cooperative use of data derived from secondary sources by intelligent surgical controllers

专利摘要:
The present invention relates to several surgical controllers. A surgical controller is used with a medical imaging device at a remote surgical site in a surgical procedure. The central surgical controller comprises a circuit configured to: receive a live transmission from the surgical site from the medical imaging device; capture an image of a surgical stage of the surgical procedure from the live transmission; derive information relevant to the surgical stage from the data extracted from the image frame; and superimpose the information on the live stream.
公开号:BR112020012739A2
申请号:R112020012739-6
申请日:2018-07-27
公开日:2020-12-01
发明作者:Frederick E. Shelton Iv；Jason L. Harris；David C. Yates
申请人:Ethicon Llc；
IPC主号:

专利说明:

[0001] [0001] This application claims the priority benefit set forth in Title 35 of USC 119 (e) of US provisional patent application serial number 62 / 649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES, filed on March 28, 2018, whose description is hereby incorporated by reference in its entirety for reference.
[0002] [0002] This application also claims the priority benefit set forth in Title 35 of USC 119 (e) of US provisional patent application serial number 62 / 611.341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, of the application for US provisional patent serial number 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on December 28, 2017, and US provisional patent application serial number 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28 2017, whose description of each of which is incorporated herein as a reference in its entirety. BACKGROUND OF THE INVENTION
[0003] [0003] The present description refers to several surgical systems. Surgical procedures are typically performed in centers or operating rooms in a health care facility, for example, a hospital. A sterile field is typically created around the patient. The sterile field may include members of the brushing team, who are properly dressed, and all furniture and accessories in the area. Various surgical devices and systems are used to perform a surgical procedure. SUMMARY OF THE INVENTION
[0004] [0004] In a general aspect, a central surgical controller is provided. The central surgical controller is used with a medical imaging device at a remote surgical site in a surgical procedure. The central surgical controller comprises a circuit configured to: receive a live transmission of the surgical site from the medical imaging device; capture an image of a surgical stage of the surgical procedure from the live transmission; derive information relevant to the surgical stage from the data extracted from the image frame; and superimpose the information to the live broadcast.
[0005] [0005] In another general aspect, another central surgical controller is provided. The central surgical controller is used with a medical imaging device at a remote surgical site in a surgical procedure that contains surgical steps. The central surgical controller comprises a circuit configured to: receive a live transmission from the surgical site from the medical imaging device; capture image frames of the surgical stages of the surgical procedure from the live transmission; and differentiate between the surgical steps based on data extracted from the image frames.
[0006] [0006] In yet another general aspect, another central surgical controller is provided. The central surgical controller is used with a medical imaging device at a remote surgical site in a surgical procedure. The central surgical controller comprises a circuit configured to: receive a live transmission from the surgical site from the medical imaging device; capture an image frame of the live broadcast; detect a pattern of staples in the image frame; and identifying the staple cartridge based on the staple pattern. The staple pattern is defined by staples implanted from a staple cartridge into the tissue at the surgical site. FIGURES
[0007] [0007] The appeals of several 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 additional objects and advantages of the same, can be better understood in reference to the description presented below, considered together with the attached drawings as follows.
[0008] [0008] Figure 1 is a block diagram of an interactive surgical system implemented by computer, according to at least one aspect of the present description.
[0009] [0009] Figure 2 is a surgical system being used to perform a surgical procedure in an operating room, in accordance with at least one aspect of the present description.
[0010] [0010] Figure 3 is a central surgical controller paired with a visualization system, a robotic system, and an intelligent instrument, in accordance with at least one aspect of the present description.
[0011] [0011] Figure 4 is a partial perspective view of a central surgical controller compartment, and of a generator module in combination received slidingly in a drawer of the central surgical controller compartment, according to at least an aspect of the present description.
[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 description.
[0013] [0013] Figure 6 illustrates different power bus connectors for a plurality of side coupling ports of a side modular cabinet configured to receive a plurality of modules, in accordance with at least one aspect of the present description.
[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 description.
[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 health care facility, or any environment in a hospital. installation of health services specially equipped for surgical operations, in the cloud, in accordance with at least one aspect of this description.
[0016] [0016] Figure 9 illustrates an interactive surgical system implemented by computer, according to at least one aspect of this description.
[0017] [0017] Figure 10 illustrates a central surgical controller that comprises a plurality of modules coupled to the modular control tower, in accordance with at least one aspect of the present description.
[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 description.
[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 description.
[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 description.
[0021] [0021] Figure 14 illustrates a combinational logic circuit configured
[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 description.
[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 description.
[0024] [0024] Figure 17 is a schematic diagram of a robotic surgical instrument configured to operate a surgical tool described therein, in accordance with at least one aspect of the present description.
[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 description.
[0026] [0026] Figure 19 is a schematic diagram of a surgical instrument configured to control various functions, in accordance with at least one aspect of the present description.
[0027] [0027] Figure 20 is a simplified block diagram of a generator configured to provide adjustment without inductor, among other benefits, in accordance with at least one aspect of the present description.
[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 description.
[0029] [0029] Figure 22 illustrates a combined generator, in accordance with at least one aspect of the present description.
[0030] [0030] Figure 23 illustrates a method of capturing data from a combined generator and communicating captured generator data to a cloud-based system, in accordance with at least one aspect of the present description.
[0031] [0031] Figure 24 illustrates a data package of combined generator data, in accordance with at least one aspect of the present description.
[0032] [0032] Figure 25 illustrates an encryption algorithm, in accordance with at least one aspect of the present description.
[0033] [0033] Figure 26 illustrates another encryption algorithm, in accordance with at least one aspect of the present description.
[0034] [0034] Figure 27 illustrates yet another encryption algorithm, in accordance with at least one aspect of the present description.
[0035] [0035] Figure 28 illustrates a high-level representation of a datagram, in accordance with at least one aspect of the present description.
[0036] [0036] Figure 29 illustrates a more detailed representation of the datagram in Figure 28, according to at least one aspect of this description.
[0037] [0037] Figure 30 illustrates another representation of the datagram in Figure 28, in accordance with at least one aspect of the present description.
[0038] [0038] Figure 31 illustrates a method for identifying surgical data associated with a failure event and communicating the identified surgical data to a cloud-based system on a prioritized basis, in accordance with at least one aspect of the present description. - dog.
[0039] [0039] Figure 32 illustrates yet another representation of the datagram in Figure 28, according to at least one aspect of the present description.
[0040] [0040] Figure 33 illustrates a partial artificial timeline of a surgical procedure performed in an operating room using a surgical system, in accordance with at least one aspect of the present description.
[0041] [0041] Figure 34 illustrates the ultrasonic ping of an operating room wall to determine a distance between a central surgical controller and the operating room wall, in accordance with at least one aspect of the present description.
[0042] [0042] Figure 35 is a logical flowchart of a process that represents a control program or a logical configuration for pairing the central surgical controller with surgical devices from a surgical system that are located within the confines of an operating room. , in accordance with at least one aspect of the present description.
[0043] [0043] Figure 36 is a logical flowchart of a process that represents a control program or a logical configuration to selectively form and interrupt connections between devices in a surgical system, according to at least one aspect of this description.
[0044] [0044] Figure 37 is a logical flow chart of a process that represents a control program or a logical configuration to selectively re-evaluate the limits of an operating room after the detection of a new device, according to at least one aspect of this description.
[0045] [0045] Figure 38 is a logical flowchart of a process that represents a control program or a logical configuration to selectively reassess the limits of an operating room after disconnecting a paired device, in accordance with at least one aspect of this description.
[0046] [0046] Figure 39 is a logical flow chart of a process that represents a control program or a logical configuration to reevaluate the limits of an operating room by a surgical controller.
[0047] [0047] Figure 40 is a logical flowchart of a process that represents a control program or a logical configuration to selectively form the connections between devices in a surgical system, according to at least one aspect of the present description.
[0048] [0048] Figure 41 is a logical flowchart of a process that represents a control program or a logical configuration to selectively form and interrupt connections between devices in a surgical system, according to at least one aspect of this description.
[0049] [0049] Figure 42 illustrates a central surgical controller pairing a first device and a second device of a surgical system in an operating room, according to at least one aspect of the present description.
[0050] [0050] Figure 43 illustrates a central surgical controller unpairing a first device and a second device from a surgical system in an operating room, and pairing the first device with a third device in the operating room, according to at least one aspect of the present description.
[0051] [0051] Figure 44 is a logical flowchart of a process that represents a control program or a logical configuration to form and interrupt connections between devices in a surgical system in an operating room during a surgical procedure based on the progression of the steps surgical procedure, in accordance with at least one aspect of the present description.
[0052] [0052] Figure 45 is a logical flowchart of a process that represents a control program or a logical configuration to superimpose information derived from one or more static frames from a live transmission from a remote surgical site to the live transmission, from according to at least one aspect of the present description.
[0053] [0053] Figure 46 is a logical flowchart of a process that represents a control program or a logical configuration to differentiate surgical steps from a surgical procedure, according to at least one aspect of the present description.
[0054] [0054] Figure 47 is a logical flow chart of a 3230 process that represents a control program or a logical configuration to differentiate the surgical steps from a surgical procedure, according to at least one aspect of the present description.
[0055] [0055] Figure 48 is a logical flow chart of a 3240 process that represents a control program or a logical configuration for identifying a staple cartridge from information derived from one or more static frames of staples implanted from the cartridge of staples in the fabric, in accordance with at least one aspect of the present description.
[0056] [0056] Figure 49 is a partial view of a surgical system in an operating room, the surgical system including a central surgical controller that has an imaging module in communication with an imaging device at a remote surgical site, from according to at least one aspect of the present description.
[0057] [0057] Figure 50 illustrates a partial view of the stapled fabric that received a first shot of staples and a second shot of staple disposed from end to end, in accordance with at least one aspect of the present description.
[0058] [0058] Figure 51 illustrates three rows of staples implanted on one side of a stapled tissue and cut by a surgical stapler, according to at least one aspect of the present description.
[0059] [0059] Figure 52 illustrates a non-anodized clamp and an anodized clamp, in accordance with at least one aspect of the present description.
[0060] [0060] Figure 53 is a logical flowchart of a process that represents a control program or a logical configuration for coordinating a control arrangement between central surgical controllers, according to at least one aspect of the present description.
[0061] [0061] Figure 54 illustrates an interaction between two central surgical controllers in an operating room, according to at least one aspect of the present description.
[0062] [0062] Figure 55 is a logical flowchart of a process that represents a control program or a logical configuration to coordinate a control arrangement between central surgical controllers, according to at least one aspect of the present description.
[0063] [0063] Figure 56 illustrates an interaction between two central surgical controllers in different operating rooms ("OR1" and "OR3"), according to at least one aspect of the present description.
[0064] [0064] Figure 57 illustrates a secondary view in an operating room ("OR3") showing a surgical site in a colorectal procedure, according to at least one aspect of the present description.
[0065] [0065] Figure 58 illustrates a personal interface or tablet in OR1 showing the OR3 surgical site, according to at least one aspect of this description.
[0066] [0066] Figure 59 illustrates an expanded view of the OR3 surgical site shown in a main view of OR1, in accordance with at least one aspect of the present description.
[0067] [0067] Figure 60 illustrates a personal interface or tablet showing an OR1 layout that shows the available screens, according to at least one aspect of this description.
[0068] [0068] Figure 61 illustrates a recommendation for a transection site of an OR3 surgical site made by a surgical operator in
[0069] [0069] Figure 62 illustrates a timeline that represents the situational recognition of a central surgical controller, according to at least one aspect of the present description. DESCRIPTION
[0070] [0070] The applicant for this application holds the following provisional US patent applications, filed on March 28, 2018, each of which is incorporated herein by reference in its entirety: and US Provisional Patent Application no. series 62 / 649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; and US Provisional Patent Application Serial No. 62 / 649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; and US Provisional Patent Application Serial No. 62 / 649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS; and US Provisional Patent Application Serial No. 62 / 649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; and US Provisional Patent Application Serial No. 62 / 649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS; and US Provisional Patent Application Serial No. 62 / 649,291, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORED TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; and US Provisional Patent Application Serial No. 62 / 649,296, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGI-CAL DEVICES;
[0071] [0071] The applicant for this application holds the following US patent applications, filed on March 29, 2018, each of which is incorporated by reference in its entirety: and US Patent Application No. series, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; Power of Attorney Document No. END8499USNP / 170766; and US Patent Application Serial No., entitled INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HAN-
[0072] [0072] The applicant for this application holds the following US patent applications, filed on March 29, 2018, each of which is incorporated herein by reference in its entirety: and US Patent Application No. series, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES; Power of Attorney Document No. END8506USNP / 170773; and US Patent Application Serial No., entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES; Proxy Document No. END8506USNP1 / 170773-1 and US Patent Application serial number, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER; Power of Attorney Document No. END8507USNP / 170774; and US Patent Application Serial No., entitled CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHA- VIORS OF LARGER DATA SET; Power of Attorney Document No. END8507USNP1 / 170774-1; and US Patent Application Serial No., entitled CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNC- TION; Power of Attorney Document No. END8507USNP2 / 170774-2; and US Patent Application serial number, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES; no
[0073] [0073] The applicant for this application holds the following US patent applications, filed on March 29, 2018, each of which is incorporated by reference in its entirety: and US Patent Application No. series, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; Proxy Document No. END8511USNP / 170778; and US Patent Application Serial No., entitled COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; Power of Attorney Document No. END8511 USNP1 / 170778-1; and US Patent Application Serial No., entitled CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; Power of Attorney Document No. END8511USNP2 / 170778-2; and US Patent Application Serial No., entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; Power of Attorney Document No. END8512 USNP / 170779; and US Patent Application Serial No., entitled CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLAT-FORMS; Power of Attorney Document No. END8512USNP1 / 170779-1;
[0074] [0074] 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. Illustrative examples can be implemented or incorporated in other aspects, variations and modifications, and can be practiced or executed in several ways. In addition, except where otherwise indicated, the terms and expressions used in the present invention have been 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 among the other aspects, expressions of aspects and / or examples described a follow.
[0075] [0075] With reference to Figure 1, an interactive surgical system implemented by computer 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, a smart handheld surgical instrument 112, which are configured to communicate with each other and / or the central controller 106. In some respects, a surgical system 102 may include a number of central controllers M 106 , an N number of visualization systems 108, an O number of robotic systems 110, and a P number of smart, hand-held surgical instruments 112, where M, N, O, and P are larger integers or equal to one.
[0076] [0076] 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
[0077] [0077] 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 description are described in provisional patent application no. 62 / 611,339, entitled ROBOT ASSISTED SURGI-CAL PLATFORM, filed on December 28, 2017, the description of which is incorporated herein by reference in its entirety.
[0078] [0078] Several examples of cloud-based analysis that are performed by cloud 104, and are suitable for use with the present description, are described in US Provisional Patent Application Serial No. 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on December 28, 2017, the description of which is incorporated here for reference, in its entirety.
[0079] [0079] 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.
[0080] [0080] 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 directed 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.
[0081] [0081] One or more light sources can be configured to radiate electromagnetic energy in the visible spectrum, as well as in the invisible spectrum. The visible spectrum, sometimes called the optical spectrum or light spectrum, is that portion of the electromagnetic spectrum that is visible to (that is, can be detected by) the human eye and can be called visible light or simply light. A typical human eye will respond to wavelengths in the air that are from about 380 nm to about 750 nm.
[0082] [0082] 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), microwaves, 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.
[0083] [0083] In several respects, the imaging device 124 is configured for use in a minimally invasive procedure. Examples of imaging devices suitable for use with the present description include, but are not limited to, an arthroscope, angioscope, bronchoscope, choledocoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagus-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngoscope, sigmoidoscope, thoracoscope, and ureteroscope.
[0084] [0084] 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 across the electromagnetic spectrum. The wavelengths can be separated by filters or by using instruments that are sensitive to specific wavelengths, including light from frequencies beyond the visible light range, for example, IR and ultraviolet light. Spectral images can allow the extraction of additional information
[0085] [0085] 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 the 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 members of the brushing team, who are properly dressed, and all furniture and accessories in the area.
[0086] [0086] In various 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 EMR. 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, the description of which is here incorporated as a reference in its entirety.
[0087] [0087] As shown in Figure 2, a primary 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.
[0088] [0088] 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 primary screen 119 within the sterile field, where it can be seen by a sterile operator on the operating table. In one example, the entry may be in the form of a modification of the snapshot displayed on the non-sterile screen 107 or 109, which can be routed to main screen 119 by central controller 106.
[0089] [0089] 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 description of which is incorporated herein 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 description is hereby incorporated by way of reference in its entirety, for example.
[0090] [0090] 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 central controller screen 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132 and a storage matrix 134. In certain respects, as shown in Figure 3, central controller 106 additionally includes a module - smoke evacuation module 126 and / or a suction / irrigation module 128.
[0091] [0091] 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 power, data and fluid lines, which reduces the frequency of interleaving between such lines.
[0092] [0092] The aspects of the present description present a central surgical controller for use in a surgical procedure that involves the application of 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, fluid, and / or particulates generated by the application of therapeutic energy to the tissue, and a fluid line that extends from the remote surgical site to the smoke evacuation component.
[0093] [0093] 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 in the central controller compartment. In one aspect, the central controller compartment comprises a fluid interface.
[0094] [0094] 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 description 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 central modular compartment 136 is that it allows the quick removal and / or replacement of several modules.
[0095] [0095] Aspects of the present description present 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 docking port that includes first data contacts and energy contacts, being that the first power generator module is slidingly movable in an electric hitch with power and data contacts and the first power generator module is slidingly movable out of the electric hitch with the first - other power and data contacts.
[0096] [0096] In addition to the above, the modular surgical compartment also includes a second energy generator module configured to generate a second energy, different from the first energy, for application to the tissue, and a second docking station comprising a second docking port which includes second data and power contacts, the second power generating module is slidingly movable in an electrical coupling with the power and data contacts, and the second power generating module is slidingly mobile. out of the electrical coupling with the second power and data contacts.
[0097] [0097] 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.
[0098] [0098] With reference to Figures 3 to 7, aspects of the present description 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 / irrigation 128. The central modular compartment 136 further facilitates interactive communication between modules 140, 126, 128. As illustrated in Figure 5, generator module 140 can be a generator module with integrated monopoly, bipolar and ultrasonic components , supported in a single cabinet unit 139 slidably insertable in the central modular compartment 136. As shown in Figure 5, generator module 140 can be configured to connect to a monopolar device 146, a bipolar device 147 and an ultrasonic device 148. Alternatively, generator module 140 may comprise a series of monopolar, bipolar and / or ultrasonic generator modules that interact through és of the central modular compartment 136. The central modular compartment 136 can be configured to facilitate the insertion of multiple generators and the interactive communication between the generators anchored in the central modular compartment 136 so that the generators act as a single generator.
[0099] [0099] In one aspect, the central modular compartment 136 comprises a modular power and a rear communication board 149 with external and wireless communication heads to allow the removable fixing of modules 140, 126, 128 and interactive communication between the themselves.
[0100] [0100] In one aspect, the central modular compartment 136 includes docking stations, or drawers, 151, here also called drawers, which are configured to receive modules 140, 126, 128 in a sliding manner. Figure 4 illustrates a view in partial perspective of a central surgical controller compartment 136, and a combined generator module 145 received slidingly in a docking station 151 of the central surgical controller compartment 136. A docking port 152 with power and data contacts in 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 of the central controller 136 modular compartment according to the combined generator module 145 is slid into position at the corresponding docking station 151 of the central controller modular compartment 136. In one aspect, the module the combined generator 145 includes a bipolar, ultrasonic and monopolar module and a smoke evacuation module integrated into a single compartment unit 139, as shown in Figure 5.
[0101] [0101] In several respects, the smoke evacuation module
[0102] [0102] In several respects, 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 aspiration of fluids to and from the surgical site.
[0103] [0103] In one aspect, the surgical tool includes a drive shaft that has an end actuator at a distal end of the same and at least an energy treatment associated with the end actuator, a suction tube, and a irrigation pipe. 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 inlet port close to the power application implement. The energy application implement is configured to supply ultrasonic and / or RF energy to the surgical site and is coupled to the management module.
[0104] [0104] 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.
[0105] [0105] In one aspect, modules 140, 126, 128 and / or their corresponding docking stations in the central modular compartment 136 may include alignment features that are configured to align the docking ports of modules in engagement with their counterparts in the docking stations of the central modular compartment 136. For example, as shown in Figure 4, the combined generator module 145 includes side brackets 155 that are configured to slide the corresponding brackets 156 of the docking station in a sliding way corresponding 151 of the central 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 coupling port of the central modular compartment 136.
[0106] [0106] In some respects, the drawers 151 of the central modular compartment 136 have 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 brackets 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.
[0107] [0107] 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 unpaired contacts.
[0108] [0108] As shown in Figure 4, the coupling port 150 of a drawer 151 can be coupled to the coupling port 150 of another drawer 151 through a communication link 157 to facilitate interactive communication between the modules housed in the central modular compartment 136. The coupling ports 150 of the central modular compartment 136 can, alternatively or additionally, facilitate interactive wireless communication between modules housed in the central modular compartment 136. Any suitable wireless communication can be used, such as Air Titan Bluetooth.
[0109] [0109] Figure 6 illustrates individual power bus connectors for a plurality of side coupling ports of a side modular compartment 160 configured to receive a plurality of modules from a central surgical controller 206. Side modular compartment 160 is configured to receive and interconnect modules 161. laterally, modules 161 are slidably inserted into docking stations 162 of side modular compartment 160, which includes a back plate for interconnecting modules 161. As shown in Figure 6, modules 161 are arranged laterally in the side modular cabinet 160. Alternatively, modules 161 can be arranged vertically in a modular side cabinet.
[0110] [0110] 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
[0111] [0111] In several respects, 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.
[0112] [0112] During a surgical procedure, the removal of a device
[0113] [0113] 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 receive the camera module in a sliding way, 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 the pressure fitting.
[0114] [0114] 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, imaging module 138 can be configured to integrate images from different imaging devices.
[0115] [0115] Various image processors and imaging devices suitable for use with the present description are described in US patent No. 7,995,045 entitled COMBINED SBI AND CON-
[0116] [0116] 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 facility. from health 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 modular central 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.
[0117] [0117] Modular devices 1a to 1n located in the operating room can be coupled to the central controller of modular communication 203. The central network controller 207 and / or the network switch 209 can be coupled to a network router 211 to connect devices 1a to 1h to the 204 cloud or the local computer system
[0118] [0118] 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 central modular 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 can include, for example, several 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 non-contact sensor module, among others modular devices that can be connected to the modular communication central controller 203 of the surgical data network 201.
[0119] [0119] 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 of the devices 1a to 1n / 2a to 2m coupled to the central network controller or network key can collect data in real time and transfer the data to cloud computers for data processing and manipulation. It will be understood that cloud computing depends on sharing computing resources instead of having local servers or personal devices to handle software applications. The word "cloud"
