systems and methods for showing a knife position during transection for a surgical instrument

专利摘要:
The present invention relates to various systems and methods for controlling the display of a knife position of a surgical cutting instrument according to the position of a displacement member. The surgical instrument includes a movable displacement member between a first position and a second position to trigger the cutting member between an un-triggered position and a triggered position, a sensor configured to detect a position of the displacement member and provide a signal indicating the same, and a screen. The surgical instrument determines whether the knife is retracting and then only begins to decrease the shown position of the knife after the displacement member has retracted from the distal or second position of its firing stroke by a specific distance.
公开号:BR112020012386A2
申请号:R112020012386-2
申请日:2018-12-14
公开日:2020-11-24
发明作者:Raymond E. Parfett；Richard L. Leimbach
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, to surgical stapling and cutting instruments that are designed to staple and cut tissue. BACKGROUND OF THE INVENTION
[0002] [0002] In a stapling and cutting surgical instrument, the shown position of the knife is generally not detected directly, but is instead inferred based on the position of a displacement member of the drive system and mechanical tolerances. In addition, in a monoaxial stapling and cutting surgical instrument, the articulation of the instrument's end actuator and the instrument's firing are generally performed in two separate zones of the firing stroke of the displacement member, so that the joint is performed in a dead zone of the knife firing (beam with I-shaped profile). Therefore, the position of the displacement member is not necessarily a good indicator of the position of the knife when the knife is being retracted because the displacement member still needs to be retracted through the joint or dead zone of the firing stroke after the knife is completely retracted. Once the knife position is shown to the instrument operator during the transection, the operator can potentially elect to release the instrument or take other actions before the displacement member is completely retracted, based on the assumption that, because the knife it was completely retracted, so it was safe to let go of the instrument. However, premature release of the instrument and taking such actions can cause the displacement member to be stopped out of position and not completely retracted. In some situations, the displacement member can be stopped distal to the locking position without a cartridge, which can allow the instrument to subsequently be triggered with a worn or empty cartridge present in the end actuator. Firing the instrument with a spent cartridge loaded in the end actuator is very dangerous because if the instrument was used to cut the tissue, there would be no corresponding sealing of the tissue from the clips or RF energy. Therefore, it would be advantageous for surgical stapling and cutting instruments to only show that the knife is fully retracted when the displacement member is completely retracted. SUMMARY OF THE INVENTION
[0003] [0003] In one aspect, a surgical instrument comprises: a movable displacement member between a first position and a second position; a sensor configured to detect a position of the displacement member and provide a signal indicating it; a screen; and a control circuit coupled to the screen and the sensor, the control circuit being configured to: determine whether the displacement member is moving from the second position to the first position through the sensor; when the displacement member moves from the second position to the first position, determine whether the position of the displacement member is above a limit from the second position; and when the displacement member is located above the limit from the second position, make the screen display the position of the displacement member.
[0004] [0004] In another aspect, a surgical instrument comprises: a movable displacement member between a first zone and a second zone defined between a first position and a second position; a sensor configured to detect a position of the displacement member and provide a signal indicating it; a screen; and a control circuit coupled to the screen and the sensor, the control circuit being configured to: determine whether the displacement member is moving from the second position to the first position through the sensor; when the displacement member moves from the second position to the first position, determine whether the position of the displacement member is located above a first zone; and when the displacement member is located in the first zone, make the screen display the position of the displacement member.
[0005] [0005] In another aspect, a surgical instrument comprises: a movable knife between an un-fired position and a fired position; a displacement member coupled to the knife, the displacement member being movable between a proximal position and a distal position for driving the knife between the non-triggered and the triggered position; a sensor configured to detect a position of the displacement member and provide a signal indicating it; a screen; and a control circuit coupled to the screen and the sensor, the control circuit being configured to: determine if the knife is retracting; monitor the position of the displacement member through the sensor; when the knife retracts, determine if the position of the displacement member is located proximal to a limit; and when the displacement member is located proximal to the limit, cause the screen to display a knife position according to the position of the displacement member. FIGURES
[0006] [0006] The innovative features of the aspects described here are presented with particularity in the attached claims. However, these aspects, both in relation to the organization and the methods of operation, can be better understood by reference to the description below, taken in conjunction with the attached drawings.
[0007] [0007] Figure 1 is a perspective view of a surgical instrument that has a set of interchangeable drive axles operationally coupled to it, according to one aspect of this description.
[0008] [0008] Figure 2 illustrates an exploded view of a portion of the ultrasonic surgical instrument of Figure 1, according to an aspect of this description.
[0009] [0009] Figure 3 is a view of the exploded set of portions of the interchangeable drive shaft assembly, according to an aspect of this description.
[0010] [0010] Figure 4 is an exploded view of an end actuator of the surgical instrument of Figure 1, according to an aspect of this description.
[0011] [0011] Figures 5A and 5B 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.
[0012] [0012] Figure 6 is a block diagram of the control circuit of the surgical instrument of Figure 1 that illustrates interfaces between the handle assembly, the feeding assembly and the handle assembly and the interchangeable drive shaft assembly, according to with an aspect of the present description.
[0013] [0013] Figure 7 illustrates a control circuit configured to control aspects of the surgical instrument of Figure 1, according to an aspect of the present description.
[0014] [0014] Figure 8 illustrates a combinational logic circuit configured to control aspects of the surgical instrument of Figure 1, according to an aspect of the present description.
[0015] [0015] Figure 9 illustrates a sequential logic circuit configured to control aspects of the surgical instrument of Figure 1, according to an aspect of the present description.
[0016] [0016] Figure 10 is a diagram of an absolute positioning system for the surgical instrument of Figure 1, with the absolute positioning system comprising an arrangement of the controlled motor drive circuit comprising an arrangement of the sensor, according to a aspect of this description.
[0017] [0017] Figure 11 is an exploded perspective view of the sensor array for an absolute positioning system, which displays a set of control circuit board and the relative alignment of the elements of the sensor array, according to one or more aspects of this description.
[0018] [0018] Figure 12 is a diagram of a position sensor that comprises a magnetic rotating absolute positioning system, according to an aspect of the present description.
[0019] [0019] Figure 13 is a sectional view of an end actuator of the surgical instrument of Figure 1, showing a course of the firing member in relation to the tissue trapped within the end actuator in accordance with an aspect of the present description.
[0020] [0020] Figure 14 illustrates a block diagram of a surgical instrument programmed to control the distal translation of a displacement member, according to an aspect of the present description.
[0021] [0021] Figure 15 illustrates a diagram that plots two displacement limb courses performed, according to one aspect of the present description.
[0022] [0022] Figure 16 is a partial perspective view of a portion of a surgical instrument end actuator showing an elongated drive shaft assembly in a non-articulated orientation with portions omitted for clarity, according to an aspect of this description.
[0023] [0023] Figure 17 is another perspective view of the end actuator of Figure 16 showing the elongated drive shaft assembly in a non-articulated orientation, in accordance with an aspect of the present description.
[0024] [0024] Figure 18 is an exploded perspective view of the end actuator of Figure 16 showing the aspect of the elongated drive shaft assembly, in accordance with an aspect of the present description.
[0025] [0025] Figure 19 is a top view of the end actuator of Figure 16 showing the elongated drive shaft assembly in a non-articulated orientation, in accordance with an aspect of the present description.
[0026] [0026] Figure 20 is another top view of the end actuator of Figure 16 showing the elongated drive shaft assembly in a first articulated orientation, according to an aspect of the present description.
[0027] [0027] Figure 21 is another top view of the end actuator of Figure 16 showing the elongated drive shaft assembly in a second articulated orientation, in accordance with an aspect of the present description.
[0028] [0028] Figure 22 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 clamp / clamp cartridges and radio frequency cartridges ( RF) according to one aspect of this description.
[0029] [0029] Figure 23 is an exploded perspective view of the entire surgical system of Figure 22, according to an aspect of this description.
[0030] [0030] Figure 24 is an upper cross-sectional view of a portion of the set of interchangeable surgical tools of Figures 22 with its end actuator in an articulated position, according to an aspect of this description.
[0031] [0031] Figure 25 is a perspective view of an integrated circuit board layout and the RF generator plus the configuration, according to one aspect of this description.
[0032] [0032] Figure 26 illustrates a logical flow chart of a process for displaying a knife position, according to an aspect of the present description.
[0033] [0033] Figure 27 illustrates a logical flow chart of an aspect of displaying a knife position over time in accordance with an aspect of the present description.
[0034] [0034] Figure 28A illustrates a line diagram of a course of the displacement member, the displacement member firing, according to an aspect of this description.
[0035] [0035] Figure 28B illustrates a line diagram of a course of the displacement member, the displacement member retracting, according to an aspect of this description.
[0036] [0036] Figure 29 illustrates a perspective view of a surgical instrument handle assembly, according to an aspect of this description.
[0037] [0037] Figure 30 is a front view of a display screen or portion thereof with an animated graphical user interface showing the knife in a first position according to one aspect of this description.
[0038] [0038] Figure 31 illustrates a front view of a display screen or portion thereof with an animated graphical user interface showing the knife in a second position in accordance with an aspect of the present description.
[0039] [0039] Figure 32 illustrates a front view of a display screen or portion thereof with an animated graphical user interface showing the knife in a third position according to an aspect of the present description.
[0040] [0040] Figure 33 illustrates a front view of a display screen or portion thereof with an animated graphical user interface showing the knife in a fourth position according to one aspect of this description. DESCRIPTION
[0041] [0041] The applicant for the present application holds the following patent applications that were filed on September 29, 2017 and which are each incorporated by reference in their respective entirety: US patent application serial number 15 /720,800, entitled
[0042] [0042] Certain aspects are shown and described to provide an understanding of the structure, function, manufacture and use of the devices and methods described. The features shown or described in one example can be combined with the features in other examples and modifications and variations are within the scope of this description.
[0043] [0043] The terms "proximal" and "distal" refer to a doctor who manipulates the handle of the surgical instrument, with the term "proximal" referring to the portion closest to the doctor and the term "distal" referring to the portion located furthest from the doctor. For convenience,
[0044] [0044] Exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. Such devices and methods, however, can be used in other surgical procedures and applications including open surgical procedures, for example. Surgical instruments can be inserted through a natural orifice or one through an incision or perforation formed in the tissue. The functional portions or portions of the instrument's end actuator can be inserted directly into the body or via an access device that has a functional channel through which the end actuator and the elongated drive shaft of the surgical instrument can be advanced.
[0045] [0045] In some aspects, surgical instruments may include devices capable of performing the cut (as, for example, in Figures 1 and 22), stapling (as, for example, in Figure 1), electrosurgical (as, for example, in Figure 22) and / or ultrasonic operations, as described in more detail below. More details on ultrasonic surgical instruments can be found in US patent No. 6,283,981, entitled METHOD OF BALANCING ASYMMETRIC ULTRASONIC SURGICAL BLADES; US Patent No. 6,309,400, entitled CURVED ULTRASONIC WAVEGUIDE HAVING A TRAPEZOIDAL CROSS SECTION; and US patent No. 6,436,115, entitled BALANCED ULTRASONIC
[0046] [0046] Figure 1 to 4 illustrates a surgical instrument powered by motor 10 for cutting and fixing that may or may not be reused. In the illustrated examples, the surgical instrument 10 includes a compartment 12 that comprises a handle assembly 14 that is configured to be picked up, manipulated and actuated by the physician. The compartment 12 is configured to be operationally attached to an interchangeable drive shaft assembly 200 provided with an end actuator 300 operatively coupled to it that is configured to perform one or more surgical tasks or procedures. According to the present description, various forms of interchangeable drive shaft assemblies can be effectively used in connection with robotically controlled surgical systems. The term "compartment" can encompass a compartment or similar portion of a robotic system that houses or otherwise operationally supports at least one drive system configured to generate and apply at least one control movement that can be used to drive shaft assemblies drive. The term "structure" can refer to a portion of a hand held surgical instrument. The term "structure" can also represent a portion of a robotically controlled surgical instrument and / or a portion of the robotic system that can be used to operationally control the surgical instrument. Interchangeable drive shaft assemblies can be used with various robotic systems, instruments, components and methods described in US Patent No. 9,072,535, entitled SURGICAL
[0047] [0047] Figure 1 is a perspective view of a surgical instrument 10 that has an interchangeable drive shaft assembly
[0048] [0048] The handle assembly 14 may comprise a pair of interconnectable segments of the handle compartment 16, 18 interconnected by screws, push-fit elements, adhesive, etc. The handle compartment segments 16, 18 cooperate to form a handle portion of the pistol 19 that can be held and manipulated by the clinician. The handle assembly 14 operationally supports a plurality of drive systems configured to generate and apply control movements to the corresponding portions of the interchangeable drive shaft assembly that is operationally attached thereto. A screen can be provided under a cover 45.
[0049] [0049] Figure 2 is an exploded view of a portion of the surgical instrument 10 of Figure 1, according to an aspect of this description. The handle assembly 14 can include a frame 20 that operationally supports a plurality of drive systems. The structure 20 can operationally support a closing drive system 30, which can apply closing and opening movements to the interchangeable drive shaft assembly
[0050] [0050] The handle assembly 14 and the structure 20 can operationally support a trigger drive system 80, which is configured to apply trigger movements to corresponding portions of the interchangeable drive shaft assembly that is attached to it. The firing drive system 80 can employ an electric motor 82 located in the pistol grip portion 19 of the handle assembly 14. Electric motor 82 can be a brushed direct current (DC) motor that has a maximum rotation speed approximately 25,000 RPM, for example. In other arrangements, the motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable electric motor. The electric motor 82 can be powered by a power source 90 which can comprise a removable power source 92. The removable power source 92 can comprise a proximal compartment portion 94 configured to be attached to a distal compartment portion 96. A the proximal compartment portion 94 and the distal compartment portion 96 are configured to operationally support a plurality of batteries 98. Each of the batteries 98 may comprise, for example, a lithium ion battery ("LI") or other suitable battery. The distal compartment portion 96 is configured for removable operational fixation to a control circuit board 100 that is operationally coupled to the electric motor 82. Several batteries 98 connected in series can supply the surgical instrument 10. The power source 90 can be replaceable and / or rechargeable. A screen 43, which is located below cover 45, is electrically coupled to control circuit board 100. Cover 45 can be removed to expose screen 43.
[0051] [0051] The electric motor 82 may include a rotary drive shaft (not shown), which, in operational mode, interfaces with a gear reduction assembly 84 mounted on a coupling hitch with a set or rack, of drive teeth 122 in a longitudinally movable drive member 120. The longitudinally movable drive member 120 has a drive tooth rack 122 formed thereon for coupling engagement with a corresponding drive gear 86 of the gear reducer assembly 84.
[0052] [0052] In use, a voltage polarity provided by the power supply 90 can operate the electric motor 82 clockwise, and the voltage polarity applied to the electric motor by the battery can be reversed in order to operate the electric motor 82 in the anticlockwise. When the electric motor 82 is rotated in one direction, the longitudinally movable drive member 120 will be axially activated in the distal direction "DD". When the electric motor 82 is driven in the opposite rotating direction, the longitudinally movable driving member 120 will be driven axially in the proximal direction "DP". The handle assembly 14 can include a switch that can be configured to reverse the polarity applied to the electric motor 82 by the power supply 90. The handle assembly 14 can include a sensor configured to detect the position of the longitudinally movable drive member 120 and / or the direction in which the longitudinally movable drive member 120 is being moved.
[0053] [0053] The activation of the electric motor 82 can be controlled by a trigger trigger 130 that is pivotally supported on the handle assembly 14. The trigger trigger 130 can be pivoted between an unacted position and an acted position.
