electrosurgical cartridge for use in a thin profile surgical cutting and stapling instrument

专利摘要:
The present description relates to a surgical instrument that includes an end actuator configured to receive a cutting element slidably. The end actuator includes a first jaw and a second jaw that is movable with respect to the first jaw, a hot zone on a central portion of the end actuator, and cold zones on both side portions of the end actuator. The first and second jaws define an elongated slit disposed between them, for slidingly receiving the cutting member inside the elongated slit to cut the fabric located between the first and the second jaws. The first claw includes a first insulating layer and a second insulating layer in the hot zone, a first electrode layer in the first insulating layer, a second electrode layer in the second insulating layer and layers of heat sink in the cold zones. The heat sink layers are configured to cool the fabric in the cold zones to minimize lateral thermal spread.
公开号:BR112019026816A2
申请号:R112019026816-2
申请日:2018-06-12
公开日:2020-06-30
发明作者:Tamara Widenhouse；David C. Yates；Frederick E. Shelton Iv
申请人:Ethicon Llc；
IPC主号:

专利说明:

[001] [001] The present invention relates to surgical instruments and, in various circumstances, surgical instruments for stapling and cutting, and staple cartridges for them, which are designed to staple and cut fabrics. BACKGROUND
[002] [002] In several open, endoscopic and / or laparoscopic surgeries, for example, it may be desirable to clot, seal and / or fuse tissue. A tissue sealing method relies on the application of energy, such as electrical energy, to, for example, tissue captured or trapped within an end actuator or a set of end actuators in a surgical instrument to cause thermal effects within the tissue. Several monopolar and bipolar radiofrequency (RF) surgical instruments and surgical techniques have been developed for these purposes. In general, the application 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 inside the tissue. Such proteins, such as collagen, for example, can be denatured into an amalgam that mixes and fuses, or seals, as the proteins renature. As the treated region recovers over time, this biological seal can be reabsorbed by the body's wound healing process. SUMMARY
[003] [003] In one aspect, a surgical instrument includes an end actuator configured to slide a cutting member. The end actuator includes a first jaw, a second jaw that is movable relative to the first jaw, a hot zone in a central portion of the end actuator, a first cold zone in a left side portion of the end actuator, and a second cold zone on a right side portion of the end actuator. The first and second jaws define an elongated slot arranged between them to slide the cutting member into the elongated slot to slide the fabric between the first jaw and the second jaw. The elongated slot is located in the central portion of the end actuator. The first claw includes a first insulating layer and a second insulating layer in the hot zone, a first electrode layer in the first insulating layer, a second electrode layer in the second insulating layer, a first heat dissipating layer in the first cold zone and a second layer of heat dissipation in the second cold zone. The first insulating layer is on the left side of the elongated crack and the second insulating layer is on the right side of the elongated crack. The first electrode layer and the second electrode layer are configured for direct application of electrosurgical energy to the tissue in the hot zone. The first heat dissipation layer and the second heat dissipation layer are configured to cool the fabric in the first and second cold zones to minimize lateral thermal propagation.
[004] [004] In one aspect, a surgical instrument includes an end actuator configured to slide a blade. The end actuator includes a first jaw, a second jaw that is movable with respect to the first jaw, a hot zone in a central portion of the end actuator, a first cold zone in a left side portion of the end actuator, a second zone cold on a right side portion of the end actuator, and a dissector tip on a distal end of the end actuator. The first jaw and the second jaw define an elongated slot arranged between them to slide a blade into the elongated slot to cut the fabric between the first jaw and the second jaw. The elongated slot is located in the central portion of the end actuator. The first claw includes a first insulating layer and a second insulating layer in the hot zone, a first electrode layer in the first insulating layer, a second electrode layer in the second insulating layer, a first heat dissipating layer in the first cold zone and a second layer of heat dissipation in the second cold zone. The first insulating layer is on the left side of the elongated crack and the second insulating layer is on the right side of the elongated crack. The first electrode layer and the second electrode layer are configured for direct application of electrosurgical energy to the tissue in the hot zone. Each of the first electrode layer and the second electrode layer comprises a direct contact metallic electrode. The first heat dissipation layer and the second heat dissipation layer are configured to cool the fabric in the first and second cold zones to minimize lateral thermal propagation.
[005] [005] The above mentioned summary is only illustrative and is not intended to be limiting in any way. In addition to the illustrative features and characteristics described above, additional features and characteristics will become evident through reference to the drawings and detailed description below. FIGURES
[006] [006] The innovative characteristics of the aspects described here are presented with particularity in the attached claims. However, these aspects, both in relation to the organization and the methods of operation, can be better understood by reference to the description below, taken in conjunction with the attached drawings.
[007] [007] Figure 1 is a perspective view of a surgical system that includes a handle set coupled to an interchangeable surgical tool set that is configured to be used in conjunction with conventional surgical clamp / clamp cartridges and radio frequency cartridges ( RF) according to one aspect of this description.
[008] [008] Figure 2 is an exploded perspective view of the surgical system of Figure 1, according to an aspect of this description.
[009] [009] 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 an aspect of this description.
[0010] [0010] Figure 4 is an exploded view of a proximal portion of the interchangeable surgical tool set of Figures 1 to 3, according to an aspect of this description.
[0011] [0011] 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.
[0012] [0012] Figure 6 is a partial cross-sectional view of the end actuator represented in Figures 1 to 5 that supports an RF cartridge in it and with the tissue trapped between the cartridge and the anvil, according to one aspect of this description .
[0013] [0013] Figure 7 is a partial cross-sectional view of the anvil of Figure 6, according to one aspect of this description.
[0014] [0014] Figure 8 is another exploded view of a portion of the interchangeable surgical tool set of Figures 1 to 5, according to an aspect of this description.
[0015] [0015] 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.
[0016] [0016] 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 that description.
[0017] [0017] Figure 11 is a partial perspective view of portions of the RF cartridge and elongated channel of Figure 10 with a knife member, in accordance with an aspect of this description.
[0018] [0018] Figure 12 is another perspective view of the RF cartridge installed in the elongated channel of Figure 10 and illustrating a portion of a flexible drive shaft circuit arrangement, in accordance with an aspect of this description.
[0019] [0019] Figure 13 is an end view in cross section of the RF cartridge and elongated channel of Figure 12, taken along lines 13-13 in Figure 12, according to an aspect of this description.
[0020] [0020] Figure 14 is an upper cross-sectional view of a portion of the interchangeable surgical tool set of Figures 1 and 5 with its end actuator in an articulated position, according to an aspect of this description.
[0021] [0021] Figure 15 is a perspective view of an integrated circuit board layout and configuration plus RF generator, according to an aspect of this description.
[0022] [0022] Figures 16A and 16B are a block diagram of a control circuit for the surgical instrument of Figure 1 comprising two drawing sheets, according to one aspect of this description.
[0023] [0023] Figure 17 is a block diagram of the control circuit of the surgical instrument of Figure 1 illustrating interfaces between the handle assembly, the feeding assembly, and the handle assembly and the interchangeable drive shaft assembly, in accordance with an aspect of the present description.
[0024] [0024] Figure 18 is a schematic diagram of a surgical instrument configured to control various functions, according to an aspect of this description.
[0025] [0025] Figure 19 is a schematic cross-sectional view of an electrosurgical end actuator, according to an aspect of the present description.
[0026] [0026] Figure 20 is a perspective view of an end actuator, in accordance with an aspect of the present description. DESCRIPTION
[0027] [0027] The applicant for the present application holds the following patent applications filed simultaneously with the same and which are each incorporated in this document for reference in their respective totalities:
[0028] [0028] power of attorney document END8184USNP / 170063, entitled SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, by the inventors Jeffrey D. Messerly et al., Filed on June 28, 2017.
[0029] [0029] power of attorney document END8183USNP / 170064, entitled SYSTEMS AND METHODS OF DISPLAYING SURGICAL INSTRUMENT STATUS, by the inventors Jeffrey D. Messerly et al., Filed on June 28, 2017.
[0030] [0030] power of attorney document END8190USNP / 170065, entitled SHAFT MODULE CIRCUITRY ARRANGEMENTS, by the inventors Jeffrey D. Messerly et al., Filed on June 28, 2017.
[0031] [0031] n ° of the power of attorney document END8189USNP / 170066, entitled SYSTEMS AND METHODS FOR CONTROLLING CONTROL
[0032] [0032] power of attorney document END8185USNP / 160045170067, entitled FLEXIBLE CIRCUIT ARRANGEMENT FOR SURGICAL FASTENING INSTRUMENTS, by the inventors Jeffrey D. Messerly et al., Filed on June 28, 2017.
[0033] [0033] power of attorney document END8188USNP / 170068, entitled SURGICAL SYSTEM COUPLEABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND HAVING A PLURALITY OF RADIO-FREQUENCY ENERGY RETURN PATHS, by the inventors Jeffrey D. Messerly et al., Deposited on 28 June 2017.
[0034] [0034] power of attorney document END8181USNP / 170069, entitled SYSTEMS AND METHODS FOR CONTROLLING
[0035] [0035] power of attorney document END8187USNP / 170070, entitled SURGICAL END EFFECTOR FOR APPLYING
[0036] [0036] power of attorney document END8186USNP / 170072, entitled SURGICAL END EFFECTOR TO ADJUST JAW COMPRESSION, by the inventors Frederick E. Shelton, IV et al., Filed in June 2017.
[0037] [0037] n ° of the power of attorney document END8224USNP / 170073, entitled CARTRIDGE ARRANGEMENTS FOR SURGICAL CUTTING
