surgical systems with autonomously adjustable control programs

专利摘要:
It is a surgical feedback system that includes a surgical instrument, a data source and a central surgical controller configured to connect in a communicable way to the data source and the surgical instrument. The central surgical controller has a control circuit, in which the control circuit is configured to receive input from the data source, analyze the data received against a stored data set to optimize a result of a surgical procedure, and communicate a recommendation based on the data analyzed.
公开号:BR112020013013A2
申请号:R112020013013-3
申请日:2018-11-14
公开日:2020-11-24
发明作者:Frederick E. Shelton Iv；Jason L. Harris；Michael J. Vendely；Mark S. Zeiner
申请人:Ethicon Llc；
IPC主号:

专利说明:

[001] [001] This patent application claims the priority benefit of US Non-Provisional Patent Application Serial No. 16 / 182,233, entitled SURGICAL SYSTEMS WITH AUTONOMOUSLY ADJUSTA- BLE CONTROL PROGRAMS, filed on November 6, 2018, whose description it is hereby incorporated by reference, in its entirety.
[002] [002] The present application claims priority under 35 U.S.C.§ 119 (e) to U.S. Provisional Patent Application No. 62 / 729,177, entitled AUTOMATED DATA SCALING, ALIGNMENT, AND ORGANIZING
[003] [003] This application claims priority under 35 USC§ 119 (e) to provisional patent application No. 62 / 692,747, entitled SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE, filed on June 30, 2018, at US Provisional Patent Application No. 62 / 692,748, entitled SMART ENERGY ARCHITECTURE, filed on June 30, 2018 and US Provisional Patent Application No. 62 / 692,768, entitled SMART ENERGY DEVICES, filed on 30 June 2018, the description of each of which is incorporated herein by reference, in its entirety.
[004] [004] The present application claims priority under 35 U.S.C.§ 119 (e) of U.S. Provisional Patent Application No. 62 / 659,900, entitled
[005] [005] This application also claims priority under 35 USC§ 119 (e) of US Provisional Patent Application No. 62 / 650,898 filed March 30, 2018, entitled CAPACITIVE COU- PLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS, of US Provisional Patent Application Serial No. 62 / 650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, filed on March 30, 2018, of US Provisional Patent Application Serial No. 62 / 650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM, filed on March 30, 2018, and US Provisional Patent Application Serial No. 62 / 650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTROLS, filed on March 30, 2018, whose description of each one is hereby incorporated by reference, in its entirety.
[006] [006] This application also claims priority under 35 USC§ 119 (e) of US Provisional Patent Application Serial No. 62 / 640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, filed on March 8, 2018 , and US Provisional Patent Application Serial No. 62 / 640,415, entitled ESTIMATING STATE OF ULTRASONIC END EF- FECTOR AND CONTROL SYSTEM THEREFOR, filed on March 8, 2018, the respective description of which is incorporated herein by reference, in its entirety.
[007] [007] This application also claims priority under 35 USC§ 119 (e) of US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, of the Application for Provisional Patent
[008] [008] The present description refers to several surgical systems. Surgical procedures are typically performed in theaters or surgical operating rooms in a health care facility, such as 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.
[009] [009] Furthermore, in the digital and information age, medical systems and facilities are often slower to implement systems or procedures that use newer and improved technologies due to patient safety and a general desire to maintain traditional practices . However, medical systems and clinics may often lack communication and knowledge shared with other neighboring or similarly located clinics as a result. To improve patient practices, it would be desirable to find ways to help better connect medical systems and clinics. SUMMARY OF THE INVENTION
[0010] [0010] A surgical feedback system is described. The surgical feedback system comprises a surgical instrument, a data source and a central surgical controller configured to connect communicatively with the data source and the instrument.
[0011] [0011] A surgical feedback system is described. The surgical feedback system comprises a data source and a central surgical controller that comprises a control circuit. The control circuit is configured to receive an input from the data source, analyze the data received against a stored data set to optimize a result of a surgical procedure, and the stored data set comprises data collected during surgical procedures. previous reports, and communicate a recommendation based on the data analyzed.
[0012] [0012] A surgical feedback system is described. The surgical feedback system comprises a data source and a surgical instrument comprising a control circuit. The control circuit is configured to receive an input from the data source, analyze the data received against a stored data set to optimize a surgical procedure result, and the stored data set comprises data collected during previous surgical procedures, and determine a recommendation based on the analyzed data. FIGURES
[0013] [0013] The various aspects described here, both with regard to the organization and the methods of operation, together with objects and additional advantages of the same, can be better understood in reference to the description presented below, considered together with the attached drawings as follows.
[0014] [0014] Figure 1 is a block diagram of an interactive surgical system implemented by computer, according to at least one aspect of the present description.
[0015] [0015] Figure 2 illustrates 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.
[0016] [0016] 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.
[0017] [0017] Figure 4 is a partial perspective view of a central surgical controller housing, and of a combined generator module received slidingly in a central surgical controller housing, according to at least one aspect of this description.
[0018] [0018] Figure 5 is a perspective view of a generator module combined with bipolar, ultrasonic and monopolar contacts and a smoke evacuation component, in accordance with at least one aspect of the present description.
[0019] [0019] 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.
[0020] [0020] Figure 7 illustrates a vertical modular housing configured to receive a plurality of modules, according to at least one aspect of the present description.
[0021] [0021] Figure 8 illustrates a surgical data network that comprises a modular communication center configured to connect modular devices located in one or more operating rooms of a health care facility, or any environment in a utility facility specially equipped for surgical operations, to the cloud, in accordance with at least one aspect of this description.
[0022] [0022] Figure 9 illustrates an interactive surgical system implemented by computer, according to at least one aspect of the present description.
[0023] [0023] Figure 10 illustrates a central surgical controller that comprises a plurality of modules coupled to the modular control tower, according to at least one aspect of the present description.
[0024] [0024] 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.
[0025] [0025] Figure 12 is a block diagram of a cloud computing system that comprises a plurality of intelligent surgical instruments coupled to central surgical controllers that can connect to the cloud component of the cloud computing system, according with at least one aspect of the present description.
[0026] [0026] Figure 13 is a functional module architecture of a cloud computing system, according to at least one aspect of the present description.
[0027] [0027] Figure 14 illustrates a diagram of a surgical system with situational recognition, according to at least one aspect of the present description.
[0028] [0028] Figure 15 is a timeline that represents the situational recognition of a central surgical controller, in accordance with at least one aspect of the present description.
[0029] [0029] Figure 16 shows a graph representing the positive and negative results for illustrative uses of a surgical device in accordance with a calculated threshold, in accordance with at least one aspect of the present description.
[0030] [0030] Figure 17 is a block diagram representing surgical procedures that have several characteristics grouped based on the results, according to at least one aspect of this description.
[0031] [0031] Figure 18 is a diagram representing a validation analysis, according to at least one aspect of the present description.
[0032] [0032] Figure 19 is a block diagram representing a validation analysis, according to at least one aspect of the present description.
[0033] [0033] Figure 20 is a flowchart representing an algorithm for a surgical system, according to at least one aspect of this description. DESCRIPTION
[0034] [0034] The applicant of the present application holds the following U.S. Patent Applications, filed on November 6, 2018, the description of which is incorporated herein by reference, in its entirety:
[0035] [0035]  U.S. Patent Application No. 16 / 182,224, entitled SURGICAL NETWORK, INSTRUMENT, AND CLOUD RESPONSES BA- SED ON VALIDATION OF RECEIVED DATASET AND AUTHENTI- CATION OF ITS SOURCE AND INTEGRITY;
[0036] [0036]  U.S. Patent Application No. 16 / 182,230, entitled SURGI- CAL SYSTEM FOR PRESENTING INFORMATION INTERPRETED FROM EXTERNAL DATA;
[0037] [0037]  U.S. Patent Application No. 16 / 182,239, entitled AD- JUSTMENT OF DEVICE CONTROL PROGRAMS BASED ON STRATIFIED CONTEXTUAL DATA IN ADDITION TO THE DATA;
[0038] [0038]  U.S. Patent Application No. 16 / 182,243, entitled SURGI-CAL HUB AND MODULAR DEVICE RESPONSE ADJUSTMENT BA- SED ON SITUATIONAL AWARENESS;
[0039] [0039]  U.S. Patent Application No. 16 / 182,248, entitled DETECTION AND ESCALATION OF SECURITY RESPONSES OF SURGI-CAL INSTRUMENTS TO INCREASING SEVERITY THREATS;
[0040] [0040]  U.S. Patent Application No. 16 / 182,251, entitled INTERACTIVE SURGICAL SYSTEM;
[0041] [0041]  U.S. Patent Application No. 16 / 182,260, entitled AUTOMATED DATA SCALING, ALIGNMENT, AND ORGANIZING BASED ON PREDEFINED PARAMETERS WITHIN SURGICAL NETWORKS;
[0042] [0042]  U.S. Patent Application No. 16 / 182,267, entitled SEN- SING THE PATIENT POSITION AND CONTACT UTILIZING THE MONO-POLAR RETURN PAD ELECTRODE TO PROVIDE SITUATI-ONAL AWARENESS TO A SURGICAL NETWORK;
[0043] [0043]  U.S. Patent Application No. 16 / 182,249, entitled PO- WERED SURGICAL TOOL WITH PREDEFINED ADJUSTABLE CONTROL ALGORITHM FOR CONTROLLING END EFFECTOR PARAMETER;
[0044] [0044]  U.S. Patent Application No. 16 / 182,246, entitled ADJUSTMENTS BASED ON AIRBORNE PARTICLE PROPERTIES;
[0045] [0045]  U.S. Patent Application No. 16 / 182,256, entitled AD-JUSTMENT OF A SURGICAL DEVICE FUNCTION BASED ON SITUATIONAL AWARENESS;
[0046] [0046]  U.S. Patent Application No. 16 / 182,242, entitled REAL-TIME ANALYSIS OF COMPREHENSIVE COST OF ALL INSTRU- MENTATION USED IN SURGERY UTILIZING DATA FLUIDITY TO TRACK INSTRUMENTS THROUGH STOCKING AND IN-HOUSE PROCESSES;
[0047] [0047]  U.S. Patent Application No. 16 / 182,255, entitled USAGE AND TECHNIQUE ANALYSIS OF SURGEON / STAFF PERFOR- MANCE AGAINST A BASELINE TO OPTIMIZE DEVICE USED ON AND PERFORMANCE FOR BOTH CURRENT AND FUTURE PROCEDURES;
[0048] [0048]  U.S. Patent Application No. 16 / 182,269, entitled IMAGE CAPTURING OF THE AREAS OUTSIDE THE ABDOMEN TO IM- PROVE PLACEMENT AND CONTROL OF A SURGICAL DEVICE IN USE;
[0049] [0049]  U.S. Patent Application No. 16 / 182,278, entitled COMMUNICATION OF DATA WHERE A SURGICAL NETWORK IS USING CONTEXT OF THE DATA AND REQUIREMENTS OF A RE-CEIVING SYSTEM / USER TO INFLUENCE INCLUSION OR LINKAGE OF DATA AND METADATA TO ESTABLISH CONTINUITY;
[0050] [0050]  U.S. Patent Application No. 16 / 182,290, entitled SURGI- CAL NETWORK RECOMMENDATIONS FROM REAL TIME ANALYSIS OF PROCEDURE VARIABLES AGAINST A BASELINE HIGHLIGHTING DIFFERENCES FROM THE OPTIMAL SOLUTION;
[0051] [0051]  U.S. Patent Application No. 16 / 182,232, entitled CONTROL OF A SURGICAL SYSTEM THROUGH A SURGICAL BARRIER;
[0052] [0052]  U.S. Patent Application No. 16 / 182,227, entitled SURGI-CAL NETWORK DETERMINATION OF PRIORITIZATION OF COMMUNICATION, INTERACTION, OR PROCESSING BASED ON SYSTEM OR DEVICE NEEDS;
[0053] [0053]  U.S. Patent Application No. 16 / 182,231, entitled WIRE- LESS PAIRING OF A SURGICAL DEVICE WITH ANOTHER DEVICE WITHIN A STERILE SURGICAL FIELD BASED ON THE USAGE AND SITUATIONAL AWARENESS OF DEVICES;
[0054] [0054]  U.S. Patent Application No. 16 / 182,229, entitled ADJUS- TMENT OF STAPLE HEIGHT OF AT LEAST ONE ROW OF STAPLES BASED ON THE SENSED TISSUE THICKNESS OR FORCE IN CLO- SING;
[0055] [0055]  U.S. Patent Application No. 16 / 182,234, entitled STA- PLING DEVICE WITH BOTH COMPULSORY AND DISCRETIONARY LOCKOUTS BASED ON SENSED PARAMETERS;
[0056] [0056]  U.S. Patent Application No. 16 / 182,240, entitled POWE-RED STAPLING DEVICE CONFIGURED TO ADJUST FORCE, AD- VANCEMENT SPEED, AND OVERALL STROKE OF CUTTING MEMBER BER BASED ON SENSED PARAMETER OF FIRING OR CLAMPING;
[0057] [0057]  U.S. Patent Application No. 16 / 182,235, entitled VARIA-
[0058] [0058]  U.S. Patent Application No. 16 / 182,238, entitled ULTRASONIC ENERGY DEVICE WHICH VARIES PRESSURE APPLI- ED BY CLAMP ARM TO PROVIDE THRESHOLD CONTROL PRES- SURE AT A CUT PROGRESSION LOCATION.
[0059] [0059] The applicant for this application holds the following U.S. Patent Applications filed on September 10, 2018, the description of which is incorporated herein by reference in its entirety:
[0060] [0060]  U.S. Provisional Patent Application No. 62 / 729,183, entitled A CONTROL FOR A SURGICAL NETWORK OR SURGICAL NETWORK CONNECTED DEVICE THAT ADJUSTS ITS FUNCTION BASED ON A SENSED SITUATION OR USAGE;
[0061] [0061]  U.S. Provisional Patent Application No. 62 / 729,177, entitled AUTOMATED DATA SCALING, ALIGNMENT, AND ORGANIZING BA- SED ON PREDEFINED PARAMETERS WITHIN A SURGICAL NETWORK BEFORE TRANSMISSION;
[0062] [0062]  U.S. Provisional Patent Application No. 62 / 729,176, entitled INDIRECT COMMAND AND CONTROL OF A FIRST OPERA- TING ROOM SYSTEM THROUGH THE USE OF A SECOND OPE- RATING ROOM SYSTEM WITHIN A STERILE FIELD WHERE THE SECOND OPERATING ROOM SYSTEM HAS PRIMARY AND SECONDARY OPERATING MODES;
[0063] [0063]  U.S. Provisional Patent Application No. 62 / 729,185, entitled POWERED STAPLING DEVICE THAT IS CAPABLE OF ADJUSTING FORCE, ADVANCEMENT SPEED, AND OVERALL STROKE OF CUT- TING MEMBER OF THE DEVICE BASED ON SENSED PARAMETER OF FIRING OR CLAMPING;
[0064] [0064]  U.S. Provisional Patent Application No. 62 / 729,184, entitled POWERED SURGICAL TOOL WITH A PREDEFINED ADJUSTED- BLE CONTROL ALGORITHM FOR CONTROLLING AT LEAST ONE END EFFECTOR PARAMETER AND A MEANS FOR LIMITING THE ADJUSTMENT;
[0065] [0065]  U.S. Provisional Patent Application No. 62 / 729,182, entitled SENSING THE PATIENT POSITION AND CONTACT UTILIZING THE MONO POLAR RETURN PAD ELECTRODE TO PROVIDE SITUATIONAL AWARENESS TO THE HUB;
[0066] [0066]  U.S. Provisional Patent Application No. 62 / 729,191, entitled SURGICAL NETWORK RECOMMENDATIONS FROM REAL TIME ANALYSIS OF PROCEDURE VARIABLES AGAINST A BASELINE HIGHLIGHTING DIFFERENCES FROM THE OPTIMAL SOLUTION;
[0067] [0067]  U.S. Provisional Patent Application No. 62 / 729,195, entitled ULTRASONIC ENERGY DEVICE WHICH VARIES PRESSURE APPLI- ED BY CLAMP ARM TO PROVIDE THRESHOLD CONTROL PRESSU- RE AT A CUT PROGRESSION LOCATION; and
[0068] [0068]  U.S. Provisional Patent Application No. 62 / 729,186, entitled WIRELESS PAIRING OF A SURGICAL DEVICE WITH ANOTHER DEVICE WITHIN A STERILE SURGICAL FIELD BASED ON THE USAGE AND SITUATIONAL AWARENESS OF DEVICES.
