartridge 1700 includes a cartridge body 1710 in which one or more electrodes can be arranged. In the aspect represented in Figure 63A, the RF 1700 surgical cartridge can include two types of electrodes, including one or more 6038 shear electrodes and a 6238 dissector electrode. The one or more 6038 shear electrodes can generally have a elongated aspect that can extend along a longitudinal geometric axis of the RF 1700 surgical cartridge. In some non-limiting aspects, a shear electrode among a pair of 6038 shear electrodes can be arranged on each side of the elongated slot. The 6238 dissecting electrode can be disposed at a distal end of the cartridge body
[0361] [0361] The one or more 6038 shear electrodes in addition to the 6238 dissector electrode can be arranged in the flexible circuit assembly which can be part of a 1750 flexible cartridge circuit. The one or more 6038 shear electrodes can operate to release any amount of RF energy to a 6070 tissue disposed next to one or more 6038 shear electrodes. Figure 63B, for example, represents a piece of 6070 tissue pinned between the first claw set and 1600 and the second claw set 1800 according to the CM gripping movement. In some respects, a combination of RF energy released for the 6070 fabric close to the 6038 shear electrodes and the compression force generated by the first claw set 1600 and the second claw set 1800 due to CM grip movement, can result in the generation of a hemostatic seal in the tissue. The 6238 dissecting electrode can be used to treat the tissue in a specific way by providing RF energy. Each of the one or more 6038 shear electrodes and the 6238 dissector electrode can be electrically coupled to the RF energy generator.
[0362] [0362] Each of the one or more 6038 shear electrodes may additionally include one or more electrode portions. For example, as shown in Figure 10, each of the right and left shear electrodes can include a separate proximal and distal electrode (1736R, 1738R and 1736L, 1738L, respectively). For each of the right and left shear electrodes, each of the proximal electrodes and distal electrodes can be arranged along or parallel to a longitudinal geometric axis of the RF cartridge. Proximal electrodes (1736R, L) can be separately activated during a "phase one" procedure, and distal electrodes (1738R, L) can be separately activated during a "phase two" procedure. In the aspect shown in Figure 63A, each of the 6038 shear electrodes can be functionally separated into multiple functional electrode portions, 6138a-c. Similar to the aspect shown in Figure 10, the electrode portions 6138a-c can be arranged along or parallel to a longitudinal geometric axis of the RF cartridge. Each 6138a-c electrode portion can release an amount of RF energy to a tissue adjacent to it, but an amount of RF energy released by any electrode portion may differ from an amount of RF energy released by an electrode portion different. In a non-simulating example, an amount of RF energy released to a tissue adjacent to a 6138a low energy electrode portion may be less than an amount of RF energy released to a tissue adjacent to a portion of intermediate energy electrode 6138b. Similarly, the amount of RF energy released to a tissue adjacent to the intermediate energy electrode portion 6138b may be less than the amount of RF energy released to a tissue adjacent to the high energy electrode portion 6138c . In some respects, each of the 6138a-c electrode portions can be separately actuable via any suitable RF electrical switching component. In some alternative aspects, all or part of the number of 6138a-c electrode portions can be actuated together.
[0363] [0363] As noted above, the effectiveness of a hematic sealing of a tissue may depend on both a compressive pressure applied to the tissue and an amount of RF energy released to the compressed tissue. The amount of RF energy released to the tissue must be sufficient to form an effective hemostatic seal. If too little RF energy is released to the tissue, the hemostatic seal may not form properly. Alternatively, if too much RF energy is released into the tissue, the tissue may become charred or damaged and be unable to form the hemostatic seal. The amount of RF energy required to form the effective hemostatic seal may depend on tissue characteristics, including, but not limited to, a tissue thickness, tissue density and tissue composition. In some instances, a piece of fabric that will receive a hemostatic seal may be effectively homogeneous in relation to the thickness of the fabric, the density of the fabric and / or the composition of the fabric. Alternatively, a piece of fabric that will receive a hemostatic seal may be heterogeneous in relation to the thickness of the fabric, the density of the fabric and / or the composition of the fabric.
[0364] [0364] An electrosurgical device that has shear electrodes composed of a variety of electrode portions can be used to form an effective hemostatic seal through such heterogeneous tissue. In the aspect of the end actuator 1500 shown in Figure 63B, the 6070 fabric may be heterogeneous and have sections of fabric that may differ by any one or more between the thickness of the fabric, the density of the fabric and / or the composition of the fabric . In a non-limiting example, the 6070 fabric may have a high density composition 6170a, a medium density composition 6170b and a low density composition 6170c. The comparison of Figure 63A with Figure 63B illustrates that an effective hemostatic seal of a fabric having a 6170a high density composition can be made using a low energy electrode portion 6138a. Similarly, an effective hemostatic seal on a fabric having a 6170b medium density composition can be made using an intermediate energy electrode portion 6138b and an effective hemostatic seal on a fabric that has a low denier composition. 6170c density can be made using a 6138c high energy electrode portion.
[0365] [0365] The amount of RF energy released by an electrode may depend, at least in part, on the density of the RF energy on the electrode surface. In this way, a variation in one or more of the electrode's surface properties can be used to adjust the RF energy released by the electrode on that portion of the surface. In one aspect, the resistivity of the electrode surface material can be adjusted to control the RF energy released at such an electrode surface. In another aspect, the dimensions of the electrode surface (for example, electrode width) can be adjusted to control the RF energy released on that electrode surface. In another aspect, the electrode surface can incorporate physical resources that can allow control of the RF energy released on such an electrode surface. Examples of such features may include the inclusion of resistive or electrically insulating components on or within the electrode surface.
[0366] [0366] Figure 64 shows some exemplary 6038a-d shear electrodes that can incorporate any number or type of 6139a-d resources. Each of the 6038a-d shear electrodes can comprise a surface of the 6039a-shear electrode that can be composed of an electrically conductive material, especially one designed to conduct RF energy. The arrangement of the 6139a-d features on the shear electrode surface can cover one or more standardized power supply surfaces. In this way, an aspect of a 6038a shear electrode may have a 6039a shear electrode surface that has a standardized power supply surface that incorporates a set of transverse straight features 6139a. Another aspect of a 6038b shear electrode may have a 6039b shear electrode surface that has a standardized power supply surface that incorporates a set of circular features 6139b. Yet another aspect of a 6038c shear electrode may have a 6039c shear electrode surface that has a standardized power supply surface that incorporates a set of concave ("V-shaped" quadrilateral) features 6139c. Although features, such as 6139a-c, can be formed from distinct geometric shapes, features can also comprise complex components resulting in a 6139d grading feature that can span continuously or almost continuously a portion or portions of the electrode surface 6039d shearing.
[0367] [0367] It can be recognized that an amount of RF energy that can be released by a portion of a 6038 shear electrode to a tissue can be controlled by a number, type, size and / or density of the resource area 6139a-d forming a specific aspect of a standardized power supply surface. Figure 64, for example, shows that a 6138a low-energy portion of a shear electrode may have a standardized energy supply surface that incorporates a greater number of features (for example, 6139a-d) than a portion of intermediate energy 6138b of a shear electrode. Similarly, an intermediate energy portion 6138b of a shear electrode may have a standardized energy supply surface that incorporates a greater number of features (for example 6139a-d) than a high energy portion 6138c of an electrode shear.
[0368] [0368] Although three portions of energy 6138a-c are depicted in Figures 63A and 64, it can be recognized that a 6038 shear electrode can have any number of distinct energy portions. Each distinct energy portion may consist of a patterned power supply surface. Non-limiting examples of the number of portions of energy incorporated in a 6038 shear electrode may include two portions of energy, three portions of energy, four portions of energy, five portions of energy or any finite number of portions of energy . In addition, as shown above in relation to the exemplary shearing electrode 6038d, the surface of the shearing electrode 6038d may have a power supply surface endowed with a standard that incorporates a 6039d gradation feature designed to provide a continuous series of RF energies across the surface of the 6038d shear electrode. The continuous series of RF energies provided by the 6039d gradation feature may include, without limitation, a linear continuous series of RF energies along the surface of the 6038d shear electrode, a continuous continuous series of RF energies, a series logarithmic continuum of RF energies along the surface of the 6038d shear electrode or an exponential continuous series of RF energies along the surface of the 6038d shear electrode.
[0369] [0369] It should be recognized that individual resources 6139a-d as shown in Figure 64 are non-limiting examples of resources 6139a-d that can be incorporated into a 6039a-d shear electrode surface. Another non-limiting example of such features may include features that are linear, circular, elliptical, oval, rectangular, square, rounded rectangular or have a geometry defined by any closed two-dimensional shape. For any aspect of a 6038 shear electrode, all features can be of the same shape or can be of different shapes. For any aspect of a 6038 shear electrode, all features can be the same size or different sizes. For any aspect of a 6038 shear electrode, all resources can be physically isolated from one another, they can be contiguous with each other, or they can be a combination of physically isolated and contiguous to each other.
[0370] [0370] As additionally revealed above, each of the energy portions can include a power supply surface with a pattern. Each power supply surface endowed with a standard can incorporate any number, size, shape or density of resource area. Each power supply surface endowed with a pattern for a specific aspect of a shear electrode may have features that have identical shapes, although the features may differ in number, size and / or area density between any two power supply surfaces. equipped with an electrode pattern. Each power supply surface with a pattern for a specific aspect of a shearing electrode can have an identical number of features, although the features may differ in relation to the shape, size and / or density of the area between any two surfaces power supply units equipped with an electrode pattern. Each power supply surface endowed with a pattern for a specific aspect of a shearing electrode may have features that are identical in size, although the resources may differ in number, shape and / or area density between any two surfaces power supply units equipped with an electrode pattern. Each power supply surface endowed with a pattern for a specific aspect of a shear electrode may have features that have an identical resource area density on the surface of the shear electrode, although the features may differ in number, size and / or shape between any two standard electrode power supply surfaces.
[0371] [0371] As shown above, resources 6139a-d can be formed from an electrically insulating material deposited on or on a 6038 shear electrode. In a non-limiting aspect, resources 6139a-d represented in the Figure 64 can be manufactured by removing portions of the surface of the 6039a-d shear electrode to form recessed features, for example, using an end mill and then using a fabrication method to deposit the material electrically insulation in the lowered resources to form the resources. Alternative methods for fabricating the 6139a-d features may include, for example, molding the electrode to include the recessed features before depositing the electrically insulating material within them. The one or more recessed features may partially extend through a thickness of the 6038a-d shear electrode.
[0372] [0372] Alternatively, the one or more recessed features can extend completely through the thickness of the shearing electrode 6038a-d, thus allowing the recessed feature to receive the electrically insulating material from a top side or a underside of the electrode. The electrically insulating material can completely fill the recessed features, thus forming a coplanar surface with the surface of the 6039a-d shear electrode. In an alternative aspect, the electrically insulating material can incompletely fill the recessed features, thus forming a recessed surface of the 6039add shear electrode surface. In an additional aspect, the electrically insulating material can overflow the lowered resources, thus forming a surface that protrudes above the surface of the 6039a-d shear electrode.
[0373] [0373] In another non-limiting aspect, resources 6139a-d represented in Figure 64 can be manufactured by a deposition method. In a non-limiting example, the surface of the 6039a-d shear electrode can be coated with an electrically insulating material from which portions have been removed, thereby discovering the electrode surface below it. Resources 6139a-d can be manufactured by removing portions of the electrically insulating material deposited, for example, by first placing the electrically insulating material in contact with the surface of the 6039a-de shear electrode, then using a manufacturing method to remove portions of the material to form resources 6139a-d. Alternative deposition methods for fabricating the 6139a-d resources may include, for example, printing the 6139a-d resources directly on the surface of the 6039a-d shear electrode. Additional alternative methods for producing resources 6139a-d on the surface of the 6039a-d shear electrode can also be employed.
[0374] [0374] As shown above, aspects of an RF electrode that can be a component of a removable RF cartridge for use with an electrosurgical system. Such an RF electrode may incorporate one or more features embedded in one or more energy supply surfaces provided with a pattern designed to modify an amount of RF energy that can be supplied by a surface or one or more surface portions of the electrode to a tissue placed adjacent to it. Although a plurality of aspects of such resources and / or energy supply surfaces with a pattern have been represented in the present invention, such aspects should not be interpreted as limiting. In this way, standardized power supply surfaces can include any suitable features that can be configured on a surface of one or more sets of clamps or electrodes in an electrosurgical system. Standardized power supply surfaces can generally include features applied to a flat surface of an electrode, to one or more raised or elevated features that extend vertically above an electrode surface or to one or more recessed features that extend vertically below an electrode surface. It can be understood that the term "electrically insulating material disposed on an electrode" encompasses the application of the material on a flat surface of an electrode, to one or more raised or elevated features that extend vertically above a surface of a electrode or one or more lowered resources that extend vertically below an electrode surface. No limitations, expressed or implied, are here imposed on methods of fabricating resources.
[0375] [0375] Standardized power supply surfaces can cover a single resource or multiple resources. The single resource or the multiple resources may have a limited extent, such as a small circular portion of the electrically insulating material disposed on an electrode. The single resource or the multiple resources can have a wider extension, such as an elongated portion of the electrically insulating material disposed on an electrode. The single feature or multiple features - both limited in scope and extended - are not limited in their respective shapes, sizes or dimensions on an electrode surface. The single resource or multiple resources - both limited in scope and extended - are not limited in their respective dispositions on the electrode surface. Thus, as an example, an elongated portion of the electrically insulating material can extend along a geometric axis essentially parallel to a longitudinal geometric axis of the electrode.