[0038] [0038] power of attorney document END8229USNP / 170074, entitled SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH DUAL POWER SOURCES, by the inventors Jeffrey D. Messerly et al., Filed on June 28, 2017.
[0039] [0039] Electrosurgical devices can be used in many surgical operations. Electrosurgical devices can apply electrical energy to the tissue to treat the tissue. An electrosurgical device may 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 active electrode (or source) in the end actuator and returned via a return electrode. The return electrode can be a grounding block and located separately on a patient's body. During bipolar operation, current can be introduced into the tissue and returned from it, respectively, through the active and return electrodes of the end actuator.
[0040] [0040] 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 can be movable from a spaced position of the opposite claw to receive tissue in 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 tissue retained between it. The heat generated by the current flow through the tissue in combination with the compression obtained by the movement of the claw can form hemostatic seals within the tissue and / or between tissues and, therefore, 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.
[0041] [0041] Electrosurgical devices may also include mechanisms for securing 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 for placing the end actuator in a position adjacent to the tissue being treated. The drive shaft can be straight or curved, foldable or non-foldable. In an electrosurgical device that includes a straight and foldable drive shaft, the drive shaft can have one or more articulated joints to allow controlled flexing 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 an axis non-folding straight drive.
[0042] [0042] The electrical energy applied by the electrosurgical devices can be transmitted to the instrument by a generator in communication with the handpiece. The electrical energy may 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 adjacent non-target tissue.
[0043] [0043] RF energy can be in a frequency range described in document EN 60601-2-2: 2009 + A11: 2011, Definition
[0044] [0044] Figures 1 and 2 depict a motor-driven surgical system 10 that can be used to perform a variety of different surgical procedures. In the illustrated arrangement, surgical system 10 comprises an interchangeable surgical tool set 1000 which is operatively coupled to a handle set 500. In another aspect of the surgical system, the interchangeable surgical tool set can be effectively employed with a tool of a robotically controlled or automated surgical system. For example, the surgical tool set 1000 disclosed herein can be used with various robotic systems, instruments, components and methods such as, but not limited to, those disclosed in US Patent No. 9,072,535, entitled "SURGICAL STAPLING
[0045] [0045] In the illustrated aspect, the handle assembly 500 may comprise a handle compartment 502 that includes a pistol handle portion 504 that can be held and manipulated by the physician. As will be briefly discussed below, the handle set 500 operationally supports a plurality of drive systems, which 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 set handle 500 may also include a handle structure 506 that operationally supports the plurality of drive systems. For example, the 506 handle structure can operationally support a "first" closing drive system or system, generally referred to as 510, which can be used to apply closing and opening movements to the interchangeable surgical tool set
[0046] [0046] In at least one form, the handle assembly 500 and the handle structure 506 can operationally support another drive system called in the present invention a 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 the
[0047] [0047] 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 motor 505 is driven in a rotating direction, the longitudinally movable drive member 540 will be axially driven in a distal "DD" direction. When the motor 505 is driven in the opposite rotating direction, the longitudinally movable driving member 540 will be driven axially in the proximal direction "PD". The grip set 500 may include a switch 513 that can be configured to reverse the polarity applied to the electric motor 505 by power source 522 or otherwise control the engine 505. The grip set 500 may also include a sensor or sensors ( not shown) that are configured to detect the position of the drive member and / or the direction in which the drive member is being moved. The actuation of the 505 motor can be controlled by a trigger trigger (not shown) that is in a position adjacent to the closing trigger 512 and pivotally supported in the handle set 500. The trigger trigger can be pivoted between an unacted position and an acted position. The trigger can be moved to the unacted position by means of a spring or other propensity arrangement so that when the doctor releases the trigger, it can be rotated or otherwise returned to the untreated position. actuated by means of the spring or the propensity arrangement. In at least one way, the trigger trigger can be positioned "away from the center" of the closing trigger 512. As discussed in US Patent Application Publication No. 2015/0272575, the grip handle 500 can be equipped with a button trigger trigger safety (not shown) to prevent inadvertent triggering. When the closing trigger 512 is in the unacted position, the safety button is contained in the handle assembly 500, where the doctor cannot readily access it and move it between a safety position, which prevents the trigger from operating trigger, and a trigger position in which the trigger can be fired. When the physician presses the closing trigger 512, the safety button and trigger trigger 532 pivot down to a position where they can then be manipulated by the physician.
[0048] [0048] 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 gear arrangement (not shown) that interfaces with the motor. See Figure 3. Additional details regarding those features can be found in US Patent Application Publication No. 2015/0272575. In at least one provision, however,
[0049] [0049] 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 1600 comprises an elongated channel 1602 which is configured to operationally support a conventional surgical (mechanical) staple / fastener cartridge 1400 (Figure 4) or a 1700 radio frequency (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 positions and closed by actuation of the closing drive system 510. In the illustrated arrangement, the anvil 1810 is pivotally supported on a proximal end portion of the elongated channel 1602 for selective pivoting displacement around a geometric pivot axis that is transverse to the 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 which is attached to a 1920 hinge connector.
[0050] [0050] Returning to Figure 4, the hinge connector 1920 includes upper and lower protrusions 1922, 1924 that project distally from a distal end of the hinge connector 1920 to be movably coupled to an actuator closing sleeve. end or segment of distal closing tube
[0051] [0051] 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 distal closing tube segment 1930 is retracted in the proximal direction PD to an initial position. Additional details regarding the opening and closing of the 1810 anvil can be found in the US patent application, entitled
[0052] [0052] As shown in Figure 5, in at least one arrangement, the interchangeable surgical tool kit 1000 includes a tool frame assembly 1200 comprising a tool chassis 1210 that operationally supports a nozzle assembly 1240 therein. As further discussed in 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 hereof, which is hereby incorporated by reference in its entirety for reference in the present invention, 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. Such rotational 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 central column assembly 1250 that operationally supports the proximal closing tube 1910 and is coupled to the surgical end actuator 1500. In various circumstances , to facilitate assembly, the central speaker assembly 1250 can be manufactured from a segment the upper center column 1251 and a lower center column segment 1252 which are interconnected together by snap-fit, adhesive, welding, etc. In assembled form, the center column assembly 1250 includes a proximal end 1253 that is swiveled on the tool chassis 1210. In one arrangement, for example, the proximal end 1253 of the center column assembly 1250 is attached to a dorsal bearing (not shown) that is configured to be supported within the tool chassis 1210. This arrangement facilitates the swiveling attachment of the center column assembly 1250 to the tool chassis, so that the center column assembly 1250 can be selectively rotated around an axis of the SA drive shaft in relation to the tool chassis 1210.
[0053] [0053] As shown in Figure 4, the upper center column segment 1251 ends in an upper tab assembly feature 1260 and the lower center column segment 1252 ends in a lower tab assembly feature 1270. The upper tab 1260 is formed with a tab slot 1262 in it which is adapted to support a mountable upper link 1264 thereon. Similarly, the lower tab assembly feature 1270 is formed with a tab slot 1272 in it which is adapted to mount a lower assembly link 1274 thereon. The upper link 1264 includes a pivot socket 1266 in which it is displaced from the axis of the drive shaft SA. The pivot socket 1266 is adapted to pivot a pivot pin 1634 which is formed in a cap retainer or channel anvil 1630 which is fixed to a proximal end portion 1610 of the elongated channel 1602. The link of lower assembly 1274 includes a 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 in relation to the drive shaft SA geometric axis. 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 SA drive shaft geometry axis. See Figure 1. Although the hinge axis AA is transverse to the hinge axis of the SA drive shaft, in at least one arrangement, the hinge axis AA is laterally displaced from it and does not cross the hinge axis. drive system.
[0054] [0054] Returning to Figure 5, a proximal end 1912 of the proximal closing tube 1910 is rotationally coupled to a closing hook 1914 by a connector 1916 which is seated in an annular groove 1915 in the proximal closing tube segment
[0055] [0055] 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 an intermediate portion of trigger drive axis 1310 which is configured to be axially moved in the distal and proximal directions in response to the corresponding trigger movements applied to it by the trigger drive system 530. See Figure 4. As shown in Figure 5, a proximal end 1312 of the firing drive shaft intermediate portion 1310 has a firing drive shaft fixing lug 1314 formed thereon that is configured to be seated on a fixing base 544 (Figure 3) which is located at the distal end of the member longitudinally movable drive system 540 of the trigger drive system 530 within the pusher assembly 500. This arrangement facilitates the axial movement of the intermediate portion of the trigger drive shaft 1310 through the actuation of the trigger drive system 530. In the illustrated example, the intermediate portion of the trigger drive shaft 1600 is configured to be attached to a distal cut portion or knife bar
