wirelessly pairing a surgical device with another device within a sterile surgical field based on th

专利摘要:
The present invention relates to a surgical system that includes a first surgical device that comprises a control circuit. The control circuit is configured to have situational recognition of events that occur in the vicinity of the first surgical device according to the data received from a database, a patient monitoring device, or a paired surgical device, or any other device. combination of a database, a patient monitoring device, or a paired surgical device. The control circuit is configured to be wirelessly paired with a second surgical device according to the use of the first surgical device and the events of which the first surgical device is situationally aware.
公开号:BR112020013079A2
申请号:R112020013079-6
申请日:2018-11-14
公开日:2020-12-01
发明作者:Frederick E. Shelton Iv；Jason L. Harris
申请人:Ethicon Llc；
IPC主号:

专利说明:

[0001] [0001] The present application claims the priority benefit of US non-provisional patent application serial number 16 / 182.231, entitled WIRELESS PAIRING OF A SURGICAL DEVICE WITH ANOTHER DE-
[0002] [0002] The present application claims priority under 35 U.S.C. & 119 (e) of US Provisional Patent Application No. 62 / 729,186, entitled WIRELESS PAIRING OF A SURGICAL DEVICE WITH ANOTHER DE-
[0003] [0003] This application claims priority under 35 USC $ 119 (e) to provisional patent application No. 62 / 692,747, entitled SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE, filed on June 30, 2018, to the Application US Provisional Patent No. 62 / 692,748, entitled SMART ENERGY ARCHITECTURE, filed on June 30, 2018 and US Provisional Patent Application 62 / 692,768, entitled SMART ENERGY DEVICES, filed on June 30, 2018, with the description of each of which is incorporated here by way of reference, in its entirety.
[0004] [0004] The present application claims priority under 35 U.S.C. $
[0005] [0005] This application also claims priority under 35 USC $ 119 (e) of US Provisional Patent Application 62 / 650,898 filed on March 30, 2018, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS, from US Provisional Patent Application serial number 62 / 650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, filed on March 30, 2018, from US Provisional Patent Application serial number 62 / 650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM, filed on March 30, 2018, and US Provisional Patent Application serial number 62 / 650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTRROLS, filed on March 30, 2018, whose description of each one is hereby incorporated by reference, in its entirety.
[0006] [0006] This application also claims priority under 35 US $ 119 (e) of US Provisional Patent Application serial number 62 / 640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, filed on March 8, 2018, and US Provisional Patent Application Serial No. 62 / 640,415, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR, filed on March 8, 2018, the respective description of which is incorporated herein by way of reference, in its entirety.
[0007] [0007] The present application also claims priority under 35 US $ 119 (e) of US Provisional Patent Application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, of the Patent Application Provisional US Serial No. 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on December 28, 2017, and Provisional US Patent Serial No. 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on 28 December 2017, the description of each of which is incorporated herein by reference, in its entirety. BACKGROUND OF THE INVENTION
[0008] [0008] The present description refers to several surgical systems. Surgical procedures are typically performed in theaters or surgical operating rooms in a health care facility, such as a hospital. A sterile field is typically created around the patient. The sterile field may include members of the brushing team, who are properly dressed, and all furniture and accessories in the area. Various surgical devices and systems are used to perform a surgical procedure. SUMMARY OF THE INVENTION
[0009] [0009] An aspect of a surgical system may include a first surgical device that has a control circuit configured to have situational recognition of events that occur in an adherence to the first surgical device according to data received from a database, a patient monitoring device or a paired surgical device, or any combination of the database, the patient monitoring device or the paired surgical device, and wirelessly pair with a second surgical device according to a use of the first surgical device and the events of which the first surgical device has situational recognition.
[0010] [0010] In one aspect of the surgical system, the events for which the first surgical device has situational recognition include the use of the first surgical device by a first user and the use of the second surgical device by a second user.
[0011] [0011] In one aspect of the surgical system, the events that consist in the use of the first surgical device by the first user include the grip of a handle on the first surgical device by the first user.
[0012] [0012] In one aspect of the surgical system, events that consist of the first user grasping the first surgical device may include the first user's grip on the first surgical device, thus enabling a transceiver to the first user's grip. surgical device communicates with an identifier used by the first user and enabling, through the identifier, communication between the first surgical device and a central surgical controller.
[0013] [0013] In one aspect of the surgical system, the events of which the first surgical device has situational recognition can include a location of the first surgical device and a location of the second surgical device.
[0014] [0014] In one aspect of the surgical system, the control circuit is configured to determine the location of the second surgical device based on a wireless signal transmitted by the second surgical device to the first surgical device.
[0015] [0015] In one aspect of the surgical system, the control circuit is additionally configured to simultaneously activate the first surgical device and the second surgical device for a predetermined period of time when no tissue or patient is detected.
[0016] [0016] In one aspect of the surgical system, the first surgical device is located within a sterile field and the second surgical device is located outside the sterile field when the first surgical device pairs wirelessly with the second surgical device. - cool.
[0017] [0017] In one aspect of the surgical system, the control circuit is additionally configured to be paired wirelessly with a communication device.
[0018] [0018] In one aspect of the surgical system, the events from which the first surgical device has situational recognition can include a determination of a distance between the first surgical device and a tissue structure in a patient.
[0019] [0019] An aspect of a method may include having situational recognition, by a control circuit within a first surgical device, of events that occur in an adjacency of the first surgical device according to data received from a database. a patient monitoring device or a paired surgical device, or any combination of the database, the patient monitoring device or the paired surgical device, and pair wirelessly via the control circuit, with a second surgical device according to a use of the first surgical device and the events of which the first surgical device has situational recognition.
[0020] [0020] In one aspect of the method, having situational recognition, by a control circuit within a first surgical device, may include having situational recognition, by a control circuit within a first surgical device, of the use of the first device surgical by a first user and the use of the second surgical device by a second user.
[0021] [0021] In one aspect of the method, having situational recognition, by a control circuit within a first surgical device, of the use of the first surgical device by a first user may include having situational recognition, by a control circuit within a first surgical device surgical device, from the grip of a handle of the first surgical device by a first user.
[0022] [0022] In one aspect, the method may additionally include allowing a transceiver on the handle of the first surgical device to communicate with an identifier used by the first user and allowing, by the identifier, communication between the first surgical device and a central surgical controller.
[0023] [0023] In one aspect of the method, having situational recognition, by a control circuit within a first surgical device, of the use of the first surgical device by a first user and the use of the second surgical device by a second user, may include having situational recognition, by a control circuit within a first surgical device, a location of the first surgical device and a location of the second surgical device.
[0024] [0024] In one aspect, the method may additionally include determining, by the control circuit, the location of the second surgical device based on a wireless signal transmitted by the second surgical device to the first surgical device.
[0025] [0025] In one aspect, the method may include activating, through the control circuit, the first surgical device and the second surgical device for a predetermined period of time when no tissue or patient is detected.
[0026] [0026] In one aspect of the method, wirelessly pairing the control circuit with a second surgical device according to a use of the first surgical device may include wirelessly pairing the control circuit with a second surgical device outside a sterile field when the first surgical device is located within the sterile field.
[0027] [0027] In one aspect, the method may additionally include wireless pairing of the control circuit with a communication device.
[0028] [0028] In one aspect, the method may additionally include determining, by the control circuit, a distance between the first surgical device and a tissue structure in a patient. FIGURES
[0029] [0029] The various aspects described here, both with regard to 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.
[0030] [0030] Figure 1 is a block diagram of an interactive surgical system implemented by computer, according to at least one aspect of the present description.
[0031] [0031] Figure 2 is a surgical system being used to perform a surgical procedure in an operating room, in accordance with at least one aspect of the present description.
[0032] [0032] Figure 3 is a central surgical device or "hub" paired with a visualization system, a robotic system, and an intelligent instrument, according to at least one aspect of this description.
[0033] [0033] Figure 4 is a partial perspective view of a casing of the surgical hub, and of a generator module in combination received slidingly in a casing of the surgical hub, in accordance with at least one aspect of the present description.
[0034] [0034] Figure 5 is a perspective view of a generator module in combination with bipolar, ultrasonic and monopolar contacts and a smoke evacuation component, in accordance with at least one aspect of the present description.
[0035] [0035] Figure 6 illustrates different power bus connectors for a plurality of side coupling ports of a side modular cabinet configured to receive a plurality of modules, in accordance with at least one aspect of the present description.
[0036] [0036] Figure 7 illustrates a vertical modular housing configured to receive a plurality of modules, in accordance with at least one aspect of the present description.
[0037] [0037] Figure 8 illustrates a surgical data network that comprises a modular communication hub configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a facility. of public services specially equipped for surgical operations, to the cloud, according to at least one aspect of this description.
[0038] [0038] Figure 9 illustrates an interactive surgical system implemented by computer, in accordance with at least one aspect of the present description.
[0039] [0039] Figure 10 illustrates a surgical hub that comprises a plurality of modules coupled to the modular control tower, according to at least one aspect of the present description.
[0040] [0040] Figure 11 illustrates an aspect of a universal serial bus (USB) network hub device, in accordance with at least one aspect of the present description.
[0041] [0041] Figure 12 is a block diagram of a cloud computing system that comprises a plurality of intelligent surgical instruments coupled to central surgical controllers that can connect to the cloud component of the cloud computing system, according to at least one aspect of the present description.
[0042] [0042] Figure 13 is a functional module architecture of a cloud computing system, according to at least one aspect of the present description.
[0043] [0043] Figure 14 illustrates a diagram of a surgical system with situational recognition, according to at least one aspect of the present description.
[0044] [0044] Figure 15 is a timeline that represents the situational awareness of a central surgical controller, according to at least one aspect of the present description.
[0045] [0045] Figure 16 is a diagram of a pairing of a personally owned wireless device with a central surgical controller, in accordance with at least one aspect of the present description.
[0046] [0046] Figure 17 is a diagram of a cartridge configured to communicate wirelessly with a central surgical controller, in accordance with at least one aspect of the present description.
[0047] [0047] Figure 17A shows an induction supply coupling between adjacent coils, in accordance with at least one aspect of the present description.
[0048] [0048] Figure 18 is a block diagram of a resonant wireless induction power system, in accordance with at least one aspect of the present description.
[0049] [0049] Figure 19 is a diagram of a central surgical controller detecting the perimeter of a room, according to at least one aspect of the present description.
[0050] [0050] Figure 19B is a diagram of the perimeter of a room that includes one or more interference beacons, in accordance with at least one aspect of the present description.
[0051] [0051] Figure 20 is an interaction diagram between an identifier used by the user and a surgical instrument, according to at least one aspect of the present description.
[0052] [0052] Figure 21 is a diagram of a surgical system that includes a magnetic field generator to detect the position and orientation of surgical devices in relation to it, according to at least one aspect of the present description.
[0053] [0053] Figure 22 is a diagram showing a system for using LIDAR to determine the positions of devices in relation to a measurement location selected by the user, in accordance with at least one aspect of the present description.
[0054] [0054] Figure 23 is a diagram of a system for determining the relative position of devices by means of a dual antenna receiver, in accordance with at least one aspect of the present description.
[0055] [0055] Figure 24 is a graph showing the viable detected signal strength, according to at least one aspect of the present description. DESCRIPTION
[0056] [0056] The applicant for this application holds the following US patent applications, filed on November 6, 2018, the description of which is incorporated herein by reference in its entirety: and US Patent Application No. 16 /182,224, entitled SURGI- CAL NETWORK, INSTRUMENT, AND CLOUD RESPONSES BASED
[0057] [0057] The applicant for this application holds the following US patent applications filed on September 10, 2018, the description of which is incorporated herein by reference in its entirety: and US Provisional Patent Application No. 62 /729,183, entitled A CONTROL FOR A SURGICAL NETWORK OR SURGICAL NET-
[0058] [0058] The applicant for this application holds the following US patent applications, filed on August 28, 2018, the description of each of which is incorporated herein by reference, in its entirety:
[0059] [0059] The applicant for this application holds the following US patent applications, filed on August 23, 2018, the description of which is incorporated herein by reference in its entirety: and US Provisional Patent Application no. 62 / 721,995, entitled CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT AC- CORDING TO TISSUE LOCATION; and US Provisional Patent Application No. 62 / 721,998, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS; and US Provisional Patent Application No. 62 / 721,999, entitled
[0060] [0060] The applicant for the present application holds the following US patent applications, filed on June 30, 2018, the description of each of which is incorporated herein by reference in its entirety: and Provisional Patent Application US No. 62 / 692,747, entitled SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE; and US Provisional Patent Application No. 62 / 692,748, entitled SMART ENERGY ARCHITECTURE; and and US Provisional Patent Application No. 62 / 692,768, entitled SMART ENERGY DEVICES.
[0061] [0061] The applicant for this application holds the following US patent applications, filed on June 29, 2018, with the description of each of which is incorporated herein by reference in its entirety: and US Patent Application No. serial 16 / 024.090, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS; and US Patent Application Serial No. 16 / 024,057, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS; and US Patent Application Serial No. 16 / 024,067, entitled
[0062] [0062] The applicant for this application holds the following provisional US patent applications, filed on June 28, 2018, with the description of each of which is incorporated herein by reference in its entirety: e Provisional Patent Application US serial no. 62 / 691,228, entitled A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES; and US Provisional Patent Application Serial No. 62 / 691,227, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS; and US Provisional Patent Application Serial No. 62 / 691,230, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELEC- TRODE; and US Provisional Patent Application Serial No. 62 / 691,219, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTRROL; and US Provisional Patent Application serial number 62 / 691,257, entitled COMMUNICATION OF SMOKE EVACUATION SYSTEM PA- RAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM;
[0063] [0063] The applicant for the present application holds the following provisional US patent applications, filed on April 19, 2018, with the description of each of which is incorporated herein by reference, in its entirety: e Patent Application Provisional US Serial No. 62 / 659,900, entitled METHOD OF HUB COMMUNICATION.
[0064] [0064] The applicant for this application holds the following provisional US patent applications, filed on March 30, 2018, with the description of each of which is incorporated herein by reference in its entirety: e Provisional Patent Application US No. 62 / 650,898 deposited on March 30, 2018, entitled CAPACITIVE COUPLED RE-TURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS; and US Provisional Patent Application Serial No. 62 / 650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPA-BILITIES; and US Provisional Patent Application Serial No. 62 / 650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; and e US Provisional Patent Application Serial No. 62 / 650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTRROLS.
[0065] [0065] The applicant for the present application holds the following US patent applications, filed on March 29, 2018, with the description of each of which is incorporated herein by reference in its entirety: and US Patent Application No. serial 15 / 940,641, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; and US Patent Application Serial No. 15 / 940,648, entitled
[0066] [0066] The applicant for this application holds the following provisional US patent applications, filed on March 28, 2018, the description of each of which is incorporated herein by way of reference in its entirety: e Application US Provisional Patent Serial No. 62 / 649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; and US Provisional Patent Application Serial No. 62 / 649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; and US Provisional Patent Application Serial No. 62 / 649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS; and US Provisional Patent Application Serial No. 62 / 649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; and US Provisional Patent Application Serial No. 62 / 649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS; and US Provisional Patent Application serial number 62 / 649,291,
[0067] [0067] The applicant for the present application holds the following provisional US patent applications, filed on March 8, 2018, with the description of each of which is incorporated herein by reference in its entirety: e Provisional Patent Application US serial number 62 / 640,417,
[0068] [0068] The applicant for this application holds the following provisional US patent applications, filed on December 28, 2017, with the description of each of which is incorporated herein by reference in its entirety: e Provisional Patent Application US Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM; and US Provisional Patent Application Serial No. 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS; and e US Provisional Patent Application Serial No. 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM.
[0069] [0069] Before explaining in detail the various aspects of surgical instruments and generators, it should be noted that the illustrative examples are not limited, in terms of application or use, to the 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 among the other aspects, expressions of aspects and / or examples described below. lead.
[0070] [0070] With reference to Figure 1, an interactive surgical system implemented by computer 100 includes one or more surgical systems 102 and a cloud-based system (for example, cloud 104 which may include a remote server 113 coupled to a device storage 105). Each surgical system 102 includes at least one surgical hub 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 112 smart and hand-held surgical instrument, which is configured to communicate with each other and / or the hub
[0071] [0071] In several respects, smart instruments 112, as described here with reference to Figures 1 to 7, can be implemented as surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a, b (Figure 21), 200088 and 200078a, b (Figure 23), the surgical device 200078a, b (Figure 22) and the 200086 visualization system (Figure 23). Smart instruments 112 (for example, devices 1a to 1n), such as surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a, b (Figure 21), 200088 and 200078a, b (Figure 23), the surgical device 200078a, b (Figure 22) and the visualization system 200086 (Figure 23) are configured to operate on a surgical data network 201 as described with reference to Figure
[0072] [0072] Figure 2 represents an example of a surgical system 102 being used to perform a surgical procedure on a patient who is lying on an operating table 114 in a surgical operating room 116. A robotic system 110 is used in the procedure surgical procedure as a part of the surgical system 102. The robotic system 110 includes a surgeon console 118, a patient car 120 (surgical robot), and a surgical robotic hub 122. The patient car 120 can handle at least one removable-attached surgical tool 117 through a minimally invasive incision in the patient's body while the surgeon views the surgical site through the surgeon's console 118. An image of the surgical site can be obtained by a medical imaging device 124 , which can be manipulated by the patient's carriage 120 to guide the imaging device 124. The robotic hub 122 can be used to process images of the surgical site for display. subsequent to the surgeon via the surgeon's console 118.
[0073] [0073] Other types of robotic systems can be readily adapted for use with the surgical system 102. Various examples of robotic systems and surgical instruments that are suitable for use with the present description are described in provisional patent application no. 62 / 611,339, entitled ROBOT ASSISTED SURGI-CAL PLATFORM, deposited on December 28, 2017, the description of which is incorporated herein by reference in its entirety.
[0074] [0074] Several examples of cloud-based analysis that are performed by cloud 104, and are suitable for use with the present description, are described in US Provisional Patent Application Serial No. 62 / 611.340, entitled CLOUD-BASED MEDICAL ANALYTICS, deposited on December 28, 2017, the description of which is incorporated herein by reference, in its entirety.
[0075] [0075] In several aspects, the imaging device 124 includes at least one Image sensor and one or more optical components.
[0076] [0076] 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.
[0077] [0077] 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.
[0078] [0078] 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.
[0079] [0079] In several respects, the imaging device 124 is configured for use in a minimally invasive procedure. Examples of imaging devices suitable for use with the present description include, but are not limited to, an arthroscope, angioscope, bronchoscope, choledocoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagus-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngoscope, sigmoidoscope, thoracoscope, and ureteroscope.
[0080] [0080] In one aspect, the imaging device employs multiple spectrum monitoring to discriminate topography and underlying structures. A multi-spectral 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 Module" in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, the description of which is hereby 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.
[0081] [0081] 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.
[0082] [0082] 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 shown in Figure 2. In one aspect, the display system 108 includes an interface for HL7, PACS and EMR. Various components of the visualization system 108 are described under the heading "Advanced Imaging Acquisition Module" in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, the description of which is here incorporated as a reference in its entirety.
[0083] [0083] As shown in Figure 2, a primary screen 119 is positioned in the sterile field to be visible to the operator on the operating table 114. In addition, a viewing tower 111 is positioned outside the sterile field. The display tower 111 includes a first non-sterile screen 107 and a second non-sterile screen 109, which are opposite each other. Visualization system 108, guided by hub 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, hub 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 from the site surgical on main 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.