[0376] [0376] Standardized power supply surfaces can incorporate multiple features that can include any combination or combinations of portions of the electrically insulating material arranged on an electrode surface or portions removed from a coating of an electrically insulating material over the electrode surface. Multiple features can be combined. In addition, multiple features can be arranged symmetrically around the electrode surface or can be asymmetrically arranged on the electrode surface. Multiple features - both limited and extended - are not limited in their arrangement on the electrode surface with each other. contemplated. It is intended that the claims presented in the annex define the global scope.
[0377] [0377] Various aspects of the matter described in this document are defined in the following numbered examples: Example 1. An electrosurgical device comprising: a cartridge configured to be disposed within an elongated channel of an end actuator, the cartridge comprising a electrode that has a plurality of electrode portions arranged along a longitudinal geometric axis of the cartridge, the electrode being configured to be electrically coupled to a generator; wherein each electrode portion among the plurality of electrode portions is configured to release an amount of energy to a tissue placed adjacent to it; and wherein an amount of energy released by a first electrode portion from the plurality of electrode portions differs from an amount of energy released by a second electrode portion from the plurality of electrode portions.
[0378] [0378] In a surgical instrument, it can be useful to control when the cutting member can be advanced through an end actuator. In order to control when the cutting member can be advanced, the surgical instrument can provide a type of locking mechanism to prevent the cutting member from advancing in a staple / fastener cartridge in various circumstances. The locking mechanisms for the staple cartridge / fasteners mechanically prevent the cutting member from being advanced by engaging part of the cutting member to prohibit distal movement. Prevention of advancing the cutting member can be useful when a surgical cartridge has not been inserted in the end actuator, is inserted improperly in the end actuator or when the staple / fastener cartridge is empty.
[0379] [0379] While using a surgical instrument, it is possible that a mechanical stapling surgical cartridge may be inserted incorrectly, not fully inserted, or it may be empty. Therefore, it may be desirable to provide a locking mechanism that mechanically prevents a cutting member from advancing through an end actuator when a staple / clamp cartridge
[0380] [0380] As shown in Figures 10 to 12, in at least one arrangement, the RF 1700 surgical cartridge includes a 1710 cartridge body that is sized and shaped to be received and removably supported in the elongated channel 1602. For example, the 1710 cartridge body can be configured to be removably retained in a snap fit with the elongated channel 1602. In several arrangements, the 1710 cartridge body can be manufactured from a polymeric material, such as For example, a engineering thermoplastic such as liquid crystal polymer (LCP) VECTRAY, and the elongated channel 1602 can be made from metal. In at least one aspect, the cartridge body 1710 includes an elongated centrally arranged slot 1712 that extends longitudinally through the cartridge body to accommodate the longitudinal displacement of knife 1330 therethrough. As shown in Figures 10 and 11, a pair of locking engagement tails 1714 extends proximally from the 1710 cartridge body to disable the locking mechanism designed to lock the staple / fastener cartridge 1400. Each tail locking coupling 1714 has a locking block 1716 formed on the underside of the same which is sized to be received within a corresponding proximal opening portion 1642 at the bottom of channel 1620. Thus, when the cartridge 1700 is properly installed in the elongated channel 1602, locking entrance tails 1714 cover openings 1642 and projections 1654 to hold knife 1330 in an unlocked position ready to fire.
[0381] [0381] Turning now to Figure 65, still referring to Figures 12, in at least one arrangement, the surgical staple cartridge 1900 includes a cartridge body 1918 that is sized and shaped to be received and supported in removable mode in the elongated channel 1602. For example, the cartridge body 1918 can be configured to be removably retained in a snap fit with the elongated channel 1602. In various arrangements, the cartridge body 1918 can be manufactured from a polymeric material, such as, for example, an engineering thermoplastic such as liquid crystal polymer (LCP) VECTRATY, and the elongated channel 1602 can be manufactured from metal. In at least one aspect, the cartridge body 1918 includes an elongated centrally arranged slot 1912 that extends longitudinally through the cartridge body to accommodate the longitudinal displacement of knife 1330 therethrough. As shown in Figure 65, a pair of 1914 locking tails extends proximally from the cartridge body
[0382] [0382] Various aspects of the subject described in this document are defined in the following numbered examples: Example 1. A surgical cartridge set comprising: a proximal end; a distal end; an elongated channel comprising: a base; and at least one opening in the base; a cartridge body configured to be removably received in said elongated channel; a slot configured to receive a cutting member; at least one locking tab extending from the proximal end of the cartridge body, the at least one locking tab being configured to cover at least one opening when the cartridge body is received into the elongated channel , and the at least one locking tab disables a locking mechanism to allow the cutting member to advance distally through the slot.
[0383] [0383] In a surgical sealing and stapling system, it may be useful to employ a modular design that allows a single handle set to be attached to multiple nozzle sets, and that a nozzle set to be attached to multiple handle sets . Since the nozzle assembly would include the various surgical instruments on the end actuator, a special circuit on the nozzle may be required to allow instrumentation in a handle assembly to control the various functions on the end actuator of the modular nozzle assembly. In some instances, each of the various surgical instruments can be designed to perform a specific surgical function, for example, one or more types of tissue sealing functions. In addition, it may be necessary to supply power to the end actuator, which may or may not originate from the handle assembly. For example, the handle assembly can be battery powered to control the functions of the handle assembly, but it may not have enough power to control the end actuator. In addition, a system that includes a surgical sealing function may have specific energy requirements, for example, an RF power supply requirement for applying a hematic seal to a fabric, which is not otherwise , associated with a handle set.
[0384] [0384] A modular design of a surgical system that has multiple nozzle assemblies can include multiple surgical instruments, each configured for a different surgical function. In one example, a nozzle assembly may include an end actuator that is further modularized to accept removable end actuator cartridges, the surgical function of which is determined by the end actuator cartridge. In such an example, the circuit within the nozzle assembly must be able to conduct electrical signals to the end actuator cartridge as needed to allow the end actuator cartridge to operate properly. For some surgical procedures, a hemostatic seal can be inserted into the target tissue. Such a hemostatic seal may require the supply of RF energy to the tissue. In this way, the circuit can be designed to have some electrical conductors configured to apply RF energy to the end actuator cartridge. However, the circuit may have only a limited number of electrical conductors. Therefore, it is desirable for the circuit to supply RF energy to the end actuator when necessary through dedicated RF electrical conductors, however, reconfigure the RF electrical conductors and / or other circuit components to conduct energy other than RF when the energy RF is not required.
[0385] [0385] In some respects, a circuit system is included in the mouthpiece assembly that allows a user of the modular surgical instruments described here to manipulate the end actuator directly from the instrumentation contained in the handle assembly. In some examples, the nozzle assembly can be configured to provide a hemostatic seal to the tissue by applying both a gripping force and providing RF energy to the tissue. The nozzle assembly may include an integrated circuit board that allows an electrosurgical generator to attach directly to the nozzle assembly and supply radiofrequency (RF) energy to the end actuator for such surgical function. In some respects, the nozzle assembly circuit also allows the drive shaft to rotate while still providing adequate power and functionality to the end actuator.
[0386] [0386] It can be recognized that care needs to be taken to ensure that the RF energy conducted by some electrical conductors on the integrated circuit board is adequately isolated from any of the other components on the integrated circuit board. Failure to provide such insulation can result in RF energy or noise being introduced into other electronic components (such as digital electronic devices) or signal conductors on the integrated circuit board. In some respects, RF energy isolation can be accomplished by isolating the RF energy conductors in a segmented circuit component of the integrated circuit board. The segmented circuit component can be configured to incorporate the proper geometry of the electrical conductor, and the appropriate location of ground planes around the RF conductors, thereby isolating the RF energy from the other components of the circuit board integrated. Such a segmented circuit component can be located in a portion of the integrated circuit board physically separate from the other electrical components. In one aspect, the connection of the surgical instrument to an RF generator allows certain functions of the drive shaft. For example, attaching RF electrodes to the RF generator allows the integrated circuit board of the surgical instrument to isolate a portion of the drive shaft integral circuit wiring for applying RF to an interchangeable RF cartridge with stapling cartridges.
[0387] [0387] Referring to Figure 40, in some respects, the nozzle assembly 1240 that constitutes a modular portion of the surgical tool assembly 1000 may include a drive shaft module circuit configured to control various functions in the assembly drive shaft while also communicating with the handle set 500 and allows the RF generator 400 to be controlled from the powered staple handle. In Figure 40, the circuit of Figure 15 is shown in the context of an exemplary nozzle assembly 1240. The circuit according to some aspects of the present description includes integrated circuit board 1152 with several connectors. The female connectors 410 are electrically coupled to the circuit board 1152, which allows the connection to the male plug set 406 that is coupled to the generator 400, not shown.
[0388] [0388] In addition, the built-in power on / off switch 420 is electrically coupled to circuit board 1152 and positioned so that it is pressed when the nozzle assembly 1240 is attached to the handle assembly 500, according to some aspects . For example, when the nozzle assembly is locked in place (see, for example, Figure 9), the power on / off switch 420 can be positioned so that it faces proximally to the handle assembly. hard and can be pressed as the nozzle assembly slides into the handle assembly slot through the 514 lock connection (see Figure 9). In other cases, the power switch 420 is exposed so that it can be manually pressed by an operator of the surgical tool set 1000.
[0389] [0389] The circuit board 1152 includes the integrated connector 1154 configured to interface with the connector of the housing 562 (see Figure 9) in communication with the microprocessor 560 contained in the handle set 500. Thus, the set of handle 500 is able to communicate with circuit board 1152 that controls various functions in the nozzle assembly 1240. The electrical energy, for example, from the supply set 706, can also be conducted through the integrated connector 1154 to the integrated circuit board 1152. The circuit design on the 1240 nozzle assembly allows an operator to perform a variety of functions from the various controls of the grip handle 500, as well as through the various controls and consoles of available in the 500 handle set.
[0390] [0390] The 1152 circuit board also includes the 1153 proximal connector which is configured to interface with the 1150 slip ring assembly. Power can be supplied to the end actuator even while the drive shaft rotates due to the energy that the entire slip ring assembly 1150 is provided and the distal connector 1162 is in constant contact with the slip ring assembly as the 1164 drive shaft flexible circuit strip rotates within the 1910 proximal closing tube. 1164 drive shaft circuit can include numerous electrical conductors, such as 1166 electrical conductors for stapling-related activities and 1168 wider electrical conductors for RF purposes (see Figure 15).
[0391] [0391] Based on the various components described in the nozzle assembly 1240, circuit 1152 can be configured to control the RF generator 400 from the powered handle set 500, allowing communication with the various functions and interfaces of the control - with handle 500, and allowing the operation of RF functions and stapling of the end actuator of the handle set 500. Other functions may include controlling a type of algorithm to perform various surgical procedures and energy applications on the end actuator , allowing the alert functionality visible in the 500 handle set of any part of the 1240 nozzle set, and vary the energy modulation from the RF generator
[0392] [0392] In some respects, integrated circuit 1152 includes segmented RF circuit 1160, which can allow RF energy from generator 400 to be delivered to the flexible axis strip of the drive shaft through the ring assembly slide (see, for example, Figure 15). The 1160 segmented RF circuit can incorporate electrical conductors to supply RF energy and provide electrical insulation from other components of the 1152 integrated circuit board against RF energy and / or noise. The RF generator can be coupled to the integrated circuit board 1152 via the segmented RF circuit 1160. The power on / off switch 420 can be similarly connected to the segmented RF circuit 1160.
[0393] [0393] Figure 41 illustrates a block diagram of a 3200 surgical system programmed to conduct energy and control signals to or from a 3250 end actuator in accordance with an aspect of the present description. In an exemplary aspect, the 3200 surgical system may include a 3210 control circuit (for example, microprocessor 560, segmented RF circuit 1160 or distal microchip 1740) that has an electrosurgical energy control segment (or an energy control segment RF) 3220 and a drive shaft control segment 3230 (for example, drive shaft segment (segment 5), motor circuit segment (segment 7) or power segment (segment 8)). In some respects, the 3220 electrosurgical energy control segment may be located on, in, or near the 1160 segmented RF circuit of the 1152 integrated circuit board. The 3210 control circuit can be programmed to provide electrosurgical energy (for example, example, RF energy) to the electrodes (for example, 3040L, 3040R, 3050L, 3050R electrodes) on the 3250 end actuator (for example, the 1500 end actuator). The 3200 surgical system can include one or more 3260 electrical conductors (for example, 1168 electrical conductors) used to deliver electrosurgical energy from a 3240 electrosurgical energy generator (for example, the RF 400 generator), while 3250 end actuator. One or more 3260 electrical conductors can also be electrically connected between the 3250 end actuator and the 3210 control circuit (for example, the 3220 electrosurgical power control segment and the axis control segment drive system). 3260 electrical conductors can supply additional control signals to the 3250 end actuator from the 3230 drive shaft control segment or provide additional sensor signals from the 3250 end actuator to the 3230 drive shaft control segment, especially for surgical systems that have an end actuator that does not require RF energy for its function.
[0394] [0394] The 3220 electrosurgical energy control segment can be programmed to supply electrosurgical energy to the electrodes via one or more 3260 electrical conductors. In an exemplary aspect, the 3230 drive shaft control segment can be programmed to provide and / or receive a control signal to / from the end actuator 3250 (and / or the surgical tool set 1000, the drive shaft set 704) via one or more 3260 electrical conductors. , the one or more 3260 electrical conductors can be used not only to supply electrosurgical energy to the 3250 end actuator, but also to communicate control signals with the 3250 end actuator.
[0395] [0395] In an exemplary aspect, the 3220 electrosurgical energy control segment can electrically isolate one or more 3260 electrical conductors from the 3230 drive shaft control segment, for example, by supplying electrosurgical energy to the electrodes on the 3250 end actuator via one or more 3260 electrical conductors. In an exemplary aspect, the 3220 electrosurgical energy control segment can control a 3270 switch located between the one or more 3260 electrical conductors and the axis control segment 3230 drive by providing a signal via a 3280 control line to electrically isolate one or more 3260 electrical conductors from the 3230 drive shaft control segment. The 3270 switch can be configured to switch between an open state and a closed state. The control segment of the drive shaft 3230 and the one or more electrical conductors 3260 can be electrically isolated when the switch 3270 is in the open state and can be in electrical communication when the switch 3270 is in the closed state. In another exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate one or more electrical conductors 3260 from the control segment of the drive shaft 3230 in any other suitable manner. Other configurations of the 3270 switch may allow the electrical isolation of one or more 3260 electrical conductors from the 3230 drive shaft control segment by closing the 3270 switch.