[0069] [0069] The applicant of this application holds the following U.S. Patent Applications, filed on August 28, 2018, the description of each of which is incorporated herein by reference, in its entirety:
[0070] [0070]  U.S. Patent Application No. 16 / 115,214, entitled ESTIMATE- TING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR;
[0071] [0071]  U.S. Patent Application No. 16 / 115,205, entitled TEMPE-RATURE CONTROL OF ULTRASONIC END EFFECTOR AND CONTRROL SYSTEM THEREFOR;
[0072] [0072]  U.S. Patent Application No. 16 / 115,233, entitled RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS;
[0073] [0073]  U.S. Patent Application No. 16 / 115,208, entitled CON- TROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION;
[0074] [0074]  U.S. Patent Application No. 16 / 115,220, entitled CONTRACTING ACTIVATION OF AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO THE PRESENCE OF TISSUE;
[0075] [0075]  U.S. Patent Application No. 16 / 115,232, entitled DETERMINING TISSUE COMPOSITION VIA AN ULTRASONIC SYSTEM;
[0076] [0076]  U.S. Patent Application No. 16 / 115,239, entitled DE-TERMINING THE STATE OF AN ULTRASONIC ELECTROMECHA- NICAL SYSTEM ACCORDING TO FREQUENCY SHIFT;
[0077] [0077]  U.S. Patent Application No. 16 / 115,247, entitled DE-TERMINING THE STATE OF AN ULTRASONIC END EFFECTOR;
[0078] [0078]  U.S. Patent Application No. 16 / 115,211, entitled SITUATI-ONAL AWARENESS OF ELECTROSURGICAL SYSTEMS;
[0079] [0079]  U.S. Patent Application No. 16 / 115,226, entitled MECHA- NISMS FOR CONTROLLING DIFFERENT ELECTROMECHANICAL SYSTEMS OF AN ELECTROSURGICAL INSTRUMENT;
[0080] [0080]  U.S. Patent Application No. 16 / 115,240, entitled DETECTION OF END EFFECTOR IMMERSION IN LIQUID;
[0081] [0081]  U.S. Patent Application No. 16 / 115,249, entitled INTER- RUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING;
[0082] [0082]  U.S. Patent Application No. 16 / 115,256, entitled IN-CREASING RADIO FREQUENCY TO CREATE PAD-LESS MONO-POLAR LOOP;
[0083] [0083]  U.S. Patent Application No. 16 / 115,223, entitled BIPO-
[0084] [0084]  U.S. Patent Application No. 16 / 115,238, entitled ACTIVATION OF ENERGY DEVICES.
[0085] [0085] The applicant of the present application holds the following U.S. Patent Applications, filed on August 23, 2018, the description of each of which is incorporated herein by reference, in its entirety:
[0086] [0086]  U.S. Provisional Patent Application No. 62 / 721,995, entitled CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION;
[0087] [0087]  U.S. Provisional Patent Application No. 62 / 721,998, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS;
[0088] [0088]  U.S. Provisional Patent Application No. 62 / 721,999, entitled INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING;
[0089] [0089]  U.S. Provisional Patent Application No. 62 / 721,994, entitled BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY; and
[0090] [0090]  U.S. Provisional Patent Application No. 62 / 721,996, instituted
[0091] [0091] The applicant of the present application holds the following U.S. Patent Applications, filed on June 30, 2018, the description of each of which is incorporated herein, by reference, in its entirety:
[0092] [0092]  U.S. Provisional Patent Application No. 62 / 692,747, entitled SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVI-CE;
[0093] [0093]  U.S. Provisional Patent Application No. 62 / 692,748, entitled SMART ENERGY ARCHITECTURE; and
[0094] [0094]  U.S. Provisional Patent Application No. 62 / 692,768, entitled SMART ENERGY DEVICES.
[0095] [0095] The applicant of the present application holds the following U.S. Patent Applications, filed on June 29, 2018, the description of each of which is incorporated herein by reference in its entirety:
[0096] [0096]  U.S. Patent Application Serial No. 16 / 024,090, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS;
[0097] [0097]  U.S. Patent Application Serial No. 16 / 024,057, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS;
[0098] [0098]  U.S. Patent Application Serial No. 16 / 024,067, entitled SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION;
[0099] [0099]  U.S. Patent Application Serial No. 16 / 024,075, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING;
[00100] [00100]  U.S. Patent Application Serial No. 16 / 024,083, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING;
[00101] [00101]  U.S. Patent Application Serial No. 16 / 024,094, entitled SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES;
[00102] [00102]  U.S. Patent Application Serial No. 16 / 024,138, entitled SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EF- FECTOR TO CANCEROUS TISSUE;
[00103] [00103]  U.S. Patent Application Serial No. 16 / 024,150, entitled SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES;
[00104] [00104]  U.S. Patent Application Serial No. 16 / 024,160, entitled VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY;
[00105] [00105]  U.S. Patent Application Serial No. 16 / 024,124, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE;
[00106] [00106]  U.S. Patent Application Serial No. 16 / 024,132, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT;
[00107] [00107]  U.S. Patent Application Serial No. 16 / 024,141, entitled SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY;
[00108] [00108]  U.S. Patent Application Serial No. 16 / 024,162, entitled SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES;
[00109] [00109]  U.S. Patent Application Serial No. 16 / 024,066, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTROL;
[00110] [00110]  U.S. Patent Application Serial No. 16 / 024,096, entitled SURGICAL EVACUATION SENSOR ARRANGEMENTS;
[00111] [00111]  U.S. Patent Application Serial No. 16 / 024,116, entitled SURGICAL EVACUATION FLOW PATHS;
[00112] [00112]  U.S. Patent Application Serial No. 16 / 024,149, entitled SURGICAL EVACUATION SENSING AND GENERATOR CONTROL;
[00113] [00113]  U.S. Patent Application Serial No. 16 / 024,180, entitled SURGICAL EVACUATION SENSING AND DISPLAY;
[00114] [00114]  U.S. Patent Application Serial No. 16 / 024,245, entitled COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAME- TERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM;
[00115] [00115]  U.S. Patent Application Serial No. 16 / 024,258, entitled SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTRROL CIRCUIT FOR INTERACTIVE SURGICAL PLATFORM;
[00116] [00116]  U.S. Patent Application Serial No. 16 / 024,265, entitled SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION
[00117] [00117]  U.S. Patent Application Serial No. 16 / 024,273, entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.
[00118] [00118] The applicant for this application holds the following U.S. Provisional Patent Applications, filed on June 28, 2018, the description of each of which is incorporated herein by reference in its entirety:
[00119] [00119]  U.S. Provisional Patent Application Serial No. 62 / 691,228, entitled A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES;
[00120] [00120]  U.S. Provisional Patent Application Serial No. 62 / 691,227, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS;
[00121] [00121]  U.S. Provisional Patent Application Serial No. 62 / 691,230, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRO- DE;
[00122] [00122]  U.S. Provisional Patent Application Serial No. 62 / 691,219, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTRROL;
[00123] [00123]  U.S. Provisional Patent Application Serial No. 62 / 691,257, entitled COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM;
[00124] [00124]  U.S. Provisional Patent Application Serial No. 62 / 691,262, entitled SURGICAL EVACUATION SYSTEM WITH A
[00125] [00125]  U.S. Provisional Patent Application Serial No. 62 / 691,251, entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.
[00126] [00126] The applicant for the present application holds the following U.S. Provisional Patent Applications, filed on April 19, 2018, the description of each of which is incorporated herein by reference, in its entirety:
[00127] [00127]  U.S. Provisional Patent Application Serial No. 62 / 659,900, entitled METHOD OF HUB COMMUNICATION.
[00128] [00128] The applicant for this application holds the following U.S. Provisional Patent Applications, filed on March 30, 2018, the description of which is incorporated herein by reference in its entirety:
[00129] [00129]  U.S. Provisional Patent Application No. 62 / 650,898 filed on March 30, 2018, entitled CAPACITIVE COUPLED RE-TURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS;
[00130] [00130]  U.S. Provisional Patent Application Serial No. 62 / 650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES;
[00131] [00131]  U.S. Provisional Patent Application Serial No. 62 / 650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; and
[00132] [00132]  U.S. Provisional Patent Application Serial No. 62 / 650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTRROLS.
[00133] [00133] The applicant for this application holds the following U.S. Patent Applications, filed on March 29, 2018, the description of each of which is incorporated herein by reference, in its entirety:
[00134] [00134]  U.S. Patent Application Serial No. 15 / 940,641, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNI- CATION CAPABILITIES;
[00135] [00135]  U.S. Patent Application Serial No. 15 / 940,648, entitled INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES;
[00136] [00136]  U.S. Patent Application Serial No. 15 / 940,656, entitled SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES;
[00137] [00137]  U.S. Patent Application Serial No. 15 / 940,666, entitled SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING RO-WHO;
[00138] [00138]  U.S. Patent Application Serial No. 15 / 940,670, entitled COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECON- DARY SOURCES BY INTELLIGENT SURGICAL HUBS;
[00139] [00139]  U.S. Patent Application Serial No. 15 / 940,677, entitled SURGICAL HUB CONTROL ARRANGEMENTS;
[00140] [00140]  U.S. Patent Application Serial No. 15 / 940,632, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RE-CORDS AND CREATE ANONYMIZED RECORD;
[00141] [00141]  U.S. Patent Application Serial No. 15 / 940,640, entitled COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS;
[00142] [00142]  U.S. Patent Application Serial No. 15 / 940,645, entitled SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT;
[00143] [00143]  U.S. Patent Application Serial No. 15 / 940,649, entitled DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PA-RAMETER WITH AN OUTCOME;
[00144] [00144]  U.S. Patent Application Serial No. 15 / 940,654, entitled SURGICAL HUB SITUATIONAL AWARENESS;
[00145] [00145]  U.S. Patent Application Serial No. 15 / 940,663, entitled SURGICAL SYSTEM DISTRIBUTED PROCESSING;
[00146] [00146]  U.S. Patent Application Serial No. 15 / 940,668, entitled AGGREGATION AND REPORTING OF SURGICAL HUB DATA;
[00147] [00147]  U.S. Patent Application Serial No. 15 / 940,671, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER;
[00148] [00148]  U.S. Patent Application Serial No. 15 / 940,686, entitled DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LI-NEAR STAPLE LINE;
[00149] [00149]  U.S. Patent Application Serial No. 15 / 940,700, entitled STERILE FIELD INTERACTIVE CONTROL DISPLAYS;
[00150] [00150]  U.S. Patent Application Serial No. 15 / 940,629, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;
[00151] [00151]  U.S. Patent Application Serial No. 15 / 940,704, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT;
[00152] [00152]  U.S. Patent Application Serial No. 15 / 940,722, entitled CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY;
[00153] [00153]  U.S. Patent Application Serial No. 15 / 940,742, entitled DUAL CMOS ARRAY IMAGING.
[00154] [00154]  U.S. Patent Application Serial No. 15 / 940,636, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVI- CES;
[00155] [00155]  U.S. Patent Application Serial No. 15 / 940,653, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS;
[00156] [00156]  U.S. Patent Application Serial No. 15 / 940,660, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER;
[00157] [00157]  U.S. Patent Application Serial No. 15 / 940,679, entitled CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHA-VIORS OF LARGER DATA SET;
[00158] [00158]  U.S. Patent Application Serial No. 15 / 940,694, entitled CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION;
[00159] [00159]  U.S. Patent Application Serial No. 15 / 940,634, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AU-THENTICATION TRENDS AND REACTIVE MEASURES;
[00160] [00160]  U.S. Patent Application Serial No. 15 / 940,706, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK;
[00161] [00161]  U.S. Patent Application Serial No. 15 / 940,675, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;
[00162] [00162]  U.S. Patent Application Serial No. 15 / 940,627, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLAT-FORMS;
[00163] [00163]  U.S. Patent Application Serial No. 15 / 940,637, entitled COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
[00164] [00164]  U.S. Patent Application Serial No. 15 / 940,642, entitled CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
[00165] [00165]  U.S. Patent Application Serial No. 15 / 940,676, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGI-CAL PLATFORMS;
[00166] [00166]  U.S. Patent Application Serial No. 15 / 940,680, entitled CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
[00167] [00167]  U.S. Patent Application Serial No. 15 / 940,683, entitled COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
[00168] [00168]  U.S. Patent Application Serial No. 15 / 940,690, entitled DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and
[00169] [00169]  U.S. Patent Application Serial No. 15 / 940,711, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.
[00170] [00170] The applicant for this application holds the following U.S. Provisional Patent Applications, filed on March 28, 2018, the description of each of which is incorporated herein by way of reference, in its entirety:
[00171] [00171]  U.S. Provisional Patent Application No. 62 / 649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;
[00172] [00172]  U.S. Provisional Patent Application Serial No. 62 / 649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD;
[00173] [00173]  U.S. Provisional Patent Application Serial No. 62 / 649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS;
[00174] [00174]  U.S. Provisional Patent Application Serial No. 62 / 649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER;
[00175] [00175]  U.S. Provisional Patent Application No. 62 / 649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYS- TEMS;
[00176] [00176]  U.S. Provisional Patent Application No. 62 / 649,291, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT;
[00177] [00177]  U.S. Provisional Patent Application No. 62 / 649,296, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;
[00178] [00178]  U.S. Provisional Patent Application Serial No. 62 / 649,333, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATI- ON AND RECOMMENDATIONS TO A USER;
[00179] [00179]  U.S. Provisional Patent Application Serial No. 62 / 649,327, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES;
[00180] [00180]  U.S. Provisional Patent Application No. 62 / 649,315, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK;
[00181] [00181]  U.S. Provisional Patent Application Serial No. 62 / 649,313, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;
[00182] [00182]  U.S. Provisional Patent Application No. 62 / 649,320, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLAT-FORMS;
[00183] [00183]  U.S. Provisional Patent Application Serial No. 62 / 649,307, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and
[00184] [00184]  U.S. Provisional Patent Application No. 62 / 649,323, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.