[0054] [0054] Again with reference to Figure 1, the interchangeable drive shaft assembly 200 includes an end actuator 300 comprising an elongated channel 302 configured to operationally support a surgical staple cartridge 304. The end actuator 300 may include an anvil 306 which is pivotally supported in relation to the elongated channel 302. The interchangeable drive shaft assembly 200 may include a pivot joint 270. The construction and operation of end actuator 300 and pivot joint 270 are shown in US patent application publication No. 2014/0263541, entitled
[0055] [0055] Back to Figure 1, the closing tube 260 is moved distally (direction "DD") to close the anvil 306, for example, in response to the actuation of the closing trigger 32 as described in the previously mentioned reference of patent application publication no. 2014/0263541. The anvil 306 is opened by proximal translation of the closing tube 260. In the open position of the anvil, the closing tube 260 is moved to its proximal position.
[0056] [0056] Figure 3 is another exploded view of portions of the interchangeable drive shaft assembly 200, according to an aspect of this description. The interchangeable drive shaft assembly 200 may include a sustained firing member 220 to perform axial displacement inside the back 210. The firing member 220 includes an intermediate firing drive shaft 222 configured to attach to a cutting portion distal or knife bar 280. The intermediate firing drive shaft 222 may include a longitudinal slot 223 at one end configured to receive a flap 284 at the proximal end 282 of knife bar 280. The longitudinal slot 223 and the proximal end 282 can be configured to allow relative movement between them and may comprise a sliding joint 286. Sliding joint 286 may allow intermediate firing drive shaft 222 of firing member 220 to pivot end actuator 300 around pivot joint 270 without moving, or at least without substantially moving, the knife bar 280. When the end actuator
[0057] [0057] The interchangeable drive shaft assembly 200 may include a clutch assembly 400 configured to selectively and releasably couple articulation actuator 230 to the firing member
[0058] [0058] The interchangeable drive shaft assembly 200 may comprise a slip ring assembly 600 that can be configured to conduct electrical energy to the end actuator 300 and / or from it and / or communicate signals to the end actuator 300 and / or from it, for example. The slip ring assembly 600 may comprise a proximal connector flange 604 and a distal connector flange 601 positioned within a slot defined in the nozzle portions 202, 203. The flange of the proximal connector 604 may comprise a first face and the flange the distal connector 601 can comprise a second face positioned adjacent and movable with respect to the first face. The distal connector flange 601 can rotate relative to the proximal connector flange 604 around the geometric axis of the SA-SA drive shaft (Figure 1). The proximal connector flange 604 may comprise a plurality of concentric or at least substantially concentric conductors 602, defined on its first face. A connector 607 can be mounted on the proximal side of the distal connector flange 601 and can have a plurality of contacts, with each contact corresponding and in electrical contact with one of the conductors 602. Such arrangement allows the relative rotation between the flange of proximal connector 604 and the distal connector flange 601, while electrical contact is maintained between them. The proximal connector flange 604 can include an electrical connector 606 that can place the conductors
[0059] [0059] The interchangeable drive shaft assembly 200 may include a proximal portion mounted securely to the handle assembly 14, and a distal portion that is rotatable about a longitudinal geometric axis. The distal swivel portion of the drive shaft can be rotated relative to the proximal portion around the slip ring assembly 600. The flange of the distal connector 601 of the slip ring assembly 600 can be positioned on the distal swivel portion of the drive shaft.
[0060] [0060] Figure 4 is an exploded view of an aspect of an end actuator 300 of the surgical instrument 10 of Figure 1, according to an aspect of this description. End actuator 300 can include anvil 306 and surgical staple cartridge 304. Anvil 306 can be coupled to an elongated channel 302. The openings 199 can be defined in the elongated channel 302 to receive pins 152 extending from the anvil 306 to allow anvil 306 to rotate from an open position to a closed position in relation to the elongated channel 302 and surgical staple cartridge 304. A firing bar 172 is configured to translate longitudinally into the end actuator 300. A firing bar 172 may be constructed from a solid section or may include a laminated material comprising a stack of steel plates. The firing bar 172 comprises an I-beam beam 178 and a cutting edge 182 at a distal end thereof. One end of the distally designed firing bar 172 can be attached to the I-profile beam 178 to assist in spacing the anvil 306 from a surgical staple cartridge 304 positioned in the elongated channel 302 when the anvil 306 is in the closed position. The I-beam beam 178 may include a sharp cutting edge 182 to cut the fabric as the I-beam beam 178 is advanced distally by the firing bar 172. In operation, the I-beam beam 178 can engage or fire the surgical staple cartridge 304 to eject the staples 191 from it. The surgical staple cartridge 304 may include a molded cartridge body 194 that holds a plurality of staples 191 that rest on the staple actuators 192 within the respective staples cavities opened upward 195. A wedge slide 190 is driven distally by the I-profile beam 178, sliding over a cartridge tray 196 of the surgical staple cartridge 304. The wedge slide 190 moves the staple actuators 192 upwardly through cam to expel the staples 191 in contact with deformation with anvil 306, while a cutting surface 182 of the I-profile beam 178 separates the trapped fabric.
[0061] [0061] The I-profile beam 178 may include upper pins 180 that engage the anvil 306 during firing. The I-profile beam 178 may include intermediate pins 184 and a bottom base 186 for engaging portions of the cartridge body 194, the cartridge tray 196 and the elongated channel 302. When a surgical staple cartridge 304 is positioned inside the elongated channel 302, a slot 193 defined in the cartridge body 194 can be aligned with a longitudinal slot 197 defined in the cartridge tray 196 and a slot 189 defined in the elongated channel 302. In use, the i-beam beam 178 can slide through of the longitudinal slits aligned 193, 197 and 189, and, as indicated in Figure 4, the base 186 of the beam with i-shaped profile 178 can engage with a groove positioned along the lower surface of the elongated channel 302 along the length of the slot 189, the middle pins 184 can engage the upper surfaces of the cartridge tray 196 along the length of the longitudinal slot 197, and the upper pins 180 can engage with the anvil 306. The I-beam 178 can space or limit the relative movement between the anvil 306 and the surgical staple cartridge 304, as the firing bar 172 is distally advanced to fire the staples from the surgical staple cartridge 304 and / or make an incision in the captured tissue between the anvil 306 and the surgical staple cartridge 304. The firing bar 172 and the I-profile beam 178 can be retracted proximally allowing the anvil 306 to be opened to release the two stapled and cut tissue portions.
[0062] [0062] Figures 5A and 5B are a block diagram of a control circuit 700 of surgical instrument 10 of Figure 1 that comprises two drawing sheets, according to one aspect of this description. Referring mainly to Figures 5A and 5B, a handle assembly 702 can include an engine 714, which can be controlled by an engine driver 715 and can be used by the trigger system of the surgical instrument 10. In several ways, the engine 714 it can be a brushed direct current (DC) motor that has a maximum rotation speed of approximately 25,000 RPM. In other arrangements, the 714 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable type of electric motor. Motor starter 715 can comprise an H bridge starter comprising field effect transistors (FETs) 719, for example. The motor 714 can be powered by the supply set 706 releasably mounted to the handle assembly 14 to supply control power to the surgical instrument 10. The supply set 706 may comprise a battery that may include several battery cells connected in series, which can be used as the power source to power the surgical instrument 10. In certain circumstances, the battery cells in the 706 power pack may be replaceable and / or rechargeable. In at least one example, the battery cells can be Li ion batteries that can be separably coupled to the power pack
[0063] [0063] The drive shaft assembly 704 can include a drive shaft assembly controller 722 that can communicate with a safety controller and a power management controller 716 through an interface, while the drive shaft assembly 704 and the supply set 706 are coupled to the handle assembly 702. For example, the interface may comprise a first portion of interface 725, which may include one or more electrical connectors for coupling engagement with the corresponding electrical connectors of the shaft assembly drive, and a second interface portion 727, which may include one or more electrical connectors for coupling coupling with the corresponding electrical connectors of the power supply, to allow electrical communication between the controller of the drive shaft assembly 722 and the power management controller 716, while the drive shaft assembly 704 and the assembly there 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 power management controller
[0064] [0064] 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 forwarding such communication signals through a main controller 717 located in the handle set 702, for example. In other cases, the interface can facilitate a direct communication line between the power management controller 716 and the drive shaft assembly controller 722 through the handle assembly 702, while the drive shaft assembly 704 and the drive assembly 706 are coupled to the handle assembly 702.
[0065] [0065] The main controller 717 can be any single-core or multi-core processor, such as those known under the trade name of ARM Cortex available from Texas Instruments. In one respect, the main controller 717 may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single-cycle flash memory, or other non-volatile memory, from up to 40 MHz, a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with StellarisWare® software, 2 KB electrically erasable programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more analog quadrature encoder (QEI) inputs, one or more analog to digital converters 12-bit (ADC) with 12 analog input channels, details of which are available for the product data sheet.
[0066] [0066] The safety controller can be a safety controller platform that comprises two families based on controllers, such as TMS570 and RM4x known under the trade name of Hercules ARM Cortex R4, also from Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[0067] [0067] The power supply 706 may include a power management circuit which may comprise the power management controller 716, a power modulator 738 and a current sensor circuit 736. The power management circuit can be configured to modulate the battery power output based on the power needs of the drive shaft assembly 704, while the drive shaft assembly 704 and the power supply 706 are coupled to the handle assembly 702. The power management controller 716 can be programmed to control the power modulator 738 from the power output of the power supply 706, and the current sensor circuit 736 can be used to monitor the power output of the power supply 706 to provide feedback to the power management controller 716 on the battery power output, so the 716 power management controller can adjust the output power supply unit 706 to maintain a desired output. The power management controller 716 and / or the drive shaft assembly controller 722 can each comprise one or more processors and / or memory units that can store multiple software modules.
[0068] [0068] The surgical instrument 10 (Figures 1 to 4) 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 liquid crystal display (LCD) screen, light-emitting diode (LED indicators)), hearing feedback devices (for example, a loudspeaker. , a bell) or tactile feedback devices (eg haptic actuators) In certain circumstances, the output device 742 may comprise a display 743 which 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 the surgical instrument 10 via output device 742. The interface can be configured to connect the drive shaft assembly controller 722 and / or the management controller output device 716 to output device 742. Output device 742 can instead be integrated with the power supply 706. In these circumstances, communication between the output device 742 and the drive shaft assembly controller 722 can be done through the interface, while the drive shaft assembly 704 is coupled to the handle assembly 702.
[0069] [0069] Control circuit 700 comprises circuit segments configured to control the operations of the energized surgical instrument 10. A safety controller segment (segment 1)
[0070] [0070] The acceleration segment (segment 3) comprises an accelerometer. The accelerometer is configured to detect the movement or acceleration of the energized surgical instrument 10. Input from the accelerometer can be used to transition to and from a suspend mode, identify the orientation of the energized surgical instrument, and / or identify when the surgical instrument is dropped. In some examples, the acceleration segment is coupled to the safety controller and / or the main controller 717.
[0071] [0071] The display segment (segment 4) comprises a display connector coupled to the main controller 717. The display connector couples the primary controller 717 to a display via one or more drivers of the display integrated circuits. The drivers of the integrated circuits of the screen can be integrated with the screen and / or can be arranged separately from the screen. The display may comprise any suitable display, such as an organic light-emitting diode (OLED) display, a liquid crystal display (LCD), and / or any other suitable display. In some examples, the screen segment is coupled to the safety controller.
[0072] [0072] The drive shaft segment (segment 5) comprises controls for an interchangeable drive shaft set 200 (Figures 1 and 3) coupled to the surgical instrument 10 (Figures 1 to 4) and / or one or more controls for a end actuator 300 coupled to the interchangeable drive shaft assembly 200. The drive shaft segment comprises a drive shaft connector configured to couple main controller 717 to a drive shaft PCBA. The drive shaft PCBA comprises a low power microprocessor with a ferroelectric layer random access memory (FRAM), a toggle switch, a drive shaft release Hall effect switch, and a shaft PCBA EEPROM memory. drive. The drive shaft PCBA EEPROM comprises one or more parameters, routines and / or specific programs for the interchangeable drive shaft assembly 200 and / or for the drive shaft PCBA. The drive shaft PCBA can be coupled to the interchangeable drive shaft assembly 200 and / or integral with the surgical instrument 10. In some instances, the drive shaft segment comprises a second drive shaft EEPROM. The second drive shaft EEPROM comprises a plurality of algorithms, routines, parameters and / or other data that correspond to one or more sets of drive axes 200 and / or end actuators 300 that can interface with the energized surgical instrument 10 .
[0073] [0073] The position encoder segment (segment 6) comprises one or more magnetic encoders of the position of the rotation angle. 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 200 (Figures 1 and 3) and / or an end actuator 300 of the surgical instrument 10 (Figures 1 to 4). In some instances, the magnetic encoders of the rotation angle position can be coupled to the safety controller and / or the main controller 717.
[0074] [0074] The motor circuit segment (segment 7) comprises a motor 714 configured to control the movements of the energized surgical instrument 10 (Figures 1 to 4). Motor 714 is coupled to main controller 717 by an H bridge driver that comprises one or more H field effect transistors (FETs) and a motor controller. The H bridge actuator is also coupled to the safety controller. A motor current sensor is coupled in series with the motor to measure the current drain from the motor. The motor current sensor is in signal communication with the main controller 717 and / or with the safety controller. In some instances, the 714 motor is coupled to an electromagnetic interference (EMI) filter on the motor.
[0075] [0075] The motor controller controls a first motor signal and a second motor signal to indicate to the main controller 717 the status and position of the motor 714. The main controller 717 provides a high pulse width modulation (PWM) signal ), a low PWM signal, a direction signal, a synchronization signal and a motor restart signal to the motor controller via a buffer. The supply segment is configured to supply a segment voltage to each of the circuit segments.
[0076] [0076] The power segment (segment 8) comprises a battery coupled to the safety controller, main controller 717 and additional circuit segments. The battery is coupled to the circuit segmented by a battery connector and a current sensor. The current sensor is configured to measure the total current drain from the segmented circuit. In some examples, one or more voltage converters are configured to provide predetermined voltage values to one or more 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 rise to a predetermined amount, such as , for example, up to 13 V. The voltage amplification converter is configured to supply additional voltage and / or current during operations that require a lot of energy and to avoid blackouts or low power conditions.
[0077] [0077] A plurality of keys are coupled to the safety controller and / or the main controller 717. The keys can be configured to control the operations of the surgical instrument 10
[0078] [0078] Any suitable mechanical, electromechanical, or solid state switches can be used to implement the plurality of switches, in any combination. For example, the keys can limit the keys operated by the movement of components associated with the surgical instrument 10 (Figures 1 to 4) or the presence of an object. Such switches can be used to control various functions associated with the surgical instrument 10. A limit switch is an electromechanical device that consists of an actuator mechanically connected to a set of contacts. When an object comes into contact with the actuator, the device operates the contacts to make or break an electrical connection. Limit switches are used in a variety of applications and environments because of their robustness, ease of installation and reliable operation. They can determine the presence or absence, passage, positioning and end of an object's displacement. In other implementations, the switches can be solid state switches that work under the influence of a magnetic field, such as Hall effect devices, magnetoresistive (MR) devices, giant magnetoresistive devices ("GMR" - giant magneto-resistive), and magnetometers , among others. In other implementations, the switches can be solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, and ultraviolet light sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, metal oxide semiconductor FET (MOSFET), bipolar, and the like). Other switches may include wireless switches, ultrasonic switches, accelerometers, and inertia sensors, among others.
[0079] [0079] Figure 6 is another block diagram of the control circuit 700 of the surgical instrument of Figure 1 that illustrates the interfaces between the handle assembly 702 and the feeding assembly 706 and between the handle assembly 702 and the assembly of interchangeable drive shaft 704, in accordance with an aspect of the present description. The handle assembly 702 can comprise a main controller 717, a drive shaft assembly connector 726 and a power assembly connector
[0080] [0080] The surgical instrument 10 (Figures 1 to 4) can comprise an output device 742 for sensory feedback to a user. Such devices may comprise visual feedback devices (for example, an LCD monitor, LED indicators), auditory feedback devices (for example, a speaker, a bell) or tactile feedback devices (for example, actuators haptic). 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 may provide feedback to a user of the surgical instrument 10 via output device 742. Interface 727 can be configured to connect the drive shaft assembly controller 722 and / or the power management controller 716 to output device 742. Output device 742 can be integrated with the supply set 706. Communication between the output device 742 and the drive shaft assembly controller 722 can be made through interface 725 while the interchangeable drive shaft assembly 704 is coupled to the handle assembly 702. Having described a control circuit 700 (Figures 5A to 5B and 6) to control the operation of the surgical instrument 10 (Figures 1 to 4), the description now turns to various configurations of the surgical instrument 10 (Figures 1 to 4) and the control circuit 700.
