detection provisions for robot-assisted surgical platforms

专利摘要:
Various surgical systems are revealed. A surgical system comprises a robotic system. The robotic system comprises a control unit; a robotic arm comprising an attachment portion; a first detection system in signal communication with the control unit; and a second detection system. The first detection system is configured to detect a position of the fixation portion. A surgical tool is removably attached to said fixation portion. The second detection system is independent of the first detection system and is configured to detect a position of the surgical tool.
公开号:BR112020012672A2
申请号:R112020012672-1
申请日:2018-09-26
公开日:2020-12-01
发明作者:Frederick E. Shelton Iv；Jerome R. Morgan；Jason L. Harris；David C. Yates
申请人:Ethicon Llc；
IPC主号:

专利说明:

[001] [001] This application claims priority benefit under 35 U.S.C. $ 119 (e) for US provisional patent application No. 62 / 649,323, entitled SENSING. ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PATFORMS, filed on March 28, 2018, the disclosure of which is hereby incorporated by reference in its entirety.
[002] [002] The present application claims priority under 35 US $ 119 (e) to provisional patent application US serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, to the provisional patent application US serial number 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on December 28, 2017, and provisional patent application US serial number 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28 of 2017, which are, each of which are incorporated herein by reference, in their entirety. BACKGROUND
[003] [003] The present disclosure relates to robotic surgical systems. Robotic surgical systems may include a central control unit, a surgeon's control console and a robot with one or more robotic arms. Robotic surgical tools can be releasably mounted on the robotic arm (s). The number and type of robotic surgical tools may depend on the type of surgical procedure. Robotic surgical systems can be used in connection with one or more screens and / or one or more hand-held surgical instruments during a surgical procedure. SUMMARY
[004] [004] In a general aspect, a surgical system is provided. The surgical system comprises a robotic system. The robotic system comprises a control unit; a robotic arm comprising a fixation portion; a first detection system in signal communication with the control unit; and a second detection system. The first detection system is configured to detect a position of the fixation portion. The surgical system additionally comprises a surgical tool removably attached to the fixation portion. The second detection system is independent of the first detection system and is configured to detect a position of the surgical tool.
[005] [005] In another general aspect, another surgical system is provided. The surgical system comprises a robotic system. The robotic system comprises a control unit; a robotic arm comprising a first portion, a second portion and an articulation between the first and second portions; a first detection system configured to detect a position of the first and second portions of the robotic arm; and a redundant detection system. The redundant detection system is configured to detect a position of the first portion and the second portion of the robotic arm.
[006] [006] In yet another general aspect, another surgical system is provided. The surgical system comprises a surgical robot comprising: a control unit and a robotic arm. The robotic arm comprises an engine. The surgical system additionally comprises a surgical tool removably attached to the robotic arm; a first detection system in signal communication with the control unit; and a second detection system. The first detection system comprises a torque sensor on the motor and is configured to detect a position of the surgical tool. The second detection system is configured to independently detect a position of the surgical tool. BRIEF DESCRIPTION OF THE FIGURES
[007] [007] The features of various aspects are presented with particularity in the attached claims. The various aspects, however, with regard to both the organization and the methods of operation, together with objects and additional advantages of the same, can be better understood in reference to the description presented below, considered together with the drawings in attached, as follows.
[008] [008] Figure 1 is a block diagram of an interactive surgical system implemented by computer, according to at least one aspect of the present disclosure.
[009] [009] Figure 2 is a surgical system being used to perform a surgical procedure in an operating room, according to at least one aspect of the present disclosure.
[0010] [0010] Figure 3 illustrates a central surgical controller paired with a visualization system, a robotic system and an intelligent instrument, according to at least one aspect of the present disclosure.
[0011] [0011] Figure 4 is a partial perspective view of a central surgical controller compartment, and of a combined generator module received slidingly in a central surgical controller compartment, according to at least one aspect of the present disclosure. .
[0012] [0012] Figure 5 is a perspective view of a generator module in combination with bipolar, ultrasonic and monopolar contacts and a smoke evacuation component, in accordance with at least one aspect of the present disclosure.
[0013] [0013] Figure 6 illustrates different power bus connectors for a plurality of side coupling ports in a side modular cabinet configured to receive a plurality of
[0014] [0014] Figure 7 illustrates a vertical modular housing configured to receive a plurality of modules, according to at least one aspect of the present disclosure.
[0015] [0015] Figure 8 illustrates a surgical data network that comprises a central modular communication controller configured to connect modular devices located in one or more operating rooms of a healthcare facility, or in any facility environment. of health services specially equipped for surgical operations, to the cloud, according to at least one aspect of the present disclosure.
[0016] [0016] Figure 9 illustrates an interactive surgical system implemented by computer, according to at least one aspect of the present disclosure.
[0017] [0017] Figure 10 illustrates a central surgical controller that comprises a plurality of modules coupled to the modular control tower, according to at least one aspect of the present disclosure.
[0018] [0018] Figure 11 illustrates an aspect of a universal serial bus (USB) central controller device, in accordance with at least one aspect of the present disclosure.
[0019] [0019] Figure 12 illustrates a logical diagram of a control system for an instrument or surgical tool, according to at least one aspect of the present disclosure.
[0020] [0020] Figure 13 illustrates a control circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present disclosure.
[0021] [0021] Figure 14 illustrates a combinational logic circuit configured to control aspects of the surgical instrument or tool
[0022] [0022] Figure 15 illustrates a sequential logic circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present disclosure.
[0023] [0023] Figure 16 illustrates an instrument or surgical tool that comprises a plurality of motors that can be activated to perform various functions, according to at least one aspect of the present disclosure.
[0024] [0024] Figure 17 is a schematic diagram of a robotic surgical instrument configured to operate a surgical tool described here, in accordance with at least one aspect of the present disclosure.
[0025] [0025] Figure 18 illustrates a block diagram of a surgical instrument programmed to control the distal translation of the displacement member, according to an aspect of the present disclosure.
[0026] [0026] Figure 19 is a schematic diagram of a surgical instrument configured to control various functions, according to at least one aspect of the present disclosure.
[0027] [0027] Figure 20 is a simplified block diagram of a generator configured to provide tuning without an inductor, among other benefits, according to at least one aspect of the present disclosure.
[0028] [0028] Figure 21 illustrates an example of a generator, which is a form of the generator of Figure 20, according to at least one aspect of the present disclosure.
[0029] [0029] Figure 22 is a schematic diagram of a robotic surgical system, according to an aspect of the present disclosure.
[0030] [0030] Figure 23 is a perspective view of a robotic arm of a robotic surgical system and illustrates schematically with
[0031] [0031] Figure 24 is a perspective view of a robotic arm of a robotic surgical system, and additionally shows an operator manually adjusting the position of the robotic arm, in accordance with an aspect of the present disclosure.
[0032] [0032] Figure 25 is a graph of force plotted as a function of time for the robotic arm of Figure 24 in a passive energy assistance mode, according to one aspect of the present disclosure.
[0033] [0033] Figure 26 is a perspective view of a robotic arm and a secondary interactive screen within a sterile field, according to at least one aspect of the present disclosure.
[0034] [0034] Figure 27 is a graph of force plotted as a function of time for the robotic arm of Figure 26, according to one aspect of the present disclosure.
[0035] [0035] Figure 28 is a perspective view of a robotic arm and a central robotic controller of a robotic surgical system, in accordance with at least one aspect of the present disclosure.
[0036] [0036] Figure 29 is a detail view of a linear stapler end actuator attached to the robotic arm of Figure 28, representing the end actuator positioned in relation to a target tissue region during a surgical procedure, according to at least one aspect of the present disclosure.
[0037] [0037] Figure 30 is a distance and "force-to-close" graph plotted against time for the linear stapler in Figure 29, according to one aspect of the present disclosure.
[0038] [0038] Figure 31 is a schematic diagram representing a robotic surgical system that has a plurality of detection systems, according to one aspect of the present disclosure.
[0039] [0039] Figure 31A is a detailed view of a trocar in Figure 31, according to at least one aspect of the present disclosure.
[0040] [0040] Figure 32 is a flow chart representing a robotic surgical system that uses a plurality of independent detection systems, according to one aspect of the present disclosure.
[0041] [0041] Figure 33 is a timeline that represents the situational recognition of a central surgical controller, according to one aspect of the present disclosure. DETAILED DESCRIPTION
[0042] [0042] The applicant for this application holds the following provisional US patent applications, filed on March 28, 2018, which are each incorporated herein by reference in their entirety:
[0043] [0043] and US provisional patent application serial number 62 / 649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;
[0044] [0044] and US Provisional Patent Application Serial No. 62 / 649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD;
[0045] [0045] and US Provisional Patent Application Serial No. 62 / 649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS;
[0046] [0046] and US Provisional Patent Application Serial No. 62 / 649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER;
[0047] [0047] and US Provisional Patent Application Serial No. 62 / 649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;
[0048] [0048] and US provisional patent application serial number 62 / 649,291,
[0049] [0049] and US Provisional Patent Application Serial No. 62 / 649,296, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGI-CAL DEVICES;
[0050] [0050] and US Provisional Patent Application Serial No. 62 / 649,333, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATI- ON AND RECOMMENDATIONS TO A USER;
[0051] [0051] and US provisional patent application serial number 62 / 649,327, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES;
[0052] [0052] + Provisional patent application US serial number 62 / 649,315, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK;
[0053] [0053] and US Provisional Patent Application Serial No. 62 / 649,313, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;
[0054] [0054] and US Provisional Patent Application Serial No. 62 / 649,320, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGI-CAL PLATFORMS;
[0055] [0055] and US Provisional Patent Application Serial No. 62 / 649,307, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and
[0056] [0056] and US Provisional Patent Application Serial No. 62 / 649,323, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.
[0057] [0057] The applicant for this application holds the following US patent applications, filed on March 29, 2018, which are each incorporated herein by reference in their entirety:
[0058] [0058] and US patent application serial number, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION —CAPABILITIES; Attorney document number END8499USNP / 170766;
[0059] [0059] and US patent application serial number, entitled
[0060] [0060] and US patent application serial number, entitled SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES; Attorney document number END8499USNP2 / 170766-2;
[0061] [0061] and US patent application serial number, entitled SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS; Attorney document number END8499USNP3 / 170766-3;
[0062] [0062] and US patent application serial number, entitled COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS; Attorney document number END8499USNP4 / 170766-4;
[0063] [0063] and US patent application serial number, entitled SURGICAL HUB CONTROL ARRANGEMENTS; Attorney document number END8499USNP5 / 170766-5;
[0064] [0064] and US patent application serial number, entitled
[0065] [0065] and US patent application serial number, entitled COMMUNICATION HUB AND STORAGE DEVICE FOR STO-
[0066] [0066] and US patent application serial number, entitled SELF DESCRIBING DATA PACKETS GENERATED AT AN | IS-SUING INSTRUMENT; Attorney document number END8500USNP2 / 170767-2;
[0067] [0067] and US patent application serial number, entitled DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME; Attorney document number END8500USNP3 / 170767-3;
[0068] [0068] and US patent application serial number, entitled SURGICAL HUB SITUATIONAL AWARENESS; Attorney document number END8501USNP / 170768;
[0069] [0069] and US patent application serial number, entitled SURGICAL SYSTEM DISTRIBUTED PROCESSING; Attorney document number END8501USNP1 / 170768-1;
[0070] [0070] and US patent application serial number, entitled AGGREGATION AND REPORTING OF SURGICAL HUB DATA; Attorney document number END8501USNP2 / 170768-2;
[0071] [0071] and US patent application serial number, entitled
[0072] [0072] and US patent application serial number, entitled DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE; Attorney document number END8502USNP1 / 170769-1;
[0073] [0073] and US patent application serial number, entitled STERILE FIELD INTERACTIVE CONTROL DISPLAYS; Attorney document number END8502USNP2 / 170769-2;
[0074] [0074] and US patent application serial number, entitled
[0075] [0075] and US patent application serial number, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; Attorney document number END8504USNP / 170771;
[0076] [0076] and US patent application serial number, entitled “CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY; Attorney document number END8504USNP1 / 170771-1; and
[0077] [0077] and US patent application serial number, entitled DUAL CMOS ARRAY IMAGING; Attorney document number END8504USNP2 / 170771-2.
[0078] [0078] The applicant for this application holds the following US patent applications, filed on March 29, 2018, which are each incorporated herein by reference in their entirety:
[0079] [0079] + US patent application serial number, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES; Attorney document number END8506USNP / 170773;
[0080] [0080] and US patent application serial number, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS; Attorney document number END8506USNP1 / 170773-1;
[0081] [0081] + US patent application serial number, entitled- CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER; Attorney document number END8507USNP / 170774;
[0082] [0082] and US patent application serial number, entitled CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHA-
[0083] [0083] and US patent application serial number, entitled CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION; Attorney document number END8507USNP2 / 170774-2;
[0084] [0084] and US patent application serial number, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AU-THENTICATION TRENDS AND REACTIVE MEASURES; Attorney document number END8508USNP / 170775;
[0085] [0085] and US patent application serial number, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; Attorney document number END8509USNP / 170776; and
[0086] [0086] and US patent application serial number, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES; Attorney document number END8510USNP / 170777.
[0087] [0087] The applicant for this application holds the following US patent applications, filed on March 29, 2018, which are each incorporated herein by reference in their entirety:
[0088] [0088] and US patent application serial number, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLAT-FORMS; Attorney document number END8511USNP / 170778;
[0089] [0089] and US patent application serial number, entitled COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL —PLATFORMS; Attorney document number END8511USNP1 / 170778-1;
[0090] [0090] and US patent application serial number, entitled CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; Attorney document number END8511USNP2 / 170778-2;
[0091] [0091] and US patent application serial number, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGI-CAL PLATFORMS; Attorney document number END8512USNP / 170779;
[0092] [0092] and US patent application serial number, entitled CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; Attorney document number END8512USNP1 / 170779-1;
[0093] [0093] and US patent application serial number, entitled COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL —PLATFORMS; Attorney document number END8512USNP2 / 170779-2; and
[0094] [0094] and US patent application serial number, entitled DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; Attorney document number END8512USNP3 / 170779-3.
[0095] [0095] Before explaining in detail the various aspects of surgical instruments and generators, it should be noted that the illustrative examples are not limited, in terms of application or use, to the details of construction and arrangement of parts illustrated in the descriptions in the attached description. The illustrative examples can be implemented or incorporated in 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 disclosure were chosen for the purpose of describing illustrative examples 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
[0096] [0096] Referring to Figure 1, a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (for example, cloud 104 which may include a remote server 113 coupled to a device storage 105). Each surgical system 102 includes at least one central surgical controller 106 in communication with the cloud 104 which can include a remote server 113. In one example, as illustrated in Figure 1, surgical system 102 includes a display system 108, a robotic system 110, an intelligent handheld surgical instrument 112, which is configured to communicate with each other and / or with the central controller 106. In some respects, a surgical system 102 may include an M number of controlled - central surgical devices 106, an N number of visualization systems 108, an O number of robotic systems 110, and a P number of smart handheld surgical instruments 112, where M, NO and P are integers greater than or equal to 1.
[0097] [0097] Figure 3 represents an example of a surgical system 102 being used to perform a surgical procedure on a patient who is lying on an operating table 114 in a surgical operating room 116. A robotic system 110 is used in surgical procedure as a part of the surgical system 102. The robotic system 110 includes a surgeon console 118, a patient car 120 (surgical robot), and a robotic central surgical controller
[0098] [0098] Other types of robotic systems can be readily adapted for use with the surgical system 102. Various examples of robotic systems and surgical instruments that are suitable for use with the present disclosure are described in provisional patent application no. 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28, 2017, the disclosure of which is incorporated herein by reference in its entirety.
[0099] [0099] Several examples of cloud-based analysis that are performed by the cloud 104, and are suitable for use with the present disclosure, are described in US provisional patent application serial number 62 / 611.340, entitled CLOUD-BASED MEDICAL ANALYTICS, deposited on December 28, 2017, the disclosure of which is incorporated herein by reference, in its entirety.
[00100] [00100] In several aspects, the imaging device 124 includes at least one Image sensor and one or more optical components. Suitable image sensors include, but are not limited to, load-coupled device (CCD) sensors and complementary metal oxide semiconductor (CMOS) sensors.
[00101] [00101] The optical components of the imaging device 124 may include one or more light sources and / or one or more lenses. One or more light sources can be targeted to illuminate portions of the surgical field. The one or more image sensors can receive reflected or refracted light from the surgical field, including reflected or refracted light from the tissue and / or surgical instruments.
[00102] [00102] One or more light sources can be configured
[00103] [00103] The invisible spectrum (that is, the non-luminous spectrum) is that portion of the electromagnetic spectrum located below and above the visible spectrum (that is, wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths greater than about 750 nm are longer than the visible red spectrum, and they become invisible infrared (IR), microwave, radio and electromagnetic radiation. Wavelengths shorter than about 380 nm are shorter than the ultraviolet spectrum, and they become invisible ultraviolet, x-ray, and gamma-ray electromagnetic radiation.
[00104] [00104] In several aspects, the imaging device 124 is configured for use in a minimally invasive procedure. Examples of imaging devices suitable for use with the present disclosure include, but are not limited to, an arthroscope, angioscope, bronchoscope, choledocoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagus-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngoscope neproscope, sigmoidoscope, thoracoscope, and ureteroscope.
[00105] [00105] In one aspect, the imaging device employs multiple spectrum monitoring to discriminate topography and underlying structures. A multispectral image is one that captures image data within wavelength bands over
[00106] [00106] It is axiomatic that strict sterilization of the operating room and surgical equipment is necessary during any surgery. The strict hygiene and sterilization conditions required in an "operating room", that is, an operating or treatment room, justify the highest possible sterilization of all medical devices and equipment. Part of this sterilization process is the need to sterilize anything that comes into contact with the patient or enters the sterile field, including imaging device 124 and its connectors and components. It will be understood that the sterile field can be considered a specified area, such as inside a tray or on a sterile towel, which is considered free of microorganisms, or the sterile field can be considered an area, immediately around a patient, who was prepared to perform a surgical procedure. The sterile field may include sterilized team members, who are properly dressed, and all furniture and accessories in the area.
[00107] [00107] In several aspects, the visualization system 108 includes one or more imaging sensors, one or more image processing units, one or more storage arrays and one or more screens that are strategically arranged in relation to the field sterile, as shown in Figure 2. In one aspect, the visualization system 108 includes an interface for HL7, PACS and RME. Various components of the 108 visualization system are described under the heading "Advanced Imaging Acquisition Module" in US provisional patent application serial number 62 / 611.341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, whose disclosure it is hereby incorporated by reference in its entirety.
[00108] [00108] As shown in Figure 2, a main screen 119 is positioned in the sterile field to be visible to the operator on the operating table 114. In addition, a viewing tower 111 is positioned outside the sterile field. The display tower 111 includes a first non-sterile screen 107 and a second non-sterile screen 109, which are opposite each other. The visualization system 108, guided by the central controller 106, is configured to use screens 107, 109, and 119 to coordinate the flow of information to operators inside and outside the sterile field. For example, central controller 106 can have visualization system 108 display a snapshot of a surgical site, as recorded by an imaging device 124, on a non-sterile screen 107 or 109, while transmitting to the live from the surgical site on the main screen 119. The instant on the non-sterile screen 107 or 109 can allow a non-sterile operator to perform a diagnostic step relevant to the surgical procedure, for example.
[00109] [00109] In one aspect, the central controller 106 is also configured to route an input or diagnostic feedback by a non-sterile operator in the display tower 111 to the main screen 119 within the sterile field, where the input or feedback is can be seen by a sterile operator on the operating table. In one example, the entry can be in the form of a modification of the instant displayed on the non-sterile screen 107 or 109, which can be routed to the main screen 119 by the central controller 106.
[00110] [00110] With reference to Figure 2, a surgical instrument 112 is being used in the surgical procedure as part of the surgical system 102. The central controller 106 is also configured to coordinate the flow of information to a screen of the surgical instrument 112. For For example, in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, deposited on December 28, 2017, the disclosure of which is hereby incorporated by reference in its entirety for reference. An entry or diagnostic feedback inserted by a non-sterile operator in the viewing tower 111 can be routed by the central controller 106 to the screen of the surgical instrument 115 in the sterile field, where it can be seen by the operator of the surgical instrument 112. Exemplary surgical instruments that are suitable for use with surgical system 102 are described under the title "Surgical Instrument Hardware" and in the provisional patent application serial number 62 / 611.341, entitled INTE-RACTIVE SURGICAL PLATFORM, filed on December 28, 2017, whose disclosure is hereby incorporated by reference in its entirety, for example.
[00111] [00111] - Now with reference to Figure 3, a central controller 106 is shown in communication with a visualization system 108, a robotic system 110 and a smart handheld surgical instrument 112. The central controller 106 includes a controller screen central 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132 and an ar-
[00112] [00112] During a surgical procedure, the application of energy to the tissue, for sealing and / or cutting, is generally associated with the evacuation of smoke, suction of excess fluid and / or irrigation of the tissue. Fluid, power, and / or data lines from different sources are often intertwined during the surgical procedure. Valuable time can be wasted in addressing this issue during a surgical procedure. To untangle the lines, it may be necessary to disconnect the lines from their respective modules, which may require a restart of the modules. The modular compartment of the central controller 136 offers a unified environment to manage the power, data and fluid lines, which reduces the frequency of interlacing between such lines.
[00113] [00113] Aspects of the present disclosure feature a central surgical controller for use in a surgical procedure that involves applying energy to the tissue at a surgical site. The central surgical controller includes a central controller compartment and a combined generator module received slidingly at a central controller compartment docking station. The docking station includes data and power contacts. The combined generator module includes two or more of an ultrasonic energy generating component, a bipolar RF energy generating component, and a monopolar RF energy generating component which are housed in a single unit. In one aspect, the combined generator module also includes a smoke evacuation component, at least one power application cable to connect the combined generator module to a surgical instrument, at least one smoke evacuation component. configured to evacuate smoke
[00114] [00114] In one aspect, the fluid line is a first fluid line and a second fluid line extends from the remote surgical site to a suction and irrigation module received slidingly into the central controller compartment. In one aspect, the central controller compartment comprises a fluid interface.
[00115] [00115] Certain surgical procedures may require the application of more than one type of energy to the tissue. One type of energy may be more beneficial for cutting the fabric, while another type of energy may be more beneficial for sealing the fabric. For example, a bipolar generator can be used to seal the tissue while an ultrasonic generator can be used to cut the sealed tissue. Aspects of the present disclosure present a solution in which a modular compartment of central controller 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the modular compartment of the central controller 136 is that it allows quick removal and / or replacement of several modules.
[00116] [00116] Aspects of the present disclosure feature a modular surgical compartment for use in a surgical procedure that involves applying energy to the tissue. The modular surgical compartment includes a first energy generator module, configured to generate a first energy for application to the tissue, and a first docking station that comprises a first coupling port that includes first data contacts and energy contacts , and the first energy generator module is slidingly movable in an electrical coupling with the power and
[00117] [00117] In addition to the above, the modular compartment also includes a second energy generator module configured to generate a second energy, different from the first energy, for application to the fabric, and a second docking station comprising a second docking port that includes second power and data contacts, the second power generating module being slidably movable in an electrical coupling with the power and data contacts, and the second power generating module being movable sliding out of the electrical coupling with the second power and data contacts.
[00118] [00118] In addition, the modular surgical compartment also includes a communication bus between the first coupling port and the second coupling port, configured to facilitate communication between the first power generator module and the second generator module power.
[00119] [00119] With reference to Figures 3 to 7, aspects of the present disclosure are presented for a modular compartment of the central controller 136 that allows the modular integration of a generator module 140, a smoke evacuation module 126 and a suction module / irrigation 128. The modular compartment of central controller 136 further facilitates interactive communication between modules 140, 126,
[00120] [00120] In one aspect, the modular compartment of central controller 136 comprises a rear communication and modular power board 149 with external and wireless communication heads to allow the removable connection of modules 140, 126, 128 and the communication interactive communication between them.
[00121] [00121] In one aspect, the modular compartment of central controller 136 includes docking stations, or drawers, 151, here also called drawers, which are configured to slide modules 140, 126, 128 in a sliding manner. Figure 4 illustrates a partial perspective view of a central surgical controller compartment 136, and a combined generator module 145 slidably received at a docking station 151 of the central surgical controller compartment 136. A docking port 152 with contacts power and data on a rear side of the combined generator module 145 is configured to engage a corresponding docking port 150 with the power and data contacts of a corresponding docking station 151 in the controller modular compartment center 136 as the combined generator module 145 is slid into position in the corresponding docking station 151 of the modular controller compartment c entral system 136. In one aspect, the combined generator module 145 includes a bipolar, ultrasonic and
[00122] [00122] In several respects, the smoke evacuation module 126 includes a fluid line 154 that transports fluid captured / collected smoke away from a surgical site and to, for example, the smoke evacuation module 126. The vacuum suction that originates from the smoke evacuation module 126 can pull the smoke into an opening of a utility conduit at the surgical site. The utility conduit, coupled to the fluid line, can be in the form of a flexible tube that ends in the smoke evacuation module 126. The utility conduit and the fluid line define a fluid path that extends across towards the smoke evacuation module 126 which is received in the central controller compartment 136.