[0084] [0084] In one aspect, hub 106 is also configured to route a diagnostic input or feedback by a non-sterile operator in the viewing tower 111 to the primary screen 119 within the sterile field, where it can be seen by a sterile operator in the operating table. In one example, the entry may be in the form of a snapshot modification displayed on the non-sterile screen 107 or 109, which can be routed to the main screen 119 by the hub ("central device") 106.
[0085] [0085] With reference to Figure 2, a 112 surgical instrument is being used in the surgical procedure as part of the surgical system
[0086] [0086] Now with reference to Figure 3, a hub 106 is shown in communication with a visualization system 108, a robotic system 110 and a smart handheld surgical instrument 112. The central controller 106 includes a central controller screen 135, a imaging module 138, a generator module 140 (which may include a monopolar generator 142, a bipolar generator 144 and / or an ultrasonic generator 143), a communication module 130, a processor module 132 and a storage matrix 134. In certain As shown in Figure 3, the central controller 106 additionally includes a smoke evacuation module 126, a suction / irrigation module 128 and / or an OR 133 mapping module.
[0087] [0087] 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 enclosure of hub 136 provides a unified environment for managing power, data and fluid lines, which reduces the frequency of entanglement between such lines.
[0088] [0088] The aspects of the present description present a surgical hub for use in a surgical procedure that involves the application of energy to the tissue at a surgical site. The surgical hub includes a hub housing and a combination generator module received in a sliding manner at a hub housing docking station.
[0089] [0089] In one aspect, the fluid line is a first fluid line and a second fluid line extends from the remote surgical site to a suction and irrigation module received slidingly into the hub housing. In one aspect, the hub housing comprises a fluid interface.
[0090] [0090] Certain surgical procedures may require the application of more than one type of energy to the tissue. One type of energy may be more beneficial for cutting the fabric, while another type of energy may be more beneficial for sealing the fabric. For example, a bipolar generator can be used to seal the tissue while an ultrasonic generator can be used to cut the sealed tissue. Aspects of the present description present a solution in which a modular housing of the central controller 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the central modular housing 136 is that it allows quick removal and / or replacement of several modules.
[0091] [0091] Aspects of the present description present a modular surgical casing for use in a surgical procedure that involves applying energy to the tissue. The modular surgical housing includes a first energy generator module, configured to generate a first energy for application to the tissue, and a first docking station that comprises a first docking port that includes first data and energy contacts, the first module being - the power generator module is movable in a sliding way in an electric coupling with the power and data contacts and the first power generator module is movable in a sliding way out of the electric coupling with the first power and data contacts.
[0092] [0092] In addition to the above, the modular surgical enclosure also includes a second energy generator module configured to generate a second energy, different from the first energy, for application to the tissue, and a second docking station comprising a second coupling port which 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 electrical coupling with the second power and data contacts.
[0093] [0093] In addition, the modular surgical cabinet also includes a communication bus between the first coupling port and the second coupling port, configured to facilitate communication between the first power generator module and the second power generator module .
[0094] [0094] With reference to Figures 3 to 7, aspects of the present description are presented for a modular housing of hub 136 that allows the modular integration of a generator module 140, a smoke evacuation module 126, and a module suction / irrigation valve 128. The central modular housing 136 further facilitates interactive communication between modules 140, 126, 128. As illustrated in Figure 5, generator module 140 can be a generator module with monopolar, bipolar and ultrasonic components integrated, supported in a single cabinet unit 139 slidably insertable in the central modular housing 136. As shown in Figure 5, generator module 140 can be configured to connect to a monopolar device 146, a bipolar device 147 and a ultrasonic device
[0095] [0095] In one aspect, the central modular housing 136 comprises a modular power and a back communication board 149 with external and wireless communication heads to allow removable attachment of modules 140, 126, 128 and interactive communication among them.
[0096] [0096] In one aspect, the central modular housing 136 includes docking stations, or drawers, 151, here also called dowels, which are configured to slide modules 140, 126, 128. Figure 4 illustrates a partial perspective view of a central surgical controller housing 136, and a combined generating module 145 slidably received at a docking station 151 of the central surgical controller housing 136. A docking port 152 with power and data contacts on a back side of the combined generator module 145 is configured to engage a corresponding docking port 150 with the power and data contacts of a corresponding docking station 151 of the modular housing of hub 136 as per the combined generator module
[0097] [0097] In several respects, the smoke evacuation module 126 includes a fluid line 154 that carries captured / collected fluid fluid 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
[0098] [0098] In various 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.
[0099] [0099] 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.
[0100] [0100] 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 hub housing 136 separately from the module suction / irrigation 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.
[0101] [0101] In one aspect, modules 140, 126, 128 and / or their corresponding docking stations in the central modular housing 136 may include alignment features that are configured to align the docking ports of the modules in engagement with their counterparts in the docking stations of the central modular housing
[0102] [0102] In some respects, the drawers 151 of the central modular housing 136 are the same, or substantially the same size, and the modules are adjusted in size to be received in the drawers
[0103] [0103] In addition, the contacts of a specific module can be switched to engage with the contacts of a specific drawer to avoid inserting a module in a drawer with unpaired contacts.
[0104] [0104] As shown in Figure 4, the coupling port 150 of a drawer 151 can be coupled to the coupling port 150 of another drawer 151 through a communication link 157 to facilitate interactive communication between the modules housed in the central modular enclosure 136. Coupling ports 150 of central modular enclosure 136 can, alternatively or additionally, facilitate interactive wireless communication between modules housed in central modular enclosure 136. Any suitable wireless communication can be used, such as, for example, Air Titan-Bluetooth.
[0105] [0105] Figure 6 illustrates individual power bus connectors for a plurality of side coupling ports in a side modular bay 160 configured to receive a plurality of modules from a 206 surgical hub. Side modular bay 160 is configured to receive and later interconnect modules 161. Modules 161 are slidably inserted into docking stations 162 of side modular compartment 160, which includes a back plate for interconnecting modules 161. As shown in Figure 6, modules 161 they are arranged laterally in the side modular cabinet 160. Alternatively, modules 161 can be arranged vertically in a side modular cabinet.
[0106] [0106] Figure 7 illustrates a vertical modular cabinet 164 configured to receive a plurality of modules 165 from surgical hub 106.
[0107] [0107] In several respects, Imaging Module 138 comprises an integrated video processor and a modular light source and is adapted for use with various imaging devices. In one aspect, the imaging device is comprised of a modular housing that can be mounted with a light source module and a camera module. The compartment can be a disposable compartment. In at least one example, the disposable compartment is removably coupled to a reusable controller, a light source module, and a camera module. The light source module and / or the camera module can be chosen selectively depending on the type of surgical procedure. In one aspect, the camera module comprises a CCD sensor. In another aspect, the camera module comprises a CMOS sensor. In another aspect, the camera module is configured for imaging the scanned beam. Similarly, the light source module can be configured to provide a white light or a different light, depending on the surgical procedure.
[0108] [0108] During a surgical procedure, removing a surgical device from the surgical field and replacing it with another surgical device that includes a different camera or other light source may be inefficient. Temporarily losing sight of the surgical field can lead to undesirable consequences. The imaging device module of this description is configured to allow the replacement of a light source module or a "midstream" camera module during a surgical procedure, without the need to remove the imaging device from the field surgical.
[0109] [0109] 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.
[0110] [0110] 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.
[0111] [0111] Various image processors and imaging devices suitable for use with the present description are described in
[0112] [0112] Figure 8 illustrates a surgical data network 201 that comprises a modular communication hub 203 configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a hospital. installation of public services specially equipped for surgical operations, to a cloud-based system (for example, number 204 which may include a remote server 213 coupled to a storage device 205). In one aspect, the modular communication hub 203 comprises a network hub 207 and / or a network key 209 in communication with a network router. The modular communication hub 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 network hub 207 or network key 209. An intelligent surgical data network can be called a controllable hub or key. A switching hub reads the destination address of each packet and then forwards the packet to the correct port.
[0113] [0113] Modular devices 1a to 1n located in the operating room can be coupled to the modular central communication controller 203. The central network controller 207 and / or the network key 209 can be coupled to a router. network 211 to connect devices 1a to 1h to cloud 204 or to local computer system 210. Data associated with devices 1a to 1n can be transferred to cloud-based computers via the router for remote data processing and manipulation . The data associated with devices 1a to 1h can also be transferred to the local computer system 210 for processing and manipulation of the local data. Modular devices 2a to 2m located in the same operating room can also be coupled to a network switch 209. The network switch 209 can be attached to network hub 207 and / or network router 211 to connect devices 2a to 2m to cloud 204. Data associated with devices 2a to 2n can be transferred to cloud 204 through network router 211 for data processing and manipulation. The data associated with devices 2a to 2m can also be transferred to the local computer system 210 for processing and manipulation of the local data.
[0114] [0114] It will be understood that the surgical data network 201 can be expanded by interconnecting multiple network hubs 207 and / or multiple network keys 209 with multiple network routers 211. The central modular communication controller 203 may be contained in a modular control tower configured to receive multiple devices 1a to 1n / 2a to 2m. The local computer system 210 can also be contained in a modular control tower. The modular communication central controller 203 is connected to a screen 212 to show the images obtained by some of the devices 1a to 1n / 2a to 2m, for example, during surgical procedures. In various aspects, 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 a surgical device based on energy, 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 modular communication center 203 of the surgical data network 201.
[0115] [0115] In one aspect, the surgical data network 201 may comprise a combination of central network controller (s), network switches, and network routers that connect devices 1a to 1n / 2a to 2m the cloud. Any or all devices 1a to 1n / 2a to 2m coupled to the central network controller or to the network key can collect data in real time and transfer the data to cloud computers for data processing and manipulation. It will be understood that cloud computing depends on sharing computing resources instead of having local servers or personal devices to handle software applications. The word "cloud" can be used as a metaphor for "the Internet", although the term is not limited as such. Consequently, the term "cloud computing" can be used here to refer to "a type of Internet-based computing", in which different services - such as servers, storage, and applications - are applied to the hub modular communication system 203 and / or computer system 210 located in the operating room (for example, a fixed, mobile, temporary, or operating room or space) and devices connected to the modular communication hub 203 and / or computer system 210 over the Internet. The cloud infrastructure can be maintained by a cloud service provider. In this context, the cloud service provider may be the entity that coordinates the use and control of devices 1a to 1n / 2a to 2m located in one or more operating rooms. Cloud computing services can perform a large number of calculations based on data collected by intelligent surgical instruments, robots, and other computerized devices located in the operating room. The hub's hardware allows multiple devices or connections to be connected to a computer that communicates with cloud computing and storage resources.
[0116] [0116] By applying cloud computer data processing techniques to data collected by devices 1a to 1n / 2a to 2m, the surgical data network provides better surgical results, reduced costs, and better satisfaction by part of the patient. At least some of the devices 1a to 1n / 2a to 2m can be used to see tissue status to assess leaks or perfusion of sealed tissue after a tissue cutting and cutting procedure. At least some of the devices 1a to 1n / 2a to 2m can be used to identify the pathology, such as the effects of disease, with the use of cloud-based computing to examine data including images of body tissue samples for diagnostic purposes. This includes confirmation of the location and margin of the tissue and phenotypes. At least some of the devices 1a to 1n / 2a to 2m can be used to identify anatomical structures of the body using a variety of sensors integrated with imaging devices and techniques such as the overlay of images captured by multiple imaging devices. The data collected by devices 1a to 1n / 2a to 2m, including image data, can be transferred to the cloud 204 or the local computer system 210 or both for processing and manipulating data including processing. image manipulation. The data can be analyzed to improve the results of the surgical procedure by determining whether additional treatment, such as application of endoscopic intervention, emerging technologies, targeted radiation, targeted intervention, accurate robotics at specific tissue sites and conditions, can be followed. This data analysis can additionally use analytical processing of the results, and with the use of standardized approaches they can provide beneficial standardized feedback both to confirm surgical treatments and the surgeon's behavior or to suggest changes to the surgical treatments and the surgeon's behavior.
[0117] [0117] In an implementation, operating room devices 1a to 1h can be connected to the central modular communication controller 203 via a wired or wireless channel depending on the configuration of devices 1a to 1h on a central network controller. The network hub 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 it to the router in "halfduplex" mode. The network hub 207 does not store any Internet protocol / media access control (MACY / 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 network hub 207 has no routing tables or intelligence about where to send information and transmits all data on the network through each connection and to a remote server 213 (Figure 9) in the cloud 204. Network hub 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.
[0118] [0118] In another implementation, operating room devices 2a to 2m can be connected to a network switch 209 via a wired or wireless channel. The network key 209 works in the data connection layer of the OSI model. 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.
[0119] [0119] Network hub 207 and / or network key 209 are coupled to network router 211 for connection to cloud 204. Network router 211 works on the network layer of the OSI model. Network router 211 creates a route to transmit data packets received from central network controller 207 and / or network key 211 to a computer with cloud resources for future processing and manipulation of data collected by any or all devices 1aa 1n / 2a to 2m. Network router 211 can be used to connect two or more different networks located in different locations, such as different operating rooms in the same healthcare facility or different networks located in different operating rooms of different facilities health services. Network router 211 sends data in packet form to cloud 204 and works in full duplex mode. Multiple devices can send data at the same time. Network router 211 uses | P addresses to transfer data.
[0120] [0120] In one example, the network hub 207 can be implemented as a USB hub, which allows multiple USB devices to be connected to a host computer. The USB hub can expand a single USB port on multiple levels so that more ports are available to connect the devices to the system's host computer. The 207 network hub can include wired or wireless capabilities to receive information about a wired channel or a wireless channel. In one aspect, a wireless wireless, broadband, short-range wireless USB communication protocol can be used for communication between devices 1a to 1n and devices 2a to 2m located in the operating room.
[0121] [0121] In other examples, operating room devices 1a to 1n / 2a to 2m can communicate with the modular central communication controller 203 via standard Bluetooth wireless technology for exchanging data over short distances ( using short-wavelength UHF radio waves in the 2.4 to 2.485 GHz ISM band from fixed and mobile devices and building personal area networks (PANs). In other respects, operating room devices 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 via a number of wireless and wired communication standards or protocols, including including, but not limited to, Wi-Fi (IEEE 802.11 family), WiMAX
[0122] [0122] The modular communication central controller 203 can serve as a central connection for one or all operating room devices 1a to 1n / 2a to 2m and handles a data type known as frames. The tables carry the data generated by the devices 1a to 1n / 2a to 2m. When a frame is received by the modular communication hub 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 without wired or wired, as described in the present invention.
[0123] [0123] The modular communication hub 203 can be used as a standalone device or connected to compatible network hubs and network switches to form a larger network. The 203 modular central communication controller is, in general, easy to install, configure and maintain, making it a good option for the network of devices from 1 to 1n / 2a to 2m from the operating room.
[0124] [0124] Figure 9 illustrates an interactive surgical system, implemented by computer 200. The interactive surgical system implemented by computer 200 is similar in many ways to the interactive surgical system, implemented by computer 100. For example, the interactive, surgical system , implemented by computer 200 includes one or more surgical systems 202, which are similar in many respects to surgical systems 102. Each surgical system 202 includes at least one surgical hub 206 communicating with a cloud 204 that can 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 intelligent surgical instruments, robots and other computerized devices located in the operating room.
[0125] [0125] Figure 10 illustrates a surgical hub 206 comprising a plurality of modules coupled to the modular control tower 236. The modular control tower 236 comprises a modular communication hub 203, for example, a network connectivity device, and a computer system 210 to provide local processing, visualization, and imaging, for example. As shown in Figure 10, the modular communication hub 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 hub 203 and transfer data associated with modules to computer system 210, cloud computing resources, or both. As shown in Figure 10, each of the network hubs / switches on the modular communication hub 203 includes three downstream ports and one upstream port. The upstream hub / network switch 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 through a communication channel with wireless or wireless.
[0126] [0126] Surgical hub 206 employs a contactless sensor module 242 to measure the dimensions of the operating room and generate a map of the operating room using non-contact measuring devices such as laser or ultrasonic. An ultrasound-based non-contact sensor module scans the operating room by transmitting an ultrasound explosion and receiving the echo when it bounces off the perimeter of the operating room walls, as described under the heading Surgical Hub Spatial Awareness Within an Operating Room "in US Provisional Patent Application serial number 62 / 611,341,
[0127] [0127] Computer system 210 comprises a processor 244 and a network interface 245. Processor 244 is coupled to a communication module 247, storage 248, memory 249, non-volatile memory 250, and an input / output interface 251 through a system bus. The system bus can be any of several types of bus structures, including the memory bus or memory controller, a peripheral bus or external bus, and / or a local bus that uses any variety of available bus architectures including , but not limited to, 9-bit bus, industry standard architecture (ISA), Micro-Charmel Architecture (MSA), extended ISA (EISA), Smart Drive Electronics (IDE), VESA Local Bus (VLB), Interconnect peripheral components (PCI), USB, advanced 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.
[0128] [0128] Processor 244 can be any single-core or multi-core processor, such as those known under the ARM Cortex trade name available from Texas Instruments. In one respect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareO program, memory only programmable and electrically erasable readout (EEPROM) of 2 KB, one or more pulse width modulation (PWM) modules, one or more analogue quadrature encoder (QEI) inputs, one or more analog converters for 12-bit digital (ADC) with 12 analog input channels, details of which are available for the product data sheet.
[0129] [0129] 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.
[0130] [0130] 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
[0131] [0131] Computer system 210 also includes removable / non-removable, volatile / non-volatile computer storage media, such as disk storage. Disk storage includes, but is not limited to, devices such as a magnetic disk drive, floppy disk drive, tape drive, Jaz drive, Zip drive, LS-60 drive, flash memory card or memory stick ( pen drive). In addition, disk storage may include storage media separately or in combination with other storage media including, but not limited to, an optical disc drive such as a compact disc ROM (CD-ROM) drive. recordable compact disc (CD-R Drive), rewritable compact disc drive (CD-RW drive), or a versatile digital disk ROM drive (DVD-ROM). To facilitate the connection of disk storage devices to the system bus, a removable or non-removable interface can be used.
[0132] [0132] 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.
[0133] [0133] A user enters commands or information into computer system 210 through the input device (s) coupled to the 1 / O 251. interface. Input devices include, but are not limited to, a pointing device such as a mouse, trackball, stylus, keyboard, keyboard, microphone, joystick, game pad, satellite card, scanner, TV tuner card, digital camera, digital video camera, video camera web, and the like. These and other input devices connect to the processor via the system bus via the interface port (s). The interface ports include, for example, a serial port, a parallel port, a game port and a USB. Output devices use some of the same types of ports as input devices. In this way, for example, a USB port can be used to provide input to the computer system and to provide information from the computer system to an output device. An output adapter is provided to illustrate that there are some output devices, such as monitors, screens, speakers, and printers, among other output devices, that need special adapters. Output adapters include, by way of illustration and not limitation, video and sound cards that provide a means of connection between the output device and the system bus. It should be noted that other devices and / or device systems, such as remote computers, provide input and output capabilities.
[0134] [0134] 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. For the sake of brevity, only one memory storage device is illustrated with the remote computer. Remote computers are logically connected to the computer system via a network interface and then physically connected via a communication connection. The network interface covers communication networks such as local area networks (LANs) and wide area networks (WANs). LAN technologies include fiber distributed data interface (FDDI), copper distributed data interface (CDDI), Ethernet / IEEE 802.3, Token ring / IEEE 802.5 and the like. WAN technologies include, but are not limited to, point-to-point links, circuit switching networks such as digital integrated service networks (ISDN) and variations in them, packet switching networks and digital subscriber lines (DSL ).