[0120] [0120] The application of cloud computer data processing techniques to the 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 view the states of the tissue to assess the occurrence of leaks or perfusion of sealed tissue after a sealing and tissue cutting procedure. At least some of the devices 1a to 1n / 2a to 2m can be used to identify the pathology, such as the effects of disease,
[0121] [0121] In an implementation, the operating room devices 1a to 1n can be connected to the modular central communication controller 203 via a wired channel or a wireless channel depending on the configuration of the devices 1a to 1h in a central network controller. 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"). The central network controller provides connectivity to devices 1a to 1n located on the same network as the operating room. The central network controller 207 collects data in the form of packets and sends them to the router in half - duplex mode. "The central network controller 207 does not store any media access control / Internet protocol (MACY / IP ) to transfer data from the device, only one of devices 1a to 1n at a time can send data via the central network controller 207. The central network controller 207 has no routing tables or intelligence about where to send information and transmits all network data through each connection and to a remote server 213 (Figure 9) via cloud 204. The central network controller 207 can detect basic network errors, such as collisions, but have all (admit) information transmitted to multiple gateways can be a security risk and cause strangulation.
[0122] [0122] In another implementation, operating room devices 2a to 2m can be connected to a network switch 209 via 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.
[0123] [0123] 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. 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. Network router 211 uses | P addresses to transfer data.
[0124] [0124] 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 wireless, broadband and short-range wireless USB communication protocol can be used for communication between devices 1a to 1n and devices 2a to 2m located in the operating room.
[0125] [0125] 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 respects, operating room devices 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 via a number of wireless and wired communication standards or protocols, including, but not limited to, limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, long-term evolution (LTE, "long-term evolution"), and Ev-DO, HSPA +, HSDPA +, HSUPAr +, EDGE , GSM, GPRS, CDMA, TDMA, DECT, and 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 , Wi-MAX, LTE, Ev-DO, and others.
[0126] [0126] The modular communication central controller 203 can serve as a central connection for one or all operating room devices 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 communication, as described in the present invention.
[0127] [0127] The 203 modular communication central controller 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 central communication controller is
[0128] [0128] Figure 9 illustrates an interactive surgical system, implemented by computer 200. The interactive surgical system implemented by computer 200 is similar in many ways to the interactive surgical system, implemented by computer 100. For example, the interactive, surgical system , implemented by computer 200 includes one or more surgical systems 202, which are similar in many respects to surgical systems 102. Each surgical system 202 includes at least one central surgical controller 206 communicating with a cloud 204 which may include a remote server 213. In one aspect, the computer-implemented interactive surgical system 200 comprises a modular control tower 236 connected to multiple operating room devices, for example, smart surgical instruments, robots and other localized computerized devices - used in the operating room. As shown in Figure 10, the modular control tower 236 comprises a central modular communication controller 203 coupled to a computer system 210. As illustrated in the example in Figure 9, the modular control tower 236 is coupled to a imaging module 238 that is attached to an endoscope 239, a generator module 240 that is attached to a power device 241, a smoke evacuation module 226, a suction / irrigation module 228, a communication module 230, a module processor 232, a storage array 234, an intelligent device / instrument 235 optionally attached to a screen 237, and a non-contact sensor module 242. Operating room devices are coupled with cloud computing resources and the data storage via the modular control tower 236. The robot central controller 222 can also be connected
[0129] [0129] Figure 10 illustrates a central surgical controller 206 that 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 device - network connectivity device, and a computer system 210 to provide local processing, visualization, and imaging, for example. As shown in Figure 10, the 203 modular central communication controller can be connected in a layered configuration to expand the number of modules (for example, devices) that can be connected to the 203 modular central communication controller and transfer data associated with modules to computer system 210, 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 one upstream port. The upstream central controller / network key is connected to a processor to provide a communication connection to the cloud computing resources and a 217 local display. Communication with the cloud
[0130] [0130] 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 using non-contact measuring devices such as laser or ultrasonic. An ultrasound-based non-contact sensor module scans the operating room by transmitting an ultrasound explosion and receiving the echo when it bounces outside the perimeter of the operating room walls, as described under the title Surgical Hub Spatial Hardware Within an Operating Room "in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLAT-FORM, filed on December 28, 2017, which is hereby incorporated by reference in its entirety, in the which sensor module is configured to determine the size of the operating room and adjust the pairing distance limits with Bluetooth A laser-based non-contact sensor module scans the operating room by transmitting pulses of laser light, receiving pulses of laser light that jump 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 Bluetooth pairing distance limits, for example.
[0131] [0131] 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 through of a system bus. The system bus can be any one 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 buses including, but not limited to, 9-bit bus, industry standard architecture (ISA), Micro-Charmel Architecture (MSA), extended ISA (EISA), smart drive electronics (IDE), local bus VESA (VLB), Peripheral Component Interconnection (PCI), USB, Accelerated Graphics Port (AGP), PCMCIA bus (International Memory Card Association for Personal Computers, Personal Computer Memory Card International Association), Interface small computer systems (SCSI), or any other proprietary bus.
[0132] [0132] Processor 244 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 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, read-only memory programmable and electrically erasable (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 to digital converters (ADC) ) 12 bits with 12 channels of analog input, details of which are available for the product data sheet.
[0133] [0133] In one aspect, processor 244 may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the trade name Hercules ARM Cortex R4, also available from Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[0134] [0134] 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 ROM, programmable ROM (PROM) Electrically programmable ROM (EPROM), EEPROM or flash memory. Volatile memory includes random access memory (RAM), which acts as an external cache memory. In addition, RAM is available in many forms such as SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), Synchlink DRAM (SLDRAM), and direct RAM Rambus RAM (DRRAM).
[0135] [0135] Computer system 210 also includes removable / non-removable, volatile / non-volatile computer storage media, such as 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.
[0136] [0136] It is to be understood that computer system 210 includes software that acts as an intermediary between users and the basic computer resources described in a suitable 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 management capabilities by the operating system through program modules and “program data stored in the system's memory or storage disk. It is to be understood that the various components described in the present invention can be implemented with various operating systems or combinations of operating systems.
[0137] [0137] A user enters commands or information into computer system 210 through the input device (s) coupled to the 1 / O 251. interface. Input 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 computer system information to an output device. An output adapter is provided to illustrate
[0138] [0138] 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. Remote cloud computers can be a personal computer, server, router, personal network computer, workstation, microprocessor-based device, peer device, or other common network node, and the like, and typically include - in many or all of the elements described in relation to the computer system. For the sake of brevity, only one memory storage device is illustrated with the remote computer. Remote computers are logically connected to the computer system via a network interface and then physically connected via a communication connection. The network interface covers communication networks such as local area networks (LANs) and wide area networks (WANs). LAN technologies include fiber-distributed data interface (FDDI), copper-distributed data interface (CDDI), Ethernet / IEEE 802.3, Token / IEEE 802.5 ring and the like. WAN technologies include, but are not limited to, point-to-point links, circuit switching networks such as digital integrated service networks (ISDN) and variations in them, packet switching networks and digital subscriber lines (DSL ).
[0139] [0139] In several respects, the computer system 210 of Figu-
[0140] [0140] 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 serial modems, cable modems and DSL modems, ISDN adapters and Ethernet cards.
[0141] [0141] 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 description. 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 transceiver port
[0142] [0142] 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 power logic to manage power.
[0143] [0143] The USB 300 network central controller device includes a 310 series 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, data encoding / decoding non-inverted zero ( NRZI), generation and verification of CRC (token and data), generation and verification / decoding of packet ID (PID), and / or serial-
[0144] [0144] In several aspects, the USB 300 central network controller can connect 127 functions configured in up to six logical layers (levels) to a single computer. In addition, the USB 300 central network controller can connect all peripherals using a standardized four-wire cable that provides both communication and power distribution. Power settings are bus-powered and self-powered modes. The USB 300 central network controller can be configured to support four power management modes: a bus-powered central controller with individual port power management or grouped port power management, and the au central controller - powered, with individual door power management or grouped door power management. In one respect, using a USB cable, the USB 300 central network controller, the USB transceiver port 302 is plugged into a USB host controller, and the USB transceiver ports downstream 304, 306, 308 are exposed to connect compatible USB devices, and so on.
[0145] [0145] Figure 12 illustrates a logic diagram of a module of a 470 control system of a surgical instrument or tool.
[0146] [0146] 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 main microcontroller 461 can be an LM4F230H5QR ARM Cortex-M4F processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single cycle flash memory, or other non-memory. volatile, up to 40 MHz, a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle series random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellaRisWareO program, programmable and electronically erasable 2K read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder (QEI) input analogues , and / or one or more 12-bit analog to digital converters (ADC) with 12 channels of analog input, details of which are available for the product data sheet.
[0147] [0147] In one aspect, the 461 microcontroller can comprise a safety controller that comprises two families based on controllers, such as TMS570 and RM4x known under the trade name of Hercules ARM Cortex R4, also available from the 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.
[0148] [0148] The 461 microcontroller can be programmed to perform various functions, such as precise control of the speed and position of the articulation and cutting systems. In one aspect, the 461 microcontroller includes a 462 processor and a 468 memory. Electric motor 482 can be a brushed direct current (DC) motor with a gearbox and mechanical connections with a linkage system. or cut. In one aspect, a motor drive 492 can be an A3941 available from Allegro Microsystems, Inc. Other motor drives can be readily replaced for use in tracking system 480 which comprises an absolute positioning system. A detailed description of an absolute positioning system is given in the publication of US patent application 2017/0296213, entitled SYSTEMS AND METHODS FOR CONTRACTING A SURGICAL STAPLING AND CUTTING INSTRUMENT, published on October 19, 2017, which is here incorporated into the reference title in its entirety.
[0149] [0149] 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 measured response, which can detect external influences in the system.
[0150] [0150] In one aspect, the 482 motor can be controlled by the 492 motor actuator 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. The motor starter 492 can comprise an H bridge drive that comprises field effect transistors (FETs), for example. The 482 motor can be powered by a feed set mounted releasably in the handle assembly 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 for energy
[0151] [0151] The 492 motor driver can be an A3941, available from Allegro Microsystems, Inc. The 492 A3941 driver is an entire bridge controller for use with semiconductor metal oxide field effect transistors (MOSFET). 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 full door drive (> 10 V) for batteries with voltage up to 7 V and allows the A3941 to operate with a reduced door drive, up to 5.5 V. A capacitor input control can be used to supply the voltage surpassing that supplied by the battery required for N channel MOSFETs. An internal charge pump for the drive on the upper side allows operation in direct current (100% duty cycle ). The entire bridge can be triggered in fast or slow drop modes using diodes or synchronized rectification. In the slow drop mode, the current can be recirculated by means of FET from the top or from the bottom. The energy FETs are protected from the shoot-through effect through programmable dead-time resistors. Integrated diagnostics provide indication of undervoltage, overtemperature and faults in the power bridge and can be configured to protect power MOSFETs in most short-circuit conditions. Other motor drives can be readily replaced for use in the 480 tracking system comprising an absolute positioning system.
[0152] [0152] The tracking system 480 comprises a device
[0153] [0153] The 482 electric motor can 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 driving 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 provides 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 | or combinations thereof.
[0154] [0154] 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 represents the longitudinal linear distance by which the displacement member moves from the 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 revolutions for the full travel of the displacement member.
[0155] [0155] A series of switches, 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 keys is transmitted back to microcontroller 461 which applies logic to determine a single position signal corresponding to the longitudinal linear displacement of 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.
[0156] [0156] The position sensor 472 can comprise any number
[0157] [0157] In one aspect, the position sensor 472 for tracking system 480 which comprises an absolute positioning system comprises a magnetic rotating absolute positioning system. The 472 position sensor can be implemented as a rotary, magnetic, single-circuit, ASSOSSEQFT position sensor, available from Austria Microsystems, AG. The position sensor 472 interfaces with the 461 microcontroller to provide an absolute positioning system. The 472 position sensor is a low voltage, low power component and includes four effect elements in an area of the 472 position sensor located above a magnet. A high-resolution ADC and an intelligent power management controller are also provided on the integrated circuit. A CORDIC processor (digital computer for coordinate rotation), also known as the digit by digit method and Volder algorithm, is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only operations addition, subtraction, bit shift and lookup table. The angle position, alarm bits and magnetic field information are transmitted via a standard serial communication interface, such as a serial peripheral interface (SPI), to the 461 microcontroller. position 472 provides 12 or 14 bits of resolution. The position sensor 472 can be an ASS055 integrated circuit supplied in a small 16-pin QFN package whose measurement corresponds to 4Xx4x0.85 mm.
[0158] [0158] The tracking system 480 which comprises 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, other sensors may include sensor arrangements as described in US patent No. 9,345 .481 entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, granted on May 24, 2016, which is incorporated by reference in its entirety into 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 number 15 / 628,175, entitled TECHNIQUES FOR ADAPTIVE CONTRROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CU- TTING INSTRUMENT, submitted on June 20, 2017, is incorporated by reference in its entirety in 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 in the direction to the measured response. The computed response of the physical system considers the 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.
[0159] [0159] 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 reset 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 traveled to infer the position of a device actuator, actuation bar, scalpel, and the like.
[0160] [0160] 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 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.
[0161] [0161] 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 tissue attached by the end actuator comprises a 474 strain gauge sensor, such as, for example, a microstrain meter, which is configured to measure one or more parameters of the end actuator, for example. In one aspect, the 474 strain gauge sensor can measure the amplitude or magnitude of the strain exerted on a claw member of an end actuator 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 of a 461 microcontroller. A 476 load sensor can measure the force used to operate the knife element, for example, to cut the captured tissue between the blade. gorna and the staple cartridge. A magnetic field sensor can be used to measure the thickness of the captured tissue. The measurement of the magnetic field sensor can also be converted into a digital signal and supplied to the 462 processor.
[0162] [0162] Measurements of tissue compression, tissue thickness and / or force required to close the end actuator on the tissue, as measured by sensors 474, 476 respectively, can be used by microcontroller 461 to characterize the position trigger member and / or the corresponding trigger member speed value. In one case, a 468 memory can store a technique, an equation and / or a query table that can be used by the 461 microcontroller in the evaluation.
[0163] [0163] The 470 control system of the instrument or surgical tool can also comprise wired or wireless communication circuits for communication with the modular central communication controller shown in Figures 8 to 11.
[0164] [0164] Figure 13 illustrates a control circuit 500 configured to control aspects of the instrument or surgical tool according to an aspect of the present description. The control circuit 500 can be configured to implement various processes described herein. The control circuit 500 may comprise a microcontroller comprising one or more processors 502 (for example, microprocessor, microcontroller) coupled to at least one memory circuit 504. The memory circuit 504 stores instructions executable on the machine which, when executed by processor 502, cause processor 502 to execute machine instructions to implement several of the processes described here. Processor 502 can be any one of a number of single-core or multi-core processors known in the art. The memory circuit 504 may comprise volatile and non-volatile storage media. The processor 502 can include an instruction processing unit 506 and an arithmetic unit 508. The instruction processing unit can be configured to receive instructions
[0165] [0165] 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 description. The combinational logic circuit 510 can be configured to implement the various processes described here. The combinational logic circuit 510 can comprise a finite state machine that comprises 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.
[0166] [0166] Figure 15 illustrates a sequential logic circuit 520 configured to control aspects of the surgical instrument or tool according to an aspect of the present description. Sequential logic circuit 520 or combinational logic 522 can be configured to implement the process described herein. 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 may 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 to implement various processes of the present invention. In other respects, the finite state machine can comprise a combination of a combinational logic circuit (for example, a combinational logic circuit 510, Figure 14) and the circuit
[0167] [0167] 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 may be activated to perform a first function, a second engine may be activated to perform a second function, a third engine may be activated to perform a third function, a fourth engine may 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 triggering, closing, and / or articulation movements in the end actuator. The triggering, closing and / or articulation movements can be transmitted to the end actuator through a set of drive axes, for example.
[0168] [0168] In certain cases, the instrument or surgical tool system may include a 602 firing motor. The 602 firing motor can be operationally coupled to a 604 firing motor drive assembly, which can be configured to transmitting firing movements generated by the motor 602 to the end actuator, in particular, to move the beam element with profile in | In certain cases, the firing movements generated by the 602 motor can cause the clamps to be positioned from the staple cartridge in the fabric captured by the end actuator and / or by the cutting edge of the beam element with profile in | to be advanced in order to cut the captured tissue, for example. The beam element with profile in | can be retracted by reversing the direction of motor 602.
[0169] [0169] In certain cases, the instrument or surgical tool 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 by the 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.
[0170] [0170] 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 assemblies of the articulation motor 608a, 608b, which can be configured to transmit articulation movements generated by the motors 606a, 606b to the end actuator. In some cases, articulation movements can cause the end actuator to be articulated in relation to the drive shaft assembly, for example.
[0171] [0171] 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 cause the closing tube or the beam element with profile in | proceed distally, as described in more detail later in this document.
[0172] [0172] In certain cases, the instrument or surgical 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.
[0173] [0173] In at least one example, the common control module 610 can be selectively switched between the operating coupling with the 606a, 606B articulation motors, and the operating coupling with the 602 firing motor 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.
[0174] [0174] 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.
[0175] [0175] In several cases, as shown 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 drive 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 drawn by the motor, for example, while the motor is coupled to the common control module 610, as described above.
[0176] [0176] 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 (a
[0177] [0177] In certain cases, the power supply 628 can be used to supply power to the microcontroller 620, for example. In certain cases, the 628 power source 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 supply. In certain cases, the power source 628 can be replaceable and / or rechargeable, for example.
[0178] [0178] In several cases, the 622 processor can control the motor drive 626 to control the position, direction of rotation and / or speed of a motor that is coupled to the common control module 610. In certain cases cases, the 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.
[0179] [0179] 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 that comprises a 256 KB single cycle flash integrated memory, or other non-volatile memory, up to 40 MHz, an early seek buffer for optimize performance above 40 MHz, a 32 KB single cycle SRAM, an internal ROM loaded with StellarisWareG 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 the 4410 module. Consequently, this description should not be limited in this context.
[0180] [0180] 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.
[0181] [0181] In certain cases, one or more mechanisms and / or sensors, such as 630 sensors, can be used to alert the 622 processor to 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 key 614 is in 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.
[0182] [0182] Figure 17 is a schematic diagram of a robotic surgical instrument 700 configured to operate a surgical tool described in this document, according to one aspect of that description. 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 closing member, a driving shaft member and / or one or more hinge members. The 700 surgical instrument comprises
[0183] [0183] 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 position sensor 734 can be configured to provide feedback on the beam with 1714 profile to control circuit 710. Other sensors 738 can be configured to provide feedback to control circuit 710. A timer / counter 731 provides information timing and counting to control circuit 710. A power source 712 can be provided to operate the / 704a to 704e motors and a current sensor 736 provides motor current feedback to the control circuit
[0184] [0184] 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 an output signal, such as elapsed time or a digital count, to the control circuit 710 to correlate the beam position with profile at 1 714, 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 profile in | 714 at a specific time (t) in relation to an initial position or time (t) when the beam with profile in | 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 measure eternal events.
[0185] [0185] 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 tissue conditions. A trigger control program can describe the distal movement of the displacement member. Different trigger control programs can be selected to better treat different tissue conditions. For example, when a thicker tissue is present, 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, control circuit 710 can be programmed to translate the displacement member at a higher speed and / or with greater power. A closure control program can control the closing force applied to the tissue by the anvil
[0186] [0186] In one aspect, the 710 motor control circuit can generate motor setpoint signals. Motor setpoint signals can be supplied to several motor controllers 708a through 708e. Motor controllers 708a to 708e can comprise one or more circuits configured to provide motor drive signals to motors 704a to 704e in order to drive motors 704a to 704e, as described here. In some instances, motors 704a to 704e may be brushed DC motors. For example, the speed of motors 704a to 704e can be proportional to the respective motor start signals. In some examples, motors 704a to 704e can be brushless DC electric motors, and the respective motor drive signals can 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.
[0187] [0187] 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 a travel member travel. 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 response may include a translation of the distance from the displacement member during the open circuit portion, a time elapsed during the open circuit portion, the energy supplied to one of the motors 704a to 704e during the open circuit portion, a sum of pulse widths of a motor start signal, etc. After the open circuit portion, control circuit 710 can implement the selected trigger control program for a second portion of the travel member travel. For example, during a portion of the closed loop course, control circuit 710 can modulate one of the motors 704a to 704e based on the translation of the data describing a position of the displacement member
[0188] [0188] In one aspect, motors 704a through 704e can receive power from a 712 power source. Power source 712 can be a DC power source powered by an alternating main power source, a battery, a super capacitor, or any other suitable power source. Motors 704a to 704e can be mechanically coupled to individual mobile mechanical elements such as the beam with | 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 | 714. In some examples, the position sensor 734 may include an encoder configured to supply a series of pulses to the control circuit 710 according to the beam with profile | 714 transferred distally and proximally. The control circuit 710 can track the pulses to determine the position of the beam with profile in | 714. 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 profile in | 714. In addition, in some examples, the position sensor 734 may be omitted. When any of the 704a to 704e motors is a stepper motor, the control circuit 710 can track the beam position with | 714 by adding the number and direction of the steps that the 704 engine was instructed to perform. Position sensor 734 can be located on end actuator 702 or any other portion of the instrument. The outputs of each of the motors 704a to 704e include a torque sensor 744a to 744e to detect force and have an encoder to detect the rotation of the drive shaft.
[0189] [0189] In one aspect, control circuit 710 is configured to drive a firing member as the beam portion with | 714 of end actuator 702. Control circuit 710 provides a motor setpoint to a motor control 708a, which provides a drive signal to 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 which is coupled to the beam with profile in | 714. The 706a transmission comprises moving mechanical elements, such as rotating elements, and a firing member to control distal and proximally the movement of the beam with profile in | 714 along a longitudinal geometric axis of the end actuator 702. In one aspect, the motor 704a can be coupled to the knife gear assembly, which includes a knife gear reduction assembly that includes a first 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 in profile | 714. A 734 position sensor can be configured to provide the beam position with | 714 along the firing stroke or firing member position as a feedback signal to the control circuit
[0190] [0190] 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 to a motor control 708b, which provides a drive signal to motor 704b. The output shaft of the 704b motor is coupled to a 744b torque sensor. The torque sensor 744b is coupled to a 706b transmission that is coupled to the anvil
[0191] [0191] 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 from the motor to a 708c motor control, which provides a drive signal to the 704c motor. The output shaft of the 704c motor is coupled to a 744c torque sensor. The torque sensor 744c is coupled to a transmission 706c which is coupled to the shaft 740. The transmission 706c comprises moving mechanical elements, such as rotary elements, to control the rotation of the drive shaft 740 clockwise or counterclockwise until and above 360º. In one aspect, the 704c motor is coupled to the rotary transmission assembly, which includes a pipe gear segment that is formed over (or attached to) the proximal end of the proximal closing tube for engagement operable by a gear assembly rotational that is operationally supported 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 to control loop 710. Additional sensors 738, such as a drive shaft encoder, can provide the rotational position of drive shaft 740 to the drive circuit. control 710.