[00123] [00123] In several aspects, the suction / irrigation module 128 is coupled to a surgical tool comprising a fluid suction line and a fluid suction line. In one example, the suction and suction fluid lines are in the form of flexible tubes that extend from the surgical site towards the suction / irrigation module 128. One or more drive systems can be configured to cause irrigation and suction of fluids to and from the surgical site.
[00124] [00124] In one aspect, the surgical tool includes a drive shaft that has an end actuator at a distal end thereof and at least an energy treatment associated with the end actuator, a suction tube, and a tube irrigation. The suction tube can have an inlet port at a distal end of it and the suction tube extends through the drive shaft. Similarly, an irrigation pipe can extend through the drive shaft and may have an entrance port close to the power application implement. The energy application implement is configured to apply ultrasonic and / or RF energy to the surgical site and is coupled to the generator module 140 by a cable that initially extends through the drive shaft.
[00125] [00125] The irrigation tube can be in fluid communication with a fluid source, and the suction tube can be in fluid communication with a vacuum source. The fluid source and / or the vacuum source can be housed in the suction / irrigation module 128. In one example, the fluid source and / or the vacuum source can be housed in the central controller compartment 136 separately from the suction / irrigation module 128. In such an example, a fluid interface can be configured to connect the suction / irrigation module 128 to the fluid source and / or the vacuum source.
[00126] [00126] In one aspect, modules 140, 126, 128 and / or their corresponding docking stations in the central compartment modular module 136 may include alignment features that are configured to align the docking ports of the modules in contact. gate with its counterparts in the docking stations of the central compartment modular compartment 136. For example, as shown in Figure 4, the combined generator module 145 includes side supports 155 that are configured to slide the lugs together - corresponding ports 156 of the corresponding docking station 151 of the central controller modular compartment 136. The brackets cooperate to guide the coupling port contacts of the combined generator module 145 in an electrical coupling with the contacts of the modular controller compartment coupling port central 136.
[00127] [00127] In some respects, the drawers 151 of the modular compartment of the central controller 136 are the same, or substantially the same size, and the modules are adjusted in size to be received in the drawers 151. For example, the side supports 155 and / or 156 can be larger or smaller depending on the size of the module. In other respects, drawers 151 are different in size and are each designed to accommodate a specific module.
[00128] [00128] In addition, the contacts of a specific module can be switched to engage with the contacts of a specific drawer to avoid inserting a module in a drawer with contact misalignment.
[00129] [00129] As shown in Figure 4, the docking port 150 of one drawer 151 can be coupled to the docking port 150 of another drawer 151 via a communication link 157 to facilitate interactive communication between the modules housed in the modular compartment of the central controller 136. The coupling ports 150 of the modular compartment of the central controller 136 can, alternatively or additionally, facilitate interactive wireless communication between the modules housed in the modular compartment of the central controller 136. Any suitable wireless communication can be used, such as Air Titan Bluetooth.
[00130] [00130] Figure 6 illustrates individual power bus connectors for a plurality of side coupling ports of a lateral modular cabinet 160 configured to receive a plurality of modules from a central surgical controller 206. The lateral modular compartment 160 is configured to receive and later interconnect modules 161. Modules 161 are slidably inserted into the docking stations 162 of side modular compartment 160, which includes a back plate for interconnecting modules 161. As shown in Figure 6, the modules 161 are arranged laterally in the side modular cabinet 160. Alternatively, modules 161 can be arranged vertically in a modular side cabinet.
[00131] [00131] Figure 7 illustrates a vertical modular cabinet 164 configured to receive a plurality of modules 165 from the central surgical controller 106. Modules 165 are slidably inserted into docking stations, or drawers, 167 of the modular cabinet vertical 164, which includes a rear panel for interconnecting modules 165. Although the drawers 167 of the vertical modular cabinet 164 are arranged vertically, in some cases, a vertical modular cabinet 164 may include drawers that are arranged laterally. In addition, modules 165 can interact with each other through the coupling ports of the vertical modular cabinet
[00132] [00132] In several respects, the imaging module 138 comprises an integrated video processor and a modular light source and is adapted for use with various imaging devices. In one aspect, the imaging device is comprised of a modular compartment that can be mounted with a light source module and a camera module. The compartment can be a disposable compartment. In at least one example, the disposable compartment is removably coupled to a reusable controller, a light source module, and a camera module. The light source module and / or the camera module can be chosen selectively depending on the type of surgical procedure. In one aspect, the camera module comprises a CCD sensor. In another aspect, the camera module comprises a CMOS sensor. In another aspect, the camera module is configured for imaging the scanned beam. Similarly, the light source module can be configured to provide a white light or a different light, depending on the surgical procedure.
[00133] [00133] During a surgical procedure, removing a surgical device from the surgical field and replacing it with another surgical device that includes a different camera or other light source may be inefficient. Temporarily losing sight of the surgical field can lead to undesirable consequences. The imaging device module of the present disclosure is configured to allow the replacement of a light source module or a "midstream" camera module during a surgical procedure, without the need to remove the imaging device from the surgical field.
[00134] [00134] In one aspect, the imaging device comprises a tubular compartment that includes a plurality of channels. A first channel is configured to receive the Camera module in a sliding way, which can be configured for a snap-fit fit (pressure fit) with the first channel. A second channel is configured to slide the camera module, which can be configured for a snap-fit fit (pressure fit) with the first channel. In another example, the camera module and / or the light source module can be rotated to an end position within their respective channels. A threaded coupling can be used instead of a pressure fitting.
[00135] [00135] In several examples, multiple imaging devices are placed in different positions in the surgical field to provide multiple views. Imaging module 138 can be configured to switch between imaging devices to provide an ideal view. In several respects, the imaging module 138 can be configured to integrate images from different imaging devices.
[00136] [00136] Various image processors and imaging devices
[00137] [00137] Figure 8 illustrates a surgical data network 201 comprising a central modular communication controller 203 configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a installation of public services specially equipped for surgical operations, to a cloud-based system (for example, cloud 204 which may include a remote server 213 coupled to a storage device 205). In one aspect, the modular central communication controller 203 comprises a central network controller 207 and / or a network key 209 in communication with a network router. The central modular communication controller 203 can also be coupled to a local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 can be configured as a passive, intelligent, or switching network. A passive surgical data network serves as a conduit for data, allowing data to be transmitted from one device (or segment) to another and to cloud computing resources. An intelligent surgical data network includes features to allow traffic to pass through the surgical data network to be monitored and to configure each port on the 207 central network controller or network key
[00138] [00138] Modular devices 1a to 1n located in the operating room can be coupled to the modular central communication controller 203. The central network controller 207 and / or the network key 209 can be coupled to a network router 211 to connect devices 1a to 1n to the cloud 204 or to the local computer system 210. The data associated with devices 1a to 1n can be transferred to cloud-based computers via the router for remote processing and manipulation of the data. The data associated with devices 1a to 1h can also be transferred to the local computer system 210 for processing and manipulation of local data. Modular devices 2a to 2m located in the same operating room can also be attached to a network switch 209. The network switch 209 can be attached to the central network controller 207 and / or to the network router 211 to connect the devices. 2a to 2m devices to the cloud
[00139] [00139] It will be understood that the surgical data network 201 can be expanded by interconnecting multiple central network controllers 207 and / or multiple network keys 209 with multiple network routers 211. The central communication controller 203 can be contained in a modular control tower configured to receive multiple devices 1a to 1n / 2a to 2m. The local computer system 210 can also be contained in a modular control tower. The modular central communication controller 203 is connected to a screen 212 to display the images obtained by some of the devices 1a to 1n / 2a to 2m, for example, during surgical procedures. In several respects, devices 1a to 1n / 2a to 2m may include, for example, various modules such as an imaging module 138 coupled to an endoscope, a generator module 140 coupled to an energy-based surgical device, an evacuation module smoke 126, a suction / irrigation module 128, a communication module 130, a processor module 132, a storage matrix 134, a surgical device attached to a screen and / or a contactless sensor module, among other modular devices that can be connected to the modular communication central controller 203 of the surgical data network 201.
[00140] [00140] In one aspect, the surgical data network 201 may comprise a combination of central network controllers, network switches and network routers that connect devices 1a to 1n / 2a to 2m to the cloud. Any or all devices 1a to 1n / 2a to 2m coupled to the central network controller or network key can collect data in real time and transfer data to cloud computers for data processing and manipulation. It will be understood that cloud computing depends on sharing computer resources
[00141] [00141] The application of cloud computer data processing techniques to data collected by devices 1a to 1n / 2a to 2m, the surgical data network provides better surgical results, reduced costs, and better patient satisfaction. At least some of the devices 1a to 1hn / 2a to 2m can be used to visualize the states of the tissue to assess the occurrence of leaks or perfusion of sealed tissue after a procedure of sealing and cutting the tissue. At least some of the devices 1a to 1n / 2a to 2m can be used to identify pathology, such as disease effects, with the use of cloud-based computing to examine data including images of body tissue samples for diagnostic purposes . This includes confirmation of the location and margin of the tissue and phenotypes. At least some of the devices 1a to 1n / 2a to 2m can be used to identify anatomical structures of the body using a variety of sensors integrated with imaging devices and techniques such as overlaying images captured by multiple imaging devices. Data collected by devices 1a to 1n / 2a to 2m, including image data, can be transferred to the cloud 204 or the local computer system 210 or both for data processing and manipulation including image processing and manipulation. The data can be analyzed to improve the results of the surgical procedure by determining whether additional treatment, such as application of endoscopic intervention, emerging technologies, targeted radiation, targeted intervention, precise robotics to specific tissue sites and conditions, can be followed. This data analysis can additionally use analytical processing of the results, and with the use of standardized approaches they can provide beneficial standardized feedback both to confirm surgical treatments and the surgeon's behavior or to suggest changes to surgical treatments and the behavior of the surgeon. surgeon.
[00142] [00142] In an implementation, devices in the operating room 1a to 1h can be connected to the central modular communication controller 203 via a wired channel or a wireless channel depending on the configuration of devices 1a to 1h on a controller central network. The central network controller 207 can be implemented, in one aspect, as a local network transmission device that acts on the physical layer of the OSI model ("open system interconnection", or interconnection of open systems). The central
[00143] [00143] In another implementation, operating room devices 2a to 2m can be connected to a network switch 209 through a wired or wireless channel. The network key 209 works in the data connection layer of the OSI model. Network switch 209 is a multicast device for connecting devices 2a to 2m located in the same operation center to the network. The network key 209 sends data in frames to the network router 211 and works in full duplex mode. Multiple devices 2a to 2m can send data at the same time via network key 209. Network key 209 stores and uses MAC addresses of devices 2a to 2m to transfer data.
[00144] [00144] The central network controller 207 and / or the network key 209 are coupled to the network router 211 for a connection to the number 204. The network router 211 works on the network layer of the OSI model. The network router 211 creates a route to transmit data packets received from the central network controller 207 and / or the network key 211 to a computer with cloud resources for future processing and manipulation of the data collected by any among or all of the devices 1a to 1n / 2a to 2m. The network router 211 can be used to connect two or more different networks located in different locations, such as different operating rooms in the same healthcare facility or different networks located in different operating rooms. operation of the different health service facilities. Network router 211 sends data in packet form to cloud 204 and works in full duplex mode. Multiple devices can send data at the same time. The network router 211 uses IP addresses to transfer data.
[00145] [00145] In one example, the central network controller 207 can be implemented as a central USB controller, which allows multiple USB devices to be connected to a host computer. The central USB controller can expand a single USB port on several levels so that more ports are available to connect the devices to the system's host computer. The central network controller 207 can include wired or wireless capabilities to receive information about a wired channel or a wireless channel. In one aspect, a wireless radio communication protocol for wireless, broadband and short-range wireless USB can be used for communication between devices 1a to Ine and devices 2a to 2m located in the operating room.
[00146] [00146] In other examples, devices in the operating room 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 via standard Bluetooth wireless technology for exchanging data over short distances ( with the use of short-wavelength UHF radio waves in the ISM band of 2.4 to 2.485 GHz) from fixed and mobile devices and build personal area networks (PANs). In other examples,
[00147] [00147] The modular communication central controller 203 can serve as a central connection for one or all devices in the operating room 1a to 1n / 2a to 2m and handles a data type known as frames. The tables carry the data generated by the devices 1a to 1n / 2a to 2m. When a frame is received by the modular communication central controller 203, it is amplified and transmitted to the network router 211, which transfers the data to the cloud computing resources using a series of standards or protocols wireless or wired communications, as described here.
[00148] [00148] The modular communication central controller 203 can be used as a standalone device or be connected to compatible central network controllers and network switches to form a larger network. The 203 modular communication central controller is, in general, easy to install, configure and maintain, which makes it a good option for network operations of devices 1a to 1n / 2a to 2m from the operating room.
[00149] [00149] Figure9 illustrates an interactive surgical system, implemented
[00150] [00150] Figure 10 illustrates a central surgical controller 206 which comprises a plurality of modules coupled to the modular control tower 236. The modular control tower 236 comprises a central modular communication controller 203, for example, a connectivity device network, and a computer system 210 to provide local processing, visualization and imaging, for example. As shown in Figure 10, the modular communication central controller 203 can be connected in a layered configuration to expand the number of modules (for example, devices) that can be connected to the modular communication central controller 203 and transfer to the computer system 210 data associated with modules, cloud computing resources, or both. As shown in Figure 10, each of the central controllers / network switches in the modular central communication controller 203 includes three downstream ports and an upstream port. The central controller / network switch upstream is connected to a processor to provide a communication connection with the cloud computing resources and a local display 217. Communication with the cloud 204 can be done via a communication channel wired or wireless.
[00151] [00151] The central surgical controller 206 employs a non-contact sensor module 242 to measure the dimensions of the operating room and generate a map of the operating room with the use of non-contact measuring devices of the laser or ultrasonic type. An ultrasound-based non-contact sensor module scans the operating room by transmitting a burst of ultrasound and receiving the echo when it bounces off the walls surrounding an operating room, as described under the heading "Surgical Hub Spatial Awareness Within an Operating Room" in US provisional patent application serial number 62 / 611,341, entitled INTE-RACTIVE SURGICAL PLATFORM, filed on December 28, 2017, which is incorporated herein by reference in its entirety, in which the sensor module is configured to determine the operating room size and adjust the Bluetooth pairing distance limits. A laser-based non-contact sensor module scans the operating room by transmitting pulses of laser light, receiving pulses of laser light that bounce from the perimeter walls of the operating room, and comparing the phase of the transmitted pulse to the received pulse. to determine the size of the operating room and to adjust the Bluetooth pairing distance limits, for example.
[00152] [00152] Computer system 210 comprises a processor 244 and a network interface 245. Processor 244 is coupled to a communication module 247, storage 248, memory 249, non-volatile memory 250, and an input / output interface 251 via a system bus. The system bus can be any of several types of bus structures, including the memory bus or memory controller, a peripheral bus or external bus, and / or a local bus that uses any variety of architectures. available, including, but not limited to, 9-bit bus, industry standard architecture (ISA), Micro-Charmel Architecture (MSA), extended ISA (EISA), smart drive electronics (IDE), VESA local bus ( VLB), Interconnection of peripheral components (PCI), USB, accelerated graphics port (AGP), PCMCIA bus (International Association of Memory Cards for Personal Computers, "Personal Computer Memory Card International Association" ), Systems interface for small computers
[00153] [00153] Processor 244 can be any single-core or multi-core processor, such as those known under the trade name ARM Cortex available from Texas Instruments. In one respect, the processor 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, up to 40 MHz, a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareO program, memory only programmable and electrically erasable readout (EEPROM) of 2 KB, one or more pulse width modulation (PWM) modules, one or more analogs of quadrature encoder (QEI) inputs, one or more analog converters for 12 bit digital (ADC) with 12 channels of analog input, details of which are available for the product data sheet.
[00154] [00154] In one aspect, processor 244 may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the tradename Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[00155] [00155] System memory includes volatile and non-volatile memory. The basic input / output system (BIOS), containing the basic routines for transferring information between elements within the computer system, such as during startup, is stored in non-volatile memory. For example, non-volatile memory can include
[00156] [00156] Computer system 210 also includes removable / non-removable, volatile / non-volatile computer storage media, such as, for example, disk storage. Disk storage includes, but is not limited to, devices such as a magnetic disk drive, floppy disk drive, tape drive, Jaz driver, Zip driver, LS-60 driver, flash memory card or memory stick ( pen drive). In addition, the storage disc may include storage media separately or in combination with other storage media including, but not limited to, an optical disc drive such as a compact disc ROM device ( CD-ROM) writeable compact disc drive (CD-R Drive), rewritable compact disc drive (CD-RW drive), or a versatile digital disk ROM drive (DVD-ROM). To facilitate the connection of disk storage devices to the system bus, a removable or non-removable interface can be used.
[00157] [00157] It must be considered that the computer system 210 includes software that acts as an intermediary between users and the basic computer resources described in an adequate operating environment. Such software includes an operating system. The operating system, which can be stored on disk storage, acts to control and allocate computer system resources. System applications benefit from the management capabilities of the operating system through program modules and “program data stored in system memory or on the storage disk. It must be considered that the various components described here can be implemented with various operating systems or combinations of operating systems.
[00158] [00158] “A user enters commands or information into the computer system 210 via the input device (s) coupled to the 1 / O 251. Interface devices include, but are not limited to, a pointing device such as a mouse, trackball, stylus, touchpad, keyboard, microphone, joystick, game pad, satellite card, scanner, TV tuner card, digital camera, digital video camera, web camera, and the like. These and other input devices connect to the processor via the system bus via the interface port (s). The interface ports include, for example, a serial port, a parallel port, a game port and a USB. Output devices use some of the same types of ports as input devices. In this way, for example, a USB port can be used to provide input to the computer system and to provide information from the computer system to an output device. An output adapter is provided to illustrate that there are some output devices such as monitors, screens, speakers, and printers, among other output devices, that need special adapters. The output adapters include, by way of illustration and not limitation, video and sound cards that provide a means of connection between the output device and the system bus. It should be noted that other devices and / or device systems, such as remote computers, provide input and output capabilities.
[00159] [00159] Computer system 210 can operate in a networked environment using logical connections to one or more remote computers, such as cloud computers, or local computers.
[00160] [00160] In several respects, the computer system 210 of Figure 33, the imaging module 238 and / or the display system 208, and / or the processor module 232 of Figures 9 and 10 can comprise a processor of image, an image processing engine, a media processor, or any specialized digital signal processor (PSD) used to process digital images. The image processor can employ parallel computing with multi-data instruction (SIMD) or multi-data instruction (MIMD) technologies to increase speed and efficiency. The digital image processing engine can perform a number of tasks. The image processor can be an integrated circuit system with a multi-core processor architecture.
[00161] [00161] Communication connections refer to the hardware / software used to connect the network interface to the bus. Although the communication connection is shown for illustrative clarity within the computer system, it can also be external to computer system 210. The hardware / software required for connection to the network interface includes, for illustrative purposes only, internal and external technologies such as modems, including regular telephone series modems, cable modems and DSL modems, ISDN adapters and Ethernet cards.
[00162] [00162] Figure 11 illustrates a functional block diagram of an aspect of a USB 300 central network controller device, in accordance with at least one aspect of the present disclosure. In the illustrated aspect, the USB 300 network central controller device uses a TUSB2036 integrated circuit central controller available from Texas Instruments. The central network controller USB 300 is a CMOS device that provides a USB transceiver port 302 and up to three USB transceiver ports downstream 304, 306, 308 in accordance with the USB 2.0 specification. The upstream USB transceiver port 302 is a differential data root port comprising a "less" differential data input (DMO) paired with a "more" differential data input (DPO). The three ports of the downstream USB transceiver 304, 306, 308 are differential data ports, with each port including "more" differential data outputs (DP1-DP3) paired with "less" differential data zones ( DM1-DM3).
[00163] [00163] The USB 300 central network controller device is implemented with a digital state machine instead of a micro controller, and no firmware programming is required. Fully compatible USB transceivers are integrated into the circuit for the upstream USB transceiver port 302 and all downstream USB transceiver ports 304, 306, 308. The downstream USB transceiver ports 304, 306, 308 support both full speed as low speed automatically configuring the scan rate according to the speed of the device attached to the doors. The USB 300 network central controller device can be configured in bus powered or self powered mode and includes 312 central controller power logic to manage power.
[00164] [00164] The USB 300 network central controller device includes a 310 serial interface engine (SIE). The SIE 310 is the front end of the USB 300 central network controller hardware and handles most of the protocol described in chapter 8 of the USB specification. SIE 310 typically comprises signaling down to the transaction level. The functions it handles could include: packet recognition, transaction sequencing, SOP, EOP, RESET, and RESUME signal detection / generation, clock / data separation, non-return data encoding / decoding zero inverted (NRZI), generation and verification of CRC (token and data), generation and verification / decoding of packet ID (PID) and / or series-parallel / parallel-series conversion. The SIE 310 receives a clock input 314 and is coupled to a suspend / resume logic circuit and frame timer 316 and a central controller repeat circuit 318 to control communication between the upstream USB transceiver port 302 and the downstream USB transceiver ports 304, 306, 308 via port logic circuits 320, 322, 324. The SIE 310 is coupled to a command decoder 326 via interface logic to control commands from a serial EEPROM memory via a 330 serial EEPROM interface.
[00165] [00165] In several aspects, the USB 300 central network controller can connect 127 functions configured in up to six layers (levels)
[00166] [00166] Figure 12 illustrates a logic diagram of a module of a 470 control system of an instrument or surgical tool, according to one or more aspects of the present disclosure. The 470 system comprises a control circuit. The control circuit includes a microcontroller 461 comprising a processor 462 and a memory 468. One or more of the sensors 472, 474, 476, for example, provide real-time feedback to the processor
[00167] [00167] In one aspect, the 461 microcontroller can be any single-core or multi-core processor, such as those known under the ARM Cortex trade name available from Texas Instruments. In one aspect, the 461 main microcontroller may be an LM4F230H5QR ARM Cortex-M4F processor core, available from Texas Instruments, for example comprising a 256 KB integrated single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to optimize performance above 40 MHz, a 32 KB single cycle static random access memory (SRAM), and a read-only memory (ROM) loaded with StellarisWareO software, a memory programmable, electrically erasable, 2K read-only (EEPROM), one or more pulse width modulation (PWM) modules, one or more analogs of quadrature encoder (QElI) inputs, and / or one or more converters 12-bit analog to digital (ADC) with 12 analog input channels, details of which are available for the product data sheet.
[00168] [00168] In one aspect, the 461 microcontroller may comprise a safety controller that comprises two families based on controllers, such as TMS570 and RM4x known under the co-name
[00169] [00169] The 461 microcontroller can be programmed to perform various functions, such as precise control of the speed and position of the cutting and articulation systems. In one aspect, the microcontroller 461 includes a processor 462 and a memory 468. The electric motor 482 can be a brushed direct current (DC) motor with a gearbox and mechanical connections with an articulation or bisuli system. In one aspect, a 492 motor drive can be an A3941 available from Allegro Microsystems, Inc. Other motor drives can be readily replaced for use in the 480 tracking system which comprises an absolute positioning system. A detailed description of an absolute positioning system is given in US patent application publication 2017/0296213, entitled SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STA- PLING AND CUTTING INSTRUMENT, published on October 19, 2017, which is incorporated herein as a reference in its entirety.
[00170] [00170] The 461 microcontroller can be programmed to provide precise control of the speed and position of the displacement members and articulation systems. The 461 microcontroller can be configured to compute a response in the 461 microcontroller software. The computed response is compared to a measured response from the real 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 average response.
[00171] [00171] In one aspect, the 482 motor can be controlled by the 492 motor driver and can be used by the instrument trigger system or surgical tool. In many ways, the 482 motor can be a brushed direct current (DC) drive motor, with a maximum speed of approximately 25,000 RPM, for example. In other arrangements, the 482 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 492 may comprise an H bridge starter comprising field effect transistors (FETs), for example. The 482 motor can be powered by a feed set releasably mounted on the handle set or tool compartment to provide control power for the instrument or surgical tool. The power pack may comprise a battery that may include several battery cells connected in series, which can be used as the power source to energize the instrument or surgical tool. In certain circumstances, the battery cells in the power pack may be replaceable and / or rechargeable. In at least one example, the battery cells can be lithium-ion batteries that can be coupled and separable from the power pack.
[00172] [00172] Motor drive 492 can be an A3941, available from Allegro Microsystems, Inc. The drive 492 A3941 is an entire bridge controller for use with semiconductor metal oxide field effect transistors (MOSFET ) of external power, N channel, specifically designed for inductive loads, such as brushed DC motors. The 492 actuator comprises a single charge pump regulator that provides complete door drive (> 10 V) for batteries with voltage up to 7 Ve and allows the A3941 to operate with a reduced door drive,
[00173] [00173] Tracking system 480 comprises a controlled motor drive circuit arrangement comprising a position sensor 472 in accordance with an aspect of the present disclosure. The position sensor 472 for an absolute positioning system provides a unique position signal that corresponds to the location of a displacement member. In one aspect, the displacement member represents a longitudinally movable drive member comprising a rack of drive teeth for engagement with a corresponding drive gear of a gear reduction assembly. In other respects, the displacement member represents the trigger member, which can be adapted and configured to include a rack of drive teeth. In yet another aspect, the displacement member represents the firing bar or beam with | profile,
