data handling and prioritization in a cloud-based data analysis network

专利摘要:
The present invention relates to a cloud-based medical data analysis system. The system includes a processor, a memory coupled in communication with the processor, an input / output interface configured to access data from a plurality of central surgical controllers and a database that resides in memory and is configured to store the data. The central surgical controller is coupled in communication with the surgical instrument and the processor. The memory is configured to store instructions executable by the processor to receive critical data from the central surgical controller, as determined by the central surgical controller based on evaluation criteria, determine a priority status of critical data, route data of critical importance to a cloud storage location that resides in memory, and determine a response to critical data based on an operational characteristic indicated by critical data. A response time component is determined based on the priority state.
公开号:BR112020013225A2
申请号:R112020013225-0
申请日:2018-09-26
公开日:2020-12-01
发明作者:Frederick E. Shelton Iv；Jason L. Harris；David C. Yates；Gregory J. Bakos
申请人:Ethicon Llc；
IPC主号:

专利说明:

[0001] [0001] This application claims priority benefit under 35 US $ 119 (e) for US Provisional Patent Application serial number 62 / 649,315, entitled Data handling and prioritization in a cloud analytics network, filed on March 28, 2018, whose disclosure is hereby incorporated by reference in its entirety for reference.
[0002] [0002] This application claims priority under 35 US $ 119 (e) to US Provisional Patent Application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, to US Provisional Patent Application # serial number 62 / 611.340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on December 28, 2017, and to US Provisional Patent Application serial number 62 / 611.339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28, 2017 , the disclosure of each of which is incorporated herein by reference in its entirety. BACKGROUND
[0003] [0003] The present disclosure refers to several surgical systems. In the age of digital information, medical systems and facilities often have a certain resistance to implementing systems or procedures that use the latest and improved technologies due to concern for patient safety and a general desire to maintain traditional practices. However, as a result, medical systems and facilities can often be devoid of communication and knowledge shared with other neighboring facilities or in a similar situation. To improve patient practices, it would be desirable to find ways to help
[0004] [0004] In general, a cloud-based medical data analysis system is provided. The cloud-based medical data analysis system comprises at least one processor; at least one memory coupled in communication with at least one processor; an input / output interface configured to access data from a plurality of central surgical controllers, each of which is among the plurality of central surgical controllers coupled in communication with at least one surgical instrument and at least one processor; and a database that resides in at least one memory and is configured to store the data; and since at least one memory is configured to store instructions executable by at least one processor to: receive data of critical importance from the plurality of central surgical controllers, with the plurality of central surgical controllers determining data of critical importance based on evaluation criteria; determining a priority status of critical data; route critical data to a cloud storage location that resides in at least one memory; and determining a response to critical data based on an operational characteristic indicated by critical data, with a response time component determined based on the priority status.
[0005] [0005] In another general aspect, a computer-readable non-transitory medium is provided that stores computer-readable instructions executable by at least one processor of a cloud-based data analysis system. The instructions are executable by the processor to: receive critical data.
[0006] [0006] In yet another general aspect, a cloud-based medical data analysis system is provided. The cloud-based medical data analysis system comprises at least one processor; at least one memory coupled in communication with at least one processor; an input / output interface configured to access data from a plurality of central surgical controllers, each of which is among the plurality of central surgical controllers coupled in communication with at least one surgical instrument and at least one processor; and a database that resides in at least one memory and is configured to store the data; and since at least one memory is configured to store executable instructions from at least one processor to: receive critical data from the plurality of central surgical controllers, the plurality of central surgical controllers determining critical data based on evaluation criteria; determining a priority status of critical data; route critical data to a cloud storage location that resides in at least one memory; ask the plurality of central surgical controllers for additional data regarding critical importance data based on a plurality of operating conditions; determine the cause of an irregularity corresponding to critical data and additional data; and determining a response to the irregularity, a time component of the response being determined based on the priority state. FIGURES
[0007] [0007] The characteristics and resources of various aspects are presented with particularity in the attached claims. The various aspects, however, with regard to both the organization and the methods of operation, together with additional objects and advantages of them, can be better understood in reference to the description presented below, taken in conjunction with the attached drawings. , as shown below.
[0008] [0008] Figure 1 is a block diagram of an interactive surgical system implemented by computer, according to at least one aspect of the present disclosure.
[0009] [0009] Figure 2 illustrates a surgical system being used to perform a surgical procedure in an operating room, in accordance with at least one aspect of the present disclosure.
[0010] [0010] Figure 3 illustrates a central surgical controller paired with a visualization system, a robotic system and an intelligent instrument, according to at least one aspect of the present disclosure.
[0011] [0011] Figure 4 is a partial perspective view of a central surgical controller compartment, and of a combined generator module received slidingly in a central surgical controller compartment, according to at least one aspect of the present disclosure. .
[0012] [0012] Figure 5 is a perspective view of a generator module combined with bipolar, ultrasonic and monopolar contacts and a smoke evacuation component, in accordance with at least one aspect of the present disclosure.
[0013] [0013] Figure 6 illustrates different power bus connectors for a plurality of side coupling ports of a side modular cabinet configured to receive a plurality of modules, in accordance with at least one aspect of the present disclosure.
[0014] [0014] Figure 7 illustrates a vertical modular cabinet configured to receive a plurality of modules, according to at least one aspect of the present disclosure.
[0015] [0015] Figure 8 illustrates a surgical data network that comprises a central modular communication controller configured to connect modular devices located in one or more operating rooms of a healthcare facility, or in any facility environment. of health services specially equipped for surgical operations, to the cloud, according to at least one aspect of the present disclosure.
[0016] [0016] Figure 9 illustrates an interactive surgical system implemented by computer, according to at least one aspect of the present disclosure.
[0017] [0017] Figure 10 illustrates a central surgical controller that comprises a plurality of modules coupled to the modular control tower, according to at least one aspect of the present disclosure.
[0018] [0018] Figure 11 illustrates an aspect of a universal serial bus (USB) central controller device, in accordance with at least one aspect of the present disclosure.
[0019] [0019] Figure 12 illustrates a logical diagram of a control system for an instrument or surgical tool, according to at least one aspect of the present disclosure.
[0020] [0020] Figure 13 illustrates a control circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present disclosure.
[0021] [0021] Figure 14 illustrates a combinational logic circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present disclosure.
[0022] [0022] Figure 15 illustrates a sequential logic circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present disclosure.
[0023] [0023] Figure 16 illustrates an instrument or surgical tool that comprises a plurality of motors that can be activated to perform various functions, according to at least one aspect of the present disclosure.
[0024] [0024] Figure 17 is a schematic diagram of a robotic surgical instrument configured to operate a surgical tool described therein, in accordance with at least one aspect of the present disclosure.
[0025] [0025] Figure 18 illustrates a block diagram of a surgical instrument programmed to control the distal translation of the displacement member, according to an aspect of the present disclosure.
[0026] [0026] Figure 19 is a schematic diagram of a surgical instrument configured to control various functions, according to at least one aspect of the present disclosure.
[0027] [0027] Figure 20 is a simplified block diagram of a generator configured to provide tuning without an inductor, among other benefits, according to at least one aspect of the present disclosure.
[0028] [0028] Figure 21 illustrates an example of a generator, which is a form of the generator of Figure 20, according to at least one aspect of the present disclosure.
[0029] [0029] Figure 22 is a block diagram of the interactive surgical system implemented by computer, according to at least one aspect of the present disclosure.
[0030] [0030] Figure 23 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 disclosure.
[0031] [0031] Figure 24 is a flow diagram of the interactive surgical system implemented by a computer programmed to use evaluation criteria to determine critical data and to send requests to a central surgical controller for additional data, according to the least one aspect of the present disclosure.
[0032] [0032] Figure 25 is a flow diagram of an aspect of the response to critical data by the interactive surgical system implemented by computer, according to at least one aspect of the present disclosure.
[0033] [0033] Figure 26 is a flow diagram of an aspect of the classification and prioritization of data by the interactive surgical system implemented by computer, according to at least one aspect of the present disclosure.
[0034] [0034] Figure 27 is a timeline that represents the situational recognition of a central surgical controller, according to at least one aspect of the present disclosure. DESCRIPTION
[0035] [0035] The applicant for this application holds the following provisional US patent applications, filed on March 28, 2018, each of which is incorporated herein by reference in its entirety.
[0036] [0036] The applicant for this application holds the following US patent applications, filed on March 29, 2018, the disclosure of which is incorporated herein by reference in its entirety.
[0037] [0037] The applicant for the present application holds the following US patent applications, filed on March 29, 2018, the disclosure of which is incorporated herein by reference in its entirety.
[0038] [0038] The applicant for the present application holds the following US patent applications, filed on March 29, 2018, the disclosure of which is incorporated herein by reference in its entirety.
[0039] [0039] Before explaining in detail the various aspects of surgical devices and generators, it should be noted that the illustrative examples are not limited, in terms of application or use, to the details of construction and arrangement of parts illustrated in the descriptions in the attached description. Illustrative examples can be implemented or incorporated in other aspects, variations and modifications, and can be practiced or executed in several ways. In addition, except where otherwise indicated, the terms and expressions used in the present invention have been chosen for the purpose of describing illustrative examples for the convenience of the reader and not for the purpose of limiting it. In addition, it should be understood that one or more of the aspects, expressions of aspects and / or examples described below can be combined with any one or more among the other aspects, expressions of aspects and / or examples described below .
[0040] [0040] With reference to Figure 1, an interactive surgical system implemented by computer 100 includes one or more surgical systems 102 and a cloud-based system (for example, cloud 104 which may include a remote server 113 coupled to a device storage 105). Each surgical system 102 includes at least one central surgical controller 106 in communication with the cloud 104 which can include a remote server 113. In one example, as illustrated in Figure 1, surgical system 102 includes a display system 108, a robotic system 110, an intelligent handheld surgical instrument 112, which is configured to communicate with each other and / or with the central controller 106. In some respects, a surgical system 102 may include an M number of controlled - central surgical devices 106, an N number of visualization systems
[0041] [0041] Figure 3 represents an example of a surgical system 102 being used to perform a surgical procedure on a patient who is lying on an operating table 114 in a surgical operating room 116. A robotic system 110 is used in surgical procedure as part of the surgical system 102. The robotic system 110 includes a surgeon console 118, a patient car 120 (surgical robot), and a robotic central surgical controller 122. The patient car 120 can handle at least one surgical tool removably coupled 117 through a minimally invasive incision in the patient's body while the surgeon observes the surgical site through the surgeon's console 118. An image of the surgical site can be obtained by an imaging device - medical device 124, which can be manipulated by means of patient car 120 to orient the imaging device 124. The robotic central controller 122 can be used to process images of the surgical site for subsequent display to the surgeon through the surgeon's console 118.
[0042] [0042] Other types of robotic systems can be readily adapted for use with the surgical system 102. Various examples of robotic systems and surgical tools that are suitable for use with the present disclosure are described in US Provisional Patent Application serial number 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28, 2017, whose disclosure is hereby incorporated by reference in its entirety.
[0043] [0043] Several examples of cloud-based analytical processes that are performed by the cloud 104, and are suitable for use with the present disclosure, are described in US Provisional Patent Application Serial No. 62 / 611.340, entitled CLOUD- BASED MEDICAL ANALYTICS, filed on December 28, 2017, the disclosure of which is hereby incorporated by reference in its entirety.
[0044] [0044] In several aspects, the imaging device 124 includes at least one image sensor and one or more optical components. Suitable image sensors include, but are not limited to, charge-coupled device (CCD) sensors and complementary metal oxide semiconductor sensors (CMOS) or "complementary metal-oxide semiconductor ").
[0045] [0045] 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 tissue and / or surgical instruments.
[0046] [0046] 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 range from about 380 nm to about 750 nm.
[0047] [0047] 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
[0048] [0048] 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 disclosure include, but are not limited to, an arthroscope, angioscope, bronchoscope, choledocoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagoscope-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngoscope, sigmoidoscope, thoracoscope and ureteroscope.
[0049] [0049] In one aspect, the imaging device employs multiple spectrum monitoring to discriminate topography and underlying structures. A multispectral image is one that captures image data within wavelength bands across the electromagnetic spectrum. The wavelengths can be separated by filters or by using instruments that are sensitive to specific wavelengths, including light from frequencies beyond the visible light range, for example, IR and ultraviolet light. Spectral images can allow the extraction of additional information that the human eye cannot capture with its receivers for the colors red, green and blue. The use of multispectral imaging is described in more detail under the heading "Advanced Imaging Acquisition Module" in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, deposited on December 28, 2017, whose revelation is hereby incorporated by reference in its entirety. Multispectral monitoring can be a useful tool for relocating a field.
[0050] [0050] It is axiomatic that strict sterilization of the operating room and surgical equipment is a requirement during any surgery. Strict hygiene and sterilization conditions required in an "operating room", that is, an operating or treatment room, require the highest possible sterilization of all medical devices and equipment. Part of this sterilization process is the need to sterilize everything that comes into contact with the patient or enters the sterile field, including the imaging device 124 and its connectors and components. It will be understood that the sterile field can be considered a specific area, such as inside a tray or on a sterile towel, which is considered free of microorganisms, or the sterile field can be considered an area immediately around a patient who was prepared to perform a surgical procedure. The sterile field may include sterilized team members, who are properly dressed, and all furniture and accessories in the area.
[0051] [0051] In various aspects, the visualization system 108 includes one or more imaging sensors, one or more image processing units, one or more storage arrays and one or more screens that are strategically arranged in relation to the field sterile, as shown in Figure 2. In one aspect, the visualization system 108 includes an interface for HL7, PACS and RME. Various components of the 108 visualization system 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, whose disclosure it is hereby incorporated by reference in its entirety.
[0052] [0052] As shown in Figure 2, a main screen 119 is positioned in the sterile field to be visible to the operator on the operating table 114. In addition, a viewing tower 111 is positioned outside the sterile field. The viewing tower 111 includes a first non-sterile screen 107 and a second non-sterile screen 109, which are opposite each other. The visualization system 108, guided by the central controller 106, is configured to use screens 107, 109, and 119 to coordinate the flow of information to operators inside and outside the sterile field. For example, central controller 106 can have visualization system 108 display a snapshot of a surgical site, as recorded by an imaging device 124, on a non-sterile screen 107 or 109, while maintaining a live broadcast from the surgical site on the main screen 119. The instant on the non-sterile screen 107 or 109 can allow a non-sterile operator to perform a diagnostic step relevant to the surgical procedure, for example.
[0053] [0053] In one aspect, the central controller 106 is also configured to route an entry or diagnostic feedback by a non-sterile operator in the viewing tower 111 to the main screen 119 within the sterile field, where it can be seen by a sterile operator on the operating table. In one example, the entry may be in the form of a modification of the snapshot displayed on the non-sterile screen 107 or 109, which can be routed to main screen 119 by central controller 106.
[0054] [0054] With reference to Figure 2, a surgical instrument 112 is being used in the surgical procedure as part of the surgical system 102. The central controller 106 is also configured to coordinate the flow of information to a screen of the surgical instrument 112. For For example, in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, deposited on December 28, 2017, the disclosure of which is hereby incorporated
[0055] [0055] Now with reference to Figure 3, a central controller 106 is shown in communication with a visualization system 108, a robotic system 110 and an intelligent handheld surgical instrument 112. The central controller 106 includes a central controller screen 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132 and a storage matrix 134. In certain respects, as shown in Figure 3, central controller 106 additionally includes a module - smoke evacuation module 126 and / or a suction / irrigation module 128.
[0056] [0056] 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 interwoven during the surgical procedure. Valuable time can be wasted in treating this issue during a surgical procedure. To untangle the lines it may be necessary to disconnect them from their respective modules, which may require the modules to be reset. The modular compartment of the
[0057] [0057] Aspects of the present disclosure feature a central surgical controller for use in a surgical procedure that involves applying energy to the tissue at a surgical site. The central surgical controller includes a central controller compartment and a combined generator module received slidingly at a central controller compartment docking station. The docking station includes data and power contacts. The combined generator module includes two or more of an ultrasonic energy generating component, a bipolar RF energy generating component, and a monopolar RF energy generating component which are housed in a single unit. In one aspect, the combined generator module also includes a smoke evacuation component, at least one power application cable to connect the combined generator module to a surgical instrument, at least one smoke evacuation component. configured to evacuate smoke, fluid and / or particulates produced by applying therapeutic energy to the tissue, and a fluid line that extends from the remote surgical site to the smoke evacuation component.
[0058] [0058] In one aspect, the fluid line is a first fluid line and a second fluid line extends from the remote surgical site to a suction and irrigation module received slidingly in the central controller compartment. In one aspect, the central controller compartment comprises a fluid interface.
[0059] [0059] Certain surgical procedures may require the application of more than one type of energy to the tissue. One type of energy may be more beneficial for cutting the fabric, while another type of energy may be more beneficial for sealing the fabric. For example, a bipolar generator can be used to seal the tissue, while an ultrasonic generator can be used to cut the sealed tissue. Aspects of the present disclosure present a solution in which a modular compartment of central controller 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the modular compartment of the central controller 136 is that it allows the quick removal and / or replacement of several modules.
[0060] [0060] Aspects of the present disclosure feature a modular surgical compartment for use in a surgical procedure that involves applying energy to the tissue. The modular surgical compartment includes a first energy generator module, configured to generate a first energy for application to the tissue, and a first docking station that comprises a first docking port that includes first data contacts and energy contacts, being that the first power generator module is slidingly movable in an electrical coupling with the power and data contacts, and the first power generator module is slidingly movable out of the electrical coupling with the first other power and data contacts.
[0061] [0061] In addition to the above, the modular compartment also includes a second energy generator module configured to generate a second energy, different from the first energy, for application to the fabric, and a second docking station comprising a second docking port that includes second power and data contacts, the second power generator module being slidably movable in an electrical coupling with the power and data contacts, and the second power generator module being movable sliding out of the electrical coupling with the second power and data contacts.
[0062] [0062] In addition, the modular surgical compartment also includes a communication bus between the first coupling port and the second coupling port, configured to facilitate communication between the first power generator module and the second generator module power.
[0063] [0063] With reference to Figures 3 to 7, aspects of the present disclosure are presented for a modular compartment of the central controller 136 that allows the modular integration of a generator module 140, a smoke evacuation module 126 and a suction / irrigation module 128. The central compartment modular module 136 further facilitates interactive communication between modules 140, 126, 128. As shown in Figure 5, generator module 140 can be a generator module with monopolar, bipolar components and integrated ultrasonic systems, supported in a single cabinet unit 139 slidably insertable in the central compartment of the central controller 136. As shown in Figure 5, generator module 140 can be configured to connect to a monopolar device 146, a bipolar device 147 and an ultrasonic device
[0064] [0064] In one aspect, the modular compartment of central controller 136 comprises a rear communication and modular power board 149 with external and wireless communication heads to allow removable connection of modules 140, 126, 128 and interactive communication between them.
[0065] [0065] In one aspect, the modular compartment of central controller 136 includes docking stations, or drawers, 151, here also called drawers, which are configured to receive slidingly the modules 140, 126, 128. Figure 4 illustrates a partial perspective view of a central surgical controller compartment 136, and a combined generator module 145 slidably received at a docking station 151 in the central surgical controller compartment 136. A docking port 152 with the power and data contacts on a rear side of the combined generator module 145 is configured to engage a corresponding docking port 150 with the power and data contacts of a corresponding docking station 151 of the central controller 136 modular compartment as per combined generator module 145 is slid into position at the corresponding docking station 151 of the central controller modular compartment 136. In one aspect, the combined generator module 145 includes a bipolar, ultrasonic and monopolar module and a smoke evacuation module integrated into a single compartment unit 139, as shown in Figure 5.
[0066] [0066] In several respects, the smoke evacuation module 126 includes a fluid line 154 that carries smoke and / or fluid captured / collected 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 terminates in the smoke evacuation module 126. The utility conduit and the fluid line define a working
[0067] [0067] In several aspects, the suction / irrigation module 128 is coupled to a surgical tool comprising a fluid suction line and a fluid suction line. In one example, the suction and suction fluid lines are in the form of flexible tubes that extend from the surgical site towards the suction / irrigation module 128. One or more drive systems can be configured to cause irrigation and suction of fluids to and from the surgical site.
[0068] [0068] In one aspect, the surgical tool includes a drive shaft that has an end actuator at a distal end thereof and at least an energy treatment associated with the end actuator, a suction tube, and a tube irrigation. The suction tube can have an inlet port at a distal end of it and the suction tube extends through the drive shaft. Similarly, an irrigation pipe can extend through the drive shaft and may have an entrance port close to the power application implement. The energy application implement is configured to apply ultrasonic and / or RF energy to the surgical site and is coupled to the generator module 140 by a cable that initially extends through the drive shaft.
[0069] [0069] The irrigation tube can be in fluid communication with a fluid source, and the suction tube can be in fluid communication with a vacuum source. The fluid source and / or the vacuum source can be housed in the suction / irrigation module 128. In one example, the fluid source and / or the vacuum source can be housed in the central controller compartment 136 separately from the suction / irrigation module 128. In such an example, a fluid interface can be configured to connect the suction / irrigation module 128 to the fluid source and / or the vacuum source.
[0070] [0070] In one aspect, modules 140, 126, 128 and / or their corresponding docking stations in the modular compartment of central controller 136 may include alignment features that are configured to align the docking ports of the modules in engagement with their counterparts in the docking stations of the central compartment modular compartment 136. For example, as shown in Figure 4, the combined generator module 145 includes side supports 155 which are configured to slide the corresponding supports 156 of the docking station in a sliding way corresponding to 151 of the central controller 136 modular compartment. The brackets cooperate to guide the coupling port contacts of the combined generator module 145 in an electrical coupling with the contacts of the central controller modular compartment 136 port. .
[0071] [0071] In some respects, the drawers 151 of the modular compartment of the central controller 136 are the same, or substantially the same size, and the modules are adjusted in size to be received in the drawers 151. For example, the side supports 155 and / or 156 can be larger or smaller depending on the size of the module. In other respects, drawers 151 are different in size and each is designed to accommodate a specific module.
[0072] [0072] 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 misalignment of contacts.
[0073] [0073] As shown in Figure 4, the coupling door 150 of a drawer 151 can be coupled to the coupling door
[0074] [0074] Figure 6 illustrates individual power bus connectors for a plurality of side coupling ports of a lateral modular cabinet 160 configured to receive a plurality of modules from a central surgical controller 206. The modular compartment side 160 is configured to receive and interconnect modules 161 laterally. Modules 161 are slidably inserted into docking stations 162 of side modular compartment 160, which includes a back plate for interconnecting modules 161. As illustrated in Figure 6, modules 161 are arranged laterally in the side modular cabinet 160. Alternatively, modules 161 can be arranged vertically in a side modular cabinet.