[0081] [0081] Figure 7 illustrates a control circuit 800 configured to control aspects of the surgical instrument 10 (Figures 1 to 4), according to an aspect of the present description. Control circuit 800 can be configured to implement various processes described herein. The control circuit 800 may comprise a controller comprising one or more 802 processors (for example,
[0082] [0082] Figure 8 illustrates a combinational logic circuit 810 configured to control aspects of the surgical instrument 10 (Figures 1 to 4), according to an aspect of the present description. The combinational logic circuit 810 can be configured to implement various processes described here. Circuit 810 may comprise a finite state machine comprising a combinational logic circuit 812 configured to receive data associated with the surgical instrument 10 at an input 814, process the data by combinational logic 812 and provide an output 816.
[0083] [0083] Figure 9 illustrates a sequential logic circuit 820 configured to control aspects of the surgical instrument 10 (Figures 1 to 4), according to an aspect of the present description. Sequential logic circuit 820 or combinational logic circuit 822 can be configured to implement various processes described herein. Circuit 820 may comprise a finite state machine. Sequential logic circuit 820 may comprise a combinational logic circuit 822, at least one memory circuit 824 and a clock 829, for example. The at least one memory circuit 820 can store a current state of the finite state machine. In certain cases, the sequential logic circuit 820 can be synchronous or asynchronous. The combinational logic circuit 822 is configured to receive the data associated with the surgical instrument 10, an input 826, process the data through the combinational logic circuit 822, and provide an output 828. In other aspects, the circuit may comprise a combination of the processor 802 and a finite state machine for implementing various processes in the present invention. In other respects, the finite state machine may comprise a combination of the combinational logic circuit 810 and the sequential logic circuit 820.
[0084] [0084] Aspects can be implemented in the form of an article of manufacture. The article of manufacture may include a computer-readable storage medium arranged to store logic, instructions and / or data for performing various operations of one or more aspects. For example, the article of manufacture may comprise a magnetic disk, an optical disk, a flash memory or firmware containing computer program instructions suitable for execution by a general purpose processor or application specific processor.
[0085] [0085] Figure 10 is a diagram of an absolute positioning system 1100 of the surgical instrument 10 (Figures 1 to 4), with the absolute positioning system 1100 comprising a motor controlled drive circuit arrangement comprising an arrangement of sensor 1102, in accordance with an aspect of the present description. The sensor arrangement 1102 of an absolute positioning system 1100 provides a unique position signal that corresponds to the location of a displacement member 1111. Back briefly to Figures 2 to 4, in one aspect, displacement member 1111 represents the limb longitudinally movable drive 120
[0086] [0086] An electric motor 1120 may include a rotary drive shaft 1116, which, operationally, interfaces with a gear set 1114, which is mounted on a coupling hitch with a set, or rack, of drive teeth on the displacement member 1111. A sensor element 1126 can be operationally coupled to a gear assembly 1114, so that a single revolution of the sensor element 1126 corresponds to some linear longitudinal translation of the displacement member 1111. An array of gears and sensors can be connected to the linear actuator by means of a rack and pinion arrangement, or by a rotary actuator, by means of a sprocket or other connection. A power supply 1129 supplies power to the absolute positioning system 1100 and an output screen / indicator 1128 can show the output of the absolute positioning system 1100. In Figure 2, the drive member 1111 represents the longitudinally movable drive member 120 comprising a rack of drive teeth 122 formed therein for coupling engagement with a corresponding drive gear 86 of the gear reduction assembly 84. The displacement member 1111 represents the longitudinally movable firing member 220, the firing bar 172, the beam with I 178 profile, or combinations thereof.
[0087] [0087] A single revolution of the sensor element 1126 associated with the position sensor 1112 is equivalent to a longitudinal linear displacement d1 of the displacement member 1111, where d1 represents the longitudinal linear distance by which the displacement member 1111 moves from the point " a "to point" b "after a single revolution of the sensor element 1126 coupled to the displacement member 1111. The sensor arrangement 1102 can be connected by means of a gear reduction which results in the completion of one or more revolutions by the position sensor 1112 of the full travel of the travel member 1111. The position sensor 1112 can complete multiple revolutions of the full travel of the travel member 1111.
[0088] [0088] A series of keys 1122a to 1122n, where n is an integer greater than one, can be used alone or in combination with gear reduction to provide a single position signal for more than one revolution of the 1112 position sensor. The state of the switches 1122a to 1122n is fed back to a controller 1104 that applies logic to determine a single position signal that corresponds to the longitudinal linear displacement d1 + d2 +… dn of the displacement member 1111. The position sensor output 1124 1112 is provided to controller 1104. Position sensor 1112 of sensor array 1102 may comprise a magnetic sensor, an analog rotary sensor, such as a potentiometer, and an array of analog Hall effect elements, which emit a unique combination of signals or position values.
[0089] [0089] The absolute positioning system 1100 provides an absolute positioning of the displacement member 1111 with the energization of the instrument without having to retract or advance the driving member 1111 to the restart position (zero or initial), as can be case of conventional rotary encoders that merely count the number of progressive or regressive steps that the 1120 motor has traveled to infer the position of a device actuator, actuation bar, scalpel, and the like.
[0090] [0090] Controller 1104 can be programmed to perform various functions, such as precise control of the speed and position of the joint and knife systems. In one aspect, controller 1104 includes a processor 1108 and memory 1106. Electric motor 1120 can be a brushed DC motor with a gearbox and mechanical connections with a hinge or knife system. In one aspect, an 1110 motor driver can be an A3941 available from Allegro Microsystems, Inc. Other motor drivers can be readily replaced for use in the 1100 absolute positioning system. A more detailed description of the 1100 absolute positioning system is described in US patent application No. 15 / 130,590, entitled SYSTEMS AND
[0091] [0091] Controller 1104 can be programmed to provide precise control of the speed and position of displacement member 1111 and articulation systems. Controller 1104 can be configured to compute a response in the software of controller 1104. The computed response is compared to a measured response from the actual system to obtain an "observed" response, which is used for actual feedback-based decisions. The observed response is a favorable and adjusted value, which balances the uniform and continuous nature of the simulated response with the measured response, which can detect external influences in the system.
[0092] [0092] The absolute positioning system 1100 can comprise and / or be programmed to implement a proportional-integral-derivative controller (PID), feedback controller, such as a PID, status feedback and adaptive controller. An 1129 power supply converts the signal from the feedback controller to a physical input to the system, in this case, the voltage. Other examples include a voltage, current and force PWM. Other 1118 sensors can be provided to measure the physical parameters of the physical system, in addition to the position measured by the 1112 position sensor. In some respects, the other 1118 sensors may include sensor arrangements as described in US Patent No. 9,345,481 entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, which is incorporated by reference in its entirety into this document; US patent application publication No. 2014/0263552, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, which is hereby incorporated by reference in its entirety. and US patent application No. 15 / 628,175, entitled
[0093] [0093] The 1110 motor driver can be an A3941 driver, available from Allegro Microsystems, Inc. The A3941 1110 driver is an entire bridge controller for use with metal oxide semiconductor field effect transistors (MOSFETs - metal oxide semiconductor field effect transistors) of external N-channel power, specifically designed for inductive loads, such as brushed DC motors. The 1110 actuator comprises a single charge pump regulator, which provides complete door drive (> 10 V) for batteries with voltage up to 7 V and allows the A3941 to operate with a reduced door drive, up to 5.5 V. Input command capacitor can be used to supply the voltage supplied by the above battery required for the N channel MOSFETs. An internal charge pump for the upper side drive allows direct current operation (100% duty cycle). The entire bridge can be triggered in fast or slow drop modes using diodes or synchronized rectification. In the slow drop mode, the current can be recirculated by means of FET from the top or from the bottom. Power FETs are protected from the shoot-through effect through programmable dead-time resistors. The integrated diagnostics provide indication of undervoltage, overtemperature and faults in the power bridge and can be configured to protect power MOSFETs in most short-circuit conditions. Other motor drives can be replaced immediately for use in the 1100 absolute positioning system.
[0094] [0094] Having described a general architecture for implementing aspects of an absolute positioning system 1100 for a sensor array 1102, the description now turns to Figures 11 to 12 for a description of an aspect of a sensor array
[0095] [0095] The sensor array 1102 can comprise any number of magnetic detection elements, such as, for example, magnetic sensors classified according to their ability to measure the total magnetic field or the vector components of the magnetic field. The techniques used to produce both types of magnetic sensors cover many aspects of physics and electronics. Technologies used for magnetic field detection include flow meter, saturated flow, optical pumping, nuclear precession, superconducting quantum interference device (SQUID), Hall effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive / piesoelectric compounds, magnetodiode, magnetic transistor, optical fiber, magneto-optics and magnetic sensors based on microelectromechanical systems, among others.
[0096] [0096] A gear set comprises a first gear 1208 and a second gear 1210 in coupling hitch to provide a connection with a gear ratio of 3: 1. A third gear 1212 rotates about a drive shaft 1214. The third gear 1212 is engaged in coupling with the drive member 1111 (or 120 as shown in Figure 2) and rotates in a first direction as the drive 1111 moves in a distal direction D and rotates in a second direction as the drive member 1111 retracts in a proximal direction P. The second gear 1210 also rotates about the drive shaft 1214 and therefore the rotation of the second gear 1210 around the drive shaft 1214 corresponds to the longitudinal translation of the drive member 1111. Thus, a full stroke of the drive member 1111, either in the distal or proximal direction, D, P, corresponds to three rotations of the second gear 1210 and a single rotation of the first gear
[0097] [0097] The position sensor 1200 is supported by a position sensor holder 1218, defining an aperture 1220 suitable for containing position sensor 1200 in precise alignment with a magnet 1202 rotating down inside the magnet holder 1204. The accessory it is coupled to bracket 1216 and circuit 1205 and remains stationary while magnet 1202 rotates with magnet holder 1204. A hub 1222 is provided that attaches to first gear 1208 and magnetic support 1204. Second gear 1210 and third gear 1212 coupled to axis 1214 are also shown.
[0098] [0098] Figure 12 is a diagram of a position sensor 1200 of an absolute positioning system 1100, which comprises a rotating magnetic absolute positioning system, according to an aspect of this description. The position sensor 1200 can be implemented as a rotary, magnetic, single-circuit, AS5055EQFT position sensor, available from Austria Microsystems, AG. Position sensor 1200 interfaces with controller 1104 to provide an absolute positioning system
[0099] [0099] The Hall effect elements 1228A, 1228B, 1228C, 1228D are located directly above the rotating magnet 1202 (Figure 11). The Hall effect is a well-known effect and for convenience it will not be described in detail in this document; however, in general, the Hall effect produces a potential difference (the Hall voltage) through an electric conductor, transversal to an electric current in the conductor, and a magnetic field perpendicular to the current. The Hall coefficient is defined as the ratio between the induced electric field and the product of the current density by the applied magnetic field. It is a characteristic of the material from which the conductor is made, since its value depends on the type, number and properties of the load carriers that make up the chain. In the AS5055 1200 position sensor, Hall effect elements 1228A, 1228B, 1228C, 1228D are capable of producing a voltage signal indicative of the absolute positioning of magnet 1202 in terms of the angle relative to a single revolution of magnet 1202. This value The angle, which is a single position signal, is calculated by the CORDIC 1236 processor and stored integrated in the AS5055 1200 position sensor in a register or memory. The angle value that is indicative of the position of magnet 1202 during a revolution is provided to controller 1104 in a variety of techniques, for example, by energizing or upon demand from controller 1104.
[0100] [0100] The AS5055 1200 position sensor requires only a few external components to operate when connected to the controller
[0101] [0101] Due to the measurement principle of the AS5055 1200 position sensor, only a single angle measurement is performed in a very short time (~ 600 µs) after each energization sequence. As soon as an angle measurement is completed, the AS5055 1200 position sensor enters the de-energized state. There is no filter of the angle value by digital average implemented in the integrated circuit, as this would require more than one angle measurement and, consequently, a longer energization time, which is not desired in low power applications. The angle variation can be reduced by averaging several angle samples on controller 1104. For example, an average of four samples reduces the variation by 6 dB (50%).
[0102] [0102] Figure 13 is a sectional view of an end actuator 2502 of surgical instrument 10 (Figures 1 to 4) showing a firing stroke of the beam with I-2514 profile in relation to the tissue 2526 trapped inside the actuator. end 2502, in accordance with an aspect of the present description. The end actuator 2502 is configured to operate with the surgical instrument 10 shown in Figures 1 to 4. The end actuator 2502 comprises an anvil 2516, an elongated channel 2503 with a staple cartridge 2518 positioned in the elongated channel 2503. An firing 2520 is translatable distally and proximally along a longitudinal geometric axis 2515 of end actuator 2502. When end actuator 2502 is not pivoted, end actuator 2502 is in line with the instrument driving shaft. An I-beam profile 2514 comprising a cutting edge 2509 is shown in a distal portion of the firing bar
[0103] [0103] An exemplary I-profile beam firing stroke 2514 is illustrated by a graphic 2529 aligned with end actuator 2502. The exemplary fabric 2526 is also shown aligned with end actuator 2502. The firing member course can comprise an initial position of the stroke 2527 and an end position of the stroke 2528. During a firing stroke of the I-beam beam 2514, the I-beam beam 2514 can be advanced distally from the initial position of the stroke 2527 to the end position of the 2528 stroke. The I-beam beam 2514 is shown in an example location of an initial position of the 2527 stroke. The 2529 stroke profile of the I-beam beam firing member 2529 illustrates five stroke regions of the firing member 2517, 2519, 2521, 2523, 2525. In a first firing stroke region 2517, the beam with I-profile 2514 can begin to advance distally. In the first firing stroke region 2517, the I-profile beam 2514 can contact the wedge slide 2513 and start moving it distally. While in the first region, however, cutting edge 2509 may not come into contact with the fabric and the wedge slide 2513 may not come into contact with a 2511 clamp driver. Once the static friction is overcome, the force required to driving the beam with i-profile 2514 in the first region 2517 can be substantially constant.
[0104] [0104] In the second stroke region of firing member 2519, cutting edge 2509 may start to come into contact and cut the fabric
[0105] [0105] As discussed above and with reference now to Figures 10 to 13, the electric motor 1122 positioned inside the handle set of the surgical instrument 10 (Figures 1 to 4) can be used to advance and / or retract the trigger system of the drive shaft assembly 1200, including the I-profile beam 2514, in relation to the end actuator 2502 of the drive shaft assembly for stapling and / or cutting the tissue captured inside the end actuator 2502. The beam with I 2514 profile can be advanced or retracted at a desired speed, or within a desired speed range.
[0106] [0106] The force acting on the beam with I 2514 profile can be determined using various techniques. The force on the i-profile beam 2514 can be determined by measuring the current of the motor 2504, where the current of the motor 2504 is based on the load on the i-profile beam 2514 as it advances distally. The strength of the beam with I-2514 profile can be determined by placing a tension meter on the drive member 120 (Figure 2), on the firing member 220 (Figure 3), on the beam with I-2514 profile (beam with I-profile 178, Figure 4), on the firing bar 172 (Figure 4), and / or at a proximal end of the cutting edge 2509. The beam with the I-profile 2514 can be determined by monitoring the actual position of the beam with the profile in i 2514 moving at an expected speed based on the current set speed of the engine 2504 after a predetermined period of time T1 has elapsed and by comparing the actual position of the i-beam beam 2514 with the expected position of the i-beam beam 2514 based on the current set speed of the 2504 engine at the end of the T1 period. Thus, if the actual position of the I-2514 beam is less than the expected position of the I-2514 beam, the force on the I-2514 beam is greater than a nominal force. On the other hand, if the actual position of the beam with i 2514 profile is greater than the expected position of the beam with i 2514 profile, the force on the beam with i 2514 profile will be less than the nominal force. The difference between the actual and expected positions of the beam with I 2514 profile is proportional to the deviation of the force in the beam with I 2514 profile from the nominal force. Such techniques are described in US patent application No. 15 / 628,075, entitled SYSTEMS
[0107] [0107] Figure 14 illustrates a block diagram of a 2500 surgical instrument programmed to control the distal translation of a displacement member according to an aspect of the present description. In one aspect, the surgical instrument 2500 is programmed to control the distal translation of a displacement member 1111 such as the I-profile beam 2514. The surgical instrument 2500 comprises an end actuator 2502 that can comprise an anvil 2516, a beam with I profile 2514 (including a sharp cutting edge 2509), and a removable staple cartridge 2518. End actuator 2502, anvil 2516, i-profile beam 2514 and staple cartridge 2518 can be configured as described here , for example, in relation to Figures 1 to 13.