[00174] [00174] The 482 electric motor may include a rotary drive shaft, which interfaces operationally with a gear set, which is mounted on a coupling coupling with a set or rack of drive teeth on the drive member. A sensor element can be operationally coupled to a gear assembly so that a single revolution of the position sensor element 472 corresponds to some linear longitudinal translation of the displacement member. 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 supplies power to the absolute positioning system and an output indicator can display the output from the absolute positioning system. The drive member represents the longitudinally movable drive member comprising a rack of drive teeth formed thereon for engagement with a corresponding drive gear of the gear reducer assembly. The displacement member represents the longitudinally movable firing member, the firing bar, the beam with a | profile, or combinations thereof.
[00175] [00175] A single revolution of the sensor element associated with the position sensor 472 is equivalent to a longitudinal linear displacement d1 of the displacement member, where d1 is the longitudinal linear distance by which the displacement member moves from point "a" to point "b" after a single revolution of the sensor element coupled to the displacement member. The sensor arrangement can be connected by means of a gear reduction which results in the position sensor 472 completing one or more revolutions for the complete travel of the displacement member. The 472 position sensor can complete multiple re-
[00176] [00176] A series of keys, where n is an integer greater than one, can be used alone or in combination with a gear reduction to provide a single position signal for more than one revolution of the 472 position sensor. of the switches is performed on microcontroller 461 that applies logic to determine a single position signal corresponding to the longitudinal linear displacement d1 + d2 + ... of the displacement member. The output of the position sensor 472 is supplied to the microcontroller 461. In several embodiments, the position sensor 472 of the sensor arrangement may comprise a magnetic sensor, an analog rotary sensor, such as a potentiometer, or a series of effect elements. Analog halls, which emit a unique combination of position of signals or values.
[00177] [00177] The position sensor 472 can comprise any number of magnetic detection elements, such as, for example, magnetic sensors classified according to whether they 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, SQUID, Hall effect, anisotropic magneto-resistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive compounds / piezoelectric, magnetodiode, magnetic transistor, optical fiber, magneto-optics and magnetic sensors based on microelectromechanical systems, among others.
[00178] [00178] In one aspect, the position sensor 472 for the tracking system 480 which comprises an absolute positioning system comprises an absolute rotating positioning system mag-
[00179] [00179] The tracking system 480 comprising an absolute positioning system can comprise and / or be programmed to implement a feedback controller, such as a PID, state feedback, and adaptive controller. A 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 sensors can be provided in order to measure the parameters of the physical system in addition to the position measured by the position sensor 472. In some respects, the other sensors may include sensor arrangements as described in US patent No. 9.345.481 entitled STAPLE CARTRIDGE TISSUE THI-CKNESS SENSOR SYSTEM, granted on May 24, 2016, which is incorporated by reference in its entirety in this document; US patent application serial number 2014/0263552, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, published on September 18, 2014, is incorporated by reference in its entirety into this document; and US patent application serial no. 15 / 628,175, entitled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, submitted on June 20, 2017, is incorporated by reference in its entirety into this document. In a digital signal processing system, an absolute positioning system is coupled with a digital data capture system where the output of the absolute positioning system will have a finite resolution and sampling frequency. The absolute positioning system can comprise a comparison and combination circuit to combine a computed response with a measured response through the use of algorithms, such as a weighted average and a theoretical control loop, that trigger the calculated response towards the measured response. The computed response of the physical system considers properties, such as mass, inertia, viscous friction, resistance to inductance, etc., to predict what the states and exits of the physical system will be, knowing the input.
[00180] [00180] The absolute positioning system provides an absolute positioning of the displaced member on the activation of the instrument without having to retract or advance the longitudinally movable drive member to the restart position (zero or initial), as may be required by conventional rotary encoders that merely count the number of progressive or regressive steps that the 482 motor has traversed to infer the position of a device actuator, actuation bar, scalpel, and the like.
[00181] [00181] A 474 sensor, such as a strain gauge or a micro strain gauge, is configured to measure one or more parameters of the end actuator, such as, for example, the amplitude of the strain exerted on the anvil during a gripping operation, which can be indicative of tissue compression. The measured effort is converted into a digital signal and fed to the 462 processor. Alternatively, or in addition to the 474 sensor, a 476 sensor, such as a load sensor, can measure the closing force applied by the drive system. anvil closure. The 476 sensor, such as a load sensor, can measure the firing force applied to a beam with a | in a course of firing the instrument or surgical tool. The beam with profile in | it is configured to engage a wedge slide, which is configured to move the clamp drivers upward to force the clamps to deform in contact with an anvil. The beam with profile in | includes a sharp cutting edge that can be used to separate fabric as the beam with a profile | it is advanced distally by the firing bar. Alternatively, a current sensor 478 can be used to measure the current drained by the 482 motor. The force required to advance the trigger member can correspond to the current drained by the 482 motor, for example. The measured force is converted into a digital signal and supplied to the 462 processor.
[00182] [00182] In one form, a 474 strain gauge sensor can be used to measure the force applied to the tissue by the end actuator. A strain gauge can be attached to the end actuator to measure the force applied to the tissue being treated by the end actuator. A system for measuring forces applied to the
[00183] [00183] Measurements of tissue compression, tissue thickness and / or force required to close the end actuator on the fabric, as measured by sensors 474, 476, respectively, can be used by microcontroller 461 to characterize the selected trigger member position and / or the corresponding trigger member speed value. In one case, a 468 memory can store a technique, an equation and / or a look-up table that can be used by the 461 microcontroller in the evaluation.
[00184] [00184] The control system 470 of the instrument or surgical tool can also comprise wired or wireless communication circuits for communication with the central modular communication controller shown in Figures 8 to 11.
[00185] [00185] Figure 13 illustrates a control circuit 500 configured to control aspects of the instrument or surgical tool according to an aspect of the present disclosure. The control circuit 500 can be configured to implement various processes described herein.
[00186] [00186] Figure 14 illustrates a combinational logic circuit 510 configured to control aspects of the instrument or surgical tool according to an aspect of the present disclosure. The combinational logic circuit 510 can be configured to implement the various processes described here. The combinational logic circuit 510 may comprise a finite state machine comprising a combinational logic 512 configured to receive data associated with the instrument or surgical tool at an input 514, process the data by the combinational logic 512 and provide an output 516.
[00187] [00187] Figure 15 illustrates a sequential logic circuit 520 configured to control aspects of the instrument or surgical tool according to an aspect of the present disclosure. Sequential logic circuit 520 or combinational logic 522 can be configured to implement the process described here. Sequential logic circuit 520 may comprise a finite state machine. Sequential logic circuit 520 may comprise combinational logic 522, at least one memory circuit 524, a clock 529 and, for example. The at least one memory circuit 524 can store a current state of the finite state machine. In certain cases, the sequential logic circuit 520 can be synchronous or asynchronous. Combinational logic 522 is configured to receive data associated with the surgical instrument or tool from an input 526, process the data using combinational logic 522, and provide an output 528. In other respects, the circuit may comprise a combination of a processor ( for example, processor 502, Figure 13) and a finite state machine for implementing various processes of the present invention. In other respects, the finite state machine may comprise a combination of a combinational logic circuit (for example, a combinational logic circuit 510, Figure 14) and the sequential logic circuit 520.
[00188] [00188] Figure 16 illustrates an instrument or surgical tool that comprises a plurality of motors that can be activated to perform various functions. In certain cases, a first engine can be activated to perform a first function, a second engine can be activated to perform a second function, a third engine can be activated to perform a third function, a fourth engine can be activated to perform a fourth function, and so on. In certain cases, the plurality of motors of the robotic surgical instrument 600 can be individually activated to cause firing, closing, and / or articulation movements in the end actuator. The firing, closing and / or articulation movements can be transmitted to the end actuator through a set of drive axes, for example.
[00189] [00189] In certain cases, the instrument or surgical tool system may include a 602 trip motor. The 602 trip motor can be operationally coupled to a drive set
[00190] [00190] In certain cases, the surgical tool or instrument may include a closing motor 603. The closing motor 603 can be operationally coupled to a drive assembly of the closing motor 605 that can be configured to transmit closing movements generated motor 603 to the end actuator, particularly to move a closing tube to close the anvil and compress the fabric between the anvil and the staple cartridge. Closing movements can cause the end actuator to transition from an open configuration to an approximate configuration to capture tissue, for example. The end actuator can be moved to an open position by reversing the direction of the 603 motor.
[00191] [00191] In certain cases, the surgical instrument or tool may include one or more articulation motors 606a, 606b, for example. The motors 606a, 606b can be operationally coupled to the drive sets of the articulation motor 608a, 608b, which can be configured to transmit joint movements generated by the motors 606a, 606b to the end actuator. In certain cases, articulation movements can cause the end actuator to be articulated in relation to the con-
[00192] [00192] As described above, the instrument or surgical tool can include a plurality of motors that can be configured to perform various independent functions. In certain cases, the plurality of motors of the instrument or surgical tool can be activated individually or separately to perform one or more functions, while other motors remain inactive. For example, the hinge motors 606a, 606b can be activated to cause the end actuator to be pivoted, while the firing motor 602 remains inactive. Alternatively, the firing motor 602 can be activated to fire the plurality of clamps, and / or advance the cutting edge, while the hinge motor 606 remains inactive. In addition, the closing motor 603 can be activated simultaneously with the firing motor 602 to make the closing tube and the beam element with profile in | advance distally, as described in more detail later in this document.
[00193] [00193] In certain cases, the surgical instrument or tool may include a common control module 610 that can be used with a plurality of motors of the instrument or surgical tool. In certain cases, the common control module 610 can accommodate one of the plurality of motors at a time. For example, the common control module 610 can be coupled to and separable from the plurality of motors of the robotic surgical instrument individually. In certain cases, a plurality of instrument or surgical tool motors may share one or more common control modules, such as the common control module 610. In certain cases, a plurality of instrument or surgical tool motors may be individually and selectively engaged with the common control module 610. In certain cases, the common control module 610 can be selectively switched between interfacing with one of a plurality of instrument motors or surgical tool to interface with another among the plurality of motors of the instrument or surgical tool.
[00194] [00194] In at least one example, the common control module 610 can be selectively switched between the operating coupling with the articulation motors 606a, 606B, and the operating coupling with the firing motor 602 or the closing motor 603 In at least one example, as shown in Figure 16, a key 614 can be moved or transitioned between a plurality of positions and / or states. In the first position 616, the switch 614 can electrically couple the common control module 610 to the trip motor 602; in a second position 617, the switch 614 can electrically couple the control module 610 to the closing motor 603; in a third position 618a, the switch 614 can electrically couple the common control module 610 to the first articulation motor 606a; and in a fourth position 618b, the switch 614 can electrically couple the common control module 610 to the second articulation motor 606b, for example. In certain cases, separate common control modules 610 can be electrically coupled to the firing motor 602, closing motor 603, and hinge motors 606a, 606b at the same time. In certain cases, key 614 can be a mechanical key, an electromechanical key, a solid state key, or any suitable switching mechanism.
[00195] [00195] Each of the 602, 603, 606a, 606b motors can comprise a torque sensor to measure the output torque on the motor drive shaft. The force on an end actuator can be detected in any conventional manner, such as by means of force sensors on the outer sides of the jaws or by a motor torque sensor that drives the jaws.
[00196] [00196] In several cases, as illustrated in Figure 16, the common control module 610 may comprise a motor starter 626 that may comprise one or more H-Bridge FETs. The motor driver 626 can modulate the energy transmitted from a power source 628 to a motor coupled to the common control module 610, based on an input from a microcontroller 620 (the "controller"), for example. In certain cases, the microcontroller 620 can be used to determine the current drained by the motor, for example, while the motor is coupled to the common control module 610, as described above.
[00197] [00197] In certain examples, the microcontroller 620 may include a microprocessor 622 (the "processor") and one or more non-transitory computer-readable media or 624 memory units (the "memory"). In certain cases, memory 624 can store various program instructions which, when executed, can cause the processor 622 to perform a plurality of functions and / or calculations described here. In certain cases, one or more of the memory units 624 can be coupled to the processor 622, for example.
[00198] [00198] In certain cases, the power supply 628 can be used to supply power to the microcontroller 620, for example. In certain cases, the power source 628 may comprise a battery (or "battery pack" or "power source"), such as a Li ion battery, for example. In certain cases, the battery pack can be configured to be releasably mounted to the handle to supply power to the surgical instrument 600. Several battery cells connected in series can be used as the 628 power source. In certain cases, power source 628 can be replaceable and / or rechargeable, for example.
[00199] [00199] In several cases, the 622 processor can control the 626 motor starter to control the position, direction of rotation and / or speed of a motor that is coupled to the common 610 control module. In some cases, processor 622 can signal the motor driver 626 to stop and / or disable a motor that is coupled to the common control module 610. It should be understood that the term "processor", as used here , includes any microprocessor, microcontroller or other suitable basic computing device that incorporates the functions of a central computer processing unit (CPU) in an integrated circuit or, at most, some integrated circuits. The processor is a programmable multipurpose device that accepts digital data as input, processes it according to instructions stored in its memory, and provides results as output. This is an example of sequential digital logic, as it has internal memory. Processors operate on numbers and symbols represented in the binary numeral system.
[00200] [00200] In one example, the 622 processor can be any single-core or multi-core processor, such as those known by the Texas Instruments ARM Cortex trade name. In certain cases, the 620 microcontroller may be an LM 4F230H5QR, available from Texas Instruments, for example. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core comprising an integrated 256 KB single cycle flash memory, or other non-volatile memory, up to 40 MHz, a search buffer anticipated to optimize performance above 40 MHz, a 32 KB single cycle SRAM, an internal ROM loaded with StellarisWareOQ software, 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, one or more 12-bit ADCs with 12 analog input channels, among other features that are readily available for the product data sheet. Other microcontrollers can be readily replaced for use with module 4410. Consequently, the present disclosure should not be limited
[00201] [00201] In certain cases, memory 624 may include program instructions for controlling each of the motors of the surgical instrument 600 that are attachable to the common control module 610. For example, memory 624 may include program instructions for controlling the firing motor 602, the closing motor 603 and the hinge motors 606a, 606b. Such program instructions can cause the 622 processor to control the trigger, close, and link functions according to inputs from the instrument or surgical tool control algorithms or programs.
[00202] [00202] In certain cases, one or more mechanisms and / or sensors, such as 630 sensors, can be used to alert the 622 processor about the program instructions that need to be used in a specific configuration. For example, sensors 630 can alert the 622 processor to use the program instructions associated with triggering, closing, and pivoting the end actuator. In certain cases, sensors 630 may comprise position sensors that can be used to detect the position of switch 614, for example. Consequently, the 622 processor can use the program instructions associated with firing the beam with | the end actuator by detecting, through sensors 630, for example, that switch 614 is in the first position 616; the processor 622 can use the program instructions associated with closing the anvil upon detection through sensors 630, for example, that switch 614 is in second position 617; and processor 622 can use the program instructions associated with the articulation of the end actuator upon detection through sensors 630, for example, that switch 614 is in the third or fourth position 618a, 618b.
[00203] [00203] Figure 17 is a schematic diagram of a robotic surgical instrument 700 configured to operate a surgical tool described in this document, in accordance with an aspect of that disclosure. The robotic surgical instrument 700 can be programmed or configured to control the distal / proximal translation of a displacement member, the distal / proximal displacement of a closing tube, the rotation of the drive shaft, and articulation, either with a single type or multiple articulation drive links. In one aspect, the surgical instrument 700 can be programmed or configured to individually control a firing member, a locking member, a driving shaft member and / or one or more hinge members. Surgical instrument 700 comprises a control circuit 710 configured to control motor-driven firing members, closing members, driving shaft members and / or one or more hinge members.
[00204] [00204] In one aspect, the robotic surgical instrument 700 comprises a control circuit 710 configured to control an anvil 716 and a beam portion with profile in | 714 (including a sharp cutting edge) of an end actuator 702, a removable clamp cartridge 718, a drive shaft 740 and one or more hinge members 742a, 742b through a plurality of motors 704a to 704e . A 734 position sensor can be configured to provide information about the beam with profile | 714 to the control circuit
[00205] [00205] In one aspect, the control circuit 710 may comprise one or more microcontrollers, microprocessors or other processors suitable for executing instructions that cause the processor or processors to perform one or more tasks. In one aspect, a timer / counter 731 provides control circuit 710 with an output signal, such as elapsed time or a digital count, to correlate the beam's position with | 714, as determined by the position sensor 734, with the timer / counter output 731 so that the control circuit 710 can determine the position of the beam with 1 714 profile at a specific time (t) in relation to an initial position or time (t) when the beam with a profile | 714 is in a specific position in relation to an initial position. The timer / counter 731 can be configured to measure elapsed time, count external events or record eternal events.
[00206] [00206] In one aspect, control circuit 710 can be programmed to control functions of end actuator 702 based on one or more tissue conditions. The control circuit 710 can be programmed to directly or indirectly detect tissue conditions, such as thickness, as described here. Control circuit 710 can be programmed to select a trigger control program or closing control program based on the conditions of the fabric. 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 thicker tissue is present, control circuit 710 can be programmed to translate the displacement member at a lower speed and / or with a lower power. When a thinner tissue is present, the control circuit 710 can be programmed to transfer the displacement member.
[00207] [00207] In one aspect, the motor control circuit 710 can generate motor setpoint signals. Motor setpoint signals can be provided for various motor controllers 708a through 708e. Motor controllers 708a to 708e can comprise one or more circuits configured to provide motor start signals for motors 704a to 704e in order to drive motors 704a to 704e, as described here. In some instances, motors 704a to 704e can be direct current electric motors with brushes. For example, the speed of motors 704a to 704e can be proportional to the respective motor start signals. In some instances, motors 704a to 704e may be brushless DC electric motors, and the respective motor drive signals may comprise a PWM signal provided for one or more stator windings of motors 704a to 704e. In addition, in some examples, motor controllers 708a to 708e can be omitted and control circuit 710 can directly generate motor drive signals.
[00208] [00208] In one aspect, the control circuit 710 can initially operate each of the motors 704a to 704e in an open circuit configuration for a first open circuit portion of the travel of the displacement member. Based on the response of the robotic surgical instrument 700 during the open circuit portion of the stroke, control circuit 710 can select a trigger control program in a closed circuit configuration. The instrument's response may include a translation of the distance of the displacement member during
[00209] [00209] In one aspect, motors 704a to 704e can receive power from a power source 712. Power source 712 can be a DC power source powered by an alternating main power supply, a battery, a super capacitor, or any other suitable power source. Motors 704a to 704e can be mechanically coupled to individual movable mechanical elements such as the beam with profile in | 714, the anvil 716, the drive shaft 740, the hinge 742a and the hinge 742b, through the respective transmissions 706a to 706e. Transmissions 706a through 706e may include one or more gears or other connecting components for coupling motors 704a to 704e to moving mechanical elements. A 734 position sensor can detect a beam position with a | 714. The position sensor 734 can be or can include any type of sensor that is capable of generating position data that indicate a beam position with profile in |
[00210] [00210] In one aspect, the control circuit 710 is configured to drive a firing member as the beam portion with profile in | 714 from end actuator 702. Control circuit 710 provides a motor setpoint for motor control 708a, which provides a drive signal for motor 704a. The output shaft of the motor 704a is coupled to a torque sensor 744a. The torque sensor 744a is coupled to a transmission 706a that is coupled to the beam with profile in | 714. The 706a transmission comprises moving mechanical elements, such as rotating elements, and a firing member for distally and proximally controlling the movement of the beam with a profile in 1 714 along a longitudinal geometric axis of the end actuator 702. In one In this respect, the 704a motor can be coupled to the knife gear assembly, which includes a knife gear reduction assembly that includes a first knife drive gear and a second knife drive gear. A torque sensor 744a provides a feedback signal from the firing force to the control circuit 710. The firing force signal represents the force required to fire or move the beam with a profile in |
[00211] [00211] In one aspect, control circuit 710 is configured to drive a closing member, such as anvil portion 716 of end actuator 702. Control circuit 710 provides a motor setpoint for motor control 708b, which provides a drive signal for motor 704b. The output shaft of the 704b motor is coupled to a 744b torque sensor. The torque sensor 744b is coupled to a transmission 706b that is coupled to the anvil 716. The transmission 706b comprises moving mechanical elements, such as rotating elements and a closing member, to control the movement of the anvil 716 between the open and closed positions. In one aspect, the 704b motor is coupled to a closing gear assembly, which includes a closing reduction gear assembly that is supported in gear engaged with the closing sprocket. The torque sensor 744b provides a closing force feedback signal to control circuit 710. The closing force feedback signal represents the closing force applied to the 716. The position sensor 734 can be configured to provide the position of the closing member as a feedback signal to the control circuit 710. Additional sensors 738 on the end actuator 702 can provide the feedback signal of the closing force to the control circuit 710. The pivoting anvil 716 is positioned opposite the staple cartridge 718. When ready for use, control circuit 710 can provide a closing signal to motor control 708b. In response to the closing signal, motor 704b advances a closing member to secure the fabric between the anvil 716 and the staple cartridge 718.
[00212] [00212] In one aspect, control circuit 710 is configured to rotate a drive shaft member, such as drive shaft 740, to rotate end actuator 702. Control circuit 710 provides a set point motor for a 708c motor control, which provides a drive signal for the 704c motor. The output shaft of the motor 704c is coupled to a torque sensor 744c. The torque sensor 744c is coupled to a transmission 706c which is coupled to the axis 740. The transmission 706c comprises moving mechanical elements, such as rotary elements, to control the rotation of the drive shaft 740 clockwise or counterclockwise. up and over 360º. In one aspect, the 704c engine is coupled to the rotary drive assembly, which includes a pipe gear segment that is formed over (or attached to) the proximal end of the proximal closing tube for operable engagement by a rotational gear assembly that is supported operationally on the tool mounting plate. The torque sensor 744c provides a rotation force feedback signal for control circuit 710. The rotation force feedback signal represents the rotation force applied to the drive shaft 740. The position sensor 734 can be configured to provide the position of the closing member as a feedback signal for control circuit 710. Additional sensors 738, such as a drive shaft encoder, can provide the rotational position of the drive shaft 740 to the control circuit 710.
[00213] [00213] In one aspect, control circuit 710 is configured to articulate end actuator 702. Control circuit 710 provides a motor setpoint for a 708d motor control, which provides a drive signal for the 704d engine. The output shaft of the 704d motor is coupled to a 744d torque sensor. The torque sensor 744d is coupled to a transmission 706d which is coupled to a link member 742a. The 706d transmission comprises moving mechanical elements, such as articulation elements, to control the articulation of the 702 + 65º end actuator. In one aspect, the 704d motor is coupled to a pivot nut, which is rotatably seated over the proximal end portion of the distal column portion and is pivotally driven by a pivot gear assembly. The 744d torque sensor provides a hinge force feedback signal to control circuit 710. The hinge force feedback signal represents the hinge force applied to the end actuator 702. The 738 sensors, as a co - articulation difficult, it can supply the articulation position of the end actuator 702 to the control circuit 710.
[00214] [00214] In another aspect, the articulation function of the robotic surgical system 700 may comprise two articulation members, or connections, 742a, 742b. These hinge members 742a, 742b are driven by separate disks at the robot interface (the
[00215] [00215] In one aspect, the one or more motors 704a to 704e may comprise a brushed DC motor with a gearbox and mechanical connections to a firing member, closing member or articulation member. Another example includes electric motors 704a to 704e that operate the moving mechanical elements such as the displacement member, the articulation connections, the closing tube and the drive shaft. An external influence is an excessive and unpredictable influence of things like tissue, surrounding bodies, and friction in the physical system. This external influence can be called drag, which acts in opposition to one of the electric motors 704a to 704e. External influence, such as drag, can cause the functioning of the physical system to deviate from a desired operation of the physical system.
[00216] [00216] In one aspect, the position sensor 734 can be implemented as an absolute positioning system. In one aspect, the position sensor 734 can comprise an absolute rotary magnetic positioning system implemented as a single integrated circuit rotary magnetic position sensor ASSOSSEQFT, available from Austria Microsystems, AG. The position sensor 734 can interface with the control circuit 710 to provide an absolute positioning system. The position can include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit by digit method and Volder's algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only addition, subtraction, bit shift and lookup table operations.
[00217] [00217] In one aspect, the control circuit 710 can be in communication with one or more sensors 738. The sensors 738 can be positioned on the end actuator 702 and adapted to work with the robotic surgical instrument 700 to measure various parameters derivatives 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 738 sensors can comprise a magnetic sensor, a magnetic field sensor, a stress meter, a load cell, a pressure sensor, a force sensor, a torque sensor, an inductive sensor such as a current sensor parasite, a resistive sensor, a capacitive sensor, an optical sensor and / or any other suitable sensor to measure one or more parameters of the end actuator
[00218] [00218] In one aspect, the one or more sensors 738 may comprise a strain gauge such as, for example, a micro-strain gauge, configured to measure the magnitude of the strain on the burner 716 during a clamped condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. Sensors 738 may comprise a pressure sensor configured to detect pressure generated by the presence of compressed tissue between anvil 716 and staple cartridge 718. Sensors 738 can be configured to detect the impedance of a section of fabric located between the anvil 716 and the staple cartridge 718 which is indicative of the thickness and / or completeness of the fabric located between them.
[00219] [00219] In one aspect, the 738 sensors can be implemented as one or more limit switches, electromechanical devices, solid state switches, Hall effect devices, magneto-resistive devices (MR) giant magneto-resistive devices (GMR), magnetometers, among others. In other implementations, the 738 sensors can be implemented as solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, MOSFET, bipolar and the like). In other implementations, the 738 sensors can include driverless electric switches, ultrasonic switches, accelerometers and inertia sensors, among others.
