systems and methods for controlling control circuits for independent power supply in segmented secti

专利摘要:
The present invention relates to a surgical instrument for controlling control circuits for an independent power supply to segmented sections. The surgical instrument comprises an end actuator comprising a first jaw and a second jaw, a first set of electrodes and a second set of electrodes and a slit defined between the first set of electrodes and the second set of electrodes. A cutting member is configured to reciprocate within the slot. A control circuit is configured to receive information about the impedance of the tissue located between the first jaw and the second jaw of the end actuator, to supply electrosurgical energy to the first set of electrodes and to the second set of electrodes, to alternately alternate the electrosurgical energy between the first set of electrodes and the second set of electrodes in a predetermined time interval and advance the cutting member.
公开号:BR112019027117A2
申请号:R112019027117-1
申请日:2018-06-12
公开日:2020-07-07
发明作者:David C. Yates；Frederick E. Shelton Iv；Jason L. Harris；Jeffrey D. Messerly
申请人:Ethicon Llc；
IPC主号:

专利说明:

[0001] [0001] The present invention relates to surgical instruments and, in various circumstances, surgical instruments for stapling and cutting, and staple cartridges for them, which are designed for stapling and cutting fabrics. BACKGROUND
[0002] [0002] In several open, endoscopic and / or laparoscopic surgeries, for example, it may be desirable to clot, seal and / or fuse the tissue. A method of sealing tissue depends on the application of energy, such as electrical energy, for example, to tissue captured or trapped within an end actuator or a set of end actuator of a surgical instrument in order to cause thermal effects. - cos inside the fabric. Several monopolar and bipolar radiofrequency (RF) surgical instruments and surgical techniques have been developed for such 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 a proteinaceous amalgam that mixes and fuses or seals as the proteins are renatured. As the treated region recovers over time, this biological seal can be reabsorbed by the body's wound healing process. SUMMARY
[0003] [0003] In one aspect, a surgical instrument is provided. The surgical instrument comprises an end actuator that
[0004] [0004] In another aspect, the surgical instrument includes an end actuator, a cutting member and a control circuit. The end actuator includes a first jaw having a proximal portion and a distal portion, a second jaw that is movable with respect to the first jaw, a first set of electrodes located in the proximal portion of the first jaw, and a second set of electrodes located in the distal portion of the first claw. The first jaw and the second jaw define an elongated slit between them that extends from a proximal end of the first jaw and the cutting member is received slidingly into the elongated slit to cut the fabric between the first jaw and the second claw. The control circuit is programmed to supply electrosurgical energy to the first set of electrodes and the second set of electrodes, the
[0005] [0005] The innovative features of the aspects described here are presented with particularity in the attached claims. However, these aspects, both in terms of organization and methods of operation, can be better understood by referring to the description below, taken in conjunction with the attached drawings.
[0006] [0006] Figure 1 is a perspective view of a surgical system that includes a handle set attached to an interchangeable surgical tool set that is configured to be used in conjunction with conventional surgical clip / clamp cartridges and radio frequency (RF) cartridges according to one aspect of this description.
[0007] [0007] Figure 2 is an exploded perspective view of the surgical system in Figure 1, according to an aspect of this description.
[0008] [0008] Figure 3 is another perspective view explored of portions of the handle set and the interchangeable surgical tool set of Figures 1 and 2, according to one aspect of this description.
[0009] [0009] Figure 4 is an exploded view of a proximal portion of the interchangeable surgical tool set of Figures 1 to 3, according to an aspect of this description.
[0010] [0010] Figure 5 is another exploded view of a distal portion of the interchangeable surgical tool set of Figures 1 to 5, according to an aspect of this description.
[0011] [0011] Figure 6 is a partial cross-sectional view of the end actuator represented in Figures 1 to 5 that supports an RF cartridge in it and with the tissue stuck between the cartridge and the anvil, according to an aspect of this description.
[0012] [0012] Figure 7 is a partial cross-sectional view of the bib of Figure 6, according to an aspect of this description.
[0013] [0013] 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.
[0014] [0014] Figure 9 is another exploded view of the interchangeable surgical tool set and the handle set of Figures 1 and 2, according to an aspect of the present description.
[0015] [0015] Figure 10 is a perspective view of an RF cartridge and an elongated channel of the interchangeable surgical tool set of Figures 1 to 5, according to an aspect of that description.
[0016] [0016] 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.
[0017] [0017] 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.
[0018] [0018] 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.
[0019] [0019] Figure 14 is a top cross-sectional view of a portion of the Fi-
[0020] [0020] Figure 15 is a perspective view of an integrated circuit board layout and configuration plus RF generator, according to an aspect of this description.
[0021] [0021] 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.
[0022] [0022] Figure 17 is a block diagram of the control circuit of the surgical instrument of Figure 1 illustrating interfaces between the handle assembly and the feed assembly and the handle assembly and the interchangeable drive shaft assembly , according to one aspect of this description.
[0023] [0023] Figure 18 is a schematic diagram of a surgical instrument configured to control various functions, according to an aspect of this description.
[0024] [0024] Figure 19 is a schematic top view of a claw on an end actuator, according to an aspect of this description.
[0025] [0025] Figure 20 is a graph representing the voltage applied to the electrodes as a function of time, according to one aspect of this description.
[0026] [0026] Figure 21 illustrates a block diagram of a surgical system programmed to transmit control and energy signals with an end actuator, according to an aspect of this description.
[0027] [0027] Figure 22 is a logic flow diagram representing a process of a control program or a logical configuration to operate the surgical instrument, according to an aspect of this description.
[0028] [0028] Figure 23 is a graph of a tissue impedance curve as a function of time, according to one aspect of this description.
[0029] [0029] Figure 24 is a graph representing an exemplary motor voltage curve, according to one aspect of this description.
[0030] [0030] Figure 25 is a logic flow diagram representing a process of a control program or a logical configuration to operate the surgical instrument, according to an aspect of this description.
[0031] [0031] Figure 26 is a graph of a tissue impedance curve as a function of time, according to one aspect of this description.
[0032] [0032] Figure 27 is a graph representing an exemplary motor voltage curve, according to one aspect of this description. DESCRIPTION
[0033] [0033] The applicant for the present application holds the following patent applications filed simultaneously with the same and which are each incorporated in this document by way of reference in their respective totalities: number of the power of attorney document END8184USNP / 170063, entitled SURGICAL SYSTEM COUPLABLE WITH STAPLE CAR- TRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, by the inventors Jeffrey D. Messerly et al., Deposited on June 28, 2017.
[0034] [0034] 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 can comprise an instrument that has a distally mounted end actuator that comprises one or more electrodes. The end actuator can be positioned against the fabric, so that electric current can be introduced into the fabric. Electrosurgical devices can be configured for monopolar or bipolar operation. During monopolar operation, current can be introduced into the tissue by an active electrode (or source) in the end actuator and returned via a return electrode. The return electrode can be a grounding block located separately on a patient's body. During bipolar operation, the current can be introduced into the fabric and returned from it, respectively, by the active and return electrodes of the end actuator.
[0035] [0035] 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 where 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.
[0036] [0036] 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 to place 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. which has a straight, non-folding drive shaft.
[0037] [0037] 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 can be in the form of radio frequency energy ("RF"). RF energy is a form of electrical energy that can be in the frequency range of 200 kilohertz (kHz) to 1 megahertz (MHz). In application, an electrosurgical instrument can transmit RF energy at low frequency through the tissue, which causes friction, or ionic agitation, that is, resistive heating, which, therefore, increases the tissue temperature. Due to the fact that a precise boundary is created between the affected tissue and the surrounding tissue, surgeons can operate with a high level of precision and control, without sacrificing adjacent non-target tissue. The low operating temperatures of the RF energy are useful for removing, shrinking or sculpting soft tissues while simultaneously cauterizing blood vessels. RF energy works particularly well in connective tissue, which mainly comprises collagen and shrinks when it comes in contact with heat.
[0038] [0038] RF energy can be in a frequency range described in document EN 60601-2-2: 2009 + A11: 2011, Definition
[0039] [0039] 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, the surgical system 10 comprises an interchangeable surgical tool set
[0040] [0040] In the illustrated aspect, the handle assembly 500 may comprise a handle compartment 502 that includes a pistol handle portion 504 that can be handled and handled 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 handle assembly 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 designated as 510, which can be used to apply closing and opening movements to the assembly interchangeable surgical tool
[0041] [0041] 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 US Patent Application Publication No. 2015/0272575, the triggering system 530 can employ an electric motor 505 which is located in the pistol grip portion 504 of the grip assembly 500. In many ways, the 505 motor can be a brushless DC drive motor, with a maximum speed of approximately 25,000 RPM, for example. In other arrangements, the 505 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable type of electric motor. The motor 505 can be powered by a power supply 522 which, in one form, can comprise a removable power source. The power source can support a plurality of lithium ion batteries ("Li ions") or other suitable ones therein. Several batteries, which can be connected in series, can be used as the 522 power source for the surgical system 10. In addition, the 522 power source can be replaceable and / or rechargeable.
[0042] [0042] The electric motor 505 is configured to axially drive a longitudinally movable driving member 540 (Figure 3) in the distal and proximal directions depending on the polarity of the motor. For example, when the 505 electric motor is driven in a direction of rotation, the longitudinally movable drive member will be axially driven in a distal "DD" direction. When motor 505 is driven in the opposite rotating direction, the longitudinally movable drive member 540 will be driven axially in the proximal direction "PD". The handle assembly 500 may include a key 513 that can be configured to reverse the polarity applied to the electric motor 505 by the power source 522 or otherwise control the motor
[0043] [0043] In at least one way, the long-acting drive member
[0044] [0044] In the illustrated aspect, the interchangeable surgical tool set 1000 includes a surgical end actuator 1500 comprising a first jaw 1600 and a second jaw 1800. In one arrangement, the first jaw comprises an elongated channel 1602 which is configured to operationally support a conventional surgical (mechanical) staple / fastener cartridge 1400 (Figure 4) or a 1700 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 and closed positions. through the 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 that is attached to a 1920 hinge connector.
[0045] [0045] Returning to Figure 4, the hinge connector 1920 includes upper and lower protrusions 1922, 1924 that protrude distally from a distal end of the hinge connector 1920 to be movably coupled to a closing sleeve. end actuator or distal closing tube segment 1930. See Figure 3. The distal closing tube segment 1930 includes an upper protrusion 1932 and a lower protrusion (not shown) that project proximally from a proximal end the same. An upper double pivot link 1940 includes proximal and distal pins 1941, 1942 that engage the corresponding holes in the upper protrusions 1922, 1932 of the articulation connector 1920 and the distal closing tube segment 1930, respectively. Similarly, an upper double pivot link 1944 includes proximal and distal pins 1945, 1946 that engage the corresponding holes in the lower protrusions 1924 of the articulation connector tube segment 1920 and the distal closing tube segment 1930, respectively .
[0046] [0046] Still with reference 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 related to the opening and closing of the 1810 anvil can be found in the US Patent Application, entitled SURGICAL INSTRUMENT WITH POSITIVE JAW OPENING FEATURES, power of attorney document number END8208USNP / 170096, filed on the same date of this document, whose The description is hereby incorporated by reference in the present invention.
[0047] [0047] As shown in Figure 5, in at least one arrangement, the interchangeable surgical tool set 1000 includes a tool frame set 1200 comprising a tool frame 1210 that operationally supports a nozzle set 1240 on the same. As further discussed in detail in the US Patent Application, entitled SURGICAL INSTRUMENT WITH AXI-ALLY MOVABLE CLOSURE MEMBER, power of attorney document END8209USNP / 170097, filed on the same date as this document, which is incorporated herein by reference in its entirety 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 SA drive shaft in relation to the tool chassis 1210. Such displacement rotational is represented by the arrow R in Figure 1. As also shown in
