阅读说明：本技术 增加射频以创建无垫单极环路 (Adding radio frequencies to create a pad-less monopole loop ) 是由 D·C·耶茨 F·E·谢尔顿四世 于 2018-10-12 设计创作，主要内容包括：在一些方面,本公开呈现了一种利用电容耦合的外科系统。所述外科系统可包括：单极能量发生器；外科器械,所述外科器械被配置为能够在外科部位处将电外科能量通过所述电极传输到患者的组织；以及至少一个检测电路,该至少一个检测电路被配置为能够：测量电外科能量的返回路径中的导电量；确定所述返回路径中的所述导电量下降到预定阈值以下；以及传输信号以使所述单极发生器通过增大所述电外科能量发生中的交流电频率来增加所述外科系统中的电流泄漏。所述单极能量发生器可进一步包括传感器,所述传感器被配置为能够通过检测所述电流泄漏已到达所述单极能量发生器中的接地端子来确定单极能量电路完成。(In some aspects, the present disclosure presents a surgical system utilizing capacitive coupling. The surgical system may include: a monopolar energy generator; a surgical instrument configured to transmit electrosurgical energy through the electrode to tissue of a patient at a surgical site; and at least one detection circuit configured to be capable of: measuring an amount of electrical conduction in a return path of the electrosurgical energy; determining that the amount of conductivity in the return path falls below a predetermined threshold; and transmitting a signal to cause the monopolar generator to increase current leakage in the surgical system by increasing the frequency of the alternating current in the generation of the electrosurgical energy. The monopolar energy generator may further comprise a sensor configured to be able to determine that monopolar energy circuit completion by detecting that the current leakage has reached a ground terminal in the monopolar energy generator.)

1. A surgical system, comprising:

a monopolar energy generator;

a surgical instrument electrically coupled to a monopolar energy generator comprising an electrode and configured to transmit electrosurgical energy through the electrode to tissue of a patient at a surgical site;

at least one detection circuit configured to be capable of:

measuring a conductivity in a return path of the electrosurgical energy;

determining that the amount of conductivity in the return path falls below a predetermined threshold; and

transmitting a signal to cause the monopolar generator to increase current leakage in the surgical system by increasing the frequency of the alternating current in the generation of electrosurgical energy;

wherein the monopolar energy generator comprises a sensor configured to be able to determine that a monopolar energy circuit is complete by detecting that the current leakage has reached a ground terminal in the monopolar energy generator.

2. The surgical system of claim 1, wherein increasing the current leakage allows monopolar electrosurgery of the patient to be performed using the surgical instrument.

3. The surgical system of claim 1, wherein the monopolar energy generator further comprises a control circuit configured to:

receiving an indication from the sensor that the current leakage has not reached the ground terminal in the monopolar energy generator; and

in response to the indication, further increasing the alternating current frequency.

4. The surgical system of claim 3, wherein the control circuit is further configured to:

receiving a second indication from the sensor that the current leakage has reached the ground terminal in the monopolar energy generator in response to further increasing the alternating current frequency; and

in response to the second indication, ceasing to increase the alternating current frequency.

5. The surgical system of claim 1, wherein the surgical system is further configured to provide instructions to isolate any return path pad from the surgical system to minimize electrical conductivity flowing through any of the return path pads.

6. The surgical system of claim 1, wherein increasing the frequency comprises increasing the frequency to a range of 500KHz to 4 MHz.

7. A monopolar energy generator of a surgical system, the monopolar energy generator coupled to a surgical instrument configured to deliver electrosurgical energy to tissue of a patient at a surgical site, the energy generator comprising:

a power source configured to generate monopolar electrosurgical energy;

completing the circuit sensor;

a control circuit; and

a ground terminal;

wherein the control circuitry is configured to be capable of:

receiving a signal from a detection circuit that an amount of conduction in a return path of the monopolar electrosurgical energy falls below a predetermined threshold; and

in response to the signal; causing the power source to increase current leakage by increasing alternating current frequency;

wherein the completion circuit sensor is configured to be able to determine that a unipolar energy circuit is complete by detecting that the current leakage has reached the ground terminal.

8. The monopolar energy generator of claim 7, wherein increasing the current leakage allows monopolar electrosurgery of the patient to be performed using the surgical instrument.

9. The monopolar energy generator of claim 7, wherein the control circuit is further configured to be capable of:

receiving an indication from the completion circuit sensor that the current leakage has not reached the ground terminal; and

in response to the indication, further increasing the alternating current frequency.

10. The monopolar energy generator of claim 9, wherein the control circuit is further configured to be capable of:

receiving a second indication from the sensor that the current leakage has reached the ground terminal in the monopolar energy generator in response to further increasing the alternating current frequency; and

in response to the second indication, ceasing to increase the alternating current frequency.

11. The monopolar energy generator of claim 7, further configured to provide instructions to isolate any return path pad from the surgical system to minimize electrical conductivity flowing through any of the return path pads.

12. The monopolar energy generator of claim 7, wherein increasing the frequency includes increasing the frequency to a range of 500KHz to 4 MHz.

13. A closed-loop method of a surgical system including a monopolar energy generator, a surgical instrument coupled to the energy generator, and a detection circuit communicatively coupled to the energy generator, the method comprising:

generating, by the energy generator, electrosurgical energy for the surgical instrument;

transmitting electrosurgical energy to tissue of a patient through an electrode at a surgical site by the surgical instrument;

measuring, by the detection circuit, a conductivity amount in a return path of the electrosurgical energy;

determining, by the detection circuit, that the amount of conductivity in the return path falls below a predetermined threshold;

transmitting, by the detection circuit, a signal to the monopolar energy generator to cause the energy generator to increase current leakage in the surgical system by increasing the frequency of the alternating current in the electrosurgical energy generation; and

determining, by a sensor in the monopolar energy generator, that a monopolar energy circuit is complete by detecting that the current leakage has reached a ground terminal in the monopolar energy generator.

14. The method of claim 13, wherein increasing the current leakage allows monopolar electrosurgery of the patient to be performed using the surgical instrument.

15. The method of claim 13, further comprising:

receiving an indication from the sensor that the current leakage has not reached the ground terminal in the monopolar energy generator; and

in response to the indication, further increasing the alternating current frequency.

16. The method of claim 15, further comprising:

receiving a second indication from the sensor that the current leakage has reached the ground terminal in the monopolar energy generator in response to further increasing the alternating current frequency; and

in response to the second indication, ceasing to increase the alternating current frequency.

17. The method of claim 13, further comprising providing instructions to isolate any return path pad from the surgical system to minimize electrical conductivity flowing through any of the return path pads.

18. The method of claim 13, wherein increasing the frequency comprises increasing the frequency to a range of 500KHz to 4 MHz.

Background

The present disclosure relates generally and in various aspects to surgical systems utilizing Radio Frequency (RF) energy in electrosurgery.

Electrosurgical systems typically utilize a generator to supply electrosurgical energy (e.g., alternating current at a radio frequency level) to an active electrode that applies the electrosurgical energy to a surgical site on a patient's body. The surgical instrument may utilize this energy as needed to perform various types of surgical procedures, such as cutting or coagulating tissue. Monopolar electrosurgery involves the application of a surgical instrument to the tissue of a patient using a single active electrode and completing an electrical circuit through the patient via a patient return electrode. The return electrode is typically connected back to the monopolar energy generator. However, capacitive coupling is a persistent problem in such systems, potentially causing undesirable burns at an initially unknown location on the patient's body. It is desirable to take capacitive coupling into account to minimize or eliminate unintended injury to the patient.