[0075] [0075] Figure 7 illustrates a vertical modular cabinet 164 configured to receive a plurality of modules 165 from the central surgical controller 106. Modules 165 are slidably inserted into docking stations, or drawers, 167 of vertical modular cabinet 164, which includes a rear panel for interconnection of modules 165. Although drawers 167 of vertical modular cabinet 164 are arranged vertically, in certain cases, a vertical modular cabinet 164 may include drawers that are arranged laterally . In addition, modules 165 can interact with each other through the coupling ports of the vertical modular cabinet 164. In the example in Figure 7, a screen 177 is provided to show data relevant to the operation of modules 165. In addition, the vertical modular compartment 164 includes a master module 178 that houses a plurality of submodules that are received slidingly in the master module 178.
[0076] [0076] In several respects, the imaging module 138 comprises an integrated video processor and a modular light source and is adapted for use with various imaging devices. In one aspect, the imaging device is comprised of a modular compartment that can be mounted with a light source module and a camera module. The compartment can be a disposable compartment. In at least one example, the disposable compartment is removably coupled to a reusable controller, a light source module, and a camera module. The light source module and / or the camera module can be chosen selectively depending on the type of surgical procedure. In one aspect, the camera module comprises a CCD sensor. In another aspect, the camera module comprises a CMOS sensor. In another aspect, the camera module is configured for imaging the scanned beam. Similarly, the light source module can be configured to provide a white light or a different light, depending on the surgical procedure.
[0077] [0077] During a surgical procedure, removing a surgical device from the surgical field and replacing it with another surgical device that includes a different camera or another light source can be an inefficient practice. Temporarily losing sight of the surgical field can lead to undesirable consequences. The imaging device module of the present disclosure is configured to allow the replacement of a light source module or a "midstream" camera module during a surgical procedure, without the need for
[0078] [0078] In one aspect, the imaging device comprises a tubular compartment that includes a plurality of channels. A first channel is configured to receive the Camera module in a sliding way, which can be configured for a snap-fit fit (pressure fit) with the first channel. A second channel is configured to receive the camera module in a sliding way, which can be configured for a snap-fit fit (pressure fit) with the first channel. In another example, the camera module and / or the light source module can be rotated to an end position within their respective channels. A threaded coupling can be used instead of the pressure fitting.
[0079] [0079] 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.
[0080] [0080] Various image processors and imaging devices suitable for use with the present disclosure are described in US patent No. 7,995,045 entitled COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR, granted on August 9, 2011 which is incorporated herein as a reference in its entirety. In addition, US patent No. 7,982,776, entitled SBI MOTION ARTIFACT REMOVAL APPARATUS AND METHOD, issued on July 19, 2011, which is incorporated herein by reference in its entirety, describes various systems for removing motion artifacts from the data of image. Such systems can be integrated with the imaging module 138. In addition to these, US Patent Application Publication No. 2011/0306840, entitled CONTROLLA-BLE MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPA- RATUS, published on December 15, 2011, and US Patent Application Publication 2014/0243597, entitled SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE, published on August 28, 2014, which are each incorporated herein by reference in their entirety.
[0081] [0081] Figure 8 illustrates a surgical data network 201 comprising a central modular communication controller 203 configured to connect modular devices located in one or more operating rooms of a health care facility, or any environment in a hospital. installation of utilities specially equipped for surgical operations, to a cloud-based system (for example, cloud 204 which may include a remote server 213 coupled to a storage device 205). In one aspect, the modular central communication controller 203 comprises a central network controller 207 and / or a network key 209 in communication with a network router. The modular central communication controller 203 can also be coupled to a local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 can be configured as a passive, intelligent, or switching network. A passive surgical data network serves as a conduit for the data, allowing the data to be transmitted from one device (or segment) to another and to cloud computing resources. An intelligent surgical data network includes features to allow traffic to pass through the surgical data network to be monitored and to configure each port on the central network controller 207 or network key 209. An intelligent surgical data network can be called a central controller or control key
[0082] [0082] Modular devices 1a to 1n located in the operating room can be coupled to the central communication controller modular 203. The central network controller 207 and / or the network key 209 can be coupled to a network router 211 to connect devices 1a to 1n to the 204 cloud or to the local computer system
[0083] [0083] It will be understood that the surgical data network 201 can be expanded by interconnecting multiple central network controllers 207 and / or multiple network switches 209 with multiple network routers 211. The central communication controller 203 can be contained in a modular control tower configured to receive multiple devices 1a to 1n / 2a to 2m. The local computer system 210 can also be contained in a modular control tower. The central modular communication controller 203 is connected to a screen 212 to display the images obtained by some of the devices 1a to 1n / 2a to 2m, for example, during surgical procedures. In several respects, devices 1a to 1n / 2a to 2m may include, for example, various modules such as an imaging module 138 coupled to an endoscope, a generator module 140 coupled to an energy-based surgical device, an evacuation module smoke 126, a suction / irrigation module 128, a communication module 130, a processor module 132, a storage matrix 134, a surgical device attached to a screen and / or a non-contact sensor module, among other devices modular devices that can be connected to the modular communication central controller 203 of the surgical data network 201.
[0084] [0084] In one aspect, the surgical data network 201 can comprise a combination of central network controllers, network switches and network routers that connect devices 1a to 1n / 2a to 2m to the cloud. Any or all devices 1a to 1n / 2a to 2m coupled to the central network controller or network key can collect data in real time and transfer data to cloud computers for data processing and manipulation. It will be understood that cloud computing depends on sharing 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 central controller of 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 connected devices
[0085] [0085] The application of cloud computer data processing techniques to the data collected by devices 1a to 1n / 2a to 2m, the surgical data network provides better surgical results, reduced costs, and better patient satisfaction. At least some of the devices 1a to 1n / 2a to 2m can be used to view tissue status to assess leakage or perfusion of sealed tissue after a tissue sealing and cutting procedure. At least some of the devices 1a to 1n / 2a to 2m can be used to identify 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 overlaying images captured by multiple imaging devices. Data collected by devices 1a to 1n / 2a to 2m, including image data, can be transferred to the cloud 204 or the local computer system 210 or both for data processing and manipulation including data processing and manipulation. Image. The data can be analyzed to improve the results of the surgical procedure by determining whether additional treatment, such as the application of endoscopic intervention, emerging technologies, targeted radiation, targeted intervention, precise robotics at specific sites and conditions of fabric, 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 behavior of the surgeon or to suggest modifications to the surgical treatments and the behavior of the surgeon. surgeon.
[0086] [0086] In an implementation, operating room devices 1a to 1n can be connected to the modular central communication controller 203 via a wired channel or a wireless channel depending on the configuration of devices 1a to 1h in a central network controller. The central network controller 207 can be implemented, in one aspect, as a local network transmission device that acts on the physical layer of the OSI model ("open system interconnection", or interconnection of open systems). The central network controller provides connectivity to devices 1a to 1n located on the same network as the operating room. The central network controller 207 collects data in the form of packets and sends them to the router in "half-duplex" mode. The central network controller 207 does not store any media access control / Internet protocol (MAC / IP) for transferring device data. Only one of the devices 1a to 1n at a time can send data through the central network controller 207. The central network controller 207 does not have routing tables or intelligence about where to send information and transmits all network data through each connection and a remote server 213 (Figure 9) in the cloud 204. The central network controller 207 can detect basic network errors, such as collisions, but having all the information transmitted to multiple input ports can be a security risk and cause bottlenecks.
[0087] [0087] In another implementation, operating room devices 2a to 2m can be connected to a network switch 209 through a wired or wireless channel. The network key 209 works in the data connection layer of the OSI model. Network switch 209 is a multicast device for connecting devices 2a to 2m located in the same operation center to the network. The network key 209 sends data in frames to the network router 211 and works in full duplex mode. Multiple devices 2a to 2m can send data at the same time via network key 209. Network key 209 stores and uses MAC addresses of devices 2a to 2m to transfer data.
[0088] [0088] The central network controller 207 and / or the network key 209 are coupled to the network router 211 for a connection with the number 204. The network router 211 works on the network layer of the OSI model. The network router 211 creates a route to transmit data packets received from the central network controller 207 and / or the network key 211 to a computer with cloud resources for future processing and manipulation of the data collected by any among or all of the devices 1a to 1n / 2a to 2m. The network router 211 can be used to connect two or more different networks located in different locations, such as different operating rooms in the same healthcare facility or different networks located in different operating rooms. different health service facilities. Network router 211 sends data in packet form to cloud 204 and works in full duplex mode. Multiple devices can send data at the same time. Network router 211 uses | P addresses to transfer data.
[0089] [0089] In one example, the central network controller 207 can be implemented as a central USB controller, which allows multiple USB devices to be connected to a host computer. The central USB controller can expand a single USB port on several levels so that more ports are available to connect the devices to the system's host computer. The central network controller 207 can include wired or wireless capabilities to receive information about a wired channel or a wireless channel. In one aspect, a wireless wireless, broadband and short-range wireless USB communication protocol can be used for communication between devices 1a to 1n and devices 2a to 2m located in the operating room.
[0090] [0090] In other examples, devices in the operating room 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 via standard Bluetooth wireless technology for exchanging data over short distances ( with the use of short-wavelength UHF radio waves in the ISM band of 2.4 to 2.485 GHz) from fixed and mobile devices and build personal area networks (PANs). In other respects, operating room devices 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 via a number of wireless and wired communication standards or protocols, including, but not limited to, limited to, Wi-Fi (IEXE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, long-term evolution (LTE, "long-term evolution"), and Ev-DO, HSPA +, HSDPA +, HSUPAr +, EDGE , GSM, GPRS, CDMA, TDMA, DECT, and Ethernet derivatives thereof, as well as any other wireless and wired protocols that are designated as 3G, 4G, 5G, and beyond. The computer module
[0091] [0091] The modular communication central controller 203 can serve as a central connection for one or all devices in the operating room 1a to 1n / 2a to 2m and handles a data type known as frames. The tables carry the data generated by the devices 1a to 1n / 2a to 2m. When a frame is received by the modular communication central controller 203, it is amplified and transmitted to the network router 211, which transfers the data to the cloud computing resources using a series of standards or protocols wireless or wired communications, as described in this disclosure.
[0092] [0092] The modular communication central controller 203 can be used as a stand-alone device or be connected to compatible central network controllers and network switches to form a larger network. The 203 modular communication central controller is, in general, easy to install, configure and maintain, which makes it a good option for network operations of devices 1a to 1n / 2a to 2m from the operating room.
[0093] [0093] 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
[0094] [0094] Figure 10 illustrates a central surgical controller 206 that comprises a plurality of modules coupled to the modular control tower 236. The modular control tower 236 comprises a central modular communication controller 203, for example, a device - network connectivity device, and a computer system 210 to provide local processing, visualization and imaging, for example. As shown in Figure 10, the 203 modular central communication controller can be connected in a layered configuration to expand the number of modules (for example, devices) that can be connected to the 203 modular central communication controller and transfer for the computer system 210 data associated with modules, cloud computing resources, or both. As shown in Figure 10, each of the central controllers / network switches in the modular central communication controller 203 includes three downstream ports and one upstream port. The central controller / network key upstream is connected to a processor to provide a communication connection to the cloud computing resources and a local display 217. Communication with the cloud 204 can be done via a communication channel wired or wireless.
[0095] [0095] The central surgical controller 206 employs a non-contact sensor module 242 to measure the dimensions of the operating room and generate a map of the operating room with the use of non-contact measuring devices of the laser or ultrasonic type. An ultrasound-based non-contact sensor module scans the operating room by transmitting a burst of ultrasound and receiving the echo when it bounces off the walls surrounding an operating room, as described under the heading "Surgical Hub Spatial Awareness Within an
[0096] [0096] Computer system 210 comprises a processor 244 and a network interface 245. Processor 244 is coupled to a communication module 247, storage 248, memory 249, non-volatile memory 250, and an input / output interface 251 through of a system bus. The system bus can be any one of several types of bus structures, including the memory bus or memory controller, a peripheral bus or external bus, and / or a local bus that uses any variety of architectures available buses including, but not limited to, 9-bit bus, industry standard architecture (ISA), Micro-Charmel Architecture (MSA), extended ISA (EISA), smart drive electronics (IDE), local bus VESA (VLB), Peripheral Component Interconnection (PCI), USB, Accelerated Graphics Port (AGP), PCMCIA bus (International Memory Card Association for Personal Computers, Personal Computer Memory Card International Association), Interface small computer systems (SCSI), or any other proprietary bus.
[0097] [0097] Processor 244 can be any single-core or multi-core processor, such as those known under the trade name of ARM Cortex available from Texas Instruments. In one respect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz , a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareO program, read-only memory programmable and electrically erasable (EEPROM) of 2 KB, one or more pulse width modulation (PWM) modules, one or more analogs of quadrature encoder (QEI) inputs, one or more analog to digital converters (ADC) ) 12 bits with 12 channels of analog input, details of which are available for the product data sheet.
[0098] [0098] In one aspect, processor 244 may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the tradename Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[0099] [0099] System memory includes volatile and non-volatile memory. The basic input / output system (BIOS), containing the basic routines for transferring information between elements within the computer system, such as during startup, is stored in non-volatile memory. For example, non-volatile memory can include ROM, programmable ROM (PROM), electrically programmable ROM (EPROM), EE-PROM or flash memory. Volatile memory includes random access memory (RAM), which acts as an external cache memory. In addition, RAM is available in many forms such as SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), Synchlink DRAM (SLDRAM), and direct RAM Rambus RAM (DRRAM).
[0100] [0100] Computer system 210 also includes removable / non-removable, volatile / non-volatile computer storage media, such as disk storage. Disk storage includes, but is not limited to, devices such as a magnetic disk drive, floppy disk drive, tape drive, Jaz driver, Zip driver, LS-60 driver, flash memory card or memory stick ( pen drive). In addition, the storage disc may include storage media separately or in combination with other storage media including, but not limited to, an optical disc drive such as a compact disc ROM device ( CD-ROM) writeable compact disc drive (CD-R Drive), rewritable compact disc drive (CD-RW drive), or a versatile digital disk ROM drive (DVD-ROM). To facilitate the connection of disk storage devices to the system bus, a removable or non-removable interface can be used.
[0101] [0101] It is to be understood that computer system 210 includes software that acts as an intermediary between users and the basic computer resources described in a suitable operating environment. Such software includes an operating system. The operating system, which can be stored on disk storage, acts to control and allocate computer system resources. System applications benefit from management capabilities by the operating system through program modules and “program data stored in the system's memory or storage disk. It is to be understood that the various components described in the present invention can be implemented with various operating systems or combinations of operating systems.
[0102] [0102] A user enters commands or information into computer system 210 through the input device (s) coupled to the I / O interface 251. Input devices include, but are not limited to, a pointing device such as a mouse, trackball, stylus, touchpad, keyboard, microphone, joystick, game pad, satellite card, scanner, TV tuner card, digital camera, digital video camera, web camera, and the like. These and other input devices connect to the processor via the system bus via the interface port (s). Interface ports include, for example, a serial port, a parallel port, a game port and a USB. Output devices use some of the same types of ports as input devices. In this way, for example, a USB port can be used to provide input to the computer system and to provide computer system information 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.
[0103] [0103] Computer system 210 can operate in a networked environment using logical connections to one or more computers
[0104] [0104] In several respects, the computer system 210 of Figure 10, the imaging module 238 and / or the display system 208, and / or the processor module 232 of Figures 9 and 10 can comprise an image processor. image, an image processing engine, a media processor, or any specialized digital signal processor (PSD) used to process digital images. The image processor can employ parallel computing with multi-data instruction (SIMD) or multi-data instruction (MIMD) technologies to increase speed and efficiency. The digital image processing engine can perform a number of tasks. The image processor can be an integrated circuit system with a multi-core processor architecture.
[0105] [0105] The communication connection (s) refers to the hardware / software used to connect the network interface to the bus. Although the communication connection is shown for illustrative clarity within the computer system, it can also be external to computer system 210. The hardware / software required for connection to the network interface includes, for illustrative purposes only, internal and external technologies such as modems, including regular telephone serial modems, cable modems and DSL modems, ISDN adapters and Ethernet cards.
[0106] [0106] Figure 11 illustrates a functional block diagram of an aspect of a USB 300 central network controller device, in accordance with at least one aspect of the present disclosure. In the illustrated aspect, the USB 300 network central controller device uses a TUSB2036 integrated circuit central controller available from Texas Instruments. The central network controller USB 300 is a CMOS device that provides a USB transceiver port 302 and up to three USB transceiver ports downstream 304, 306, 308 in accordance with the USB 2.0 specification. The upstream USB transceiver port 302 is a differential data root port comprising a "less" differential data input (DMO) paired with a "more" differential data input (DPO). The three ports of the downstream USB transceiver 304, 306, 308 are differential data ports, each port including "more" differential data outputs (DP1-DP3) paired with "less" differential data outputs (DM1- DM3).
[0107] [0107] The USB 300 central network controller device is implemented with a digital state machine instead of a microcontroller, and no firmware programming is required. Fully compatible USB transceivers are integrated into the circuit for the upstream USB transceiver port 302 and all downstream USB transceiver ports 304, 306, 308. The downstream USB transceiver ports 304, 306, 308 support both full speed as low speed automatically configuring the scan rate according to the speed of the device attached to the doors. The USB 300 network central controller device can be configured in bus powered or self-powered mode and includes 312 central controller power logic to manage power.
[0108] [0108] 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 central network controller hardware and handles most of the protocol described in chapter 8 of the USB specification. SIE 310 typically comprises signaling down to the transaction level. The functions it handles could include: packet recognition, transaction sequencing, SOP, EOP, RESET, and RESUME signal detection / generation, clock / data separation, data encoding / decoding non-inverted zero ( NRZI), generation and verification of CRC (token and data), generation and verification / decoding of packet ID (PID), and / or series-parallel / parallel-series conversion. The SIE 310 receives a clock input 314 and is coupled to a suspend / resume logic circuit and frame timer 316 and a central controller repeat circuit 318 to control communication between the USB transceiver port upstream 302 and the USB transceiver ports downstream 304, 306, 308 through the port logic circuits 320, 322, 324. The SIE 310 is coupled to a command decoder 326 through the interface logic to control the commands of a serial EEPROM through a serial EEPROM 330 interface.
[0109] [0109] In several aspects, the USB 300 central network controller can connect 127 functions configured in up to six logical layers (levels) to a single computer. In addition, the USB 300 central network controller can connect all peripherals using a standardized four-wire cable that provides both communication and power distribution. Power settings are bus-powered and self-powered modes. The USB 300 central network controller can be configured to support four power management modes: a bus-powered central controller with individual port power management or grouped port power management, and the au central controller - powered, with individual door power management or grouped door power management. In one respect, using a USB cable, the USB 300 central network controller, the USB transceiver port 302 is plugged into a USB host controller, and the USB transceiver ports downstream 304, 306, 308 are exposed to connect compatible USB devices, and so on.
[0110] [0110] Figure 12 illustrates a logic diagram of a module of a 470 control system of an instrument or surgical tool, according to one or more aspects of the present disclosure. The 470 system comprises a control circuit. The control circuit includes a microcontroller 461 comprising a processor 462 and a memory 468. One or more of the sensors 472, 474, 476, for example, provide real-time feedback to the processor
[0111] [0111] In one aspect, the 461 microcontroller can be any single-core or multi-core processor, such as those known under the ARM Cortex trade name available from Texas Instruments. In one aspect, the 461 main microcontroller may be an LM4F230H5QR ARM Cortex-M4F processor core, available from Texas Instruments, for example comprising a 256 KB integrated single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to optimize performance above 40 MHz, a 32 KB single cycle static random access memory (SRAM), and a read-only memory (ROM) loaded with StellarisWareO software, a memory programmable, electrically erasable, 2 KB read-only (EEPROM), one or more pulse width modulation (PWM) modules, one or more analogs of quadrature encoder (QEI) inputs, and / or one or more converters 12-bit analog to digital (ADC) with 12 analog input channels, details of which are available for the product data sheet.
[0112] [0112] In one aspect, the 461 microcontroller can comprise a safety controller that comprises two families based on controllers, such as TMS570 and RM4x known under the trade name of Hercules ARM Cortex R4, also available from Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[0113] [0113] The 461 microcontroller can be programmed to perform various functions, such as precise control of the speed and position of the knife and joint systems. In one aspect, the microcontroller 461 includes a processor 462 and a memory 468. The electric motor 482 can be a brushed direct current (DC) motor with a gearbox and mechanical connections with a joint or knife. In one aspect, a motor drive 492 can be an A3941 available from Allegro Microsystems, Inc. Other motor drives can be readily replaced for use in the tracking system 480 which comprises an absolute positioning system. A detailed description of an absolute positioning system is given in US Patent Application Publication 2017/0296213, entitled SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT, published on October 19, 2017, which is hereby incorporated by reference in its entirety.
[0114] [0114] The 461 microcontroller can be programmed to provide precise control of the speed and position of the displacement members and articulation systems. The 461 microcontroller can be configured to compute a response in the 461 microcontroller software. The computed response is compared to a measured response from the real system to obtain an "observed" response, which is used for actual feedback-based decisions. The observed response is a favorable and adjusted value, which balances the uniform and continuous nature of the simulated response with the measured response, which can detect external influences in the system.
[0115] [0115] In one aspect, the 482 motor can be controlled by the 492 motor actuator and can be used by the instrument trigger system or surgical tool. In many ways, the 482 motor can be a brushed direct current (DC) motor with a maximum speed of approximately 25,000 RPM, for example. In other arrangements, the 482 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable type of electric motor. The motor starter 492 can comprise an H bridge drive that comprises field effect transistors (FETs), for example. The 482 motor can be powered by a feed set mounted releasably in the handle assembly or tool compartment to provide control power for the instrument or surgical tool. The power pack may comprise a battery that may include several battery cells connected in series, which can be used as the power source to power the instrument or surgical tool. Under certain circumstances, the battery cells in the 706 power pack may be replaceable and / or rechargeable. In at least one example, the battery cells can be lithium-ion batteries that can be coupled and separable from the power pack.
[0116] [0116] The 492 motor driver can be an A3941, available from Allegro Microsystems, Inc. The 492 A3941 driver is an entire bridge controller for use with semiconductor metal oxide field effect transistors (MOSFET). external power, N channel, specifically designed for inductive loads, such as DC motors with brushes. The 492 actuator comprises a single charge pump regulator that provides full door drive (> 10 V) for batteries with voltage up to 7 V and allows the A3941 to operate with a reduced door drive, up to 5.5 V. A capacitor input control can be used to supply the voltage surpassing that supplied by the battery required for N channel MOSFETs. An internal charge pump for the drive on the upper side allows operation in direct current (100% duty cycle ). The entire bridge can be triggered in fast or slow drop modes using diodes or synchronized rectification. In the slow drop mode, the current can be recirculated by means of FET from the top or from the bottom. The energy FETs are protected from the shoot-through effect through programmable dead-time resistors. Integrated diagnostics provide indication of undervoltage, overtemperature and faults in the power bridge and can be configured to protect power MOSFETs in most short-circuit conditions. Other motor drives can be readily replaced for use in the 480 tracking system comprising an absolute positioning system.