[0396] [0396] In an exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate one or more electrical conductors 3260 from the control segment of the drive shaft 3230 when the 3210 control circuit detects that the electrosurgical energy generator 3240 is connected to the 3265 connector (for example, female connectors 410), for example, by continuously checking the 3265 connector or detecting the application of electrosurgical energy. For example, when the male plug set 406 is plugged into the female connectors 410, the electrosurgical energy control segment 3220 can isolate the electrical conductors 3260 from the control segment of the drive shaft 3230. In another exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate the one or more electrical conductors 3260 from the control segment of the drive shaft 3230 when electrosurgical energy is supplied to the 3250 end actuator or under any other suitable condition.
[0397] [0397] In an exemplary aspect, the surgical system can include one or more 3290 electrical conductors (for example, 1166 electrical conductors) used to operate the 3250 end actuator (and / or the surgical tool set 1000, the set drive shaft 704). In an exemplary aspect, the one or more 3290 electrical conductors may not be used to release electrosurgical energy to the 3250 end actuator. The 3230 drive shaft control segment can be programmed to provide and / or receive an control and / or a sensor signal to / from the 3250 end actuator via one or more 3290 electrical conductors. In an exemplary aspect, the 3230 drive shaft control segment can use the one or more electrical conductors 3290 to provide and / or receive the control signal to / from the 3250 end actuator while the 3270 switch is in an open state (for example, while the electrosurgical power control segment
[0398] [0398] The 3270 switch can be a transistor switch, a mechanical switch or any other suitable switch. In an exemplary aspect, the control signals communicated between the 3210 control circuit and the 3250 end actuator (and / or the surgical tool set 1000, the drive shaft set 704) through the 3260 electrical conductors , 3290 include, but are not limited to, signals to drive the 3250 end actuator (and / or the surgical tool set 1000, the drive shaft set 704) in cutting and / or coagulation operating modes, measuring the electrical characteristics of the 3200 surgical system and / or the tissue clamped on the 3250 end actuator, providing feedback to a user of the surgical system, communication of sensor signals and identification of certain characteristics of the 3250 end actuator (eg example, used / unused situation).
[0399] [0399] Consequently, aspects of the present description can advantageously reduce the number of electrical conductors needed to communicate control signals between the 3210 control circuit and the 3250 end actuator (and / or the 1000 surgical tool set , the drive shaft assembly 704) through the use of some of the electrical conductors (for example, electrical conductors 3260) used to supply electrosurgical energy to communicate control signals when these electrical conductors are not used for electrosurgical energy. In addition, by isolating the electrical conductors from other circuit segments (for example, the 3230 drive shaft control segment) by supplying electrosurgical energy through these electrical conductors, aspects of this description can prevent electrosurgical energy or electrosurgical energy noise flows into the other circuit segments and / or electrical conductors (for example, 3290 electrical conductors) connected to those circuit segments, preventing damage to those circuit segments and / or electrical conductors.
[0400] [0400] As shown, for example, in Figures 40 and 41 and as shown above, a modular nozzle assembly may include an integrated circuit board configured to allow a user to communicate with and control an end actuator of a surgical system. Control and / or communication with the end actuator may include control and / or communication with the end actuator as a whole or with any one or more components of the end actuator. For example, the end actuator can be configured to releasably incorporate one or more modules and / or cartridges as revealed above, each of which can be designed for a specific surgical function. In one example, the end actuator may incorporate a removable staple cartridge. In another example, the end actuator can incorporate a removable RF cartridge. Each of the removable cartridges can have any number or type of electrical conductors configured to electrically couple with one or more electrical conductors on the integrated circuit board. The electrical conductors of each removable cartridge can be configured to conduct any type of electrical signal, including, but not limited to, an analog signal, a digital signal, a DC signal (direct current), an AC signal (current) alternating) and an electrical power signal. Such electrical signals may come from the integrated circuit board or electrical components from a removable cartridge.
[0401] [0401] Although the electrical circuit as shown above is called a "circuit board", the circuit itself can be manufactured according to any suitable medium using any suitable material. Thus, for example, the circuit board can be a single layer board, a multilayer board, a flexible circuit or any other suitable device on which electrical components can be properly mounted. Similarly, electrical conductors may include, without limitation, wires and traces from the circuit board.
[0402] [0402] Various aspects of the subject described in this document are defined in the following numbered examples: Example 1. A control circuit for a surgical instrument, the control circuit comprising: a control segment of the drive shaft; a first electrical conductor configured to conduct a first electrical signal between the control segment of the drive shaft and a removable surgical instrument cartridge; an electrosurgical energy control segment; a second electrical conductor configured to conduct a second electrical signal between the electrosurgical energy control segment and the removable surgical instrument cartridge; and a connector electrically coupled to the electrosurgical energy control segment and configured to receive energy from the electrosurgical generator from an electrosurgical generator, the electrosurgical energy control segment being configured to: detect a connection of the electrosurgical generator with the connector; and electrically isolate the control segment from the drive axis of the electrosurgical generator when the electrosurgical energy control segment detects the connection between the electrosurgical generator and the connector.
[0403] [0403] Figure 66 illustrates a 1950 method of using the interchangeable tool set 1000 according to various aspects. For a first procedure, the surgical staple / clamp cartridge 1400 can be inserted 1952 into and retained inside the elongated channel 1602 of the first claw 1600 of the end actuator 1500 of the interchangeable surgical tool set 1000, thus coupling the staple cartridge / surgical clamp 1400 to the interchangeable surgical tool kit 1000. The clamp cartridge / surgical clamp 1400 can then be used to release 1954 clamps from the clamp cartridge / surgical clamp 1400 to a tissue in a patient.
[0404] [0404] After at least some of the staples are released onto the tissue on the patient, the surgical staple / clamp cartridge 1400 can be removed 1956 from the end actuator 1500 of the interchangeable surgical tool set 1000, effectively uncoupling the staple cartridge / surgical clamps 1400 of the interchangeable surgical tool set 1000. For cases where at least a portion of the interchangeable surgical tool set 1000 is positioned inside the patient's body, the end actuator 1500 is removed from the patient's body before removal of the staple cartridge / surgical clamps 1400 from the end actuator 1500. The interchangeable tool set 1000, or portions thereof, can then be cleaned and sterilized to properly prepare the interchangeable tool set 1000 for subsequent use.
[0405] [0405] After the surgical staple / clamp cartridge 1400 has been removed from the end actuator 1500 of the interchangeable surgical tool set 1000, for a second procedure, the radio frequency cartridge 1700 can be inserted 1958 inside and retained in the channel elongated 1602 of the first claw 1600 of the end actuator 1500 of the interchangeable surgical tool set 1000, thus coupling the radio frequency cartridge 1700 to the set of interchangeable surgical tool 1000 and effectively replacing the staple cartridge / surgical fasteners 1400 When the 1700 radio frequency cartridge is in place and the radio frequency generator 400 is coupled to the 1160 segmented radio frequency circuit of the 1000 interchangeable surgical tool set, the 1700 radio frequency cartridge can then be used to release 1960 radio frequency energy (eg, coagulating electrical current) to a tissue in a patient. The first procedure occurs during a first period of time and the second procedure occurs during a second period of time. The second procedure can be a continuation of the first procedure or be different from it. Therefore, the fabric that receives radio frequency energy can be the same general fabric that previously received the staples or it may be a different fabric from the fabric that previously received the staples. Similarly, the patient associated with the first procedure may be the same or it may be another patient associated with the second procedure.
[0406] [0406] After at least part of the radio frequency energy is released to the tissue in the patient, the radio frequency cartridge 1700 can be removed 1962 from the end actuator 1500 from the interchangeable surgical tool set 1000, effectively uncoupling the radio frequency cartridge 1700 from the interchangeable surgical tool set 1000. When the radio frequency cartridge is removed from the interchangeable tool set 1000, the segmented radio frequency circuit 1160 from the interchangeable surgical tool set 1000 can also be uncoupled of the radio frequency generator 400. For cases where at least a portion of the interchangeable surgical tool set 1000 is positioned inside the patient's body, the end actuator 1500 is removed from the patient's body before removal of the radio cartridge - frequency 1700 of end actuator 1500. The set of interchangeable tools 1000, or portions of the even, they can then be cleaned and sterilized to properly prepare the set of interchangeable tools 1000 for subsequent use. Each occurrence of such subsequent use may involve both the 1400 surgical staple / fastener cartridge (effectively replacing the 1700 radio frequency cartridge) and the 1700 radio frequency cartridge.
[0407] [0407] Although the above description of the 1950 method describes the surgical clamp / clamp cartridge 1400 being used with the interchangeable surgical tool set 1000 for a first procedure and a 1700 radio frequency cartridge being used with the set from interchangeable surgical tool 1000 for a second procedure, the method described above 1950 is not strictly limited to the described order of uses or to the strictly alternate uses of the 1400 surgical clamp / clamp cartridge and the 1700 radio frequency cartridge. For example, as shown in Figure 66, the radio frequency cartridge 1700 can be used by the interchangeable surgical tool set 1000 for an initial procedure and the surgical clamp / clamp cartridge 1400 can be used for a subsequent procedure. . In addition, the interchangeable surgical tool set 1000 can use the respective surgical staple / clamp cartridges 1400 for any number of sequential procedures before using the 1700 radio frequency cartridge for a subsequent procedure (or respective procedures). radio frequency cartridges 1700 1400 for any number of subsequent procedures). When the respective staple cartridges / surgical clamps 1400 are used sequentially, the respective clamp cartridges / surgical clamps 1400 can be the same or different. For example, one of the respective surgical staple / clamp cartridges 1400 may have an effective longitudinal stapling length that is different from the effective longitudinal stapling length of a different cartridge among the respective surgical clamp / clamp cartridges. 1400. Similarly, the interchangeable surgical tool set 1000 can use the respective radio frequency cartridges
[0408] [0408] Various aspects of the subject described in this document are defined in the following numbered examples: Example 1. A method is provided. The method comprises applying staples from a surgical staple cartridge of a surgical instrument to a first tissue during a first procedure, removing the surgical staple cartridge from the surgical instrument and supplying radiofrequency energy from a radiofrequency cartridge of the surgical instrument to a second tissue during a second procedure.
[0409] [0409] Aspects of the surgical instrument can be practiced without the specific details revealed in the present invention. Some aspects were shown as block diagrams instead of details. Parts of this description can be presented in terms of instructions that operate on data stored in a computer's memory. In general, the aspects described here, which can be implemented, individually and / or collectively, by a wide range of hardware, software, firmware, or any combination thereof, can be seen as being composed of several types of "circuits" electrical ". Consequently, "electrical circuit" includes, but is not limited to, electrical circuits that have at least one separate electrical circuit, electrical circuits that have at least one integrated circuit, electrical circuits that have at least one integrated circuit to apply specific circuits, electrical circuits that form a general-purpose computer device configured by a computer program (for example, a general-purpose computer or processor configured by a computer program that at least partially performs the processes and / or devices described herein), electrical circuits that form a memory device (for example, random access memory forms), and / or electrical circuits that form a communications device (for example, a modem, routers or optical-electrical equipment). These aspects can be implemented in analog or digital form, or combinations of the same.
[0410] [0410] The previously mentioned description presented aspects of the devices and / or processes through the use of block diagrams, flowcharts, and / or examples, which may contain one or more functions and / or operation. Each function and / or operation within such block diagrams, flowcharts or examples can be implemented, individually and / or collectively, by a wide range of hardware, software, firmware or virtually any combination thereof. In one aspect, several portions of the subject described here can be implemented by means of application-specific integrated circuits (ASICs), field programmable port arrangements (FPGAs), digital signal processors (DSPs), programmable logic devices (PLDs), circuits, registers and / or software components, for example, programs, subroutines, logic and / or combinations of hardware and software components, logic gates, or other integrated formats. Some aspects disclosed here, in whole or in part, can be implemented in an equivalent way in integrated circuits, such as one or more computer programs running on one or more computers (for example, as one or more programs operating on one or more computer systems), as one or more programs operating on one or more processors (for example, as one or more programs operating on one or more microprocessors), as firmware, or virtually as any combination thereof, and that designing the circuit and / or writing the code for the software and firmware would be within the scope of practice of a person skilled in the art in the light of this description.
[0411] [0411] The mechanisms of the revealed subject can be distributed as a program product in a variety of ways, and an illustrative aspect of the subject described here is applicable regardless of the specific type of signal transmission media used to effectively execute the distribution. Examples of a signal transmission medium include, but are not limited to, the following: recordable media such as a floppy disk, a hard disk drive, a compact disc (CD), a digital video disc (DVD), digital tape, computer memory, etc .; and a transmission type media, such as digital and / or analog communication media (for example, a fiber optic cable, a waveguide, an electrical conductor communication link, an electrically conductive communication link (for example, example, transmitter, receiver, transmission logic, reception logic, etc.).
[0412] [0412] The previously mentioned description of one or more aspects has been presented for purposes of illustration and description. This description is not intended to be exhaustive or to limit the invention to the precise form disclosed. Modifications or variations are possible in light of the above teachings. These aspects were chosen and described for the purpose of illustrating the principles and practical application, thus allowing the person skilled in the art to use the various aspects and with various modifications, as they are convenient to the specific use contemplated. It is intended that the claims presented in the annex define the global scope.