Disclosure of Invention

In some aspects, a surgical system is presented. The surgical system may include: a monopolar energy generator; a surgical instrument electrically coupled to a monopolar energy generator comprising an electrode and configured to transmit electrosurgical energy through the electrode to tissue of a patient at a surgical site; at least one detection circuit configured to be capable of: measuring an amount of electrical conduction in a return path of the electrosurgical energy; determining that the amount of conductivity in the return path falls below a predetermined threshold; and transmitting a signal to cause the monopolar generator to increase current leakage in the surgical system by increasing the frequency of the alternating current in the generation of the electrosurgical energy; wherein the monopolar energy generator comprises a sensor configured to be able to determine that a monopolar energy circuit is complete by detecting that the current leakage has reached a ground terminal in the monopolar energy generator.

In some aspects of the surgical system, increasing the current leakage allows for the use of a surgical instrument to perform monopolar electrosurgery of a patient.

In some aspects of the surgical system, the monopolar energy generator further comprises a control circuit configured to: receiving an indication from the sensor that the current leakage has not reached the ground terminal in the monopolar energy generator; and further increasing the alternating current frequency in response to the indication.

In some aspects of the surgical system, the control circuit is further configured to: receiving a second indication from the sensor that the current leakage has reached the ground terminal in the monopolar energy generator in response to further increasing the alternating current frequency; and in response to the second indication, ceasing to increase the alternating current frequency.

In some aspects of the surgical system, the surgical system is further configured to provide instructions to isolate any of the return path pads from the surgical system to minimize electrical conductivity flowing through any of the return path pads.

In some aspects of the surgical system, increasing the frequency comprises increasing the frequency to a range of 500KHz to 4 MHz.

Drawings

The features of the various aspects are set out with particularity in the appended claims. The various aspects (relating to the surgical tissues and methods) and further objects and advantages thereof, however, may best be understood by reference to the following description taken in conjunction with the accompanying drawings.

Fig. 1 is a block diagram of a computer-implemented interactive surgical system in accordance with at least one aspect of the present disclosure.

Fig. 2 is a surgical system for performing a surgical procedure in an operating room in accordance with at least one aspect of the present disclosure.

Fig. 3 is a surgical hub paired with a visualization system, a robotic system, and a smart instrument according to at least one aspect of the present disclosure.

Fig. 4 is a partial perspective view of a surgical hub housing and a composite generator module slidably received in a drawer of the surgical hub housing according to at least one aspect of the present disclosure.

Fig. 5 is a perspective view of a combined generator module having bipolar, ultrasonic and monopolar contacts and a smoke evacuation device according to at least one aspect of the present disclosure.

Fig. 6 illustrates a single power bus attachment for a plurality of lateral docking ports of a lateral modular housing configured to be capable of housing a plurality of modules, in accordance with at least one aspect of the present disclosure.

Fig. 7 illustrates a vertical modular housing configured to be capable of receiving a plurality of modules in accordance with at least one aspect of the present disclosure.

Fig. 8 illustrates a surgical data network including a modular communication hub configured to connect modular devices located in one or more operating rooms of a medical facility or any room in the medical facility dedicated to surgical procedures to a cloud in accordance with at least one aspect of the present disclosure.

Fig. 9 is a computer-implemented interactive surgical system according to at least one aspect of the present disclosure.

Fig. 10 illustrates a surgical hub including a plurality of modules coupled to a modular control tower according to at least one aspect of the present disclosure.

Fig. 11 illustrates one aspect of a Universal Serial Bus (USB) hub device in accordance with at least one aspect of the present disclosure.

Fig. 12 illustrates a logic diagram of a control system of a surgical instrument or tool in accordance with at least one aspect of the present disclosure.

Fig. 13 illustrates a control circuit configured to control various aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure.

Fig. 14 illustrates a combinational logic circuit configured to control various aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure.

Fig. 15 illustrates sequential logic circuitry configured to control aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure.

Fig. 16 illustrates a surgical instrument or tool including multiple motors that can be activated to perform various functions in accordance with at least one aspect of the present disclosure.

Fig. 17 is a schematic view of a robotic surgical instrument configured to operate a surgical tool described herein, according to at least one aspect of the present disclosure.

Fig. 18 illustrates a block diagram of a surgical instrument programmed to control distal translation of a displacement member in accordance with at least one aspect of the present disclosure.

Fig. 19 is a schematic view of a surgical instrument configured to control various functions in accordance with at least one aspect of the present disclosure.

Fig. 20 is a system configured to execute an adaptive ultrasonic blade control algorithm in a surgical data network including a modular communication hub, according to at least one aspect of the present disclosure.

Fig. 21 illustrates an example of a generator in accordance with at least one aspect of the present disclosure.

Fig. 22 is a surgical system including a generator and various surgical instruments that may be used therewith according to at least one aspect of the present disclosure.

Fig. 23 is an end effector according to at least one aspect of the present disclosure.

Fig. 24 is an illustration of the surgical system of fig. 22 in accordance with at least one aspect of the present disclosure.

Fig. 25 is a model illustrating dynamic branch current in accordance with at least one aspect of the present disclosure.

Fig. 26 is a structural view of a generator architecture according to at least one aspect of the present disclosure.

Fig. 27A-27C are functional views of a generator architecture according to at least one aspect of the present disclosure.

Fig. 28A-28B are structural and functional aspects of a generator according to at least one aspect of the present disclosure.

Fig. 29 provides a diagram illustrating an exemplary system having an apparatus for detecting capacitive coupling in accordance with at least one aspect of the present disclosure.

Fig. 30 is a logic flow diagram depicting a control program or logic configuration of an exemplary method for limiting the effects of capacitive coupling in the disclosed surgical system, in accordance with at least one aspect of the present disclosure.

Fig. 31 is a logic flow diagram depicting a control program or logic configuration of an exemplary method that may be performed by a surgical system utilizing monopolar energy generation to determine whether to utilize parasitic capacitive coupling in accordance with at least one aspect of the present disclosure.

Description

The applicant of the present patent application owns the following U.S. patent applications filed on 28.8.2018, the disclosure of each of which is incorporated herein by reference in its entirety:

U.S. patent application Ser. No. END8536USNP2/180107-2 entitled ultrasonic END EFFECTOR estimated states AND its control SYSTEM (ESTIMATING STATE OF U L TRANSSONIC END EFFECTOR AND CONTRO L SYSTEM THEREFOR);

U.S. patent application Ser. No. END8560USNP2/180106-2 entitled ultrasonic END EFFECTOR TEMPERATURE control AND control System THEREFOR (TEMPERATURE CONTRO L OF U L TRANSSONIC END EFFECTOR AND CONTRO L SYSTEM THEREFOR);

U.S. patent application publication No. END8561USNP1/180144-1 entitled RADIO FREQUENCY energy device FOR delivering combined electrical signals (RADIO FREQUENCY resonance ENERGY DEVICE FOR DE L electric communication L etrica L signal L S);

U.S. patent application Ser. No. END8563USNP1/180139-1 entitled controlling ultrasonic surgical INSTRUMENTs based on TISSUE position (ContRO LL ING AN U L TRANSSONIC SURGICA L INSTRUMENT ACCORDING TO TISSUE L OCATION);