[00220] [00220] In one aspect, sensors 738 can be configured to measure the forces exerted on the anvil 716 by the closing drive system. For example, one or more sensors 738 may be at a point of interaction between the closing tube and the anvil 716 to detect the closing forces applied by the tube
[00221] [00221] In one aspect, a current sensor 736 can be used to measure the current drained by each of the 704a to 704e motors. The force required to advance any of the moving mechanical elements such as the beam with a profile | 714 corresponds to the current drained by one of the motors 704a to 704e. The force is converted into a digital signal and supplied to control circuit 710. Control circuit 710 can be configured to simulate the response of the instrument's actual system in the controller software. A displacement member can be actuated to move a beam with a profile | 714 on end actuator 702 at or near target speed. The robotic surgical instrument 700 may include a feedback controller, which may be one or any of the feedback controllers, including, but not limited to, a PID controller, state feedback, linear quadratic (LOR) and / or an adaptive controller , for example. The robotic surgical instrument 700 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. Additional details are disclosed in US patent application serial number 15 / 636,829, entitled CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT, filed on June 29, 2017, which is hereby incorporated by reference in its entirety.
[00222] [00222] Figure 18 illustrates a block diagram of a surgical instrument 750 programmed to control the distal translation of a displacement member according to an aspect of the present disclosure. In one aspect, the 750 surgical instrument is programmed to control the distal translation of a displacement member, such as the beam with a | 764. The surgical instrument 750 comprises an end actuator 752 which may comprise an anvil 766, a beam with a profile in | 764 (including a sharp cutting edge) and a removable staple cartridge 768.
[00223] [00223] The position, movement, displacement and / or translation of a member of linear displacement, such as the beam with profile in | 764, can be measured by an absolute positioning system, sensor arrangement and a position sensor 784. As the beam with | 764 is coupled to a longitudinally movable drive member, the position of the beam with profile in | 764 can be determined by measuring the position of the longitudinally movable drive member employing the 784 position sensor. Consequently, in the following description, the position, displacement and / or translation of the beam with | 764 can be obtained by the position sensor 784, as described here. A control circuit 760 can be programmed to control the translation of the displacement member, such as the beam with | 764. The control circuit 760, 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 destroying member.
[00224] [00224] Control circuit 760 can generate a setpoint signal for motor 772. The setpoint signal for motor 772 can be supplied to a motor controller 758. Motor controller 758 can comprise one or more circuits configured to supply a motor 774 drive signal to motor 754 to drive motor 754, as described here. In some instances, the 754 motor may be a DC motor with a brushed DC electric motor. For example, the speed of motor 754 can be proportional to the drive signal of motor 774. In some instances, motor 754 can be a brushless DC electric motor and the motor drive signal 774 can comprise a supplied PWM signal for one or more motor stator windings 754. In addition, in some instances, motor controller 758 can be omitted, and control circuit 760 can generate motor drive signal 774 directly.
[00225] [00225] Motor 754 can receive power from a power source 762. Power source 762 can be or include a battery, a super capacitor, or any other suitable power source. The 754 engine can be mechanically coupled to the beam with | 764 by means of a transmission 756. The transmission 756 may include one or more gears or other connecting components for coupling the motor 754 to the beam with profile | 764. A 784 position sensor can detect a beam position with | 764. The position sensor 784 can be or can include any type of sensor that is capable of generating position data that indicate a position of the beam with | 764. In some examples, the position sensor 784 may include an encoder configured to supply a series of pulses to the control circuit 760 according to the beam with profile in | 764 moved distally and proximally. The control circuit 760 can track the pulses to determine the position of the beam with profile in | 764. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals that indicate the movement of the beam with | 764. In addition, in some examples, the position sensor 784 can be omitted. If the motor 754 is a stepper motor, the control circuit 760 can track the beam position with | 764 by adding the number and direction of the steps that the 754 engine was instructed to perform. Position sensor 784 can be located on end actuator 752 or any other portion of the instrument.
[00226] [00226] The control circuit 760 can be in communication with one or more sensors 788. The sensors 788 can be positioned on the end actuator 752 and adapted to work with the surgical instrument 750 to measure the various derived parameters, such as distance span in relation to time, compression of the tissue in relation to time and tension of the anvil in relation to time. The 788 sensors can comprise a magnetic sensor, a magnetic field sensor, a stress meter, a pressure sensor, a force sensor, an inductive sensor such as a eddy current sensor, a resistive sensor, a capacitive sensor, a sensor optical and / or any other sensors suitable for measuring one or more parameters of the 752 end actuator. The 788 sensors may include one or more sensors.
[00227] [00227] One or more sensors 788 may comprise a stress meter, such as a microstrain meter, configured to measure the magnitude of the stress on the anvil 766 during a grip condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The 788 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The 788 sensors can be configured to detect the impedance of a section of tissue located between the anvil 766 and the staple cartridge 768 which is indicative of the thickness and / or completeness of the fabric located between them.
[00228] [00228] The 788 sensors can be configured to measure the forces exerted on the anvil 766 by a closing drive system. For example, one or more sensors 788 may be at a point of interaction between the closing tube and the anvil 766 to detect the closing forces applied by a closing tube to the anvil 766. The forces exerted on the anvil 766 can be representative of the tissue compression experienced by the tissue section captured between the anvil 766 and the staple cartridge 768. The one or more sensors 788 can be positioned at various points of interaction throughout the closing drive system to detect the closing forces applied to the anvil 766 by the closing drive system. The one or more 788 sensors can be sampled in real time during a gripping operation by a processor from the control circuit 760. The control circuit 760 receives sample measurements in real time to provide and analyze basic information. - seals in time and evaluate, in real time, the closing forces applied to the anvil 766.
[00229] [00229] “A current sensor 786 can be used to measure the current drained by the 754 motor. The force necessary to advance the beam with profile in | 764 corresponds to the current drained by the motor
[00230] [00230] The control circuit 760 can be configured to simulate the response of the real system of the instrument in the controller software. A displacement member can be actuated to move a beam with a profile | 764 on end actuator 752 at or near a target speed. The surgical instrument 750 may include a feedback controller, which can be any or any feedback controller, including, but not limited to, a PID controller, status feedback, LOR, and / or an adaptive controller , for example. The surgical instrument 750 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.
[00231] [00231] The actual drive system of the surgical instrument 750 is configured to drive the displacement member, the cutting member or the beam with profile in | 764, by a brushed DC motor with gearbox and mechanical connections to an articulation and / or cutting system. Another example is the 754 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 754 electric motor. External influence, like drag, can cause the functioning of the physical system to deviate from a desired operation of the physical system.
[00232] [00232] Several exemplifying aspects are directed to a surgical instrument 750 that comprises an end actuator 752 with surgical implements of stapling and cutting driven by motor. For example, a 754 motor can drive a displacement member distally and proximally along a longitudinal geometric axis of end actuator 752. End actuator 752 can comprise an articulating anvil 766 and, when configured to the use, an ultrasonic blade 768 positioned on the opposite side of the whisker 766. A doctor can hold the tissue between the anvil 766 and the staple cartridge 768, as described here. When ready to use the 750 instrument, the physician can provide a trigger signal, for example, by pressing a trigger on the 750 instrument. In response to the trigger signal, motor 754 can drive the displacement member distally along from the longitudinal geometric axis of the end actuator 752 from a proximal start position to an end position distal from the start position. As the displacement member moves distally, the beam with | 764 with a cutting element positioned at a distal end, you can cut the fabric between the 768 staple cartridge and the anvil
[00233] [00233] In several examples, the surgical instrument 750 can comprise a control circuit 760 programmed to control the distal translation of the displacement member, such as the beam with profile in | 764, for example, based on one or more tissue conditions. The control circuit 760 can be programmed to directly or indirectly detect tissue conditions, such as thickness, as described here. Control circuit 760 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 thicker tissue is present, control circuit 760 can be programmed to move the displacement member at a lower speed and / or with a lower power. When a thinner fabric is present, the control circuit 760 can be programmed to move the displacement member at a higher speed and / or with greater power.
[00234] [00234] In some examples, the control circuit 760 may initially operate the motor 754 in an open circuit configuration for a first open circuit portion of a travel of the displacement member. Based on an instrument response 750 during the open circuit portion of the stroke, control circuit 760 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 754 during the open circuit portion, a sum of pulse widths a motor start signal, etc. After the open circuit portion, control circuit 760 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 760 can modulate motor 754 based on translation data that describes a position of the displacement member in a closed circuit manner to translate the displacement member into a constant speed. Additional details are revealed in US patent application serial number 15 / 720,852, entitled SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT, filed on September 29, 2017, which is hereby incorporated by reference in its entirety.
[00235] [00235] Figure 19 is a schematic diagram of a 790 surgical instrument configured to control various functions according to an aspect of the present disclosure. In one aspect, surgical instrument 790 is programmed to control the distal translation of a displacement member, such as the beam with a | 764. The surgical instrument 790 comprises an end actuator 792 which may comprise an anvil 766, a beam with a profile | 764 and a removable staple cartridge 768 that can be exchanged with an RF cartridge 796 (shown in dashed line).
[00236] [00236] In one aspect, the 788 sensors can be implemented as a limit switch, electromechanical device, solid state switches, Hall effect devices, MRI devices, GMR devices, magnetometers, among others. In other implementations, 638 sensors can be solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, MOSFET, bipolar and the like). In other implementations, 788 sensors can include driverless electric switches, ultrasonic switches, accelerometers, inertia sensors, and more.
[00237] [00237] In one aspect, the position sensor 784 can be implemented as an absolute positioning system, which comprises a rotating magnetic absolute positioning system implemented as a rotating integrated magnetic position sensor single ASSOSSEQFT, available from Austria Microsystems, AG. The position sensor 784 can interface with the control circuit 760 to provide an absolute positioning system. The position can include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit by digit method and Volder's algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only addition, subtraction, bit shift and lookup table operations.
[00238] [00238] In one aspect, the beam with | 764 can be implemented as the cutting member which comprises a knife body that operationally supports a fabric cutting blade and can additionally include flaps or anvil engaging features and channel engaging features or a base. In one aspect, the 768 staple cartridge can be implemented as the standard (mechanical) surgical clamp cartridge. In one aspect, the RF 796 cartridge can be implemented as an RF cartridge. These and other sensor arrangements are described in Commonly Owned US Patent Application No. 15 / 628,175, entitled TECHNI-
[00239] [00239] The position, movement, displacement and / or translation of a member of linear displacement, such as the beam with profile in | 764, can be measured by an absolute positioning system, sensor arrangement and position sensor represented as the position sensor 784. As the beam with | 764 is coupled to the longitudinally movable drive member 120, the beam position with | 764 can be determined by measuring the position of the longitudinally movable drive member 120 that employs the position sensor 784. Consequently, in the following description, the position, displacement and / or translation of the beam with profile in | 764 po-
[00240] [00240] Control circuit 760 can generate a motor setpoint signal 772. The motor setpoint signal 772 can be supplied to a motor controller 758. Motor controller 758 can comprise one or more circuits configured to supply a motor 774 drive signal to motor 754 to drive motor 754, as described here. In some instances, the 754 motor may be a DC motor with a brushed DC electric motor. For example, the speed of motor 754 can be proportional to the drive signal of motor 774. In some instances, motor 754 can be a brushless DC electric motor and the motor drive signal 774 can comprise a supplied PWM signal for one or more motor stator windings 754. In addition, in some instances, motor controller 758 can be omitted, and control circuit 760 can generate motor drive signal 774 directly.
[00241] [00241] Motor 754 can receive power from a power source 762. Power source 762 can be or include a battery, a super capacitor, or any other suitable power source. The 754 engine can be mechanically coupled to the beam with | 764 by means of a transmission 756. The transmission 756 may include one or more gears or other connecting components for coupling the motor 754 to the beam with profile | 764. A 784 position sensor can detect a beam position with | 764. The position sensor 784 can be or can include any type of sensor that is capable of generating position data that indicate a position of the beam with | 764. In some examples, the position sensor 784 may include an encoder configured to supply a series of pulses to the control circuit 760 according to the beam with profile in | 764 moved distally and proximally. The control circuit 760 can track the pulses to determine the position of the beam with profile in | 764. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals that indicate the movement of the beam with | 764. In addition, in some examples, the position sensor 784 can be omitted. If the motor 754 is a stepper motor, the control circuit 760 can track the beam position with | 764 by adding the number and direction of the steps that the engine was instructed to perform. Position sensor 784 can be located on end actuator 792 or any other portion of the instrument.
[00242] [00242] The control circuit 760 can be in communication with one or more sensors 788. The sensors 788 can be positioned on the end actuator 792 and adapted to work with the instrument.
[00243] [00243] Oum or more sensors 788 may comprise a stress meter, such as a microstrain meter, configured to measure the magnitude of the stress on the anvil 766 during a grip condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The 788 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The 788 sensors can be configured to detect the impedance of a section of tissue located between the anvil 766 and the staple cartridge 768 which is indicative of the thickness and / or completeness of the fabric located between them.
[00244] [00244] The 788 sensors can be configured to measure the forces exerted on the anvil 766 by the closing drive system. For example, one or more sensors 788 may be at a point of interaction between the closing tube and the anvil 766 to detect the closing forces applied by a closing tube to the anvil 766. The forces exerted on the anvil 766 can be re - presents of the tissue compression experienced by the tissue section captured between the anvil 766 and the staple cartridge 768. The one or more sensors 788 can be positioned at various points of interaction along the closing drive system to detect the closing forces applied to the anvil 766 by the closing drive system. The one or more 788 sensors can be sampled in real time during a gripping operation by a processor portion of the 760 control circuit. The 760 control circuit receives sample measurements in real time to provide and analyze information based on in real time and evaluate, in real time, the closing forces applied to the 766 anvil.
[00245] [00245] A current sensor 786 can be used to measure the current drained by the 754 motor. The force necessary to advance the beam with profile in | 764 corresponds to the current drained by the motor
[00246] [00246] An RF power source 794 is coupled to the end actuator 792 and is applied to the RF 796 cartridge when the RF 796 cartridge is loaded on the end actuator 792 in place of the clamp cartridge 768. The circuit Control Panel 760 controls the supply of RF energy to the 796 RF cartridge.
[00247] [00247] Additional details are disclosed in US patent application serial number 15 / 636,096, entitled SURGICAL SYSTEM COUPLA- BLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, filed on 28 June 2017 , which is hereby incorporated as a reference in its entirety. Generator hardware
[00248] [00248] Figure 20 is a simplified block diagram of a generator 800 configured to provide tuning without an inductor, among other benefits. Additional details of generator 800 are described in US patent No. 9,060,775, entitled SURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES, issued on
[00249] [00249] In certain forms, ultrasonic and electrosurgical trigger signals can be supplied simultaneously to different surgical instruments and / or to a single surgical instrument, such as a multifunctional surgical instrument, with the capacity to supply both ultrasonic and electrosurgical energy to the tissue. It will be noted that the electrosurgical signal provided by both the dedicated electrosurgical instrument and the electrosurgical / ultrasonic combined multifunctional instrument can be both a therapeutic and subtherapeutic signal, where the subtherapeutic signal can be used,
[00250] [00250] The non-isolated stage 804 may comprise a power amplifier 812 that has an output connected to a primary winding 814 of the power transformer 806. In certain forms, the power amplifier 812 may comprise a push amplifier -pull ". For example, the non-isolated stage 804 may additionally contain a logic device 816 to provide a digital output to a digital-to-analog converter (DAC) circuit 818 which, in turn, provides an analog signal corresponding to an input from the power amplifier 812. In certain ways, the logic device 816 may comprise a programmable gate array (PGA), an FPGA (field FPGA) -programmable gate array "), a programmable logic device (PLD, for" programmable logic device "), among other logic circuits, for example. The logic device 816, by controlling the input of the power amplifier 812 through the DAC 818 can,
[00251] [00251] Power can be supplied to a power rail of the power amplifier 812 by a key mode regulator 820, such as, for example, a power converter. In certain forms, the key mode regulator 820 may comprise an adjustable voltage regulator, for example. The non-isolated stage 804 can also comprise a first processor 822 which, in a way, can comprise a PSD processor as an analog device APSD-21469 SHARC PSD, available from Analog Devices, Norwood, MA, USA , for example, although in various forms, any suitable processor can be used. In certain ways, the PSD 822 processor can control the operation of the key mode regulator 820 responsive to voltage feedback data from the power amplifier 812 by the PSD 822 processor via an ADC 824 circuit. Thus, for example, the PSD 822 processor can receive the waveform envelope of a signal (for example, an RF signal) as input via the ADC 824 circuit, being amplified by the power amplifier 812. The PSD 822 processor you can then control the key mode regulator 820 (for example, via a PWM output) so that the rail voltage supplied to the power amplifier 812 follows the waveform aging of the amplified signal. Dynamically modulating
[00252] [00252] In certain forms, the logical device 816, in conjunction with the PSD 822 processor, can implement a digital synthesis circuit as a control scheme with direct digital synthesizer (DDS) to control the waveform, frequency and / or the amplitude of the trigger signals emitted by the generator 800. In one way, for example, the logic device 816 can implement a DDS control algorithm by retrieving waveform samples stored in a lookup table (LUT, " look-up table ") dynamically updated, like a RAM LUT that can be integrated into an FPGA. This control algorithm is particularly useful for ultrasonic applications in which an ultrasonic transducer can be driven by a clean sinusoidal current at its resonant frequency. as other frequencies can excite parasitic resonances, minimizing or reducing the total distortion of the branching current can correspondingly minimize or reduce the undesirable effects of resonance. As the waveform of a drive signal output by generator 800 is impacted by various sources of distortion present in the output drive circuit (for example, power transformer 806, power amplifier 812), data voltage and current feedback information based on the drive signal can be provided to an algorithm, such as an algorithm for error control implemented by the PSD 822 processor, which compensates for the distortion through adequate pre-distortion or modification of the waveform samples stored in the LUT in a dynamic and continuous manner (for example, in real time). In one way, the amount or degree of pre-distortion applied to the LUT samples can be based on the error between a current from the computerized motion branch and a desired current waveform, the error being determined on a basis of sample by sample. In this way, pre-distorted LUT samples, when processed through the drive circuit, can result in a trigger signal from the motion branch that has the desired waveform (for example, sinusoidal) to drive optimally the ultrasonic transducer. In such forms, the LUT waveform samples will therefore not represent the desired waveform of the trigger signal, but the waveform that is needed to ultimately produce the desired waveform. of the trigger signal of the movement branch, when the distortion effects are taken into account.
[00253] [00253] The non-isolated stage 804 may additionally comprise a first ADC 826 circuit and a second ADC 828 circuit coupled to the output of the power transformer 806 by means of the respective isolation transformers, 830 and 832, for respectively sampling the voltage and current of drive signals emitted by generator 800. In certain ways, ADC 826 and 828 circuits can be configured for high-speed sampling (eg, 80 mega samples per second (MSPS)) to allow over-sampling of signals drive. In one way, for example, the sampling speed of the ADC 826 and 828 circuits can allow an oversampling of approximately 200x (depending on the frequency) of the drive signals. In certain ways, the sampling operations of the ADC 826 and 828 circuit can be performed by a single ADC circuit receiving voltage and current input signals through a bidirectional multiplexer. The use of high-speed sampling in the forms of generator 800 can allow, among other things, the calculation of the complex current flowing through the branch of motion (which can be used in certain ways to implement DDS-based waveform control described above), accurate digital filtering of the sampled signals and the calculation of actual energy consumption with a high degree of accuracy. The feedback data about voltage and current emitted by ADC 826 and 828 circuits can be received and processed (for example, first-in-first-out (FIFO), multiplexer) temporary storage by logic device 816 and stored in data memory for subsequent retrieval, for example, by the 822 processor. As noted above, feedback data on voltage and current can be used as input to an algorithm for pre-distortion or modification of samples - waveforms in the LUT, in a dynamic and continuous way. In some ways, this may require that each stored voltage and current feedback data pair be indexed based on, or otherwise associated with, a corresponding LUT sample that was provided by logic device 816 when the voltage and current feedback data pair was captured. The synchronization of the LUT samples with the feedback data about voltage and current in this way contributes to the correct timing and stability of the pre-distortion algorithm.
[00254] [00254] In certain forms, voltage and current feedback data can be used to control the frequency and / or amplitude (for example, current amplitude) of the drive signals. In one form, for example, voltage and current feedback data can be used to determine the impedance phase. The frequency of the trigger signal can then be controlled to minimize or reduce the difference between the determined impedance phase and an impedance phase setpoint (eg 0º), thereby minimizing or reducing the effects of distortion and, correspondingly, accentuating the accuracy of the impedance phase measurement. The determination of the phase impedance and a frequency control signal can be implemented in the PSD 822 processor, for example, with the frequency control signal being supplied as input to a DDS control algorithm implemented by the logic device 816.
[00255] [00255] In another form, for example, the current feedback data can be monitored in order to maintain the current amplitude of the drive signal at a current amplitude setpoint. The current amplitude set point can be specified directly or indirectly determined based on the specified set points for voltage and power amplitude. In certain ways, the control of the current amplitude can be implemented by the control algorithm, such as a proportional-integral-derivative control algorithm (PID), in the PSD 822 processor. The variables controlled by the control algorithm to properly control the current amplitude of the drive signal may include, for example, the scaling of the LUT waveform samples stored in logic device 816 and / or the full-scale output voltage of the DAC 818 circuit (which provides input to the power amplifier 812) via a DAC 834 circuit.
[00256] [00256] The non-isolated stage 804 can additionally comprise a second processor 836 to provide, among other things, the functionality of the user interface (UI). In one form, the 836 processor can comprise an Atmel AT91SAM9263 processor with an ARM 926EJ-S core, available from Atmel Corporation, of San Jose, California, USA, for example. Examples of UI functionality supported by the 836 processor may include audible and visual feedback from the user, communication with peripheral devices (eg via a USB interface),
[00257] [00257] In certain ways, both the PSD 822 processor and the UI 836 processor can, for example, determine and monitor the operational status of generator 800. For the PSD 822 processor, the operational state of generator 800 can determine, for example , which control and / or diagnostic processes are implemented by the PSD 822 processor. For the UI 836 processor, the operational state of the generator 800 can determine, for example, which elements of a UI (for example, display screens, sounds) are presented to a user. The respective UI and PSD processors 822 and 836 can independently maintain the current operational status of the generator 800, as well as recognize and evaluate possible transitions out of the current operational state. The PSD 822 processor can act as the master in this relationship, and can determine when transitions between operational states should occur. The UI 836 processor can be aware of valid transitions between operational states, and can confirm that a particular transition is suitable. For example, when the PSD 822 processor instructs the UI 190 processor to transition to a specific state, the UI 836 processor can verify that the requested transition is valid. If a requested transition between states is determined to be invalid by the UI 836 processor, the UI 836 processor can cause generator 800 to enter a fault mode.
[00258] [00258] The non-isolated stage 804 can also contain an 838 controller for monitoring input devices (for example, a capacitive touch sensor used to turn the 800 on and off, a sensitive capacitive screen touch). In certain ways, controller 838 may comprise at least one processor and / or another controller device in communication with the UIL 836 processor. In one form, for example, controller 838 may comprise a processor (e.g., a controller Meg168 8-bit available from Atmel) configured to monitor the inputs provided by the user through one or more capacitive touch sensors. In one form, the 838 controller can comprise a touchscreen controller (for example, a QT5480 touchscreen controller available from Atmel) to control and manage touch data capture from a capacitive touchscreen.
[00259] [00259] In certain ways, when generator 800 is in an "off" state, controller 838 can continue to receive operational power (for example, through a line from a generator 800 power supply, such as power supply 854 discussed below). In this way, controller 838 can continue to monitor an input device (for example, a capacitive touch sensor located on a front panel of generator 800) to turn generator 800 on and off. When generator 800 is on slipped state
[00260] [00260] In certain forms, controller 838 may cause generator 800 to provide audible feedback or other sensory feedback to alert the user that an on or off sequence has been initiated. This type of alert can be provided at the beginning of a sequence on or off, and before the start of other processes associated with the sequence.
[00261] [00261] In certain forms, the isolated stage 802 may comprise an instrument interface circuit 840 to, for example, offer a communication interface between a control circuit of a surgical instrument (for example, a control circuit that handle handles) and non-isolated stage 804 components, such as logic device 816, PSD processor 822 and / or UI processor 836. Instrument interface circuit 840 can exchange information with non-insulated stage components
[00262] [00262] In one form, the instrument interface circuit 840 may comprise a logic circuit 842 (for example, a logic circuit, a programmable logic circuit, PGA, FPGA, PLD) in communication with a signal conditioning circuit 844 The signal conditioning circuit 844 can be configured to receive a periodic signal from logic circuit 842 (for example, a 2 kHz square wave) to generate a bipolar interrogation signal that has an identical frequency. The question mark can be generated, for example, using a bipolar current source powered by a differential amplifier. The question mark can be communicated to a surgical instrument control circuit (for example, using a conductor pair on a cable connecting the generator 800 to the surgical instrument) and monitored to determine a status or configuration the control circuit. The control circuit can comprise numerous switches, resistors and / or diodes to modify one or more characteristics (for example, amplitude, rectification) of the question mark so that a state or configuration of the control circuit is discernible, unequivocally, based on this one or more characteristics. In one form, for example, the signal conditioning circuit 844 may comprise an ADC circuit for generating samples of a voltage signal appearing between inputs of the control circuit, resulting from the passage of the interrogation signal through it. The logical instrument 842