[0056] [0056] In the illustrated example, the surgical end actuator 1500 is selectively pivotable around the geometric hinge axis AA by a hinge system 1360. In one form, hinge system 1360 includes proximal hinge driver 1370 that is coupled to pivoting mode to a pivot link 1380. As can be seen more particularly in Figure 4, a displacement fixing tab 1373 is formed at a distal end 1372 of the proximal pivot driver 1370. A pivot hole 1374 is formed in the pivot tab displacement fixation 1373 and is configured to pivotally receive a proximal connecting pin 1382 formed at the proximal end 1381 of the pivot link 1380. A distal end 1383 of the pivot link 1380 includes a pivot hole 1384 which is configured to receive from pivoting mode therein a channel pin 1618 formed in the proximal end portion 1610 of the elongated channel 1602. Thus, the movement axial axis of the proximal articulation actuator 1370 will thus apply articulation movements to the elongated channel 1602 to thereby cause the surgical end actuator 1500 to articulate around the geometric axis of articulation AA in relation to the central column assembly 1250. In In various circumstances, the 1370 proximal articulation trigger can be held in position by the 1390 articulation lock when the 1370 proximal articulation trigger is not being moved in the proximal or distal directions. Additional details related to an exemplary form of the 1390 joint lock can be found in the US patent application, SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM LOCKABLE TO A FRAME, power of attorney document number END8217USNP / 170102, filed on the same date as this document , the description of which is hereby incorporated by reference in the present invention.
[0057] [0057] 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 shown in Figure 5 , in one form, displacer assembly 1100 includes a locking collar or locking sleeve 1110 positioned around the mid-portion of the firing drive shaft 1310 of the firing system 1300, where the locking sleeve 1110 can be rotated between an engaged position, in which the locking sleeve 1110 operationally couples the proximal articulation driver 1370 to the trigger member 1300, and a disengaged position, in which the proximal articulation driver 1370 is not operationally coupled to the trigger member assembly 1300. When the locking sleeve 1110 is in its engaged position, the distal movement of the firing member assembly 1300 may move er the proximal articulation actuator 1370 distally 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 assembly firing member 1300 is not transmitted to the proximal pivot driver 1370 and, as a result, the firing member set 1300 can move independently of the proximal pivot driver 1370. In various circumstances, the proximal pivot driver 1370 can be held in position by hinge lock 1390 when the proximal hinge driver 1370 is not being moved in the proximal or distal directions by the firing member assembly 1300.
[0058] [0058] In the illustrated arrangement, the intermediate portion of the firing drive shaft 1310 of the firing member assembly 1300 is formed with two opposite flat sides with a driving notch 1316 formed there. 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 trigger drive shaft intermediate portion. 1310 through it.
[0059] [0059] In the illustrated example, the relative movement of the locking sleeve 1110 between its engaged and disengaged positions can be controlled by the shifter assembly 1100 that interfaces with the proximal closing tube 1910. Still referring to Figure 5, the set of Shifter 1100 additionally includes a shifter key 1120 that is configured to be slidably received within a key groove formed at the outer perimeter of the locking sleeve 1110. Such an arrangement allows shifter key 1120 to move axially with respect to the sleeve locking
[0060] [0060] In an arrangement, for example, when the proximal closing tube 1910 is in a non-actuated configuration (the anvil 1810 is in an open position spaced in the opposite direction to the cartridge mounted in the elongated channel 1602) the actuation of the intermediate portion of firing drive axis 1310 will result in axial movement of the 1370 proximal pivoting actuator to facilitate pivoting of the 1500 end actuator. Once the user has pivoted the surgical end actuator 1500 to a desired orientation, the user can then act the proximal closing tube portion 1910. 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 proximal closing 1910 will result in the cam opening still interacting in cam mode with a cam portion of shifter 112 0 to thereby cause the shifter key 1120 to 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 of the drive notch 1316 in the intermediate portion of the trigger drive axis 1310. When in such a configuration, the trigger drive system 530 can be actuated to actuate the intermediate portion of the 1310 trigger drive shaft without activating the 1370 proximal articulation trigger. Additional details related to the operation of the 1130 key drum and locking sleeve 1110, as well as alternative articulation trigger and trigger arrangements that can be employed with the various interchangeable surgical tool sets described herein, can be found in US Patent Application Serial No. 13 / 803,086, now US Patent Application Publication No. 2014/0263541 and US Patent Application Publication US Patent Application No. series 15 / 019.196, the full descriptions of which are hereby incorporated by reference in the present invention.
[0061] [0061] As also illustrated in Figures 5 and 15, the interchangeable surgical tool set 1000 can comprise a slip ring set 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 1152 integrated circuit board while facilitating the rotational displacement of the drive shaft and end actuator 1500 around the geometric axis of the SA drive axis in relation to to the tool chassis 1210 by rotating the nozzle assembly 1240. As shown in Figure 15, in at least one arrangement, integrated circuit board 1152 includes an integrated connector 1154 that is configured to interface with a slot connector 562 ( Figure 9) that communicates with a microprocessor 560 that is supported on the handle set 500 or robotic system controller, for example. The 1150 slip ring assembly is configured to interface with a 1153 proximal connector that interfaces with the 1152 integrated circuit board. More details on the 1150 slip ring assembly and associated connectors can be found in US Patent Application no. Serial No. 13 / 803,086, currently US Patent Application Publication No. 2014/0263541 and US Patent Application No. Serial No. 15 / 019,196, each of which has been incorporated by reference in its respective entirety as well as in US Patent Application Serial No. 13 / 800.067 entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, currently US Patent Application Publication US Patent Application Serial No. 2014/0263552, which is hereby incorporated by reference in its entirety.
[0062] [0062] An exemplary version of the interchangeable surgical tool set 1000 disclosed in the present invention can be used in connection with a standard (mechanical) surgical clamp cartridge 1400 or a 1700 cartridge that is configured to facilitate cutting the tissue with the limb. knife and seal the cut fabric using radio frequency (RF) energy. Again with reference to Figure 4, a cartridge of the conventional or standard mechanical type 1400 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, cartridge body 1402 can be configured to be removably retained by pressure engagement with elongate channel 1602. Cartridge body 1402 includes an elongated slot 1404 to accommodate axial displacement of knife member 1330 through the same. Cartridge body 1402 operationally supports a plurality of clip drivers (not shown) which are aligned in rows on each side of a centrally arranged elongated slot 1404. The drivers are associated with corresponding clip / fastener pockets 1412 that open through the upper platform surface 1410 of the cartridge body 1402. Each of the clamp actuators holds one or more clamps or surgical clamps (not shown) on it. A slide assembly 1420 is supported within a proximal end of cartridge body 1402 and is located proximal to the drivers and fasteners in an initial position when cartridge 1400 is new and not fired. Slider assembly 1420 includes a plurality of inclined or wedge-shaped cams 1422, with each cam 1422 corresponding to a specific line of fasteners or drivers located on one side of slot 1404. Slider assembly 1420 is configured to be placed in contact and driven by knife member 1330, as the knife member is driven distally through the fabric that is trapped between the anvil and the 1410 cartridge platform surface. As the drives are driven upward toward the on the platform surface of the 1410 cartridge, the fastener (or fasteners) supported therein is driven out of their staple pockets 1412 and through the fabric that is trapped between the anvil and the cartridge.
[0063] [0063] Still with reference to Figure 4, the anvil 1810, in at least one form, includes an anvil mounting portion 1820 that has a pair of anvil sleeves 1822 that project laterally from it to be received hinged on corresponding trunnion bases 1614 formed on the vertical walls 1622 of the proximal end portion 1610 of the elongated channel 1602. Anvil trunnions 1822 are pivotally retained in their corresponding trunnion bases 1614 by the channel cover or anvil retainer 1630. The anvil mounting portion 1820 is movably or pivotally supported on the elongated channel 1602 for selective pivoting displacement with respect to it around a fixed anvil pivot geometry axis that is transverse to the geometric axis of the drive axis SA. As shown in Figures 6 and 7, in at least one shape, the anvil 1810 includes an anvil body portion 1812 that is manufactured from an electrically conductive metallic material, for example, and has a lower staple forming surface 1813 which has a series of fastener-forming pockets 1814 formed therein on each side of a centrally arranged anvil slot 1815 which is configured to slide the knife member 1330 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 actuated through the T fabric and in formation contact with the corresponding clamp formation pockets 1814. The anvil body 1812 can have an opening in the upper portion of it to facilitate installation, for example. An anvil cover 1818 can be inserted into it and welded to the anvil body 1812 to close the opening and improve the overall stiffness of the anvil body 1812. As shown in Figure 7, to facilitate the use of the end actuator 1500 in connection with RF 1700 cartridges, the segments facing the fabric 1817 of the bottom fastener forming surface 1813 may have electrically insulating material 1819 in them.
[0064] [0064] In the illustrated arrangement, the interchangeable surgical tool set 1000 is configured with a trigger member locking system, generally designated as 1640. See Figure