U.S. patent application Ser. No. END8563USNP2/180139-2 entitled controlling ACTIVATION OF AN ultrasonic surgical INSTRUMENT based on the presence OF TISSUE (ContRO LL ING ACTIVATION OF AN U L TRANSSONIC SURGICA L INSTRUMENT ACCORDING TO THE PRESENCE OF TISSUE);

U.S. patent application publication No. END8563USNP3/180139-3 entitled determination of tissue composition via ultrasound SYSTEM (DETERMINING TISSUE COMPOSITION VIA AN U L TRASONIC SYSTEM);

U.S. patent application Ser. No. END8563USNP4/180139-4 entitled determining the status OF AN ultrasound electromechanical system from FREQUENCY SHIFTs (DETERMINING THE STATE OF AN U L TRANSSONIC E L ECTROTECCHANICA L SYSTEM CORDING TO FREQUENCY SHIFT);

U.S. patent application Ser. No. END8563USNP5/180139-5, entitled determining ultrasonic END EFFECTOR status (DETERMINING THE STATE OF AN U L TRANSSONIC END EFFECTOR);

U.S. patent application publication number END8564USNP1/180140-1 entitled situational awareness for electrosurgical SYSTEMS (situtation a L AWARENESS OF E L ECTROSURGICA L SYSTEMS);

U.S. patent application Ser. No. END8564USNP2/180140-2 entitled mechanism for controlling different electromechanical SYSTEMS OF AN electrosurgical INSTRUMENT (MECHANISMS FOR CONTRO LL ING DIFFERENT E L ECTROMECHANICA L SYSTEMS OF AN E L ECTROSURGICA L INSTRUMENT);

U.S. patent application Ser. No. END8564USNP3/180140-3 entitled detecting END EFFECTOR IMMERSION IN liquid (DETECTION OF END EFFECTOR IN L IQUED);

U.S. patent application publication number END8565USNP1/180142-1 entitled ENERGY INTERRUPTION DUE TO improper capacitive coupling (INTERRUPTION OF ENERGY DUE TO inadequately capacitive coupling L ING);

united states patent application publication number END8566USNP1/180143-1 entitled Bipolar Combined device for automatically adjusting pressure BASED ON ENERGY modalities (BIPO L AR COMMUNICATION DEVICE THAT AUTOMATICA LL Y ADJUSTSPRESSURE BASE ENERGY MODE L ITY), and

U.S. patent application publication number END8573USNP1/180145-1, entitled ACTIVATION energy device (activity OF ENERGY DEVICES).

The applicant of the present patent application owns the following U.S. patent applications filed on 23.8.8.2018, the disclosure of each of which is incorporated herein by reference in its entirety:

U.S. provisional patent application 62/721,995 entitled control of ultrasonic surgical INSTRUMENTs based on TISSUE position (Contro LL ING AN U L TRANSSONIC SURGICA L INSTRUMENT ACCORDING TO TISSUE L OCATION);

U.S. provisional patent application 62/721,998, entitled situational awareness for electrosurgical SYSTEMS (SITUATIONA L AWARENESS OF E L ECTROSURGICA L SYSTEMS);

U.S. provisional patent application 62/721,999 entitled ENERGY INTERRUPTION DUE TO unintentional capacitive coupling (INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUP L ING);

U.S. provisional patent application 62/721,994 entitled Bipolar Combined device for automatically adjusting PRESSURE based on ENERGY modality (BIPO L AR COMMUNICATION DEVICE THAT AUTOMATICA LL Y ADJUSTS PRESSURE BASON ENERGY MODA L ITY), and

us provisional patent application 62/721,996 entitled RADIO FREQUENCY energy device FOR delivering COMBINED electrical signals (RADIO FREQUENCY resonance ENERGY DEVICE FOR DE L interference COMBINED E L acquisition L signal L S).

The applicant of the present patent application owns the following U.S. patent applications filed on 30.6.2018, the disclosure of each of which is incorporated herein by reference in its entirety:

U.S. provisional patent application 62/692,747 entitled Smart ACTIVATION OF energy DEVICE BY ANOTHER DEVICE (SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE);

U.S. provisional patent application 62/692,748 entitled SMART energy architecture (SMART energy architecture); and

us provisional patent application 62/692,768 entitled smart energy device (SMART ENERGYDEVICES).

The applicant of the present patent application owns the following U.S. patent applications filed on 29.6.2018, the disclosure of each of which is incorporated herein by reference in its entirety:

U.S. patent application serial No. 16/024,090, entitled capacitively coupled RETURN path pad with separable ARRAY elements (CAPACITIVE COUP L ED RETURN PATH PAD WITH separator L E ARRAY E L engines);

U.S. patent application Ser. No. 16/024,057 entitled surgical Instrument control based on SENSED closure PARAMETERS (ContRO LL ING A SURGICA L INSTRUMENT ACCORDING TO SENSED C L OSURE PARAMETERS);

U.S. patent application Ser. No. 16/024,067, entitled System FOR ADJUSTING END EFFECTOR PARAMETERS BASED on intraoperative INFORMATION (SYSTEM FOR ADJUSE END EFFECTOR PARAMETERS BASED ONPERIORATIVE INFORMATION);

U.S. patent application serial No. 16/024,075, entitled safety system FOR intelligently POWERED surgical suturing (SAFETY SYSTEMS FOR SMART POWERED surgery L STAP L ING);

U.S. patent application serial No. 16/024,083, entitled safety system FOR intelligently POWERED surgical suturing (SAFETY SYSTEMS FOR SMART POWERED surgery L STAP L ING);

U.S. patent application Ser. No. 16/024,094, entitled surgical System FOR detecting end EFFECTOR TISSUE maldistribution (SURGICA L SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTIONIRREGUS L ARITIES);

U.S. patent application Ser. No. 16/024,138, entitled System FOR DETECTING the approach OF a surgical END EFFECTOR to cancerous TISSUE (SYSTEM FOR DETECTING PROXIMITY OF SURGICA L END EFFECTOR TO CANCEROUS TISSUE);

U.S. patent application serial No. 16/024,150, entitled surgical INSTRUMENT CARTRIDGE SENSOR assembly (SURGICA L INSTRUMENT CARTRIDGE SENSOR assembly L IES);

U.S. patent application serial No. 16/024,160, entitled variable OUTPUT CARTRIDGE SENSOR assembly (VARIAB L E OUTPUT CARTRIDGE SENSOR assembly L Y);

U.S. patent application Ser. No. 16/024,124, entitled surgical INSTRUMENT with Flexible electrodes (SURGICA L INSTRUMENTT HAVING A F L EXIB L E E L ECTRODE);

U.S. patent application Ser. No. 16/024,132, entitled surgical Instrument with Flexible Circuit (SURGICA L INSTRUMENTS HAVING A F L EXIB L E CIRCUIT);

U.S. patent application Ser. No. 16/024,141, entitled surgical Instrument WITH TISSUE MARKING Assembly (SURGICA L INSTRUMENT WITH A TISSUE MARKING ASSEMBLY L Y);

U.S. patent application serial No. 16/024,162, entitled surgical system with PRIORITIZED DATA TRANSMISSION capabilities (SURGICA L SYSTEMS WITH PRIORITIZED DATA TRANSMISSION capabilities L ITIES);