[0108] [0108] The position, movement, displacement, and / or translation of a displacement member 1111, such as the beam with I-profile 2514, can be measured by the absolute positioning system 1100, by the sensor arrangement 1102, and by the position sensor 1200 as shown in Figures 10 to 12 and represented as the position sensor 2534 in Figure 14. As the beam with I-profile 2514 is coupled to a longitudinally movable drive member 120, the position of the beam with profile in I 2514 can be determined by measuring the position of the longitudinally movable drive member 120 that employs the 2534 position sensor. Consequently, in the following description, the position, displacement and / or translation of the beam with I 2514 profile can be obtained by the position sensor 2534, as described in the present invention. A control circuit 2510, such as control circuit 700 described in Figures 5A and 5B, can be programmed to control the translation of the displacement member 1111, such as the I-profile beam 2514, as described together with Figures 10 to 12 The 2510 control circuit, in some examples, may comprise one or more microcontrollers, microprocessors or other suitable processors to execute the instructions that cause the processor or processors to control the displacement member, for example, the I-profile beam 2514, as described. In one aspect, a timer / counter circuit 2531 provides an output signal, such as elapsed time or a digital count, to control circuit 2510 to correlate beam position with I-profile 2514, as determined by position sensor 2534, with the output of the timer / counter circuit 2531 so that the control circuit 2510 can determine the position of the beam with I-profile 2514 at a specific time (t) in relation to an initial position. The timer / counter circuit 2531 can be configured to measure elapsed time, count external events or measure external events.
[0109] [0109] Control circuit 2510 can generate a 2522 motor setpoint signal. The 2522 motor setpoint signal can be supplied to a 2508 motor controller. The 2508 motor controller can comprise one or more circuits configured to provide a motor 2524 drive signal to motor 2504 to drive motor 2504, as described in the present invention. In some instances, the 2504 motor may be a brushed direct current (DC) electric motor, such as motor 82, 714, 1120 shown in Figures 1, 5B, 10. For example, the speed of the 2504 motor may be proportional to the motor 2524 drive signal. In some examples, motor 2504 may be a brushless DC electric motor and the motor 2524 drive signal may comprise a PWM signal provided for one or more motor stator windings
[0110] [0110] The 2504 motor can receive power from a power source
[0111] [0111] The 2510 control circuit can be in communication with one or more 2538 sensors. The 2538 sensors can be positioned on the end actuator 2502 and adapted to work with the 2500 surgical instrument to measure the various derived parameters, such as span distance in relation to time, compression of the tissue in relation to time and deformation of the anvil in relation to time. The 2538 sensors can comprise a magnetic sensor, a magnetic field sensor, a stress meter, a pressure sensor, a force sensor, an inductive sensor such as an eddy current sensor, a resistive sensor, a sensor capacitive, an optical sensor and / or any other sensors suitable for measuring one or more parameters of the end actuator 2502. The 2538 sensors may include one or more sensors.
[0112] [0112] The one or more 2538 sensors may comprise an effort meter, such as a microstrain meter, configured to measure the magnitude of the stress on the 2516 anvil during a tight condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The 2538 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 2516 and the staple cartridge 2518. The 2538 sensors can be configured to detect the impedance of a section of tissue located between the anvil 2516 and the staple cartridge 2518 which is indicative of the thickness and / or completeness of the fabric located between them.
[0113] [0113] The 2538 sensors can be configured to measure the forces exerted on the anvil 2516 by the closing drive system 30. For example, one or more 2538 sensors can be at an interaction point between the closing tube 260 (Figure 3 ) and the anvil 2516 to detect the closing forces applied by the closing tube 260 to the anvil 2516. The forces exerted on the anvil 2516 may be representative of the tissue compression experienced by the section of tissue captured between the anvil 2516 and the staple cartridge 2518. The one or more 2538 sensors can be positioned at various points of interaction throughout the closing drive system 30 (Figure 2) to detect the closing forces applied to the anvil 2516 by the closing drive system 30. The one or more 2538 sensors can be sampled in real time during a hold operation by a processor as described in Figures 5A and 5B. The 2510 control circuit receives sample measurements in real time to provide analyzed information based on time and evaluate, in real time, the closing forces applied to the 2516 anvil.
[0114] [0114] A current sensor 2536 can be used to measure the current drained by the 2504 motor. The force required to advance the beam with I-profile 2514 corresponds to the current drained by the motor
[0115] [0115] Using the physical properties of the instruments described here, together with Figures 1 to 13, and with reference to Figure 14, a 2510 control circuit can be configured to simulate the actual system response of the instrument in the controller software. A displacement member can be actuated to move a beam with I-profile 2514 on end actuator 2502 at or near a target speed. The 2500 surgical instrument may include a feedback controller, which can be any or any feedback controller, including, but not limited to, a PID, state feedback, linear quadratic regulator (LQR), and / or a controller adaptable, for example. The 2500 surgical instrument can include a power source to convert the signal from the feedback controller to a physical input such as case voltage, PWM voltage, frequency-modulated voltage, current, torque and / or force, for example.
[0116] [0116] The actual drive system of the 2500 surgical instrument is configured to drive the displacement member, the cutting member or the I-shaped profile 2514, by a brushed DC motor with gearbox and mechanical connections to a system articulation and / or scalpel. Another example is the 2504 electric motor that operates the displacement member and the articulation drive, for example, from an interchangeable drive shaft assembly. An external influence is an excessive and unpredictable influence on things like tissue, surrounding bodies, and friction in the physical system. This external influence can be called drag, which acts in opposition to the 2504 electric motor. External influence, like drag, can cause the functioning of the physical system to deviate from a desired operation of the physical system.
[0117] [0117] Before explaining in detail the aspects of the 2500 surgical instrument, it should be noted that the exemplifying aspects are not limited, in terms of application or use, to the details of construction and arrangement of the parts illustrated in the drawings and in the attached description . The exemplifying aspects can be implemented or incorporated into other aspects, variations and modifications, and can be practiced or executed in several ways. Furthermore, except where otherwise indicated, the terms and expressions used in the present invention were chosen for the purpose of describing the exemplifying aspects for the convenience of the reader and not for the purpose of limiting it. In addition, it should be understood that one or more of the aspects, expressions of aspects and / or examples described below can be combined with any one or more of the other aspects, expressions of aspects and / or examples described below.
[0118] [0118] Several exemplifying aspects are directed to a 2500 surgical instrument that comprises a 2502 end actuator with motor-driven surgical stapling and cutting implements. For example, a motor 2504 can drive a displacement member distally and proximally along a longitudinal axis of the end actuator 2502. The end actuator
[0119] [0119] In several examples, the 2500 surgical instrument may comprise a 2510 control circuit programmed to control the distal translation of the displacement member, such as the I-profile beam 2514, for example, based on one or more tissue conditions . The 2510 control circuit can be programmed to directly or indirectly detect tissue conditions, such as thickness, as described here. The 2510 control circuit can be programmed to select a control program based on tissue conditions. A trigger control program can describe the distal movement of the displacement member. Different trigger control programs can be selected to better treat different tissue conditions. For example, when a thicker tissue is present, the control circuit 2510 can be programmed to translate the displacement member at a lower speed and / or with a lower power. When a thinner fabric is present, the 2510 control circuit can be programmed to move the displacement member at a higher speed and / or with greater power.
[0120] [0120] In some examples, control circuit 2510 may initially operate motor 2504 in an open circuit configuration for a first open circuit portion of a travel member travel. Based on a response from the 2500 instrument during the open circuit portion of the course, the 2510 control circuit can select a trip control program. The response of the instrument may include a travel distance of the displacement member during the open circuit portion, a time elapsed during the open circuit portion, the power supplied to the motor 2504 during the open circuit portion, a sum of pulse widths a motor start signal, etc. After the open circuit portion, control circuit 2510 can implement the selected trigger control program for a second portion of the travel member travel. For example, during the closed loop portion of the stroke, control circuit 2510 can modulate motor 2504 based on translation data that describes a position of the displacement member in a closed circuit manner to translate the displacement member into one constant speed.
[0121] [0121] Figure 15 illustrates a diagram 2580 that plots two exemplifying courses of the displacement member performed according to one aspect of the present description. Diagram 2580 comprises two geometric axes. A horizontal geometric axis 2584 indicates the elapsed time. A vertical axis 2582 indicates the position of the i-profile beam 2514 between an initial position of the stroke 2586 and an end position of the stroke 2588. On the horizontal axis 2584, the control circuit 2510 can receive the trigger signal and begin provide the initial motor configuration at t0. The open circuit portion of the travel of the displacement member is an initial period of time that can elapse between t0 and t1.
[0122] [0122] A first example 2592 shows a response from the surgical instrument 2500 when a thick tissue is positioned between the anvil 2516 and the staple cartridge 2518. During the open circuit portion of the travel of the displacement member, for example, the period of initial time between t0 and t1, the beam with i-profile 2514 can traverse from the initial position of stroke 2586 to position 2594. Control circuit 2510 can determine that position 2594 corresponds to a trigger control program that advances the beam with i 2514 profile at a selected constant speed (Vlenta), indicated by the slope of example 2592 after t1 (for example, in the closed circuit portion). The control circuit 2510 can drive the beam with I-profile 2514 to Vlenta speed by monitoring the position of the beam with I-profile 2514 and the modulation of the signal of the motor setpoint 2522 and / or the drive signal of the 2524 engine to maintain the Vlenta.
[0123] [0123] A second example 2590 shows a response from the surgical instrument 2500 when a thin tissue is positioned between the anvil 2516 and the staple cartridge 2518. During the initial time period (for example, the open circuit period) between t0 and t1, the i-profile beam 2514 can traverse from the initial position of the 2586 course to position 2596. The control circuit can determine that position 2596 corresponds to a trigger control program that advances the displacement member at a selected speed constant (Vrápida). Because the fabric in example 2590 is thinner than the fabric in example 2592, it can provide less resistance to movement of the I-profile beam 2514. As a result, the I-profile beam 2514 can move a larger portion of the course over the initial time period. In addition, in some instances, a thinner fabric (e.g., a larger portion of the displacement limb travel during the initial time period) may correspond to higher velocities of the displacement member after the initial time period.
[0124] [0124] Figures 16 to 21 illustrate a 2300 end actuator of a 2010 surgical instrument showing how the 2300 end actuator can be articulated in relation to the elongated drive shaft assembly 2200 around an articulated joint 2270, according to with an aspect of the present description. Figure 16 is a partial perspective view of a portion of end actuator 2300 showing an elongated drive shaft assembly 2200 in a non-articulated orientation, with some of its portions omitted for clarity. Figure 17 is a perspective view of the end actuator 2300 of Figure 16 showing the elongated drive shaft assembly 2200 in a non-articulated orientation. Figure 18 is an exploded perspective view of the end actuator 2300 of Figure 16 showing the elongated drive shaft assembly 2200. Figure 19 is a top view of the end actuator 2300 of Figure 16 showing the drive shaft assembly. elongated drive 2200 in a non-articulated orientation. Figure 20 is a top view of the end actuator 2300 of Figure 16 showing the elongated drive shaft assembly 2200 in a first articulated orientation. Figure 21 is a top view of the end actuator 2300 of Figure 16 showing the elongated drive shaft assembly 2200 in a second articulated orientation.
[0125] [0125] With reference now to Figures 16 to 21, the end actuator 2300 is adapted to cut and staple fabric and includes a first claw in the form of an elongated channel 2302 which is configured to operationally support a staple cartridge. surgical 2304. The end actuator 2300 further includes a second claw in the form of an anvil 2310 which is supported in the elongated channel 2302 for movement with respect to it. The elongated drive shaft assembly 2200 includes a hinge system 2800 that uses a hinge lock 2810. Hinge lock 2810 can be configured and operated to selectively lock the surgical end actuator 2300 in various hinged positions. This arrangement allows the surgical end actuator 2300 to be rotated, or pivoted, in relation to the closing tube 260 of the drive shaft when the hinge lock 2810 is in its unlocked state. Specifically with reference to Figure 18, the elongated drive shaft assembly 2200 includes a central column 210 that is configured to (1) slide a firing member 220 slidingly inside it and (2) to slide the pipe closure 260 (Figure 16) that extends around the central column 210. The closing shaft of the drive shaft 260 is fixed to a closing sleeve of the end actuator 272 which is pivotally fixed to the closing pipe 260 by a 271 double joint closure sleeve assembly.
[0126] [0126] The central column 210 also slidably supports a proximal articulation actuator 230. The proximal articulation actuator 230 has a distal end 231 that is configured to operationally engage the articulation lock 2810. The articulation lock 2810 further comprises a drive shaft structure 2812 which is attached to the central column 210 in the various ways disclosed herein. The drive shaft structure 2812 is configured to mobilely support a proximal portion 2821 of a distal hinge driver 2820. The distal hinge driver 2820 is movably supported within the elongated drive shaft assembly 2200 for selective longitudinal displacement in a distal DD direction and a proximal DP direction, along a geometric axis of articulation AAA that is laterally displaced and parallel to the geometric axis of the drive axis SA-SA, in response to joint control movements applied to it.
[0127] [0127] In Figures 17 and 18, the drive shaft structure 2812 includes a distal end portion 2814 that has a pivot pin 2818 formed thereon. Pivot pin 2818 is adapted to be pivotally received within a pivot hole 2397 formed in the pivot base portion 2395 of a 2390 end actuator mounting assembly. The 2390 end actuator mounting assembly is attached to the proximal end 2303 of the elongated channel 2302 by means of a spring pin 2393 or equivalent. The pivot pin 2818 defines a pivot geometric axis BB transverse to the geometric axis of the SA-SA drive axis to facilitate the pivoting displacement (that is, the pivot) of the end actuator 2300 around the pivot geometric axis BB in relation to to the 2812 drive shaft structure.
[0128] [0128] As shown in Figure 18, a link pin 2825 is formed at a distal end 2823 of the distal hinge driver 2820 and is configured to be received inside a hole 2904 at a proximal end 2902 of a cross link 2900. The cross link 2900 extends transversely across the geometric axis of the SA-SA drive shaft and includes a distal end portion 2906. A distal link hole 2908 is provided through the distal end portion 2906 of the cross link 2900 and is configured to pivotally receive a 2398 base pin that extends from the bottom of the pivot base portion 2395 of the end actuator assembly
[0129] [0129] Figure 19 shows the articulated joint 2270 in a straight position, that is, at a zero angle θ0 in relation to the longitudinal direction shown as drive axis SA, according to one aspect. Figure 20 shows the articulated joint 2270 of Figure 19 articulated in a direction of at a first angle θ1 defined between the axis SA of the drive axis and the axis EA of the end actuator, according to one aspect. Figure 21 illustrates the articulated joint 2270 of Figure 19 articulated in another direction at a second angle θ2 defined between the axis SA of the drive shaft and the axis EA of the end actuator.
[0130] [0130] The surgical end actuator 2300 in Figures 16 to 21 comprises a surgical cutting and stapling device that uses a trigger member 220 among the various types and configurations described here. However, the surgical end actuator 2300 may comprise other forms of surgical end actuators that do not cut and / or staple tissue. An intermediate support member 2950 is supported pivoting and sliding in relation to the back
[0131] [0131] The surgical instrument can also be configured to determine the angle at which the 2300 end actuator is oriented. In several modalities, the position sensor 1112 of the sensor arrangement 1102 can comprise one or more magnetic sensors, analog rotary sensors (such as a potentiometer), analog hall sensor arrays, which emit a unique combination of signals or values, among others, for example. In one aspect, the pivot joint 2270 of the aspect shown in Figures 16 to 21 may further comprise an arrangement of the pivot sensor that is configured to determine the angular position, i.e. pivot angle, of the end actuator 2300 and provide a unique position sign corresponding to it.
[0132] [0132] The articulation sensor arrangement can be similar to the 1102 sensor arrangement described above and illustrated in Figures 10 to
[0133] [0133] In another aspect, the surgical instrument is configured to determine the angle at which the end actuator 2300 is positioned indirectly by monitoring the absolute position of the articulation actuator 230 (Figure 3). As the position of the hinge actuator 230 corresponds to the angle at which the end actuator 2300 is oriented in a known manner, the absolute position of the hinge actuator 230 can be traced and then shifted to the angled position of the end actuator 2300. In this regard, the surgical instrument comprises an articulation sensor arrangement that is configured to determine the absolute linear position of the articulation actuator 230 and provide a unique position signal corresponding to it. In some respects, the articulation sensor arrangement or the controller operationally coupled to the disposition articulation sensor arrangement is further configured to translate or calculate the angular position of the 2300 end actuator from a single position signal.