[0065] [0065] Still referring to Figure 8, the trigger member locking system 1640 also includes an unlocking assembly 1660 formed or supported at a distal end of the trigger member body 1332. The unlocking assembly 1660 includes a protrusion that distally extends 1662 which is configured to engage an unlocking feature 1426 formed in the slide assembly 1420 when the slide assembly 1420 is in its initial position in an untapped surgical staple cartridge 1400. Thus, when a surgical staple cartridge not fired 1400 is properly installed in the elongated channel 1602, the projection 1662 on the unlocking set 1660 comes into contact with the unlocking feature 1426 on the slide assembly 1420 which serves to tilt the knife member 1330 upwards, so that the features central channel hitch 1137 and / or foot 1338 clean the vertical projections 1654 at the bottom of channel 1620 to facilitate ironing axial groove of knife member 1330 through elongate channel 1602. If a partially fired cartridge 1400 is inadvertently installed in the elongated channel, slide assembly 1420 will not be in the home position and knife member 1330 will remain in the locked position.
[0066] [0066] 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 interchangeable surgical tool set 1000 above or adjacent to the distal end of the grip structure 506 so that the tapered clamping portions 1212 formed on the tool frame
[0067] [0067] During a typical surgical procedure, the doctor can introduce 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 drive shaft SA (non-articulated state). Once the surgical end actuator 1500 passes 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. That is, before closing the anvil 1810 on the target tissue, so that the closing drive system 510 remains unactivated. When in this position, actuation of the trigger drive system 530 will result in the application of joint movements to the proximal articulation driver 1370. Once the end actuator 1500 has reached the desired articulated position, the trigger drive system 530 is deactivated and the hinge lock 1390 can hold the surgical end actuator 1500 in the hinged position. The physician can then actuate the closing drive system 510 to close the anvil 1810 on the target tissue. Such actuation of the closing drive system 510 can also result in the displacement assembly 1100 that detaches the proximal articulation driver 1370 from the intermediate portion of the trigger drive axis 1310. Thus, once the target tissue was captured in the actuator surgical end cap 1500, the physician can again trigger the trigger drive system 530 to axially advance the trigger member 1330 through the surgical clamp / clamp cartridge 1400 or RF cartridge 1700 to cut the trapped tissue and trigger the clamps / clamps in the cutting fabric T. Other closing and trigger actuating arrangements, actuator arrangements (portable, manual and automated or robotic) can also be used to control the axial movement of the closing system components, the articulation system components and / or trigger system components of the surgical tool set 1000 without departing from the scope of the this description.
[0068] [0068] As indicated above, the surgical tool set 1000 is configured to be used in conjunction with conventional mechanical surgical clamp / clamp cartridges 1400, as well as with RF 1700 cartridges. In at least one way, the 1700 cartridge can facilitate the mechanical cutting of the fabric that is stuck between the anvil 1810 and the RF cartridge 1700 with the knife member 1330, while the electric coagulation current is applied to the fabric in the current path. Alternative arrangements for mechanically cutting and coagulating tissue using electrical current are disclosed, for example, in US Patent Applications No. 5,403,312; No. 7,780,663 and patent application No. US 15 / 142,609, entitled ELECTROSURGICAL
[0069] [0069] As shown in Figures 10 to 12, in at least one arrangement, the RF surgical cartridge 1700 includes a cartridge body 1710 that is sized and shaped to be received and removably supported in the elongated channel 1602. For example, the cartridge body 1710 can be configured to be removably retained by pressure engagement with the elongated channel 1602. In various arrangements, the cartridge body 1710 can be manufactured from a polymeric material, such as a thermoplastic engineering materials such as Vectra ™ liquid crystal polymer (LCP) and elongated channel 1602 can be manufactured 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 the knife 1330 therethrough. As shown in Figures 10 and 11, a pair of locking engagement tails 1714 extends proximally from the cartridge body 1710. Each locking engagement tail 1714 has a locking block 1716 formed on the underside of it that is sized to be received within a corresponding proximal opening portion 1642 at the channel bottom 1620. Thus, when the cartridge 1700 is properly installed in the elongated channel 1602, the locking engagement tails 1714 cover openings 1642 and projections 1654 to retain the knife 1330 in an unlocked position ready for firing.
[0070] [0070] Now with reference to Figures 10 to 13, in the illustrated example, 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 from the center of the electrode block 1720 and serves to divide the block 1720 into a left block segment 1720L and a right block segment 1720R. A right flexible circuit set 1730R is attached to the right cushion segment 1720R and a left flexible circuit set 1730L is attached to the left cushion 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 sheath / member that is fixed to the 1720R right block. In addition, the 1730R right flexible circuit assembly includes a 1736R "first phase" proximal right electrode and a 1738R "second phase" 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 that are supported or secured or embedded in a 1734L left insulating sheath / member that is attached to the left 1720L block. In addition, the 1730L left flexible circuit assembly includes a 1736L proximal left "first phase" electrode and a 1738L distal left "second phase" electrode. The left and right electrical conductors 1732L, 1732R are attached to a distal integrated microcircuit 1740 mounted on the distal end portion of the cartridge body 1710. In one arrangement, for example, each of the right and left flexible circuits 1730R, 1730L can have a total "CW" width of approximately 0.025 inches and each of the 1736R, 1736L, 1738R, 1738R electrodes has an "EW" width of approximately 0.010 inches, for example. See Figure 13. However, other widths / sizes are contemplated that can be used in alternative aspects.
[0071] [0071] In at least one arrangement, the RF energy is supplied to the surgical tool kit 1000 by a conventional RF generator 400 via a supply lead 402. In at least one arrangement, the supply conductor 402 includes a set male plug 406 that is configured to plug into corresponding female connectors 410 that are attached to a segmented RF circuit 1160 on an 1152 integrated circuit board. See Figure 15. This arrangement facilitates the rotational displacement of the shaft end actuator drive 1500 around the axis of the drive shaft SA in relation to the tool chassis 1210 by rotating the nozzle assembly 1240 without winding the supply conductor 402 of the generator 400. An integrated on / off switch 420 is supported in the assembly locking 1280 and on 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, the integrated segmented RF circuit 1160 communicates with microprocessor 560 through connectors 1154 and 562. As shown in Figure 1, handle set 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 that includes a strip or flexible circuit assembly of drive shaft 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. This arrangement facilitates sufficient flexing of knife bar 1320 and the strip drive shaft flexible circuit 1164 during articulation of end actuator 1500 while remaining sufficiently rigid to allow knife member 1330 to be distally advanced through the trapped tissue.
[0072] [0072] Again with reference to Figure 10, in at least one illustrated arrangement, the elongated channel 1602 includes a channel circuit 1670 supported 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 recess in wall 1625 formed in one of the walls of channel 1622 and is folded over, and attached to, an upper edge 1627 of the wall of channel 1622. A series of contacts corresponding exposed 1676 are provided at the distal end 1674 of 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 integrated chip 1740 and is affixed to the distal end portion of the cartridge body 1710. Another end 1754 is folded over the edge of the 1711 cartridge platform surface and includes exposed contacts 1756 configured to make electrical contact with the exposed contacts 1676 of the 1670 channel circuit. Thus, when the RF cartridge 1700 is installed in the elongated channel 1602, the electrodes, as well as the distal integrated microcircuit 1740 are fed and communicate with the integrated circuit board 1152 through the contact between the flexible cartridge circuit 1750, the flexible channel circuit 1670, the flexible drive shaft circuit 1164 and slip ring assembly 1150.
[0073] [0073] Figures 16A and 16B are a block diagram of a control circuit 700 of surgical instrument 10 of Figure 1 which 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 several ways, the engine 714 it can be a DC direct drive motor with brushes, having 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 electric motor. Motor starter 715 may comprise an H bridge starter comprising field-effect transistors ("FETs" - field-effect transistors) 719, for example. The motor 714 can be powered by the supply set 706 releasably mounted on the handle set 500 to supply control energy 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 energy source to energize the surgical instrument 10. In certain circumstances, the battery cells in the 706 power pack may 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 power pack
[0074] [0074] The drive shaft assembly 704 may include a drive shaft controller 722 that can communicate with the safety controller and the power management controller 716 through an interface, while the drive shaft assembly 704 and the supply set 706 are coupled to the handle assembly 702. For example, the interface may comprise a first portion of interface 725, which may include one or more electrical connectors for coupling engagement with electrical driveshaft assembly connectors corresponding, and a second interface portion 727, which may include one or more electrical connectors for coupling coupling with the corresponding electrical connectors of the power supply set, to enable electrical communication between the controller of the drive shaft assembly 722 and the controller management system 716 while the drive shaft assembly 704 and the power assembly 706 are coupled to the handle assembly 702. One or more communication signals can be transmitted through the interface to communicate one or more of the power requirements of the fixed interchangeable drive shaft assembly 704 to the power management controller 716. In response , the power management controller can modulate the battery power output of the 706 power pack, as described in more detail below, according to the power requirements of the fixed drive shaft assembly 704. The connectors can comprise switches that they can be activated after mechanical coupling of the handle assembly 702 to the drive shaft 704 and / or the power supply 706 to enable electrical communication between the drive assembly controller 722 and the power management controller 716.
