screen arrangements for robot-assisted surgical platforms

专利摘要:
The present invention relates to a surgical system comprising a robotic tool, a robot control system, a surgical instrument and a central surgical controller. The robot control system comprises a control console and a control unit in signal communication with the control console and the robotic tool. The central surgical controller comprises a screen. The central surgical controller is in signal communication with the robot control system. The central surgical controller is configured to detect the surgical instrument and represent the surgical instrument on the screen.
公开号:BR112020013059A2
申请号:R112020013059-1
申请日:2018-09-26
公开日:2020-12-01
发明作者:Frederick E. Shelton Iv；David C. Yates；Jason L. Harris
申请人:Ethicon Llc；
IPC主号:

专利说明:

[001] [001] This application claims the priority benefit set forth in Title 35 of USC $ 119 (e) over US Provisional Patent Application Serial No. 62 / 649,307, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS, filed on 28 March 2018, whose invention is included in this document as a reference in its entirety.
[002] [002] This application also claims the priority benefit provided for in title 35 of USC $ 119 (e) over provisional patent application US serial number 62 / 611.341, entitled INTERACTIVE SURGI-CAL PLATFORM, filed on December 28 of 2017, on US provisional patent application serial number 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on December 28, 2017, and on US provisional patent application serial number 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28, 2017, the descriptions of which are hereby incorporated by reference, in their entirety. BACKGROUND OF THE INVENTION
[003] [003] The present invention relates to robotic surgical systems. Robotic surgical systems can include a central control unit, a surgeon's command console and a robot that has one or more robotic arms. Robotic surgical tools can be releasably mounted to the robotic arm (s). The number and type of robotic surgical instruments may depend on the type of surgical procedure. Robotic surgical systems can be used in connection with one or more screens and / or one or more portable surgical instruments during a surgical procedure. SUMMARY OF THE INVENTION
[004] [004] In one aspect, a surgical system is provided. The surgical system comprises a robotic tool; a robot control system; a surgical instrument; and a central surgical controller. The robot control system comprises a control console and a control unit in signal communication with the control console and the robotic tool. The central surgical controller comprises a screen. The central surgical controller is in signal communication with the robot control system. The central surgical controller is configured to detect the surgical instrument and represent the surgical instrument on the screen.
[005] [005] In another general aspect, a surgical system is provided. The surgical system comprises: a robotic tool and a robot control system, which comprises a control console and a control unit in signal communication with the control console and the robotic tool. The surgical system additionally comprises a surgical instrument operable in a plurality of operating states and also comprises a central surgical controller. The central surgical controller comprises a screen. The central surgical controller is in signal communication with the robot control system. The central surgical controller is configured to detect an activated operating state of the surgical instrument and represent the active operating state on the screen.
[006] [006] In yet another general aspect, a surgical system is provided. The surgical system comprises: a robotic tool and a robot control system comprising a control console and a control unit in signal communication with the control console and the robotic tool. The surgical system also includes a surgical instrument, a central surgical controller and a screen. The central surgical controller is in signal communication with the robot control system. The central surgical controller is configured to detect the surgical instrument. The screen is in signal communication with the central surgical controller. The central surgical controller is configured to represent the surgical instrument on the screen. BRIEF DESCRIPTION OF THE FIGURES
[007] [007] The appeals of several aspects are presented with particularity in the attached claims. The various aspects, however, with regard to both the organization and the methods of operation, together with additional objects and advantages of the same, can be better understood in reference to the description presented below, considered together with the attached drawings as follows.
[008] [008] Figure 1 is a block diagram of an interactive surgical system implemented by computer, in accordance with at least one aspect of the present invention.
[009] [009] Figure 2 is a surgical system being used to perform a surgical procedure in an operating room, in accordance with at least one aspect of the present invention.
[0010] [0010] Figure 3 is a central surgical controller paired with a visualization system, a robotic system, and an intelligent instrument, in accordance with at least one aspect of the present invention.
[0011] [0011] Figure 4 is a partial perspective view of a compartment of the central surgical controller, and of a generator module in combination received slidingly in a compartment of the central surgical controller, according to at least one aspect of this invention.
[0012] [0012] Figure 5 is a perspective view of a generator module in combination with bipolar, ultrasonic and monopolar contacts and a smoke evacuation component, in accordance with at least one aspect of the present invention.
[0013] [0013] Figure 6 illustrates different power bus accessories for a plurality of side coupling ports of a lateral modular cabinet configured to receive a plurality of modules, in accordance with at least one aspect of the present invention. .
[0014] [0014] Figure 7 illustrates a vertical modular housing configured to receive a plurality of modules, according to at least one aspect of the present invention.
[0015] [0015] Figure 8 illustrates a surgical data network that comprises a central modular communication controller configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a healthcare facility. healthcare services specially equipped for surgical operations, in the cloud, in accordance with at least one aspect of the present invention.
[0016] [0016] Figure 9 illustrates an interactive surgical system implemented by computer, in accordance with at least one aspect of the present invention.
[0017] [0017] Figure 10 illustrates a central surgical controller that comprises a plurality of modules coupled to the modular control tower, according to at least one aspect of the present invention.
[0018] [0018] Figure 11 illustrates an aspect of a universal serial bus (USB) central controller device, in accordance with at least one aspect of the present invention.
[0019] [0019] Figure 12 illustrates a logical diagram of a control system for an instrument or surgical tool, according to at least one aspect of the present invention.
[0020] [0020] Figure 13 illustrates a control circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present invention.
[0021] [0021] Figure 14 illustrates a combinational logic circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present invention.
[0022] [0022] Figure 15 illustrates a sequential logic circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present invention.
[0023] [0023] Figure 16 illustrates an instrument or surgical tool that comprises a plurality of motors that can be activated to perform various functions, according to at least one aspect of the present invention.
[0024] [0024] Figure 17 is a schematic diagram of a robotic surgical instrument configured to operate a surgical tool described therein, in accordance with at least one aspect of the present invention.
[0025] [0025] Figure 18 illustrates a block diagram of a surgical instrument programmed to control the distal translation of the displacement member, according to an aspect of the present invention.
[0026] [0026] Figure 19 is a schematic diagram of a surgical instrument configured to control various functions, in accordance with at least one aspect of the present invention.
[0027] [0027] Figure 20 is a simplified block diagram of a generator configured to provide adjustment without inductor, among other benefits, in accordance with at least one aspect of the present invention.
[0028] [0028] Figure 21 illustrates an example of a generator, which is a form of the generator of Figure 20, according to at least one aspect of the present invention.
[0029] [0029] Figure 22 illustrates a robotic surgical system, in accordance with an aspect of the present invention.
[0030] [0030] Figure 23 is a schematic of a robotic surgical system, according to at least one aspect of the present invention.
[0031] [0031] Figure 24 is a block diagram of control components for the robotic surgical system of Figure 23, in accordance with at least one aspect of the present invention.
[0032] [0032] Figure 25A is an elevation view of an ultrasonic surgical tool positioned out of contact with the tissue, in accordance with at least one aspect of the present invention.
[0033] [0033] Figure 25B is an elevation view of the ultrasonic surgical tool of Figure 25A positioned in contiguous contact with the tissue, in accordance with at least one aspect of the present invention.
[0034] [0034] Figure 26A is an elevation view of a monopolar characterization pencil positioned out of contact with the tissue, in accordance with at least one aspect of the present invention.
[0035] [0035] Figure 26B is an elevation view of the monopolar cauterization pencil of Figure 26A positioned in contiguous contact with the tissue, in accordance with at least one aspect of the present invention.
[0036] [0036] Figure 27 is a graphical display of continuity and current over time for the ultrasonic surgical tool of Figures 25A and 25B, in accordance with at least one aspect of the present invention.
[0037] [0037] Figure 28 illustrates an end actuator comprising radio frequency (RF) data sensors located on a claw member, in accordance with at least one aspect of the present invention.
[0038] [0038] Figure 29 illustrates the sensors shown in Figure 28 mounted on or formed integrally with a flexible circuit, according to at least one aspect of the present invention.
[0039] [0039] Figure 30 is a flow chart that represents a mode of automatic activation of a surgical instrument, according to at least one aspect of the present invention.
[0040] [0040] Figure 31 is a perspective view of an end actuator of a bipolar radiofrequency (RF) surgical tool that has a smoke evacuation pump for use with a robotic surgical system, representing the pin surgical tool starting and treating a fabric, in accordance with at least one aspect of the present invention.
[0041] [0041] Figure 32 is a block diagram of a surgical system comprising a robotic surgical system, a hand-held surgical instrument and a central surgical controller, in accordance with at least one aspect of the present invention.
[0042] [0042] Figure 33 is a perspective view of a handle portion of a hand held surgical instrument including a screen and additionally representing a detailed view of the screen showing information from the instrument itself, according to at least one aspect of the present invention.
[0043] [0043] Figure 34 is a perspective view of the handle portion of the hand held surgical instrument of Figure 33 representing the instrument paired with a central surgical controller and additionally including a detailed view of the screen showing information to from the central surgical controller, in accordance with at least one aspect of the present invention.
[0044] [0044] Figure 35 is a schematic of a colon resection procedure, in accordance with at least one aspect of the present invention.
[0045] [0045] Figure 36 is a graphical display of strength versus time for the colon resection procedure displayed on the instrument screen in Figure 35, in accordance with at least one aspect of the present invention.
[0046] [0046] Figure 37 is a schematic of a robotic surgical system during a surgical procedure including a plurality of central controllers and secondary interactive screens, according to at least one aspect of the present invention.
[0047] [0047] Figure 38 is a detailed view of the secondary interactive screens in Figure 37, according to at least one aspect of the present invention.
[0048] [0048] Figure 39 is a block diagram of a robotic surgical system comprising more than one robotic arm, in accordance with at least one aspect of the present invention.
[0049] [0049] Figure 40 is a schematic of a surgical procedure that uses the robotic surgical system of Figure 39, in accordance with at least one aspect of the present invention.
[0050] [0050] Figure 41 shows graphical representations of forces and positional displacements experienced by the robotic arms of Figure 39, in accordance with at least one aspect of the present invention.
[0051] [0051] Figure 42 is a flowchart that represents an algorithm to control the position of the robotic arms of a robotic surgical system, according to at least one aspect of the present invention.
[0052] [0052] Figure 43 is a flowchart that represents an algorithm to control the forces exerted by the robotic arms of a robotic surgical system, according to at least one aspect of the present invention.
[0053] [0053] Figure 44 is a flowchart that represents an algorithm to monitor the position and forces exerted by the robotic arms of a robotic surgical system, in accordance with at least one aspect of the present invention.
[0054] [0054] Figure 45 is a block diagram of a surgical system comprising a robotic surgical system, a hand-held surgical instrument equipped with an engine and a central surgical controller, in accordance with at least one aspect of the present invention.
[0055] [0055] Figure 46 is a perspective view of a robotic tool and a hand held surgical instrument during a surgical procedure, in accordance with at least one aspect of the present invention.
[0056] [0056] Figure 47 is a schematic representing communication links between central surgical controllers and a primary server, in accordance with at least one aspect of the present invention.
[0057] [0057] Figure 48 is a flow chart representing a queue for external output of data received from the various central surgical controllers of Figure 47, in accordance with at least one aspect of the present invention.
[0058] [0058] Figure 49 is a timeline representing the situational recognition of a central surgical controller, in accordance with an aspect of the present invention. DETAILED DESCRIPTION
[0059] [0059] The applicant for this application holds the following provisional US patent applications, filed on March 28, 2018, with the invention of each of which in this document incorporated by reference in its entirety: * —US provisional patent application serial number 62 / 649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; * —US Provisional Patent Application Serial No. 62 / 649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; * —US provisional patent application serial number 62 / 649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS;
[0060] [0060] The applicant for the present application holds the following US patent applications, filed on March 29, 2018, the invention of each of which is incorporated by reference in its entirety for reference in its entirety: * “Application for US patent serial number, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; Attorney document number END8499USNP / 170766; * - “US patent application serial number, entitled INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HAN-DLING OF DEVICES AND DATA CAPABILITIES; Attorney document number END8499USNP1 / 170766-1; * “US patent application serial number, entitled SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES; Attorney document number END8499USNP2 / 170766-2; * “US patent application serial number, entitled SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS; Attorney document number END8499USNP3 / 170766-3; * “US patent application serial number, entitled COOPERATIVE UTILIZATION OF DATA DERIVED FROM
[0061] [0061] The applicant of the present application holds the following US patent applications, filed on March 29, 2018, the invention of each of which is incorporated by reference in its entirety for reference in its entirety: * “US patent application serial number, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES; Attorney document number END8506USNP / 170773; * “US patent application serial number, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS; Attorney document number END8506USNP1 / 170773-1; * “US patent application serial number, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER; proxy document number END8507USNP / 170774; * “US patent application serial number, entitled CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL
[0062] [0062] The applicant for the present application holds the following US patent applications, filed on March 29, 2018, the invention of each of which in this document is incorporated by reference in its entirety: * “Application for US patent serial number, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; Attorney document number END8511USNP / 170778; * “US patent application serial number, entitled COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; Attorney document number END8511USNP1 / 170778-1; * “US patent application serial number, entitled CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; Attorney document number END8511USNP2 / 170778-2;
[0063] [0063] Before explaining in detail the various aspects of the surgical instruments and generators, it should be noted that the illustrative examples are not limited, in terms of application or use, to the construction details and arrangement of parts illustrated in the drawings and in the attached description. Illustrative examples can be implemented or incorporated into other aspects, variations and modifications, and can be practiced or executed in a variety of ways. Furthermore, except where otherwise indicated, the terms and expressions used in the present invention have been chosen for the purpose of describing illustrative examples for the convenience of the reader and not for the purpose of limiting it. In addition, it should be understood that one or more of the aspects, expressions of aspects and / or examples described below can be combined with any one or more of the other aspects, expressions of aspects and / or examples described below. - guide.
[0064] [0064] Referring to Figure 1, a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (for example, cloud 104 which may include a remote server 113 coupled to a device storage 105). Each surgical system 102 includes at least one central surgical controller 106 in communication with the cloud 104 which can include a remote server 113. In one example, as illustrated in Figure 1, surgical system 102 includes a visualization system 108, a robotic system 110, a smart handheld surgical instrument 112, which is configured to communicate with one another and / or with the central controller 106. In some respects, a surgical system 102 may include a number of central controllers M 106, an N number of visualization systems 108, an O number of robotic systems 110, and a P number of smart, hand-held surgical instruments 112, where M, N, O and P are integers greater than or equal to one .
[0065] [0065] Figure 3 represents an example of a surgical system 102 being used to perform a surgical procedure on a patient who is lying on an operating table 114 in a surgical operating room 116. A robotic system 110 is used in surgical procedure as part of the surgical system 102. The robotic system 110 includes a surgeon console 118, a patient car 120 (surgical robot), and a robotic central surgical controller 122. The patient car 120 can handle at least a 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 124, which can be manipulated by patient car 120 to guide imaging device 124. Robotic central controller 122 can be used to process images from the surgical site for subsequent display to the surgeon through the surgeon's console 118.
[0066] [0066] 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 invention are described in provisional patent application no. 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28, 2017, the invention of which is hereby incorporated by reference in its entirety for reference.
[0067] [0067] Various examples of cloud-based analysis that are performed by the cloud 104, and are suitable for use with the present invention, are described in US provisional patent application serial number 62 / 611.340, entitled CLOUD-BASED MEDICAL ANALYTICS , deposited on December 28, 2017, whose invention is incorporated in the present document for reference, in its entirety.
[0068] [0068] In several respects, the imaging device 124 includes at least one Image sensor and one or more optical components.
[0069] [0069] The optical components of the imaging device 124 may include one or more light sources and / or one or more lenses. One or more light sources can be directed to illuminate portions of the surgical field. The one or more image sensors can receive reflected or refracted light from the surgical field, including reflected or refracted light from the tissue and / or surgical instruments.
[0070] [0070] The 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.
[0071] [0071] The invisible spectrum (that is, the non-luminous spectrum) is that portion of the electromagnetic spectrum located below and above the visible spectrum (that is, wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths greater than about 750 nm are longer than the visible red spectrum, and they become invisible infrared (IR), microwaves, radio and electromagnetic radiation. Wavelengths smaller than about 380 nm are shorter than the ultraviolet spectrum, and they become invisible ultraviolet, x-ray, and electromagnetic gamma-ray radiation.
[0072] [0072] In several respects, the imaging device 124 is configured for use in a minimally invasive procedure. Examples of imaging devices suitable for use with the present invention include, but are not limited to, an arthroscope, angioscope, bronchoscope, choledocoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagus-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngoscope, sigmoidoscope, thoracoscope, and ureteroscope.
[0073] [0073] 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 along the electromagnetic spectrum. Wavelengths can be separated by filters or 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 greater detail under the heading "Advanced Imaging Acquisition Model" in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017 , whose invention is in the present document incorporated by reference in its entirety. 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.
[0074] [0074] It is axiomatic that strict sterilization of the operating room and surgical equipment is necessary during any surgery. The strict hygiene and sterilization conditions required in an "operating room", that is, an operating or treatment room, justify the highest possible sterilization of all medical devices and equipment. Part of this sterilization process is the need to sterilize anything that comes in contact with the patient or person in the sterile field, including imaging device 124 and its connectors and components. It will be understood that the sterile field can be considered a specified area, such as inside a bank 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.
[0075] [0075] In several aspects, the visualization system 108 includes one or more imaging sensors, one or more image processing units, one or more storage matrices and one or more screens that are strategically arranged in relation to the field sterile, as illustrated in Figure 2. In one aspect, the display system 108 includes an interface for HL7, PACS and EMR. Various components of the 108 display system are described under the heading "Advanced Imaging Acquisition Module" in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLAT-FORM, filed on December 28, 2017, whose invention is hereby incorporated by reference in its entirety for reference.
[0076] [0076] As illustrated 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, the central controller 106 can have the visualization system 108 display a snapshot of a surgical site, as recorded by an imaging device 124, on a non-sterile screen 107 or 109, while maintaining a live transmission of the surgical site on primary screen 119. Snapshot on non-sterile screen 107 or 109 may allow a non-sterile operator to perform a diagnostic step relevant to the surgical procedure, for example.
[0077] [0077] In one aspect, the central controller 106 is also configured to route an entry or diagnostic feedback by a non-sterile operator in the display tower 111 to the primary screen 119 within the sterile field, where it can be seen by a sterile operator on the operating table. In one example, the entry may be in the form of a modification of the snapshot displayed on the non-sterile screen 107 or 109, which can be routed to primary screen 119 by central controller 106.
[0078] [0078] With reference to Figure 2, a 112 surgical instrument is being used in the surgical procedure as part of the surgical system
[0079] [0079] Now with reference to Figure 3, a central controller 106 is shown in communication with a display system 108, a robotic system 110 and a smart handheld surgical instrument 112. The central controller 106 includes a central controller screen 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132 and a storage matrix 134. In certain respects, as illustrated in Figure 3, the central controller 106 additionally includes a module smoke evacuation system 126 and / or a suction / irrigation module 128.
[0080] [0080] During a surgical procedure, the application of energy to the tissue, for sealing and / or cutting, is generally associated with the evacuation of smoke, suction of excess fluid and / or irrigation of the tissue. Fluid, power and / or data lines from different sources are often intertwined during the surgical procedure. Valuable time can be wasted in addressing this issue during a surgical procedure. To untangle the lines, it may be necessary to disconnect the lines from their respective modules, which may require a restart of the modules. The modular compartment of central controller 136 offers a unified environment for managing power, data and fluid lines, which reduces the frequency of interlacing between such lines.
[0081] [0081] Aspects of the present invention feature a central surgical controller for use in a surgical procedure that involves applying energy to tissue at a surgical site. The central surgical controller includes a central controller compartment and a combination generator module received slidingly in a central controller compartment docking station. The docking station includes data and power contacts. The combined generator module includes two or more of an ultrasonic energy generating component, a bipolar RF energy generating component, and a monopolar RF energy generating component that are housed in a single unit. In one aspect, the combined generator module also includes a smoke evacuation component, at least one power application cable to connect the combined generator module to a surgical instrument, at least one smoke evacuation component configured to evacuate smoke. , fluid and / or particulates generated by the application of therapeutic energy to the tissue, and a fluid line that extends from the remote surgical site to the smoke evacuation component.
[0082] [0082] In one aspect, the fluid line is a first fluid line and a second fluid line extends from the remote surgical site to a suction and irrigation module received slidingly in the central controller compartment. In one aspect, the central controller compartment comprises a fluid interface.
[0083] [0083] 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 tissues, while another type of energy may be more beneficial for sealing tissue. 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 invention present a solution in which a modular compartment of central controller 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the modular compartment of the central controller 136 is that it allows quick removal and / or replacement of several modules.
[0084] [0084] Aspects of the present invention feature a modular surgical compartment for use in a surgical procedure that involves applying energy to the tissue. The modular surgical compartment includes a first energy generator module, configured to generate a first energy for application to the tissue, and a first docking station that comprises a first coupling port that includes first data and power contacts, the first power generator module is slidingly movable for an electrical coupling with the data and power contacts and the first power generator module is slidingly movable out of the electric coupling with the first contacts power and data.
[0085] [0085] In addition to the above, the modular surgical compartment also includes a second energy generator module configured to generate a second energy, different from the first energy, for application to the tissue, and a second docking station that comprises 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 sliding way out of the electric coupling with the second data and power contacts.
[0086] [0086] In addition, the modular surgical compartment also includes a communication bus between the first coupling port and the second coupling port, configured to facilitate communication between the first power generator module and the second generator module power.
[0087] [0087] With reference to Figures 3 to 7, aspects of the present invention are presented for a modular compartment of the central controller 136 that allows the modular integration of a generator module 140, a smoke evacuation module 126 and a module suction / irrigation system 128. The modular compartment of the central controller 136 further facilitates interactive communication between modules 140, 126,
[0088] [0088] In one aspect, the modular compartment of the central controller 136 comprises a modular power and a rear communication panel 149 with external and wireless communication heads to allow the removable fixing of modules 140, 126, 128 and interactive communication between them.
[0089] [0089] In one aspect, the modular compartment of the central controller 136 includes docking stations, or drawers, 151, in this document also called drawers, which are configured to receive modules 140, 126, 128 in a sliding manner. Figure 4 illustrates a partial perspective view of a central surgical controller compartment 136, and a combined generator module 145 slidably received in a docking station 151 of the central surgical controller compartment 136. A steel door - device 152 with data and power contacts on a rear side of the combined generator module 145 is configured to engage a corresponding docking port 150 with the data and power contacts of a corresponding docking station 151 of the central controller modular compartment 136 as the combined generator module 145 is slid into position in the corresponding docking station 151 of the modular controller compartment central
[0090] [0090] In several respects, the smoke evacuation module 126 includes a fluid line 154 that carries the captured / collected fluid 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
[0091] [0091] 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 make with which the irrigation and aspiration of fluids to and from the surgical site.
[0092] [0092] In one aspect, the surgical tool includes a drive shaft that has an end actuator at a distal end of the same and at least an energy treatment associated with the end actuator, a suction tube, and a irrigation pipe. The suction tube can have an inlet port at a distal end and the suction tube extends through the drive shaft. Similarly, an irrigation pipe can extend through the drive shaft and may have an entrance port close to the power application implement. The power application implement is configured to supply ultrasonic and / or RF energy to the surgical site and is coupled to the generator module 140 by a cable that initially extends through the drive shaft.
[0093] [0093] The irrigation tube can be in fluid communication with a fluid source, and the suction tube can be in fluid communication with a vacuum source. The fluid source and / or the vacuum source can be housed in the suction / irrigation module 128. In one example, the fluid source and / or the vacuum source can be housed in the central controller compartment 136 separately from the suction / irrigation module 128. In such an example, a fluid interface can be configured to connect the suction / irrigation module 128 to the fluid source and / or the vacuum source.
[0094] [0094] In one aspect, modules 140, 126, 128 and / or their corresponding docking stations in the modular compartment of central controller 136 may include alignment features that are configured to align the docking ports of the modules in engagement with their counterparts in the docking stations of the central compartment modular compartment 136. For example, as shown in Figure 4, the combined generator module 145 includes side supports 155 which are configured to slide the corresponding supports 156 from the corresponding docking station 151 of the central controller 136 modular compartment. The supports cooperate to guide the coupling port contacts of the combined generator module 145 in an electrical coupling with the contacts of the modular controller compartment port. central 136.
[0095] [0095] In some respects, the drawers 151 of the central controller module compartment 136 are the same or substantially the same size, and the modules are adjusted in size to be received in the drawers 151. For example, the side supports 155 and / or 156 can be larger or smaller depending on the size of the module. In other respects, drawers 151 are different in size and are each designed to accommodate a specific module.
[0096] [0096] 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.
[0097] [0097] 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 through a communication link 157 to facilitate interactive communication between the modules housed in the compartment modular design of the central controller 136. The coupling ports
[0098] [0098] Figure 6 illustrates individual power bus accessories for a plurality of side coupling ports of a side modular cabinet 160 configured to receive a plurality of modules from a central surgical controller 206. Side modular cabinet 160 is configured to receive and later interconnect modules 161. Modules 161 are slidably inserted into docking stations 162 of side modular cabinet 160, which includes a rear panel for interconnecting modules 161. As shown in Figure 6, modules 161 are arranged laterally in the side modular cabinet 160. Alternatively, modules 161 can be arranged vertically in a side modular cabinet.
[0099] [0099] 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 the modules
[00100] [00100] 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 cabinet that can be mounted with a light source module and a camera module. The case can be a disposable case. In at least one example, the disposable cabinet 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 selected 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.
[00101] [00101] 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 another light source may be inefficient. Losing sight of the surgical field temporarily can lead to undesirable consequences. The imaging device module of the present invention is configured to allow the replacement of a light source module or a camera module
[00102] [00102] In one aspect, the imaging device comprises a tubular compartment that includes a plurality of channels. A first channel is configured to receive the camera module in a sliding way, which can be configured for a snap-fit fit (pressure fit) with the first channel. A second channel is configured to receive the camera module in a sliding way, which can be configured for a snap-fit fit (press 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.
[00103] [00103] In several examples, multiple imaging devices are placed in different positions in the surgical field to provide multiple views. Imaging module 138 can be configured to switch between imaging devices to provide an ideal view. In several respects, imaging module 138 can be configured to integrate images from different imaging devices.
[00104] [00104] Various image processors and imaging devices suitable for use with the present invention are described in US patent No. 7,995,045 entitled COMBINED SBI AND CONVENTIO-NAL IMAGE PROCESSOR, granted on August 9, 2011 which is in the present document incorporated as a reference in its entirety. In addition, US patent No. 7,982,776, entitled SB! MO- TION ARTIFACT REMOVAL APPARATUS AND METHOD, granted on July 19, 2011, which is incorporated herein by reference in its entirety for reference, describes various systems for removing motion artifacts from image data. Such systems can be integrated with the imaging module 138. In addition, the publication of US patent application No. 2011/0306840, entitled CONTROLLABLE MAGNETIC SOURCE TO FIXTURE INTRACORPO- REAL APPARATUS, published on December 15, 2011, and US Patent Application Publication No. 2014/0243597, entitled SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEEDURE, published on August 28, 2014, which are, each of which, in this document, incorporated by reference in its entirety.
[00105] [00105] ArFigura8 illustrates a surgical data network 201 that comprises a central modular communication controller 203 configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a healthcare facility. health services specially equipped for surgical operations, to a cloud-based system (for example, cloud 204 which may include a remote server 213 coupled to a storage device 205). In one aspect, the modular central communication controller 203 comprises a central network controller 207 and / or a network key 209 in communication with a network router. The modular central communication controller 203 can also be coupled to a local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 can be configured as a passive, intelligent or switching network. A passive surgical data network serves as a conduit for the data, allowing the data to be transmitted from one device (or segment) to another and to cloud computing resources. An intelligent surgical data network includes features to allow traffic to pass through the surgical data network to be monitored and to configure each port on the central network controller 207 or network key 209. An intelligent surgical data network can be called a central controller or controllable key. A central switching controller reads the destination address of each packet and then forwards the packet to the correct port.
[00106] [00106] Modular devices 1a to 1n located in the operating room can be coupled to the central controller of modular communication 203. The central network controller 207 and / or the network switch 209 can be coupled to a network router 211 to connect devices 1a to 1h to the 204 cloud or the local computer system
[00107] [00107] It will be understood that the surgical data network 201 can be expanded by interconnecting multiple central network controllers 207 and / or multiple network keys 209 with multiple network routers 211. The central communication controller 203 can be contained in a modular control roaster configured to receive multiple devices 1a to 1n / 2a to 2m. The local computer system 210 can also be contained in a modular control tower. The central modular communication controller 203 is connected to a screen 212 to display the images obtained by some of the devices 1a to 1n / 2a to 2m, for example, during surgical procedures. In several respects, devices 1a to 1n / 2a to 2m 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 smoke evacuation module 126, a suction / irrigation module 128, a communication module 130, a processor module 132, a storage matrix 134, a surgical device attached to a screen, and / or a non-contact sensor module, among other modular devices that can be connected to the central modular communication controller 203 of the surgical data network 201.
[00108] [00108] In one aspect, the surgical data network 201 may comprise a combination of central network controller (or controllers), network key (or keys) and network router (or routers) connecting devices 1a to 1n / 2a to 2m to the cloud. Any or all of the devices 1a to 1n / 2a to 2m coupled to the central network controller or network key can collect data in real time and transfer the data to cloud computers for data processing and manipulation.
[00109] [00109] —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.
[00110] [00110] In an implementation, operating room devices 1a to 1h can be connected to the central modular communication controller 203 via a wired channel or a wireless channel depending on the configuration of devices 1a to 1h in a central controller - network terminal. The central network controller 207 can be implemented, in one aspect, as a local network transmission device that acts on the physical layer of the OSI model ("open system interconnection"). The central network controller provides connectivity to devices 1a to 1n located on the same network as the operating room. The central network controller 207 collects data in the form of packets and sends them to the router in half - duplex mode. The central network controller 207 does not store any media access control / Internet protocol (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 of each 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 have all (admit that) the information transmitted to multiple input ports it can be a security risk and cause strangulation.
[00111] [00111] In another implementation, operating room devices 2a to 2m can be connected to a network switch 209 through a wired or wireless channel. The network key 209 works in the data connection layer of the OSI model. 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 key 209 sends data in frame form to the network router 211 and works in full duplex mode. Multiple devices 2a to 2m can send data at the same time via network key 209. Network key 209 stores and uses MAC addresses of devices 2a to 2m to transfer data.
[00112] [00112] The central network controller 207 and / or the network key 209 are coupled to the network router 211 for a connection to the cloud
[00113] [00113] 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 in the operating room.
[00114] [00114] In other examples, devices in the operating room 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 via standard Bluetooth wireless technology for exchanging data over short distances ( with the use of short-wavelength UHF radio waves in the ISM band of 24 to 2.485 GHz) from fixed and mobile devices and to build personal area networks (PANs). In other respects, operating room devices 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 through a number of wireless and wired communication standards or protocols, including, but not limited to, limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, long-term evolution (LTE, "long-term evolution"), and Ev-DO, HSPA +, HSDPA +, HSUPA +, EDGE , GSM, GPRS, CDMA, TDMA, DECT, and Ethernet derivatives thereof, as well as any other wireless and wired protocols that are designated as
[00115] [00115] The modular communication central controller 203 can serve as a central connection for one or all operating room devices 1a to 1n / 2a to 2m and handles a data type known as frames. The tables carry the data generated by the devices 1a to 1n / 2a to 2m. When a frame is received by the modular central communication controller 203, it is amplified and transmitted to the network router 211, which transfers the data to the cloud computing resources using a series of communication standards or protocols. wireless or wired, as described in the present invention.
[00116] [00116] The modular communication central controller 203 can be used as a standalone device or be connected to compatible central network controllers and network switches to form a larger network. The 203 modular communication central controller is, in general, easy to install, configure and maintain, making it a good option for the network of devices 1a to 1n / 2a to 2m from the operating room.
[00117] [00117] Figure 9 illustrates an interactive surgical system, implemented by computer 200. The interactive surgical system implemented by computer 200 is similar in many respects to the interactive surgical system, implemented by computer 100. For example, the interactive, surgical system computer implemented 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 computer-implemented interactive surgical system 200 comprises a modular control tower 236 connected to multiple operating room devices such as, for example, smart surgical instruments, robots and other computerized devices located in the operating room.
[00118] [00118] Figure 10 illustrates a central surgical controller 206 comprising a plurality of modules coupled to the modular control tower 236. The modular control tower 236 comprises a central modular communication controller 203, for example, a connectivity device network, and a computer system 210 to provide local processing, visualization, and imaging, for example. As shown in Figure 10, the modular communication central controller 203 can be connected in a layered configuration to expand the number of modules (for example, devices) that can be connected to the modular communication central controller 203 and transfer associated data 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 communication central controller 203 includes three downstream ports and an upstream port. The central controller / network switch upstream is connected to a processor to provide a communication connection with the cloud computing resources and a local display 217. Communication with the cloud 204 can be done via a communication channel wired or wireless.