U.S. patent application Ser. No. 16/024,066, entitled surgical EVACUATION sensing and Motor control (SURGICA L EVACUATION SENSING AND MOTOR CONTRO L);

U.S. patent application Ser. No. 16/024,096, entitled surgical EVACUATION SENSOR arrangement (SURGICA L EVACUATION SENSOR ARRANGEMENTS);

U.S. patent application Ser. No. 16/024,116, entitled surgical EVACUATION flow Path (SURGICA L EVACUATION F L OW PATHS);

U.S. patent application Ser. No. 16/024,149, entitled surgical EVACUATION sensing and Generator control (SURGICA L EVACUATION SENSING AND GENERATOR CONTRO L);

U.S. patent application serial No. 16/024,180, entitled surgical EVACUATION sensing and display (SURGICA L EVACUATION SENSING AND DISP L AY);

U.S. patent application Ser. No. 16/024,245 entitled Smoke EVACUATION System parameters TO HUB OR cloud IN Smoke EVACUATION Module FOR Interactive surgical platform (COMMUNICATION OF SMOKE EVACUATION SYSTEMPARAMETERS TO HUB OR C L OUD IN SMOKE EVACUATION MODU L E FOR INTERACTIVITY CACA L P L ATFORM);

U.S. patent application serial No. 16/024,258, entitled SMOKE EVACUATION system including segmented control circuitry FOR an INTERACTIVE surgical platform (SMOKE evacution SYSTEM INC L learning A SEGMENTED control L CIRCUIT FOR INTERACTIVE surgery L P L ATFORM);

U.S. patent application Ser. No. 16/024,265 entitled surgical extraction System with COMMUNICATION Circuit FOR COMMUNICATION BETWEEN Filter AND extractor (SURGICA L EVACUTION SYSTEM WITH A COMMUNICATION DEVICE A FI L TER AND A SMOKE EVACUTION DEVICE)

U.S. patent application serial No. 16/024,273 entitled dual tandem macroand minidroplet filters (DUA L IN-SERIES L ARGE AND SMA LL DROP L ET FI L TERS).

The applicant of the present patent application owns the following U.S. provisional patent applications filed on 2018, 6/28, the disclosure of each of which is incorporated herein by reference in its entirety:

U.S. provisional patent application serial No. 62/691,228, entitled a METHOD OF USING an enhanced flex circuit WITH multiple SENSORS having an electrosurgical device (a METHOD OF USING a sensing device F L EX circuit switching MU L TIP L E SENSORS WITH E L ECTROSURGICA L DEVICES);

U.S. provisional patent application serial No. 62/691,227, entitled control of a surgical INSTRUMENT based on SENSED closure parameters (control LL ING A SURGICA L INSTRUMENT ACCORDING TO SENSED C L OSUREPARAMETERS);

U.S. provisional patent application serial No. 62/691,230, entitled surgical INSTRUMENT with flexible electrodes (SURGICA L INSTRUMENT HAVING a F L EXIB L E E L ECTRODE);

U.S. provisional patent application serial No. 62/691,219, entitled surgical EVACUATION SENSING and motor control (SURGICA L evacution SENSING and motor control L);

U.S. provisional patent application serial No. 62/691,257, entitled SMOKE EVACUATION system parameters FOR delivery TO a HUB OR cloud IN a SMOKE EVACUATION module FOR an interactive surgical platform (COMMUNICATION OF SMOKE EVACUATION system TO HUB OR C L OUD IN SMOKE EVACUATION module L E FOR interactive surgical center L P L atom);

U.S. provisional patent application Ser. No. 62/691,262, entitled surgical EVACUATION System with COMMUNICATION Circuit FOR COMMUNICATION BETWEEN Filter AND Smoke EVACUATION DEVICE (SURGICA L EVACUTION SYSTEM WITH ACOMMUNICATION CICUIT FOR COMMUNICATION BETWEEN A FI L TER AND SMOKEVACCATION DEVICE), AND

U.S. provisional patent application serial No. 62/691,251 entitled dual tandem macroand minidroplet filters (DUA L IN-SERIES L ARGE AND SMA LL DROP L ET FI L TERS);

the applicant of the present patent application owns the following U.S. provisional patent applications filed on 2018, 4/19, the disclosures of which are incorporated herein by reference in their entirety:

U.S. provisional patent application serial No. 62/659,900, entitled hub COMMUNICATION METHOD (METHOD office COMMUNICATION);

the applicant of the present patent application owns the following U.S. provisional patent applications filed on 30.3.2018, the disclosure of each of which is incorporated herein by reference in its entirety:

us provisional patent application 62/650,898 filed 3, 30, 2018, entitled capacitively coupled RETURN PATH PAD with separable ARRAY elements (CAPACITIVE COUP L ED RETURN PATH PAD with separator L E ARRAY E L engines);

U.S. provisional patent application serial No. 62/650,887, entitled surgical system with OPTIMIZED SENSING capabilities (SURGICA L SYSTEMS WITH OPTIMIZED SENSING CAPABI L its);

U.S. patent application Ser. No. 62/650,882 entitled Smoke EVACUATION Module FOR Interactive surgical platform (SMOKE EVACUATION MODU L E FOR INTERACTIVE SURGICA L P L ATFORM), and

united states patent application Ser. No. 62/650,877 entitled surgical Smoke EVACUATION sensing and control (SURGICA L SMOKE EVACUTION SENSING AND CONTRO L S)

The applicant of the present patent application owns the following U.S. patent applications filed on 29/3/2018, the disclosures of which are incorporated herein by reference in their entirety:

U.S. patent application serial No. 15/940,641, entitled interactive surgical system with encrypted COMMUNICATION capability (INTERACTIVE SURGICA L SYSTEMS WITH ENCRYPTED COMMUNICATION capabilities L ITIES);

U.S. patent application serial No. 15/940,648, entitled interactive surgical system with conditional processing device and data capabilities (INTERACTIVE SURGICA L SYSTEMS WITH conditioning HAND L ING OF DEVICESAND DATA CAPABI L ITIES);

U.S. patent application Ser. No. 15/940,656 entitled surgical HUB COORDINATION OF operating room device control AND COMMUNICATION (SURGICA L HUB COORDINATION OF CONTRO L AND COMMUNICATION OF OPERATING DEVICES);

U.S. patent application serial No. 15/940,666, entitled spatial perception of a surgical hub IN an OPERATING room (SPATIA L AWARENESS OF SURGICA L HUBS IN OPERATING ROOMS);

U.S. patent application Ser. No. 15/940,670, entitled COOPERATIVE utilization OF data derived FROM secondary sources BY an intelligent surgical hub (COOPERATIVE UTI L IZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTE LL IGENT SURGICA L HUBS);

U.S. patent application serial No. 15/940,677, entitled surgical hub control arrangement;

U.S. patent application Ser. No. 15/940,632, entitled data stripping METHOD for data interrogation of PATIENT RECORDS and creation of anonymous RECORDS (DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORD and ANDCREATE ANONYMIZED RECORD);

U.S. patent application Ser. No. 15/940,640, entitled COMMUNICATION HUB AND storage DEVICE FOR STORING parameters AND conditions OF a surgical DEVICE TO BE shared with a cloud-BASED analysis system (COMMUNICATION HUB AND STORAGEVECTOR FOR STORING PARAMETERS AND STATUS OF A SURGICA L DEVICE TO BE SHAREDWITH C L OUD BASED ANA L YTICS SYSTEMS);