[0192] [0192] In one aspect, control circuit 710 is configured to link end actuator 702. Control circuit 710 provides a motor setpoint to a 708d motor control, which provides a drive signal to motor 704d . 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 pivot 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 torque sensor 744d 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 hinge encoder , can provide the pivoting position of end actuator 702 for control circuit 710.
[0193] [0193] In another aspect, the articulation function of the robotic surgical system 700 may comprise two articulation members, or connections, 742a, 742b. These articulation members 742a, 742b are driven by separate disks at the robot interface (the rack), which are driven by the two motors 708d, 708e. When the separate firing motor 704a is provided, each hinge link 742a, 742b can be antagonistically driven with respect to the other link to provide a resistive holding motion and a load to the head when it is not moving and to provide a articulation movement when the head is articulated. The hinge members 742a, 742b attach to the head in a fixed radius when the head is rotated. Consequently, the mechanical advantage of the push and pull link changes when the head is rotated. This change in mechanical advantage can be more pronounced with other drive systems for the articulation connection.
[0194] [0194] 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.
[0195] [0195] In one aspect, the position sensor 734 can be implemented as an absolute positioning system. In one aspect, the 734 position sensor 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 functions and trigonometry that require only addition, subtraction, bit shift and lookup table operations.
[0196] [0196] 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 derived parameters such as span distance in relation to time, compression of the tissue in relation to time, and deformation of the anvil in relation to time. The 738 sensors can comprise a magnetic sensor, a magnetic field sensor, a strain gauge, a load cell, a pressure sensor, a force sensor, a torque sensor, an inductive sensor as a sensor eddy current, a resistive sensor, a capacitive sensor, an optical sensor and / or any other sensor suitable for measuring one or more parameters of the end actuator 702. The 738 sensors may include one or more sensors. The sensors 738 can be located on the platform of the staple cartridge 718 to determine the location of the tissue using segmented electrodes. The torque sensors 744a to 744e can be configured to detect force such as firing force, closing force, and / or articulation force, among others. Consequently, the control circuit 710 can detect (1) the closing load experienced by the distal closing tube and its position, (2) the trigger member in the rack and its position, (3) the portion of the ultrasonic blade 718 that presents tissue in the same and (4) the load and position on both articulation rods.
[0197] [0197] 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. The 738 sensors may comprise a pressure sensor configured to detect a pressure generated by the presence of
[0198] [0198] 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.
[0199] [0199] 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 closing tube on the anvil 716. The forces exerted on the anvil 716 can be representative of the tissue compression experienced by the tissue section captured between the anvil 716 and the staple cartridge 718. The one or more sensors 738 can be positioned at various points of interaction throughout the drive system closing to detect the closing forces applied to the anvil 716 by the closing drive system. The one or more 738 sensors can be sampled in real time during a hold operation by the control circuit processor 710. The control circuit 710 receives sample measurements in real time to provide and analyze information based on time and evaluate, in real time, the closing forces applied to the anvil
[0200] [0200] In one aspect, a current sensor 736 can be used to measure the current drawn by each of the 704a to 704e motors. The force necessary 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 the control circuit 710. The 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 used to move a beam with a profile in | 714 on end actuator 702 at or near a target speed. The robotic surgical instrument 700 may include a re-information controller, which may be one or any of the re-information controllers, including, but not limited to, a PID controller, state feedback, linear quadratic (LQOR) and / or an adaptable 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 revealed 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.
[0201] [0201] Figure 18 illustrates a block diagram of an instrument
[0202] [0202] 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 profile in | 764 is coupled to a longitudinally movable drive member, the beam position with | 764 can be determined by measuring the position of the longitudinally movable drive member using the 784 position sensor. Consequently, in the following description, the position, displacement and / or translation of the beam with profile in | 764 can be obtained by the position sensor 784, as described in the present invention. 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 displacement member, for example, the beam with profile on | 764, as described. In one aspect, a timer / counter 781 provides an output signal, such as elapsed time or a digital count, to control circuit 760 to correlate the position of the beam with | 764 as determined by the position sensor 784 with the timer output
[0203] [0203] Control circuit 760 can generate a 772 motor setpoint signal. The 772 motor setpoint signal can be supplied to a 758 motor controller. The 758 motor controller can comprise one or more circuits configured to provide a motor 774 drive signal to motor 754 to drive motor 754, as described in the present invention. 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 drive signal of motor 774 can comprise a supplied PWM signal for one or more motor stator windings 754. In addition, in some examples, motor controller 758 can be omitted, and control circuit 760 can generate motor drive signal 774 directly.
[0204] [0204] The 754 motor can receive power from a power source
[0205] [0205] 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.
[0206] [0206] The 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 hold 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.
[0207] [0207] 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 can be at a point of interaction between a closing tube and anvil 766 to detect the closing forces applied by a closing tube to anvil 766. The forces exerted on 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 anvil 766 by the closing drive system. The one or more sensors 788 can be sampled in real time during a hold operation by a processor from the control circuit 760. The control circuit 760 receives sample measurements in real time to provide and analyze information based on time and evaluate, in real time, the closing forces applied to the anvil 766.
[0208] [0208] A current sensor 786 can be used to measure the current drained by the 754 motor. The force required to advance the beam with profile in | 764 corresponds to the current drained by the motor
[0209] [0209] 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 in | 764 on end actuator 752 at or near a target speed. The surgical instrument 750 may include a feedback controller, which can be one or any of the feedback feedback controllers, including, but not limited to, a PID controller, status feedback, LOR, and / or an adaptive controller, for example. 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, voltage modulated by frequency, current, torque and / or force, for example plo.
[0210] [0210] 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.
[0211] [0211] Several exemplifying aspects are directed to a 750 surgical instrument that comprises a 752 end actuator with motor-driven surgical stapling and cutting implements. For example, a motor 754 can drive a displacement member distally and proximally along a longitudinal geometry axis of end actuator 752. End actuator 752 may comprise an articulating anvil 766 and, when configured for use, a cartridge of staples 768 positioned on the opposite side of anvil 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, the 754 motor can drive the displacement member distally along the axis longitudinal geometric pattern of end actuator 752 from a proximal start position to a distal end position from the start position. As the displacement member moves distally, the beam with | 764 with a cutting element positioned at a distal end can cut the fabric between the staple cartridge 768 and the anvil 766.
[0212] [0212] In several examples, the surgical instrument 750 may 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 displacement member's distal movement. 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 translate
[0213] [0213] In some examples, control circuit 760 may initially operate motor 754 in an open circuit configuration for a first open circuit portion of a travel member travel. 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.
[0214] [0214] Figure 19 is a schematic diagram of a 790 surgical instrument configured to control various functions in accordance with an aspect of the present description. In one aspect, the surgical instrument 790 is programmed to control the distal translation of a displacement member, such as the beam with a | 764. Surgical instrument 790 comprises an end actuator 792 which may comprise an anvil 766, a beam with a profile in | 764 and a removable staple cartridge 768 that can be interchanged with an RF cartridge 796 (shown in dashed line).
[0215] [0215] 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, among others.
[0216] [0216] In one aspect, the 784 position sensor can be implemented as an absolute positioning system, which comprises a rotating magnetic absolute positioning system implemented as a rotating, magnetic position sensor. single integrated, 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 algorithm, which is provided to implement a simple and efficient algorithm for
[0217] [0217] In one aspect, the beam with a profile | 764 can be implemented as the knife member comprising a knife body which operationally supports a tissue cutting blade therein and may additionally include flaps or anvil engaging features and channel engaging features or a base. In one aspect, the staple cartridge 768 can be implemented as a standard surgical (mechanical) clamp cartridge. In one aspect, the RF cartridge 796 can be implemented as an RF cartridge. These and other sensor arrangements are described in US Commonly Owned Patent Application Serial No. 15 / 628,175, entitled TECHNI-
[0218] [0218] 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 profile in | 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 that employs the position sensor 784. 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 in the present invention. A control circuit 760 can be programmed to control the translation of the displacement member,
[0219] [0219] Control circuit 760 can generate a motor setpoint signal 772. Motor setpoint signal 772 can be supplied to a motor controller 758. Motor controller 758 can comprise one or more circuits configured to provide a motor 774 drive signal to motor 754 to drive motor 754, as described in the present invention. 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 drive signal of motor 774 can comprise a supplied PWM signal for one or more motor stator windings 754. In addition, in some examples, motor controller 758 can be omitted, and control circuit 760 can generate motor drive signal 774 directly.
[0220] [0220] The 754 motor can receive power from a power source
[0221] [0221] 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 surgical instrument 790 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 end actuator 792. The 788 sensors may include one or more sensors.
[0222] [0222] The 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.
[0223] [0223] 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 a closing tube and anvil 766 to detect the closing forces applied by a closing tube to anvil 766. The forces exerted on the anvil 766 po - they must 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 drive system. closing to detect the closing forces applied to the anvil
[0224] [0224] A current sensor 786 can be used to measure the current drained by the 754 motor. The force required to advance the beam with profile in | 764 corresponds to the current drained by the motor
[0225] [0225] 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 staple cartridge 768. The circuit Control Panel 760 controls the delivery of RF energy to the 796 RF cartridge.
[0226] [0226] Additional details are disclosed in US Patent Application Serial No. 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
[0227] [0227] Figure 20 is a block diagram of a generator 800 configured to provide adjustment without inductor, among other benefits. Additional details for generator 800 are described in US Patent No.
[0228] [0228] In certain forms, ultrasonic and electrosurgical trigger signals can be delivered simultaneously to separate surgical instruments and / or to a single surgical instrument, such as a multifunctional surgical instrument, with the ability 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 / ultrasound multifunction combined instrument can be both a therapeutic and subtherapeutic signal, where the subtherapeutic signal can be used, for example, to monitor tissue or the conditions of the instruments and provide feedback to the generator. For example, RF and ultrasonic signals can be provided separately or simultaneously from a generator with a single output port in order to provide the desired output signal to the surgical instrument, as will be discussed in more detail below. Consequently, the generator can combine the RF and ultrasonic electrosurgical energies and supply the combined energies to the multifunctional electro-surgical / ultrasonic instrument. Bipolar electrodes can be placed on one or both claws of the end actuator. A claw can be triggered by ultrasonic energy in addition to RF electrosurgical energy, working simultaneously. Ultrasonic energy can be used to perform tissue dissection while RF electrosurgical energy can be used to cauterize vessels.
[0229] [0229] 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 an amplifier of the type push and pull. For example, the non-isolated stage 804 may additionally comprise a logic device 816 for providing a digital output to a digital-to-analog converter (DAC) circuit 818 which, in turn, provides an ana signal - logic corresponding to a power amplifier 812 input. In certain ways, logic device 816 may comprise a programmable gate array ("PGA"), a field programmable gate array ("FPGA" - field -programmable gate array), a programmable logic device ("PLD" - 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 circuit 818, can therefore control any of several parameters (for example frequency, waveform, amplitude of the waveform) of signals drive appearing at drive signal outputs 810a, 810b and 810c. In certain ways and as discussed below, logic device 816, in conjunction with a processor (for example, a PSD discussed below), can implement various control algorithms based on digital signal processing (PSD) and / or others to control the parameters of the drive signal outputs provided by generator 800.
[0230] [0230] Power can be supplied to a power rail of the power amplifier 812 by a key mode regulator 820, such as a power converter. In certain forms, the key mode regulator 820 may comprise an adjustable antagonistic regulator, for example. The non-isolated stage 804 can also comprise a first processor 822 which, in a way, can comprise a PSD processor such as an ADSP- 21469 SHARC DSP, available from Analog Devices, Norwood, MA, USA, for example , although in various forms, any suitable processor can be used. In certain ways, the DSP processor 822 can control the operation of the key mode regulator 820 responsive to voltage feedback data received from the power amplifier 812 by the DSP processor 822 via an ADC 824 circuit. , for example, the DSP processor 822 can receive the waveform envelope of a signal (for example, an RF signal) as an input through the ADC 824 circuit, amplified by the power amplifier 812. The PSD 822 processor can then control the key mode regulator 820 (for example, via a pulse-width modulated output ("(PWM" - pulse-width modulated) so that the rail voltage provided to the power 812 track the waveform envelope of the amplified signal By dynamically modulating the rail voltage of the 812 power amplifier based on the waveform envelope, the efficiency of the 812 power amplifier can be significantly improved and with respect to amplifier schemes with fixed rail voltage.
[0231] [0231] In certain ways, the logic device 816, in conjunction with the PSD 822 processor, can implement a digital synthesis circuit as a control scheme with a direct digital synthesizer 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, such as an ultrasonic transducer, can be driven by a clean sinusoidal current at its resonant frequency. Since 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 affected by several sources of distortion present in the output drive circuit (for example, the power transformer 806, the power amplifier 812), voltage and current feedback based on the trigger signal can be provided to an algorithm, such as an error control algorithm implemented by the PSD 822 processor, which compensates for the distortion through adequate pre-distortion or sample modification waveforms stored in the LUT in a dynamic and continuous manner (for example, in real time). In a
[0232] [0232] 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, to sample the voltage and the current of drive signals emitted by the generator 800. In certain ways, the ADC 826 and 828 circuits can be configured for sampling at high speeds (for example, 80 mega samples per second ("MSPS" - mega samples per second) ) to allow over-sampling of the trigger signals. In one form, for example, the sampling speed of the ADC 826 and 828 circuits can allow an oversampling of approximately 200 x (depending on the frequency) of the drive signals. In certain ways, the sampling operations of the ADC circuit 826 and 828 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 the generator 800 can allow, among other things, the calculation of the complex current flowing through the motion branch (which can be used in certain forms to implement waveform control based on in DDS described above), digital filtering needs the sampled signals and calculates the actual energy consumption with a high degree of precision. The voltage and current feedback data emitted by the ADC 826 and 828 circuits can be received and processed (for example, first-in-first-out buffer ("FIFO" - first-in-first-out ") , multiplexer) by logic device 816 and stored in data memory for subsequent retrieval, for example, by processor 822. As noted above, voltage and current feedback data can be used as input to an algorithm for pre -distortion or modification of waveform samples in the LUT, in a dynamic and continuous manner In some ways, this may require that each stored voltage and current feedback data pair be indexed based on, or otherwise associated with, a sample of the corresponding LUT that was provided by logic device 816 when the voltage and current feedback data pair was captured. and current in this way contributes to the correct timing and stability of the pre-distortion algorithm.
[0233] [0233] In certain forms, voltage and current feedback data can be used to control the frequency and / or amplitude (eg 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 (for example,
[0234] [0234] 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, for example, a proportional-integral-derivative control algorithm (PID), in the DSP 822 processor. The variables controlled by the algorithm control systems to properly control the current amplitude of the drive signal may include, for example, scaling the LUT waveform samples stored in logic device 816 and / or the full-scale output voltage of the circuit DAC 818 (which provides input to the power amplifier 812) via a DAC circuit
[0235] [0235] 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 UIl 836 processor can comprise an Atmel AT91SAM9263 processor with an ARM 926EJ-S core, available from Atmel Corporation, of San Jose, CA, USA, for example. Examples of UI functionality supported by the UI 836 processor may include audible and visual feedback from the user, communication with peripheral devices (eg via a USB interface), communication with the foot switch, communication with a data entry device (for example, a touchscreen) and communication with an output device (for example, a speaker). The UI processor 836 can communicate with the DSP processor 822 and logic device 816 (for example, via SPI buses). Although the UI 836 processor can primarily support UI functionality, it can also coordinate with the PSD 822 processor to implement risk mitigation in certain ways. For example, the 836 processor can be programmed to monitor various aspects of user inputs and / or other inputs (for example, touchscreen inputs, foot switch inputs, temperature sensor inputs) and can disable the output generator 800 when an error condition is detected.
[0236] [0236] In certain ways, both the PSD 822 processor and the UI 836 processor can, for example, determine and monitor the operational state 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 UI elements (for example, display, sounds) are presented to a user. The respective UIL and PSD processors 822 and 836 can independently maintain the current operational state of 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 specific transition is appropriate. For example, when the PSD 822 processor instructs the UI 836 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.
[0237] [0237] The non-isolated platform 804 may also contain an 838 controller for monitoring input devices (for example, a capacitive touch sensor used to turn the generator 800 on and off, a capacitive touch screen). In certain forms, controller 838 may comprise at least one processor and / or another controller device in communication with the UI 836 processor. In one form, for example, controller 838 may comprise a processor (for example, example, an 8-bit Meg168 controller available from Atmel) configured to monitor user-supplied inputs via 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 screen capacitive touch.
[0238] [0238] 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 in the off state , controller 838 can activate the power supply (for example, enable the operation of one or more DC / DC voltage converters 856 of the power supply 854), if the activation of the input device is detected "on / off" by a user. Controller 838 can therefore initiate a sequence to transition the generator 800 to an "on" state. On the other hand, controller 838 can initiate a sequence to transition the generator 800 to the off state if activation of the "on / off" input device is detected, when the generator 800 is in the on state. In certain ways, for example, controller 838 may report the activation of the "on / off" input device to processor 836 which, in turn, implements the necessary process sequence to transition from generator 800 to state off. In such ways, controller 838 may not have any independent capacity to cause the removal of power from generator 800 after its on state has been established.
[0239] [0239] In certain ways, controller 838 can 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.
[0240] [0240] In certain forms, the isolated stage 802 may comprise an instrument interface circuit 840 to, for example, provide a communication interface between a control circuit of a surgical instrument (for example, a control circuit that comprises grip keys) and non-insulated stage 804 components, such as logic device 816, DSP processor 822 and / or UI processor 836. The instrument interface circuit
[0241] [0241] 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 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 source of bipolar current fed by a differential amplifier. The question mark can be communicated to a surgical instrument control circuit (for example, using a conductive pair on a cable that connects the generator 800 to the surgical instrument) and monitored to determine a state or configuration of the control circuit . The control circuit can comprise a number of 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, so unambiguous, 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 interference signal.
[0242] [0242] In one form, 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 pri - first data circuit disposed in a surgical instrument or otherwise associated with it. In certain forms, for example, a first data circuit may be arranged on a cable integrally attached to a handle of the surgical instrument 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 ways, the first data circuit may comprise a non-volatile storage device, such as an EEPROM device. In certain ways, the first data circuit interface 846 can be implemented separately from logic circuit 842 and comprises a suitable circuitry (for example, separate logic devices, a processor) to allow communication between logic circuit 842 and the first data circuit. In other forms, the first data circuit interface 846 can be integral with logic circuit 842.
[0243] [0243] In certain ways, 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 instrument interface circuit 840 (for example, logic circuit 842), transferred to a non-isolated stage component 804 (for example, to logic device 816, PSD processor 822 and / or UI 836 processor) for presentation to a user by means of an output device and / or to control a function or operation of the generator 800. Additionally, any type of information can be communicated to the first data circuit for storage in the same through the first interface of data circuit 846 (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.
[0244] [0244] As discussed earlier, a surgical instrument can be removed from a handle (for example, the multifunctional surgical instrument can be removed from the handle) to promote interchangeability and / or disposability of the instrument. In such 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 backward compatible 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.
[0245] [0245] 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, a 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 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.
[0246] [0246] In some ways, the second data circuit can store information about the ultrasonic and / or electronic properties of an associated ultrasonic transducer, end actuator or ultrasonic drive system. For example, the first data circuit can indicate an initialization frequency slope, as described here. In addition or alternatively, any type of information can be communicated to the second data circuit for storage on the same through the second interface.
[0247] [0247] 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 from and to the second data circuit using a wire bus communication scheme, implemented in the existing wiring, as one of the conductors used to transmit signals. question marks 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.
[0248] [0248] In certain forms, the isolated stage 802 may comprise at least one blocking capacitor 850-1 connected to the output of the drive signal 810b to prevent the passage of direct current (DC) to a patient. A single blocking capacitor may be required to comply with medical regulations and standards, for example. Although failures in single-capacitor designs are relatively uncommon, such failures can still have negative consequences. In one form, a second blocking capacitor 850-2 can be placed in series with the blocking capacitor 850-1, with current dispersion of one point between the blocking capacitors 850-1 and 850-2 being monitored, for example, by an ADC 852 circuit for sampling a voltage induced by leakage current. Samples can be received, for example, via logic circuit 842. Changes based on the leakage current (as indicated by the voltage samples), generator 800 can determine when at least one of the 850- 1, 850-2 has failed, thus offering a benefit over single capacitor designs that have a single point of failure.
[0249] [0249] In certain embodiments, the non-isolated stage 804 may comprise a power supply 854 to provide DC power with adequate voltage and current. The power supply may comprise, for example, a 400 W power supply to deliver a system voltage of 48 VDC. The power supply 854 can additionally comprise one or more DC / DC voltage converters 856 to receive the output from the power supply to generate DC outputs at the voltages and currents required by the various components of generator 800. As discussed above in relation to the controller 838, one or more of the 856 DC / DC voltage converters can receive an input from the 838 controller when the user activates the "on / off" input device
[0250] [0250] 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 types of energy to a surgical instrument. The 900 generator provides ultrasonic and RF signals to supply energy to a surgical instrument, independently or simultaneously. Ultrasonic and RF signals can be provided alone or in combination and can be provided simultaneously. As indicated above, at least one generator output can provide multiple energy modes (for example, ultrasonic, bipolar or monopolar RF, irreversible and / or reversible electroporation, and / or microwave energy, among others) through a single port, and these signals can be supplied separately or simultaneously to the end actuator to treat tissue. The generator 900 comprises a processor 902 coupled to a waveform generator 904. The processor 902 and the waveform generator 904 are configured to generate various signal waveforms based on information stored in a memory attached to the memory. processor 902, not shown for clarity of description. 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 to an analog output. The analog output is fed to an amplifier 1106 for signal conditioning and amplification. The conditioned and amplified output of 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 supplied to the surgical instrument between the terminals identified as ENERGY1 and RETURN. A second signal from a second energy modality is coupled by a 910 capacitor and is supplied to the surgical instrument between the terminals identified as ENERGY2 and RETURN. It will be recognized that more than two modes of energy can be issued and, therefore, the subscript "n" can be used to designate that up to n ENERGIAn terminals can be provided, where n is a positive integer greater than 1. It will also be recognized that up to "n" return paths, RETURN can be provided without departing from the scope of this description.
[0251] [0251] A first 912 voltage detection circuit is coupled through the terminals identified as ENERGY1 and the RETURN path to measure the output voltage between them. A second voltage detection circuit 924 is 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 leg on the secondary side of the power transformer 908, as shown to measure the output current for any type of energy. If different return paths are provided for each energy modality, then a separate current detection circuit would be provided on each return leg. 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 voltage transformers isolation 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 provided to processor 902 for processing and additional computing. Output voltages and output current feedback information can be used
[0252] [0252] In one aspect, impedance can be determined by processor 902 by dividing the output of the first voltage detection circuit 912 coupled over the terminals identified as ENERGIA1V / RETORNO or the second voltage detection circuit 924 coupled over the terminals identified as ENERGY2 / RETURN by the output of the current detection circuit 914 arranged in series with the RETURN leg on the secondary side of the power transformer 908. The outputs of the first and second voltage detection circuits 912, 924 are provided for separate the transformer isolations 916, 922 and the output of the current detection circuit 914 is provided to another isolation transformer 916. The digitalized voltage and current detection measurements from the ADC circuit 926 are provided to the processor 902 for compute the impedance. As an example, the first mode of energy ENERGIA1 may be ultrasonic energy and the second mode of energy ENERGIA 2 may 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. In addition, 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, multiple RETURN return paths can be provided for each ENERGY energy mode.
[0253] [0253] As shown in Figure 21, generator 900 comprising at least one output port can include a power transformer 908 with a single output and multiple taps to provide power in the form of one or more types 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 coagulation point using monopolar or bipolar RF electrosurgical electrodes. The output waveform of the generator 900 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 would preferably be located between the output identified as ENERGY1 and RETURN, as shown in Figure 21. In one example, a connection of bipolar RF electrodes to the output of generator 900 would be preferred. located between the outlet identified as ENERGY and the RETURN. In the case of a monopolar output, the preferred connections would be an active electrode (for example, light beam or other probe) for the ENERGY2 output and a suitable return block connected to the RETURN output.