[0134] [0134] The arrangement of the articulation sensor in this aspect may similarly be similar to the arrangement of sensor 1102 described above and illustrated in Figures 10 to 12. In a similar aspect to the aspect illustrated in Figure 10 in relation to the limb displacement 1111, the articulation sensor arrangement comprises a position sensor and a magnet that rotates once for each complete stroke of the longitudinally movable articulation driver 230. The position sensor comprises one or more magnetic sensing elements, such as effect sensors Hall, and is positioned next to the magnet. Consequently, as the magnet rotates, the magnetic sensing elements of the position sensor determine the absolute angular position of the magnet during a revolution.
[0135] [0135] In one aspect, a single revolution of the sensor element associated with the position sensor is equivalent to a longitudinal linear displacement d1 of the longitudinally movable articulation driver 230. In other words, d1 is the longitudinal linear distance by which the articulation drive longitudinally movable 230 moves from point "a" to point "b" after a single revolution of a sensor element coupled to the longitudinally movable articulation driver 230.
[0136] [0136] In several respects, any number of magnetic detection elements can be used in the arrangement of the joint sensor, such as, for example, magnetic sensors classified according to their ability to measure the total magnetic field or the vector components of the magnetic field . The number of magnetic detection elements used corresponds to the desired resolution to be detected by the arrangement of the articulation sensor. In other words, the greater the number of magnetic detection elements used, the greater the degree of articulation that can be detected by the arrangement of the articulation sensor. The techniques used to produce both types of magnetic sensors cover many aspects of physics and electronics. Technologies used for magnetic field detection include flow meter, saturated flow, optical pumping, nuclear precession, SQUID, Hall effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive / piesoelectric compounds, magnetodiode, magnetic transistor, fiber optics, magneto-optics and magnetic sensors based on microelectromechanical systems, among others.
[0137] [0137] In one aspect, the position sensor of the various aspects of the articulation sensor arrangement can be implemented in a similar way to the positioning system illustrated in Figure 12 to track the position of the 1111 displacement member. In one aspect, the arrangement of the articulation sensor can be implemented as an AS5055EQFT single integrated circuit magnetic rotary position sensor, available from Austria Microsystems, AG. The position sensor interfaces with the controller to provide an absolute positioning system to determine the absolute angular position of the 2300 end actuator, either directly or indirectly. The position sensor is a low voltage and low power component and includes four Hall effect elements 1228A, 1228B, 1228C, 1228D in an area 1230 of the position sensor 1200 located above magnet 1202 (Figure 11). A 1232 high-resolution A-D converter and 1238 intelligent power management controller are also provided on the integrated circuit. A CORDIC 1236 (Coordinate Rotation Digital Computer) processor, also known as digit-by-digit method and Volder algorithm, is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only operations addition, subtraction, bit offset and lookup table. The angular position, alarm bits and magnetic field information are transmitted via a standard serial communication interface, such as an SPI 1234 interface, to controller 1104. Position sensor 1200 provides 12 or 14 bits of resolution. The position sensor 1200 can be an AS5055 integrated circuit supplied in a small 16-pin QFN package whose measurement corresponds to 4x4x0.85 mm.
[0138] [0138] With reference to Figures 1 to 4 and 10 to 12, the position of the articulation joint 2270 and the position of the beam with I-shaped profile 178 (Figure 4) can be determined with the absolute position feedback signal / value of the absolute positioning system 1100. In one aspect, the articulation angle θ can be determined based on the driving member 120 of the surgical instrument 10. As described above, the movement of the longitudinally movable driving member 120 (Figure 2) can be tracked by the absolute positioning system 1100 and, when the articulation actuator is operationally coupled to the firing member 220 (Figure 3) by the clutch assembly 400 (Figure 3), for example, the absolute positioning system 1100 can, in effect, track the movement of the articulation system through the drive member 120. As a result of tracking the movement of the articulation system, the controller of the surgical instrument can track the angle the articulation θ of the end actuator 2300. In various circumstances, as a result, the articulation angle θ can be determined as a function of the longitudinal displacement of the drive member 120. How the longitudinal displacement of the drive member 120 can be determined with accuracy based on the absolute position signal / value provided by the absolute positioning system 1100, the pivot angle θ can be determined as a function of longitudinal displacement.
[0139] [0139] In another aspect, the articulation angle θ can be determined by the location sensors on the 2270 articulation joint. The sensors can be configured to detect the rotation of the 2270 articulation joint using the absolute positioning system 1100 of a adapted way to measure the absolute rotation of the articulation joint 2270, instead of the longitudinal displacement of the driving member 120, as described above. For example, the sensor arrangement 1102 comprises a position sensor 1200, a magnet 1202 and a magnet holder 1204 adapted to detect the rotation of the articulated joint 2270. The position sensor 1200 comprises one or more magnetic detection elements, such as elements Hall, and is positioned close to magnet 1202. Position sensor 1200 described in Figure 12 can be adapted to measure the angle of rotation of the articulated joint 2270. Consequently, as magnet 1202 rotates, the magnetic sensing elements of the position sensor 1200 determines the absolute angular position of magnet 1202 located on articulation joint 2270. This information is provided to controller 1104 to calculate the articulation angle of articulation joint 2270. Consequently, the articulation angle of end actuator 2300 can be determined by the absolute positioning system 1100 adapted to measure the absolute rotation of the articulated joint 2270.
[0140] [0140] In one aspect, the firing rate or speed of the I-profile beam 178 can be varied as a function of the articulation angle of the end actuator 2300 to decrease the force to fire in the firing drive system 80 and, in particular, the force for firing the I-profile beam 178, among other components of the firing drive system 80 discussed here. To adapt the variable firing force of the I-profile beam 178 as a function of the articulation angle of the end actuator 2300, a variable motor control voltage can be applied to motor 82 to control the speed of motor 82. The speed of the motor 82 can be controlled by comparing the firing force of the I-profile beam 178 with different maximum limits based on the articulation angle of the end actuator 2300. The speed of the electric motor 82 can be varied by adjusting the tension, current, pulse width modulation (PWM) or duty cycle (0 to 100%) applied to motor 82, for example.
[0141] [0141] Figures 22 and 23 show a motor-driven surgical instrument 10 that can be used to perform a variety of different surgical procedures. The surgical instrument 10 may comprise an end actuator 3602, which may comprise one or more electrodes. The 3602 end actuator can be positioned against the fabric, so that electric current can be introduced into the fabric. The surgical instrument 10 can be configured for monopolar or bipolar operation. During monopolar operation, the current can be introduced into the tissue by an active electrode (or source) in the 3602 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, current can be introduced into the tissue and returned from it, respectively, through the active and return electrodes of the end actuator.
[0142] [0142] The end actuator 3602 can comprise a first jaw 3604 and a member of the second jaw 3608. At least one of the jaw members 3604, 3608 may have at least one electrode. At least one of the 3604, 3608 jaw members can be movable from a spaced position of the opposite jaw to receive fabrics in a position in which the space between the 3604, 3608 jaw 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 surgical instrument 10 can comprise a knife member 3628 which is extendable through the end actuator 3602. The knife member 3628 can be movable with respect to the tissue and the electrodes to transect the tissue.
[0143] [0143] Surgical instrument 10 may include mechanisms for securing tissue, such as a stapling device and / or mechanisms for cutting tissue, such as a tissue knife. An electrosurgical instrument 10 may include a drive shaft for placing the end actuator 3602 in a position adjacent to the tissue being subjected to treatment. The drive shaft can be straight or curved, foldable or non-foldable. In an electrosurgical instrument 10 that includes a straight and foldable drive shaft, the drive shaft may have one or more hinge joints to allow controlled flexing of the drive shaft. Such joints may allow a user of the electrosurgical instrument 10 to place the end actuator in contact with the tissue at an angle to the drive axis when the tissue being treated is not readily accessible using an electrosurgical device that has a straight, non-folding drive shaft.
[0144] [0144] The electrical energy applied by electrosurgical devices can be transmitted to the instrument by a 3400 generator in communication with the 3500 handle set. The electrical energy may be in the form of radio frequency (RF) energy. RF energy is a form of electrical energy that can be in the frequency range of 200 kilohertz (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 sharp 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.
[0145] [0145] RF energy can be in a frequency range described in document EN 60601-2-2: 2009 + A11: 2011, Definition
[0146] [0146] In the illustrated arrangement, surgical instrument 10 comprises a set of interchangeable surgical tools 3600 that is operationally coupled to a 3500 handle set. In another aspect of the surgical system, the set of interchangeable surgical tools 3600 can also be used effectively with a tool drive set from a robotic or automated controlled surgical system. For example, the 3600 surgical tool set described herein can be used with various robotic systems, instruments, components and methods such as, but not limited to, those described in US Patent No. 9,072,535, entitled
[0147] [0147] In the illustrated aspect, the 3500 handle assembly may comprise a handle compartment 3502 that includes a pistol handle portion that can be handled and handled by the physician. As will be briefly discussed below, the 3500 handle set 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 3600. As shown in Figure 22, the set handle 3500 may also include a handle structure 3506 that operationally supports the plurality of drive systems. For example, the 3506 handle structure can operationally support a "first" closing drive system or system, designated as 3510, which can be used to apply closing and opening movements to the 3600 interchangeable surgical tool set. At least In a way, the closing drive system 3510 can include an actuator in the form of a closing trigger 3512, which is hingedly supported by the grip structure 3506. This arrangement allows the closing trigger 3512 to be handled by a physician , so that when the doctor grips the pistol grip portion 504 of the grip assembly 3500, the closing trigger 3512 can be easily rotated from an initial or "not actuated" position
[0148] [0148] In at least one form, the 3500 handle assembly and the 3506 handle structure can operationally support another drive system called in the present invention a 3530 trigger drive system, which is configured to apply firing movements to the portions corresponding to the set of interchangeable surgical tools that is attached to it. As described in detail in US patent application publication No. 2015/0272575, the 3530 firing drive system may employ an 3505 electric motor which is located in the pistol grip portion of the 3500 grip assembly. In various forms, the 3505 motor can be a brushed DC motor with a maximum speed of approximately 25,000 RPM, for example. In other provisions, the 3505 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable type of electric motor. The 3505 engine can be powered by a 3522 power supply which, in one form, can comprise a removable battery. The power source can support a plurality of LI batteries ("Li ions") or other suitable ones therein. Several batteries can be connected in series, can be used as the 3522 power source for the surgical instrument 10. In addition, the 3522 power source can be replaceable and / or rechargeable.
[0149] [0149] The 3505 electric motor is configured to axially drive a 3540 longitudinally movable driving member in the distal and proximal directions depending on the polarity of the motor. For example, when the 3505 motor is driven in a direction of rotation, the longitudinally movable drive member will be axially driven in a distal "DD" direction. When the 3505 motor is driven in the opposite rotating direction, the 3540 longitudinally movable driving member will be axially driven in the "DP" proximal direction. The 3500 handle set may include a 3513 switch that can be configured to reverse the polarity applied to the 3505 electric motor by the 3522 power source or otherwise control the 3505 motor. The 3500 handle set may also include a sensor or sensors ( not shown) that is configured to detect the position of the drive member and / or the direction in which the drive member is being moved. The actuation of the 3505 engine can be controlled by a firing trigger (not shown) that is in a position adjacent to the 3512 closing trigger and pivotally supported on the 3500 handle assembly. and an acted position. The trigger can be moved to the unacted position by means of a spring or other propensity arrangement so that when the doctor releases the trigger, it can be rotated or otherwise returned to the untreated position. actuated by means of the spring or the propensity arrangement. In at least one way, the trigger trigger can be positioned "away from the center" of the 3512 closing trigger. As discussed in US Patent Application Publication No. 2015/0272575, the 3500 handle assembly can be equipped with a button trigger trigger safety (not shown) to prevent inadvertent triggering. When the 3512 closing trigger is in the non-actuated position, the safety button is contained in the 3500 handle set, where the doctor cannot readily access it and move it between a safety position, which prevents the trigger from operating. trigger, and a trigger position at which the trigger can be fired. As the doctor presses the closing trigger, the safety button and the trigger trigger pivot down to a position where they can then be manipulated by the doctor.
[0150] [0150] In at least one form, the 3540 longitudinally movable drive member may have a toothed rack formed thereon for engagement with a corresponding drive gear arrangement (not shown) that interfaces with the motor. Additional details regarding those features can be found in US patent application publication no.
[0151] [0151] As shown in Figure 22, in at least one arrangement, the interchangeable surgical tool set 3600 includes a tool frame set 3610 comprising a tool chassis that operationally supports a nozzle set 3612 therein. As discussed in detail in US patent application No. 15 / 635,631, entitled SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER, which is incorporated herein by reference in its entirety, the tool chassis and nozzle assembly 3612 facilitate rotation of the 3602 surgical end actuator around an SA axis of the drive shaft in relation to the tool frame. Such rotational displacement is represented by the arrow R in Figure 22. The interchangeable surgical tool set 3600 includes a central column set 3630 (see Figures 3 and 24) that operationally supports the proximal closing tube 3622 and is coupled to the surgical end actuator 3602. In various circumstances, to facilitate assembly, the 3630 center column assembly can be manufactured from an upper center column segment and a lower center column segment that are interconnected together by pressure fitting, adhesive, weld features , etc. In assembled form, the center column assembly 3630 includes a proximal end that is swiveled on the tool frame 1210. In one arrangement, for example, the proximal end of the center column assembly 3630 is attached to a center column bearing (not shown) that is configured to be supported within the tool chassis. This arrangement facilitates the swiveling attachment of the center column assembly 3630 to the tool chassis, so that the center column assembly can be selectively rotated around a drive axis SA axis relative to the tool chassis.
[0152] [0152] In the illustrated aspect, the interchangeable surgical tool set 3600 includes a 3602 surgical end actuator comprising a first 3604 jaw and a second 3608 jaw. In one arrangement, the first jaw comprises an elongated channel 3614 that is configured to support operationally a conventional staple cartridge / surgical clamps (mechanical) 304 (Figure 4) or a radio frequency cartridge (RF) 3606 (Figures 22 and 23) in it. The second claw 3608 comprises an anvil 3616 which is pivotally supported in relation to the elongated channel 3614. The anvil 3616 can be selectively moved towards a surgical cartridge supported in the elongated channel 3614, and in the opposite direction to it, between the positions open and closed by actuation of the closing drive system 3510. In the illustrated arrangement, the anvil 3616 is pivotally supported on a proximal end portion of the elongated channel 3614 for selective pivoting displacement around a pivot geometric axis that is transverse to the drive axis SA geometric axis. The actuation of the closing drive system 3510 can result in the distal axial movement of a proximal closing member or proximal closing tube 3622 which is attached to a hinge connector 3618. The actuation of the proximal closing tube 3622 will result in the distal displacement of the segment of the distal closing tube 3620 to finally apply a closing movement to the anvil 3616.
[0153] [0153] In at least one arrangement, RF energy is supplied to the 3600 surgical tool set by a conventional 3400 RF generator via a 3402 supply lead. In at least one arrangement, the 3402 supply lead includes a set 3406 male plug connector that is configured to be plugged into corresponding female 3410 connectors that are attached to a 3656 segmented RF circuit on a 3654 integrated circuit board. See Figure 25. This arrangement facilitates the rotational displacement of the drive shaft and the end actuator 3602 around the drive shaft SA geometric axis in relation to the tool chassis by rotating the nozzle assembly 3612 without winding the supply lead 3402 of the generator 3400. An integrated on / off switch 3420 is supported in the assembly 3624 and on the tool chassis to turn the RF generator on and off. When the 3600 tool set is operationally coupled to the 3500 handle set or robotic system, the segmented RF circuit
[0154] [0154] In at least one arrangement, the elongated channel 3614 includes a channel circuit 3642 supported in a recess that extends from the proximal end of the elongated channel 3614 to a distal location in the lower portion of the elongated channel 3614. channel 3642 includes a proximal contact portion which contacts a distal contact portion 3644 of the flexible drive shaft circuit strip 3646 for electrical contact therewith. In at least one arrangement, the distal end of the channel circuit 3642 is received within a recess in the corresponding wall formed in one of the walls of the elongated channel 3614 and is folded and attached to an upper edge of the wall of the elongated channel 3614. A series corresponding exposed contacts are provided at the distal end of the 3642 channel circuit. Correspondingly, the 3606 cartridge may include a flexible circuit cartridge that is attached to a distal integrated chip and is attached to the distal end portion of the 3606 cartridge body. One end of the flexible cartridge circuit is folded over the edge of the 3606 cartridge platform surface and includes exposed contacts configured to make electrical contact with the exposed contacts of the 3642 channel circuit. This way, when the 3606 RF cartridge is installed in the elongated channel 3614, the electrodes, as well as the distal microcircuit of the RF 3606 cartridge are fed and eaten connect with the integrated circuit board 3654 through the contact between the flexible cartridge circuit, the flexible channel circuit 3642, the flexible drive shaft circuit 3646 and the slip ring assembly 3652. Additional details on the RF cartridges 3606 and the sensor arrangements of the surgical instrument 10 that communicate and / or interact with the RF 3606 cartridges can be found in US patent application No. 15 / 636,096, entitled
