control of a surgical system through a surgical barrier

专利摘要:
The present invention relates to a set of surgical systems. The surgical system set includes a first surgical system and a second surgical system coupled to the first surgical system. The second surgical system includes a control circuit. The control circuit is configured to operate in a first mode or a second mode and to control one or more functions of the first surgical system when the second surgical system is in the second mode.
公开号:BR112020013241A2
申请号:R112020013241-1
申请日:2018-11-14
公开日:2020-12-01
发明作者:Frederick E. Shelton Iv；Jason L. Harris；Taylor W. Aronhalt
申请人:Ethicon Llc；
IPC主号:

专利说明:

[0001] [0001] The present application claims the benefit of the priority of the non-provisional patent application US serial number 16 / 182.232, entitled CONTROL OF A SURGICAL SYSTEM THROUGH A SURGICAL BARRIER, filed on November 6, 2018, whose description it is hereby incorporated by reference, in its entirety.
[0002] [0002] The present application claims priority under 35 U.S.C.8 119 (e) of US provisional patent application No. 62 / 729,176, entitled INDI- RECT COMMAND AND CONTROL OF A FIRST OPERATING ROOM
[0003] [0003] This application claims priority under 35 US $ 119 (e) to provisional patent application No. 62 / 692,747, entitled SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE, filed on June 30, 2018, to the application US Provisional Patent No. 62 / 692,748, entitled SMART ENERGY ARCHITECTURE, filed on June 30, 2018 and US Provisional Patent Application 62 / 692,768, entitled SMART ENERGY DEVICES, filed on June 30, 2018, with the description of each of which is incorporated here by way of reference, in its entirety.
[0004] [0004] The present application also claims priority under 35 USC $ 119 (e) of provisional US patent application 62 / 659,900, entitled METHOD OF HUB COMMUNICATION, filed on April 19, 2018, the description of which is incorporated herein as a reference,
[0005] [0005] The present application also claims priority under 35 USC $ 119 (e) of US provisional patent application 62 / 650,898, filed on March 30, 2018, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS, of US provisional patent application serial number 62 / 650,887, entitled SURGI-CAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, filed on March 30, 2018, of US provisional patent application serial number 62 / 650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM, filed on March 30, 2018, and US provisional patent application serial number 62 / 650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTROLS, filed on March 30, 2018, whose description of each is incorporated here for reference, in its entirety.
[0006] [0006] This application also claims priority under 35 US $ 119 (e) of provisional patent application US serial number 62 / 640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, filed on March 8, 2018, and US provisional patent application serial number 62 / 640,415, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR, filed on March 8, 2018, the respective description of which is incorporated by reference in its entirety for reference.
[0007] [0007] The present application also claims priority under 35 US $ 119 (e) of US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, of the patent application US provisional serial number 62 / 611.340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on December 28, 2017, and the patent application provided
[0008] [0008] The present invention relates to various surgical systems. Surgical procedures are typically performed in surgical operating rooms or environments in a health care facility, such as a hospital. A sterile field is typically created around the patient. The sterile field may include staff members in hospital sanitary clothes, who are properly dressed, and all furniture and accessories in the area. Various surgical devices and systems are used to perform a surgical procedure. FIGURES
[0009] [0009] The various aspects described here, both with regard to the organization and the methods of operation, together with additional objects and advantages of the same, can be better understood in reference to the description presented below, considered together with the attached drawings as follows.
[0010] [0010] Figure 1 is a block diagram of an interactive surgical system implemented by computer, according to at least one aspect of the present description.
[0011] [0011] Figure 2 is a surgical system being used to perform a surgical procedure in an operating room, in accordance with at least one aspect of the present description.
[0012] [0012] Figure 3 is a central surgical controller paired with a visualization system, a robotic system, and an intelligent instrument, in accordance with at least one aspect of the present description.
[0013] [0013] Figure 4 is a partial perspective view of a central surgical controller housing, and of a generator module in combination received slidingly in a central surgical controller drawer, according to at least one aspect of this description.
[0014] [0014] Figure 5 is a perspective view of a generator module in combination with bipolar, ultrasonic and monopolar contacts and a smoke evacuation component, in accordance with at least one aspect of the present description.
[0015] [0015] Figure 6 illustrates different power bus connectors for a plurality of side coupling ports of a side modular cabinet configured to receive a plurality of modules, in accordance with at least one aspect of the present description.
[0016] [0016] Figure 7 illustrates a vertical modular cabinet configured to receive a plurality of modules, according to at least one aspect of the present description.
[0017] [0017] Figure 8 illustrates a surgical data network that comprises a central modular communication controller configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a healthcare facility. public services specially equipped for surgical operations, to the cloud, in accordance with at least one aspect of this description.
[0018] [0018] Figure 9 illustrates an interactive surgical system implemented by computer, according to at least one aspect of the present description.
[0019] [0019] Figure 10 illustrates a central surgical controller that comprises a plurality of modules coupled to the modular control tower, according to at least one aspect of the present description.
[0020] [0020] Figure 11 illustrates an aspect of a universal serial bus (USB) central network controller device, in accordance with at least one aspect of the present description.
[0021] [0021] Figure 12 is a block diagram of a cloud computing system that comprises a plurality of intelligent surgical instruments coupled to central surgical controllers that can connect to the cloud component of the cloud computing system, according to at least one aspect of the present description.
[0022] [0022] Figure 13 is a functional module architecture of a cloud computing system, according to at least one aspect of the present description.
[0023] [0023] Figure 14 illustrates a diagram of a surgical system with situational recognition, according to at least one aspect of the present description.
[0024] [0024] Figure 15 is a timeline that represents the situational recognition of a central surgical controller, according to at least one aspect of the present description.
[0025] [0025] Figure 16 is a view of a display screen for a surgical procedure, representing a surgical site and a distal portion of a surgical device at the surgical site, in accordance with at least one aspect of the present description.
[0026] [0026] Figure 17 is a view of the surgical device of Figure 16 that extends through a surgical barrier at the surgical site, in accordance with at least one aspect of the present description.
[0027] [0027] Figure 18 is a perspective view of a handle portion of the surgical device of Figures 16 and 17, in which the handle portion has an entry key for changing the surgical device between operating modes, according to at least one aspect of the present description.
[0028] [0028] Figure 19 is a diagram that represents devices to be used close to the body that communicate with surgical instruments to facilitate pairing and delivery of surgical instruments, according to at least one aspect of the present description.
[0029] [0029] Figure 20 is a diagram of a wrist device to be worn close to the body, according to at least one aspect of this description.
[0030] [0030] Figure 21 is a diagram of a ring device to be worn close to the body, according to at least one aspect of the present description.
[0031] [0031] Figure 22A is a first view of a display screen, in which the display screen is configured to receive operator input to control a first surgical device - a combined energy device - according to at least one aspect of this description.
[0032] [0032] Figure 22B is a second view of the display screen of Figure 22A, in which the display screen is configured to receive operator input to control a second surgical device - a stapler - according to at least one aspect of this description. DESCRIPTION
[0033] [0033] The applicant of the present application holds the following US patent applications, filed on November 6, 2018, the description of each of which is incorporated herein by reference, in its entirety: * US patent application No. 16 /182,224, entitled SURGICAL NETWORK, INSTRUMENT, AND CLOUD RESPONSES BASED ON
[0034] [0034] The applicant for this application holds the following US patent applications filed on September 10, 2018, the description of which is incorporated herein by reference in its entirety: * US provisional patent application 62 /729,183, entitled A CONTROL FOR A SURGICAL NETWORK OR SURGICAL NETWORK
[0035] [0035] The applicant for this application holds the following US patent applications, filed on August 28, 2018, the description of which is incorporated herein by reference in its entirety: * US patent application No. 16 /115,214, entitled ESTIMAT- ING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYS- TEM THEREFOR; * patent application U, nº 16 / 115,205, entitled TEMPERA-
[0036] [0036] The applicant for this application holds the following US patent applications, filed on August 23, 2018, the description of which is incorporated herein by reference in its entirety for reference: * Provisional US patent application no. 62 / 721,995, entitled CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT AC- CORDING TO TISSUE LOCATION; * US Provisional Patent Application No. 62 / 721,998, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS; * US Provisional Patent Application No. 62 / 721,999, entitled INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE
[0037] [0037] The applicant for this application holds the following US patent applications, filed on June 30, 2018, the description of each of which is incorporated herein by reference in its entirety: * Provisional patent application US No. 62 / 692,747, entitled SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE; * US Provisional Patent Application No. 62 / 692,748, entitled SMART ENERGY ARCHITECTURE; and * US Provisional Patent Application No. 62 / 692,768, entitled SMART ENERGY DEVICES.
[0038] [0038] The applicant for this application holds the following US patent applications, filed on June 29, 2018, the description of which is incorporated herein by reference in its entirety: * US patent application serial no. 16 / 024.090, entitled CA-PACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE AR-RAY ELEMENTS; * US patent application serial number 16 / 024,057, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS; * US patent application serial number 16 / 024,067, entitled SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED
[0039] [0039] The applicant for this application holds the following provisional US patent applications, filed on June 28, 2018, with the description of each of which is incorporated herein by reference in its entirety: * Provisional patent application US serial no. 62 / 691,228, entitled A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES; * US provisional patent application serial number 62 / 691.227, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS; * US provisional patent application serial number 62 / 691.230, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELEC- TRODE;
[0040] [0040] The applicant for the present application holds the following provisional US patent applications, filed on April 19, 2018, the description of each of which is incorporated herein by reference, in its entirety: * Application US provisional patent serial number 62 / 659,900, entitled METHOD OF HUB COMMUNICATION.
[0041] [0041] The applicant for the present application holds the following provisional US patent applications, filed on March 30, 2018, the description of each of which is incorporated herein by reference, in its entirety: * Patent application US Provisional No. 62 / 650,898 filed on March 30, 2018, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS; * US provisional patent application serial number 62 / 650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPA-BILITIES; * US provisional patent application serial number 62 / 650,882,
[0042] [0042] The applicant for the present application holds the following US patent applications, filed on March 29, 2018, the description of each of which is incorporated herein by reference in its entirety: * US patent application serial no. 15 / 940,641, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; * US patent application serial number 15 / 940,648, entitled IN-
[0043] [0043] The applicant for the present application holds the following provisional US patent applications, filed on March 28, 2018, with the description of each of which is incorporated herein by reference in its entirety: * provisional patent application US No. 62 / 649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; * US provisional patent application serial number 62 / 649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; * US provisional patent application serial number 62 / 649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS;
[0044] [0044] The applicant for the present application holds the following provisional US patent applications, filed on March 8, 2018, with the description of each of which is incorporated herein by reference in its entirety: * Provisional patent application US serial number 62 / 640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR; and * US provisional patent application serial number 62 / 640,415, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR.
[0045] [0045] The applicant for this application holds the following provisional US patent applications, filed on December 28, 2017, with the description of each of which is incorporated herein by reference in its entirety: * Provisional patent application US Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM; * US provisional patent application serial number 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS; and * US provisional patent application serial number 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM.
[0046] [0046] Before explaining in detail the various aspects of surgical instruments and generators, it should be noted that the illustrative examples are not limited, in terms of application or use, to the construction details and arrangement of parts illustrated in the drawings and in the attached description. Illustrative examples can be implemented or incorporated into other aspects, variations and modifications, and can be practiced or executed in a variety of ways. In addition, unless stated otherwise, the terms and expressions used in the present invention have been chosen for the purpose of describing illustrative examples for the convenience of the reader and not for the purpose of limiting it. In addition, it should be understood that one or more of the aspects, expressions of aspects, and / or examples described below can be combined with any one or more among the other aspects, expressions of aspects and / or examples described a follow. Central surgical controllers
[0047] [0047] Referring to Figure 1, a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (for example, cloud 104 which may include a remote server 113 coupled to a device storage 105). Each surgical system 102 includes at least one central surgical controller 106 in communication with the cloud 104 which can include a remote server 113. In one example, as shown in Figure 1, surgical system 102 includes a display system 108 , a robotic system 110, a smart handheld surgical instrument 112, which are configured to communicate with each other and / or the central controller 106. In some respects, a surgical system 102 may include an M number of central controllers 106 , an N number of visualization systems 108, an O number of robotic systems 110 and a P number of smart, hand-held surgical instruments 112, where M, N, O and P are whole numbers greater than or equal to one.
[0048] [0048] In several respects, the smart instruments 112 as described in the present invention with reference to Figures 1 to 7 can be implemented as a surgical device 214002 (Figures 16 to 18), a display screen (Figure 16) , a device to be used close to the body 214100, 214102, 214200, 214202 (Figures 19 to 21), and a screen 214400 (Figures 22A and 22B). Intelligent instruments 112 (for example, devices 12-1n), such as the surgical device
[0049] [0049] Figure 2 represents an example of a surgical system 102 being used to perform a surgical procedure on a patient who is lying on an operating table 114 in a surgical operating room 116. A robotic system 110 is used in the procedure surgical procedure as a part of surgical system 102. Robotic system 110 includes a surgeon console 118, patient trolley 120 (surgical robot) and a robotic central surgical controller 122. Patient trolley 120 can handle at least one ci tool - surgically removably coupled 117 through a minimally invasive incision in the patient's body while the surgeon views the surgical site through the surgeon's console 118. An image of the surgical site can be obtained by a medical imaging device 124 , which can be manipulated by the patient cart 120 to guide the imaging device 124. The robotic central surgical controller 122 can be used to proc display images of the surgical site for subsequent display to the surgeon via the surgeon's console
[0050] [0050] Other types of robotic systems can be readily adapted for use with the surgical system 102. Various examples of robotic systems and surgical instruments that are suitable for use with the present description are described in provisional patent application no. 62 / 611,339, entitled ROBOT ASSISTED SURGI-CAL PLATFORM, deposited on December 28, 2017, the description of which is incorporated herein by reference in its entirety.
[0051] [0051] Several examples of cloud-based analysis that are performed by the cloud 104, and are suitable for use with the present description, are described in US provisional patent application serial number 62 / 611.340, entitled CLOUD-BASED MEDICAL ANALYTICS, deposited on December 28, 2017, the description of which is incorporated herein by reference, in its entirety.
[0052] [0052] In several respects, the imaging device 124 includes at least one Image sensor and one or more optical components. Suitable image sensors include, but are not limited to, load-coupled device (CCD) sensors and complementary metal oxide semiconductor sensors (CMOS).
[0053] [0053] The optical components of the imaging device 124 may include one or more light sources and / or one or more lenses. One or more light sources can be directed to illuminate portions of the surgical field. The one or more image sensors can receive reflected or refracted light from the surgical field, including reflected or refracted light from the tissue and / or surgical instruments.
[0054] [0054] The one or more light sources can be configured to radiate electromagnetic energy in the visible spectrum, as well as in the invisible spectrum. The visible spectrum, sometimes called the optical spectrum or light spectrum, is that portion of the electromagnetic spectrum that is visible to (that is, can be detected by) the human eye and can be called visible light or simply light. A typical human eye will respond to wavelengths in the air that are from about 380 nm to about 750 nm.
[0055] [0055] The invisible spectrum (that is, the non-luminous spectrum) is that portion of the electromagnetic spectrum located below and above the visible spectrum (that is, wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths greater than about 750 nm are longer than the visible red spectrum, and they become invisible infrared (IR), microwave, and radio radiation. Wavelengths shorter than about 380 nm are shorter than the ultraviolet spectrum, and they become invisible ultraviolet, x-ray and gamma-ray electromagnetic radiation.
[0056] [0056] In several respects, the imaging device 124 is configured for use in a minimally invasive procedure. Examples of imaging devices suitable for use with the present description include, but are not limited to, an arthroscope, angioscope, bronchoscope, choledocoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagus-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngoscope, sigmoidoscope, thoracoscope, and ureteroscope.
[0057] [0057] In one aspect, the imaging device employs multiple spectrum monitoring to discriminate topography and underlying structures. A multi-spectral image is one that captures image data within wavelength bands along the electromagnetic spectrum. Wavelengths can be separated by filters or using instruments that are sensitive to specific wavelengths, including light from frequencies beyond the visible light range, for example, IR and ultraviolet light. Spectral images can allow the extraction of additional information that the human eye cannot capture with its receivers for the colors red, green, and blue. The use of multispectral imaging is described in greater detail under the heading "Advanced Imaging Acquisition Module" in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, whose description is hereby incorporated by reference in its entirety. Multispectral monitoring can be a useful tool for relocating a surgical field after a surgical task is completed to perform one or more of the tests previously described on the treated tissue.
[0058] [0058] It is axiomatic that strict sterilization of the operating room and surgical equipment is necessary during any surgery. The strict hygiene and sterilization conditions required in an "operating room", that is, an operating or treatment room, justify the highest possible sterilization of all medical devices and equipment. Part of this sterilization process is the need to sterilize anything that comes in contact with the patient or person in the sterile field, including imaging device 124 and its connectors and components. It will be understood that the sterile field can be considered a specified area, such as inside a bank or on a sterile towel, which is considered free of microorganisms, or the sterile field can be considered an area, immediately around a patient, who was prepared to perform a surgical procedure. The sterile field may include team members with hospital sanitary clothes, who are properly dressed, and all furniture and accessories in the area.
[0059] [0059] In several aspects, the visualization system 108 includes one or more imaging sensors, one or more image processing units, one or more storage matrices and one or more screens that are strategically arranged in relation to the field sterile, as shown in Figure 2. In one aspect, the display system 108 includes an interface for HL7, PACS and EMR. Various components of the 108 display system are described under the heading "Advanced Imaging Acquisition Module" in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLAT-FORM, filed on December 28, 2017, the description of which is here incorporated as a reference in its entirety.
[0060] [0060] As shown in Figure 2, a primary screen 119 is positioned in the sterile field to be visible to the operator on the operating table 114. In addition, a viewing tower 111 is positioned outside the sterile field. The display tower 111 includes a first non-sterile screen 107 and a second non-sterile screen 109, which are opposite each other. The visualization system 108, guided by the central controller 106, is configured to use screens 107, 109, and 119 to coordinate the flow of information to operators inside and outside the sterile field. For example, the central controller 106 can have the visualization system 108 display a snapshot of a surgical site, as recorded by an imaging device 124, on a non-sterile screen 107 or 109, while maintaining a transmission over the live from the surgical site on the main screen 119. The snapshot 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.
[0061] [0061] In one aspect, the central controller 106 is also configured to route an input or diagnostic feedback by a non-sterile operator in the viewing tower 111 to the primary screen 119 within the sterile field, where it can be seen by a sterile operator on the operating table. In one example, the 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 the main screen 119 by the central controller 106.
[0062] [0062] With reference to Figure 2, a 112 surgical instrument is being used in the surgical procedure as part of the surgical system
[0063] [0063] Now with reference to Figure 3, a central controller 106 is shown in communication with a visualization system 108, a robotic system 110 and a smart handheld surgical instrument 112. Central controller 106 includes a central controller screen 135, an imaging module 138, a generator module 140 (which may include a monopolar generator 142, a bipolar generator 144 and / or an ultrasonic generator 143), a communication module 130, a processor module 132 and a storage matrix 134 In certain respects, as illustrated in Figure 3, the central controller 106 additionally includes a smoke evacuation module 126, a suction / irrigation module 128 and / or an OR 133 mapping module.