[00185] [00185] The applicant for this application holds the following provisional U.S. Patent Applications, filed on March 8, 2018, the description of which is incorporated herein by reference.
[00186] [00186]  U.S. Provisional Patent Application Serial No. 62 / 640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR; and
[00187] [00187]  U.S. Provisional Patent Application Serial No. 62 / 640,415, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR.
[00188] [00188] The applicant for this application holds the following provisional U.S. Patent Applications, filed on December 28, 2017, the description of which is incorporated herein by reference in its entirety:
[00189] [00189]  U.S. Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM;
[00190] [00190]  U.S. Provisional Patent Application Serial No. 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS; and
[00191] [00191]  U.S. Provisional Patent Application Serial No. 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM.
[00192] [00192] Before explaining in detail the various aspects of surgical instruments and generators, it should be noted that the illustrative examples are not limited, in terms of application or use, to the details of construction and arrangement of parts illustrated in the descriptions in the attached description. The illustrative examples can be implemented or incorporated in other aspects, variations and modifications, and can be practiced or executed in several ways. Furthermore, except where otherwise indicated, the terms and expressions used in the present invention were chosen for the purpose of describing illustrative examples for the convenience of the reader and not for the purpose of limiting it. In addition, it should be understood that one or more of the aspects, expressions of aspects, and / or examples described below can be combined with any one or more of the other aspects, expressions of aspects and / or examples described below. Central surgical controllers
[00193] [00193] 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 volume 105). Each surgical system 102 includes at least one central surgical controller 106 in communication with the number 104 which can include a remote server 113. In one example, as shown in Figure 1, the surgical system 102 includes a visualization 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 an M number of central controllers 106, an N number of display 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.
[00194] [00194] Figure 2 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 the surgical procedure as a part of surgical system 102. Robotic system 110 includes a surgeon console 118, patient car 120 (surgical robot), and a robotic central surgical controller 122. Patient car 120 can handle at least one tool - surgical tool removably coupled 117 through a minimally invasive incision in the patient's body while the surgeon views the surgical site through the surgeon's console 118. An image of the surgical site can be obtained by a medical imaging device 124, which can be manipulated by patient car 120 to guide the imaging device 124. The robotic central surgical controller 122 can be used to process the images of the surgical site for subsequent display to the surgeon through the surgeon's console 118.
[00195] [00195] 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 SURGICAL PLATFORM, filed on December 28, 2017, whose description is hereby incorporated by reference in its entirety for reference.
[00196] [00196] Various examples of cloud-based analysis that are performed by the 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 , deposited on December 28, 2017, the description of which is incorporated herein by reference, in its entirety.
[00197] [00197] In several respects, 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.
[00198] [00198] The optical components of the imaging device 124 may include one or more light sources and / or one or more lenses. One or more light sources can be targeted to illuminate portions of the surgical field. The one or more image sensors can receive reflected or refracted light from the surgical field, including reflected or refracted light from the tissue and / or instruments.
[00199] [00199] 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.
[00200] [00200] The invisible spectrum (that is, the non-luminous spectrum) is that portion of the electromagnetic spectrum located below and above the visible spectrum (that is, wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths greater than about 750 nm are longer than the visible red spectrum, and they become invisible infrared (IR), microwave, radio and electromagnetic radiation. Wavelengths shorter than about 380 nm are shorter than the ultraviolet spectrum, and they become invisible ultraviolet, x-ray, and gamma-ray electromagnetic radiation.
[00201] [00201] In several aspects, the imaging device 124 is configured for use in a minimally invasive procedure. Examples of imaging devices suitable for use with the present description include, but are not limited to, an arthroscope, angioscope, bronchoscope, choledocoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagus-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngoscope neproscope, sigmoidoscope, thoracoscope, and ureteroscope.
[00202] [00202] 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 that the human eye cannot capture with its receivers for the colors red, green and blue. The use of multispectral imaging is described in more detail under the heading "Advanced Imaging Acquisition Module" in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, deposited on December 28, 2017, whose description is hereby incorporated by reference in its entirety for reference. Multispectral monitoring can be a useful tool for relocating a surgical field after a surgical task is completed to perform one or more of the tests previously described on the treated tissue.
[00203] [00203] 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 a "surgical center", 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 in contact with the patient or penetrates 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.
[00204] [00204] 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 visualization system 108 are described under the heading "Advanced Imaging Acquisition Module" in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed December 28, 2017, the description of which is here incorporated by reference in its entirety.
[00205] [00205] 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 an instant 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
[00206] [00206] In one aspect, the central controller 106 is also configured to route an input or diagnostic feedback by a non-sterile operator in the viewing 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 input 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 the main screen 119 by the central controller 106.
[00207] [00207] 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, the flow of coordinated information is further described in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, deposited on December 28, 2017, the content of which is incorporated here reference, in its entirety. 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. Instruments exemplary surgical instruments that are suitable for use with surgical system 102 are described under the title "Surgical Instrument Hardware" and in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28 December 2017, the description of which is incorporated herein by reference in its entirety, for example.
[00208] [00208] Now with reference to Figure 3, a central controller 106 is shown in communication with a visualization system 108, a system
[00209] [00209] 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 housing of the central controller 136 offers a unified environment for managing power, data and fluid lines, which reduces the frequency of entanglement between such lines.
[00210] [00210] 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 housing and a combination generator module received slidably at a central controller housing docking station. The docking station includes data and power contacts. The combined generator module includes two or more of an ultrasonic energy generating component, an energy generating component
[00211] [00211] 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 housing. In one aspect, the central controller housing comprises a fluid interface.
[00212] [00212] 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 housing of the central controller 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the central modular housing 136 is that it allows quick removal and / or replacement of several modules.
[00213] [00213] Aspects of the present description present a modular surgical wrap for use in a surgical procedure that involves applying energy to the tissue. The modular surgical housing includes a first energy generator module, configured to generate a first energy for application to the tissue, and a first
[00214] [00214] In addition to the above, the modular surgical enclosure 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 coupling port that includes second data and power contacts, the second power generator module being slidably movable in an electrical coupling with the power and data contacts, and the second power generator module being movable sliding way out of the electrical coupling with the second power and data contacts.
[00215] [00215] In addition, the modular surgical cabinet 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.
[00216] [00216] With reference to Figures 3 to 7, aspects of the present description are presented for a modular housing of the central controller 136 that allows the modular integration of a generator module 140, a smoke evacuation module 126, and a suction module - tion / irrigation 128. The central modular housing 136 further facilitates interactive communication between modules 140, 126, 128. As shown in Figure 5, generator module 140 can be a generator module with monopolar, bipolar and ultrasonic components integrated,
[00217] [00217] In one aspect, the modular housing of the central controller 136 comprises a rear panel of communication and modular power 149 with external and wireless communication heads to allow the removable fixing of modules 140, 126, 128 and communication interactive between them.
[00218] [00218] In one aspect, the central modular housing 136 includes docking stations, or drawers, 151, here also called drawers, which are configured to receive sliding modules 140, 126, 128. Figure 4 illustrates a partial perspective view of a central surgical controller housing 136, and a combined generator module 145 received slidably at a docking station 151 of the central surgical controller housing 136. A power port 152 with power and data contacts on a rear side of the combined generator module 145 is configured to engage a corresponding docking port 150 with the power and data contacts of a corresponding docking station 151 of the modular housing of the central controller 136 according to the module combined generator 145 is slid into position at the corresponding docking station 151 of the modular housing of central controller 136. In one aspect, the combined generator module do 145 includes a bipolar, ultrasonic and monopolar module and a smoke evacuation module integrated in a single 139 compartment unit, as shown in Figure 5.
[00219] [00219] In several respects, the smoke evacuation module 126 includes a fluid line 154 that transports fluid captured / collected smoke away from a surgical site and to, for example, the smoke evacuation module 126. The vacuum suction that originates from the smoke evacuation module 126 can pull the smoke into an opening of a utility conduit at the surgical site. The utility conduit, coupled to the fluid line, can be in the form of a flexible tube that ends in the smoke evacuation module 126. The utility conduit and the fluid line define a fluid path that extends across towards the smoke evacuation module 126 which is received in the central controller housing 136.
[00220] [00220] In several aspects, the suction / irrigation module 128 is coupled to a surgical tool comprising a fluid suction line and a fluid suction line. In one example, the suction and suction fluid lines are in the form of flexible tubes that extend from the surgical site towards the suction / irrigation module 128. One or more drive systems can be configured to cause irrigation and aspiration of fluids to and from the surgical site.
[00221] [00221] In one aspect, the surgical tool includes a drive shaft that has an end actuator at a distal end of it 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
[00222] [00222] 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 housing 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.
[00223] [00223] In one aspect, modules 140, 126, 128 and / or their corresponding docking stations in the central modular housing 136 may include alignment features that are configured to align the docking ports of the modules in engagement with their counterparts - at the docking stations of the central modular enclosure 136. For example, as shown in Figure 4, the combined generator module 145 includes side supports 155 which are configured to slide the corresponding supports 156 of the corresponding docking station 151 in a sliding way of the central enclosure of the central controller 136. The brackets cooperate to guide the contacts of the coupling port of the combined generator module 145 in an electrical coupling with the contacts of the coupling port of the central enclosure of the central controller 136.
[00224] [00224] In some respects, the drawers 151 of the central modular housing 136 are the same, or substantially the same size, and the modules are adjusted in size to be received in the drawers
[00225] [00225] In addition, the contacts of a specific module can be switched to engage with the contacts of a specific drawer to avoid the insertion of a module in a drawer with unpaired contacts.
[00226] [00226] As shown in Figure 4, the coupling port 150 of one drawer 151 can be coupled to the coupling port 150 of another drawer 151 via a communication link 157 to facilitate interactive communication between the modules housed in the modular housing. central module 136. The coupling ports 150 of the central modular housing 136 can, alternatively or additionally, facilitate interactive wireless communication between modules housed in the central modular housing 136. Any suitable wireless communication can be used, such as example, Air Titan Bluetooth.
[00227] [00227] Figure 6 illustrates individual power bus connectors for a plurality of side coupling ports of a lateral modular compartment 160 configured to receive a plurality of modules from a central surgical controller 206. The modular compartment side 160 is configured to receive and interconnect modules 161 laterally. Modules 161 are slidably inserted into docking stations 162 of side modular cabinet 160, which includes a rear panel for interconnecting modules
[00228] [00228] Figure 7 illustrates a vertical modular cabinet 164 configured to receive a plurality of modules 165 from the central surgical controller 106. Modules 165 are slidably inserted into docking stations, or drawers, 167 of the modular cabinet vertical 164, which includes a rear panel for interconnecting modules 165. Although the drawers 167 of the vertical modular cabinet 164 are arranged vertically, in some cases, a vertical modular cabinet 164 may include drawers that are arranged laterally. In addition, modules 165 can interact with each other through the coupling ports of the vertical modular cabinet
[00229] [00229] In several respects, the imaging module 138 comprises an integrated video processor and a modular light source and is adapted for use with various imaging devices. In one aspect, the imaging device is comprised of a modular compartment that can be mounted with a light source module and a camera module. The compartment can be a disposable compartment. In at least one example, the disposable compartment is removably coupled to a reusable controller, a light source module, and a camera module. The light source module and / or the camera module can be chosen selectively depending on the type of surgical procedure. In one aspect, the camera module comprises a CCD sensor. In another aspect, the camera module comprises a CMOS sensor. In another aspect, the camera module is configured for imaging the scanned beam. Similarly, the light source module can be configured to provide a white light or a different light, depending on the surgical procedure.
[00230] [00230] During a surgical procedure, removing a surgical device from the surgical field and replacing it with another surgical device that includes a different camera or other light source may be inefficient. Temporarily losing sight of the surgical field can lead to undesirable consequences. The imaging device module of the present description is configured to allow the replacement of a light source module or a "midstream" camera module during a surgical procedure, without the need to remove the imaging device from the field surgical.
[00231] [00231] In one aspect, the imaging device comprises a tubular compartment that includes a plurality of channels. A first channel is configured to receive the Camera module in a sliding way, which can be configured for a snap-fit fit (pressure fit) with the first channel. A second channel is configured to slide the camera module, which can be configured for a snap-fit fit (pressure fit) with the first channel. In another example, the camera module and / or the light source module can be rotated to an end position within their respective channels. A threaded coupling can be used instead of a pressure fitting.
[00232] [00232] In several examples, multiple imaging devices are placed in different positions in the surgical field to provide multiple views. Imaging module 138 can be configured to switch between imaging devices to provide an ideal view. In several respects, the imaging module 138 can be configured to integrate images from different imaging devices.
[00233] [00233] 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 CONVENTIONAL IMAGE PROCESSOR, granted on August 9, 2011 which is here incorporated as a reference in its entirety. In addition, US patent No. 7,982,776, entitled SBI MOTION ARTIFACT REMOVAL APPARATUS AND METHOD, issued on July 19, 2011, which is incorporated herein by reference in its entirety, describes various systems for removing motion artifacts from image data. Such systems can be integrated with imaging module 138. In addition to these, the publication of US Patent Application No. 2011/0306840, entitled CONTROLLA- BLE MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPA- RATUS, published on December 15, 2011 , and the publication of US Patent Application No. 2014/0243597, entitled SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE, published on August 28, 2014, which are each incorporated herein by reference in their entirety .
[00234] [00234] Figure 8 illustrates a surgical data network 201 comprising a modular communication center 203 configured to connect modular devices located in one or more operating rooms of a health care facility, or any environment in a facility from utilities specially equipped for surgical operations, to a cloud-based system (for example, cloud 204 which can include a remote server 213 coupled to a storage device 205). In one aspect, the modular communication central controller 203 comprises a central network controller 207 and / or a network switch 209 in communication with a network router. The modular communication center 203 can also be coupled to a local computer system
[00235] [00235] Modular devices 1a to 1n located in the operating room can be coupled to the modular communication center
[00236] [00236] It will be understood that the surgical data network 201 can be expanded by interconnecting multiple central network controllers 207 and / or multiple network switches 209 with multiple network routers 211. The central controller of modular communication 203 may be contained in a modular control tower configured to receive multiple devices 1a to 1n / 2a to 2m. The local computer system 210 may also be contained in a modular control tower. The modular communication center 203 is connected to a screen 212 to display the images obtained by some of the devices 1a to 1n / 2a to 2m, for example, during surgical procedures. In several respects, devices 1a to 1n / 2a to 2m may include, for example, several modules such as an imaging module 138 coupled to an endoscope, a generator module 140 coupled to an energy-based surgical device, a module smoke evacuation system 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 sensor module without contact, among other modular devices that can be connected to the modular communication center 203 of the surgical data network 201.
[00237] [00237] 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 switch 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 must
[00238] [00238] The application of cloud computer data processing techniques in 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 1n / 2a to 2m can be used to view tissue status 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 pathology, such as disease effects, with the use of cloud-based computing to examine data including images of body tissue samples for diagnostic purposes. . This includes confirmation of the location and margin of the tissue and phenotypes. At least some of the devices 1a to 1n / 2a to 2m can be used to identify anatomical structures of the body with the use of a variety of sensors integrated with imaging devices and techniques such as overlaying images captured by multiple devices. imaging devices. Data collected by devices 1a to 1n / 2a to 2m, including image data, can be transferred to the cloud 204 or the local computer system 210, or both, for data processing and manipulation including image processing and manipulation. The data can be analyzed to improve the results of the surgical procedure by determining additional treatment, such as application of endoscopic intervention, emerging technologies, targeted radiation, targeted intervention, precise robotics to specific tissue sites and conditions , can be followed. This data analysis can additionally use analytical processing of the results, and with the use of standardized approaches they can provide beneficial standardized feedback both to confirm surgical treatments and the surgeon's behavior or to suggest modifications to surgical treatments and the behavior of the surgeon. surgeon.