权利要求:
Claims (19)
[1]
1. Method characterized by the fact that it comprises: applying staples from a surgical staple cartridge of a surgical instrument to a first tissue during a first procedure; remove the surgical staple cartridge from the surgical instrument; and applying radio frequency energy from a radio frequency cartridge of the surgical instrument to a second tissue during a second procedure.
[2]
2. Method according to claim 1, characterized in that the application of radio frequency energy from the radio frequency cartridge occurs before the application of the staples of the surgical staple cartridge.
[3]
3. Method, according to claim 1, characterized by the fact that the second procedure is different from the first procedure.
[4]
4. Method, according to claim 1, characterized by the fact that it also includes inserting the surgical staple cartridge into the surgical instrument before applying the staples.
[5]
5. Method, according to claim 4, characterized in that the insertion of the surgical staple cartridge in the surgical instrument comprises inserting the surgical staple cartridge in a set of interchangeable tools.
[6]
6. Method, according to claim 1, characterized by the fact that it also includes, before the application of radio frequency energy, inserting a second cartridge of surgical clamps in the surgical instrument.
[7]
7. Method, according to claim 1, characterized by the fact that it also comprises, before the application of radio frequency energy:
insert the radio frequency cartridge into the surgical instrument; and coupling the radio frequency cartridge to a radio frequency generator.
[8]
8. Method, according to claim 7, characterized by the fact that the insertion of the radio frequency cartridge in the surgical instrument comprises inserting the radio frequency cartridge in a set of interchangeable tools.
[9]
9. Method, according to claim 1, characterized by the fact that it also includes removing the radio frequency cartridge from the surgical instrument.
[10]
10. Method, according to claim 9, characterized by the fact that it also includes inserting a second radio frequency cartridge into the surgical instrument.
[11]
11. Method, according to claim 9, characterized by the fact that it also includes inserting a second cartridge of surgical clips into the surgical instrument.
[12]
12. Method for using a set of interchangeable tools, the method being characterized by the fact that it comprises: using a staple cartridge attached to the set of interchangeable tools to apply staples to seal a first fabric during the first period of time; replace the staple cartridge; and use a radio frequency cartridge coupled to the set of interchangeable tools to apply radio frequency energy to seal a second tissue during the second period of time.
[13]
13. Method, according to claim 12, characterized in that the replacement of the staple cartridge comprises: uncoupling the staple cartridge from the set of interchangeable tools; and attach the radio frequency cartridge to the set of interchangeable tools.
[14]
14. Method, according to claim 13, characterized in that the coupling of the radio frequency cartridge to the set of interchangeable tools comprises coupling the radio frequency cartridge to an end actuator of the set of interchangeable tools.
[15]
15. Method, according to claim 12, characterized by the fact that it also comprises, before the use of the staple cartridge, coupling the staple cartridge to an end actuator of the set of interchangeable tools.
[16]
16. Method, according to claim 12, characterized by the fact that it also comprises, before using the radio frequency cartridge: coupling the radio frequency cartridge to the set of interchangeable tools; and coupling the set of interchangeable tools to a radio frequency generator.
[17]
17. Method, according to claim 12, characterized by the fact that it also comprises a second staple cartridge to the set of interchangeable tools.
[18]
18. Method, according to claim 12, characterized by the fact that it also comprises coupling a second radio frequency cartridge to the set of interchangeable tools.
[19]
19. Method characterized by the fact that it comprises: sealing a first tissue with staples from a staple cartridge removable from a surgical instrument; sterilize the surgical instrument; and sealing a second tissue with radio frequency energy applied by a radio frequency cartridge removable from the surgical instrument.