[0064] [0064] During a surgical procedure, the application of energy to the tissue, for sealing and / or cutting, is generally associated with the evacuation of smoke, suction of excess fluid and / or irrigation of the tissue. Fluid, power and / or data lines from different sources are often intertwined during the surgical procedure. Valuable time can be wasted in addressing this issue during a surgical procedure. To untangle the lines, it may be necessary to disconnect the lines from their respective modules, which may require a restart of the modules. The modular housing of the central controller 136 offers a unified environment for managing power, data and fluid lines, which reduces the frequency of interlacing between such lines.
[0065] [0065] The aspects of this description present a central surgical controller for use in a surgical procedure that involves the application of energy to the tissue at a surgical site. The central surgical controller includes a central controller housing and a combination generator module received slidingly at a central controller housing docking station. The docking station includes data and power contacts. The combined generator module includes two or more of an ultrasonic energy generating component, a bipolar RF energy generating component, and a monopolar RF energy generating component that are housed in a single unit. In one aspect, the combined generator module also includes a smoke evacuation component, at least one power application cable to connect the combined generator module to a surgical instrument, at least one smoke evacuation component configured to evacuate smoke, fluid , and / or particulates generated by applying therapeutic energy to the tissue, and a fluid line that extends from the remote surgical site to the smoke evacuation component.
[0066] [0066] In one aspect, the fluid line is a first fluid line and a second fluid line extends from the remote surgical site to a suction and irrigation module received slidingly in the central controller housing. In one aspect, the central controller housing comprises a fluid interface.
[0067] [0067] Certain surgical procedures may require the application of more than one type of energy to the tissue. One type of energy may be more beneficial for cutting the fabric, while another type of energy may be more beneficial for sealing the fabric. For example, a bipolar generator can be used to seal the tissue while an ultrasonic generator can be used to cut the sealed tissue. Aspects of the present description present a solution in which a modular housing of the central controller 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the central modular housing 136 is that it allows quick removal and / or replacement of several modules.
[0068] [0068] Aspects of the present description present a modular surgical casing for use in a surgical procedure that involves applying energy to the tissue. The modular surgical housing includes a first energy generating module, configured to generate a first energy for application to the tissue, and a first docking station comprising a first docking port that includes first data and energy contacts, in which the first module The power generator is slidably movable in an electrical coupling with the power and data contacts and the first power generator module is slidably movable out of the electric coupling with the first power and data contacts.
[0069] [0069] In addition to the above, the modular surgical enclosure also includes a second energy generator module configured to generate a second energy, different from the first energy, for application to the tissue, and a second docking station comprising a second coupling port that includes second data and power contacts in which the second power generator module is slidably movable in an electrical coupling with power and data contacts, and in which the second power generator module energy is slidably movable out of the electrical coupling with the second power and data contacts.
[0070] [0070] In addition, the modular surgical enclosure also includes a communication bus between the first coupling port and the second coupling port, configured to facilitate communication between the first power generator module and the second power generator module .
[0071] [0071] With reference to Figures 3 to 7, aspects of the present description are presented for a modular housing of the central controller 136 that allows the modular integration of a generator module 140, a smoke evacuation module 126, and a suction module - tion / irrigation 128. The central modular housing 136 further facilitates interactive communication between modules 140, 126, 128. As shown in Figure 5, generator module 140 can be a generator module with monopolar, bipolar and ultrasonic components integrated, supported in a single cabinet unit 139 slidably inserted into the central modular housing 136. As shown in Figure 5, generator module 140 can be configured to connect to a monopolar device 146, a bipolar device 147 and a ultrasonic device 148. Alternatively, generator module 140 may comprise a series of monopolar, bipolar and / or ultrasonic generator modules that interact through the enclosure central modular ucro
[0072] [0072] In one aspect, the central modular housing 136 comprises a modular power and a back communication board 149 with external and wireless communication heads to allow removable fixing of modules 140, 126, 128 and interactive communication among them.
[0073] [0073] In one aspect, the central modular housing 136 includes docking stations, or drawers, 151, here also called
[0074] [0074] In several respects, the smoke evacuation module 126 includes a fluid line 154 that carries captured / collected fluid fluid away from a surgical site and to, for example, the smoke evacuation module 126. The vacuum suction that originates from the smoke evacuation module 126 can pull the smoke into an opening of a utility conduit at the surgical site. The utility line, coupled to the fluid line, can be in the form of a flexible tube that ends in the smoke evacuation module 126. The utility line and the fluid line define a fluid path that extends across towards the smoke evacuation module 126 which is received in the central controller housing 136.
[0075] [0075] In several aspects, the suction / irrigation module 128 is coupled to a surgical tool comprising a fluid suction line and a fluid suction line. In one example, the suction and suction fluid lines are in the form of flexible tubes that extend from the surgical site towards the suction / irrigation module 128. One or more drive systems can be configured to make with which the irrigation and aspiration of fluids to and from the surgical site.
[0076] [0076] In one aspect, the surgical tool includes a drive shaft that has an end actuator at a distal end of the same and at least an energy treatment associated with the end actuator, a suction tube, and a irrigation pipe. The suction tube can have an inlet port at a distal end and the suction tube extends through the drive shaft. Similarly, an irrigation pipe can extend through the drive shaft and may have an entrance port close to the power application implement. The power application implement is configured to supply ultrasonic and / or RF energy to the surgical site and is coupled to the generator module 140 by a cable that initially extends through the drive shaft.
[0077] [0077] The irrigation tube can be in fluid communication with a fluid source, and the suction tube can be in fluid communication with a vacuum source. The fluid source and / or the vacuum source can be housed in the suction / irrigation module 128. In one example, the fluid source and / or the vacuum source can be housed in the central controller housing 136 separately from the suction / irrigation module 128. In such an example, a fluid interface can be configured to connect the suction / irrigation module 128 to the fluid source and / or the vacuum source.
[0078] [0078] In one aspect, modules 140, 126, 128 and / or their corresponding docking stations in the central modular housing 136 may include alignment features that are configured to feed
[0079] [0079] In some respects, the drawers 151 of the central modular housing 136 are the same, or are substantially the same size, and the modules are adjusted in size to be received in the drawers 151. For example, the side brackets 155 and / or 156 can be larger or smaller depending on the size of the module. In other respects, drawers 151 are different in size and are each designed to accommodate a specific module.
[0080] [0080] In addition, the contacts of a specific module can be switched to engage with the contacts of a specific drawer to avoid the insertion of a module in a drawer with unpaired contacts.
[0081] [0081] As shown in Figure 4, the coupling port 150 of one drawer 151 can be coupled to the coupling port 150 of another drawer 151 via a communication link 157 to facilitate interactive communication between the modules housed in the modular housing. central module 136. The coupling ports 150 of the central modular housing 136 can, alternatively or additionally, facilitate interactive wireless communication between modules housed in the central modular housing 136. Any suitable wireless communication can be used, such as example, Air Titan Bluetooth.
[0082] [0082] Figure 6 illustrates individual power bus connectors for a plurality of side coupling ports of a side modular cabinet 160 configured to receive a plurality of modules from a central surgical controller 206. The side modular cabinet 160 is configured to receive and interconnect modules 161. laterally, modules 161 are slidably inserted into docking stations 162 of side modular cabinet 160, which includes a back plate for interconnecting modules 161. As shown in Figure 6, the modules 161 are arranged laterally in the side modular cabinet 160. Alternatively, modules 161 can be arranged vertically in a side modular cabinet.
[0083] [0083] Figure 7 illustrates a vertical modular cabinet 164 configured to receive a plurality of modules 165 from the central surgical controller 106. Modules 165 are slidably inserted into docking stations, or drawers, 167 of the modular cabinet vertical 164, which includes a rear panel for interconnecting the modules
[0084] [0084] In several respects, the imaging module 138 comprises an integrated video processor and a modular light source and is adapted for use with various imaging devices. In one aspect, the imaging device is comprised of a modular cabinet that can be mounted with a light source module and a camera module. The case can be a disposable case. In at least one example, the disposable cabinet is removably coupled to a reusable controller, a light source module, and a camera module. The light source module and / or the camera module can be selected selectively depending on the type of surgical procedure. In one aspect, the camera module comprises a CCD sensor. In another aspect, the camera module comprises a CMOS sensor. In another aspect, the camera module is configured for imaging the scanned beam. Similarly, the light source module can be configured to provide a white light or a different light, depending on the surgical procedure.
[0085] [0085] 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 a different light source may be inefficient. Temporarily losing sight of the surgical field can lead to undesirable consequences. The imaging device module of this description is configured to allow the replacement of a light source module or a "midstream" camera module during a surgical procedure, without the need to remove the imaging device from the field surgical.
[0086] [0086] In one aspect, the imaging device comprises a tubular cabinet 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 a pressure fitting.
[0087] [0087] 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.
[0088] [0088] Various image processors and imaging devices suitable for use with the present description are described in US patent No. 7,995,045 entitled COMBINED SBI AND CONVENTIO-NAL 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 several systems for removing motion artifacts from the - image data. Such systems can be integrated with imaging module 138. In addition to these, the publication of US patent application No. 2011/0306840, entitled CONTROLLABLE MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPARATUS, published on December 15, 2011, and the publication of the application for US patent No. 2014/0243597, entitled SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE, published on August 28, 2014, which are each incorporated herein by reference in their entirety.
[0089] [0089] Figure 8 illustrates a surgical data network 201 that comprises a central modular communication controller 203 configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a utility installation 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 communication central 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 207 central network controller or network key
[0090] [0090] Modular devices 1a to 1n located in the operating room can be coupled to the central controller of modular communication 203. The central network controller 207 and / or network switch 209 can be coupled to a network router 211 to connect devices 1a to 1h to the 204 cloud or the local computer system
[0091] [0091] It will be understood that the surgical data network 201 can be expanded by interconnecting multiple central network controllers 207 and / or multiple network keys 209 with multiple network routers 211. The central controller of modular communication 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, several modules such as an imaging module 138 coupled to an endoscope, a generator module 140 coupled to an energy-based surgical device, a smoke evacuation module 126, a suction / irrigation module 128, a communication module 130, a processor module 132, a storage matrix 134, a surgical device attached to a screen, and / or a non-contact sensor module, among other modular devices that can be connected to the central controller of modular communication
[0092] [0092] In one aspect, the surgical data network 201 may comprise a combination of central network controllers, network switches, and network routers that connect devices 1a to 1n / 2a to 2m to the cloud. Any or all of the devices 1a to 1n / 2a to 2m coupled to the central network controller or network key can collect data in real time and transfer the data to cloud computers for data processing and manipulation. It will be understood that cloud computing depends on sharing computing resources instead of having local servers or personal devices to handle software applications. The word "cloud" 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 controller modular communication central 203 and / or computer system 210 located in the operating room (for example, a fixed, mobile, temporary, or operating room or space) and devices connected to the central controller of modular communication 203 and / or computer system 210 via the Internet. The cloud infrastructure can be maintained by a cloud service provider. In this context, the cloud service provider may be the entity that coordinates the use and control of devices 1a to 1n / 2a to 2m located in one or more operating rooms. Cloud computing services can perform a large number of calculations based on data collected by smart surgical instruments, robots, and other computerized devices located in the operating room. The central controller hardware allows multiple devices or connections to be connected to a computer that communicates with cloud computing and storage resources.
[0093] [0093] The application of cloud computer data processing techniques in the data collected by devices 1a to 1n / 2a to 2m, the surgical data network provides better surgical results, reduced costs, and better patient satisfaction. At least some of the devices 1a to 1n / 2a to 2m can be used to view tissue status to assess 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. image- ing. Data collected by devices 1a to 1n / 2a to 2m, including image data, can be transferred to the cloud 204 or the local computer system 210 or both for data processing and manipulation including image processing and manipulation. gem. The data can be analyzed to improve the results of the surgical procedure by determining whether additional treatment, such as application of endoscopic intervention, emerging technologies, targeted radiation, targeted intervention, accurate robotics at specific tissue sites and conditions, can be followed. This data analysis can additionally use analytical processing of the results, and with the use of standardized approaches they can provide beneficial standardized feedback both to confirm treatment
[0094] [0094] In an implementation, operating room devices 1a to 1h can be connected to the central modular communication controller 203 via a wired channel or a wireless channel depending on the configuration of devices 1a to 1h on a controller central network. The central network controller 207 can be implemented, in one aspect, as a LAN transmission device that acts on the physical layer of the open system interconnection model ("OSI" - open system interconnection). The central network controller provides connectivity to devices 1a to 1n located on the same network as the operating room. The central network controller 207 collects data in the form of packets and sends it to the router in "half duplex" mode. The central network controller 207 does not store any media / Internet protocol (MAC / IP) access control for transferring data from the device. Only one of the devices 1a to In at a time can send data via the central network controller
[0095] [0095] In another implementation, operating room devices 2a to 2m can be connected to a network switch 209 through a wired or wireless channel. The network key 209 works in the data connection layer of the OSI model. The network key 209 is a multicast device for connecting devices 2a to 2m located in the same operation center to the network. The network key 209 sends data in frame form to the network router 211 and works in full duplex mode. Multiple devices 2a to 2m can send data at the same time via network key 209. Network key 209 stores and uses MAC addresses of devices 2a to 2m to transfer data.
[0096] [0096] The central network controller 207 and / or the network key 209 are coupled to the network router 211 for a connection to the cloud
[0097] [0097] In one example, the central network controller 207 can be implemented as a central USB controller, which allows multiple USB devices to be connected to a host computer. The central USB controller can expand a single USB port on several levels so that more ports are available to connect the devices to the system's host computer. The central network controller 207 can include wired or wireless capabilities to receive information about a wired channel or a wireless channel. In one aspect, a wireless wireless, broadband and short-range wireless USB communication protocol can be used for communication between devices 1a to 1n and devices 2a to 2m in the operating room.
[0098] [0098] In other examples, devices in the operating room 1a to 1n / 2a to 2m can communicate with the modular central communication controller 203 via standard Bluetooth wireless technology for exchanging data over short distances ( using short-wavelength UHF radio waves in the 2.4 to 2.485 GHz ISM band from fixed and mobile devices and building personal area networks ("PANs"). In other respects, operating room devices 1a to 1n / 2a to 2m can communicate with the modular 203 central communication controller through a number of wireless and wired communication standards or protocols, including, but not limited to, limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE family
[0099] [0099] The modular communication central controller 203 can serve as a central connection for one or all operating room devices 1a to 1n / 2a to 2m and handles a data type known as frames. The tables carry the data generated by the devices 1a to 1n / 2a to 2m. When a frame is received by the modular central communication controller 203, it is amplified and transmitted to the network router 211, which transfers the data to the cloud computing resources using a series of communication standards or protocols. wireless or wired, as described in the present invention.
[0100] [0100] The 203 modular communication central controller can be used as a standalone device or be connected to compatible central network controllers and network switches to form a larger network. The 203 modular communication central controller is, in general, easy to install, configure and maintain, making it a good option for the network of devices 1a to 1n / 2a to 2m from the operating room.
[0101] [0101] 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 computer implemented 200 includes one or more surgical systems 202, which are similar in many respects to surgical systems 102. Each surgical system 202 includes at least one central surgical controller 206 in communication with a cloud 204 which may include a remote server 213. In one aspect, the computer-implemented interactive surgical system 200 comprises a modular control tower 236 connected to multiple operating room devices such as, for example, smart surgical instruments, robots and other computerized devices located in the operating room. As shown in Figure 10, the modular control tower 236 comprises a central modular communication controller 203 coupled to a computer system 210. As illustrated in the example in Figure 9, the modular control tower 236 is coupled to a control module. imaging 238 that is attached to an endoscope 239, a generator module 240 that is attached to a power device 241,
[0102] [0102] Figure 10 illustrates a central surgical controller 206 which 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 connectivity device network, and a computer system 210 to provide local processing, visualization, and imaging, for example. As shown in Figure 10, the 203 modular communication central controller can be connected in a tiered configuration to expand the number of modules (for example, devices) that can be connected to the 203 modular communication controller and transferring data associated with the modules to computer system 210, cloud computing resources, or both. As shown in Figure 10, each of the central controllers / network keys in the modular central communication controller 203 includes three downstream ports and one upstream port. The central controller / network switch upstream is connected to a processor to provide a communication connection to the cloud computing resources and a local display 217. Communication with the cloud 204 can be done through a channel of wired or wireless communication.
[0103] [0103] The central surgical controller 206 employs a non-contact sensor module 242 to measure the dimensions of the operating room and generate a map of the operating room using non-contact measuring devices such as laser or ultrasonic. An ultrasound-based non-contact sensor module scans the operating room by transmitting an ultrasound explosion and receiving echo when it bounces outside the perimeter of an operating room's walls, as described under the heading "Surgical Hub Spatial Awareness Within an Operating Room "in US provisional patent application serial number 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, which is hereby incorporated by reference in its entirety, in which the module sensor is configured to determine the size of the operating room and adjust the limits of the Bluetooth pairing distance. A laser-based non-contact sensor module scans the operating room by transmitting pulses of laser light, receiving pulses of laser light that bounce off the perimeter walls of the operating room, and comparing the phase of the transmitted pulse to the received pulse to determine the size of the operating room and to adjust the Bluetooth pairing distance limits, for example.
[0104] [0104] Computer system 210 comprises a processor 244 and a network interface 245. Processor 244 is coupled to a communication module 247, storage 248, memory 249, non-volatile memory 250, and an input / output interface 251 via a system bus. The system bus can be any of several types of bus structures, including the memory bus or memory controller, a peripheral bus or external bus, and / or a local bus that uses any variety of available bus architectures including , but not limited to, 9-bit bus, industry standard architecture (ISA), Micro-Charmel Architecture (MSA), extended ISA (EISA), Smart Drive Electronics (IDE), VESA Local Bus (VLB), Interconnect of peripheral components (PCI), USB, accelerated graphics port (AGP), bus of international association of memory cards for personal computers ("PCMCIA" - Personal Computer Memory Card International Association), Interface of systems for small computers (SCSI), or any other proprietary bus.
[0105] [0105] Processor 244 can be any single-core or multi-core processor, such as those known under the ARM Cortex trade name available from Texas Instruments. In one respect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWareO program, memory only programmable and electrically erasable readout (EEPROM) of 2 KB, one or more pulse width modulation (PWM) modules, one or more analogue quadrature encoder (QEI) inputs, one or more analog converters for 12-bit digital (ADC) with 12 analog input channels, details of which are available for the product data sheet.
[0106] [0106] In one aspect, processor 244 may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the tradename Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for critical safety applications IEC 61508 and ISO 26262, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[0107] [0107] 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).
[0108] [0108] Computer system 210 also includes removable / non-removable, volatile / non-volatile computer storage media, for example disk storage. Disk storage includes, but is not limited to, devices such as a magnetic disk drive, floppy disk drive, tape drive, Jaz drive, Zip drive, LS-60 drive, 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 (CD-ROM) drive. recordable compact disc (CD-R Drive), rewritable compact disc drive (CD-RW drive), or a versatile digital disk ROM drive (DVD-ROM). To facilitate the connection of disk storage devices to the system bus, a removable or non-removable interface can be used.