U.S. patent application Ser. No. 15/940,645, entitled self-DESCRIBING data packet generated at ISSUING INSTRUMENT (SE L F descriptive DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT);

U.S. patent application Ser. No. 15/940,649, entitled data pairing for interconnecting DEVICE measurement parameters with results (DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH ANOUTCOME);

U.S. patent application Ser. No. 15/940,654, entitled surgical HUB situational awareness (SURGICA L HUB SITUATIONA L AWARENESS);

U.S. patent application Ser. No. 15/940,663, entitled surgical System DISTRIBUTED PROCESSING (SURGICA L SYSTEM DISTRIBUTED PROCESSING);

U.S. patent application Ser. No. 15/940,668, entitled AGGREGATION AND REPORTING OF surgical HUB DATA (AGGREGATION AND REPORTING OF SURGICA L HUB DATA);

U.S. patent application serial No. 15/940,671, entitled surgical HUB spatial perception for determining devices in an operating room (SURGICA L HUB spartia L AWARENESS TO DETERMINE DEVICES IN operationthoeater);

U.S. patent application Ser. No. 15/940,686, entitled showing alignment OF staple cartridges with previously linear staple lines (DISP L AY OF A L IGNMENT OF STAP L E CARTRIDGE TO PRIOR L INEAR STAP L E L INE);

U.S. patent application Ser. No. 15/940,700 entitled sterile field Interactive control display (STERI L EFIE L D INTERACTIVE CONTRO L DISP L AYS);

U.S. patent application serial No. 15/940,629, entitled COMPUTER-implemented interactive surgical system (COMPUTER IMP L EMENTED INTERACTIVE SURGICA L SYSTEMS);

U.S. patent application Ser. No. 15/940,704, entitled "USE OF laser and Red-Green-blue coloration" TO determine the characteristics OF backscattered light (USE OF L ASER L IGHT AND RED-GREEN-B L UE CO L ORATION TO DETERMINEPIERTIES OF BACK SCATTERED L IGHT);

U.S. patent application Ser. No. 15/940,722, entitled method for characterizing TISSUE irregularities by using monochromatic light refractive index (CHARACTERIZATION OF TISSUE IRREGUGU L ARITIES THROUGH THE USE OF MONO-CHROMATIC L IGHT REFRACTIVITY), and

U.S. patent application serial No. 15/940,742 entitled dual Complementary Metal Oxide Semiconductor (CMOS) array imaging (DUA L CMOS ARRAY IMAGING);

U.S. patent application Ser. No. 15/940,636 entitled ADAPTIVE PROGRAM update FOR surgical DEVICES (ADAPTIVE control L PROGRAM UPDATES FOR SURGICAs L DEVICES);

U.S. patent application Ser. No. 15/940,653, entitled ADAPTIVE control PROGRAM update FOR surgical hub (ADAPTIVE control L PROGRAM UPDATES FOR SURGICA L HUBS);

U.S. patent application Ser. No. 15/940,660, entitled cloud-BASED medical analysis FOR CUSTOMIZATION AND recommendation to USERs (C L OUD-BASED MEDIA L ANA L YTICS FOR CURSTOMIZATION AND RECOMMENDATION STOSTOS A USER);

U.S. patent application Ser. No. 15/940,679, entitled cloud-BASED medical analysis FOR linking local USAGE trends with RESOURCE ACQUISITION behavior FOR larger datasets (C L OUD-BASED MEDIA L ANA L YTICS FOR L INKING OF L OCA L USAGE TRENDS WITH THE RESOURCE ACQUISION BEAVORS OF L ARGER DATA SET);

U.S. patent application Ser. No. 15/940,694, entitled cloud-BASED medical analysis OF medical facilities FOR personalizing device functional segments (C L OUD-BASED MEDIA L ANA L YTICS FOR MEDICA L FACI L ITYSEGMENTED INDIVIDUA L IZATION OF INSTRUMENTS FUNCTIONS);

U.S. patent application Ser. No. 15/940,634, entitled cloud-BASED medical analysis FOR Security AND certification trends AND reactivity measurements (C L OUD-BASED MEDIA L ANA L YTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES);

U.S. patent application Ser. No. 15/940,706 entitled DATA processing AND PRIORITIZATION IN cloud analysis NETWORKs (DATA HAND L ING AND PRIORITIZATION IN A C L OUD ANA L YTICS NETWORK), AND

U.S. patent application Ser. No. 15/940,675, entitled cloud INTERFACE FOR coupled surgical DEVICES (C L OUD INTERFACE FOR COUP L ED SURGICA L DEVICES);

U.S. patent application serial No. 15/940,627, entitled drive arrangement FOR a robotic-ASSISTED surgical platform (DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED surgery L P L atformms);

U.S. patent application Ser. No. 15/940,637, entitled COMMUNICATION arrangement FOR a robotic ASSISTED surgery platform (COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICA L P L ATFORMS);

U.S. patent application Ser. No. 15/940,642, entitled control FOR a robotically-ASSISTED surgical platform (Contro L S FOR ROBOT-ASSISTED surgery L P L ATFORMS);

U.S. patent application Ser. No. 15/940,676, entitled AUTOMATIC tool adjustment FOR robotically-ASSISTED surgical platforms (AUTOMATIC TOO L ADJUSTMENTS FOR ROBOT-ASSISTED SURGICA L P L ATFORMS);

U.S. patent application serial No. 15/940,680, entitled controller FOR a robotic-ASSISTED surgical platform (control LL ERS FOR ROBOT-ASSISTED surgery L P L atformms);

U.S. patent application Ser. No. 15/940,683, entitled COOPERATIVE surgical action FOR a robotically-ASSISTED surgical platform (COOPERATIVE surgical SURGICA L ACTIONS FOR ROBOT-ASSISTED surgery L P L ATFORMS);

U.S. patent application Ser. No. 15/940,690 entitled display arrangement FOR a robotically-ASSISTED surgical platform (DISP L AY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICA L P L ATFORMS), and

U.S. patent application serial No. 15/940,711, entitled sensing arrangement FOR a robotic-ASSISTED surgical platform (SENSING ARRANGEMENTS FOR ROBOT-ASSISTED surgery L P L atformms).

The applicant of the present patent application owns the following U.S. provisional patent applications filed on 2018, 3, 28, the disclosure of each of which is incorporated herein by reference in its entirety:

U.S. provisional patent application serial No. 62/649,302, entitled interactive surgical system with encrypted communication capability (INTERACTIVE SURGICA L SYSTEMS WITH ENCRYPTED COMMUNICATIONCAPABI L ITIES);

U.S. provisional patent application serial No. 62/649,294, entitled data stripping METHOD for interrogating PATIENT RECORDS and creating anonymous RECORDS (DATA STRIPPING METHOD TO interface PATIENT RECORDS and anonymous RECORDS);

U.S. patent application Ser. No. 62/649,300, entitled surgical HUB situational awareness (SURGICA L HUB SITUATIONA L AWARENESS);

U.S. provisional patent application serial No. 62/649,309, entitled surgical HUB spatial perception for determining devices in an operating room (SURGICA L HUB sparia L AWARENESS TO DETERMINE DEVICES INOPERATING tool);

U.S. patent application serial No. 62/649,310, entitled COMPUTER-implemented interactive surgical system (COMPUTER IMP L EMENTED INTERACTIVE SURGICA L SYSTEMS);