[00263] [00263] In one way, the instrument interface circuit 840 may comprise a first data circuit interface 846 to enable the exchange of information between logic circuit 842 (or another element of the instrument interface circuit 840) and a first data circuit disposed in a surgical instrument or otherwise associated with it. In certain ways, for example, a first data loop can be arranged on a wire integrally attached to a surgical instrument handle or on an adapter to interface between a specific type or model of surgical instrument and the generator 800. The first data circuit can be implemented in any suitable way and can communicate with the generator according to any suitable protocol, including, for example, as described here with respect to the first data circuit. In certain forms, the first data circuit may comprise a non-volatile storage device, such as an EEPROM device. In some ways, the first data circuit interface 846 can be implemented separately from logic circuit 842 and comprises a suitable circuit set (for example, separate logic devices, a processor) to allow communication between the logic circuit 842 and the first data circuit. In other ways, the first data circuit interface 846 can be integral with logic circuit 842.
[00264] [00264] In certain forms, the first data circuit can store information related to the specific surgical instrument with which it is associated. This information may include, for example, a model number, a serial number, a number of operations in which the surgical instrument was used, and / or any other types of information. This information can be read by the interface circuit.
[00265] [00265] As previously discussed, a surgical instrument can be removable from a handle (for example, the multifunctional surgical instrument can be removable from the handle) to promote interchangeability and / or disposability of the instrument. In these cases, conventional generators may be limited in their ability to recognize specific instrument configurations being used, as well as to optimize the control and diagnostic processes as needed. The addition of readable data circuits to surgical instruments to resolve this issue is problematic from a compatibility point of view, however. For example, designing a surgical instrument so that it remains retrocompatible with generators that lack the indispensable data reading functionality may be impractical due, for example, to different signaling schemes, design complexity and cost. The forms of instruments discussed here address these concerns through the use of data circuits that can be implemented in existing surgical instruments, economically and with minimal design changes to preserve the compatibility of surgical instruments with current generator platforms.
[00266] [00266] Additionally, the shapes of the generator 800 can allow communication with instrument-based data circuits. For example, generator 800 can be configured to communicate with a second data circuit contained in an instrument (for example, the multifunctional surgical instrument). In some ways, the second data circuit can be implemented in a manner similar to that of the first data circuit described here. The instrument interface circuit 840 may comprise a second data circuit interface 848 to enable such communication. In one form, the second data circuit interface 848 can comprise a three-state digital interface, although other interfaces can also be used. In certain ways, the second data circuit can generally be any circuit for transmitting and / or receiving data. In one form, for example, the second data loop can store information related to the specific surgical instrument with which it is associated. Such information may include, for example, a model number, a serial number, a number of operations in which the surgical instrument was used, and / or any other types of information.
[00267] [00267] In some ways, the second data circuit can store information about the electrical and / or ultrasonic properties of an associated ultrasonic transducer, an end actuator or an ultrasonic drive system. For example, the first data loop may indicate a slope of the initialization frequency, as described here. In addition or alternatively, any type of information can be communicated to the second data circuit for storage via the second data circuit interface 848 (for example, using logic circuit 842). This information may include, for example, an updated number of operations in which the surgical instrument was used and / or the dates and / or times of its use. In certain ways, the second data circuit can transmit data captured by one or more sensors (for example, an instrument-based temperature sensor). In certain ways, the second data circuit can receive from the generator 800 and provide an indication to a user (for example, an LED indication or other visible indication) based on the received data.
[00268] [00268] In certain ways, the second data circuit and the second data circuit interface 848 can be configured so that communication between logic circuit 842 and the second data circuit can be carried out without the need to provide additional conductors - for this purpose (for example, dedicated cable conductors connecting a handle to the 800 generator). In one way, for example, information can be communicated to, and from, the second data circuit using a wire bus communication scheme, implemented in the existing wiring, as one of the conductors used for transmitting interrogation signals from signal conditioning circuit 844 to a control circuit on a handle. In this way, changes or modifications to the design of the surgical device that may otherwise be necessary are minimized or reduced. In addition, due to the fact that different types of communications implemented on a common physical channel can be separated based on frequency, the presence of a second data circuit can be "invisible" to generators that do not have the essential functionality of reading of data, which, therefore, allows the backward compatibility of the surgical instrument.
[00269] [00269] In certain forms, the isolated stage 802 may comprise at least one blocking capacitor 850-1 connected to the output of the trigger signal 810b to prevent the passage of direct current to a patient. A single blocking capacitor may be required to comply with medical regulations and standards, for example.
[00270] [00270] In certain forms, the non-isolated stage 804 can comprise a power supply 854 to deliver DC power with adequate voltage and current. The power supply can comprise, for example, a 400 W power supply to deliver a system voltage of 48 VDC. The power supply 854 may additionally comprise one or more DC / DC voltage converters 856 to receive the power supply output to generate DC outputs at the voltages and currents required by the various components of generator 800. As discussed above in relation to controller 838, one or more of the 856 dc / dc voltage converters can receive an input from controller 838 when the activation of the "on / off" input device by a user is detected by the controller - 838 controller, to enable the operation or awakening of the 856 DC / DC voltage converters.
[00271] [00271] Figure 21 illustrates an example of generator 900, which is a form of generator 800 (Figure 20). The 900 generator is configured to supply multiple modes of energy to a cyclic instrument
[00272] [00272] Generator 900 comprises a processor 902 coupled to a waveform generator 904. Processor 902 and waveform generator 904 are configured to generate various signal waveforms based on information stored in a memory. coupled to processor 902, not shown for clarity of disclosure. The digital information associated with a waveform is provided to the waveform generator 904 that includes one or more DAC circuits to convert the digital input into an analog output. The analog output is powered by an amplifier 1106 for signal conditioning and amplification. The amplified conditioned output of the amplifier 906 is coupled to a power transformer 908. The signals are coupled by the power transformer 908 to the secondary side, which is on the patient isolation side. A first signal of a first energy modality is provided to the surgical instrument between the terminals identified as ENERGY1 and RETURN. A second signal from a second energy mode is coupled by a 910 capacitor and is supplied to the surgical instrument between the terminals identified as ENERGY and RETURN. It will be recognized that more than two types of energy can be issued and, therefore, the subscript "n" can be used to determine
[00273] [00273] A first voltage detection circuit 912 is coupled through the terminals identified as ENERGY1 and the RETURN path to measure the output voltage between them. Is a second voltage detection circuit 924 connected via the terminals identified as ENERGY and the RETURN path to measure the output voltage between them. A current detection circuit 914 is arranged in series with the RETURN branch on the secondary side of the power transformer 908, as shown, to measure the output current for any energy modality. If different return paths are provided for each energy modality, then a separate current detection circuit would be provided for each return branch. The outputs of the first and second voltage detection circuits 912, 924 are supplied to the respective isolation transformers 916, 922 and the output of the current detection circuit 914 is supplied to another isolation transformer 918. The outputs of the Isolation formers 916, 928, 922 on the primary side of the power transformer 908 (non-isolated side of the patient) are supplied to one or more ADC 926 circuits. The digitized output from the ADC 926 circuit is supplied to the 902 processor for processing additional and computing. The output voltages and the output current feedback information can be used to adjust the output voltage and the current supplied to the surgical instrument, and to compute the output impedance, among other parameters. Input / output communications between the 902 processor and the patient's isolated circuits are provided via a 920 interface circuit. The sensors can also be in electrical communication with the processor
[00274] [00274] In one aspect, impedance can be determined by processor 902 by dividing the output of the first voltage detection circuit 912 coupled to the terminals identified as ENERGIAI / RETORNO or the second voltage detection circuit 924 connected to the terminals identified as ENERGY2 / RETURN, through the output of the current detection circuit 914 arranged in series with the RETURN branch on the secondary side of the power transformer 908. The outputs of the first and second voltage detection circuits 912, 924 are provided to separate the insulation transformers 916, 922 and current detection circuit 914 output is provided to another isolation transformer 916. Digitized current and voltage detection measurements from ADC circuit 926 are provided to processor 902 to compute impedance . As an example, can the first ENERGY1 energy modality be ultrasonic energy and the second ENERGY energy modality it could be RF energy. However, in addition to the ultrasonic and bipolar or monopolar RF energy modalities, other energy modalities include irreversible and / or reversible electroporation and / or microwave energy, among others. Furthermore, although the example shown in Figure 21 shows a single RETURN return path that can be provided for two or more energy modes, in other respects, several RETURN return paths can be provided for each energy mode. ENERGY Thus, as described here, the impedance of the ultrasonic transducer can be measured by dividing the output of the first voltage detection circuit 912 by the current detection circuit 914, and the fabric impedance can be measured by dividing the output of the second voltage detection circuit 924 by the current detection circuit 914.
[00275] [00275] As shown in Figure 21, the generator 900 comprising at least one output port may include a power transformer 908 with a single output and with multiple taps to provide power in the form of one or more modes of energy, such as ultrasonic, bipolar or monopolar RF, irreversible and / or reversible electroporation, and / or microwave energy, among others, for example to the end actuator depending on the type of tissue treatment being performed. For example, the 900 generator can supply energy with higher voltage and lower current to drive an ultrasonic transducer, with lower voltage and higher current to conduct RF electrodes to seal the tissue or with a coagulation waveform for point coagulation using monopolar or bipolar RF electrosurgical electrodes. The output waveform of the 900 generator can be oriented, switched or filtered to supply the frequency to the end actuator of the surgical instrument. The connection of an ultrasonic transducer to the output of generator 900 is preferably located between the output identified as ENERGY and the RETURN, as shown in Figure 21. In one example, a connection of bipolar RF electrodes to the generator output 900 would preferably be located between the exit identified as ENERGY and RETURN. In the case of a monopolar output, would the preferred connections be an active electrode (for example, a light beam or another probe) for the ENERGY output and a suitable return block connected to the RETURN outlet.
[00276] [00276] Additional details are revealed in US patent application publication No. 2017/0086914 entitled TECHNIQUES FOR OPERA-
[00277] [00277] As used throughout this description, the term "wireless" and its derivatives can be used to describe circuits, devices, systems, methods, techniques, communication channels etc., which can communicate data through the use of electromagnetic radiation modulated through a non-solid medium. The term does not imply that the associated devices do not contain any wires, although in some respects they may not. The communication module can implement any of a number of wireless and wired communication standards or protocols, including, but not limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20 , long-term evolution (LTE, "long-term evolution"), Ev-DO, HSPAr, HSDPA +, HSUPA +, EDGE, GSM, GPRS, CDMA, TDMA, DECT, Bluetooth, Ethernet derivatives thereof, as well as any other wireless and wired protocols that are designated as 3G, 4G, 5G, and beyond. The computing module can include a plurality of communication modules. For example, a first communication module can be dedicated to short-range wireless communications like Wi-Fi and Bluetooth, and a second communication module can be dedicated to longer-range wireless communications like GPS, EDGE, GPRS , CDMA, WiMAX, LTE, Ev-DO, and others.
[00278] [00278] “As used here, a processor or processing unit is an electronic circuit that performs operations on some external data source, usually memory or some other data flow. The term is used here to refer to the central processor (central processing unit) in a computer system or systems (specifically systems on a chip (SoCs)) that combine several specialized "processors".
[00279] [00279] As used here, a system on a chip or system on the chip (SoC or SOC) is an integrated circuit (also known as an "IC" or "chip") that integrates all components of a computer or others electronic systems. It may contain digital functions,
[00280] [00280] “As used here, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuits and memory. A microcontroller (or MCU for the microcontroller unit) can be implemented as a small computer on a single integrated circuit. It can be similar to a SoC; a SoC can include a microcontroller as one of its components. A microcontroller can contain one or more core processing units (CPUs) together with memory and programmable input / output peripherals. Program memory in the form of ferroelectric RAM, NOR flash or OTP ROM is also often included on the chip, as well as a small amount of RAM. Microcontrollers can be used for integrated applications, in contrast to microprocessors used in personal computers or other general purpose applications that consist of several separate integrated circuits.
[00281] [00281] As used here, the term "controller" or "microcontroller" can be an independent chip or IC (integrated circuit) device that interfaces with a peripheral device. This can be a connection between two parts of a computer or a controller on an external device that manages the operation of (and connection to) that device.
[00282] [00282] “Any of the processors or microcontrollers described here can be any implemented by any single-core or multi-core processor, such as those known under the trade name of ARM Cortex by Texas Instruments. In one aspect,
[00283] [00283] In one aspect, the processor may comprise a safety controller that comprises two controller-based families, such as TMS570 and RM4x, known under the tradename Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[00284] [00284] The modular devices include the modules (as described in connection with Figures 3 and 9, for example) that are receivable within a central surgical controller and the devices or surgical instruments that can be connected to the various modules a in order to connect or pair with the corresponding central surgical controller. Modular devices include, for example, smart surgical instruments, medical imaging devices, suction / irrigation devices, smoke evacuators, power generators, fans, insufflators and displays. Modular devices
[00285] [00285] - Situational recognition is the ability of some aspects of a surgical system to determine or infer information related to a surgical procedure from data received from databases and / or instruments. The information may include the type of procedure being performed, the type of tissue being operated on or the body cavity that is the object of the procedure. With contextual information related to the surgical procedure, the surgical system can, for example, improve the way in which it controls the modular devices (for example, a robotic arm and / or robotic surgical instrument) that are connected to it and providing contextualized information or suggestions to the surgeon during the course of the surgical procedure.
[00286] [00286] - Now with reference to Figure 56, a timeline 5200 is shown representing the situational recognition of a central controller, such as the central surgical controller 106 or 206, for example. Timeline 5200 is an illustrative surgical procedure and the contextual information that the central surgical controller 106, 206 can derive from data received from data sources at each stage of the surgical procedure. Timeline 5200 represents the typical steps that would be taken by nurses, surgeons, and other medical personnel during the course of a pulmonary segmentectomy procedure, starting with the setup of the operating room and ending with the transfer of the patient to a post-op recovery room.
[00287] [00287] The central surgical controller with situation recognition 106, 206 receives data from data sources throughout the course of the surgical procedure, including the data generated each time medical personnel use a modular device that is paired with the central surgical controller 106, 206. central surgical controller 106, 206 can receive this data from paired modular devices and other data sources and will continually derive inferences (that is, contextual information) about the proce - ongoing procedure as new data are received, such as which stage of the procedure is being performed at any given time. The situational recognition system of the central surgical controller 106, 206 is able, for example, to record data related to the procedure to generate reports, verify the steps taken by medical personnel, provide data or warnings (for example , via a display screen) that may be relevant to the specific step of the procedure, adjust the modular devices based on the context (for example, activate monitors, adjust the field of view (FOV) of the medical imaging device, or change the energy level of an ultrasonic surgical instrument or RF electrosurgical instrument), and take any other action described above.
[00288] [00288] In the first step 5202, in this illustrative procedure, members of the hospital team retrieve the patient's electronic medical record (RME) from the hospital's RME database. Based on patient selection data in the RME, the central surgical controller 106, 206 determines that the procedure to be performed is a thoracic procedure.
[00289] [00289] In the second step 5204, the team members scan the entry of medical supplies for the procedure. The central surgical controller 106, 206 cross-references scanned supplies with a list of supplies that are used in various types of procedures and confirms that the mixing of supplies corresponds to a thoracic procedure. In addition, the central surgical controller 106, 206 is also able to determine that the procedure is not a wedge resection procedure (because the inlet supplies have an absence of certain supplies that are necessary for a resection procedure in thoracic wedge or, otherwise, the inlet supplies do not correspond to a thoracic wedge resection procedure).
[00290] [00290] In the third step 5206, the medical staff scans the patient's bank with a scanner that is connected in communication with the central surgical controller 106, 206. The central surgical controller 106, 206 can then confirm the patient's identity with based on the scanned data.
[00291] [00291] In the fourth step 5208, the medical staff turns on the auxiliary equipment. The auxiliary equipment being used may vary according to the type of surgical procedure and the techniques to be used
[00292] [00292] In the fifth step 5210, the team members fix the electrocardiogram (ECG) electrodes and other patient monitoring devices on the patient. ECG electrodes and other patient monitoring devices are able to pair with the central surgical controller 106, 206. According to the cyclic controller
[00293] [00293] In the sixth step 5212, the medical personnel induced anesthesia in the patient. Central surgical controller 106, 206 can infer that the patient is under anesthesia based on data from modular devices and / or from patient monitoring devices, including ECG data, blood pressure (PS) data, patient data fan, or combinations thereof, for example. After the completion of the sixth step 5212, the preoperative portion of the lung segmentectomy procedure is completed and the operative portion begins.
[00294] [00294] In the seventh step 5214, the lung of the patient who is being operated on is retracted (while ventilation is switched to the contralateral lung). The central surgical controller 106, 206 can infer from the ventilator data that the patient's lung has been retracted, for example. The central surgical controller 106, 206 can infer that the operative portion of the procedure started when it can compare the detection of the patient's lung collapse in the expected stages of the procedure (which can be accessed or retrieved earlier) and thus determine that lung retraction is the first operative step in this specific procedure.
[00295] [00295] In the eighth step 5216, the medical imaging device (for example, a display device) is inserted and the video from the medical imaging device is started. Central surgical controller 106, 206 receives data from the medical imaging device (i.e., video or image data) through its connection to the medical imaging device. After receiving data from the medical imaging device, the central surgical controller 106, 206 can determine which portion of the laparoscopic surgical procedure
[00296] [00296] In the ninth step 5218 of the procedure, the surgical team starts the dissection step. Central surgical controller 106, 206 can infer that the surgeon is in the process of dissecting to mobilize the patient's lung because he receives data from the RF or ultrasonic generator that indicate that an energy instrument is being triggered. Central surgical controller 106, 206 can cross-check the received data with the steps retrieved from the surgical procedure to determine that an energy instrument is being triggered at that point in the process (that is, after completing the previously discussed steps of the procedure) corresponds to the dissection stage. In certain cases, the energy instrument may be a power tool mounted on a robotic arm in a robotic surgical system.
[00297] [00297] In the tenth step 5220 of the procedure, the surgical team proceeds to the connection step. Central surgical controller 106, 206 can infer that the surgeon is ligating the arteries and veins because he receives data from the surgical stapling and cutting instrument indicating that the instrument is being fired. Similar to the previous step, the central surgical controller 106, 206 can derive this inference by crossing the reception data from the surgical stapling and cutting instrument with the steps recovered in the process. In some cases, the surgical instrument can be a surgical tool mounted on a robotic arm of a robotic surgical system.
[00298] [00298] In the eleventh step 5222, the segmentation portion of the procedure is performed. The central surgical controller
[00299] [00299] In the twelfth step 5224, the node dissection step is then performed. The central surgical controller 106, 206 can infer that the surgical team is dissecting the node and performing a leak test based on the data received from the generator that indicates which ultrasonic or RF instrument is being fired. For this specific procedure, an RF or ultrasonic instrument being used after the parenchyma has been transected corresponds to the node dissection step, which allows the central surgical controller 106, 206 to make this inference. It should be noted that surgeons regularly switch between surgical stapling / cutting instruments and surgical energy instruments (that is, RF or ultrasonic) depending on the specific step in the procedure because different instruments are better adapted for specific tasks. Therefore, the specific sequence in which cutting / stapling instruments and surgical energy instruments are used can indicate which stage of the procedure the surgeon is performed on. In addition, in certain cases, robotic tools can be used for one or more steps in a surgical procedure and / or surgical hand instruments can be used
[00300] [00300] In the thirteenth stage 5226, the patient's anesthesia is reversed. The central surgical controller 106, 206 can infer that the patient is emerging from anesthesia based on ventilator data (that is, the patient's respiratory rate begins to increase), for example.
[00301] [00301] Finally, in the fourteenth step 5228 is that medical personnel remove the various patient monitoring devices from the patient. The central surgical controller 106, 206 can therefore infer that the patient is being transferred to a recovery room when the central controller loses ECG, blood pressure and other data from patient monitoring devices. As can be seen from the description of this illustrative procedure, the central surgical controller 106, 206 can determine or infer when each step of a given surgical procedure is taking place according to the data received from the various data sources that are coupled in communication with the central surgical controller 106, 206.
[00302] [00302] Situational recognition is additionally described in US provisional patent application serial number 62 / 611,341, entitled INTE-RACTIVE SURGICAL PLATFORM, filed on December 28, 2017, which is hereby incorporated by reference in its entirety. In certain cases, the operation of a robotic surgical system, including the various robotic surgical systems disclosed here, for example, can be controlled by the central controller 106, 206 based on its situational recognition and / or the feedback provided by its components and / or based on information from the cloud
[00303] [00303] Robotic surgical systems can be used in minimally invasive medical procedures. During such medical procedures, a patient can be placed on a platform adjacent to a robotic surgical system and a surgeon positioned on a console that is remote from the platform and / or the robot. For example, the surgeon can position himself outside the sterile field that surrounds the surgical site. The surgeon provides input to a user interface using an input device on the console to manipulate a surgical tool attached to an arm of the robotic system. Input devices can be mechanical input devices, such as control handles or joystick, for example, or non-contact input devices, such as optical gesture sensors, for example.
[00304] [00304] The robotic surgical system may include a robotic tower that supports one or more robotic arms. At least one surgical tool (for example an end actuator and / or endoscope) can be mounted on the robotic arm. The one or more surgical tools can be configured to articulate in relation to the respective robotic arm through a joint handle assembly and / or to move in relation to the robotic arm through a linear sliding mechanism, for example. example. During the surgical procedure, the surgical tool can be inserted into a small incision in a patient through a cannula or trocar, for example, or into a patient's natural orifice to position the distal end of the surgical tool at the surgical site within the patient's body. Additionally or alternatively, the robotic surgical system can be used in an open surgical procedure in certain cases.
[00305] [00305] A schematic of the robotic surgical system 15000 is shown in Figure 22. The robotic surgical system 15000 includes a central control unit 15002, a surgeon console 15012, a robot 15022 including one or more robotic arms 15024 and a main screen 15040 operationally coupled to the 15002 control unit. The 15012 surgeon console includes a 15014 screen and at least one 15016 manual input device (eg keys, buttons, touch screens, joysticks, gimbals, etc.) that allow the surgeon telemanipulate the 15024 robotic arms of the 15022 robot. The reader will understand that additional and alternative input devices can be employed.
[00306] [00306] The 15002 central control unit includes a 15004 processor operationally coupled to a 15006 memory. The 15004 processor includes a plurality of inputs and outputs to interface with the components of the robotic surgical system 15000. The processor 15004 can be configured to receive input signals and / or generate output signals to control one or more of the various components (for example, one or more motors, sensors and / or screens) of the 15000 robotic surgical system. output may include, and / or be based on, algorithmic instructions that can be pre-programmed and / or entered by the surgeon or another doctor. The 15004 processor can be configured to accept a plurality of inputs from a user, such as the surgeon at the 15012 console, and / or can interface with a remote system. The 15006 memory can be directly and / or indirectly coupled to the 15004 processor to store instructions and / or databases.
[00307] [00307] The 15022 robot includes one or more 15024 robotic arms. Each 15024 robotic arm includes one or more 15026 motors and each 15026 motor is coupled to one or more 15028 motor drives. For example, 15026 motors, which can be assigned to different drivers and / or mechanisms, they can be housed in a conveyor or housing assembly. In certain cases, an intermediate transmission between a 15026 motor and one or more 15028 actuators may allow the coupling and decoupling of the 15026 motor with one or more 15028 actuators. The 15028 actuators can be configured to implement one or more surgical functions. For example, one or more actuators 15028 may be in charge of moving a robotic arm 15024 by rotating the robotic arm 15024 and / or a connection and / or articulation thereof. Additionally, one or more 15028 actuators can be coupled to a 15030 surgical tool and can implement functions such as pivoting, rotating, clamping, sealing, stapling, energizing, firing, cutting and / or opening, for example. In some cases, 15030 surgical tools can be interchangeable and / or replaceable. Examples of robotic surgical systems and surgical tools are described in detail below.
[00308] [00308] The | reader will readily understand that the interactive surgical system implemented by computer 100 (Figure 1) and the interactive surgical system implemented by computer 200 (Figure 9) can incorporate the robotic surgical system 15000. Additional or alternatively , the robotic surgical system 15000 can include several features and / or components of the interactive surgical systems implemented by computer 100 and 200.
[00309] [00309] In one example, the robotic surgical system 15000 can encompass the robotic system 110 (Figure 2), which includes the surgeon console 118, the surgical robot 120 and the robotic central controller
[00310] [00310] Another robotic surgical system is the VERSIUSO robotic surgical system from Cambridge Medical Robots Ltd. of Cambridge, England. An example of such a system is shown in Figure 23. With reference to Figure 23, the surgical robot includes an arm 14400 that extends from a base 14401. The arm 14400 includes a series of rigid segments 14402 that are coupled by articulations of resolution 14403. The most proximal segment 14402a is coupled to the base 14401 by a joint 14403a. The most proximal segment 14402a and the other segments (for example segments 14402b and 14402c) are coupled in series to additional segments in the joints 14403. A handle 14404 can consist of up to four individual revolutions joints. The handle 14404 couples a segment (for example, a segment 14402b) to the most distal segment (for example, the segment 14402c in Figure 23) of the 14400 arm. The most distal segment 14402c has an attachment 14405 for a 14406 surgical tool. - link 14403 of arm 14400 has one or more 14407 engines, which can be operated to cause rotating movement in the respective links, and one or more position and / or torque sensors 14408, which provide information about the load and / or current joint configuration
[00311] [00311] The 14400 arm ends at annex 14405 to interface with the surgical instrument 14406. annex 14405 includes a drive set to drive the articulation of the surgical tool