[00119] [00119] The central surgical controller 206 employs a non-contact sensor module 242 to measure the dimensions of the operating room and generate a map of the operating room using non-contact measuring devices such as laser or ultrasonic. An ultrasound-based non-contact sensor module scans the operating room by transmitting an ultrasound explosion and receiving an echo when it bounces off the perimeter walls of an operating room, as described under the heading "SURGICAL HUB SPATIAL AWARENESS WITHIN AN OPERATING ROOM "in US provisional patent application serial number 62 / 611.341, entitled INTE-RACTIVE SURGICAL PLATFORM, filed on December 28, 2017, which is hereby incorporated by reference in in its entirety, in which the sensor module is configured to determine the size of the operating room and to 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 jump from the perimeter walls of the operating room, and comparing the phase of the transmitted pulse to the received pulse to determine the size of the operating room and to adjust the Bluetooth pairing distance limits, for example.
[00120] [00120] 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 input / output interface 251 through 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 local bus that uses any variety of available bus architectures including, but not limited to, 9-bit bus, industry standard architecture (ISA), Micro-Charme! Architecture (MSA), Extended ISA (EISA), Smart Drive Electronics (IDE), VESA Local Bus (VLB), Peripheral Component Interconnection (PCI), USB, Accelerated Graphics Port (AGP), PCMCIA Bus (International Association of Memory Cards for Personal Computers, "Personal Computer Memory Card International Association"), Systems Interface for Small Computers (SCSI), or any other proprietary bus.
[00121] [00121] Processor 244 can be any single-core or multi-core processor, such as those known under the trade name of ARM Cortex available from Texas Instruments. In one respect, the 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 temporary advance search storage 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 program StellarisWareO &, programmable and electrically erasable read-only memory (EEPROM) of 2 KB, one or more pulse width modulation (PWM) modules, one or more analogs of quadrature encoder (QEI) inputs, one or more 12-bit analog to digital converters (ADC) with 12 analog input channels, details of which are available for the product data sheet.
[00122] [00122] In one aspect, processor 244 may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the tradename Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for critical safety applications IEC 61508 and ISO 26262, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[00123] [00123] 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), EE-PROM or flash memory. Volatile memory includes random access memory (RAM), which acts as an external cache memory. In addition, RAM is available in many forms such as SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), Synchlink DRAM (SLDRAM), and direct RAM Rambus RAM (DRRAM).
[00124] [00124] Computer system 210 also includes removable / non-removable, volatile / non-volatile computer storage media, such as, for example, disk storage. Disk storage includes, but is not limited to, devices such as a magnetic disk drive, floppy disk drive, tape drive, drive
[00125] [00125] 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 in disk storage, acts to control and allocate computer system resources. System applications benefit from management capabilities by the operating system through program modules and “program data stored in 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.
[00126] [00126] A user enters commands or information into the computer system 210 through the input device (s) coupled to the 1 / O interface 251. Input devices include, but are not limited to, a pointing device such as a mouse, trackball, stylus, touchscreen
[00127] [00127] Computer system 210 can operate in a networked environment using logical connections to one or more remote computers, such as cloud computers, or local computers. Remote cloud computers can be a personal computer, server, router, personal network computer, workstation, microprocessor-based device, peer device, or other common network node, and the like, and typically include many or all of the elements described in relation to the computer system.
[00128] [00128] In several respects, computer system 210 of Figure 10, imaging module 238 and / or display system 208, and / or processor module 232 of Figures 9 to 10, may comprise a processor of image, image processing engine, media processor, or any specialized digital signal processor (PSD) 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 range of tasks. The image processor can be an integrated circuit system with a multi-core processor architecture.
[00129] [00129] 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 technologies and external as modems, including regular telephone series modems, cable modems and DSL modems, ISDN adapters and Ethernet cards.
[00130] [00130] Figure 11 illustrates a functional block diagram of an aspect of a USB 300 central network controller device, in accordance with an aspect of the present invention. In the illustrated aspect, the USB 300 network central controller device uses a TUSB2036 integrated circuit central controller available from Texas Instruments. The central USB network controller 300 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. Upstream USB transceiver port 302 is a differential data root port comprising a "minus" differential data input (DMO) paired with a "plus" differential data input (DPO). The three ports of the downstream USB transceiver 304, 306, 308 are differential data ports, with each port including "more" differential data outputs (DP1-DP3) paired with "less" differential data outputs (DM1- DM3).
[00131] [00131] The USB 300 central network controller device is implemented with a digital state machine instead of a microcontroller, 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 ports. 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.
[00132] [00132] The USB 300 network central controller device includes a 310 series interface engine (SIE). The SIE 310 is the front end of the USB 300 central network controller hardware and handles most of the protocol described in chapter 8 of the USB specification. The SIE 310 typically comprises signaling down to the level of the transaction. The functions it handles could include: packet recognition, transaction sequencing, SOP, EOP, RESET, and RESUME signal detection / generation, clock / data separation, data encoding / decoding non-inverted zero ( NRZI), generation and verification of CRC (token and data), generation and verification / decoding of packet ID (PID), and / or series-parallel / parallel-series conversion. The 310 receives a clock input 314 and is coupled with a suspend / resume logic circuit and frame timer 316 and a central controller repeat circuit 318 to control communication between the upstream USB transceiver port 302 and the trans port - USB receiver downstream 304, 306, 308 through the logic circuits of ports 320, 322, 324. The SIE 310 is coupled to a command decoder 326 through the logic interface to control the commands of a serial EEPROM via a serial EEPROM interface
[00133] [00133] 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. 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 central bus-powered controller with individual port power management or grouped port power management, and the controller self-powered central, with individual door energy management or grouped door energy management. In one respect, using a USB cable, the USB 300 central network controller, the USB upstream transceiver port 302 is plugged into a USB host controller, and the downstream USB transceiver ports 304, 306, 308 are exposed to connect compatible USB devices, and so on. Surgical instrument hardware
[00134] [00134] Figure 12 illustrates a logic diagram of a module of a 470 control system of a surgical instrument or tool, according to one or more aspects of the present invention. The 470 system comprises a control circuit. The control circuit includes a microcontroller 461 comprising a processor 462 and memory 468. One or more of the sensors 472, 474, 476, for example, provide real-time feedback to the processor 462. A 482 engine, actuated by a motor drive 492, it operationally engages a longitudinally movable displacement member to drive the knife element of the beam with profile in | A tracking system 480 is configured to determine the position of the longitudinally movable displacement member. Position information is provided to the 462 processor, which can be programmed or configured to determine the position of the longitudinally movable drive member, as well as the position of a firing member, firing bar and a beam knife element with profile in |. Additional motors can be provided at the instrument driver interface to control the firing of the beam with an i-profile, the displacement of the closing tube, the rotation of the drive shaft and the articulation. A 473 screen displays a variety of instrument operating conditions and can include touchscreen functionality for data entry. The information displayed on screen 473 can be overlaid with images captured using endoscopic imaging modules.
[00135] [00135] In one aspect, the 461 microcontroller can be any single-core or multi-core processor, such as those known under the ARM Cortex trade name available from Texas Instruments. In one aspect, the 461 main microcontroller may be an LM4F230H5QR ARM Cortex-M4F processor, available from Texas Instruments, for example, which comprises a 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a pre-fetch buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareO program , 2 KB electronically programmable and erasable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more analogs of quadrature encoder (QEI) inputs, and / or a or more 12-bit analog to digital converters (ADC) with 12 channels of analog input, details of which are available for the product data sheet.
[00136] [00136] In one aspect, the 461 microcontroller may comprise a safety controller that comprises two families based on controllers, such as TMS570 and RM4x known under the trade name of Hercules ARM Cortex R4, also available from Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[00137] [00137] The 461 microcontroller can be programmed to perform various functions, such as precise control of the speed and position of the joint and knife systems. In one aspect, the microcontroller 461 includes a processor 462 and a memory 468. The electric motor 482 can be a brushed direct current (DC) motor with a gearbox and mechanical connections with an articulation or scalpel system. In one aspect, a 492 motor drive can be an A3941 available from Allegro Microsystems, Inc. Other motor drives can be readily replaced for use in the 480 tracking system which comprises an absolute positioning system. A detailed description of an absolute positioning system is provided in US patent application publication 2017/0296213, entitled SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STA- PLING AND CUTTING INSTRUMENT, published on October 19, 2017, which is in the present document incorporated as a reference in its entirety.
[00138] [00138] The 461 microcontroller can be programmed to provide precise control of the speed and position of the displacement members and articulation systems. The 461 microcontroller can be configured to compute a response in the microcontroller software
[00139] [00139] In one aspect, the 482 motor can be controlled by the 492 motor driver and can be used by the instrument trigger system or surgical tool. In many ways, the 482 motor can be a brushed direct current (DC) drive motor, with a maximum speed of approximately 25,000 RPM, for example. In other arrangements, the 482 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable electric motor. Motor starter 492 may comprise an H bridge starter comprising field effect transistors (FETs), for example. The 482 motor can be powered by a feed set releasably mounted on the handle set or tool compartment to provide control power for the instrument or surgical tool. The power pack can comprise a battery that can include several battery cells connected in series, which can be used as the power source to energize the instrument or surgical tool. In certain circumstances, the battery cells in the power pack may be replaceable and / or rechargeable. In at least one example, the battery cells can be lithium-ion batteries that can be coupled and separable from the power supply.
[00140] [00140] The 492 motor driver can be an A3941, available from Allegro Microsystems, Inc. The 492 A3941 driver is an entire bridge controller for use with semiconductor metal oxide field effect transistors (MOSFET). external power, N channel, specifically designed for inductive loads, such as brushed DC motors. The 492 actuator comprises a single charge pump regulator that provides full door drive (> 10 V) for batteries with voltage up to 7 V and allows the A3941 to operate with a reduced door drive, up to 5.5 V. An input command capacitor can be used to supply the voltage surpassing that supplied by the battery required for the N channel MOSFETs. An internal charge pump for the upper side drive allows operation in direct current (100% cycle work). The entire bridge can be triggered in fast or slow drop modes using diodes or synchronized rectification. In the slow drop mode, the current can be recirculated by means of FET from the top or from the bottom. Energy FETs are protected from the shoot-
[00141] [00141] The tracking system 480 comprises a controlled motor drive circuit arrangement comprising a position sensor 472 in accordance with an aspect of the present invention. The position sensor 472 for an absolute positioning system provides a unique position signal that corresponds to the location of a displacement member. In one aspect, the displacement member represents a longitudinally movable drive member comprising a rack of drive teeth for engagement with a drive gear corresponding to a gear reduction assembly. In other respects, the displacement member represents the firing member, which can be adapted and configured to include a rack of drive teeth. In yet another aspect, the displacement member represents a firing bar or the beam with a | profile, each of which can be adapted and configured to include a drive tooth rack. Consequently, as used in the present invention, the term "displacement member" is used generically to refer to any moving member of the instrument or surgical tool, such as the driving member, the firing member, the firing bar, the beam with profile in | or any element that can be moved. In one aspect, the longitudinally movable drive member is coupled to the firing member, the firing bar and the beam with an | profile. Consequently, the absolute positioning system can, in effect, track the linear displacement of the beam with | by tracking the linear displacement of the longitudinally movable drive member. In several other respects, the displacement member can be coupled to any position sensor 472 suitable for measuring linear displacement. In this way, the longitudinally movable drive member, the firing member, the firing bar or the beam with a | profile, or combinations thereof, can be coupled to any suitable linear displacement sensor. Linear displacement sensors can include contact or non-contact displacement sensors. Linear displacement sensors can comprise Variable Differential Linear Transformers (LVDT), Variable Reluctance Differential Transducers (DVRT), a potentiometer, a magnetic detection system that comprises a moving magnet and a series linearly arranged in Sensors. Hall effect, a magnetic detection system comprising a fixed magnet and a series of mobile devices, linearly arranged in Hall Effect Sensors, a mobile optical detection system comprising a mobile light source and a series of photodiodes or linearly arranged photodetectors, an optical detection system comprising a fixed light source and a mobile series of linearly arranged photodiodes or photodetectors, or any combination thereof.
[00142] [00142] The electric motor 482 can include a rotary drive shaft, which interfaces operationally with a gear set, which is mounted on a coupling coupling with a set or rack of driving teeth on the drive member. A sensor element can be operationally coupled to a gear assembly so that a single revolution of the position sensor element 472 corresponds to some linear longitudinal translation of the displacement member. An array of gears and sensors can be connected to the linear actuator by means of a rack and pinion arrangement, or by a rotary actuator, by means of a gear wheel or other connection. A power source supplies power to the absolute positioning system and an output indicator can display the output from the absolute positioning system. The drive member represents the longitudinally movable drive member comprising a rack of drive teeth formed thereon for engagement with a corresponding drive gear of the gear reducer assembly. The displacement member represents the longitudinally movable shooting member, the firing bar, the beam with a | or combinations thereof.
[00143] [00143] A single revolution of the sensor element associated with the position sensor 472 is equivalent to a longitudinal linear displacement of di of the displacement member, where d1 represents the longitudinal linear distance by which the displacement member moves from the point " a "to point" b "after a single revolution of the sensor element coupled to the displacement member. The sensor arrangement can be connected by means of a gear reduction which results in the position sensor 472 completing one or more revolutions for the complete travel of the displacement member. The 472 position sensor can complete multiple revolutions for the full travel of the displacement member.
[00144] [00144] A series of keys, where n is an integer greater than one, can be used alone or in combination with a gear reduction to provide a single position signal for more than one revolution of the 472 position sensor. of the switches is transmitted back to microcontroller 461 which applies logic to determine an exclusive position signal corresponding to the longitudinal linear displacement of d1 + d2 + ... dn of the displacement member. The output of the position sensor 472 is supplied to the microcontroller 461. In several embodiments, the position sensor 472 of the sensor arrangement may comprise a magnetic sensor, an analog rotary sensor, such as a potentiometer, or a series of effect elements. Analog halls, which emit a unique combination of position of signs or values.
[00145] [00145] The position sensor 472 can comprise any number of magnetic detection elements, such as, for example, magnetic sensors classified according to whether they measure the total magnetic field or the vector components of the magnetic field. The techniques used to produce both types of magnetic sensors cover many aspects of physics and electronics. Technologies used for magnetic field detection include flow meter, saturated flow, optical pumping, nuclear precession, SQUID, Hall effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive / piesoelectric compounds, magnetodiode, magnetic transistor, optical fiber,
[00146] [00146] In one aspect, the position sensor 472 for the tracking system 480 which comprises an absolute positioning system comprises a magnetic rotating absolute positioning system. The 472 position sensor can be implemented as a rotary, magnetic, single-chip, ASSOSSEQFT position sensor, available from Austria Microsystems, AG. The position sensor 472 interfaces with the 461 microcontroller to provide an absolute positioning system. The 472 position sensor is a low voltage, low power component and includes four effect elements in an area of the 472 position sensor located above a magnet. A high-resolution ADC and an intelligent power management controller are also provided on the integrated circuit. A CORDIC (digital computer for coordinate rotation) processor, also known as the digit-by-digit method and Volder algorithm, is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only opera - addition, subtraction, bit shift and search table sections. The angle position, alarm bits and magnetic field information are transmitted via a standard serial communication interface, such as a serial peripheral interface (SPI), to the 461 microcontroller. The position sensor 472 provides 12 or 14 bits of resolution. The 472 position sensor can be an AS5055 chip supplied in a small 16 x 4 x 4 x 0.85 mm 16-pin QFN package.
[00147] [00147] The tracking system 480 comprising an absolute positioning system can comprise and / or be programmed to implement a feedback controller, such as a PID, state feedback, and adaptive controller.
[00148] [00148] The absolute positioning system provides an absolute positioning of the displaced member on the activation of the instrument without having to retract or advance the longitudinally movable drive member to the restart position (zero or initial ), as may be required by conventional rotary encoders that merely count the number of progressive or regressive steps that the 482 motor has traveled to infer the position of a device actuator, actuation bar, scalpel, and the like.
[00149] [00149] A 474 sensor, such as, for example, a strain gauge or a micro strain gauge, is configured to measure one or more parameters of the end actuator, such as, for example, the magnitude of the stress exerted on the anvil during a gripping operation, which can be indicative of tissue compression. The measured effort is converted into a digital signal and supplied to the 462 processor. Alternatively, or in addition to the 474 sensor, a 476 sensor, such as a load sensor, can measure the closing force applied by the closure system by the anvil. The 476 sensor, such as a load sensor, can measure the firing force applied to a beam with a | in a course of firing the instrument or surgical tool. The i-profile beam is configured to engage a wedge slider, which is configured to move the clamp drivers upward to force the clamps to deform in contact with an anvil. The i-profile beam includes a sharp cutting edge that can be used to separate fabric, as the i-profile beam is advanced distally by the firing bar. Alternatively, a 478 current sensor can be used to measure the current drained by the motor
[00150] [00150] In one form, a 474 strain gauge sensor can be used to measure the force applied to the tissue by the end actuator. A strain gauge can be attached to the end actuator to measure the force applied to the tissue being treated by the end actuator. A system for measuring forces applied to the tissue attached by the end actuator comprises a 474 strain gauge sensor, such as, for example, a microstrain gauge, which is configured to measure one or more parameters of the end actuator, for example. In one aspect, the 474 strain gauge sensor can measure the amplitude or magnitude of the strain exerted on a claw member of an end actuator during a gripping operation, which can be indicative of the compression of the fabric. The measured effort is converted into a digital signal and fed to the 462 processor of a 461 microcontroller. A 476 load sensor can measure the force used to operate the knife element, for example, to cut the tissue captured between the anvil and the cartridge of staples. A magnetic field sensor can be used to measure the thickness of the captured tissue. The measurement of the magnetic field sensor can also be converted into a digital signal and supplied to the 462 processor.
[00151] [00151] Measurements of tissue compression, tissue thickness and / or force required to close the end actuator on the tissue, as measured by sensors 474, 476, can be used by microcontroller 461 to specify the position selected trigger member and / or the corresponding trigger member speed value. In one case, a 468 memory can store a technique, an equation and / or a look-up table that can be used by the 461 microcontroller in the evaluation.
[00152] [00152] The control system 470 of the instrument or surgical tool can also comprise wired or wireless communication circuits for communication with the modular central communication controller shown in Figures 8 to 11.
[00153] [00153] Figure 13 illustrates a control circuit 500 configured to control aspects of the instrument or surgical tool according to an aspect of the present invention. The control circuit 500 can be configured to implement various processes in this document described. The control circuit 500 may comprise a microcontroller comprising one or more processors 502 (for example, microprocessor, microcontroller) coupled to at least one memory circuit 504. The memory circuit 504 stores instructions executable on a machine that, when executed by processor 502, they cause processor 502 to execute machine instructions to implement several of the processes described in this document. The 502 processor can be any one of a number of single-core or multi-core processors known in the art. The memory circuit 504 may comprise volatile and non-volatile storage media. The processor 502 may include an instruction processing unit 506 and an arithmetic unit
[00154] [00154] Figure 14 illustrates a combinational logic circuit 510 configured to control aspects of the instrument or surgical tool according to an aspect of the present invention. The combination logic circuit 510 can be configured to implement the various processes described in this document. The combinational logic circuit 510 can comprise a finite state machine comprising a combinational logic 512 configured to receive data associated with the surgical instrument or tool at an input 514, process the data by combinational logic 512 and provide an output 516.
[00155] [00155] Figure 15 illustrates a sequential logic circuit 520 configured to control aspects of the surgical instrument or tool according to an aspect of the present invention. Sequential logic circuit 520 or combinational logic 522 can be configured to implement the process in this described document. Sequential logic circuit 520 may comprise a finite state machine. Sequential logic circuit 520 may comprise combinational logic 522, at least one memory circuit 524, a clock 529 and, for example. The at least one memory circuit 524 can store a current state of the finite state machine. In certain cases, the sequential logic circuit 520 may be synchronous or asynchronous. Combined logic
[00156] [00156] Figure 16 illustrates an instrument or surgical tool that comprises a plurality of motors that can be activated to perform various functions. In certain cases, a first engine can be activated to perform a first function, a second engine can be activated to perform a second function, a third engine can be activated to perform a third function, a fourth engine can be activated to perform a fourth function, and so on. In certain cases, the plurality of motors of the robotic surgical instrument 600 can be individually activated to cause firing, closing, and / or articulation movements on the end actuator. The triggering, closing and / or articulation movements can be transmitted to the end actuator via a drive shaft assembly, for example.
[00157] [00157] In certain cases, the instrument or surgical tool system may include a 602 firing motor. The 602 firing motor can be operationally coupled to a 604 firing motor drive assembly, which can be configured to transmit motion. - triggering elements, generated by the motor 602, to the end actuator, particularly to move the beam element with profile in | In certain cases, the firing movements generated by the 602 motor can cause the staples to be triggered from the staple cartridge in the fabric captured by the end actuator and / or by the cutting edge of the beam element with profile in | to be advanced in order to cut the captured tissue, for example. The beam element with profile in | can be retracted by reversing the direction of motor 602.
[00158] [00158] In certain cases, the surgical instrument or tool may include a closing motor 603. The closing motor 603 can be operationally coupled to a drive assembly of the closing motor 605 that can be configured to transmit closing movements , generated by the 603 motor to the end actuator, particularly to move a closing tube to close the anvil and compress the fabric between the anvil and the staple cartridge. Closing movements can cause the end actuator to transition from an open configuration to an approximate configuration to capture the tissue, for example. The end actuator can be moved to an open position by reversing the direction of the 603 motor.
[00159] [00159] In certain cases, the surgical instrument or tool may include one or more articulation motors 606a, 606b, for example. The motors 606a, 606b can be operationally coupled to the drive assemblies of the articulation motor 608a, 608b, which can be configured to transmit articulation movements generated by the motors 606a, 606b to the end actuator. In certain cases,
[00160] [00160] As described above, the surgical instrument or tool can include a plurality of motors that can be configured to perform various independent functions. In certain cases, the plurality of motors of the instrument or surgical tool can be activated individually or separately to perform one or more functions, while other motors remain inactive. For example, the articulation motors 606a, 606b can be activated to cause the end actuator to be articulated, while the firing motor 602 remains inactive. Alternatively, the firing motor 602 can be activated to fire the plurality of clamps, and / or advance the cutting edge, while the articulation motor 606 remains inactive. In addition, the closing motor 603 can be activated simultaneously with the firing motor 602 to make the closing tube or the beam element with profile in | proceed distally, as described in more detail later in this document.
[00161] [00161] In certain cases, the surgical instrument or tool may include a common control module 610 that can be used with a plurality of the instrument's instruments or surgical tool. In some cases, the common control module 610 can accommodate one of the plurality of motors at a time. For example, the common control module 610 can be coupled to and separable from the plurality of motors of the robotic surgical instrument individually. In certain cases, a plurality of surgical instrument or tool motors may share one or more common control modules, such as the common control module 610. In certain cases, a plurality of surgical instrument or tool motors may be individually and selectively coupled to the common control module 610. In certain cases, the common control module 610 can be selectively switched between interfacing with one of a plurality of instrument motors or surgical tool to interface with another among the plurality of instrument motors or surgical tool.
[00162] [00162] Just one example, the common control module 610 can be selectively switched between the operating coupling with the 606a, 606b articulation motors, and the operating coupling with the 602 firing motor or the 603 closing motor. At least an example, as illustrated in Figure 16, a key 614 can be moved or transitioned between a plurality of positions and / or states. In the first position 616, the switch 614 can electrically couple the common control module 610 to the trip motor 602; in a second position 617, switch 614 can electrically couple control module 610 to closing motor 603; in a third position 618a, the switch 614 can electrically couple the common control module 610 to the first articulation motor 606a; and in a fourth position 618b, the switch 614 can electrically couple the common control module 610 to the second articulation motor 606b, for example. In certain cases, separate common control modules 610 can be electrically coupled to the firing motor 602, closing motor 603, and hinge motors 606a, 606b at the same time. In certain cases, key 614 can be a mechanical key, an electro-mechanical key, a solid-state key or any suitable switching mechanism.
[00163] [00163] Each of the 602, 603, 606a, 606b motors can comprise a torque sensor to measure the output torque on the motor drive shaft. The force on an end actuator can be detected in any conventional manner, such as by means of force sensors on the outer sides of the jaws or by a motor torque sensor that drives the jaws.
[00164] [00164] In several cases, as illustrated in Figure 16, the common control module 610 may comprise a motor starter 626 that may comprise one or more H-Bridge FETs. The motor driver 626 can modulate the energy transmitted from a power source 628 to a motor coupled to the common control module 610, based on an input from a microcontroller 620 (the "controller"), for example . In certain cases, the microcontroller 620 can be used to determine the current drawn by the motor, for example, while the motor is coupled to the common control module 610, as described above.
[00165] [00165] In certain examples, the microcontroller 620 may include a microprocessor 622 (the "processor") and one or more non-transitory computer-readable media or 624 memory units (the "memory"). In certain cases, memory 624 can store various program instructions which, when executed, can cause processor 622 to perform a plurality of functions and / or calculations described in this document. In certain cases, one or more of the memory units 624 can be coupled to the processor 622, for example.
[00166] [00166] In certain cases, the power source 628 can be used to supply power to the microcontroller 620, for example. In certain cases, the power source 628 may comprise a battery (or "battery pack" or "power source"), such as a Li ion battery, for example. In certain cases, the battery pack can be configured to be releasably mounted to the handle to supply power to the surgical instrument 600. Several battery cells connected in series can be used as the 628 power source. the power source 628 can be replaceable and / or rechargeable, for example.
[00167] [00167] In several cases, the 622 processor can control the motor driver 626 to control the position, direction of rotation and / or speed of a motor that is coupled to the common control module 610. In certain cases, the processor 622 can signal the motor starter 626 to stop and / or disable a motor that is coupled to the common control module 610. It should be understood that the term "processor", as used in this document, includes any either microprocessor, microcontroller or other suitable basic computing device that incorporates the functions of a central computer processing unit (CPU) in an integrated circuit or, at most, some integrated circuits. The processor is a programmable multipurpose device that accepts digital data as input, processes it according to instructions stored in its memory, and provides results as output. This is an example of sequential digital logic, as it has internal memory. Processors operate on numbers and symbols represented in the binary numeral system.
[00168] [00168] In one example, the 622 processor can be any single-core or multi-core processor, such as those known by the Texas Instruments ARM Cortex trade name. In certain cases, the 620 microcontroller may be an LM 4F230H5QR, available from Texas Instruments, for example. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core that comprises a 256 KB single cycle flash integrated memory, or another non-volatile memory, up to 40 MHz, a temporary storage of early search to optimize performance above 40 MHz, a 32 KB single cycle SRAM, an internal ROM loaded with StellarisWare & O software, 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, one or plus 12-bit ADCs with 12 analog input channels, among other features that are readily available for the product data sheet. Other microcontrollers can be readily replaced for use with the 4410 module. Consequently, the present invention should not be limited in this context.
[00169] [00169] In certain cases, memory 624 may include program instructions for controlling each of the motors of the surgical instrument 600 that are attachable to the common control module 610. For example, memory 624 may include program instructions for controlling the firing motor 602, the closing motor 603 and the hinge motors 606a, 606b. Such program instructions can cause the 622 processor to control the trigger, close, and link functions according to inputs from the instrument or surgical tool control algorithms or programs.
[00170] [00170] In certain cases, one or more mechanisms and / or sensors, such as 630 sensors, can be used to alert the 622 processor about the program instructions that should be used in a specific configuration. For example, sensors 630 can alert the 622 processor to use the program instructions associated with triggering, closing and pivoting the end actuator. In certain cases, sensors 630 may comprise position sensors that can be used to detect the position of switch 614, for example. Consequently, the 622 processor can use the program instructions associated with firing the beam with | the end actuator by detecting, through sensors 630, for example, that key 614 is in the first position 616; the processor 622 can use the program instructions associated with closing the anvil upon detection through sensors 630, for example, that switch 614 is in second position 617; and the processor 622 can use the program instructions associated with the articulation of the end actuator upon detection through sensors 630, for example, that switch 614 is in the third or fourth position 618a, 618b.
[00171] [00171] Figure 17 is a schematic diagram of a robotic surgical instrument 700 configured to operate a surgical tool described in this document, in accordance with an aspect of this invention. The robotic surgical instrument 700 can be programmed or configured to control the distal / proximal translation of a displacement limb, the distal / proximal displacement of a closing tube,
[00172] [00172] In one aspect, the robotic surgical instrument 700 comprises a control circuit 710 configured to control a burner 716 and a beam portion with profile in | 714 (including a sharp cutting edge) of an end actuator 702, a removable clamp cartridge 718, a drive shaft 740 and one or more hinge members 742a, 742b through a plurality of engines 704a to 704e. A 734 position sensor can be configured to provide position feedback on the beam with profile | 714 to control circuit 710. Other sensors 738 can be configured to provide feedback to control circuit 710. A timer / counter 731 provides timing and counting information to control circuit 710. A power source 712 can be supplied to operate the 704a to 704e motors and a current sensor 736 provides motor current feedback to the control circuit
[00173] [00173] In one aspect, the control circuit 710 may comprise one or more microcontrollers, microprocessors or other processors suitable for executing instructions that cause the processor or processors to perform one or more tasks. In one aspect, a timer / counter 731 provides an output signal, such as elapsed time or a digital count, to control circuit 710 to correlate the position of the beam with | 714, as determined by the position sensor 734, with the output of the timer / counter 731 so that the control circuit 710 can determine the position of the beam with profile in | 714 at a specific time (t) in relation to an initial position or time (t) when the beam with profile in | 714 is in a specific position in relation to an initial position. The timer / counter 731 can be configured to measure elapsed time, count external events, or to delay external events.
[00174] [00174] In one aspect, control circuit 710 can be programmed to control functions of end actuator 702 based on one or more tissue conditions. The control circuit 710 can be programmed to directly or indirectly detect tissue conditions, such as thickness, as described in this document. Control loop 710 can be programmed to select a trigger control program or closure control program based on tissue conditions. A trigger control program can describe the distal movement of the displacement member. Different trigger control programs can be selected to better treat different tissue conditions. For example, when a thicker tissue is present, the control circuit 710 can be programmed to translate the displacement member to a lower speed and / or with a lower power. When a thinner fabric is present, the control circuit 710 can be programmed to move the displacement member at a higher speed and / or with greater power. A closing control program can control the closing force applied to the tissue by the anvil 716. Other control programs control the rotation of the drive shaft 740 and the hinge members 742a, 742b.
[00175] [00175] In one aspect, the 710 control circuit can generate motor setpoint signals. Motor setpoint signals can be provided for various motor controllers 708a through 708e. Motor controllers 708a to 708e can comprise one or more circuits configured to provide motor drive signals for motors 704a to 704e in order to drive motors 704a to 704e, as described in this document. In some instances, motors 704a to 704e may be brushed DC (direct current) electric motors. For example, the speed of motors 704a to 704e can be proportional to the respective motor start signals. In some examples, motors 704a to 704e may be brushless DC electric motors, and the respective motor drive signals may comprise a PWM signal provided for one or more stator bearings for motors 704a to 704e. In addition, in some instances, motor controllers 708a to 708e can be omitted and control circuit 710 can directly generate motor drive signals.
[00176] [00176] In one aspect, the control circuit 710 can initially operate each of the motors 704a to 704e in an open circuit configuration for a first open circuit portion of a travel of the displacement member. Based on the response of the robotic surgical instrument 700 during the open circuit portion of the stroke, control circuit 710 can select a trigger control program in a closed circuit configuration. The instrument response may include a translation of the distance of the displacement member during the open circuit portion, a time elapsed during the open circuit portion, the energy supplied to one of the motors 704a to 704e during the open circuit portion, a sum of pulse widths of a motor start signal, etc. After the open circuit portion, control circuit 710 can implement the selected trip control program for a second portion of the travel member travel. For example, during a portion of the closed circuit course, control circuit 710 can modulate one of the motors 704a to 704e based on the translation of the data describing a position of the displacement member in closed circuit to translate the displacement member at a constant speed.
[00177] [00177] In one aspect, motors 704a to 704e can receive power from a 712 power source. Power source 712 can be a DC power source powered by an alternating main power source, a battery, a super capacitor, or any other suitable power source. Motors 704a to 704e can be mechanically coupled to individual mobile mechanical elements such as the beam with profile in | 714, the anvil 716, the drive shaft 740, the hinge 742a and the hinge 742b, through the respective transmissions 706a to 706e. Transmissions 706a through 706e may include one or more gears or other connecting components for coupling motors 704a to 704e to moving mechanical elements. A position sensor 734 can detect a position of the beam with a profile in 1714. The position sensor 734 can be or can include any type of sensor that is capable of generating position data that indicate a position of the beam with a profile in | 714. In some examples, the position sensor 734 may include an encoder configured to supply a series of pulses to the control circuit 710 such as the beam with 1714 profile translated distally and proximally. The control circuit 710 can track the pulses to determine the position of the beam with profile in | 714. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals that indicate the movement of the beam with 1 714 profile. In addition, in some examples, the position sensor 734 can be omitted. When any of the 704a to 704e motors is a stepper motor, the control circuit 710 can track the beam position with | 714 aggregating the number and direction of the steps that the 704 engine was instructed to perform. The position sensor 734 can be located on the end actuator 702 or any other portion of the instrument. The outputs of each of the motors 704a to 704e include a torque sensor 744a to 744e to detect force and have an encoder to detect the rotation of the drive shaft.
[00178] [00178] In one aspect, the control circuit 710 is configured to drive a firing member as the beam portion with profile in | 714 of end actuator 702. Control circuit 710 provides a motor setpoint for motor control 708a, which provides a drive signal for motor 704a.
[00179] [00179] In one aspect, control circuit 710 is configured to drive a closing member, such as anvil portion 716 of end actuator 702. Control circuit 710 provides a motor setpoint for 708b motor control , which provides a drive signal for the 704b engine. The output shaft of the motor 704b is coupled to a torque sensor 744b. The torque sensor 744b is coupled to a transmission 706b which is coupled to the anvil 716. The transmission 706b comprises moving mechanical elements, such as rotating elements and a closing member, to control the movement of the anvil 716 between the open and closed positions. . In one aspect, the 704b motor is coupled to a closing gear assembly, which includes a closing reduction gear assembly that is supported in gear engaged with the closing sprocket. The 744b torque sensor provides a closing force feedback signal to the control circuit