[0048] [0048] As shown in Figure 4, the upper center column segment 1251 ends at an upper pin assembly feature 1260 and the lower center column segment 1252 ends at a lower pin assembly feature 1270. The upper pin assembly feature 1260 is formed with a pin slot 1262 in it which is adapted to support a mountable upper link 1264 in it. Similarly, the lower pin assembly feature 1270 is formed with a pin slot 1272 in it which is adapted to mount a lower assembly link 1274 thereon. The upper mounting link 1264 includes a pivot socket 1266 in which it is displaced from the axis of the drive shaft SA. The pivot socket
[0049] [0049] Returning to Figure 5, a proximal end 1912 of the proximal closing tube 1910 is rotationally coupled to a closing launcher 1914 by a connector 1916 which is seated in an annular groove 1915 in the proximal closing tube segment
[0050] [0050] The trigger drive system 530 in the handle set 500 is configured to be operationally coupled to a trigger system 1300 that is operationally supported in the interchangeable surgical tool set 1000. The trigger system 1300 can include a portion intermediate firing drive axis 1310 which is configured to be axially moved in the distal and proximal directions in response to the corresponding firing movements applied to it by the firing 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 pin 1314 formed thereon that is configured to be seated on a mounting base 544 (Figure 3) located at the distal end of the longitudinally movable drive member 540 of the trigger drive system 530 within the set handle 500. This arrangement facilitates axial movement of the intermediate portion of the firing drive shaft 1310 through the actuation of the firing drive system 530. In the illustrated example, the middle portion of the firing drive shaft firing 1310 is configured for attachment to a distal cut portion or knife bar
[0051] [0051] 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 which is pivotally coupled to a hinge link 1380. As can be seen more particularly in Figure 4, a displacement fixing pin 1373 is formed at a distal end 1372 of the proximal hinge driver 1370. A pivot hole 1374 is formed on the displacement fixing pin 1373 and is configured to pivotally receive a proximal connecting pin 1382 formed at the proximal end 1381 of the articulation link 1380. A distal end 1383 of the articulation link 1380 includes a pivot 1384 which is configured to pivotally receive a channel pin 1618 formed at the proximal end portion 1610 of the elongated channel 1602. Thus, the movement axial toggle of the proximal articulation actuator 1370 will, therefore, apply articulation movements to the elongated channel 1602 in order to make the surgical end actuator 1500 articulate around the geometric axis of articulation AA in relation to the central column assembly 1250. In various circumstances, the proximal articulation actuator 1370 can be held in position by the articulation lock 1390 when the proximal articulation actuator 1370 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 US Patent Application, entitled SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM LOCKABLE TO A FRAME, proxy document number END8217USNP / 170102, filed on the same date of this document, the description of which is hereby incorporated by reference in the present invention.
[0052] [0052] In addition to the above, the interchangeable surgical tool set 1000 may 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. According to shown in Figure 5, in one form, the shifter assembly 1100 includes a locking collar or locking sleeve 1110 positioned around the middle portion of the firing axle 1310 of the firing system 1300, in which 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 assembly, and a disengaged position, in which the proximal articulation driver 1370 does not it is operationally coupled to the firing member assembly 1300. When the locking sleeve 1110 is in its engaged position, the distal movement of the firing member assembly 130 0 can move the proximal articulation actuator 1370 distally, and correspondingly, the proximal movement of the trigger member assembly 1300 can proximally move the proximal articulation actuator
[0053] [0053] 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.
[0054] [0054] In the illustrated example, the relative movement of the locking sleeve 1110 between its engaged and disengaged positions can be controlled by the displacer assembly 1100 that interfaces with the 1910 proximal closing tube. Still referring to Figure 5 , the shifter assembly 1100 additionally includes a shifter key 1120 which is configured to be slidably received within a key groove formed on the outer perimeter of the locking sleeve 1110. This arrangement allows the shifter key 1120 moves axially in relation to the locking sleeve 1110. As discussed in more detail in US Patent Application, entitled
[0055] [0055] In an arrangement, for example, when the proximal closing tube 1910 is in a non-actuated configuration (anvil 1810 is in an open position spaced in the opposite direction to the cartridge mounted in the elongated channel 1602) the intermediate portion of the firing drive shaft 1310 will result in axial movement of the proximal pivot actuator 1370 to facilitate pivoting of the 1500 end actuator. Once the user has pivoted the surgical end actuator 1500 for a desired orientation , the user can then act the proximal closing tube portion
[0056] [0056] As also illustrated in Figures 5 and 15, the interchangeable surgical tool set 1000 may comprise a set of slip ring 1150 that can be configured to conduct electrical energy to and / or from the surgical end actuator 1500 and / or communicate signals to and / or from the surgical end actuator 1500 back to an integrated circuit board 1152 while facilitating the rotational displacement of the drive shaft and end actuator 1500 around the geometric axis of the drive SA in relation to the tool chassis 1210 by rotating the nozzle assembly 1240. As shown in Figure 15, in at least one arrangement, the integrated circuit board 1152 includes an integrated connector 1154 which is configured to make interface with a compartment connector 562 (Figure 9) that communicates with a microprocessor 560 that is supported on the handle set 500 or robotic system controller, can r 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 the Order US Patent Application Serial No. 13 / 803,086, currently US Patent Application Publication No. 2014/0263541 and US Patent Application 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 Serial No. 2014/0263552, which is hereby incorporated by reference in its entirety.
[0057] [0057] 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 knife limb and seal the cut tissue 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, the cartridge body 1402 can be configured to be removably retained in pressure engagement with the elongated channel 1602. The cartridge body 1402 includes an elongated slot 1404 to accommodate the displacement axis of knife member 1330 therethrough. The 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 drivers holds one or more clamps or surgical clips (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 particular 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 to upwards towards the platform surface of the cartridge 1410, the fastener (or fasteners) supported on them is driven out of their pockets for staples 1412 and through the fabric that is stuck between the anvil and the cartridge.
[0058] [0058] Still with reference to Figure 4, the anvil 1810, in at least one shape, includes an anvil mounting portion 1820 that has a pair of anvil sleeves 1822 that project laterally from it to be received articulated in bases of corresponding rotating pins 1614 formed in the vertical walls 1622 of the proximal end portion 1610 of the elongated channel
[0059] [0059] In the illustrated arrangement, the interchangeable surgical tool set 1000 is configured with a trigger member locking system, generally designated as 1640. See Figure
[0060] [0060] 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 extends distally 1662 which is configured to engage an unlock feature 1426 formed in slide set 1420 when slide set 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 protrusion 1662 in the unlocking set 1660 comes into contact with the unlocking feature 1426 in the slide set 1420 which serves to tilt the knife member 1330 upwards , so that the central channel hitch 1137 and / or foot 1338 features clean the vertical projections 1654 at the bottom of the channel 1620 to facilitate the axial passage of the knife member 1330 through the elongated channel 1602. If a partially fired cartridge 1400 is inadvertently installed in the elongated channel, the slide assembly 1420 will not be in the starting position and the knife member 1330 will remain in the locked position.
[0061] [0061] The attachment of the interchangeable surgical tool set 1000 to the handle set 500 will now be described with reference to Figures 3 and 9. To start the coupling process, the doctor can position the tool frame 1210 of the set interchangeable surgical tool 1000 above or adjacent to the distal end of the grip structure 506 so that the tapered clamping portions 1212 formed on the tool frame 1210 are aligned with the slot slots 507 in the grip structure 506 The physician can then move the interchangeable surgical tool set 1000 along an installation axis IA that is perpendicular to the drive axis SA to seat the tapered clamping portions 1212 in "operating engagement" with the corresponding slot-receiving slots 507 at the distal end of the grip structure 506. In doing so, the drive shaft fixing pin 1314 on the intermediate portion of the firing drive shaft 1310 will also be seated on the base 544 on the longitudinally movable driving member 540 within the handle assembly 500 and the portions of a pin 516 on a closing link 514 will be seated on the corresponding hooks 1917 on closing shuttle 1914. As used in the present invention, the term "operable hitch" in reference to two components means that the two components are engaged with each other in such a way that, by applying an actuation movement to them, the components perform the desired action, function and / or procedure. In addition, during this process, the integrated connector 1154 in the surgical tool set 1000 is coupled to the compartment connector 562 that communicates with the microprocessor 560 that is supported in the handle set 500 or robotic system controller, for example.
[0062] [0062] During a typical surgical procedure, the doctor can insert the surgical end actuator 1500 into the surgical site through a trocar or other opening in the patient to access the target tissue. In doing so, the physician typically axially aligns the surgical end actuator 1500 along the geometric axis of the 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 position it advantageously adjacent to the target tissue. That is, before closing the anvil 1810 on the target tissue, so that the closing drive system 510 remains unacted. When in this position, the actuation of the triggering system 530 will result in the application of articulation movements to the proximal articulation driver 1370. Once the end actuator 1500 has reached the desired articulated position, the triggering 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 displacer assembly 1100 which detaches the proximal articulation driver 1370 from the intermediate portion of the firing drive shaft
[0063] [0063] As indicated above, the surgical tool set
[0064] [0064] 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, for example, a engineering thermoplastic such as liquid crystal polymer (LCP) liquid crystal polymer Vectra'Y and the elongated channel 1602 can be made from metal. In at least one aspect, the cartridge body 1710 includes an elongated centrally arranged slot 1712 that extends longitudinally through the cartridge body to accommodate the longitudinal displacement of the knife 1330 therethrough. As shown in Figures and 11, a pair of locking engagement tails 1714 extends proximally from the cartridge body 1710. Each locking input tail 1714 has a locking block 1716 formed on the underside of it. sized to be received within a corresponding proximal opening portion 1642 at channel bottom 1620. Thus, when cartridge 1700 is properly installed in elongated channel 1602, locking tails 1714 cover openings 1642 and protrusions 1654 to hold knife 1330 in an unlocked position ready for firing.
[0065] [0065] Now with reference to Figures 10 to 13, in the illustrated example, the cartridge body 1710 is formed with a central electrode block arranged centrally 1720. As can be seen more particularly in Figure 6, the elongated slot 1712 extends through the center of the electrode block 1720 and serves to divide the block 1720 into a left block segment 1720L and a right block segment 1720R. A 1730R right flexible circuit assembly is attached to the 1720R right cushion segment and a 1730L left flexible circuit assembly is attached to the 1720L left cushion segment. 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 1730L left flexible circuit assembly comprises a plurality of 1732L electrical conductors which may include, for example,
[0066] [0066] 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 lead 402 includes a set of male plug 406 that is configured to be plugged into corresponding female connectors 410 that are attached to a segmented RF circuit 1160 on an 1152 integrated circuit board. See Figure 15. This arrangement facilitates rotational displacement of the actuator drive shaft end position 1500 around the SA drive shaft geometry axis in relation to the tool chassis 1210 by rotating the nozzle assembly 1240 without winding the supply lead 402 of the generator 400. An on / off switch integrated 420 is supported on the locking set 1280 and the tool chassis 1210 to turn the RF generator on and off. When the tool set 1000 is operationally coupled to the handle set 500 or robotic system, the integrated segmented RF circuit 1160 communicates with the microprocessor 560 through connectors 1154 and 562. As shown in Figure 1, the 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 sliding ring assembly 1150 interfaces with a distal connector 1162 that includes a flexible drive shaft strip or circuit assembly 1164 that can include a plurality of narrow electrical conductors 1166 for activities related to stapling and wider 1168 electrical conductors used for RF purposes. As shown in Figures 14 and 15, the flexible drive shaft 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 of the flexible drive shaft circuit range 1164 during articulation of end actuator 1500 while remaining sufficiently rigid to allow knife member 1330 to be distally advanced through the trapped tissue.
[0067] [0067] 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 flexible drive shaft circuit strip 1164 for electrical contact therewith. A distal end 1674 of the channel circuit 1670 is received within a corresponding wall recess 1625 formed in one of the walls of the channel 1622 and is folded over and fixed to an upper edge 1627 of the channel wall 1622. A series of contacts corresponding posts 1676 are provided at the distal end 1674 of the channel circuit 1670, as shown in Figure 10. As can also be seen in Figure 10, an end 1752 of a flexible cartridge circuit 1750 is attached to the distal integrated chip 1740 and is affixed to the distal end portion of the cartridge body