[0075] [0075] The interface can facilitate the transmission of one or more communication signals between the power management controller 716 and the drive shaft assembly controller 722 by routing these communication signals through a main controller 717 resident in the assembly handle grip 702, for example. In other cases, the interface can facilitate a direct communication line between the power management controller 716 and the drive shaft assembly controller 722 through the handle assembly 702, while the drive shaft assembly 704 and the drive assembly 706 are coupled to the handle assembly 702.
[0076] [0076] 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 Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single-cycle flash memory, or other non-volatile memory,
[0077] [0077] 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 from 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.
[0078] [0078] The power supply 706 may include a power management circuit which may comprise the power management controller 716, a power modulator 738 and a current sensor circuit 736. The power management circuit can be configured to modulate the battery power output 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 handle assembly 702. The power management controller 716 can be programmed to control the power modulator 738 from the power output of the power supply 706, and the 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 on the battery power output, so the 716 power management controller 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 can each comprise one or more processors and / or memory units that can store multiple software modules.
[0079] [0079] The 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 an LCD screen, LED indicators), auditory feedback devices (for example, a speaker, a bell) or tactile feedback devices ( eg haptic actuators). In certain circumstances, the output device 742 may comprise a screen 743 which may be included in the handle 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 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
[0080] [0080] The control circuit 700 comprises segments configured to control the operations of the energized surgical instrument 10. A segment of the safety controller (Segment 1) comprises a safety controller and the segment of the main controller 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, an encoder segment, a motor and a power segment. Each of the circuit segments can be coupled to the safety controller and / or 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 assembly ("PCBA") inside the energized surgical instrument 10. It must 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 717 main controller is a programmable multipurpose device that accepts digital data as input, processes it according to 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.
[0081] [0081] The acceleration segment (Segment 3) comprises an accelerometer. The accelerometer is configured to detect the movement or acceleration of the energized surgical instrument 10. The accelerometer input is used to transition to and from a suspend mode, identify the orientation of the energized surgical instrument and / or identify when the surgical instrument was dropped. In some examples, the acceleration segment is coupled to the safety controller and / or the main controller 717.
[0082] [0082] The screen segment (Segment 4) comprises a screen connector coupled to the main controller 717. The screen connector couples the main controller 717 to a screen through one or more drivers of the integrated circuits of the screen. The drivers of the integrated circuits of the display may be integrated with the display and / or may be located separately from the display. The screen may comprise any suitable screen, such as an organic light-emitting diode (OLED) screen, a liquid crystal screen (LCD) and / or any other suitable screen. In some examples, the screen segment is coupled to the security processor.
[0083] [0083] 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 an end actuator 1500 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 microcontroller with ferroelectric random access memory ("FRAM" - ferroelectric random access memory), an articulation switch, a drive shaft release Hall switch and a PCBA EEPROM . The drive shaft PCBA EEPROM 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 coupled to the interchangeable drive shaft assembly 500 and / or be integral with the surgical instrument 10. In some instances, the drive shaft segment comprises a second drive shaft EEPROM. The second EEPROM of the drive shaft comprises a plurality of algorithms, routines, parameters and / or other data that correspond to one or more sets of drive shaft 500 and / or end actuators 1500 that can interface with the energized surgical instrument 10 .
[0084] [0084] The position encoding segment (Segment 6) comprises one or more rotary magnetic angle position encoders. One or more magnetic encoders of the rotation angle position are configured to identify the rotational position of the motor 714, an interchangeable drive shaft assembly 500 and / or an end actuator 1500 of the surgical instrument 10 (Figures 1 to 5). In some examples, rotary magnetic angle position encoders can be coupled to the safety controller and / or the main controller
[0085] [0085] The motor circuit segment (segment 7) comprises a motor 714 configured to control the movements of the energized surgical instrument 10 (Figures 1 to 5). Motor 714 is coupled to the primary microcontroller processor 717 by an H bridge driver that comprises one or more H bridge field effect transistors (FETs). The H bridge actuator is also coupled to the safety controller. A motor current sensor is connected in series to the motor to measure the current drain of the motor. The motor current sensor is in signal communication with the main controller 717 and / or with the safety controller. In some instances, the 714 motor is coupled to an electromagnetic interference (EMI) filter on the motor.
[0086] [0086] 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 (PWM) signal ), 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.
[0087] [0087] The power segment (Segment 8) comprises a battery coupled to the safety controller, 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 to one or more segments of the circuit. For example, in some instances, 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 , for example, up to 13 V. The voltage amplification 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.
[0088] [0088] The plurality of keys that 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 state 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 on the left side left pivot to the right side, a right pivot key 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 an end actuator 300 (Figures 1 and 4). A reverse key on the left and a reverse key on the right side are coupled to the main controller 717. The keys on the left side which comprise the key on the left pivot side for the left side, the key on the right pivot side for the left side , the central articulation key for the left side and the reverse key for the left side are coupled to the main controller 717 by a flex connector on the left. The keys on the right side comprising the key on the left pivot side for the right side, the key on the right pivot side for the right side, the central pivot key for the right side and the reverse key on the right side are coupled to the main controller 717 via a right-hand flex connector. A trip switch, a grapple release key and a key attached to the drive shaft are coupled to the main controller 717.
[0089] [0089] Any suitable mechanical, electromechanical or solid state switches can be employed to implement the plurality of switches in any combination. For example, the keys can be limit switches 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, magnetoresistive (MR) devices, giant magnetoresistive devices ("GMR" - giant magneto-resistive), 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" - metal-oxide semiconductor-FET), bipolar and the like). Other switches may include switches without an electrical conductor, ultrasonic switches, accelerometers, inertia sensors, among others.
[0090] [0090] Figure 17 is another block diagram of the control circuit 700 of the surgical instrument of Figure 1 illustrating interfaces between the handle assembly 702 and the feeding assembly 706 and between the handle assembly 702 and the shaft assembly. interchangeable drive 704, in accordance with an aspect of the present description. The handle assembly 702 can comprise a main controller 717, a drive shaft assembly connector 726 and a power assembly connector
[0091] [0091] The 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, an LCD monitor, LED indicators), audio feedback devices (for example, a speaker, a bell) or tactile feedback devices (for example, haptic actuators). In certain circumstances, the output device 742 may comprise a screen 743 which may be included in the handle 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 output device 742. Interface 727 can be configured to connect the drive shaft assembly controller 722 and / or the power management controller 716 to output device 742. Output device 742 can be integrated with the supply set 706. Communication between the output device 742 and the drive shaft assembly controller 722 can be made through interface 725 while the interchangeable drive shaft assembly 704 is coupled to the handle assembly 702. Having A control circuit 700 (Figures 16A, 16B and 6) has been described to control the operation of the surgical instrument 10 (Figures 1 to 5), the description now turns to various configurations of the surgical instrument 10 (Figures 1 to 5) and the control circuit 700.
[0092] [0092] Figure 18 is a schematic diagram of a surgical instrument 600 configured to control various functions accordingly, 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 I-profile beam 614. The surgical instrument 600 comprises an end actuator 602 that can comprise an anvil 616, a beam with I-614 profile and a removable staple cartridge 618 that can be interchanged with an RF 609 cartridge (shown in dashed line). The end actuator 602, the anvil 616, the I-beam profile 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, several aspects of the present description can be described with reference to Figure 18. It will be understood that the components shown schematically in Figure 18 such as control circuit 610, sensors 638, position sensor 634, end actuator 602, beam with I-profile 614, cartridge staples 618, RF cartridge 609, anvil 616, are described in connection with Figures 1 to 17 of the present description.
[0093] [0093] 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 circuit control 700 shown and described in connection with Figures 16 to 17. In one aspect, sensors 638 can be implemented as a limit switch, electromechanical device, solid state switches, Hall effect devices, magnetoresistive devices (MR) magnetoresistive devices giants (GMR), magnetometers, among others. In other implementations, 638 sensors can be solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others.