[0254] [0254] Additional details are revealed in US patent application publication 2017/0086914 entitled TECHNIQUES FOR OPE-
[0255] [0255] 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.
[0256] [0256] As used in the present invention, 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 in the present invention 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".
[0257] [0257] 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 other electronic systems. It can contain digital, analog, mixed and often radio frequency functions - all on a single substrate. A SoC integrates a microcontroller (or microprocessor) with advanced peripherals such as a graphics processing unit (GPU), i-Fi module, or coprocessor. An SoC may or may not contain internal memory.
[0258] [0258] As used here, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuits and memory. A microcontroller (or MCU for 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) along 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.
[0259] [0259] As used in the present invention, the term controller or microcontroller can be a chip or IC device
[0260] [0260] Any of the processors or microcontrollers in the present invention can be any implemented by any single-core or multi-core processor, such as those known under the trade name of ARM Cortex available from Texas Instruments. In one respect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, comprising a 256 KB 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 serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareO program, 2 KB electronically erasable programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more analog quadrature encoder (QEI) inputs, one or more analog converters for 12 bit digital (ADC) with 12 channels of analog input, details of which are available for the product data sheet.
[0261] [0261] In one aspect, the processor may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the trade name Hercules ARM Cortex R4, also available from Texas Instruments . The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[0262] [0262] The modular devices include the modules (as described in connection with Figures 3 and 9, for example) that are received 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. The modular devices described here can be controlled by control algorithms. The control algorithms can be executed on the modular device itself, on the central surgical controller to which the specific modular device is paired, or on both the modular device and the central surgical controller (for example, surgical (for example, through a distributed computing) In some examples, the control algorithms of the modular devices control the devices based on the data detected by the modular device itself (that is, by sensors on, over or connected to the modular device). - to the patient being operated on (for example, tissue properties or insufflation pressure) or to the modular device itself (for example, the rate at which a knife is being advanced, the motor current, or the levels For example, a control algorithm for a surgical stapling and cutting instrument can control the rate at which the instrument's motor drives u the knife through the fabric according to the resistance encountered by the knife as it progresses. Long distance communication and manipulation of device and data condition
[0263] [0263] Surgical procedures are performed by different surgeons in different locations, some with much less experience than others. For a given surgical procedure, there are many parameters that can be varied to try to achieve a desired result. For example, for a particular surgical procedure that uses energy supplied by a generator, the surgeon often relies on experience only to determine which mode of energy to use, what level of output power to use, the duration of the energy application , etc., in order to try to get the desired result. To increase the likelihood of obtaining the desired results from a plurality of different surgical procedures, each surgeon should receive recommendations for good practice that are based on important relationships identified within large sets of accurate data associated with multiple information. surgical procedures performed in multiple locations over time. However, there are many ways in which such data sets can become compromised, inaccurate, and / or unsafe, thus questioning the applicability of the best practice recommendations derived from them. For example, for data sent from a source to a cloud-based system, data may be lost while in transit to the cloud-based system, data may be corrupted while in transit to the cloud-based system, the Data confidentiality can be understood while in transit to the cloud-based system and / or the content of the data can be changed while in transit to the cloud-based system.
[0264] [0264] Each of a plurality of operating rooms located in multiple locations can be equipped with a central surgical controller. When a specific surgical procedure is performed in a given operating room, the surgical controller
[0265] [0265] Consequently, in one aspect, the present description provides a central surgical controller to transmit the generator data associated with a surgical procedure to a cloud-based system communicatively coupled to a plurality of central surgical controllers. The central surgical controller comprises a processor and a memory attached to the processor. The memory stores instructions executable by the processor to receive data from a generator, encrypt the data, generate a message authentication code (MAC) based on the data, generate a datagram that comprises the encrypted data, the generated MAC, a source identifier and a destination identifier, and transmit the datagram to a cloud-based system. The data is structured in a data package comprising at least two of the following fields: a field indicating the source of the data, an exclusive timestamp, a field indicating a generator power mode, a field indicating the generator power output and a field indicating a duration of the generator power output. The datagram allows the cloud-based system to decrypt the encrypted data from the transmitted datagram, verifying
[0266] [0266] In several respects, the present description provides a control circuit for transmitting generator data associated with a surgical procedure to a cloud-based system communicatively coupled to a plurality of central surgical controllers, as described above. In many respects, the present description provides a non-transitory, computer-readable medium that stores computer-readable instructions that, when executed, cause a machine to transmit generator data associated with a surgical procedure to a nu-based system - comes communicatively coupled with a plurality of central surgical controllers, as described above.
[0267] [0267] In another aspect, the present description provides a cloud-based system coupled in a communicative way to a plurality of central surgical controllers. Each central surgical controller is configured to transmit data from the generator associated with a surgical procedure to the cloud-based system. The cloud-based system comprises a processor and memory attached to the processor. The memory stores instructions executable by the processor to receive a datagram generated by a central surgical controller of the surgical instrument, decrypt the encrypted generator data, verify the integrity of the generator data based on MAC data, authenticate the controller central surgical as the source of the datagram and validating a transmission path followed by the datagram the central surgical controllers and the cloud-based system. The generator comprises generator data captured from a generator associated with the surgical controller
[0268] [0268] In several respects, the present description provides a control circuit to transmit data from the generator associated with a surgical procedure to the cloud-based system. In many respects, the present description provides a non-transitory, computer-readable medium that stores computer-readable instructions that, when executed, cause a machine to transmit generator data associated with a surgical procedure to the cloud-based system.
[0269] [0269] In another aspect, the present description provides a method that comprises capturing data from a combined generator of a central surgical controller during a surgical procedure, the combined generator being configured to supply two or more different modes of energy . Encrypt the captured generator data, generate a MAC based on the captured generator data, generate a datagram comprising the encrypted generator data, the MAC, a source identifier and a destination identifier, and communicate the datagram to from the central surgical controller to a cloud-based system. The datagram allows the cloud-based system to authenticate the integrity of the reported generator data, authenticate the central surgical controller as a source of the datagram and determine a communication path followed by the datagram between the central surgical controller and the surgical system based on a cloud.
[0270] [0270] By sending generator data captured from a plurality of different central surgical controllers to a cloud-based system, the cloud-based system is able to quickly build large data sets of information associated with multiple surgical procedures performed in multiple locations over time. In addition, due to the composition of the respective datagrams, for a given datagram, the cloud based system is able to determine whether the datagram was originally sent by one of the central surgical controllers (origin validation), thus providing an indication that the generator data received in the cloud-based system is legitimate. For the given datagram, the cloud-based system is also able to determine whether the generator data received in the cloud-based system is identical to the generator data sent by the central surgical controller (data integrity), thus enabling data authenticity generator received is verified. Additionally, for the given datagram, the cloud-based system is also able to re-trace the communication path followed by the datagram, thus enabling improved problem resolution if a datagram received by the nu-based system - comes originally sent from a device other than the central surgical controllers and / or if the content of the datagram changes during transit to the cloud-based system. Notably, the present description refers to the generator data, in particular. Here, the present description should not be limited as being able to process only generator data. For example, the central surgical controller 206 and / or the cloud-based system 205 can process data received from any component (for example, imaging module 238, generator module 240, smoke evacuation module 226, suction / irrigation module 228, communication module 230, processor module 232, storage matrix 234, smart device / instrument 235, non-contact sensor module 242, robotic central surgical controller 222, non-robotic central surgical controller 206, intelligent device - wireless te / instrument 235, visualization system 208 of surgical system 202 that is coupled to central surgical controller 206 and / or data from any device (eg endoscope 239, power device 241) coupled to / via such components (for example, see Figures 9 and 10), in a similar manner, as discussed here.
[0271] [0271] Unfortunately, the result of a surgical procedure is not always ideal. For example, a failure event, such as a failure of the surgical device, an unwanted tissue perforation, a post-operative hemorrhage, or the like, can occur. The occurrence of a failure event can be attributed to any one of a variety of different people and devices, including one or more surgeons, one or more devices associated with surgery, a patient's condition and combinations of them. When a given failure occurs, it is not always clear who or what caused the failure event or how the occurrence of the failure event can be mitigated in connection with future surgery.
[0272] [0272] During a given surgical procedure, a large amount of data associated with the surgical procedure can be generated and captured. All captured data can be communicated to a central surgical controller, and captured data can be stamped with a date and time before or after being received at the central surgical controller. When a failure event associated with the surgical procedure is detected and / or identified,
[0273] [0273] When a given surgical procedure is performed, a large amount of data associated with the surgical procedure can be generated and captured. All captured data can be communicated to a central surgical controller, where the information can be removed from all "personal" associations. Captured data can be timestamped before being received at the central surgical controller, after being received at the central surgical controller, before being stripped of "personal" associations or after being stripped of "personal" associations.
[0274] [0274] Consequently, in one aspect, the present description provides a central surgical controller to prioritize surgical data associated with a surgical procedure for a cloud-based system communicatively coupled to a plurality of central surgical controllers. The central surgical controller comprises a processor and a memory attached to the processor. The memory stores instructions executable by the processor to capture surgical data, the surgical data comprising data associated with a surgical device, stamping the captured surgical data with date and time, identifying a failure event, identifying a period time associated with the failure event, isolate the surgical data from the failure event from the surgical data not associated with the failure event based on the identified time period, place the surgical data from the failure event in chronological order by timestamp, encrypt the surgical data of the failure event in chronological order, generate a datagram comprising the surgical data of the failure event and transmit the datagram to a cloud-based system. The datagram is structured to include a field that includes an indicator that prioritizes the surgical data from the encrypted failure event over other encrypted data in the da- tagrama. The datagram enables the cloud-based system to decrypt the encrypted failure event surgical data, concentrate the analysis on the surgical data of the failure event and not on the surgical data not associated with the failure event, and indicate the surgical device associated with the failure event. failure during at least one of: removal of an operating room, return to a manufacturer
[0275] [0275] In several aspects, the present description provides a control circuit to prioritize surgical data associated with a surgical procedure for a cloud-based system communicatively coupled to a plurality of central surgical controllers. In many respects, the present description provides a non-transitory, computer-readable medium that stores computer-readable instructions that, when executed, cause a machine to prioritize surgical data associated with a surgical procedure to a cloud-based system coupled communicative to a plurality of central surgical controllers.
[0276] [0276] In another aspect, the present description provides a method that comprises capturing data during a surgical procedure, communicating the captured data to a central surgical controller, stamping the date and time on the captured data, identifying a failure event associated with the surgical procedure, determine which captured data are associated with the failure event, separate the captured data associated with the failure event from all other captured data, place the captured data in chronological order associated with the failure event and communicate the captured data in chronological order to a cloud-based system in a priority manner.
[0277] [0277] By capturing the large amount of data associated with the surgical procedure and with the data stamped with date and time, the portion of captured data that is relevant to the detected / identified failure event can be more easily isolated from all the other data captured, thus enabling a subsequent analysis more focused on only the relevant data captured. The data associated with the failure event can then be placed in chronological order (this requires less
[0278] [0278] To help ensure that best practice recommendations are developed based on accurate data, it would be desirable to ensure that the generator data received on the cloud-based system is the same as the generator data communicated to the cloud-based system. In addition, to help determine the cause of a failure event as quickly as possible, it would be desirable to ensure that surgical data associated with the failure event is communicated to the cloud-based system in a prioritized manner (in relation to the data not associated with the failure event) so that the analysis of the surgical data can be carried out in an accelerated way.
[0279] [0279] Aspects of a system and method for communicating data associated with a surgical procedure are described in the present invention. As shown in Figure 9, various aspects of the computer-implemented interactive surgical system 200 include a device / instrument 235, a generator module 240, a modular control tower 236 and a cloud-based system 205. As shown in Figure 10 , device / instrument 235, generator module 240 and modular control tower 236 are components / portions of a central surgical controller 206.
[0280] [0280] In several respects, generator module 240 of central surgical controller 206 can deliver radio frequency energy, such as monopolar radio frequency energy, bipolar radio frequency energy, advanced bipolar energy and / or ultrasonic energy, to a device / instrument 235 for use in a surgical procedure. Thus, generator module 240 can be called a combined generator. An example of this type of combined generator is shown in Figure 22, where the combined generator 3700 generator is shown as including a monopolar module 3702, a bipolar module 3704, an advanced bipolar module 3706 and an ultrasound module 3708. When used during a surgical procedure, the respective energy modules (for example, 3702, 3704, 3706 and / or 3708) of the combined generator 3700 can provide data from the generator, such as the type of energy supplied to the device instrument (for example, energy frequency, ultrasonic energy, radio frequency energy and ultrasonic energy), type of radio frequency energy (for example, monopolar, bipolar, advanced bipolar), frequency, power output, duration, etc., for the 3710 data communication module of the combined generator 3700.
[0281] [0281] Figure 23 illustrates various aspects of a method of capturing data from a combined 3700 generator and communicating captured data to a 205 cloud-based system. Notably, as discussed in this document, this des - description should not be limited to the data processing of the generator. Thus, the method of Figure 23 extends, similarly, to other types of data received from other components coupled to the central surgical controller 206 (for example, data from imaging module data, smoke evacuator data, suction data - tion / irrigation, device / instrument data). The method comprises (1) capturing 3712 data from a combined generator 3700 from a central surgical controller 206 during a surgical procedure, with the combined generator 3700 being configured to provide two or more different energy modes; (2) encrypt 3714 captured generator data; (3) generate 3716 a MAC based on the captured generator data; (4) generate a 3718 datagram comprising the encrypted generator data, the MAC, a source identifier and a destination identifier; (5) and communicate the datagram 3720 from the central surgical controller 206 to a cloud-based system 205, the datagram enabling the cloud-based system 205 (i) to authenticate the integrity of the reported generator data , (ii) authenticate the central surgical controller as a source of the datagram and (iii) determine a communication path followed by the datagram between the central surgical controller 206 and the cloud-based surgical system 205.
[0282] [0282] More specifically, since the data generator is received in the data communication module 3710 of the combined generator 3700, the data from the generator can be communicated to the modular communication center 203 of the central surgical controller 206 for subsequent communication to the cloud-based system 205. The data communication module 3710 can communicate data from the generator to the modular communication center 203 in series over a single line of communication or in parallel over a plurality lines of communication, and such communication can be done in real time or in near real time. Alternatively, such communication can be carried out in batches.
[0283] [0283] In addition, the 3710 data communication module can compress the generator data and / or encrypt the generator data before communicating the generator data to the modular communication center 203. The specific method of compression and / or cryptography can be the same or different from the compression and / or cryptography that can be performed by the central surgical controller 206, as described in detail below.
[0284] [0284] The modular communication center 203 can receive the generator data communicated from the combined generator 3700 (for example, via the data communication module 3710), and the generator data can subsequently be communicated to the system. 205 cloud-based theme (for example, over the internet). According to several aspects, the modular communication core 203 can receive the generator data through a central controller / key 207/209 of the modular communication core 203 (see Figure 10), and the generator data they can be communicated to the cloud-based system 205 by a router 211 of the modular communication core 203 (see Figure 10). Generator data can be communicated in real time, close to real time or in batches to the cloud-based system 205 or can be stored in the central surgical controller 206 before being communicated to the cloud-based system 205. Generator data can be stored
[0285] [0285] In several respects, for cases where the data received from the generator at the modular communication center 203 is not encrypted, before the data received from the generator is transmitted to the cloud-based system 205, the generator data is encrypted to help ensure the confidentiality of generator data, while it is being stored on the central surgical controller 206 or while it is being transmitted to cloud 204 using the internet or other computer networks. According to several aspects, a component of the central surgical controller 206 uses an encryption algorithm to convert the generator data from a readable version to an encrypted version, thus forming encrypted generator data. The component of the central surgical controller 206 that uses / executes the encryption algorithm may be, for example, processor module 232, processor 244 of computer system 210 and / or combinations thereof. The encryption algorithm used / executed can be a symmetric encryption algorithm and / or an asymmetric encryption algorithm.
[0286] [0286] Using a symmetric encryption algorithm, the central surgical controller 206 would encrypt the generator data using a shared secret (for example, private key, passphrase, password). In this respect, a recipient of the encrypted generator data (for example, cloud-based system 205) would then decrypt the generator data encrypted using the same shared secret. In such an aspect, the central surgical controller 206 and the recipient would need to access and / or know the same shared secret. In one aspect, a shared secret can be generated / chosen by the central surgical controller 206 and delivered securely (for example, physically) to the recipient before encrypted communications to the recipient.
[0287] [0287] Alternatively, using an asymmetric encryption algorithm, the central surgical controller 206 would encrypt the generator data using a public key associated with a recipient (for example, cloud-based system 205). This public key could be received by the central surgical controller 206 from a certificate authority that issues a digital certificate certifying that the public key is owned by the recipient. The certificate authority can be any entity trusted by the central surgical controller 206 and the recipient. In such an aspect, the recipient of the encrypted generator data would then decrypt the generator data encrypted using a private key (that is, known only to the recipient) paired with the public key used by the central surgical controller 206 to encrypt the generator data. Notably, in such an aspect, the encrypted generator data can be decrypted only with the use of the recipient's private key.
[0288] [0288] According to aspects of the present description, the components (eg surgical device / instrument 235, energy device 241, endoscope 239) of surgical system 202 are associated with unique identifiers, which may be under the form of serial numbers. Thus, according to several aspects of this description, when a component is coupled to a central surgical controller 206, the component can establish a secret shared with the central surgical controller 206 using the unique identifier of the coupled component as the shared secret. Additionally, in such an aspect, the component can derive a checksum value by applying a checksum function / algorithm for the unique identifier and / or other data that is communicated to the central surgical controller 206. Here , the checksum function / algorithm is configured to produce a significantly different checksum value if there is a change in the underlying data.
[0289] [0289] In one aspect, the component can initially encrypt the unique identifier of a coupled component using a public key associated with the central surgical controller (for example, received by the central surgical controller component 206 before / after connection) and communicate the encrypted unique identifier to the central surgical controller 206. In other respects, the component can encrypt the unique identifier and the checksum value derived from a coupled component using a public key associated with the central surgical controller 206 and communicate the encrypted unique identifier and the checksum value connected / associated to the central surgical controller 206.
[0290] [0290] In still other aspects, the component can encrypt the unique identifier and a checksum function / algorithm using a public key associated with the central surgical controller 206 and communicate the encrypted unique identifier and the function / summation verification algorithm for the central surgical controller 206. In these aspects, the central surgical controller 206 would then decrypt the encrypted unique identifier or the encrypted unique identifier and the linked checksum value / associated or the encrypted unique identifier and the checksum function / algorithm using a private key (ie known only to the central surgical controller 206) paired to the public key used by the component to encrypt the unique identifier.
[0291] [0291] As the encrypted unique identifier can be deciphered only using the private key of the central surgical controller
[0292] [0292] Notably, asymmetric cryptography algorithms can
[0293] [0293] According to other aspects of the present description, the components (for example, surgical device / instrument 235, energy device 241, endoscope 239) of the surgical system 202 may comprise subcomponents (for example, handle, shaft drive, end actuator, cartridge), each associated with its own unique identifier. Thus, according to several aspects of the present description, when a component is coupled to the central surgical controller 206, the component can establish a secret shared with the central surgical controller 206 with the use of an exclusive build / sequence ( for example, ordered or random) of the unique identifiers associated with the subcomponents that combine to form the coupled component. In one aspect, the component can initially encrypt the compilation / unique sequence of the coupled component using a public key associated with the central part 206 and communicate the unique encrypted compilation / sequence to the central surgical controller 206. In such an aspect, the central surgical controller 206 would then decrypt the unique build / sequence using a private key (that is, known only to the central surgical controller 206) paired with the public key used by the component to encrypt the unique build / sequence. Since the compilation / sequence of the encrypted unique identifier can be deciphered only using the private key of the central surgical controller 206 and the private key is known only to the central surgical controller 206, this is a safe way to communicate a shared secret ( for example, the compilation / exclusive sequence of the coupled component) for the central surgical controller 206. In addition, in such an aspect, with a shared secret established, the component can encrypt future communications to the central surgical controller 206, and the central surgical controller 206 can decrypt future component communications using the shared secret (for example, the compilation / exclusive sequence of the coupled component).
[0294] [0294] Again, asymmetric encryption algorithms can be complex and may require significant computational resources to perform each communication. Thus, establishing the exclusive compilation / sequence of the coupled component (that is, readily combinable by the component), since the shared secret is not only faster (for example, there is no need to generate a shared secret with the use of a pseudo-random key generator), it also increases computational efficiency (for example, it allows the execution of faster, less complex symmetric encryption algorithms) for all subsequent communications. In several respects, this established shared secret can be used by the component and the central surgical controller 206 until the component is decoupled from the central surgical controller 206 (for example, the surgical procedure has ended). In addition, in such an aspect, since several subcomponents may be reusable (for example, handle, drive shaft, end actuator), while other subcomponents may not be reusable (for example, end actuator, cartridge), each new combination of subcomponents that combine to form the coupled component provides a unique build / sequence usable as a shared secret for component communications to the central surgical controller 206.
[0295] [0295] In accordance with additional aspects of the present description, the components (e.g. surgical device / instrument 235, energy device 241, endoscope 239) of surgical system 202 are associated with unique identifiers. Thus, according to several aspects of the present description, when a component is coupled to the central surgical controller 206, the central surgical controller 206 can establish a secret shared with a recipient (for example, cloud-based system 205) with the use of the unique identifier of the coupled component. In one aspect, the central surgical controller 206 can initially encrypt the unique identifier of a coupled component using a public key associated with the recipient and communicate the encrypted unique identifier to the recipient. In such an aspect, the recipient would then decrypt the unique identifier using a private key (i.e., known only to the recipient) paired with the public key used by the central surgical controller 206 to encrypt the unique identifier. Since the encrypted unique identifier can only be decrypted using the recipient's private key and the private key is known only to the recipient, this is a secure way to communicate a shared secret (for example, the unique identifier of the attached component) to the recipient (for example, example, cloud-based system). Additionally, in such aspect, with a shared secret established, the surgical controller
[0296] [0296] Notably, asymmetric cryptography algorithms can be complex and may require significant computational resources to perform each communication. Thus, establishing the unique identifier of the coupled component (that is, readily available to the central surgical controller 206), since the shared secret is not only faster (for example, there is no need to generate a secret shared with the use of a pseudo-random key generator), it also increases computational efficiency, for example, allowing the execution of faster, less complex symmetric encryption algorithms for all subsequent communications. In many respects, this established shared secret can be used by the central surgical controller 206 until the component is decoupled from the central surgical controller (for example, the surgical procedure has ended).
[0297] [0297] In accordance with still other aspects of the present description, the components (for example, surgical device / instrument 235, energy device 241, endoscope 239) of the surgical system 202 may comprise subcomponents (for example, handle, drive shaft, end actuator, cartridge), each associated with its own unique identifier. Thus, according to several aspects of the present description, when a component is coupled to the central surgical controller 206, the central surgical controller 206 can establish a shared secret with a recipient (for example, cloud-based system 205) with the use of a unique compilation / sequence (for example, ordered or random) of the unique identifiers associated with the subcomponents that combine to form the coupled component.