[0068] [0068] Figures 16A and 16B are a block diagram of a control circuit 700 of the surgical instrument 10 of Figure 1 that comprises two drawing sheets according to an aspect of this description. Referring mainly to Figures 16A and 16B, a handle assembly 702 can include an engine 714, which can be controlled by an engine driver 715 and can be employed by the trigger system of the surgical instrument 10. In various ways, the motor 714 can be a brushed dc motor, having a maximum rotational speed of approximately 25,000 RPM. In other arrangements, the 714 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable type of electric motor. Motor starter 715 may comprise an H bridge starter comprising field-effect transistors ("FETs" - field-effect transistors) 719, for example. The motor 714 can be powered by the supply set 706 releasably mounted to the handle set 500 to supply control energy to the surgical instrument 10. The supply set 706 may comprise a battery which may include several cells battery cells connected in series, which can be used as the power source to energize the surgical instrument 10. In certain circumstances, the battery cells of the 706 power supply set can be replaceable and / or rechargeable. In at least one example, the battery cells can be lithium ion batteries that can be separately separable to the 706 power pack.
[0069] [0069] The drive shaft assembly 704 can include a drive shaft controller 722 that can communicate with the safety controller and the power management controller 716 through an interface, while the shaft assembly drive 704 and the power supply 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 coupling with electrical connector connectors of corresponding drive axes, and a second portion of interface 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 set drive shaft 722 and power management controller 716 while drive shaft assembly 704 and the power supply 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 interchangeable drive shaft assembly 704 to the management controller 716 power supply. In response, the power management controller can modulate the battery power output of the power supply 706, as described in more detail below, according to the power requirements of the fixed drive shaft assembly 704. The connectors may comprise switches that can be activated after mechanically coupling 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. energy 716.
[0070] [0070] 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 supply set 706 are coupled to handle set 702.
[0071] [0071] The main controller 717 can be any single-core or multi-core processor, such as those known under the trade name of ARM Cortex from Texas Instruments. In one respect, the main controller 717 may be a Core Cor- tex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single cycle flash memory, or other memory non-volatile, up to 40 MHz, a prefetch buffer to optimize performance above
[0072] [0072] 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 critical safety applications IEC 61508 and ISO 26262, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[0073] [0073] 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 sensing circuit 736. The power management circuit may 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 power supply 706 are coupled to the handle assembly 702. The con- 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 716 power management controller about the battery power output, so the 716 power management controller can adjust the power output of the power supply 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.
[0074] [0074] 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 LCD screen, LED indicators), hearing feedback devices (for example, a speaker, a bell) or devices tactile feedback (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 an user of 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 output device 742. The output device 742 can instead be integrated into the power supply 706. Under these circumstances, communication between output device 742 and the drive shaft assembly controller 722 can be done via the interface, while the drive shaft 704 is coupled to the handle assembly 702.
[0075] [0075] The control circuit 700 comprises segments configured to control the operations of the energized surgical instrument
[0076] [0076] The acceleration segment (Segment 3) comprises an accelerometer. The accelerometer is configured to detect movement or the 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.
[0077] [0077] 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 screen can be integrated with the screen and / or they can be located separately from the screen. 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.
[0078] [0078] The drive shaft segment (segment 5) comprises controls for an interchangeable drive shaft assembly 500 coupled to surgical instrument 10 (Figures 1 to 5) and / or one or more controls for a 1500 end actuator coupled to the interchangeable drive shaft assembly 500. The drive shaft segment comprises a drive shaft connector configured to couple main controller 717 to a drive shaft PCBA. The drive shaft PCBA comprises a low power microcontroller with ferroelectric random access memory ("(FRAM" - ferroelectric random access memory), an articulation switch, a drive shaft release Hall effect switch -
[0079] [0079] The position encoder 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 717.
[0080] [0080] 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 color sensor
[0081] [0081] The motor controller controls a first motor signal and a second motor signal to indicate the status and position of motor 714 to main controller 717. Main controller 717 provides a high pulse width modulation signal (PWM), a low PWM signal, a direction signal, a synchronization signal and a motor restart signal to the motor controller via a buffer. The supply segment is configured to supply a segment voltage to each of the circuit segments.
[0082] [0082] The power segment (Segment 8) comprises a battery coupled to the safety controller, the main controller 717 and the 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 circuit segments. 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 lift. up to a predetermined quantity, 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.
[0083] [0083] 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 Hall effect switch for ejection are configured to indicate the state of the 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 a drive shaft assembly 500 (Figures 1 and 3) and / or an end actuator 300 (Figures 1 and 4). A reverse key on the left side 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 left flex connector. 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.
[0084] [0084] Any suitable mechanical, electromechanical or solid state switches can be used to implement the plurality of switches in any combination. For example, keys can
[0085] [0085] 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 feed assembly 706 and between the handle assembly 702 and the shaft assembly. interchangeable drive 704, according to one aspect of this description. The handle assembly 702 can comprise a main controller 717, a drive shaft assembly connector 726 and a power assembly connector 730. The power assembly 706 may include a power assembly connector 732, a power circuit. power management 734 which can comprise the power management controller 716, a power modulator 738 and a current sensor circuit 736. The drive shaft assembly connectors 730, 732 form an interface 727. The management circuit power supply 734 can be configured to modulate the battery power output 707 based on the power needs of the interchangeable drive shaft assembly 704, while the interchangeable drive shaft assembly 704 and the power assembly 706 are coupled to the handle set 702. The power management controller 716 can be programmed to control power modulator 738 from the power output of the power supply 706 and the current sensor circuit 736 can be used to monitor the power output of the power supply 706 to provide feedback to the power management controller 716 about the power output of the battery 707 so that the power management controller 716 can adjust the power output of the power supply 706 to maintain a desired output. The drive shaft assembly 704 comprises a drive shaft processor 719 coupled to a non-volatile memory 721 and the drive shaft assembly 728 for electrically coupling the drive shaft assembly connector 704 to the drive assembly assembly. handle 702. The driveshaft assembly connectors 726, 728 form the interface 725. The main controller 717, the drive shaft processor 719 and / or the power management controller 716 can be configured to implement one or more of the processes described herein.
[0086] [0086] 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, a monitor with LCD screen, LED indicators), audio feedback devices (for example, a speaker, a bell) or tactile feedback devices (for example, eg haptic actuators). In certain circumstances, the output device 742 may comprise a screen 743 that may be included in the handle assembly 702. The drive shaft assembly controller 722 and / or the power management controller 716 can provide feedback to a user of 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. The output 742 can be integrated into power supply 706. Communication between output device 742 and drive shaft assembly controller 722 can be done via interface 725 while interchangeable drive shaft assembly 704 is coupled to the handle assembly 702. Having described a control circuit 700 (Figures 16A to 16B) to control the operation of the surgical instrument 10 (Figure as 1 to 5), the description now turns to various configurations of the surgical instrument 10 (Figures 1 to 5) and the control circuit 700.
[0087] [0087] Figure 18 is a schematic diagram of a surgical instrument 600 configured to control various functions according to an aspect of this description. In one aspect, the surgical instrument 600 is programmed to control the distal translation of a displacement member, such as the beam with a | 614. The surgical instrument 600 comprises an end actuator 602 which can comprise an anvil 616, a beam with a profile in | 614 and a removable staple cartridge 618 that can be interchanged with an RF cartridge 609 (shown in dashed line). The end actuator 602, the anvil 616, the beam with 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, various 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, the beam with profile | 614, staple cartridge 618, RF cartridge 609, anvil 616, are described with reference to Figures 1 to 17 of the present description.
[0088] Consequently, the components represented schematically in Figure 18 can be readily replaced by the equivalent physical and functional components described in connection with Figures 1 to 17. For example, in one aspect, the control circuit 610 can be implemented as the control circuit 700 shown and described in connection with Figures 16 to 17. In one aspect, sensors 638 can be implemented as a limit switch, electromechanical device, solid state switches, Hall effect devices , magneto-resistive devices (MR) giant magneto-resistive devices (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. 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). In other implementations, the 638 sensors may include electrical switches without a driver, ultrasonic switches, accelerometers, inertia sensors, among others. In one aspect, the 634 position sensor can be implemented as an absolute positioning system, which comprises an absolute, rotating and magnetic positioning system implemented as a single-chip, magnetic, rotating position sensor, ASSOSSEQFT, available together to Austria Microsystems, AG.
[0089] [0089] The position, movement, displacement and / or translation of a member of linear displacement, such as the beam with profile in | 614, can be measured by an absolute positioning system, arrangement of sensor and position sensor represented as position sensor 634. As the beam with i-profile 614 is coupled to a longitudinally movable drive member 540, the position of the i-profile beam 614 can be determined by measuring the position of the longitudinally movable driving member 540 using the position sensor 634. Consequently, in the following description, the position, displacement and / or translation of the beam with profile in i 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 beam with | 614, as described in the present invention. The control circuit 610, in some examples, 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 profile beam in i 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 beam position with i 614 profile as determined by the sensor. position 634 with the output of the timer / counter circuit 631 so that the control circuit 610 can
[0090] [0090] 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 some instances, the 604 motor may be a brushless DC electric motor and the 624 motor drive signal may comprise a pulse width modulation (PWM) signal supplied to one or more 604 motor stator windings. In addition, in some examples, motor controller 608 can be omitted and control circuit 610 can generate motor drive signal 624 directly.
[0091] [0091] The 604 motor can receive power from a power source
[0092] [0092] Control circuit 610 can be in communication with one or more sensors 638. Sensors 638 can be positioned on end actuator 602 and adapted to work with surgical instrument 600 to measure the various derived parameters such as distance the gap in relation to time, the compression of the tissue in relation to time, and the deformation of the anvil in relation to time. The 638 sensors can comprise, for example, 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 sensor resistive, a capable sensor, an optical sensor and / or any other sensors suitable for measuring one or more end actuator parameters
[0093] [0093] The one or more 638 sensors may comprise a strain gauge such as, for example, a microdeformation 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 638 sensors 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.
[0094] [0094] The 638 sensors can be configured to measure the forces exerted on the 616 anvil by the closing drive system. For example, one or more sensors 638 may be at an interaction point between the closing tube 1910 (Figures 1a4) and the anvil 616 to detect the closing forces applied by the closing tube 1910 to the anvil 616. The forces exerted on the anvil 616 can be representative of the tissue compression experienced by the section of tissue captured between the anvil 616 and the staple cartridge 618. The one or more sensors 638 can be positioned at various points of interaction throughout the closing drive system for detect the closing forces applied to the anvil 616 by the closing drive system. The one or more sensors 638 can be sampled in real time during a gripping operation by a processor as described in Figures 16A to 16B. The control circuit 610 receives sample measurements in real time to provide and analyze information based on time and evaluate, in real time, the closing forces applied to the anvil 616.