[0094] [0094] The position, movement, displacement and / or translation of a linear displacement member, such as the beam with I 614 profile, can be measured by an absolute positioning system, sensor arrangement and position sensor represented as the sensor position 634. Since the I-beam beam 614 is coupled to the longitudinally movable drive member 540, the position of the I-beam beam 614 can be determined by measuring the position of the longitudinally mobile drive member 540 using the position sensor 634. Consequently, in the description below, the position, displacement and / or translation of the I-profile beam 614 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 the present invention. The control circuit 610, in some instances, may comprise one or more microcontrollers, microprocessors or other processors suitable for executing instructions that cause the processor or processors to control the displacement member, for example, the I-profile beam 614, in the manner 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 the beam position with I 614 profile, as determined by the 634 position sensor with the output of the timer / counter circuit 631 so that the control circuit 610 can determine the position of the I-profile beam 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.
[0095] [0095] 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 brushed direct current (DC) electric motor, 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 In some examples, motor 604 may be a brushless direct current (DC) electric motor and the motor start signal 624 may comprise a pulse width modulation (MLP) signal supplied to one or more motor stator windings
[0096] [0096] The 604 motor can receive power from a power source
[0097] [0097] 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 adapted to work with the surgical instrument 600 to measure the various derived parameters such as the gap distance in relation to time, compression of the tissue in relation to time, and the deformation of the anvil in relation to time. The 638 sensors may comprise a magnetic sensor, a magnetic field sensor, a stress meter, a pressure sensor, a force sensor, an inductive sensor such as a eddy current sensor, a resistive sensor, a capacitive sensor, a sensor optical and / or any other sensor suitable for measuring one or more parameters of end actuator 602. Sensors 638 may include one or more sensors.
[0098] [0098] The one or more 638 sensors may comprise a strain gauge such as, for example, a micro strain gauge, configured to measure the magnitude of strain on anvil 616 during a stuck condition. The effort meter provides an electrical signal whose amplitude varies with the magnitude of the effort. 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 anvil 616 and the staple cartridge 618 which is indicative of the thickness and / or completeness of the fabric located between them.
[0099] [0099] 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 a point of interaction between the closing tube 1910 (Figures 1 to 4) 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. One or more sensors 638 can be positioned at various points of interaction throughout the closing drive system to detect the closing forces applied to the anvil 616 by the closing drive system. The one or more 638 sensors can be sampled in real time during a gripping operation by a processor as described in Figures 16A to 16B. The control circuit 610 receives sample measurements in real time to provide and analyze information based on time analyzed and evaluate, in real time, the closing forces applied to the anvil 616.
[00100] [00100] 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-shaped profile 614 corresponds to the current drained by the motor
[00101] [00101] The RF 400 power source is coupled to the end actuator 602 and is applied to the RF 609 cartridge when the RF 609 cartridge is loaded on the end actuator 602 in place of the staple cartridge 618. The control circuit 610 controls the supply of RF energy to the RF 609 cartridge.
[00102] [00102] In certain provisions of a bipolar RF surgical instrument, the surgical instrument may comprise an opposing first and second jaw, each jaw being capable of comprising 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 can seal many types of tissue, such as anatomical structures with walls with thick or irregular fibrous content, bundles of uneven anatomical structures, and / or substantially thick or thin anatomical structures.
[00103] [00103] In general, when electrosurgical energy is applied through electrodes to a target tissue stapled to an electrosurgical end actuator of a surgical device, the heat supplied to the target tissue in the target zone (for example, near 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 undergoing surgical procedures because more tissue is damaged and this may require a longer recovery time. In addition, the electrodes used to transmit electrosurgical energy can typically be placed on an electrically 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 target zone and damage to the collateral tissue.
[00104] [00104] Aspects of the present description can address the problems mentioned above. In an exemplary aspect, an end actuator may include a first claw (for example, a cartridge and a channel) and a second claw (for example, anvil), a hot zone in a central portion of the end actuator, and cold zones on the side portions of the end actuator. The first jaw and the second jaw can define an elongated slot arranged between them, and a cutting member can be slidably received inside the elongated slot to cut the fabric located between the first jaw and the second jaw. The first claw can include electrically and thermally insulating and non-conductive 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 electrically insulating and thermally conductive 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 attached to the end actuator. The heat dissipation layers can be configured to cool the fabric in the cold zones by transferring the heat in the fabric in the cold zones to the outside area to minimize the damage caused by the transfer of heat from the target fabric in the hot zone to the fabric around the hot zone.
[00105] [00105] 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 surfaces of contact with the tissue, so that more pressure and, ultimately, more heat, can be applied only to the target tissue with greater precision, reducing to the at the same time the thermal propagation to the lateral tissue. The raised blocks, in combination with the heat dissipation layers that cool the tissue around the target zone (for example, the hot zone) can lower the temperature of the tissue around the target zone significantly and thereby , enable a doctor to perform a more accurate sealing of the tissue without excessive lateral thermal propagation.
[00106] [00106] In an exemplary aspect, the insulating layers can 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 prevent burning or overheating of the fabric, preventing lateral thermal propagation that can be caused by excessive heat from overheating.
[00107] [00107] Figure 19 shows a schematic cross-sectional view of a 5500 end actuator, in accordance with 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, example, a 5700 cartridge) in it. In an exemplary aspect, the first jaw 5505 and the second jaw 5610 can define a gap between them. A cutting member (for example, a blade or knife member
[00108] [00108] 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 illustrated example, the first insulating layer 5510L, the second insulating layer, and the elongated slot 5560 are arranged in a central portion of the first jaw 5505. In an exemplary aspect, the central portion of jaws 5505, 5610 can cover about 1 / 3-1 / 2 of the total portions of jaws 5505, 5610 and be located in the center thereof . 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.
[00109] [00109] 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 layer of electrode 5540L and the second layer of electrode 5540R can be configured for direct application of electrosurgical energy (for example, RF energy) to the tissue (T) to form a hemostatic line (coagulation or cauterization) on the tissue adjacent 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 layer of electrode 5540R may include a direct contact metallic 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 metallic 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 next to the first and second electrode layers 5540L, 5540R. As shown in Figure 19, the hot zone 5650 can be in the central portion of the end actuator 5500 (and in the first and second jaws 5505, 5610).
[00110] [00110] In an exemplary aspect, the first 5505 jaw may include a first 5520L heat dissipation layer on a left side portion of the first 5505 jaw and a second 5520R heat dissipation layer on a right side portion of the first 5505 jaw. The first heat dissipation layer 5520L can include a first surface of contact with the fabric 5525L, and the second heat dissipation layer 5520R can include a second surface of contact with the fabric 5525R. The 5525L, 5525R fabric contact surfaces may be in direct contact with the fabric (T) when the fabric (T) is attached to the end actuator
[00111] [00111] In an exemplary aspect, the first and second insulating layers 5510L, 5510R can be around 0.01 to 0.10 inches in the opposite direction to a center line C of the end actuator 5500. 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 heat dissipation layers 5520L, 5520R can be around 0.03 to 0.20 inches away from the C-axis.
[00112] [00112] In an exemplary aspect, the first layers of 5540L electrode 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, second layers of 5540R electrode and second layers of heat dissipation 5520R can define a second horizontal distance 5545R between second layers of electrode 5540R and second layers of heat dissipation 5520R. The first and second horizontal distances 5545L, 5545R can be too small to provide an accurate tissue seal for a thin profile end actuator with little or no lateral thermal spread. In an exemplary aspect, the first and second horizontal distances 5545L, 5545R can be in the range of 0.00 to about 0.50 inch, preferably in the range of about 0.00 to 0.10 inch, more preferably in the range of 0.00 to about 0.03 inch. In an exemplary aspect, the first and second horizontal distances 5545L, 5545R can be less than half the width of the electrode layers 5540L, 5540R. In another exemplary aspect, the first and second horizontal distances 5545L, 5545R can be any other suitable length.
[00113] [00113] In an exemplary aspect, the first claw 5505 can 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 5550 can enable the first electrode layer 5540L and the second electrode layer 5540R to be elevated compared to the 5525L, 5524L fabric contact surfaces, so that more 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 and with less lateral thermal spread.
[00114] [00114] In general, the thickness of typical electrodes themselves can 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 spread. In an exemplary aspect, the raised blocks 5550L, 5550R may not include the electrode layers 5540L, 5540R. The raised blocks 5550L, 5550R can comprise insulating layers 5510L, 5510R, or a combination of insulating layers 5510L, 5510R and 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 lateral thermal propagation.
[00115] [00115] 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 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 water vapor to escape through the elongated slit 5560 to prevent burning or overheating of the tissue which can cause damage to the collateral tissue.