[00239] [00239] In an implementation, operating room devices 1a to 1n can be connected to the modular communication center 203 via a wired channel or a wireless channel depending on the configuration of devices 1a to 1n on a controller. central network. The central network controller 207 can be implemented, in one aspect, as a local network transmission device that acts on the physical layer of the model ("OSI" - 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 (MAC / IP) to transfer data from the device. Only one of the devices 1a to 1n at a time can send data via the central network controller 207. The central network controller 207 does not have routing tables or intelligence about where to send information and transmits all data on the network via ca - from the connection and to a remote server 213 (Figure 9) in the cloud 204. The central network controller 207 can detect basic network errors, such as collisions, but having all the information transmitted to multiple input ports can be a risk safety and cause bottlenecks.
[00240] [00240] In another implementation, operating room devices 2a to 2m can be connected to a network switch 209 through a wired or wireless channel. The network switch 209 works in the data connection layer of the OSI model. The network switch 209 is a multicast device for connecting devices 2a to 2m located in the same operation center to the network. The network switch 209 sends data in the form of 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 switch 209. Network switch 209 stores and uses MAC addresses of devices 2a to 2m to transfer data.
[00241] [00241] The central network controller 207 and / or the network switch 209 are coupled to the network router 211 for connection to the cloud
[00242] [00242] 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.
[00243] [00243] In other examples, operating room devices 1a to 1n / 2a to 2m can communicate with the modular 203 central communication controller via the Bluetooth wireless technology standard for exchanging data over short distances (using short wavelength UHF radio waves in the ISM band from 2.4 to
[00244] [00244] The modular communication center 203 can serve as a central connection for one or all operating room devices 1a to 1n / 2a to 2m and handles a type of data 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 center 203, it is amplified and transmitted to the network router 211, which transfers the data to the cloud computing resources using a series of communication standards or protocols. wireless or wired, as described in the present invention.
[00245] [00245] The modular communication central controller 203 can be used as a standalone device or be connected to compatible central network controllers and network switches to form a larger network. The modular communication center 203 is, in general, easy to install, configure and maintain, making it a good option for the network of devices 1a to 1n / 2a to 2m from the operating room.
[00246] [00246] Figure 9 illustrates an interactive surgical system implemented by computer 200. The interactive surgical system implemented by computer 200 is similar in many aspects to the interactive surgical system implemented by computer 100. For example, the computer-implemented interactive surgical system 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 in communication with a cloud 204 which may include a remote server 213. In one aspect, the interactive surgical system implemented by computer 200 comprises a modular control tower 236 connected to multiple operating room devices, such as intelligent surgical instruments, robots and other computer devices. located in the operating room. As shown in Figure 10, the modular control tower 236 comprises a modular communication center 203 coupled to a computer system
[00247] [00247] 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 modular communication center 203, for example, a network connectivity, and a computer system 210 to provide local processing, visualization, and imaging, for example. As shown in Figure 10, the modular communication center 203 can be connected in a layered configuration to expand the number of modules (for example, devices) that can be connected to the modular communication center 203 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 an upstream port. The central controller / network switch upstream is connected to a processor to provide a communication connection to the cloud computing resources and a local display 217. Communication with the cloud 204 can be done via a wired communication channel or wireless.
[00248] [00248] The central surgical controller 206 employs a non-contact sensor module 242 to measure the dimensions of the operating room and generate a map of the operating room with the use of non-contact measuring devices of the laser or ultrasonic type. An ultrasound-based non-contact sensor module scans the operating room by transmitting an ultrasound explosion and receiving the echo when it bounces outside the perimeter of the operating room walls, as described under the heading "Surgical Hub Spatial Hardware Within an Operating Room "in US Provisional Patent Application Serial No. 62 / 611,341, entitled" INTERACTIVE SURGICAL PLAT-FORM ", filed on December 28, 2017, which is hereby incorporated by reference in in its entirety, in which the sensor module is configured to determine the size of the operating room and adjust the limits of the pairing distance 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 bounce off the perimeter walls of the operating room, and comparing the phase of the transmitted pulse to the received pulse to determine the size of the operating room and to adjust the Bluetooth pairing distance limits, for example.
[00249] [00249] Computer system 210 comprises a processor 244 and a network interface 245. Processor 244 is coupled to a communication module 247, storage 248, memory 249, non-volatile memory 250, and an input / output interface 251 via a system bus. The system bus can be any of several types of bus structures, including the memory bus or memory controller, a peripheral bus or external bus, and / or a local bus that uses any variety of architectures. available, including, but not limited to,
[00250] [00250] Processor 244 can be any single-core or multi-core processor, such as those known under the trade name ARM Cortex available from Texas Instruments. In one respect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a 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 Stella-risWare® program , 2 KB electrically erasable, programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more analog encoder (QEI) inputs, one or more converters 12-bit analog to digital (ADC) with 12 channels of analog input, details of which are available for the product data sheet.
[00251] [00251] 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 by Texas Instruments. The safety controller can be configured specifically for critical safety applications IEC 61508 and ISO 26262, among others, for
[00252] [00252] 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 (ES-DRAM), Synchlink DRAM (SLDRAM), and Direct RAM Rambus RAM (DRRAM).
[00253] [00253] Computer system 210 also includes removable / non-removable, volatile / non-volatile computer storage media, for example disk storage. Disk storage includes, but is not limited to, devices such as a magnetic disk drive, floppy disk drive, tape drive, Jaz drive, Zip drive, LS-60, flash memory card or memory stick. memory (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) writable compact disc drive (CD-R Drive), rewritable compact disc drive (CD-RW drive), or a versatile digital disk ROM drive (DVD-ROM). To make it easier to connect disk storage devices to the system bus, a removable or non-removable interface can be used.
[00254] [00254] 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 an appropriate operating environment. Such software includes an operating system. The operating system, which can be stored on disk storage, acts to control and allocate computer system resources. System applications benefit from the management capabilities of the operating system through program modules and program data stored in system memory or on the storage disk. It 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.
[00255] [00255] A user enters commands or information into computer system 210 through the input device (s) coupled to the I / O interface 251. 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). Interface ports include, for example, a serial port, a parallel port, a game port and a USB. Output devices use some of the same types of ports as input devices. In this way, for example, a USB port can be used to provide input to the computer system and to provide information from the computer system to an output device. An output adapter is provided to illustrate that there are some output devices such as monitors, screens, speakers, and printers, among other output devices, that require special adapters. Output adapters include, by way of illustration and not limitation
[00256] [00256] Computer system 210 can operate in a networked environment using logical connections with 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 many or all 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 ring / IEEE 802.5 and the like. WAN technologies include, but are not limited to, point-to-point links, circuit switching networks such as integrated service digital networks (ISDN) and variations in the same, packet switching networks and digital subscriber lines (DSL ).
[00257] [00257] In several respects, the computer system 210 of Figure 10, the imaging module 238 and / or display system 208, and / or the processor module 232 of Figures 9 and 10, may comprise an image processor. image, image processing engine, media processor, or any specialized digital signal processor (DSP) used for processing digital images. The image processor can employ parallel computing with single multi-data instruction (SIMD) or multi-data instruction (MIMD) technologies to increase speed and efficiency. The digital image processing engine can perform a number of tasks. The image processor can be an integrated circuit system with a multi-core processor architecture.
[00258] [00258] Communication connections refer to the hardware / software used to connect the network interface to the bus. Although the communication connection is shown for illustrative clarity within the computer system, it can also be external to computer system 210. The hardware / software required for connection to the network interface includes, for illustrative purposes only, internal and external technologies such as modems, including regular telephone series modems, cable modems and DSL modems, ISDN adapters and Ethernet cards.
[00259] [00259] 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 USB 300 core network controller is a CMOS device that provides one USB transceiver port 302 and up to three USB transceiver ports downstream 304, 306, 308 in accordance with the USB 2.0 specification. The upstream USB transceiver port 302 is a differential data root port comprising a "minus" (DM0) differential data input paired with a "plus" (DP0) differential data input. The three USB transceiver ports downstream 304, 306, 308 are differential data ports, each port including different data outputs
[00260] [00260] 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 central network controller device can be configured in bus powered or self powered mode and includes 312 central power logic to manage power.
[00261] [00261] The USB 300 central network controller device includes a 310 serial interface engine (SIE). The SIE 310 is the hardware front end of the USB 300 central network controller and handles most of the protocol described in chapter 8 of the USB specification. SIE 310 typically comprises signaling down to the transaction level. The functions it handles could include: packet recognition, transaction sequencing, SOP, EOP, RESET, and RESUME signal detection / generation, clock / data separation, non-zero data encoding / decoding inverted (NRZI), generation and verification of CRC (token and data), generation and verification / decoding of packet ID (PID), and / or series-parallel / parallel-series conversion. The 310 receives a clock input 314 and is coupled to a suspend / resume logic circuit and frame timer 316 and a repeating circuit 318 of the central controller to control communication between the upstream USB transceiver port 302 and the transceiver ports Downstream USB 304, 306, 308 through the logic circuits of ports 320, 322, 324. The SIE 310 is coupled to a command decoder 326 through logic interface 328 to control the commands of a serial EEPROM via an interface EEPROM serial 330.
[00262] [00262] In several aspects, the central network controller USB 300 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. The 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 self-powered central controller, with individual door power management or grouped door power management. In one aspect, using a USB cable, the central USB network controller 300, the USB transceiver port 302 is connected to a USB host controller, and the USB transceiver ports downstream 304, 306, 308 are exposed to connect USB-compatible devices, and so on.
[00263] [00263] Additional details related to the structure and function of the central surgical controller and / or networks of central surgical controllers can be found in US Provisional Patent Application No. 62 / 659,900, entitled METHOD OF HUB COMMUNICATION, filed on April 19, 2018 , which is incorporated herein by reference, in its entirety. Cloud system hardware and functional modules
[00264] [00264] Figure 12 is a block diagram of the interactive surgical system implemented by computer, according to at least one aspect of the present description.
[00265] [00265] In addition, surgical instruments 7012 can comprise transceivers for data transmission to and from their corresponding central surgical controllers 7006 (which can also comprise transceivers). Combinations of surgical instruments 7012 and corresponding central controllers 7006 can indicate specific locations, such as operating rooms in health posts (for example, hospitals), to provide medical operations. For example, the memory of a central surgical controller 7006 can store location data. As shown in Figure 12, cloud 7004 comprises central servers 7013 (which can be the same or similar to remote server 113 in Figure 1 and / or remote server 213 in Figure 9), application servers for central controllers 7002, 7034 data analysis modules and an input / output ("I / O") interface 7007. Central servers 7013 of the cloud 7004 collectively manage the cloud computing system, which includes monitoring requests by central client controllers 7006 and manage the processing capacity of the 7004 cloud to execute requests. Each of the central servers 7013 comprises one or more processors 7008 coupled with suitable memory devices 7010 which may include volatile memory, such as random access memory (RAM), and non-volatile memory, such as magnetic storage devices. 7010 memory devices can comprise machine executable instructions that, when executed, cause 7008 processors to run 7034 data analysis modules for cloud-based data analysis, operations,
[00266] [00266] Based on connections with several central surgical controllers 7006 through the network 7001, the cloud 7004 can aggregate data from specific data generated by various surgical instruments 7012 and their corresponding central controllers 7006. Such aggregate data can be stored in aggregate medical databases 7011 of cloud 7004. In particular, cloud 7004 can advantageously perform data analysis and operations on aggregate data to produce insights and / or perform functions that individual central controllers 7006 could not achieve on their own. For this purpose, as shown in Figure 12, cloud 7004 and central surgical controllers 7006 are communicatively coupled to transmit and receive information. The I / O interface 7007 is connected to the plurality of central surgical controllers 7006 via the network 7001. In this way, the I / O interface 7007 can be configured to transfer information between the central surgical controllers 7006 and the databases. aggregate doctors 7011. Consequently, the I / O interface 7007 can facilitate the read / write operations of the cloud-based data analysis system. Such read / write operations can be performed in response to requests from central controllers 7006. These requests can be transmitted to central controllers 7006 via applications for central controllers. The 7007 I / O interface may include one or more high-speed data ports, which may include universal serial bus (USB) ports, IEEE 1394 ports, as well as Wi-Fi and Bluetooth I / O interfaces for connect cloud 7004 to central controllers 7006. Application servers for central controllers 7002 from cloud 7004 are configured to host and provide shared capabilities to software applications (for example, applications for central controllers) run by controllers central surgical 7006. For example, application servers for central controllers 7002 can manage requests submitted by applications to central controllers through central controllers 7006, control access to aggregate medical databases 7011 and perform load balancing . The data analysis modules 7034 are described in more detail with reference to Figure 13.
[00267] [00267] The configuration of the specific cloud computing system described in this description is specifically designed to address various issues raised in the context of medical operations and procedures performed using medical devices, such as surgical instruments 7012, 112 In particular, surgical instruments 7012 can be digital surgical devices configured to interact with the 7004 cloud to implement techniques to improve the performance of surgical operations. Various surgical instruments 7012 and / or central surgical controllers 7006 can comprise touch-controlled user interfaces, so that clinicians can control aspects of interaction between surgical instruments 7012 and the cloud 7004. Other user interfaces suitable for control, such as audible alert-controlled user interfaces, can also be used.
[00268] [00268] Figure 13 is a block diagram that illustrates the functional architecture of the interactive surgical system implemented by computer,
[00269] [00269] For example, the 7022 data collection and aggregation module could be used to generate self-describing data (for example, metadata), including the identification of notable features or configuration (for example, trends), the management of sets of redundant data and the storage of data in paired data sets that can be grouped by surgery, but not necessarily linked to surgical dates and to real surgeons. In particular, paired data sets generated from operations of the 7012 surgical instruments may comprise application of a binary classification, for example, a bleeding or non-bleeding event. More generally, the binary classification can be characterized as a desirable event (for example, a successful surgical procedure) or an undesirable event (for example, a surgical instrument with failure or misuse 7012). The aggregated self-describing data can correspond to individual data received from various groups or subgroups of central surgical controllers 7006. Consequently, the 7022 data collection and aggregation module can manage aggregated metadata or other data organized based on raw data received of central surgical controllers
[00270] [00270] The resource optimization module 7020 can be configured to analyze these aggregated data to determine an optimal use of resources for a specific group or group of health posts. For example, the resource optimization module 7020 can determine an ideal ordering point for surgical stapling instruments 7012 for a group of clinics based on the corresponding expected demand for such instruments
[00271] [00271] The 7028 patient results analysis module can analyze surgical results associated with currently used operating parameters of 7012 surgical instruments. The 7028 patient results analysis module can also analyze and evaluate other potential operational parameters. In this context, the 7030 recommendations module could recommend the use of these other
[00272] [00272] The 7026 control program update module can be configured to implement various 7012 surgical instrument recommendations when the corresponding control programs are updated. For example, the Patient Results Analysis Module 7028 could identify correlations that link specific control parameters with successful (or unsuccessful) results. These correlations can be addressed when updated control programs are transmitted to 7012 surgical instruments via the 7026 control program update module. Updates to 7012 instruments that are transmitted via a corresponding central controller 7006 can incorporate aggregated performance data that has been gathered and analyzed by the 7022 cloud 7004 data collection and aggregation module. Additionally, the 7028 patient results analysis module and the recommendations module
[00273] [00273] The cloud-based data analysis system can include safety features implemented by the 7004 cloud. These safety features can be managed by the authorization and safety module 7024. Each 7006 central surgical controller can have unique credentials associated with username, password and other appropriate security credentials. These credentials could be stored in memory 7010 and be associated with a level of access allowed to the cloud. For example, based on the provision of exact credentials, a 7006 central surgical controller can be granted access to communicate with the cloud to a predetermined point (for example, only certain defined types can participate in the transmission or receipt) information). For this purpose, the aggregated medical databases 7011 of the cloud 7004 can comprise a database of authorized credentials to verify the accuracy of the credentials provided. Different credentials can be associated with varying levels of permission to interact with the 7004 cloud, such as a predetermined level of access to receive data analysis generated by the 7004 cloud.