[00312] [00312] The surgical tool 14406 additionally includes an end actuator to perform an operation. The end actuator can take any suitable shape. For example, the end actuator may include smooth claws, serrated claws, tweezers, a pair of scissors, a suture needle, a camera, a laser, a knife, a stapler, one or more electrodes, an ultrasonic blade, an cauterizer and / or a suction device. Alternative end actuators are further described here. The 14406 surgical tool may include a hinge joint between the drive shaft and the end actuator, which can allow the end actuator to move in relation to the geometric axis of the tool. The joints in the articulation joint can be actuated by drive elements, such as pulley cables. Pulley arrangements for the articulation of the 14406 surgical tool are described in US patent application publication No. 2017/0172553, entitled PULLEY ARRANGEMENT FOR ARTICULATING A SURGICAL INSTRUMENT, filed on December 9, 2016 and published on June 22, 2017, which is hereby incorporated by reference in its entirety. The drive elements for articulating the surgical tool 14406 are attached to interface elements of the tool interface. In this way, the robotic arm 14400 can transfer the drive movements to the end actuator as follows: the movement of an interface element of the drive assembly moves an element of the tool interface, which moves a drive element in the tool
[00313] [00313] Controllers for 14407 motors and 14408 sensors (for example, torque sensors and encoders) are distributed within the 14400 robotic arm. The controllers are connected via a communication bus to a control unit
[00314] [00314] The control unit 14409 is coupled to the 14407 motors to drive them according to the outputs generated by the execution of the software. The control unit 14409 is coupled to sensors 14408 to receive the inputs detected by sensors 14408, and to the control interface 14412 to receive data from said interface. The respective couplings can, for example, be each via optical or electrical cables and / or can be provided over a wireless connection. The 14412 control interface includes one or more input devices through which a user can request to move the end actuator as desired. The input devices could be, for example, manually operated mechanical input devices, such as control handles or joysticks, or non-contact input devices, such as optical gesture sensors. The software stored in memory 14411 is configured to respond to these inputs and cause the articulations of arm 14400 and tool 14406 to move accordingly, in accordance with a predetermined control strategy. The control strategy may include safety features that moderate the movement of the arm 144400 and tool 14406 in response to command inputs. In summary, a surgeon at command interface 14412 can control surgical tool 14406 to move it to perform a desired surgical procedure. Control unit 14409 and / or control interface 14412 can be remote from arm 14400.
[00315] [00315] Additional features and operations of a surgical robot system, such as the robotic surgical system shown in Figure 23, are additionally described in the following references, each of which is incorporated herein by reference in its entirety:
[00316] [00316] and Publication of international patent application No. WO 2016/116753, entitled ROBOT TOOL RETRACTION, filed at
[00317] [00317] and US Patent Application Publication No. 2016/0331482, entitled METHOD FOR MAKING A SURGICAL STAPLER, deposited on May 13, 2016 and published on November 17, 2016;
[00318] [00318] and US Patent Application Publication No. 2017/0021507, entitled DRIVE MECHANISMS FOR ROBOT ARMS, filed on July 22, 2016 and published on January 27, 2017;
[00319] [00319] and Publication of US patent application No. 2017/0021508 instituted GEAR PACKAGING FOR ROBOTIC ARMS, filed on July 22, 2016 and published on January 27, 2017;
[00320] [00320] and Publication of US patent application No. 2017/0165012, entitled GUIDING ENGAGEMENT OF A ROBOT ARM AND SURGICAL INSTRUMENT, filed on December 9, 2016 and published on June 2017; and
[00321] [00321] and Publication of US patent application No. 2017/0172553, entitled PULLEY ARRANGEMENT FOR ARTICULATING A SURGICAL INSTRUMENT, filed on December 9, 2016 and published on June 22, 2017.
[00322] [00322] In one instance, the robotic surgical systems and features disclosed here can be employed with the VERSIUSO robotic surgical system and / or the robotic surgical system of Figure 23. The reader will also understand that the various systems and / or resources here shown here can also be used with alternative surgical systems including the computer-implemented interactive surgical system 100, the computer-implemented interactive surgical system 200, the robotic surgical system 110, the robotic central controller 122, the central controller robotic 222 and / or the robotic surgical system 15000, for example.
[00323] [00323] In several cases, a robotic surgical system may include a robotic control tower, which can house the system's control unit. For example, the control unit 14409 of the robotic surgical system shown in Figure 23 can be housed inside a robotic control tower. The robotic control tower can include a robotic central controller, such as a robotic central controller 122 (Figure 2) or robotic central controller 222 (Figure 9), for example. Such a robotic central controller can include a modular interface for coupling with one or more generators, such as an ultrasonic generator and / or a radio frequency generator, and / or one or more modules, such as an imaging module, a suction module, a module irrigation system, a smoke evacuation module and / or a communication module, for example.
[00324] [00324] The reader will readily understand that the interactive surgical system implemented by computer 100 (Figure 1) and the interactive surgical system implemented by computer 200 (Figure 9) disclosed here may incorporate the robotic arm 14400. In addition or alternatively, the system robotic surgery depicted in Figure 23 can include various features and / or components of interactive surgical systems implemented by computer 100 and 200.
[00325] [00325] A robotic central controller can include a situational recognition module, which can be configured to synthesize data received from various sources to determine an appropriate response to a surgical event. For example, a situational recognition module can determine the type of surgical procedure, the step in the surgical procedure, the type of tissue and / or characteristics of the tissue, as further described in this document. In addition, such a module can recommend a specific course of action or possible choices for the robotic system based on the synthesized data. In many cases, a detection system that covers a plurality of sensors distributed throughout the robotic system can provide data, images and / or other information for the situational recognition module. Such a situational recognition module can be incorporated into a control unit, such as the control unit 14409, for example. In several cases, the situational recognition module can obtain data and / or information from a non-robotic central surgical controller and / or a cloud, such as central surgical controller 106, central surgical controller 206, the cloud 104 and / or cloud 204, for example. The situational recognition of a surgical system is further revealed here and in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, and in US provisional patent application no. serial number 62/611340, entitled CLOUD-BASED MEDICAL ANALYTICS, deposited on December 28, 2017, which are each incorporated herein by reference in their entirety.
[00326] [00326] “Again with reference to Figure 23, the robotic arm 14400 does not include a linear sliding mechanism for moving the fixed surgical tool 14406 along a longitudinal geometric axis of the tool 14406. Instead, the segments 14402 of the arm 14400 are configured to rotate around several joints 14403 of the arm 14400 to move the surgical tool 14406. In other words, even the movement of the surgical tool 14406 along its longitudinal geometric axis Ar requires the articulation of several segments 14402. For example, to move the surgical tool 14406 along the longitudinal geometric axis Ar, the robotic arm 14400 would move in multiple articulations of revolution 14403 thereof. Indeed, the linear displacement of the 14406 tool to extend the end actuator through a trocar, retract the trocar end actuator and / or for localized displacements of the 14406 surgical tool along the longitudinal geometric axis Ar, as during a The suturing process, for example, would require the actuation of multiple articulations of revolution 14403 and the corresponding movement of multiple portions of rigid segments 14402 of arm 14400.
[00327] [00327] In cases where a robotic surgical system is devoid of a linear sliding mechanism, as described here, intelligent detection systems, additional communication paths and / or interactive screens may allow more precise control of the robotic arm which includes the application of control movements that involve a linear displacement of the surgical tool along its geometric axis. For example, to ensure accurate positioning of the 14406 tool and to avoid unintentional collisions within an operating room, it may be desirable to include additional systems in the robotic system to determine the position of a 14406 surgical instrument and / or portions of the robotic arm 14400, for repositioning of the robotic arm 14400 from within the sterile field, to inform the position of the surgical tool 14406 in relation to the surgical site, to view the surgical tool 14406 at the surgical site and / or to manipulate the surgical tool 14406 through the surgical site, for example.
[00328] [00328] In one aspect, a robotic surgical system may include a primary control mechanism for positioning the tool and a secondary means for measuring, directly and / or independently, the position of the tool. In one aspect, a redundant or secondary detection system can be configured to determine and / or check the position of a robotic arm and / or a surgical tool attached to the robotic arm. The secondary detection system can be independent of a primary detection system.
[00329] [00329] In one case, the primary control mechanism can be based on closed loop feedback to calculate the position of the tool. For example, a control unit of a surgical system
[00330] [00330] In addition to a primary detection system, as described here, a redundant or secondary detection system can be employed by the robotic surgical system. The secondary detection system can include one or more sensors located distally. The sensors located distally can be positioned within the sterile field and / or on the end actuator, for example. The sensors located distally are distal to the sensors located proximally to the primary detection system, for example. In one example, the sensors located distally may be "local" sensors because they are close to the sterile field and / or the surgical site, and the proximally located sensors can be "remote" sensors because they are away from the sterile field and / or the surgical site.
[00331] [00331] Now with reference to Figure 31, portions of a robotic surgical system 14300 are represented schematically. The surgical system 14300 is similar in many ways to the surgical robotic system of Figure 23. For example, the ro- bottic 14300 includes a plurality of movable components 14302. In one aspect, movable components 14302 are rigid segments that are mechanically coupled in series to the joints of revolution. Such mobile components 14302 can form a robotic arm, similar to the robotic arm 14440 (Figure 23), for example. The most distal component 14302 includes an attachment for releasing interchangeable surgical tools, such as the surgical tool 14306, for example. Each 14302 component of the robotic arm has one or more 14307 motors and 14314 motor drives, which can be operated to affect the rotary movement in the respective joints.
[00332] [00332] Each component 14302 includes one or more sensors 14308, which can be position sensors and / or torque sensors, for example. 14308 sensors can provide information about the current configuration and / or load in the respective joints between components
[00333] [00333] A primary detection system 14310 is incorporated into the control unit 14309. In one aspect, the primary detection system 14310 can be configured to detect the position of one or more components 14302. For example, the primary detection system river 14310 can include sensors 14308 for engines 14307 and / or actuators 14314. Such sensors 14308 are moved away from patient P and located outside the sterile field. Although located outside the sterile field, the primary detection system 14310 can be configured to detect the respective positions of the one or more components 14302 and / or the tool 14306 in the sterile field, as in the position of the distal end of the robotic arm and / or the fixing portion thereof. Based on the position of the robotic arm 14302 and its components, the control unit 14309 can extrapolate the position of the surgical tool 14306, for example.
[00334] [00334] The robotic surgical system 14300 of Figure 31 also includes a secondary detection system 14312 for directly tracking the position and / or orientation or various parts of the robotic surgical system 14300 and / or parts of a non-robotic system - cited, as handheld surgical instruments 14350. Also referring to Figure 31, the secondary detection system 14312 includes a magnetic field emitter 14320 that is configured to emit a magnetic field near one or more magnetic sensors to detect its positions. The 14302 components of the robotic arm include 14322 magnetic sensors, which can be used to determine and / or verify the position of the respective components
[00335] [00335] In certain cases, 14322 magnetic sensors can be positioned within the sterile field. For example, surgical tool 14306 may include magnetic sensor 14324, which can be used to determine and / or verify the position of surgical tool 14306 attached to the robotic arm and / or to determine and / or check the position of a component of the surgical tool 14306, as a trigger element, for example. Additionally or alternatively, one or more 14326 patient sensors can be positioned inside patient P to measure the patient's anatomical location and / or orientation. Additionally or alternatively, one or more trocar sensors 14328 can be positioned on a 14330 trocar to measure the location and / or orientation of the trocar, for example.
[00336] [00336] With reference again to the robotic arm 14400 represented in Figure 23, the surgical tool 14406 is attached to the fixation portion 14405 at the distal end of the robotic arm 14400. When the surgical tool 14406 is positioned inside a trocar, the system - robotic surgery can establish a virtual pivot that can be fixed by the robotic surgical system, so that the arm 14400 and / or the surgical tool 14406 can be manipulated around it to avoid and / or minimize the application of lateral forces when trocar. In certain cases, applying force (s) to the trocar can damage the surrounding tissue, for example. This way, to avoid involuntary damage to the fabric, the robotic arm 14400 and / or the surgical instrument 14406 can be configured to move around the virtual pivot axis of the trocar without disturbing its position and, in this way, , without disturbing the corresponding trocar position. Even when a linear displacement of the 14406 surgical tool is applied to enter or exit the exchange, the virtual pivot can remain unchanged.
[00337] [00337] In one aspect, the trocar sensor (s) 14328 in Figure 31A can be positioned on a virtual pivot axis 14332 on the 14330 exchange. In other instances, the trocar 14328 can be adjacent to virtual pivot 14332. The placement of the 14328 troop sensors in, and / or adjacent to, your 14332 virtual pivot, allows you to track the position of the 14330 trocar and virtual pivot 14332, and helps to ensure that the 14330 trocar will not move during the displacement of the tool
[00338] [00338] Additionally or alternatively, one or more 14352 sensors can be positioned on one or more 14350 hand-held surgical instruments, which can be used during a surgical procedure in combination with the 14306 surgical tools used by the 14300 robotic surgical system. secondary detection system 14312 is configured to detect the position and / or orientation of one or more 14350 hand-held surgical instruments within the surgical field, for example, within the operating room and / or the sterile field. Such 14350 hand-held surgical instruments may include autonomous control units, which may not be controlled robotically, for example. As shown in Figure 31, 14350 handheld surgical instruments can include sensors 14352, which can be detected by the magnetic field emitter 14320, for example, so that the position and / or location of 14350 handheld surgical instruments can be verified by the robotic surgical system 14300. In other instances, the components of 14350 hand-held surgical instruments can provide a detectable output. For example, an engine and / or a battery can be detectable by a sensor in the operating room.
[00339] [00339] In one aspect, the 14320 magnetic field emitter can be incorporated into a main robotic tower. Sensors 14322, 14324, 14326, 14328 and / or 14352 within the sterile field can reflect the magnetic field back to the main robotic tower to identify their positions. In several cases, data from the 14320 magnetic field emitter can be communicated
[00340] [00340] In other cases, the 14320 magnetic field emitter may be external to the robotic control tower. For example, the 14320 magnetic field emitter can be incorporated into a central controller.
[00341] [00341] Similar to the secondary detection system 14312, which includes the magnetic field emitter 14320, in certain cases, the ToF sensors ("time-of-flight") can be positioned in one or more among: robot components 14302, surgical tools 14306, patients P, trocars 14328 and / or surgical hand instruments 14350 to provide a matrix of distances between the emitting and reflecting points. Such ToF sensors can provide primary or secondary (for example, redundant) detection of the position of robot components 14302, surgical tools 14306, patients P, trocars 14328 and / or surgical instruments 14350, for example. In one case, ToF sensors can employ a pulse of infrared light to provide distance mapping and / or facilitate 3D imaging within the sterile field.
[00342] [00342] In one case, the secondary detection system 14312 may include a redundant detection system that is configured to control
[00343] [00343] Again with reference to Figure 31, in one case, the components 14302 of the robotic surgical system 14300 can correspond to different robotic arms, such as the robotic arms 15024 in the robotic surgical system 15000 (Figure 22) and / or the arms robotics represented in Figure 2, for example. The secondary detection system 14312 can be configured to detect the position of the robotic arms and / or portions of them, as the multiple arms are manipulated in the operating room. In certain cases, if one or more arms are commanded to move towards a possible collision, the secondary detection system 14312 can alert the surgeon with an alarm and / or an indication on the surgeon's console. to avoid such an involuntary collision of the arms.
[00344] [00344] Now with reference to Figure 32, a flowchart for a robotic surgical system is shown. The flowchart can be used by the robotic surgical system 14300 (Figure 31), for example. In several cases, two independent detection systems can be configured to detect the location and / or orientation of a surgical component, such as a portion of a robotic arm and / or a surgical tool. The first detection system, or primary detection system, can be based on the load and / or torque sensors on the motors and / or motor drivers of the robotic arm. The second detection system, or secondary detection system, can be based on the ToF and / or magnetic sensors of the robotic arm and / or the surgical tool. The first and second detection systems are configured to operate independently and in parallel. For example, in step 14502, the first detection system determines the location and orientation of a robotic component and, in step 14504, it communicates the location and orientation detected to a control unit. Simultaneously, in step 14506, the second detection system determines the location and orientation of the robotic component and, in step 14508, it communicates the location and orientation detected to the control unit.
[00345] [00345] The locations and orientations determined independently of the robotic component are communicated to a central control unit in step 14510, such as the robotic control unit 14309, and / or to a central surgical controller. By comparing locations and / or orientations, the control movements of the robotic component can be optimized in step 14512. For example, discrepancies between independently determined positions can be used to improve the accuracy and precision of movements of control. In certain cases, the control unit can calibrate the control movements based on the feedback provided by the secondary detection system. Data from the primary and secondary detection systems can be aggregated by a central controller, such as central controller 106 or central controller 206, for example, and / or stored in a cloud, such as cloud 104 or cloud 204, for example. example, to further optimize the control movements of the robotic surgical system.
[00346] [00346] In certain cases, the robotic system 14300 may be in signal communication with a central controller, such as central controller 106 or central controller 206, for example. Central controller 106, 206 may include a situational recognition module, as further described in this document. In one respect,
[00347] [00347] The reader will understand that several independent and redundant detection systems disclosed herein can be used by a robotic surgical system to optimize the accuracy of the control movements, especially when the surgical tool is moved along a longitudinal geometric axis without depend on a linear sliding mechanism, for example.
[00348] [00348] In one aspect, the central surgical controller includes a processor and a coupled memory in communication with the processor, as described here. The memory stores instructions executable by the processor to detect a position of a robotically controlled component independent of a primary detection system, as described above.
[00349] [00349] In several respects, the present disclosure provides a control circuit configured to detect a position of a computer.
[00350] [00350] In one aspect, a robotic surgical system can be configured to communicate wirelessly with one or more intelligent surgical tools mounted on a robotic arm thereof. The control unit of the robotic system can communicate with one or more intelligent surgical tools via a wireless connection, for example. In addition or alternatively, the robotic surgical system may include a central robotic controller, which can communicate wirelessly with the mounted intelligent surgical tool (s) on the robotic arm (s). In still other cases, a non-robotic central surgical controller can communicate wirelessly with the smart surgical tool (s) mounted on a robotic arm. In certain cases, information and / or commands can be provided to the intelligent surgical tool (s) from the control unit via the wireless connection. For example, certain functions of a surgical tool can be controlled via data received via a wireless communication link on the surgical tool. Similarly, in one aspect, closed-loop feedback can be provided to the robotic surgical system through data received via the wireless communication link of the surgical tool.
[00351] [00351] With reference mainly to Figures 28 to 30, a surgical tool 14206 is mounted on a robotic arm 14000 of a surgical robot. Robotic arm 14000 is similar in many respects to robotic arm 14400 in Figure 23. For example, arm 14000 includes a plurality of moving components 14002. In one aspect, moving components 14002 are rigid segments that are mechanically coupled in series on the 14003 return joints. Such mobile components 14002 form the 14400 robotic arm, similar to the 14400 arm (Figure 23), for example. A more distal component 14002c of the robotic arm 14400 includes an attachment 14005 for releasably attaching interchangeable surgical tools, such as the surgical tool 14206. Each 14002 component of the 14000 arm has one or more motors and motor drivers, which can be operated to affect the rotating movement in the respective joint 14003.
[00352] [00352] Each component 14002 includes one or more sensors, which can be position sensors and / or torque sensors, for example, and can provide information about the configuration and / or current load in the respective joints between the components 14002. The motors can be controlled by the control unit, such as the control unit 14409 (Figure 23), which is configured to receive inputs from the 14008 sensors and / or a command interface, such as the 14412 surgeon's command console (Figure 23 ), for example.
[00353] [00353] The surgical tool 14206 is a linear stapler that includes a wireless communication module 14208 (Figure 29). The linear stapler can be an intelligent linear stapler and can include an intelligent gripper cartridge, an intelligent end actuator and / or an intelligent drive shaft, for example. Smart surgical components can be configured to determine various tissue properties, for example. In one example, one or more advanced end actuator functions can be implemented based on the detected tissue properties. The surgical end actuator can include one or more sensors to determine thickness, compression and / or impedance of the tissue, for example. In addition, certain parameters detected may indicate variations in the tissue, such as the location of a tumor, for example. Intelligent surgical devices to detect various properties of the tissue are additionally presented in the following references:
[00354] [00354] and US Patent No. 9,757,128, filed on September 5, 2014, entitled MULTIPLE SENSORS WITH ONE SENSOR AF- FECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION, granted on September 12, 2017;
[00355] [00355] and US patent application No. 14 / 640,935, entitled OVERLAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION, filed on March 6, 2015, now publication of US patent application No. 2016/0256071, pu - closed on September 8, 2016;
[00356] [00356] and US patent application No. 15 / 382,238, entitled MODULAR
[00357] [00357] and US patent application No. 15 / 237,753, entitled CONTRACT OF ADVANCEMENT RATE AND APPLICATION FORCE BA- SED ON MEASURED FORCES, filed on August 16, 2016, now publication of US patent application No. 2018/0049822, published on February 22, 2018;
[00358] [00358] that are, each of which, here incorporated by reference in their entirety.
[00359] [00359] - As shown in Figure 28, a communication link
[00360] [00360] The wireless link 14212 between the surgical tool 14206 and the central surgical controller 14212 makes it possible to transfer data in real time through a sterile barrier
[00361] [00361] In certain cases, it may be difficult to confirm the position of surgical tool 14206 within the operating room, by the surgical site and / or in relation to the target tissue. For example, the lateral displacement of the surgical tool 14206 can be restricted by physical separation, such as a trocar that extends longitudinally, for example. In such cases, the lateral displacement of the surgical tool 14206 could
[00362] [00362] When the surgical tool 14206 is moved along the longitudinal geometric axis of the Ar tool (Figure 29), which is collinear with the driving axis of the surgical tool 14206, it can be difficult to determine and / or confirm the exact position of the surgical tool
[00363] [00363] Referring mainly to Figure 29, in one instance, the surgical tool 14206 can be used to remove a cancerous tumor 14242 from a patient's T tissue. To ensure complete removal of tumor 14242 and at the same time minimize the removal of healthy tissue, a predefined margin zone 14240 can be defined around tumor 14242. The margin zone can be determined by the surgeon based on patient data, aggregate data received from a central controller and / or a cloud, and / or data detected by one or more intelligent components of the surgical system, for example. During operation, surgical tool 14206 can transect T tissue along margin zone 14240 so that margin zone 14240 is removed along with tumor 14242. Primary and secondary detection systems 14310 and 14312 (Figure 31) they can determine the position of the 14206 surgical tool in relation to the margin zone, for example. In addition, the wireless communication module 14208 can communicate the detected position (s) to the control unit.
[00364] [00364] In certain cases, the robotic system of Figures 28 to 30 may be configured to act (for example, firing) the surgical tool 14206 when the surgical tool 14206 moves within the 14240 margin zone. For example, referring mainly to Figure 30, a 14250 distance and closing force plot is shown as a function of time for linear stapler 14206 during the surgical procedure in Figure 28. As the surgical tool 14206 approaches the 14240 margin zone at time ti, the force to close (FTC) increases indicating that the surgical tool 14206 is being attached to tissue T around tumor 14242 between time tr and time t2. More specifically, surgical tool 14206 is secured when moved into position at a distance between distances D, and D2. The distance D; can refer to the external contour of the marking zone
[00365] [00365] In several cases, the control unit and its processor can automatically affect the gripping movement when the surgical tool 14206 is positioned at an appropriate distance based on the input received, a primary detection system and / or secondary detection system. In other cases, the control unit and its processor can automatically alert the surgeon that the 14206 surgical tool is positioned at an adequate distance. Similarly, in certain cases, the processor may automatically trigger the surgical tool 14206 and / or suggest to the surgeon that the surgical tool 14206 can be triggered based on the detected position (s) of the surgical tool 14206. The reader will readily realize that other actuation movements can be contemplated, such as energizing an energy tool and / or articulating an articulating end actuator, for example.
[00366] [00366] In certain cases, the central controller 14212 may include a situational recognition system, as further described in this document. In one aspect, the position of the tumor 14242 and / or the margin zone 14240 around it can be determined by the central recognition module or system of the central controller 14212. In certain cases, the communication module wireless 14208 can be in signal communication with the central controller 14212 situational recognition module. For example, again with reference to Figure 33, the stapler data and / or the cartridge data provided in steps 5220 and 5222 can be provided via the wireless communication module 14208 of the stapling tool 14206, for example.
[00367] [00367] In one aspect, sensors positioned on the surgical tool 14206 can be used to determine and / or confirm the position of the surgical tool 14206 (for example, a secondary detection system). In addition, the detected position of the linear stapler can be communicated to the central surgical controller 14212 via the wireless communication link 14210, as further described in this document. In such cases, the central surgical controller 14212 can obtain in real time, or near real time, information about the position of the surgical tool 14206 in relation to the tumor 14242 and the margin zone 14240 based on the data communicated through the communication link without wire 14230. In several cases, the robotic surgical system can also determine the position of the surgical tool 14206 based on the engine control algorithms used to position the robotic arm 14000 in the operating room (for example, a primary detection).
[00368] [00368] In one aspect, a robotic surgical system can be integrated with an imaging system. The real-time feeds from the surgical site, which are obtained by the imaging system, can be communicated to the robotic surgical system. For example, again with reference to Figures 2 and 3, real-time feeds from imaging module 138 in central controller 106 can be communicated to robotic surgical system 110. For example, real-time feeds can be communicated to the robotic central controller
[00369] [00369] In certain cases, the superimposition of the feeds in real time on a robotic screen may allow the surgical tools to be controlled precisely within a system of axes that is defined by the surgical tool and / or its act (s). - edge worshiper (s), as viewed by the real-time imaging system. In several cases, the cooperation between the robotic surgical system 110 and the imaging system 138 can provide triangulation and instrument mapping of surgical tools within the field of view, which can allow precise control of tool angles and / or advances thereof. In addition, change control from a standard fixed multi-axis Cartesian coordinate system to the axis defined by the currently assembled tool and / or the tool end actuator can allow the surgeon to issue commands along planes and / or clear axes. For example, a processor in the robotic surgical system can direct a displacement of a surgical tool along the geometric axis of the elongated drive axis of the surgical tool or a rotation of the surgical tool at a specific angle from the current position with based on a selected point around which to rotate. In one example, the superimposed feeding of a surgical tool can incorporate a secondary or redundant detection system, as described here further, to determine the location and / or orientation of the surgical tool.