[00116] [00116] The elongated channel 5530 can be formed under the insulating layers 5510L, 5510R and the 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 further be transferred to the metal channel 5530 and this can help to reduce the temperature of the fabric in the cold zones 5660, 5670 more quickly.
[00117] [00117] 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
[00118] [00118] In an exemplary aspect, the second claw 5610 can comprise an anvil which 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 surgical cartridge supported on the elongated channel 5630 between the open and closed positions through the actuation of a closing drive system (for example, the closing drive system 510). In Figure 19, the end actuator 5500 is in a closed position with the fabric (T) trapped between the first jaw 5505 and the second jaw 5610. The anvil slot 5630 can open in an upper opening 5640 that is wider than the anvil slot 5630, as shown in Figure 19. The upper opening can extend longitudinally through the second claw 5610, for example, to accommodate the anvil hitch features (for example, the anvil hitch feature 1336) over the cutting member (for example, knife member 1330) during firing. The second jaw 5610 may also include fastener forming pockets 5620 (e.g., fastener forming pockets 1814) formed there on each side of the anvil slot 5630.
[00119] [00119] Figure 20 shows a perspective view of the 5500 end actuator, in accordance with an aspect of the present description. In Figure 20, the 5500 end actuator is in a closed position. The second jaw 5610 may be movable relative to the first jaw 5505. The first jaw 5505 may include a 5700 cartridge that is sized and shaped to be removably received and supported in the elongated channel 5530. In an exemplary aspect, the 5700 cartridge may include insulating layers 5510L, 5510R, heat dissipation layers 5520L, 5520R and 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 20, and the elongated slot 5560 can extend through the center of the 5540L, 5540R electrodes . 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 can be arranged on the right side of the second layer of electrode 5540R.
[00120] [00120] The first 5505 jaw can include a 5710 microcircuit in the distal portion of the first 5505 jaw. The 5710 microcircuit can be configured to control the 5540L, 5540R electrode layers (for example, providing electrosurgical power). The 5710 microcircuit 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 jaw can also include a 5730 dissector electrode at a 5740 distal end. The 5730 dissector 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 5730 dissector electrode can be isolated and operated separately from the 5540L, 5540R electrode layers.
[00121] [00121] The 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, through a wide range of hardware, software, firmware or any combination of these, 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 for a specific application, electrical circuits forming a general-purpose computing 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, forms of random access memory), 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 them.
[00122] [00122] The previous description presented aspects of 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 of them. In one aspect, several portions of the material 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 running on one or more computer systems). computer), as one or more programs running on one or more processors (for example, as one or more programs running on one or more microprocessors), as firmware, or virtually as any combination of them, and to design the circuitry and / or writing the code for the software and firmware would be within the scope of practice of one skilled in the art in light of this description.
[00123] [00123] The mechanisms of the subject described here can be distributed as a program product in a variety of ways and that an illustrative aspect of the subject described here is applicable regardless of the specific type of signal transmission medium used to effectively perform the distribution. Examples of a signal transmission medium include the following: a recordable medium such as a floppy disk, a hard disk drive, a compact disc (CD), a digital video disc (DVD), a digital tape, a memory computer, etc .; and a transmission type media, such as digital and / or analog communication media (for example, a fiber optic cable, a waveguide, a communications link with an electrical conductor, a communication link without an electrical conductor (for example, example, transmitter, receiver, transmission logic, reception logic), etc.).
[00124] [00124] The previously mentioned description of these 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 in order to illustrate the principles and practical application to, thus, enable the person skilled in the art to use the various aspects and with several modifications, as they are convenient to the specific use contemplated. It is intended that the claims presented in the annex define the global scope.
[00125] [00125] Various aspects of the subject described in this document are defined in the following numbered examples:
[00126] [00126] 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 cutting member slidingly inside the elongated slit to cut the fabric located between the first jaw and the second jaw, the elongated slot is located in the central portion of the end actuator; the first claw comprising:
[00127] [00127] 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.
[00128] [00128] Example 2. Surgical instrument of Example 1, one of the first and second layers of heat dissipation comprising a thermally conductive ceramic material.
[00129] [00129] Example 3. Surgical instrument, according to one or more of Example 1 and 2, each one of the first electrode layer and the second electrode layer comprising a direct contact metallic electrode.
[00130] [00130] Example 4. Surgical instrument, according to Example 3, each one of the first electrode layer and the second electrode layer additionally comprising a flexible circuit, with the metallic electrode of direct contact being deposited in the circuit flexible.
[00131] [00131] Example 5. Surgical instrument, according to one or more of Examples 1 to 4, each of which between the first heat dissipation layer and the second heat dissipation layer comprises a contact surface with the tissue .
[00132] [00132] Example 6. Surgical instrument, according to Example 5, each of which between the first electrode layer and the second electrode layer is elevated in comparison to the tissue contact surfaces of the first dissipation layer of heat and the second layer of heat dissipation, which allows the end actuator to apply pressure to the fabric through the first electrode layer and the second electrode layer in the hot zone that is greater than a pressure applied to the fabric through the fabric contact surfaces of the first heat dissipation layer and the second heat dissipation layer.
[00133] [00133] Example 7. Surgical instrument, according to one or more of Examples 1 to 6, the first insulating layer and the second insulating layer comprising a thermally and electrically non-conductive material.
[00134] [00134] Example 8. Surgical instrument, according to one or more of Examples 1 to 7, the first insulating layer comprising a first surface facing the first electrode layer and a second surface facing the elongated slit, being that the first and second surfaces define a first edge, the first edge being chamfered to allow water vapor to escape.
[00135] [00135] Example 9. Surgical instrument, according to Example 8, the second insulating layer comprising a third surface facing the second electrode layer and a fourth surface facing the elongated slit, the third surface and the fourth surface defines a second edge, the second edge of which is chamfered to allow water vapor to escape.
[00136] [00136] Example 10. Surgical instrument, according to one or more of Examples 1 to 9, the first jaw additionally comprising a channel under the first and second layers of heat dissipation.
[00137] [00137] Example 11. Surgical instrument, according to Example 10, the channel comprising a thermally conductive metallic material, and the channel being in direct contact with the first and second layers of heat dissipation to facilitate the cooling of the fabric in the first and second cold zones.
[00138] [00138] Example 12. 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; a second cold zone on a right side portion of the end actuator; a dissector tip at a distal end of the end actuator; and an elongated slit defined between the first jaw and the second jaw, the elongated slit being configured to slide a blade into the elongated slit to cut the fabric between the first jaw and the second jaw, the elongated slit being it is 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; each of the first electrode layer and the second electrode layer comprising a direct contact metallic electrode; 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.
[00139] [00139] Example 13. Surgical instrument, according to Example 12, one of the first and second layers of heat dissipation comprising a thermally conductive ceramic material.
[00140] [00140] Example 14. Surgical instrument, according to one or more of Examples 12 to 12, each of which between the first electrode layer and the second electrode layer additionally comprises a flexible circuit, the metal electrode of which is direct contact is deposited in the flexible circuit.
[00141] [00141] Example 15. Surgical instrument, according to one or more of Example 12 to Example 14, each one of the first heat dissipation layer and the second heat dissipation layer comprising a contact surface with fabric.
[00142] [00142] Example 16. Surgical instrument, according to Example 15, each of which between the first electrode layer and the second electrode layer is elevated in comparison to the tissue contact surfaces of the first dissipation layer of heat and the second layer of heat dissipation, which allows the end actuator to apply pressure to the fabric through the first electrode layer and the second electrode layer in the hot zone that is greater than a pressure applied to the fabric through the fabric contact surfaces of the first heat dissipation layer and the second heat dissipation layer.
[00143] [00143] Example 17. Surgical instrument, according to one or more of Example 12 to example 16, the first insulating layer and the second insulating layer comprising a thermally and electrically non-conductive material.
[00144] [00144] Example 18. Surgical instrument, according to one or more of Example 12 to Example 17, the first insulating layer comprising a first surface facing the first electrode layer and a second surface facing the elongated slit, the first surface and the second surface defining a first edge, the first edge being chamfered to allow water vapor to escape.
[00145] [00145] Example 19. Surgical instrument, according to one or more of Example 12 to Example 18, the first jaw additionally comprising a channel under the first and second layers of heat dissipation.
[00146] [00146] Example 20. Surgical instrument, according to Example 19, the channel comprising a thermally conductive metallic material, and the channel being in direct contact with the first and second layers of heat dissipation to facilitate the cooling of the fabric in the first and second cold zones.