[0109] [0109] It is to be understood that computer system 210 includes software that acts as an intermediary between users and the basic computer resources described in an appropriate operating environment. Such software includes an operating system. The operating system, which can be stored in disk storage, acts to control and allocate computer system resources. System applications benefit from management capabilities by the operating system through program modules and “program data stored in system memory or on the storage disk. It is to be understood that the various components described in the present invention can be implemented with various operating systems or combinations of operating systems.
[0110] [0110] A user enters commands or information into the computer system 210 via the input device (s) coupled to the 1 / O interface 251. Input devices include, but are not limited to, a pointing device such as a mouse, trackball, stylus, keyboard, keyboard, microphone, joystick, game pad, satellite card, scanner, TV tuner card, digital camera, digital video camera, video camera web, and the like. These and other input devices connect to the processor via the system bus via the interface port (s). The interface ports include, for example, a serial port, a parallel port, a game port and a USB.
[0111] [0111] Computer system 210 can operate in a networked environment using logical connections to one or more remote computers, such as cloud computers, or local computers. Remote cloud computers can be a personal computer, server, router, personal network computer, workstation, microprocessor-based device, peer device, or other common network node, and the like, and typically include many or all of the elements described in relation to the computer system. For the sake of brevity, only one memory storage device is illustrated with the remote computer. Remote computers are logically connected to the computer system via a network interface and then physically connected via a communication connection. The network interface covers communication networks such as local area networks (LANs) and wide area networks (WANs). LAN technologies include fiber distributed data interface (FDDI), copper distributed data interface (CDDI), Ethernet / IEEE 802.3, Token ring / IEEE 802.5 and the like. Technologies
[0112] [0112] In several respects, computer system 210 of Figure 10, imaging module 238 and / or display system 208, and / or processor module 232 of Figures 9 to 10, may comprise a processor of image, image processing engine, media processor, or any specialized digital signal processor (DSP) used for processing digital images. The image processor can use 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 a system in an integrated circuit with a multi-core processor architecture.
[0113] [0113] Communication connections refer to the hardware / software used to connect the network interface to the bus. Although the communication connection is shown for illustrative clarity within the computer system, it can also be external to computer system 210. The hardware / software required for connection to the network interface includes, for illustrative purposes only, internal technologies and external as modems, including regular telephone series modems, cable modems and DSL modems, ISDN adapters and Ethernet cards.
[0114] [0114] In several respects, devices / instruments 235, described with reference to Figures 9 to 10, can be implemented as the surgical device 214002 (Figures 16 to 18), the display screen (Figure 16), the devices to be used next to the body 214100, 214102, 214200, 214202 (Figures 19 to 21), and the screen 214400 (Figures
[0115] [0115] Figure 11 illustrates a functional block diagram of an aspect of a USB 300 central network controller device, in accordance with at least one aspect of the present description. In the illustrated aspect, the USB 300 central network controller device uses a TUSB2036 integrated circuit central controller available from Texas Instruments. The USB 300 core network controller is a CMOS device that provides one USB transceiver port 302 and up to three USB transceiver ports downstream 304, 306, 308 in accordance with the USB 2.0 specification. Upstream USB transceiver port 302 is a differential data root port comprising a "minus" differential data input (DMO) paired with a "plus" differential data input (DPO). The three ports of the downstream USB transceiver 304, 306, 308 are differential data ports, where each port includes "more" differential data outputs (DP1-DP3) paired with "less" differential data outputs (DM1- DM3).
[0116] [0116] The USB 300 central network controller device is implemented with a digital state machine instead of a microcontroller, and no firmware programming is required. Fully compatible USB transceivers are integrated into the circuit for the upstream USB transceiver port 302 and all downstream USB transceiver ports 304, 306, 308. The downstream USB transceiver ports 304, 306, 308 support both full speed as low speed automatically configuring the scan rate according to the speed of the device attached to the ports. The USB 300 central network controller device can be configured in bus-powered or self-powered mode and includes 312 central power logic to manage power.
[0117] [0117] The USB 300 central network controller device includes a 310 series interface engine (SIE). The SIE 310 is the front end of the USB 300 central network controller hardware and handles most of the protocol described in chapter 8 of the USB specification. The SIE 310 typically comprises signaling down to the level of the transaction. The functions it handles could include: packet recognition, transaction sequencing, SOP, EOP, RESET, and RESUME signal detection / generation, clock / data separation, data encoding / decoding non-inverted zero ( NRZI), generation and verification of CRC (token and data), generation and verification / decoding of packet ID (PID), and / or series-parallel / parallel-series conversion. The 310 receives a clock input 314 and is coupled with a suspend / resume logic circuit and frame timer 316 and a repeating circuit 318 of the central controller to control communication between the upstream USB transceiver port 302 and the trans port - downstream USB receiver 304, 306, 308 through the logic circuits of ports 320, 322, 324. The SIE 310 is coupled to a control decoder 326 through logic interface 328 to control the commands of a serial EEPROM via 330 series EEPROM interface.
[0118] [0118] 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 auto central controller - powered, with individual port power management or grouped port power management. In one aspect, 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.
[0119] [0119] Additional details regarding the structure and function of the central surgical controller and / or networks of central surgical controllers can be found in US provisional patent application No. 62 / 659,900, entitled METHOD OF HUB COMMUNICATION, deposited in 19 April 2018, which is incorporated herein by reference, in its entirety.
[0120] [0120] Figure 12 is a block diagram of the interactive surgical system implemented by computer, according to at least one aspect of the present description. In one aspect, the computer-implemented interactive surgical system is configured to monitor and analyze data related to the operation of various surgical systems that include central surgical controllers, surgical instruments, robotic devices, and operating rooms or healthcare facilities. The computer-implemented interactive surgical system comprises a cloud-based data analysis system. Although the cloud-based data analysis system is described as a surgical system, it is not necessarily limited with such and could be a cloud-based medical system in general. As shown in Figure 12, the cloud-based data analysis system comprises a plurality of surgical instruments 7012 (can be the same or similar to instruments 112), a plurality of central surgical controllers 7006 (can be the same or similar to central controllers 106) and a surgical data network 7001 (can be the same or similar to network 201) to couple central surgical controllers 7006 to cloud 7004 (can be the same or similar to cloud 204). Each of the plurality of central surgical controllers 7006 is communicatively coupled to one or more surgical instruments 7012. Central controllers 7006 are also communicably coupled to the cloud 7004 of the interactive surgical system implemented by computer over the 7001 network. The 7004 cloud is a remote centralized source of hardware and software for storing, manipulating and communicating data generated based on the operation of various surgical systems. As shown in Figure 12, access to the 7004 cloud is achieved through the 7001 network, which can be the Internet or some other suitable computer network.
[0121] [0121] In addition, surgical instruments 7012 can comprise transceivers for transmitting data to and from their corresponding central surgical controllers 7006 (which can also comprise transceivers). Combinations of surgical instruments 7012 and corresponding central controllers 7006 can indicate specific locations, such as operating rooms in health posts (for example, hospitals), to provide medical operations. For example, the memory of a central surgical controller 7006 can store location data. As shown in Figure 12, cloud 7004 comprises central servers 7013 (which can be the same or similar to remote server 113 in Figure 1 and / or remote server 213 in Figure 9), application servers for central controllers 7002, analysis modules data 7034 and an input / output interface ("I / O") 7007. Central servers 7013 of the cloud 7004 collectively manage the cloud computing system, which includes monitoring requests by central client controllers 7006 and managing the processing capacity of the 7004 cloud to execute requests. Each of the central servers 7013 comprises one or more processors 7008 coupled with suitable memory devices 7010 which may include volatile memory, such as random access memory (RAM), and non-volatile memory, such as magnetic storage devices. The 7010 memory devices can comprise machine executable instructions that, when executed, cause the 7008 processors to run the 7034 data analysis modules for cloud-based data analysis, operations, recommendations and other operations described below. In addition, 7008 processors can run 7034 data analysis modules independently or in conjunction with applications for central controllers independently run by 7006 central controllers. 7013 central servers also comprise 2212 aggregated medical data databases , which can reside in memory 2210.
[0122] [0122] Based on connections to multiple surgical centers 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 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 the central controllers individual 7006 could not reach on their own. For this purpose, as shown in Figure 12, cloud 7004 and central surgical controllers 7006 are communicatively coupled to transmit and receive information. The I / O interface 7007 is connected to the plurality of central surgical controllers 7006 via the network 7001. In this way, the I / O interface 7007 can be configured to transfer information between the central surgical controllers 7006 and the databases. aggregated medical data
[0123] [0123] The configuration of the specific cloud computing system described in this description is designed specifically to address various issues raised in the context of medical operations and procedures performed using medical devices, such as surgical instruments 7012, 112 In particular, surgical instruments 7012 can be digital surgical devices configured to interact with the 7004 cloud to implement techniques to improve the performance of surgical operations. Various surgical instruments 7012 and / or central surgical controllers 7006 can comprise touch-controlled user interfaces, so that clinicians can control aspects of interaction between surgical instruments 7012 and the cloud 7004. Other user interfaces suitable for control, such as audible alert controlled user interfaces, can also be used.
[0124] [0124] Figure 13 is a block diagram that illustrates the functional architecture of the interactive surgical system implemented by computer,
[0125] [0125] For example, the 7022 data collection and aggregation module could be used to generate self-describing data (for example, metadata), including the identification of notable features or configuration (for example, trends), the management of sets of redundant data and the storage of data in paired data sets that can be grouped by surgery, but not necessarily linked to surgical dates and to real surgeons. In particular, paired data sets generated from the operations of 7012 surgical instruments may comprise application of a binary classification, for example, a bleeding or non-bleeding event. More generally, the binary classification can be characterized as a desirable event (for example, a successful surgical procedure) or an undesirable event (for example, a surgical instrument with failure or misuse 7012). The aggregated self-describing data can correspond to individual data received from various groups or subgroups of central surgical controllers 7006. Consequently, the data collection and aggregation module 7022 can manage aggregated metadata or other organized data based on raw data received from central surgical controllers 7006. For this purpose, 7008 processors can be operationally coupled to applications for central controllers 7014 and aggregated medical data databases 7011 to perform the analysis modules of 7034 data. The 7022 data collection and aggregation module can store the aggregated data organized in the aggregated medical data databases 2212.
[0126] [0126] The resource optimization module 7020 can be configured to analyze this aggregated data to determine an optimal use of resources for a specific group or group of health posts. For example, the resource optimization module 7020 can determine an ideal ordering point for surgical stapling instruments 7012 for a group of clinics based on the corresponding expected demand of such instruments 7012. The resource optimization module 7020 it could also assess resource use or other operational settings at various health posts to determine whether resource use could be improved. Similarly, the 7030 recommendation module can be configured to analyze aggregated data organized from the 7022 data collection and aggregation module to provide recommendations. For example, the 7030 recommendations module could recommend for health care facilities (for example, medical service providers such as hospitals) that a specific surgical instrument 7012 should be upgraded to an improved version based on a higher than expected error rate. , for example. In addition, the 7030 recommendation module and / or the 7020 resource optimization module could recommend better supply chain parameters, such as product refueling points, and provide suggestions for a different 7012 surgical instrument, uses of it or steps procedure to improve surgical results. Health clinics can receive such recommendations through corresponding 7006 central surgical controllers. More specific recommendations on parameters or configurations of various 7012 surgical instruments can also be provided. Central controllers 7006 and / or surgical instruments 7012 can each also have display screens that display data or recommendations provided by the 7004 cloud.
[0127] [0127] The 7028 patient outcome analysis module can analyze surgical results associated with currently used operating parameters of 7012 surgical instruments. The 7028 patient outcome analysis module can also analyze and evaluate other potential operating parameters. In this context, the 7030 recommendations module could recommend the use of these other potential operating parameters based on obtaining better surgical results, such as better sealing or less bleeding. For example, the 7030 recommendation module could transmit recommendations to a central surgical controller 7006 about when to use a particular cartridge for a corresponding 7012 stapling surgical instrument. In this way, the cloud-based data analysis system, while controlling common variables, can be configured to analyze the large collection of raw data and provide centralized recommendations on multiple health posts (advantageously determined based on data aggregates). For example, the cloud-based data analysis system could analyze, evaluate and / or aggregate data based on the type of medical practice, type of patient, number of patients, geographical similarity between medical providers, which providers / medical posts use types similar to instruments, etc., in a way that no health post alone would be able to analyze independently.
[0128] [0128] The 7026 control program update module can be configured to implement various 7012 surgical instrument recommendations when the corresponding control programs are updated. For example, the Patient Results Analysis Module 7028 could identify correlations that link specific control parameters with successful (or unsuccessful) results. These correlations can be addressed when updated control programs are transmitted to 7012 surgical instruments via the 7026 control program update module. Updates to 7012 instruments that are transmitted via a corresponding central controller 7006 can incorporate aggregated performance data that were collected and analyzed by the data collection and aggregation module 7022 from the cloud 7004. Additionally,
[0129] [0129] The cloud-based data analysis system can include safety features implemented by the 7004 cloud. These safety features can be managed by the authorization and safety module 7024. Each 7006 central surgical controller can have unique credentials associated with username, password and other appropriate security credentials. These credentials could be stored in memory 7010 and be associated with a level of access allowed to the cloud. For example, based on providing exact credentials, a 7006 central surgical controller can be granted access to communicate with the cloud up to a predetermined point (for example, only certain defined types of information can participate in transmitting or receiving information) ). For this purpose, the aggregated medical data databases 7011 of the cloud 7004 may comprise a database of authorized credentials to verify the accuracy of the supplied credentials. Different credentials can be associated with varying levels of permission to interact with the 7004 cloud, such as a predetermined level of access to receive data analysis generated by the cloud
[0130] [0130] In addition, for security purposes, the cloud could maintain a database of 7006 central controllers, 7012 instruments and other devices that may comprise a "black list" of prohibited devices. In particular, a blacklisted central surgical controller 7006 may not be allowed to interact with the cloud, while blacklisted 7012 surgical instruments may not have functional access to a corresponding 7006 central controller and / or may be prevented from functioning fully when paired with its corresponding central controller 7006. In addition or alternatively, cloud 7004 can signal instruments 7012 based on incompatibility or other specified criteria. In this way, counterfeit medical devices and inadequate reuse of such devices throughout the cloud-based data analysis system can be identified and addressed.
[0131] [0131] 7012 surgical instruments can use wireless transceivers to transmit wireless signals that can represent, for example, authorization credentials to access the corresponding central controllers 7006 and the 7004 cloud. Wired transceivers can also be used to transmit signals. These authorization credentials can be stored in the respective memory devices of the surgical instruments 7012. The authorization and security module 7024 can determine whether the authorization credentials are accurate or forged. The 7024 authorization and security module can also dynamically generate authorization credentials for increased security. Credentials could also be encrypted, such as using hash-based encryption. After transmitting the appropriate authorization, the surgical instruments 7012 can transmit a signal to the corresponding central controllers 7006 and finally to the cloud 7004 to indicate that the instruments 7012 are ready to obtain and transmit medical data. In response, the 7004 cloud can transition to a state enabled to receive medical data for storage in the 7011 aggregated medical data databases. This availability for data transmission could be indicated, for example, by an indicator luminous on 7012 instruments. The 7004 cloud can also transmit signals to 7012 surgical instruments to update its associated control programs. The 7004 cloud can transmit signals that are targeted to a specific class of 7012 surgical instruments (for example, electrosurgical instruments), so that software updates for control programs are transmitted only to the appropriate 7012 surgical instruments. , the 7004 cloud could be used to implement comprehensive system solutions to address local or global problems based on selective data transmission and authorization credentials. For example, if a group of 7012 surgical instruments is identified as having a common manufacturing defect, cloud 7004 can change the authorization credentials that correspond to that group to implement an operational lockout for the group.
[0132] [0132] The cloud-based data analysis system can enable the monitoring of multiple health posts (for example, medical posts such as hospitals) to determine improved practices and recommend changes (via the 2030 recommendations module) , for example) accordingly. In this way, processors 7008 from the 7004 cloud can analyze the data associated with an individual health clinic to identify the health clinic and aggregate the data with other data associated with other health clinics in a group. Groups could be defined based on similar operating practices or geographic location, for example. In this way, the 7004 cloud can provide analysis and recommendations for the entire group of health posts. The cloud-based data analysis system could also be used to increase situational awareness. For example, 7008 processors can predictively model the effects of recommendations on cost and effectiveness for a specific post (in relation to general operations and / or various medical procedures). The cost and effectiveness associated with that specific post can also be compared to a corresponding local region of other posts or any other comparable post.
[0133] [0133] The 7032 data classification and prioritization module can prioritize and classify data based on severity (for example, the severity of a medical event associated with the data, unpredictability, distrust). This classification and prioritization can be used in conjunction with the functions of the other 7034 data analysis modules described above to improve the operation and analysis of cloud-based data described here. For example, the 7032 data classification and prioritization module can assign a priority to the data analysis performed by the 7022 data collection and aggregation module and the 7028 patient outcome analysis module. Different levels of prioritization can result in responses specific to the 7004 cloud (corresponding to a level of urgency), such as escalation to an accelerated response, special processing, exclusion from the 7011 aggregated medical data databases or other appropriate responses. In addition, if necessary, the 7004 cloud can transmit a request (for example, a push message) through application servers to central controllers for additional data from corresponding 7012 surgical instruments. The push message can result in a notification displayed on the corresponding 7006 central controllers to request support or additional data. This push message may be required in situations where the cloud detects an irregularity or results outside of significant limits and the cloud cannot determine the cause of the irregularity. Central 7013 servers can be programmed to activate this push message in certain significant circumstances, such as when data is determined to be different from an expected value beyond a predetermined threshold or when it appears that security has been compounded, for example .
[0134] [0134] In several respects, the surgical instrument (s) 7012 described above with reference to Figures 12 and 13 can be implemented as the surgical device 214002 (Figures 16 to 18), the display screen (Figure 16), the devices to be used next to the body 214100, 214102, 214200, 214202 (Figures 19 to 21), and the screen 214400 (Figures 22A and 22B). Consequently, the surgical device 214002 (Figures 16 to 18), the display screen (Figure 16), the devices to be used close to the body 214100, 214102, 214200, 214202 (Figures 19 to 21), and the screen 214400 (Figures 22A and 22B) are configured to interface with the central surgical controller 7006 and the 2001 network, which is configured to interface with the 7004 cloud. Consequently, the processing power provided by central servers 7013 and the data analysis 7034 are configured to process information (for example, data and control) from surgical device 214002 (Figures 16 to 18), the display screen (Figure 16), devices to be used with the body 214100, 214102, 214200, 214202 (Figures 19 to 21), and the screen 214400 (Figures 22A and 22B).
[0135] [0135] Additional details related to the cloud data analysis system can be found in US provisional patent application No. 62 / 659,900, entitled METHOD OF HUB COMMUNICATION, filed on April 19, 2018, which is incorporated herein as title reference, in its entirety. Situational recognition