[00370] [00370] In certain cases, a robotic arm, such as the robotic arm 14400 (Figure 23) can be significantly heavy. For example, the weight of a robotic arm may be such that lifting or manually repositioning it would be difficult for most physically able doctors. In addition, the motors and drive mechanisms of the robotic arm can only be controlled by a primary control system located on the control unit based on the inputs of the surgeon's command console. In other words, a robotic surgical system
[00371] [00371] A robotic arm in a robotic surgical system may be prone to involuntary collisions with equipment and / or people within the sterile field. For example, during a surgical procedure, one or more surgeons, nurses and / or medical assistants positioned within the sterile field can move through the sterile field and / or around the robotic arms. In certain cases, one or more surgeons, nurses and / or medical assistants, for example, can reposition equipment within the sterile field, such as tables and / or carts, for example. When a surgeon positioned outside the sterile field is controlling the robotic arm, another surgeon, nurse and / or medical assistant within the sterile field may also want to manually move and / or adjust the position of one or more robotic arms to avoid a possible collision with the arm (s), interlacing the arm with other equipment and / or other arms, and / or to replace, reload and / or reconfigure a surgical tool mounted on the arm. However, to reposition the robotic arm, the surgeon may need to turn off the robotic surgical system to allow the physician in the sterile field to manually reposition the robotic arm. In such cases, it may be necessary for the physician to carry the significant weight of the disconnected robotic arm.
[00372] [00372] In one example, a robotic surgical system may include an interactive screen that is local to the sterile area and / or the robotic arm (s). Such a local screen can facilitate the manipulation and / or positioning of the arm (s) by a doctor within the sterile field. In other words, an operator other than the surgeon at the control console can control the position of the robotic arm (s).
[00373] [00373] Now with reference to Figure 24, a doctor applies force to the robotic arm 14000 to manually adjust the position of the robotic arm 14000. In certain cases, the robotic surgical system using the robotic arm 14000 may employ a mode of passive energy assistance, in which the 14400 robotic arm can be easily repositioned by a physician within the sterile field. For example, although the robotic arm 14000 is powered and controlled by a remote control unit, the doctor can manually adjust the position of the robotic arm 14000 without having to carry the entire weight of the robotic arm 14000. The doctor can attach and / or push the robotic arm 14000 to adjust the position of the arm. In passive energy assistance mode, energy for the robotic arm 14000 can be restricted and / or limited to allow passive repositioning by the physician.
[00374] [00374] Now with reference to Figure 25, a 14050 graph of force is plotted as a function of time for the robotic arm 14000 (Figure 24) in a passive energy assistance mode. In passive energy assistance mode, a physician can apply a manual force to the robotic arm 14000 to initiate repositioning of the robotic arm 14000. The physician may be within the sterile field. In certain cases, the passive energy assistance mode can be activated when the robotic arm 14000 detects manual manipulation.
[00375] [00375] As shown in Figure 25, the manual force exerted by a doctor can increase until it exceeds a predefined limit, such as the limit of 11.34 kg (25 lb) indicated in Figure 25, for example, to affect the repositioning of the 14000 robotic arm. In certain cases, the predefined limit can correspond to the maximum force that a physically fit auxiliary can easily exert on the 14000 robotic arm without causing tension or deformation. In other cases, the predefined limit may correspond to a minimum force limit on the robotic arm 14000 to avoid providing energized assistance to unintentional or involuntary contacts with the robotic arm
[00376] [00376] When the user exerts a force on the robotic arm 14000 above the predefined limit, one or more motors (for example, motors 14407 in Figure 23) of the robotic surgical system can apply an auxiliary force to the robotic arm 14000 to help reposition the robotic arm 14000 in the direction indicated by the operator's force on the robotic arm 14000. In such cases, the operator can easily manipulate the position of the arm to avoid unintentional collisions and / or entanglements and, when the operator's strength exceeds a comfortable force limit, the engines can assist or assist in repositioning the arm. The passive energy assistance provided by the motors of the robotic surgical system can compensate for the weight of the robotic arm 14000. In other cases, the auxiliary force may be less than the weight of the robotic arm 14000. In certain cases, the auxiliary force may be limited to a maximum force, such as the 2.27 kg (5 | b) limit shown in Figure 25, for example. The auxiliary force limit can ensure that the robotic arm 14000 does not collide strongly with a person, surgical equipment and / or other robotic arm in the operating room.
[00377] [00377] In one aspect, the passive energy assistance mode can be disabled or locked during portions of a surgical procedure. For example, when a surgical tool is positioned at the surgical site or within a predefined radius of the surgical site and / or the target tissue, the passive energy assist mode can be locked. Additionally or alternatively, during certain stages of a surgical procedure, the passive energy assist mode can be locked. Situational recognition can be configured to determine whether passive energy assistance mode should be locked. For example, based on information that a central controller has about the stage of the surgical procedure (see, for example, Figure 33), a passive energy assistance mode may be poorly advised by the situational awareness module. . Similarly, the passive energy assist mode can be activated during certain portions of the surgical timeline shown in Figure 33.
[00378] [00378] In one aspect, the control unit for operating a robotic arm includes a processor and a coupled memory in communication with the processor, as described here. The memory stores instructions executable by the processor to operate in a passive energy assistance mode, in which the processor is configured to process a manual force applied to the robotic arm and, if the manual force exceeds a predefined limit, direct one or more robotic arm motors to provide an auxiliary force to reposition the robotic arm in the direction indicated by manual force.
[00379] [00379] In several aspects, the present disclosure provides a control circuit configured to operate in a passive energy assistance mode, as described above. In many respects, the present disclosure provides a computer-readable, non-transitory medium that stores computer-readable instructions that, when executed, cause a machine to operate in a passive energy assistance mode, as described above.
[00380] [00380] Now with reference to Figures 26 and 27, a doctor within the sterile field uses a 14160 control module within a location of the sterile field to affect the repositioning of a robotic arm 14100. The robotic arm 14100 is similar, in many respects, to the robotic arm 14400 of Figure 23. For example, the robotic arm 14100 includes a plurality of moving components 14102. Moving components 14102 are rigid segments that are mechanically coupled in series to the joints of revolution
[00381] [00381] Each 14102 component includes one or more sensors, which can be position sensors and / or torque sensors, for example, and can provide information about the configuration and / or current load on the respective joints between the 14102 components. The motors can be controlled by the control unit, such as the control unit 14409 (Figure 23), which is configured to receive inputs from the sensors and / or a surgical control interface, such as the 14412 surgical control interface (Figure 23), for example.
[00382] [00382] The local control module 14160 includes an interactive screen 14164 and a touchscreen 14166 that is configured to accept inputs, such as inputs from a finger and / or a pen 14168, for example. The 14160 local control module is a portable mobile digital electronic device. For example, the 14160 local control module can be an iPadO & tablet or another mobile tablet or smartphone, for example. In use, the physician provides repositioning instructions for the robotic arm 14100 via screen 14164 and / or the touch screen 14166 of the 14160 local control module. The 14160 local control module is a 14162 wireless communication module so that the inputs provided by the physician can be communicated to the 14140 robotic arm to affect control arm movements. The 14140 local control module can communicate wirelessly with the 14140 robotic arm and / or a control unit (for example, the control unit 14409 in Figure 23) via the robotic system. Wi-Fi connection, for example.
[00383] [00383] The robotic arm 14100 includes six degrees of freedom indicated by the six arrows in Figure 26. The proximal degrees of freedom can be controlled by the local control module 14160 and the distal degrees of freedom can be controlled by remote control module. In one instance, the three most proximal degrees of freedom (articulation around the two most proximal joints 14103 and rotation of the intermediate segment 14102 around their geometric axis) can be controlled by the local control module, and the three degrees more distal freedom points (articulation around the most distal joint 14103, the rotation of the most distal segment 14102c around its geometrical axis, and displacement of the surgical tool 14106 along its geometric axis) can be controlled by the module remote control. In such cases, the doctor in the sterile field may affect the grosser control movements of the robotic arm, such as the control movements of the arms and / or proximal joints. For example, the physician in the sterile field can quickly and easily move a robotic arm to a general position, such as a pre-operating position, tool change position and / or a refill position via the 14160 local control module. In such cases, the local control module 14160 is a secondary control system for the robotic arm 14100. The surgeon outside the sterile field can affect the most localized or precise control movements of the robotic arm through interface inputs. of the 14412 surgeon (Figure 23). In such cases, the 14412 surgeon's command interface outside the sterile field is the primary control system.
[00384] [00384] The | reader will readily appreciate that a number less than or greater than six degrees of freedom is contemplated in the present invention. Other alternative degrees of freedom are also contemplated. In addition, different degrees of freedom can be attributed
[00385] [00385] Referring mainly to Figure 27, a 14150 force plot is shown as a function of time for the robotic arm 14100. From time O to time t1, locally driven field forces are applied to the robotic arm 14100 by a doctor within the sterile field to adjust the general position of the robotic arm 14100. In certain cases, the force attributable to inputs from the local control module 14160 may be limited to a first maximum force (for example, the limit of 22, 7 kg (50 lb) shown in Figure 27). Using the 14160 local control module, the physician within the sterile field can quickly reposition the robotic arm 14100 to change and / or reload the 14160 surgical tool, for example. The interval between time O and time t; may correspond to a local drive mode. Active adjustment or reload time in a surgical procedure can occur during the local trigger mode. For example, during the local drive mode, the robotic arm 14100 may be out of contact with the patient's tissue and / or out of a predefined outline at the surgical site, for example.
[00386] [00386] Thereafter, the surgeon at the surgeon's control console can additionally actuate the robotic arm 14100. For example, from time t2 to time t3, the forces acted remotely are attributable to inputs on the control console of the surgeon. Remotely actuated forces can be limited to a second maximum force (for example, the 2.27 kg (5 lb) limit shown in Figure 27), which is less than the first maximum force. By limiting the second maximum force, a surgeon is less likely to cause a high-impact or high-speed collision in the sterile field, while the first maximum force
[00387] [00387] In one aspect, the local activation mode and / or the remote activation mode can be deactivated or locked during portions of a surgical procedure. For example, the local drive mode can be locked when the surgical instrument is interacting with tissue or is otherwise positioned at the surgical site. Situational recognition can be configured to determine whether the local drive mode should be locked. For example, based on information that a central controller has about the stage of the surgical procedure (see, for example, Figure 33), a local mode of action may be poorly advised by the situational recognition module. Similarly, the remote activation mode may be ill-advised during other portions of the surgical procedure.
[00388] [00388] In one aspect, the control unit for operating a robotic arm includes a processor and a memory coupled in communication with the processor, as described herein. The memory stores instructions executable by the processor to provide control movements to the robotic arm based on information received from a local control module during the portion (s) of a surgical procedure and to provide control movements to the robotic arm based on information received from a remote control module during the portion (s) of the surgical procedure. The first maximum force can limit the control movements from the local control module and a second maximum force can limit the control movements from the remote control module.
[00389] [00389] In several aspects, the present disclosure provides a control circuit configured to operate a robotic arm through a local control module and a remote control module, as described above. In several respects, the present disclosure provides a non-transitory, computer-readable medium that stores computer-readable instructions that, when executed, cause a machine to operate a robotic arm through a local control module and a control module. remote control, as described above.
[00390] [00390] The totality of the revelations of:
[00391] [00391] and US Patent No. 9,072,535, filed on May 27, 2011, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTA-TABLE STAPLE DEPLOYMENT ARRANGEMENTS, granted on July 7, 2015;
[00392] [00392] and US Patent No. 9,072,536, filed on June 28, 2012, entitled DIFFERENTIAL LOCKING ARRANGEMENTS FOR RATARY POWERED SURGICAL INSTRUMENTS, granted on July 7, 2015;
[00393] [00393] and US Patent No. 9,204,879, filed on June 28, 2012, entitled FLEXIBLE DRIVE MEMBER, granted on December 8, 2015;
[00394] [00394] e. US Patent No. 9,561,038, filed on June 28, 2012, entitled INTERCHANGEABLE CLIP APPLIER, issued on February 7, 2017;
[00395] [00395] and US Patent No. 9,757,128, filed on September 5, 2014, entitled MULTIPLE SENSORS WITH ONE SENSOR AF-
[00396] [00396] and US Patent Application No. 14 / 640,935, entitled OVERLAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION, filed on March 6, 2015, now publication of US patent application No. 2016/0256071, pu - closed on September 8, 2016;
[00397] [00397] and US patent application No. 15 / 382,238, entitled MODULAR
[00398] [00398] and US patent application No. 15 / 237,753, entitled CONTRACT OF ADVANCEMENT RATE AND APPLICATION FORCE BA- SED ON MEASURED FORCES, filed on August 16, 2016, now publication of US patent application No. 2018/0049822, published on February 22, 2018;
[00399] [00399] that are, each of which, here incorporated by reference in their entirety. Examples
[00400] [00400] Various aspects of the subject described in this document are defined in the numbered examples below.
[00401] [00401] Example 1. A surgical system comprising: a robotic system, comprising: a control unit; a robotic arm comprising an attachment portion; and a first detection system in signal communication with said control unit, said first detection system being configured to detect a position of said fixing portion. The surgical system further comprises a surgical tool removably attached to said fixation portion. The surgical system additionally comprises a second detection system configured to detect a position of said surgical tool, said secondary detection system being independent of said first detection system.
[00402] [00402] “Example 2. The surgical system of Example 1, in which said second detection system comprises: a magnetic field emitter and a magnetic field sensor incorporated in said surgical tool.
[00403] [00403] “Example 3.0 The surgical system of any of Examples 1 and 2, which additionally comprises a battery-powered hand surgical instrument comprising an instrument sensor, the said second detection system being configured to detect a position of said instrument sensor.
[00404] [00404] “Example 4. The surgical system of Example 3, which further comprises a real-time screen configured to show the position of said surgical tool and the position of said instrument sensor based on data provided by said sequence. second detection system.
[00405] [00405] Example 5. The surgical system of any of Examples 3 and 4, in which said battery-powered hand surgical instrument comprises an autonomous control unit.
[00406] [00406] Example 6. The surgical system of any of Examples 1 to 5, which further comprises a trocar comprising a trocar sensor, said second detection system being configured to detect a position of said sensor trocar.
[00407] [00407] Example 7. The surgical system of Example 6, which additionally comprises a real-time screen configured to show the position of said surgical tool and the position of said exchange based on data provided by said second system of detection.
[00408] [00408] Example 8. The surgical system of any of Examples 1 to 7, which further comprises a plurality of patient sensors applied to a patient, said second detection system being configured to detect the position of said patient sensors.
[00409] [00409] “Example 9. The surgical system of Example 8, which further comprises a real-time screen configured to show the position of said surgical tool and the position of said patient sensor based on data provided by said second system detection.
[00410] [00410] Example 10. A surgical system comprising: a robotic system, comprising: a control unit; a robotic arm comprising a first portion, a second portion and an articulation between said first and second portions; a first detection system configured to detect a position of said first portion and said second portion of said robotic arm; and a redundant detection system configured to detect a position of said first portion and said second portion of said robotic arm.
[00411] [00411] Example 11. The surgical system of Example 10, wherein said robotic arm comprises a motor, and said first detection system comprises a torque sensor in said motor.
[00412] [00412] Example 12. The surgical system of Examples 10 and 11, wherein said redundant detection system comprises a magnetic field emitter and a plurality of magnetic sensors positioned on said robotic arm.
[00413] [00413] Example 13. The surgical system of any of Examples 10 to 12, wherein said control unit comprises a processor and a memory coupled in communication with the product
[00414] [00414] Example 14. The surgical system of any of Examples 10 to 13, which additionally comprises a control circuit configured to compare the position detected by said first detection system with the position detected by said redundant detection system for optimize the control movements of said robotic arm.
[00415] [00415] Example 15. A surgical system comprising: a surgical robot, comprising: a control unit; and a robotic arm comprising an engine. The surgical system additionally includes a surgical tool removably attached to said robotic arm; The surgical system also comprises a first detection system in signal communication with said control unit, said first detection system comprising a torque sensor in said engine, and said first detection system being configured to detect a position of said surgical tool. The surgical system additionally comprises a second detection system configured to independently detect a position of said surgical tool.
[00416] [00416] Example 16.The surgical system of Example 15, wherein said second detection system comprises: a magnetic field emitter and a magnetic field sensor incorporated in said surgical tool.
[00417] [00417] Example 17. The surgical system of any of Examples 15 and 16, which additionally comprises a battery-powered hand surgical instrument comprising an instrument sensor, said second detection system being configured to detect a position of said instrument sensor.
[00418] [00418] Example 18. The surgical system of any of Examples 15 to 17, which additionally comprises a trocar comprising a trocar sensor, said second detection system being configured to detect a position of said trocar sensor.
[00419] [00419] Example 19. The surgical system of any of Examples 15 to 18, which further comprises a plurality of patient sensors applied to the patient's tissue, said second detection system being configured to detect the position of the said patient sensors.
[00420] [00420] Example 20. The surgical system of any of Examples 15 to 19, which additionally comprises a real-time screen configured to show one or more positions of said surgical tool based on data provided by said first system detection system and the said second detection system.
[00421] [00421] Example 21. The surgical system of any one of Examples 15 to 20, which additionally comprises a central controller comprising a situational recognition system, said first detection system and said second detection system comprising data sources for said situational recognition system.
[00422] [00422] “Although several forms have been illustrated and described, it is not the applicant's intention to restrict or limit the scope of the claims attached to such detail. Numerous modifications, variations, alterations, substitutions, combinations and equivalents of these forms can be implemented and will occur to those skilled in the art without departing from the scope of the present disclosure. In addition, the structure of each element associated with the shape can alternatively be described as a means to provide the function performed by the element. In addition, where materials are revealed for certain components, other materials can be used. It should be understood, therefore, that the preceding description and the appended claims are intended to cover all these modifications, combinations and variations that fall within the scope of the modalities presented. The appended claims are intended to cover all such modifications, variations, alterations, substitutions, modifications and equivalents.
[00423] [00423] The previous detailed description presented various forms of devices and / or processes through the use of block diagrams, flowcharts and / or examples. Although these block diagrams, flowcharts and / or examples contain one or more functions and / or operations, it will be understood by those skilled in the art that each function and / or operation within these block diagrams, flowcharts and / or examples can be implemented , individually and / or collectively, through a wide range of hardware, software, firmware or almost any combination thereof. Those skilled in the art will recognize, however, that some aspects of the aspects disclosed here, in whole or in part, can be implemented in an equivalent way in integrated circuits, such as one or more computer programs running on one or more computers (for example , such as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (for example, as one or more programs running on one or more microprocessors), as firmware, or virtually like any combination thereof, and that designing the set of circuits and / or writing the code for the software and firmware would be within the scope of practice of those skilled in the art, in light of this disclosure. In addition, those skilled in the art will understand that the mechanisms of the subject described here can be distributed as one or more program products in a variety of ways and that an illustrative form of the subject described here is applicable regardless of the specific type of program. means of signal transmission used to effectively carry out the distribution.
[00424] [00424] The instructions used to program the logic to execute various revealed aspects can be stored in a memory in the system, such as dynamic random access memory (DRAM), cache, flash memory or other storage. In addition, instructions can be distributed over a network or via other computer-readable media. Thus, machine-readable media can include any mechanism for storing or transmitting information in a machine-readable form (for example, a computer), but is not limited to, floppy disks, optical disks, compact memory disc read-only (CD-ROMs), and optical-dynamo discs, read-only memory (ROM), random access memory (RAM), erasable programmable read-only memory (EPROM), erasable programmable read-only memory electrically (EEPROM), magnetic or optical cards, flash memory, or a machine-readable tangible storage medium used to transmit information over the Internet via an electrical, optical, acoustic cable or other forms of propagated signals ( for example, carrier waves, infrared signal, digital signals, etc.). Consequently, computer-readable non-transitory media includes any type of machine-readable media suitable for storing or transmitting instructions or electronic information in a machine-readable form (for example, a computer).
[00425] [00425] As used in any aspect of the present invention, the term "control circuit" can refer to, for example, a set of wired circuits, programmable circuits (for example, a
[00426] [00426] As used in any aspect of the present invention, the term "logical" can refer to an application, software, firmware and / or circuit configured to perform any of the aforementioned operations. The software can be incorporated as a software package, code, instructions, instruction sets and / or data recorded on the computer-readable non-transitory storage media. The firmware can be incorporated as code, instructions or instruction sets and / or data that are hard-coded (for example, non-volatile) in memory devices.
[00427] [00427] As used in any aspect of the present invention, the terms "component", "system", "module" and the like may refer to a computer-related entity, be it hardware, a combination of hardware and software, software or running software.
[00428] [00428] “As used here in one aspect of the present disclosure, an" algorithm "refers to the self-consistent sequence of steps that lead to the desired result, where a" step "refers to the manipulation of physical quantities and / or logical states that can , although not necessarily necessary, take the form of electrical or magnetic signals that can be stored, transferred, combined, compared and manipulated in any other way. It is common use to call these signs bits, values, elements, symbols, characters, terms, numbers or the like. These terms and similar terms can be associated with the appropriate physical quantities and are merely convenient identifications applied to these quantities and / or states.
[00429] [00429] “A network can include a packet-switched network. Communication devices may be able to communicate with each other using a selected packet switched network communications protocol. An exemplary communications protocol may include an Ethernet communications protocol that may be able to allow communication using a transmission control protocol / Internet protocol
[00430] [00430] Unless otherwise stated, and as made evident by the aforementioned disclosure, it should be understood that, throughout said disclosure, discussions that use terms such as "processing", or "computation", or "calculation" , or "determination", or "display", or the like, refer to the action and processes of a computer
[00431] [00431] One or more components can be called in the present disclosure of "configured for", "configurable for", "operable / operational for", "adapted / adaptable for", "capable of", "as movable / conformed to ", etc. Those skilled in the art will recognize that "configured for" can, in general, encompass components in an active state and / or components in an inactive state and / or components in a standby state, except when the context dictates otherwise.
[00432] [00432] The terms "proximal" and "distal" are used here with reference to a doctor who handles the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the doctor, and the term "distal" refers to the portion located opposite the doctor. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down" can be used in the present disclosure with respect to the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.
[00433] [00433] Persons skilled in the art will recognize that, in general, the terms used here, and especially in the appended claims (eg, bodies of the appended claims) are generally intended as "open" terms (eg, the term "including" should be interpreted as "including, but not limited to", the term "having" should be interpreted as "having, at least", the term "includes" should be interpreted as "includes, but is not limited to ", etc.). It will also be understood by those skilled in the art that, when a specific number of a claim statement entered is intended, that intention will be expressly mentioned in the claim and, in the absence of such mention, no intention will be present. For example, as an aid to understanding, the following appended claims may contain the use of the introductory phrases "at least one" and "one or more" to introduce claim statements. However, the use of such phrases should not be interpreted as implying that the introduction of a claim statement by the indefinite articles "one, ones" or "one, ones" limits any specific claim containing the claim mention. claims that contain only such a mention are introduced, even when the same claim includes the introductory phrases "one or more" or "at least one" and indefinite articles, such as "one, ones" or "one, ones" (for example, example, "one, ones" and / or "one, ones" should typically be interpreted as meaning "at least one" or "one or more"); the same goes for the use of defined articles used to introduce claims.
[00434] [00434] Furthermore, even if a specific number of an introduced claim statement is explicitly mentioned, those skilled in the art will recognize that that statement must typically be interpreted as meaning at least the number mentioned (for example, the mere mention of "two mentions", without other modifiers, typically means at least two mentions, or two or more mentions). In addition, in cases where a convention analogous to "at least one of A, B and C, etc." is used, in general this construction is intended to have the meaning in which the convention would be understood by (for example, example, "a system that has at least one among
[00435] [00435] With respect to the appended claims, those skilled in the art will understand that the operations mentioned in the same can, in general, be performed in any order. In addition, although several operational flow diagrams are presented in one or more sequences, it must be understood that the various operations can be performed in other orders than those shown, or can be performed simultaneously. Examples of these alternative orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplementary, simultaneous, inverse or other variant orders, except when the context determines otherwise. In addition, terms such as "responsive to", "related to" or other adjectival participles are not intended in general to exclude these variants, unless the context otherwise requires.
[00436] [00436] It is worth noting that any reference to "one (1) aspect", "one aspect", "an example" or "one (1) example" ", and the like means that a given resource, structure or characteristic described in connection with the aspect it is included in at least one aspect. Thus, the use of expressions such as "in one (1) aspect", "in one aspect", "in an example", "in one (1) example", in several places throughout this specification it does not necessarily refer to the same aspect. In addition, specific resources, structures or characteristics can be combined in any appropriate way in one or more aspects.
[00437] [00437] Any patent application, patent, non-patent publication or other description material mentioned in this descriptive report and / or mentioned in any order data sheet is incorporated by reference, until the point where the materials incorporated are not inconsistent with this. Accordingly, and to the extent necessary, the disclosure as explicitly presented herein replaces any conflicting material incorporated by reference to the present invention. Any material, or portion thereof, that is incorporated herein by reference, but which conflicts with the definitions, statements, or other disclosure materials presented herein, will be incorporated here only to the extent that it does not there is a conflict between the embedded material and the existing disclosure material.
[00438] [00438] In short, numerous benefits have been described that result from the use of the concepts described in this document. The previously mentioned description of one or more modalities 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. One or more modalities were chosen and described in order to illustrate the principles and practical application to, thus, allow those skilled in the art to use the various modalities and with various modifications, as they are convenient to the specific use contemplated.
It is intended that the claims presented in the annex define the global scope.