[0155] [0155] Figure 26 illustrates a logical flow chart of a process 5000 for displaying a knife position, as performed by controller 1104 (Figure 10) in accordance with an aspect of the present description. In several respects, the surgical instrument 10 can be configured to perform processes, such as the 5000 process, which are configured to monitor the knife position during transection (which includes firing and retracting the knife) and show the change in position knife like an animation or a slide show of images over time. Such functionality can be useful, for example, to allow doctors to visualize the knife position without the need to see the knife itself during a transection operation. As shown in Figure 30, the position of the knife can be shown on a display screen 5302 arranged over the handle assembly 5300 of the surgical instrument 10. The display screen 5302 can feature a slide show 5304 or animation that includes a graphical representation the knife position, a numerical representation of the knife position or a combination thereof. In the following description of process 5000, reference should also be made to Figures 3, 10 and 16 to 23. As used in the present invention, the term "knife" can refer collectively to knife bar 280 (also called firing bar) 172), the cutting edge 182 and the other related components that are advanced distally through the end actuator 3602 (Figure 23) to transect the tissue.
[0156] [0156] Consequently, process 5000 determines 5002 if surgical instrument 10 is in a trigger state. The triggering state is an operational state of the surgical instrument 10 with the knife bar 280 being transferred to transect the tissue captured in the end actuator 3602. Controller 1104 can determine that the surgical instrument 10 is in a state ( for example, a trigger state, a hold state, an articulation state, and so on) by detecting multiple inputs and then generating relationships between the detected inputs. It may be necessary to generate relationships between detected inputs to determine if the surgical instrument 10 is in certain operating states because some detected inputs are inconclusive as to what operating status of the surgical instrument 10 is when individually detected. For example, detecting whether triggering system 80 is activated cannot simply say whether surgical instrument 10 is triggering the knife / clamps or articulating because triggering system 80 triggers both of these operations. For other operations, detecting an individual entry may be sufficient. For example, detecting whether the closing drive system 30 is activated tells you that the surgical instrument 10 is stuck or in the process of fixing. However, even when the detection of an individual entry may be hypothetical enough to determine whether the surgical instrument 10 is in a particular operational state, it may nevertheless be desirable to generate relationships between multiple detected entries to verify that the detected parameters relate exactly to the operational status of the surgical instrument 10.
[0157] [0157] Specifically in relation to determining 5002 whether the surgical instrument 10 is in an operational trigger state, controller 1104 can determine whether the cutter bar 280 is being triggered by generating relationships between a variety of detected parameters of the surgical instrument 10, including detecting whether a displacement member 1111 (for example, the longitudinally movable drive member 120) is being translated through a position sensor 1112, detecting whether coupling assembly 400 is engaged, detecting whether a voltage is being applied to motor 1120, detect the position of the trigger trigger, detect whether the closing drive system 30 has been activated, and / or detect the relative positions of the claws 3604, 3608 (or the anvil 3616 and the cartridge 3606) of the end actuator 2300, among other such detected inputs. In a general aspect, if controller 1104 detects that trigger trigger system 80 has been activated and closing trigger system 30 has been activated, then process 5000 determines that surgical instrument 10 is in a trigger state. In another general aspect, if controller 1104 detects that the trigger trigger has been actuated and end actuator 2300 is stuck, then process 5000 determines that the surgical instrument 10 is in a trigger state.
[0158] [0158] Controller 1104 can detect that the knife is being fired in a variety of different ways. In one aspect, controller 1104 is configured to directly detect the translation of knife bar 280. In this aspect, displacement member 1111 tracked by position sensor 1112 represents knife bar 280. In other aspects, controller 1104 is configured to indirectly detect the translation of the knife bar 280 instead of detecting the translation of a component that is coupled to the knife bar 280. In these aspects, the displacement member 1111 tracked by the position sensor 1112 can represent the longitudinally movable driving member 120 (Figure 2), the firing member 220 (Figure 3) or another movable component coupled to the knife bar 280. In any of these aspects, when the position sensor 1112 detects that the displacement member 1111 is moving between a first position (ie, proximal or initial) to a second position (ie, distal), controller 1104 can thus determine that knife bar 280 is being fired or retracted. In another aspect, controller 1104 can be communicably coupled to a current sensor 2536 (Figure 14) that is configured to detect when motor 2504 is drawing power from power source 2512. When current sensor 2536 detects that motor 2504 is draining power (that is, a voltage is being applied to motor 2504), controller 1104 can therefore determine that knife bar 280 is being fired because motor 2504 drives knife bar 280 when a voltage is applied to it. In yet another aspect, the other 1118 sensor (s) may include a trigger trigger sensor configured to determine when the trigger trigger (not shown) was triggered. As the trigger trigger causes trigger trigger system 80 to fire, detecting whether trigger trigger has been actuated, this serves as an indicator to determine the trigger status of surgical instrument 10 (alone or in combination with other detected inputs ). The trigger trigger sensor may include, for example, a position sensor configured to detect the position of the trigger trigger in relation to the 3500 handle assembly. Various other aspects include combinations of said sensor arrangements and / or several additional sensors configured to detect when the knife system or trigger drive system 80 is activated.
[0159] [0159] Controller 1104 can detect that end actuator 2300 is attached in a variety of different ways. In one aspect, the other 1118 sensor (s) may include a closing trigger sensor configured to determine when the 3512 closing trigger has been actuated. When the 3512 closing trigger causes the 3510 closing drive system to be activated, detecting whether the 3512 closing trigger has been acted thus serves as a substitute for determining whether the 2300 end actuator is in a locked position or not stuck. The closing trigger sensor may include, for example, a position sensor configured to detect the position of the closing 3512 trigger in relation to the 3500 handle assembly. Other aspects may include a trigger trigger sensor or a push button sensor. trigger to detect the activation of the trigger controls. The other 1118 sensors may also include a closing drive system sensor configured to detect activation of the closing drive system 3510. For example, the other 1118 sensors may include a sensor configured to measure the forces exerted on the 3616 anvil by closing tube 3620 or a sensor configured to measure the relative position of the closing tube 3620 or another moving component of the closing drive system that moves between a first position and a second position to effect the closing of the 2300 end actuator. The others sensors 1118 may further include a claw sensor configured to determine whether the claws 3604, 3608 of the end actuator 2300 are in a clamped or non-clamped position. For example, the other 1118 sensor (s) may include a sensor configured to detect a distance between the first 3604 jaw and the second 3608 jaw, a pressure sensor disposed on at least one of the first jaw 3604 and / or the second jaw 3608 which is configured to detect when the end actuator 2300 is attached to an object (for example, fabric), or an impedance sensor configured to detect the impedance of the fabric located between the first jaw 3604 and the second 3608 claw.
[0160] [0160] In a specific example, surgical instrument 10 includes a trigger trigger sensor, as described above, and a claw sensor, as also described above. If controller 1104 detects that the trigger trigger (which controls the trigger drive system 80) has been actuated and that the claws 3604, 3608 of the end actuator 2300 are attached via the aforementioned sensors, then process 5000 consequently determines 5002 that the surgical instrument 10 is in the firing state (i.e., knife bar 280 is being advanced to transect the tissue or is being retracted after tissue transection). Various other aspects may include the sensor arrangements described above either in isolation or in other combinations to generate relationships between the detected inputs to determine whether the surgical instrument 10 is in a trip state. Additional information regarding various sensor arrangements can be found in the patent application
[0161] [0161] If surgical instrument 10 is not in a trigger state, then process 5000 continues along the NO branch and controller 1104 causes display screen 5302 to display 5004 an initial screen image. The initial screen image can include an entry menu to receive commands from a user and / or display general information about the surgical instrument 10.
[0162] [0162] If surgical instrument 10 is in a trigger state, then process 5000 continues along the YES branch and determines 5006 the position of knife bar 280 in relation to its initial position. In one aspect, process 5000 determines 5006 the position of knife bar 280 by directly detecting its position. In this respect, the displacement member 1111 tracked by the position sensor 1112 can represent knife bar 280. In other respects, process 5000 determines 5006 the position of knife bar 280 by detecting a position of the longitudinally movable driving member 120 (Figure 2) or another movable component of the firing drive system 80, which is coupled to the knife bar 280. Regardless of the displacement member 1111 representing the knife bar 280, the longitudinally movable driving member 120, or other such a longitudinally movable component coupled to knife bar 280, process 5000 can determine 5006 the position of knife bar 280 by detecting the position of displacement member 1111 in relation to its initial position (i.e. the initial or proximal position) and / or its final position (that is, the terminal or distal position). If the displacement member 1111 represents knife bar 280, then the position of knife bar 280 can be determined directly. If the displacement member 1111 does not represent the knife member 280, the position of the displacement member 1111, nevertheless, still corresponds to the position of the cutter member 280 in a known manner because the displacement member 1111 and the knife member 280 are operationally coupled together. In other words, the translation of, for example, the longitudinally movable drive member 120, causes knife bar 280 to translate correspondingly because knife bar 280 is operationally coupled to longitudinally movable drive member 120, as described above. Therefore, where offset 1111 is located in relation to its initial position and / or its end position, it generally corresponds to the relative position of the knife bar 280 in relation to its own initial and end positions. Controller 1104 can then calculate the absolute position of knife bar 280 from its determined relative position because the starting position and end position of knife bar 280 are known values. Controller 1104 can be configured to retrieve the start and end positions of knife bar 280 and / or travel member 1111 from, for example, memory 1106 and then compare their current positions with the start and end positions terminal recovered.
[0163] [0163] In one aspect, the surgical instrument 10 includes a secondary sensor or an alternative method for calculating the position of the displacement member 1111. In such aspects, the secondary sensor can be used to verify the distance measurement of the position sensor 1112 In such aspects, the surgical instrument 10 may include a position sensor arrangement that is configured to detect the position of an alternative component of the knife system or trigger drive system 80. For example, in aspects where the position 1112 tracks the movement of the longitudinally movable drive member 120, the surgical instrument 10 may include a second position sensor arrangement that is configured to track the movement of the beam with I-profile 2514 (Figure 14). In these respects, controller 1104 can compare the output of position sensor 1112 with the output of the second sensor to verify that position sensor 1112 is correctly tracking the movement of the respective displacement member 1111. If there is a discontinuity between the two outputs, then controller 1104 can determine that there is an error in at least one of the sensor arrangements.
[0164] [0164] After process 5000 determines 5006 the relative position of knife bar 280, process 5000 then displays an animation or a series of images representing the calculated position of knife bar 280 during the transection. The transection can correspond to both firing and retraction of knife bar 280. In one aspect, the position of knife bar 280 is displayed in real time. In another aspect, controller 1104 tests the position of knife bar 280 at a specific speed, or process 5000 includes a delay between the 2008 display of each successive image of the position of cut bar 280 during transfection.
[0165] [0165] Figure 27 illustrates a logical flow chart of a 5100 process of displaying a knife position over time as performed by controller 1104 in accordance with an aspect of the present description. In the following description of process 5100, reference is also made to Figures 3, 10, 14, 16 to 23 and 26. The display step 5008 of the position of the knife bar 280 as the knife bar 280 transects the fabric and then retracts, as described in connection with process 5000 depicting in Figure 26, can be implemented through various processes, such as process 5100. Consequently, process 5100 begins when transection begins 5102, that is, when the bar knife 280 is fired to cut the tissue captured on end actuator 2300. Controller 1104 can determine that the transection has started 5102 according to the relationships between various detected inputs, as described above.
[0166] [0166] After the transection has started 5102, process 5100 determines the limit position. Figures 28A and 28B represent a line diagram 5200 of a firing stroke representative of a displacement member 5202, including limit position 5210. Limit position 5210 is located between a first position 5206 (for example, the proximal position) and a second position 5208 (e.g., the distal position) of the firing stroke of the displacement member 5202. Limit position 5210 can be represented as displaced from the first position 5206 or the second position 5208 of the firing stroke of the displacement member 5202. The 5210 limit position forks the firing stroke into a first zone, or proximal zone, adjacent to the first position 5206 and a second zone, or distal zone, adjacent to the second position 5208. Controller 1104 can execute various processes according to which the displacement member 5202 is positioned. It should be noted that the line diagram 5200 shown in Figures 28A and 28B is intended only for representative purposes to illustrate the various zones and / or limits 5210, 5212 through which the displacement member 5202 is translated during a firing stroke. Furthermore, when it is said that the displacement member 5202 is "positioned" in a zone, what is meant is that the distal end 5204 of the displacement member 5202 is situated in the specific zone or in the specific position.
[0167] [0167] In one aspect, limit position 5210 represents the locking position of the travel path of the displacement member 5202. The locking position corresponds to the position beyond which the displacement member 5202 is mechanically or electronically prevented from advancing by a trigger locking system if certain conditions occur, such as when there is no 304, 3606 cartridge present in the 2300 end actuator. In some respects, the locking position corresponds to a cartridge locking position, where the locking system firing prevents the knife from advancing beyond the locking position when the surgical instrument 10 does not have a cartridge or when a spent cartridge is placed inside the 2300 end actuator. The firing locking system can initiate a firing locking state of a motor current peak if the cutting bar 280 or the displacement member 1111 is locked (o) or otherwise cannot advance when it (it ) reaches the blocking position (that is, the 5210 limit position). In one aspect, the surgical instrument 10 is configured with an electronic trigger locking system.
[0168] [0168] Controller 1104 can determine 5104 the 5210 limit position by, for example, retrieving the 5210 limit position value from a 1106 memory. The 5210 limit position value can represent an absolute measurement of a distance from the first position 5206 or second position 5208 of the firing stroke of the displacement member 5202 or a relative position in the firing stroke.
[0169] [0169] Process 5100 also determines 5106 the complete retraction position of the displacement member of the 5202 position. The complete retraction position can correspond to the initial or proximal position 5206 of the displacement member 5202 in its firing stroke. Controller 1104 can determine the complete retract position by, for example, detecting the position of displacement member 5202 before displacement member 5202 is triggered or retrieving the value of the complete retraction position from memory 1106. The value of the complete retraction position can represent an absolute measurement of a distance from the first position 5206 or the second position 5208 of the firing stroke of the displacement member 5202 or a relative position in the firing stroke.
[0170] [0170] When process 5100, as performed by controller 1104, determines 5104 the limit position 5210 and determines the position of complete retraction, process 5100 below determines 5108 the position of the displacement member 5202 using, for example, a sensor position 1112. The position of the displacement member 5202 can be tracked over time through a trip stroke of the displacement member 5202 through a combination of inputs from, for example, a position sensor 1112 and a circuit timer / counter 2531. Then process 5100 displays 5110 the position of the knife according to the difference between the determined position of displacement member 5202 and limit position 5210. Controller 1104 can cause screen 1128 to display the position of the knife as a numerical value (represented in, for example, mm), a graphic representation of an animated knife moving between the minimum and maximum positions, and in other formats or combinations thereof.