[0117] [0117] Tracking system 480 comprises a controlled motor drive circuit arrangement comprising a position sensor 472 in accordance with an aspect of the present disclosure. The position sensor 472 for an absolute positioning system provides a unique position signal that corresponds to the location of a displacement member. In one aspect, the displacement member represents a longitudinally movable drive member comprising a rack of drive teeth for engagement with a corresponding drive gear of a gear reduction assembly. In other respects, the displacement member represents the trigger member, which can be adapted and configured to include a rack of drive teeth.
[0118] [0118] The 482 electric motor can include a rotary drive shaft, which interfaces operationally with a gear set, which is mounted in coupling hitch with a set or rack of driving teeth on the drive member. A sensor element can be operationally coupled to a gear assembly so that a single revolution of the position sensor element 472 corresponds to some linear longitudinal translation of the displacement member. An array of gears and sensors can be connected to the linear actuator by means of a rack and pinion arrangement, or by a rotary actuator, by means of a sprocket or other connection. A power source supplies power to the absolute positioning system and an output indicator can display the output from the absolute positioning system. The drive member represents the longitudinally movable drive member which comprises a drive tooth rack formed thereon for engagement with a corresponding drive gear of the gear reducer assembly. The displacement member represents the longitudinally movable firing member, the firing bar, the I-beam, or combinations thereof.
[0119] [0119] A single revolution of the sensor element associated with the position sensor 472 is equivalent to a longitudinal linear displacement di of the displacement member, where d1 is the longitudinal linear distance by which the displacement member moves from the point
[0120] [0120] A series of switches, where n is an integer greater than one, can be used alone or in combination with a gear reduction to provide a single position signal for more than one revolution of the 472 position sensor. of the keys is fed back to the 461 microcontroller which applies logic to determine a single position signal corresponding to the longitudinal linear displacement d1 + d2 + ... of the displacement member. The output of the position sensor 472 is supplied to the microcontroller 461. The position sensor 472 of the sensor array can comprise a magnetic sensor, an analog rotary sensor, such as a potentiometer, or a series of analog Hall effect elements. , which emit a unique combination of position of signs or values.
[0121] [0121] The position sensor 472 can comprise any number of magnetic detection elements, such as, for example, magnetic sensors classified according to whether they measure the total magnetic field or the vector components of the magnetic field. The techniques used to produce both types of magnetic sensors cover many aspects of physics and electronics. The technologies used for magnetic field detection include flow meter, saturated flow, optical pumping, nuclear precession, SQUID, Hall effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetic / piezoelectric compounds, magnetodiode, magnetic transistor, optical fiber
[0122] [0122] In one aspect, the position sensor 472 for the tracking system 480 which comprises an absolute positioning system comprises a magnetic rotating absolute positioning system. The 472 position sensor can be implemented as a rotary, magnetic, single-circuit, ASSOSSEQFT position sensor, available from Austria Microsystems, AG. The position sensor 472 interfaces with the 461 microcontroller to provide an absolute positioning system. The 472 position sensor is a low voltage, low power component and includes four effect elements in an area of the 472 position sensor located above a magnet. A high-resolution ADC and an intelligent power management controller are also provided on the integrated circuit. A CORDIC processor (digital computer for coordinate rotation), also known as the digit by digit method and Volder algorithm, is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only operations addition, subtraction, bit shift and lookup table. The angle position, alarm bits and magnetic field information are transmitted via a standard serial communication interface, such as a serial peripheral interface (SPI), to the 461 microcontroller. The 472 position sensor provides 12 or 14 bits of resolution. The position sensor 472 can be an ASS055 integrated circuit supplied in a small 16-pin QFN package with dimensions of 4 x 4 x 0.85 mm.
[0123] [0123] Tracking system 480 comprising an absolute positioning system can comprise and / or be programmed to implement a feedback controller, such as a PID, status feedback, and adaptive controller. A power source converts the signal from the feedback controller to a physical input to the system, in this case the voltage. Other examples include a voltage, current and force PWM. Other sensors can be provided in order to measure the parameters of the physical system in addition to the position measured by the position sensor 472. In some respects, the other sensors may include sensor arrangements as described in US Patent No. 9,345,481 entitled STAPLE CAR-TRIDGE TISSUE THICKNESS SENSOR SYSTEM, granted on May 24, 2016, which is incorporated by reference in its entirety in this document; US Patent Application Serial No. 2014/0263552, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, published on September 18, 2014, is incorporated by reference in its entirety into this document; and US Patent Application Serial No. 15 / 628,175, entitled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STA- PLING AND CUTTING INSTRUMENT, submitted on June 20, 2017, is incorporated by reference in its entirety into this document. . In a digital signal processing system, an absolute positioning system is coupled to a digital data capture system where the output of the absolute positioning system will have a finite resolution and sampling frequency. The absolute positioning system can comprise a comparison and combination circuit to combine a computed response with a measured response through the use of algorithms, such as a weighted average and a theoretical control loop, that trigger the calculated response towards the measured response. The computed response of the physical system considers properties, such as mass, inertia, viscous friction, resistance to inductance, etc., to predict what the states and outputs of the physical system will be, knowing the input.
[0124] [0124] The absolute positioning system provides a position
[0125] [0125] A 474 sensor, such as a strain gauge or a micro strain gauge, is configured to measure one or more parameters of the end actuator, such as the amplitude of the strain exerted on the anvil during a clamping operation, which may be indicative of tissue compression. The measured effort is converted into a digital signal and fed to the 462 processor. Alternatively, or in addition to the 474 sensor, a 476 sensor, such as a load sensor, can measure the closing force applied by the drive system. anvil closure. The 476 sensor, such as a load sensor, can measure the firing force applied to a beam with an i-profile in a firing stroke of the system or surgical tool. The i-profile beam is configured to engage a hinge slider, which is configured to move the clamp actuators upward to force the clamps to deform in contact with an anvil. The i-profile beam includes a sharp cutting edge that can be used to separate fabric as the i-profile beam | it is advanced distally by the firing bar. Alternatively, a current sensor 478 can be used to measure the current drained by the 482 motor. The force required to advance the trigger member can correspond to the current drained by the 482 motor, for example. The measured force is converted into a digital signal and supplied to the 462 processor.
[0126] [0126] In one form, a 474 strain gauge sensor can be used to measure the force applied to the tissue by the extremity actuator. A strain gauge can be attached to the end actuator to measure the force applied to the tissue being treated by the end actuator. A system for measuring forces applied to the tissue attached by the end actuator comprises a 474 strain gauge sensor, such as, for example, a microstrain meter, which is configured to measure one or more parameters of the end actuator, for example. In one aspect, the 474 strain gauge sensor can measure the amplitude or magnitude of the mechanical stress exerted on a claw member of an end actuator during a clamping operation, which can be indicative of the compression of the fabric. The measured effort is converted into a digital signal and fed to the 462 processor of a microcontroller
[0127] [0127] Measurements of tissue compression, tissue thickness and / or the force required to close the end actuator on the tissue, as measured by sensors 474, 476 respectively, can be used by microcontroller 461 to characterize the position trigger member and / or the corresponding trigger member speed value. In one case, a 468 memory can store a technique, an equation and / or a query table that can be used by the 461 microcontroller in the evaluation.
[0128] [0128] The control system 470 of the instrument or surgical tool can also comprise wired or wireless communication circuits for communication with the central modular communication controller shown in Figures 8 to 11.
[0129] [0129] Figure 13 illustrates a control circuit 500 configured to control aspects of the instrument or surgical tool according to an aspect of the present disclosure. The control circuit 500 can be configured to implement various processes described herein. The control circuit 500 may comprise a microcontroller comprising one or more processors 502 (for example, microprocessor, microcontroller) coupled to at least one memory circuit 504. The memory circuit 504 stores instructions executable on the machine which, when executed by processor 502, cause processor 502 to execute machine instructions to implement several of the processes described here. Processor 502 can be any one of a number of single-core or multi-core processors known in the art. The memory circuit 504 may comprise volatile and non-volatile storage media. The processor 502 can include an instruction processing unit 506 and an arithmetic unit 508. The instruction processing unit can be configured to receive instructions from the memory circuit 504 of the present disclosure.
[0130] [0130] Figure 14 illustrates a combinational logic circuit 510 configured to control aspects of the instrument or surgical tool according to an aspect of the present disclosure. The combinational logic circuit 510 can be configured to implement the various processes described here. The combinational logic circuit 510 can comprise a finite state machine that comprises a combinational logic 512 configured to receive data associated with the instrument or surgical tool at an input 514, process the data by the combinational logic 512 and provide an output 516.
[0131] [0131] Figure 15 illustrates a 520 sequential logic circuit
[0132] [0132] Figure 16 illustrates an instrument or surgical tool that comprises a plurality of motors that can be activated to perform various functions. In certain cases, a first engine may be activated to perform a first function, a second engine may be activated to perform a second function, a third engine may be activated to perform a third function, a fourth engine may be activated to perform a fourth function, and so on. In certain cases, the plurality of motors of the robotic surgical instrument 600 can be individually activated to cause triggering, closing, and / or articulation movements in the end actuator.
[0133] [0133] In certain cases, the instrument or surgical tool system may include a 602 firing motor. The 602 firing motor can be operationally coupled to a 604 firing motor drive assembly, which can be configured to transmitting firing movements generated by the motor 602 to the end actuator, in particular to move the beam element with an i-profile. In certain cases, the firing movements generated by the firing motor 602 can cause the staples to be positioned from the staple cartridge in the fabric captured by the end actuator and / or the cutting edge of the beam element with i-profile to be advanced to cut the captured tissue, for example. The beam element with an i-profile can be retracted by reversing the direction of the 602 motor.
[0134] [0134] In certain cases, the surgical instrument or tool may include a closing motor 603. The closing motor 603 can be operationally coupled to a drive assembly of the closing motor 605 that can be configured to transmit closing movements , generated by the motor 603 to the end actuator, particularly to move a closing tube to close the anvil and compress the fabric between the anvil and the staple cartridge. Closing movements can cause the end actuator to transition from an open configuration to an approximate configuration for capturing tissue, for example. The end actuator can be moved to an open position by reversing the direction of the 603 motor.
[0135] [0135] In certain cases, the surgical instrument or tool may include one or more articulation motors 606a, 606b, for example.
[0136] [0136] As described above, the surgical instrument or tool can include a plurality of motors that can be configured to perform various independent functions. In certain cases, the plurality of motors of the instrument or surgical tool can be activated individually or separately to perform one or more functions, while other motors remain inactive. For example, the hinge motors 606a, 606b can be activated to cause the end actuator to be pivoted, while the firing motor 602 remains inactive. Alternatively, the firing motor 602 can be activated to fire the plurality of clamps, and / or advance the cutting edge, while the hinge motor 606 remains inactive. In addition, the closing motor 603 can be activated simultaneously with the firing motor 602 to cause the closing tube and the I-beam beam element to move distally, as described in more detail later in this document.
[0137] [0137] In certain cases, the surgical instrument or tool may include a common control module 610 that can be used with a plurality of the instrument's instruments or surgical tool. In certain cases, the common control module 610 can accommodate one of the plurality of motors at a time. For example, the common control module 610 can be coupled to and separable from the plurality of motors of the robotic surgical instrument individually.
[0138] [0138] In at least one example, the common control module 610 can be selectively switched between the operational coupling with the 606a, 606B articulation motors, and the operational coupling with the 602 firing motor or the 603 closing motor. at least one example, as shown in Figure 16, a key 614 can be moved or transitioned between a plurality of positions and / or states. In the first position 616, the switch 614 can electrically couple the common control module 610 to the trip motor 602; in a second position 617, the switch 614 can electrically couple the control module 610 to the closing motor 603; in a third position 618a, the switch 614 can electrically couple the common control module 610 to the first articulation motor 606a; and in a fourth position 618b, the switch 614 can electrically couple the common control module 610 to the second articulation motor 606b, for example. In certain cases, separate common control modules 610 can be electrically coupled to the firing motor 602, closing motor 603, and hinge motors 606a, 606b at the same time. In certain cases, key 614 can be a mechanical key, an electromechanical key, a solid state key, or any suitable switching mechanism.
[0139] [0139] Each of the 602, 603, 606a, 606b motors can comprise a torque sensor to measure the output torque on the motor drive shaft. The force on an end actuator can be detected in any conventional manner, such as by means of force sensors on the outer sides of the jaws or by a motor torque sensor that drives the jaws.
[0140] [0140] In several cases, as shown in Figure 16, the common control module 610 may comprise a motor starter 626 that may comprise one or more H-Bridge FETs. The motor driver 626 can modulate the energy transmitted from a power source 628 to a motor coupled to the common control module 610, based on an input from a microcontroller 620 (the "controller"), for example. In certain cases, microcontroller 620 can be used to determine the current drained by the motor, for example, while the motor is coupled to the common control module 610, as described above.
[0141] [0141] In certain cases, the microcontroller 620 may include a microprocessor 622 (the "processor") and one or more non-transitory computer-readable media or 624 memory units (the "memory"). In certain cases, memory 624 can store various program instructions that, when executed, can cause processor 622 to perform a plurality of functions and / or calculations described herein. In certain cases, one or more of the memory units 624 can be coupled to the processor 622, for example.
[0142] [0142] In certain cases, the power source 628 can be used to supply power to the microcontroller 620, for example. In certain cases, the 628 power source may comprise a battery (or "battery pack" or "power source"), such as a Li ion battery, for example. In certain cases, the battery pack can be configured to be releasably mounted to the handle to supply power to the surgical instrument 600. Several battery cells connected in series can be used as the 628 power source. In certain cases, the power source 628 can be replaceable and / or rechargeable, for example.
[0143] [0143] In several cases, the 622 processor can control the motor drive 626 to control the position, direction of rotation and / or speed of a motor that is coupled to the common control module 610. In certain cases cases, the processor 622 can signal the motor driver 626 to stop and / or disable a motor that is coupled to the common control module 610. It should be understood that the term "processor", as used here, includes any microprocessor , microcontroller or other suitable basic computing device that incorporates the functions of a central computer processing unit (CPU) in an integrated circuit or, at most, some integrated circuits. The processor is a programmable multipurpose device that accepts digital data as input, processes it according to instructions stored in its memory, and provides results as output. This is an example of sequential digital logic, as it has internal memory. Processors operate on numbers and symbols represented in the binary numeral system.
[0144] [0144] In one example, the 622 processor can be any single-core or multi-core processor, such as those known by the Texas Instruments ARM Cortex trade name. In certain cases, the 620 microcontroller may be an LM 4F230H5QR, available from Texas Instruments, for example. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core comprising an integrated 256 KB single cycle flash memory, or other non-volatile memory, up to 40 MHz, a search buffer anticipated to optimize performance above 40 MHz, a 32 KB single cycle SRAM, an internal ROM loaded with StellarisWareG software, 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, one or more 12-bit ADCs with 12 analog input channels, among other features that are readily available for the product data sheet. Other microcontrollers can be readily replaced for use with the 4410 module. Consequently, the present disclosure should not be limited in this context.
[0145] [0145] In certain cases, memory 624 may include program instructions for controlling each of the motors of the surgical instrument 600 that are attachable to the common control module 610. For example, memory 624 may include program instructions for controlling the firing motor 602, the closing motor 603 and the hinge motors 606a, 606b. Such program instructions can cause the 622 processor to control the trigger, close, and link functions according to inputs from the instrument or surgical tool control algorithms or programs.
[0146] [0146] In certain cases, one or more mechanisms and / or sensors, such as 630 sensors, can be used to alert the 622 processor about program instructions that need to be used in a specific configuration. For example, sensors 630 can alert the 622 processor to use the program instructions associated with triggering, closing and pivoting the end actuator. In certain cases, sensors 630 may comprise position sensors that can be used to detect the position of switch 614, for example. Consequently, the processor 622 can use the program instructions associated with firing the beam with the i-profile of the end actuator by detecting, through sensors 630, for example, that the key 614 is in the first position 616; the 622 processor can use the instructions
[0147] [0147] Figure 17 is a schematic diagram of a robotic surgical instrument 700 configured to operate a surgical tool described in this document, in accordance with an aspect of that disclosure. The robotic surgical instrument 700 can be programmed or configured to control the distal / proximal translation of a displacement member, the distal / proximal displacement of a closing tube, the rotation of the drive shaft, and articulation, either with a single type or multiple articulation drive links. In one aspect, the surgical instrument 700 can be programmed or configured to individually control a firing member, a closing member, a driving shaft member and / or one or more hinge members. The surgical instrument 700 comprises a control circuit 710 configured to control motor-driven firing members, closing members, drive shaft members and / or one or more articulation members.
[0148] [0148] In one aspect, the robotic surgical instrument 700 comprises a control circuit 710 configured to control an anvil 716 and an i-profile beam portion 714 (including a sharp cutting edge) of an end actuator 702, a removable clamp cartridge 718, a drive shaft 740 and one or more hinge members 742a, 742b through a plurality of motors 704a to 704e. A position sensor 734 can be configured to provide control circuit 710 with beam feedback with i 714 profile. Other sensors 738 can be configured
[0149] [0149] In one aspect, the control circuit 710 may comprise one or more microcontrollers, microprocessors or other processors suitable for executing instructions that cause the processor or processors to perform one or more tasks. In one aspect, a timer / counter 731 provides control circuit 710 with an output signal, such as elapsed time or a digital count, to correlate the beam position with i 714 profile, as determined by the position sensor 734 , with the timer / counter output 731 so that the control circuit 710 can determine the position of the beam with i-shaped profile 714 at a specific time (t) in relation to an initial position or the time (t) when the beam with i 714 profile is in a specific position in relation to an initial position. The timer / counter 731 can be configured to measure elapsed time, count external events or measure external events.
[0150] [0150] In one aspect, control circuit 710 can be programmed to control functions of end actuator 702 based on one or more tissue conditions. Control circuit 710 can be programmed to detect, directly or indirectly, tissue conditions, such as thickness, as described here. Control circuit 710 can be programmed to select a trigger control program or closing control program based on tissue conditions. A trigger control program can describe the distal movement of the displacement member. Different trigger control programs can be selected to better treat different tissue conditions. For example, when a thicker tissue is present, control circuit 710 can be programmed to translate the displacement member at a lower speed and / or with a lower power. When a thinner tissue is present, control circuit 710 can be programmed to translate the displacement member at a higher speed and / or with greater power. A closure control program can control the closing force applied to the tissue by the anvil
[0151] [0151] In one aspect, the 710 motor control circuit can generate motor setpoint signals. Motor setpoint signals can be provided for various motor controllers 708a through 708e. Motor controllers 708a to 708e can comprise one or more circuits configured to provide motor start signals for motors 704a to 704e in order to drive motors 704a to 704e, as described here. In some instances, motors 704a to 704e may be brushed DC motors. For example, the speed of motors 704a to 704e can be proportional to the respective motor start signals. In some examples, motors 704a to 704e may be brushless DC electric motors, and the respective motor drive signals may comprise a PWM signal provided for one or more stator windings of motors 704a to 704e. In addition, in some instances, motor controllers 708a through 708e can be omitted and control circuit 710 can directly generate motor drive signals.
[0152] [0152] In one aspect, the control circuit 710 can initially operate each of the motors 704a to 704e in an open circuit configuration for a first open circuit portion of the travel of the travel member. Based on the response of the robotic surgical instrument 700 during the open circuit portion of the stroke, control circuit 710 can select a trigger control program in a closed circuit configuration. The instrument response may include a translation of the distance from the displacement member during the open circuit portion, a time elapsed during the open circuit portion, the energy supplied to one of the motors 704a to 704e during the open circuit portion, a sum of pulse widths of a motor start signal, etc. After the open circuit portion, control circuit 710 can implement the selected trigger control program for a second portion of the travel member travel. For example, during a portion of the closed loop course, control circuit 710 can modulate one of the motors 704a to 704e based on the translation of data describing a position of the closed displacement member to translate the displacement member to a constant speed.
[0153] [0153] In one aspect, motors 704a to / 04e can receive power from a power source 712. Power source 712 can be a DC power source powered by an alternating main current source, a battery, a super capacitor , or any other suitable energy source. Motors 704a to 704e can be mechanically coupled to individual moving mechanical elements such as the i-beam beam 714, the anvil 716, the drive shaft 740, the joint 742a and the joint 742b, through the respective transmissions 706a to 706e . Transmissions 706a through 706e may include one or more gears or other connecting components for coupling motors 704a to 704e to moving mechanical elements. A position sensor 734 can detect a position of the beam with an i-profile 714. The position sensor 734 can be or can include any type of sensor that is capable of generating position data that indicate a position of the beam with an i-profile 714 In some examples, the position sensor 734 may include an encoder configured to provide a series of pulses to the control circuit 710 according to the beam with i-profile 714 translated distally and proximally. Control circuit 710 can track pulses to determine the position of the i-profiled beam 714. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals that indicate the movement of the beam with an i 714 profile. In addition, in some examples, the position sensor 734 can be omitted. When any of the motors 704a to 704e is a stepper motor, control circuit 710 can track the beam position with i-profile 714 by aggregating the number and direction of steps that the 704 motor was instructed to run. The position sensor 734 can be located on end actuator 702 or any other portion of the instrument. The outputs of each of the engines 704a to 704e include a torque sensor 744a to 744e to detect force and have an encoder to detect the rotation of the drive shaft.
[0154] [0154] In one aspect, the control circuit 710 is configured to drive a firing member as the portion of the i-profile beam 714 of end actuator 702. Control circuit 710 provides a motor setpoint for a motor control 708a, which provides a drive signal for motor 704a. The output shaft of the motor 704a is coupled to a torque sensor 744a. The 744a torque sensor is coupled to a transmission
[0155] [0155] In one aspect, control circuit 710 is configured to drive a closing member, such as anvil portion 716 of end actuator 702. Control circuit 710 provides a motor setpoint to a motor control 708b, which provides a drive signal to motor 704b. The output shaft of the 704b motor is coupled to a 744b torque sensor. The torque sensor 744b is coupled to a 706b transmission that is coupled to the anvil
[0156] [0156] In one aspect, control circuit 710 is configured to rotate a drive shaft member, such as drive shaft 740, to rotate end actuator 702. Control circuit 710 provides a set point motor for a 708c motor control, which provides a drive signal for the 704c motor. The output shaft of the 704c engine is coupled to a torque sensor
[0157] [0157] In one aspect, control circuit 710 is configured to link end actuator 702. Control circuit 710 provides a motor setpoint for a 708d motor control, which provides a drive signal for the motor 704d. The output shaft of the 704d motor is coupled to a 744d torque sensor. Torque sensor 744d is coupled to a transmission 706d which is coupled to a pivot member 742a. The 706d transmission comprises moving mechanical elements, such as articulation elements, to control the articulation of the 702 + 65º end actuator. In one aspect, the 704d motor is coupled to a pivot nut, which is rotatably seated on the proximal end portion of the distal column portion and is pivotally driven thereon by a pivot gear assembly. The torque sensor 744d provides a feedback signal from the articulation force to the control circuit 710. The feedback signal from the articulation force represents the articulation force applied to the end actuator 702. The sensors 738, as an articulation encoder, can supply the articulation position of end actuator 702 to control circuit 710.
[0158] [0158] In another aspect, the hinge function of the robotic surgical system 700 may comprise two hinge members, or connections, 742a, 742b. These hinge members 742a, 742b are driven by separate disks at the robot interface (the rack), which are driven by the two motors 708d, 708e. When the separate firing motor 704a is provided, each hinge link 742a, 742b can be antagonistically driven with respect to the other link to provide a resistive holding motion and a load to the head when it is not moving and to provide a articulation movement when the head is articulated. The hinge members 742a, 742b attach to the head in a fixed radius when the head is rotated. Consequently, the mechanical advantage of the push and pull link changes when the head is rotated. This change in mechanical advantage can be more pronounced with other drive systems for the articulation connection.