权利要求:
Claims (21)
[1]
1. Surgical system, characterized by comprising: a robotic system comprising: a control unit; a robotic arm comprising an attachment portion; and a first detection system in signal communication with said control unit, said first detection system being configured to detect a position of said fixing portion; and a surgical tool removably attached to said fixation portion; and a second detection system configured to detect a position of said surgical tool, said secondary detection system being independent of said first detection system.
[2]
2. Surgical system according to claim 1, characterized in that said second detection system comprises: a magnetic field emitter; and a magnetic field sensor incorporated in the said surgical tool.
[3]
3. Surgical system, according to claim 2, characterized by additionally comprising a battery-powered portable surgical instrument comprising an instrument sensor, said second detection system being configured to detect a position of said instrument sensor.
[4]
4, Surgical system, according to claim 3, characterized by additionally comprising a real-time screen configured to show the position of said surgical tool and the position of said instrument sensor based on data provided by said second detection system.
[5]
5. Surgical system, according to claim 4, characterized in that said portable surgical instrument powered by battery comprises an autonomous control unit.
[6]
6. Surgical system, according to claim 1, characterized in that it additionally comprises a trocar comprising a trocar sensor, said second detection system being configured to detect a position of said trocar sensor.
[7]
7. Surgical system, according to claim 6, characterized by additionally comprising a real-time screen configured to show the position of said surgical tool and the position of said trocar based on data provided by said second detection.
[8]
8. Surgical system according to claim 1, characterized in that it further comprises a plurality of patient sensors applied to a patient, said second detection system being configured to detect the position of said patient sensors.
[9]
9. Surgical system, according to claim 8, characterized by additionally comprising a real-time screen configured to show the position of said surgical tool and the position of said patient sensors based on data provided by said second detection system.
[10]
10. Surgical system, characterized by comprising: a robotic system comprising: a control unit;
a robotic arm comprising a first portion, a second portion and an articulation between said first and second portions; a first detection system configured to detect a position of said first portion and said second portion of said robotic arm; and a redundant detection system configured to detect a position of said first portion and said second portion of said robotic arm.
[11]
11. Surgical system according to claim 10, characterized in that said robotic arm comprises a motor, and said first detection system comprises a torque sensor in said motor.
[12]
Surgical system according to claim 10, characterized in that said redundant detection system comprises a magnetic field emitter and a plurality of magnetic sensors positioned on said robotic arm.
[13]
13. Surgical system, according to claim 10, characterized in that said control unit comprises a processor and a memory coupled in communication with the processor, said memory stores instructions executable by said processor to compare the detected position by said first detection system with the position detected by said redundant detection system to optimize the control movements of said robotic arm.
[14]
14. Surgical system, according to claim 10, characterized in that it additionally comprises a control circuit configured to compare the position detected by said first detection system with the position detected by said detection system
redundant protection to optimize the control movements of said robotic arm.
[15]
15. Surgical system, characterized by comprising: a surgical robot that comprises: a control unit; and a robotic arm comprising an engine; a surgical tool removably attached to said robotic arm; a first detection system in signal communication with said control unit, said first detection system comprising a torque sensor in said motor, and said first detection system being configured to detect a position - tion of said surgical tool; and a second detection system configured to independently detect a position of said surgical tool.
[16]
16. Surgical system according to claim 15, characterized in that said second detection system comprises: a magnetic field emitter; and a magnetic field sensor incorporated in the said surgical tool.
[17]
17. Surgical system according to claim 16, characterized in that it additionally comprises a portable surgical instrument powered by a battery comprising an instrument sensor, said second detection system being configured to detect a position of said instrument sensor.
[18]
18. Surgical system, according to claim 16, characterized in that it additionally comprises a trocar comprising a trocar sensor, said second detection system being configured to detect a position of said trocar sensor.
[19]
19. Surgical system according to claim 16, characterized in that it further comprises a plurality of patient sensors applied to the patient's tissue, said second detection system being configured to detect the position of said patient sensors.
[20]
20. Surgical system, according to claim 16, characterized by additionally comprising a real-time screen configured to show one or more positions of said surgical tool based on data provided by said first detection system and by said second detection system.
[21]
21. Surgical system according to claim 15, characterized by additionally comprising a central controller comprising a situational recognition system, said first detection system and said second detection system comprising data sources for the said situational recognition system.

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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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US201762611339P| true| 2017-12-28|2017-12-28|

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US201762611340P| true| 2017-12-28|2017-12-28|

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US201762611341P| true| 2017-12-28|2017-12-28|

---

US62/611,341|2017-12-28|

---

US62/611,339|2017-12-28|

---

US62/611,340|2017-12-28|

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US201862649323P| true| 2018-03-28|2018-03-28|

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US62/649,323|2018-03-28|

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US15/940,711|US20190201120A1|2017-12-28|2018-03-29|Sensing arrangements for robot-assisted surgical platforms|

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US15/940,711|2018-03-29|

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PCT/IB2018/057438|WO2019130092A1|2017-12-28|2018-09-26|Sensing arrangements for robot-assisted surgical platforms|

---