[0095] [0095] A current sensor 636 can be used to measure the current drained by the 604 motor. The force required to advance the beam with i 614 profile corresponds to the current drained by the 604 motor. The measured force is converted into a signal digital and supplied to the 610 control circuit.
[0096] [0096] The RF 400 power source is coupled to end actuator 602 and is applied to RF cartridge 609 when RF cartridge 609 is loaded on end actuator 602 in place of clamp cartridge 618. Control circuit 610 controls the supply of RF energy to the RF cartridge 609.
[0097] [0097] In certain provisions of a bipolar radio frequency (RF) surgical instrument, the surgical instrument may comprise an opposing first and second claw, each claw being able to comprise an electrode. In use, the fabric can be captured between the claws, so that energy can flow between the electrodes in the opposite claws and through the fabric positioned between them. Such instruments may have to seal many types of tissues, such as anatomical structures that have walls with different or irregular fibrous content, bundles of uneven anatomical structures, and / or substantially thick or thin anatomical structures.
[0098] [0098] In general, it is difficult to supply electrosurgical energy to the low impedance fabric continuously until the welding of the fabric is substantially completed. For example, during the supply of electrosurgical energy to the low impedance tissue, there is a point where the tissue impedance becomes too low, acting as a short circuit, so that the tissue drains merely a large part of the current while supplying little or no electrosurgical energy to the tissue. This can result in several undesirable results including, for example, incomplete tissue welding, excessive heating of the electrodes, a delay in surgery, inconvenience or frustration of the doctor, among others.
[0099] [0099] Aspects of this description can resolve the deficiency noted above by controlling the control circuits for an Independent power supply in segmented sections. In an exemplary aspect, a surgical instrument may include an end actuator that has a first jaw with a distal portion and a proximal portion, a second jaw that is movable in relation to the first jaw, a first set of electrodes located in the portion distal of the first claw, and a second set of electrodes located in the proximal portion of the first claw. The surgical instrument may also include a control circuit programmed to deliver electrosurgical energy (for example, RF energy) to the first set of electrodes and the second set of electrodes. The electrosurgical energy supplied to the first set of electrodes and the second set of electrodes can alternate repeatedly between the first set of electrodes and the second set of electrodes in a predetermined time interval; For example, electrosurgical energy can be supplied to the first set of electrodes for a first period of time (for example, 0.25 seconds), to the second set of electrodes for a second period of time (for example, 0.25 second) after the first period of time and then to the first set of electrodes for a third period of time (0.25 seconds), and so on. The alternation of electrosurgical energy between the first set of electrodes and the second set of electrodes can be repeated, for example, until the welding of the fabric begins to be done or is substantially completed. The alternation of electrosurgical energy in a very short period of time (for example, 0.25 seconds) between the first set of electrodes and the second set of electrodes can facilitate the complete welding of the low impedance tissue without excessive heating of the electrodes or a delay in surgery. In one example, this alternation of electrosurgical energy can be performed by a microcircuit in the first claw or a processor in the body of the surgical instrument using the RF energy supplied from a conventional RF energy generator.
[0100] [0100] Thus, aspects of this description may allow the surgical instrument to supply electrosurgical energy to the tissue that has low impedance until the welding of the low impedance tissue is substantially completed. In addition, aspects of this description can advantageously use a microcircuit in the first claw or a processor in the body of the surgical instrument to alternate electrosurgical energy between the two sets of electrodes using RF energy from a power generator conventional RF.
[0101] [0101] Figure 19 shows a schematic top view of a 3000 jaw on an end actuator (eg 1500 end actuator) of a surgical instrument (eg, surgical system 10 or surgical tool set 1000), according to with an aspect of this description. The claw 3000 can include a cartridge 3010, a flexible circuit 3020 that has flexible circuit contacts 3025 (for example, exposed contacts 1756), and an elongated slot 3030, within which a cutting member (for example, the knife member 1330) is received in a sliding way to cut the tissue trapped inside the end actuator along a cut line 3035. The elongated slot can extend from a proximal end of the claw 3000. In an exemplary aspect, the flexible circuit 3020 can also include a microcircuit (for example, distal microcircuit 1740), and then the 3010 cartridge can be called a Smart cartridge. The claw 3000 may also include a first set of electrodes 3040L, 3040R in a first zone 3060, and a second set of electrodes 3050L, 3050R in a second zone 3065. In an exemplary aspect, the first zone 3060 may be located in a portion proximal to the claw 3000 and the second zone 3065 can be located in a distal portion of the claw 3000. In another exemplary aspect, the first zone 3060 and the second zone 3065 can be located in any other suitable locations of the claw 3000.
[0102] [0102] The first and second sets of 3040L electrodes,
[0103] [0103] Electrosurgical energy can be in the form of radio frequency (RF) energy. RF energy is a form of electrical energy that can be in the frequency range of 200 kilohertz (kKHz) to 1 megahertz (MHz). In application, an electrosurgical device can transmit RF energy at low frequency through the tissue, which causes friction, or ionic agitation, that is, resistive heating, which, therefore, increases the temperature of the tissue. The low operating temperatures of the RF energy are useful for removing, shrinking or sculpting soft tissues while simultaneously cauterizing blood vessels. RF energy works particularly well in connective tissue, which mainly comprises collagen and shrinks when it comes in contact with heat. The first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be electronically connected to the control circuit via flexible circuit 3020. The first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be configured to emit RF energy to form a hemostatic line (or a coagulation) in the tissue adjacent to the 3040L, 3040R, 3050L electrodes,
[0104] [0104] In an exemplary aspect, the length 3070 of the first set of electrodes 3040L, 3040R can be in the range of about 10 mm to about 100 mm, preferably in the range of about 20 mm to about 50 mm, more preferably, in the range of about 25 mm to about 35 mm. Similarly, in an exemplary aspect, the length 3075 of the second set of electrodes 3050L, 3050R can be in the range of about 10 mm to about 100 mm and, preferably, in the range of about 20 mm to about 50 mm and, more preferably, in the range of about 25 mm to about 35 mm. In another exemplary aspect, the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can have any other suitable length. In an exemplary aspect, a gap between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be very small, so that the claimed fabric can be welded from the first zone 3060 and the second zone 3065 continuously without the fabric located between the two zones 3060 and 3065 being unsealed / welded. In an exemplary aspect, the length 3072 of the gap between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be in the range of about 0.1 mm to about 20 mm and, preferably, in the range from about 0.5 mm to about 5 mm and, more preferably, in the range from about 1 mm to about 3 mm. In another exemplary aspect, the length 3072 of the gap between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be any other suitable length. The total length 3080 of the first set of electrodes 3040L, 3040R, the second set of electrodes 3050L, 3050R, and the span can be in the range of about 20 mm to about 210 mm and, preferably, in the range of about 60 mm to about 100 mm, and more preferably,
[0105] [0105] In an exemplary aspect, the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be electrically coupled to the wider wires 1168 from which the first set of electrodes 3040L, 3040R and the second set of 3050L, 3050R electrodes can receive electrosurgical energy (for example, RF energy). The first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be electronically coupled to a plurality of wires (for example, 1732L and 1732R wires) in flexible circuit 3020 through which the wider wires 1168 can supply the RF energy for the 3040L, 3040R, 3050L, 3050R electrodes. In an exemplary aspect, wires 1168, 1732L, 1732R can be insulated to protect components (for example, a 1740 microcircuit, a central column assembly 1250, laminated plates 1322, a flexible circuit 3020) adjacent to wires 1168, 1732L, 1732R of inadvertent RF energy. In an exemplary aspect, the 3010 cartridge can be interchangeable. When the cartridge is changed, the narrow and wider wires 1166, 1168 in the surgical instrument can be connected to the new wires and electrodes in the new cartridge.
[0106] [0106] In an exemplary aspect, the cutting member (for example, knife member 1330) can be coupled directly or indirectly to a motor (for example, 505 motor). When the control circuit supplies voltage to the motor, the cutting member can be advanced to the first zone 3060 or to the second zone 3065 to cut the fabric in the first and second zones 3060, 3065.
[0107] [0107] Figure 20 shows a 3100 graph representing the voltage applied to the 3040L, 3040R, 3050L, 3050R electrodes as a function of time, according to a non-limiting aspect. Pulses 3110 can represent the voltage applied to electrodes 3040L, 3040R in the first zone 3060. Pulses 3120 can represent the voltage applied to electrodes 3050L, 3050R in the second zone 3065. When the voltage is connected to the first zone 3060, the electrosurgical energy it can be applied to the tissue adjacent to the first set of 3040L, 3040R electrodes to form a coagulation / welding line on it. Similarly, when the voltage is connected to the second zone 3065, electrosurgical energy can be applied to the tissue adjacent to the second set of electrodes 3050L, 3050R to form a coagulation / welding line in it. As shown in Figure 20, in an exemplary aspect, the control circuit can apply a defined voltage alternately throughout all alternation cycles. Then, the power / energy applied to the tissue can change as the tissue impedance changes. In another exemplary aspect, the control circuit or generator 400 can change the voltage applied to the electrodes (for example, 30 volts during the first 5 cycles, 50 volts for the next 5 cycles, 80 volts for the next 5 cycles ). In another exemplary aspect, the control circuit or generator 400 can change the voltage applied to the electrodes to provide constant energy to the tissue. In that case, the voltage may change as the tissue impedance changes.
[0108] [0108] In an exemplifying aspect, electrosurgical energy can alternate repeatedly between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R in a predetermined time interval. For example, electrosurgical energy can be supplied to the first set of 3040L, 3040R electrodes for a first period of time (eg 0.25 seconds) and then to the second set of 3050L, 3050R electrodes for a second time period (for example, 0.25 seconds). Then, it can be switched to the first set of electrodes 3040L, 3040R and the alternation of electrosurgical energy between the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can be repeated, for example, until the impedance of the trapped tissue reaches a predetermined impedance value. In an exemplary aspect, the predetermined time interval can be in the range of about 0.05 seconds to about 0.5 seconds, preferably in the range of about 0.1 seconds to about 0.4 seconds, with more preferably, in the range of about 0.2 seconds to about 0.3 seconds. In another exemplary aspect, the predetermined time interval can have any other suitable time period. In an exemplary aspect, the predetermined time interval for alternating electrosurgical energy can be fast enough that the supply of electrosurgical energy to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R can appear simultaneous.
[0109] [0109] In an exemplary aspect, the alternation of electrosurgical energy can be initiated once the integrated on / off switch 420 is turned on and the alternation can continue without input from a user of the electrosurgical device until the switch on / integrated switch 420 is switched off. The integrated on / off switch 420 can be automatically turned off when the measured fabric impedance reaches a predetermined impedance value (for example, an impedance value indicating that the trapped fabric is completely sealed). The number of cycles (for example, n times) of alternating electrosurgical energy that is required to achieve the predetermined impedance value can vary depending on several parameters, including type of tissue, thickness of tissue, how much moisture is in the tissue, etc.
[0110] [0110] In an exemplifying aspect, as shown in Figure 20, the time interval for the first set of electrodes
[0111] [0111] In an exemplary aspect, the control circuit can include two modes of operation, Mode | and Mode Il. In Mode |, the control circuit can cut the fabric after welding the fabric or when it is finished. In Mode 2, the control circuit can cut the fabric while fabric welding is in progress. Examples of these modes are described in more detail below and as shown in Figures 21 to 27.
[0112] [0112] Figure 21 illustrates a block diagram of a 3200 surgical system programmed to transmit control and energy signals with a 3250 end actuator, according to one aspect of this description. In an exemplary aspect, the 3200 surgical system may include a 3210 control circuit (for example, microprocessor 560, segmented RF circuit 1160, or distal integrated microcircuit 1740) that has an electrosurgical energy control segment (or a segment 3220 RF power control segment) and a 3230 drive shaft control segment (for example, drive shaft segment (Segment 5), motor circuit segment (Segment 7) or power segment (Segment 8 )). The 3210 control circuit can be programmed to deliver electrosurgical energy (for example, RF energy) to the electrodes on the 3250 end actuator (for example, 1500 end actuator). The 3200 surgical system can include one or more 3260 electrical conductors (for example, 1168 electrical conductors) used to supply electrosurgical energy from a 3240 electrosurgical energy generator (for example, the RF 400 generator), while 3250 end actuator. One or more 3260 electrical conductors can be electrically connected between the 3250 end actuator and the 3210 control circuit (for example, the 3220 electrosurgical power control segment and the 3230 drive shaft control segment ).