[0136] [0136] Although a "smart" device, including control algorithms responsive to detected data, can be an improvement over a "stupid" device that operates without taking the detected data, some detected data can be incomplete or inconclusive when considered in isolation, that is, without the context of the type of surgical procedure being performed or the type of tissue that is undergoing the surgery. Without knowing the context of the procedure (for example, knowing the type of tissue that is undergoing surgery, or the type of procedure that is being performed), the control algorithm may control the modular device incorrectly or suboptimally, detected data without specific context is provided. For example, the ideal way for a control algorithm to control a surgical instrument in response to a particular parameter detected may vary according to the type of particular tissue being operated on. This is due to the fact that different types of tissue have different properties (for example, tear resistance) and thus respond differently to actions performed by surgical instruments. Therefore, it may be desirable for a surgical instrument to perform different actions when the same measurement is detected for a specific parameter. As a specific example, the optimal way in which to control a surgical stapling and cutting instrument in response to the instrument detecting an unexpectedly high force to close its end actuator, will vary depending on whether the type of tissue is susceptible or resistant to tearing . For tissues that are susceptible to tearing, such as lung tissue, the instrument's control algorithm would optimally slow the engine in response to an unexpectedly high force to close to prevent tearing of the tissue. For tissues that are tear resistant, such as stomach tissue, the instrument's control algorithm would optimally accelerate the engine in response to an unexpectedly high force to close to ensure that the end actuator is properly trapped in the tissue. Without knowing whether lung or stomach tissue has been trapped, the control algorithm can make a decision below what is considered ideal.
[0137] [0137] One solution uses a central surgical controller including a system configured to derive information about the surgical procedure being performed based on data received from various data sources, and then control, accordingly, the modular devices Paired. In other words, the central surgical controller is configured to infer information about the surgical procedure from data received and, then, to control modular devices paired with the central surgical controller based on the inferred context of the surgical procedure. . Figure 14 illustrates a diagram of a surgical system with 5100 situational recognition, in accordance with at least one aspect of the present description. In some examples, data sources 5126 include, for example, modular devices 5102 (which may include sensors configured to detect parameters associated with the patient and / or the modular device itself), databases 5122 (for example, an EMR database containing the patient's medical record), and 5124 monitoring devices (for example, a blood pressure (BP) monitor and an electrocardiography (ECG) monitor)).
[0138] [0138] A central surgical controller 5104 that can be similar to surgical controller 106 in many ways, can be configured to derive contextual information related to the surgical procedure from the data based, for example, on the combination (s) ( specific data (s) received or in the specific order in which data are received from data sources 5126. Contextual information inferred from data received may include, for example, the type of surgical procedure being performed, the stage specific to the surgical procedure that the surgeon is performing, the type of tissue being operated on, or the body cavity that is the object of the procedure. This ability for some aspects of the 5104 central surgical controller to derive or infer information related to the surgical procedure from received data, can be called "re-
[0139] [0139] The situational perception system of the central surgical controller 5104 can be configured to derive contextual information from data received from data sources 5126 in several ways. In one example, the situational perception system includes a pattern recognition system, or machine learning system (for example, an artificial neural network), which has been trained in training data to correlate various inputs ( for example, data from databases 5122, patient monitoring devices 5124, and / or modular devices 5102) to corresponding contextual information regarding a surgical procedure. In other words, a machine learning system can be trained to accurately derive contextual information regarding a surgical procedure from the inputs provided. In another example, the situational perception system may include a lookup table that stores pre-characterized contextual information regarding a surgical procedure in association with one or more entries (or ranges of entries) corresponding to the contextual information. In response to a query with one or more entries, the lookup table can return the corresponding contextual information to the situational perception system to control the 5102 Modular devices. In an example, the contextual information received by the system's situational perception system central surgical controller 5104, are associated with a control setting or set of control settings
[0140] [0140] A 5104 central surgical controller, which incorporates a situational perception system, provides several benefits to the 5100 surgical system. One benefit includes improving the interpretation of detected and captured data, which, in turn, improves processing accuracy and / or data usage during the course of a surgical procedure. To return to an earlier example, a 5104 central surgical controller with situational awareness could determine what type of tissue was being operated on; therefore, when an unexpectedly high force is detected to close the end actuator of the surgical instrument, the central surgical controller with situational perception 5104 could correctly accelerate or decelerate the surgical instrument motor for the tissue type.
[0141] [0141] As another example, the type of fabric being operated can affect the adjustments that are made to the load and compression rate thresholds of a stapling and surgical cutting instrument for a specific span measurement. A central surgical controller with situational perception 5104 could infer whether a surgical procedure being performed is a thoracic or abdominal procedure, allowing the central surgical controller 5104 to determine whether tissue pinched by an instrument end actuator stapling and surgical cutting instrument is lung tissue (for a thoracic procedure) or stomach tissue (for an abdominal procedure). The central surgical controller 5104 can then adjust
[0142] [0142] As yet another example, the type of body cavity being operated during an insufflation procedure, can affect the function of a smoke evacuator. A central surgical controller with situational perception 5104 can determine if the surgical site is under pressure (by determining that the surgical procedure is using insufflation) and determine the type of procedure. As a type of procedure is generally performed in a specific body cavity, the 5104 central surgical controller can then adequately control the speed of the smoke evacuator motor to the body cavity being operated on. In this way, a central surgical controller equipped with 5104 situational awareness can provide a consistent amount of smoke evacuation to both thoracic and abdominal procedures.
[0143] [0143] As yet another example, the type of procedure being performed may affect the ideal energy level for an ultrasonic surgical instrument or radio frequency (RF) electrosurgical instrument to operate. Arthroscopic procedures, for example, require higher energy levels because the end actuator of the ultrasonic surgical instrument or RF electrosurgical instrument is immersed in fluid. A central surgical controller with situational perception 5104 can determine whether the surgical procedure is an arthroscopic procedure. The 5104 central surgical controller can then adjust the RF power level or the generator's ultrasonic range (ie, the "energy level") to compensate for the fluid-filled environment. Related to this, the type of tissue being operated on can affect the ideal energy level at which an ultrasonic surgical instrument or RF electrosurgical instrument operates. A central surgical controller
[0144] [0144] As yet another example, data can be extracted from additional data sources 5126 to improve the conclusions that the central surgical controller 5104 draws from a 5126 data source. A central surgical controller with situational perception 5104 can augment the data that he receives from modular devices 5102 with contextual information that he has accumulated, referring to the surgical procedure, from other data sources 5126. For example, a central surgical controller with situational perception 5104 can be configured to determine if hemosystems occurred tasia (that is, if bleeding has stopped at a surgical site), according to video or image data received from a medical imaging device. However, in some cases, video or image data may be inconclusive. So, in an example,
[0145] [0145] Another benefit includes proactively and automatically controlling paired modular devices 5102, according to the specific stage of the surgical procedure being performed to reduce the number of times medical personnel are required to interact com or control the 5100 surgical system during the course of a surgical procedure. For example, a central surgical controller with situational perception 5104 can proactively activate the generator to which an RF electrosurgical instrument is connected, if it is determined that a subsequent step in the procedure requires the use of the instrument. Proactively activating the power source allows the instrument to be ready for use as soon as the preceding step of the procedure is complete.
[0146] [0146] As another example, a central surgical controller with situational perception 5104 could determine whether the current or subsequent stage of the surgical procedure requires a different view or degree of magnification of the screen, according to the resource (s) in the surgical site that the surgeon is expected to see. The central surgical controller 5104 could then proactively change the displayed view (provided, for example, by a Medical Imaging device to the visualization system 108), so that the screen automatically adjusts throughout the surgical procedure.
[0147] [0147] As yet another example, a central surgical controller with situational perception 5104 could determine which stage of the surgical procedure is being performed or will be performed subsequently and whether specific data or comparisons between the data will be required for that stage of the surgical procedure . The 5104 central surgical controller can be configured to call screens automatically based on data about the stage of the surgical procedure being performed, without waiting for the surgeon to request specific information.
[0148] [0148] Another benefit includes checking for errors during the configuration of the surgical procedure or during the course of the surgical procedure. For example, a central surgical controller with situational perception 5104 could determine whether the operating room is properly or ideally configured for the surgical procedure to be performed. The central surgical controller 5104 can be configured to determine the type of surgical procedure being performed, retrieve the corresponding checklists, product location, or configuration needs (for example, from a memory), and then compare the layout of the current operating room with the standard layout for the type of surgical procedure that the 5104 central surgical controller determines is being performed. In one example, the central surgical controller 5104 can be configured to compare the list of items for the procedure scanned by a suitable scanner, for example and / or a list of devices paired with the central surgical controller 5104 to a recognized manifest.
[0149] [0149] As another example, the central surgical controller with situational perception 5104 could determine whether the surgeon (or other medical personnel) was making a mistake or otherwise deviating from the expected course of action during the course of a surgical procedure. For example, the central surgical controller 5104 can be configured to determine the type of surgical procedure being performed, retrieve the corresponding list of steps or order of use of the equipment (for example, from a memory), and then compare the steps being performed or the equipment being used during the course of the surgical procedure with the steps or with the equipment expected for the type of surgical procedure that the central surgical controller 5104 determined is being used executed. In one example, the central surgical controller 5104 can be configured to provide an alert indicating that an unexpected action is being taken or an unexpected device is being used at the specific stage in the surgical procedure.
[0150] [0150] In general, the situational perception system for the 5104 central surgical controller improves the results of the surgical procedure by adjusting the surgical instruments (and other 5102 modular devices) to the specific context of each surgical procedure. (such as adjustment to different types of tissue), and when validating actions during a surgical procedure. The situational perception system also improves the surgeon's efficiency in performing surgical procedures by automatically suggesting the next steps, providing data, and adjusting screens and other 5102 modular devices in the operating room, according to the specific context of the procedure.
[0151] [0151] In one aspect, as described later in this document with reference to Figures 24 to 40, the modular device 5102 is implemented as the surgical device 214002 (Figures 16 to 18), the display screen (Figure 16), the devices to be used next to the body 214100, 214102, 214200, 214202 (Figures 19 to 21), and the screen 214400 (Figures 22A and 22B). Consequently, the modular device 5102 implemented as the surgical device 214002 (Figures 16 to 18), the display screen (Figure 16), the devices to be used close to the body 214100, 214102, 214200, 214202 (Figures 19 to 21), or screen 214400 (Figures 22A and 22B) are configured to operate as a data source 5126 and to interact with database 5122 and patient monitoring devices 5124. Modular device 5102 implemented as surgical device 214002 (Figures 16 to 18), the display screen (Figure 16), the devices to be used next to the body 214100, 214102, 214200, 214202 (Figures 19 to 21), and the screen 214400 (Figures 22A and 22B) they are additionally configured to interact with the central surgical controller 5104 to provide information (for example, data and control) to the central surgical controller 5104 and receive information (for example, data and control) from the central surgical controller 5104.
[0152] [0152] Referring now to Figure 15, a 5200 timeline is shown representing the situational recognition of a central controller, such as central surgical controller 106 or 206 (Figures 1 to 11), for example. Timeline 5200 is an illustrative surgical procedure and the contextual information that the central surgical controller 106, 206 can derive from data received from data sources at each stage in the surgical procedure. Timeline 5200 represents 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.
[0153] [0153] Situational recognition of a central surgical controller 106, 206 receives data from data sources throughout the course of the surgical procedure, including data generated each time medical personnel use a modular device that is paired with the center surgical 106, 206. Central surgical controller 106, 206 can receive this data from paired modular devices and other data sources and continuously derive inferences (ie contextual information) about the ongoing procedure as new data 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 capable, for example, of recording data related to the procedure to generate reports, verifying the steps being taken by medical personnel, providing data or warnings (for example, through display screen) that may be relevant to the specific step of the procedure, adjust the modular devices based on the context (for example, activate monitors, adjust the field of view (FOV) of the medical imaging device, or change the energy level of an ultrasonic surgical instrument or RF electrosurgical instrument), and take any other action described above.
[0154] [0154] In the first step 5202, in this illustrative procedure, the members of the hospital team retrieve the electronic patient record (PEP) from the hospital's PEP database. Based on the patient selection data in the PEP, the central surgical controller 106, 206 determines that the procedure to be performed is a thoracic procedure.
[0155] [0155] In the second step 5204, the team members scan the incoming medical supplies for the procedure. The central surgical controller 106, 206 cross-references the scanned supplies with a list of supplies that are used in various types of procedures and confirms that the supply mix corresponds to a thoracic procedure. In addition, the central surgical controller 106, 206 is also able to determine that the procedure is not a wedge procedure (because the inlet supplies have an absence of certain supplies that are necessary for a thoracic wedge procedure or, if not, that the input supplies do not correspond to a thoracic wedge procedure).
[0156] [0156] 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 based on the scanned data .
[0157] [0157] In the fourth step 5208, the medical personnel turns on the auxiliary equipment. The auxiliary equipment being used may vary according to the type of surgical procedure and the techniques to be used by the surgeon, but in this illustrative case they include a smoke evacuator, an insufflator and a medical imaging device. When activated, auxiliary equipment that is modular devices can automatically pair with the central surgical controller 106, 206 which is located within a specific vicinity of the modular devices as part of its initialization process. The central surgical controller 106, 206 can then derive contextual information about the surgical procedure by detecting the types of modular devices that correspond with it during that preoperative or initialization phase. In this particular example, the central surgical controller 106, 206 determines that the surgical procedure is a VATS (video-assisted thoracic surgery) procedure based on this specific combination of paired modular devices. Based on the combination of data from the electronic patient record (PEP), the list of medical supplies to be used in the procedure, and the type of modular devices that connect to the central controller, the central surgical controller 106, 206 it can, in general, infer the specific procedure that the surgical team will perform. After the central surgical controller 106, 206 recognizes which specific procedure is being performed, the central surgical controller 106, 206 can then retrieve the steps of that process from a memory or from the cloud and then cross 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.
[0158] [0158] In the fifth step 5210, the team members fix the elements
[0159] [0159] 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 patient monitoring devices, including ECG data, blood pressure data, ventilator data, or combinations of them, for example. After the completion of the sixth step 5212, the preoperative portion of the lung segmentation procedure is completed and the operative portion begins.
[0160] [0160] In the seventh step 5214, the lung of the patient being operated on is retracted (while ventilation is switched to the contralateral lung). The central surgical controller 106, 206 can infer from the ventilator data that the patient's lung has been retracted, for example. The central surgical controller 106, 206 can infer that the operative portion of the procedure started when he could compare the detection of the patient's lung collapse in the expected steps of the procedure (which can be accessed or retrieved earlier) and thus determine that lung retraction is the first operative step in this specific procedure.
[0161] [0161] In the eighth step 5216, the medical imaging device (for example, a display device) is inserted and the video from the medical imaging device is started. The central surgical controller 106, 206 receives data from the medical imaging device (i.e., video or image data) through its connection to the medical imaging device.
[0162] [0162] 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 being fired at that point in the process (that is, after the completion of the previously discussed steps of the procedure) corresponds to the step of dissection. In some cases, the energy instrument can be an energy tool mounted on a robotic arm of a robotic surgical system.
[0163] [0163] In the tenth step 5220 of the procedure, the surgical team proceeds to the connection step. Central surgical controller 106, 206 can infer that the surgeon is ligating the arteries and veins because he receives data from the surgical stapling and cutting instrument indicating that the instrument is being fired. Similar to the previous step, the central surgical controller 106, 206 can derive this inference by crossing the reception data from the surgical stapling and cutting instrument with the steps recovered in the process. In certain cases, the surgical instrument can be a surgical tool mounted on a robotic arm of a robotic surgical system.
[0164] [0164] 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 segmentectomy portion of the procedure is being performed.
[0165] [0165] 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 nodule 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 nodule dissection step, which allows the central surgical controller 106, 206 to make this inference. It should be noted that surgeons regularly switch between surgical stapling / cutting instruments and surgical energy instruments (that is, RF or ultrasonic) depending on the specific step in the procedure because different instruments are better adapted for specific tasks. Therefore, the specific sequence in which cutting / stapling instruments and surgical energy instruments are used can indicate which stage of the procedure the surgeon is performing. In addition, in certain cases, robotic tools can be used for one or more steps in a surgical procedure and / or hand surgical instruments can be used for one or more steps in 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.
[0166] [0166] 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.
[0167] [0167] Finally, in the fourteenth step 5228 is that medical personnel remove the various patient monitoring devices from the patient. Central surgical controller 106, 206 can thus infer that the patient is being transferred to a recovery room when the central controller loses ECG, blood pressure and other data from patient monitoring devices. As can be seen from the description of this illustrative procedure, the central surgical controller 106, 206 can determine or infer when each step of a given surgical procedure is taking place according to the data received from the various data sources which are communicably coupled to the central surgical controller 106, 206.
[0168] [0168] In several aspects, the surgical device 214002 (Figures 16 to 18), the display screen (Figure 16), the devices to be used next to the body 214100, 214102, 214200, 214202 (Figures 19 to 21) , and screen 214400 (Figures 22A and 22B) are configured to operate in a situational recognition in a central environment, such as the control
[0169] [0169] In several cases, digital surgical devices can be controlled via one or more surgical barriers. Surgical barriers include sterile physical barriers, sterile intangible barriers and a patient's body walls. In one aspect, a first operating room system located within a sterile field can be indirectly commanded and controlled through the use of a second operating room system, which can have a primary operating mode and a primary operating mode. secondary operation, which is designed to interact with the first operating room system to provide commands and control. For example, in primary operating mode, the second operating room system can perform a primary surgical function. In the secondary operating mode, the primary surgical function can be disabled. In addition, in secondary operating mode, the second operating room system can command and control the first operating room system. For example, a surgical instrument can be configured to run the tissue in the first mode of operation and to command and control an image system and / or a display of it in the second mode of operation.
[0170] [0170] In certain cases, a doctor may want to contribute to a remote surgical system and / or a central surgical controller coupled in a communicative way to the remote surgical system from within the sterile field. For example, a doctor holding a first operating room system (for example, a surgical device) may want to provide commands or inputs to another operating room system (for example, an imaging or visualization and / or display system positioned outside the sterile field. In certain cases, it may be desirable to use the first operating room system to communicate or interact with the other operating room system through a surgical barrier, such as the outline of a patient's sterile field and / or body.
[0171] [0171] To facilitate such an interaction, the first operating room system can include a plurality of operating modes including a primary and a secondary mode. The first operating room system can switch between operating modes to selectively interact with the second operating room system. In such cases, the physician can interact with the second operating room system without delivering or releasing the first operating room system and / or without removing the first operating room system from the surgical site.