类似技术:

---

公开号 | 公开日 | 专利标题

---

BR112019026576A2|2020-06-23|SURGICAL SYSTEM COUPLABLE TO A CLAMP CARTRIDGE AND A RADIO FREQUENCY CARTRIDGE AND METHOD OF USE OF THE SAME

---

JP2020525188A|2020-08-27|Electrosurgical cartridge for use in thin surgical cutting and stapling instruments

---

BR112019027006A2|2020-06-30|systems and methods for controlling control circuits for independent power supply in segmented sections

---

BR112019026766A2|2020-06-30|drive shaft module circuit arrangements

---

BR112019026805A2|2020-06-30|flexible circuit arrangement for surgical fastening instruments

---

JP2020525225A|2020-08-27|Cartridge configuration for surgical cutting and fastening instruments with lockout disabling feature

---

BR112019027117A2|2020-07-07|systems and methods for controlling control circuits for independent power supply in segmented sections

---

BR112019027525A2|2020-07-07|surgical cutting and clamping instruments with dual energy sources

---

JP2020525205A|2020-08-27|Surgical end effector for adjusting jaw compression

---

BR112019027049A2|2020-06-30|surgical system attachable with staple cartridge and radio frequency cartridge and that has a plurality of radiofrequency energy return paths

---

BR112019026927A2|2020-07-07|systems and methods for displaying the status of the surgical instrument

---

BR112019026525A2|2020-07-21|surgical end actuator to apply electrosurgical energy to different electrodes at different time periods

---

US11272976B2|2022-03-15|Surgical end effector for applying electrosurgical energy to different electrodes on different time periods

---

US11278346B2|2022-03-22|Systems and methods of displaying surgical instrument status

同族专利:

---

公开号 | 公开日

---

CN110809442A|2020-02-18|

---

US20190000478A1|2019-01-03|

---

WO2019003008A2|2019-01-03|

---

JP2020525199A|2020-08-27|

---

EP3420932A1|2019-01-02|

---

US20200397432A1|2020-12-24|

引用文献:

---

公开号 | 申请日 | 公开日 | 申请人 | 专利标题

---

---

US5403312A|1993-07-22|1995-04-04|Ethicon, Inc.|Electrosurgical hemostatic device|

---

US5817093A|1993-07-22|1998-10-06|Ethicon Endo-Surgery, Inc.|Impedance feedback monitor with query electrode for electrosurgical instrument|

---

EP2404555B1|2002-04-16|2017-03-15|Covidien LP|Surgical stapler and method|

---

US7431720B2|2003-11-25|2008-10-07|Ethicon, Inc.|Multi-function clamping device with stapler and ablation heads|

---

US8100822B2|2004-03-16|2012-01-24|Macroplata Systems, Llc|Anoscope for treating hemorrhoids without the trauma of cutting or the use of an endoscope|

---

US20120292367A1|2006-01-31|2012-11-22|Ethicon Endo-Surgery, Inc.|Robotically-controlled end effector|

---

US7780663B2|2006-09-22|2010-08-24|Ethicon Endo-Surgery, Inc.|End effector coatings for electrosurgical instruments|

---

US8931682B2|2007-06-04|2015-01-13|Ethicon Endo-Surgery, Inc.|Robotically-controlled shaft based rotary drive systems for surgical instruments|

---

US8636736B2|2008-02-14|2014-01-28|Ethicon Endo-Surgery, Inc.|Motorized surgical cutting and fastening instrument|

---

US8608045B2|2008-10-10|2013-12-17|Ethicon Endo-Sugery, Inc.|Powered surgical cutting and stapling apparatus with manually retractable firing system|

---

US8888776B2|2010-06-09|2014-11-18|Ethicon Endo-Surgery, Inc.|Electrosurgical instrument employing an electrode|

---

US8453906B2|2010-07-14|2013-06-04|Ethicon Endo-Surgery, Inc.|Surgical instruments with electrodes|

---

US9072535B2|2011-05-27|2015-07-07|Ethicon Endo-Surgery, Inc.|Surgical stapling instruments with rotatable staple deployment arrangements|

---

US20140263552A1|2013-03-13|2014-09-18|Ethicon Endo-Surgery, Inc.|Staple cartridge tissue thickness sensor system|

---

US9687230B2|2013-03-14|2017-06-27|Ethicon Llc|Articulatable surgical instrument comprising a firing drive|

---

US9913642B2|2014-03-26|2018-03-13|Ethicon Llc|Surgical instrument comprising a sensor system|

---

US10595930B2|2015-10-16|2020-03-24|Ethicon Llc|Electrode wiping surgical device|US9060770B2|2003-05-20|2015-06-23|Ethicon Endo-Surgery, Inc.|Robotically-driven surgical instrument with E-beam driver|

---

US20070084897A1|2003-05-20|2007-04-19|Shelton Frederick E Iv|Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism|

---

US8215531B2|2004-07-28|2012-07-10|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument having a medical substance dispenser|

---

US7669746B2|2005-08-31|2010-03-02|Ethicon Endo-Surgery, Inc.|Staple cartridges for forming staples having differing formed staple heights|

---

US10159482B2|2005-08-31|2018-12-25|Ethicon Llc|Fastener cartridge assembly comprising a fixed anvil and different staple heights|

---

US9237891B2|2005-08-31|2016-01-19|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical stapling devices that produce formed staples having different lengths|

---

US11246590B2|2005-08-31|2022-02-15|Cilag Gmbh International|Staple cartridge including staple drivers having different unfired heights|

---

US20070106317A1|2005-11-09|2007-05-10|Shelton Frederick E Iv|Hydraulically and electrically actuated articulation joints for surgical instruments|

---

US8820603B2|2006-01-31|2014-09-02|Ethicon Endo-Surgery, Inc.|Accessing data stored in a memory of a surgical instrument|

---

US8708213B2|2006-01-31|2014-04-29|Ethicon Endo-Surgery, Inc.|Surgical instrument having a feedback system|

---

US7753904B2|2006-01-31|2010-07-13|Ethicon Endo-Surgery, Inc.|Endoscopic surgical instrument with a handle that can articulate with respect to the shaft|

---

US11224427B2|2006-01-31|2022-01-18|Cilag Gmbh International|Surgical stapling system including a console and retraction assembly|

---

US20110295295A1|2006-01-31|2011-12-01|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical instrument having recording capabilities|

---

US8186555B2|2006-01-31|2012-05-29|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting and fastening instrument with mechanical closure system|

---

US11207064B2|2011-05-27|2021-12-28|Cilag Gmbh International|Automated end effector component reloading system for use with a robotic system|

---

US20120292367A1|2006-01-31|2012-11-22|Ethicon Endo-Surgery, Inc.|Robotically-controlled end effector|

---

US7845537B2|2006-01-31|2010-12-07|Ethicon Endo-Surgery, Inc.|Surgical instrument having recording capabilities|

---

US8360297B2|2006-09-29|2013-01-29|Ethicon Endo-Surgery, Inc.|Surgical cutting and stapling instrument with self adjusting anvil|

---

US8652120B2|2007-01-10|2014-02-18|Ethicon Endo-Surgery, Inc.|Surgical instrument with wireless communication between control unit and sensor transponders|

---

US8684253B2|2007-01-10|2014-04-01|Ethicon Endo-Surgery, Inc.|Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor|

---

US11039836B2|2007-01-11|2021-06-22|Cilag Gmbh International|Staple cartridge for use with a surgical stapling instrument|

---

US7735703B2|2007-03-15|2010-06-15|Ethicon Endo-Surgery, Inc.|Re-loadable surgical stapling instrument|

---

US8931682B2|2007-06-04|2015-01-13|Ethicon Endo-Surgery, Inc.|Robotically-controlled shaft based rotary drive systems for surgical instruments|

---

US7753245B2|2007-06-22|2010-07-13|Ethicon Endo-Surgery, Inc.|Surgical stapling instruments|

---

US7866527B2|2008-02-14|2011-01-11|Ethicon Endo-Surgery, Inc.|Surgical stapling apparatus with interlockable firing system|

---

US8573465B2|2008-02-14|2013-11-05|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical end effector system with rotary actuated closure systems|

---

US8636736B2|2008-02-14|2014-01-28|Ethicon Endo-Surgery, Inc.|Motorized surgical cutting and fastening instrument|

---

JP5410110B2|2008-02-14|2014-02-05|エシコン・エンド−サージェリィ・インコーポレイテッド|Surgical cutting / fixing instrument with RF electrode|

---

US8758391B2|2008-02-14|2014-06-24|Ethicon Endo-Surgery, Inc.|Interchangeable tools for surgical instruments|

---

US7819298B2|2008-02-14|2010-10-26|Ethicon Endo-Surgery, Inc.|Surgical stapling apparatus with control features operable with one hand|

---

US9179912B2|2008-02-14|2015-11-10|Ethicon Endo-Surgery, Inc.|Robotically-controlled motorized surgical cutting and fastening instrument|

---

US9585657B2|2008-02-15|2017-03-07|Ethicon Endo-Surgery, Llc|Actuator for releasing a layer of material from a surgical end effector|