[0113] [0113] The 3220 electrosurgical energy control segment can be programmed to supply electrosurgical energy to the electrodes via one or more 3260 electrical conductors. In an exemplary aspect, the 3230 drive shaft control segment can be programmed to provide and / or receive a control signal to / from the end actuator 3250 (and / or the surgical tool set 1000, the drive shaft set 704) via one or more 3260 electrical conductors. , the one or more 3260 electrical conductors can be used not only to supply electrosurgical energy to the 3250 end actuator, but also to communicate control signals with the 3250 end actuator.
[0114] [0114] In an exemplary aspect, the 3220 electrosurgical energy control segment can electrically isolate one or more 3260 electrical conductors from the 3230 drive shaft control segment, for example, when it supplies electrosurgical energy to the electrodes in the 3250 end actuator through one or more 3260 electrical conductors. In an exemplary aspect, the 3220 electrosurgical energy control segment can control a 3270 switch located between one or more 3260 electrical conductors and the control axis control segment. 3230 drive by providing a signal via a 3280 control line to electrically isolate one or more 3260 electrical conductors from the 3230 drive shaft control segment. The 3270 switch can be configured to switch between a state open and a closed state. The drive shaft control segment 3230 and one or more electrical conductors 3260 can be electrically isolated when the 3270 switch is in the open state, and can be in electrical communication when the 3270 switch is in the closed state. In another exemplary aspect, the electrosurgical energy control segment 3220 can electrically isolate one or more electrical conductors 3260 from the drive shaft control segment 3230 in any other suitable manner. Other configurations of the 3270 switch may allow the electrical isolation of one or more 3260 electrical conductors from the 3230 drive shaft control segment by closing the 3270 switch.
[0115] [0115] In an exemplary aspect, the surgical system can include one or more 3290 electrical conductors (for example, 1166 electrical conductors) used to operate the 3250 end actuator (and / or the surgical tool set 1000, the set drive shaft 704). In an exemplary aspect, one or more 3290 electrical conductors cannot be used to release electrosurgical energy to the 3250 end actuator. The 3230 drive shaft control segment can be programmed to supply and / or receive a control signal to / from the 3250 end actuator through one or more 3290 electrical conductors. In an exemplary aspect, the 3230 drive shaft control segment can use the one or more 3290 electrical conductors to supply and / or receive the control signal to / from the 3250 end actuator while the 3270 switch is in an open state (for example, while the 3220 electrosurgical power control segment is formed)
[0116] [0116] The 3270 switch can be a transistor switch, a mechanical switch or any other suitable switch. In an exemplary aspect, the control signals communicated between the 3210 control circuit and the 3250 end actuator (and / or the surgical tool set 1000, the drive shaft set 704) through the 3260 electrical conductors , 3290 include, but are not limited to, signals to drive the 3250 end actuator (and / or the surgical tool set 1000, the drive shaft set 704) in the cutting and / or coagulation operating modes, measure the electrical characteristics of the 3200 surgical system and / or the tissue clamped on the 3250 end actuator, provide feedback for use, communicate sensor signals and identify certain characteristics of the 3250 end actuator (eg used / not used condition) .
[0117] [0117] Consequently, aspects of the present description can advantageously reduce the number of electrical conductors needed to communicate control signals between the 3210 control circuit and the 3250 end actuator (and / or the 1000 surgical tool set , the drive shaft assembly 704) with the use of some of the electrical conductors (for example, electrical conductors 3260) used for the application of electrosurgical energy to communicate control signals when these electrical conductors are not used for energy electrosurgical. In addition, by insulating the electrical conductors from other circuit segments (for example, drive shaft control segment 3230) by supplying electrosurgical energy through these electrical conductors, aspects of this description may prevent electrosurgical energy flows into the other circuit segments and / or electrical conductors (for example, 3290 electrical conductors) connected to the circuit segments, preventing damage to the circuit segments and / or electrical conductors.
[0118] [0118] Figure 22 is a logic flow diagram representing a 4500 process from a control program or a logical configuration for operating the surgical instrument, according to Mode |. Although the 4500 example process is described with reference to the logical flowchart illustrated in Figure 22, it will be understood that many other methods for performing actions associated with the method can be used. For example, the order of some of the blocks can be changed, certain blocks can be combined with other blocks, and some of the described blocks are optional.
[0119] [0119] In the example illustrated and with reference also to Figure 18, a control circuit 610 (Figure 18), can receive 4510 information about the tissue impedance. For example, control circuit 610 may include an impedance feedback circuit and measure the impedance of the tissue trapped in the end actuator 602 (eg the end actuator 1500), such as the tissue adjacent to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R. In an exemplary aspect, control circuit 610 can measure tissue impedance periodically (for example, every 0.1 second, every 0.5 second, or every second). In another exemplary aspect, the control circuit 610 can measure tissue impedance at random or in any other suitable way. The 610 control circuit can supply 4520 electrosurgical energy to a first set of electrodes and a second set of electrodes, the supply of electrosurgical energy alternating repeatedly between the first set of electrodes and the second set of electrodes over a predetermined time interval. For example, control circuit 610 can supply electrosurgical energy to the first set of 3040L, 3040R electrodes and a second set of 3050L, 3050R electrodes alternately at a predetermined time interval, as described above in relation to the Figure
[0120] [0120] Then, at some points, the control circuit 610 may determine 4530 that the tissue impedance reaches a predetermined impedance value. For example, the predetermined impedance value may be a value that indicates that the tissue adjacent to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R is substantially or completely welded or coagulated. Control circuit 610 can determine that fabric welding is substantially completed by comparing the measured fabric impedance to the predetermined terminating impedance value. Then, the control circuit 610 can interrupt 4540 the supply of electrosurgical energy to the first set of electrodes and the second set of electrodes. Then, the control circuit 610 can advance a cutting member 4550, such as the i-profile beam 614, to cut the fabric. In an exemplary aspect, the control circuit 610 can advance the cutting member (for example, i-profile beam 614) to the first zone 3060 to cut the fabric in the first zone 3060 and then to the second zone 3065 to cut the fabric in the second zone
[0121] [0121] Figure 23 shows a 4600 plot of an impedance curve for tissue 4605 as a function of time. The tissue impedance curve 4605 can represent a change in the tissue impedance claimed in the end actuator 1500 when the control circuit 610 (Figure 18) is operating in Mode |. As shown in Figure 23, tissue impedance tends to follow a common "bath" pattern, decreasing at the start of the power switch during a first time period 4625 (for example, 0.3 to 1.5 seconds) , reaching a minimum impedance value (Zv) in the first time (t1) 4615 and then increasing during a second time period 4630 (for example, 0.3 to 1.5 seconds) as the trapped tissue is being a soldier. Then, the tissue impedance can reach a point 4610 in a second time (t2) 4620, where the tissue impedance at point 4610 is equal to a predetermined terminating impedance (21).
[0122] [0122] In the first time period 4625, the tissue impedance drops from an initial value and decreases, for example, it has a negative slope, until it reaches the minimum impedance value (Zvm) because after the energy is applied to the fabric over a period of time, the moisture content of the fabric evaporates, causing the fabric to dry out and causing the impedance of the fabric to start increasing, for example, positive angular co-efficient, subsequently, in the second time period 4630 to that the fabric impedance reaches the predetermined terminating impedance Z1, at which point in time the power to the end actuator can be turned off. In an exemplary aspect, tissue impedance can maintain the minimum impedance rate Zvm for a certain period of time (for example, 0.5 to 5 seconds), when the tissue impedance curve 4605 almost aligns to that period of time. If electrosurgical energy (for example, RF energy) is applied continuously instead of being turned off at the 4610 terminating impedance point, the tissue impedance may increase continuously from 4610 point.
[0123] [0123] In an exemplary aspect, the predetermined termination impedance (Z7) can correspond to a point where the tissue adjacent to the 3040L, 3040R, 3050L, 3050R electrodes can be substantial or completely welded in order to cut the tissue ( for example, blood vessel) without bleeding. The predetermined terminating impedance can be stored in a surgical instrument memory device (for example, surgical system 10 or surgical tool set 1000).
[0124] [0124] When the tissue impedance reaches the predetermined termination impedance, the control circuit can interrupt the supply of electrosurgical energy to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R, re- resulting in a sudden drop in tissue impedance at t2 4620. In an exemplary aspect, this sudden drop in tissue impedance can occur because the control circuit interrupts the measurement of tissue impedance when the electrosurgical energy supply is interrupted. As shown in Figure 24 representing a 4650 graph of an exemplary motor voltage curve, when or after the electrosurgical power supply is interrupted at t2, the control circuit can supply motor 4660 voltage (for example, 505 motor) to cut the fabric in the first zone 3060. Then, the control circuit can also supply voltage 4670 to the motor to cut the fabric in the second zone 3065. As shown in Figures 23 and 24, in Mode |, the cutting of the stuck fabric can begin for a third time period 4635 after the fabric impedance reaches the predetermined terminating impedance value (for example, the completion of fabric welding).
[0125] [0125] Figure 25 is a logic flow diagram representing a 4700 process from a control program or a logical configuration for operating the surgical instrument, according to Mode Il. Although the 4700 example process is described with reference to the logic flow diagram illustrated in Figure 25, it will be understood that many other methods of performing the actions associated with the method can be used. For example, the order of some of the blocks can be changed, certain blocks can be combined with other blocks, and some of the blocks described are optional.
[0126] [0126] In the example illustrated and with reference also to Figure 18, a control circuit 610 can receive 4710 information about the importance of the fabric. For example, control circuit 610 can measure the impedance of the tissue trapped in end actuator 602 (for example, end actuator 1500). In an exemplary aspect, the 610 control circuit can measure tissue impedance periodically (for example, every 0.1 second, every 0.5 second, or every second). In another exemplary aspect, the control circuit 610 can measure tissue impedance randomly or in any other suitable way. The 610 control circuit can supply 4720 electrosurgical energy to a first set of electrodes in a proximal portion of a claw and to a second set of electrodes in a distal portion of the claw, with the electrosurgical energy supply alternating. repeatedly between the first set of electrodes and the second set of electrodes at a predetermined time interval. For example, the 610 control circuit can supply electrosurgical energy to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R alternately in a predetermined time interval, as described above in relation to Figure 20.
[0127] [0127] Then, in some points, the control circuit 610 can determine 4730 that the tissue impedance reaches a predetermined impedance value. For example, the predetermined impedance value may be a value that indicates that the welding of the tissue adjacent to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R begins to be made. Then, the control circuit 610 can advance the cutting member 4740, like the beam with i-profile 614 to cut the tissue in the proximal portion, while supplying electrosurgical energy to the first set of electrodes and the second set of electrodes. electrodes. After cutting the tissue in the proximal portion of the claw, the control circuit 610 can advance the cutting member 4740 (for example, i-profile beam 614) to cut the tissue in the distal portion while supplying electrosurgical energy to the second set of it - trodos.
[0128] [0128] In an exemplary aspect, the control circuit 610 can advance the cutting member 4750 (for example, beam with i-profile 614) to cut the tissue in the distal portion while supplying electrosurgical energy to the first set of 3040L electrodes, 3040R and the second set of electrodes 3050L, 3050R. In another exemplifying aspect, the 610 control circuit can interrupt the supply of electrosurgical energy to the first set of electrodes after cutting the tissue in the proximal portion, and supply the electrosurgical energy only to the second set of electrodes during the cutting the tissue in the distal portion. In this case, the supply of electrosurgical energy to the second set of electrodes 3050L, 3050R can still be discontinuous. For example, electrosurgical energy can be supplied for the second set of electrodes 3050L, 3050R for a certain period of time (for example, 0.25 seconds) and then no electrosurgical energy can be supplied for the second set of electrodes. electrodes 3050L, 3050R during the next defined time period (for example, 0.25 seconds) and then electrosurgical energy can be supplied for the second set of 3050L, 3050R electrodes during the next defined time period (for example , 0.25 seconds). This process can be repeated when cutting the tissue in the distal portion of the claw (for example, the second zone 3065).
[0129] [0129] In another exemplary aspect, the control circuit 610 can interrupt the supply of electrosurgical energy to the first set of electrodes 3040L, 3040R and the second set of electrodes 3050L, 3050R after cutting the tissue in the first zone. In this case, no electrosurgical energy can be supplied to the tissue while cutting the tissue in the second zone 3065. In an exemplary aspect, the 610 control circuit can interrupt the supply of electrosurgical energy to the first set of electrodes 3040L, 3040R and to the second set of electrodes 3050L, 3050R when the tissue impedance reaches a predetermined termination impedance value during tissue cutting in the first zone 3060 and / or in the second zone 3065.