U.S. provisional patent application Ser. No. 62/649291, entitled "USE OF laser and Red-Green-blue coloration" TO determine the characteristics OF backscattered light (USE OF L ASER L IGHT AND RED-GREEN-B L UE CO L ORATION TO DETERMINEPIERTIES OF BACK SCATTERED L IGHT);

U.S. patent application Ser. No. 62/649,296 entitled ADAPTIVE PROGRAM update FOR surgical DEVICES (ADAPTIVE control L PROGRAM UPDATES FOR SURGICAs L DEVICES);

U.S. provisional patent application serial No. 62/649,333, entitled cloud-BASED medical analysis FOR CUSTOMIZATION and recommendation TO USERs (C L OUD-BASED medical L ANA L times FOR custom mixing and applications TO USERs);

U.S. provisional patent application serial No. 62/649,327, entitled cloud-BASED medical analysis FOR SECURITY and certification trends and responsiveness measurements (C L OUD-BASED medicine L ANA L YTICS FOR SECURITY and certification authorities TRENDS AND REACTIVE MEASURES);

U.S. provisional patent application serial No. 62/649,315 entitled DATA processing AND priority IN cloud analysis NETWORKs (DATA HAND L ING AND priority IN a C L OUD ANA L YTICS NETWORK);

U.S. patent application Ser. No. 62/649,313, entitled cloud INTERFACE FOR coupled surgical DEVICES (C L OUD INTERFACE FOR COUP L ED SURGICA L DEVICES);

U.S. patent application serial No. 62/649,320, entitled drive arrangement FOR a robotic-ASSISTED surgical platform (DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED surgery L P L atformms);

U.S. provisional patent application Ser. No. 62/649,307 entitled AUTOMATIC tool adjustment FOR robotically-ASSISTED surgical platforms (AUTOMATIC TOO L ADJUSTMENTS FOR ROBOT-ASSISTED SURGICA L P L ATFORMS), and

U.S. provisional patent application serial No. 62/649,323, entitled sensing arrangement FOR a robotic-ASSISTED surgical platform (SENSING ARRANGEMENTS FOR ROBOT-ASSISTED surgery L P L atformms).

The applicant of the present patent application owns the following U.S. provisional patent applications filed on 8.3.2018, the disclosure of each of which is incorporated herein by reference in its entirety:

U.S. provisional patent application Ser. No. 62/640,417 entitled TEMPERATURE control IN an ultrasound device and control System therefor (TEMPERATURE CONTRO L IN U L TRANSSONIC DEVICE AND CONTRO L SYSTEM THEREFOR), and

U.S. provisional patent application serial No. 62/640,415, entitled method OF estimating the state OF an ultrasonic END EFFECTOR AND control SYSTEM THEREFOR (ESTIMATING STATE OF U L TRASONIC END EFFECTOR AND control L SYSTEM thermal).

The applicant of the present patent application owns the following U.S. provisional patent applications filed on 2017, 12, 28, the disclosure of each of which is incorporated herein by reference in its entirety:

U.S. provisional patent application serial No. 62/611,341, provisional patent application serial No. 62/611,341, entitled interactive surgical platform (INTERACTIVE SURGICA L P L ATFORM);

U.S. provisional patent application Ser. No. 62/611,340 entitled cloud-BASED medical analysis (C L OUD-BASED MEDICA L ANA L YTICS), and

U.S. patent application serial No. 62/611,339, entitled robot-assisted surgical platform (ROBOTASSISTED SURGICA L P L ATFORM);

before explaining various aspects of the surgical device and generator in detail, it should be noted that the example illustrated application or use is not limited to the details of construction and arrangement of parts illustrated in the accompanying drawings and description. The illustrative examples may be implemented alone or in combination with other aspects, variations and modifications, and may be practiced or carried out in various ways. Furthermore, unless otherwise indicated, the terms and expressions employed herein have been chosen for the purpose of describing the illustrative embodiments for the convenience of the reader and are not for the purpose of limiting the invention. Moreover, it is to be understood that expressions of one or more of the following described aspects, and/or examples may be combined with any one or more of the other below described aspects, and/or examples.

Aspects relate to improved ultrasonic surgical devices, electrosurgical devices, and generators for use therewith. Aspects of an ultrasonic surgical device may be configured to transect and/or coagulate tissue, for example, during a surgical procedure. Aspects of the electrosurgical device may be configured to transect, coagulate, target, weld, and/or desiccate tissue, for example, during a surgical procedure.

Referring to fig. 1, a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (e.g., cloud 104, which may include a remote server 113 coupled to a storage device 105). Each surgical system 102 includes at least one surgical hub 106 in communication with cloud 104, which may include a remote server 113. In one example, as shown in fig. 1, the surgical system 102 includes a visualization system 108, a robotic system 110, and a handheld smart surgical instrument 112 configured to be able to communicate with each other and/or with the hub 106. In some aspects, surgical system 102 may include M number of hubs 106, N number of visualization systems 108, O number of robotic systems 110, and P number of handheld intelligent surgical instruments 112, where M, N, O and P are integers greater than or equal to one.

Fig. 3 shows an example of a surgical system 102 for performing a surgical procedure on a patient lying on an operating table 114 in a surgical room 116. The robotic system 110 is used as part of the surgical system 102 in a surgical procedure. The robotic system 110 includes a surgeon's console 118, a patient side cart 120 (surgical robot), and a surgical robot hub 122. The patient side cart 117 can manipulate at least one removably coupled surgical tool 118 through a minimally invasive incision in the patient's body as the surgeon views the surgical site through the surgeon's console 120. An image of the surgical site may be obtained by the medical imaging device 124, which may be manipulated by the patient side cart 120 to orient the imaging device 124. The robot hub 122 may be used to process images of the surgical site for subsequent display to the surgeon via the surgeon's console 118.

Various examples of robotic systems and surgical tools suitable for use with the present disclosure are described in U.S. provisional patent application serial No. 62/611,339 entitled ROBOT-ASSISTED surgical platform (ROBOT ASSISTED surgery L P L ATFORM), filed on 28.12.2017, the disclosure of which is incorporated herein by reference in its entirety.

Various examples of cloud-BASED analyses performed by the cloud 104 and suitable for use with the present disclosure are described in U.S. provisional patent application serial No. 62/611,340 entitled "cloud-BASED medical analysis (C L OUD-BASED medical L ANA L YTICS)" filed on 28.12.2017, the disclosure of which is incorporated by reference herein in its entirety.

In various aspects, the imaging device 124 includes at least one image sensor and one or more optical components. Suitable image sensors include, but are not limited to, Charge Coupled Device (CCD) sensors and Complementary Metal Oxide Semiconductor (CMOS) sensors.

The optics of the imaging device 124 may include one or more illumination sources and/or one or more lenses. One or more illumination sources may be directed to illuminate portions of the surgical field. The one or more image sensors may receive light reflected or refracted from the surgical field, including light reflected or refracted from tissue and/or surgical instruments.

The one or more illumination sources may be configured to radiate electromagnetic energy in the visible spectrum as well as the invisible spectrum. The visible spectrum (sometimes referred to as the optical spectrum or the luminescence spectrum) is that portion of the electromagnetic spectrum that is visible to (i.e., detectable by) the human eye, and may be referred to as visible light or simple light. A typical human eye will respond to wavelengths in air from about 380nm to about 750 nm.