[00180] [00180] In one aspect, control circuit 710 is configured to rotate a drive shaft member, such as drive shaft 740, to rotate end actuator 702. Control circuit 710 provides a motor setpoint for a motor control 708c, which provides a drive signal for motor 704c. The output shaft of the motor 704c is coupled to a torque sensor 744c. The torque sensor 744c is coupled to a transmission 706c which is coupled to the axis 740. The transmission 706c comprises moving mechanical elements, such as rotary elements, to control the rotation of the drive shaft 740 clockwise or counterclockwise up and over 360º. In one aspect, the 704c motor is coupled to the rotary drive assembly, which includes a pipe gear segment that is formed over (or attached to) the proximal end of the proximal closing tube for engagement operable by a gear assembly rotational that is operationally supported on the tool mounting plate. The torque sensor 744c provides a rotation force feedback signal for control circuit 710. The rotation force feedback signal represents the rotation force applied to the drive shaft 740. The position sensor 734 can be configured to provide the position of the closing member as a feedback signal to control circuit 710. Additional sensors 738, such as a drive shaft encoder,
[00181] [00181] In one aspect, control circuit 710 is configured to pivot end actuator 702. Control circuit 710 provides a motor setpoint for a 708d motor control, which provides a trigger signal for the 704d engine. The output shaft of the motor 704d is coupled to a torque sensor 744d. The torque sensor 744d is coupled to a transmission 706d which is coupled to a pivot member 742a. The 706d transmission comprises moving mechanical elements, such as articulation elements, to control the articulation of the 702 + 65º end actuator. In one aspect, the 704d motor is coupled to a pivot nut, which is rotatably seated on the proximal end portion of the distal column portion and is pivotally driven thereon by a pivot gear assembly. The torque sensor 744d provides a hinge force feedback signal to control circuit 710. The hinge force feedback signal represents the hinge force applied to the end actuator 702. The 738 sensors, as an articulation encoder, can supply the articulation position of end actuator 702 to control circuit 710.
[00182] [00182] In another aspect, the articulation function of the robotic surgical system 700 may comprise two articulation members, or connections, 742a, 742b. These hinge members 742a, 742b are driven by separate disks at the robot interface (the rack), which are driven by the two motors 708d, 708e. When the separate firing motor 704a is provided, each hinge connection 742a,
[00183] [00183] In one aspect, the one or more motors 704a to 704e may comprise a brushed DC motor with a gearbox and mechanical connections to a firing member, closing member or articulation member. Another example includes electric motors 704a to 704e that operate the moving mechanical elements such as the displacement member, the articulation connections, the closing tube and the drive shaft. An external influence is a negligible and unpredictable influence on things like tissue, surrounding bodies, and friction in the physical system. This external influence can be called drag, which acts in opposition to one of the electric motors 704a to 704e. External influence, such as drag, can cause the functioning of the physical system to deviate from a desired operation of the physical system.
[00184] [00184] In one aspect, the position sensor 734 can be implemented as an absolute positioning system. In one aspect, the position sensor 734 can comprise an absolute rotary magnetic positioning system implemented as a single chip rotary magnetic position sensor, ASSOSSEQFT, available from Austria Microsystems, AG. The position sensor 734 can interface with the control circuit 710 to provide an absolute positioning system. The position can include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit by digit method and Volder algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic functions and trigonometry that require only addition, subtraction, bit shift and lookup table operations.
[00185] [00185] In one aspect, the control circuit 710 can be in communication with one or more sensors 738. The sensors 738 can be positioned on the end actuator 702 and adapted to work with the robotic surgical instrument 700 to measure the several derived parameters such as span distance in relation to time, tissue compression in relation to time, and anvil deformation in relation to time. The 738 sensors can comprise a magnetic sensor, a magnetic field sensor, a stress meter, a load cell, a pressure sensor, a force sensor, a torque sensor, an inductive sensor such as a current sensor rasita, a resistive sensor, a capacitive sensor, an optical sensor and / or any other sensor suitable for measuring one or more parameters of the end actuator 702. The 738 sensors may include one or more sensors. The sensors 738 can be located on the platform of the staple cartridge 718 to determine the location of the tissue using segmented electrodes. The torque sensors 744a to 744e can be configured to detect force such as firing force, closing force, and / or articulation force, among others. Consequent-
[001868] [001868] In one aspect, one or more 738 sensors may comprise an effort meter, such as a microstrain meter, configured to measure the magnitude of the stress on the anvil 716 during a grip condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. Sensors 738 can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 716 and the staple cartridge 718. Sensors 738 can be configured to detect the impedance of a section of tissue located between the anvil 716 and the staple cartridge 718 which is indicative of the thickness and / or completeness of the fabric located between them.
[00187] [00187] In one aspect, the 738 sensors can be implemented as one or more limit switches, electromechanical devices, solid state switches, Hall effect devices, magneto-resistive devices (MR) giant magneto-resistive devices (GMR) , magnetometers, among others. In other implementations, the 738 sensors can be implemented as solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid-state devices such as transistors (for example,
[00188] [00188] In one aspect, sensors 738 can be configured to measure the forces exerted on the anvil 716 by the closing drive system. For example, one or more sensors 738 may be at a point of interaction between the closing tube and the anvil 716 to detect the closing forces applied by the closing tube to the anvil 716. The forces exerted on the anvil 716 may be representative of the tissue compression experienced by the tissue section captured between the anvil 716 and the staple cartridge 718. The one or more sensors 738 can be positioned at various points of interaction throughout the closing drive system to detect closing forces applied to the anvil 716 by the closing drive system. The one or more sensors 738 can be sampled in real time during a gripping operation by the processor of the control circuit 710. The control circuit 710 receives sample measurements in real time to provide and analyze information based on time and evaluate, in real time, the closing forces applied to the anvil 716.
[00189] [00189] In one aspect, a current sensor 736 can be used to measure the current drained by each of the 704a to 704e motors. The force required to advance any of the moving mechanical elements such as the beam with a profile | 714 corresponds to the current drained by one of the motors 704a to 704e. The force is converted into a digital signal and supplied to the control circuit 710. The control circuit 710 can be configured to simulate the response of the instrument's actual system in the controller software. A displacement member can be actuated to move a beam with a profile | 714 on end actuator 702 at or near a target speed. The robotic surgical instrument 700 may include a feedback controller, which may be one or any of the feedback controllers, including, but not limited to, a PID controller, state feedback, linear quadratic (LQR) and / or a adaptive controller, for example. The robotic surgical instrument 700 can include a power source to convert the signal from the feedback controller to a physical input such as case voltage, PWM voltage, frequency-modulated voltage, current, torque and / or force, for example. Additional details are described in US patent application serial number 15 / 636,829, entitled CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT, filed on June 29, 2017, which is incorporated herein by reference in its entirety for reference. .
[00190] [00190] Figure 18 illustrates a block diagram of a surgical instrument 750 programmed to control the distal translation of a displacement member in accordance with an aspect of the present invention. In one aspect, the 750 surgical instrument is programmed to control the distal translation of a displacement member, such as the beam with a | 764. The surgical instrument 750 comprises an end actuator 752 which can comprise an anvil 766, a beam with a profile | 764 (including a sharp cutting edge) and a removable staple cartridge 768.
[00191] [00191] The position, movement, displacement and / or translation of a linear displacement member, such as the beam with 1 764 profile, can be measured by an absolute positioning system, a sensor arrangement and a sensor of position 784. Since the beam with profile in | 764 is coupled to a longitudinally movable drive member, the beam position with | 764 can be determined by measuring the position of the longitudinally movable drive member using the 784 position sensor. Consequently, in the following description, the position, displacement and / or translation of the beam with profile in | 764 can be obtained by the position sensor 784, as described in the present invention.
[00192] [00192] Control circuit 760 can generate a setpoint signal for motor 772. The setpoint signal for motor 772 can be supplied to a motor controller 758. Motor controller 758 can comprise one or more circuits configured to provide a motor 774 drive signal to motor 754 to drive motor 754, as described in the present invention. In some instances, the 754 motor may be a DC motor with a brushed DC electric motor. For example, the speed of motor 754 may be proportional to the drive signal of motor 774. In some instances, motor 754 may be a brushless DC electric motor and the drive signal of motor 774 may comprise a signal PWM provided for one or more stator windings of motor 754. In addition, in some instances, motor controller 758 can be omitted, and control circuit 760 can generate motor drive signal 774 directly.
[00193] [00193] The 754 motor can receive power from an energy source
[00194] [00194] The control circuit 760 can be in communication with one or more sensors 788. The sensors 788 can be positioned on the end actuator 752 and adapted to work with the surgical instrument 750 to measure the various derived parameters, such as distance span in relation to time, compression of the tissue in relation to time and anvil tension in relation to time. The 788 sensors can comprise a magnetic sensor, a magnetic field sensor, a stress meter, a pressure sensor, a force sensor, an inductive sensor such as a eddy current sensor, a resistive sensor, a capacitive sensor, a sensor optical and / or any other sensor suitable for measuring one or more parameters of the 752 end actuator. The 788 sensors may include one or more sensors.
[00195] [00195] Oum or more sensors 788 can comprise a stress meter, such as a microstrain meter, configured to measure the magnitude of the stress on the anvil 766 during a grip condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The 788 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The 788 sensors can be configured to detect the impedance of a section of fabric located between the anvil 766 and the staple cartridge 768 which is indicative of the thickness and / or completeness of the fabric located between them.
[00196] [00196] The 788 sensors can be configured to measure the forces exerted on the anvil 766 by a closing drive system. For example, one or more sensors 788 can be at a point of interaction between a closing tube and anvil 766 to detect the closing forces applied by a closing tube to anvil 766. The forces exerted on anvil 766 can be representative of the tissue compression experienced by the tissue section captured between the anvil 766 and the staple cartridge 768. The one or more sensors 788 can be positioned at various points of interaction throughout the closing drive system to detect the forces of closure applied to the anvil 766 by the closing drive system. The one or more 788 sensors can be sampled in real time during a gripping operation by a processor from the 760 control circuit. The 760 control circuit receives sample measurements in real time to provide and analyze time-based information and evaluate, in real time, the closing forces applied to the anvil 766.
[00197] [00197] A current sensor 786 can be used to measure the current drained by the 754 motor. The force necessary to advance the beam with profile in | 764 corresponds to the current drained by the motor
[00198] [00198] The control circuit 760 can be configured to simulate the actual system response of the instrument in the controller software. A displacement member can be actuated to move a beam with a profile | 764 on end actuator 752 at or near a target speed. The surgical instrument 750 may include a feedback controller, which may be one or any of the feedback controllers, including, but not limited to, a PID controller, status feedback, LOR, and / or a adaptable controller, for example. The surgical instrument 750 can include a power source to convert the signal from the feedback controller to a physical input such as case voltage, PWM voltage, frequency-modulated voltage, current, torque and / or force, for example.
[00199] [00199] The actual drive system of the surgical instrument 750 is configured to drive the displacement member, the cutting member or the beam with profile in | 764, by a brushed DC motor with gearbox and mechanical connections to a joint and / or knife system. Another example is the 754 electric motor that operates the displacement member and the articulation drive, for example, from an interchangeable drive shaft assembly. An external influence is an excessive and unpredictable influence on things like tissue, surrounding bodies, and friction in the physical system. This external influence can be called drag, which acts in opposition to the 754 electric motor. External influence, like drag, can cause the functioning of the physical system to deviate from a desired operation of the physical system.
[00200] [00200] Several exemplifying aspects are directed to a surgical instrument 750 that comprises an end actuator 752 with surgical implements of stapling and cutting driven by motor. For example, a 754 motor can drive a displacement member distally and proximally along a longitudinal axis of the end actuator 752. End actuator 752 may comprise a pivoting anvil 766 and, when configured for use , a staple cartridge 768 positioned on the opposite side of the anvil 766. A doctor can hold the tissue between the anvil 766 and the staple cartridge 768, as described in the present invention. When ready to use the 750 instrument, the physician can provide a trigger signal, for example, by pressing a trigger on the instrument
[00201] [00201] In several examples, the surgical instrument 750 can comprise a control circuit 760 programmed to control the distal translation of the displacement member, such as the beam with profile in | 764, for example, based on one or more tissue conditions. The control circuit 760 can be programmed to directly or indirectly detect tissue conditions, such as thickness, as described in this document. Control circuit 760 can be programmed to select a trigger control program based on tissue conditions. A trigger control program can describe the distal movement of the displacement member. Different trigger control programs can be selected to better treat different tissue conditions. For example, when a thicker tissue is present, control circuit 760 can be programmed to translate the displacement member at a lower speed and / or with a lower power. When a thinner tissue is present, the control circuit 760 can be programmed to move the displacement member at a higher speed and / or with greater power.
[00202] [00202] In some examples, the control circuit 760 may initially operate the motor 754 in an open circuit configuration for a first open circuit portion of a travel of the travel member. Based on a response from instrument 750 during the open circuit portion of the course, control circuit 760 can select a trip control program. The response of the instrument may include a travel distance of the displacement member during the open circuit portion, a time elapsed during the open circuit portion, the energy supplied to the motor 754 during the open circuit portion, a sum pulse widths of a motor start signal, etc. After the open circuit portion, control circuit 760 can implement the selected trigger control program for a second portion of the travel member travel. For example, during the closed loop portion of the stroke, control circuit 760 can modulate motor 754 based on the translation data that describes a position of the displacement member in a closed circuit manner to translate the member displacement at a constant speed. Additional details are described in US Patent Application Serial No. 15 / 720,852, entitled
[00203] [00203] Figure 19 is a schematic diagram of a 790 surgical instrument configured to control various functions in accordance with an aspect of the present invention. In one aspect, the surgical instrument 790 is programmed to control the distal translation of a displacement member, such as the beam with a | 764. The surgical instrument 790 comprises an end actuator 792 that can comprise an anvil 766, a beam with a profile in | 764 and a removable staple cartridge 768 that can be interchanged with an RF 796 cartridge (shown in dashed line).
[00204] [00204] In one aspect, the 788 sensors can be implemented as a limit switch, electromechanical device, solid state switches, Hall effect devices, MRI devices, GMR devices, magnetometers, among others. In other implementations, 638 sensors can be solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, MOSFET, bipolar, and the like). In other implementations, 788 sensors can include driverless electric switches, ultrasonic switches, accelerometers, inertia sensors and, among others.
[00205] [00205] In one aspect, the position sensor 784 can be implemented as an absolute positioning system, which comprises a rotating magnetic absolute positioning system implemented as a single-chip rotating magnetic position sensor, ASSOSSEQFT, available from Austria Microsystems, AG. The position sensor 784 can interface with the control circuit 760 to provide an absolute positioning system. The position can include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit by digit method and Volder algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions which only require addition, subtraction, bit shift and lookup table operations.
[00206] [00206] In one aspect, the beam with profile in | 764 can be implemented as the knife member comprising a knife body which operationally supports a tissue cutting blade therein and may additionally include flaps or anvil engaging features and channel engaging features or a base. In one aspect, the staple cartridge 768 can be implemented as a standard surgical (mechanical) fastener cartridge. In one aspect, the RF cartridge 796 can be implemented as an RF cartridge. These and other sensor provisions are described in Common Patent Application US Serial No. 15 / 628,175, entitled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STA- PLING AND CUTTING INSTRUMENT, filed on 20, 2017, which this document is incorporated by reference in its entirety for reference.
[00207] [00207] The position, movement, displacement and / or translation of a linear displacement member, such as the beam with profile in | 764, can be measured by an absolute positioning system, array of sensor and position sensor represented as the position sensor 784. Since the beam with profile in | 764 is coupled to the longitudinally movable drive member, the position of the beam with profile in | 764 can be determined by measuring the position of the longitudinally movable drive member that employs the position sensor 784. Consequently, in the description below, the position, displacement and / or translation of the beam with | 764 can be obtained by the position sensor 784, as described in the present invention. A control circuit 760 can be programmed to control the translation of the displacement member, such as the beam with | 764, as described in this document. The control circuit 760, in some examples, may comprise one or more microcontrollers, microprocessors or other suitable processors to execute the instructions that cause the processor or processors to control the displacement member, for example, the beam with profile on | 764, as described. In one aspect, a timer / counter 781 provides an output signal, such as elapsed time or a digital count, to control circuit 760 to correlate the position of the beam with | 764 as determined by position sensor 784 with timer / counter output 781 so that control circuit 760 can determine the position of the beam with profile in | 764 at a specific time (t) in relation to an initial position. The 781 timer / counter can be configured to measure elapsed time, count external events, or measure timeless events.
[00208] [00208] Control circuit 760 can generate a setpoint signal for motor 772. The setpoint signal for motor 772 can be supplied to a motor controller 758. Motor controller 758 can comprise one or more circuits configured to provide a motor 774 drive signal to motor 754 to drive motor 754, as described in the present invention. In some instances, the 754 motor may be a DC motor with a brushed DC electric motor. For example, the speed of motor 754 may be proportional to the drive signal of motor 774. In some instances, motor 754 may be a brushless DC electric motor and the drive signal of motor 774 may comprise a signal PWM provided for one or more stator windings of motor 754. In addition, in some instances, motor controller 758 can be omitted, and control circuit 760 can generate motor drive signal 774 directly.
[00209] [00209] The 754 motor can receive power from a power source
[00210] [00210] The control circuit 760 can be in communication with one or more sensors 788. The sensors 788 can be positioned on the end actuator 792 and adapted to work with the surgical instrument 790 to measure the various derived parameters, such as distance span in relation to time, compression of the tissue in relation to time and anvil tension in relation to time. The 788 sensors may comprise a magnetic sensor, a magnetic field sensor, a stress meter, a pressure sensor, a force sensor, an inductive sensor such as a eddy current sensor,
[00211] [00211] Oum or more sensors 788 can comprise a stress meter, such as a microstrain meter, configured to measure the magnitude of the stress on the anvil 766 during a grip condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The 788 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The 788 sensors can be configured to detect the impedance of a section of fabric located between the anvil 766 and the staple cartridge 768 which is indicative of the thickness and / or completeness of the fabric located between them.
[00212] [00212] The 788 sensors can be configured to measure the forces exerted on the anvil 766 by the closing drive system. For example, one or more sensors 788 may be at a point of interaction between a closing tube and anvil 766 to detect the closing forces applied by a closing tube to anvil 766. The forces exerted on anvil 766 can be re - presents of the tissue compression experienced by the tissue section captured between the anvil 766 and the staple cartridge 768. The one or more sensors 788 can be positioned at various points of interaction along the closing drive system to detect the closing forces applied to the anvil 766 by the closing drive system. The one or more sensors 788 can be sampled in real time during a gripping operation by a processor portion of the control circuit 760. The control circuit 760 receives sample measurements in real time to provide and analyze information based on time and evaluate , in real time, the closing forces applied to the clamping arm 766.
[00213] [00213] “A current sensor 786 can be used to measure the current drained by the 754 motor. The force necessary to advance the beam with profile in | 764 corresponds to the current drained by the motor
[00214] [00214] Is an RF 794 power source attached to the 792 end actuator and is applied to the RF cartridge 796 when the RF cartridge 796 is loaded on the end actuator 792 in place of the clamp cartridge 768. The control circuit 760 controls the delivery of RF energy to the RF cartridge 796.
[00215] [00215] Additional details are described in US patent application serial number 15 / 636,096, entitled SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, filed on June 28, 2017, which is contained in this document incorporated as a reference in its entirety. Generator hardware
[00216] [00216] Figure 20 is a simplified block diagram of a generator 800 configured to provide adjustment without inductor, among other benefits. Additional details of generator 800 are described in US patent No. 9,060,775, entitled SURGICAL GENERATOR FOR ULTRASO- NIC AND ELECTROSURGICAL DEVICES, granted on June 23,
[00217] [00217] In certain forms, ultrasonic and electrosurgical trigger signals can be provided simultaneously to different surgical instruments and / or to a single surgical instrument, such as the multifunctional surgical instrument, with the ability to supply both ultrasonic and electrosurgical energy for the fabric. It will be
[00218] [00218] The non-isolated stage 804 may comprise a power amplifier 812 having an output connected to a primary winding 814 of the power transformer 806. In certain forms, the power amplifier 812 may comprise a push-type amplifier and to pull. For example, the non-isolated stage 804 can further comprise a logic device 816 to provide a digital output to a digital-to-analog converter (DAC) circuit 818 which, in turn, provides an analog signal corresponding to an input from the power amplifier 812. In certain ways,
[00219] [00219] Power can be supplied to a power rail of the power amplifier 812 by a key mode regulator 820, for example, a power converter. In certain forms, the key mode regulator 820 may comprise an adjustable buck regulator, for example. The non-isolated stage 804 may further comprise a first processor 822 which, in one form, may comprise a PSD processor, such as a PSD of analog devices ADSP-21469 SHARC, available from Analog Devices, Norwood, MA, for example, although in various forms, any suitable processor can be used. In certain ways, the PSD 822 processor can control the operation of the key mode regulator 820 responsive to voltage feedback data received from the power amplifier 812 by the PSD 822 processor via an ADC circuit ("analog-to- digital converter "- analog to digital converter)
[00220] [00220] In certain forms, the logic device 816, in conjunction with the PSD 822 processor, can implement a digital synthesis circuit as a direct digital synthesizer control scheme to control the waveform, frequency and / or the amplitude of the drive signals emitted by the generator 800. In one way, for example, the logical device 816 can implement a DDS control algorithm ("direct digital synthesizer") by means of recovery of waveform samples stored in a look-up table (LUT) dynamically updated, such as a RAM LUT that can be integrated into an FPGA. This control algorithm is particularly useful for ultrasonic applications in which an ultrasonic transducer, such as an ultrasonic transducer, can be driven by a clean sinusoidal current at its resonant frequency.
[00221] [00221] The non-isolated stage 804 can also comprise a first ADC circuit 826 and a second ADC circuit 828 coupled to the output of the power transformer 806 by means of respective isolation transformers, 830 and 832, to sample respectively, the voltage and current of the trigger signals emitted by the generator 800. In certain ways, the ADC 826 and 828 circuits can be configured for sampling at high speeds (for example, 80 mega-samples per second (MSPS "mega" sample per second ")) to allow over-sampling of the trigger signals.
[00222] [00222] In some ways, voltage and current feedback data can be used to control the frequency and / or amplitude (for example, current amplitude) of the drive signals. In one way, for example, feedback data about voltage and current can be used to determine the impedance phase. The frequency of the trigger signal can then be controlled to minimize or reduce the difference between the determined impedance phase and an impedance phase setpoint (eg 0º), thereby minimizing or reducing the effects harmonic distortion and, correspondingly, accentuating the accuracy of the impedance phase measurement. The determination of phase impedance and a frequency control signal can be implemented in the PSD 822 processor, for example, with the frequency control signal being supplied as input to a DDS control algorithm implemented by logic device 816.
[00223] [00223] In another form, for example, the current feedback data can be monitored in order to maintain the current amplitude of the drive signal at a current amplitude setpoint. The current amplitude set point can be specified directly or determined indirectly based on the specified set points for voltage and power amplitude. In certain ways, the control of the current amplitude can be implemented by the control algorithm, such as, for example, a proportional-integral-derived control algorithm (PID "proportional-integral-derivative"), in the PSD processor 822. Variables controlled by the control algorithm to adequately control the current amplitude of the trigger signal may include, for example, the scaling of LUT waveform samples stored in logic device 816 and / or the output voltage full-scale DAC circuit 818 (which provides input to the power amplifier 812) through a DAC circuit 834.
[00224] [00224] The non-isolated stage 804 can further comprise a second processor 836 to provide, among other things, the functionality of the user interface (UI "user interface"). In one form, the UIL 836 processor can comprise an Atmel AT91SAM9263 processor with an ARM 926EJ-S core, available from Atmel Corporation, of San Jose, California, USA, for example. Examples of UI functionality supported by the UI 836 processor can include audible and visual feedback from the user, communication with peripheral devices (for example, via a USB interface ("universal serial bus")) , communication with a basic key, communication with an input device (for example, a touchscreen) and communication with an output device (for example, a speaker). The UI processor 836 can communicate with the PSD processor 822 and the logic device 816 (for example, via SPI buses ("serial peripheral interface"). While the UI 836 processor can primarily support UI functionality, it can also coordinate with the PSD 822 processor to implement risk mitigation in certain ways. For example, the UI 836 processor can be programmed to monitor various aspects of user actions and / or other inputs (for example, touchscreen inputs, basic key inputs, temperature sensor inputs) and it can disable the drive output of generator 800 when an erroneous condition is detected.
[00225] [00225] In certain ways, both the PSD 822 processor and the UI 836 processor can, for example, determine and monitor the operational status of the generator 800. For the PSD 822 processor, the operational status of the generator 800 can determine, for example, which control and / or diagnosis processes are implemented by the PSD 822 processor. For the UI 836 processor, the operational state of generator 800 can determine, for example, which elements of a UI (for example, display screens, sounds) are presented to a user. The respective PSD and UI processors 822 and 836 can independently maintain the current operational state of the generator 800, as well as recognize and evaluate possible transitions out of the current operational state. The PSD 822 processor can act as the master in this relationship and determine when transitions between operational states should occur. The UI 836 processor can be aware of valid transitions between operational states and can confirm that a particular transition is adequate. For example, when the PSD 822 processor instructs the UI 836 processor to transition to a specific state, the UI 836 processor can verify that the requested transition is valid. If a requested transition between states is determined to be invalid by the UI 836 processor, the UI 836 processor can cause generator 800 to enter a fault mode.
[00226] [00226] The non-isolated platform 804 can also comprise a controller 838 for monitoring input devices (for example, a capacitive touch sensor used to turn the generator 800 on and off, a capacitive touch screen). In certain forms, controller 838 may comprise at least one processor and / or other controller device in communication with the UI processor
[00227] [00227] In certain ways, when generator 800 is in an "off" state, controller 838 can continue to receive operating power (for example, through a line from a generator 800 power supply, as the source 854 power supply discussed below). In this way, controller 838 can continue to monitor an input device (for example, a capacitive touch sensor located on a front panel of the generator 800) to turn the generator on and off
[00228] [00228] In certain forms, controller 838 may cause generator 800 to provide audible feedback or other sensory feedback to alert the user that an on or off sequence has been initiated. This type of alert can be provided at the beginning of an on or off sequence, and before the start of other processes associated with the sequence.
[00229] [00229] In certain forms, the isolated stage 802 may comprise an instrument interface circuit 840 to, for example, provide a communication interface between a control circuit of a surgical instrument (for example, a control circuit that comprises grip keys) and non-isolated stage 804 components, such as logic device 816, PSD processor 822 and / or UI processor 836. Instrument interface circuit 840 can exchange information with components of the non-isolated stage 804 via a communication link that maintains an adequate degree of electrical isolation between the isolated and non-isolated stages 802 and 804 such as, for example, an IR-based communication link ("infrared" - infrared) ). Power can be supplied to the instrument interface circuit 840 using, for example, a low-voltage voltage regulator powered by an isolation transformer driven from the 804 non-isolated stage.
[00230] [00230] In one form, the instrument interface circuit 840 may comprise a logic circuit 842 (for example, a logic circuit, a programmable logic circuit, PGA, FPGA, PLD) in communication with a conditioner circuit. signal 844. The signal conditioning circuit 844 can be configured to receive a periodic signal from logic circuit 842 (for example, a 2 kHz square wave) to generate a bipolar interrogation signal that has a frequency identical. The question mark can be generated, for example, using a bipolar current source powered by a differential amplifier. The question mark can be communicated to a surgical instrument control circuit (for example, using a conductive pair on a cable that connects the generator 800 to the surgical instrument) and monitored to determine a state or configuration. - tion of the control circuit. The control circuit may comprise numerous switches, resistors and / or diodes to modify one or more characteristics (for example, amplitude, rectification) of the interrogation signal so that a state or configuration of the control circuit is unambiguously discernible based on in this one or more characteristics. In one form, for example, the signal conditioning circuit 844 may comprise an ADC circuit for generating samples of a voltage signal appearing through control circuit inputs resulting from passing the interrogation signal through it. Logic circuit 842 (or a non-isolated stage component 804) can then determine the status or configuration of the control circuit based on the ADC circuit samples.
[00231] [00231] In one form, the instrument interface circuit 840 may comprise a first data circuit interface 846 to enable the exchange of information between logic circuit 842 (or another element of the instrument interface circuit 840) and a first data circuit disposed in a surgical instrument or otherwise associated with it. In certain ways, for example, a first data loop may be arranged on a cable integrally attached to the handle of a surgical instrument, or on an adapter to interface between a specific type or model of surgical instrument and the generator 800. The first data circuit can be implemented in any suitable way and can communicate with the generator according to any suitable protocol, including, for example, as described in this document with respect to the first data circuit . In certain forms, the first data circuit may comprise a non-volatile storage device, such as an EEPROM device. In some ways, the first data circuit interface 846 can be implemented separately from logic circuit 842 and can comprise a suitable circuit (for example, separate logic devices, a processor) to allow communication between the circuit logic 842 and the first data circuit. In other forms, the first data circuit interface 846 can be integral with logic circuit 842.
[00232] [00232] In certain ways, the first data circuit can store information related to the specific surgical instrument with which it is associated. This information may include, for example, a model number, a serial number, a number of operations in which the surgical instrument was used, and / or any other types of information. This information can be read by instrument interface circuit 840 (for example, logic circuit 842), transferred to a non-isolated stage component 804 (for example, to logic device 816, PSD 822 processor and / or UI 836 processor) for presentation to a user by means of an output device and / or to control a function or operation of the generator 800. Additionally, any type of information can be communicated to the first data circuit for storage in the same through the first interface of the data circuit 846 (for example, using logic circuit 842). This information may include, for example, an updated number of operations in which the surgical instrument was used and / or the dates and / or times of its use.
[00233] [00233] As discussed earlier, a surgical instrument can be removable from a handle (for example, the multifunctional surgical instrument can be removable from the handle) to promote interchangeability and / or disposability of the instrument. In such cases, conventional generators may be limited in their ability to recognize specific instrument configurations being used, as well as to optimize the control and diagnostic processes as needed. The addition of readable data circuits to surgical instruments to address this issue is problematic from a compatibility point of view, however. For example, designing a surgical instrument so that it remains retrocompatible with generators that lack the indispensable data reading functionality may be impractical due, for example, to different signaling schemes, design complexity and cost. The instrument forms discussed in this document address these concerns through the use of data circuits that can be implemented in existing surgical instruments, economically and with minimal design changes to preserve the compatibility of surgical instruments with current generator platforms.
[00234] [00234] - In addition, the shapes of the generator 800 can allow communication with instrument-based data circuits. For example, generator 800 can be configured to communicate with a second data circuit contained in an instrument (for example, the multifunctional surgical instrument). In some ways, the second data circuit can be implemented in a manner similar to that of the first data circuit in the present document described. The instrument interface circuit 840 may comprise a second data circuit interface 848 to enable such communication. In one form, the second data circuit interface 848 can comprise a three-state digital interface, although other interfaces can also be used. In certain ways, the second data circuit can generally be any circuit for transmitting and / or receiving data. In one form, for example, the second data circuit can store information related to the specific surgical instrument with which it is associated. This information may include, for example, a model number, a serial number, a number of operations in which the surgical instrument was used, and / or any other types of information.
[00235] [00235] In some ways, the second data circuit can store information about the ultrasonic and / or electronic properties of an associated transducer, end actuator or ultrasonic drive system. For example, the first data circuit can indicate an initialization frequency slope, as described in this document. In addition or alternatively, any type of information can be communicated to the second data circuit for storage in it via the second data circuit interface 848 (for example, using logic circuit 842). This information may include, for example, an updated number of operations in which the surgical instrument was used and / or the dates and / or times of its use. In certain ways, the second data circuit can transmit data captured by one or more sensors (for example, an instrument-based temperature sensor). In some ways, the second data circuit can receive data from generator 800 and provide an indication to a user (for example, a light-emitting diode or other visible indication) based on the received data.
[00236] [00236] In certain ways, the second data circuit and the second data circuit interface 848 can be configured so that communication between logic circuit 842 and the second data circuit can be carried out without the need to provide additional conductors - suitable for this purpose (for example, dedicated conductors of a cable connecting a handle to the generator 800). In one way, for example, information can be communicated to and from the second data circuit using a wire bus communication scheme implemented in existing cabling, as one of the conductors used to transmit interrogation signals to from signal conditioning circuit 844 to a control circuit on a handle. In this way, changes or modifications to the design of the surgical device that may otherwise be necessary are minimized or reduced. In addition, due to the fact that different types of communications implemented on a common physical channel can be separated based on frequency, the presence of a second data circuit can be "invisible" to generators that do not have the essential functionality of reading of data, which, therefore, allows the backward compatibility of the surgical instrument.
[00237] [00237] In certain forms, the isolated stage 802 may comprise at least one blocking capacitor 850-1 connected to the output of the trigger signal 810b to prevent the passage of DC current to a patient. A single blocking capacitor may be required to comply with medical regulations and standards, for example. Although failures in single-capacitor designs are relatively uncommon, this type of failure can still have negative consequences. In one form, a second blocking capacitor 850-2 can be placed in series with the blocking capacitor 850-1, with current leakage from one point between the blocking capacitors 850-1 and 850-2 being monitored, for example, by an ADC 852 circuit for sampling a voltage induced by leakage current. Samples can be received, for example, via logic circuit 842. Based on changes in leakage current (as indicated by the voltage samples), generator 800 can determine when at least one of the 850-1 blocking capacitors, 850-2 failed, thus offering a benefit over single capacitor designs that have a single point of failure.
[00238] [00238] In certain embodiments, the non-isolated stage 804 may comprise a power supply 854 to release DC power with adequate voltage and current. The power supply can comprise, for example, a 400 W power supply to deliver a system voltage of 48 VDC. The power supply 854 can further comprise one or more DC / DC voltage converters 856 to receive the output from the power supply to generate DC outputs at the voltages and currents required by the various components of generator 800. As discussed above in relation to the controller 838, one or more of the 856 DC / DC voltage converters can receive an input from the 838 controller when the activation of the "on / off" input device by a user is detected by the 838 controller to enable operation or the awakening of the 856 DC / DC voltage converters.
[00239] [00239] Figure 21 illustrates an example of generator 900, which is a form of generator 800 (Figure 20). The 900 generator is configured to supply multiple types of energy to a surgical instrument. The 900 generator provides ultrasonic and RF signals to supply power to a surgical instrument, independently or simultaneously. Ultrasonic and RF signals can be provided alone or in combination and can be provided simultaneously. As indicated above, at least one generator output can provide multiple types of energy (for example, ultrasonic, bipolar or monopolar RF, irreversible and / or reversible electroporation, and / or microwave energy, among others) through a single port, and these signals can be supplied separately or simultaneously to the end actuator to treat tissue.