[0130] [0130] Figure 26 shows a 4800 graph of an 4805 tissue impedance curve as a function of time. The tissue impedance curve 4805 can represent a change in the tissue impedance claimed in the end actuator 1500 when the control circuit is operating in Mode Il. As seen in Figure 26, the impedance of the fabric here also tends to follow a common "bathtub" pattern, decreasing at the beginning of the power switch (for example, between the first set of electrodes 3040L, 3040R and the second with electrodes 3050L, 3050R) for a first period of time 4835 (for example 0.3 to 1.5 seconds), reaching a minimum impedance value (Zvm) in a first period (t1) 4820 and then increasing over a second time period 4840 (for example, 0.3 to 1.5 seconds). As explained above, in the first period of time 4835, the impedance of the tissue falls from an initial value and decreases, for example, it has a negative slope, until it reaches the minimum impedance value (Zwm), because after the energy is applied to the fabric for a certain period, the moisture content of the fabric evaporates, causing the fabric to dry out and causing the impedance of the fabric to start increasing, for example, positive slope, subsequently, in the second period of time 4840 to that the tissue impedance reaches the termination impedance Zr11. In an exemplary aspect, the impedance of the tissue can maintain the minimum impedance rate for a period of time (for example, 0.5 to 5 seconds), where the impedance curve of the 4805 tissue almost aligns to that period - all time.
[0131] [0131] In an exemplary aspect, when the fabric impedance reaches the minimum impedance value ((Zv), an impedance change rate (for example, decrease) can become approximately zero, as shown in Figure 26. Welding of the trapped tissue can begin to be completed at this point. In an exemplary aspect, in Mode Il, the control circuit can begin to advance the cutting member when the tissue impedance reaches the minimum impedance value ( For example, the control circuit may determine that the tissue impedance reaches the minimum impedance value (Zm) when the impedance change rate (for example, decrease) becomes approximately zero. In another exemplary aspect, in Mode Il, the control circuit can start advancing the cutting member at any other suitable time before the trapped tissue is completely welded. temp period o (for example, 0.5 to seconds), the control circuit can start advancing the cutting member at any suitable time during that time period (for example, at the start / middle / end of the flat curve).
[0132] [0132] As shown in Figure 27, and with reference also to Figure 18, control circuit 610 can supply voltage 4860 to motor 604 (for example, motor 505) to cut the fabric in the first zone 3060 when or after the impedance of fabric reaches the minimum impedance value (Zvm) before fabric welding is completed. The termination impedance Zr1: can represent the fabric impedance at the conclusion of the cut in a second time (t2) 4825. Then, the control circuit can supply voltage 4870 to motor 604 (for example, motor 505) for cut the fabric in the second zone 3065 after cutting the fabric in the first zone 3060. The termination impedance Zr2 can represent the impedance of the fabric at the completion of the cut in a third time (t3) 4830. The impedance curve 4805 may fall close the second time 4825 just after cutting the tissue in the first zone 3060, due to the fact that the trapped tissue can be wetted with some fluids (eg blood or any other bodily fluids) that are produced during the cut of the fabric in the first zone
[0133] [0133] In an exemplary aspect, the control circuit 610 can consider the amount of time needed to cut the tissue trapped in the end actuator 602 in determining when to start advancing the cutting member such as the i-profile beam 614. For example, if it takes 1 second to cut the fabric in the first zone 3060, the control circuit 610 can start to advance the cutting member (for example, i-beam beam 614) around 1 second before the fabric impedance reaches a predetermined terminating impedance value (at which approximately at that time the fabric welding is normally completed) so that the fabric welding is completed 3060. In another exemplary aspect, the cutting speed can be adjusted so that the fabric weld is substantially completed by the end of the cut. For example, if 0.5 seconds is needed from the moment the fabric impedance reaches the minimum impedance until the moment it reaches the termination impedance (for example, when fabric welding is complete), the speed cut can be adjusted so that it would take 0.5 seconds to cut the fabric in the first or second zones 3060, 3065.
[0134] [0134] As explained above, in an exemplary aspect, the 610 control circuit can provide electrosurgical energy for both the first set of 3040L, 3040R electrodes and the second set of 3050L, 3050R electrodes while cutting the tissue in the second zone 3065 during the third time period 4845. In this case, since the trapped tissue received additional electrosurgical energy for the third time period 4845, the Z12 termination impedance in the third time 4830 may be higher than the impedance of termination Zr1: in the second time 4825, as seen in Figure 26.
[0135] [0135] In an exemplary aspect, the 610 control circuit can interrupt the supply of electrosurgical energy to the first set of electrodes after cutting the tissue in a first zone 3060 and supply electrosurgical energy only to the second set of electrodes during the cut of the tissue in the second zone 3065. In this case, the impedance of termination of the tissue in the second zone 3065 may be greater than the termination impedance of the tissue in the first zone 3060 since the tissue in the second zone 3065 received more electrosurgical energy during the third time period 4845 than the tissue in the first zone 3060, assuming that the predetermined time intervals for the two sets of electrodes are the same.
[0136] [0136] The functions or processes 4500, 4700 described herein can be performed by any of the processing circuits described here, such as the control circuit 700 described together with Figures 16 to 17, the control circuit 610 described together with Figure 18.
[0137] [0137] 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 to apply specific circuits, electrical circuits that form a general-purpose computer device configured by a computer program (for example, a general-purpose computer or processor configured by a computer program that at least partially performs the processes and / or devices described herein), electrical circuits that form a memory device (for example, random access memory forms), and / or electrical circuits that form a communications device (for example, a modem, routers or optical-electrical equipment). These aspects can be implemented in analog or digital form or combinations of them.
[0138] [0138] 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 gate arrangements (FPGAs), digital signal processors (DSP's), 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 executed on one or more computers (for example, as one or more programs executed on one or more computer systems), 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 that designing the circuitry and / or writing the code for the software and firmware would be within the scope of practice of a person skilled in the art in the light of this description.
[0139] [0139] 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.).
[0140] [0140] 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 for the purpose of illustrating the principles and practical application to, thus, enable the person skilled in the art to use the various aspects and with various modifications, as they are convenient to the specific use contemplated. plated. The claims presented in the annex are intended to define the global scope.
[0141] [0141] Various aspects of the matter described in this document are defined in the following numbered examples: Example 1. Surgical instrument comprising: an end actuator comprising: a first jaw and a second jaw, the first jaw being it includes a proximal portion and a distal portion and the second jaw is movable in relation to the first jaw; a first set of electrodes and a second set of electrodes, the first set of electrodes being located in a proximal portion of the first claw and the second set of electrodes is located in a distal portion of the first claw; and a gap defined between the first set of electrodes and the second set of electrodes; a cutting member configured to reciprocate within the slot; and a control circuit configured to: receive information about the impedance of the tissue located between the first jaw and the second jaw of the end actuator; supply electrosurgical energy to the first set of electrodes and the second set of electrodes and repeatedly alternate the electrosurgical energy between the first set of electrodes and the second set of electrodes in a predetermined time interval; and advance the cutting member.
Example 2. Surgical instrument, according to example 1, in which the control circuit is configured to advance the cutting member to the proximal portion to cut the tissue in the proximal portion after welding the tissue or when it is substantially closed completed.
Example 3. Surgical instrument, according to example 2, in which the control circuit is configured to interrupt the supply of electrosurgical energy to the first set of electrodes and the second set of electrodes before advancing the cutting member to the proximal portion.
Example 4. Surgical instrument, according to one or more of examples 2 to 3, in which the control circuit is configured to advance the cutting member to the distal portion to cut the tissue in the distal portion after cutting the tissue in the proximal portion .
Example 5. Surgical instrument, according to one or more of examples 2 to 4, in which the control circuit is configured to determine that the welding of the tissue is substantially complete by comparing the information on the impedance of the tissue with a value of predetermined termination impedance.
Example 6. Surgical instrument, according to one or more of examples 1 to 5, in which the control circuit is configured to advance the cutting member to the proximal portion to cut the tissue in the proximal portion before welding the tissue in the proximal portion is completed, while supplying electrosurgical energy to the first set of electrodes and the second set of electrodes.
Example 7. Surgical instrument, according to example 6, in which the control circuit is configured to advance the cutting member to the proximal portion to cut the tissue in the proximal portion when the welding of the fabric begins to be done.
Example 8. Surgical instrument, according to example 7, in which the control circuit is configured to determine that tissue welding begins to be performed when an impedance decrease rate becomes approximately zero.
Example 9. Surgical instrument, according to one or more of examples 6 to 8, in which the control circuit is configured to advance the cutting member to the distal portion to cut the tissue in the distal portion after cutting the tissue in the portion proximal, while supplying electrosurgical energy to the second set of electrodes.
Example 10. Surgical instrument, according to one or more of Examples 1 to 9, in which the predetermined time interval is in the range of about 0.1 to 0.5 seconds.
Example 11. Surgical instrument, according to one or more of Examples 1 to 10, in which the electrosurgical energy comprises radiofrequency energy.
Example 12. Surgical instrument comprising: an end actuator comprising: a first claw comprising a proximal portion and a distal portion; a second claw that is movable in relation to the first claw; a first set of electrodes located in the proximal portion of the first claw; and a second set of electrodes located in the distal portion of the first claw; a cutting member, the first jaw and the second jaw defining an elongated slit between them extending from a proximal end of the first jaw and the cutting member can be received slidingly into the elongated slit to cut the fabric between the first jaw and the second jaw; a control circuit configured to supply electrosurgical energy to the first set of electrodes and the second set of electrodes, the supply of electrosurgical energy alternating repeatedly between the first set of electrodes and the second set of electrodes over a period of time predetermined, and the control circuit is configured to receive information about the impedance of the tissue located between the first claw and the second claw.
Example 13. Surgical instrument, according to example 12, in which the control circuit is configured to advance the cutting member to the proximal portion to cut the tissue in the proximal portion after welding the tissue or when it is substantially closed completed.
Example 14. Surgical instrument, according to example 13, in which the control circuit is configured to interrupt the supply of electrosurgical energy to the first set of electrodes and the second set of electrodes and then to advance the cutting member to the proximal portion.
Example 15. Surgical instrument, according to one or more of examples 13 to 14, in which the control circuit is configured to advance the cutting member to the distal portion to cut the tissue in the distal portion after cutting the tissue in the proximal portion .
Example 16. Surgical instrument, according to one or more of examples 13 to 15, in which the control circuit is configured to determine that the welding of the tissue is substantially complete and to compare the information on the impedance of the tissue with a value predetermined terminating impedance.
Example 17. Surgical instrument, according to one or more of Examples 12 to 16, in which the control circuit is configured to advance the cutting member to the proximal portion to cut the tissue in the proximal portion before welding the tissue in the proximal portion is completed, and supply electrosurgical energy to the first set of electrodes and the second set of electrodes.
Example 18. Surgical instrument, according to example 17, in which the control circuit is configured to advance the cutting member to the proximal portion to cut the tissue in the proximal portion when the welding of the fabric begins to be done.
Example 19. Surgical instrument, according to example 18, in which the control circuit is configured to determine that the welding of the tissue begins to be carried out when an impedance decrease rate becomes approximately zero.
Example 20. Surgical instrument, according to one or more of examples 17 to 19, in which the control circuit is configured to advance the cutting member to the distal portion to cut the tissue in the distal portion after cutting the tissue in the portion proximal, and simultaneously supply electrosurgical energy to the second set of electrodes.