[0135] [0135] In various 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 image processing engine, media processor, or any specialized digital signal processor (DSP) used for processing digital images. The image processor can employ parallel computing with single multi-data instruction (SIMD) or multi-data instruction (MIMD) technologies to increase speed and efficiency. The digital image processing engine can perform a number of tasks. The image processor can be an integrated circuit system with a multi-core processor architecture.
[0136] [0136] 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.
[0137] [0137] In several respects, the devices / instruments 235 described with reference to Figures 9 to 10, can be implemented as surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a, b (Figure 21), 200088 and 200078a, b (Figure 23), the surgical device 200078a, b (Figure 22) and the 200086 visualization system (Figure 23). Consequently, like surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a, b (Figure 21), 200088 and 200078a, b (Figure 23), the surgical device 200078a, b (Figure 22) and the view 200086 (Figure 23) are configured to interface with the 236 modular control tower and the central surgical controller 206. Once connected to the central surgical controller 206, the surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a, b (Figure 21), 200088 and 200078a, b (Figure 23), the surgical device 200078a, b (Figure 22) and the 200086 visualization system (Figure 23) are configured to interface with the cloud 204, server 213, other central controller surgical instruments, central controller screen 215 or display system 209, or combinations thereof. In addition, once connected to the central controller 206, surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a, b (Figure 21), 200088 and 200078a, b (Figure 23), the surgical device 200078a, b (Figure 22) and the 200086 display system (Figure 23) can use the processing circuits available on the central computer system of the central controller 210.
[0138] [0138] Figure 11 illustrates a functional block diagram of an aspect of a USB 300 network hub device, in accordance with at least one aspect of the present description. In the illustrated aspect, the USB 300 network hub device uses a TUSB2036 integrated circuit hub available from Texas Instruments. The USB network hub 300 is a CMOS device that provides a USB transceiver port 302 and up to three USB transceiver ports downstream 304, 306, 308 in accordance with the USB 2.0 specification. The upstream USB transceiver port 302 is a differential data root port comprising a "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).
[0139] [0139] The USB 300 network hub 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 and low speed devices automatically configuring the scan rate according to the speed of the device attached to the ports. The USB 300 network hub device can be configured in bus powered or self powered mode and includes 312 central power logic to manage power.
[0140] [0140] The USB 300 central network controller device includes a 310 serial interface engine (SIE). The SIE 310 is the front end of the USB 300 network hub hardware and handles most of the protocol described in chapter 8 of the USB specification. SIE 310 typically comprises signaling down to the transaction level. The functions it handles could include: packet recognition, transaction sequencing, SOP, EOP, RESET, and RESUME signal detection / generation, clock / data separation, non-return data encoding / decoding zero inverted (NRZI), generation and verification of CRC (token and data), generation and verification / decoding of package ID (PID), and / or series-parallel / parallel-series conversion. The 310 receives a clock input 314 and is coupled to a logic suspend / resume and frame timer circuit 316 and a repeater circuit of the central controller 318 to control communication between the upstream USB transceiver port 302 and downstream USB transceiver ports 304, 306, 308 through the logic circuits of ports 320, 322, 324. The SIE 310 is coupled to a command decoder 326 through logic interface 328 to control the commands of a serial EEPROM via 330 series EEPROM interface.
[0141] [0141] In several aspects, the USB 300 network hub can connect 127 functions configured in up to six logical layers (levels) to a single computer. In addition, the USB 300 network hub 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 network hub can be configured to support four power management modes: a bus powered hub, with individual port power management or grouped port power management, and the self powered hub, with managed port power management or grouped port power management. In one aspect, using a USB cable, the USB network hub 300, the USB transceiver port 302 is plugged into a USB host controller, and the USB transceiver ports downstream 304, 306, 308 are exposed to connect compatible USB devices, and so on.
[0142] [0142] Additional details regarding the structure and function of the central surgical controller and / or networks of central surgical controllers can be found in US Provisional Patent Application No. 62 / 659,900, entitled METHOD OF HUB COMMUNICATION, filed 19 April 2018, which is incorporated herein by reference, in its entirety.
[0143] [0143] Figure 12 is a block diagram of the interactive surgical system implemented by computer, according to at least one aspect of the present description. In one aspect, the computer-implemented interactive surgical system is configured to monitor and analyze data related to the operation of various surgical systems that include central surgical controllers, surgical instruments, robotic devices, and operating rooms or healthcare facilities. The computer-implemented interactive surgical system comprises a cloud-based data analysis system. Although the cloud-based data analysis system is described as a surgical system, it is not necessarily limited to this and could in general be a cloud-based medical system. As illustrated in Figure 12, the cloud-based data analysis system comprises a plurality of surgical instruments 7012 (can be the same or similar to instruments 112), a plurality of central surgical controllers 7006 (can be the same or similar to central controllers 106) and a surgical data network 7001 (can be the same or similar to network 201) to couple central surgical controllers 7006 to cloud 7004 (can be the same or similar to cloud 204). Each of the plurality of central surgical controllers 7006 is coupled in a communicable manner to one or more surgical instruments 7012. Central controllers 7006 are also coupled in a communicable manner to the cloud 7004 of the interactive surgical system implemented by computer over the 7001 network. The 7004 cloud is a remote centralized source of hardware and software for storing, manipulating, and communicating the data generated based on the operation of various surgical systems. As shown in Figure 12, access to the 7004 cloud is achieved through the 7001 network, which may be the internet or some other suitable computer network. Central surgical controllers 7006 that are coupled to the 7004 cloud can be considered the client side of the cloud computing system (ie, cloud-based data analysis system). Surgical instruments 7012 are paired with central surgical controllers 7006 for control and implementation of various surgical procedures or operations as described here.
[0144] [0144] In addition, surgical instruments 7012 can comprise transceivers for transmitting data to and from their corresponding central surgical controllers 7006 (which can also comprise transceivers). Combinations of surgical instruments 7012 and corresponding central controllers 7006 may indicate specific locations, such as operating rooms in healthcare facilities (for example, hospitals), to provide medical operations. For example, the memory of a central surgical controller 7006 can store location data. As shown in Figure 12, the number 7004 comprises central servers 7013 (which can be the same or similar to remote server 113 in Figure 1 and / or remote server 213 in Figure 9), application servers for central controllers 7002, data analysis 7034 and an input / output ("I / O") interface 7007. Central servers 7013 of the cloud 7004 administered
[0145] [0145] Based on connections with several central surgical controllers 7006 over the network 7001, the cloud 7004 can aggregate the specific data data generated by various surgical instruments 7012 and their corresponding central controllers 7006. Such aggregated data can be stored in the aggregated medical databases 7011 of the cloud 7004. In particular, the cloud 7004 can advantageously perform data analysis and operations on the aggregated data to produce information and / or perform individual functions that the individual 7006 central controllers could not reach on their own. For this purpose, as shown in Figure 12, the cloud 7004 and the central surgical controllers 7006 are communicatively coupled to transmit and receive information. The 1 / O interface 7007 is connected to the plurality of central surgical controllers 7006 via the network 7001. In this way, the interface of 1 / O 7007 can be configured to transfer information between the central surgical controllers 7006 and the databases. aggregate doctors 7011. Consequently, the 7007 1 / O interface can facilitate the read / write operations of the cloud-based data analysis system. Such read / write operations can be performed in response to requests from the central controllers 7006. These requests can be transmitted to the central controllers 7006 through the applications of the central controllers. The 7007 1 / O interface may include one or more high-speed data ports, which may include universal serial bus (USB) ports, IEEE 1394 ports, as well as Wi-Fi and Bluetooth I / O interfaces for connect the 7004 cloud to the 7006 central controllers. The 7004 cloud 7004 central controller application servers are configured to host and provide shared capabilities to software applications (for example, central controller applications) run by the central surgical controllers. 7006. For example, application servers for central controllers 7002 can manage requests submitted by applications for central controllers through central controllers 7006, control access to aggregated medical databases 7011 and perform load balancing. The 7034 data analysis modules are described in more detail with reference to Figure 13.
[0146] [0146] The configuration of the specific cloud computing system described in this description is designed specifically to address various issues raised in the context of medical operations and procedures performed using medical devices, such as surgical instruments 7012, 112 In particular, surgical instruments 7012 can be digital surgical devices configured to interact with the 7004 cloud to implement techniques to improve the performance of surgical operations. Various surgical instruments 7012 and / or central surgical controllers 7006 can comprise touch-controlled user interfaces, so that clinicians can control aspects of interaction between surgical instruments 7012 and the cloud 7004. Other user interfaces suitable for control as audibly controlled user interfaces can also be used.
[0147] [0147] Figure 13 is a block diagram that illustrates the functional architecture of the interactive surgical system implemented by a computer, according to at least one aspect of the present description. The cloud-based data analysis system includes a plurality of 7034 data analysis modules that can be run by the 7008 cloud 7004 processors to provide data analysis solutions for problems that arise specifically in the medical field. As shown in Figure 13, the functions of the 7034 cloud-based data analysis modules can be aided by applications for central controllers 7014 hosted by the application servers for central controllers 7002 that can be accessed on central surgical controllers 7006 The 7008 cloud computing processors and the 7014 central controller applications can operate together to run the 7034 data analysis modules. 7016 application programming interfaces (APIs) define the set of protocols and routines that correspond to central controller applications 7014. Additionally, APIs 7016 manage the storage and retrieval of data in / from the aggregated medical data databases 7011 for the operations of 7014 applications. 7018 caches also store data (for example , temporarily) and are coupled to APIs 7016 to recover
[0148] [0148] For example, the 7022 data collection and aggregation module could be used to generate self-describing data (for example, metadata), including the identification of notable features or configuration (for example, trends), the management of sets of redundant data and the storage of data in paired data sets that can be grouped by surgery, but not necessarily linked to surgical dates and to real surgeons. In particular, paired data sets generated from the operations of 7012 surgical instruments may comprise application of a binary classification, for example, a bleeding or non-bleeding event. More generally, the binary classification can be characterized either as a desirable event (for example, a successful surgical procedure) or as an undesirable event (for example, a surgical instrument used improperly or poorly triggered 7012) . The aggregated self-describing data can correspond to individual data received from various groups or subgroups of central surgical controllers 7006. Consequently, the 7022 data collection and aggregation module can generate aggregated metadata or other data organized based on raw data received from central surgical controllers 7006. For this purpose,
[0149] [0149] The resource optimization module 7020 can be configured to analyze this aggregated data to determine an optimal use of resources for a specific health service facility or group of health care facilities. For example, the resource optimization module 7020 can determine an ideal ordering point for surgical stapling instruments 7012 for a group of healthcare facilities based on the corresponding expected demand for such instruments 7012. The optimization module 7020 resource management could also assess resource use or other operational configurations of various healthcare facilities to determine whether resource use could be improved. Similarly, the 7030 recommendation module can be configured to analyze aggregated organized data from the 7022 data collection and aggregation module to provide recommendations. For example, the 7030 recommendations module could recommend to health care facilities (for example, medical providers such as hospitals) that a specific 7012 surgical instrument should be upgraded to an improved version based on a error rate higher than expected, for example. In addition, the 7030 recommendations module and / or the 7020 resource optimization module could recommend better supply chain parameters such as product repurchase points and provide suggestions for different 7012 surgical instruments, their uses, or pro steps. - provision to improve surgical results. Health care facilities can receive such recommendations through corresponding 7006 central surgical controllers. More specific recommendations related to the parameters or configurations of various 7012 surgical instruments can also be provided. Central controllers 7006 and / or surgical instruments 7012 may also have display screens that display data or recommendations provided by the 7004 cloud.
[0150] [0150] The 7028 patient results analysis module can analyze surgical results associated with operating parameters currently used in 7012 surgical instruments. The 7028 patient results analysis module can also analyze and evaluate other operational parameters potential. In this context, the 7030 recommendations module could recommend the use of these other potential operational parameters based on the production of better surgical results, such as better sealing or less bleeding. For example, the 7030 recommendation module could transmit recommendations to a central surgical controller 7006 about when to use a particular cartridge for a corresponding 7012 stapling surgical instrument. In this way, the cloud-based data analysis system, while controlling common variables, can be configured to analyze the large collection of raw data and provide centralized recommendations across multiple health service facilities (advantageously determined based on data). aggregates). For example, the cloud-based data analysis system could analyze, evaluate and / or aggregate data based on the type of medical practice, type of patient, number of patients, geographical similarity between medical providers, which providers / facilities. Medical institutions use similar types of instruments, etc., in a way that no health service facility alone would be able to independently analyze.
[0151] [0151] The 7026 control program update module can be configured to implement various 7012 surgical instrument recommendations when corresponding control programs are updated. For example, the 7028 patient outcome analysis module could identify correlations by linking specific control parameters to successful (or unsuccessful) results. Such correlations can be resolved when updated control programs are transmitted to 7012 surgical instruments via the 7026 control program update module. Updates to 7012 instruments that are transmitted via a corresponding central controller 7006 can incorporate aggregated performance data that has been collected and analyzed by the data collection and aggregation module 7022 of the 7004 cloud. Additionally, the patient results analysis module 7028 and the recommendations module 7030 could identify improved methods of using the 7012 instruments based on data from aggregate performance.
[0152] [0152] The cloud-based data analysis system can include safety features implemented by the 7004 cloud. These safety features can be managed by the authorization and safety module 7024. Each central surgical controller 7006 can have unique credentials associated with it such as username, password, and other appropriate security credentials. These credentials can be stored in memory 7010 and be associated with an allowed level of cloud access. For example, based on providing exact credentials, a central surgical controller 7006 can be granted access to communicate with the cloud to a predetermined degree (for example, it can only participate in transmitting or receiving certain types information). For this purpose, the aggregated medical data databases 7011 of the cloud 7004 may comprise a database of authorized credentials to verify the accuracy of the credentials provided. Different credentials can be associated with different levels of permission to interact with the 7004 cloud, such as a predetermined level of access to receive data analysis generated by the cloud
[0153] [0153] In addition, for security purposes, the cloud could maintain a database of 7006 central controllers, 7012 instruments and other devices that may comprise a "black list" of prohibited devices. In particular, a blacklisted central surgical controller 7006 may not be allowed to interact with the cloud, while blacklisted 7012 surgical instruments may not have functional access to a corresponding central controller 7006 and / or may be prevented from function fully when paired with its corresponding central controller 7006. Additional or alternatively, cloud 7004 can identify instruments 7012 based on incompatibility or other specified criteria. In this way, counterfeit medical devices and improper reuse of such devices across the cloud-based data analysis system can be identified and addressed.
[0154] [0154] 7012 surgical instruments can use wireless transceivers to transmit wireless signals that can represent, for example, credentials for authorizing access to the corresponding central controllers 7006 and the 7004 cloud. Wired transceivers can also be used to transmit signals. Such authorization credentials can be stored in the respective memory devices of surgical instruments 7012. The authorization and security module 7024 can determine whether the authorization credentials are accurate or falsified. The 7024 authorization and security module can also dynamically generate authorization credentials for increased security. Credentials could also be encrypted, such as using hash-based encryption. After transmitting the authorization authorization, the surgical instruments 7012 can transmit a signal to the corresponding central controllers 7006 and finally to the cloud 7004, to indicate that the instruments 7012 are ready to obtain and transmit medical data. In response, the 7004 cloud can transition to a state enabled to receive medical data for storage in aggregate medical databases
[0155] [0155] The cloud-based data analysis system can enable the monitoring of multiple healthcare facilities (eg, medical posts such as hospitals) to determine improved practices and recommend changes (through the 2030 recommendations module , for example) properly. In this way, cloud 7004 processors 7008 can analyze the data associated with a healthcare facility to identify the facility and aggregate the data to other data associated with other healthcare facilities in a group. Groups could be defined based on similar operating practices or geographic location, for example. In this way, the 7004 cloud can provide analysis and recommendations regarding a health service facility that covers an entire group. The cloud-based data analysis system could also be used to improve situational recognition. For example, 7008 processors can predictively demonstrate the effects of recommendations on cost and effectiveness for a specific installation (in relation to operations and / or various general medical procedures). The cost and effectiveness associated with that specific facility can also be compared to a corresponding local region of other facilities or any other comparable facility.
[0156] [0156] The 7032 data classification and prioritization module can prioritize and classify data based on severity (for example, the severity of a medical event associated with the data, unpredictability, distrust). This classification and prioritization can be used in conjunction with the functions of the other 7034 data analysis modules described above to improve the cloud-based data analysis and operations described here. For example, the 7032 data classification and prioritization module can assign a priority to the data analysis performed by the 7022 data collection and aggregation module and 7028 patient outcome analysis modules. Different levels of prioritization can result in specific responses from the cloud 7004 (corresponding to a level of urgency), such as escalation to an accelerated response, special processing, exclusion from the aggregated medical databases 7011 or other appropriate responses. In addition, if necessary, the 7004 cloud can transmit a request (for example, a push message) through the application servers to central controllers for additional data from corresponding 7012 surgical instruments. The automatic message can result in a notification displayed on the corresponding central controllers 7006 to request supporting or additional data. This automatic message may be necessary in situations where the cloud detects a significant irregularity or results outside the limits and the cloud cannot determine the cause of the irregularity. 7013 central servers can be programmed to activate this automatic message in certain significant circumstances, such as when the data is determined to be different from an expected value beyond a predetermined threshold, or when it appears that security has been understood , for example.
[0157] [0157] In several respects, the surgical instruments 7012 described above with reference to Figures 12 and 13, can be implemented as surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a, b (Figure 21), 200088 and 200078a, b (Figure 23), the surgical device 200078a, b (Figure 22) and the 200086 visualization system (Figure 23). Consequently, the surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a, b (Figure 21), 200088 and 200078a, b (Figure 23), the surgical device 200078a, b (Figure 22) and the system 200086 (Figure 23) are configured to interface with the 7006 central surgical controller and the 2001 network, which is configured to interface with the 7004 cloud. Consequently, the processing power provided by the 7013 central servers and the analysis module 7034 data sets are configured to process information (for example, data and control) from surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a, b (Figure 21), 200088 and 200078a, b (Figure 23) , the surgical device 200078a, b (Figure 22) and the visualization system 200086 (Figure 23).
[0158] [0158] Additional details related to the cloud data analysis system can be found in US Provisional Patent Application No. 62 / 659,900, entitled METHOD OF HUB COMMUNICATION, filed on April 19, 2018, which is incorporated herein as a reference, in its entirety.
[0159] [0159] Although a "smart" device, including control algorithms responsive to detected data, can be an improvement over a "stupid" device that operates without taking the detected data, some detected data can be incomplete or inconclusive when considered in isolation, that is, without the context of the type of surgical procedure being performed or the type of tissue that is undergoing the surgery. Without knowing the context of the procedure (for example, knowing the type of tissue that is undergoing surgery, or the type of procedure that is being performed), the control algorithm may control the modular device incorrectly or suboptimally, detected data without specific context is provided. For example, the ideal way for a control algorithm to control a surgical instrument in response to a particular parameter detected may vary according to the type of particular tissue being operated on. This is due to the fact that different types of tissue have different properties (for example, tear resistance) and thus respond differently to actions performed by surgical instruments. Therefore, it may be desirable for a surgical instrument to perform different actions when the same measurement is detected for a specific parameter. As a specific example, the optimal way in which to control a surgical stapling and cutting instrument in response to the instrument detecting an unexpectedly high force to close its end actuator, will vary depending on whether the type of tissue is susceptible or resistant to tearing . For tissues that are susceptible to tearing, such as lung tissue, the instrument's control algorithm would optimally slow the engine in response to an unexpectedly high force to close to prevent tearing of the tissue. For tissues that are tear resistant, such as stomach tissue, the instrument's control algorithm would optimally accelerate the engine in response to an unexpectedly high force to close to ensure that the end actuator is properly trapped in the tissue. Without knowing whether lung or stomach tissue has been trapped, the control algorithm can make a decision below what is considered ideal.