[0159] [0159] In one aspect, the one or more motors 704a to 704e may comprise a brushed DC motor with a gearbox and mechanical connections to a firing member, closing member or hinge member. Another example includes electric motors 704a to 704e that operate the moving mechanical elements such as the displacement member, the articulation connections, the closing tube and the drive shaft. An external influence is an excessive and unpredictable influence on things like fabric,
[0160] [0160] In one aspect, the position sensor 734 can be implemented as an absolute positioning system. In one aspect, the 734 position sensor can comprise an absolute rotary magnetic positioning system implemented as a single integrated circuit rotary magnetic position sensor, ASSOSSEQFT, available from Austria Microsystems, AG. The position sensor 734 can interface with the control circuit 710 to provide an absolute positioning system. The position can include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit by digit method and Volder's algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic functions and trigonometry that require only addition, subtraction, bit shift and lookup table operations.
[0161] [0161] In one aspect, the control circuit 710 can be in communication with one or more sensors 738. The sensors 738 can be positioned on the end actuator 702 and adapted to work with the robotic surgical instrument 700 to measure various derived parameters such as span distance in relation to time, compression of the tissue in relation to time, and deformation of the anvil in relation to time. The 738 sensors can comprise a magnetic sensor, a magnetic field sensor, a strain gauge, a load cell, a pressure sensor, a force sensor, a torque sensor, an inductive sensor as a sensor eddy current, a resistive sensor, a capacitive sensor, an optical sensor and / or any other sensor suitable for measuring one or more parameters of the end actuator 702. The 738 sensors may include one or more sensors. The sensors 738 can be arranged on the staple cartridge platform 718 to determine the location of the tissue using segmented electrodes. The torque sensors 744a to 744e can be configured to detect force such as firing force, closing force, and / or articulation force, among others. Consequently, control circuit 710 can detect (1) the closing load experienced by the distal closing tube and its position, (2) the trigger member on the rack and its position, (3) which portion of the staple cartridge 718 contains tissue, and (4) the load and position on both articulation rods.
[0162] [0162] In one aspect, the one or more sensors 738 may comprise a strain gauge such as, for example, a micro strain gauge, configured to measure the magnitude of the strain on the burner 716 during a clamped condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. Sensors 738 may comprise a pressure sensor configured to detect pressure generated by the presence of compressed tissue between anvil 716 and staple cartridge 718. Sensors 738 can be configured to detect the impedance of a section of fabric located between the anvil 716 and the staple cartridge 718 which is indicative of the thickness and / or completeness of the fabric located between them.
[0163] [0163] In one aspect, the 738 sensors can be implemented as one or more limit switches, electromechanical devices, solid state switches, Hall effect devices, magneto-resistive devices (MR) giant magneto-resistive devices (GMR), magnetometers, among others. In other implementations, the 738 sensors can be implemented as solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, MOSFET, bipolar and the like). In other implementations, the 738 sensors can include driverless electric switches, ultrasonic switches, accelerometers and inertia sensors, among others.
[0164] [0164] In one aspect, sensors 738 can be configured to measure the forces exerted on the anvil 716 by the closing drive system. For example, one or more sensors 738 may be at a point of interaction between the closing tube and anvil 716 to detect the closing forces applied to the anvil 716 by the closing tube. The forces exerted on the anvil 716 may be representative of the tissue compression experienced by the section of tissue captured between the anvil 716 and the staple cartridge 718. The one or more sensors 738 can be positioned in several interaction points along the closing drive system to detect the closing forces applied to the anvil 716 by the closing drive system. The one or more sensors 738 can be sampled in real time by the processor of the control circuit 710 during a clamping operation. The 710 control circuit receives sample measurements in real time to provide and analyze time-based information and evaluate, in real time, the closing forces applied to the anvil
[0165] [0165] In one aspect, a current sensor 736 can be used to measure the current drawn by each of the 704a to 704e motors. The force required to advance any of the moving mechanical elements, such as the beam with i 714 profile, corresponds to the current drawn by one of the motors 704a to 704e. The force is converted into a digital signal and supplied to the control circuit 710. The control circuit 710 can be configured to simulate the response of the instrument's actual system in the controller software. A displacement member can be actuated to move an i-beam beam 714 on end actuator 702 at or near a target speed. The robotic surgical instrument 700 may include a feedback controller, which can be one or any of the feedback controllers, including, but not limited to, a PID controller, state feedback, linear quadratic (LQR) and / or an adaptable controller, for example. The robotic surgical instrument 700 can include a power source to convert the signal from the feedback controller to a physical input such as case voltage, PWM voltage, frequency modulated voltage, current, torque and / or force, for example. Additional details are disclosed in US Patent Application Serial No. 15 / 636,829, entitled CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT, filed June 29, 2017, which is hereby incorporated by reference in its entirety.
[0166] [0166] Figure 18 illustrates a block diagram of a surgical instrument 750 programmed to control the distal translation of a displacement member according to an aspect of the present disclosure. In one aspect, the surgical instrument 750 is programmed to control the distal translation of a displacement member, such as the beam with an I-shaped profile 764. The surgical instrument 750 comprises an end actuator 752 that can comprise a 766 anvil. , an i-profile beam 764 (including a sharp cutting edge), and a removable staple cartridge 768.
[0167] [0167] The position, movement, displacement and / or translation of a linear displacement member, such as the beam with i 764 profile, can be measured by an absolute positioning system,
[0168] [0168] Control circuit 760 can generate a motor setpoint signal 772. The motor setpoint signal 772 can be supplied to a motor controller 758. Motor controller 758 can comprise one or more circuits configured to provide a motor 774 drive signal to motor 754 to drive motor 754, as described in the present disclosure. In some instances, the 754 motor may be a DC motor with a brushed DC electric motor. For example, motor speed 754 may be proportional to the motor 774 drive signal. In some instances, motor 754 may be a brushless DC electric motor and the motor 774 drive signal may comprise a PWM signal provided. - for one or more stator windings of motor 754. In addition, in some examples, motor controller 758 can be omitted, and control circuit 760 can generate motor drive signal 774 directly.
[0169] [0169] The 754 motor can receive power from a power source
[0170] [0170] The control circuit 760 can be in communication with one or more sensors 788. The sensors 788 can be positioned on the end actuator 752 and adapted to work with the surgical instrument 750 to measure the various derived parameters, such as distance span over time, tissue compression over time and anvil effort over time. The 788 sensors may comprise a magnetic sensor, a magnetic field sensor, an effort meter, a pressure sensor, a force sensor, an inductive sensor such as a currents current sensor, a resistive sensor, a sensor capacitive, an optical sensor and / or any other sensors suitable for measuring one or more parameters of the 752 end actuator. The 788 sensors may include one or more sensors.
[0171] [0171] The one or more sensors 788 may comprise a stress meter, such as a microstrain meter, configured to measure the magnitude of the stress on the anvil 766 during a clamped condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The 788 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The 788 sensors can be configured to detect the impedance of a section of fabric located between the anvil 766 and the staple cartridge 768 which is indicative of the thickness and / or completeness of the fabric located between them.
[0172] [0172] The 788 sensors can be configured to measure the forces exerted on the anvil 766 by a closing drive system. For example, one or more sensors 788 may be at a point of interaction between a closing tube and anvil 766 to detect the closing forces applied to anvil 766 by a closing tube. The forces exerted on the anvil 766 can be representative of the tissue compression experienced by the section of tissue captured between the anvil 766 and the staple cartridge 768. The one or more sensors 788 can be positioned at various points of interaction throughout the system. closing drive to detect the closing forces applied to the anvil 766 by the closing drive system. The one or more sensors 788 can be sampled in real time during a hold operation by a processor from the control circuit 760. The control circuit 760 receives sample measurements in real time to provide and analyze information based on time and evaluate, in real time, the closing forces applied to the anvil 766.
[0173] [0173] A current sensor 786 can be used to measure the current drained by the 754 motor. The force required to advance the beam with i 764 profile corresponds to the current drained by the motor
[0174] [0174] The control circuit 760 can be configured to simulate the response of the real system of the instrument in the controller software. A displacement member can be actuated to move a beam with an i 764 profile on end actuator 752 at or near a target speed. The surgical instrument 750 may include a feedback controller, which can be one or any of the feedback feedback controllers, including, but not limited to, a PID controller, status feedback, LOR, and / or an adaptive controller, for example. example. The surgical instrument 750 can include a power source to convert the signal from the feedback controller.
[0175] [0175] The actual drive system of the surgical instrument 750 is configured to drive the displacement member, cutting member or beam with i 764 profile, by a brushed DC motor with gearbox and mechanical connections to a system joint and / or knife. Another example is the 754 electric motor which operates the displacement member and the articulation drive, for example, from an interchangeable drive shaft assembly. An external influence is an excessive and unpredictable influence on things like tissue, surrounding bodies, and friction in the physical system. This external influence can be called drag, which acts in opposition to the 754 electric motor. External influence, like drag, can cause the functioning of the physical system to deviate from a desired operation of the physical system.
[0176] [0176] Several exemplifying aspects are directed to a 750 surgical instrument that comprises a 752 end actuator with motor-driven surgical stapling and cutting implements. For example, a motor 754 can drive a displacement member distally and proximally along a longitudinal geometric axis of end actuator 752. End actuator 752 may comprise a pivoting anvil 766 and, when configured for use, a staple cartridge 768 positioned opposite anvil 766. A doctor can hold the tissue between the anvil 766 and the staple cartridge 768, as described in the present disclosure. When ready to use the 750 instrument, the physician can provide a trigger signal, for example, by pressing a trigger on the 750 instrument. In response to the trigger signal, motor 754 can drive the displacement member distally along the ge axis -
[0177] [0177] In several examples, the surgical instrument 750 may comprise a control circuit 760 programmed to control the distal translation of the displacement member, such as the beam with i-profile 764, for example, based on one or more conditions of the tissue - of. The control circuit 760 can be programmed to directly or indirectly detect tissue conditions, such as thickness, as described here. Control circuit 760 can be programmed to select a trigger control program based on tissue conditions. A trigger control program can describe the distal movement of the displacement member. Different trigger control programs can be selected to better treat different tissue conditions. For example, when a thicker tissue is present, the control circuit 760 can be programmed to transfer the displacement member at a lower speed and / or with a lower power. When thinner tissue is present, control circuit 760 can be programmed to translate the displacement member at a higher speed and / or with greater power.
[0178] [0178] In some examples, control circuit 760 may initially operate motor 754 in an open circuit configuration for a first open circuit portion of a travel member travel. Based on an instrument response 750 during the open circuit portion of the stroke, control circuit 760 can select a trip control program. The response of the instrument may include a travel distance of the displacement member during the open circuit portion, a time elapsed during the open circuit portion, the power supplied to the motor 754 during the open circuit portion, a sum of pulse widths a motor start signal, etc. After the open circuit portion, control circuit 760 can implement the selected trigger control program for a second portion of the travel member travel. For example, during the closed loop portion of the stroke, control circuit 760 can modulate motor 754 based on translation data that describes a position of the displacement member in a closed circuit manner to translate the displacement member into a constant speed. Additional details are disclosed in US Patent Application Serial No. 15 / 720,852, entitled SYSTEM AND METHODS FOR CONTROL- LING A DISPLAY OF A SURGICAL INSTRUMENT, filed on September 29, 2017, which is hereby incorporated by reference in its entirety.
[0179] [0179] Figure 19 is a schematic diagram of a 790 surgical instrument configured to control various functions in accordance with an aspect of the present disclosure. In one aspect, the surgical instrument 790 is programmed to control the distal translation of a displacement member, such as the i-profile beam 764. Surgical instrument 790 comprises an end actuator 792 that can comprise an anvil 766 , an i-profile beam 764 and a removable staple cartridge 768 that can be interchanged with an RF cartridge 796 (shown in dashed line).
[0180] [0180] In one aspect, the 788 sensors can be implemented as a limit switch, electromechanical device, solid state switches, Hall effect devices, MRI devices, GMR devices, magnetometers, among others. In other implementations, 638 sensors can be solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, MOSFET, bipolar and the like). In other implementations, 788 sensors can include driverless electric switches, ultrasonic switches, accelerometers, inertia sensors and, among others.
[0181] [0181] In one aspect, the position sensor 784 can be implemented as an absolute positioning system, which comprises a rotating magnetic absolute positioning system implemented as a rotating magnetic position sensor, with a circuit single integrated, ASSOSSEQFT, available from Austria Microsystems, AG. The position sensor 784 can interface with the control circuit 760 to provide an absolute positioning system. The position can include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit by digit method and Volder algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only addition, subtraction, bit shift and lookup table operations.
[0182] [0182] In one aspect, the 764 I-beam can be implemented as a knife member comprising a knife body which operationally supports a fabric cutting blade and may additionally include flaps or anvil hitching features and channel hitch or base features. In one aspect, the staple cartridge 768 can be implemented as a standard surgical (mechanical) fastener cartridge. In one aspect, the RF cartridge 796 can be implemented as an RF cartridge. These and other sensor provisions are described in Commonly Owned US Patent Application No. 15 / 628,175, entitled TECHNIQUES FOR
[0183] [0183] The position, movement, displacement and / or translation of a linear displacement member, such as the beam with i 764 profile, can be measured by an absolute positioning system, an array of sensors and a sensor of position represented as the 784 position sensor. Since the i-profile beam 764 is coupled to the longitudinally movable drive member, the position of the | 764 can be determined by measuring the position of the longitudinally movable drive member using the 784 position sensor. Consequently, in the following description, the position, displacement and / or translation of the beam with an i-profile 764 can be obtained by the position sensor 784, as described in the present disclosure. A control circuit 760 can be programmed to control the translation of the displacement member, such as the i-profile beam 764, as described in the present disclosure. The control circuit 760, in some examples, may comprise one or more microcontrollers, microprocessors or other suitable processors to execute the instructions that cause the processor or processors to control the displacement member, for example, the beam with i 764 profile, as described. In one aspect, a timer / counter 781 provides an output signal, such as elapsed time or a digital count, to control circuit 760 to correlate beam position with i 764 profile as determined by position sensor 784 with output - timer / counter flow 781 so that the control circuit
[0184] [0184] The control circuit 760 can generate a setpoint signal for the engine 772. The setpoint signal for the engine 772 can be supplied to a 758 motor controller. The 758 motor controller can comprise one or more circuits configured to provide motor 754 with a motor 774 drive signal to drive motor 754, as described in the present disclosure. In some instances, the 754 motor may be a DC motor with a brushed DC electric motor. For example, the speed of motor 754 may be proportional to the drive signal of motor 774. In some instances, motor 754 may be a brushless DC electric motor and the motor 774 drive signal may comprise a supplied PWM signal for one or more motor stator windings 754. In addition, in some examples, motor controller 758 can be omitted, and control circuit 760 can generate motor drive signal 774 directly.
[0185] [0185] The 754 motor can receive power from a power source
[0186] [0186] The control circuit 760 can be in communication with one or more sensors 788. The sensors 788 can be positioned on the end actuator 792 and adapted to work with the surgical instrument 790 to measure the various derived parameters, such as distance span over time, tissue compression over time and anvil effort over time. The 788 sensors may comprise a magnetic sensor, a magnetic field sensor, an effort meter, a pressure sensor, a force sensor, an inductive sensor such as a currents current sensor, a resistive sensor, a sensor capacitive, an optical sensor and / or any other sensors suitable for measuring one or more parameters of the end actuator 792. The 788 sensors may include one or more sensors.
[0187] [0187] The one or more sensors 788 may comprise a stress meter, such as a microstrain meter, configured to measure the magnitude of the stress on the anvil 766 during a clamped condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The 788 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The 788 sensors can be configured to detect the impedance of a section of fabric located between the anvil 766 and the staple cartridge 768 which is indicative of the thickness and / or completeness of the fabric located between them.
[0188] [0188] The 788 sensors can be configured to measure the forces exerted on the anvil 766 by the closing drive system. For example, one or more sensors 788 may be at a point of interaction between a closing tube and anvil 766 to detect the closing forces applied to anvil 766 by a closing tube. The forces exerted on the anvil 766 may be representative of the tissue compression experienced by the section of tissue captured between the anvil 766 and the staple cartridge
[0189] [0189] A current sensor 786 can be used to measure the current drained by the 754 motor. The force required to advance the beam with i 764 profile corresponds to the current drained by the motor
[0190] [0190] An RF power source 794 is coupled to the end actuator 792 and is applied to the RF 796 cartridge when the RF 796 cartridge is loaded on the end actuator 792 in place of the staple cartridge 768. The circuit Control Panel 760 controls the supply of RF energy to the 796 RF cartridge.
[0191] [0191] Additional details are disclosed in US Patent Application Serial No. 15 / 636,096, entitled SURGICAL SYSTEM COUPLA- BLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, filed on 28 June 2017 , which is hereby incorporated as a reference in its entirety. Generator hardware
[0192] [0192] Figure 20 is a simplified block diagram of a generator 800 configured to provide tuning without an inductor, among other benefits. Additional details of generator 800 are described in US patent 9,060,775, entitled SURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES, granted on June 23, 2015, which is hereby incorporated in its entirety for reference in its entirety. The generator 800 can comprise an isolated stage of patient 802 in communication with a non-isolated stage 804 via a power transformer 806. A secondary winding 808 of power transformer 806 is contained in isolated stage 802 and can comprise a bypass configuration (for example, a central bypass or non-central bypass configuration) to define the drive signal outputs 810a, 810b, 810c, to transmit drive signals to different surgical instruments, such as For example, an ultrasonic surgical device and an electrosurgical RF instrument, and a multifunctional surgical instrument that includes ultrasonic and RF energy modes that can be delivered alone or simultaneously.
[0193] [0193] In certain forms, ultrasonic and electrosurgical trigger signals can be provided simultaneously to different surgical instruments and / or to a single surgical instrument, such as the multifunctional surgical instrument, with the ability to supply both ultrasonic and electrosurgical energy to the fabric. It will be noted that the electrosurgical signal provided by both the dedicated electrosurgical instrument and the electrosurgical / ultrasonic multifunctional combined instrument can be both a therapeutic and subtherapeutic level signal, where the subtherapeutic signal can be used, for example, to monitor tissue or the conditions of the instruments and provide feedback to the generator. For example, RF and ultrasonic signals can be provided separately or simultaneously from a generator with a single output port in order to provide the desired output signal to the surgical instrument, as will be discussed in more detail below. Consequently, the generator can combine the RF and ultrasonic electrosurgical energies and supply the combined energies to the multifunctional electrosurgical / ultrasonic instrument. Bipolar electrodes can be placed on one or both claws of the end actuator. A claw can be triggered by ultrasonic energy in addition to RF electrosurgical energy, working simultaneously. Ultrasonic energy
[0194] [0194] The non-isolated stage 804 may comprise a power amplifier 812 that has an output connected to a primary winding 814 of the power transformer 806. In certain forms, the power amplifier 812 may comprise an amplifier of the type push and pull. For example, the non-isolated stage 804 may additionally contain a logic device 816 to provide a digital output to a digital-to-analog converter (DAC) 818 which, in turn, , provides an analog signal corresponding to a power amplifier 812 input. In certain forms, logic device 816 may comprise a programmable gate array (PGA), an FPGA (field FPGA) -programmable gate array "), a programmable logic device (PLD, of" programmable logic device "), among other logic circuits, for example. The logic device 816, by controlling the input of the power amplifier 812 through the DAC 818, can therefore control any of several parameters (for example, frequency, waveform, amplitude of the waveform) of drive signals appearing at the drive signal outputs 810a, 810b and 810c. In certain ways and as discussed below, logic device 816, in conjunction with a processor (for example, a PSD, discussed below), can implement a number of PSD-based control algorithms and / or other algorithms control for control parameters of the drive signals provided by generator 800.
[0195] [0195] Power can be supplied to a power rail of the power amplifier 812 by a key mode regulator 820, such as a power converter. In certain ways, the key mode regulator 820 may comprise a regulator
[0196] [0196] In certain ways, the logic device 816, in conjunction with the PSD 822 processor, can implement a digital synthesis circuit as a control scheme with a direct digital synthesizer to control the waveform, frequency and / or the amplitude of the trigger signals emitted by the generator 800. In one way, for example, the logic device 816 can implement a DDS control algorithm by retrieving waveform samples stored in a lookup table (LUT , "look-up table")
[0197] [0197] The non-isolated stage 804 may additionally comprise a first ADC 826 circuit and a second ADC 828 circuit coupled to the output of power transformer 806 by means of the respective isolation transformers, 830 and 832, to respectively sample the voltage and current of drive signals emitted by generator 800. In certain ways, ADC 826 and 828 circuits can be configured for high-speed sampling (eg, 80 mega samples per second (MSPS)) to allow over-sampling of signals drive. In one way, for example, the sampling speed of the ADC 826 and 828 circuits can allow an oversampling of approximately 200x (depending on the frequency) of the drive signals. In certain ways, the sampling operations of the ADC 826 and 828 circuit can be performed by a single ADC circuit receiving voltage and current input signals through a bidirectional multiplexer. The use of high-speed sampling in the forms of the generator 800 can allow, among other things, the calculation of the complex current flowing through the branch of motion (which can be used in certain ways to implement DDS-based waveform control described above), accurate digital filtering of the sampled signals and the calculation of actual energy consumption with a high degree of accuracy. The feedback data about voltage and current emitted by the ADC 826 and 828 circuits can be received and processed (for example, first-in-first-out (FIFO) temporary storage, multiplexer) by logic device 816 and stored in memory of data for subsequent recovery, for example, by the 822 processor. As noted above, the feedback data on voltage and current can be used as input to an algorithm for pre-distortion or modification of sample form.
[0198] [0198] In certain forms, voltage and current feedback data can be used to control the frequency and / or amplitude (for example, current amplitude) of the drive signals. In one form, for example, feedback data on voltage and current can be used to determine the impedance phase. The frequency of the trigger signal can then be controlled to minimize or reduce the difference between the determined impedance phase and an impedance phase setpoint (eg 0º), thereby minimizing or reducing the effects of distortion harmonic and, correspondingly, accentuating the accuracy of the impedance phase measurement. The determination of the phase impedance and a frequency control signal can be implemented in the PSD 822 processor, for example, with the frequency control signal being supplied as input to a DDS control algorithm implemented by the device programmable logic 816.
[0199] [0199] In another form, for example, current feedback data can be monitored in order to maintain the current amplitude of the drive signal at a current amplitude setpoint. The current amplitude set point can be specified directly or indirectly determined based on the specified set points for voltage and power amplitude.
[0200] [0200] Non-isolated stage 804 may additionally comprise a second processor 836 to provide, among other things, user interface (UI) functionality. In one form, processor 836 may comprise an Atmel AT91SAM9263 processor with an ARM 926EJ-S core, available from Atmel Corporation, of San Jose, CA, USA, for example. Examples of UI functionality supported by the UI 836 processor may include audible and visual feedback from the user, communication with peripheral devices (for example, via a USB interface), communication with a foot switch, communication with a data entry device (for example, a touchscreen) and communication with an output device (for example, a speaker). The UI processor 836 can communicate with the PSD processor 822 and logic device 816 (for example, via serial peripheral interface buses (SPI)). Although the UI 836 processor can mainly support UI functionality, it can also coordinate with the PSD 822 processor to implement risk mitigation in certain ways. For example, the UI 836 processor can be programmed to monitor various aspects of inputs by the user and / or other inputs (eg,
[0201] [0201] In certain ways, both the PSD 822 processor and the UI 836 processor can, for example, determine and monitor the operational status of generator 800. For the PSD 822 processor, the operational state of generator 800 can determine, for example, which control and / or diagnostic processes are implemented by the PSD 822 processor. For the UI 836 processor, the operational state of the generator 800 can determine, for example, which elements of a UI (for example, screens display, sounds) are presented to a user. PSD and UI processors 822 and 836, respectively, can independently maintain the current operating status of generator 800, and recognize and evaluate possible transitions out of the current operational state. The PSD 822 processor can act as the master in this relationship, and can determine when transitions between operational states should occur. The UI 836 processor can be aware of valid transitions between operational states, and can confirm that a particular transition is adequate. For example, when the PSD 822 processor instructs the UI 1090 processor to transition to a specific state, the UI 836 processor can verify that the requested transition is valid. If a requested transition between states is determined to be invalid by the UI 836 processor, the UI 836 processor can cause generator 800 to enter a fault mode.