---

US8210411B2|2008-09-23|2012-07-03|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting instrument|

---

US9386983B2|2008-09-23|2016-07-12|Ethicon Endo-Surgery, Llc|Robotically-controlled motorized surgical instrument|

---

US8608045B2|2008-10-10|2013-12-17|Ethicon Endo-Sugery, Inc.|Powered surgical cutting and stapling apparatus with manually retractable firing system|

---

US8517239B2|2009-02-05|2013-08-27|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument comprising a magnetic element driver|

---

US20110024477A1|2009-02-06|2011-02-03|Hall Steven G|Driven Surgical Stapler Improvements|

---

US8444036B2|2009-02-06|2013-05-21|Ethicon Endo-Surgery, Inc.|Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector|

---

US8220688B2|2009-12-24|2012-07-17|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting instrument with electric actuator directional control assembly|

---

US9629814B2|2010-09-30|2017-04-25|Ethicon Endo-Surgery, Llc|Tissue thickness compensator configured to redistribute compressive forces|

---

JP6224070B2|2012-03-28|2017-11-01|エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ．|Retainer assembly including tissue thickness compensator|

---

JP6305979B2|2012-03-28|2018-04-04|エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ．|Tissue thickness compensator with multiple layers|

---

US8777004B2|2010-09-30|2014-07-15|Ethicon Endo-Surgery, Inc.|Compressible staple cartridge comprising alignment members|

---

US9861361B2|2010-09-30|2018-01-09|Ethicon Llc|Releasable tissue thickness compensator and fastener cartridge having the same|

---

US10945731B2|2010-09-30|2021-03-16|Ethicon Llc|Tissue thickness compensator comprising controlled release and expansion|

---

BR112013027794B1|2011-04-29|2020-12-15|Ethicon Endo-Surgery, Inc|CLAMP CARTRIDGE SET|

---

US8695866B2|2010-10-01|2014-04-15|Ethicon Endo-Surgery, Inc.|Surgical instrument having a power control circuit|

---

US9072535B2|2011-05-27|2015-07-07|Ethicon Endo-Surgery, Inc.|Surgical stapling instruments with rotatable staple deployment arrangements|

---

US9044230B2|2012-02-13|2015-06-02|Ethicon Endo-Surgery, Inc.|Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status|

---

MX350846B|2012-03-28|2017-09-22|Ethicon Endo Surgery Inc|Tissue thickness compensator comprising capsules defining a low pressure environment.|

---

US9101358B2|2012-06-15|2015-08-11|Ethicon Endo-Surgery, Inc.|Articulatable surgical instrument comprising a firing drive|

---

RU2636861C2|2012-06-28|2017-11-28|Этикон Эндо-Серджери, Инк.|Blocking of empty cassette with clips|

---

US20140005718A1|2012-06-28|2014-01-02|Ethicon Endo-Surgery, Inc.|Multi-functional powered surgical device with external dissection features|

---

US20140001231A1|2012-06-28|2014-01-02|Ethicon Endo-Surgery, Inc.|Firing system lockout arrangements for surgical instruments|

---

US9364230B2|2012-06-28|2016-06-14|Ethicon Endo-Surgery, Llc|Surgical stapling instruments with rotary joint assemblies|

---

US9289256B2|2012-06-28|2016-03-22|Ethicon Endo-Surgery, Llc|Surgical end effectors having angled tissue-contacting surfaces|

---

US11197671B2|2012-06-28|2021-12-14|Cilag Gmbh International|Stapling assembly comprising a lockout|

---

RU2669463C2|2013-03-01|2018-10-11|Этикон Эндо-Серджери, Инк.|Surgical instrument with soft stop|

---

US9687230B2|2013-03-14|2017-06-27|Ethicon Llc|Articulatable surgical instrument comprising a firing drive|

---

US9629629B2|2013-03-14|2017-04-25|Ethicon Endo-Surgey, LLC|Control systems for surgical instruments|

---

US10136887B2|2013-04-16|2018-11-27|Ethicon Llc|Drive system decoupling arrangement for a surgical instrument|

---

MX369362B|2013-08-23|2019-11-06|Ethicon Endo Surgery Llc|Firing member retraction devices for powered surgical instruments.|

---

US20150053746A1|2013-08-23|2015-02-26|Ethicon Endo-Surgery, Inc.|Torque optimization for surgical instruments|

---

US9962161B2|2014-02-12|2018-05-08|Ethicon Llc|Deliverable surgical instrument|

---

US11259799B2|2014-03-26|2022-03-01|Cilag Gmbh International|Interface systems for use with surgical instruments|

---

US10004497B2|2014-03-26|2018-06-26|Ethicon Llc|Interface systems for use with surgical instruments|

---

JP6612256B2|2014-04-16|2019-11-27|エシコンエルエルシー|Fastener cartridge with non-uniform fastener|

---

US10561422B2|2014-04-16|2020-02-18|Ethicon Llc|Fastener cartridge comprising deployable tissue engaging members|

---

US9757128B2|2014-09-05|2017-09-12|Ethicon Llc|Multiple sensors with one sensor affecting a second sensor's output or interpretation|

---

BR112017004361A2|2014-09-05|2017-12-05|Ethicon Llc|medical overcurrent modular power supply|

---

BR112017005981A2|2014-09-26|2017-12-19|Ethicon Llc|surgical staplers and ancillary materials|

---

US9801627B2|2014-09-26|2017-10-31|Ethicon Llc|Fastener cartridge for creating a flexible staple line|

---

US10076325B2|2014-10-13|2018-09-18|Ethicon Llc|Surgical stapling apparatus comprising a tissue stop|

---

US9924944B2|2014-10-16|2018-03-27|Ethicon Llc|Staple cartridge comprising an adjunct material|

---

US11141153B2|2014-10-29|2021-10-12|Cilag Gmbh International|Staple cartridges comprising driver arrangements|

---

US9844376B2|2014-11-06|2017-12-19|Ethicon Llc|Staple cartridge comprising a releasable adjunct material|

---

US10736636B2|2014-12-10|2020-08-11|Ethicon Llc|Articulatable surgical instrument system|

---

US10085748B2|2014-12-18|2018-10-02|Ethicon Llc|Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors|

---

US9844374B2|2014-12-18|2017-12-19|Ethicon Llc|Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member|

---

US9844375B2|2014-12-18|2017-12-19|Ethicon Llc|Drive arrangements for articulatable surgical instruments|

---

US9968355B2|2014-12-18|2018-05-15|Ethicon Llc|Surgical instruments with articulatable end effectors and improved firing beam support arrangements|

---

US9987000B2|2014-12-18|2018-06-05|Ethicon Llc|Surgical instrument assembly comprising a flexible articulation system|

---

US11154301B2|2015-02-27|2021-10-26|Cilag Gmbh International|Modular stapling assembly|

---

US9993248B2|2015-03-06|2018-06-12|Ethicon Endo-Surgery, Llc|Smart sensors with local signal processing|

---

US9924961B2|2015-03-06|2018-03-27|Ethicon Endo-Surgery, Llc|Interactive feedback system for powered surgical instruments|

---

US10245033B2|2015-03-06|2019-04-02|Ethicon Llc|Surgical instrument comprising a lockable battery housing|

---

US9901342B2|2015-03-06|2018-02-27|Ethicon Endo-Surgery, Llc|Signal and power communication system positioned on a rotatable shaft|

---

US10617412B2|2015-03-06|2020-04-14|Ethicon Llc|System for detecting the mis-insertion of a staple cartridge into a surgical stapler|

---

US9808246B2|2015-03-06|2017-11-07|Ethicon Endo-Surgery, Llc|Method of operating a powered surgical instrument|

---

US10687806B2|2015-03-06|2020-06-23|Ethicon Llc|Adaptive tissue compression techniques to adjust closure rates for multiple tissue types|

---

US10548504B2|2015-03-06|2020-02-04|Ethicon Llc|Overlaid multi sensor radio frequencyelectrode system to measure tissue compression|

---

US11058425B2|2015-08-17|2021-07-13|Ethicon Llc|Implantable layers for a surgical instrument|

---

US10105139B2|2015-09-23|2018-10-23|Ethicon Llc|Surgical stapler having downstream current-based motor control|

---

US10238386B2|2015-09-23|2019-03-26|Ethicon Llc|Surgical stapler having motor control based on an electrical parameter related to a motor current|

---

US10299878B2|2015-09-25|2019-05-28|Ethicon Llc|Implantable adjunct systems for determining adjunct skew|

---

US10285699B2|2015-09-30|2019-05-14|Ethicon Llc|Compressible adjunct|

---

US10980539B2|2015-09-30|2021-04-20|Ethicon Llc|Implantable adjunct comprising bonded layers|

---

US10561420B2|2015-09-30|2020-02-18|Ethicon Llc|Tubular absorbable constructs|

---

US10548655B2|2015-10-16|2020-02-04|Ethicon Llc|Control and electrical connections for electrode endocutter device|

---

US10292704B2|2015-12-30|2019-05-21|Ethicon Llc|Mechanisms for compensating for battery pack failure in powered surgical instruments|

---

US10265068B2|2015-12-30|2019-04-23|Ethicon Llc|Surgical instruments with separable motors and motor control circuits|

---

US10368865B2|2015-12-30|2019-08-06|Ethicon Llc|Mechanisms for compensating for drivetrain failure in powered surgical instruments|

---

US10413291B2|2016-02-09|2019-09-17|Ethicon Llc|Surgical instrument articulation mechanism with slotted secondary constraint|

---

US11213293B2|2016-02-09|2022-01-04|Cilag Gmbh International|Articulatable surgical instruments with single articulation link arrangements|

---

US11224426B2|2016-02-12|2022-01-18|Cilag Gmbh International|Mechanisms for compensating for drivetrain failure in powered surgical instruments|

---

US10617413B2|2016-04-01|2020-04-14|Ethicon Llc|Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts|

---

US11179150B2|2016-04-15|2021-11-23|Cilag Gmbh International|Systems and methods for controlling a surgical stapling and cutting instrument|

---

US10357247B2|2016-04-15|2019-07-23|Ethicon Llc|Surgical instrument with multiple program responses during a firing motion|

---

US10335145B2|2016-04-15|2019-07-02|Ethicon Llc|Modular surgical instrument with configurable operating mode|

---

US10456137B2|2016-04-15|2019-10-29|Ethicon Llc|Staple formation detection mechanisms|

---

US10492783B2|2016-04-15|2019-12-03|Ethicon, Llc|Surgical instrument with improved stop/start control during a firing motion|

---

US10368867B2|2016-04-18|2019-08-06|Ethicon Llc|Surgical instrument comprising a lockout|

---

US20180168633A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical stapling instruments and staple-forming anvils|

---

US10888322B2|2016-12-21|2021-01-12|Ethicon Llc|Surgical instrument comprising a cutting member|