[0160] [0160] One solution uses a central surgical controller including a system configured to derive information about the surgical procedure being performed based on data received from various data sources, and then control, accordingly, the modular devices Paired. In other words, the central surgical controller is configured to infer information about the surgical procedure from data received and, then, to control modular devices paired with the central surgical controller based on the inferred context of the surgical procedure. . Figure 14 illustrates a diagram of a surgical system with 5100 situational recognition, in accordance with at least one aspect of the present description. In some examples, data sources 5126 include, for example, modular devices 5102 (which may include sensors configured to detect parameters associated with the patient and / or the modular device itself), databases 5122 (for example, an EMR database containing the patient's medical record), and 5124 monitoring devices (for example, a blood pressure (BP) monitor and an electrocardiography (ECG) monitor)).
[0161] [0161] A central surgical controller 5104 that can be similar to surgical controller 106 in many ways, can be configured to derive contextual information related to the surgical procedure from data based, for example, on the combination (s) ( specific data (s) received or in the specific order in which data are received from data sources 5126. Contextual information inferred from data received may include, for example, the type of surgical procedure being performed, the step specific to the surgical procedure that the surgeon is performing, the type of tissue being operated on, or the body cavity that is the object of the procedure. This ability by some aspects of the 5104 central surgical controller to derive or infer information related to the surgical procedure from received data, can be called "situational awareness." In one example, the 5104 central surgical controller can incorporate a situational perception system, which is the hardware and / or programming associated with the central surgical controller 5104 that derives contextual information related to the surgical procedure based on the data received.
[0162] [0162] The situational perception system of the central surgical controller 5104 can be configured to derive contextual information from data received from data sources 5126 in several ways. In one example, the situational perception system includes a pattern recognition system, or machine learning system (for example, an artificial neural network), which has been trained in training data to correlate various inputs ( for example, data from databases 5122, patient monitoring devices 5124, and / or modular devices 5102) to corresponding contextual information regarding a surgical procedure. In other words, a machine learning system can be trained to accurately derive contextual information regarding a surgical procedure from the inputs provided. In another example, the situational perception system may include a lookup table that stores pre-characterized contextual information regarding a surgical procedure in association with one or more entries (or ranges of entries) corresponding to the contextual information. In response to a query with one or more entries, the lookup table can return the corresponding contextual information to the situational perception system to control the 5102 Modular devices. In an example, the contextual information received by the system's situational perception system central surgical controller 5104, are associated with a control setting or set of specific control settings for one or more modular devices 5102. In another example, the situational perception system includes a learning system by additional machine, look-up table or other such system, generating or retrieving one or more control settings for one or more 5102 modular devices, when contextual information is provided as input.
[0163] [0163] A 5104 central surgical controller, which incorporates a situational awareness system, provides several benefits to the 5100 surgical system. One benefit includes improving the interpretation of detected and captured data, which, in turn, improves processing accuracy and / or data usage during the course of a surgical procedure. To return to an earlier example, a 5104 central surgical controller with situational awareness could determine what type of tissue was being operated on; therefore, when an unexpectedly high force is detected to close the end actuator of the surgical instrument, the central surgical controller with situational perception 5104 could correctly accelerate or decelerate the surgical instrument motor for the tissue type.
[0164] [0164] As another example, the type of tissue being operated can affect the adjustments that are made to the load and compression rate thresholds of a stapling and surgical cutting instrument for a specific span measurement. A central surgical controller with situational perception 5104 could infer whether a surgical procedure being performed is a thoracic or abdominal procedure, allowing the central surgical controller 5104 to determine whether tissue pinched by an instrument end actuator stapling and surgical cutting instrument is lung tissue (for a thoracic procedure) or stomach tissue (for an abdominal procedure). The central surgical controller 5104 can then properly adjust the load and compression rate of the stapling and surgical cutting instrument for the tissue type.
[0165] [0165] As yet another example, the type of body cavity being operated during an insufflation procedure can affect the function of a smoke evacuator. A central surgical controller with situational perception 5104 can determine if the surgical site is under pressure (by determining that the surgical procedure is using insufflation) and determine the type of procedure. As a type of procedure is generally performed in a specific body cavity, the 5104 central surgical controller can then adequately control the speed of the smoke evacuator motor to the body cavity being operated on. In this way, a central surgical controller equipped with 5104 situational awareness can provide a consistent amount of smoke evacuation to both thoracic and abdominal procedures.
[0166] [0166] As yet another example, the type of procedure being performed can affect the ideal energy level for an ultrasonic surgical instrument or radio frequency (RF) electrosurgical instrument to operate. Arthroscopic procedures, for example, require higher energy levels because the end actuator of the ultrasonic surgical instrument or RF electrosurgical instrument is immersed in fluid. A central surgical controller with situational perception 5104 can determine whether the surgical procedure is an arthroscopic procedure. The 5104 central surgical controller can then adjust the RF power level or the generator's ultrasonic range (ie, the "energy level") to compensate for the fluid-filled environment. Related to this, the type of tissue being operated on can affect the ideal energy level at which an ultrasonic surgical instrument or RF electrosurgical instrument operates. A central surgical controller equipped with situational perception 5104 can determine what type of surgical procedure is being performed and then customize the energy level for the ultrasonic surgical instrument or RF electrosurgical instrument, respectively, according to the tissue profile expected for the surgical procedure. In addition, a central surgical controller equipped with 5104 situational awareness can be configured to adjust the energy level for the ultrasonic surgical instrument or RF electrosurgical instrument throughout the course of a surgical procedure, rather than just on a procedure-by-procedure basis. A central surgical controller with situational perception 5104 can determine which step of the surgical procedure is being performed or will be performed subsequently and then update the control algorithms for the generator and / or ultrasonic surgical instrument or RF electrosurgical instrument for adjust the energy level to an appropriate value for the type of tissue, according to the stage of the surgical procedure.
[0167] [0167] As yet another example, data can be extracted from additional data sources 5126 to improve the conclusions that the central surgical controller 5104 draws from a 5126 data source. A central surgical controller with situational perception 5104 can augment the data that he receives from modular devices 5102 with contextual information that he has accumulated, referring to the surgical procedure, from other data sources 5126. For example, a central surgical controller with situational perception 5104 can be configured to determine if hemosystems occurred tasia (that is, if bleeding has stopped at a surgical site), according to video or image data received from a medical imaging device. However, in some cases, video or image data may be inconclusive. Therefore, in one example, the 5104 central surgical controller can be additionally configured to compare a physiological measurement (for example, blood pressure detected by a PA monitor communicatively connected to the 5104 central surgical controller) with the visual data or hemostasis imaging (for example, from a Medical Imaging Device 124 (Figure 2) coupled communicably to the central surgical controller 5104) to make a determination on the integrity of the staple line or tissue union. In other words, the situational perception system of the central surgical controller 5104 can consider the physiological measurement data to provide additional context in the analysis of the visualization data. The additional context can be useful when the visualization data may be inconclusive or incomplete on its own.
[0168] [0168] Another benefit includes proactively and automatically controlling paired modular devices 5102, according to the specific stage of the surgical procedure being performed to reduce the number of times medical personnel are required to interact com or control the 5100 surgical system during the course of a surgical procedure. For example, a central surgical controller with situational perception 5104 can proactively activate the generator to which an RF electrosurgical instrument is connected, if it is determined that a subsequent step in the procedure requires the use of the instrument. Proactively activating the power source allows the instrument to be ready for use as soon as the preceding step of the procedure is complete.
[0169] [0169] As another example, a central surgical controller with situational perception 5104 could determine whether the current or subsequent stage of the surgical procedure requires a different view or degree of magnification of the screen, according to the resource (s) in the surgical site that the surgeon is expected to see. The central surgical controller 5104 could then proactively change the displayed view (provided, for example, by a Medical Imaging device to the visualization system 108), so that the screen automatically adjusts throughout the surgical procedure.
[0170] [0170] As yet another example, a central surgical controller with situational perception 5104 could determine which stage of the surgical procedure is being performed or will be performed subsequently and whether specific data or comparisons between the data will be required for that stage of the surgical procedure . The 5104 central surgical controller can be configured to call screens automatically based on data about the stage of the surgical procedure being performed, without waiting for the surgeon to request specific information.
[0171] [0171] Another benefit includes checking for errors during the configuration of the surgical procedure or during the course of the surgical procedure. For example, a central surgical controller with situational perception 5104 could determine whether the operating room is properly or ideally configured for the surgical procedure to be performed. The central surgical controller 5104 can be configured to determine the type of surgical procedure being performed, retrieve the corresponding checklists, product location, or configuration needs (for example, from a memory), and then compare the layout of the current operating room with the standard layout for the type of surgical procedure that the 5104 central surgical controller determines is being performed. In one example, the central surgical controller 5104 can be configured to compare the list of items for the procedure scanned by a suitable scanner, for example and / or a list of devices paired with the central surgical controller 5104 with a recommended or anticipated manifest of items and / or devices for the given surgical procedure. If there are any discontinuities between the lists, the central surgical controller 5104 can be configured to provide an alert indicating that a specific modular device 5102, patient monitoring device 5124 and / or another surgical item is missing. . In one example, the central surgical controller 5104 can be configured to determine the position or relative distance of modular devices 5102 and patient monitoring devices 5124 using proximity sensors, for example. The central surgical controller 5104 can compare the relative positions of the devices with a recommended or anticipated layout for the specific surgical procedure. If there are any discontinuities between the layouts, the 5104 central surgical controller can be configured to provide an alert indicating that the current layout for the surgical procedure deviates from the recommended layout.
[0172] [0172] As another example, the central surgical controller with situational awareness 5104 could determine whether the surgeon (or other medical personnel) was making a mistake or otherwise deviating from the expected course of action during the course of a surgical procedure. For example, the central surgical controller 5104 can be configured to determine the type of surgical procedure being performed, retrieve the corresponding list of steps or order of use of the equipment (for example, from a memory), and then compare the steps being performed or the equipment being used during the course of the surgical procedure with the steps or with the equipment expected for the type of surgical procedure that the central surgical controller 5104 determined is being used executed. In one example, the central surgical controller 5104 can be configured to provide an alert indicating that an unexpected action is being taken or an unexpected device is being used at the specific stage in the surgical procedure.
[0173] [0173] In general, the situational perception system for the 5104 central surgical controller improves the results of the surgical procedure by adjusting surgical instruments (and other 5102 modular devices) to the specific context of each surgical procedure. (such as adjustment to different types of tissue), and when validating actions during a surgical procedure. The situational perception system also improves the surgeon's efficiency in performing surgical procedures by automatically suggesting the next steps, providing data, and adjusting screens and other 5102 modular devices in the operating room, according to the specific context of the procedure.
[0174] [0174] In one aspect, as described later in this document with reference to Figures 24 to 40, the modular device 5102 is implemented as one of the surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a , b (Figure 21), 200088 and 200078a, b (Figure 23), the surgical device 200078a, b (Figure 22) and the visualization system 200086 (Figure 23). Consequently, the modular device 5102 implemented as one of the surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a, b (Figure 21), 200088 and 200078a, b (Figure 23), the surgical device 200078a, B
[0175] [0175] With reference now to Figure 15, a time line 5200 is shown, representing, for example, the situational recognition of a central controller, such as the central surgical controller 106 or 206 (Figures 1 to 11). Time line 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 shows the typical steps that would be taken by nurses, surgeons, and other medical personnel during the course of a lung segmentation procedure, starting with the setup of the operating room and ending with the transfer of the patient. to a postoperative recovery room.
[0176] [0176] Situational recognition of a central surgical controller 106, 206 receives data from data sources throughout the course of the surgical procedure, including the data generated each time the medical team uses a modular device that is paired with the operating room 106 , 206. 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 procedure is being performed at any given time. The situational recognition system of the central surgical controller 106, 206 is capable of, for example, recording data related to the procedure to generate reports, verify the measures taken by the medical team, provide data or warnings (for example, through a screen display) that may be relevant to the specific step of the procedure, adjust the modular devices based on the context (for example, activate monitors, adjust the field of view (FOV) of the medical imaging device, or change the energy level of an ultrasonic surgical instrument or the RF electrosurgical instrument), and take any other action described above.
[0177] [0177] In the first step 5202, in this illustrative procedure, members of the hospital team retrieve the patient's electronic medical record (PEP) from the hospital's PEP database. Based on the patient selection data in the PEP, the central surgical controller 106, 206 determines that the procedure to be performed is a thoracic procedure.
[0178] [0178] In the second step 5204, the team members scan the incoming medical supplies for the procedure. Central surgical controller 106, 206 cross-references the scanned supplies with a list of supplies that are used in various types of procedures and confirms that the combination of supplies corresponds to a thoracic procedure. In addition, the central surgical controller 106, 206 is also able to determine that the procedure is not a wedge procedure (because the incoming supplies either lack certain supplies that are necessary for a thoracic or wedge procedure). , otherwise, that the incoming supplies do not correspond to a thoracic wedge procedure).
[0179] [0179] In the third step 5206, the medical team scans the patient's band with a scanner that is communicably connected to the central surgical controller 106, 206. Surgical controller 106, 206 can then confirm the patient's identity based on the data scanned.
[0180] [0180] In the fourth step 5208, the medical team turns on the auxiliary equipment. The auxiliary equipment in use 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 neighborhood of modular devices as part of their initialization process. Surgical controller 106, 206 can then derive contextual information about the surgical procedure by detecting the types of modular devices paired 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 (PEP), the list of medical supplies to be used in the procedure, and the type of modular devices that connect to the central controller, the central surgical controller 106 , 206 can, in general, infer the specific procedure that the surgical team will perform. After the central surgical controller 106, 206 recognizes that a 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 the data that subsequently
[0181] [0181] In the fifth step 5210, team members fix 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 the patient's monitoring devices , the central surgical controller 106, 206 thus confirms that the patient is in the operating room.
[0182] [0182] In the sixth step 5212, the medical team induces anesthesia in the patient. Central surgical controller 106, 206 can infer that the patient is under anesthesia based on data from modular devices and / or patient monitoring devices, including ECG data, blood pressure data, ventilator data , or combinations thereof, for example. After the completion of the sixth step 5212, the preoperative portion of the pulmonary segment surgery procedure is completed and the operative portion begins.
[0183] [0183] 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 was initiated since it can compare the detection of the patient's lung retraction to the expected steps of the procedure (which can be accessed or retrieved earlier) and so on. determine that lung retraction is the first operative step in this specific procedure.
[0184] [0184] In the eighth step 5216, the medical imaging device (for example, an endoscope) is inserted and the video of the medical imaging device is started.
[0185] [0185] In the ninth stage 5218, the surgical team starts the stage of dissection of the procedure. The central surgical controller 106, 206 can infer that the surgeon is in the dissection process 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.
[0186] [0186] In the tenth step 5220 of the procedure, the surgical team proceeds to the connection step. Central surgical controller 106, 206 can infer that the surgeon is ligating the arteries and veins because he receives data from the surgical stapling and cutting instrument indicating that the instrument is being fired. Similar to the previous step, the central surgical controller 106, 206 can derive this inference by crossing the data received from the surgical stapling and cutting instrument with the steps recovered in the process. In certain cases, the surgical instrument may be a surgical tool mounted on a robotic arm of a robotic surgical system.
[0187] [0187] In the eleventh step 5222, the portion of the segmentectomy procedure is performed. The central surgical controller 106, 206 can infer that the surgeon is transecting the parenchyma based on the data from the surgical stapling and cutting instrument, including the data from its cartridge. The cartridge data can correspond to the size or type of clamp being triggered by the instrument, for example. As different types of staples are used for different types of fabrics, the cartridge data can thus indicate the type of fabric that is being stapled and / or carried. In this case, the type of clamp that is fired is used for the parenchyma (or other similar types of tissue), which allows the central surgical controller 106, 206 to infer which portion of the segmentectomy procedure is being performed.
[0188] [0188] In the twelfth step 5224, the node dissection step is then performed. 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 which indicates which ultrasonic or RF instrument is being fired. For this specific procedure, an RF or ultrasonic instrument being used after the parenchyma has been transected corresponds to the node dissection step, which allows the central surgical controller 106, 206 to make this inference. It should be noted that surgeons regularly switch between surgical stapling / surgical cutting instruments and surgical energy instruments (that is, RF or ultrasound).
[0189] [0189] In the thirteenth stage 5226, the patient's anesthesia is reversed. The central surgical controller 106, 206 can infer that the patient is coming out of anesthesia based on ventilator data (that is, the patient's respiratory rate begins to increase), for example.
[0190] [0190] Finally, in the fourteenth step 5228, the medical team removes 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.
[0191] [0191] In several aspects, the surgical instruments 200018 (Figure 17), 200062 (Figure 20), 200072a, b (Figure 21), 200088 and 200078a, b (Figure 23), the surgical device 200078a, b (Figure 22) and the 200086 visualization system (Figure 23) are configured to operate in situational recognition in a central controller environment, such as central surgical controller 106 or 206 (Figures 1 to 11), for example, as shown in timeline 5200. Situational recognition is further described in US Provisional Patent Application serial number 62 / 659,900, entitled METHOD OF HUB COMMUNICATION, filed on April 19, 2018, which is incorporated here, as reference, in its entirety. In certain cases, the operation of a robotic surgical system, including the various robotic surgical systems disclosed here, for example, can be controlled by the central controller 106, 206 based on its situational recognition and / or feedback from its components and / or based on information from the cloud 104. Wireless central controller interaction Device-device intercom
[0192] [0192] In several respects, various techniques are described here for pairing devices and rules that define device interactions. Consequently, wireless interactive pairing for central surgical controller devices is described here.
[0193] [0193] In one aspect, wireless pairing of a surgical device with another device within the sterile surgical field is based on the use and situational recognition of the devices. In one aspect, situational awareness could include recognizing which user has control over which devices based on user location devices. In one aspect, the pairing between the devices could be based on the simultaneous activation of the two devices during a predetermined interval of time when no tissue or patient is detected by the active device. In another aspect, one device could be in the sterile field while the other device could be outside the sterile field. Pairing personal-owned wireless devices
[0194] [0194] Various techniques for pairing personal wireless devices are described here. In one respect, an encrypted key can be used to authenticate a smartphone, a device to be worn close to the body, or another personal property device that is provided to a given user. The definition of the functions that a personal device will ask the central controller to perform certain data input elements. In one aspect, carrying the personally owned device in the system provides a connection from the device to the central surgical controller to perform an internal function. For example, a device can be connected to a central controller and music from a library or playlist on the device can be carried over (that is, transmitted through) the central controller's speakers. As another example, a phone or other device can be connected to a central controller and the device options can be connected through the central controller to allow portability of calls via the central controller monitors and speakers. In an application, an automatic reply text or voice message can be sent to incoming calls or text messages stating that the user is not available when the user's device is connected to the central controller, unless, for example , the call or text message is from a selected subset of numbers (for example, from other doctors who can call to ask about cases). In another application, a contact list from a connected phone can be stored so that calls received on the surgeon's phone during