[0171] [0171] Process 5100 determines 5112 whether the knife is retracting by, for example, detecting whether displacement member 5202 is moving in a distal (firing) direction or in a proximal (retraction) direction, if the knife itself (for example, knife bar 280) is moving in a distal (firing) or proximal (retracting) direction, the voltage polarity applied to the 1120 motor, the rotational direction of the rotary drive driven by the 1120 motor, and / or other parameters indicative of the state of the knife. If the knife is not retracting, then process 5100 continues along the NO branch and returns to determine 5108 again the position of displacement member 5202 and then displays 5110 an updated position of the knife according to the change in position of the member displacement 5202 relative to limit position 5210. The 5100 process thus continues this circuit of sequentially updating the shown position of the knife as the knife is advanced distally, until the knife begins to retract.
[0172] [0172] If the knife is retracting, then process 5100 continues along the YES branch and determines 5114 the position of displacement member 5202 as it is retracting. Process 5100 below determines 5116 if the detected position of displacement member 5202 has retracted beyond a second limit position 5212, shown in Figure 28B. In one aspect, the second 5212 limit position can be defined as being shifted from the second 5208 position by at least a distance equal to the difference between the 5210 limit position and the full retraction position or the 5206 first position. Since the process 5100 causes the shown knife position to start increasing from when the displacement member 5202 passes from the limit position 5210, if the 5100 process started to reduce the knife position shown immediately from when the displacement member 5202 retracted, the knife position shown could be indicated as zero or completely retracted when displacement member 5202 retracted to limit position 5210. This would be disadvantageous because then the knife would be shown as completely retracted before displacement member 5202 is actually completely retracted (i.e. , located in the first position 5206). In response to the surgical instrument 10 showing that the knife is fully retracted without the displacement member 5202 being correspondingly completely retracted, the operator of the surgical instrument can, for example, release the end actuator 2300 while the displacement member 5202 is located in a position distal to the locking position, potentially allowing the surgical instrument 10 to subsequently be triggered without the protection provided by the trigger lock system. Therefore, process 5100 determines 5116 whether displacement member 5202 has retracted beyond a second limit 5212 before starting to reduce the shown position of the knife to ensure that the position of the knife is shown only as completely retracted when the offset 5202 is completely retracted. Displaying the knife as being fully retracted only when the displacement member 1111 (for example, the longitudinally movable drive member 120) is completely retracted prevents doctors from prematurely releasing the surgical instrument 10 or otherwise causing the retraction of the limb of travel 1111 stops prematurely.
[0173] [0173] If displacement member 5202 is not retracted beyond the second limit position 5212, then process 5100 continues along branch NO and continues retraction 5118 and returns to determine 5114 the position of displacement member 5202 again and then again determines 5116 if the displacement member 5202 retracts beyond the second limit position 5212. Process 5100 thus continues this monitoring circuit of the position of the displacement member 5202 until it has retracted beyond the second limit position 5212.
[0174] [0174] If displacement member 5202 has retracted beyond the second limit position 5212, then process 5100 continues along the YES branch and displays 5120 the position of the knife according to the position of displacement member 5202. In one aspect, process 5100 updates the displayed knife position according to the detected absolute position of the displacement member 5202, the position of the displacement member 5202 in relation to the first position 5206, the position of the displacement member 5202 in relation to the second limit position 5212 , and so on. For example, in the line diagram shown in Figure 28B, the shown position of the knife can be reduced according to the position of the distal end 5204 of the displacement member 5202 in relation to the second limit position 5212, so that the position of the knife is shown as zero when the displacement member 5202 is completely retracted (i.e., the distance between the displacement member 5202 and the second limit 5212 is equal to the distance of the displacement member 5202 translated between the first limit position 5210 and the second position 5208 when fired ).
[0175] [0175] Process 5100 below determines 5122 if the knife is completely retracted, for example, by comparing the determined position 5114 of the displacement member 5202 with the complete retract position determined 5106 thereof. If the detected position of the displacement member 5202 is equal to the position of complete retraction, then the knife is completely retracted; otherwise, the knife is not completely retracted. If the knife is completely retracted, then process 5100 continues along the YES branch and the transection is completed 5128. When the transection is completed 5128, controller 1104 can, for example, cause screen 1128 to display instructions that indicate that the 2300 end actuator must be released. If the knife is not completely retracted, then process 5100 continues along the NO branch and then continues to retract 5124, again determines 5126 the position of displacement member 5202, and displays 5120 the position of the knife according to the updated position of the displacement member 5202. Process 5100 thus continues this circuit to update the shown knife position until displacement member 5202 is completely retracted.
[0176] [0176] Figures 30 to 33 illustrate the front views of a 5400 display screen or portion thereof with an animated graphical user interface showing the knife as it advances from a first position to a second position, according to a aspect of this description. The display of the 5402 graphic representation of the knife on the display screen 5400 in the sequence shown in Figure 30 to Figure 33 can be controlled, for example, using process 5000 and / or process 5100, as executed by controller 1104. As the knife is fired distally to transect the tissue, from Figure 30 to Figure 33, the length of the knife graph 5402 shown on the 5400 display screen increases accordingly. In other words, the length of the graphical representation 5402 can be proportional to the distance that the knife has advanced in relation to its maximum distance that it can advance. When the knife is retracted from an extended position, the length of the graphical representation 5402 of the knife shown on the display screen 5400 decreases accordingly (for example, in reverse order from Figure 33 to Figure 30). The numerical representation 5406 of the distance that the knife traveled can consequently also increase. Controller 1104 can calculate the numerical representation 5406 of the distance traveled by the knife (ie the knife cut line) by, for example, determining the distance that the longitudinally movable drive member 120 or the distance that the knife bar 280 moved. The 5400 display screen can also include a 5404 indicator to provide an additional visual indication to a doctor about the distance the knife has traveled. In several respects, the 5404 indicator may include a check mark, a line highlighting the front edge of the knife 5402 graphic representation and other similar visual cues.
[0177] [0177] Screen 5400 can also be controlled by controller 1104 to include a 5408 resistance graph that represents the resistance being encountered during the transection. The resistance encountered during the transection may correspond to the thickness of the tissue or the type of tissue through which the knife is advancing. The resistance found during the transection can be determined by means of several sensor arrangements, such as current sensor 2536 (Figure 14) that can be communicated to control circuit 2510 (Figure 14) to monitor the impedance of the motor 2504 ( Figure 14). Control circuit 2510 can be configured to vary the speed at which motor 2504 is driving displacement member 5202 according to the resistance detected.
[0178] [0178] The functions or processes of controlling a screen to display the knife position during a transection operation described herein can be performed by any of the processing circuits described here, such as the control circuit 700 described in relation to Figures 5A to 6, circuits 800, 810 and 820 described in Figures 7 to 9, controller 1104 described in relation to Figures 10 and 12 and / or control circuit 2510 described in Figure 14.
[0179] [0179] Aspects of the motorized surgical instrument can be practiced without the specific details described here. 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. An algorithm refers to a self-consistent sequence of steps that lead to the desired result, where a "step" refers to the manipulation of physical quantities that can take the form of electrical or magnetic signals that can be stored, transferred, combined, compared and handled in any other way. These signs can be called bits, values, elements, symbols, characters, terms, or numbers. These terms and similar terms can be associated with the appropriate physical quantities and are merely convenient identifications applied to these quantities.
[0180] [0180] In general, the aspects described here, which can be implemented, individually and / or collectively, by a wide range of hardware, software, firmware, or any combination thereof, can be seen as being composed of several types of "electrical circuits". Consequently, "electrical circuit" includes, but is not limited to, electrical circuits that have at least one separate electrical circuit, electrical circuits that have at least one integrated circuit, electrical circuits that have at least one integrated circuit for a specific application (ASIC) , electrical circuits that form a general-purpose computing device configured by a computer program (for example, a general-purpose computer or processor configured by a computer program that at least partially performs the processes and / or devices described herein), electrical circuits that form a memory device (for example, forms of random access memory), and / or electrical circuits that form a communications device (for example, a modem, routers or optical-electrical equipment). These aspects can be implemented in analog or digital form, or combinations thereof.
[0181] [0181] The previously mentioned description presented aspects of the devices and / or processes through the use of block diagrams, flowcharts and / or examples, which may contain one or more functions and / or operation. Each function and / or operation within such block diagrams, flowcharts or examples can be implemented, individually and / or collectively, by a wide range of hardware, software, firmware or virtually any combination thereof. In one aspect, several portions of the subject described here can be implemented using application-specific integrated circuits (ASICs), field programmable port arrangements (FPGAs), digital signal processors (DSPs), programmable logic devices (PLDs), circuits, registers and / or software components, for example, programs, subroutines, logic and / or combinations of hardware and software components, logic gates, or other integrated formats. Some aspects described here, in whole or in part, can be implemented in an equivalent way in integrated circuits, such as one or more computer programs running on one or more computers (for example, as one or more programs operating on one or more computer systems). computer), as one or more programs operating on one or more processors (for example, as one or more programs operating on one or more microprocessors), as firmware, or virtually as any combination thereof, and to design 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.
[0182] [0182] The mechanisms of the subject described can be distributed as a program product in a variety of ways, and an illustrative aspect of the subject described here is applicable regardless of the specific type of signal transmission media used to effectively perform the distribution. Examples of a media for carrying signals include the following: a recordable type media such as a floppy disk, a hard disk drive, a compact disc (CD), a digital video disc (DVD), a digital tape, a computer memory , etc., and transmission-type media such as digital and / or analog communication media (for example, a fiber optic cable, a waveguide, a wired communication link, a wireless communication link (for example , transmitter, receiver, transmission logic, reception logic.)).
[0183] [0183] The previously mentioned description of one or more aspects has been presented for purposes of illustration and description. This description is not intended to be exhaustive or to limit the invention to the precise form disclosed. Modifications or variations are possible in light of the above teachings. These aspects were chosen and described in order to illustrate the principles and practical application, thus allowing the person skilled in the art to use the various aspects and with various modifications, as they are convenient to the specific use contemplated. It is intended that the claims presented in the annex define the global scope.
[0184] [0184] Various aspects of the subject described in this document are defined in the following numbered examples:
[0185] [0185] Example 1. A surgical instrument comprising: a movable displacement member between a first position and a second position; a sensor configured to detect a position of the displacement member and provide a signal indicating it; a screen; and a control circuit coupled to the screen and the sensor, the control circuit being configured to: determine whether the displacement member is moving from the second position to the first position through the sensor; when the displacement member moves from the second position to the first position, determine whether the position of the displacement member is above a limit from the second position; and when the displacement member is located above the limit from the second position, make the screen display the position of the displacement member.
[0186] [0186] Example 2. The surgical instrument of Example 1, where the limit is a distance from the second position equal to a difference between a locking position and the first position, the locking position being located between the first position and the second position.
[0187] [0187] Example 3. The surgical instrument of Example 2, which further comprises an end actuator configured to receive a cartridge, the locking position corresponding to a position beyond which the displacement member cannot be moved unless a cartridge is present in the end actuator.
[0188] [0188] Example 4. The surgical instrument of one or more of Examples 1 to 3, which further comprises a knife coupled to the displacement member, the knife being driven between an un-fired position and a position triggered by the movement of the limb displacement between the first position and the second position.
[0189] [0189] Example 5. The surgical instrument of Example 4, in which the position of the displacement member corresponds to a position of the knife.
[0190] [0190] Example 6. The surgical instrument of one or more of Examples 1 to 5, wherein the first position corresponds to a proximal position of the displacement member and the second position corresponds to a distal position of the displacement member.
[0191] [0191] Example 7. The surgical instrument from one or more of Examples 1 to 6, in which the control circuit is further configured to: determine whether the displacement member is moving from the first position to the second position through the sensor; and when the displacement member moves from the first position to the second position, cause the screen to show a difference between the position of the displacement member and the limit.
[0192] [0192] Example 8. The surgical instrument from one or more of Examples 1 to 7, in which the control circuit is configured to cause the screen to display the position of the displacement member as a numerical value.
[0193] [0193] Example 9. A surgical instrument comprising: a movable displacement member through a first zone and a second zone defined between a first position and a second position; a sensor configured to detect a position of the displacement member and provide a signal indicating it; a screen; and a control circuit coupled to the screen and the sensor, the control circuit being configured to: determine whether the displacement member is moving from the second position to the first position through the sensor; when the displacement member moves from the second position to the first position, determine whether the position of the displacement member is located above a first zone; and when the displacement member is located in the first zone, make the screen display the position of the displacement member.
[0194] [0194] Example 10. The surgical instrument of Example 9, in which the first zone is defined between the first position and a limit from the second position and the second zone is defined between the limit from the second position and the second position .
[0195] [0195] Example 11. The surgical instrument of Example 10, where the limit is a distance from the second position equal to a difference between a locking position and the first position, the locking position being located between the first position and the second position.
[0196] [0196] Example 12. The surgical instrument of Example 11, which further comprises an end actuator configured to receive a cartridge, the locking position corresponding to a position beyond which the displacement member cannot be moved unless a cartridge is present in the end actuator.
[0197] [0197] Example 13. The surgical instrument of one or more of Examples 9 to 12, which further comprises a knife coupled to the displacement member, the knife being driven between an un-fired position and a position triggered by the movement of the limb displacement between the first position and the second position.
[0198] [0198] Example 14. The surgical instrument of Example 13, in which the position of the displacement member corresponds to a position of the knife.
[0199] [0199] Example 15. The surgical instrument of one or more of Examples 9 to 14, in which the first zone is located proximal to the second zone between the first position and the second position.
[0200] [0200] Example 16. The surgical instrument from one or more of Examples 9 to 15, in which the control circuit is further configured to: determine whether the displacement member is moving from the first position to the second position through the sensor; and when the displacement member moves from the first position to the second position, cause the screen to show a difference between the position of the displacement member and a limit.
[0201] [0201] Example 17. A surgical instrument comprising: a movable knife between an un-fired position and a fired position; a displacement member coupled to the knife, the displacement member being movable between a proximal position and a distal position for driving the knife between the non-triggered and the triggered position; a sensor configured to detect a position of the displacement member and provide a signal indicating it; a screen; and a control circuit coupled to the screen and the sensor, the control circuit being configured to: determine if the knife is retracting; monitor the position of the displacement member through the sensor; when the knife retracts, determine if the position of the displacement member is located proximal to a limit; and when the displacement member is located proximal to the limit, cause the screen to display a knife position according to the position of the displacement member.
[0202] [0202] Example 18. The surgical instrument of Example 17, where the limit is a distance from the distal position equal to a difference between a locking position and the proximal position, the locking position being located between the proximal and the distal position.
[0203] [0203] Example 19. The surgical instrument of Example 18, which further comprises an end actuator configured to receive a cartridge, the locking position corresponding to a position beyond which the displacement member cannot be moved unless a cartridge is present in the end actuator.
[0204] [0204] Example 20. The surgical instrument from one or more of Examples 17 to 19, in which the control circuit is further configured to: determine whether the knife is firing; and by firing the knife, make the screen display a difference between the position of the displacement member and the limit.