[0202] [0202] The non-isolated stage 804 can also contain a controller 838 for monitoring input devices (for example, a capacitive touch sensor used to turn the generator 800 on and off, a capacitive touch screen). In some ways, controller 838 may comprise at least one processor and / or other
[0203] [0203] In certain ways, when generator 800 is in an "off" state, controller 838 can continue to receive operational power (for example, through a line from a generator 800 power supply, such as power supply 854 discussed below). In this way, controller 838 can continue to monitor an input device (for example, a capacitive touch sensor located on a front panel of generator 800) to turn generator 800 on and off. When generator 800 is in the off state , controller 838 can wake up the power supply (for example, enable the operation of one or more DC / DC voltage converters 856 of power supply 854), if the activation of the input device is detected "on / off" by a user. Controller 838 can therefore initiate a sequence to transition generator 800 to an "on" state. On the other hand, controller 838 can initiate a sequence to transition the generator 800 to the off state if activation of the "on / off" input device is detected, when the generator 800 is in the on state. In certain ways, for example, controller 838 can report activation of the "on / off" input device 110 to the UI 836 processor, which in turn implements the necessary process sequence for
[0204] [0204] In certain forms, controller 838 may cause generator 800 to provide audible feedback or other sensory feedback to alert the user that an on or off sequence has been initiated. This type of alert can be provided at the beginning of a sequence on or off, and before the start of other processes associated with the sequence.
[0205] [0205] In certain forms, the isolated stage 802 may comprise an instrument interface circuit 840 to, for example, offer a communication interface between a control circuit of a surgical instrument (for example, a control circuit that comprises grip keys) and non-insulated stage components 804, such as logic device 816, PSD processor 822 and / or UI processor 836. Instrument interface circuit 840 can switch information with components of the non-isolated stage 804 through a communication link that maintains an adequate degree of electrical isolation between the isolated and non-isolated stages 802 and 804, for example, an infrared (IR) -based communication link . Power can be supplied to the instrument interface circuit 840 using, for example, a low loss voltage regulator powered by an isolation transformer driven from the 804 non-isolated stage.
[0206] [0206] In one form, the instrument interface circuit 840 may comprise a logic circuit 842 (for example, a logic circuit, a programmable logic circuit, PGA, FPGA, PLD) in communication with a signal conditioning circuit 844 Signal conditioning circuit 844 can be configured to receive a periodic signal from logic circuit 842 (for example, a 2 kHz square wave) to generate a bipolar interrogation signal that has an identical frequency. The question mark can be generated, for example, using a source of bipolar current fed by a differential amplifier. The question mark can be communicated to a surgical instrument control circuit (for example, using a conductive pair on a cable that connects the generator 800 to the surgical instrument) and monitored to determine a state or configuration of the control circuit . The control circuit can comprise a number of switches, resistors and / or diodes to modify one or more characteristics (for example, amplitude, rectification) of the question mark so that a state or configuration of the control circuit is discernible, so unambiguous, based on this one or more characteristics. In one form, for example, the signal conditioning circuit 844 may comprise an ADC circuit for generating samples of a voltage signal appearing between inputs of the control circuit, resulting from the passage of the interrogation signal through it. The logic instrument 842 (or a non-isolated stage component 804) can then determine the status or configuration of the control circuit based on the samples of ADC circuits.
[0207] [0207] In one form, the instrument interface circuit 840 may comprise a first data circuit interface 846 to enable the exchange of information between logic circuit 842 (or another element of the instrument interface circuit 840) and a pri - first data circuit arranged on a surgical instrument or otherwise associated with it. In certain ways, for example, a first data circuit can be arranged on a wire integrally attached to a handle of the surgical instrument, or on an adapter to interface between a specific type or model of instrument.
[0208] [0208] In certain forms, the first data circuit can store information related to the specific surgical instrument with which it is associated. This information may include, for example, a model number, a serial number, a number of operations in which the surgical instrument was used, and / or any other types of information. This information can be read by the instrument interface circuit 840 (for example, logic circuit 842), transferred to a non-isolated stage component 804 (for example, to logic device 816, the PSD processor 822 and / or the UI 836 processor) for presentation to a user by means of an output device and / or to control a function or operation of the generator 800. Additionally, any type of information can be communicated to the first data circuit for storage through the first interface of data circuit 846 (for example, using logic circuit 842). This information may include, for example, an updated number of operations in which the surgical instrument was used and / or the dates and / or times of its use.
[0209] [0209] As discussed earlier, a surgical instrument can be removable from a handle (for example, the multifunctional surgical instrument can be removable from the handle) to promote interchangeability and / or disposability of the instrument. In such cases, conventional generators may be limited in their ability to recognize specific instrument configurations being used, as well as to optimize the control and diagnostic processes as needed. The addition of legible data circuits to surgical instruments to resolve this issue is problematic from a compatibility point of view, however. For example, designing a surgical instrument so that it remains backward compatible with generators that lack the indispensable data reading functionality may be impractical due, for example, to different signaling schemes, design complexity and cost. The forms of instruments discussed here address these concerns through the use of data circuits that can be implemented in existing surgical instruments, economically and with minimal design changes to preserve the compatibility of surgical instruments with current generator platforms.
[0210] [0210] Additionally, the forms of the generator 800 can enable communication with instrument-based data circuits. For example, generator 800 can be configured to communicate with a second data circuit contained in an instrument (for example, the multifunctional surgical instrument). In some ways, the second data circuit can be implemented in a manner similar to that of the first data circuit described here. The instrument interface circuit 840 may comprise a second data circuit interface 848 to enable such communication. In one form, the second data circuit interface 848 can comprise
[0211] [0211] In some ways, the second data circuit can store information about the ultrasonic and / or electrical properties of an associated transducer, an end actuator 122, or an ultrasonic drive system. For example, the first data loop can indicate an initialization frequency slope, as described here. Additionally or alternatively, any type of information can be communicated to the second data circuit for storage there via the second data circuit interface 848 (for example, using logic circuit 842). This information may include, for example, an updated number of operations in which the surgical instrument was used and / or the dates and / or times of its use. In certain ways, the second data circuit can transmit data captured by one or more sensors (for example, an instrument-based temperature sensor). In certain ways, the second data circuit can receive data from generator 800 and provide an indication to a user (for example, a light-emitting diode or other visible indication) based on the received data.
[0212] [0212] In certain ways, the second data circuit and the second data circuit interface 848 can be configured so that communication between logic circuit 842 and the second data circuit can be carried out without the need to provide additional conductors. for this purpose (for example, dedicated cable conductors connecting a handle to the 800 generator). In one way, for example, information can be communicated to and from the second data circuit using a wire bus communication scheme, implemented in existing cabling, as one of the conductors used transmitting interrogation signals from signal conditioning circuit 844 to a control circuit on a handle. In this way, changes or modifications to the design of the surgical device that may otherwise be necessary are minimized or reduced. In addition, due to the fact that different types of communications implemented on a common physical channel can be separated based on frequency, the presence of a second data circuit can be "invisible" to generators that do not have the indispensable data reading functionality, which, therefore, allows the backward compatibility of the surgical instrument.
[0213] [0213] In certain forms, the isolated stage 802 may comprise at least one blocking capacitor 850-1 connected to the output of the trigger signal 810b to prevent the passage of direct current to a patient. A single blocking capacitor may be required to comply with medical regulations and standards, for example. Although failures in designs with a single capacitor are relatively uncommon, this type of failure can still have negative consequences. In one form, a second 850-2 blocking capacitor can be placed in series with the 850-1 blocking capacitor, with one-point current dispersion between the 850-1 and 850-2 blocking capacitors being monitored. , for example, by an ADC 852 circuit for sampling a voltage induced by the leakage current. Samples can be received, for example, by the circuit
[0214] [0214] In certain forms, the non-isolated stage 804 may comprise a power supply 854 to provide DC power under suitable voltage and current. The power supply can comprise, for example, a 400 W power supply to deliver a system voltage of 48 VDC. The power supply 854 can additionally comprise one or more DC / DC voltage converters 856 to receive the output from the power supply to generate DC outputs at the voltages and currents required by the various components of generator 800. As discussed above in relation to to controller 838, one or more of the 856 dc / dc voltage converters can receive an input from controller 838 when the activation of the "on / off" input device by a user is detected by controller 838, to enable operation or the awakening of the 856 DC / DC voltage converters.
[0215] [0215] Figure 21 illustrates an example of generator 900, which is a form of generator 800 (Figure 20). The 900 generator is configured to supply multiple types of energy to a surgical instrument. The 900 generator provides ultrasonic and RF signals to supply energy to a surgical instrument, independently or simultaneously. Ultrasonic and RF signals can be provided alone or in combination and can be provided simultaneously. As indicated above, at least one generator output can provide multiple energy modes (for example, ultrasonic, bipolar or monopolar RF, irreversible and / or reversible electroporation, and / or microwave energy, among others) through a single port, and these signals can be supplied separately or simultaneously to the end actuator to treat tissue.
[0216] [0216] Generator 900 comprises a processor 902 coupled to a waveform generator 904. Processor 902 and waveform generator 904 are configured to generate various signal waveforms based on information stored in a memory. coupled to processor 902, not shown for clarity of disclosure. The digital information associated with a waveform is provided to the waveform generator 904 that includes one or more DAC circuits to convert the digital input into an analog output. The analog output is powered by an amplifier 1106 for signal conditioning and amplification. The amplified conditioned output of the amplifier 906 is coupled to a power transformer 908. The signals are coupled via the power transformer 908 to the secondary side, which is the isolation side of the patient. A first signal of a first energy modality is supplied to the surgical instrument between the terminals identified as ENERGY1 and RETURN. A second signal from a second energy mode is coupled to a 910 capacitor and is supplied to the surgical instrument between the terminals identified as ENERGY2 and RETURN. It will be recognized that more than two types of energy can be issued and, therefore, the subscript "n" can be used to designate that up to n ENERGY terminals can be provided, where n is a positive integer greater than 1. It will also be it is recognized that up to "n" return paths, RETURN can be provided without departing from the scope of the present disclosure.
[0217] [0217] A first voltage detection circuit 912 is coupled to the terminals identified as ENERGY1 and RETURN path to measure the output voltage between them. A second voltage detection circuit 924 is coupled to the terminals identified as
[0218] [0218] In one aspect, impedance can be determined by processor 902 by dividing the output of the first voltage detection circuit 912 coupled to the terminals identified as ENERGY1 / RETURN or the second voltage detection circuit 924 connected to the terminals identified as ENERGY2 / RETURN, by the output of the current detection circuit 914 arranged in series with the RETURN branch on the secondary side of the power transformer.
[0219] [0219] As shown in Figure 21, generator 900 comprising at least one output port can include a power transformer 908 with a single output and multiple taps to provide power in the form of one or more energy modalities such as ultrasonic, bipolar or monopolar RF, irreversible and / or reversible electroporation, and / or microwave energy, among others, for example, to the end actuator depending on the type of tissue treatment being performed. For example, the 900 generator can supply energy with higher voltage and lower current to drive an ultrasonic transducer, with lower voltage and higher current to conduct RF electrodes to seal the tissue or with a coagulation waveform for coagulation point using monopolar or bipolar RF electrosurgical electrodes. The output waveform of the 900 generator can be directed, switched or filtered to supply the frequency to the end actuator of the surgical instrument. The connection of an ultrasonic transducer to the output of generator 900 would preferably be located between the output identified as ENERGY1 and RETURN, as shown in Figure 21. In one example, a connection of bipolar RF electrodes to the generator output 900 would preferably be located between the exit identified as ENERGY2 and the RETURN. In the case of monopolar output, the preferred connections would be an active electrode (for example, light beam or other probe) for the ENERGIA2 output and a suitable return block connected to the RETURN output.
[0220] [0220] Additional details are revealed in US Patent Application Publication 2017/0086914 entitled TECHNIQUES FOR OPE-
[0221] [0221] As used throughout this description, the term "wireless" and its derivatives can be used to describe circuits, devices, systems, methods, techniques, communication channels, etc., which can communicate data through the use of electromagnetic radiation modulated through a non-solid medium. The term does not imply that the associated devices do not contain any wires, although in some respects they may not. The communication module can implement any of a number of wireless and wired communication standards or protocols, including, but not limited to, Wi-Fi
[0222] [0222] As used here, a processor or processing unit is an electronic circuit that performs operations on some external data source, usually memory or some other data flow. The term is used in the present invention to refer to the central processor (central processing unit) in a computer system or systems (specifically systems on a chip (SoCs)) that combine several specialized "processors".
[0223] [0223] As used here, a system on a chip or system on the chip (SoC or SOC) is an integrated circuit (also known as an "IC" or "chip") that integrates all components of a computer or other electronic systems. It can contain digital, analog, mixed and often radio frequency functions - all on a single substrate. A SoC integrates a microcontroller (or microprocessor) with advanced peripherals such as a graphics processing unit (GPU), Wi-Fi module, or coprocessor. A SoC may or may not contain internal memory.
[0224] [0224] As used here, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuits and memory. A microcontroller (or MCU for microcontroller unit)
[0225] [0225] As used here, the term controller or microcontroller can be an independent chip or IC (integrated circuit) device that interfaces with a peripheral device. This can be a connection between two parts of a computer or a controller on an external device that manages the operation of (and connection to) that device.
[0226] [0226] Any of the processors or microcontrollers in the present invention can be any implemented by any single-core or multi-core processor, such as those known under the trade name ARM Cortex by Texas Instruments. In one respect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single cycle flash memory, or other non-volatile memory , up to 40 MHz, a prefetch buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareO program, read-only memory
[0227] [0227] In one aspect, the processor may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the trade name Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[0228] [0228] The modular devices include the modules (as described in connection with Figures 3 and 9, for example) that are receivable within a central surgical controller and the devices or surgical instruments that can be connected to the various modules a in order to connect or pair with the corresponding central surgical controller. Modular devices include, for example, smart surgical instruments, medical imaging devices, suction / irrigation devices, smoke evacuators, power generators, fans, insufflators and displays. The modular devices described here can be controlled by control algorithms. The control algorithms can be executed on the modular device itself, on the central surgical controller with which the specific modular device is paired, or on both the modular device and the central surgical controller (for example, through a computer architecture distributed). In some examples, al-
[0229] [0229] Figure 22 is a block diagram of the interactive surgical system implemented by computer, according to at least one aspect of the present disclosure. In one respect, 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 can be a generic cloud-based medical system. As illustrated in Figure 22, the cloud-based data analysis system comprises a plurality of surgical instruments 7012 (which may be the same or similar to instruments 112), a plurality of central surgical controllers 7006 (which may be the same or similar) to central surgical controllers 106), and a 7001 surgical data network (which can be the same or similar to
[0230] [0230] In addition, surgical instruments 7012 can comprise transceivers for transmitting data to / from their corresponding central surgical controllers 7006 (which can also comprise transceivers). Combinations of surgical instruments 7012 and the corresponding central controllers 7006 can indicate specific locations, such as operating rooms in health care facilities (eg, hospitals), to provide medical operations. For example, the memory of a central surgical controller 7006 can store location data. As shown in Figure 22, cloud 7004 comprises central servers 7013 (which can be the same or similar to remote server 113, 213),
[0231] [0231] Based on connections with several central surgical controllers 7006 over the network 7001, the cloud 7004 can aggregate data from specific data generated by various surgical instruments 7012 and their corresponding central controllers 7006. Such aggregated data can be stored in the aggregated medical data databases 7011 of the cloud 7004. In particular, the cloud 7004 can advantageously perform data analysis and operations on the aggregated data to produce insights and / or perform functions that individual 7006 central controllers could not perform on your own. For this purpose, as shown in Figure 22, cloud 7004 and central surgical controllers 7006 are coupled in communication to transmit and receive information. The I / O interface 7006 is connected to the plurality of central surgical controllers 7006 over the network 7001. In this way, the I / O interface 7006 can be configured to transfer information between the central surgical controllers 7006 and the databases. of aggregated medical data 7011. Consequently, the I / O interface 7006 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 7006 central controllers. These requests can be transmitted to 7006 central controllers via applications for central controllers. The 7006 I / O interface may include one or more high-speed data ports, which may include universal serial bus (USB) ports, IEEE 1394 ports, as well as Wi-Fi and Bluetooth I / O interfaces for connecting to 7004 cloud to 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 7006 central surgical controllers. For example , application servers for central controllers 7002 can manage requests made by applications for central controllers 7006, control access to the aggregated medical data databases 7011 and perform load balancing. The 7034 data analysis modules are described in more detail with reference to Figure 23.
[0232] [0232] The configuration of the particular cloud computing system described in the present disclosure 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 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 physicians can control the interaction aspects between surgical instruments 7012 and the 7004 cloud. Other user interfaces suitable for control as audible alert controlled user interfaces can also be used.
[0233] [0233] Figure 23 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 disclosure. 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 23, the functions of the 7034 cloud-based data analysis modules can be assisted through applications for central controllers 7014 hosted by the application servers for central controllers 7002 that can be accessed on surgical controllers. central 7006. The cloud computing processors 7008 and the applications for central controllers 7014 can operate together to perform the 7034 data analysis modules. The application programming interfaces (API - "Application Programming Interface") 7016 define the set of protocols and routines corresponding to the applications for 7014 central controllers. In addition, APIs 7016 manage the storage and retrieval of data in / from the aggregated medical data databases 7011 for the operations of 7014 applications. 7018 cache memories also store data (for example, temporarily) and are coupled to 7016 APIs for retrieval more efficient use of the data used by the 7014 applications. The data analysis modules 7034 in Figure 23 include modules for resource optimization 7020, data collection and aggregation 7022, authorization and security 7024, update of data programs. control 7026, analysis of patient results 7028, recommendations 7030, and data classification and prioritization 7032. Other suitable data analysis modules could also be implemented by the 7004 cloud, according to some aspects. In one respect, data analysis modules are used for specific recommendations based on analysis of trends, results and other data.
[0234] [0234] For example, the 7022 data collection and aggregation module could be used to generate self-describing data (for example, metadata) including identifying important features or settings (for example, trends), managing data sets redundant, and storage of data in paired data sets that can be grouped by type of surgery, but not necessarily linked to actual dates and surgeons. In particular, the pairing of data sets generated from the operations of 7012 surgical instruments may comprise the application of a binary classification, for example, a bleeding or non-bleeding event. More generally, the binary classification can be characterized as a desirable event (for example, a successful surgical procedure), or an undesirable event (for example, failure or misuse of a 7012 surgical instrument). The aggregated self-describing data may correspond to individual data received from various groups or subgroups of surgical controllers.
[0235] [0235] The resource optimization module 7020 can be configured to analyze this aggregated data to determine an optimal use of resources for a given facility or group of healthcare facilities. For example, the resource optimization module 7020 can determine an ideal replacement point for surgical stapling instruments 7012 for a group of healthcare facilities based on the expected demand corresponding to such instruments 7012. The resource optimization module 7020 could also assess the use of resources or other operational configurations of various health care facilities to determine whether the use of resources could be improved. Similarly, the 7030 recommendation module can be configured to analyze aggregate organized data received 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 service providers, such as hospitals) that a particular 7012 surgical instrument should be upgraded to an enhanced version based on a higher than expected error rate, for example. In addition, the 7030 recommendation module and / or the optimization optimization
[0236] [0236] The 7028 patient results analysis module can analyze surgical results associated with operating parameters using 7012 surgical instruments. The 7028 patient results analysis module can also analyze and evaluate other possible operational parameters. In this context, the 7030 recommendations module could recommend the use of these other possible 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 set of raw data and provide centralized recommendations (advantageously determined based on aggregated data) for multiple service facilities. Cheers. 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 service providers, which providers / medical facilities use similar types of instruments, etc., in such a way that no health care facility would be able to independently perform these tasks on its own. The 7026 control program update module can be configured to implement various 7012 surgical instrument recommendations when the corresponding control programs are updated. For example, the patient outcome analysis module 7028 could identify correlations by associating specific control parameters with successful (or unsuccessful) results. Such correlations can be considered 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 central controller 7006 correspondent can incorporate aggregated performance data that has been collected and analyzed by the 7022 cloud 7004 data collection and aggregation module. In addition, the 7028 patient outcome analysis module and the 7030 recommendations module could identify improved methods of using 7012 instruments based on aggregated performance data.
[0237] [0237] The cloud-based data analysis system can also include safety features implemented by the 7004 cloud. These security features can be managed by the authorization and security module 7024. Each central surgical controller 7006 can have credentials associated exclusives, such as username, password and other appropriate security credentials. These credentials can be stored in memory 7010 and can be associated with an allowed level of cloud access. For example, by providing exact credentials, a central surgical controller 7006 can be granted access authorization to communicate with the cloud to a predetermined degree (for example, if it only involves the transmission or reception of certain types of defined information). From). 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 access level to receive data analysis generated by the 7004 cloud. In addition, for security purposes, the cloud can maintain a database of central controllers 7006, instruments 7012 and other devices that may comprise a "black list" of prohibited devices. In particular, blacklisted central surgical controllers 7006 may not be allowed to interact with the cloud, whereas blacklisted surgical instruments 7012 may not have functional access to a corresponding central controller 7006 and / or may prevented from functioning fully when paired with their corresponding 7006 central controller. Additionally or alternatively, the 7004 cloud can tag instruments 7012 based on incompatibility or other specified criteria. In this way, counterfeit medical devices and the inappropriate reuse of such devices across the cloud-based data analysis system can be identified and verified.
[0238] [0238] Surgical instruments 7012 can use wireless transceivers to transmit wireless signals that can represent, for example, authorization credentials to access the corresponding central controllers 7006 and the cloud 7004. Wireless transceivers can also be used to transmit signals . Such authorization credentials can be stored in the respective memory devices of the surgical instruments 7012. The authorization and security module 7024 can determine whether the authorization credentials are accurate or falsified.