---

US20180168625A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical stapling instruments with smart staple cartridges|

---

US10736629B2|2016-12-21|2020-08-11|Ethicon Llc|Surgical tool assemblies with clutching arrangements for shifting between closure systems with closure stroke reduction features and articulation and firing systems|

---

US11160551B2|2016-12-21|2021-11-02|Cilag Gmbh International|Articulatable surgical stapling instruments|

---

US20180168618A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical stapling systems|

---

JP2020501779A|2016-12-21|2020-01-23|エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ|Surgical stapling system|

---

US11191539B2|2016-12-21|2021-12-07|Cilag Gmbh International|Shaft assembly comprising a manually-operable retraction system for use with a motorized surgical instrument system|

---

US10426471B2|2016-12-21|2019-10-01|Ethicon Llc|Surgical instrument with multiple failure response modes|

---

US11134942B2|2016-12-21|2021-10-05|Cilag Gmbh International|Surgical stapling instruments and staple-forming anvils|

---

US11179155B2|2016-12-21|2021-11-23|Cilag Gmbh International|Anvil arrangements for surgical staplers|

---

US10675026B2|2016-12-21|2020-06-09|Ethicon Llc|Methods of stapling tissue|

---

US20180168598A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Staple forming pocket arrangements comprising zoned forming surface grooves|

---

US20180168608A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical instrument system comprising an end effector lockout and a firing assembly lockout|

---

US10779823B2|2016-12-21|2020-09-22|Ethicon Llc|Firing member pin angle|

---

US10980537B2|2017-06-20|2021-04-20|Ethicon Llc|Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations|

---

US11090046B2|2017-06-20|2021-08-17|Cilag Gmbh International|Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument|

---

USD890784S1|2017-06-20|2020-07-21|Ethicon Llc|Display panel with changeable graphical user interface|

---

USD879809S1|2017-06-20|2020-03-31|Ethicon Llc|Display panel with changeable graphical user interface|

---

US11071554B2|2017-06-20|2021-07-27|Cilag Gmbh International|Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements|

---

US10307170B2|2017-06-20|2019-06-04|Ethicon Llc|Method for closed loop control of motor velocity of a surgical stapling and cutting instrument|

---

US10881399B2|2017-06-20|2021-01-05|Ethicon Llc|Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument|

---

US10646220B2|2017-06-20|2020-05-12|Ethicon Llc|Systems and methods for controlling displacement member velocity for a surgical instrument|

---

USD879808S1|2017-06-20|2020-03-31|Ethicon Llc|Display panel with graphical user interface|

---

US10813639B2|2017-06-20|2020-10-27|Ethicon Llc|Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions|

---

US10881396B2|2017-06-20|2021-01-05|Ethicon Llc|Surgical instrument with variable duration trigger arrangement|

---

US10624633B2|2017-06-20|2020-04-21|Ethicon Llc|Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument|

---

US10888321B2|2017-06-20|2021-01-12|Ethicon Llc|Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument|

---

US10779820B2|2017-06-20|2020-09-22|Ethicon Llc|Systems and methods for controlling motor speed according to user input for a surgical instrument|

---

US11141154B2|2017-06-27|2021-10-12|Cilag Gmbh International|Surgical end effectors and anvils|

---

US10856869B2|2017-06-27|2020-12-08|Ethicon Llc|Surgical anvil arrangements|

---

US10772629B2|2017-06-27|2020-09-15|Ethicon Llc|Surgical anvil arrangements|

---

US10993716B2|2017-06-27|2021-05-04|Ethicon Llc|Surgical anvil arrangements|

---

US11266405B2|2017-06-27|2022-03-08|Cilag Gmbh International|Surgical anvil manufacturing methods|

---

US11129666B2|2017-06-28|2021-09-28|Cilag Gmbh International|Shaft module circuitry arrangements|

---

US10888369B2|2017-06-28|2021-01-12|Ethicon Llc|Systems and methods for controlling control circuits for independent energy delivery over segmented sections|

---

US10888325B2|2017-06-28|2021-01-12|Ethicon Llc|Cartridge arrangements for surgical cutting and fastening instruments with lockout disablement features|

---

US10813640B2|2017-06-28|2020-10-27|Ethicon Llc|Method of coating slip rings|

---

USD865175S1|2017-06-28|2019-10-29|Ethicon Llc|Staple cartridge for surgical instrument|

---

USD906355S1|2017-06-28|2020-12-29|Ethicon Llc|Display screen or portion thereof with a graphical user interface for a surgical instrument|

---

US11103301B2|2017-06-28|2021-08-31|Cilag Gmbh International|Surgical system coupleable with staple cartridge and radio frequency cartridge, and having a plurality of radio-frequency energy return paths|

---

US11246592B2|2017-06-28|2022-02-15|Cilag Gmbh International|Surgical instrument comprising an articulation system lockable to a frame|

---

US10716614B2|2017-06-28|2020-07-21|Ethicon Llc|Surgical shaft assemblies with slip ring assemblies with increased contact pressure|

---

US10639037B2|2017-06-28|2020-05-05|Ethicon Llc|Surgical instrument with axially movable closure member|

---

US11013552B2|2017-06-28|2021-05-25|Cilag Gmbh International|Electrosurgical cartridge for use in thin profile surgical cutting and stapling instrument|

---

US20190000474A1|2017-06-28|2019-01-03|Ethicon Llc|Surgical instrument comprising selectively actuatable rotatable couplers|

---

US11058477B2|2017-06-28|2021-07-13|Cilag Gmbh International|Surgical cutting and fastening instruments with dual power sources|

---

USD893717S1|2017-06-28|2020-08-18|Ethicon Llc|Staple cartridge for surgical instrument|

---

USD908216S1|2017-06-28|2021-01-19|Ethicon Llc|Surgical instrument|

---

US11065048B2|2017-06-28|2021-07-20|Cilag Gmbh International|Flexible circuit arrangement for surgical fastening instruments|

---

US11259805B2|2017-06-28|2022-03-01|Cilag Gmbh International|Surgical instrument comprising firing member supports|

---

USD869655S1|2017-06-28|2019-12-10|Ethicon Llc|Surgical fastener cartridge|

---

US10765427B2|2017-06-28|2020-09-08|Ethicon Llc|Method for articulating a surgical instrument|

---

US10903685B2|2017-06-28|2021-01-26|Ethicon Llc|Surgical shaft assemblies with slip ring assemblies forming capacitive channels|

---

US11160604B2|2017-06-28|2021-11-02|Cilag Gmbh International|Surgical end effector to adjust jaw compression|

---

US10898183B2|2017-06-29|2021-01-26|Ethicon Llc|Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing|

---

US11007022B2|2017-06-29|2021-05-18|Ethicon Llc|Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument|

---

US10932772B2|2017-06-29|2021-03-02|Ethicon Llc|Methods for closed loop velocity control for robotic surgical instrument|

---

US10743872B2|2017-09-29|2020-08-18|Ethicon Llc|System and methods for controlling a display of a surgical instrument|

---

USD917500S1|2017-09-29|2021-04-27|Ethicon Llc|Display screen or portion thereof with graphical user interface|

---

US10796471B2|2017-09-29|2020-10-06|Ethicon Llc|Systems and methods of displaying a knife position for a surgical instrument|

---

US10729501B2|2017-09-29|2020-08-04|Ethicon Llc|Systems and methods for language selection of a surgical instrument|

---

USD907647S1|2017-09-29|2021-01-12|Ethicon Llc|Display screen or portion thereof with animated graphical user interface|

---

US10765429B2|2017-09-29|2020-09-08|Ethicon Llc|Systems and methods for providing alerts according to the operational state of a surgical instrument|

---

USD907648S1|2017-09-29|2021-01-12|Ethicon Llc|Display screen or portion thereof with animated graphical user interface|

---

US11103268B2|2017-10-30|2021-08-31|Cilag Gmbh International|Surgical clip applier comprising adaptive firing control|

---

US11141160B2|2017-10-30|2021-10-12|Cilag Gmbh International|Clip applier comprising a motor controller|

---

US11090075B2|2017-10-30|2021-08-17|Cilag Gmbh International|Articulation features for surgical end effector|

---

US11229436B2|2017-10-30|2022-01-25|Cilag Gmbh International|Surgical system comprising a surgical tool and a surgical hub|

---

US11134944B2|2017-10-30|2021-10-05|Cilag Gmbh International|Surgical stapler knife motion controls|

---

US10779903B2|2017-10-31|2020-09-22|Ethicon Llc|Positive shaft rotation lock activated by jaw closure|

---

US10842490B2|2017-10-31|2020-11-24|Ethicon Llc|Cartridge body design with force reduction based on firing completion|

---

US11033267B2|2017-12-15|2021-06-15|Ethicon Llc|Systems and methods of controlling a clamping member firing rate of a surgical instrument|

---

US10779826B2|2017-12-15|2020-09-22|Ethicon Llc|Methods of operating surgical end effectors|

---

US10743875B2|2017-12-15|2020-08-18|Ethicon Llc|Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member|

---

US10966718B2|2017-12-15|2021-04-06|Ethicon Llc|Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments|

---

US11071543B2|2017-12-15|2021-07-27|Cilag Gmbh International|Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges|

---

US11006955B2|2017-12-15|2021-05-18|Ethicon Llc|End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments|

---

US10687813B2|2017-12-15|2020-06-23|Ethicon Llc|Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments|

---

US10869666B2|2017-12-15|2020-12-22|Ethicon Llc|Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument|

---

US10743874B2|2017-12-15|2020-08-18|Ethicon Llc|Sealed adapters for use with electromechanical surgical instruments|

---

US10828033B2|2017-12-15|2020-11-10|Ethicon Llc|Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto|

---

US11197670B2|2017-12-15|2021-12-14|Cilag Gmbh International|Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed|

---

US10779825B2|2017-12-15|2020-09-22|Ethicon Llc|Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments|

---

US11045270B2|2017-12-19|2021-06-29|Cilag Gmbh International|Robotic attachment comprising exterior drive actuator|

---

USD910847S1|2017-12-19|2021-02-16|Ethicon Llc|Surgical instrument assembly|

---

US10835330B2|2017-12-19|2020-11-17|Ethicon Llc|Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly|

---

US10729509B2|2017-12-19|2020-08-04|Ethicon Llc|Surgical instrument comprising closure and firing locking mechanism|

---

US10716565B2|2017-12-19|2020-07-21|Ethicon Llc|Surgical instruments with dual articulation drivers|

---

US11020112B2|2017-12-19|2021-06-01|Ethicon Llc|Surgical tools configured for interchangeable use with different controller interfaces|

---

US10743868B2|2017-12-21|2020-08-18|Ethicon Llc|Surgical instrument comprising a pivotable distal head|

---

US11076853B2|2017-12-21|2021-08-03|Cilag Gmbh International|Systems and methods of displaying a knife position during transection for a surgical instrument|