[0172] [0172] For example, a surgical system may include a first device comprising a first control circuit and a second device configured to perform a surgical function, wherein the second device comprises a second control circuit in signal communication with the first control circuit, and where the second control circuit is configured to selectively switch the second device between a secondary operating mode, in which the second device is configured to indirectly control the first device, and an operating mode primary, in which the second device is configured to control surgical function. Each control circuit can include a processor and a memory communicatively coupled with the processor, where the memory stores instructions executable by the processor to receive an input signal. In response to the input signal, the second control circuit can switch between the primary operating mode and the secondary operating mode. In primary operating mode, the second control circuit can trigger a surgical function, for example. When in secondary operating mode, the second control circuit can control a display screen, for example. In many cases, a computer-readable non-tangible medium can store computer-readable instructions that, when executed, cause a surgical device to receive an input signal. In response to the input signal, the second control circuit can switch between the primary operating mode and the secondary operating mode. In the primary operating mode, the second control circuit can trigger a surgical function, for example. When in secondary operating mode, the second control loop can control a display screen, for example.
[0173] [0173] In one aspect, a surgical device can interface with a main screen to adjust and / or control the main screen. For example, the main screen can be controlled by means of a visual interface using a secondary control function of the surgical tool. In other words, the surgical device can be shown on the main screen and can act as a cursor or indicator on the screen to interact with a screen user interface. In addition, entries for the surgical device can be entries for the screen and / or a central surgical controller that includes the screen. In such cases, the surgical device can be an input device for an interaction technique, user interface technique, or input technique, which uses a combination of hardware and software to enable a computer (or control circuit). yourself) perform a task. The output can be displayed on the main screen and / or communicated to a central surgical controller, as output resulting from a mouse click and / or selection provides an input command, which can be displayed or otherwise communicated via a computer monitor, for example.
[0174] [0174] With reference to Figures 16 to 18, a 214000 surgical system includes a 214002 surgical device and a display screen
[0175] [0175] In several cases, the display screen 214004 can be a video monitor, which is operationally configured to display a live transmission of images from the surgical site. The display screen 214004 can represent a live, live video of the surgical site during a surgical procedure. Additionally or alternatively, the display screen 214004 can be configured to display an augmented reality view of the surgical site. For example, the display screen 214004 can demonstrate hidden anatomical structures and / or hidden surgical devices. Such an augmented reality view can be turned on and off, for example. The display screen 214004 also includes a graphical user interface. An operator can interact with the graphical user interface to provide commands or input controls for the display system and / or a surgical system communicatively coupled to the display system, as further described in the present invention.
[0176] [0176] Surgical device 214002 is a hand held surgical instrument including a handle 214006, an elongated drive shaft 214008 that extends distally from handle 214006, and an end actuator 214010 that extends distally from axis elongated drive 214008. End actuator 214010 is configured to make the fabric. In one example, the hand-held surgical device may be an ultrasonic device. In such cases, the 214010 end actuator may include an ultrasonic blade. A claw arm can be positioned opposite the ultrasonic blade to facilitate tissue clamping against the ultrasonic blade in several cases. Additionally or alternatively, the 214010 end actuator may include tissue contact electrodes that are configured to apply RF current to the tissue. In certain cases, the 214010 end actuator may include a reciprocating knife, stapler, clip applicator and / or claw, for example. In certain cases, the 214002 surgical device may include a cabinet that can be releasably attached to a robotic arm. In such cases, the 214002 surgical device can be controlled by a physician on a surgeon's console for the robotic surgical system.
[0177] [0177] The surgical device 214002 is configured to switch between a first mode and a second mode. The first mode can be an operational mode in which the 214002 surgical device is configured to perform a surgical function. For example, in the first mode, the surgical device 214002 can be configured to apply vibrational energy to the tissue. The second mode can be a cursor mode or control mode, in which the surgical device 214002 can be configured to provide inputs to the display screen 214004.
[0178] [0178] Referring mainly to Figure 17, the surgical device 214002 extends through a surgical barrier 214012 into the surgical site. The surgical barrier 214012 is an anatomical wall of a patient. The surgical device 214002 can also extend through a sterile field boundary that forms another surgical barrier. At the surgical site, an imaging system is configured to obtain views of the surgical site and the surgical device
[0179] [0179] The end actuator 214010 can switch or switch between the primary mode and the second mode, which can be called the secondary mode. The selected mode can be displayed on the display screen 214004. For example, the display screen 214004 in Figure 16 shows a cursor mode icon 214052 to indicate that the end actuator 214010 is acting as a cursor in a se mode. - secondary. In the secondary mode, the end actuator 214010 can be used to interact with the display screen 214004 and indirectly control the visualization system or a surgical system communicatively coupled to it. The 214010 end actuator shown on the display screen 214004 can function as a pointer or cursor to the graphical interface shown on the display screen 214004. In such cases, the clinician does not have to remove his hands from the 214002 surgical device or remove the surgical device 214002 on the patient's body to engage the display screen 214004 and provide input to the display screen 214004. In many cases, the imaging device's camera (for example, a laparoscopic camera) can be configured to track the movement of surgical devices at the surgical site. For example, the camera can scan or otherwise adjust its field of view to follow one or more surgical devices (or portions of them) around the surgical site. In several cases, the doctor can select which surgical device (s) and / or portion (s) of the same (s) are tracked by the camera. In such cases, the camera can track the end actuator 214010, which can ensure that the end actuator 214010 is shown on the display screen 214004 when the surgical device 214002 is in secondary mode.
[0180] [0180] In secondary mode, the surgical device 214002 can be used as an input device such as a computer mouse or a joystick, for example, to move a cursor around the interface on the display screen 214004 to manipulate the functions shown on the display screen 214004. When the displayed portion of the device is used as a cursor, the tip of the device (i.e. "cursor") can press buttons on the display screen 214004, and drag and drop display items, circle and / or highlight a portion of the video (e.g.,
[0181] [0181] The operating mode of the 214002 surgical device can be selected by the physician. For example, the doctor can alternatively switch or selectively switch the surgical device 214002 between primary and secondary mode. In one instance, the secondary mode can be activated with a voice command. In another case, a tactile action by a doctor may activate the secondary mode. Referring mainly to Figure 18, the surgical device 214002 includes a manual key 214018, which can enable the physician to switch between operating modes. The first position of the 214018 hand switch can correspond to the main mode, and a second position of the 214018 hand switch can correspond to the secondary mode. The physician can move the 214018 hand key to switch the 214002 surgical device between operating modes.
[0182] [0182] In one example, the 214002 surgical device is an ultrasonic surgical instrument like the HARMONIC ACEG scissors from Ethicon Endo-Surgery, LLC. This ultrasonic surgical instrument can include a plurality of input actuators, such as 214020 and 214022 maximum and minimum power buttons. The 214020 maximum power button can generate ultrasonic energy at a first energy level, or within a first range, in primary mode, and the 214022 minimum power button can generate ultrasonic energy at a second energy level, or in a second range, in primary mode. The second energy level, or second range, may be less than the first energy level, or first range. In several cases, the 214020, 214022 buttons can define a range of positions that correspond to different levels and / or can detect the operator's strength and adjust the energy level accordingly. For example, at least one of the buttons 214020, 214022 can define a rotating element to scroll between levels and / or selections, similar to a rotating wheel on a computer mouse, for example.
[0183] [0183] In secondary mode, the ultrasonic sealing and cutting function can be disabled and the maximum and minimum power buttons 214020 and 2104022 on surgical device 214002 can act as buttons on a computer mouse. The clinician can point the tip of the surgical device 214002 (as shown on the display screen 214004) to something displayed on the display screen 214004 and the buttons can then interact with the display screen 214004, as described above. The 214002 surgical device's double-button entry features can be intuitive for the physician familiar with a two-button computer mouse, for example. In several cases, the two buttons can be used to select icons, drag and drop icons and / or adjust and interact with various features of the display screen 214004, as further described in the present invention.
[0184] [0184] In several cases, the display screen 214004 is communicatively coupled to a central surgical controller, such as
[0185] [0185] In several cases, the physician can interact with the display screen 214004 to control and / or provide input to the central surgical controller. In cases where the display screen 214004 is positioned outside the sterile field, such as main screen 119 in Figure 2, for example, the doctor can exercise control of the display screen
[0186] [0186] In several aspects, a device to be worn close to the body, that is, "that can be worn", can be configured to facilitate interaction with one or more devices connected in a communicative way. For example, a device to be used by the physician close to the body within a sterile field can be used to interact with a surgical system outside the sterile field. The device to be worn close to the body can be an interactive device that is configured to interact with a remote system. In many cases, the device to be worn close to the body can identify the user, that is, the doctor using the device, and can identify the surgical device (s) within a range of positions around device to be worn close to the body. Such a device for use on the body can determine whether and how a doctor is holding a specific surgical device, for example. A device to be worn next to the body worn on the wrist 214100 is shown in Figure 20, and a device to be worn next to the body worn on the finger 214102 is shown in Figure 21. The device to be worn next to the body worn on the wrist 214100 can be attached to the doctor's "W" wrist like a watch or a bracelet, for example. The device to be worn close to the body worn on the 214102 finger can be attached to the "T" thumb or "F" finger of the doctor's hand like a ring, for example.
[0187] [0187] The devices to be used close to the body 214100, 214102 each include a communication module 214104 that facilitates communication between the devices to be used close to the body
[0188] [0188] In one aspect, devices to be used close to the body can assist the physician in interacting with screens, such as a main screen, such as main screen 119 (Figure 2), located outside the sterile field. For example, a device to be worn close to the body may allow a surgeon to enter, select, advance, resize and gesture against a graphical user interface on the device to be used close to the body to adjust or control the main screen. For example, inserting a zoom operation on the device for use on the body can enlarge a portion of the video stream on the main screen. In one example, the device to be worn close to the body may include a simplified and / or minimized version of the information on the main screen, similar to a page on a mobile device that displays a simplified and / or minimized version of the information available at a desktop. The device to be worn close to the body can include a graphical user interface and a touchscreen so that inputs for the graphical user interface on the touchscreen can be communicated to the main screen. In such an implementation, a doctor can interact with a capacitive interactive surface sealed on the device to be worn close to the body, which can be worn like a wristwatch, with infused capacitive latex gloves, for example.
[0189] [0189] In several cases, the device to be used close to the body can be tracked with image and / or object recognition techniques. For example, image and / or video data can be processed using a variety of techniques for machine vision, image processing, object recognition and optical tracking to track features, properties, actions and movements of the device to be used close to the body. For example, the device to be worn close to the body can be recognized from images captured by one or more cameras in the operating room using a variety of image and / or object recognition techniques, including techniques based on appearance and characteristics. tics. For example, captured images can be processed using an edge detection algorithm (for example, a Canny edge detector algorithm) to generate contours of the various objects within each image. An algorithm can then compare target object models (for example, the device (s) to be used next to the target body) to the images containing the outlined objects to determine if any of the target objects is located in the images. As another example, an algorithm can extract characteristics from images
[0190] [0190] In certain cases, the device to be used close to the body may include an array of magnets, which can be detected by a sensor inside the operating room. Based on the position (or positions) of the device to be used close to the body detected by the sensor, the surgical system can determine the movement of the device to be used close to the body. The movement may correspond to gestures by the doctor, for example. In such cases, the surgical system can determine one or more gestures by the doctor and, in several cases, such gestures can be communicated to another surgical system, such as an imaging system. For example, gestures may correspond to entering commands on a display screen of the imaging system. Magnetic detection matrices are described in more detail in the currently filed US patent application, entitled IMAGE CAPTURING OF THE AREAS OUT-
[0191] [0191] As another example, a device to be worn close to the body may allow tracking of surgical devices by looking at surgical devices during delivery, such as when a handheld surgical instrument is picked up and / or delivered to a doctor , for example. Referring mainly to Figure 19, a physician C is using two devices to be worn on the body: a first device of the type 214200 is on the right wrist of the doctor RW, and a second device for dressing 214202 is on the doctor's left LW pulse. Devices to be worn close to the body 214200, 214202 can be configured to determine which surgical device is positioned in which clinician's hand. For example, the first device to be used close to the body 214200 can pair with a first surgical device 214210 in the right hand of the doctor, and the second device to be used close to the body 214202 can be paired with a second surgical device 214212 when the second surgical device 214212 is delivered to the doctor. In an implementation, the device to be worn close to the body 214200 and / or 214202 may include a built-in RFID tag or near-field communication device that allows a grip on the doctor's hand to recognize which doctor is holding the surgical device so that the surgical device can be automatically paired or repaired for the doctor. For example,
[0192] [0192] For example, a first arrangement of controls and / or selections can be used for a right-handed doctor and a second different arrangement of controls and / or selections can be used for a left-handed doctor. Additionally or alternatively, the layout of the controls and / or the availability of certain controls may depend on the possibility that the surgical device is positioned in the dominant or non-dominant hand of the physician and / or based on recognition situational from a central surgical controller. In several cases, a device to be worn close to the body can identify the doctor, for example, and thus include the doctor's personalized settings, including the identification of the doctor's dominant hand, for example.
[0193] [0193] In several cases, the control of a surgical device can be shared by different control devices and / or the control of the surgical device can switch between multiple control devices. For example, a surgical device may include a stand-alone control mode, in which control inputs are provided by the device itself. For example, a doctor can engage an actuator on the surgical device (for example, a button, switch, lever, trigger, etc.) to activate a surgical function (for example, power activation, clamping, triggering, etc.) on the device surgical. Surgical hand tools and robotic surgical tools can operate in an autonomous control mode, for example. For robotic surgical tools, the input control (s) may be on the surgeon's control console. For a hand held surgical tool, the entry control (s) may be on the handle, for example.
[0194] [0194] In certain cases, the surgical device can be controlled and / or subdued by another surgical device, which can selectively issue control inputs to the surgical device. In such cases, the surgical device can be called a "controlled surgical device" and the other surgical device can be called a "surgical control device." In one aspect, a mobile device that has wireless communication capabilities, such as a smartphone or tablet, for example, can be a surgical control device, which is selectively configured to provide control inputs to a controlled surgical device. Such a mobile device can be positioned in the sterile field. Additionally or alternatively, a device to be worn close to the body can be a surgical control device, which is configured to provide control inputs to a controlled surgical device, as further described in the present invention. In still other cases, a surgical control device, which can be paired and / or communicatively coupled to a controlled surgical device using a central surgical controller, for example, can be configured to provide input controls to the controlled surgical device . In other cases, a display screen can be a surgical control device, which is configured to provide input controls for a controlled surgical device and / or a surgical control device can interact with a visualization system (for example, as a cursor on a display screen) to provide input controls to the visualization system and / or other connected surgical device, that is, the controlled surgical device (s). In the previous examples, the controlled surgical device can maintain at least some degree of autonomous control while the surgical control device (s) selectively exercise variable degrees of control of the surgical instrument. controlled as well. In other cases, the controlled controls of the controlled surgical device may be disabled when control by a surgical control device is enabled and / or activated. In many cases, multiple surgical devices (including the controlled surgical device itself in certain cases) can simultaneously share control of the controlled surgical device. The reader will understand that several interactions of control interactions are contemplated in cases where a central surgical controller couples multiple surgical devices together in a cooperative surgical system.
[0195] [0195] In examples in which multiple surgical devices share control and / or switch between control features, a physician may want to know which surgical control devices have control over a controlled surgical device at any given time during the surgical procedure. For example, a surgical system can provide tactile, audible and / or visual indications to the physician regarding the control mode.
[0196] [0196] In one aspect, the surgical system can provide various tactile, audible and / or visual indications to physicians through a user interface, for example. The surgical system can highlight, emphasize or otherwise attract attention to display visual indications in the user interface. Additionally or alternatively, the surgical system can nest or overlap fundamental data and information. For example, certain information can be provided with an augmented reality view in the user interface and / or in a live transmission of images, video or other real-time data obtained by the surgical system. In another aspect, the surgical system can provide an enhanced indication of a control function and / or a limitation of it. For example, when control by a surgical device is disabled or is otherwise not viable, the surgical device, control or screen may vibrate to communicate that the control input has not been accepted.
[0197] [0197] As an example, if situational recognition indicates that a crude engine step is being performed during a surgical procedure, a doctor in the sterile field may be able to manipulate the position of a controlled surgical instrument using a device. surgical control within the sterile field, as with a tablet-type computer or device to be used close to the body located in the sterile field. However, if situational recognition indicates that a fine motor step is being performed during the surgical procedure, the control functionality of the surgical control device can be disabled so that only a physician operating the surgical device, such as the doctor at the surgeon's console, for example, can provide input controls to the controlled surgical device. In such cases, the surgical control device can provide a tactile, audible and / or visual warning to the physician in the sterile field to indicate that these control features are disabled. For example, the surgical control device can simply go into a "suspended" mode so that the inputs cannot be provided by the physician in the sterile field. In certain cases, the surgical control device may provide a verbal warning and / or beep, for example, to communicate that the desired control functionality is not feasible. In addition or alternatively, the surgical control device may vibrate or otherwise provide tactile feedback when the physician in the sterile field attempts to provide a non-viable control input.
[0198] [0198] As another example, the autonomous control of a surgical device can replace the control of the surgical device with another surgical device in various circumstances. For example, if a doctor on the surgeon's console is actively controlling a robotic tool, then a secondary control, such as the control input (s) provided by a doctor in the sterile field via a surgical control device, can be ignored. However, when the doctor on the surgeon's console stops actively controlling the robotic tool, the control inputs from the surgical control device within the sterile field can control the robotic tool. When the robotic tool is being controlled by the surgical control device within the sterile field, a user interface on the robotic console can use tactile, audible and / or visual indications to communicate that the control is being shared with a surgical control device . Similarly, when the robotic tool is being controlled by the physician on the surgeon's console, a user interface on the surgical control tool can indicate that its control functionality is disabled.
[0199] [0199] In several cases, the controls for a surgical device can be configured to interface with one or more screens to communicate the interaction between the various controls. For example, a surgical control device can be configured to provide secondary control functionality for a controlled surgical device. In addition, one or more indications may indicate or otherwise communicate the paired control function between the controlled surgical device and the surgical control devices. These indications can be provided on one or more screens, such as the non-sterile screens 107 and 109, the main screen 119, the central controller screen 135 and / or the screen on the surgeon console 118 as shown in Figures 2 and 3 , for example. In one aspect, a touch screen on a surgical device can be used by a doctor to interact with a main screen on the central surgical controller. For example, a surgical device in the sterile field may include a capacitive touchscreen. Surgical devices such as hand-held surgical instruments, robotic tools, devices to be worn close to the body and display screens may include a touchscreen within the sterile field. In several cases, a doctor in the sterile field can slide, roll and / or otherwise configure a primary central surgical controller from the touchscreen within the surgical field. For example, by scanning, zooming or otherwise adjusting the view on the touchscreen within the sterile field, the doctor can scan, zoom or otherwise adjust the main screen for the central surgical controller.