[0195] [0195] In one aspect, a central surgical controller can be configured to display functional imported data (for example, data imported from a mobile device) on a secondary screen due to the recognition by the central controller of the data type and / or the how common is the use of data. In one aspect, information can be displayed on a secondary screen when data is sent / imported into the central surgical controller. In another aspect, an interactive menu can become active on the main screen or in use when data is loaded / imported into the central surgical controller when interaction is available. For example, when a call is received by a mobile device connected to a central surgical controller, the caller identification information from the mobile device's contact list may appear on selected monitors visible by the surgeon and nurses. As another example, the caller identification information could be displayed on a secondary monitor to display auxiliary information, such as device settings, or on a tablet-type computer positioned in the sterile field that the surgeon could touch to see if necessary in order to avoid cluttering the main surgical screen with pop-up windows. As another example, depending on the specific detected user, the number of times the user uses the secondary device and other parameters, the central controller can be configured to signal the most commonly used and / or most appropriate option or menu. according to the specific interaction. In some ways, the central controller can be configured to show the option or menu in the user interface without interfering with the task in progress.
[0196] [0196] Figure 16 shows an example of a pairing of a personal property wireless device 200002 with a central surgical controller 200006. The wireless device 200002 and the central surgical controller 200006 can communicate with each other via a wireless link 200004. As shown above, the central surgical controller 200006 can display imported data received from the wireless device 200002 on one or more screens visible to members of the surgical team. In one aspect, the central surgical controller 200006 can cause imported data to be displayed on a primary display monitor or in use 200008. In another aspect, the central surgical controller 200006 can cause imported data are displayed on a secondary display monitor
[0197] [0197] Various techniques for communicating the smart cartridge with the central controller, without using the instrument to which the cartridge is attached as a means of communication, are described here.
[0198] [0198] In several aspects, a cartridge can be configured so that there is a wired connection between the device and the cartridge and that physical contact is required between the instrument and the cartridge to transfer energy to the cartridge. In one of these aspects, the cartridge may include an identification circuit that includes a portion that requires both the instrument slide and at least a clamp to make contact with it for continuity. If any of the slider or clamp is not in contact with the circuit, the transfer of energy to the cartridge will not occur and the device will be blocked. In these respects, the described circuit can be used to provide a secondary or backup method to prevent an instrument from being used with a spent cartridge.
[0199] [0199] In several aspects, the cartridge can be configured to communicate with the central controller, without requiring any power from the surgical instrument (for example, a surgical stapler).
[0200] [0200] In one of these aspects, the insertion of the cartridge in the device is configured to supply a momentary amount of energy to the cartridge, which is then configured to communicate directly with the central controller without going through the device. In some ways, the cartridge does not include a battery or an integrated power source. In some respects, the small amount of energy can be extracted at the connection and during transmission, after which energy drain from the cartridge is interrupted. For example, Figure 17 is a diagram of a 200012 cartridge configured to communicate wirelessly with a central surgical controller 200006, in accordance with at least one aspect of the present description. In one aspect, communication can be carried out via a wireless communication circuit 200028 embedded in the 200012 cartridge. In this example, power is transferred wirelessly from the device to the cartridge via inductive coupling. In one aspect, a first 200014 wire transmission antenna coil is printed on the 200016 wall of an instrument channel
[0201] [0201] Figure 17A shows the overlap 200022 of the transmission coil 200014 and the receiving coil 20020. The transmission coil 200014 can receive energy 200024 from the instrument.
[0202] [0202] In such respects, the proximity and alignment of the transmission coil 200014 and the receiving coil 20020 can be obtained with shoulder features 200030 formed in the cartridge body
[0203] [0203] In some respects, the cartridge and / or instrument additionally includes resonant circuits to increase the efficiency of energy transfer between them. For example, Figure 18 is a block diagram of a 200034 resonant wireless induction power system, in accordance with at least one aspect of the present description. The 200034 resonant wireless induction power system can include, for example, a 200040 transmitter oscillator that receives power from a 200042 power source. The 200040 transmitter oscillator can supply AC current to a transmission coil
[0204] [0204] The 200048 receiver coil can be coupled to the 200044 transmission coil through the magnetic field (B) generated by the 200044 transmission coil. In some aspects, the 200046 rectifier can convert the AC power received from the 200040 transmitting oscillator to power DC for a 200050 load. In one example, a 200050 load can include the 200028 communication circuit. The 200034 resonant wireless induction supply system can also include, for example, one or more resonance coils 200036a, b made of wire copper, for example, that resonate with their internal capacitance (indicated as capacitors 200038a, b in dashed line) at a resonant frequency (for example, at 10 MHz). In some respects, the resonance coils 200036a, b can have correlated impedances to optimize the power transmission from the transmitting oscillator 200040 to the rectifier 200046.
[0205] [0205] In another aspect, the 200012 cartridge can include a battery that can power the 200028 communication circuit when the 200012 cartridge is inserted into the 200018 instrument. In this respect, the 200028 communication circuit can be energized regardless of the state of 200018 instrument power.
[0206] [0206] In another aspect, a sterile scanning base can be configured to scan a 200018 instrument and / or a 200012 cartridge. In operation, the scanning base can be present on an auxiliary table within the room operator (SO) and a healthcare professional can scan the 200018 instrument or 200012 cartridge by placing the 200018 instrument or 200012 cartridge on the scan bed. Data from the 200018 instrument or 200012 cartridge can be supplied to the central controller when the 200018 instrument or 200012 cartridge is opened and placed on the scanner bed. In some respects, the 200018 instrument or 200012 cartridge can be scanned, for example by radio frequency (RF), to activate the 200018 instrument or 200012 cartridge and track it through the central controller. In some additional aspects, there may be a wired connection from the base to the central controller to provide power for scanning. Detection of environment and configuration of an area bounded by geofence
[0207] [0207] Various techniques for detecting an environment and establishing a geofence are described here.
[0208] [0208] Figure 19 is a diagram of a central surgical controller detecting an area or the perimeter of a room, for example the perimeter of an operating room (SO), according to at least one aspect of the present description. In one aspect, a 200052 perimeter of a space detectable by a central surgical controller 200006 can be defined by one or more independent 200054a-d beacons with directional antennas. In one aspect, the 200054a-d beacons can be placed in desired positions within a room in which the central controller 200006 is or will be located. In one aspect, the 200052 perimeter bounded by the 200054a-d beacons can form an outline of a device detection space by the central surgical controller 200006. The 200054a-d beacons can be used, for example, to define a zone that has a shape regular three-dimensional or irregular three-dimensional shape. In some applications, only three beacons (generally, 200054) are sufficient to define a simple device detection perimeter, such as the interior of a square or rectangular room. In other respects, more than three 200054a-d beacons can be used to delimit a detection zone that has an irregular shape, as shown in Figure
[0209] [0209] In some respects, 200054a-d beacons can be active or passive. Active beacons 200054a-d can actively transmit information for reception by central controller 200006 without requiring central controller 200006 to transmit any information to them. Passive beacons 200054a-d can be activated only upon receipt of one or more transmissions from central controller 200006. Passive beacons 200054a-d can then respond to an initial query from central controller 200006 and transmit in response to receipt of initial query from central controller 200006, a response signal. The signals transmitted by the 200054a-d beacons can be in any suitable form including, but not limited to, a wireless signal, an acoustic signal or a light signal. The signals transmitted by the 200054a-d beacons may include any appropriate information, such as identification information, location information or any other information that the central controller 200006 can use to determine the location of the 200054a-de beacons. thereby allowing central controller 200006 to determine perimeter 200052.
[0210] [0210] As revealed above, the perimeter 200052 can define a detection zone in which the central controller 200006 can scan for one or more Surgical Instruments or other devices. Devices within the detection zone can be recognized by the central controller 200006 as being potentially associated with a surgical procedure. It can be understood that, in this respect, devices located outside the detection zone may not be recognized by the central controller 200006 as being potentially associated with a surgical procedure. Alternatively, beacons can be used to define an excluded zone in which devices may not be recognized by central controller 200006. In some respects, the angle of signal transmission by beacons 200054a-d can be adjustable. Starting at about 90 degrees, multiple 200054a-d beacons could be placed on the floor or walls of the SO to define the perimeter 200052. In some respects, the perimeter 200052 can form a detection zone.
[0211] [0211] Figure 19B shows some aspects of a management system that can additionally include an "interference" beacon
[0212] [0212] It can be recognized that the use of an "interference" beacon 200056 may operate differently from the use of beacons 200054a-d to define an exclusion zone. For example, an "interference" beacon 200056 can be associated with a mobile instrument cabinet 200058. The "interference" function of the "interference" beacon 200056 can prevent central controller 200006 from communicating with medical instruments stored in the instrument cabinet 200058 regardless of the location of the instrument cabinet 200058.
[0213] [0213] In some applications, the positioning of the 200054a-d beacons along the edges of a room, such as an operating room, can establish a controlled means for determining the actual size and orientation of the OS in relation to the central controller 200006.
[0214] [0214] In one aspect, the central controller and / or devices connectable to the central controller can be configured for wireless and interactive pairing with each other. Consequently, multiple controllers and controlled devices can be configured for dynamic wireless pairing, without the need for any direct user control. For example, Figure 20 is a 200060 user and device pairing diagram between a central controller 200006, an identifier used by the user 200066 and a surgical instrument 200062, in accordance with at least one aspect of the present description. In the aspect shown, a 200066 identifier can be used or attached by hand to each user. The 200066 identifier can interact with a 200064 receiver that is part of or attached to a 200062 surgical device. In one aspect, the 200064 receiver can be integrated within a handle of the surgical device
[0215] [0215] In operation, whenever a user picks up a 200062 device, the device's 200064 receiver automatically pairs the 200062 device with the 200066 identifier. In response to the pairing between the 200064 receiver and the 200066 identifier, the central controller 200006 recognizes device 200062, allowing central controller 200006 to control and / or receive state data from device 200062. In some aspects, central controller 200006 can communicate directly with device 200062. In other aspects, central controller 200006 can communicate with the 200062 device via a communication link from the central controller 200006 through the 200066 identifier to the 200064 device receiver. The NFC connection allows the 200062 surgical device to communicate with the 200066 identifier, which in turn communicates with central controller 200006. In some respects, identifier 200066 can act as a relay for communication 200068 between central controller 200006 and surgical device 200062, allowing identification information and / or sensor from surgical device 200062 to be transmitted to central controller 200006, and control data to be transmitted from central controller 200006 to control the 200062 surgical device.
[0216] [0216] In some other respects, the identifier 200066 can transmit information to one or both of the central controller 200006 and the surgical device 200062. In some respects, the information from identifier 200066 may include an identification of the user. In some other respects, the 200066 identifier information may include which hand is using the surgical device
[0217] [0217] In several aspects, the control of surgical instruments paired with central surgical controllers can be switched interchangeably between different central surgical controllers.
[0218] [0218] The initiation of the change of control between the paired instruments and the central surgical controllers can be controlled and / or indicated for users / other devices in different ways. In one aspect, a predefined sequence could be used to indicate by the user the release of a controlled device to the control device (eg, the central surgical controller) and / or associated devices (eg, other devices connected to the controller central surgical center).
[0219] [0219] The designation of a new relationship between the control device and the controlled device can be controlled and / or indicated for users / other devices in different ways. In one aspect, once released or when not paired with a control system within the OS's local network, a series of steps could be used to connect two systems for the purpose of controlling one system with the other system. In an alternative aspect, the sterile field interaction and control device can be used to display all paired links within the SO and to redistribute them in a different order.
[0220] [0220] The identification and notification of a change of control of a device, without the use of a control device, can be done in different ways. In one aspect, the illumination of a handheld device's built-in display screen could be configured to change from a first color (for example, blue or green) to a second color (for example, red) and / or a first state (for example, solid color) to a second state (for example, blinking) to indicate and notify the user of changes in the device's control state. For example, the first color and / or the first state can include
[0221] [0221] In one aspect, control can be shared from more than one control device to a single controlled device. For example, the system could be used to allow two wireless control devices to control the same device simultaneously or to control multiple devices from a single control device. Position detection and device orientation
[0222] [0222] Various techniques for detecting the position and orientation of devices are described here.
[0223] [0223] In one aspect, measurements in relation to a co-ordinate system or in relation to each other can be displayed. In such aspects, a display system can be configured to display user-selectable measurements of the position of the device in relation to the patient, the central controller or a device (for example, a switch). Figure 21 shows an aspect of a 200070 operating room in which surgical instruments (for example, surgical instruments 200072a, b) are used as part of a surgical procedure.
[0224] [0224] In one aspect, the display system could be configured to show the current location of surgical instruments 200072a, b in relation to a local coordinate system. In another aspect, the display system could be configured to calculate whether or not there is an interaction between surgical instruments 200072a, b. In one aspect, the monitor could switch from displaying local coordinate measurements to calculating interaction as the surgical instruments 200072a, b approach each other or tissue. The interaction calculation could be used to prevent inadvertent collisions between the 200072a, b surgical instruments or to allow users to coordinate the movement of two 200072a, b surgical instruments specifically to control the interaction between them.
[0225] [0225] In one aspect, the display system is configured to display the actual position of the 200072a surgical instruments, b in relation to an externally established reference structure. For example, triangulation beacons that interface with the central controller can be positioned by the SO to establish the location and orientation of any devices within the SO (see, for example, Figures 19A, B). In addition, a beacon could be attached to each of the 200072a surgical instruments, b to establish the location of each of the 200072a surgical instruments, b in relation to each other, other devices and / or other beacons. In one aspect, a trocar can be marked with a beacon, which would allow central controller 200006 to identify which of the 200072a, b surgical instruments is currently inserted in the trocar. The display system can display an identifier for a surgical instrument (for example, surgical instruments 200072a, b) to ensure that the surgical instrument and the trocar in which it is inserted are retained on the screen.
[0226] [0226] By determining the relative positions and / or the orientation of the surgical instruments 200072a, b in relation to each other or in relation to other instruments, the central controller 200006 can provide the angle, depth of insertion and relative orientation of the surgical instruments 200072a, b and / or an end actuator of each of the surgical instruments 200072a, b by a member of the surgical team. In some respects, the position and / or orientation of surgical instruments 200072a, b can be determined in relation to the patient, a surgical site or incision site for positioning a critical instrument.
[0227] [0227] As disclosed above, surgical instruments 200072a, b and / or other devices may include one or more beacons to assist in determining their relative position and / or orientation relative to each other. Such beacons could be based on RF, magnetism or another form of energy wave capable of penetrating tissue, as well as air to send and receive triangulation signals. In some aspects, the central controller 200006 can receive the triangulation signals emitted by the beacons. In some respects, triangulation signals may include identifier information that allows central controller 20006 to determine which beacon is associated with which triangulation signal. In some aspects, an elongated surgical element (such as surgical instruments 200072a, b) may have multiple beacons attached to a handle and a driving shaft so that the orientation of the driving shaft of the instrument in relation to the handle of the instrument. instrument can be determined by central controller 200006
[0228] [0228] As revealed above, the location and / or orientation of a surgical instrument can be determined in relation to the location and / or orientation of another surgical instrument or other surgical device. In another aspect, the location and / or orientation of the surgical instruments 200072a, b can be determined in relation to one or more local references. In some respects, one or more local references may include one or more wireless or RF beacons arranged within the operating room. In another aspect, a local reference may include a 200074 magnetic field generator in a bracket within the SO or attached to a wall or ceiling. The 200074 magnetic field generator can be configured to create a predefined magnetic field within the room, as shown in Figure 21. In addition, each surgical instrument or medical device can include one or more embedded or coupled sensors to detect the field magnetic (or RF field for use with one or more RF beacons) and determine the orientation of the device with respect to the magnetic field (or RF field).
[0229] [0229] Each device (such as surgical instruments 200072a, b) can transmit location and / or guidance information to the central controller 200006 via a wired or wireless communication system to allow the central controller 200006 track the position and orientation of the device. In one aspect, each of the 200072a, b surgical instruments could include several sensors that would be able to detect their respective distances and orientations in relation to the predefined magnetic field. Multiple sensors can be useful for surgical instruments that include an elongated drive shaft connected to a hand unit. For example, magnetic sensors can be arranged with the hand unit, half the length of the elongated drive shaft and on a distal end actuator coupled to the elongated drive shaft. The instrument could then report its location and orientation of the elongated drive shaft and the end actuator to a central procedure system (executed, for example, by central controller 200006). The procedure system can then calculate and track the use and disposition of all instruments within the SO, and display or highlight it to the user on a visual screen when there are special interactions or conditions.
[0230] [0230] In another aspect, each of the 200072a, b surgical instruments can define a local coordinate system for the instrument. In some respects, local coordinate systems can be determined in relation to one or more local references, such as a magnetic field generator 200074. In another example, local coordinate systems can be established in relation to a local point such as a trocar port on the patient. The use of a local point, close to the surgical instruments 200072a, b, can establish a system of local coordinates with higher spatial resolution compared to a coordinate system based on a distant beacon (such as the magnetic field generator 200074 ). Such a higher resolution coordinate system can provide detailed information on the location and orientation of a surgical instrument that passes through the trocar. In addition, the trocar positions themselves can be used to assist in understanding the placement of the door and other operations to inform other systems, both intraoperatively and post-operatively, for training purposes.
[0231] [0231] In one aspect, a first reference structure is established in relation to a device (for example, a scope) positioned on the patient and a second reference structure is established outside the patient in relation to a preset position. In addition, the system may include a means for associating one reference structure with another to be able to establish the position of the instrument for the position of the claw in relation to the tissue. Consequently, the position and orientation of the devices can be determined
[0232] [0232] In one aspect, a coupling sensor could be used to associate an internal viewing image within a surgical site with the external viewing image of the surgical field in order to coordinate the position of an instrument end actuator surgical in relation to tissues of patients in the surgical field and an external position and orientation of a surgical instrument handle. For example, the primary internal visualization system could be used to determine positions, distances and speeds between aspects of the instruments and tissues of interest within the body. In one aspect, a primary internal visualization system can use a specialized frame capture imaging device. Such a device can capture the image of the internal surgical site with the use of a beam of light that is reflected by an internal structure of the surgical site and any devices arranged therein. Consequently, the refraction of the light beam by the tissue can be used to determine the distance between the internal tissue structures and the devices, rather than the reflectivity of the tissues.
[0233] [0233] In one respect, LIDAR can be used as the measurement method for this type of system. LIDAR measurements can use a pulsed laser to create a pattern and thus reflected pulses are measured. In some ways, this technique can be called laser scanning. In many respects, a CMOS array of multiple laser light sources used for advanced visualization can be employed for this technique. For example, Figure 22 shows a 200076 system for using LIDAR to determine the positions of surgical devices 200078a, b with respect to a measurement location selected by the user 200080, in accordance with at least one aspect of the present description. As shown in Figure. 22, the primary internal visualization system can allow a user of surgical devices 200078a, b to evaluate a distance 200082 between the end actuators of surgical devices 200078a, b. In some ways, a central surgical controller can display the positions of the end actuators within the surgical site. In some additional aspects, the central surgical controller can provide a warning, such as a visual indicator on a screen, to warn the user about surgical devices 200078a, b if surgical devices 200078a, b are approaching or at a distance minimum collision between them.