[0239] [0239] The cloud-based data analysis system can allow monitoring of multiple health care facilities (eg medical facilities, such as hospitals) to determine improved practices and recommend changes (via the recommendations module) 2030, for example) appropriately. In this way, the 7008 processors from the 7004 cloud can analyze the data associated with a particular health care facility to identify the facility and aggregate other data associated with other healthcare facilities in a group to the data. Groups can be defined based on similar operating practices or geographic location, for example. In this way, the 7004 cloud can provide analysis and recommendations for the entire group of healthcare facilities. The cloud-based data analysis system can also be used to improve situational recognition. For example, 7008 processors can predictively model the effects of the recommendations on cost and effectiveness for a given facility (in relation to the overall operations of the facility and / or in relation to various 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.
[0240] [0240] The 7032 data classification and prioritization module can prioritize and classify data based on critical importance (for example, the severity of a medical event associated with the data, unpredictability, suspicion). This classification and prioritization can be used in conjunction with the functions of the other 7034 data analysis modules described above to improve the analysis and cloud-based operations described here. For example, the 7032 data classification and prioritization module can assign a priority to data analysis performed by the data collection and aggregation module.
[0241] [0241] Below are additional example details of the various functions described. Each of the various descriptions can use the cloud architecture described in Figures 22 and 23 as an example of implementing hardware and software. Data handling and prioritization
[0242] [0242] Aspects of the present disclosure are presented for a cloud computing system (interactive surgical system implemented by computer as described above) to enable the handling, classification and prioritization of data, which can be applied to data of importance criticism generated during various medical operations. The cloud computing system constitutes a cloud-based data analysis system, coupled in communication with a plurality of 7006 central surgical controllers and intelligent medical instruments such as surgical instruments
[0243] [0243] To help facilitate the improved classification, handling and prioritization of data in a timely manner, it would be desirable if a common source connected to multiple health care facilities could classify, handle and prioritize data holistically of critical importance from such medical facilities. In this way, the common source can generate insights based on the use of these aggregated data received from multiple health service facilities. In many respects, the cloud-based data analysis system comprises the cloud 7004 which is coupled in communication with knowledge centers in a medical facility, such as one or more central surgical controllers 7006, and is configured to classify, handle and prioritize medical data received from multiple health care facilities. In particular, the cloud-based system can identify critical data and respond to such critical data based on the extent of associated critical importance. For example, the cloud-based system could prioritize a response that required urgent action based on critical data indicating a severe failure of a 7012 surgical instrument in the perioperative period, such as one that requires postoperative treatment in an intensive care unit (ICU). The data handling, classification and prioritization functions described here can be performed by the 7008 processors from the 7013 cloud 7004 central servers by, for example, executing one or more data analysis modules
[0244] [0244] Critically important data can thus be determined
[0245] [0245] In general, the cloud-based data analysis system may be able to aggregate, classify, handle and prioritize data
[0246] [0246] Figure 24 is a flow diagram of the interactive surgical system implemented by a computer programmed to use evaluation criteria to determine critical data and to send requests to a central surgical controller for additional data, according to a aspect of the present revelation. In one aspect, when a central controller 7006 receives data from device 11002 from a surgical instrument 7012, the data can be marked and / or determined to be of critical importance based on predetermined evaluation criteria. As shown in Figure 24, central controller 7006 applies 11004 the evaluation criteria to mark devices and to identify critical data. The evaluation criteria include severity, unpredictability, suspicion and security. Severity can refer to the severity of any adverse consequences resulting from a medical operation performed using the 7012 surgical instrument. Severity could be assessed using a 7012 surgical instrument failure severity limit. For example, the severity limit can be a time limit or blood loss rate, such as more than 1.0 milliliters per minute (ml / minute). Other suitable severity limits could be used. Unpredictability can refer to a medical parameter of a deviation that exceeds a limit, such as an amount of standard deviation from the average value of the medical parameter, such as a certain tissue compression parameter that significantly exceeds the expected average value in a given time during an operation.
[0247] [0247] Suspicion may refer to data that appears to have been mishandled or tampered with. For example, the value of the "total therapeutic energy applied to the tissue" indicated by the data may be impossible due to the total amount of energy applied through the generator of the surgical instrument 7012. In this situation, the impossibility of the data suggests an improper manipulation or a violation. Similarly, security can refer to improperly protected data, such as data including a "force to close" parameter that has been accidentally deleted. The evaluation criteria
[0248] [0248] The determination of critical data and marking of the surgical instrument 7012 by the central controller 7006 may include determining a location for storing data. The data can be routed or stored based on the determination that the data is of critical importance and the corresponding 7012 surgical instrument is marked. For example, binary criteria can be used to classify data in two storage locations, that is, a memory from a central surgical controller 7006 or memory 7010 from the cloud 7004. Surgical instruments 7012 generate medical data and transmit that data, which are denoted as device data 11002 in Figure 24, for their corresponding central surgical devices 7006. Figure 24 illustrates an example of this binary classification process. Specifically, in an
[0249] [0249] If the determination in step 11006 is "No", then the flowchart proceeds to step 11008 in Figure 24, where central surgical controller 7006 determines whether the patient has been transferred to a post-care unit -operative (ICU) non-standard for treatment after operation with the specific surgical instrument 7012. However, even if the determination in step 11006 is "No", the verification in step 11008 can still be performed. If the determination in step 11008 is "Yes", then the critical device data 11002 is transmitted to cloud 7004. For example, the determination in step 11008 will be "Yes" if a patient was transferred from the room of operation for the ICU after a routine bariatric surgical procedure. After transferring a patient to the ICU, the 7006 central surgical controller can receive a signal from the 7012 surgical instrument used to perform the procedure.
[0250] [0250] In addition or alternatively, the specific surgical instrument 7012 can also be marked by the central controller 7006 or the cloud 7004 to trigger data handling by the cloud 7004, which can comprise an internal response from the cloud 7004. When the instrument surgical 7012 is marked or device data 11002 is determined to be of critical importance, the triggered response may be the transmission by the 7004 cloud of a signal comprising a request for additional data relating to surgical instrument 7012. Additional data may be related to the 11002 critical device data. The 7004 cloud can also request additional data even if the specific surgical instrument 7012 is not marked, as in the case where the 11002 device data is determined to be of critical importance without the surgical instrument 7012 is marked. The marking could also indicate an alarm or an alert associated with surgical instrument 7012. In general, the central controller 7006 is configured to perform a determination logic to determine whether data
[0251] [0251] Sending a 11014 request for additional data via the 7004 cloud to the central controller 7006 can be done based on a set of queries, as shown in Figure 24. This triggered request 11014 can be a "push" request sent by central servers 7013 in the cloud 7004. In particular, processors 7008 can run the data collection and aggregation module 7022 to implement this trigger condition functionality. This push request can comprise an update request sent by the 7004 cloud to the central controller 7006 to collect new data associated with device data 11002 indefinitely. That is, the central controller 7006 can collect additional data until the cloud 7004 transmits another message terminating the update request. The "push" request could also be a conditional update request. Specifically, the "push" request could comprise initiating an instruction for the central controller 7006 to send additional information only if certain conditions or events occur. For example, a condition could be "if the sealing temperature used by surgical instrument 7012 to treat tissue exceeds a predetermined limit". The "push" request could also have a time-out component. In other words, the "push" request can cause the central surgical controller 7006 to obtain additional data over a predetermined period of time, such as three months. The time period could be based on an estimated remaining service life of the surgical instrument 7012, for example. As discussed above, request 11014 for additional data may occur after the specific surgical instrument 7012 is marked, which may be due to a positive determination in steps 11006, 11008 described above.
[0252] [0252] As shown in Figure 24, the request triggered by 11014 for additional data can include four inquiries that can be considered triggering conditions for additional information. In the first query, the central controller 7006 determines 11016 whether device data 11002 represents an out-of-range value without a known cause. For example, the application of therapeutic energy to the tissue during a surgical procedure by the surgical instrument 7012 can cause bleeding in the patient even though the surgical parameters appear to be within a normal range (for example, the temperature and pressure values are within the expected range ). In this situation, critical device data 11002 indicates an irregularity for no known reason. The determination of the value outside the limits 11016 can be done based on the comparison of the device data 11002 with an expected value, or based on an adequate methodology of statistical process control. For example, it can be determined that an actual value of device data 11002 is an out-of-range value based on a comparison of the actual value with a median value.
[0253] [0253] The second query is another example of a trigger condition. In step 11018, central controller 7006 determines 11018 whether device data 11002 involves data that can be classified as suspect, which can be implemented by the authorization and security module 7024. For example, suspicious data can include situations in which unauthorized manipulation is detected. Such situations include cases in which the data appears to be significantly different than expected to suggest unauthorized use or violation, the data or serial numbers appear to be modified, the safety of the surgical instruments 7012 or the controller corresponding central 7006 appears to be compromised. Significantly different data may refer, for example, to an unexpected general surgical outcome, such as a surgical procedure being successful despite the time of using the 7012 surgical instrument being significantly shorter than expected, or an unexpected surgical parameter as a power level applied to the tissue is significantly higher than what would be expected for the tissue (for example, calculated based on a tissue impedance property). Significant data discrepancies may indicate data or serial number changes. In one example, a 7012 stapling surgical instrument can generate a unique distinct staple pattern in a given surgical operation that can be used to track or verify the serial number of the 7012 stapling surgical instrument in question. was subsequently modified. In addition, the modification of data or serial number, as in a violation, can be detected by means of other associated information from a 7012 surgical instrument that can be independently verified with the aggregated medical data databases 7011 or some other suitable data modification detection technique.
[0254] [0254] Additionally, compromised security, such as unauthorized or irregular access to any central surgical controller 7006 or other protected data sets stored in the 7004 cloud, can be detected by a cloud-based security and authentication system. which incorporates the 7024 authorization and security module. The security and authentication system can be a cloud-based intrusion detection system (SDI) suitable for detecting compromised security or integrity.
[0255] [0255] The third and fourth questions represent additional triggering conditions. In step 11020, central controller 7006 can determine that device data 11002 indicates a unique identifier for surgical instrument 7012 that corresponds to an identifier kept on a watch list (for example, a "black list" of devices prohibited). As described above, the "black list" is a watch list that can be maintained as a set of database records comprising identifiers that correspond to prohibited 7006 central surgical controllers, 7012 surgical instruments, and other medical devices. The blacklist can be implemented by the authorization and security module 7024. In addition, the blacklisted 7012 surgical instruments may be prevented from functioning fully or may be restricted from access with 7006 central surgical controllers. For example, an electrosurgical instrument 7012 can be prevented from operating (ie, an operational crash) via the 7004 cloud or the central surgical controller 7006 can be prevented from transmitting a signal to the central controller 7006 or the surgical instrument 7012 to prevent the generator from providing power to the electrosurgical instrument
[0256] [0256] The use of counterfeit authentication codes can be a security breach that is detectable by the cloud-based SDI system. The resale of 7012 surgical instruments to other regions could be detected using region-specific indicators for 7012 surgical instruments or 7006 central surgical controllers resold, for example. The region-specific indicator could be encrypted using an appropriate encryption technique. Thus, the 7004 cloud could detect when the region-specific indicators of a resold 7012 surgical instrument do not correspond to the region of intended use. The reuse of a 7012 surgical instrument designed for a single use can be monitored by detecting tampering with a locking mechanism (for example, a staple cartridge locking mechanism for a stapling surgical instrument) , programming a microprocessor for the single-use surgical instrument 7012 to transmit an alarm signal to the corresponding central surgical controller 7006 when more than one use occurs, or another suitable detection technique. The deviation in performance can be monitored with the use of statistical process control methods, as described above. The design specifications of specific 7012 surgical instruments can be considered as the control limits of a
[0257] [0257] The trigger condition in step 11022 comprises the determination by central controller 70006 of the possibility that device data 11002 indicates that surgical instrument 7012 has failed. In one aspect, a failure of a 7012 surgical instrument results in an automatic product inquiry via the corresponding central surgical controller 7006. The central controller 7006 which sends 11024 additional data to the cloud 7004 may include the immediate transmission of all relevant data from the surgical instrument 7012 to the cloud via the central surgical controller 7006, which can result in execution, by the 7008 processors of the 7013 central server of the 7004 cloud, from an automatic product inquiry algorithm. However, such an algorithm may not be executed immediately, or at all, if the failure is not significant. The 7004 cloud can be configured to record this pertinent data set for all 7012 surgical instruments for use when such automatic product inquiries are instituted. The automatic product inquiry algorithm comprises the search, by the 7004 cloud, for previous incidents that are related to the failure. The 7004 cloud can populate a group of records in the aggregated medical data databases 7011 with any incidents or activities related to the failure. Subsequently, a corrective and preventive action (CAPA) portion of the algorithm can be instituted to reduce or eliminate such failures or nonconformities. The CAPA portion and the automatic product inquiry algorithm are an example of a possible internal response 11102 from cloud 7004 of the cloud-based data analysis system.
[0258] [0258] The function of the CAPA portion involves investigating, recording and analyzing the cause of a failure or non-compliance. To implement the CAPA portion, the cloud 7004 can analyze the related records filled in the aggregated medical data databases 7011, which can include aggregated data fields, such as date of manufacture of the surgical instrument 7012, times of use, state parameters initial / final and number of uses of the surgical instrument
[0259] [0259] For example, cloud 7004 can determine a watch list priority status for surgical instrument 7012 so that surgical instrument 7012 can be monitored for a period of time after the failure is detected and repaired. In addition, the failure can cause the 7004 cloud to expand a list of medical items to be tracked (for example, the integrity of tissue seals made during surgery). This list of items to be tracked can be done in conjunction with the patient results monitoring by the patient results analysis module 7028. The 7004 cloud can also respond to an irregularity indicated by the failure by monitoring the corresponding patient results such irregularity. For example, cloud 7004 can monitor whether irregularity corresponds to unsuccessful surgical operations during a predetermined period of time, such as 30 days. Any corrective action can also be evaluated by the 7004 cloud. Other data fields can also be monitored in addition to the fields discussed above. In this way, the cloud can quickly diagnose and respond to failures of the surgical instrument 7012 with the use of individual and aggregate data in a way that a healthcare facility could not do alone.
[0260] [0260] In one aspect, if the response to any of the steps 11016, 11018, 11020, 11022 (ie the trigger conditions) is affirmative (ie, the trigger condition is activated), then additional associated or pertinent data device data 11002 is sent to the 7004 cloud, as shown in Figure 24. This additional data can be handled by the 7032 data classification and prioritization module, while the 7028 patient outcome analysis module can analyze the data, for example.
[0261] [0261] The critical importance of the data can be identified based on the evaluation criteria as described above, or by any other appropriate data analysis technique. In one aspect, as shown in Figure 25, when critical data is determined, an internal analytical response 11102 from cloud 7004 can be initiated. The internal analytical response 11102 can advantageously be done in a timely manner, such as in real time or almost in real time. As discussed above, the critical importance of the data can be identified based on the severity of an event, the unexpected nature of the data, the suspicion of the data, or some other evaluation criteria (for example, an internal business brand) . The determination of critical data may involve a request generated by a central surgical controller 7006 based on the detection by the central surgical controller 7006 of an irregularity or failure of a corresponding 7012 surgical instrument or a component of the central surgical controller 7006 itself At the request of the central surgical controller 7006, it can comprise a request for specific prioritization or special treatment of critical data by the cloud 7004. In several aspects, the internal analytical response 11102 of the cloud could increase the priority an alarm or response based on the frequency of the event associated with the 11002 critical device data, route the 11002 device data to different locations in the cloud computing system, or delete the 11002 device data from the data databases aggregate doctors 7011. In addition, the 7004 cloud could also automatically change a defective 7012 surgical instrument parameter so that modifications to repair the failure can be implemented in real time or near real time. In this way, even failures that are not readily detected by a doctor in a health care facility, for example, can still be advantageously addressed quickly by the 7004 cloud.
[0262] [0262] Figure 25 is a flow diagram of an aspect of the response to critical data by the interactive surgical system implemented by computer, according to an aspect of the present disclosure. In particular, the internal analytical response 11102 given by cloud 7004 may include handling critical data, which includes determining a priority state to define a time component or prioritizing the response. The answer 11102 itself can be based on an operational characteristic indicated by the data of critical importance, such as the characteristics described above in connection with the evaluation criteria or the activation conditions shown in Figure 24. The internal response 11102 can be implemented by the classification and prioritization of data 7032 as well as by the data collection and aggregation module 7022. As shown in Figure 25, in the flow diagram prioritization branch (identified as Q1 in Figure 25) the cloud can incorporate the binary decision to exclude or not the critical data from the aggregated 7011 medical data databases with an increased priority decision structure. In step 11104 of Figure 25, cloud 7004 determines whether critical data should be excluded from aggregated medical data databases 7011. Determination of exclusion can be considered a limit determination.
[0263] [0263] It may be desirable to exclude critical data from aggregated medical data databases 7011 for verification purposes. For example, critical data that is marked or assigned for special routing can be included in a waiting list maintained by the 7004 cloud. The waiting list is kept in a separate storage location in memory 7010 in relation to aggregated medical data databases 7011 within the 7004 cloud, as well as cache memories 7018. Excluded critical data could also be stored in a more permanent storage location in memory 7010. Consequently, if the response to step 11104 is "Yes", cloud 7004 stores 11118 critical data on the waiting list. The 7004 cloud can then validate or verify that the 11002 critical device data is accurate. For example, cloud 7004 can analyze whether device data 11002 is logical in light of a corresponding patient result or analyze additional associated data from device data
[0264] [0264] However, if device data 11002 is verified
[0265] [0265] The third most urgent priority state is notification, which is designated at level C of priority status classification 11106. In this situation, depending on the nature of device data 11002, cloud 7004 transmits a signal wireless for an employee, doctor, administrative department, or other responsible area of the healthcare facility. The notification signal can be received at a receiving device located in a suitable location within the health care facility, for example. The receipt of the notification signal can be indicated by a vibration or a sound to notify the responsible area in the health care facility. The person responsible for the receiving device (for example, a doctor at the health care facility) can then conduct additional analysis of critical data from device 11002 or additional data, or other analysis, to repair an indicated irregularity. If a solution to the irregularity is known, it can be implemented in a timely manner. The most urgent priority state, as represented in the 11106 priority status classification, is the required urgent action, which is designated as level D. The required urgent action indicates that a responsible area, device or instrument must immediately analyze and diagnose the problem implied by critical data. Once the proper diagnosis is made, an appropriate response must be generated immediately. In this way, the 7004 cloud can implement a comprehensive approach to prioritizing and sorting critical data in a way that no medical facility could manage on its own. Critically important data can be handled quickly, according to the appropriate priority levels, capable of solving time-sensitive problems that may arise in the health field. In addition, the 7004 cloud can prioritize the aggregated critical importance data received from all health service facilities categorized in a given region. Consequently, the prioritized approach sensitive to the time factor of handling critical data can be applied throughout the system, such as to a group of healthcare facilities. In addition, the 7004 cloud can generate an alert for a responsible area to respond to critical data (and associated problems implied by such critical data) in a timely manner as in real time or near real time according to corresponding priority state. This indication can be received by an appropriate receiver in the responsible area. The priority status of device data 11002 could also be determined based on the severity of the surgical problem implied by device data 11002. As discussed above, cloud 7004 can receive additional data from central surgical controllers 7006 or surgical instruments 7012 ( through central controllers 7006), which causes the cloud 7004 to raise the priority status of device data 11002.
[0266] [0266] In one aspect, based on a priority state, device data 11002 may be subject to mark evaluation at a specific time depending on the priority.
[0267] [0267] An increase in the number of times that this insufficient sealing temperature occurs can be monitored to increase the priority state in step 11116, based on frequency limits (see step 11112), for example. If in step 11110, the event is not increasing in frequency, the data can be stored 11118 in the waiting list. If the answer in step 11110 is "Yes" (ie, the event is increasing in frequency), the flow diagram proceeds to step 11112. In step 11112, another data verification query is made. In particular, specific limits such as the frequency limits described above can be applied to determine whether the combination of device data 11002 or additional data is sufficiently correct to ensure that critical data should be added to the databases. aggregated medical data data 7011. In addition, the data verification query in step 11112 may comprise a decision as to whether the sample size of critical data is sufficiently large (that is, whether critical mass has been reached). Additionally or alternatively, the sample size is analyzed to see if there is enough information to determine an adequate internal response 11102 from the cloud 7004. The data verification query may also comprise verifying the accuracy of the data by comparing it with predetermined standards or verification tests. If the answer to the question in step 11112 is negative, then the critical data is stored in a separate storage location (for example, the waiting list) in the cloud
[0268] [0268] In addition to prioritizing critical data, internal response 11102 from cloud 7004 can advantageously also include the routing, grouping or classification of critical data or critical data aggregated in a timely manner. In particular, data can be routed to different storage locations within the 7004 cloud, as in memory devices 7010. This is illustrated by the routing branch of the flow diagram identified as Q2 in Figure 25 in step 11120. In this way, the memory devices 7010 of the central servers 7013 of the number 7004 can be organized in several locations that correspond to a characteristic of the critical data or to an answer corresponding to the critical data. For example,
[0269] [0269] In step 11124, alternate routing 11120 can comprise routing for device data 11002 or additional data that requires a fast internal response 11102 from the cloud
[0270] [0270] Figure 26 is a flow diagram of an aspect of the class.
[0271] [0271] Figure 26 also shows that critical data associated with a second medical event 11204 is detected by the central surgical controller 7006 and transmitted to the cloud
[0272] [0272] As shown in Figure 26, critical data associated with a third medical event 11206 is detected by the central surgical controller 7006 and transmitted to the cloud
[0273] [0273] In general, the cloud-based data analysis system described here can determine critical data and perform data handling, classification and prioritization in a timely manner based on priority status and specific limits, as described above. As a result, the cloud-based data analysis system advantageously handles critical data quickly, systematically and holistically across multiple health care facilities. Handling critical data involves internal responses from the 7004 cloud based on the assigned priority levels. In addition, based on requests made by central surgical controllers 7006, special data routing on memory device 7010 from the cloud 7004 can be achieved. Redirection, prioritization, confirmation or request
[0274] [0274] Situational recognition is the ability of some aspects of a surgical system to determine or infer information related to a surgical procedure from data received from databases and / or instruments. The information may include the type of procedure being performed, the type of tissue being operated on, or the body cavity that is the object of the procedure. With contextual information related to the surgical procedure, the surgical system can, for example, improve the way in which it controls the modular devices (for example, a robotic arm and / or robotic surgical tool) that are connected to it and provide contextualized information or suggestions to the surgeon during the course of the surgical procedure. Situational recognition can be applied to perform and / or improve any of the functions described in Figures 22 to 26, for example.
[0275] [0275] Now with reference to Figure 27, a 5200 timeline is shown representing the situational recognition of a central controller, such as central surgical controller 106 or 206, for example. Timeline 5200 is an illustrative surgical procedure and the contextual information that the central surgical controller 106, 206 can derive from data received from data sources at each stage of the surgical procedure. Timeline 5200 represents typical steps that would be taken by nurses, surgeons, and other medical personnel during the course of a pulmonary segmentectomy procedure, starting with the setup of the operating room and ending with the transfer of the patient to a post-op recovery room.