[0200] [0200] In several cases, a secondary device may contain controls that are only comparable with other devices for connecting command and control functions. For example, the secondary device can be a controller for controlling one or more other surgical devices. In several cases, the secondary device or surgical control device can be a screen located in the sterile field. For example, the secondary device can be a mobile device, such as a tablet or mobile phone, for example, that includes a screen. The screen can be a touch screen, for example, which is configured to receive control input from a doctor in the sterile field. In addition or alternatively, the screen may include a built-in LED that highlights the control functionality in a way that pairs or connects the control functionality to a particular controlled surgical device.
[0201] [0201] With reference to Figures 22A and 22B, a screen 214400 is shown. Screen 214400 represents a first plurality of information 214402 in Figure 22A and a second plurality of information 214404 in Figure 22B. A user can switch between the different views in Figures 22A and 22B by interacting with screen 214400. For example, screen 214400 includes a capacitive screen. In several cases, the doctor can interact with the 214400 screen by touching a portion of the interface. Screen 214400 is configured to communicate different types of information to the physician. For example, the 214400 screen can communicate specific patient information by selecting the PATIENT 214410 icon, specific procedure information by selecting the PROCEDURE 214412 icon, and device specific information by selecting the DEVICE icon 214414. The DEVICE icon 214414 was selected in Figures 22A and 22B, as indicated by the highlight around the DEVICE icon 214414. In other cases, the selected icon 214410, 214412, 214414 can be communicated from another way, as showing the selected icon 214410, 214412, 214414 in a different size, in a different position, a different color, in a different style and / or with another identifier such as an arrow or symbol in relation to it. As the DEVICE icon 214414 is selected in Figures 22A and 22B, the device specific information is depicted. For example, the surgical devices being used during the surgical procedure are listed. In many cases, Screen 214400 can selectively provide input commands to one or more of the surgical devices during the surgical procedure.
[0202] [0202] The surgical devices listed are a combined energy surgical device indicated with the first icon 214420, a surgical stapler indicated with the second icon 214422, and a suction / irrigation device indicated with the third icon 214424. The icons 214420, 214422, 214424 are textual words in Figures 22A and 22B; however, in other cases, icons 214420, 214422, and 214424 may include graphics and / or may be symbols, such as a symbolic representation of the surgical device, for example. In certain cases, less than three or more than three surgical devices can be listed. In certain cases, only controllable surgical devices can be listed. In other cases, all surgical devices used during a surgical procedure can be listed; however, a physician may only be able to select controllable surgical devices from the list. Alternative surgical devices are contemplated (for example, an ultrasonic device, an electrosurgical device, a clip applicator, a claw, a knife, etc.).
[0203] [0203] The icon 214420 corresponding to the combined energy surgical device was selected in Figure 22A, and the icon 214422 corresponding to the stapler was selected in Figure 22B, as indicated with the highlight around the respective icon 214420,
[0204] [0204] Now with reference to Figure 22B, as the icon 214422 corresponding to the surgical stapler was selected, the available input commands correspond to commands for the surgical stapler. For example, a physician can select a surgical function from a plurality of 214432 modes such as a clamping mode and a triggering mode. In many cases, 214432 modes may include subcategories or additional settings, which can be selected from a menu. For example, tightening and / or firing can be carried out manually or automatically and / or the speed can be selected from various speeds, such as slow, medium and fast. Alternative modes are also contemplated. The doctor can select the mode to control the surgical function of the surgical stapler. In several cases, the user entry on screen 214400 can be communicated to the central surgical controller by one or more communication protocols described here. Similarly, the central surgical controller can relay the user's input to the surgical stapler.
[0205] [0205] In several cases, the pairing (s) between the screen 214400 and the surgical device (s) can be communicated to the doctor. For example, the 214400 screen can include at least one built-in LED that can light up in a color that is the same as a color of a controlled surgical device and / or a color identifier on the controlled surgical device. In one aspect, the controlled surgical device may include a similar LED color identifier, for example. The LED embedded in the 214400 screen can light red, and a red LED can light on the paired surgical device to indicate pairing. In many cases, screen 214400 can be configured to control multiple surgical devices, and in such cases, multiple colors can be displayed on screen 214400 and the corresponding colors can be provided in respective identifiers throughout the operating room. For example, when the physician selected the first 214420 icon (Figure 22A) corresponding to the combined energy surgical device, a portion of the 214400 screen (for example, the first 214420 icon) may light up in a specific color and an LED on the device combined energy surgical lamp can light in the same color. Similarly, when the physician selected the second icon 214422 (Figure 22B) corresponding to the surgical stapler, a portion of the 214400 screen (for example, the second icon 214422) may light up in a specific color and an LED on the surgical stapler may light up with the same color. Different colors can be assigned to different surgical devices. In several cases, icons 214420, 214422, 214424 on the screen can be illuminated in different colors and / or the icons can be highlighted in different colors. For example, the formats around the selected icon 214420, 214422, 214424 may be a specific color that corresponds to an indicator on the paired surgical device.
[0206] [0206] The identifier on a controlled surgical device (for example, the combined energy surgical device, cyclic stapler)
[0207] [0207] In several cases, one control interface can be used to activate a surgical function and the other control interface can be used for sequencing through the instrument's modes. For example, a single trigger on the surgical device can perform different surgical functions, and the specific surgical function can be determined by the control interface on screen 214400. More specifically, in relation to Figure 22A, a trigger or actuator on a combined energy surgical device can apply ultrasonic energy to the tissue; however, if another mode was selected by the doctor, the same trigger or actuator would apply a different energy modularity to the fabric. In several cases, energy modalities and / or power levels can be controlled via screen 214400. Now with reference to Figure 22B, a trigger or actuator on the surgical stapler can be configured to hold when the tightening function is selected on the screen 214400, and the trigger can be configured to fire when the trigger function is selected on the screen 214400. Additionally, adjustments (for example, manual or automatic, tightening speed, firing speed, etc.) can be made on the screen 214400.
[0208] [0208] In other cases, multiple control devices may have activation capabilities for the same surgical device. For example, screen 214400 may include an activation control, which activates the surgical function on the surgical device. In certain cases, the power level for each activation may differ between the different control devices.
[0209] [0209] In one aspect, the control of a secondary function can allow fine control from one controller and coarse control from another controller. Secondary functions may include articulation of an end actuator and rotation of the distal head, for example. In such cases, when coarse control is desired, an integral or built-in device control, for example, an autonomous control in the surgical device, can control the function. When fine control is desired, a secondary controller, such as screen 214400, can control the function. For example, when a doctor is using another aspect of a surgical device, such as holding a trigger, for example, the fine control functionality can still be implemented with the secondary controller, which is paired with the surgical device to create movement secondary function. In certain cases, certain functions such as articulation and rotation of the distal head can be blocked when another function, such as energy activation, clamping or triggering, is in operation. However, when the secondary controller for the secondary function is activated by another doctor or by another hand of the same doctor, fine-tuning may be allowed even if the doctor is using another control to operate the other function. In this mode of operation, the secondary function can have a limited operational envelope to ensure that the forces it applies and / or the speed at which it is operated are limited to produce the desired fine control or fine precision. Additionally or alternatively, you can
[0210] [0210] Various aspects of the subject described in this document are defined in the following numbered examples:
[0211] [0211] Example 1 - A surgical system comprising a first device comprising a first control circuit and a second device configured to perform a surgical function. The second device comprises a second control circuit in signal communication with the first control circuit. The second control circuit is configured to selectively switch the second device between a secondary operating mode, in which the second device is configured to control the first device, and a primary operating mode, in which the second device is configured to control surgical function.
[0212] [0212] Example 2- The surgical system of Example 1, in which the first device comprises a screen, in which the second device comprises an end actuator positioned within a sterile field, and in which the end actuator is visible on the screen.
[0213] [0213] Example 3 - The surgical system of Examples 1 or 2, in which the secondary operating mode comprises a cursor mode, and in which the primary operating mode comprises a tissue treatment mode.
[0214] [0214] Example 4 - The surgical system of any of Examples 1 to 3, in which the second device comprises a handle that comprises a movable input switch between a first position and a second position, and in that the first position corresponds to the primary operating mode and the second position corresponds to the secondary operating mode.
[0215] [0215] Example 5 - The surgical system of any of Examples 1 to 4, in which the second control circuit is configured to switch between primary and secondary operating modes in response to a command audible by a doctor.
[0216] [0216] Examples 6 - The surgical system of Example 3, in which the end actuator is configured to drag and drop an icon across the screen in cursor mode.
[0217] [0217] Example 7 - The surgical system of Examples 3 or 6, in which the end actuator is configured to select an anatomical feature on the screen in the cursor mode.
[0218] [0218] Example 8 - The surgical system of any of Examples 1 to 7, in which the second device comprises an ultrasonic instrument configured to apply ultrasonic vibrations to the tissue, in which the ultrasonic instrument comprises a first actuation button and a second actuation button, in which, in primary operating mode, the first actuation button is configured to act on a first energy level and the second actuation button is configured to act on a second energy level, and in which, in the secondary operating mode, the first actuation button comprises a first cursor button and the second actuation button comprises a second cursor button.
[0219] [0219] Example 9 - A surgical system that comprises an imaging system that comprises a camera and a display screen. The surgical system further comprises a surgical device configured to perform a surgical function. The surgical device comprises a control circuit comprising a processor and a memory communicatively coupled to the processor, where the memory stores instructions executable by the processor to receive an input signal in response to the input signal. - switch, switch between a first operating mode and a second operating mode, in the first operating mode, operating the surgical function and in the second operating mode, controlling the display screen.
[0220] [0220] Example 10 - The surgical system of Example 9, in which the surgical device is configured to control the display screen through a surgical barrier.
[0221] [0221] Example 11 - The surgical system of Examples 9 or 10, where the display screen comprises a video monitor in an operating room, and where the surgical device comprises a laparoscopic device comprising an end actuator positioned on a patient in the operating room.
[0222] [0222] Example 12 - The surgical system of Example 11, in which the surgical device comprises an end actuator, and in which the camera is configured to track the end actuator in the patient.
[0223] [0223] Example 13 - The surgical system of Examples 11 or 12, in which, in the second operating mode, the end actuator is configured to interact with one or more icons on the video monitor as a cursor.
[0224] [0224] Example 14 - The surgical system of any of Examples 11 to 13, in which, in the second operating mode, the end actuator is configured to interact as a cursor with a video transmission on the monitor of video.
[0225] [0225] Example 15 - The surgical system of any of Examples 9 to 14, in which the surgical device comprises a handle that comprises a movable input switch between a first position and a second position, and in that the first position corresponds to the first operating mode and the second position corresponds to the second operating mode.
[0226] [0226] Example 16 - The surgical system of any of Examples 9 to 14, in which the control circuit is configured to switch between the first operating mode and the second operating mode in response to a command audible by a doctor.
[0227] [0227] Example 17 - A non-transitory, computer-readable medium that stores computer-readable instructions that, when executed, cause a surgical system to receive an input signal in response to the input signal, toggle between a first operating mode and a second operating mode, in the first operating mode, perform a surgical function and, in the second operating mode, interact with a display screen through a surgical barrier.
[0228] [0228] Example 18 - The computer-readable non-transitory media of Example 17, in which the surgical system is configured to interact with the display screen through the surgical barrier by clicking on an icon on the display screen.
[0229] [0229] Example 19 - The computer-readable non-transitory media of Examples 17 or 18, in which the surgical system is configured to interact with the display screen through the surgical barrier, by dragging and dropping an icon on the display screen.
[0230] [0230] Example 20 - The computer readable non-transitory media of Examples 17 to 19, in which the surgical system is configured to interact with the display screen through the surgical barrier by selecting a portion of a video.
[0231] [0231] 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, changes, substitutions, combinations and equivalents of these forms can be implemented and will occur to those skilled in the art without departing from the scope of the present description. In addition, the structure of each element associated with the shape can alternatively be described as a means to provide the function performed by the element.
[0232] [0232] 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 run on one or more computers ( for example, as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (for example, as one or more programs running on one or more microprocessors), as firmware , or virtually as any combination thereof, and that designing the circuitry and / or writing the code for the software and firmware would be within the scope of practice of those skilled in the art, in light of this description. In addition, those skilled in the art will understand that the mechanisms of the subject described herein can be distributed as one or more program products in a variety of ways and that an illustrative form of the subject described here is applicable regardless of the specific type of transmission medium. signals used to effectively carry out the distribution.
[0233] [0233] The instructions used to program the logic to execute various revealed aspects can be stored in a memory in the system, such as dynamic random access memory (DRAM), memory, flash memory or other storage. In addition, instructions can be distributed over a network or other computer-readable media. Thus machine-readable media can include any mechanism for storing or transmitting information in a machine-readable form (for example, a computer), but is not limited to, floppy disks, optical discs, compact discs read-only memory (CD-ROMs), and optical-dynamo discs, read-only memory (ROM), random access memory (RAM), erasable programmable read-only memory (EPROM), read-only memory programmable electrically erasable (EEPROM), magnetic or optical cards, flash memory, or machine-readable tangible storage media used to transmit information over the Internet via an electrical, optical, acoustic cable or other forms of propagated (for example, carrier waves, infrared signal, digital signals, etc.). Consequently, 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).
[0234] [0234] As used in any aspect of the present invention, the term "control circuit" can refer to, for example, a set of wired circuits, programmable circuits (for example, a computer processor that includes one or more processing cores
[0235] [0235] 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 may be incorporated as a software package, code, instructions, instruction sets and / or data recorded on the computer-readable non-transitory storage media. The firmware can be embedded as code, instructions or instruction sets and / or data that are hard-coded (for example, non-volatile) in memory devices.
[0236] [0236] As used in any aspect of the present invention, the terms "component", "system", "module" and the like may refer to a computer-related entity, be it hardware, a combination of hardware and software, software or running software.
[0237] [0237] 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 can, although they do not necessarily need to, 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 adequate physical quantities and are merely convenient identifications applied to those quantities and / or states.
[0238] [0238] A network can include a packet-switched network. Communication devices may be able to communicate with each other using a selected packet switched network communications protocol. An exemplary communications protocol may include an Ethernet communications protocol that may be able to allow communication using a transmission control protocol / Internet protocol (TCP / IP). The protocol
[0239] [0239] Unless otherwise stated, as is evident from the preceding description, it is understood that, throughout the preceding description, discussions using terms such as "processing", or "computation", or "calculation ", or" determination ", or" display ", or similar, refers to the action and processes of a computer, or similar electronic computing device, that manipulates and transforms the represented data in the form of physical quantities (electronic) in computer records and memories in other data represented in a similar way in the form of physical quantities in computer memories or records, or in other similar information storage, transmission or display devices.
[0240] [0240] One or more components in the present invention may be called "configured for", "configurable for", "operable / operable for", "adapted / adaptable for", "capable of", "conformable / conforming sent to ", etc. Those skilled in the art will recognize that "configured for" can, in general, encompass components in an active state and / or components in an inactive state and / or components in a state of wait, except when the context dictates otherwise.
[0241] [0241] The terms "proximal" and "distal" are used in the present invention with reference to a physician who handles the handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the doctor, and the term "distal" refers to the portion located 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 drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.
[0242] [0242] Persons skilled in the art will recognize that, in general, the terms used here, and especially in the appended claims (eg, bodies of the appended claims) are generally intended as "open" terms (eg, the term "including" should be interpreted as "including, but not limited to", the term "having" should be interpreted as "having, at least", the term "includes" should be interpreted as "includes, but not limits to ", etc.). It will also be understood by those skilled in the art that, when a specific number of a claim statement entered is intended, that intention will be expressly mentioned in the claim and, in the absence of such mention, no intention will be present. For example, as an aid to understanding, the following appended claims may contain the use of the introductory phrases "at least one" and "one or more" to introduce claim statements. However, the use of such phrases should not be interpreted as implying that the introduction of a claim statement by the indefinite articles "one, ones" or "one, ones" limits any specific claim containing the mention of the claim entered to claims that contain only such a mention, even when the same claim includes the introductory phrases "one or more" or "at least one" and indefinite articles, such as "one, ones" or "one, ones" (for example, "one , ones "and / or" one, ones "should typically be interpreted as meaning" at least one "or" one or more "); the same goes for the use of defined articles used to introduce claims.
[0243] [0243] Furthermore, even if a specific number of an introduced claim statement is explicitly mentioned, those skilled in the art will recognize that that statement needs to be typically interpreted as meaning at least the number mentioned (for example, the mere mention of "two mentions", without other modifiers, typically means at least two mentions, or two or more mentions). In addition, in cases where a convention analogous to "at least one of A, B and C, etc." is used, in general this construction is intended to have the meaning in which the convention would be understood by (for example, "a system that has at least one of A, B and C" 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,
[0244] [0244] With respect to the attached claims, those skilled in the art will understand that the operations mentioned in the same can, in general, be performed in any order. In addition, although several operational flow diagrams are presented in one or more sequences, it must be understood that the various operations can be performed in other orders than those shown, or can be performed simultaneously. Examples of such alternative orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplementary, simultaneous, inverse or other variant orders, unless the context determines otherwise. Furthermore, terms such as "responsive to", "related to" or other adjectives participles are not intended in general to exclude these variants, except when the context determines otherwise.
[0245] [0245] It is worth noting that any reference to "one (1) aspect", "one aspect", "an exemplification" or "one (1) exemplification", and the like means that a particular resource, structure or feature described in connection with the aspect is included in at least one aspect. Thus, the use of expressions such as "in one (1) aspect", "in one aspect", "in an exemplification", "in one (1) exemplification", in several places throughout this specification does not necessarily refer to - refer to the same aspect. In addition, specific resources, structures or characteristics can be combined in any appropriate way in one or more aspects.
[0246] [0246] Any patent application, patent, non-patent publication or other description material mentioned in this specification and / or mentioned in any order data sheet is hereby incorporated by reference, up to the point in that the embedded materials are not inconsistent with this. Accordingly, and as necessary, the description as explicitly presented herein replaces any conflicting material incorporated into the present invention by way of reference. Any material, or portion thereof, which is incorporated herein by reference, but which conflicts with the definitions, statements, or other description materials contained herein, will be incorporated here only to the extent that there is no conflict between the embedded material and the existing description material.
[0247] [0247] In summary, numerous benefits have been described that result from the use of the concepts described in this document. The previously mentioned description of one or more modalities has been presented for purposes of illustration and description. This description is not intended to be exhaustive or to limit the invention to the precise form disclosed. Modifications or variations are possible in light of the above teachings. One or more modalities were chosen and described in order to illustrate the principles and practical application to, thus,
allow those skilled in the art to use the various modalities and with various modifications, as they are convenient for the specific use contemplated.
It is intended that the claims presented in the annex define the global scope.