---

US11129680B2|2017-12-21|2021-09-28|Cilag Gmbh International|Surgical instrument comprising a projector|

---

US11253315B2|2017-12-28|2022-02-22|Cilag Gmbh International|Increasing radio frequency to create pad-less monopolar loop|

---

US11056244B2|2017-12-28|2021-07-06|Cilag Gmbh International|Automated data scaling, alignment, and organizing based on predefined parameters within surgical networks|

---

US11234756B2|2017-12-28|2022-02-01|Cilag Gmbh International|Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter|

---

US11166772B2|2017-12-28|2021-11-09|Cilag Gmbh International|Surgical hub coordination of control and communication of operating room devices|

---

US11051876B2|2017-12-28|2021-07-06|Cilag Gmbh International|Surgical evacuation flow paths|

---

US11160605B2|2017-12-28|2021-11-02|Cilag Gmbh International|Surgical evacuation sensing and motor control|

---

US10849697B2|2017-12-28|2020-12-01|Ethicon Llc|Cloud interface for coupled surgical devices|

---

US11179208B2|2017-12-28|2021-11-23|Cilag Gmbh International|Cloud-based medical analytics for security and authentication trends and reactive measures|

---

US10943454B2|2017-12-28|2021-03-09|Ethicon Llc|Detection and escalation of security responses of surgical instruments to increasing severity threats|

---

US11213359B2|2017-12-28|2022-01-04|Cilag Gmbh International|Controllers for robot-assisted surgical platforms|

---

US11076921B2|2017-12-28|2021-08-03|Cilag Gmbh International|Adaptive control program updates for surgical hubs|

---

US10932872B2|2017-12-28|2021-03-02|Ethicon Llc|Cloud-based medical analytics for linking of local usage trends with the resource acquisition behaviors of larger data set|

---

US20190274716A1|2017-12-28|2019-09-12|Ethicon Llc|Determining the state of an ultrasonic end effector|

---

US11257589B2|2017-12-28|2022-02-22|Cilag Gmbh International|Real-time analysis of comprehensive cost of all instrumentation used in surgery utilizing data fluidity to track instruments through stocking and in-house processes|

---

US10695081B2|2017-12-28|2020-06-30|Ethicon Llc|Controlling a surgical instrument according to sensed closure parameters|

---

US10944728B2|2017-12-28|2021-03-09|Ethicon Llc|Interactive surgical systems with encrypted communication capabilities|

---

US20190205001A1|2017-12-28|2019-07-04|Ethicon Llc|Sterile field interactive control displays|

---

US11045591B2|2017-12-28|2021-06-29|Cilag Gmbh International|Dual in-series large and small droplet filters|

---

US11266468B2|2017-12-28|2022-03-08|Cilag Gmbh International|Cooperative utilization of data derived from secondary sources by intelligent surgical hubs|

---

US10758310B2|2017-12-28|2020-09-01|Ethicon Llc|Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices|

---

US10966791B2|2017-12-28|2021-04-06|Ethicon Llc|Cloud-based medical analytics for medical facility segmented individualization of instrument function|

---

US11132462B2|2017-12-28|2021-09-28|Cilag Gmbh International|Data stripping method to interrogate patient records and create anonymized record|

---

US20190201146A1|2017-12-28|2019-07-04|Ethicon Llc|Safety systems for smart powered surgical stapling|

---

US11202570B2|2017-12-28|2021-12-21|Cilag Gmbh International|Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems|

---

US10892899B2|2017-12-28|2021-01-12|Ethicon Llc|Self describing data packets generated at an issuing instrument|

---

US20190206551A1|2017-12-28|2019-07-04|Ethicon Llc|Spatial awareness of surgical hubs in operating rooms|

---

US20190201087A1|2017-12-28|2019-07-04|Ethicon Llc|Smoke evacuation system including a segmented control circuit for interactive surgical platform|

---

US11100631B2|2017-12-28|2021-08-24|Cilag Gmbh International|Use of laser light and red-green-blue coloration to determine properties of back scattered light|

---

US10987178B2|2017-12-28|2021-04-27|Ethicon Llc|Surgical hub control arrangements|

---

US11096693B2|2017-12-28|2021-08-24|Cilag Gmbh International|Adjustment of staple height of at least one row of staples based on the sensed tissue thickness or force in closing|

---

US11013563B2|2017-12-28|2021-05-25|Ethicon Llc|Drive arrangements for robot-assisted surgical platforms|

---

US11109866B2|2017-12-28|2021-09-07|Cilag Gmbh International|Method for circular stapler control algorithm adjustment based on situational awareness|

---

US11147607B2|2017-12-28|2021-10-19|Cilag Gmbh International|Bipolar combination device that automatically adjusts pressure based on energy modality|

---

US10892995B2|2017-12-28|2021-01-12|Ethicon Llc|Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs|

---

US11069012B2|2017-12-28|2021-07-20|Cilag Gmbh International|Interactive surgical systems with condition handling of devices and data capabilities|

---

US11259830B2|2018-03-08|2022-03-01|Cilag Gmbh International|Methods for controlling temperature in ultrasonic device|

---

US11197668B2|2018-03-28|2021-12-14|Cilag Gmbh International|Surgical stapling assembly comprising a lockout and an exterior access orifice to permit artificial unlocking of the lockout|

---

US11219453B2|2018-03-28|2022-01-11|Cilag Gmbh International|Surgical stapling devices with cartridge compatible closure and firing lockout arrangements|

---

US11166716B2|2018-03-28|2021-11-09|Cilag Gmbh International|Stapling instrument comprising a deactivatable lockout|

---

US10973520B2|2018-03-28|2021-04-13|Ethicon Llc|Surgical staple cartridge with firing member driven camming assembly that has an onboard tissue cutting feature|

---

US11213294B2|2018-03-28|2022-01-04|Cilag Gmbh International|Surgical instrument comprising co-operating lockout features|

---

US11096688B2|2018-03-28|2021-08-24|Cilag Gmbh International|Rotary driven firing members with different anvil and channel engagement features|

---

US11090047B2|2018-03-28|2021-08-17|Cilag Gmbh International|Surgical instrument comprising an adaptive control system|

---

US20190298350A1|2018-03-28|2019-10-03|Ethicon Llc|Methods for controlling a powered surgical stapler that has separate rotary closure and firing systems|

---

US11207067B2|2018-03-28|2021-12-28|Cilag Gmbh International|Surgical stapling device with separate rotary driven closure and firing systems and firing member that engages both jaws while firing|

---

US11083458B2|2018-08-20|2021-08-10|Cilag Gmbh International|Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions|

---

US11045192B2|2018-08-20|2021-06-29|Cilag Gmbh International|Fabricating techniques for surgical stapler anvils|

---

US10779821B2|2018-08-20|2020-09-22|Ethicon Llc|Surgical stapler anvils with tissue stop features configured to avoid tissue pinch|

---

US11253256B2|2018-08-20|2022-02-22|Cilag Gmbh International|Articulatable motor powered surgical instruments with dedicated articulation motor arrangements|

---

USD914878S1|2018-08-20|2021-03-30|Ethicon Llc|Surgical instrument anvil|

---

US11207065B2|2018-08-20|2021-12-28|Cilag Gmbh International|Method for fabricating surgical stapler anvils|

---

US11039834B2|2018-08-20|2021-06-22|Cilag Gmbh International|Surgical stapler anvils with staple directing protrusions and tissue stability features|

---

US10912559B2|2018-08-20|2021-02-09|Ethicon Llc|Reinforced deformable anvil tip for surgical stapler anvil|

---

US10842492B2|2018-08-20|2020-11-24|Ethicon Llc|Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system|

---

US10856870B2|2018-08-20|2020-12-08|Ethicon Llc|Switching arrangements for motor powered articulatable surgical instruments|

---

US11259807B2|2019-02-19|2022-03-01|Cilag Gmbh International|Staple cartridges with cam surfaces configured to engage primary and secondary portions of a lockout of a surgical stapling device|

---

US11147551B2|2019-03-25|2021-10-19|Cilag Gmbh International|Firing drive arrangements for surgical systems|

---

US11147553B2|2019-03-25|2021-10-19|Cilag Gmbh International|Firing drive arrangements for surgical systems|

---

US11172929B2|2019-03-25|2021-11-16|Cilag Gmbh International|Articulation drive arrangements for surgical systems|

---

US11218822B2|2019-03-29|2022-01-04|Cilag Gmbh International|Audio tone construction for an energy module of a modular energy system|

---

US11253254B2|2019-04-30|2022-02-22|Cilag Gmbh International|Shaft rotation actuator on a surgical instrument|

---

US20200375596A1|2019-05-28|2020-12-03|Ethicon Llc|Nozzle Fluid Ingress Prevention Features for Surgical Stapler|

---

US11207146B2|2019-06-27|2021-12-28|Cilag Gmbh International|Surgical instrument drive systems with cable-tightening system|

---

US11013569B2|2019-06-27|2021-05-25|Cilag Gmbh International|Surgical systems with interchangeable motor packs|

---

US11051807B2|2019-06-28|2021-07-06|Cilag Gmbh International|Packaging assembly including a particulate trap|

---

US11259803B2|2019-06-28|2022-03-01|Cilag Gmbh International|Surgical stapling system having an information encryption protocol|

---

US11224497B2|2019-06-28|2022-01-18|Cilag Gmbh International|Surgical systems with multiple RFID tags|

---

US11219455B2|2019-06-28|2022-01-11|Cilag Gmbh International|Surgical instrument including a lockout key|

---

US11241235B2|2019-06-28|2022-02-08|Cilag Gmbh International|Method of using multiple RFID chips with a surgical assembly|

---

US11246678B2|2019-06-28|2022-02-15|Cilag Gmbh International|Surgical stapling system having a frangible RFID tag|

---

USD928726S1|2019-09-05|2021-08-24|Cilag Gmbh International|Energy module monopolar port|

---

USD928725S1|2019-09-05|2021-08-24|Cilag Gmbh International|Energy module|

---

USD939545S1|2019-09-05|2021-12-28|Cilag Gmbh International|Display panel or portion thereof with graphical user interface for energy module|

---

US11234698B2|2019-12-19|2022-02-01|Cilag Gmbh International|Stapling system comprising a clamp lockout and a firing lockout|

法律状态:
2021-11-03| B350| Update of information on the portal [chapter 15.35 patent gazette]|

优先权:

---

申请号 | 申请日 | 专利标题

---

US15/636,096|2017-06-28|

---

US15/636,096|US20190000478A1|2017-06-28|2017-06-28|Surgical system couplable with staple cartridge and radio frequency cartridge, and method of using same|

---

PCT/IB2018/054259|WO2019003008A2|2017-06-28|2018-06-12|Surgical system couplable with staple cartridge and radio frequency cartridge, and method of using same|

---