[00240] [00240] Generator 900 comprises a processor 902 coupled to a waveform generator 904. Processor 902 and waveform generator 904 are configured to generate various signal waveforms based on information stored in a memory. coupled to the 902 processor, not shown for clarity of the invention. The digital information associated with a waveform is provided to the 904 waveform generator that includes one or more DAC circuits to convert the digital input into an analog output. The analog output is powered by an amplifier 1106 for signal conditioning and amplification. The conditioned and amplified output of the amplifier 906 is coupled to a power transformer 908. The signals are coupled via the power transformer 908 to the secondary side, which is on the patient isolation side. A first signal of a first energy modality is supplied to the surgical instrument between the terminals identified as ENERGY1 and RETURN. A second signal of a second energy modality is coupled through a capacitor 910 and is supplied to the surgical instrument between the terminals identified as ENERGY2 and RETURN. It will be recognized that more than two modes of energy can be emitted and, therefore, the subscript "n" can be used to designate that up to n ENERGIAn terminals can be provided, where n is a positive integer greater than 1. It will also be recognized that up to "n" return paths, RETURN can be provided without departing from the scope of the present invention.
[00241] [00241] A first voltage detection circuit 912 is coupled through the terminals identified as ENERGY and the RETURN path to measure the output voltage between them. A second voltage detection circuit 924 is connected via the terminals identified as ENERGY and the RETURN path to measure the output voltage between them. A current detection circuit 914 is arranged in series with the RETURN branch on the secondary side of the power transformer 908 as shown to measure the output current for any energy modality. If different return paths are provided for each energy modality, then a separate current detection circuit would be provided on each return leg. The outputs of the first and second voltage detection circuits 912, 924 are supplied to the respective isolation transformers 916, 922 and the output of the current detection circuit 914 is supplied to another isolation transformer 918. The outputs of the
[00242] [00242] In one aspect, impedance can be determined by processor 902 by dividing the output of the first voltage detection circuit 912 coupled through the terminals identified as ENERGY1 / RETURN or the second voltage detection circuit 924 coupled through the terminals identified as ENERGY2 / RETURN by the output of the current detection circuit 914 arranged in series with the RETURN branch on the secondary side of the power transformer 908. The outputs of the first and second voltage detection circuits 912, 924 are provided to separate transformer isolations 916, 922 and current detection circuit 914 output is provided to another isolation transformer 916. Digitized current and voltage detection measurements from ADC circuit 926 are provided to processor 902 to compute the impedance. As an example, the first ENERGIA1 energy modality can be ultrasonic energy and the second ENERGIA2 energy modality can be RF energy. However, in addition to the ultrasonic and bipolar or monopolar RF energy modalities, other energy modalities include irreversible and / or reversible electroporation and / or microwave energy, among others. In addition, while the example shown in Figure 21 shows that a single RETURN return path can be provided for two or more energy modes, in other aspects, multiple RETURN return paths can be provided for each ENERGY energy mode. Thus, as in the present document described, the impedance of the ultrasonic transducer can be measured by dividing the output of the first voltage detection circuit 912 by the current detection circuit 914, and the fabric impedance can be measured by dividing the output of the second voltage detection circuit. voltage detection 924 by current detection circuit 914.
[00243] [00243] As shown in Figure 21, the generator 900 comprising at least one output port may include a power transformer 908 with a single output and multiple taps to provide power in the form of one or more modes of energy, such as ultrasonic, bipolar or monopolar RF, irreversible and / or reversible electroporation and / or microwave energy, among others, for example, to the end actuator depending on the type of tissue treatment being performed. For example, the 900 generator can supply energy with higher voltage and lower current to drive an ultrasonic transducer, with lower voltage and higher current to conduct RF electrodes to seal the tissue or with a coagulation waveform for point coagulation using monopolar or bipolar RF electrosurgical electrodes. The output waveform of generator 900 can be oriented,
[00244] [00244] Additional details are described in US Patent Application Publication 2017/0086914 entitled TECHNIQUES FOR OPERA-
[00245] [00245] As used throughout this description, the term "wireless" and its derivatives can be used to describe circuits, devices, systems, methods, techniques, communication channels etc., which can communicate data through the use of electromagnetic radiation modulated using a non-solid medium. The term does not imply that the associated devices do not contain any wires, although in some ways they may not. The communication module can implement any of a number of wireless and wired communication standards or protocols, including, but not limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20 , long-term evolution (LTE, "long-term evolution"), Ev-DO, HSPA +, HSDPA +, HSUPAr +,
[00246] [00246] “As used in the present invention, a processor or processing unit is an electronic circuit that performs operations on some external data source, usually memory or some other data flow. The term is used in the present invention to refer to the central processor (central processing unit) in a computer system or systems (specifically systems on a chip (SoCs)) that combine several specialized "processors".
[00247] [00247] As used in this document, a system on a chip or system on the chip (SoC or SOC) is an integrated circuit (also known as an "IC" or "chip") that integrates all components of a computer or other electronic systems. It can contain digital, analog, mixed and often radio frequency functions - all on a single substrate. A SoC integrates a microcontroller (or microprocessor) with advanced peripherals such as a graphics processing unit (GPU), i-Fi module, or coprocessor. An SoC may or may not contain internal memory.
[00248] [00248] “As used in this document, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuits and memory. A microcontroller (or MCU for the microcontroller unit) can be implemented as a small computer on a single integrated circuit. It can be similar to a SoC; a SoC can include a microcontroller as one of its components. A microcontroller can contain one or more core processing units (CPUs) together with memory and programmable input / output peripherals. Program memory in the form of ferroelectric RAM, NOR flash or OTP ROM is also often included on the chip, as well as a small amount of RAM. Microcontrollers can be used for integrated applications, in contrast to microprocessors used in personal computers or other general purpose applications consisting of several distinct integrated circuits.
[00249] [00249] As used in the present invention, the term controller or microcontroller can be an independent chip or IC (integrated circuit) device that interfaces with a peripheral device. This can be a connection between two parts of a computer or a controller on an external device that manages the operation of (and connection to) that device.
[00250] [00250] Any of the processors or microcontrollers in the present invention can be any implemented by any single-core or multi-core processor, such as those known under the trade name ARM Cortex by Texas Instruments. In one aspect, the processor can be a Core Cortex-M4F processor
[00251] [00251] In one aspect, the processor may comprise a safety controller that comprises two controller-based families, such as TMS570 and RM4x, known under the tradename Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[00252] [00252] Modular devices include modules (as described in connection with Figures 3 and 9, for example) that are receivable within a central surgical controller and the surgical devices or instruments that can be connected to the various modules a in order to connect or pair with the corresponding central surgical controller
[00253] [00253] Situational recognition is the ability of some aspects of a surgical system to determine or infer information related to a surgical procedure from data received from databases and / or instruments. The information may include the type of procedure that is performed, the type of tissue being operated on or the body cavity that is the object of the procedure. With contextual information related to the surgical procedure, the surgical system can, for example, improve the way in which it controls the modular devices (for example, a robotic arm and / or a robotic surgical tool) that are connected to it and provide contextual information or suggestions to the surgeon during the course of the surgical procedure.
[00254] [00254] With reference now to Figure 49, a timeline 5200 is represented representing the situational recognition of a central surgical controller, such as central surgical controller 106 or 206, for example. Timeline 5200 is an illustrative surgical procedure and the contextual information that the central surgical controller 106, 206 can derive from data received from data sources at each stage in the surgical procedure. Timeline 5200 represents typical steps that would be taken by nurses, surgeons, and other medical personnel during the course of a pulmonary segmentectomy procedure, starting with the setup of the operating room and ending with the transfer of the patient to a post-op recovery room.
[00255] [00255] Situational recognition of a central surgical controller 106, 206 receives data from data sources throughout the course of the surgical procedure, including data generated each time medical personnel use a modular device that is paired with the center surgical 106, 206. The central surgical controller 106, 206 can receive this data from paired modular devices and other data sources and continuously derive inferences (ie contextual information) about the ongoing procedure as new data is received, such as which step of the procedure is being performed at any given time. The situational recognition system of the central surgical controller 106, 206 is, for example, able to record data referring to the procedure to generate reports, verify the steps being taken by medical personnel, provide data or warnings (for example, 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 ultrasonic surgical instrument or RF electrosurgical instrument), and take any other action described above.
[00256] [00256] In the first step 5202 of this illustrative procedure, members of the hospital team retrieve the patient's electronic medical record ("EMR" - electronic medical record) from the hospital's EMR database. Based on patient selection data in the EMR, the central surgical controller 106, 206 determines that the procedure to be performed is a thoracic procedure.
[00257] [00257] In the second step 5204, the team members scan the entry of medical supplies for the procedure. The central surgical controller 106, 206 cross-references 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 the inlet supplies have an absence of certain supplies that are necessary for a thoracic wedge procedure or, if not, that the input supplies do not correspond to a thoracic wedge procedure).
[00258] [00258] In the third step 5206, the medical staff scans the patient's band with a scanner that is communicably 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.
[00259] [00259] In the fourth step 5208, the medical staff turns on the auxiliary equipment. The auxiliary equipment being used may vary according to the type of surgical procedure and the techniques to be used by the surgeon, but in this illustrative case they include a smoke evacuator, an insufflator and a medical imaging device. When activated, auxiliary equipment that is modular devices can automatically pair with the central surgical controller 106, 206 which is located within a specific vicinity of the modular devices as part of its initialization process. The central surgical controller 106, 206 can then derive contextual information about the surgical procedure by detecting the types of modular devices that correspond with it during that 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 (EMR), the list of medical supplies to be used in the procedure, and the type of modular devices that connect to the central surgical 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 this 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.
[00260] [00260] 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 the central surgical controller 106, 206 begins to receive data from patient monitoring devices, the surgical controller Central 106, 206, in this way, confirms that the patient is in the operating room.
[00261] [00261] 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 of them, for example. After the completion of the sixth step 5212, the preoperative portion of the lung segmentation procedure is completed and the operative portion begins.
[00262] [00262] In the seventh step 5214, the lung of the patient being operated on is retracted (while ventilation is switched to the contralateral lung). The central surgical controller 106, 206 can infer from the ventilator data that the patient's lung has been retracted, for example. The central surgical controller 106, 206 can infer that the operative portion of the procedure started when he could compare the detection of the patient's lung collapse in the expected steps of the procedure (which can be accessed or retrieved earlier) and thus determine that lung retraction is the first operative step in this specific procedure.
[00263] [00263] In the 8th step 5216, the medical imaging device (for example, a display device) is inserted and the video from the medical imaging device is started. The 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. Upon receipt of 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 based on data received in the second step 5204 of the procedure). The data from the medical imaging device 124 (Figure 2) can be used to determine contextual information about the type of procedure being performed in a number of different ways, including by 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, that are activated and paired with the surgical center 106, 206), and monitor the types of devices used.
[00264] [00264] In the second stage of the procedure, the surgical team begins the dissection stage. 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. The 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 being fired at that point in the process (that is, after the completion of the previously discussed steps of the procedure) corresponds to the step of dissection. In some cases, the energy instrument can be an energy tool mounted on a robotic arm of a robotic surgical system.
[00265] [00265] In the tenth step 5220 of the procedure, the surgical team continues until 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 certain cases, the surgical instrument can be a surgical tool mounted on a robotic arm of a robotic surgical system.
[00266] [00266] In the eleventh step 5222, the segmentectomy portion of the procedure is performed. Central surgical controller 106, 206 can infer that the surgeon is transecting the parenchyma based on data from the surgical stapling and cutting instrument, including
[00267] [00267] 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 was used after the parenchyma was transected, corresponding to the node dissection step, which allows the central surgical controller 106, 206 to make this inference. It should be noted that surgeons regularly switch between surgical stapling / cutting instruments and surgical energy instruments (ie, RF or ultrasonic) depending on the specific step in the procedure because different instruments are better adapted for specific tasks. Therefore, the specific sequence in which the cutting / stapling instruments and surgical energy instruments are used can indicate which stage of the procedure the surgeon is performing. In addition, in certain cases, robotic tools can be used for one or more steps in a surgical procedure and / or Hand held surgical instruments can be used for one or more steps in the surgical procedure. The surgeon can switch between robotic tools and hand-held surgical instruments and / or can use the devices simultaneously, for example. After the completion of the twelfth stage 5224, the incisions are closed and the post-operative portion of the process begins.
[00268] [00268] 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.
[00269] [00269] Finally, in the fourteenth step 5228 is that medical personnel remove the various patient monitoring devices from the patient. Central surgical controller 106, 206 can thus 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 which are communicably coupled to the central surgical controller 106, 206.
[00270] [00270] Situational recognition is further described in US provisional patent application serial number 62 / 611.341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, the invention of which is hereby incorporated by reference in its wholeness. In certain cases, the operation of a robotic surgical system, including the various robotic surgical systems described in this document, for example, can be controlled by the central controller 106, 206 based on its situational recognition and / or in the feedback of its components and / or based on information from the cloud 104. Robotic systems
[00271] [00271] Robotic surgical systems can be used in minimally invasive medical procedures. During such medical procedures, a patient can be placed on a platform adjacent to a robotic surgical system and a surgeon can be placed on a control console that is remote from the platform and / or the robot. For example, the surgeon can be positioned outside the sterile field that surrounds the surgical site. The surgeon provides input to a user interface via an input device on the command console to manipulate a surgical tool attached to an arm of the robotic system. The input device may consist of mechanical input devices, such as control handles or joysticks, for example, or non-contact input devices, such as optical gesture sensors, for example.
[00272] [00272] The robotic surgical system may include a robotic tower that supports one or more robotic arms. At least one surgical tool (for example, an end actuator and / or endoscope) can be mounted on the robotic arm. The surgical tool (or the surgical tools) can be configured to articulate in relation to the respective robotic arm through a pivoting handle assembly and / or to translate in relation to the robotic arm through a linear sliding mechanism, for example example. During the surgical procedure, the surgical tool can be inserted into a small incision in a patient through a cannula or trocar, for example, or into a patient's natural orifice to position the distal end of the surgical tool in the surgical site within the patient's body. Additionally or alternatively, the robotic surgical system can be used in an open surgical procedure in certain cases.
[00273] [00273] A schematic of a robotic surgical system 15000 is shown in Figure 22. The robotic surgical system 15000 includes a central control unit 15002, a surgeon console 15012, a robot 15022 including one or more robotic arms 15024 and a primary screen 15040 operationally coupled to the control unit
[00274] [00274] The 15002 central control unit includes a 15004 processor operationally coupled to a 15006 memory. The 15004 processor includes a plurality of inputs and outputs to interface with the components of the robotic surgical system 15000. The processor 15004 can be configured to receive input signals and / or generate output signals to control one or more of the various components (for example, one or more motors, sensors and / or screens) of the 15000 robotic surgical system. output signals can include, and / or can be based on, algorithmic instructions that can be pre-
[00275] [00275] The 15022 robot includes one or more 15024 robotic arms. Each 15024 robotic arm includes one or more 15026 motors and each 15026 motor is coupled to one or more 15028 motor drives. For example, 15026 motors, which can be assigned to different actuators and / or mechanisms, they can be housed in a carrier set or cabinet. In certain cases, an intermediate transmission between a 15026 motor and one or more 15028 drives may allow coupling and decoupling the 15026 motor to one or more 15028 drives. The 15028 drives can be configured to implement one or more surgical functions . For example, one or more actuators 15028 may be responsible for moving a robotic arm 15024 by rotating the robotic arm 15024 and / or a connection and / or articulation thereof. Additionally, one or more 15028 actuators can be coupled to a 15030 surgical tool and can implement articulation, rotation, gripping, sealing, stapling, energizing, firing, cutting and / or opening, for example. In some cases, 15030 surgical tools can be interchangeable and / or replaceable. Examples of robotic surgical systems and surgical tools are further described in this document.
[00276] [00276] The reader will readily understand that the interactive surgical system implemented by computer 100 (Figure 1) and the interactive surgical system implemented by computer 200 (Figure 9) can incorporate the robotic surgical system 15000. Additionally or alternatively, the system robotic surgical 15000 can include several features and / or components of the interactive surgical systems implemented by computer 100 and 200.
[00277] [00277] In one example, the robotic surgical system 15000 can encompass the robotic system 110 (Figure 2), which includes the surgeon console 118, the surgical robot 120 and the robotic central controller
[00278] [00278] Another robotic surgical system is illustrated in Figures 23 and
[00279] [00279] “Each of the robotic arms 13002, 13003 is composed of a plurality of elements connected through the joints and includes a surgical set 13010 connected to a distal end of a corresponding robotic arm 13002, 13003. The support of multiple arms is additionally described in US patent application publication No. 2017/0071693, filed on November 11, 2016, entitled
[00280] [00280] The robotic arms 13002, 13003 can be activated by electrical drives that are connected to the control device
[00281] [00281] The control device 13004 can control a plurality of motors (for example, motor | ... n) with each motor configured to drive a pull or pull on one or more cables, such as cables coupled to the actuator. end 13023 of the surgical instrument 13020. In use, how these cables are pushed and / or pulled
[00282] [00282] The actuator configurations for surgical instruments, such as actuating arrangements for a surgical end actuator, are further described in international patent publication No. WO2016 / 183054, filed on May 10, 2016, instituted COUPLING INSTRUMENT DRIVE UNIT AND ROBOTIC SURGI- CAL INSTRUMENT, in international patent publication No. WO 2016/205266, filed on June 15, 2016, entitled RO-BOTIC SURGICAL SYSTEM TORQUE TRANSDUCTION SENSING, in international patent publication No. WO2016 / 205452 , filed on June 16, 2016, entitled CONTROLLING ROBOTIC SURGI-CAL INSTRUMENTS WITH BIDIRECTIONAL COUPLING and in international patent publication No. WO2017 / 053507, filed on September 22, 2016, entitled ELASTIC SURGICAL INTERFACE FOR ROBOTIC SURGICAL SYSTEMS, each one of which is in the present document incorporated as a reference in its entirety. The modular fixation of surgical instruments to a driver is further described in international patent publication No. WO 2016/209769, filed on June 20, 2016, entitled ROBOTIC SURGICAL ASSEMBLIES, which is in this document incorporated to reference title in its entirety. Cabinet and interface configurations of a surgical instrument driver are further described in international patent publication WO 2016/144998, filed on March 9, 2016, entitled ROBOTIC SURGICAL SYSTEMS, INSTRUMENT DRIVE UNITS, AND DRIVE ASSEMBLIES , which is hereby incorporated by reference in its entirety for reference. Various configurations of the cutting instrument for use with the robotic arms 13002, 13003 are further described in international patent publication No. WO 2017/053358, filed on September 21, 2016, entitled
[00283] [00283] The control device 13004 includes any suitable logic control circuit adapted to perform calculations and / or operate according to a set of instructions. The control device 13004 can be configured to communicate with a "RS" remote system, either through a wireless connection (for example, Wi-Fi, Bluetooth, LTE, etc.) and / or wired. The "RS" remote system can include data, instructions and / or information related to the various components, algorithms and / or operations of the 13000 system. The "RS" remote system can include any suitable electronic service, database, platform, cloud " C "(cloud) (see Figure 23), or similar. The control device 13004 can include a central processing unit connected operationally to the memory. The memory can include transient type memory (eg RAM memory) and / or non-transitory type memory (eg flash media, disk media, etc.). In some examples, the memory is part of and / or is operationally coupled to the remote "RS" system.
[00284] [00284] The control device 13004 can include a plurality of inputs and outputs to interface with the components of the 13000 system, such as via a driver circuit. The 13004 control device can be configured to receive input signals and / or generate output signals to control one or more of the various components (for example, one or more motors) of the 13000 system. Output signals can include and / or they can be based on algorithmic instructions that can be pre-programmed and / or entered by a user. The 13004 control device can be configured to accept a plurality of user actions from a user interface (eg, keys, buttons, touchscreen, etc., 13005 console operation) that can be coupled to the "RS" remote system.
[00285] [00285] A 13014 memory can be directly and / or indirectly coupled to the control device 13004 to store instructions and / or databases including preoperative data of living beings and / or anatomical atlases. Memory 13014 can be part of and / or operationally coupled to the remote system "RS".
[00286] [00286] According to an example, the distal end of each robotic arm 13002, 13003 is configured to releasably attach the end actuator 13023 (or other surgical tool) to it and can be configured to receive any number of tools or instruments surgical procedures, such as a trocar or retractor, for example.
[00287] [00287] “A simplified functional block diagram of a 13400 system architecture of the 13010 robotic surgical system is shown in the Figure. 24. The 13400 system architecture includes a 13420 core module, a 13430 surgeon master module, a 13440 robotic arm module and a 13450 instrument module. The 13420 core module serves as a central surgical controller for the system robotic surgical 13000 and coordinates the operations of all other modules 13430, 13440, 13450. For example, core module 13420 maps control devices to arms 13002, 13003, determines the current state, performs all kinematics and transformations frame and relays the resulting motion commands. In this sense, the core module 13420 receives and analyzes data from each of the other modules 13430, 13440, 13450 to provide instructions or commands to the other modules 13430, 13440, 13450 for execution inside the robotic surgical system 13000. Although represented as separate modules, one or more of modules 13420, 13430, 13440 and 13450 are a unique component in other examples.
[00288] [00288] Core module 13420 includes models 13422, observers 13424, a collision manager 13426, controllers 13428 and a skeleton 13429. Models 13422 include units that provide abstract representations (base classes) for controlled components, such as engines (for example, engine | ... n) and / or arms 13002, 13003. Observers 13424 create state estimates based on input and output signals received from other modules 13430, 13440, 13450. The collision manager 13426 avoids collisions between the components that have been registered within the 13010 system. The 13429 skeleton tracks the 13010 system from the point of view of kinematics and dynamics. For example, the kinematics item can be implemented either as forward or reverse kinematics in an example. The dynamics item can be implemented as algorithms used to model the dynamics of the system components.
[00289] [00289] The surgeon master module 13430 communicates with surgeon control devices on console 13005 and retransmits inputs received from console 13005 to core module 13420. According to an example, the master module of surgeon 13430 communicates the status of the button and positions of the control device to the core module 13420 and includes a node controller 13432 that includes a state / mode manager 13434, a fault controller 13436 and an actuator of degree N of freedom ("DOF "- degree of freedom) 13438.
[00290] [00290] The robotic arm module 13440 coordinates the operation of a robotic arm subsystem, an arm carriage subsystem, a configuration arm and an instrument subsystem to control the movement of a corresponding arm 13002, 13003. Although a single 13440 robotic arm module is included, it will be understood that the 13440 robotic arm module corresponds to and controls a single arm. As such, the additional 13440 robotic arm modules are included in configurations in which the 13010 system includes multiple 13002, 13003 arms. The 13440 robotic arm module includes a 13442 node controller, a 13444 state / mode manager, a fault controller 13446 and an actuator of degree N of freedom ("DOF")
[00291] [00291] The 13450 instrument module controls the movement of an instrument and / or tool component attached to the arm 13002,
[00292] [00292] The position of the data collected by the 13450 instrument module is used by the 13420 core module to determine when the instrument is within the surgical site, within a cannula, adjacent to an access door or above an access door. access in free space. The 13420 core module can determine whether to provide instructions for opening or closing the claws of the instrument based on its placement. For example, when the position of the instrument indicates that the instrument is inside a cannula, instructions are provided to maintain a gripper assembly in a closed position. When the position of the instrument indicates that the instrument is outside an access door, instructions are provided to open the grapple assembly.
[00293] [00293] The additional features and operations of a robotic surgical system, such as the surgical robot system represented in Figures 23 and 24, are additionally described in the following references, each of which is incorporated in this document. - reference title in its entirety:
[00294] [00294] The robotic surgical systems and features described in the present invention can be used with the robotic surgical system of Figures 23 and 24. The reader will also understand that the various systems and / or features described in the present invention can also be used
[00295] [00295] In several cases, a robotic surgical system may include a robotic control tower, which can house the system's control unit. For example, the 13004 control unit of the 13000 robotic surgical system (Figure 23) can be housed within a robotic control tower. The robotic control tower can include a robotic central controller such as robotic central controller 122 (Figure 2) or robotic central controller 222 (Figure 9), for example. Such a robotic central controller may include a modular interface for coupling with one or more generators, such as an ultrasonic generator and / or a radio frequency generator, and / or one or more modules, such as an imaging module, a suction module, an irrigation module, a smoke evacuation module and / or a communication module.
[00296] [00296] A robotic central controller can include a situational recognition module, which can be configured to synthesize data from various sources to determine an appropriate response to a surgical event. For example, a situational recognition module can determine the type of surgical procedure, the step in the surgical procedure, the type of tissue and / or characteristics of the tissue, as further described in this document. In addition, this module can recommend a specific course of action or possible choices for the robotic system based on the synthesized data. In several cases, a sensor system that covers a plurality of sensors distributed throughout the robotic system can provide data, images and / or other information for the situational recognition module. Such a situational recognition module can be incorporated into a control unit, such as the 13004 control unit, for example. In several cases, the situational recognition module can obtain data and / or information from a non-robotic central surgical controller and / or a cloud, such as central surgical controller 106 (Figure 1), central surgical controller 206 (Figure 10), cloud 104 (Figure 1) and / or cloud 204 (Figure 9), for example. The situational recognition of a surgical system is further described in this document and in US provisional patent application serial number 62 / 611.341, entitled INTERACTIVE SURGICAL PLATFORM, deposited on December 28, 2017 and in the provisional US patent application. Serial No. 62 / 611.340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on December 28, 2017, the description of each of which in this document is incorporated by reference in its entirety.
[00297] [00297] In certain cases, the activation of a surgical tool at certain times during a surgical procedure and / or for certain durations may cause trauma to the tissue and / or may prolong a surgical procedure. For example, a robotic surgical system can use an electrosurgical tool with an energy application surface that should only be energized when a limit condition is met. In one example, the energy application surface should be activated only when the energy application surface is in contact with the appropriate or intended tissue. As another example, a robotic surgical system can use a suction element that should only be activated when a limit condition is satisfied, such as when an adequate volume of fluid is present. Due to visibility restrictions, involving situations and the multiplicity of moving parts during a robotic surgical procedure, it can be difficult for a doctor to determine and / or monitor certain conditions at the surgical site. For example, it can be difficult to determine if an energy application surface of an electrosurgical tool is in contact with the tissue. It can also be difficult to determine whether a specific suction pressure is sufficient for the volume of fluid in the vicinity of the suction port.
[00298] [00298] In addition, a plurality of surgical devices can be used in certain robotic surgical procedures. For example, a robotic surgical system may use one or more surgical tools during the surgical procedure. In addition, one or more manual instruments can also be used during the surgical procedure. One or more of the surgical devices may include a sensor. For example, multiple sensors can be positioned around the surgical site and / or the operating room. A sensor system that includes one or more sensors can be configured to detect one or more conditions at the surgical site. For example, data from the sensor system can determine whether a surgical tool mounted on the surgical robot is being used and / or whether a feature of the surgical tool should be activated. More specifically, a sensor system can detect whether an electrosurgical device is positioned in contiguous contact with the tissue, for example. As another example, a sensor system can detect whether a suction element on a surgical tool applies sufficient suction force to the fluid at the surgical site.
[00299] [00299] “When in an automatic activation mode, the robotic surgical system can automatically activate one or more features of one or more surgical tools based on data, images and / or other information received from the sensor system. For example, an energy application surface of an electrosurgical tool can be activated by detecting that the electrosurgical tool is in use (for example, positioned in contiguous contact with the tissue). As another example, a suction element on a surgical tool can be activated when the suction port is moved to contact a fluid. In certain cases, the surgical tool can be adjusted based on the conditions detected.
[00300] [00300] A robotic surgical system that incorporates an automatic activation mode can automatically provide a specific state result based on the detected condition (or the detected conditions) at the surgical site. The scenario-specific outcome can be outcome-based, for example, and can simplify the physician's decision-making process. In certain cases, such an automatic activation mode can improve the doctor's efficiency and / or effectiveness. For example, the robotic surgical system can aggregate data to compile a more complete view of the surgical site and / or the surgical procedure to determine the best possible course of action. Additionally or alternatively, in cases where the physician makes fewer decisions, the physician may be more focused on other tasks and / or may process other information more efficiently.
[00301] [00301] In one example, a robotic surgical system can automatically adjust a surgical tool based on the tool's proximity to a visually detectable need and / or situational recognition of the system. With reference to Figures 25A and 25B, an ultrasonic surgical tool for a 13050 robotic system is represented in two different positions. In a first position, as shown in Figure 25A, the blade 13052 of a 13050 ultrasonic surgical tool is positioned out of contact with the 13060 tissue. In such a position, a sensor on the 13050 ultrasonic surgical tool can detect high resistance. When the detected resistance is above a limit value, the 13052 ultrasonic blade can be de-energized. Now with reference to Figure 25B, the 13052 ultrasonic blade is represented in a second position in which the distal end of the 13052 blade is positioned in contiguous contact with the 13060 tissue. In such cases, a sensor in the 13050 ultrasonic surgical tool can detect a low resistance. When the detected resistance is below a limit value, the 13052 ultrasonic blade can be activated so that therapeutic energy is applied to the 13060 tissue. Alternative sensor configurations are also envisaged and several sensors are further described in this document.
[00302] [00302] With reference to Figures 26A and 26B, another surgical tool, a 13055 monopolar cauterization pencil, is shown in two different positions. In a first position, as shown in Figure 26A, the 13055 monopolar cauterization pencil is positioned out of contact with the tissue. In such a position, a sensor in the 13055 monopolar cauterization pencil can detect high resistance.
[00303] [00303] Figure 27 shows a 13070 graphical display of continuity C and current | over time t for the 13050 ultrasonic surgical tool of Figures 25A and 25B. Similarly, the 13055 monopolar cauterization pencil can generate a graphic display similar in many ways to the 13070 graphic display in certain cases. In graphical display 13070, continuity C is represented by a dotted line, and the current | is represented by a continuous line. When the resistance is high and above a limit value, continuity C can also be high. The limit value can be between 40 and 400 ohms, for example. At time A ', continuity C may decrease below the limit value, which may indicate a degree of contact with the tissue. As a result, the robotic surgical system can automatically activate advanced tissue energy treatment. The ultrasonic transducer current shown in Figure 27 increases from time A 'to B' when the continuity parameters indicate the degree of contact with the tissue. In several cases, the current | it can be finished at a maximum value indicated in B ', which can correspond to an open claw transducer limit, as in cases where the claw is not clamped, as shown in Figures 25A and 25B. In several cases, the situational recognition module of the robotic surgical system can indicate that the claw is not clamped. Again with reference to graphical display 13070 in Figure 27, energy is applied up to time C ', the time when a loss of contact with the tissue is indicated by the increase in continuity C above the limit value. As a result, the current | of the ultrasonic transducer can decrease to zero as the ultrasonic blade is de-energized.
[00304] [00304] In several cases, a sensor system can be configured to detect at least one condition at the surgical site. For example, a sensor in the sensor system can detect contact with the tissue by measuring continuity along the energy application surface of the ultrasonic blade. In addition or alternatively, the sensor system may include one or more additional sensors positioned around the surgical site. For example, one or more tools and / or one or more surgical instruments that are used in the surgical procedure can be configured to detect a condition at the surgical site. The sensor system can be communicating by signal with a robotic surgical system processor. For example, the robotic surgical system may include a central control tower that includes a control unit that houses a processor and a memory, as further described in the present invention. The processor can issue commands to the surgical tool based on inputs from the sensor system. In several cases, situational recognition can also dictate and / or influence the commands issued by the processor.
[00305] [00305] Again with reference to Figure 28, the 196400 end actuator includes RF data sensors 196406, 196408a, 196408b located on claw member 196402. The 196400 end actuator includes a 196402 claw member and a ultrasonic blade 196404. The claw arm 196402 is shown holding the 196410 tissue located between the claw arm 196402 and the ultrasonic blade
[00306] [00306] The 196400 end actuator is an exemplary end actuator for the various surgical devices described in this document. The sensors 196406, 196408a, 196408b are electrically connected to a control circuit via interface circuits. The 196406, 196408a, 196408b sensors are battery powered and the signals generated by the 196406, 196408a, 196408b sensors are supplied to the analog and / or digital processing circuits of the control circuit.
[00307] [00307] In one aspect, the first 196406 sensor is a force sensor to measure a normal F3 force applied to the 196410 fabric by the 196402 claw member. The second and third sensors 196408a,
[00308] [00308] "One or more sensors such as a magnetic field sensor, an effort meter, a pressure sensor, a force sensor, an inductive sensor, such as, for example, an eddy current sensor, a resistive sensor, a sensor capacitive, an optical sensor and / or any other suitable sensor, can be adapted and configured to measure tissue compression and / or impedance.
[00309] [00309] Figure 29 illustrates an aspect of flexible circuit 196412 shown in Figure 28, in which sensors 196406, 196408a, 196408b can be mounted on it or formed integrally with it. The flexible circuit 196412 is configured to connect securely to the claw member 196402. As shown particularly in Figure 29, the asymmetric temperature sensors 196414a, 196414b are mounted on the flexible circuit 196412 to allow measurement of the temperature of the 196410 fabric (Figure 28).
[00310] [00310] The reader will understand that alternative surgical tools can be used in the automatic activation mode described above with respect to Figures 25A to 29.
[00311] [00311] Figure 30 is a 13150 flow chart that represents a 13151 automatic activation mode of a surgical tool. In several cases, the robotic surgical system and processor are configured to implement the processes shown in Figure
[00312] [00312] In several cases, the robotic surgical system may allow a 13153 manual override mode. For example, by enabling the 13160 manual override entry, as by a doctor,
[00313] [00313] In several cases, an automatic activation mode can be used with a robotic surgical system that includes a suction feature. In one example, a robotic surgical system can communicate with a suction and / or irrigation tool. For example, a suction and / or irrigation device (see module 128 in Figure 3) can communicate with a robotic surgical system via central surgical controller 106 (Figure 1) and / or central surgical controller 206 (Figure 9) and a suction and / or irrigation tool can be mounted on a robotic arm. The suction / irrigation device can include a distal suction port and a sensor. In another example, a robotic surgical tool, such as an electrosurgical tool, may include a suction feature and a suction port on the tool end actuator.
[00314] [00314] Referring to Figure 31, when a suction port on a 13210 end actuator is moved to contact a fluid, a processor in the robotic surgical system can automatically activate the suction feature. For example, a 13230 fluid detection sensor in the 13200 tool can detect 13220 fluid in the vicinity of the 13200 tool and / or in contact with the tool
[00315] [00315] In several cases, the tool can be a smoke evacuation tool and / or it can include a smoke evacuation system, for example. A detailed view of a 13210 end actuator from a 13200 bipolar radiofrequency surgical tool is shown in Figure 31. The 13210 end actuator is shown in a gripping configuration. In addition, smoke and steam 13220 from an RF weld accumulates around the 13210 end actuator. In several cases, to improve the visibility and effectiveness of the 13200 tool, the smoke and steam 13220 at the surgical site they can be evacuated along a 13240 smoke evacuation channel that extends proximally from the end actuator. The evacuation channel 13240 can extend through the drive shaft 13205 of the surgical tool 13200 to the interface of the surgical tool 13200 and the robot. The evacuation channel 13240 can be coupled to a pump to drain smoke and / or steam 13220 along the smoke evacuation channel 13240 within the drive shaft 13205 of the surgical tool 13200. In several cases, the surgical tool 13200 may also include insufflation, cooling and / or irrigation capacities.