[00274] [00274] In addition, for security purposes, the cloud could maintain a database of 7006 central controllers, 7012 instruments and other devices that may comprise a "black list" of prohibited devices. In particular, a blacklisted central surgical controller 7006 may not be allowed to interact with the cloud, while blacklisted surgical instruments 7012 may not have functional access to a corresponding 7006 central controller and / or may be prevented from fully functioning when paired with its corresponding central controller 7006. Additionally or alternatively, the cloud 7004 can signal instruments 7012 based on incompatibility or other specified criteria. In this way, counterfeit medical devices and inadequate reuse of such devices across the cloud-based data analysis system can be identified and addressed.
[00275] [00275] Surgical instruments 7012 can use wireless transceivers to transmit wireless signals that can represent, for example, authorization credentials to access the corresponding central controllers 7006 and the 7004 cloud. Wired transceivers can also be used to transmit signals. These authorization credentials can be stored in the respective memory devices of the surgical instruments 7012. The authorization and security module 7024 can determine whether the authorization credentials are accurate or falsified. The 7024 authorization and security module can also dynamically generate authorization credentials for increased security. Credentials could also be encrypted, such as using hash-based encryption. After transmitting the appropriate authorization, surgical instruments 7012 can transmit a signal to the corresponding central controllers 7006 and finally to cloud 7004 to indicate that instruments 7012 are ready to obtain and transmit medical data. In response, the 7004 cloud can transition to a state enabled to receive medical data for storage in the aggregated medical databases 7011. This availability for data transmission could be indicated, for example, by a light indicator on the 7012 instruments. cloud 7004 can also transmit signals to 7012 surgical instruments to update its associated control programs. The 7004 cloud can transmit signals that are targeted to a specific class of 7012 surgical instruments (for example, electrosurgical instruments), so that software updates for control programs are transmitted only to the appropriate surgical instruments.
[00276] [00276] The cloud-based data analysis system can allow monitoring of multiple health posts (for example, medical posts like hospitals) to determine improved practices and recommend changes (through the 2030 recommendations module, for example) accordingly . In this way, the 7008 processors of the 7004 cloud can analyze the data associated with an individual health post to identify the post and aggregate the data with other data associated with other posts in a group. Groups could be defined based on similar operating practices or geographic location, for example. In this way, the 7004 cloud can provide analysis and recommendations for the entire group of health posts. The cloud-based data analysis system could also be used to increase situational awareness. For example, 7008 processors can predictively model the effects of recommendations on cost and effectiveness for a specific post (in relation to general operations and / or various medical procedures). The cost and effectiveness associated with that specific post can also be compared to a corresponding local region of other posts or any other comparable post.
[00277] [00277] The 7032 data classification and prioritization module can prioritize and classify data based on severity (for example, the severity of a medical event associated with the data, unpredictability, distrust). This classification and prioritization can be used in conjunction with the functions of the other 7034 data analysis modules described above to improve the operation and analysis of cloud-based data described here. For example, the 7032 data classification and prioritization module can assign a priority to the data analysis performed by the 7022 data collection and aggregation module and the 7028 patient outcome analysis module. Different levels of prioritization can result in specific responses from the 7004 cloud (corresponding to an urgency level), such as escalation to an accelerated response, special processing, exclusion from the aggregated medical databases 7011 or other appropriate responses. In addition, if necessary, the 7004 cloud can transmit a request (for example, a push message) through the application servers to central controllers for additional data from corresponding 7012 surgical instruments. The push message can result in a notification displayed on the corresponding central controllers 7006 to request support or additional data. This push message may be necessary in situations where the cloud detects an irregularity or results outside significant limits and the cloud cannot determine the cause of the irregularity. The 7013 central servers can be programmed to activate this push message under certain significant circumstances, such as when data is determined to be different from an expected value beyond a predetermined threshold or when it appears that security has been compounded, for example.
[00278] [00278] Additional details related to the cloud data analysis system can be found in US Provisional Patent Application No. 62 / 659,900, entitled METHOD OF HUB COMMUNICATION, filed on April 19, 2018, which is incorporated herein reference title in its entirety. Situational recognition
[00279] [00279] Although a "smart" device including control algorithms responsive to detected data, it can be an improvement over a "stupid" device that operates without taking the detected data, some detected data can be incomplete or inconclusive when considered in isolation, that is, without the context of the type of surgical procedure being performed or the type of tissue that is undergoing the surgery.
[00280] [00280] One solution uses a central surgical controller including a system configured to derive information about the surgical procedure that is being performed based on data received from various data sources, and then control, accordingly, the modular devices Paired. In other words, the central surgical controller is configured to infer information about the surgical procedure from data received and, then, control the modular devices paired with the central surgical controller based on the inferred context of the surgical procedure. Figure 14 illustrates a diagram of a surgical system with 5100 situational recognition, in accordance with at least one aspect of the present description. In some examples, data sources 5126 include, for example, modular devices 5102 (which may include sensors configured to detect parameters associated with the patient and / or the modular device itself), databases 5122 (for example, an EMR database containing the patient's medical record), and 5124 monitoring devices (for example, a blood pressure monitor (BP) and an electrocardiography monitor (ECG)).
[00281] [00281] A central surgical controller 5104 that can be similar to surgical controller 106 in many ways, can be configured to derive contextual information related to the surgical procedure from the data based, for example, on the combination (s) ( specific data (s) received or in the specific order in which data are received from data sources 5126. Contextual information inferred from data received may include, for example, the type of surgical procedure being performed, the step es-
[00282] [00282] The situational perception system of the central surgical controller 5104 can be configured to derive contextual information from data received from data sources 5126 in several ways. In one example, the situational perception system includes a pattern recognition system, or machine learning system (for example, an artificial neural network), which has been trained in training data to correlate various inputs ( for example, data from databases 5122, patient monitoring devices 5124, and / or modular devices 5102) to corresponding contextual information regarding a surgical procedure. In other words, a machine learning system can be trained to accurately derive contextual information regarding a surgical procedure from the inputs provided. In another example, the situational perception system may include a lookup table that stores pre-characterized contextual information regarding a surgical procedure in association with one or more entries (or ranges of entries) corresponding to the contextual information. In response to a query with one or more entries, the lookup table can return the corresponding contextual information to the recognition system.
[00283] [00283] A 5104 central surgical controller, which incorporates a situational perception system, provides several benefits to the 5100 surgical system. One benefit includes improving the interpretation of detected and captured data, which in turn improves the accuracy of processing and / or using the data during the course of a surgical procedure. To return to a previous example, a 5104 central surgical controller with situational awareness could determine what type of tissue was being operated on; therefore, when an unexpectedly high force is detected to close the end actuator of the surgical instrument, the central surgical controller with situational perception 5104 could correctly accelerate or decelerate the surgical instrument motor for the type of tissue.
[00284] [00284] As another example, the type of fabric being operated can affect the adjustments that are made to the load and compression thresholds of a stapling and surgical cutting instrument for a specific span measurement. A central surgical controller with situational perception 5104 could infer whether a surgical procedure being performed is a thoracic or abdominal procedure, allowing the central surgical controller
[00285] [00285] As yet another example, the type of body cavity being operated during an insufflation procedure can affect the function of a smoke evacuator. A central surgical controller with situational perception 5104 can determine if the surgical site is under pressure (by determining that the surgical procedure is using insufflation) and determine the type of procedure. As a type of procedure is generally performed in a specific body cavity, the 5104 central surgical controller can then adequately control the speed of the smoke evacuator motor to the body cavity being operated on. In this way, a central surgical controller with 5104 situational awareness can provide a consistent amount of smoke evacuation to both thoracic and abdominal procedures.
[00286] [00286] As yet another example, the type of procedure being performed can affect the ideal energy level for an ultrasonic surgical instrument or radio frequency (RF) electrosurgical instrument to operate. Arthroscopic procedures, for example, require higher energy levels because the end actuator of the ultrasonic surgical instrument or RF electrosurgical instrument is immersed in fluid. A central surgical controller with situational perception 5104 can determine whether the surgical procedure is an arthroscopic procedure. The central surgical controller 5104 can then adjust the RF power level or the ultrasonic amplitude of the generator (i.e., the "energy level") to compensate for the fluid-filled environment. Related to this, the type of tissue being operated on can affect the ideal energy level at which an ultrasonic surgical instrument or RF electrosurgical instrument operates. A central surgical controller with situational awareness 5104 can determine what type of surgical procedure is being performed and then customize the energy level for the ultrasonic surgical instrument or RF electrosurgical instrument, respectively, according to the profile of tissue expected for the surgical procedure. In addition, a central surgical controller equipped with 5104 situational awareness can be configured to adjust the energy level for the ultrasonic surgical instrument or RF electrosurgical instrument throughout the course of a surgical procedure, rather than just on a procedural basis. -by-procedure. A central surgical controller with situational perception 5104 can determine which stage of the surgical procedure is being performed or will be performed subsequently and then update the control algorithms for the generator and / or ultrasonic surgical instrument or RF electrosurgical instrument for adjust the energy level to an appropriate value for the type of tissue, according to the stage of the surgical procedure.
[00287] [00287] Yet as another example, data can be extracted from additional data sources 5126 to improve the conclusions that the central surgical controller 5104 extracts from a data source 5126. A central surgical controller with situational perception 5104 can augment the data that it receives from modular devices 5102 with contextual information it has accumulated, referring to the surgical procedure, from other data sources 5126. For example, a surgical controller with situational recognition 5104 can be configured to determine whether hemostasis has occurred (that is, if stopped bleeding at a surgical site), according to video or image data received from a medical imaging device. However, in some cases, video or image data may be inconclusive. Therefore, in an example, the 5104 central surgical controller can be additionally configured to compare a physiological measurement (eg, blood pressure detected by a BP monitor communicatively connected to the 5104 central surgical controller). visual or hemostasis image data (for example, from a medical imaging device 124 (Figure 2) communicatively coupled to the 5104 central surgical controller) to make a determination on the integrity of the staple line or the union of the fabric. In other words, the situational perception system of the central surgical controller 5104 can consider the physiological measurement data to provide additional context in the analysis of the visualization data. The additional context can be useful when the visualization data can be inconclusive or incomplete on its own.
[00288] [00288] Another benefit includes proactively and automatically controlling paired modular devices 5102, according to the specific stage of the surgical procedure being performed to reduce the number of times medical personnel are required to interact com or control the 5100 surgical system during the course of a surgical procedure. For example, a central surgical controller with situational perception 5104 can proactively activate the generator to which an RF electrosurgical instrument is connected, if it is determined that a subsequent step in the procedure requires the use of the instrument. Proactively activating the power source allows the instrument to be ready for use as soon as the preceding step of the procedure is complete.
[00289] [00289] As another example, a central surgical controller with situational perception 5104 could determine whether the current or subsequent stage of the surgical procedure requires a different view or degree of magnification of the screen, according to the resource (s) (s) at the surgical site that the surgeon is expected to see. The central surgical controller 5104 could then proactively change the displayed view (provided, for example, by a medical imaging device to the visualization system 108), so that the screen automatically adjusts throughout the procedure surgical.
[00290] [00290] As yet another example, a central surgical controller with situational perception 5104 could determine which stage of the surgical procedure is being performed or will be performed subsequently and whether specific data or comparisons between the data will be required for that stage of the procedure. surgical procedure. The central surgical controller 5104 can be configured to call screens automatically based on data on the stage of the surgical procedure being performed, without waiting for the surgeon to request specific information.
[00291] [00291] Another benefit includes checking for errors during the configuration of the surgical procedure or during the course of the surgical procedure. For example, a central surgical controller with situational perception 5104 could determine whether the operating room is properly or ideally configured for the surgical procedure to be performed. Central surgical controller 5104 can be configured to determine the type of surgical procedure being performed, retrieve the corresponding checklists, product location, or configuration needs (for example, from a memory), and then compare the layout of the current operating room with the standard layout for the type of surgical procedure that the 5104 central surgical controller determines is being performed. In one example, the 5104 central surgical controller can be configured to compare the list of items for the procedure read by a suitable scanner, for example, and / or a list of devices paired with the 5104 central surgical controller with a list of items and / or devices recommended or expected for the given surgical procedure. If there are any discontinuities between the lists, the central surgical controller 5104 can be configured to provide an alert indicating that a specific modular device 5102, patient monitoring device 5124 and / or another surgical item is missing. In one example, the central surgical controller 5104 can be configured to determine the relative position or distance of modular devices 5102 and patient monitoring devices 5124 using proximity sensors, for example. The central surgical controller 5104 can compare the relative positions of the devices with a recommended or planned layout for the specific surgical procedure. If there are any discontinuities between the layouts, the 5104 central surgical controller can be configured to provide an alert indicating that the current layout for the surgical procedure deviates from the recommended layout.
[00292] [00292] As another example, the central surgical controller with situational perception 5104 could determine whether the surgeon (or other medical personnel) was making a mistake or otherwise deviating from the expected course of action during the course of a pro - surgical procedure. For example, the central surgical controller 5104 can be configured to determine the type of surgical procedure being performed, retrieve the corresponding list of steps or order of use of the equipment (for example, from a memory), and then compare the steps being performed or the equipment being used during the course of the surgical procedure with the steps or with the equipment expected for the type of surgical procedure that the 5104 central surgical controller determined is being performed. In an example, the control
[00293] [00293] In general, the situational perception system for the 5104 central surgical controller improves the results of the surgical procedure by adjusting the surgical instruments (and other modular devices 5102) for the specific context of each surgical procedure (such as the different types of tissue), and when validating actions during a surgical procedure. The situational perception system also improves the surgeon's efficiency in carrying out surgical procedures by automatically suggesting the next steps, providing data, and adjusting screens and other 5102 modular devices in the operating room, according to specific context of the procedure.
[00294] [00294] With reference now to Figure 15, a time line 5200 is shown representing the situational recognition of a central controller, such as the central surgical controller 106 or 206 (Figures 1 to 11), 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, starting with the setup of the operating room and ending with the transfer of the patient to a hospital. recovery room in the postoperative period.