[0298] [0298] In one aspect, the central surgical controller 206 can initially encrypt the compilation / sequence of the coupled component using a public key associated with the recipient and communicate the exclusive compilation / sequence to the recipient. In such an aspect, the recipient would then decrypt the compilation / exclusive sequence encrypted using a private key (that is, known only to the recipient) paired with the public key used by the central surgical controller 206 to encrypt exclusive compilation / sequence. Since the encrypted unique build / string can only be decrypted using the recipient's private key and the private key is known only to the recipient, this is a secure way to communicate a shared secret (for example, the unique build / string of the attached component) to the recipient. With a shared shared secret, the central surgical controller 206 can encrypt future communications to the recipient (for example, cloud-based system 205), and the recipient can decrypt future communications from the central surgical controller 206 using the shared secret (for example, the exclusive compilation / sequence of the coupled component). Again, asymmetric encryption algorithms can be complex and may require significant computational resources to perform each communication. Thus, establishing the exclusive compilation / sequence of the coupled component (that is, readily combinable by the central surgical controller 206), since the shared secret is not only faster (for example, there is no need to generate a shared secret with the use of a pseudo-random key generator), it also increases computer efficiency (for example, it allows the execution of cryptography algorithms).
[0299] [0299] In many respects, this shared shared secret can be used by the central surgical controller 206 until the component is decoupled from the central surgical controller (for example, the surgical procedure has ended). In addition, in this regard, since several subcomponents may be reusable (for example, grip, drive shaft, end actuator), while other subcomponents may not be reusable (eg end actuator , cartridge), each new combination of subcomponents that combine to form the coupled component provides a unique build / sequence usable as a shared secret for communications from the central surgical controller 206 to the recipient.
[0300] [0300] In some ways, an encryption-after-MAC (EtM) approach can be used to produce the encrypted generator data. An example of this approach is shown in Figure 25, in which the generator's unencrypted data (ie, the plain text 3742, for example, the data packet 3722) is first encrypted 3743 (for example, via key 3746) to produce a ciphertext 3744 (ie, the encrypted generator data), then a MAC 3745 is produced based on the resulting ciphertext 3744, key 3746 and the MAC algorithm (ie, a function hash 3747). More specifically, the ciphertext 3744 is processed using the MAC algorithm using the 3746 key. In an aspect similar to the symmetric cryptography discussed in the present invention, the 3746 key is a secret key accessible / known to the surgical controller. central logic 206 and the recipient (e.g., cloud-based system 205). In this respect, the secret key is a shared secret associated with / chosen by the central surgical controller 206, a shared secret associated with / chosen by the recipient, or a key selected through a pseudo random key generator. For this approach, as generally shown in 3748, the encrypted generator data (ie, the ciphertext 3744) and MAC 3745 would be communicated together to the 205-based system.
[0301] [0301] In other respects, an encryption-e-MAC (E&M) approach can be used to produce the encrypted generator data. An example of this approach is shown in Figure 26, in which MAC 3755 is produced based on the generator's unencrypted data (ie, a plain text 3752, for example, data packet 3722), a key 3756 and a MAC algorithm (for example, a 3757 hash function). More specifically, the 3752 plain text is processed using the MAC algorithm using the 3756 key. In a similar aspect to the symmetric cryptography discussed in the present invention, the 3756 key is a secret key accessible / known to the central surgical controller 206 and by the recipient (for example, 205 cloud-based system). In this respect, the secret key is a shared secret associated with / chosen by the central surgical controller 206, a shared secret associated with / chosen by the recipient, or a key selected using a pseudo-random key generator. In addition, in such an aspect, the unencrypted data of the generator (ie, plain text 3752, for example, data packet 3722) is encrypted 3753 (for example, using key 3756) to produce a ciphertext 3754. For this approach, as shown in general in 3758, MAC 3755 (ie produced on the basis of unencrypted generator data) and encrypted generator data (ie ciphertext 3754) would be communicated together with the 205 cloud-based system.
[0302] [0302] In some ways, a MAC-after- approach
[0303] [0303] In alternative aspects, the key used to encrypt the generator's unencrypted data (for example, Figure 25 and Figure 26) or the generator's unencrypted data and the MAC (for example, Figure 27) may be different of the key (for example, keys 3746, 3756, 3766) used to produce the MAC. For example, the key used to encrypt the generator's unencrypted data (for example, Figure 25 and Figure 26) or the generator's unencrypted data and the MAC (for example, Figure 27) can be a different shared secret or a public key associated with the recipient.
[0304] [0304] Instead of using the MAC to provide a subsequent guarantee of data integrity to the cloud-based system 205, according to other aspects, the central surgical controller 206 can use a digital signature to enable the system based on 205 cloud subsequently authenticates the integrity of the reported generator data. For example, processor module 232 and / or processor 244 of computer system 210 may use one or more algorithms to generate a digital signature associated with the generator data, and the cloud-based system 205 may use an algorithm to determine the authenticity of the data received from the generator. The algorithms used by processor module 232 and / or processor 244 of computer system 210 may include: (1) a key generation algorithm that randomly selects a private key from a set. possible private keys, in which the key generation algorithm issues the private key and a corresponding public key; and (2) a signature algorithm that, given the data generator and a private key, produces a digital signature associated with the generator data. The cloud-based system 205 can use a signature verification algorithm that, given the generator data received, public key and digital signature, can accept the generator data received as authentic if the digital signature is determined to be authentic or considers the generator data to be compromised or changed if the digital signature is not determined to be authentic.
[0305] [0305] In accordance with other aspects of the present description, the central surgical controller 206 may use a commercial authentication program (for example, Secure Hash Algorithm (SHA-2 comprising SHA-256)) to provide a subsequent guarantee of data integrity for the shared generator
[0306] [0306] After the generator data has been encrypted (for example, through EtM, E&M, MtE), a component of the central surgical controller 206 can communicate the encrypted generator data to the cloud-based system 205. The component the central surgical controller 206 that communicates the encrypted generator data to the cloud-based system 205 can be, for example, processor module 232, a central surgical controller / key 207/209 of the communication center modular 203, router 211 of modular communication center 203, communication module 247 of computer system 210, etc.
[0307] [0307] According to several aspects, the communication of the encrypted generator data over the internet can follow an IP that: (1) defines datagrams that encapsulate the encrypted generator data to be delivered and / or (2) defines methods addresses that are used to label the datagram with the source and destination information. A high-level representative of an example 3770 datagram is shown in Figure 28, where datagram 3770 includes a header 3772 and a payload 3774 and, in other respects, may also include a trailer (not shown). A more detailed representation of an example of datagram 3780 is shown in Figure 29, where header 3782 can include fields for information such as the address | P of origin 3786 that is sending the datagram ( for example, router 211 of modular communication center 203), destination IP address 3788 which is to receive the datagram (for example, cloud 204 and / or remote server 213 associated with the cloud-based system 205), a type of service designation (not shown), a header length 3790, a payload length 3792 and a checksum value 3794. In such an aspect, the central surgical controller 206 can apply additionally a checksum function / algorithm to the unencrypted generator data (ie, plain text 3742, for example data packet 3722) or at least a portion of the unencrypted generator data (for example, an ID 3726 combined generator) to derive the sum value of v erification 3794. Here, the checksum function / algorithm is configured to produce a significantly different checksum value if there is any change (for example even a small change) in the underlying data (for example, generator data). After decrypting generator data encrypted by its recipient (for example, cloud-based system 205), the recipient can apply the same checksum function / algorithm to decrypted generator data to generate a checksum value of validation.
[0308] [0308] According to several aspects, before the generator data is encrypted, the generator data can be stamped with a date and time (if they have not already been stamped with a date and time by the combined generator 3700) and / or the generator data can be compressed (if not already compressed by the combined generator 3700). The timestamp allows the cloud-based system 205 to correlate generator data with other data (for example, removed patient data) that can be communicated to the cloud-based system 205. Compression enables less representation of the generator data is subsequently encrypted and communicated to the cloud-based system 205. For compression, a component of the central surgical controller 206 can use a compression algorithm to convert a representation of the generator data into one smaller representation of generator data, thus enabling more efficient and economical encryption of generator data (for example, less data to encrypt uses less processing resources) and more efficient and economical communication of generator data encrypted (for example, smaller representations of generator data within the payload of the datagrams (for example, Figures 28 and 29) allow m more generator data is included in a given datagram, that more generator data is communicated within a given time period and / or that generator data is communicated with less communication resources). The component of the central surgical controller 206 that uses / performs the compression algorithm can be, for example, processor module 232, processor 244 of the computer system and / or combinations thereof.
[0309] [0309] Once the data generator and MAC of a given da- tagrama has been received in the cloud-based system 205 (for example Figure 25, reference 3748; Figure 26, 3758; and Figure 27, reference 3768), cloud-based system 205 can decrypt the generator data encrypted from the communicated datagram payload to obtain the communicated generator data.
[0310] [0310] In one respect, again with reference to Figure 25, the recipient (for example, cloud-based system 205) can, similar to the central surgical controller 206, process the ciphertext 3744 using the same MAC algorithm using the same known / accessible secret key to produce an authenticating MAC. If the received MAC 3745 matches that authenticating MAC, the recipient (for example, cloud-based system 205) can safely assume that the ciphertext 3744 has not been altered and comes from the central surgical controller 206. The recipient (for example , cloud-based system 205) can then decrypt the ciphertext 3744 (for example, using key 3746) to obtain plain text 3742 (for example, data package comprising generator data).
[0311] [0311] In another aspect, with reference again to Figure 26, the recipient (for example, cloud-based system 205) can decrypt the ciphertext 3754 (for example, using the key 3756) to obtain the plain text 3752 (for example, data package comprising generator data). Then, similar to the central surgical controller 206, the recipient (for example, cloud-based system 205) can process the plain text 3752 through the same MAC algorithm using the same secret key known / accessible for produce an authenticating MAC. If the received MAC 3755 matches that authenticating MAC, the recipient (for example, cloud-based system 205) can safely assume
[0312] [0312] In yet another aspect, with reference again to Figure 27, the recipient (for example, cloud-based system 205) can decrypt the ciphertext 3764 (for example, using the key 3766) to obtain the plain text 3762 ( for example, data package comprising generator data) and MAC 3765. Next, similar to the central surgical controller 206, the recipient (for example, cloud-based system 205) can process plain text 3762 using the same algorithm MAC using the same known / accessible secret key to produce an authenticating MAC. If the received MAC 3765 matches that authenticating MAC, the recipient (for example, cloud-based system 205) can safely assume that the ciphertext 3762 has not been altered and comes from the central surgical controller 206.
[0313] [0313] In alternative aspects, the key used to encrypt generator data not encrypted (for example, Figure 25 and Figure 26) or generator data unencrypted and the MAC (for example, Figure 27) may be different from the key (for example example, keys 3746, 3756, 3766) used to produce the MAC. For example, the key used to encrypt the generator's unencrypted data (for example, Figure 25 and Figure 26) or the generator's unencrypted data and the MAC (for example, Figure 27) may be a different shared secret or a public key associated with the recipient. In such aspects, with reference to Figure 25, the recipient (for example, cloud-based system 205), after verifying the MAC authentication using key 3746 (described above), can then decrypt the ciphertext 3744 (for example, through the different shared secrets or private key associated with the recipient) to obtain the plain text 3742 (for example, data package comprising
[0314] [0314] In short, with reference to Figures 25 to 27, if an MAC authentication, as determined / calculated by the 205 cloud based system, is the same as the MAC that was received with the data program, the system cloud-based 205 can be sure that the generator data received is authentic (that is, it is the same as the generator data that was communicated by the central surgical controller 206) and that the data generator data integrity has not been compromised or changed. As described above, the recipient can additionally apply plain text 3742, 3752, 3762, or at least a portion of it, to the checksum function / algorithm (that is, used by the central surgical controller 206) to generate a validation checksum value in order to recheck the generator data integrity based on the checksum value stored in the communicated datagram header.
[0315] [0315] Additionally, based on the decrypted datagram, the source | P address (for example, Figure 29, reference 3786) that originally communicated the datagram to the cloud-based system 205 can be determined from the communicated datagram header. If the source determined is a recognized source, the cloud-based system 205 can be sure that the generator data originates from a trusted source, thus providing origin authentication and further guaranteeing the integrity of the generator data. In addition, as each router through which the datagram passed on its way to the 205 cloud-based system includes its IP address with its forwarded communication, the 205 cloud-based system is able to track the trajectory followed by the datagram and identify each router that manipulated the datagram. The ability to identify the respective routers can be useful in cases where the content of the datagram received in the cloud-based system 205 is not the same as the content of the datagram as originally communicated by the central surgical controller 206. For aspects where the trajectory of communication was pre-specified and included in the header of the communicated datagram, the ability to identify the respective routers can enable the trajectory to be validated and provide additional security for the authenticity of the generator data received.
[0316] [0316] Furthermore, according to several aspects, after the authentication of the generator data received, the cloud-based system 205 can communicate a message (for example, a handshake or similar message) to the central surgical controller 206 through the internet or other communication network, confirming / guaranteeing that the datagram communicated from the central surgical controller 206 was received intact by the cloud-based system 205, thus effectively closing the loop of that specific datagram.
[0317] [0317] Aspects of the communication method described above, and / or variations thereof, can also be used to communicate data in addition to generator data to the system based on numbers.
[0318] [0318] In addition to communicating generator data to the cloud-based system 205, the central surgical controller 206 can also use the communication method described above, and / or variations thereof, to communicate data in addition to the generator data for the cloud-based system 205. For example, the central surgical controller 206 can also communicate other information associated with the surgical procedure to the 205-based system. This other information may include, for example, the type of surgical procedure to be performed, the name of the facilities where the surgical procedure is being performed, the location of the facilities where the surgical procedure is being performed, an identification of the operating room within the facility where the surgical procedure is being performed , the name of the surgeon performing the surgical procedure, the patient's age and data associated with the patient's condition (eg blood pressure, frequency cardiac disease, current medications). According to several aspects, this other information may be devoid of all information that could identify the specific surgery, patient or surgeon, so that the information is essentially anonymized for further processing and analysis by the system. cloud-based 205. In other words, the data removed is not correlated to a specific surgery, patient, or surgeon. Deprecated information can be communicated to the cloud-based system 205 together with or separately from the reported generator data.
[0319] [0319] For cases in which the deprived / other data must be communicated separately from the generator data, the deprived / other data can be stamped with the date and time, compressed and / or encrypted in the same or different way as described above in relation to the generator data, and the central surgical controller 206 can be programmed / configured to generate a datagram that includes the encrypted / other deprived information in place of the encrypted generator data. The datagram can then be communicated from the central surgical controller 206 via the internet to the cloud-based system 205 following an IP that: (1) defines datagrams that encapsulate the generator's encrypted data / other data to be and (2) define addressing methods that are used to identify the datagram with the source and destination information.
[0320] [0320] For cases in which the deprived / other information must be communicated separately from the generator data, the deprived / other data can be stamped with the date and time, compressed and / or encrypted in the same or different way as that described above in relation to the generator data, and the central surgical controller 206 can be programmed / configured to generate a datagram that includes the encrypted generator data and the encrypted / other deprived information.
[0321] [0321] As presented above, it is a sad reality that the results of all surgical procedures are not always ideal and / or adequate. For cases where a failure event is detected and / or identified, a variation of the communication methods described above can be used to isolate surgical data that is associated with the failure event (for example, surgical data from the failure event) of the surgical data that are not associated with the failure event (for example, surgical data not of the failure event) and communicate the surgical data that are associated with the failure event (for example, failure event data) from the surgical controller central 206 for the cloud-based surgical system 205 in a prioritized manner for analysis. According to one aspect of the present description, the surgical data of the failure event is communicated from the central surgical controller 206 to the cloud-based system 205 in a prioritized manner in relation to the surgical data not of the failure event.
[0322] [0322] Figure 31 illustrates various aspects of a method implemented by the system to identify surgical data associated with a failure event (for example, surgical data from the failure event) and communicate the surgical data identified for a surgical system cloud-based 205 in a prioritized manner. The method comprises (1) receiving 3838 surgical data in a central surgical controller 206, and the surgical data are associated with a procedure
[0323] [0323] More specifically, various surgical data can be captured during a surgical procedure and the captured surgical data, as well as other surgical data associated with the surgical procedure, can be communicated to the central surgical controller 206. Surgical data may include, for example, example, data associated with a surgical device / instrument (for example, Figure 9, surgical device / instrument 235) used during surgery, data associated with the patient, data associated with the facilities where the surgical procedure was performed and data associated with the surgeon. Before or after being communicated and received by the central surgical controller 206, surgical data can be stamped with the date and time and / or removed from all information that could identify the surgery, the patient or the specific surgeon, so that information is essentially anonymized for further processing and analysis by the cloud-based system 205.
[0324] [0324] Once a failure event has been detected and / or identified (for example, which may be during or after the surgical procedure), the central surgical controller 206 can determine which surgical data are associated with the failure event (for example,
[0325] [0325] In some respects, a failure event is considered to cover a certain period of time, and all data associated with that particular period of time can be considered associated with the failure event.
[0326] [0326] After the surgical data associated with the failure event has been identified, the surgical data identified (for example, surgical data from the failure event) can be separated or isolated from all other surgical data associated with the surgical procedure (for example, surgical data not from the failure event). Separation can be performed, for example, by marking or signaling the identified surgical data, storing the identified surgical data separately from all other surgical data associated with the surgical procedure, or storing only the other surgical data, continuing, at the same time, the processing of the identified surgical data for subsequent prioritized communication to the cloud-based system
[0327] [0327] The timestamp of all surgical data (for example, before or after surgical data is received at the central surgical controller) can be used by a component of the central surgical controller 206 to put in order chronologically identified surgical data associated with the failure event. The component of the central surgical controller 206 that uses the time stamp to place the identified surgical data in chronological order can be, for example, processor module 232, processor 244 of computer system 210 and / or combinations of the same. By placing the surgical data in chronological order, the cloud-based system 205 and / or other interested parties can subsequently better understand the conditions that were present that led to the occurrence of the failure event and possibly identify the exact cause of the failure. failure event, thus providing the knowledge to possibly mitigate a similar failure event that may occur during a similar surgical procedure performed at a future date.
[0328] [0328] Once surgical data has been placed in chronological order, surgical data in chronological order can be encrypted in a manner similar to that described above in relation to the encryption of generator data. In this way, the identified surgical data can be encrypted to help ensure the confidentiality of the identified surgical data, while it is being stored in the central surgical controller 206 or while it is being transmitted to the 205-based system using the internet or other computer networks. According to several aspects, a component of the central surgical controller 206 uses an encryption algorithm to convert the identified surgical data from a readable version to a coded version, thus forming encrypted surgical data associated with the failure event (for example, Figures 25 to 27). The component of the central surgical controller using the encryption algorithm can be, for example, processor module 232, processor 244 of computer system 210 and / or combinations thereof. The encryption algorithm used can be a symmetric encryption algorithm or an asymmetric encryption algorithm.
[0329] [0329] After the identified surgical data has been encrypted, a component of the central surgical controller can communicate the encrypted surgical data associated with the failure event (for example, encrypted surgical event data) to the system based on cloud 205. The central surgical controller component that communicates encrypted surgical data to the cloud-based system 205 can be, for example, processor module 232, a central surgical controller / 207/209 key from the modular communication center 203, router 211 of the modular communication center 203 or communication module 247 of computer system 210. According to various aspects, the communication of encrypted surgical data (for example, surgical data from the failure) over the internet can follow an IP that: (1) defines datagrams that encapsulate the encrypted surgical data to be delivered, and (2) defines addressing methods which are used to mark the datagram with source and destination information.
[0330] [0330] According to various aspects, before being encrypted, the identified surgical data (for example, surgical data from the failure event) can be compressed (if not already compressed by the source (or sources) of the surgical data relevant). Compression enables a smaller representation of the surgical data associated with the failure event to be subsequently encrypted and communicated to the cloud-based system 205. For compression, a component of the central surgical controller 206 can use a compression algorithm to convert a representation of the identified surgical data into a smaller representation of the identified surgical data, thus enabling more efficient and economical encryption of the identified surgical data (for example, less data to encrypt uses less processing resources) and communication more efficient and economical of the identified surgical data (for example, smaller representations of the surgical data within the payload of the datagrams allow more identified surgical data to be included in a given datagram, more identified surgical data to be communicated within a given period of time and / or what data c workers identified are communicated with less communication resources). The component of the central surgical controller 206 that uses the compression algorithm can be, for example, processor module 232, processor 244 of computer system 210 and / or combinations thereof. The compression algorithm used can be a lossless compression algorithm or a lossy compression algorithm.
[0331] [0331] In cases where other non-prioritized surgical data (for example, non-failure event surgical data) must be reported to the prioritized surgical data (for example, cyclic data
[0332] [0332] In some respects, once a failure event associated with a surgical procedure has been identified, the central surgical controller 206 and / or the cloud-based system 205 can subsequently mark or signal a device / surgical instrument 235 that was used during the surgical procedure as inoperative and / or removed. For example, in one aspect, information (for example, serial number, ID) associated with surgical device / instrument 235 and stored in the central surgical controller 206 and / or the cloud-based system 205 can be used to effectively block the surgical device / instrument 235 to be used again (for example, blacklisted). In another aspect, information (for example, serial number, ID) associated with the surgical device / instrument can initiate the printing of a delivery note and shipping instructions to return the 235 device / surgical instrument to a manufacturer. or another part designated so that a thorough analysis / inspection of the surgical device / instrument 235 can be performed (for example, to determine the cause of the failure). According to several aspects described here, once the cause of a failure is determined (for example, via the central surgical controller 206 and / or the cloud-based system 205), the central surgical controller 206 can download a cloud-based system program 205 to be executed by the surgical device / instrument 235 that corrects the determined cause of the failure (ie, program that alters the parameters of the surgical device / instrument to prevent the failure from occurring again).
[0333] [0333] According to some aspects, the central surgical controller 206 and / or the cloud-based system 205 may also provide / display a reminder (for example, via the central surgical controller 215 screen and / or the surgical device / instrument 237) for administrators, staff and / or other employees to physically remove the surgical device / instrument 235 from the operating room (for example, if detected as still present in the operating room) and / or send the device / surgical instrument 235 for the manufacturer or other designated party. In one respect, the reminder can be set to be provided / displayed periodically until an administrator can remove the sign or mark from the surgical device / instrument 235 of the central surgical controller 206 and / or the cloud-based system 205. According with various aspects, an administrator can remove the flagging or marking once the administrator can confirm (for example, system tracking of the surgical device / instrument 235 through its serial / ID number) that the device / surgical instrument 235 was received by the manufacturer or other designated party. Using the method described above to signal and / or track surgical data associated with a failure event, a closed loop control of the surgical data associated with the failure event and / or a surgical device / instrument 235 can be used. accomplished. Additionally, in view of the above, it will be understood that the central surgical controller 206 can be used to effectively manage the use (or non-use) of surgical devices / instruments 235 that were or could be used during a surgical procedure.
[0334] [0334] In various aspects of the present description, the central surgical controller 206 and / or cloud-based system 205 may want to control which components (eg surgical device / instrument 235, energy device 241) are being used in its interactive surgical system 100/200 to perform surgical procedures (for example, to minimize future failure events, to avoid the use of unauthorized or counterfeit components).
[0335] [0335] As such, in various aspects of the present description, since an interactive surgical system 100 can comprise a plurality of central surgical controllers 106, a cloud-based system 105 and / or each central surgical controller 106 of the system. interactive surgical theme 100 may wish to track central surgical component-controller combinations used over time. In one aspect, when / after a component (see Figure 9, for example, surgical device / instrument 235, energy device 241) is connected to / used with a specific central surgical controller 106 (for example, wired / wireless surgical device / instrument 235 connected to a specific central surgical controller 106, the power device 241 connected to the central surgical controller 106 via generator module 240), the specific central surgical controller 106 can communicate a register / block of that connection / use (for example, by linking the respective unique identifiers of the connected devices) to the cloud-based system 105 and / or to the other central surgical controllers 106 in the interactive surgical system 100. For example, by / after connection / use of an energy device 241, a central surgical controller 106 can communicate register / block (for example, by linking a unique identifier of the energy device ia 241 to a unique identifier of a generator module 240 to a unique identifier of the central surgical controller 106) for the cloud-based system 105 and / or for the other central surgical controllers 106 in the interactive surgical system 100. In such an aspect , if this is the first time the component (for example, power device) is connected to / used with a central surgical controller 106 in the interactive surgical system 100, the cloud-based system 105 and / or each controller central surgeon 106 of the interactive surgical system 100 can store the record / block as a genesis record / block.