[0234] [0234] In another aspect, RF could be used to determine the locations of the end actuators within the abdomen cavity or within any internal surgical field. Figure 23 shows such a system. The radiofrequency flight time would be a measure to determine the distance for smart devices. For example, a primary transmitter and receiver could be used in a 200086 scope or display system. In one aspect, the primary transmitter can include a first antenna 200084a and the receiver can include a second antenna 200084b. In another aspect, the first 200084a antenna can be used both as a transmitting element and as a receiving element. Similarly, the second antenna 200084b can be used both as a transmitting element and as a receiving element. By incorporating the primary transmitter and receiver at one end of the 200086 viewing system, the receiver can measure the distance from the 200086 viewing system to a first target device in relation to the viewing focus, thereby allowing the user to measure the from a reference structure based on which the user can see.
[0235] [0235] In one aspect, a 200083 antenna array associated with the 200086 scope or display system can be composed of the first antenna 200084a and the second antenna 200084b. In one aspect, an antenna (such as the first antenna 200084a) of the antenna array 200083 can be configured to transmit a signal at a frequency, while a second antenna (such as the first antenna 200084a) of the antenna array 200083 can be configured be configured to receive a signal transmitted back from a target 200088 first surgical instrument. As an example, the frequency of the signal transmitted by the antenna array 200083 can be about 13.56 MHz. In another example, the signal strength received by the first target surgical instrument 200088 can be about -36 dbm RSSI. In some respects, a return signal to the 200083 antenna array can be transmitted by the first target 200088 surgical instrument at a different frequency than the signal transmitted by the 200083 antenna array. Such a communication protocol is considered a full-duplex communication 200090 Separate transmit and receive frequencies can be used to avoid interference from the transmit signal by the receive signal (and vice versa). In addition, separate transmit and receive frequencies can allow measurement of the round trip time of the signal to and from a target 200088 first surgical instrument. In some respects, the round trip time of the signal to and from a first target 200088 surgical instrument can be used to calculate a distance from the first target 200088 surgical instrument from the antenna array
[0236] [0236] In another aspect, the distance from the first target 200088 surgical instrument to the 200083 antenna array to the first target 200088 surgical instrument can be calculated based on the loss of power of a signal transmitted by the 200083 antenna array or by by means of a response signal transmitted by the first target 200088 surgical instrument. Geometric factors, such as the propagation of the signal transmitted over the distance, as well as the loss of absorption due to the medium between the antenna array 200083 and the first target surgical instrument 200088 may allow such a distance measurement. In general, the distance between the antenna array 200083 and the first target 200088 surgical instrument is proportional to the ratio between the intensity of the signal received by the first target target 200088 and the intensity of the signal originally transmitted by the antenna array 200083 Alternatively, the distance between the antenna array 200083 and the first target surgical instrument 200088 can be calculated from the ratio between the intensity of the response signal received by the antenna array 200083 and the intensity of the signal transmitted by the first surgical instrument 200088 target. In some examples of this technique, the signal transmitted by the first target 200088 surgical instrument may incorporate information about the signal strength of the transmitted signal.
[0237] [0237] Consequently, intelligent systems could determine the relative position when receiving and then return a signal. The receiving matrix could include a field-programmable gate array (FPGA) and a microcontroller configured to handle the speed of the necessary measurements of multiple instruments in real time. In one aspect, the receiver antenna array 200083 could consist of two different antennas, for example, a first antenna 200084a and a second antenna 200084b. The system could compare the differences in the signal received at the two antennas (the first antenna 200084a and the second antenna 200084b) and triangulate the position of the sources in 3D space, as shown in Figure 23. Figure 23 is a diagram of a system to determine the relative position of devices by means of a 200083 dual antenna array, in accordance with at least one aspect of the present description. In the system shown in Figure 23, the 200083 dual antenna array is arranged in a 200086 scope and receives actively transmitted signals or passive signals from devices to determine the relative positions of the devices. In one aspect, the passive signal technique may include the 200090 full-duplex communication system shown in relation to the first target 200088 surgical instrument. In another aspect, active signal communication 200092 may involve a second target 200094 surgical instrument. The position of the devices can be determined from the detected signal strength, as shown in Figure 24.
[0238] [0238] Figure 24 shows a 200110 graph of an example of spatial resolution to determine the position of multiple target surgical instruments based on the detected signal strength. The abscissa represents a signal strength ratio, in dBm, of a wireless communication between, for example, a target surgical instrument and a transceiver mounted on a reference device. The ordinate is the distance (for example in cm) that can be resolved based on the reason for the signal strength. It can be seen in graph 200110 that a difference between a maximum distance 200112 and a minimum distance 200114 can increase with the increase in the signal strength ratio.
[0239] [0239] Returning to Figure 23, in another aspect, the instrument end actuators (for example, the second target 200094 surgical instrument) could include one or more 200096 transmitters that are capable of communicating continuously with an antenna array receiver 200083 attached to the 200086 display device. In some non-limiting examples, the 200096 transmitter can transmit a signal at a frequency between about 860 mHz to about 960 mHz. In some examples, the transmitted signal may have a signal strength of about -60 dbm. The one or more transmitters 200096 could transmit a unique ID, as well as the expected signal strength, so that the receiver of the antenna array 200083 can then calculate the distance based on the received intensity. In another aspect, the one or more transmitters 200096 can transmit signals to be received by multiple antennas (for example, the first antenna 200084a and the second antenna 200084b of the antenna array 200083). The difference in the reception time or signal strength of the transmitted signal as determined by the first antenna and the second antenna 200084a 200084b can be used to triangulate the position of one or more transmitters 200096 and, thus, the position of the actuator of end of the second target 200094 surgical instrument.
[0240] [0240] In another aspect, an RFID tag can be placed on or inside an end actuator of each target surgical instrument. The RFID tag can be activated by a signal transmitted by a transmitting antenna. In some respects, the transmission antenna may be part of a 200083 antenna array arranged in a 200086 surgical display device. In some respects, each antenna in the 200083 antenna array (for example, the first 200084a antenna and the second 200084b antenna) can act as a separate broadcast antenna. Alternatively, one of the antennas of the 200083 antenna array may be a transmitting antenna and the other of the antennas of the 200083 antenna array may be a receiving antenna. Consequently, the strength of the transmitted signal received by an RFID tag can be used to determine the distance from the RFID tag to the transmitting antenna. In another aspect, the energy transmission intensity of the transmitted signal could be varied, allowing the RFID tag activation process to be used to determine the distance. The RFID tag activation process can be initiated by receiving a radio frequency signal with a power greater than a limit power. It is recognized that the power of a transmitted signal is attenuated over the distance. In this way, an RFID tag placed at a distance resulting in an attenuated received signal will not initiate the activation process. However, an RFID tag placed at a closer distance can receive the transmitted signal with sufficient power to start the activation process. In either of these examples, the transmitting antenna transmits a power signal for reception by the passive RFID tag on the end actuator. Upon receiving a transmitted signal with sufficient power, the RFID tag can be activated and then transmit a return RF signal to be received by the receiving antenna. This return signal can include a unique identifier that the system could use to measure distance from itself to multiple devices within the operating location.
[0241] [0241] Returning to Figure 23, in another aspect, a separate scanning matrix laser could be used to detect 200098 distances between itself and structures within the body
[0242] [0242] In another aspect, tracking and infrared ID can be used by means of projected light and a camera that observes the OS. For example, at least two separate reflectors or a reflector with aspect in at least two planes could be used to determine the location and orientation of a target surgical instrument in relation to a trocar and, later, in relation to the image of the es - cup on the patient. Examples
[0243] [0243] Various aspects of the subject described in this document are defined in the following numbered examples:
[0244] [0244] Example 1. Surgical system characterized by comprising: a first surgical device comprising a control circuit, the control circuit being configured for:
[0245] [0245] Example 2. The surgical system of Example 1, the events of which the first surgical device has situational recognition include the use of the first surgical device by a first user and the use of the second surgical device by a second user .
[0246] [0246] Example 3. The surgical system of Example 2, the events that include the use of the first surgical device by the first user include the grip of a handle of the first surgical device by the first user.
[0247] [0247] Example 4. The surgical system of Example 3, and the events that comprise the first user's grip on the first surgical device comprise the first user's grip on the first surgical device, thus enabling a transceiver on the first user's grip. surgical device communicates with an identifier used by the first user and allowing, through the identifier, a communication between the first surgical device and a central surgical controller.
[0248] [0248] Example 5. The surgical system of any one or more of Examples 2 to 4, the events of which the first surgical device has situational recognition comprise a location of the first surgical device and a location of the second surgical device.
[0249] [0249] Example 6. The surgical system of Example 5, the control circuit being configured to determine the location of the second surgical device based on a wireless signal transmitted by the second surgical device to the first surgical device.
[0250] [0250] Example 7. The surgical system of any one or more of Examples 1 to 6, the control circuit is additionally configured to simultaneously activate the first surgical device and the second surgical device for a predetermined period of time when no tissue or patient is detected.
[0251] [0251] Example 8. The surgical system of any one or more of Examples 1 to 7, the first surgical device being located within a sterile field and the second surgical device being located outside the sterile field when the first device surgical device pairs wirelessly with the second surgical device.
[0252] [0252] Example 9. The surgical system of any one or more of Examples 1 to 8, the control circuit being additionally configured to be paired wirelessly with a communication device.
[0253] [0253] Example 10. The surgical system of any one or more of Examples 1 to 9, the events of which the first surgical device has situational recognition comprise a determination of a distance between the first surgical device and a specific structure of tissue within a patient.
[0254] [0254] Example 11. Method, characterized by understanding: situational recognition, through a control circuit within a first surgical device, of events that occur in the vicinity of a first surgical device according to the data received a database, a patient monitoring device, or a paired surgical device, or any combination of the database, the patient monitoring device, or the paired surgical device; and wireless pairing, through the control circuit, with a second surgical device according to a use of the first surgical device and with the events of which the first surgical device has situational recognition.
[0255] [0255] Example 12. The method of Example 11, being that situational recognition, through a control circuit within a first surgical device, comprises having situational recognition, through a control circuit within a first surgical device, the use of the first surgical device by a first user and the use of the second surgical device by a second user.
[0256] [0256] Example 13. The method of Example 12, whereby situational recognition, through a control circuit within a first surgical device, of the use of the first surgical device by a first user comprises having situational recognition, through - through a control circuit within a first surgical device, a first user grasping a handle of the first surgical device.
[0257] [0257] Example 14. The method of Example 13, which additionally comprises enabling a transceiver on the handle of the first surgical device to communicate with an identifier used by the first user and enabling, through the identifier, communication between the first device and a central surgical controller.
[0258] [0258] Example 15. The method of any one or more of Examples 12 to 14, with situational recognition, through a control circuit within a first surgical device, of the use of the first surgical device by a first user and the use of the second surgical device by a second user, comprises having situational recognition, through a control circuit within a first surgical device, a location of the first surgical device and a location of the second surgical device.
[0259] [0259] Example 16. The method of Example 15, which additionally comprises determining, via the control circuit, the location of the second surgical device based on a wireless signal transmitted by the second surgical device to the first ci device - surgical.
[0260] [0260] Example 17. The method of any one or more of Examples 11 to 16, which additionally comprises activating, through the control circuit, the first surgical device and the second surgical device for a predetermined period of time when no tissue or patient is detected.
[0261] [0261] Example 18. The method of any one or more of Examples 11 to 17, the wireless pairing, through the control circuit, with a second surgical device according to a use of the first surgical device comprises the wireless pairing through the control circuit with a second surgical device outside a sterile field when the first surgical device is located within the sterile field.
[0262] [0262] Example 19. The method of any one or more of Examples 11 to 18, further comprising the wireless pairing of the control circuit with a communication device.
[0263] [0263] Example 20. The method of any one or more of Examples 11 to 19, further comprising determining, through a control circuit, a distance between the first surgical device and a tissue structure within a patient.
[0264] [0264] Although several forms have been illustrated and described,
[0265] [0265] The previous detailed description presented various forms of the 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 forms disclosed here, in whole or in part, can be implemented in an equivalent way in integrated circuits, such as one or more computer programs running on one or more computers ( for example, 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
[0266] [0266] The instructions used to program the logic to execute various revealed aspects can be stored in a memory in the system, such as dynamic random access memory (DRAM), memory, flash memory or other storage. In addition, instructions can be distributed over a network or other computer-readable media. Thus machine-readable media can include any mechanism for storing or transmitting information in a machine-readable form (for example, a computer), but is not limited to, floppy disks, optical discs, compact discs read-only memory (CD-ROMs), and magneto-optical discs, read-only memory (ROM), random access memory (RAM), erasable programmable read-only memory (EPROM), programmable read-only memory electrically erasable (EEPROM), magnetic or optical cards, flash memory, or a machine-readable tangible storage medium used to transmit information over the Internet via an electrical, optical, acoustic cable or other forms of propagated signals (for example , carrier waves, infrared signals, digital signals, etc.). Therefore,
[0267] [0267] As used in any aspect of the present invention, the term "control circuit" can refer to, for example, a set of wired circuits, programmable circuits (for example, a computer processor that includes one or more individual instruction processing cores, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic matrix (PLA), or field programmable port arrangement (FPGA)), state machine circuits, firmware that stores instructions executed by the programmable circuit, and any combination thereof. The control circuit can, collectively or individually, be incorporated as an electrical circuit that is part of a larger system, for example, an integrated circuit (IC), an application-specific integrated circuit (ASIC), an on-chip system (SoC), desktop computers, laptop computers, tablet computers, servers, smart phones, etc. Consequently, as used in the present invention, "control circuit" includes, but is not limited to, a set of electrical circuits that have at least one discrete electrical circuit, a set of electrical circuits that have at least one circuit integrated circuits, 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 the processes and / or devices described here, or a microprocessor configured by a computer program that at least partially execute the processes and / or devices described here), electrical circuits that form a memory device ( forms of random access memory), and / or a set of 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 described here can be implemented in an analog or digital way, or in some combination of these.
[0268] [0268] As used in any aspect of the present invention, the term "logic" can refer to an application, software, firmware and / or circuit configured to perform any of the aforementioned operations. The software can be incorporated as a software package, code, instructions, instruction sets and / or data recorded on computer-readable non-transitory storage media. The firmware can be embedded as code, instructions or instruction sets and / or hard coded (for example, non-volatile) data in memory devices.
[0269] [0269] As used in any aspect of the present invention, the terms "component", "system", "module" and the like may refer to a computer-related entity, be it hardware, a combination of hardware and software, software or running software.
[0270] [0270] As used here in any respect, an "algorithm" refers to the self-consistent sequence of steps that lead to the desired result, where a "step" refers to the manipulation of physical quantities and / or logical states that can, although not necessarily necessary, take the form of electrical or magnetic signals that can be stored, transferred, combined, compared and manipulated in any other way. It is 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.
[0271] [0271] A network can include a packet-switched network. Communication devices may be able to communicate with each other using a selected packet switched network communications protocol. An exemplary communications protocol can include an Ethernet communications protocol that can enable communication using a transmission control protocol / Internet protocol (TCP / IP). The Ethernet protocol may comply with or be compatible with the Ethernet standard published by the Institute of Electrical and Electronics Engineers (IEEE) entitled "IEEE 802.3 Standard", published in December 2008 and / or later versions of this standard. Alternatively or in addition, communication devices may be able to communicate with each other using an X.25 communications protocol. The X.25 communications protocol can conform or be compatible with a standard promulgated by the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T). Alternatively or in addition, communication devices may be able to communicate with each other using a frame-relay communication protocol. The frame-relay communications protocol can conform to or be compatible with a standard promulgated by the Consultative Committee for International Telegraph and Telephone (CCITT) and / or the American National Standards Institute (ANSI). Alternatively or in addition, transceivers may be able to communicate with each other using an ATM communication protocol ("asynchronous transfer mode"). The ATM communication protocol may comply with or be compatible with an ATM standard published by the ATM forum entitled "ATM-MPLS Network Interworking 2.0" published in August 2001, and / or later versions of that standard. Obviously, different and / or post-developed connection-oriented network communication protocols are also contemplated in the present invention.
[0272] [0272] Unless stated otherwise, as is evident from the preceding description, it is understood that, throughout the preceding description, discussions using terms such as "processing", or "computation", or "calculation ", or" determination ", or" display ", or similar, refers to the action and processes of a computer, or similar electronic computing device, that manipulates and transforms the represented data in the form of physical quantities (electronic) in computer records and memories in other data represented in a similar way in the form of physical quantities in computer memories or records, or in other similar information storage, transmission or display devices.
[0273] [0273] One or more components in the present invention may be called "configured for", "configurable for", "operable / operational for", "adapted / adaptable for", "capable of", "conformable / conforming sent to ", etc. Those skilled in the art will recognize that "configured for" can, in general, encompass components in an active state and / or components in an inactive state and / or components in a state of wait, except when the context dictates otherwise.
[0274] [0274] 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.
[0275] [0275] Persons skilled in the art will recognize that, in general, the terms used here, and especially in the appended claims (eg, bodies of the appended claims) are generally intended as "open" terms (eg, the term "including" should be interpreted as "including, but not limited to", the term "having" should be interpreted as "having, at least", the term "includes" should be interpreted as "includes, but not limits to ", etc.). It will also be understood by those skilled in the art that, when a specific number of a claim statement entered is intended, that intention will be expressly mentioned in the claim and, in the absence of such mention, no intention will be present. For example, as an aid to understanding, the following appended claims may contain the use of the introductory phrases "at least one" and "one or more" to introduce claim statements. However, the use of such phrases should not be interpreted as implying that the introduction of a claim statement by the indefinite articles "one, ones" or "one, ones" limits any specific claim containing the mention of the claim entered to claims that contain only such a mention, even when the same claim includes the introductory phrases "one or more" or "at least one" and indefinite articles, such as "one, ones" or "one, ones" (for example, "one , ones "and / or" one, ones "should typically be interpreted as meaning" at least one "or" one or more "); the same goes for the use of defined articles used to introduce claims.
[0276] [0276] 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
[0277] [0277] Regarding the attached claims, those skilled in the art will understand that the operations mentioned in them can, in general, be carried out 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 orders other than those shown, or can be performed simultaneously. Examples
[0278] [0278] 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 feature 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.
[0279] [0279] Any patent application, patent, non-patent publication or other description material mentioned in this specification and / or mentioned in any order data sheet is hereby incorporated by reference, up to the point in that the embedded materials are not inconsistent with this. Accordingly, and as necessary, the description as explicitly presented herein replaces any conflicting material incorporated into the present invention by way of reference. Any material, or portion thereof, which is incorporated herein by reference, but which conflicts with the definitions, statements, or other description materials contained herein, will be incorporated here only to the extent that there is no conflict between the embedded material and the existing description material.
[0280] [0280] In summary, numerous benefits have been described that result from the use of the concepts described in this document.
The previously mentioned description of one or more modalities has been presented for purposes of illustration and description.
This description is not intended to be exhaustive or to limit the invention to the precise form disclosed.
Modifications or variations are possible in light of the above teachings.
One or more modalities were chosen and described with the purpose of illustrating the principles and practical application, thus allowing the person skilled in the art to use the various modalities and with several modifications, as they are convenient for the specific use contemplated.
It is intended that the claims presented in the annex define the global scope.