The invisible spectrum (i.e., the non-luminescent spectrum) is the portion of the electromagnetic spectrum that lies below and above the visible spectrum (i.e., wavelengths below about 380nm and above about 750 nm). The human eye cannot detect the invisible spectrum. Wavelengths greater than about 750nm are longer than the red visible spectrum and they become invisible Infrared (IR), microwave and radio electromagnetic radiation. Wavelengths less than about 380nm are shorter than the violet spectrum and they become invisible ultraviolet, x-ray and gamma-ray electromagnetic radiation.

In various aspects, the imaging device 124 is configured for use in a minimally invasive procedure. Examples of imaging devices suitable for use in the present disclosure include, but are not limited to, arthroscopes, angioscopes, bronchoscopes, cholangioscopes, colonoscopes, cytoscopes, duodenoscopes, enteroscopes, esophago-duodenoscopes (gastroscopes), endoscopes, laryngoscopes, nasopharyngo-nephroscopes, sigmoidoscopes, thoracoscopes, and intrauterine scopes.

The use of multispectral imaging is described in more detail under the heading advanced imaging Acquisition Module (advanced imaging Acquisition Module) of U.S. provisional patent application Serial No. 62/611,341 entitled "Interactive surgical platform (INTERACTIVE SURGICA L P L ATFORM)" filed on 28.12.2017, the disclosure of which is incorporated herein by reference in its entirety.

It is self-evident that strict disinfection of the operating room and surgical equipment is required during any surgery. The stringent hygiene and disinfection conditions required in a "surgical room" (i.e., an operating room or a treatment room) require the highest possible sterility of all medical devices and equipment. Part of this sterilization process is any substance that needs to be sterilized, including the imaging device 124 and its attachments and devices, in contact with the patient or penetrating the sterile field. It should be understood that a sterile field may be considered a designated area that is considered free of microorganisms, such as within a tray or within a sterile towel, or a sterile field may be considered an area around a patient that has been prepared for a surgical procedure. The sterile field may include a properly worn swabbed team member, as well as all furniture and fixtures in the area.

In various aspects, the visualization system 108 includes one or more imaging sensors, one or more image processing units, one or more storage arrays, and one or more displays strategically arranged with respect to a sterile field, as shown in FIG. 2. in one aspect, the visualization system 108 includes interfaces for H L7, PACS, and EMR various components of the visualization system 108 are described under the heading advanced imaging Acquisition Module (advanced Acquisition Module) of U.S. provisional patent application Ser. No. 62/611,341 entitled "Interactive surgical platform (INTERACTIVE SURGICA L P L ATFORM)" filed on 28.12.2017, the disclosure of which is incorporated herein by reference in its entirety.

As shown in fig. 2, a main display 119 is positioned in the sterile field to be visible to the operator at the surgical table 114. Further, the visualization tower 111 is positioned outside the sterile field. Visualization tower 111 includes a first non-sterile display 107 and a second non-sterile display 109 facing away from each other. Visualization system 108, guided by hub 106, is configured to be able to coordinate information flow to operators inside and outside the sterile field using displays 107, 109, and 119. For example, the hub 106 may cause the imaging system 108 to display a snapshot of the surgical site recorded by the imaging device 124 on the non-sterile display 107 or 109 while maintaining a real-time feed of the surgical site on the main display 119. A snapshot on non-sterile display 107 or 109 may allow a non-sterile operator to, for example, perform diagnostic steps related to a surgical procedure.

In one aspect, hub 106 is further configured to be able to route diagnostic inputs or feedback entered by non-sterile operators at visualization tower 111 to main display 119 within the sterile field, where it can be viewed by sterile operators on the operating floor. In one example, the input may be a modified form of a snapshot displayed on non-sterile display 107 or 109, which may be routed through hub 106 to main display 119.

Referring to fig. 2, a Surgical Instrument 112 is used in a Surgical procedure as part of the Surgical system 102. the hub 106 is further configured to coordinate the flow of information to the display of the Surgical Instrument 112. for example, U.S. provisional patent application serial No. 62/611,341 entitled "interactive Surgical platform (INTERACTIVE SURGICA L P L ATFORM)" filed on 28.12.2017, the disclosure of which is incorporated herein by reference in its entirety. diagnostic input or feedback entered by a non-sterile operator at the visualization tower 111 may be routed by the hub 106 to the Surgical Instrument display 115 within the sterile field where the operator of the Surgical Instrument 112 may view the input or feedback.

Referring now to fig. 3, hub 106 is depicted in communication with visualization system 108, robotic system 110, and handheld intelligent surgical instrument 112. Hub 106 includes a hub display 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132, and a storage array 134. In certain aspects, as shown in fig. 3, hub 106 further includes a smoke evacuation module 126 and/or a suction/irrigation module 128.

The application of energy to tissue for sealing and/or cutting during a surgical procedure is typically associated with smoke evacuation, aspiration of excess fluid, and/or irrigation of the tissue. Fluid lines, power lines, and/or data lines from different sources are often tangled during a surgical procedure. Valuable time may be lost in addressing the problem during a surgical procedure. Disconnecting the lines may require disconnecting the lines from their respective modules, which may require resetting the modules. The hub modular housing 136 provides a unified environment for managing power, data, and fluid lines, which reduces the frequency of entanglement between such lines.

Aspects of the present disclosure provide a surgical hub for a surgical procedure involving application of energy to tissue at a surgical site. The surgical hub includes a hub housing and a composite generator module slidably received in a docking station of the hub housing. The docking station includes data contacts and power contacts. The combined generator module includes two or more of an ultrasonic energy generator device, a bipolar RF energy generator device, and a monopolar RF energy generator device seated in a single cell. In one aspect, the combined generator module further comprises a smoke evacuation device, at least one energy delivery cable for connecting the combined generator module to a surgical instrument, at least one smoke evacuation device configured to evacuate smoke, fluids and/or particles generated by application of therapeutic energy to tissue, and a fluid line extending from the remote surgical site to the smoke evacuation device.

In one aspect, the fluid line is a first fluid line and the second fluid line extends from the remote surgical site to a suction and irrigation module slidably received in the hub housing. In one aspect, the hub housing includes a fluid interface.

Certain surgical procedures may require more than one energy type to be applied to the tissue. One energy type may be more advantageous for cutting tissue, while a different energy type may be more advantageous for sealing tissue. For example, a bipolar generator may be used to seal tissue, while an ultrasonic generator may be used to cut the sealed tissue. Aspects of the present disclosure provide a solution in which the hub modular housing 136 is configured to accommodate different generators and facilitate interactive communication therebetween. One of the advantages of the hub modular housing 136 is the ability to quickly remove and/or replace various modules.

Aspects of the present disclosure provide a modular surgical housing for use in a surgical procedure involving application of energy to tissue. The modular surgical housing includes a first energy generator module configured to generate a first energy for application to tissue, and a first docking station including a first docking port including a first data and power contact, wherein the first energy generator module is slidably movable into electrical engagement with the power and data contact, and wherein the first energy generator module is slidably movable out of electrical engagement with the first power and data contact,

as further described above, the modular surgical housing further includes a second energy generator module configured to generate a second energy different from the first energy for application to tissue, and a second docking station including a second docking port including second data and power contacts, wherein the second energy generator module is slidably movable into electrical engagement with the power and data contacts, and wherein the second energy generator is slidably movable out of electrical contact with the second power and data contacts.