[0336] [0336] According to various aspects of the present description, the cloud-based system 105 and / or each central surgical controller 106 can use such registers / blocks to track the use of a specific component and / or a subcomponent to its use in the interactive surgical system 100. For example, if a specific component (eg surgical instrument / device 235) is flagged / marked as related to a failure event, the cloud-based system 105 and / or a central surgical controller 106 can analyze such registers / blocks to determine whether past use of that component and / or a subcomponent of that component contributed to or caused the failure event (e.g., overuse). In one example, the cloud-based system 105 may determine that a subcomponent (for example, end actuator) of that component may actually be contributing / causing the failure event and then flagging / signaling that component for inoperability and / or removal based on the determination.
[0337] [0337] According to another aspect, the cloud-based system 205 and / or the central surgical controller 206 can control which components (eg surgical device / instrument 235, energy device 241) are being used in a cyclic system interactive surgical 200 to perform surgical procedures by authenticating the component and / or its supplier / manufacturer.
[0338] [0338] According to another aspect, the electronic integrated circuit of a component (for example, surgical device / instrument 235, energy device 241) can store (for example, in memory) data associated with the use of that device component (ie usage data, for example number of uses with a limited use device, number of remaining uses, triggering algorithms performed, designation as a single use component). In such an aspect, the central surgical controller 206 and / or the cloud-based system 205, upon / after connecting the component to the interactive surgical system, can read such data from the memory of a component and write at least a portion of that data for use for storage (for example, within memory 249) in the central surgical controller 206 and / or for storage in the system based on number 205 (for example, individually and / or under a chain-block approach discussed here). According to this aspect, the control
[0339] [0339] Additional details are revealed in US patent application publication 2017/0086914 entitled TECHNIQUES FOR OPE-
[0340] [0340] One of the functions of the central surgical controller 106 is to pair (also referred to in the present invention as "connecting" or "coupling") with other components of the surgical system 102 to control, collect information from or coordinate interactions between the components of the surgical system 102. Since the operating rooms of a hospital are likely to be in physical proximity to each other, a central surgical controller 106 of a surgical system 102 may inadvertently pair with components of a surgical system 102 in a operating room. neighboring operation, which could significantly interfere with the functions of the central surgical controller 106. For example, the central surgical controller 106 may accidentally activate a surgical instrument in a different operating room or record information about a different continuous surgical procedure in a neighboring operating room.
[0341] [0341] Aspects of the present description present a solution, in which a central surgical controller 106 pairs only with detected devices of the surgical system 102 that are located within the limits of its operating room.
[0342] [0342] In addition, the central surgical controller 106 depends on its knowledge of the location of other components of the surgical system 102 within its operating room to make decisions on, for example, which surgical instruments should be paired with each other. others or activated. A change in the position of the central surgical controller 106 or another component of the surgical system 102 can be problematic.
[0343] [0343] Aspects of the present description additionally present a solution in which the central surgical controller 106 is configured to reevaluate or redeterminate the limits of its operating room when detecting that the central surgical controller 106 has been moved. Aspects of the present description additionally present a solution in which the central surgical controller 106 is configured to redefine the limits of its operating room by detecting a potential device in the surgical system 102, which may be an indication that the central surgical controller 106 has been moved.
[0344] [0344] In several respects, a central surgical controller 106 is used with a surgical system 102 in a surgical procedure performed in an operating room. Central surgical controller 106 comprises a control circuit configured to determine
[0345] [0345] In one aspect, the control circuit is configured to determine the limits of the operating room after activation of the central surgical controller 106. In one aspect, the central surgical controller 106 includes a communication circuit configured to detect tar and pair with the devices of the surgical system located within the limits of the operating room. In one aspect, the control circuit is configured to redetermin the limits of the operating room after a possible device in the surgical system 102 is detected. In one aspect, the control circuit is configured to periodically determine the limits of the operating room.
[0346] [0346] In one aspect, the central surgical controller 106 comprises an operating room mapping surgical that includes a plurality of non-contact sensors configured to measure the limits of the operating room.
[0347] [0347] In several aspects, the central surgical controller 106 includes a processor and a memory attached to the processor. The memory stores instructions executable by the processor to pair the central surgical controller with devices from the surgical system 102 located within the limits of the operating room, as described above. In several respects, the present description provides a non-transitory, computer-readable medium that stores computer-readable instructions that, when executed, cause a machine to pair the central surgical controller 106 with surgical system devices 102 located within the limits of the operating room, as described above.
[0348] [0348] Figures 35 and 36 are logical process flowcharts representing control programs or logic configurations for the pairing of the central surgical controller 106 with devices of the surgical system 102 located within the limits of the operating room, as described above.
[0349] [0349] The central surgical controller 106 performs a wide range of functions that require short- and long-range communication, such as assistance with a surgical procedure, coordination between devices of the surgical system 102 and data collection and transmission to the cloud 104. To perform its functions properly, the central surgical controller 106 is equipped with a communication module 130 capable of short-range communication with other devices of the surgical system 102. The communication module 130 is also capable of long-range communication with the cloud 104.
[0350] [0350] The central surgical controller 106 is also equipped with an operating room mapping module 133 that is capable of identifying the limits of an operating room and identifying devices of the surgical system 102 within the operating room. The central surgical controller 106 is configured to identify the limits of an operating room and to pair or connect only to possible devices in the surgical system 102 that are detected within the operating room.
[0351] [0351] In one aspect, the pairing comprises establishing a link or communication route. In another aspect, the pairing comprises establishing a link or control route.
[0352] [0352] An initial mapping or evaluation of the operating room boundaries occurs during an initial activation of the central surgical controller 106. In addition, the central surgical controller 106 is configured to maintain spatial recognition during the operation through the mapping your operating room, which can be useful in determining whether central surgical controller 106 has been moved. The 3017 revaluation can be performed periodically or can be triggered by an event such as the observation of a change in the devices of the surgical system 102 that are considered inside the operating room. In one aspect, the change is the 3010 detection of a new device that was not previously considered to be within the limits of the operating room, as shown in Figure 37. In another aspect, the change is a disappearance, disconnection or unpairing of a paired device that was previously considered to reside within the operating room, as shown in Figure 38. The central surgical controller 106 can continuously monitor the connection with the paired devices 3035 to detect 3034 missing, disconnected or not paired a paired device.
[0353] [0353] In other aspects, the events triggering the reevaluation may be, for example, changes in the positions of surgeons, changes in instrumentation or detection of a new set of tasks performed by the central surgical controller 106.
[0354] [0354] In one aspect, the evaluation of the room limits by the central surgical controller 106 is performed by activating a sensor matrix of the mapping module of the operating room 133 inside the central surgical controller 106 that allows it to detect the walls of the operating room.
[0355] [0355] Other components of the surgical system 102 can be made to have spatial recognition in the same or similar way as the central surgical controller 106. For example, a robotic central controller 122 can also be equipped with a room mapping module operation 133.
[0356] [0356] The spatial recognition of the central surgical controller 106 and its ability to map the operating room in relation to possible components of the surgical system 102 allows the con-
[0357] [0357] In one aspect, the central surgical controller 106 employs the operating room mapping module 133 to determine the limits of the operating room (for example, an operating room or a fixed, mobile space or temporary) with the use of measuring devices without ultrasonic or laser contact.
[0358] [0358] Referring to Figure 34, non-contact sensors based on ultrasound 3002 can be used to scan the operating room by transmitting an ultrasound explosion and receiving echo when it jumps outside the perimeter of walls 3006 of an operating room to determine the size of the operating room and adjust the Bluetooth pairing distance limits. In one example, the 3002 non-contact sensors can be Ping ultrasonic distance sensors, as shown in Figure
[0359] [0359] Figure 34 shows how an ultrasonic sensor 3002 sends a short hiss with its ultrasonic speaker 3003 and allows a microcontroller 3004 from the operating room mapping module 133 to measure how long the echo takes to return to the ultrasonic microphone of the 3005 ultrasonic sensor. The microcontroller
[0360] [0360] In one example, as illustrated in Figure 33, a central surgical controller 106 can be equipped with four ultrasonic sensors 3002, each of the four ultrasonic sensors being configured to evaluate the distance between the surgical controller central co 106 and an operating room wall 3000. The central surgical controller 106 can be equipped with more or less than four ultrasonic sensors 3002 to determine the limits of an operating room.
[0361] [0361] Other distance sensors can be used by the operating room mapping module 133 to determine the limits of an operating room. In one example, the operating room mapping module 133 can be equipped with one or more photoelectric sensors that can be used to assess the limits of an operating room. In one example, suitable laser distance sensors can also be employed to assess the limits of an operating room. Laser-based non-contact sensors scan the operating room for transmitting pulses of light
[0362] [0362] With reference to the upper left corner of Figure 33, a central surgical controller 106 is placed in an operating room 3000. Central surgical controller 106 is activated at the beginning of the preparation that occurs before the surgical procedure. In the example in Figure 33, preparation starts at a real time of 11:31:14 (EST) based on a real-time clock. However, at the initial time of preparation for the established procedure, the central surgical controller 106 initiates a 3001 real-time clock timing scheme selected at artificial artificial time at an artificial real time 07:36:00 to protect the private information of the patient.
[0363] [0363] In artificial real time 07:36:01, the operating room mapping module 133 employs ultrasonic distance sensors to ultrasonic ping the room (for example, sending an ultrasound explosion and hearing the echo when it hits the perimeter of the operating room walls as described above) to check the size of the operating room and adjust the pairing distance limits.
[0364] [0364] In artificial real time 07:36:03, data is removed and stamped with date and time. In artificial real time 07:36:05, the central surgical controller 106 begins to pair the devices located only inside the operating room 3000, as verified with the use of ultrasonic distance sensors 3002 of the mapping module operating room 133. The upper right corner of Figure 33 illustrates several exemplifying devices that are within the limits of operating room 3000 and are paired with central surgical controller 106, including a secondary display device 3020, a secondary central controller 3021, a common interface device 3022, a stapler equipped with a 3023 motor, a video tower module 3024 and a handheld dissector equipped with a 3025 motor. On the other hand, the secondary central controller 3021 ', the secondary display 3020 'and the stapler equipped with a 3026 engine are all outside the limits of the operating room 3000 and, consequently, are not paired with the ciru controller central logic 106.
[0365] [0365] In addition to establishing a communication link with the devices of the surgical system 102 that are inside the operating room, the central surgical controller 106 also assigns a unique sequence or number of communication and identification to each of the devices . The unique string can include the name of the device and a timestamp of when the communication was first established. Other appropriate device information can also be incorporated into the device's unique sequence.
[0366] [0366] As shown in the upper left corner of Figure 33, the central surgical controller 106 determined that the limits of operating room 3000 are at distances a, -a, b and -b from the central surgical controller 106. Like device "D" it is outside the defined limits of its operating room 3000, the central surgical controller 106 does not match the device "D". Figure 35 is an example of an algorithm illustrating how the central surgical controller 106 pairs only with devices within the limits of its operating room. After activation, the central surgical controller 106 determines the operating room limits 3007 using the operating room mapping module 133, as described above.
[0367] [0367] With reference to Figure 36, after an initial determination of the room boundaries and after an initial pairing of the devices located within those limits, the central surgical controller 106 continues to detect 3015 new devices that become available for pairing. If a new device is detected 3016, the central surgical controller 106 is configured to re-evaluate 3017 the limits of the operating room before pairing with the new device. If it is determined that the new device 3018 is within the recently determined limits of the operating room, then the central surgical controller 106 pairs with device 3019 and assigns 3030 a unique identifier to the new device. If, however, the central surgical controller 106 determines that the new device is outside the newly determined limits of the operating room, the central surgical controller 106 ignores 3031 the device.
[0368] [0368] For pairing, the operating room mapping module 133 contains an integrated Bluetooth compass and transceiver. Other communication mechanisms, which are not significantly affected by the hospital environment or geographic location.
[0369] [0369] In situations where multiple central surgical controllers 106 and / or other peripherals are present in the same operating room, as shown in the upper right corner of Figure 33, the operating room mapping module 133 is configured to map the location of each module that resides inside the operating room. This information could be used by the user interface to display a virtual map of the room, allowing the user to more easily identify which modules are present and enabled, as well as their current situation. In one aspect, the mapping data collected by the central surgical controllers 106 is sent to the cloud 104, where the data is analyzed to identify how an operating room is physically configured, for example.
[0370] [0370] The central surgical controller 106 is configured to determine a location of the device by evaluating the transmission of the radio signal strength and direction. For Bluetooth protocols, the received signal strength indication ("RSSI" -
[0371] [0371] In one aspect, one or more of the processes shown in Figures 35 to 39 can be performed by a control circuit of a central surgical controller 106, as shown in Figure 10 (processor 244). In another aspect, one or more of the processes shown in Figures 35 to 39 can be performed by a cloud computing system 104, as shown in Figure 1. In yet another aspect, one or more among the The processes shown in Figures 35 to 39 can be performed by at least one of the aforementioned cloud computing systems 104 and / or a control circuit of a central surgical controller 106 in combination with a control circuit of a modular device, such as the microcontroller 461 of the surgical instrument shown in Figure 12, microcontroller 620 of the surgical instrument shown in Figure 16, control circuit 710 of the robotic surgical instrument shown 700 in Figure 17, control circuit 760 of surgical instruments 750, 790 shown in Figures 18 and 19 or the controller 838 of the generator 800 shown in Figure 20. Spatial recognition of the central surgical controllers in the operating rooms
[0372] [0372] During a surgical procedure, a surgical instrument, such as an ultrasonic or RF surgical instrument, can be attached to a generator module 140 of the central surgical controller
[0373] [0373] Aspects of the present description are presented for a central surgical controller 106 configured to establish and separate the pairings between the components of the surgical system 102 within the limits of the operating room to coordinate the flow of information and the control actions between such components. The central surgical controller 106 can be configured surgically to establish a pairing between a surgical instrument controller and a surgical instrument that reside within the confines of an operating room of the central surgical controller 106.
[0374] [0374] In several aspects, the central surgical controller 106 can be configured to establish and separate the pairings between the components of the surgical system 102 based on the operator's request and the situational and / or spatial recognition. The central controller's situational recognition is described in more detail below in connection with Figure 62.
[0375] [0375] Aspects of the present description are presented for a central surgical controller for use with a surgical system in a surgical procedure performed in an operating room. The central surgical controller includes a control circuit that selectively forms and separates the pairings between devices in the surgical system. In one aspect, the central surgical controller includes a control circuit configured to pair the central surgical controller with a first device in the surgical system, assign a first identifier to the first device, pair the central controller with a second device in the surgical system, assign a second identifier to the second device and selectively pair the first device with the second device. In one aspect, the central surgical controller includes a storage medium, the control circuit being configured to store a record indicating the pairing between the first device and the second device on the storage media. In one aspect, the pairing between the first device and the second device defines a communication route between them. In one aspect, the pairing between the first device and the second device defines a control route for transmitting control actions from the second device to the first device.
[0376] [0376] In addition to the above, in one aspect, the control circuit is additionally configured to pair the central surgical controller with a third device in the surgical system, assign a third identifier to the third device, separate the pairing between the first device and the second device and selectively pair the first device with the third device. In one aspect, the control circuit is additionally configured to store an indicative record of the pairing between the first device and the third device on the storage media. In one aspect, the pairing between the first device and the third device defines a communication route between them. In one aspect, the pairing between the first device and the third device defines a control route for transmitting control actions from the third device to the first device.
[0377] [0377] In several respects, the central surgical controller includes a processor and a memory attached to the processor. The memory stores instructions executable by the processor to selectively form and separate pairs between devices in the surgical system, as described above. In several respects, the present description
[0378] [0378] In one aspect, the central surgical controller 106 establishes a first pairing with a surgical instrument and a second pairing with the surgical instrument controller. The central surgical controller 106 then links the pairings allowing the surgical instrument and the surgical instrument controller to operate with each other. In another aspect, the central surgical controller 106 can separate an existing communication link between a surgical instrument and a surgical instrument controller, then connect the surgical instrument to another surgical instrument controller that is connected to the controller central surgical
[0379] [0379] In one aspect, the surgical instrument controller is paired with two sources. First, the surgical instrument controller is paired with the central surgical controller 106, which includes generator module 140 to control its activation. Second, the surgical instrument controller is also paired with a specific surgical instrument to prevent inadvertent activation of the wrong surgical instrument.
[0380] [0380] With reference to Figures 40 and 42, the central surgical controller 106 can cause the communication module 130 to match 3100 or establish a first communication link 3101 with a first device 3102 of the surgical system 102, which can be a first surgical instrument. The central surgical controller 3104 can then assign a first identification number to the first device 3102. This is a unique identification and communication sequence or number that can include the device name and a time stamp from when the communication was first established.
[0381] [0381] In addition, the central surgical controller 106 can then cause communication module 130 to pair 3106 or establish a second communication link 3107 with a second device 3108 of surgical system 102, which can be a surgical instrument controller. Central surgical controller 106 then assigns 3110 to a second identification number for second device 3108.
[0382] [0382] In several respects, the steps of pairing a central surgical controller 106 with a device may include detecting the presence of a new device, determining that the new device is within the limits of the operating room, as described in more detail above, and pairing only with the new device, if the new device is located within the limits of the operating room.
[0383] [0383] Central surgical controller 106 can then pair 3112 or allow a communication link 3114 to be established between the first device 3102 and the second device 3108, as shown in Figure 42. A record indicating the communication link 3114 is stored by the central surgical controller 106 in the storage matrix 134. In one aspect, the communication link 3114 is established through the central surgical controller 106. In another aspect, as shown in Figure 42, the communication link 3114 is a direct link between the first device 3102 and the second device 3108.
[0384] [0384] Referring to Figures 41 and 43, the central surgical controller 106 can then detect and pair 3120 or establish a third communication link 3124 with a third device 3116 of surgical system 102, which can be another cyclic controller central surgery, for example. The central surgical controller 106 can then assign 3126 a third identification number to the third device 3116.
[0385] [0385] In certain respects, as shown in Figure 43, the central surgical controller 106 can then pair 3130 or allow a communication link 3118 to be established between the first device 3102 and the third device 3116, while making that the communication link 3114 is separated 3128, as illustrated in Figure 43. A record indicating the formation of the communication link 3118 and separation of the communication link 3114 is stored by the central surgical controller 106 in the storage matrix 134. In one aspect, the communication link 3118 is established through the central surgical controller 106. In another aspect, as illustrated in Figure 43, the communication link 3118 is a direct link between the first device 3102 and the third device 3116 .
[0386] [0386] As described above, the central surgical controller 106 can manage indirect communication between devices in the surgical system 102. For example, in situations where the first device 3102 is a surgical instrument and the second device 3108 is an instrument controller surgical, an output from the surgical instrument controller can be transmitted via the communication link 3107 to the central surgical controller 106, which can then transmit the output to the surgical instrument via the communication link 3101.
[0387] [0387] When making a decision to connect or separate a connection between devices in the surgical system 102, the central surgical controller 106 may depend on the perioperative data received or generated by the central surgical controller 106. Perioperative data includes input data operator, situational recognition of the central controller, spatial recognition of the central controller and / or cloud. For example, a request can be transmitted to the central surgical controller 106 from an operator user interface to assign a surgical instrument controller to a surgical instrument. If the central surgical controller 106 determines that the surgical instrument controller is already connected to another surgical instrument, the central surgical controller 106 can separate the connection and establish a new connection at the operator's request.
[0388] [0388] In certain examples, the central surgical controller 106 may establish a first communication link between the visualization system 108 and the primary screen 119 to transmit an image, or other information, from the visualization system 108, which resides outside the sterile field, to the main screen 119, which is located within the sterile field. The central surgical controller 106 can then separate the first communication link and establish a second communication link between a robotic central surgical controller 122 and the main screen 119 to transmit another image, or other information, from the controller robotic central surgical 122 for main screen 119, for example. The ability of the central surgical controller 106 to assign and reassign the main screen 119 to different components of the surgical system 102 allows the central surgical controller 106 to manage the flow of information within the operating room, particularly between components within the sterile field and outside the sterile field, without physically moving these components.
[0389] [0389] In another example that involves situational recognition
[0390] [0390] Referring to Figure 44, the central surgical controller 106 can track 3140 the progression of the surgical steps in a surgical procedure and can coordinate the pairing and unpairing of the devices of the surgical system 102 based on such progression. For example, the central surgical controller 106 may determine that a first surgical step requires the use of a first surgical instrument, while a second surgical step, which occurs after the completion of the first surgical step, requires the use of a second surgical instrument. Consequently, the central surgical controller 106 can assign a surgical instrument controller to the first surgical instrument over the duration of the first surgical step. After detecting the 3142 completion of the first surgical step, the central surgical controller 106 can cause the communication link between the first surgical instrument and the surgical instrument controller to be separated 3144. The central surgical controller 106 can then assign the surgical instrument controller to the second surgical instrument by pairing 3146 or authorize the establishment of a communication link between the surgical instrument controller and the second surgical instrument.
[0391] [0391] Several other examples of situational recognition of the central controller, which can influence the decision to connect or disconnect devices from the surgical system 102, are described in more detail below in connection with Figure 62.
[0392] [0392] In certain aspects, the central surgical controller 106 can use its spatial recognition capabilities, as described in more detail elsewhere in the present invention, to track the progression of the surgical stages of a surgical procedure and autonomously reassign a surgical instrument controller from one surgical instrument to another surgical instrument within the operating room of the central surgical controller
[0393] [0393] In the example illustrated in Figure 2, the central surgical controller 106 is paired with a first surgical instrument held by a surgical operator on the operating table and a second surgical instrument positioned on a side tray. A surgical instrument controller can be selectively paired with the first surgical instrument or the second surgical instrument. Using the pairing information via Bluetooth and compass, the central surgical controller 106 autonomously assigns the surgical instrument controller to the first surgical instrument due to its proximity to the patient.
[0394] [0394] After the completion of the surgical step that involved the use of the first surgical instrument, the first surgical instrument can be returned to the side tray or, otherwise, moved in the opposite direction to the patient. Upon detecting a change in the position of the first surgical instrument, the central surgical controller 106 can separate the communication link between the first surgical instrument and the surgical instrument controller to protect against inadvertent activation of the first surgical instrument by the ins-
[0395] [0395] In many respects, surgical system devices 102 are equipped with an easy control transfer operation mode that would allow a user to provide activation control from a device he currently controls to another instrument controller. surgical procedure within the reach of another operator. In one aspect, the devices are equipped to perform the transfer of control through a predetermined activation sequence of the devices that cause the devices that are activated in the predetermined activation sequence to pair with each other.
[0396] [0396] In one aspect, the activation sequence is carried out by energizing the devices to be paired with each other in a specific order. In another aspect, the activation sequence is carried out by energizing the devices to be paired with each other within a predetermined period of time. In one aspect, the activation sequence is carried out by activating communication components, such as Bluetooth, of the devices to be paired with each other in a specific order. In another aspect, the activation sequence is carried out by activating communication components, such as Bluetooth, of the devices to be paired with each other within a predetermined period of time.
[0397] [0397] Alternatively, the transfer of control can also be performed by selecting a device using one of the surgical operator input devices. After the selection is completed, the next activation by another controller would allow the new controller to gain control.
[0398] [0398] In several respects, the central surgical controller 106 can be configured to directly identify components of the surgical system 102, as they are placed in an operating room. In one aspect, the devices of the surgical system 102 can be equipped with an identifiable identifier by the central surgical controller 106, such as, for example, a bar code or a radio frequency identification tag ("RFID" - Radio-Frequency Identification ). Proximity field communication ("NFC" - Near Field Communication) can also be used. The central surgical controller 106 can be equipped with a surgical reader or scanner suitable for detecting devices placed in the operating room.