[00316] [00316] In one case, the intensity of the suction pressure can be adjusted automatically based on a measured parameter of one or more surgical devices. In such cases, the suction pressure may vary depending on the parameters detected. The suction tubing may include a sensor to detect the volume of fluid that is drawn from the surgical site. When larger volumes of fluid are being drawn, the power of the suction feature can be increased so that the suction pressure is increased. Similarly, when smaller volumes of fluid are being drawn, the power of the suction feature can be decreased so that the suction pressure is decreased.
[00317] [00317] In several cases, the detection system of a suction tool may include a pressure sensor. The pressure sensor can detect when an occlusion is obstructing, or partially obstructing, the flow of fluid. The pressure sensor can also detect when the suction port is moved to contiguous contact with the tissue. In such cases, the processor may reduce and / or pause the suction force to release the tissue and / or clear the obstruction. In several cases, the processor can compare the pressure detected to a maximum limit pressure. Exceeding the maximum limit pressure can lead to unintentional tissue trauma from the suction tool. Thus, to avoid such trauma, the processor can reduce and / or pause the suction force to protect the integrity of the tissue close to it.
[00318] [00318] “A user can manually override the automatic settings implemented in the automatic activation mode (or modes) described in this document. Manual overrun can be a one-time adjustment for the surgical tool. In other cases, manual override can be an adjustment that turns off the automatic activation mode for a given surgical action, a specific duration and / or an overall override for the entire procedure.
[00319] [00319] In one aspect, the robotic surgical system includes a processor and a memory communicatively coupled to the processor, as described in the present invention. The processor is communally coupled to a sensor system, and the memory stores instructions executable by the processor to determine the use of a robotic tool based on the sensor system input and automatically energize a power application surface. of the robotic tool when use is determined, as described in the present invention.
[00320] [00320] In several aspects, the present invention provides a control circuit to automatically energize an energy application surface, as described in the present invention. In several respects, the present invention provides a non-transitory, computer-readable medium that stores computer-readable instructions that, when executed, cause a machine to automatically energize a power application surface of a robot tool, as described in the present invention.
[00321] [00321] In one aspect, the robotic surgical system includes a processor and a memory communicatively coupled to the processor,
[00322] [00322] In several aspects, the present invention provides a control circuit to automatically activate a suction mode, as described in the present invention. In several respects, the present invention provides a non-transient, computer-readable medium that stores computer-readable instructions that, when executed, cause a machine to automatically activate a suction mode, as described in the present invention.
[00323] [00323] “Multiple surgical devices, including a robotic surgical system and several hand instruments, can be used by a doctor during a specific surgical procedure. When manipulating one or more robotic tools in the robotic surgical system, a physician is often positioned on a surgeon's console or command module, which is also called a remote control console. In many cases, the remote control console is positioned outside a sterile field and, thus, can be remote to the sterile field and, in some cases, remote to the patient and even the operating room. If the physician wishes to use a handheld instrument, the physician may need to exit the remote control console. At this point, the doctor may be unable to control the robotic tools. For example, the doctor may be unable to adjust the position or use the functionality of robotic tools. After moving away from the remote control console, the doctor may also lose sight of one or more screens in the robotic surgical system. The separation between the control points for hand instruments and the robotic surgical system can inhibit the effectiveness with which the doctor can use the surgical devices, both the robotic tools and the surgical instruments, together.
[00324] [00324] In several cases, a secondary interactive screen is configured to be in signal communication with the robotic surgical system. The secondary interactive screen includes a control module in several cases. In addition, the secondary interactive screen is configured to be wireless and mobile throughout an operating room. In many cases, the secondary interactive screen is positioned within a sterile field. In one example, the secondary interactive screen allows the physician to manipulate and control one or more robotic tools in the robotic surgical system without having to be physically present on the remote control console. In one case, the physician's ability to operate the robotic surgical system away from the remote control console allows multiple devices to be used in a synchronized manner. As a safety measure, in certain cases, the remote control console includes an override function configured to prohibit the control of robotic tools by the secondary interactive screen.
[00325] [00325] Figure 32 shows a 13100 surgical system for use during a surgical procedure using a 13140 surgical instrument and a 13110 robotic surgical system. The 13140 surgical instrument is a hand-held instrument equipped with a motor. The 13140 surgical instrument can be a radio frequency (RF) instrument, an ultrasonic instrument, a surgical stapler and / or a combination of them, for example. The 13140 surgical instrument includes a 13142 display and a 13144 processor. In certain cases, the 13140 handheld surgical instrument can be an intelligent surgical instrument that has a plurality of sensors and a wireless communication module.
[00326] [00326] The 13110 robotic surgical system includes a 13112 robot that includes at least one 13117 robotic tool configured to perform a specific surgical function. The 13110 robotic surgical system is similar in many respects to the 13000 robotic surgical system in this document discussed. The 13117 robotic tool is mobile in a space defined by a 13110 robotic surgical system control envelope. In several cases, the 13117 robotic tool is controlled by multiple physician inputs on a 13116 remote control console. In other words, when a doctor applies an entry to the 13116 remote control console, the doctor is away from the patient's body and out of a 13138 sterile field. The doctor's entry into the 13116 remote control console is communicated to a 13114 robotic control unit which includes a 13113 robot screen and a 13115 processor. The 13115 processor directs the robotic tool (or robotic tools) 13117 to perform the desired function (or the desired functions).
[00327] [00327] In several cases, surgical system 13100 includes a central surgical controller 13120, which is similar in many ways to central controller 106, central controller 206, robotic central controller 122 or robotic central controller 222, for example. The 13120 central surgical controller is configured to enhance the co-operative and / or coordinated use of the 13110 robotic surgical system and the
[00328] [00328] In other cases, the 13110 robotic surgical system may comprise the 13120 central surgical controller and / or the 13114 control unit may be incorporated into the 13120 central surgical controller. For example, the 13110 robotic surgical system may include a control - central robotic side that includes a modular control tower that includes a computer system and a central controller for modular communication. One or more modules can be installed in the modular control tower of the robotic central controller. Examples of robotic central controllers are further described in this application and in US provisional patent application serial number 62 / 611.341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, the invention of which is hereby incorporated by way of reference in its entirety.
[00329] [00329] Processor 13144 of the surgical instrument (or surgical instruments) 13140 is configured to send information to the central surgical controller 13120 in relation to the surgical instrument
[00330] [00330] In several cases, a 13125 central controller screen is in signal communication with the 13120 central surgical controller and can be incorporated into the modular control tower, for example. The 13125 central controller screen is configured to display information received from the 13110 robotic surgical system and 13140 surgical instrument (or surgical instruments). The 13125 central controller screen can be similar in many ways to the 108 display system (Figure 1 ), for example. In one aspect, the central controller screen
[00331] [00331] In several cases, the 13120 central surgical controller is configured to recognize when the 13140 surgical instrument is activated by a physician via a wireless signal (or signals). After activation, the 13140 surgical instrument is configured to send identification information to the 13120 central surgical controller. Such identification information may include, for example, a model number of the surgical instrument, an operating state of the surgical instrument and / or a location of the surgical instrument, although other suitable device parameters can be communicated. In several cases, the 13120 central surgical controller is configured to use the reported information to assess the compatibility of the 13140 surgical instrument with the capabilities of the 13120 central surgical controller. Examples of central surgical controller capabilities with compatible surgical instruments are discussed further details in the present invention.
[00332] [00332] In several cases, the control unit 13114 of the robotic surgical system 13110 is configured to communicate a video transmission to the central surgical controller 13120, and the central surgical controller 13120 is configured to communicate information, or a portion thereof, the surgical instrument 13140, which can replicate a portion of the robot screen 13113, or other information from the robotic surgical system 13110, on a screen 13142 of the surgical instrument 13140. In other cases, the robotic surgical system 13110 (for example, the control unit 13114 or surgical tool 13117) can communicate directly with the surgical instrument
[00333] [00333] —In addition to reference to Figure 32, in several cases, the surgical system 13100 additionally includes a secondary interactive screen 13130 within the sterile field 13138. The secondary interactive screen 13130 is also a local control module within the sterile field 13138. The 13116 remote control console, or the primary control, can be positioned outside the 13138 sterile field. For example, the 13130 secondary interactive screen can be a handheld mobile electronic device, such as an iPadO tablet computer, that can be placed on a patient or the patient's table during a surgical procedure. For example, the 13130 secondary interactive screen can be placed on the patient's abdomen or leg during the surgical procedure. In other cases, the secondary interactive screen 13130 can be incorporated into the 13140 surgical instrument within the sterile field
[00334] [00334] Still with reference to Figure 32, in several cases, the 13120 central surgical controller is configured to transmit robot status information from the 13100 surgical robot system to the 13140 surgical instrument, and the 13140 surgical instrument is configured to require - see the robot status information on screen 13142 of the 13140 surgical instrument.
[00335] [00335] In several cases, the screen 13142 of the surgical instrument 13140 is configured to communicate commands via the central surgical controller 13120 to the control unit 13114 of the robotic surgical system 13110. After viewing and interpreting the robot status information displayed on the screen 13142 of the 13140 surgical instrument as described in the present invention, a physician may wish to use one or more functions of the 13110 robotic surgical system. Using the buttons and / or a touchscreen 13142 on the 13140 surgical instrument, the physician is able to insert a desired use and / or adjustment in the 13110 robotic surgical system. Information entered by the physician is communicated from the 13140 surgical instrument to the 13120 central surgical controller. The 13120 central surgical controller is then configured to communicate the physician's entry to the unit control system 13114 of the robotic surgical system 13110 to implement the desired function. In other cases, the 13140 handheld surgical instrument can communicate directly with the control unit 13114 of the robotic surgical system 13110, as when the robotic surgical system 13110 includes a robotic central controller, for example.
[00336] [00336] In several cases, the 13120 central surgical controller is in signal communication with both the 13110 robotic surgical system and the 13140 surgical instrument, allowing the 13100 surgical system to adjust multiple surgical devices in a synchronized, coordinated and / or cooperative. The information communicated between the 13120 central surgical controller and the various surgical devices includes, for example, information identifying the surgical instrument and / or the operational status of the various surgical devices. In many cases, the 13120 central surgical controller is configured to detect when the 13140 surgical instrument is activated. In one case, the 13140 surgical instrument is an ultrasonic dissector. Upon activation of the ultrasonic dissector, the 13120 central surgical controller is configured to communicate the received activation information to the 13114 control unit of the robotic surgical system
[00337] [00337] In several cases, the central surgical controller 13120 automatically communicates information to the control unit 13114 of the robotic surgical system 13110. The reader will understand that the information can be communicated at any time, speed, inter-
[00338] [00338] In several cases, the 13120 central surgical controller can calculate the parameters, such as smoke generation intensity, for example, based on the additional information communicated from the 13140 surgical instrument. By communicating the parameter calculated to the unit control unit 13114 of the 13110 robotic surgical system, the 13114 control unit is configured to move at least one robotic tool and / or adjust the operating mode to take into account the calculated parameter. For example, when the 13110 robotic surgical system enters smoke evacuation mode, control unit 13114 is configured to adjust a smoke evacuation motor speed to be proportional to the calculated smoke generation intensity.
[00339] [00339] In certain cases, an ultrasonic tool mounted on the 13112 robot may include a smoke evacuation feature that can be activated by the 13114 control unit to operate in a smoke evacuation mode. In other cases, a separate smoke evacuation device can be used. For example, a smoke evacuation tool can be mounted on another robotic arm and used during the surgical procedure. In still other instances, a smoke evacuation instrument that is separate from the 13110 robotic surgical system can be used. The 13120 central surgical controller can coordinate communication between the robotically controlled ultrasonic tool and the smoke evacuation instrument, for example.
[00340] [00340] In Figures 33 to 36, several surgical devices and components thereof are described with reference to a colon resection procedure. The reader will understand that the devices, systems and surgical procedures described in relation to the figures are an exemplary application of the system in Figure 32. Referring now to Figure 33, a handle portion 13202 of a 13300 hand held surgical instrument is shown. aspects, the hand surgical instrument 13300 corresponds to the surgical instrument 13140 of the surgical system 13100 in Figure 32. In one instance, the hand surgical instrument 13300 is a circular stapler equipped with a motor and includes a 13310 mesh in the handle portion 13302 the same.
[00341] [00341] Before pairing the 13300 hand-held surgical instrument with a robotic surgical system (for example the robotic surgical system 13110 in Figure 32) via the central surgical controller 13320 (Figure 34), as described in the present invention , the screen 13310 on the handle 13302 of the hand surgical instrument 13300 can include information about the status of the instrument 13300, such as the grip load 13212, the status of the anvil 13214 and / or the status of the 13216 cartridge instrument, for example . In several cases, the 13310 screen of the 13300 handheld surgical instrument includes an alert 13318 to the user that communicates the status of the trigger system. In many cases, screen 13310 is configured to display information in a way that communicates the most important information to the user. For example, in many cases, screen 13310 is configured to display alert information at a larger size, intermittently and / or in a different color. When the 13300 handheld surgical instrument is not paired with a surgical center, the 13310 screen can show information gathered only from the 13300 handheld surgical instrument itself.
[00342] [00342] - Now with reference to Figure 34, after pairing the 13300 handheld surgical instrument with the 13320 central surgical controller, as described in this document in relation to Figure 32, for example, the information detected and displayed by the instrument surgical hand 13300 can be communicated to the central surgical controller 13320 and displayed on a central controller screen (for example, the central controller screen 13125 in Figure 32). Additionally or alternatively, the information can be displayed on the screen of the robotic surgical system. In addition or alternatively, the information can be displayed on screen 13310 of the handle portion 13302 of the hand surgical instrument 13300. In several cases, a physician can decide which information is displayed at one or multiple locations. As mentioned above, in several cases, the physician is able to remove any unwanted information displayed on the 13310 screen of the 13300 hand-held surgical instrument, on the robotic surgical system screen and / or on the central controller screen display.
[00343] [00343] Still referring to Figure 34, after the pairing of the 13300 handheld surgical instrument with the robotic surgical system, the 13310 screen in the handhold portion 13302 of the 13300 handheld surgical instrument may be different from the 13310 handheld instrument 13300 before pairing with the robotic surgical system. For example, the procedural information from the 13320 central surgical controller and / or the robotic surgical system can be displayed on the motor-equipped circular stapler. For example, as seen in Figure 34, robot status information including alignment information 13312 from the central surgical controller 13320 and one or more retraction stresses 13316, 13317 exerted by a robotic tool on a specific tissue ( or specific tissues), are displayed on the 13310 screen of the 13300 handheld surgical instrument for the convenience of the physician. In several cases, the 13310 screen of the 13300 handheld surgical instrument includes a 13318 alert for the user that communicates a parameter monitored by the 13320 central surgical controller during a surgical procedure. In many cases, screen 13310 is configured to display information in a way that communicates the most important information to the user. For example, in many cases, screen 13310 is configured to display alert information at a larger size, intermittently and / or in a different color.
[00344] [00344] Still with reference to Figure 34, the screen 13310 of the hand surgical instrument 13300 is configured to display information regarding one or more retraction stresses 13316, 13317 exerted by one or more devices during a surgical procedure that enters develop one or more robotic tools. For example, the 13300 hand-held surgical instrument, the motor-powered circular stapler, is involved in the colon resection procedure in Figure 35. In this procedure, a device (for example, a robotic tool) is configured to hold the tissue the colon and another device (for example, the circular hand stapler) is configured to hold the rectal tissue. As the devices move away from each other, the retraction force of the Frc colon tissue and the retraction force of the FrRr rectal tissue are monitored. In the illustrated example, a 13318 alert notification is issued to the user as the retraction force of the colon tissue exceeds a predetermined threshold. Predetermined limits for both retraction forces Frc, Frr are indicated by | horizontal dotted lines on screen 13310. The user is notified when one or both limits are exceeded and / or reached in an effort to minimize damage and / or trauma to the surrounding tissue.
[00345] [00345] In Figure 36, graphical displays 13330, 13340 of retraction forces Frc, FrRRr are illustrated. In the circumstances illustrated in graphical displays 13330, 13340, the user is notified when predetermined limits are exceeded, represented by the shaded region 13332 of the graphical display 13330, indicating that the retraction force of the Frc colon tissue has exceeded a predetermined limit of 0.5 pound.
[00346] [00346] In certain cases, it may be difficult to align the end actuator of a circular stapler with the target tissue during a colorectal procedure because of visibility limitations. For example, again with reference to Figure 35, during a colon resection, the surgical instrument 13300, a circular stapler, can be positioned adjacent to a transected rectum 13356. In addition, the anvil 13301 of the surgical instrument 13300 can be attached with a transected colon 13355. A robotic tool 133175 is configured to engage the anvil 13301 and apply the Frc retraction force. It can be difficult to confirm the relative position of the 13300 surgical instrument with the target tissue, for example, with the staple line through the transected colon 13355. In certain cases, information from the 13320 central surgical controller and robotic surgical system can facilitate alignment. For example, as shown in Figure 34, the center of surgical instrument 13300 can be shown in relation to the center of target tissue 13318 on display screen 13310 of surgical instrument 13300. In certain cases, and as shown in Figure 35, sensors and a wireless transmitter on the 13300 surgical instrument can be configured to transmit positioning information to the 13320 central surgical controller, for example.
[00347] [00347] A colorectal procedure, visual limitations of the same and an alignment tool for a central surgical controller are additionally described in the present invention and in the provisional patent application US serial number 62 / 611.341, entitled INTERACTIVE SURGICAL PLATFORM, deposited in December 28, 2017, whose invention is hereby incorporated by reference in its entirety for reference.
[00348] [00348] “As mentioned above, screen 13310 on the 13300 hand instrument can also be configured to alert the doctor in certain situations. For example, screen 13310 in Figure 34 includes an alert 13318 since one or more of the forces exceeds the predefined force limits. Again with reference to Figures 35 and 36, during the colon resection, the robotic arm can exert a first Frc force on the anvil, and the 13300 hand instrument can exert a second Frr force on the rectum 13356. The tension on the rectum 13356 by the circular stapler can be terminated at a first limit (for example, 0.5 pound in Figure 36), and the tension over the colon 13355 of the robotic arm can be terminated at a second limit (for example, 0.5 pound at Figure 36). An intervention can be suggested to the doctor when the tension on the rectum 13356 or colon 13355 exceeds a limit value.
[00349] [00349] The stress on the Frc colon in Figures 35 and 36 can be confirmed by resistance to the robotic arm, and thus can be determined by a control unit (for example, control unit 13114 of the 13110 robotic surgical system) . Such information can be communicated to the 13300 handheld surgical instrument and displayed on screen 13310 of the same in the sterile field so that the information is readily available to the appropriate physician in real time, or close to real time, or at any time. appropriate interval, speed and / or schedule, for example.
[00350] [00350] In several cases, a surgical system, such as a 13360 surgical system of Figures 37 and 38, includes secondary interactive screens 13362, 13364 within the sterile field. The secondary interactive screens 13362, 13364 are also mobile control modules in certain cases and may be similar to the secondary interactive screens 13130 in Figure 32, for example. A surgeon's command console, or remote control module, 13370, is the primary control module and can be positioned outside the sterile field. In one example, the secondary interactive screen 13362 can be a mobile device, a wristwatch and / or a small tablet computer, which can be worn on the user's wrist and / or forearm, and the secondary interactive screen 13364 it can be a handheld mobile electronic device, such as an iPadO tablet computer, which can be placed on a 13361 patient or the patient's table during a surgical procedure. For example, the secondary interactive screens 13362, 13364 can be placed on the abdomen or leg of the patient 13361 during the surgical procedure. In other cases, the secondary interactive screens 13362, 13364 can be incorporated into a 13366 hand-held surgical instrument in the sterile field.
[00351] [00351] In one example, the 13360 surgical system is shown during a surgical procedure. For example, the surgical procedure may be the colon resection procedure in this document described with reference to Figures 33 to 36. In such cases, the 13360 surgical system includes a 13372 robot and an inward 13374 robotic tool surgical site. The robotic tool can be an ultrasonic device comprising an ultrasonic blade and a clamping arm, for example. The 13360 surgical system also includes the 13370 remote control console which comprises a 13380 robotic central controller. The control unit for the 13372 robot is housed in the 13380 robotic central controller. A 13371 surgeon is positioned
[00352] [00352] Referring mainly to Figure 37, central controllers 13380, 13382 include wireless communication modules so that a wireless communication link is established between the two central controllers 13380, 13382. Additionally, the robotic central controller 13380 is in signal communication with the secondary interactive screens 13362, 13364 in the sterile field. Central controller 13382 is in signal communication with the hand held surgical instrument 13366. If surgeon 13371 moves towards patient 13361 in the sterile field (as indicated by reference character 13371 '), the surgeon 13371 can use one of the 13362, 13364 wireless interactive screens to operate the 13372 robot away from the 13370 remote control console. The plurality of secondary screens 13362, 13364 in the sterile field allows the 13371 surgeon to move away from the 13370 remote control without losing sight of important information for the surgical procedure and the controls of the robotic tools used in it.
[00353] [00353] Secondary interactive screens 13362, 13364 allow the physician to move away from the 13370 remote control console and enter the sterile field while maintaining control of the 13372 robot. For example, the secondary interactive screens 13362, 13364 allow the physician to maintain a cooperative and / or coordinated control over the hand-held surgical instrument (or surgical instruments) equipped with a 13366 engine and the robotic surgical system at the same time. In several cases, information is communicated between the robotic surgical system, one or more hand-held surgical instruments equipped with a 13366 engine, central surgical controllers 13380, 13382 and secondary interactive screens 13362, 13364. This information may include, for example, on-screen images of the robotic surgical system and / or hand-held surgical instruments equipped with an engine, a parameter of the robotic surgical system and / or hand-operated surgical instruments equipped with an engine and / or a control command. control for the robotic surgical system and / or hand-held surgical instruments powered by a motor.
[00354] [00354] In several cases, the control unit of the robotic surgical system (for example, the control unit 13113 of the robotic surgical system 13110) is configured to communicate at least one display element from the surgeon's control console (for example, example, the 13116 console) to a secondary interactive screen (for example, the 13130 screen). In other words, a portion of the screen on the surgeon's console is replicated in the display of the secondary interactive screen, integrating the robot screen with the secondary interactive screen. The replication of the robot screen in the display of the secondary interactive screen allows the doctor to move away from the remote control console without losing the visual image that is displayed there. For example, at least one of the secondary interactive screens 13362, 13364 can display information from the robot, such as information from the robot screen and / or the 13370 surgeon command console.
[00355] [00355] In several cases, the secondary interactive screens 13362, 13364 are configured to control and / or adjust at least one operating parameter of the robotic surgical system. Such control can occur automatically and / or in response to a physician's action. Interacting with a touchscreen and / or buttons on the secondary interactive screen (or secondary interactive screens) 13362, 13364, the doctor is able to enter a command to control the movement and / or functionality of one or more tools robotic. For example, when using a 13366 handheld surgical instrument, the physician may wish to move the 13374 robotic tool to a different position. To control the 13374 robotic instrument, the physician applies an entry on the secondary interactive screen (or secondary interactive screens) 13362, 13364 and the respective secondary interactive screen (or secondary interactive screens) 13362, 13364 communicates the doctor's entry to the unit control of the robotic surgical system in the 13380 robotic central controller.
[00356] [00356] In several cases, a physician positioned on the 13370 remote control console of the robotic surgical system can manually override any robot command initiated by a physician's input on one or more secondary interactive screens 13362, 13364. For example, when a physician entry is received from one or more secondary interactive screens 13362, 13364, a physician positioned on the 13370 remote control console can allow the command to be issued and the desired function to be performed, or the physician can override the command by interacting with the 13370 remote control console and prohibit the command from being issued.
[00357] [00357] In certain cases, a doctor in the sterile field may need to request permission to control the 13372 robot and / or the 13374 robotic tool mounted on it. Surgeon 13371 on the 13370 remote control console can grant or deny the physician's request. For example, the surgeon may receive a pop-up notification or other notification indicating that permission is being requested by another doctor who operates a hand-held surgical instrument and / or interacts with a secondary interactive screen 13362, 13364.
[00358] [00358] “In several cases, the processor of a robotic surgical system, such as robotic surgical systems 13000 (Figure 23), 13400 (Figure 24), 13150 (Figure 30), 13100 (Figure 32) and / or central surgical controller 13380, 13382, for example, is programmed with pre-approved functions of the robotic surgical system. For example, if a physician entry from the secondary interactive screen 13362, 13364 corresponds to a pre-approved function, the robotic surgical system allows the secondary interactive screen 13362, 13364 to control the robotic surgical system and / or does not prohibit the secondary interactive screen 13362, 13364 controls the robotic surgical system. If a physician entry from the secondary interactive screen 13362, 13364 does not correspond to a pre-approved function, the secondary interactive screen 13362, 13364 is unable to command the robotic surgical system to perform the desired function. In one instance, a situational recognition module in the 13370 robotic central controller and / or in the 13382 central surgical controller is configured to determine and / or influence when the secondary interactive screen can issue control movements to the surgical system. robotic.
[00359] [00359] In several cases, a secondary interactive screen 13362, 13364 has control over a portion of the robotic surgical system by making contact with the portion of the robotic surgical system. For example, when the secondary interactive screen 13362, 13364 is placed in contact with the robotic tool 13374, control of the contacted robotic tool 13374 is granted to the secondary interactive screen 13362, 13364. A doctor can then use a sen screen - touch sensitive and / or buttons on the secondary interactive screen 13362, 13364 to enter a command to control a movement and / or functionality of the contacted robotic tool 13374. This control scheme allows a doctor to reposition a robotic arm, reload - water a robotic tool and / or, otherwise, reconfigure the robotic surgical system. In a manner similar to that discussed above, physician 13371 positioned on remote control console 13370 of the robotic surgical system can manually override any robot command initiated by the secondary interactive screen 13362, 13364.
[00360] [00360] In one aspect, the robotic surgical system includes a processor and a memory communicatively coupled to the processor, as described in the present invention. The memory stores instructions executable by the processor to receive a first user action from a console and to receive a second user action from a mobile wireless control module to control a function of a robotic surgical tool, such as in this document described.
[00361] [00361] In several respects, the present invention provides a control circuit for receiving a first user action from a console and receiving a second user action from a mobile wireless control module to control a function of a robotic surgical tool. as described in this document. In many respects, the present invention provides a computer-readable non-transitory medium that stores computer-readable instructions that, when executed, cause a machine to receive a first user action from a console and receive a second user action of a mobile wireless control module to control a function of a robotic surgical tool, as described in this document.
[00362] [00362] A robotic surgical system may include multiple robotic arms that are configured to assist the physician during a surgical procedure. Each robotic arm can be operated independently of the others. There may be a lack of communication between each of the robotic arms, as they are operated independently, which can increase the risk of trauma to the tissue. For example, in a scenario where a robotic arm is configured to apply a force that is stronger and in a different direction than a force configured to be applied by a second robotic arm, this can result in trauma to the tissue. For example, trauma and / or tearing of the tissue can occur when a first robotic arm applies a strong retraction force to the tissue while a second robotic arm is configured to hold the tissue rigidly in place.
[00363] [00363] In several cases, one or more sensors are attached to each robotic arm of a robotic surgical system. The one or more sensors are configured to detect a force applied to the surrounding tissue during the operation of the robotic arm. Such forces may include, for example, a clamping force, a retracting force and / or a dragging force. The sensor of each robotic arm is configured to communicate the magnitude and direction of the detected force to a control unit of the robotic surgical system. The control unit is configured to analyze the forces communicated and establish limits for maximum loads in order to avoid causing trauma to the tissue at a surgical site. For example, the control unit can minimize the clamping force applied by a first robotic arm if the retraction or drag force applied by a second robotic arm increases.
[00364] [00364] Figure 39 represents a robotic surgical system 13800 that includes a control unit 13820 and a robot 13810. The robotic surgical system 13800 is similar in many ways to the robotic surgical system 13000 that includes robot 13002 (Figure 23), for example. The 13820 control unit includes a 13822 processor and a display
[00365] [00365] The first robotic arm 13830 includes a first driver 13834 and a first engine 13836. When activated by processor 13822, the first engine 13836 drives the first driver 13834 by actuating the corresponding component of the first robotic arm 13830. The second robotic arm 13840 includes a second driver 13844 and a second engine 13846. When activated by processor 13822, the second engine 13846 drives the second driver 13844 acting on the corresponding component of the second robotic arm 13840.
[00366] [00366] Each of the robotic arms 13830, 13840 includes a sensor 13832, 13842 in signal communication with processor 13822 of control unit 13820. Sensors 13832, 13842 can be positioned on actuators 13834, 13844, respectively, and / or engines 13836, 13846, respectively. In several cases, sensors 13832, 13842 are configured to detect the location of each individual robotic arm 13830, 13840 within the control envelope of the robotic surgical system 13800. Sensors 13832, 13842 are configured to report the locations detected to the processor 13822 of robotic surgical system 13800. In several cases, the positions of robotic arms 13830, 13840 are displayed on screen 13824 of control unit 13820. As described in more detail below, in several cases, processor 13822 is configured to execute an algorithm to implement specific position limits for each 13830, 13840 robotic arm in an effort to prevent tissue trauma and damage to the 13800 robotic surgical system, for example. Such position limits can increase the physician's ability to cooperatively operate several robotic arms 13830, 13840 of the robotic surgical system 13800 at the same time.
[00367] [00367] In several cases, sensors 13832, 13842 are configured to detect the force exerted by each robotic arm 13830,
[00368] [00368] —For example, Figure 40 represents a surgical site and a portion of the 13800 surgical system, which includes three robotic arms, including a 13850 robotic arm (a third robotic arm) in addition to the 13830 and 13840 robotic arms, which are also represented schematically in Figure 39. The first robotic arm 13830 is configured to hold a portion of connective tissue in the stomach. In order to hold the connective tissue portion of the stomach, the first robotic arm 13830 exerts an upward Fui force and the second robotic arm 13840 applies a drag and / or Fp2 cut force to the tissue. Simultaneously, the third robotic arm 13850 retracts a portion of liver tissue in the opposite direction to the current surgical cut site, further exposing the next surgical cut site. In order to move the tissue portion of the liver out of the way of the advancing second robotic arm 13840, the third robotic arm 13850 applies a retraction force Fr3 in the opposite direction to the second robotic arm 13840. In several examples, as As the second robotic arm 13840 advances further into the surgical site, the control unit of the robotic surgical system directs the third robotic arm 13850 to increase the Fr3 retraction force exerted to continue exposing the next surgical cut site. Although Figure 40 represents a specific surgical procedure and specific robotic arms, any suitable surgical procedure can be performed, and any suitable combination of robotic arms can use the control algorithms presented in the present invention.
[00369] [00369] Figure 41 shows graphical representations 13852, 13854 of the forces exerted by robotic arms 13830, 13840 and 13850 of
[00370] [00370] In several cases, the control unit of the robotic surgical system imposes at least a strength limit, such as a maximum strength limit, as shown in graphical display 13852. In this way, the third robotic arm 13850 is prevented from exert a Fr3 retraction force greater than the maximum retraction force limit. These maximum strength limits are imposed in order to avoid trauma to the tissue and / or to prevent damage to the various robotic arms 13830, 13840 and 13850, for example.
[00371] [00371] In addition or alternatively, the 13820 control unit of the robotic surgical system 13800 can impose at least one force limit, such as a minimum force limit, as shown in graphical display 13852. In the example shown, the first robotic arm 13830 is prevented from exerting a clamping force Fx; less than the minimum holding force limit. These minimum force limits are imposed to avoid maintaining adequate tissue tension and / or the visibility of the surgical site, for example.
[00372] [00372] In several cases, the 13820 control unit of the 13800 robotic surgical system imposes maximum force differentials detected between several robotic arms during a load control mode. To establish the maximum strength differentials, the 13820 control unit of the robotic surgical system is configured to continuously monitor the difference in magnitude and direction of opposing forces by the robotic arms. As stated above, the first robotic arm 13830 is configured to hold a portion of the connective tissue of the stomach by applying a fixation force Fx1. The second robotic arm 13840 is configured to apply a drag force Fp2, which is opposed to the clamping force Fx, exerted by the first robotic arm 13830. In several cases, maximum force differentials prevent overload and / or inadvertent damage to a trapped object between robotic arms 13830, 13840 and 13850. Such objects include, for example, surrounding tissue and / or surgical components such as clasps, gastric bands and / or sphincter reinforcing devices. Opposite Fmax represents the maximum force differential defined by the 13820 control unit in this specific example.
[00373] [00373] “As can be seen in the graphical display 13852, the clamping force Fun; and the drag force Fo2 increase in magnitude at the beginning of the surgical procedure. Such an increase in magnitudes may indicate tissue traction. The clamping force Fr: and the drag force Fo2 increase in opposite directions to a point where the difference between the opposite forces is equal to the opposite Fmax. In graphical display 13852, the sloping lines highlight the point in time when the opposite Fmax is reached. Upon reaching the opposite Fmax, Processor 13822 instructs the first robotic arm 13830 to reduce the clamping force Fx; and it continues to allow the second robotic arm 13840 to exert the drag force Fp2 by the same amount, and can enable a doctor to increase the drag force. In several cases, the opposite Fmax value is determined by processor 13822 based on several variables, such as the type of surgery and / or relevant patient demographics. In many cases, the opposite Fmax is a default value stored in a processor memory
[00374] [00374] The relative positions of the robotic arms 13830, 13840 and 13850 within the surgical site are represented in graphical display 13854 of Figure 41. As the first robotic arm 13830 exerts a clamping force Fx: on the connective tissue of the stomach and the third robotic arm 13850 exerts a Fr3 retraction force on the liver tissue, the surgical site is clear and allows the second robotic arm 13840 to exert a drag and / or Fp2 cut on the desired tissue. The second robotic arm 13840 and the third robotic arm 13850 move away from the first robotic arm 13830 as the procedure progresses. When the opposite differential force Fmax is reached between the clamping force Fx and the drag force Fp2, the first robotic arm 13830 is moved closer to the second robotic arm 13840, decreasing the clamping force Fx exerted by the first 13830 robotic arm. In one aspect, the processor
[00375] [00375] In several cases, the control unit 13820 of the robotic surgical system directs the first robotic arm 13830 to maintain a specific position until a predetermined force limit between the first robotic arm 13830 and a second robotic arm 13840 is reached. When the predetermined strength limit is reached, the first robotic arm 13830 is configured to move automatically along with the second robotic arm 13840 to maintain the predetermined strength limit. The first robotic arm 13830 stops moving (or can move at a different speed) when the detected force of the second robotic arm 13840 no longer maintains the predetermined force limit.