[0276] [0276] The situational recognition system 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 medical personnel use a modular device that is paired with the center central surgical 106, 206. Central surgical controller 106, 206 can receive this data from paired modular devices and other data sources and continuously derive inferences (that is, contextual information) about the procedure in question. course as new data are received, such as which step of the procedure is being performed at any given time. The situational recognition system of the central surgical controller 106, 206 is, for example, able to record data referring to the procedure to generate reports, verify the steps being taken by medical personnel, provide data or warnings (for example , via a display screen) that may be relevant for the specific step of the procedure, adjust the modular devices based on the context (for example, activate monitors, adjust the field of view (FOV) of the medical imaging device, or change the energy level of an ultrasonic surgical instrument or RF electrosurgical instrument), and take any other action described above.
[0277] [0277] As the first step 5202 in this illustrative procedure, members of the hospital team obtain the patient's electronic medical record (RME) from the hospital's RME database. Based on the patient selection data in the RME, the central surgical controller 106, 206 determines that the procedure to be performed is a thoracic procedure.
[0278] [0278] In the second step 5204, the team members scan the incoming medical supplies for the procedure. The central surgical controller 106, 206 cross-references scanned supplies with a list of supplies that are used in various types of procedures and confirms that the supply mix corresponds to a thoracic procedure. In addition, the central surgical controller 106, 206 is also able to determine that the procedure is not a wedge resection procedure (because the inlet supplies have an absence of certain supplies that are necessary for a thoracic wedge resection procedure. or, otherwise, that the inlet supplies do not correspond to a thoracic wedge resection procedure).
[0279] [0279] In the third step 5206, medical personnel scan the patient's band with a scanner that is communicably connected to the central surgical controller 106, 206. The central surgical controller 106, 206 can then confirm the patient's identity with based on the scanned data.
[0280] [0280] In the fourth step 5208, the medical staff connects the auxiliary equipment. The auxiliary equipment being used may vary according to the type of surgical procedure and the techniques to be used by the surgeon, but in this illustrative case they include a smoke evacuator, an insufflator and a medical imaging device. When activated, auxiliary equipment that is a modular device can automatically pair with the central surgical controller 106, 206 which is located in a specific neighborhood of the modular devices as part of its initialization process. The central surgical controller 106, 206 can then derive contextual information about the surgical procedure by detecting the types of modular devices 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 procedure (video-assisted thoracic surgery) based on this specific combination of paired modular devices. Based on the combination of the patient's electronic medical record (RME) data, 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 In general, infer the specific procedure that the surgical team will perform. After the central surgical controller 106, 206 recognizes which specific procedure is being performed, the central surgical controller 106, 206 can then retrieve the steps of that process from a memory or from the cloud and then cross the data it subsequently receives from the connected data sources (for example, modular devices and patient monitoring devices) to infer which stage of the surgical procedure the surgical team is performing.
[0281] [0281] 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 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.
[0282] [0282] In the sixth step 5212, medical personnel induced anesthesia in the patient. Central surgical controller 106, 206 can infer that the patient is under anesthesia based on data from modular devices and / or from patient monitoring devices, including ECG data, blood pressure (PS) data, patient data ventilator, or combinations thereof, for example. After the completion of the sixth step 5212, the preoperative portion of the lung segmentectomy procedure is completed and the operative portion begins.
[0283] [0283] In the seventh step 5214, the lung of the patient who is being operated on is retracted (while ventilation is switched to the lung)
[0284] [0284] In the eighth step 5216, the medical imaging device (for example, a visualization device) is inserted and the video from the medical imaging device is started. Central surgical controller 106, 206 receives data from the medical imaging device (i.e., video or image data) through its connection to the medical imaging device. Upon receiving data from the medical imaging device, the central surgical controller 106, 206 can determine that the portion of the laparoscopic surgical procedure has started. In addition, the central surgical controller 106, 206 can determine that the specific procedure being performed is a segmentectomy, rather than a lobectomy (note that a wedge resection procedure has already been discarded by the central surgical controller 106, 206 based on data received in the second step 5204 of the procedure). The medical imaging device data 124 (Figure 2) can be used to determine contextual information about the type of procedure being performed in a number of different ways, including by determining the angle at which the medical imaging device is. oriented towards visualizing the patient's anatomy, monitor the number or medical imaging devices being used (ie, which are activated and paired with the operating room 106, 206), and monitor the types of visualization devices used.
[0285] [0285] In the ninth step 5218 of the procedure, the surgical team starts the dissection step. Central surgical controller 106, 206 can infer that the surgeon is in the process of dissecting to mobilize the patient's lung because he receives data from the RF or ultrasonic generator that indicate that an energy instrument is being triggered. 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 is being fired at that point in the process (that is, after completion of the steps previously discussed in the procedure) corresponds to the dissection step. In certain cases, the energy instrument can be a power tool mounted on a robotic arm of a robotic surgical system.
[0286] [0286] In the tenth step 5220 of the procedure, the surgical team proceeds to the connection step. The central surgical controller 106, 206 can infer that the surgeon is ligating the arteries and veins because he receives data from the stapling and surgical cutting instrument indicating that the instrument is being fired. Similar to the previous step, the central surgical controller 106, 206 can derive this inference by crossing the reception data of the stapling and surgical cutting instrument with the steps recovered in the process. In certain cases, the surgical instrument can be a surgical tool mounted on a robotic arm of a robotic surgical system.
[0287] [0287] In the eleventh step 5222, the segmentectomy portion of the procedure is performed. Central surgical controller 106, 206 can infer that the surgeon is transecting the parenchyma based on data from the surgical stapling and cutting instrument, including data from its cartridge. The cartridge data can correspond to the size or type of clamp being triggered by the instrument, for example. As different types of staples are used for different types of fabrics, the cartridge data can thus indicate the type of fabric being stapled and / or transected. In this case, the type of clamp that is fired is used for the parenchyma (or other similar types of tissue), which allows the central surgical controller 106, 206 to infer which segment of the procedure is being performed.
[0288] [0288] In the twelfth step 5224, the node dissection step is then performed. The central surgical controller 106, 206 can infer that the surgical team is dissecting the node and performing a leak test based on the data received from the generator that indicates which ultrasonic or RF instrument is being fired. For this specific procedure, an RF or ultrasonic instrument being used after the parenchyma has been transected corresponds to the node dissection step, which allows the central surgical controller 106, 206 to make this inference. It should be noted that surgeons regularly alternate between surgical stapling / cutting instruments and surgical energy instruments (ie, RF or ultrasonic) depending on the specific step in the procedure because different instruments are better adapted for specific tasks. - specific. Therefore, the specific sequence in which the cutting / stapling instruments and surgical energy instruments are used can indicate which stage of the procedure the surgeon is performing. In addition, in certain cases, robotic tools can be used for one or more steps in a surgical procedure and / or hand-held surgical instruments can be used for one or more steps in the surgical procedure. The surgeon can switch between robotic tools and hand-held surgical instruments and / or can use the devices simultaneously, for example. After the completion of the twelfth stage 5224, the incisions are closed and the post-operative portion of the process begins.
[0289] [0289] In the thirteenth stage 5226, the patient's anesthesia is reversed. The central surgical controller 106, 206 can infer that the patient is emerging from anesthesia based on ventilator data (that is, the patient's respiratory rate begins to increase), for example.
[0290] [0290] Finally, in the fourteenth step 5228 is that medical personnel remove the various patient monitoring devices from the patient. Central surgical controller 106, 206 can therefore infer that the patient is being transferred to a recovery room when the central controller loses ECG, blood pressure and other data from patient monitoring devices. As can be seen from the description of this illustrative procedure, the central surgical controller 106, 206 can determine or infer when each step of a given surgical procedure is taking place according to the data received from the various data sources that are communicably coupled to the central surgical controller 106, 206.
[0291] [0291] Situational recognition is further described in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, which is hereby incorporated by reference in its entirety . In certain cases, the operation of a robotic surgical system, including the various robotic surgical systems disclosed here, for example, can be controlled by the central controller 106, 206 based on its situational recognition and / or the feedback provided by its components and / or based on information from the cloud 102.
[0292] [0292] Several aspects of the subject described here are defined in the following numbered examples:
[0293] [0293] Example 1. A cloud-based medical data analysis system comprising: at least one processor; at least one memory coupled in communication with at least one processor; an input / output interface configured to access data from a plurality of central surgical controllers, each of which is among the plurality of central surgical controllers coupled in communication with at least one surgical instrument and at least one processor; and a database that resides in at least one memory and is configured to store the data; and since at least one memory is configured to store instructions executable by at least one processor to: receive data of critical importance from the plurality of central surgical controllers, with the plurality of central surgical controllers determining data of critical importance based on evaluation criteria; determining a priority status of critical data; route critical data to a cloud storage location that resides in at least one memory; and determining a response to critical data based on an operational characteristic indicated by critical data, with a response time component determined based on the priority status.
[0294] [0294] Example 2. The cloud-based medical data analysis system of Example 1, where the assessment criteria comprise one or more of: severity, unpredictability, suspicion and security.
[0295] [0295] Example 3. The cloud-based medical data analysis system of any of Examples 1 and 2, where the severity assessment criteria comprise an extension of a perioperative device failure and a transition to post-operative treatment - a non-standard patient.
[0296] [0296] Example 4. The cloud-based medical data analysis system of any of Examples 1 to 3, in which at least one memory is additionally configured to store executable instructions from at least one processor to request plura - quality of central surgical controllers additional data relating to critical data.
[0297] [0297] Example 5. The cloud-based medical data analysis system of Example 4, in which at least one memory is additionally configured to store executable instructions from at least one processor to request additional data based on a plurality activation conditions.
[0298] [0298] Example 6. The cloud-based medical data analysis system of Example 5, in which the plurality of activation conditions comprises one or more of: exceeding a predetermined limit of unpredictability, unauthorized modification of data of critical importance, unsecured data communication, inclusion of at least one surgical instrument on a watch list.
[0299] [0299] Example 7. The cloud-based medical data analysis system of any of Examples 1 to 6, in which critical data comprises aggregated data received from the plurality of central surgical controllers.
[0300] [0300] Example 8. The cloud-based medical data analysis system of any of Examples 1 to 7, in which at least one processor transmits critical data to the database.
[0301] [0301] Example 9. A non-transitory, computer-readable medium that stores computer-readable instructions executable by at least one processor in a cloud-based data analysis system to: receive critical data from a plurality of central surgical controllers, with the plurality of central surgical controllers determining critical importance data based on evaluation criteria and each of the plurality of central surgical controllers is coupled in communication with at least one instrument surgical and at least one processor; determining a priority status of critical data; route critical data to a cloud storage location that resides on at least one memory attached to at least one processor; and determining a response to critical data based on an operational characteristic indicated by critical data, with a response time component determined based on the priority status.
[0302] [0302] Example 10. The computer-readable non-transitory media of Example 9, in which the priority status is determined by at least one processor based on one or more of the following conditions: the data of critical importance corresponds to the at least one surgical instrument included on a watch list; critical data correspond to an automatic response; critical data corresponds to a notification response; critical data correspond to an urgent response.
[0303] [0303] Example 11. The computer-readable non-transitory media of Example 10, in which at least one surgical instrument is included in the watch list based on one or more of: counterfeit products, deviation in the performance of the surgical instrument and unauthorized use.
[0304] [0304] Example 12. Computer readable non-transitory media, according to any of Examples 10 and 11, where the automatic response comprises corrective and preventive action.
[0305] [0305] Example 13. Computer readable non-transitory media, according to any of Examples 1 to 9, in which at least one processor stores critical data in a waiting list in at least one memory and validates the accuracy of critical data.
[0306] [0306] Example 14. A medical cloud-based data analysis system comprising: at least one processor; at least one memory coupled in communication with at least one processor; an input / output interface configured to access data from a plurality of central surgical controllers, each of which is among the plurality of central surgical controllers coupled in communication with at least one surgical instrument and at least one processor; and a database that resides in at least one memory and is configured to store the data; and since at least one memory is configured to store instructions executable by at least one processor to: receive data of critical importance from the plurality of central surgical controllers, with the plurality of central surgical controllers determining data of critical importance based on evaluation criteria; determining a priority status of critical data; route critical data to a cloud storage location that resides in at least one memory; request from the plurality of central surgical controllers additional data related to critical data based on a plurality of activation conditions; determine the cause of an irregularity corresponding to critical data and additional data; and determining a response to the irregularity, with a time component of the response being determined based on the priority status.
[0307] [0307] Example 15. The cloud-based medical data analysis system of Example 14, in which at least one processor responds to the irregularity by transmitting a signal to at least one surgical instrument corresponding to the irregularity, being that the signal causes an operational lock-up of at least one surgical instrument.
[0308] [0308] Example 16. The cloud-based medical data analysis system of any of Examples 14 and 15, where at least one processor requests the plurality of surgical controllers
[0309] [0309] Example 17. The cloud-based medical data analysis system of Example 16, in which at least one processor requests the plurality of central surgical controllers for additional data during the predetermined interval of time based on a occurrence of a predetermined medical event.
[0310] [0310] Example 18. The cloud-based medical data analysis system of any of Examples 14 to 17, in which at least one processor responds to the irregularity by monitoring patient results that match the irregularity - of during a predetermined interval of time.
[0311] [0311] Example 19. The cloud-based medical data analysis system of any of Examples 14 to 18, in which at least one processor responds to the error by transmitting a signal to the plurality of controllers central surgical procedures corresponding to the irregularity to indicate corrective action.
[0312] [0312] Example 20. The cloud-based medical data analysis system of any of Examples 14 to 19, in which at least one processor transmits critical data to the database for aggregation of data from critical importance, and critical data are classified as corresponding to a positive patient result or a negative patient result.
[0313] [0313] Although several forms have been illustrated and described, it is not the applicant's intention to restrict or limit the scope of the claims attached to such detail. Numerous modifications, variations, alterations, substitutions, combinations and equivalents of these forms can be implemented and will occur to those skilled in the art without departing from the scope of the present disclosure. In addition, the
[0314] [0314] The previous detailed description presented various forms of devices and / or processes through the use of block diagrams, flowcharts and / or examples. Although these block diagrams, flowcharts and / or examples contain one or more functions and / or operations, it will be understood by those skilled in the art that each function and / or operation within these block diagrams, flowcharts and / or examples can be implemented , individually and / or collectively, through a wide range of hardware, software, firmware or almost any combination thereof. Those skilled in the art will recognize, however, that some aspects of the aspects disclosed here, in whole or in part, can be implemented in an equivalent way in integrated circuits, such as one or more computer programs running on one or more computers (for example , such as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (for example, as one or more programs running on one or more microprocessors), as firmware, or virtually like any combination thereof, and that designing the set of circuits and / or writing the code for the software and firmware would be within the scope of practice of those skilled in the art, in light of this disclosure.
[0315] [0315] The instructions used to program the logic to execute various revealed aspects can be stored in a memory in the system, such as dynamic random access memory (DRAM), cache, flash memory or other storage. In addition, instructions can be distributed over a network or through other computer-readable media. In this way, machine-readable media can include any mechanism to store or transmit information in a machine-readable form (for example, a computer), but is not limited to, floppy disks, optical discs, memory-only compact discs. read (CD-ROMs), and optical-dynamos discs, read-only memory (ROM), random access memory (RAM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM) , magnetic or optical cards, flash memory, or a machine-readable tangible storage medium used to transmit information over the Internet via an electrical, optical, acoustic cable or other forms of propagated signals (for example , carrier waves, infrared signal, digital signals, etc.). Consequently, the computer-readable non-transitory media includes any type of machine-readable media suitable for storing or transmitting instructions or electronic information in a machine-readable form (for example, a computer).
[0316] [0316] As used in any aspect of the present invention, the term "control circuit" can refer to, for example, a set of wired circuits, programmable circuits (for example, a computer processor comprising one or more individual instruction processing cores, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (PSD), programmable logic device (PLD), programmable logic matrix (PLA), or field programmable port arrangement (FPGA)), state machine circuits, hardware that stores instructions executed by the programmable circuit, and any combination thereof.
[0317] [0317] 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 the computer-readable non-transitory storage media. The firmware can be incorporated as code, instructions or instruction sets and / or data that are hard-coded (for example, non-volatile) in memory devices.
[0318] [0318] As used in any aspect of the present invention, the terms "component", "system", "module" and the like may refer to a computer-related entity, be it hardware, a combination of hardware and software, software or software running.
[0319] [0319] As used here in one aspect of the present invention, an "algorithm" refers to the self-consistent sequence of steps that lead to the desired result, where a "step" refers to the manipulation of physical quantities and / or logical states that they may, although not necessarily need, take the form of electrical or magnetic signals that can be stored, transferred, combined, compared and manipulated in any other way. It is common use to call these signs bits, values, elements, symbols, characters, terms, numbers or the like. These terms and similar terms may be associated with the appropriate physical quantities and are merely convenient identifications applied to these quantities and / or states.
[0320] [0320] 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.
[0321] [0321] Unless otherwise stated, and as made evident by the aforementioned disclosure, it should be understood that, throughout said disclosure, discussions that use terms such as "processing", or "computation", or "calculation" , or "determination", or "display", or similar, refers to the action and processes of a computer, or similar electronic computing device, that manipulates and transforms data represented in the form of physical (electronic) quantities ) in the computer's records and memories in other data represented in a similar way in the form of physical quantities in the computer's records or memories, or other similar information storage, transmission or display devices.
[0322] [0322] One or more components in the present invention may be called "configured for", "configurable for", "operable / operational for", "adapted / adaptable for", "capable of", "conformable / conformed to ", etc. Those skilled in the art will recognize that "configured for" can, in general, encompass components in an active state and / or components in an inactive state and / or components in a standby state, except when the context determines otherwise.
[0323] [0323] The terms "proximal" and "distal" are used here with reference to a situation in which a physician manipulates 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.
[0324] [0324] Persons skilled in the art will recognize that, in general, the terms used here, and especially in the appended claims (eg, bodies of the appended claims) are generally intended as "open" terms (eg, the term "including" should be interpreted as "including, but not limited to", the term "having" should be interpreted as "having, at least", the term "includes" should be interpreted as "includes, but is not limited to ", etc.). It will also be understood by those skilled in the art that, when a specific number of a claim statement entered is intended, that intention will be expressly mentioned in the claim and, in the absence of such mention, no intention will be present. For example, as an aid to understanding, the following appended claims may contain the use of the introductory phrases "at least one" and "one or more" to introduce claim statements. However, the use of such phrases should not be interpreted as implying that the introduction of a claim statement by the indefinite articles "one, ones" or "one, ones" limits any specific claim containing the claim mention. claims that contain only such a mention are introduced, even when the same claim includes the introductory phrases "one or more" or "at least one" and indefinite articles, such as "one, ones" or "one, ones" (for example, example, "one, ones" and / or "one, ones" should typically be interpreted as meaning "at least one" or "one or more"); the same goes for the use of defined articles used to introduce claims.
[0325] [0325] Furthermore, even if a specific number of an introduced claim statement is explicitly mentioned, those skilled in the art will recognize that that statement must typically be interpreted as meaning at least the number mentioned (for example, the mere mention of "two mentions", without other modifiers, typically means at least two mentions, or two or more mentions). In addition, in cases where a convention analogous to "at least one of A, B and C, etc." is used, in general this construction is intended to have the meaning in which the convention would be understood by (for example, For example, "a system that has at least one of A, B and C" would include, but not be limited to, systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and / or A, B and C together, etc.). In cases where a convention analogous to "at least one of A, B or C, etc." is used, this construct is generally intended to have the meaning in which the convention would be understood by (for example, "a system that has at least one of A, B and C" would include, but not be limited to, systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and / or A, B and C together, etc.). It will be further understood by those skilled in the art that typically a disjunctive word and / or phrase presenting two or more alternative terms, whether in the description, in the claims or in the drawings, should be understood as contemplating the possibility of including one of the terms , either term, or both terms, except where the context dictates to indicate something different. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "AeB".
[0326] [0326] With respect to the appended claims, those skilled in the art will understand that the operations mentioned in the same can, in general, be performed in any order. In addition, although several operational flow diagrams are presented in one or more sequences, it must be understood that the various operations can be performed in other orders than those shown, or can be performed simultaneously. Examples of these alternative sorts may include overlapping, merged, interrupted, reordered, incremental,
[0327] [0327] It is worth noting that any reference to "one (1) aspect", "one aspect", "an exemplification" or "one (1) exemplification", and the like means that a particular resource, structure or characteristic described in connection with the aspect is included in at least one aspect. Thus, the use of expressions such as "in one (1) aspect", "in one aspect", "in an exemplification", "in one (1) exemplification", in several places throughout this specification it does not necessarily refer to the same aspect. In addition, specific features, structures or characteristics can be combined in any appropriate way in one or more aspects.
[0328] [0328] Any patent application, patent, non-patent publication or other description material mentioned in this specification and / or mentioned in any order data sheet is hereby incorporated by reference, to the extent that the Embedded materials are not inconsistent with this. In this way, and to the extent necessary, the disclosure as explicitly presented herein replaces any conflicting material incorporated by reference in this invention. Any material, or portion thereof, which is incorporated herein by reference, but which conflicts with the definitions, statements, or other disclosure materials contained herein, will be incorporated here only to the extent that there is no conflict. between the embedded material and the existing developer material.
[0329] [0329] In short, numerous benefits have been described that result from the use of the concepts described in this document. The previously mentioned description of one or more modalities has been presented for purposes of illustration and description.
This description is not intended to be exhaustive or to limit the invention to the precise form disclosed.
Modifications or variations are possible in light of the above teachings.
One or more modalities were chosen and described in order to illustrate the principles and practical application to, thus, allow those skilled in the art to use the various modalities and with various modifications, as they are convenient to the specific use contemplated.
It is intended that the claims presented in the annex define the global scope.