权利要求:
Claims (20)
[1]
1. Surgical system, characterized by comprising: a first surgical device comprising a control circuit, the control circuit being configured to: have the capacity for situational recognition of events that occur in the vicinity of the first surgical device according to the data received from a database, a patient monitoring device, or a paired surgical device, or any combination of the database, the patient monitoring device, or the paired surgical device; and be paired wirelessly with a second surgical device according to a use of the first surgical device and the events of which the first surgical device has situational recognition.
[2]
2. Surgical system, according to claim 1, characterized by the events in which the first surgical device is able to situationally understand the use of the first surgical device by a first user and the use of the second surgical device by a second user.
[3]
3. Surgical system, according to claim 2, characterized in that the events that include the use of the first surgical device by the first user comprise the grip of a handle of the first surgical device by the first user.
[4]
4. Surgical system, according to claim 3, characterized by the events that comprise the grip of the first surgical device by the first user, understanding the grip of the handle of the first surgical device by the first user, thus enabling a transceiver in the the handle of the first surgical device communicates with an identifier used by the first user and allows, through the identifier, a communication between the first surgical device and a central surgical controller.
[5]
5. Surgical system, according to claim 2, characterized in that the events of which the first surgical device has situational recognition comprise a location of the first surgical device and a location of the second surgical device.
[6]
6. Surgical system, according to claim 5, characterized in that the control circuit is configured to determine the location of the second surgical device based on a wireless signal transmitted by the second surgical device to the first surgical device - cool.
[7]
7. Surgical system, according to claim 1, characterized in that the control circuit is further configured to simultaneously activate the first surgical device and the second surgical device for a predetermined period of time when no tissue or patient is detected.
[8]
8. Surgical system according to claim 1, characterized in that the first surgical device is located within a sterile field and the second surgical device is located outside the sterile field when the first surgical device pairs wirelessly with the second surgical device.
[9]
9. Surgical system, according to claim 1, characterized in that the control circuit is further configured to be paired wirelessly with a communication device.
[10]
10. Surgical system according to claim 1, characterized in that the events of which the first surgical device has situational recognition comprise a determination of a distance between the first surgical device and a tissue structure within a patient.
[11]
11. Method, characterized by understanding: situational recognition, through a control circuit within a first surgical device, of events that occur in the vicinity of a first surgical device according to the data received from a database. data, a patient monitoring device, or a paired surgical device, or any combination of the database, the patient monitoring device, or the paired surgical device; and wireless pairing, through the control circuit, with a second surgical device according to a use of the first surgical device and with the events of which the first surgical device has situational recognition.
[12]
12. Method, according to claim 11, characterized in that situational recognition, through a control circuit within a first surgical device, comprises having situational recognition, through a control circuit within a first surgical device, the use of the first surgical device by a first user and the use of the second surgical device by a second user.
[13]
13. Method, according to claim 12, characterized by the situational recognition, through a control circuit within a first surgical device, of the use of the first surgical device by a first user to understand to have situational recognition, through a control circuit inside a first surgical device, a first user grasping a handle of the first surgical device.
[14]
14. Method, according to claim 13, characterized in that it also allows a transceiver on the handle of the first surgical device to communicate with an identifier used by the first user and enable, through the identifier, a communication between the first surgical device and a central surgical controller.
[15]
15. Method, according to claim 12, characterized by the situational recognition, through a control circuit within a first surgical device, of the use of the first surgical device by a first user and the use of the second surgical device by a second user, understanding having situational recognition, through a control circuit within a first surgical device, a location of the first surgical device and a location of the second surgical device.
[16]
16. Method according to claim 15, characterized in that it further comprises determining, through the control circuit, the location of the second surgical device based on a wireless signal transmitted by the second surgical device to the first surgical device.
[17]
17. Method, according to claim 11, characterized in that it also comprises activating, through the control circuit, the first surgical device and the second surgical device for a predetermined period of time when no tissue or patient is detected.
[18]
18. Method according to claim 11, characterized in that the wireless pairing, through the control circuit, with a second surgical device according to a use of the first surgical device comprises the wireless pairing through the cir - control cuff, with a second surgical device outside a sterile field when the first surgical device is located within the sterile field.
[19]
19. Method according to claim 11, characterized in that it further comprises the wireless pairing of the control circuit with a communication device.
[20]
20. Method according to claim 11, characterized in that it further comprises determining, through a control circuit, a distance between the first surgical device and a tissue structure within a patient.
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BR112020013098A2|2020-11-24|determination of prioritization of communication, interaction or processing of surgical network based on system or device needs