[00376] [00376] In several cases, the 13820 control unit of the robotic surgical system is configured to switch between position control mode and load control mode in response to conditions detected by robotic arms 13830, 13840 and 13850. For example , when the first robotic arm 13830 and the second robotic arm 13840 of the robotic surgical system 13800 move freely along a surgical site, the control unit 13820 can impose a maximum force that each arm 13830, 13840 can exert. In several cases, the first and second arms 13830, 13840 each include a sensor configured to detect resistance. In other cases, the sensors can be positioned on a surgical tool, such as a surgical stapler or smart claw tool. Resistance can be found through contact with tissue and / or other surgical instruments. When such resistance is detected, the 13820 control unit can activate the load control mode and decrease the forces exerted by one and / or more than one of the 13830, 13840 robotic arms to, for example, reduce tissue damage. In several cases, the 13820 control unit can activate the position control mode and move the one and / or more than one among the robotic arms 13830, 13840 to a position where such resistance is no longer detected.
[00377] [00377] In one aspect, the 13822 processor of the 13820 control unit is configured to switch from load control mode to position control mode by moving a surgical tool mounted on one of the 13830 robotic arms , 13840 outside a defined surgical space. For example, if one of the 13830, 13840 robotic arms moves out of a defined contour around the surgical site, or to contiguous contact with an organ or other tissue, or too close to another surgical device, the 13822 processor can switch to a position control mode and avoid further movement of the robotic arm 13830, 13840 and / or moving the robotic arm 13830, 13840 back into the defined surgical space.
[00378] [00378] Now referring to the flowchart shown in Figure 42, a 13500 algorithm is started in step 13501 when the doctor and / or the robotic surgical system activates one or more of the robotic arms in step 13505. The 13500 algorithm can be employed by the ci system - robotic surgical 13800 in Figure 39, for example. Each robotic arm is in signal communication with the 13822 processor of the robotic surgical system. After activation, each robotic arm is configured to send information to the processor. In several cases, the information may include, for example, an identification of the tool clamping and / or the initial position of the activated robotic arm. In several cases, such information is communicated automatically after the tool is attached to the robotic arm, by activating the robotic arm by the robotic surgical system, and / or after interrogating the robotic arm by the processor, although the information may be sent at any appropriate time. In addition, information can be sent automatically and / or in response to a question mark.
[00379] [00379] Based on the information gathered from each of the robotic arms activated in step 13510, the processor is configured to define a position limit for each specific robotic arm within a working envelope of the robotic surgical system in step 13515. The position limit can define the three-dimensional contours where each robotic arm can move. The definition of position limits allows the efficient and cooperative use of each activated robotic arm, while, for example, it prevents trauma to the surrounding tissue and / or collisions between activated robotic arms. In many cases, the processor includes a memory that includes a set of stored data to assist in defining each position limit. The stored data can be specific to the surgical procedure
[00380] [00380] The processor is then configured to assess whether the detected position is within the predefined position limit (s) in step 13530. In cases where it is impossible to gather information from the robotic arm and the doctor's entry is absent, a standard position limit is assigned in step 13533. This standard position limit assigns a conservative three-dimensional outline to minimize, for example, tissue trauma and / or collisions between robotic arms. If the detected limit is within the position limit, the processor is configured to allow the robotic arm (or arms) to remain in position and / or move (m) freely within the surgical site in step 13535, and the monitoring process continues as long as the robotic arm is still activated. If the detected limit is outside the position limit, the processor is configured to move the robotic arm back to the position limit in step 13532, and the monitoring process continues as long as the robotic arm is still activated.
[00381] [00381] The processor is configured to continuously monitor the position of each robotic arm in step 13525. In several cases, the processor is configured to send interrogation signals repeatedly at predetermined time intervals. As discussed above, if the detected position exceeds the position limit defined for the specific robotic arm, in certain cases, the processor is configured to automatically move the robotic arm back into the three-dimensional boundary in step 13532. In certain cases , the processor is configured to readjust the position limits of the other rotary arms in response to a robotic arm that exceeds its original position limit. In certain cases, before moving the robotic arm back into its position limit and / or adjusting the position limits of the other robotic arms, the processor is configured to alert the physician. If the detected position is within the established position limit for the robotic arm, the processor allows the robotic arm to remain in the same position and / or move freely until the detected position exceeds the position limit in step 13535. If the processor is unable to detect the position of the robotic arm, the processor is configured to alert the physician and / or assign the robotic arm the default position limit in step 13533. The processor is configured to monitor the position of each robotic arm until the surgery is completed and / or the robotic arm is disabled.
[00382] [00382] Similar to the algorithm in Figure 42, the flowchart in Figure 43 represents a 13600 algorithm that starts in step 13601 when a doctor and / or a robotic surgical system activates one or more of the robotic arms in step 13605. The 13600 algorithm can be
[00383] [00383] Based on the information collected from each of the activated robotic arms, the processor is configured to set a force limit for each specific robotic arm in step 13615. The force limit defines maximum and minimum force limits for forces exercised by each robotic arm. Additionally or alternatively, a strength limit can be the maximum strength differential between two or more arms. Force limit settings allow efficient and cooperative use of all activated robotic arms, while, for example, preventing trauma to the surrounding tissue and / or damage to the robotic arms. In several cases, the processor includes a memory that includes a set of stored data to assist in defining each strength limit. The stored data can be specific to the specific surgical procedure, the fixation of a robotic tool and / or relevant patient demographic data, for example. In several cases, the doctor can assist in setting the strength limit for each activated robotic arm. In cases where it is not possible to collect information from the robotic arm and the doctor's input is absent, a standard strength limit is assigned. Such a standard strength limit assigns conservative maximum and minimum strength limits to minimize, for example, tissue trauma and / or damage to robotic arms.
[00384] [00384] The processor is configured to determine whether the robotic arm is active in step 13620. If the processor determines that the robotic arm has been disabled, the processor is configured to stop monitoring the force in step 13622. After having determined that the robotic arm is still activated in step 13620, the processor is configured to continuously monitor the force exerted by each robotic arm in step 13625. In several cases, the processor is configured to send repeated interrogation signals - at predetermined time intervals. If the detected force exceeds the maximum force limit established for the specific robotic arm, in certain cases, the processor is configured to automatically decrease the force exerted by the robotic arm and / or decrease an opposite force exerted by another robotic arm in the step 13632. In certain cases, the processor is configured to reset the force limits assigned to the other robotic arms in response to a robotic arm that exceeds its original strength limits. In certain cases, before adjusting the force exerted by the robotic arm, adjusting the opposite force exerted by another robotic arm and / or adjusting the force limit of the other robotic arms, the processor is configured to alert the doctor. If the detected force is within the force limit established for the robotic arm, the robotic arm can maintain the application of force and / or the physician can increase or decrease the force exerted until the force is outside the limit of force. force defined in step
[00385] [00385] Similar to the algorithms in Figures 42 and 43, the flowchart in Figure 44 represents a 13700 algorithm that starts 13701 when a doctor and / or a robotic surgical system activates one or more of the 13705 robotic arms. The 13700 algorithm can be used robotic surgical system 13800 in Figure 39, for example. Each robotic arm is in signal communication with the processor. After activation, each robotic arm is configured to send information to the processor at step 13710. In several cases, the information may include, for example, the identification of tool clamping, forces detected by one or more force sensors on the robotic arm and / or the initial position of the activated robotic arm. In several cases, such information is communicated automatically after the tool is attached to the robotic arm, by activating the robotic arm by the robotic surgical system, and / or after interrogating the robotic arm by the processor, although the information can be sent in any appropriate time. In several cases, information is sent automatically and / or in response to a question mark.
[00386] [00386] Based on the information collected from all activated robotic arms, the processor is configured to adjust both a position limit within a working envelope of the robotic surgical system and a force limit for each robotic arm. specific point in step 13715. The limit position defines three-dimensional contours where each robotic arm can move. Defining position limits allows for efficient and cooperative use of all activated robotic arms, while, for example, preventing trauma to the surrounding tissue and / or collisions between activated robotic arms. The force limit defines maximum and / or minimum force limits for forces exerted by each robotic arm. Additionally or alternatively, a strength limit can be the maximum strength differential between two or more arms. The definition of force limits allows the efficient and cooperative use of activated robotic arms, while, for example, it prevents trauma to the surrounding tissue and / or damage to the robotic arms.
[00387] [00387] In several cases, the processor includes a memory that includes a set of stored data to assist in the definition of each position limit and force limit. The stored data can be specific to the specific surgical procedure, the fixation of a robotic tool and / or relevant patient demographic data, for example. In several cases, the doctor can assist in setting the position limit and strength limit for each activated robotic arm. In cases where it is not possible to collect information from the robotic arm and the physician's input is absent, a standard position limit and / or standard strength limit is assigned to the robotic arm. Such a standard position limit assigns a conservative three-dimensional contour to minimize, for example, trauma to tissue and / or collisions between robotic arms, while the standard force limit assigns maximum and / or minimum force limits to minimize, for example. example, tissue trauma and / or damage to robotic arms. In several cases, the processor is configured to adjust the position limit of one robotic arm based on the strength limit of another robotic arm, adjust the strength limit of one robotic arm based on the position limit of another robotic arm , and vice versa.
[00388] [00388] The processor is configured to determine whether the robotic arm is active in step 13720. After the processor has determined that the robotic arm is active in step 13720, the processor is configured to continuously monitor the position of each arm 13737 and the force exerted by each robotic arm in step 13725. If the robotic arm is no longer activated, the processor is configured to end position monitoring in step 13727 and end force monitoring in step 13722. In In many cases, the processor is configured to send interrogation signals repeatedly at predetermined time intervals. If the detected condition exceeds the position limit defined for the specific robotic arm, in certain cases, the processor is configured to automatically move the robotic arm back into the three-dimensional contour in the step
[00389] [00389] In certain cases, the robotic surgical system includes a manual override configured to control the position of each robotic arm. If the detected force exceeds the maximum force limit established for the specific robotic arm, in certain cases, the processor is configured to automatically decrease the force exerted by the robotic arm and / or decrease an opposite force exerted by another robotic arm in the step 13732. In certain cases, before decreasing the force exerted by the robotic arm and / or decreasing the opposite force exerted by another robotic arm, the processor is configured to alert the physician. If the detected force is within the force limit set for the robotic arm, the robotic arm can maintain the application of force and / or increase or decrease the force exerted until the force is outside the force limit defined in step 13735 If the processor is unable to detect the force exerted on the robotic arm, the processor is configured to alert the physician and / or rewrite the original strength limit of the robotic arm with the standard force limit in step 13733. The processor is configured to monitor the force exerted on each robotic arm until surgery is completed and / or the robotic arm is disabled.
[00390] [00390] In several cases, the position monitoring system and the force monitoring system are interconnected. In certain cases, the force monitoring system may override the resulting decision 13742, 14743, 14745 from the position detection step
[00391] [00391] A doctor can manually override the automatic adjustments implemented in the mode (or modes) of load control and / or position described in the present invention. Manual overrun can be a one-time adjustment for the surgical robot. In other cases, manual overrun can be an adjustment that turns off the automatic load mode and / or position for a given surgical action, a specific duration and / or an overall override for the entire procedure.
[00392] [00392] In one aspect, the robotic surgical system includes a processor and a memory communicatively coupled to the processor, as described in the present invention. The processor is communally coupled to a first force sensor and a second force sensor, and the memory stores instructions executable by the processor to perform the cooperative movement of a first robotic arm and a second robotic arm based on a first input to from the first force sensor and from a second input from the second force sensor in a load control mode, as described in the present invention.
[00393] [00393] In several aspects, the present invention provides a control circuit to affect the cooperative movement of a first robotic arm and a second robotic arm, as described in the present invention. In several respects, the present invention provides a non-transitory, computer-readable medium that stores computer-readable instructions that, when executed, cause the machine to affect the cooperative movement of a first robotic arm and a second robotic arm, as described in the present invention.
[00394] [00394] “During a specific surgical procedure, doctors can count on one or more hand-held surgical instruments equipped with a motor in addition to a robotic surgical system. In several cases, the instruments are controlled and monitored through different platforms, which can inhibit the communication between the instruments and the robotic surgical system. For example, instruments can be produced by different manufacturers and even by competitors. Such instruments may have different communication packages and / or communication and / or connection protocols. The lack of communication between an instrument equipped with a motor and the robotic surgical system can delay cooperative and / or coordinated use and can complicate the surgical procedure for the physician. For example, each surgical instrument can include an individual screen to communicate various information and operating parameters. In such a scenario, a doctor may need to look at several instrument-specific screens to monitor operational status and analyze data gathered by each device.
[00395] [00395] In several cases, a robotic surgical system is configured to detect the presence of other surgical instruments equipped with a motor that are controlled by platforms other than the robotic surgical system. The robotic surgical system can incorporate a central controller, that is, a robotic central controller like the robotic central controllers 122 (Figure 2) and 222 (Figure 9), which can detect other surgical instruments equipped with a motor, for example. In other cases, an autonomous central surgical controller such as central controller 106 (Figures 1 to 3) or central controller 206 (Figure 9) in communication with the robotic surgical system can facilitate the detection of non-robotic surgical instruments and the use co-operative and / or coordinated surgical instruments detected with the robotic surgical system. The central controller, which can be a robotic central controller or a central surgical controller, is configured to display the position and orientation of surgical instruments equipped with a motor in relation to the working envelope of the robotic surgical system. In certain cases, the work envelope can be an operating room, for example. A central surgical controller that has situational recognition capabilities is further described in this document and in US provisional patent application serial number 62 / 611.341, entitled INTERACTIVE SURGICAL PLAT-FORM, filed on December 28, 2017, which is in this document incorporated as a reference in its entirety. In one aspect, the central controller can first check the contours of the work envelope and then detect the presence of other surgical instruments equipped with a motor inside the work envelope.
[00396] [00396] Figure 45 shows a surgical system 13860 that includes a robotic surgical system 13865, a surgical instrument 13890 and a central surgical controller 13870. The surgical instrument 13890 is a hand-held instrument equipped with a motor, and can be a motorized surgical stapler, such as the motorized linear stapler described in Figure 46, for example. The 13865 surgical system can be similar in many ways to the 13000 robotic surgical system (Figure 23), for example. As described in the present invention, the central surgical controller 13870 can be incorporated into the robotic surgical system 13865, for example. Central surgical controller 13870 is configured to be in signal communication with robotic surgical system 13865 and surgical instrument 13890. In other cases, surgical system 13860 may include additional hand-held surgical instruments. The robotic surgical system 13865 includes a robot 13861, which may be similar to robot 13002, for example. The 13865 robotic surgical system also includes a 13862 control unit and a surgeon control console, or remote control module, 13864. The surgeon control console 13864 is configured to receive an action from the doctor. The 13862 control unit includes a 13868 robot screen and a 13866 processor. The 13890 surgical instrument includes a 13894 screen and a 13892 processor.
[00397] [00397] In several cases, the 13870 central surgical controller includes a 13880 central surgical controller screen, which may be similar to the screens of the visualization system 108 (Figure 1). The 13880 central surgical controller screen may include, for example, an attention screen. Central surgical controller 13880 is configured to detect the presence of surgical instrument 13890 within a certain distance from central surgical controller 13870. For example, central surgical controller 13870 is configured to detect the presence of all activated surgical instruments 13890 inside an operating room, although any suitable distance can be monitored. In several cases, the 13870 central surgical controller is configured to display the presence of all activated 13890 surgical instruments on the 13880 central surgical controller screen.
[00398] [00398] “A specific hand-held surgical instrument communicates through a first communication process using a first language. A specific robotic surgical system communicates through a second communication process using a second language. In many cases, the first communication process is the same as the second communication process. When the first communication process is the same as the second communication process, the 13890 surgical instrument is configured to communicate information directly to the 13870 central surgical controller and / or to the 13865 robotic surgical system. Such information includes, for example , a model number and / or type of the surgical instrument, a position of the surgical instrument, an operational status of the surgical instrument and / or any other relevant parameter of the surgical instrument.
[00399] [00399] In several cases, the first communication process is different from the second communication process. For example, a surgical system (for example, a robot) developed by a first manufacturer may use a proprietary first language or communication scheme and a surgical system (for example, a hand held surgical tool) developed by a second manufacturer may use a different second proprietary language or communication scheme. Despite the language difference / barrier, the 13870 central surgical controller and / or the 13865 surgical robot are configured to detect 13890 surgical instruments that operate in different communication processes. When the 13870 central surgical controller does not recognize the communication process used by a handheld surgical instrument equipped with a specific motor, the 13870 central surgical controller is configured to detect various signals, such as transmissions over Wi-Fi and Bluetooth, emitted by instruments surgical instruments equipped with motor. Based on the detected signal transmissions, the 13870 central surgical controller is configured to alert the physician to all motor-powered surgical instruments that do not use the same communication process as the 13865 robotic surgical system. All data received from newly detected hand-held surgical instruments with motor can be stored inside the 13870 central surgical controller so that newly detected hand-operated surgical instruments are recognized by the 13870 central surgical controller in the future.
[00400] [00400] In several cases, the 13870 central surgical controller is configured to detect the presence of hand-held surgical instruments equipped with a motor by detecting the magnetic presence of a battery, energy use and / or an electromagnetic field emitted at starting from hand-operated surgical instruments equipped with an active motor, regardless of whether the hand-operated surgical instruments equipped with an engine made any attempt to communicate with another surgical instrument, such as the robotic surgical system.
[00401] [00401] Orobô13861 and surgical instrument 13890 are exemplified in an exemplary surgical procedure in Figure 46. In this example, surgical instrument 13890 is an articulated linear stapler. As shown in Figure 46, the surgical instrument 13890 includes a motor 13895 in the handle 13892 thereof. In other cases, the surgical instrument 13890 may include a plurality of motors positioned along the surgical instrument. The 13895 motor is configured to emit a 13896 electromagnetic field, which can be detected by the 13865 robotic surgical system or the 13870 central surgical controller. For example, the main robot tower or the 13870 central surgical controller modular control tower may include a receiver to detect electromagnetic fields within the operating room.
[00402] [00402] In one aspect, a processor of the robotic surgical system (for example, a processor from the 13862 control unit) is configured to calculate a contour around the surgical instrument
[00403] [00403] In one example, the robotic surgical system can calculate a broader first B2 contour around the surgical instrument. When a robotic surgical instrument approaches the broader B2 contour, the 13861 robotic surgical tool may issue a notification or alert to the surgeon that the robotic surgical tool attached to the 13861 robot is approaching another 13890 surgical instrument. In certain cases, if the surgeon continues to advance the robotic surgical tool towards surgical instrument 13890 and towards a second contour B; narrower, the robotic surgical system 13865 can stop the advancement of the robotic surgical tool. For example, if the robotic surgical tool crosses the B: narrower boundary, the advancement of the robotic surgical tool may be interrupted. In such cases, if the surgeon still wants to continue advancing the robotic surgical tool within the B: narrower contour, the surgeon can overcome the sudden stop feature of the robotic surgical system 13865.
[00404] [00404] - Again with reference to Figure 45, the 13860 surgical system includes multiple display monitors. Each 13890 handheld surgical instrument and 13865 robotic surgical system are configured to communicate a video transmission and / or representative image of the screen on each device to the 13870 central surgical controller and / or the 13880 central controller screen. This video transmission and / or image can include operating parameters and / or conditions detected by each 13890 handheld surgical instrument and / or by the robotic surgical system 13865. The central controller 13870 is configured to control the video and / or image transmissions in each within one or more display monitors throughout the 13800 system. In several cases, each display monitors displays an individual video and / or image transmission from a specific surgical device or system. In several cases, the individual video and / or image transmission can be superimposed on additional information and / or video and / or image transmissions from other devices or systems. Such information may include operational parameters and / or conditions detected. The 13870 central surgical controller is configured to request which display monitor displays which video and / or image transmission. In other words, the communication link between the central surgical controller 13870 and the central controller screen 13880 allows the central surgical controller 13870 to dictate which video and / or image transmission is assigned to which display monitor, while the control direct from one or more display monitors remains with the central video controller. In several cases, the 13880 central controller screen is configured to separate one or more display monitors from the 13870 central surgical controller and allow a different central surgical controller or surgical device to display relevant information on separate display monitors. .
[00405] [00405] In several cases, the central surgical controller is configured to communicate stored data with other data systems within an institutional data barrier that allows cooperative use of data. Such established data systems may include, for example, a database of electronic medical records (EMR). The central surgical controller is configured to use communication between the central surgical controller and the EMR database to link the hospital's general surgical trends to local data sets recorded while using the central surgical controller.
[00406] [00406] In several cases, the central surgical controller is located in a specific operating room in a hospital and / or surgical center. As shown in Figure 47, the hospital and / or operating room include OR, OR2, OR; 3 and OR operating rooms. Three of the OR2, OR3 and OR 'operating rooms shown in Figure 47 include a central surgical controller 13910, 13920, 13930, respectively; however, any suitable number of central surgical controllers can be used. Each 13910, 13920, 13930 central surgical controller is configured to be in signal communication with each other, represented by signal arrows A. Each 13910, 13920, 13930 central surgical controller is also configured to be in communication via signal with a primary server 13940, represented by the arrows B in Figure 47.
[00407] [00407] In several examples, how data is communicated between the central surgical controller (or central surgical controllers) 13910, 13920, 13930 and the various surgical instruments during a surgical procedure, the central surgical controller (or central surgical controllers) 13910, 13920, 13930 is (are) configured (s) to temporarily store the reported data. At the end of the surgical procedure and / or at the end of a predetermined period of time, each central surgical controller 13910, 13920, 13930 is configured to communicate the stored information to the primary server 13940. When the stored information is communicated to the primary server 13940 , the information can be deleted from the memory of the individual central surgical controller 13910, 13920,
[00408] [00408] “With reference to Figures 47 and 48, as data begins to be communicated from each central control controller 13910, 13920, 13930 to the primary server 13940, a 13990 queue is created to prioritize the order in which the data is communicated. In many cases, the 13990 queue prioritizes data as first entry, first exit, although any suitable prioritization protocol can be used. In many cases, the 13990 queue is configured to re-prioritize the order in which the received data is communicated when priority events and / or abnormal data are detected. As shown in Figure 48, a first central surgical controller communicates a first data set at time t = 1 in block 13960. Since the first data set has the only data in the queue for external output in block 13992, the first data set is the first to be reported. Thus, row 13990 prioritizes the first set of data for external output in block 13965. A second central surgical controller communicates a second set of data at time t = 2 in block 13970. At time t = 2, the first data set was not communicated externally in block 13994. However, since no priority events and / or abnormal data are present in the second data set, the second data set is the second in the queue to be reported in block 13975 externally. A third central surgical controller communicates a third set of data marked as urgent at time t = 3 in block 13980. At time t = 3, the first data set and the second data set were not communicated externally, however, a priority event was detected in the third data set in block 13985. The queue is configured to re-prioritize data sets to allow the third prioritized data set to be in the first position for exit block 13996, above the first set of data and the second set of data collected at times t = 1 and t = 2, respectively.
[00409] [00409] In one aspect, the central surgical controller includes a processor and a memory communicatively coupled to the processor, as described in the present invention. The memory stores instructions executable by the processor to detect the presence of a surgical instrument equipped with a motor and represent the surgical instrument equipped with a motor on a central controller screen, as described in the present invention.
[00410] [00410] In several aspects, the present invention provides a control circuit to detect the presence of a surgical instrument equipped with a motor and represent the surgical instrument equipped with a motor on a central controller screen, as described in the present document. In several respects, the present invention provides a minimum
[00411] [00411] All of the descriptions of: * “US Patent No. 9,072,535, filed on May 27, 2011, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTA-TABLE STAPLE DEPLOYMENT ARRANGEMENTS, which was granted on July 7, 2015; * US Patent No. 9,072,536, filed on June 28, 2012, entitled DIFFERENTIAL LOCKING ARRANGEMENTS FOR ROTARY POWERED SURGICAL INSTRUMENTS, which was granted on July 7, 2015; * US Patent No. 9,204,879, filed on June 28, 2012, entitled FLEXIBLE DRIVE MEMBER, which was granted on December 8, 2015; * “US Patent No. 9,561,038, filed on June 28, 2012, entitled INTERCHANGEABLE CLIP APPLIER, which was granted on February 7, 2017; * US Patent No. 9,757,128, filed on September 5, 2014, entitled MULTIPLE SENSORS WITH ONE SENSOR AF- FECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION, which was granted on September 12, 2017; * —US patent application serial number 14 / 640,935, entitled OVERLAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION, filed on March 6, 2015, now publication of US patent application No. 2016/0256071; * —US patent application serial number 15 / 382,238, entitled MODULAR BATTERY POWERED HANDHELD SURGICAL INSTRUENT WITH SELECTIVE APPLICATION OF ENERGY BASED ON TIS-SUE CHARACTERIZATION, filed on December 16, 2016, now publication of US patent application no. 2017/0202591; and * “US patent application No. 15 / 237,753, entitled CON-
[00412] [00412] Various aspects of the subject described in this document are defined in the following numbered examples.
[00413] [00413] Example 1- A surgical system comprises a robotic tool, a robot control system, a surgical instrument and a central surgical controller comprising a screen. The robot control system comprises a control console and a control unit in signal communication with the control console and the robotic tool. The central surgical controller is communicating the signal with the robot control system, and the central surgical controller is configured to detect the surgical instrument and represent the surgical instrument on the screen.
[00414] [00414] Example2-oThe surgical system according to Example 1, in which the surgical instrument comprises a motorized autonomous surgical instrument.
[00415] [00415] Example3-The surgical system according to any of Examples 1 and 2, in which the surgical instrument is Independent of the robot control system.
[00416] [00416] Example4-oThe surgical system according to any of Examples 1 to 3, in which the central surgical controller is configured to show a location of the surgical instrument on said screen.
[00417] [00417] Example5-The surgical system according to any of Examples 1 to 4, in which the central surgical controller is configured to show an operational status of the surgical instrument on the screen.
[00418] [00418] Example6 - The surgical system according to any of Examples 1 to 5, in which the screen comprises an attention screen.
[00419] [00419] Example 7-The surgical system according to any of Examples 1 to 6, in which the central surgical controller additionally comprises a situational recognition module configured to recommend a surgical function based on the detection of the surgical instrument in relative to a position of the robotic tool.
[00420] [00420] Example 8 - A surgical system comprises a robotic tool, a robot control system, a surgical instrument operable in a plurality of operating states and a central surgical controller comprising a screen. The robot control system comprises a control console and a control unit in signal communication with the control console and the robotic tool. The central surgical controller is in signal communication with the robot control system, and the central surgical controller is configured to detect an activated operating state of the surgical instrument and represent the active operating state on the screen.
[00421] [00421] Example 9 -The surgical system according to Example 8, in which the surgical instrument comprises a motorized surgical device.
[00422] [00422] Example 10 - The surgical system according to any of Examples 8 and 9, in which the surgical instrument is an autonomous surgical instrument.
[00423] [00423] Example 11-0The surgical system according to any of Examples 8 to 10, in which the central surgical controller is configured to show an orientation of the surgical instrument on the screen.
[00424] [00424] Example 12-0The surgical system according to any of Examples 8 to 11, in which the central surgical controller is configured to show an operational status of the surgical instrument on the screen.
[00425] [00425] “Example 13-The surgical system according to any of Examples 8 to 12, which additionally comprises a situational recognition module configured to recommend a surgical function based on the detection of the surgical instrument in relation to a position of the robotic tool .
[00426] [00426] Example 14 - A surgical system comprises a robotic tool, a robot control system, a surgical instrument, a central surgical controller and a screen in signal communication with the central surgical controller. The robot control system comprises a control console and a control unit in signal communication with the control console and the robotic tool. The central surgical controller is in signal communication with the robot control system, and the central surgical controller is configured to detect the surgical instrument; The central surgical controller is configured to represent the surgical instrument on the screen.
[00427] [00427] Example 15-0The surgical system according to Example 14, wherein the surgical instrument comprises a motorized surgical instrument.
[00428] [00428] Example 16 -The surgical system according to any of Examples 14 and 15, in which the surgical instrument is independent of the robot control system.
[00429] [00429] “Example 17 -The surgical system according to any of Examples 14 to 16, in which the central surgical controller is configured to show a position of the surgical instrument on the screen.
[00430] [00430] Example 18-The surgical system according to any of Examples 14 to 17, in which the central surgical controller is configured to show an operational status of the surgical instrument on the screen.
[00431] [00431] Example 19 -The surgical system according to any of Examples 14 to 18, in which the screen comprises an attention screen.
[00432] [00432] Example 20 - The surgical system according to any of Examples 14 to 19, which additionally comprises a situational recognition module configured to recommend a surgical function based on the detection of the surgical instrument in relation to a position of the tool robotics
[00433] [00433] 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,
[00434] [00434] 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 in this document described, in whole or in part, can be implemented in an equivalent way in integrated circuits, such as one or more computer programs executed in one or more computers (for example, 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 any combination thereof, and that designing the circuit and / or writing the code for the software and firmware would be within the scope of practice of the person skilled in the art, in light of this invention. In addition, those skilled in the art will understand that the mechanisms of the subject in this document described can be distributed as one or more program products in a variety of ways and that an illustrative form of the subject in this document is applicable regardless of the specific type of signal transmission medium used to effectively carry out the distribution.
[00435] [00435] 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), read-only memory electrically erasable programmable (EEPROM), magnetic or optical cards, flash memory, or a machine-readable tangible storage medium used to transmit information over the Internet via electrical, optical, acoustic or other forms of propagated signals ( for example, carrier waves, infrared signal, digital signals, etc.). As a result, computer-readable non-transitory media includes any type of machine-readable media suitable for storing or transmitting instructions or electronic information in a machine-readable form (for example, a computer).
[00436] [00436] As used in any aspect of the present invention, the term "control circuit" can refer to, for example, a wired circuit, programmable circuits (for example, a computer processor comprising one or more cores individual instruction processing units, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (PSD), programmable logic device (PLD), programmable logic matrix (PLA), or arrangement field programmable ports (FPGA), state machine circuits, firmware that stores instructions executed by the programmable circuit, and any combination of them. 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 integrated circuit for a 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 execute processes and / or devices described in this document, or a microprocessor configured by a computer program that at least partially execute the processes and / or devices described in this document), 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 key, or optical-electrical equipment). Those skilled in the art will recognize that the subject in this document described can be implemented in an analog or digital way, or in some combination of these.
[00437] [00437] 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 may 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 embedded as code, instructions or instruction sets and / or data that are hard-coded (for example, non-volatile) in memory devices.
[00438] [00438] “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 software running.
[00439] [00439] As in the present document 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 states logic that can, although not necessarily need, take the form of electrical or magnetic signals that can be stored, transferred, combined, compared and manipulated in any other way. It is a common use to call these signs bits, values, elements, symbols, characters, terms, numbers or the like. These terms and similar terms can be associated with the appropriate physical quantities and are merely convenient identifications applied to these quantities and / or states.
[00440] [00440] 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 "EEE 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
[00441] [00441] Unless otherwise stated, as is evident from the preceding invention, it is understood that, throughout the preceding invention, discussions using terms such as "processing", "computation", "calculation", "determination", "display" or similar, refer to the action and processes of a computer system, or similar electronic computing device, that manipulates and transforms the data represented in the form of physical (electronic) quantities in the records and in the computer system memories in other data represented in a similar way in the form of physical quantities in the memories or records of the computer system, or other similar information storage, transmission or display devices.
[00442] [00442] “One or more components in the present invention may be called" configured for "," configurable for "," operable / operable for "," adapted / adaptable for "," capable of "," conformable / conformed for ", etc. Those skilled in the art will recognize that "configured for" can, in general, encompass components in an active state and / or components in an inactive state and / or components in a state of wait, except when the context dictates otherwise.
[00443] [00443] The terms "proximal" and "distal" are used in the present invention with reference to a physician who handles the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the doctor, and the term "distal" refers to the portion located opposite the doctor. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down" can be used in the present 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.
[00444] [00444] Persons skilled in the art will recognize that, in general, the terms used in this document, and especially in the appended claims (for example, appended claim bodies) are generally intended as "open" terms (for example, 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,
[00445] [00445] 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, "a system that has at least one of A, B and C"
[00446] [00446] 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
[00447] [00447] 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 particular 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 exemplification", "in one (1) exemplification", in several places throughout this specification does not necessarily refer to - refer to the same aspect. In addition, specific resources, structures or characteristics can be combined in any appropriate way in one or more aspects.
[00448] [00448] “Any patent application, patent, non-patent publication or other description material mentioned in this specification and / or mentioned in any order data sheet is in this document incorporated by reference, until the point where the embedded materials are not inconsistent with this. Accordingly, and to the extent necessary, the invention as explicitly presented herein replaces any conflicting material incorporated by reference into the present invention. Any material, or portion thereof, taken as in this document incorporated by reference, but which conflicts with the definitions, declarations, or other invention materials present in this document, will be presented in this document only to the extent that there is no conflict between the built-in material and the existing inventive material.
[00449] [00449] In summary, numerous benefits have been described that result from the use of the concepts described in this document. The previously mentioned description of one or more modalities has been presented for purposes of illustration and description. This description is not intended to be exhaustive or to limit the invention to the precise form 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 several modifications, as they are convenient for the specific use contemplated. The claims presented in the annex are intended to define the global scope.