权利要求:
Claims (20)
[1]
1. Cloud-based medical data analysis system characterized by comprising: at least one processor; at least one memory coupled in communication with at least one processor; an input / output interface configured to access data from a plurality of central surgical controllers, each one of the plurality of central surgical controllers coupled in communication with at least one surgical instrument and at least one processor; and a database that resides in at least one memory and is configured to store the data; and since at least one memory is configured to store instructions executable by at least one processor for: receiving critical data from the plurality of central surgical controllers, the plurality of central surgical controllers determining data critical importance based on evaluation criteria; determining a priority status for critical data; route critical data to a cloud storage location that resides in at least one memory; and determining a response to critical data based on an operational characteristic indicated by critical data, with a response time component determined based on the priority state.
[2]
2. Cloud-based medical data analysis system, according to claim 1, characterized by the evaluation criteria
include one or more of: severity, unpredictability, suspicion and security.
[3]
3. Cloud-based medical data analysis system, according to claim 2, characterized in that the severity assessment criteria comprise an extension of a perioperative device failure and a transition to non-standard post-operation treatment of a patient.
[4]
4. Number-based medical data analysis system according to claim 1, characterized in that the at least one memory is additionally configured to store executable instructions for at least one processor to request that the plurality of surgical controllers central agencies obtain additional data on critical data.
[5]
5. Number-based medical data analysis system, according to claim 4, characterized in that the at least one memory is additionally configured to store executable instructions from at least one processor to request additional data based on a plurality of activation conditions.
[6]
6. Number-based medical data analysis system, according to claim 5, characterized in that the plurality of activation conditions comprises one or more of: exceeding a predetermined limit of unpredictability, unauthorized modification of data of critical importance, unsecured data communication, inclusion of at least one surgical instrument on a watch list.
[7]
7. Cloud-based medical data analysis system, according to claim 1, characterized in that the critical data comprises aggregated data received from the plurality of central surgical controllers.
[8]
8. Medical data analysis system based on number, according to claim 1, characterized in that the at least one processor transmits the critical data to the database.
[9]
9. Non-transient, computer-readable media characterized by storing computer-readable instructions executable by at least one processor of a cloud-based data analysis system to: receive critical data from a plurality of central surgical controllers, the plurality of central surgical controllers determining data of critical importance based on evaluation criteria and each of the plurality of central surgical controllers is coupled in communication with at least one surgical instrument and at least one processor ; determining a priority status for critical data; route critical data to a cloud storage location that resides in at least one memory attached to at least one processor; and determining a response to critical data based on an operational characteristic indicated by critical data, with a response time component determined based on the priority state.
[10]
10. Computer readable non-transitory media according to claim 9, characterized in that the priority status is determined by at least one processor based on one or more of the following conditions: the critical data corresponds to at least one surgical instrument included in a watch list; critical data corresponds to an automatic response; critical data correspond to
give a notification response; critical data is an urgent response.
[11]
11. Non-transient, computer-readable media according to claim 10, characterized in that the at least one surgical instrument is included in the watch list based on one or more of: counterfeit products, deviation in the performance of the surgical instrument and unauthorized use.
[12]
12. Computer readable non-transitory media, according to claim 10, characterized by the automatic response comprising a corrective and preventive action response.
[13]
13. Computer readable non-transitory media according to claim 9, characterized in that at least one processor stores critical data in a waiting list in at least one memory and validates the accuracy of the import data critical importance.
[14]
14. Medical data-based data analysis system characterized by comprising: at least one processor; at least one memory coupled in communication with at least one processor; an input / output interface configured to access data from a plurality of central surgical controllers, each one of the plurality of central surgical controllers coupled in communication with at least one surgical instrument and at least one processor; and a database that resides in at least one memory and is configured to store the data; and since at least one memory is configured to store instructions executable by at least one processor for:
receiving data of critical importance from the plurality of central surgical controllers, the plurality of central surgical controllers determining data of critical importance based on evaluation criteria; determining a priority status for critical data; route critical data to a cloud storage location that resides in at least one memory; request from the plurality of central surgical controllers additional data related to critical data based on a plurality of activation conditions; determine the cause of an irregularity corresponding to critical data and additional data; and determining a response to the irregularity, a time component of the response being determined based on the priority state.
[15]
15. Number-based medical data analysis system, according to claim 14, characterized in that at least one processor responds to the irregularity by transmitting a signal to at least one corresponding surgical instrument corresponding to the irregularity, and the signal causes an operational lock-up of at least one surgical instrument.
[16]
16. Cloud-based medical data analysis system according to claim 14, characterized in that at least one processor requests the plurality of central surgical controllers to obtain additional data over a predetermined time interval.
[17]
17. Number-based medical data analysis system according to claim 16, characterized in that at least one processor requests the plurality of central surgical controllers to obtain additional data during the predetermined interval of time based on an occurrence of a predetermined medical event.
[18]
18. Number-based medical data analysis system according to claim 14, characterized in that at least one processor responds to the irregularity by monitoring the patient's results that correspond to the irregularity during a predetermined interval of time.
[19]
19. Number-based medical data analysis system, according to claim 14, characterized in that at least one processor responds to the irregularity by transmitting a signal to the plurality of central surgical controllers corresponding to the irregularity to indicate corrective action.
[20]
20. Medical data analysis system based on number, according to claim 14, characterized in that at least one processor transmits critical data to the database for aggregation of critical data, without - than critical data is classified as corresponding to a positive patient result or a negative patient result.
The
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AND
UNIT MONITOR 135 MODULE OF 106 us [| IMAGE SYSTEM
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128 MODULE | SUCTION / IRRIGATION
MODULE OF
INSTRUMENT 130 | SMART COMMUNICATION 12 MODULE 132 | 136 MATRIX PROCESSOR 134 STORAGE
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MAPPING OF 133 OPERATION ROOM

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公开号 | 公开日

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

优先权:

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申请号 | 申请日 | 专利标题

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

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

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

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

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

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

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US201862649315P| true| 2018-03-28|2018-03-28|

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US62/649,315|2018-03-28|

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US15/940,706|2018-03-29|

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US15/940,706|US20190206561A1|2017-12-28|2018-03-29|Data handling and prioritization in a cloud analytics network|

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PCT/IB2018/057439|WO2019130093A1|2017-12-28|2018-09-26|Data handling and prioritization in a cloud analytics network|

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