[00295] [00295] The central surgical controller with situational recognition 106, 206 receives data from data sources throughout the course of the surgical procedure, including the data generated each time medical personnel use a modular device that is paired with the surgical controller central 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 the procedure step is being carried out at any given time. The situational recognition system of the central surgical controller 106, 206 is, for example, able to record data regarding the procedure to generate reports, verify the steps being taken by medical personnel, provide data or warnings (for example, through a display screen) that may be relevant to the specific step of the procedure, adjust the modular devices based on the context (for example, activate monitors, adjust the field of view (FOV) of the medical imaging device, or change the energy level of an ultrasonic surgical instrument or RF electrosurgical instrument), and take any other action described above.
[00296] [00296] In the first step 5202, in this illustrative procedure, the members of the hospital team retrieve the electronic patient 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.
[00297] [00297] In the second step 5204, the team members scan the entry of medical supplies for the procedure. Central surgical controller 106, 206 cross-references the scanned supplies with a list of supplies that are used in various types of procedures and confirms that the supply mix corresponds to a thoracic procedure. In addition, the central surgical controller 106, 206 is also able to determine that the procedure is not a wedge procedure (because inlet supplies have an absence of certain supplies that are necessary for a thoracic wedge procedure or, otherwise, that the incoming supplies do not correspond to a thoracic wedge procedure).
[00298] [00298] In the third step 5206, the medical staff scans the patient's band with a scanner that is communicatively connected to the central surgical controller 106, 206. The central surgical controller 106, 206 can then confirm the patient's identity based on the scanned data.
[00299] [00299] In the fourth step 5208, the medical personnel 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 a modular device can automatically pair with the central surgical controller 106, 206 which is located within a specific neighborhood 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 the same during this preoperative or initialization phase. In this particular example, the central surgical controller 106, 206 determines that the surgical procedure is a VATS (video-assisted thoracic surgery) procedure based on this specific combination of paired modular devices. Based on the combination of data from the electronic patient record (PEP), the list of medical supplies to be used in the procedure, and the type of modular devices that connect to the central controller, the central surgical controller 106, 206 can, in general, infer the specific procedure that the surgical team will perform. After the central surgical controller 106, 206 recognizes which specific procedure is being performed, the central surgical controller 106, 206 can then retrieve the steps of that process from a memory or from the cloud and then cross over the data which subsequently receives from connected data sources (for example, modular devices and patient monitoring devices) to infer which stage of the surgical procedure the surgical team is performing.
[00300] [00300] In the fifth step 5210, the team members fix the electrocardiogram (ECG) electrodes and other patient monitoring devices on the patient. ECG electrodes and other patient monitoring devices are able to pair with the central surgical controller 106, 206. As central surgical controller 106, 206 begins to receive data from the patient's monitoring devices, the central surgical controller 106, 206 thus confirms that the patient is in the operating room.
[00301] [00301] In the sixth step 5212, the medical personnel induced anesthesia in the patient. Central surgical controller 106, 206 can infer that the patient is under anesthesia based on data from modular devices and / or patient monitoring devices, including ECG data, blood pressure data, ventilator data, or combinations thereof, for example. After the completion of the sixth step 5212, the preoperative portion of the lung segmentectomy procedure is completed and the operative portion begins.
[00302] [00302] In the seventh step 5214, the lung of the patient who is being operated on is retracted (while ventilation is switched to the contralateral lung). The central surgical controller 106, 206 can infer from the ventilator data that the patient's lung has been retracted, for example. Central surgical controller 106, 206 can infer that the operative portion of the procedure started when it could
[00303] [00303] In the eighth step 5216, the medical imaging device (for example, a display device) is inserted and the video from the medical imaging device is started. Central surgical controller 106, 206 receives data from the medical imaging device (i.e., video or image data) through its connection to the medical imaging device. After receiving data from the medical imaging device, the central surgical controller 106, 206 can determine 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 received 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 determining the angle at which the medical imaging device is oriented in relation to the visualization of the patient's anatomy, monitor the number or medical imaging devices being used (ie, which are activated and paired with the central surgical controller 106, 206), and monitor the types of visualization devices used. For example, a technique to perform a VATS lobectomy places the camera in the lower anterior corner of the patient's chest cavity above the diaphragm, while a technique to perform a VATS segmentectomy places the camera in an anterior intercostal position in relation to the segment fissure. . With the use of standard recognition or machine learning techniques, for example, the situational recognition system can be trained to recognize the positioning of the medical imaging device according to the visualization of the patient's anatomy. As another example, a technique for performing a VATS lobectomy uses a single medical imaging device, while another technique for performing a VATS segmentectomy uses multiple cameras. As yet another example, a technique for performing a VATS segmentectomy uses an infrared light source (which can be communicatively coupled to the central surgical controller as part of the visualization system) to visualize the segment crack, which is not used in a VATS lobectomy. By tracking any or all of these data from the medical imaging device, the central surgical controller 106, 206 can thus determine the specific type of surgical procedure being performed and / or the technique being used for a specific type of procedure surgical.
[00304] [00304] In the ninth step 5218 of the procedure, the surgical team starts the dissection step. Central surgical controller 106, 206 can infer that the surgeon is in the process of dissecting to mobilize the patient's lung because he receives data from the RF or ultrasonic generator that indicate that an energy instrument is being triggered. Central surgical controller 106, 206 can cross-check the received data with the steps retrieved from the surgical procedure to determine that an energy instrument is being triggered at that point in the process (that is, after completing the previously discussed steps of the procedure) corresponds to the dissection stage. In certain cases, the energy instrument may be a power tool mounted on a robotic arm in a robotic surgical system.
[00305] [00305] In the tenth step 5220 of the procedure, the surgical team proceeds to the connection step. Central surgical controller 106, 206 can infer that the surgeon is ligating the arteries and veins because he receives data from the surgical stapling and cutting instrument indicating that the instrument is being fired. Similar to the previous step, the central surgical controller 106, 206 can derive this inference by crossing the reception data from the surgical stapling and cutting instrument with the steps recovered in the process. In some cases, the surgical instrument can be a surgical tool mounted on a robotic arm of a robotic surgical system.
[00306] [00306] In the eleventh step 5222, the segmentation 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 segmentectomy portion of the procedure is being performed.
[00307] [00307] 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 correctly transected
[00308] [00308] In the thirteenth stage 5226, the patient's anesthesia is reversed. The central surgical controller 106, 206 can infer that the patient is emerging from anesthesia based on ventilator data (that is, the patient's respiratory rate begins to increase), for example.
[00309] [00309] Finally, in the fourteenth step 5228 is that medical personnel remove the various patient monitoring devices from the patient. The central surgical controller 106, 206 can therefore infer that the patient is being transferred to a recovery room when the central controller loses ECG, blood pressure and other data from patient monitoring devices. As can be seen from the description of this illustrative procedure, the central surgical controller 106, 206 can determine or infer when each step of a given surgical procedure is taking place according to the data received from the various data sources that are coupled to each other. communicative mode with the central surgical controller 106, 206.
[00310] [00310] Situational recognition is further described in US Provisional Patent Application Serial No. 62 / 659,900, entitled METHOD OF HUB COMMUNICATION, filed on April 19, 2018, which is hereby incorporated by reference in its entirety. . In certain cases, the operation of a robotic surgical system, including the various robotic surgical systems described here, for example, can be controlled by the central controller 106, 206 based on its situational recognition and / or feedback from its components and / or based on information from the cloud
[00311] [00311] In several respects, OR systems control programs (operating room) can be adjusted based on a remote analysis involving supervised and / or unsupervised learning techniques, including repeated multivariate analysis of different combinations of variables in search of correlations, and an assessment of the predictive ability of the analysis result against a separate group of data not used in the original analysis.
[00312] [00312] In one aspect, the control programs of a central surgical controller (eg 102, 202) and / or a modular device (eg 1a to 1n / 2a to 2m) can be modified based on analysis learning processes per performance machine and results recorded over more than one procedure. In one respect, the program response changes of a central surgical controller (eg 102, 202) and / or a modular device (eg 1a to 1n / 2a to 2m) could be based on identifying impacts interrelated with the device. In one example, the impacts are from patient-specific causes. In another example, the impacts result from interactions of the modular devices (for example, 1a to 1n / 2a to 2m) used.
[00313] [00313] In one aspect, the program response changes for the central surgical controller could be updating a device control program or adjusting its operational parameters. In one respect, changes in program response to the central surgical controller could be suggestions or other procedural changes indicated to the surgeon. In one aspect, the program response changes for a modular device could be the adaptation of an actuation speed, waiting time, or other operational parameter of the modular device.
[00314] [00314] In one aspect, machine learning analysis can be based on supervised or unsupervised learning. In one aspect, the analysis can be done within the local network of connected devices in the installation or it could be exported to a remote location for compilation and then returned to the network.
[00315] [00315] In several aspects, machine learning systems can be programmed to perform computational linguistics, natural language processing and / or ethnographic analysis. Supervised learning
[00316] [00316] In several respects, the machine learning systems of the present description use supervised learning methods to group pairs of data into categories not predefined based not only on results, but also in the context of metadata. In one aspect, supervised machine learning can be performed on cloud data received from central surgical controllers (eg 102, 202) to find unidentified data groups. Cloud-based data analysis of machine learning can identify, for example, regional differences in patient and surgical outcomes.
[00317] [00317] Supervised learning methods may include, for example, parametric learning methods or non-parametric learning methods. Parametric learning methods may include, for example, regression (for example, continuous data prediction, discrete data, or the (maximum) gradient method, which is a sequential process used to determine the model's minimum), classification , and vector cluster analysis. Vector cluster analysis is a process that, given a set of training examples, creates the system's ability to take new examples and place them within the grouping defined by the training examples. The vector cluster analysis can also include margin definition, which is the maximization of the margin between the groups to minimize the error of grouping marginal data points. Non-parametric learning methods can include, for example, decision trees and k-NN algorithms.
[00318] [00318] Methods of data compilation may include, for example, single value decomposition, normalization and dimensionality reduction.
[00319] [00319] Figure 16 is a graph representing the positive and negative results for illustrative uses of a modular device (for example, 1a to 1n / 2a to 2m) in accordance with a calculated threshold, according to at least an aspect of the present description. Figure 17 is a block diagram representing surgical procedures that have several characteristics grouped based on the results, according to at least one aspect of the present description. Machine learning can be used to identify interrelated causes and effects in the data, which can then be used to independently develop control program updates for surgical instruments, central surgical controllers and / or other modular devices. Metadata context
[00320] [00320] In several respects, the data metadata context can be used to expand the zone between at least two groups and, therefore, adjust the data to their groups based on the results and their contributing factors. Supervised machine learning techniques can be used to define groups of data by their results and contributing factors.
[00321] [00321] The supervision methodology can be adjusted according to the group validation and sensitivity.
[00322] [00322] Figure 18 is a diagram representing a validation analysis, according to at least one aspect of the present description. Figure 19 is a block diagram representing a validation analysis, according to at least one aspect of the present description. In many respects, an analysis system can use a set of adjustable validation data to perform validation tests. The learning algorithms are trained through a set of training examples that the learning algorithms then use to apply the learned cluster to new data. A set of validation data then allows the algorithm to check that the created data set contains the predicted data and then remove any unforeseen data. As shown in Figures 18 and 19, being able to adjust this set of validation data will allow fine tuning of the grouping process.
[00323] [00323] The sensitivity of the supervision methodology can be adjusted to control the so-called "overlearning", or intensification of learning and the threshold / cut probability of the machine learning model. Overlearning is the adjustability or the ratio between flexibility and algorithmic bias. A highly flexible algorithm will fit all the variable data in a data set, while a highly biased algorithm will fix a very limited set of data points in a data set. Limit and probability cut is the tolerance of the false positive machine learning model in relation to false negatives. Unsupervised learning
[00324] [00324] In many respects, unsupervised (or "untrained") learning techniques can be used to determine relationships of data pairs coming from the central surgical controller that contain connections or result from a complication or morbidity, instead of the treatment step directly. In other words, machine learning can be used to identify causes unrelated to devices and adapt the responses of the central surgical controller accordingly.
[00325] [00325] Unsupervised learning is the process of training a machine learning model on unmarked data. With the results learned based on time or in sequential order, a program can determine the next steps with the greatest probability of success based on a predefined number of initial responses. These answers could be problems encountered, preoperative conditions of the patient, or problems detected in the surgical procedure. Various unsupervised learning techniques can be used, including, for example, cluster analysis (for example, hierarchical cluster analysis and k-averaging cluster analysis), which provides protection against potential threats that are outside the learned behavior "normal", and the unsupervised simulation of one instance of the program trying to override another instance of the program. Unsupervised learning techniques can also include deep learning and neural networks, which are analysis techniques that analyze trends and connections without considering the meaning of the data. Artificial neural networks can be used for, for example, image processing to improve the ability to identify critical underlying structures by identifying images with the areas previously identified in the image, while there is no information on the parameters of the structures themselves.
[00326] [00326] These data points could be used to identify to the user that there is an underlying cause for future evaluation, or that there is a need to reinforce additional treatment, not because the device is not able to verify a predictively, but because the tissue or patient requires special care.
[00327] [00327] The result could be the identification for the surgeon that an additional procedure step is justified, and an auxiliary treatment considered, or that a more robust alternative product is needed. For example, during an anterior lower colorectal resection procedure, an imaging system can detect excessive blood supply limitation to the region after mobilization as a portion of the metadata generated from the procedure. Consequently, a vessel regeneration product or drug could be justified due to the implications of not being able to maintain an adequate blood supply to the transected tissue.
[00328] [00328] As another example, during an anterior lower colorectal resection procedure, comorbidities or chemical treatments can indicate in the metadata generated from the procedure that the tissue is very easily friable. Consequently, an absorbable pressure-distributing auxiliary stapling product could be justified to reduce anastomosis stress, a deviation may need to be created to prevent intestinal content from causing undue stress to the new anastomosis and / or an additional suture or an fibrin / thrombin sealant might need to be applied to ensure that no improper leakage occurs in the first days of curing. A surgical system 200 can be programmed to recommend the appropriate product, drug or treatment to the physician after the procedure is complete.
[00329] [00329] Consequently, the settings of the instrument, device or machine can be adjusted according to the relationships determined through unsupervised learning techniques to provide better results. In at least one example, a surgical stapling instrument is updated to move more slowly or more quickly depending on the type of tissue, the resistance to pushing the knife, and so on. In another example, energy devices (for example, ultrasonic surgical instruments and electrosurgical instruments) are updated to change the current applied by the transection (that is, to increase or decrease it slowly, or to take other such measures) . Additionally, in several examples, one or more of the modular devices (for example, 1 to 1n / 2 to 2m) of the present description are programmed to automatically update their settings based on the correlations learned by a learning process. machine run by the cloud-based system (eg 104, 204).
[00330] [00330] In some aspects, the surgeon could have the ability to cancel the learned settings. In one respect, the learning settings could be the default settings. In one respect, a modular device (for example, 1 to 1n / 2 to 2m) could suggest the new configurations and allow the surgeon to choose between accepting the new configurations and maintaining the previous standards.