权利要求:
Claims (20)
[1]
1. Surgical instrument, characterized by comprising: a movable displacement member between a first position and a second position; a sensor configured to detect a position of the displacement member and provide a signal indicating it; a screen; and a control circuit coupled to the monitor and the sensor, the control circuit being configured to: determine whether the displacement member is moving from the second position to the first position through the sensor; when the displacement member moves from the second position to the first position, determine whether the position of the displacement member is above a limit from the second position; and when the displacement member is located above the limit from the second position, make the screen display the position of the displacement member.
[2]
2. Surgical instrument, according to claim 1, characterized in that the limit is a distance from the second position equal to a difference between a locking position and the first position, the locking position being located between the first position and the second position.
[3]
3. Surgical instrument according to claim 2, characterized in that it also comprises an end actuator configured to receive a cartridge, in which the locking position corresponds to a position beyond which the displacement member cannot be moved unless a cartridge is present in the end actuator.
[4]
4. Surgical instrument, according to claim 1, characterized in that it also comprises a knife coupled to the displacement member, in which the knife is driven between an unstressed position and a position triggered by the movement of the displacement member between the first position and the second position.
[5]
5. Surgical instrument according to claim 4, characterized in that the position of the displacement member corresponds to a position of the knife.
[6]
6. Surgical instrument according to claim 1, characterized in that the first position corresponds to a proximal position of the displacement member and the second position corresponds to a distal position of the displacement member.
[7]
7. Surgical instrument, according to claim 1, characterized in that the control circuit is further configured to: determine whether the displacement member is moving from the first position to the second position through the sensor; and when the displacement member moves from the first position to the second position, cause the screen to show a difference between the position of the displacement member and the limit.
[8]
8. Surgical instrument, according to claim 1, characterized in that the control circuit is configured to cause the screen to display the position of the displacement member as a numerical value.
[9]
9. Surgical instrument, characterized by comprising: a movable displacement member through a first zone and a second zone defined between a first position and a second position; a sensor configured to detect a position of the displacement member and provide a signal indicating it; a screen; and a control circuit coupled to the monitor and the sensor, where the control circuit is configured to: determine whether the displacement member is moving from the second position to the first position through the sensor; when the displacement member moves from the second position to the first position, determine whether the position of the displacement member is located in the first zone; and when the displacement member is located in the first zone, make the screen display the position of the displacement member.
[10]
Surgical instrument according to claim 9, characterized in that the first zone is defined between the first position and a limit from the second position and the second zone is defined between the limit from the second position and the second position.
[11]
11. Surgical instrument according to claim 10, characterized in that the limit is a distance from the second position equal to a difference between a locking position and the first position, the locking position being located between the first position and the second position.
[12]
Surgical instrument according to claim 11, characterized in that it also comprises an end actuator configured to receive a cartridge, in which the locking position corresponds to a position beyond which the displacement member cannot be moved unless a cartridge is present in the end actuator.
[13]
13. Surgical instrument, according to claim 9, characterized in that it further comprises a knife coupled to the displacement member, in which the knife is driven between an unstressed position and a position triggered by the movement of the displacement member between the first position and the second position.
[14]
Surgical instrument according to claim 13, characterized in that the position of the displacement member corresponds to a position of the knife.
[15]
15. Surgical instrument according to claim 9, characterized in that the first zone is located proximal to the second zone between the first position and the second position.
[16]
16. Surgical instrument, according to claim 9, characterized in that the control circuit is further configured to: determine whether the displacement member is moving from the first position to the second position through the sensor; and when the displacement member moves from the first position to the second position, cause the screen to show a difference between the position of the displacement member and the limit.
[17]
17. Surgical instrument, characterized by comprising: a movable knife between a non-fired position and a fired position; a displacement member coupled to the knife, the displacement member being movable between a proximal position and a distal position for driving the knife between the non-triggered and the triggered position; a sensor configured to detect a position of the displacement member and provide a signal indicating it; a screen; and a control circuit coupled to the monitor and the sensor, where the control circuit is configured to: determine whether the knife is retracting; determine the position of the displacement member through the sensor; when the knife retracts, determine if the position of the displacement member is located proximal to a limit; and when the displacement member is proximal to the limit, make the screen display a knife position according to the position of the displacement member.
[18]
18. Surgical instrument, according to claim 17, characterized in that the limit is a distance from the distal position equal to a difference between a locking position and the proximal position, the locking position being located between the proximal position and the distal position.
[19]
19. Surgical instrument according to claim 18, characterized in that it further comprises an end actuator configured to receive a cartridge, in which the locking position corresponds to a position beyond which the displacement member cannot be moved unless a cartridge is present in the end actuator.
[20]
20. Surgical instrument, according to claim 17, characterized in that the control circuit is configured to: determine whether the knife is retracting; and and by firing the knife, make the screen display a difference between the position of the displacement member and the limit.

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同族专利:

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公开号 | 公开日

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EP3501416A1|2019-06-26|

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CN111511294A|2020-08-07|

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WO2019123175A1|2019-06-27|

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US11076853B2|2021-08-03|

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US20190192144A1|2019-06-27|

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JP2021506488A|2021-02-22|

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法律状态:
2021-12-07| B350| Update of information on the portal [chapter 15.35 patent gazette]|

优先权:

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申请号 | 申请日 | 专利标题

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US15/849,785|2017-12-21|

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PCT/IB2018/060116|WO2019123175A1|2017-12-21|2018-12-14|Systems and methods of displaying a knife position during transection for a surgical instrument|

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