权利要求:
Claims (20)
[1]
1. Surgical instrument characterized by comprising: an end actuator comprising: a first jaw and a second jaw, in which the first jaw includes a proximal portion and a distal portion and the second jaw is movable in relation to the first jaw; a first set of electrodes and a second set of electrodes, in which the first set of electrodes is located in a proximal portion of the first claw and the second set of electrodes is located in a distal portion of the first claw; and a defined gap between the first set of electrodes and the second set of electrodes; a cutting member configured to reciprocate within the slot; and a control circuit configured to: receive information about the impedance of the tissue located between the first jaw and the second jaw of the end actuator; supply electrosurgical energy to the first set of electrodes and the second set of electrodes and repeatedly alternate the electrosurgical energy between the first set of electrodes and the second set of electrodes in a predetermined interval of time; and advance the cutting member.
[2]
2. Surgical instrument according to claim 1, characterized in that the control circuit is configured to advance the cutting member to the proximal portion to cut the tissue in the proximal portion after welding the tissue or when it is substantially completed .
[3]
3. Surgical instrument, according to claim 2, characterized in that the control circuit is configured to interrupt the supply of electrosurgical energy to the first set of electrodes and the second set of electrodes before advancing the cutting member to the portion proximal.
[4]
4. Surgical instrument according to claim 2, characterized in that the control circuit is configured to advance the cutting member to the distal portion to cut the tissue in the distal portion after cutting the tissue in the proximal portion.
[5]
5. Surgical instrument according to claim 2, characterized in that the control circuit is configured to determine that the welding of the tissue is substantially completed by comparing the information on the impedance of the tissue with a predetermined terminating impedance value .
[6]
6. Surgical instrument according to claim 1, characterized in that the control circuit is configured to advance the cutting member to the proximal portion to cut the tissue in the proximal portion before the welding of the tissue in the proximal portion is completed , supplying, at the same time, electrosurgical energy to the first set of electrodes and the second set of electrodes.
[7]
7. Surgical instrument, according to claim 6, characterized in that the control circuit is configured to advance the cutting member to the proximal portion to cut the tissue in the proximal portion when the welding of the fabric begins to be done.
[8]
8. Surgical instrument, according to claim 7, characterized in that the control circuit is configured to determine that the welding of the tissue begins to be carried out when an impedance decrease rate becomes approximately zero.
[9]
9. Surgical instrument according to claim 6, characterized in that the control circuit is configured to advance the cutting member to the distal portion to cut the tissue in the distal portion after cutting the tissue in the proximal portion, while providing the same time, electrosurgical energy to the second set of electrodes.
[10]
10. Surgical instrument according to claim 1, characterized in that the predetermined time interval is in the range of about 0.1 to 0.5 seconds.
[11]
11. Surgical instrument, according to claim 1, characterized in that the electrosurgical energy comprises radio frequency energy.
[12]
12. Surgical instrument characterized by comprising: an end actuator comprising: a first claw comprising a proximal portion and a distal portion; a second claw that is movable in relation to the first claw; a first set of electrodes located in the proximal portion of the first claw; and a second set of electrodes located in the distal portion of the first claw; a cutting member, wherein the first jaw and second jaw define an elongated slot between them extending from a proximal end of the first jaw and where the cutting member can be slidably received in the elongated slot to cut the fabric located between the first claw and the second claw; a control circuit configured to deliver electrosurgical energy to the first set of electrodes and the second set of electrodes, where the supply of electrosurgical energy alternates alternately between the first set of electrodes and the second set of electrodes over a period of time predetermined, in which the control circuit is configured to receive information about the impedance of the tissue located between the first jaw and the second jaw.
[13]
13. Surgical instrument, according to claim 12,
characterized in that the control circuit is configured to advance the cutting member to the proximal portion to cut the fabric in the proximal portion after welding the fabric or when it is substantially completed.
[14]
14. Surgical instrument, according to claim 13, characterized in that the control circuit is configured to interrupt the supply of electrosurgical energy to the first set of electrodes and the second set of electrodes and, then, advance the cutting member until the proximal portion.
[15]
15. Surgical instrument according to claim 13, characterized in that the control circuit is configured to advance the cutting member to the distal portion to cut the tissue in the distal portion after cutting the tissue in the proximal portion.
[16]
16. Surgical instrument according to claim 13, characterized in that the control circuit is configured to determine that the welding of the tissue is substantially completed and to compare the information about the impedance of the tissue with a predetermined termination impedance value.
[17]
17. Surgical instrument according to claim 12, characterized in that the control circuit is configured to advance the cutting member to the proximal portion to cut the tissue in the proximal portion before the welding of the tissue in the proximal portion is completed , and supply electrosurgical energy to the first set of electrodes and the second set of electrodes.
[18]
18. Surgical instrument according to claim 17, characterized in that the control circuit is configured to advance the cutting member to the proximal portion to cut the tissue in the proximal portion when the welding of the fabric begins to be done.
[19]
19. Surgical instrument, according to claim 18, characterized in that the control circuit is configured to determine that the welding of the tissue begins to be carried out when an impedance decrease rate becomes approximately zero.
[20]
20. Surgical instrument according to claim 17, characterized in that the control circuit is configured to advance the cutting member to the distal portion to cut the tissue in the distal portion after cutting the tissue in the proximal portion, and simultaneously supply the electrosurgical energy to the second set of electrodes.