---

US20190200980A1|2019-07-04|Surgical system for presenting information interpreted from external data

---

BR112020013177A2|2020-12-01|surgical network recommendations based on real-time analysis of procedure variables in relation to a baseline highlighting differences in relation to the optimal solution

---

BR112020013241A2|2020-12-01|control of a surgical system through a surgical barrier

---

BR112020013169A2|2020-12-01|surgical tool equipped with motor with predefined adjustable control algorithm to control end actuator parameters

---

BR112020013013A2|2020-11-24|surgical systems with autonomously adjustable control programs

---

BR112020013228A2|2020-12-01|data communication in which a surgical network uses context of the data and requirements of a receiver / user system to influence the inclusion or link of data and metadata to establish continuity

---

US20210192914A1|2021-06-24|Surgical hub and modular device response adjustment based on situational awareness

---

US11278281B2|2022-03-22|Interactive surgical system

---

BR112020013087A2|2020-12-01|detection and escalation of surgical instrument safety responses to threats of increasing severity

---

US11273001B2|2022-03-15|Surgical hub and modular device response adjustment based on situational awareness

---

BR112020013162A2|2020-12-01|interactive surgical system

---

BR112020012957A2|2020-12-01|surgical system to present information interpreted from external data

---

BR112020013031A2|2020-11-24|response adjustment of modular device and central surgical controller based on situational recognition

---

BR112020013176A2|2020-12-01|adjustments based on the properties of airborne particles

同族专利:

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公开号 | 公开日

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CN111741725A|2020-10-02|

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US11179204B2|2021-11-23|

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US10758310B2|2020-09-01|

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JP2021509058A|2021-03-18|

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EP3505113A1|2019-07-03|

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US20190201122A1|2019-07-04|

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US20210000555A1|2021-01-07|

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WO2019133135A1|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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US201762611340P| true| 2017-12-28|2017-12-28|

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US201762611341P| 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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US201862640417P| true| 2018-03-08|2018-03-08|

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US201862640415P| true| 2018-03-08|2018-03-08|

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US62/640,417|2018-03-08|

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US201862650877P| true| 2018-03-30|2018-03-30|

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US201862650887P| true| 2018-03-30|2018-03-30|

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US201862650898P| true| 2018-03-30|2018-03-30|

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US201862659900P| true| 2018-04-19|2018-04-19|

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US201862692748P| true| 2018-06-30|2018-06-30|

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US201862692747P| true| 2018-06-30|2018-06-30|

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US201862692768P| true| 2018-06-30|2018-06-30|

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US62/692,748|2018-06-30|

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US201862729186P| true| 2018-09-10|2018-09-10|

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US62/729,186|2018-09-10|

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US16/182,231|2018-11-06|

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US16/182,231|US10758310B2|2017-12-28|2018-11-06|Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices|

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PCT/US2018/060969|WO2019133135A1|2017-12-28|2018-11-14|Wireless pairing of a surgical device with another device within a sterile surgical filed based on the usage and situational awareness of devices|

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