[00331] [00331] This description describes a surgical system (for example, 100, 200) that is configured to optimize results of surgical procedures through machine learning. Patterns of treatment can be recognized over the course of numerous procedures that, when implemented, lead to a successful and / or safe outcome for a specific patient. Such treatment standards may include, for example, the type (or types) of surgical instrument to be used during the procedure, additional procedures to be performed and / or any concerns that require additional monitoring. The data collected during each specific procedure, the treatment performed and / or the result of the specific procedure can be stored in a database (for example, remote server 113) for future analysis. The collected data can be used to reinforce and / or update existing treatment recommendations. Analyzing a patient's various health statistics, such as a medical record and / or the patient's current vital statistics, in the light of recognized standards, can further optimize the probability of success of the specific procedure.
[00332] [00332] As described in more detail above, a surgical system (for example, 100, 200) comprises a central information controller, or a central surgical controller (for example, 106, 206). The central surgical controller is configured to facilitate communication between any surgical instruments used in the surgical procedure, the data source and / or the physician. A central information controller, such as, for example, the central surgical controller described here, can store the data collected during each specific procedure. In several cases, the central surgical controller can store data specific to the specific surgical procedure and / or the specific patient locally. The central surgical controller can store additional data relevant to different procedures on an external server (for example, remote server 113).
[00333] [00333] In several examples, with reference to Figure 10, a control
[00334] [00334] Exemplary surgical instruments that are suitable for use with the 206 central surgical controller are described under the title "Surgical Instrument Hardware" and in US Provisional Patent Application Serial No. 62 / 611.341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, the description of which is incorporated herein as a reference in its entirety. Various components of the surgical visualization system, such as the visualization system 108, are described under the heading "Advanced Imaging Acquisition Module" in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on 28 December 2017, the description of which is incorporated herein as a reference in its entirety.
[00335] [00335] After receiving an entry, or data, from the data source, the central surgical controller 206 analyzes the received data against a stored data set. In several examples, the stored data set is stored in a 249 memory. This analysis is performed with the aim of optimizing a result of a surgical procedure. In many instances, data storage and / or machine learning analysis can be performed locally at the level of the central surgical controller. In addition or alternatively, data storage and / or machine learning analysis can be performed on the 204 cloud, for example.
[00336] [00336] In several cases, the central surgical controller 206 analyzes the received data against a stored data set using one or more untrained machine learning techniques. The use of an untrained or unsupervised machine learning technique can allow the determination of relationships between data pairs and / or the identification of a complication resulting from the surgical procedure performed.
[00337] [00337] Central surgical controller 206 identifies similarities in both received and stored data and responds based on the presence or absence of such similarities in each item of data analyzed. Primary techniques in untrained machine learning include, for example, cluster analysis or "clustering". The purpose of cluster analysis is to create groups of data points so that points in different clusters are dissimilar and points in the same cluster are similar. In other words, cluster analysis offers protection against potential threats that are outside of "normal" learned behavior. In several cases, the control circuit is configured to use cluster analysis when analyzing received data against stored data. Cluster analysis techniques include, for example, cluster analysis of k-means and hierarchical cluster analysis. In the k-mean cluster analysis, data points are grouped into k groups. A larger k creates smaller groups with more granularity, while a smaller k means larger groups and more granularity. Each group is defined by the creation of a centroid for each group, and the grouping captures the points closest to it and adds them to the group. In hierarchical clustering analysis, similar data points are grouped into clusters. To decide which clusters should be combined, or where a cluster should be divided, a measurement of the dissimilarity between data sets is necessary. This is done using an appropriate metric, or a measure of the distance between data pairs, and a linkage criterion that specifies the level of dissimilarity between data pairs.
[00338] [00338] Untrained machine learning techniques can develop recommendations based on the creation of artificial neural networks. For example, a surgical imaging system, such as the surgical visualization system 108, can collect data representative of structures within the surgical site. After receiving the collected structural data, the central surgical controller 206 analyzes the collected data against a stored structural data set. Untrained machine learning techniques analyze trends and connections without considering the meaning of the data. This analysis allows the 244 processor to recommend identities of underlying critical structures in a surgical site using images with previously identified areas, while there is no information on the parameters of the critical structures themselves.
[00339] [00339] Based on the analysis of learning by untrained machine, the central surgical controller 206 is configured to recommend an action. The recommended action (or actions) can be presented to the doctor in the form of an instruction. The analyzed data can be used to identify for a doctor that an additional procedural step is justified, an auxiliary treatment must be considered and / or an alternative treatment is necessary. Alternative treatment may include the use of a different surgical instrument and / or the implementation
[00340] [00340] For example, a doctor may be performing a procedure of lower anterior colorectal resection on a patient. During the surgical procedure, a surgical visualization system 108 can detect an excessive limitation of blood supply to the region after mobilization. When the surgical imaging system, or an alternative data source, reports the detected excessive blood supply limitation to the central surgical controller 206, processor 244 analyzes the detected excessive blood supply limitation against the previously collected data . Using an untrained machine learning technique, processor 244 assesses similarities between the excessive blood supply detected limitation and the previously collected data. Based on the similarities evaluated, the 244 processor is configured to develop a recommendation to optimize a result of the surgical procedure. A possible recommendation may be, for example, to use a vessel regenerating product and / or drug due to the implications of not being able to maintain an adequate blood supply to the transected tissue.
[00341] [00341] In another example, a doctor may be performing the same procedure for anterior lower colorectal resection as described above. Before and / or during the procedure, the patient's medical records may contain information that indicates that the patient has a comorbidity, or the simultaneous presence of another chronic disease or condition, and / or that he has undergone chemotherapy before . When a data source communicates the data included in the patient's medical records to the central surgical controller 206, processor 244 analyzes current medical records against previously collected data.
[00342] [00342] Using a non-trained machine learning technique
[00343] [00343] The use of an untrained or unsupervised machine learning technique may allow the determination of relationships between data pairs and / or the identification of a complication resulting from the surgical procedure performed. Processor 244 identifies similarities in the received data and stored data and responds based on the presence or absence of such similarities in each data item analyzed. Based on this analysis, processor 244 recommends an action. The recommended action (or actions) can be presented to a surgical instrument in the form of an operating program and / or parameter. In other words, the recommended action (or actions) can be in the form of modified machine and / or device configurations (for example, modular devices 1a to 1n / 2a to 2m) to provide improved results. For example, several surgical instruments can receive the following changes and / or updates to the instrument's operating program: (1) Surgical staplers can be moved slower or more quickly depending on factors such as tissue type, resistance exerted on the knife, etc .; and (2) surgical energy devices can alter the current that flows through the transition by slowly increasing or decreasing it, etc. In several cases, the central surgical controller 206 is configured to automatically update
[00344] [00344] Although an operating program for a surgical instrument can be updated automatically and / or changed with the recommendations of the central surgical controller 206, the physician may also be able to override the implemented recommendations. In several cases, the central surgical controller 206 can present the doctor with the recommended changes to the operating program of the surgical instrument. The doctor can then accept the recommended changes or maintain previous operating parameters. In other cases, the recommended changes may take effect automatically, and the doctor can return to using the previous operating parameters if he wishes.
[00345] [00345] As described above, upon receiving an input, or data, from the data source, processor 244 of the central surgical controller 206 analyzes the received data against a stored data set. Such analysis is performed with the objective of optimizing a result of a surgical procedure. In several cases, processor 244 analyzes received data against a stored data set using one or more trained machine learning techniques. In supervised learning, processor 244 predicts a parameter as accurately as possible when receiving new examples where inputs and outputs are unknown.
[00346] [00346] Primary techniques in trained machine learning include, for example, parametric learning and nonparametric learning. Regression, classification and cluster analysis are the tasks involved in parametric learning. The regression predicts a continuous target variable, allowing the processor 244 to estimate a value based on the input data received. Continuous variables, such as height, weight, emphysema air leak rate, etc., from a patient, mean that there are no discontinuities in the value that the predicted parameter can have. Discrete variables, on the other hand, can only take on a finite number of values - for example, the color of a staple cartridge inside the end actuator.
[00347] [00347] For example, a doctor may wish to predict the rate of emphysema air leak based on factors such as the stage of emphysema present in the patient, the firing speed of a surgical stapler, the force required to close the claws of an end actuator, the type and / or color of the staple cartridge in the end actuator, etc. A surgical stapler is used to staple lung tissue to a patient with emphysema. A suitable staple cartridge is selected based on the condition of the patient and / or the condition of the lung tissue to be stapled by the surgical stapler. The color of the staple cartridge may reflect the size of the surgical stapler, for example.
[00348] [00348] In several examples, the central surgical controller 206 builds a surgical model that approximates the relationship f between the above factors and the corresponding emphysema air leak rate. As shown in Figure 18, in supervised learning, processor 244 attempts to learn the relationship between, for example, the rate of emphysema air leakage and the factors previously identified by running training data marked 250810 through a learning algorithm. The learned function can be used by processor 244 to estimate the rate of emphysema air leak in a patient whose rate of emphysema air leak is unknown. The estimate is made based on several inputs including the stage of emphysema, the trigger speed of the surgical stapler, the force required to close the claws of the end actuator, and / or the type and / or color of the staple cartridge inside the end actuator.
[00349] [00349] Figure 16 represents exemplifying data collected during previous surgical procedures. In Figure 16, patients were diagnosed with a specific stage of emphysema. The calculated threshold 250700 represents the point at which the result (or results) of the surgical procedure is acceptable. The positive (+) side represents a good, or beneficial, result of the surgical procedure, while the negative (-) side represents a bad, or harmful, result for the surgical procedure. It has been observed that radiation hardens the lung tissue, while emphysema softens the lung tissue. This observation has an effect on the operating program of a surgical instrument, such as a surgical stapler. For example, advancing a firing limb too quickly through diseased tissue can have a detrimental impact on the outcome of the surgical procedure.
[00350] [00350] A first patient with stage 2 emphysema is represented by line 250710 and a second patient with stage 2 emphysema is represented by line 250715. A firing member of a surgical stapler was advanced at a slow speed during the surgical procedure of the first patient 250710, and a firing limb was advanced at a rapid speed during the surgical procedure of the second patient 250715. As represented by the respective dashed lines 250710, 250715, the velocity of the firing limb appears to be irrelevant when the patient has stage 2 emphysema, since both patients had a good or beneficial result. Notably, the rapid velocity of the firing limb brought the second patient 250715 closer to the threshold of acceptable results of the surgical procedure.
[00351] [00351] A first patient with stage 3 emphysema is represented by line 250720 and a second patient with stage 3 emphysema is represented by line 250725. A firing member of a surgical stapler was advanced at a slow speed during the surgical procedure of the first patient 250720, and a firing limb was advanced at a rapid speed during the surgical procedure of the second patient 250725. As represented by the dotted line 250725, the rapid advancement of the firing limb in a patient with emphysema of stage 3 produces unacceptable and / or harmful results for the surgical procedure, while the dotted line 250720 shows that the slow progression of the firing limb in a patient with stage 3 emphysema results in an acceptable and / or beneficial result for the same surgical procedure. A first patient with stage 4 emphysema is represented by line 250730 and a second patient with stage 4 emphysema is represented by line 250735. A trigger member of a surgical stapler was advanced at a slow speed during the procedure. surgical treatment of the first patient 250730, and a firing limb was advanced at a rapid speed during the surgical procedure of the second patient 250735. As represented by the respective dashed lines 250730, 250735, the firing limb speed appears to be irrelevant when the patient has stage 4 emphysema, since both patients have had a bad or harmful result.
[00352] [00352] As shown in Figure 17, data similar to those collected for Figure 16, are collected in relation to several parameters, including, for example: (1) the 250750 emphysema stage; (2) if the patient received radiation 250752; (3) the strength required for a surgical stapler to advance its firing member 250754; (4) patient's blood pressure 250756; (5) advancing the firing member at a low speed 250758; and / or (6) advance the firing member at a high speed 250759. As represented by the position of the parameters measured along the 250700 threshold line, each
[00353] [00353] Blocks 250760 represent measured parameters detected in individual patients whose combination produced a bad, or harmful, result for the surgical procedure. Blocks 250770 represent measured parameters detected in individual patients whose combination produced a good, or beneficial, result for the surgical procedure. As described in more detail with reference to Figure 19, blocks 250765 represent measured parameters detected in individual patients whose combination produced unexpected results that are not representative of other patients. In several cases, strenuous circumstances affected the outcome of the surgical procedure for patients represented by 250,765.
[00354] [00354] The data collected previously, as shown in Figure 16, is divided into a training data set 250810 and test data sets 250820, 250830. The training data set 250810 has markers, so the count - central surgical controller 206 can learn from these marked examples. Such markers can include, for example, various rates of emphysema air leakage determined and their corresponding stage of emphysema, the firing speed of the surgical stapler, the force required to close the claws of an end actuator, and the type and / or color of the end actuator cartridge. Test sets 250820, 250830 comprise data that have no labels, that is, processor 244 does not yet know the value it is trying to predict. In other words, the 244 processor needs to generalize to situations it has not encountered before so that it can provide the most accurate prediction for test data 250820, 250830.
[00355] [00355] The central surgical controller 206 creates a mathematical model 250840 based on the previously collected data marked as the training data set 250810. The training data set is formed by a large universe of samples, that is, n = 1000, to define a function. A 250820, 250830 test set, or a validation data set, allows the central surgical controller 206 to verify that the 250820, 250830 test sets fit the given mathematical model. Test sets 250820, 250830 comprise a smaller sample universe, that is, n = 50. Analysis 250835 of test sets 250820, 250830 results in a validation model 250850 for comparison with the mathematical model 250840 generated. In several cases, this gives the central surgical controller 206 the opportunity to maintain the predicted data and eliminate any unforeseen data. The ability to adjust to the 250840 mathematical model allows fine tuning of the grouping process to fill 250855 with a final mathematical model for use in data analysis. The developed model can be applied in the analysis of the collected data to estimate, for example, the emphysema air leak rate.
[00356] [00356] As discussed above, some data points are out of range results and should be removed from the data set to fine-tune the mathematical model.
[00357] [00357] Now with reference to Figure 20, a 250950 algorithm for a 200 surgical system is shown. The 250950 algorithm is designed to allow adjustment of surgical instrument control programs and / or other system components surgical 200 based on a remote analysis involving supervised and / or unsupervised learning techniques. Such techniques, as described in more detail above, include repeated multivariate analysis of different combinations of variables in search of correlations, and an assessment of the predictive ability of the analysis result against a separate group of data not used in the original analysis.
[00358] [00358] Several surgical systems described here, such as, for example, surgical systems 100, 200, can use the algorithm 250950 in Figure 20. In addition, the reader will readily understand that, in certain cases, the algorithm 250950 in Figure 20 can be combined with one or more additional algorithms described here. Decisions made by surgical system 200 can be implemented, for example, by a control circuit that includes processor 244. The control circuit is configured to receive 250952 data from a source. The data received may include, for example, data relating to the patient's vital statistics, the patient's medical history, the type of surgical procedure to be performed, the type of surgical instrument being used, any data detected by a surgical instrument and / or surgical visualization system, etc.
[00359] [00359] The control circuit of the surgical system 200 is configured to analyze the received data 250954 against a stored data set. Such analysis 250954 can be based on supervised or unsupervised learning. Such analysis 250954 can be performed within the local network of connected devices in the installation or it could be exported to a remote location for compilation and then returned to the network.