类似技术:

---

公开号 | 公开日 | 专利标题

---

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

---

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

---

BR112019026816A2|2020-06-30|electrosurgical cartridge for use in a thin profile surgical cutting and stapling instrument

---

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

---

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

---

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

---

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

---

US10888325B2|2021-01-12|Cartridge arrangements for surgical cutting and fastening instruments with lockout disablement features

---

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

---

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

---

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

---

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

同族专利:

---

公开号 | 公开日

---

WO2019003004A1|2019-01-03|

---

US20190000536A1|2019-01-03|

---

EP3420980A1|2019-01-02|

---

US10265120B2|2019-04-23|

---

JP2020525200A|2020-08-27|

---

CN110831525A|2020-02-21|

引用文献:

---

公开号 | 申请日 | 公开日 | 申请人 | 专利标题

---

---

US5007907A|1987-10-07|1991-04-16|Olympus Optical Co., Ltd.|Resectoscope apparatus|

---

US6730081B1|1991-10-18|2004-05-04|Ashvin H. Desai|Endoscopic surgical instrument|

---

GR940100335A|1993-07-22|1996-05-22|Ethicon Inc.|Electrosurgical device for placing staples.|

---

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

---

US5658281A|1995-12-04|1997-08-19|Valleylab Inc|Bipolar electrosurgical scissors and method of manufacture|

---

US6004320A|1997-09-19|1999-12-21|Oratec Interventions, Inc.|Clip on electrocauterizing sheath for orthopedic shave devices|

---

WO1999037225A1|1998-01-26|1999-07-29|Surgical Laser Technologies, Inc.|Attachable electrosurgical device|

---

US7223267B2|2004-02-06|2007-05-29|Misonix, Incorporated|Ultrasonic probe with detachable slidable cauterization forceps|

---

GB2414185A|2004-05-20|2005-11-23|Gyrus Medical Ltd|Morcellating device using cutting electrodes on end-face of tube|

---

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

---

US9924998B2|2007-01-12|2018-03-27|Atricure, Inc.|Ablation system, clamp and method of use|

---

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

---

US8622274B2|2008-02-14|2014-01-07|Ethicon Endo-Surgery, Inc.|Motorized cutting and fastening instrument having control circuit for optimizing battery usage|

---

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

---

US8277446B2|2009-04-24|2012-10-02|Tyco Healthcare Group Lp|Electrosurgical tissue sealer and cutter|

---

GB2472216A|2009-07-28|2011-02-02|Gyrus Medical Ltd|Bipolar electrosurgical instrument with four electrodes|

---

US8986302B2|2009-10-09|2015-03-24|Ethicon Endo-Surgery, Inc.|Surgical generator for ultrasonic and electrosurgical devices|

---

US8764747B2|2010-06-10|2014-07-01|Ethicon Endo-Surgery, Inc.|Electrosurgical instrument comprising sequentially activated electrodes|

---

US8663222B2|2010-09-07|2014-03-04|Covidien Lp|Dynamic and static bipolar electrical sealing and cutting device|

---

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

---

US8888771B2|2011-07-15|2014-11-18|Covidien Lp|Clip-over disposable assembly for use with hemostat-style surgical instrument and methods of manufacturing same|

---

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

---

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

---

US9814514B2|2013-09-13|2017-11-14|Ethicon Llc|Electrosurgical medical instruments for cutting and coagulating tissue|

---

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

---

US9980769B2|2014-04-08|2018-05-29|Ethicon Llc|Methods and devices for controlling motorized surgical devices|

---

US20160270842A1|2015-03-20|2016-09-22|Ethicon Endo-Surgery, Llc|Electrosurgical device having controllable current paths|

---

US10595930B2|2015-10-16|2020-03-24|Ethicon Llc|Electrode wiping surgical device|

---

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

---

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

---

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

---

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

---

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

---

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

---

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

---

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

---

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

---

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

---

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

---

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

---

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

---

EP3518348B1|2018-01-26|2020-11-11|Vestel Elektronik Sanayi ve Ticaret A.S.|Electrical socket apparatus, electrical plug apparatus and method of operation|

---

US20210196346A1|2019-12-30|2021-07-01|Ethicon Llc|Variation in electrode parameters and deflectable electrode to modify energy density and tissue interaction|

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

优先权:

---

申请号 | 申请日 | 专利标题

---

US15/636,144|US10265120B2|2017-06-28|2017-06-28|Systems and methods for controlling control circuits for an independent energy delivery over segmented sections|

---

US15/636,144|2017-06-28|

---

PCT/IB2018/054253|WO2019003004A1|2017-06-28|2018-06-12|Systems and methods for controlling control circuits for and independent energy delivery over segmented sections|

---