权利要求:
Claims (20)
[1]
1. Surgical instrument, characterized by comprising: an end actuator comprising: a first claw; a second movable jaw in relation to said first jaw; 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 within the elongated slit to cut the fabric located between the first jaw and the second jaw, where the elongated slot is located in the central portion of the end actuator; wherein the first claw comprises: 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 heat sink layer in the first cold zone; and a second heatsink layer in the second cold zone, the first heatsink layer and the second heatsink layer being configured to cool the fabric in the first and second cold zones to minimize lateral thermal spread.
[2]
2. Surgical instrument according to claim 1, characterized in that each of the first and second heatsink layers comprises a thermally conductive ceramic material.
[3]
3. Surgical instrument, according to claim 1, characterized in that each of the first electrode layer and the second electrode layer comprises a direct contact metallic electrode.
[4]
4. Surgical instrument, according to claim 3, characterized in that each of the first electrode layer and the second electrode layer additionally comprises a flexible circuit, with the metallic electrode of direct contact being deposited in the flexible circuit.
[5]
5. Surgical instrument according to claim 1, characterized in that each of the first heatsink layer and the second heatsink layer comprise a contact surface with the tissue.
[6]
6. Surgical instrument according to claim 5, characterized in that each of the first electrode layer and the second electrode layer is raised in comparison to the tissue contact surfaces of the first heat sink and second layer heatsink layer, which allows the end actuator to apply pressure to the fabric through the first electrode layer and the second electrode layer in the hot zone that is greater than the pressure applied to the fabric through the contact surfaces with the fabric of the first heat sink layer and the second heat sink layer.
[7]
7. Surgical instrument according to claim 1, characterized in that the first insulating layer and the second insulating layer comprise a thermally and electrically non-conductive material.
[8]
Surgical instrument according to claim 1, characterized in that the first insulating layer comprises a first surface facing the first electrode layer and a second surface facing the elongated slit, the first surface and the second surface defining a first edge, where the first edge is chamfered to allow water vapor to escape.
[9]
Surgical instrument according to claim 8, characterized in that the second insulating layer comprises a third surface facing the second electrode layer and a fourth surface facing the elongated slot, wherein the third surface and the fourth surface define a second edge, the second edge being chamfered to allow water vapor to escape.
[10]
Surgical instrument according to claim 1, characterized in that the first jaw additionally comprises a channel under the first and second heatsink layers.
[11]
11. Surgical instrument, according to claim 10, characterized in that the channel comprises a thermally conductive metallic material, and in which the channel is in direct contact with the first and second layers of heat sink to facilitate the cooling of the tissue in the first and second cold zones.
[12]
12. Surgical instrument, characterized by comprising: an end actuator comprising: a first claw;
a second movable jaw in relation to said first jaw; a hot zone in a central portion of the end actuator; a first cold zone on a left side portion of the end actuator; a second cold zone on a right side portion of the end actuator; and a dissector tip at a distal end of the end actuator; and an elongated slit defined between the first jaw and the second jaw, the elongated slit being configured to slide a blade into the elongated slit to cut the fabric between the first jaw and the second jaw, in which the elongated slit it is located in the central portion of the end actuator; wherein the first claw comprises: 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; wherein each of the first electrode layer and the second electrode layer comprises a direct contact metallic electrode;
a first heat sink layer in the first cold zone; and a second heatsink layer in the second cold zone, the first heatsink layer and the second heatsink layer being configured to cool the fabric in the first and second cold zones to minimize lateral thermal spread.
[13]
Surgical instrument according to claim 12, characterized in that each of the first and second heatsink layers comprises a thermally conductive ceramic material.
[14]
14. Surgical instrument according to claim 12, characterized in that each of the first electrode layer and the second electrode layer additionally comprises a flexible circuit, the metallic electrode of direct contact being deposited in the flexible circuit.
[15]
Surgical instrument according to claim 12, characterized in that each of the first heat sink layer and the second heat sink layer comprise a contact surface with the tissue.
[16]
16. Surgical instrument according to claim 15, characterized in that each of the first electrode layer and the second electrode layer is elevated in comparison to the tissue contact surfaces of the first heat sink and second layer heatsink layer, which allows the end actuator to apply pressure to the fabric through the first electrode layer and the second electrode layer in the hot zone that is greater than the pressure applied to the fabric through the contact surfaces with the fabric of the first heat sink layer and the second heat sink layer.
[17]
17. Surgical instrument according to claim 12, characterized in that the first insulating layer and the second insulating layer comprise a thermally and electrically non-conductive material.
[18]
18. Surgical instrument according to claim 12, characterized in that the first insulating layer comprises a first surface facing the first electrode layer and a second surface facing the elongated slit, the first surface and the second surface defining a first edge, where the first edge is chamfered to allow water vapor to escape.
[19]
19. Surgical instrument according to claim 12, characterized in that the first jaw additionally comprises a channel under the first and second heatsink layers.
[20]
20. Surgical instrument according to claim 19, characterized in that the channel comprises a thermally conductive metallic material, and the channel is in direct contact with the first and the second heat sink layers to facilitate the cooling of the tissue in the first and second in the second cold zones.

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同族专利:

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公开号 | 公开日

---

WO2019003005A1|2019-01-03|

---

US11013552B2|2021-05-25|

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CN110809450A|2020-02-18|

---

US20190000538A1|2019-01-03|

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EP3420996A1|2019-01-02|

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JP2020525188A|2020-08-27|

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

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

优先权:

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申请号 | 申请日 | 专利标题

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US15/636,162|US11013552B2|2017-06-28|2017-06-28|Electrosurgical cartridge for use in thin profile surgical cutting and stapling instrument|

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US15/636,162|2017-06-28|

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PCT/IB2018/054256|WO2019003005A1|2017-06-28|2018-06-12|Electrosurgical cartridge for use in thin profile surgical cutting and stapling instrument|

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