[00360] [00360] The control circuit is configured to, after analysis 250954, communicate a recommendation 250956 based on the analysis. The recommendation can be based on the identification of impacts interrelated to devices, specific patient impacts and / or interaction of devices used. The recommendation can be communicated to a doctor in the form of an instruction and / or can be communicated to a specific surgical instrument in the form of updated operating parameters. In one example, recommendations are communicated via a cloud 204 to a modular device (for example, 1 to 1n / 2 to 2m) directly, or via the central surgical controller 206. In one example, the recommendations are communicated to a surgical controller central 206. In any case, the recommendation may include, for example, an instruction to update a modular device control program or adjust the operating parameters of the modular device. In several cases, the recommendations may include suggestions or other procedural changes to be indicated to the physician. In certain cases, recommendations include, for example, adapting an actuation speed, waiting time and / or other operating parameters for a modular device. Examples
[00361] [00361] Various aspects of the subject described in this document are defined in the following numbered examples:
[00362] [00362] Example 1 - A surgical feedback system is described. The surgical feedback system comprises an
[00363] [00363] Example 2 - The surgical feedback system, according to Example 1, in which the control circuit is additionally configured to adjust an operational parameter of the surgical instrument based on the recommendation communicated.
[00364] [00364] Example 3 - The surgical feedback system, according to any one of Examples 1 and 2, in which the control circuit is additionally configured to update a surgical instrument control program based on the reported recommendation.
[00365] [00365] Examples 4 - The surgical feedback system, according to any one of Examples 1 to 3, in which the control circuit is configured to communicate the recommendation suggesting a procedural modification to a user.
[00366] [00366] Examples 5 - The surgical feedback system, according to any one of Examples 1 to 4, in which the control circuit is configured to analyze the data received and the data set stored with the use of a supervised learning technique.
[00367] [00367] Examples 6 - The surgical feedback system, according to any one of Examples 1 to 5, in which the control circuit is configured to analyze the data received and the data set stored using a learning technique
[00368] [00368] Examples 7 - The surgical feedback system, according to any one of Examples 1 to 6, in which the control circuit is configured to analyze the data received within a local network.
[00369] [00369] Examples 8 - The surgical feedback system, according to any one of Examples 1 to 7, in which the control circuit is configured to analyze the data received by exporting the data to a remote location for compilation.
[00370] [00370] Examples 9 - The surgical feedback system, according to any one of Examples 1 to 8, in which the stored data set comprises data collected during previous surgical procedures.
[00371] [00371] Examples 10 - The surgical feedback system, according to any one of Examples 1 to 9, in which the data source comprises data specific to a specific patient.
[00372] [00372] Examples 11 - The surgical feedback system, according to any one of Examples 1 to 10, in which the control circuit is additionally configured to update the data set stored with the communicated recommendation.
[00373] [00373] Example 12 - A surgical feedback system is described. The surgical feedback system comprises a data source and a central surgical controller that comprises a control circuit. The control circuit is configured to receive an input from the data source, analyze the data received against a stored data set to optimize a result of a surgical procedure, and the stored data set comprises data collected during previous surgical procedures, and communicate a recommendation based on the analyzed data.
[00374] [00374] Example 13 - The surgical feedback system, according to Example 12, in which the reported recommendation is based on a specific surgical instrument positioned within a surgical site.
[00375] [00375] Example 14 - The surgical feedback system, according to any one of Examples 12 and 13, in which the control circuit is additionally configured to adjust an operating parameter of the surgical instrument based on the recommendation communication communicated.
[00376] [00376] Example 15 - The surgical feedback system, according to any one of Examples 12 to 14, in which the control circuit is configured to analyze the data received against the data set stored using a supervised learning technique.
[00377] [00377] Example 16 - The surgical feedback system, according to any one of Examples 12 to 15, in which the control circuit is configured to analyze the data received against the data set stored with the use of an unsupervised learning technique.
[00378] [00378] Example 17 - The surgical feedback system, according to any one of Examples 12 to 16, in which the control circuit is configured to communicate the recommendation suggesting a procedural modification to a user.
[00379] [00379] Example 18 - A surgical feedback system is described. The surgical feedback system comprises a data source and a surgical instrument that comprises a control circuit. The control circuit is configured to receive an input from the data source, to analyze the data received against a stored data set to optimize a result of a surgical procedure, and the stored data set comprises data collected during previous surgical procedures, and determine a recommendation based on the analyzed data.
[00380] [00380] Example 19 - The surgical feedback system, according to Example 18, in which the control circuit is additionally configured to adjust an operating parameter of the surgical instrument based on the determined recommendation.
[00381] [00381] Example 20 - The surgical feedback system, according to any one of Examples 18 and 19, in which the control circuit is additionally configured to update the data set stored with the determined recommendation.
[00382] [00382] 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 for certain components are described, other materials can be used. It should be understood, therefore, that the preceding description and the appended claims are intended to cover all these modifications, combinations and variations that fall within the scope of the modalities presented. The appended claims are intended to cover all such modifications, variations, alterations, substitutions, modifications and equivalents.
[00383] [00383] 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 described here, in whole or in part, can be implemented in an equivalent way in integrated circuits, such as one or more computer programs running on one or more computers (for example , 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.
[00384] [00384] The instructions used to program the logic to execute various aspects described can be stored in a memory in the system, such as dynamic random access memory (DRAM), cache, flash memory or other storage. In addition, instructions can be distributed over a network or via other computer-readable media. In this way, a machine-readable media 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 discs, 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 machine-readable tangible storage media used to transmit information over the Internet via an electrical, optical, acoustic cable or other forms of propagated signals (for example , carrier waves, infrared signal, digital signals, etc.). Consequently, 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).
[00385] [00385] 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 which includes 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 field programmable port arrangement (FPGA)), state machine circuits, firmware that stores instructions performed by the programmable circuit, and any combination thereof. The control circuit can, collectively or individually, be incorporated as an electrical circuit that is part of a larger system, for example, an integrated circuit (IC), an application-specific integrated circuit (ASIC), an on-chip system (SoC ), desktop computers, laptop computers, tablet computers, servers, smart headsets, etc. Consequently, as used in the present invention, "control circuit" includes, but is not limited to, electrical circuits that have at least one discrete electrical circuit, electrical circuits that have at least one integrated circuit, electrical circuits that have at least one circuit integrated for specific application, electrical circuits that form a general purpose computing device configured by a computer program (for example, a general purpose computer configured by a computer program that at least partially performs processes and / or devices described herein, or a microprocessor configured by a computer program that at least partially performs the processes and / or devices described here), electrical circuits that form a memory device (for example, forms of random access memory), and / or electrical circuits that form a communications device (for example, a modem, communication switch, u optical-electrical equipment). Those skilled in the art will recognize that the subject described here can be implemented in an analog or digital way, or in some combination of these.
[00386] [00386] As used in any aspect of the present invention, the term "logical" can refer to an application, software, firmware and / or circuit configured to perform any of the aforementioned operations. The software can be incorporated as a software package, code, instructions, instruction sets and / or data recorded on the computer-readable non-transitory storage media. The firmware can be incorporated as code, instructions or instruction sets and / or data that are hard-coded (for example, non-volatile) in memory devices.
[00387] [00387] 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.
[00388] [00388] As used in one aspect of the present invention, an "algorithm" refers to the self-consistent sequence of steps that lead to the desired result, where a "step" refers to the manipulation of physical quantities and / or logical states that can , although not necessarily necessary, take the form of electrical or magnetic signals that can be stored, transferred, combined, compared and manipulated in any other way. It is common use to call these signs bits, values, elements, symbols, characters, terms, numbers or the like. These terms and similar terms can be associated with adequate physical quantities and are merely convenient identifications applied to these quantities and / or states.
[00389] [00389] 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 Engineers (IEEE) entitled "IEEE 802.3 Standard", published in December 2008 and / or later versions of this standard. Alternatively or in addition, communication devices may be able to communicate with each other using an X.25 communications protocol. The X.25 communications protocol can conform or be compatible with a standard promulgated by the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T). Alternatively or in addition, communication devices may be able to communicate with each other using a frame-relay communications protocol. The frame-relay communications protocol can conform or be compatible with a standard promulgated by the Consultative Committee for Internati-
[00390] [00390] Unless otherwise stated, as is evident from the preceding description, it is understood that, throughout the preceding description, discussions that use terms such as "processing", or "computation", or "calculation ", or" determination ", or" display ", or similar, refers to the action and processes of a computer, or similar electronic computing device, that manipulates and transforms the data represented in the form of physical (electronic) quantities in the computer's records and memories in other data represented in a similar way in the form of physical quantities in the computer's memories or records, or in other similar information storage, transmission or display devices.
[00391] [00391] One or more components can be called in the present invention "configured for", "configurable for", "operable / operational for", "adapted / adaptable for", "capable of", "con- formable / conformed to ", etc. Those skilled in the art will recognize that "configured for" may, in general, include components in an active state and / or components in an inactive state and / or components in a standby state, except when the context determines otherwise .
[00392] [00392] The terms "proximal" and "distal" are used in the present invention with reference to a physician who handles the handle portion of a 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 the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.
[00393] [00393] Persons skilled in the art will recognize that, in general, the terms used here, and especially in the appended claims (eg bodies of the appended claims) are generally intended as "open" terms (eg, the term "including" should be interpreted as "including, but not limited to", the term "having" should be interpreted as "having, at least", the term "includes" should be interpreted as "includes, but is not limited to ", etc.). It will also be understood by those skilled in the art that, when a specific number of a claim statement entered is intended, that intention will be expressly mentioned in the claim and, in the absence of such mention, no intention will be present. For example, as an aid to understanding, the following appended claims may contain the use of the introductory phrases "at least one" and "one or more" to introduce claim statements. However, the use of such phrases should not be interpreted as implying that the introduction of a claim statement by the indefinite articles "one, ones" or "one, ones" limits any specific claim containing the claim mention. claims that contain only such a mention are introduced, even when the same claim includes the introductory phrases "one or more" or "at least one" and indefinite articles, such as "one, ones" or "one, ones" (for example, example, "one, ones" and / or "one, ones" should typically be interpreted as meaning "at least one" or "one or more"); the same goes for the use of defined articles used to introduce claims.
[00394] [00394] Furthermore, even if a specific number of an introduced claim statement is explicitly mentioned, those skilled in the art will recognize that that statement needs to be typically 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, this construct is generally intended to have the meaning in which the convention would be understood by (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.). It will be further understood by those skilled in the art that typically a disjunctive word and / or phrase presenting two or more alternative terms, whether in the description, in the claims or in the drawings, should be understood as contemplating the possibility of including one of the terms , either term, or both terms, except where the context dictates to indicate something different.
[00395] [00395] 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 these alternative orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplementary, simultaneous, inverse or other variant orders, except when the context determines otherwise. In addition, terms such as "responsive to", "related to" or other adjectival participles are not intended in general to exclude these variants, unless the context otherwise requires.
[00396] [00396] 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 resource, structure or characteristic described in connection with the aspect is included in at least one aspect. Thus, the use of expressions such as "in one (1) aspect", "in one aspect", "in an example", "in one (1) example", in several places throughout this specification it does not necessarily refer to the same aspect. In addition, specific resources, structures or characteristics can be combined in any appropriate way in one or more aspects.
[00397] [00397] Any patent application, patent, publication of non-patent or other description material mentioned in this descriptive report and / or mentioned in any order data sheet is hereby incorporated by reference, until the point at which the materials
[00398] [00398] In short, numerous benefits have been described that result from the use of the concepts described in this document. The previously mentioned description of one or more modalities has been presented for purposes of illustration and description. This description is not intended to be exhaustive or to limit the invention to the precise form described. 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. Surgical feedback system characterized by comprising: a surgical instrument; a data source; and a central surgical controller configured to connect in a communicable way to the data source and the surgical instrument, in which the central surgical controller comprises a control circuit, and in which the control circuit is configured to: receive a input of the data source; analyze the data received against a set of stored data to optimize a result of a surgical procedure; and communicating a recommendation based on the analyzed data.
[2]
2. Surgical feedback system, according to claim 1, characterized in that the control circuit is additionally configured to adjust an operating parameter of the surgical instrument based on the communicated recommendation.
[3]
3. Surgical feedback system, according to claim 1, characterized in that the control circuit is additionally configured to update a surgical instrument control program based on the communicated recommendation.
[4]
4. Surgical feedback system, according to claim 1, characterized in that the control circuit is configured to communicate the recommendation suggesting a procedural modification to a user.
[5]
5. Surgical feedback system, according to claim 1, characterized in that the control circuit is configured to analyze the data received and the data set stored
with the use of a supervised learning technique.
[6]
6. Surgical feedback system, according to claim 1, characterized in that the control circuit is configured to analyze the data received and the data set stored using an unsupervised learning technique.
[7]
7. Surgical feedback system, according to claim 1, characterized in that the control circuit is configured to analyze the data received within a local network.
[8]
8. Surgical feedback system, according to claim 1, characterized in that the control circuit is configured to analyze the data received by exporting the data to a remote location for compilation.
[9]
9. Surgical feedback system, according to claim 1, characterized in that the set of stored data comprises data collected during previous surgical procedures.
[10]
10. Surgical feedback system, according to claim 1, characterized in that the data source comprises data specific to a specific patient.
[11]
11. Surgical feedback system, according to claim 1, characterized in that the control circuit is additionally configured to update the set of stored data with the communicated recommendation.
[12]
12. Surgical feedback system characterized by comprising: a data source; and a central surgical controller comprising a control circuit, in which the control circuit is configured to: receive input from the data source; analyze the data received against a set of stored data to optimize a result of a surgical procedure, in which the set of stored data comprises data collected during previous surgical procedures; and communicating a recommendation based on the analyzed data.
[13]
13. Surgical feedback system, according to claim 12, characterized in that the recommendation communicated is based on a specific surgical instrument positioned within a surgical site.
[14]
14. Surgical feedback system, according to claim 12, characterized in that the control circuit is additionally configured to adjust an operating parameter of the surgical instrument based on the communicated recommendation.
[15]
15. Surgical feedback system, according to claim 12, characterized in that the control circuit is configured to analyze the data received against the set of data stored with the use of a supervised learning technique.
[16]
16. Surgical feedback system, according to claim 12, characterized in that the control circuit is configured to analyze the data received against the set of data stored with the use of an unsupervised learning technique.
[17]
17. Surgical feedback system, according to claim 12, characterized in that the control circuit is configured to communicate the recommendation suggesting a procedural modification to a user.
[18]
18. Surgical feedback system characterized by comprising: a data source; and a surgical instrument comprising a control circuit
trolley, in which the control circuit is configured to: receive an input from the data source; analyze the data received against a set of stored data to optimize a result of a surgical procedure, in which the set of stored data comprises data collected during previous surgical procedures; and determine a recommendation based on the analyzed data.
[19]
19. Surgical feedback system, according to claim 18, characterized in that the control circuit is additionally configured to adjust an operating parameter of the surgical instrument based on the determined recommendation.
[20]
20. Surgical feedback system, according to claim 18, characterized in that the control circuit is additionally configured to update the set of stored data with the determined recommendation.

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同族专利:

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公开号 | 公开日

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JP2021509203A|2021-03-18|

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CN111758135A|2020-10-09|

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WO2019133136A8|2020-08-06|

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WO2019133136A1|2019-07-04|

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US20190201123A1|2019-07-04|

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EP3506306A1|2019-07-03|

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