权利要求:
Claims (20)
[1]
1. Surgical system, characterized by comprising: a robotic tool; a robot control system comprising: a control console; and a control unit in signal communication with said control console and said robotic tool; a surgical instrument; and a central surgical controller comprising a screen, said central surgical controller being in signal communication with said robot control system, and said central surgical controller being configured to detect said surgical instrument and represent said surgical instrument on said screen.
[2]
2. Surgical system, according to claim 1, characterized in that said surgical instrument comprises a motorized autonomous surgical instrument.
[3]
3. Surgical system, according to claim 1, characterized in that said surgical instrument is independent of said robot control system.
[4]
4. Surgical system, according to claim 1, characterized in that said central surgical controller is configured to show a location of said surgical instrument on said screen.
[5]
5. Surgical system, according to claim 1, characterized in that said central surgical controller is configured to show an operational state of said surgical instrument in said screen.
[6]
6. Surgical system, according to claim 1, characterized in that said screen comprises a user interface screen.
[7]
7. Surgical system, according to claim 1, characterized in that said central surgical controller further comprises a situational recognition module configured to recommend a surgical function based on the detection of said surgical instrument in relation to a position of the said robotic tool.
[8]
8. Surgical system, characterized by comprising: a robotic tool; a robot control system comprising: a control console; and a control unit in signal communication with said control console and said robotic tool; a surgical instrument operable in a plurality of operational states; and a central surgical controller comprising a screen, said central surgical controller being in signal communication with said robot control system, and said central surgical controller being configured to detect an operational state activated of said surgical instrument and represent said active operational state in said screen.
[9]
9. Surgical system, according to claim 8, characterized in that said surgical instrument comprises a motorized surgical device.
[10]
10. Surgical system, according to claim 8, characterized in that said surgical instrument is an autonomous surgical instrument.
[11]
11. Surgical system, according to claim 8, characterized in that said central surgical controller is configured to show an orientation of said surgical instrument on said screen.
[12]
12. Surgical system, according to claim 8, characterized in that said central surgical controller is configured to show an operational state of said surgical instrument on said screen.
[13]
13. Surgical system, according to claim 8, characterized by also comprising a situational recognition module configured to recommend a surgical function based on the detection of said surgical instrument in relation to a position of said robotic tool.
[14]
14. Surgical system, characterized by comprising: a robotic tool; a robot control system comprising: a control console; and a control unit in signal communication with said control console and said robotic tool; a surgical instrument; a central surgical controller, said central surgical controller being in signal communication with said robot control system, and said central surgical controller being configured to detect said surgical instrument; and a screen in signal communication with said central surgical controller, said central surgical controller being configured to represent said surgical instrument on said screen.
[15]
15. Surgical system, according to claim 14, characterized in that said surgical instrument comprises a motorized surgical instrument.
[16]
16. Surgical system, according to claim 14, characterized in that said surgical instrument is independent of said robot control system.
[17]
17. Surgical system, according to claim 14, characterized in that said central surgical controller is configured to show a position of said surgical instrument on said screen.
[18]
18. Surgical system, according to claim 14, characterized in that said central surgical controller is configured to show an operational status of said surgical instrument on said screen.
[19]
19. Surgical system, according to claim 14, characterized in that said screen comprises a user interface screen.
[20]
20. Surgical system, according to claim 14, characterized by also comprising a situational recognition module configured to recommend a surgical function based on the detection of said surgical instrument in relation to a position of said robotic tool.
N o ou = | E 58 = 23
E À Sb 2 = s 3: oo o o = [ES O if ur & Ol 'ES 250 BS
EG PE zo
The 8 is
H e. f Oo as ss = ”as z mm | PSS A = 83 rr o> o | - o: o: oO o e q = o E = ll LL are ê = E = ES ã É ão 4 3 O = É E = = <oE & 2:: 3 E o = | Ee sz i Es o Seo 'Po 22S | 88T It's du TS | OE
ZOO Oo 8 At 2 o 2 | Ez ions
ES ne 2
NE N HS Ss kh | mm No NO S = SS S E - SS ISEN | / S A À = - NS> Ci ES <Y7
UNR MONITOR 135 -
IMAGE 138 [| SYSTEM 140 GENERATOR MODULE L MONOPOLAR DISPLAY 108 1a mou | 144 [1,146 [| Aan 126 MODULE EVACUATION OF ROBOTIC SMOKE 110
128 MODULE | SUCTION / IRRIGATION
INSTRUMENT MODULE 130 I INTELLIGENT COMMUNICATION 12 MODULE 132 | 136 1347 MATRIX PROCESSOR STORAGE
MODULE OF
MAPPING 133 OPERATION ROOM