[0399] [0399] The central surgical controller 106 can also be configured to check and / or update various control programs for surgical system devices 102. When detecting and establishing a communication link from a surgical system memory device 102 , the central surgical controller 106 can verify that its control program is up to date. If the central surgical controller 106 determines that a newer version of the control program is available, the central surgical controller 106 can download the latest version from cloud 104 and can update the device to the latest version. . The central surgical controller 106 can issue a sequential identification and communication number for each paired or connected device. Cooperative use of data derived from secondary sources by intelligent central surgical controllers
[0400] [0400] In a surgical procedure, the attention of a surgical operator must be focused on immediate tasks. Receive information from multiple sources, such as multiple monitors, although useful,
[0401] [0401] Aspects of the present description are presented for the cooperative use of data resulting from multiple sources, such as, for example, an imaging module 138 of the central surgical controller 106. In one aspect, imaging module 138 is configured to superimpose data derived from one or more sources to a live stream intended for main screen 119, for example. In one aspect, the overlapping data can be derived from one or more frames captured by the imaging module 138. The imaging module 138 can take picture frames on the way for display on a local screen, for example, the main screen 119. Imaging module 138 also comprises an image processor that can preform a local image processing matrix into the appropriate images.
[0402] [0402] In addition, a surgical procedure, in general, includes several surgical tasks that can be performed by one or more surgical instruments guided by a surgical operator or a surgical robot, for example. The success or failure of a surgical procedure depends on the success or failure of each of the surgical tasks. Without relevant data on individual surgical tasks, determining the reason for a failed surgical procedure is a matter of probability.
[0403] [0403] Aspects of the present description are presented to capture one or more frames from a live transmission of a surgical procedure for further processing and / or pairing with other data. The frames can be captured at the conclusion
[0404] [0404] In one aspect, one or more captured images are used to identify at least one surgical task completed previously to assess the outcome of the surgical task. In one aspect, the surgical task is a tissue stapling task. In another aspect, the surgical task is an advanced energy transection.
[0405] [0405] Figure 45 is a logical flowchart of a 3210 process that represents a control program or a logical configuration to overlay information derived from one or more static frames from a live transmission from a remote surgical site to the live mission. The 3210 process includes receiving 3212 a live transmission from a remote surgical site from a medical imaging device 124, for example, capturing 3214 at least one picture of a surgical step in the surgical procedure from the live transmission, derive 3216 the relevant information for the surgical stage from data extracted from at least one image frame and superimpose 3218 the information on the live transmission.
[0406] [0406] In one aspect, the static pictures can be from a surgical stage performed at the remote surgical site. Static charts can be analyzed for information regarding the completion of the surgical stage. In one aspect, the surgical step comprises stapling the tissue at the surgical site. In another aspect, the surgical task involves applying energy to the tissue at the surgical site.
[0407] [0407] Figure 46 is a logical flow chart of a 3220 process that represents a control program or a logical configuration to differentiate surgical steps from a surgical procedure. The 3220 process includes receiving 3222 a live transmission from a surgical site from a medical imaging device 124, for example, capturing 3224 at least a first image frame from a first surgical step in the surgical procedure from the transmission live, derive 3226 information relevant to the first surgical step from data extracted from at least one image frame, capture 3228 at least a second image frame from a second surgical step of the surgical procedure from the live transmission and to differentiate 3229 between the first surgical stage and the second surgical stage based on at least one first image frame and at least a second image frame.
[0408] [0408] Figure 47 is a logical flow chart of a 3230 process that represents a control program or a logical configuration to differentiate between the surgical steps of a surgical procedure. The 3232 process includes receiving 3232 a live transmission of the surgical site from a medical imaging device 124, for example, capturing 3234 image frames of the surgical steps of the surgical procedure from the live transmission and differentiating 3236 between the surgical steps based on data extracted from the image frames.
[0409] [0409] Figure 48 is a logical flowchart of a 3240 process that represents a control program or a logical configuration for identifying a staple cartridge from information derived from one or more static frames of staples implanted from the cartridge staples in the fabric. The 3240 process includes receiving 3242 a live transmission of the surgical site from the medical imaging device 124, for example, capturing a 3244 image frame from the live transmission, detecting a 3246 clip pattern in the frame image, and the staple pattern is defined by the staples implanted from a staple cartridge into the tissue at the surgical site. The 3240 process further includes identifying the 3248 staple cartridge based on the staple pattern.
[0410] [0410] In several respects, one or more of the steps of processes 3210, 3220, 3230, 3240 can be performed by a control circuit of an imaging module of a central surgical controller, as shown in Figures 3, 9, 10. In certain instances, the control circuit may include a processor and memory attached to the processor, with the memory storing instructions executable by the processor to perform one or more of the process steps 3210, 3220, 3230 , 3240. In certain examples, a computer-readable non-transitory medium stores computer-readable instructions that, when executed, cause a machine to perform one or more of the steps in processes 3210, 3220, 3230, 3240. For simplicity, hereinafter processes 3210, 3220, 3230, 3240 will be described as being executed by the control circuit of an imaging module of a central surgical controller; however, it must be understood that the execution of processes 3210, 3220, 3230, 3240 can be performed by any of the aforementioned examples.
[0411] [0411] With reference to Figures 34 and 49, a central surgical controller 106 is in communication with a medical imaging device 124 located at a remote surgical site during a surgical procedure. The imaging module 138 receives a live transmission from the remote surgical site transmitted by the imaging device 124 to a main screen 119, for example, according to steps 3212, 3222, 3232, 3242.
[0412] [0412] In addition to the above, the imaging module
[0413] [0413] In one aspect, the derived information can be superimposed on the live broadcast. In one aspect, the static frames and / or information resulting from the processing of the static frames can be communicated to a cloud 104 for data aggregation and further analysis.
[0414] [0414] In several respects, the 3200 frame capture device may include a digital video decoder and memory to store the captured static frames, such as a frame buffer. The 3200 frame capture device can also include a bus interface through which a processor can control capture and access data and a general purpose 1 / O to trigger image capture or control external equipment. .
[0415] [0415] As described above, imaging device 124 may be in the form of an endoscope, including a camera and a light source positioned at a remote and configured surgical site.
[0416] [0416] In several respects, image recognition algorithms can be implemented to identify resources or objects in static frames of a surgical site that are captured by the 3200 frame capture device. Useful information related to the surgical steps associated with Captured frames can be derived from the identified resources. For example, the identification of staples in the captured frames indicates that a surgical step of stapling tissue was performed at the surgical site. The type, color, layout and size of the identified staples can also be used to derive useful information about the staple cartridge and the surgical instrument used to implant the staples. As described above, this information can be superimposed on a live broadcast directed to a main screen 119 in the operating room.
[0417] [0417] The image recognition algorithms can be executed at least in part locally by the computer platform 3203 (Figure 49) of the imaging module 138. In certain cases, the image recognition algorithms can be executed by the least in part by processor module 132 of central surgical controller 106. An image database can be used in the performance of image recognition algorithms and can be stored in a 3202 memory of the 3203 computer platform. Alternatively , the imaging database can be stored in the storage matrix 134 (Figure 3) of the central surgical controller 106. The image database can be updated from cloud 104.
[0418] [0418] An exemplary image recognition algorithm that can be performed by computer platform 3203 can include a comparison based on key points and a color comparison based on region. The algorithm includes: receiving input from a processing device, such as the 3203 computer platform; the entry, including data related to a static picture of a remote surgical site; perform a recovery step, which includes recovering an image from an image database and, until the image is accepted or rejected, designating the image as a candidate image; perform an image recognition step, which includes the use of the processing device to execute an image recognition algorithm on the static frame and on the candidate images in order to obtain an image recognition algorithm output; and perform a comparison step, which includes: if the output of the image recognition algorithm is within a pre-selected range, accept the candidate image as the static frame and, if the output of the image recognition algorithm does not is within the pre-selected range, reject the candidate image and repeat the recovery, image recognition and comparison steps.
[0419] [0419] With reference to Figures 50 to 52, in one example, a surgical step involves stapling and cutting the tissue. Figure 50 represents a static frame 3250 of stapled and cut T fabric. A 3252 staple implant includes the 3252 ", 3252" staples of a first staple cartridge. A second staple implant 3254 includes staples 3254 ', 3254 "from a second staple cartridge. A proximal portion 3253 of staple implant 3252 overlaps a distal portion 3255 of staple implant 3254. Six rows of staples were positioned in each implantation, the T fabric was cut between the third and fourth files of each implant, but only one side of the stapled T fabric is completely shown.
[0420] [0420] In several respects, the imaging module 138 identifies one or more of the clips 3252 ', 3252 ", 3254', 3254" the static frame 3250, which were absent in a previous static frame captured by the scanning device. frame capture 3200. Imaging module 138 then concludes that a surgical cutting and stapling instrument was used at the surgical site.
[0421] [0421] In the example in Figure 50, the staple 3252 implant includes two different staples 3252 ', 3252 ". Likewise, the staple 3254 implant includes two different staples 3254', 3254". For the sake of brevity, the following description focuses on clamps 3252 ', 3252 ", but is equally applicable to clamps 3254", 3254 ". Clamps 3252', 3252" are arranged in a predetermined pattern or sequence that forms a unique identifier corresponding to the staple cartridge that housed staples 3252 ", 3252". The unique pattern can be in a single row or in multiple rows of the 3250 clips. In one example, the unique pattern can be obtained by alternating the clips 3252 ', 3252 "in a predetermined arrangement.
[0422] [0422] In one aspect, multiple patterns can be detected in one shot of the clips. Each pattern can be associated with a unique characteristic of the staples, the staple cartridge that housed the staples and / or the surgical instrument that was used to trigger the staple. For example, a shot of the clips may include patterns that represent the shape of the clip, the size of the clip and / or the location of the shot.
[0423] [0423] In the example in Figure 50, imaging module 138 can identify a unique pattern for 3252 staples from the 3250 static frame. A database that stores staple patterns and corresponding staple cartridge identification numbers can then , be exploited to determine a staple cartridge identification number that housed staples
[0424] [0424] The patterns in the example in Figure 50 are based on just two different clips; however, other aspects may include three or more different clips. The different clips can be coated with different coatings, which can be applied to the clips by one or more of the following methods: anodizing, coloring, electro-coating, photoluminescent coating, nitride application, methyl methacrylate, painting, powder coating , paraffin coating, oily stains or phosphorescent coatings, the use of hydroxyapatite, polymers, titanium oxynitrides, zinc sulphides, carbides, etc. It should be noted that, while the coatings mentioned are reasonably specific, as disclosed herein, other coatings known in the art for distinguishing the clip are contemplated within the scope of the present description.
[0425] [0425] In the example in Figures 50 to 52, clips 3252 'are anodized clips, while clips 3252 "are non-anodized clips. In one aspect, different clips can comprise two or more different colors. Different metal clips can understand magnetic or radioactive staple markers that differentiate them from unmarked staples.
[0426] [0426] Figure 51 illustrates a staple 3272 implantation implanted in the tissue from a staple cartridge using a surgical instrument. Only three rows of staples 3272a, 3272b, 3272c are shown in Figure 51. Rows 3272a, 3272b, 3272c are arranged between a center line, where the fabric has been cut, and a side line at the edge of the fabric. For clarity, the inner row 3272a of staples is redesigned separately on the left and the two outer rows 3272b, 3272c are redesigned separately.
[0427] [0427] Staple implant 3272 includes two different staples 3272 ', 3272 "which are arranged in predetermined patterns that serve various functions. For example, inner row 3272a comprises a pattern of alternating staples 3272', 3272" , which defines a metric for distance measurements in the surgical field. In other words, the inner row pattern 3272a acts as a ruler for measuring distances, which can be useful in accurately determining the position of a leak, for example. The outer rows 3272b, 3272c define a pattern representing an identification number of the staple cartridge that housed the staples 3272 ', 3272 ".
[0428] [0428] In addition, unique patterns at the ends of the 3272 staple implant identify the proximal end portion 3273 and the distal end portion 3275. In the example in Figure 51, an exclusive arrangement of three staples 3272 " identifies the distal end 3275, while an exclusive arrangement of four staples 3272 "identifies the proximal end 3273. The identification of the proximal and distal ends of the implantation of a staple enables the distinction by the imaging module 128 of different implantations of staples within a captured frame, which can be useful to indicate the source of a leak, for example.
[0429] [0429] In several respects, imaging module 138 can detect a sealed tissue in a static frame of a surgical site captured by the 3200 frame capture device. Detection of the sealed tissue may be indicative of a surgical step that involves application of therapeutic energy to the tissue.
[0430] [0430] The sealing of the fabric can be done by applying energy, such as electrical energy, for example, to the captured tissue.
[0431] [0431] Consequently, the sealed fabric has a different color and / or shape that can be detected by the imaging module 138 with the use of image recognition algorithms, for example. In addition, smoke detection at the surgical site may indicate that the application of therapeutic energy to the tissue is underway.
[0432] [0432] In addition to the above, the imaging module 138 of the central surgical controller 106 is able to differentiate between the surgical steps of a surgical procedure based on the captured frames. As described above, a static frame comprising triggered clips is indicative of a surgical step involving stapling tissue, while a static frame comprising a sealed tissue is indicative of a surgical step involving the application of energy to the tissue.
[0433] [0433] In one aspect, the central surgical controller 106 can selectively overlay relevant information for a surgical task completed prior to live transmission. For example, the overlapping information may comprise image data from a static picture of the surgical site captured during the surgical task completed previously. In addition, guided by common reference sites on the surgical site, imaging module 138 can interweave one image frame to another to establish and detect surgical sites and relationship data for a previously completed surgical task.
[0434] [0434] In one example, the central surgical controller 106 is configured to superimpose information regarding a potential leak in a tissue treated by stapling or applying therapeutic energy to a previously completed surgical task. The potential leak can be recognized by the imaging module 138 when processing a static tissue frame. The surgical operator can be alerted about the leak by overlapping information about the possible leak to the live broadcast.
[0435] [0435] In several respects, static pictures of a surgical instrument end actuator at a surgical site can be used to identify the surgical instrument. For example, the end actuator may include an identification number that can be recognized by the imaging module 138 during still frame image processing. Consequently, the static frames captured by the imaging module 138 can be used to identify a surgical instrument used in a surgical step of a surgical procedure. Static charts can also include useful information about the performance of the surgical instrument. All of this information can be sent to cloud 104 for data aggregation and further analysis.
[0436] [0436] In several examples, the central surgical controller 106 can also selectively overlay relevant information for a current or future surgical task, such as an anatomical site or a surgical instrument suitable for the surgical task.
[0437] [0437] Imaging module 138 can employ several techniques
[0438] [0438] In the next surgical step, the quality of the seal can be tested through different mechanisms. To ensure that the test is applied accurately to the treated tissue, the stored static picture of the surgical site is superimposed on the live broadcast in search of a match. When a match is found, testing can take place. One or more additional static frames can be obtained during the test, can be analyzed later by the imaging module 138 of the central surgical controller 106. The testing mechanisms include bubble detection, bleeding detection, dye detection (where a dye is used in the surgical site) and / or detection of elongation of rupture (where a localized deformation is applied adjacent to an anastomosis site), for example.
[0439] [0439] Imaging module 138 can capture static frames of the tissue response treated for these tests, which can be stored in memory 3202 or in the storage matrix 134 of central surgical controller 106, for example. Static charts can be stored alone or in combination with other data, such as data from the surgical instrument that performed the tissue treatment. Paired data can also be uploaded to cloud 104 for further analysis and / or pairing.
[0440] [0440] In several respects, the static frames captured by the 3200 frame capture device can be processed locally, paired with other data and can also be transmitted to the cloud 104. The size of the data processed and / or transmitted will depend on the number of frames captured. In many ways, the rate at which the 3200 frame capture device captures the static frames of the live stream can be varied in an effort to reduce the size of the data without sacrificing quality.
[0441] [0441] In one aspect, the rate of picture capture may depend on the type of surgical task being performed. Certain surgical tasks may require a greater number of static pictures than others for an assessment of success or failure. The frame rate can be scaled to accommodate such needs.
[0442] [0442] In one aspect, the frame rate is dependent on the detected movement of the imaging device 124. In use, an imaging device 124 can target a surgical site over a period of time. Observing no or small changes in the captured static frames while the imaging device 124 is not being moved, the imaging module 138 can reduce the frame capture rate of the 3200 frame capture device. If the situation however, where frequent motion is detected, imaging module 138 can respond by increasing the frame capture rate of frame capture device 3200. In other words, imaging module 138 can be configured to correlate the frame capture rate of the 3200 frame capture device with the degree of movement detected by the imaging device 124.
[0443] [0443] For more efficiency, only portions of the static frames, where motion is detected, need to be stored, processed and / or transmitted to the cloud 104. Image module 138 can be configured to select portions of the static frames where movement is detected. In one example, motion detection can be achieved by comparing a static frame to a previously captured static frame. If motion is detected, imaging module 138 can cause the frame capture device 3200 to increase the frame capture rate, but only the portions where motion is detected are stored, processed and / or transmitted to the cloud 104.
[0444] [0444] In another aspect, the data size can be managed by scaling the resolution of the captured information based on the area of the screen where the focal point is or where the end actuators are located, for example. The rest of the screen could be captured at a lower resolution.
[0445] [0445] In one aspect, the corners and edges of the screen can, in general, be captured at a lower resolution. The resolution, however, can be scaled if an event of importance is observed.
[0446] [0446] During a surgical procedure, the central surgical controller 106 can be connected to various monitoring devices in the operating room, such as heart rate monitors and inflation pumps. The data collected from these devices can improve the situational recognition of the central surgical controller 106. The situational recognition of the central controller is described in more detail below in connection with Figure 62.
[0447] [0447] In one example, the central surgical controller 106 can be configured to use patient data received from a connected heart rate monitor together with reference data.
[0448] [0448] Central surgical controller 106 can be configured surgically to determine the type of surgical procedure to be performed on a patient from data received from one or more operating room monitoring devices, such as, for example , heart rate monitors and inflation pumps. Abdominal surgical procedures generally require abdominal inflation, while inflation is not necessary in theoretical surgery. Central surgical controller 106 can be configured to determine whether a surgical procedure is an abdominal or thoracic surgical procedure by detecting whether the insufflation pump is active. In one aspect, the central surgical controller 106 can be configured to monitor insufflation pressure on the outlet side of the insufflation pump to determine whether the surgical procedure being performed requires insufflation.
[0449] [0449] The central surgical controller 106 can also collect information from other secondary devices in the operating room to assess, for example, whether the surgical procedure is a vascular or avascular procedure.
[0450] [0450] Central surgical controller 106 can also monitor the supply of AC current to one or more of its components to assess whether a component is active. In one example, the central surgical controller 106 is configured to monitor the supply of AC power to the generator module to assess whether the generator is active, which may be an indication that the surgical procedure being performed is requires the application of energy to seal the fabric.
[0451] [0451] In several respects, secondary devices in the operating room that are unable to communicate with the central surgical controller 106 can be equipped with communication interface devices (communication modules) which can facilitate the pairing of these devices with the central surgical controller
[0452] [0452] In one aspect, the central surgical controller 106 can be configured to control one or more operating parameters of a secondary device via a communication interface device. For example, the central surgical controller 106 can be configured to increase or decrease the inflation pressure through a communication interface device coupled to an inflation device.
[0453] [0453] In one aspect, the communication interface device can be configured to engage with a device interface port. In another aspect, the communication interface device may comprise an overlay or other interface that interacts directly with a control panel of the secondary device. In other respects, secondary devices, such as the heart rate monitor and / or insufflation devices, can be equipped with integrated communication modules that allow them to pair with the central controller for bidirectional communication between them .
[0454] [0454] In one aspect, the central surgical controller 106 can also be connected via a communication interface device, for example, muscle patches that are connected to nerve stimulation detection devices to improve the resolution of a nerve detection device.
[0455] [0455] In addition, the central surgical controller 106 can also be configured to manage supplies in the operating room. Different surgical procedures need different supplies. For example, two different surgical procedures may require different sets of surgical instruments. Certain surgical procedures may involve the use of a robotic system, while others may not. In addition, two different surgical procedures may require staple cartridges that are different in number, type and / or size. Consequently, supplies brought to the operating room can provide clues as to the nature of the surgical procedure to be performed.
[0456] [0456] In several aspects, the central surgical controller 106 can be integrated with an operating room supplies scanner to identify items brought into the operating room and introduced into the sterile field. Central surgical controller 106 can use data from the operating room supplies scanner, along with data from surgical system devices 102 that are paired with central surgical controller 106, to autonomously determine the type of surgical procedure that will be executed. In one example, central part 106 can record a list of smart cartridge serial numbers that will be used in the surgical procedure. During the surgical procedure, the central surgical controller 106 can gradually remove the clips that have been triggered, based on information collected from the integrated circuits of the staple cartridge. In one aspect, the surgical controller
[0457] [0457] In a surgical procedure, a second central surgical controller can be placed in an operating room already under the control of a first central surgical controller. The second central surgical controller can be, for example, a robotic central surgical controller placed in the operating room as part of a robotic system. Without coordination between the first and second central surgical controllers, the central surgical controller will attempt to pair with all other components of surgical system 102 that are within the operating room. The confusion resulting from competition between the two central controllers in a single operating room can have undesirable consequences. In addition, the classification of instrument distribution among central controllers during the surgical procedure can be time-consuming.
[0458] [0458] Aspects of the present description are presented for a central surgical controller for use with a surgical system in a surgical procedure performed in an operating room. A control circuit for the central surgical controller is configured to determine the limits of the operating room and establish a control arrangement with a detected central surgical controller located within the limits of the operating room.
[0459] [0459] In one aspect, the control disposition is an arrangement between peers. In another aspect, the control arrangement is a master-slave arrangement. In one aspect, the control circuit is configured to select one of a master operating mode or a slave operating mode in the master-slave arrangement. In one aspect, the control circuit is configured to deliver control of at least one surgical instrument to the central surgical controller detected in the slave operating mode.
[0460] [0460] In one aspect, the central surgical controller includes an operating room mapping surgical that includes a plurality of non-contact sensors configured to measure the limits of the operating room.
[0461] [0461] In several respects, the central surgical controller includes a processor and a memory attached to the processor. The memory stores instructions executable by the processor to coordinate a control arrangement between central surgical controllers, as described above. In many respects, the present description provides a non-transitory, computer-readable medium that stores computer-readable instructions that, when executed, cause a machine to coordinate a control arrangement between central surgical controllers, as described above.
[0462] [0462] Aspects of the present description are presented for a surgical system that comprises two independent central surgical controllers that are configured to interact with each other. Each of the central surgical controllers has its own attached surgical device and the control and distribution designation from which the data is recorded and processed. This interaction causes one or both central surgical controllers to change their behavior from before the interaction. In one respect, the change involves a redistribution of devices previously assigned to each of the central surgical controllers. In another aspect, the change involves establishing a master-slave arrangement between central surgical controllers. In yet another aspect, the change may be a change in the processing location shared between central surgical controllers.
[0463] [0463] Figure 53 is a logical flowchart of a process that represents a control program or a logical configuration for coordinating a control arrangement between central surgical controllers. The process in Figure 53 is similar in many respects to the process in Figure 35 except that the process in Figure 53 addresses detection of a central surgical controller by another central surgical controller. As shown in Figure 53, the central surgical controller 106 determines 3007 the limits of the operating room. After the initial determination, the central surgical controller 106 continuously searches for or detects 3008 devices within a pairing range. If a device is detected 3010, and if the device detected is located 3011 within the limits of the operating room, the central surgical controller 106 pairs 3012 with the device and assigns 3013 an identifier to the device. If through an initial interaction, as described in more detail below, the central surgical controller 106 determines 3039 that the device is another central surgical controller, a control arrangement is established 3040 between them.
[0464] [0464] Referring to Figure 54, a 3300 central robotic surgical controller enters an operating room that is already occupied by a 3300 central surgical controller. The 3310 robotic central surgical controller and 3300 central surgical controller are similar in many respects. to other central surgical controllers described in more detail elsewhere in the present invention, such as, for example, central surgical controllers 106. For example, the robotic central surgical controller 3310 includes non-contact sensors configured to measure room boundaries. operation, as described in more detail elsewhere in the present invention in connection with Figures 33, 34.
[0465] [0465] When the 3310 robotic central surgical controller is triggered, it determines the limits of the operating room and begins to pair with other components of the surgical system 102 that are
[0466] [0466] In addition to the above, the central surgical controller 3310 detects and / or is detected by the central surgical controller
[0467] [0467] In the example in Figure 54, a master-slave arrangement is established. Central surgical controllers 3300, 3310 request permission from a surgical operator for the robotic central surgical controller 3310 to obtain control of the operating room from the central surgical controller 3300. Permission can be requested through an interface or surgeon console 3304. Once authorization is granted, the central surgical controller
[0468] [0468] Alternatively, central surgical controllers 3300, 3310 can negotiate the nature of their interaction without external input based on previously collected data. For example, central surgical controllers 3300, 3310 can collectively determine that the next surgical task requires the use of a robotic system. This determination can cause the central surgical controller 3300 to autonomously deliver control of the operating room to the central robotic surgical controller 3310. Upon completion of the surgical task, the robotic central surgical controller 3310 can then autonomously return control of the operating room to the 3300 central surgical controller.