权利要求:
Claims (20)
[1]
1. Surgical system, characterized by comprising: a first device that comprises a first control circuit; and a second device configured to perform a surgical function, in which the second device comprises a second control circuit in signal communication with the first control circuit, and in which the second control circuit is configured to selectively switch the second device between a secondary operating mode, in which the second device is configured to control the first device, and a primary operating mode, in which the second device is configured to control surgical function.
[2]
2. Surgical system, according to claim 1, characterized in that the first device comprises a screen, in which the second device comprises an end actuator positioned within a sterile field, and in which the end actuator is visible on the screen.
[3]
Surgical system according to claim 2, characterized in that the secondary operation mode comprises a cursor mode, and the primary operation mode comprises a tissue treatment mode.
[4]
4, Surgical system according to claim 3, characterized in that the second device comprises a handle comprising a movable entry key between a first position and a second position, and the first position corresponding to the primary mode of operation and the second position corresponds to the secondary operating mode.
[5]
5. Surgical system, according to claim 3, characterized in that the second control circuit is configured to switch between the primary operating mode and the secondary operating mode in response to an audible command by a physician.
[6]
6. Surgical system, according to claim 3, characterized in that the end actuator is configured to drag and drop an icon across the screen in cursor mode.
[7]
7. Surgical system, according to claim 3, characterized in that the end actuator is configured to select an anatomical feature on the screen in the cursor mode.
[8]
8. Surgical system, according to claim 3, characterized in that the second device comprises an ultrasonic instrument configured to apply ultrasonic vibrations to the tissue, in which the ultrasonic instrument comprises a first actuation button and a second button actuation, in which, in the primary operating mode, the first actuation button is configured to act on a first energy level and the second actuation button is configured to act on a second energy level, and in which, in the For secondary operation, the first actuation button comprises a first cursor button and the second actuation button comprises a second cursor button.
[9]
9. Surgical system, characterized by comprising: an imaging system comprising a camera and a display screen; and a surgical device configured to perform a surgical function, in which the surgical device comprises a control circuit comprising a processor and a memory communicatively coupled to the processor, where the memory stores instructions executable by the processor to: receive an input signal; in response to the input signal, switch between a first operating mode and a second operating mode; in the first operational mode, the surgical function is activated; and in the second operating mode, control the display screen.
[10]
10. Surgical system according to claim 9, characterized in that the surgical device is configured to control the display screen through a surgical barrier.
[11]
11. Surgical system, according to claim 9, characterized in that the display screen comprises a video monitor in an operating room, and in which the surgical device comprises a laparoscopic device comprising an end actuator positioned on a patient in the operating room.
[12]
12. Surgical system, according to claim 11, characterized by the camera being configured to track the end actuator on the patient.
[13]
13. Surgical system according to claim 12, characterized in that, in the second operating mode, the end actuator is configured to interact with one or more icons on the video monitor as a cursor.
[14]
14. Surgical system according to claim 12, characterized in that, in the second operating mode, the end actuator is configured to interact as a cursor with a video transmission on the video monitor.
[15]
15. Surgical system according to claim 9, characterized in that the surgical device comprises a handle that comprises a movable entry key between a first position and a second position, and where the first position corresponds to the first mode operational and the second position corresponds to the second operating mode.
[16]
16. Surgical system, according to claim 9, characterized in that the control circuit is configured to switch between the first operating mode and the second operating mode in response to an audible command by a doctor.
[17]
17. Non-transient, computer-readable media, characterized by storing computer-readable instructions that, when executed, make a surgical system: receive an input signal; in response to the input signal, switch between a first operating mode and a second operating mode; in the first operating mode, perform a surgical function; and in the second operating mode, interact with a display screen through a surgical barrier.
[18]
18. Computer readable non-transitory media, according to claim 17, characterized in that the surgical system is configured to interact with the display screen through the surgical barrier by clicking on an icon on the display screen.
[19]
19. Non-transitory, computer-readable media, according to claim 17, characterized in that the surgical system is configured to interact with the display screen through the surgical barrier, by dragging and dropping an icon on the display screen.
[20]
20. Non-transitory, computer-readable media, according to claim 17, characterized in that the surgical system is configured to interact with the display screen through the surgical barrier by selecting a portion of a video.
NaN the 7th
AND
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HEI. :. ê: O o “ancacenes <LL o + Boa
SO 23 It is a 2z s: it is: 2 & 9 o so sz ZTE O Seo EO = | 28 287 IS GT) PE zo
O (: o g O àSé T ss | 3 O
ES neo>
3 and Ne IL and GS INSS: 7 RU: Im | 2nd NR FR Sd and RW J = SN (1a O> = RS VS.
SOuDe Mw 8% ”2 VE
Rh 135
IMAGE ias! GENERATOR NOR ARE MODULE,
VIEW 140 [| Ç 108 142 [1 14d FL sos
At 143 [|
SYSTEM MODULE 126 EVACUATION OF SMOKE ROBOTIC uo
128 SUCTION / IRRIGATION MODULE
INSTRUMENT MODULE 130 INTELLIGENT COMMUNICATION 12 MODULE 132 | 136 MATRIX PROCESSOR 134 STORAGE
MODULE OF
MAPPING 133 OPERATION ROOM