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同族专利:

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公开号 | 公开日

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EP3635742A1|2020-04-15|

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US20190201142A1|2019-07-04|

---

CN111542271A|2020-08-14|

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US20190201118A1|2019-07-04|

---

US11058498B2|2021-07-13|

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JP2021509314A|2021-03-25|

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CN111565666A|2020-08-21|

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WO2019130098A1|2019-07-04|

---

BR112020013062A2|2020-12-01|

---

US20190201135A1|2019-07-04|

---

WO2019130099A1|2019-07-04|

---

JP2021509033A|2021-03-18|

---

CN111527551A|2020-08-11|

---

US20190201145A1|2019-07-04|

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BR112020013153A2|2020-12-01|

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JP2021509305A|2021-03-25|

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JP2021509034A|2021-03-18|

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EP3634250A1|2020-04-15|

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BR112020013116A2|2020-12-01|

---

CN111512391A|2020-08-07|

---

WO2019130100A1|2019-07-04|

---

WO2019130101A1|2019-07-04|

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

优先权:

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申请号 | 申请日 | 专利标题

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

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

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

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

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

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

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US201862649307P| true| 2018-03-28|2018-03-28|

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US62/649,307|2018-03-28|

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US15/940,690|US20190201118A1|2017-12-28|2018-03-29|Display arrangements for robot-assisted surgical platforms|

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US15/940,690|2018-03-29|

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PCT/IB2018/057453|WO2019130101A1|2017-12-28|2018-09-26|Display arrangements for robot-assisted surgical platforms|

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