[0469] [0469] The result of the interaction between the 3300, 3310 central surgical controllers is illustrated on the right side of Figure 54. The 3300 central surgical controller transferred control to the 3310 central surgical controller, which also obtained control of the surgeon interface 3304 and secondary screen 3303 of the central surgical controller 3300. The robotic central surgical controller 3310 assigns new identification numbers to recently transferred devices. The central surgical controller 3300 retains control of the hand stapler 3301, the dissector equipped with the hand motor 3302 and the viewing tower 3305. In addition, the central surgical controller 3300 performs a support function, with the Processing and storage capabilities of the 3300 central surgical controller are now available for the 3310 robotic central surgical controller.
[0470] [0470] Figure 55 is a logical flowchart of a process that represents a control program or a logical configuration for coordinating a control arrangement between central surgical controllers. In several respects, two surgical controllers centered
[0471] [0471] The control arrangement between the central surgical controllers is then determined 3323 based on the input of a surgical operator or autonomously between the central surgical controllers. Central surgical controllers can store instructions on how to determine a control arrangement with each other. The control arrangement between two central surgical controllers may depend on the type of surgical procedure being performed. The control arrangement between two central surgical controllers may depend on their types, identification information and / or situation. The control arrangement between two central surgical controllers may depend on the devices paired with the central surgical controllers. The central surgical controllers then redistribute 3324 devices from surgical system 102 to each other based on the determined control arrangement.
[0472] [0472] In the master-slave arrangement, the registration communication can be unidirectional from the slave central controller to the master central controller. The master central controller may also require the central controller to transfer some of its wireless devices to consolidate communication routes. In one aspect, the slave central controller can be relegated to a
[0473] [0473] In a pairwise arrangement, each central surgical controller can retain control of its devices. In one aspect, central surgical controllers can collaborate to control a surgical instrument. In one aspect, a surgical instrument operator can designate the central surgical controller who will control the surgical instrument at the time of use.
[0474] [0474] With generic reference to Figures 56 to 61, the interaction between central surgical controllers can be extended beyond the limits of the operating room. In several respects, operating rooms in separate operating rooms can interact with each other within predefined limits. Depending on their relative proximity, central surgical controllers in separate operating rooms can interact via any wired or wireless data communication network, such as Bluetooth and WiFi. As used here, a "data communication network" represents any number of physical, virtual or logical components, including hardware, software, firmware and / or processing logic configured to support data communication between a source component and a destination component, where data communication is performed according to one or more designated communication protocols over one or more designated communication media.
[0475] [0475] In several respects, a first surgical operator in a first operating room may wish to consult a second surgical operator in a second operating room, as in the case of an emergency. A temporary communication link can be established between the central surgical controllers of the first and second operating rooms to facilitate consultation while the first and second surgical operators remain in their respective operating rooms.
[0476] [0476] The surgical operator to be consulted can receive a consultation request through the central surgical controller in the operating room. If the surgical operator accepts, he will have access to all the data compiled by the central surgical controller requesting the consultation. The surgical operator can access all previously stored data, including a complete history of the procedure. In addition, a live transmission from the surgical site in the order operating room can be done via the central surgical controllers to a screen in the receiving operating room.
[0477] [0477] When a request for consultation begins, the receiving central surgical controller begins to record all information received in a temporary storage location, which may be a dedicated portion of the central surgical controller's storage matrix. At the end of the consultation, the temporary storage location is purged of all information. In one aspect, during a consultation, the central surgical controller records all accessible data, including data on blood pressure, ventilation, oxygen statistics, generator settings and uses, and all electronic patient data. There will likely be more data recorded than data stored by the central surgical controller during normal operation, which is useful for providing the surgical operator with as much information as possible for consultation.
[0478] [0478] With reference to Figure 56, a non-limiting example of an interaction between central surgical controllers in different operating rooms is shown. Figure 56 represents an OR 1 operating room that includes a 3400 surgical system that supports a thoracic segmentectomy and a second OR 3 operating room that includes a 3410 surgical system that supports a colorectal procedure. The 3400 surgical system includes the central surgical controller 3401, the central surgical controller 3402 and the robotic central surgical controller 3403. The surgical system 3400 additionally includes a personal interface 3406, a primary screen 3408 and secondary screens 3404, 3405. The system surgical 3410 includes a central surgical controller 3411 and a secondary screen 3412. For clarity, the various components of surgical systems 3400, 3410 are removed.
[0479] [0479] In the example in Figure 56, the OR 3 surgical operator is requesting an appointment from the OR 1 surgical operator. The OR 3 central surgical controller 3411 transmits the request for consultation to one of the central surgical controllers in OR OR 1, as the central surgical controller 3401. In OR 1, the central surgical controller 3401 presents the request on a personal interface 3406 made by the surgical operator. The consultation is about selecting an ideal site for a colon transection. The OR 1 surgical operator, through a 3406 personal interface, recommends an ideal location for the transection site that avoids a section of high colon vascularization. The recommendation is transmitted in real time via the central surgical controllers 3401, 3411. Consequently, the surgical operator is able to respond to the consultation request in real time without having to leave the sterile field of his own operating room. The surgical operator who requested the consultation also did not have to leave the OR 3 sterile field.
[0480] [0480] If the central surgical controller 3401 is not communicating with the personal interface 3406, it can transmit the message to another central surgical controller, such as the central surgical controller 3402 or the central surgical controller ro bottic 3403. Alternatively, the central surgical controller 3401 can request control of the personal interface 3406 from another central surgical controller.
[0481] [0481] In any case, if the OR 1 surgical operator decides to accept the consultation request, a live transmission from a 3413 surgical site of the OR 3 colorectal procedure will be done to OR 1 through a connection established between the surgical controllers - central units 3401, 3411, for example. Figure 57 illustrates a live transmission of surgical site 3413 displayed on a secondary OR 3 screen. Central surgical controllers 3401, 3411 cooperate to send live transmission from the OR 3 surgical site to personal interface 3406 of OR 1 or as shown in Figure 58.
[0482] [0482] With reference to Figures 59 to 61, the surgical operator can expand the live transmission from OR 3 to primary screen 3405 in OR 1, for example, through the controls of the personal interface 3406. The personal interface 3406 allows the surgical operator to select a destination for live transmission by presenting icons to the surgical operator representing the views that are available in OR 1, as shown in Figure 60. Other navigation controls 3407 are available for the surgical operator via the 3406 personal interface, as shown in Figure 61. For example, the 3406 personal interface includes navigation controls to adjust the live transmission of the OR 3 surgical site in OR 1 by the surgical operator by moving their fingers in the live broadcast displayed on the personal interface 3406. To view the regions of high vascularization, the surgical operator can change the view of the live broadcast of OR 3 by entering personal terface 3406 for an advanced imaging screen. The surgical operator can then manipulate the image in multiple planes to see vascularity.
[0483] [0483] As illustrated in Figure 61, the surgical operator also has access to a matrix of relevant 3420 information, such as, for example, heart rate, blood pressure, ventilation data, oxygen statistics, settings and use of generator, and all electronic patient data in OR 3. Situational recognition
[0484] [0484] 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 undergoing 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.
[0485] [0485] Now with reference to Figure 62, a timeline 5200 represents 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 in 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, beginning with the configuration of the operating room and
[0486] [0486] Situational recognition of a central surgical controller 106, 206 receives data from data sources throughout the course of the surgical procedure, including data generated each time medical personnel use a modular device that is paired with the controller central surgical 106, 206. Central surgical controller 106, 206 can receive this data from paired modular devices and other data sources and continuously derive inferences (that is, contextual information) about the ongoing procedure as new data is received , such as which step of the procedure is being performed at any given time. The situational recognition system of the central surgical controller 106, 206 is, for example, able to record data referring to the procedure to generate reports, verify the steps being 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 of the medical imaging device or change the energy level of a ultrasonic surgical instrument or RF electrosurgical instrument) and take any other action described above.
[0487] [0487] In the first step 5202, in this illustrative procedure, members of the hospital team retrieve the patient's electronic medical record (PEP) from the hospital's PEP database. Based on patient selection data in the PEP, the central surgical controller 106, 206 determines that the procedure to be performed is a thoracic procedure.
[0488] [0488] In the second step 5204, the team members scan the incoming medical supplies for the procedure. The control
[0489] [0489] In the third step 5206, the medical team scans the patient's wrist with a scanner that is communicably connected to the central surgical controller 106, 206. The central surgical controller 106, 206 can then confirm the identity of the patient. based on the scanned data.
[0490] [0490] In the fourth step 5208, the medical team 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 by the surgeon, but in this illustrative case, they include a smoke evacuator, an insufflator and a medical imaging device. When activated, auxiliary equipment that is modular devices can automatically pair with the central surgical controller 106, 206 which is located within a specific vicinity of the modular devices as part of its initialization process. The central surgical controller 106, 206 can then derive contextual information about the surgical procedure by detecting the types of modular devices that correspond with it during this preoperative or initialization phase. In this particular example, the central surgical controller 106, 206 determines that the surgical procedure is a procedure
[0491] [0491] In the fifth step 5210, members of the medical team 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. As central surgical controller 106, 206 begins to receive data from patient monitoring devices, the central surgical controller 106, 206 thus confirming that the patient is in the operating room.
[0492] [0492] In the sixth step 5212, medical personnel induce 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 patient monitoring devices, including ECG data, blood pressure data, ventilator data, or combinations of them, for example. After the completion of the sixth step 5212, the preoperative portion of the
[0493] [0493] In the seventh stage 5214, the lung of the patient being operated on collapses (while ventilation is diverted to the contralateral lung). The central surgical controller 106, 206 can infer from the ventilator data that the patient's lung collapsed, for example. The central surgical controller 106, 206 can infer that the operative portion of the procedure started when he could compare the detection of the patient's lung collapse in the expected steps of the procedure (which can be accessed or retrieved earlier) and, thus, determine that the collapse of the lung is the first operative step in this specific procedure.
[0494] [0494] In the eighth step 5216, the medical imaging device (for example, a visualization 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, central surgical controller 106, 206 can determine that the portion of the laparoscopic surgical procedure has started. In addition, the central surgical controller 106, 206 can determine that the specific procedure being performed is a segmentectomy, rather than a lobectomy (note that a wedge procedure has already been discarded by the central surgical controller 106, 206 with based on the data received in the second step 5204 of the procedure). The data from the medical imaging device 124 (Figure 2) can be used to determine contextual information about the type of procedure being performed in several different ways, including by determining the angle at which the medical imaging device is originating. - seen in relation to the visualization of the patient's anatomy, the
[0495] [0495] In the ninth step 5218, the surgical team starts the dissection step of the procedure. The 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 feeling
[0496] [0496] In the tenth step 5220, the surgical team proceeds to the step of connecting the procedure. The central surgical controller 106, 206 can infer that the surgeon is ligating the arteries and veins because he receives data from the stapling and surgical 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 of the stapling and surgical cutting instrument with the steps recovered in the process. In certain cases, the surgical instrument can be a surgical tool mounted on a robotic arm of a robotic surgical system.
[0497] [0497] In the eleventh step 5222, the segmentectomy portion of the procedure is performed. Central surgical controller 106, 206 can infer that the surgeon is transecting the parenchyma based on data from the surgical stapling and cutting instrument, including data from its cartridge. The cartridge data can correspond to the size or type of clamp being triggered by the instrument, for example. As different types of staples are used for different types of fabrics, the cartridge data can thus indicate the type of fabric being stapled and / or transected. In this case, the type of clamp that is fired is used for the parenchyma (or other similar types of tissue), which allows the central surgical controller 106, 206 to infer which segment of the procedure is being performed.
[0498] [0498] 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 alternate between surgical stapling / cutting instruments and surgical energy instruments (ie, RF or ultrasonic) depending on the specific step in the procedure because different instruments are better adapted for specific tasks. - specific. 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 performing. In addition, in certain cases, robotic tools can be used for one or more steps in a surgical procedure and / or hand surgical instruments can be used for one or more steps in a surgical procedure. The surgeon can switch between robotic tools and hand-held surgical instruments and / or can use the devices simultaneously, for example. After the completion of the twelfth stage 5224, the incisions are closed and the post-operative portion of the process begins.
[0499] [0499] 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),
[0500] [0500] Finally, in the fourteenth step 5228, 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. between. 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 communicated together to the central surgical controller 106, 206.
[0501] [0501] Situational perception is further described in US Provisional Patent Application serial number 62 / 611.341, entitled INTEGRACTIVE SURGICAL PLATFORM, filed on December 28, 2017, which is incorporated herein by reference in its entirety - in. 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 surgical controller 106, 206 based on its situational perception and / or feedback from its components and / or based on information from the cloud
[0502] [0502] Various aspects of the subject described here are defined in the following numbered examples.
[0503] [0503] Example 1. Central surgical controller for use in a surgical procedure with a medical imaging device at a remote surgical site, the central surgical controller comprising a circuit configured to: receive a live transmission of the surgical site from the medical imaging device
[0504] [0504] Example 2. Central surgical controller, according to Example 1, in which the information refers to the completeness of the surgical step.
[0505] [0505] Example 3. Central surgical controller, according to any of Examples 1 and 2, in which the surgical step comprises implanting staples from a staple cartridge into the tissue at the surgical site.
[0506] [0506] Example 4. Central surgical controller, according to any of Examples 1 to 3, where the information identifies the staple cartridge.
[0507] [0507] Example 5. Central surgical controller, according to any of Examples 1 to 4, where the information comprises a serial number of the staple cartridge.
[0508] [0508] Example 6. Central surgical controller, according to any of Examples 1 to 5, where the information identifies a leak at the surgical site.
[0509] [0509] Example 7. Central surgical controller, according to any of Examples 1 to 7, in which the information identifies a surgical step.
[0510] [0510] Example 8. Central surgical controller for use in a surgical procedure that includes steps, with a medical imaging device, at a remote surgical site, the central surgical controller comprising a circuit configured to: receive a transmission to the live from the surgical site from the medical imaging device; capture image frames of the surgical stages of the surgical procedure from the live transmission; and differentiate between the surgical steps based on data extracted from the image frames.
[0511] [0511] Example 9. Central surgical controller, according to Example 8, in which information regarding the completion of the surgical steps is derived from the data extracted from the image frames.
[0512] [0512] Example 10. Central surgical controller, according to any of Examples 8 and 9, in which the surgical step comprises implanting staples from a staple cartridge into the tissue at the surgical site.
[0513] [0513] Example 11. Central surgical controller, according to any of Examples 8 to 10, where the information identifies the staple cartridge.
[0514] [0514] Example 12. Central surgical controller, according to any of Examples 8 to 11, where the information comprises a serial number of the staple cartridge.
[0515] [0515] Example 13. Central surgical controller, according to any of Examples 8 to 12, where the information identifies a leak at the surgical site.
[0516] [0516] Example 14. Central surgical controller, according to any of Examples 8 to 10, in which another one of the surgical steps comprises applying energy to the tissue at the surgical site.
[0517] [0517] Example 15. Central surgical controller for use in a surgical procedure with a medical imaging device at a remote surgical site, the central surgical controller comprising a circuit configured to: receive a live transmission of the surgical site from the medical imaging device; capture an image frame of the live broadcast; detecting a staple pattern in the image frame, the staple pattern being defined by staples implanted from a staple cartridge into the tissue at the surgical site; and identify the staple cartridge based on the staple pattern.
[0518] [0518] Example 16. Central surgical controller, according to Example 15, where the staple pattern corresponds to a serial number of the staple cartridge.
[0519] [0519] Example 17. Central surgical controller, according to any of Examples 15 and 16, in which the clamps comprise a first clamp and a second clamp different from the first clamp.
[0520] [0520] Example 18. Central surgical controller, according to any of Examples 15 to 17, in which the first clamp is comprised of a non-ionized material.
[0521] [0521] Example 19. Central surgical controller, according to any of Examples 15 to 18, in which the first clamp is comprised of an ionized material.
[0522] [0522] Example 20. Central surgical controller, according to any of Examples 15 to 19, in which the staple pattern is defined in a plurality of staple rows.
[0523] [0523] 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 description. 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 such modifications, combinations and variations.
[0524] [0524] 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 description. 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.
[0525] [0525] 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 through other computer-readable media. In this way, a machine-readable medium can include any mechanism to store or transmit 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-dynamos discs, read-only memory (ROM), random access memory (RAM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory ( 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 propagation signals (for example, waves carriers, infrared signal, digital signals, etc.). Consequently, non-transitory, computer-readable 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).
[0526] [0526] 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 computer processor comprising one or more individual instruction processing cores, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic matrix (PLA), or arrangement programmed doors
[0527] [0527] 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 package
[0528] [0528] 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.
[0529] [0529] As used here in one aspect of the present invention, an "algorithm" refers to the self-consistent sequence of steps leading to the desired result, where a "step" refers to the manipulation of physical quantities and / or logical states that they may, although not necessarily need, 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 may be associated with the appropriate physical quantities and are merely convenient identifications applied to these quantities and / or states.
[0530] [0530] A network may 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 (TCP / IP). The Ethernet protocol can conform to or be compatible with the Ethernet standard published by the Institute of Electrical and Electronics Engine-
[0531] [0531] Unless stated otherwise, as is evident from the preceding description, it is understood that, throughout the preceding description, discussions using terms such as "processing", "computation", "calculation", "determination", "display" or similar, refer to the action and processes of a computer, or similar electronic computing device, that manipulates and transforms the represented data in the form of physical (electronic) quantities
[0532] [0532] One or more components can be called "configured for", "configurable for", "operable / operational for", "adapted / adaptable for", "capable of", "conformable / conformed to ", etc. Those skilled in the art will recognize that "configured for" may, in general, cover 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.
[0533] [0533] The terms "proximal" and "distal" are used in the present invention with reference to a physician 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 in the opposite direction to 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 invention with respect to drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.
[0534] [0534] 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 pre-
[0535] [0535] 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, For example, "a system that has at least one of A, B and C" would include, but not be limited to, systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and / or A, B and C together, etc.). In cases where a convention analogous to "at least one of A, B or C, etc." is used, in general this construction is intended to have the meaning in which the convention would be understood by
[0536] [0536] With respect to the attached 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 such alternative orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplementary, simultaneous, inverse or other variant orders, unless the context determines otherwise. Furthermore, terms such as "responsive to", "related to" or other adjectival principles are not generally intended to exclude these variants, except when the context determines otherwise.
[0537] [0537] It is worth noting that any reference to "one (1) aspect", "one aspect", "an exemplification" or "one (1) exemplification" ", and the like means that a given feature, 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
[0538] [0538] Any patent application, patent, non-patent publication or other description material mentioned in this specification and / or mentioned in any order data sheet is hereby incorporated by reference, to the extent that the Embedded materials are not inconsistent with this. Thus, and as necessary, the description as explicitly presented here replaces any conflicting material incorporated into the present invention as a reference. Any material, or portion thereof, which is incorporated herein by reference, but which conflicts with the definitions, statements, or other description materials contained herein, will be incorporated here only to the extent that there is no conflict. between the incorporated material and the existing description material.
[0539] [0539] In summary, 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 (20)
[1]
1. Central surgical controller for use in a surgical procedure with a medical imaging device at a remote surgical site, the central surgical controller being characterized by comprising a circuit configured to: receive a live transmission from the surgical site sent by medical imaging device; capture an image of a surgical stage of the surgical procedure from the live transmission; derive information relevant to the surgical stage from the data extracted from the image frame; and overlay the information on the live stream.
[2]
2. Central surgical controller, according to claim 1, characterized in that the information refers to the completion of the surgical step.
[3]
3. Central surgical controller, according to claim 1, characterized in that the surgical step comprises implanting staples from a staple cartridge into the tissue at the surgical site.
[4]
4. Central surgical controller, according to claim 3, characterized in that the information identifies the staple cartridge.
[5]
5. Central surgical controller, according to claim 4, characterized in that the information comprises a serial number of the staple cartridge.
[6]
6. Central surgical controller, according to claim 3, characterized in that the information identifies a leak at the surgical site.
[7]
7. Central surgical controller, according to claim 1, characterized in that the information identifies the surgical step.
[8]
8. Central surgical controller for use with a medical imaging device at a remote surgical site in a surgical procedure that includes surgical steps, the central surgical controller being characterized by comprising a circuit configured to: receive a live transmission from the surgical site sent by the medical imaging device; capture image frames of the surgical stages of the surgical procedure from the live transmission; and differentiate between the surgical steps based on data extracted from the image frames.
[9]
9. Central surgical controller, according to claim 8, characterized by deriving information regarding the completeness of the surgical steps from the data extracted from the picture frames.
[10]
10. Central surgical controller, according to claim 9, characterized in that one of the surgical steps comprises implanting staples from a staple cartridge in tissue from the surgical site.
[11]
11. Central surgical controller, according to claim 10, characterized in that the information identifies the staple cartridge.
[12]
12. Central surgical controller, according to claim 11, characterized in that the information comprises a serial number of the staple cartridge.
[13]
13. Central surgical controller, according to claim 9, characterized in that the information identifies a leak in the surgical site.
[14]
14. Central surgical controller, according to claim 10, characterized by another one of the surgical steps comprising applying energy to the tissue at the surgical site.
[15]
15. Central surgical controller for use in a surgical procedure with a medical imaging device at a remote surgical site, the central surgical controller being characterized by comprising a circuit configured to: receive a live transmission from the surgical site sent by medical imaging device; capture an image frame of the live broadcast; detect a staple pattern in the image frame, the staple pattern being defined by staples implanted from a staple cartridge into the tissue at the surgical site; and identifying the staple cartridge based on the staple pattern.
[16]
16. Central surgical controller according to claim 15, characterized in that the staple pattern corresponds to a serial number of the staple cartridge.
[17]
17. Central surgical controller according to claim 16, characterized in that the clamps comprise a first clamp and a second clamp different from the first clamp.
[18]
18. Central surgical controller, according to claim 17, characterized in that the first clamp is comprised of a non-ionized material.
[19]
19. Central surgical controller, according to claim 18, characterized in that the second clamp is comprised of an ionized material.
[20]
20. Central surgical controller according to claim 15, characterized in that the staple pattern is defined in a plurality of staple rows.
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---

BR112020013040A2|2020-11-24|adaptive control program updates for central surgical controllers

---

BR112020012965A2|2020-12-01|updates of adaptive control programs for surgical devices

---

BR112020013224A2|2020-12-01|cloud-based medical analysis for segmented individualization of instrument functions in medical facilities

---

BR112020012801A2|2020-11-24|spatial recognition of central surgical controllers in operating rooms

---

BR112020013233A2|2020-12-01|capacitive coupled return path block with separable matrix elements

---

BR112020013114A2|2020-12-01|smoke evacuation system that includes a segmented control circuit for interactive surgical platform

同族专利:

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公开号 | 公开日

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JP2021509320A|2021-03-25|

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WO2019133060A1|2019-07-04|

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US11266468B2|2022-03-08|

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US20210212775A1|2021-07-15|

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CN111512384A|2020-08-07|

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US20190201116A1|2019-07-04|

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EP3506280A1|2019-07-03|

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

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

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

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

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

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US201862649302P| true| 2018-03-28|2018-03-28|

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US62/649,302|2018-03-28|

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US15/940,670|2018-03-29|

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PCT/US2018/044192|WO2019133060A1|2017-12-28|2018-07-27|Cooperative utilization of data derived from secondary sources by intelligent surgical hubs|

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