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---

公开号 | 公开日

---

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引用文献:

---

公开号 | 申请日 | 公开日 | 申请人 | 专利标题

---

---

US20070225556A1|2006-03-23|2007-09-27|Ethicon Endo-Surgery, Inc.|Disposable endoscope devices|

---

US9138129B2|2007-06-13|2015-09-22|Intuitive Surgical Operations, Inc.|Method and system for moving a plurality of articulated instruments in tandem back towards an entry guide|

---

US7995045B2|2007-04-13|2011-08-09|Ethicon Endo-Surgery, Inc.|Combined SBI and conventional image processor|

---

US7982776B2|2007-07-13|2011-07-19|Ethicon Endo-Surgery, Inc.|SBI motion artifact removal apparatus and method|

---

US8335590B2|2008-12-23|2012-12-18|Intuitive Surgical Operations, Inc.|System and method for adjusting an image capturing device attribute using an unused degree-of-freedom of a master control device|

---

EP2391259A1|2009-01-30|2011-12-07|The Trustees Of Columbia University In The City Of New York|Controllable magnetic source to fixture intracorporeal apparatus|

---

JP6021353B2|2011-08-04|2016-11-09|オリンパス株式会社|Surgery support device|

---

US10098527B2|2013-02-27|2018-10-16|Ethidcon Endo-Surgery, Inc.|System for performing a minimally invasive surgical procedure|US10013808B2|2015-02-03|2018-07-03|Globus Medical, Inc.|Surgeon head-mounted display apparatuses|

---

US11103268B2|2017-10-30|2021-08-31|Cilag Gmbh International|Surgical clip applier comprising adaptive firing control|

---

US11229436B2|2017-10-30|2022-01-25|Cilag Gmbh International|Surgical system comprising a surgical tool and a surgical hub|

---

US11141160B2|2017-10-30|2021-10-12|Cilag Gmbh International|Clip applier comprising a motor controller|

---

US11179208B2|2017-12-28|2021-11-23|Cilag Gmbh International|Cloud-based medical analytics for security and authentication trends and reactive measures|

---

US11109866B2|2017-12-28|2021-09-07|Cilag Gmbh International|Method for circular stapler control algorithm adjustment based on situational awareness|

---

US10966791B2|2017-12-28|2021-04-06|Ethicon Llc|Cloud-based medical analytics for medical facility segmented individualization of instrument function|

---

US20190201146A1|2017-12-28|2019-07-04|Ethicon Llc|Safety systems for smart powered surgical stapling|

---

US20190274716A1|2017-12-28|2019-09-12|Ethicon Llc|Determining the state of an ultrasonic end effector|

---

US11166772B2|2017-12-28|2021-11-09|Cilag Gmbh International|Surgical hub coordination of control and communication of operating room devices|

---

US11234756B2|2017-12-28|2022-02-01|Cilag Gmbh International|Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter|

---

US11069012B2|2017-12-28|2021-07-20|Cilag Gmbh International|Interactive surgical systems with condition handling of devices and data capabilities|

---

US10849697B2|2017-12-28|2020-12-01|Ethicon Llc|Cloud interface for coupled surgical devices|

---

US11257589B2|2017-12-28|2022-02-22|Cilag Gmbh International|Real-time analysis of comprehensive cost of all instrumentation used in surgery utilizing data fluidity to track instruments through stocking and in-house processes|

---

US11132462B2|2017-12-28|2021-09-28|Cilag Gmbh International|Data stripping method to interrogate patient records and create anonymized record|

---

US11045591B2|2017-12-28|2021-06-29|Cilag Gmbh International|Dual in-series large and small droplet filters|

---

US11266468B2|2017-12-28|2022-03-08|Cilag Gmbh International|Cooperative utilization of data derived from secondary sources by intelligent surgical hubs|

---

US10892995B2|2017-12-28|2021-01-12|Ethicon Llc|Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs|

---

US20190206551A1|2017-12-28|2019-07-04|Ethicon Llc|Spatial awareness of surgical hubs in operating rooms|

---

US10987178B2|2017-12-28|2021-04-27|Ethicon Llc|Surgical hub control arrangements|

---

US20190201087A1|2017-12-28|2019-07-04|Ethicon Llc|Smoke evacuation system including a segmented control circuit for interactive surgical platform|

---

US11051876B2|2017-12-28|2021-07-06|Cilag Gmbh International|Surgical evacuation flow paths|

---

US11160605B2|2017-12-28|2021-11-02|Cilag Gmbh International|Surgical evacuation sensing and motor control|

---

US11253315B2|2017-12-28|2022-02-22|Cilag Gmbh International|Increasing radio frequency to create pad-less monopolar loop|

---

US11096693B2|2017-12-28|2021-08-24|Cilag Gmbh International|Adjustment of staple height of at least one row of staples based on the sensed tissue thickness or force in closing|

---

US10695081B2|2017-12-28|2020-06-30|Ethicon Llc|Controlling a surgical instrument according to sensed closure parameters|

---

US10944728B2|2017-12-28|2021-03-09|Ethicon Llc|Interactive surgical systems with encrypted communication capabilities|

---

US11213359B2|2017-12-28|2022-01-04|Cilag Gmbh International|Controllers for robot-assisted surgical platforms|

---

US11202570B2|2017-12-28|2021-12-21|Cilag Gmbh International|Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems|

---

US10892899B2|2017-12-28|2021-01-12|Ethicon Llc|Self describing data packets generated at an issuing instrument|

---

US10758310B2|2017-12-28|2020-09-01|Ethicon Llc|Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices|

---

US11013563B2|2017-12-28|2021-05-25|Ethicon Llc|Drive arrangements for robot-assisted surgical platforms|

---

US11147607B2|2017-12-28|2021-10-19|Cilag Gmbh International|Bipolar combination device that automatically adjusts pressure based on energy modality|

---

US20190205001A1|2017-12-28|2019-07-04|Ethicon Llc|Sterile field interactive control displays|

---

US11056244B2|2017-12-28|2021-07-06|Cilag Gmbh International|Automated data scaling, alignment, and organizing based on predefined parameters within surgical networks|

---

US11076921B2|2017-12-28|2021-08-03|Cilag Gmbh International|Adaptive control program updates for surgical hubs|

---

US11100631B2|2017-12-28|2021-08-24|Cilag Gmbh International|Use of laser light and red-green-blue coloration to determine properties of back scattered light|

---

US10943454B2|2017-12-28|2021-03-09|Ethicon Llc|Detection and escalation of security responses of surgical instruments to increasing severity threats|

---

US10932872B2|2017-12-28|2021-03-02|Ethicon Llc|Cloud-based medical analytics for linking of local usage trends with the resource acquisition behaviors of larger data set|

---

US20190254753A1|2018-02-19|2019-08-22|Globus Medical, Inc.|Augmented reality navigation systems for use with robotic surgical systems and methods of their use|

---

US11259830B2|2018-03-08|2022-03-01|Cilag Gmbh International|Methods for controlling temperature in ultrasonic device|

---

US11096688B2|2018-03-28|2021-08-24|Cilag Gmbh International|Rotary driven firing members with different anvil and channel engagement features|

---

US11213294B2|2018-03-28|2022-01-04|Cilag Gmbh International|Surgical instrument comprising co-operating lockout features|

---

US20190298350A1|2018-03-28|2019-10-03|Ethicon Llc|Methods for controlling a powered surgical stapler that has separate rotary closure and firing systems|

---

US11197668B2|2018-03-28|2021-12-14|Cilag Gmbh International|Surgical stapling assembly comprising a lockout and an exterior access orifice to permit artificial unlocking of the lockout|

---

US11090047B2|2018-03-28|2021-08-17|Cilag Gmbh International|Surgical instrument comprising an adaptive control system|

---

US11219453B2|2018-03-28|2022-01-11|Cilag Gmbh International|Surgical stapling devices with cartridge compatible closure and firing lockout arrangements|

---

US11207067B2|2018-03-28|2021-12-28|Cilag Gmbh International|Surgical stapling device with separate rotary driven closure and firing systems and firing member that engages both jaws while firing|

---

US10973520B2|2018-03-28|2021-04-13|Ethicon Llc|Surgical staple cartridge with firing member driven camming assembly that has an onboard tissue cutting feature|

---

US11166716B2|2018-03-28|2021-11-09|Cilag Gmbh International|Stapling instrument comprising a deactivatable lockout|

---

US11259807B2|2019-02-19|2022-03-01|Cilag Gmbh International|Staple cartridges with cam surfaces configured to engage primary and secondary portions of a lockout of a surgical stapling device|

---

US20200405410A1|2019-06-28|2020-12-31|Ethicon Llc|Surgical rfid assemblies for instrument operational setting control|

---

WO2021163083A1|2020-02-14|2021-08-19|Covidien Lp|System and method for activation and deactivation syncrhonization handling in a surgical robotic system|

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US11207150B2|2020-02-19|2021-12-28|Globus Medical, Inc.|Displaying a virtual model of a planned instrument attachment to ensure correct selection of physical instrument attachment|

---

US11153555B1|2020-05-08|2021-10-19|Globus Medical Inc.|Extended reality headset camera system for computer assisted navigation in surgery|

---

CN112401943A|2020-10-14|2021-02-26|极限人工智能有限公司|Sterile barrier assembly and sterile minimally invasive surgery device applying same|

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

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

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

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

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

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US62/640,415|2018-03-08|

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

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US201862650882P| true| 2018-03-30|2018-03-30|

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

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

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

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US62/650,882|2018-03-30|

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US62/650,898|2018-03-30|

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US62/650,877|2018-03-30|

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US62/650,887|2018-03-30|

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

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US62/659,900|2018-04-19|

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

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

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

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US62/692,747|2018-06-30|

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

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US62/692,768|2018-06-30|

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US201862729176P| true| 2018-09-10|2018-09-10|

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US62/729,176|2018-09-10|

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US16/182,232|2018-11-06|

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US16/182,232|US20190201158A1|2017-12-28|2018-11-06|Control of a surgical system through a surgical barrier|

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PCT/US2018/061002|WO2019133149A1|2017-12-28|2018-11-14|Control of a surgical system through a surgical barrier|

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