In addition, the modular surgical housing further includes a communication bus between the first docking port and the second docking port configured to facilitate communication between the first energy generator module and the second energy generator module.

Referring to fig. 3-7, aspects of the present disclosure are presented as a hub modular housing 136 that allows for modular integration of the generator module 140, smoke evacuation module 126, and suction/irrigation module 128. The hub modular housing 136 also facilitates interactive communication between the modules 140, 126, 128. As shown in fig. 5, the generator module 140 may be a generator module with integrated monopolar, bipolar, and ultrasound devices supported in a single housing unit 139 that is slidably inserted into the hub modular housing 136. As shown in fig. 5, the generator module 140 may be configured to be connectable to a monopolar device 146, a bipolar device 147, and an ultrasound device 148. Alternatively, the generator modules 140 may include a series of monopole generator modules, bipolar generator modules, and/or ultrasonic generator modules that interact through the hub modular housing 136. The hub modular housing 136 can be configured to facilitate the insertion of multiple generators and the interactive communication between generators docked into the hub modular housing 136 such that the generators will act as a single generator.

In one aspect, the hub modular housing 136 includes a modular power and communications backplane 149 having external and wireless communications connections to enable removable attachment of the modules 140, 126, 128 and interactive communications therebetween.

In one aspect, the hub modular housing 136 includes a docking cradle or drawer 151 (also referred to herein as a drawer) configured to slidably receive the modules 140, 126, 128. Fig. 4 illustrates a partial perspective view of the surgical hub housing 136 and the composite generator module 145 slidably received in the docking station 151 of the surgical hub housing 136. The docking port 152 having power and data contacts on the back of the combined generator module 145 is configured to be able to engage the corresponding docking port 150 with the power and data contacts of the corresponding docking station 151 of the hub module housing 136 when the combined generator module 145 is slid into place within the corresponding docking station 151 of the hub module housing 136. In one aspect, the combined generator module 145 includes bipolar, ultrasonic, and monopolar modules integrated together into a single housing unit 139, as shown in fig. 5.

In various aspects, the smoke evacuation module 126 includes a fluid line 154 that transports captured/collected smoke and/or fluid away from the surgical site and to, for example, the smoke evacuation module 126. Vacuum suction from smoke evacuation module 126 may draw smoke into the opening of the common conduit at the surgical site. The common conduit coupled to the fluid lines may be in the form of a flexible tube terminating at the smoke evacuation module 126. The common conduit and fluid lines define a fluid path that extends toward the smoke evacuation module 126 housed in the hub housing 136.

In various aspects, the suction/irrigation module 128 is coupled to a surgical tool that includes an aspiration fluid line and a suction fluid line. In one example, the aspiration fluid line and the suction fluid line are in the form of flexible tubes extending from the surgical site toward the suction/irrigation module 128. The one or more drive systems may be configured to irrigate fluid to and aspirate fluid from the surgical site.

In one aspect, a surgical tool includes a shaft having an end effector at a distal end thereof and at least one energy treatment associated with the end effector, a suction tube, and an irrigation tube. The draft tube may have an inlet at a distal end thereof, and the draft tube extends through the shaft. Similarly, a draft tube may extend through the shaft and may have an inlet adjacent the energy delivery tool. The energy delivery tool is configured to deliver 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 shaft.

The irrigation tube may be in fluid communication with a fluid source, and the aspiration tube may be in fluid communication with a vacuum source. The fluid source and/or vacuum source may be seated in the suction/irrigation module 128. In one example, the fluid source and/or vacuum source may be seated in the hub housing 136 independently of the suction/irrigation module 128. In such examples, the fluid interface can connect the suction/irrigation module 128 to a fluid source and/or a vacuum source.

In one aspect, the modules 140, 126, 128 on the hub modular housing 136 and/or their corresponding docking stations may include alignment features configured to enable alignment of the docking ports of the modules into engagement with their corresponding ports in the docking stations of the hub modular housing 136. For example, as shown in fig. 4, the combined generator module 145 includes side brackets 155, the side brackets 155 configured to be slidably engageable with corresponding brackets 156 of corresponding docking mounts 151 of the hub modular housing 136. The brackets cooperate to guide the docking port contacts of the combined generator module 145 into electrical engagement with the docking port contacts of the hub modular housing 136.

In some aspects, the drawers 151 of the hub modular housing 136 are the same or substantially the same size, and the modules are sized to be received in the drawers 151. For example, the side brackets 155 and/or 156 may be larger or smaller depending on the size of the module. In other aspects, the drawers 151 are sized differently and are each designed to accommodate a particular module.

In addition, the contacts of a particular module may be keyed to engage the contacts of a particular drawer to avoid inserting the module into a drawer having unmatched contacts.

As shown in fig. 4, the docking port 150 of one drawer 151 may be coupled to the docking port 150 of another drawer 151 by a communication link 157 to facilitate interactive communication between modules seated in the hub modular housing 136. Alternatively or additionally, the docking port 150 of the hub modular housing 136 can facilitate wireless interactive communication between modules seated in the hub modular housing 136. Any suitable wireless communication may be employed, such as, for example, Air Titan-Bluetooth.

Fig. 6 illustrates a single power bus attachment for multiple lateral docking ports of a lateral modular housing 160, the lateral modular housing 160 configured to accommodate multiple modules of a surgical hub 206. The lateral modular housing 160 is configured to laterally receive and interconnect the modules 161. The modules 161 are slidably inserted into docking feet 162 of a lateral modular housing 160, which lateral modular housing 160 includes a floor for interconnecting the modules 161. As shown in fig. 6, the modules 161 are arranged laterally in a lateral modular housing 160. Alternatively, the modules 161 may be arranged vertically in a lateral modular housing.

Fig. 7 illustrates a vertical modular housing 164 configured to house a plurality of modules 165 of the surgical hub 106. The modules 165 are slidably inserted into docking feet or drawers 167 of a vertical modular housing 164, which vertical modular housing 164 includes a floor for interconnecting the modules 165. Although the drawers 167 of the vertical modular housing 164 are arranged vertically, in some cases, the vertical modular housing 164 may include laterally arranged drawers. Further, the modules 165 may interact with each other through docking ports of the vertical modular housing 164. In the example of FIG. 7, a display 177 is provided for displaying data related to the operation of module 165. In addition, the vertical modular housing 164 includes a main module 178 that seats a plurality of sub-modules slidably received in the main module 178.

In various aspects, the imaging module 138 includes an integrated video processor and modular light source, and is adapted for use with a variety of imaging devices. In one aspect, the imaging device is constructed of a modular housing that can be fitted with a light source module and a camera module. The housing may be a disposable housing. In at least one example, the disposable housing is removably coupled to the reusable controller, the light source module, and the camera module. The light source module and/or the camera module may be selectively selected according to the type of surgical procedure. In one aspect, the camera module includes a CCD sensor. In another aspect, the camera module includes a CMOS sensor. In another aspect, the camera module is configured for scanning beam imaging. Also, the light source module may be configured to be capable of delivering white light or different light, depending on the surgical procedure.

During a surgical procedure, it may be inefficient to remove the surgical device from the surgical site and replace the surgical device with another surgical device that includes a different camera or a different light source. Temporary loss of vision at the surgical site can lead to undesirable consequences. The modular imaging apparatus of the present disclosure is configured to enable replacement of a light source module or a camera module during a surgical procedure without having to remove the imaging apparatus from the surgical site.

In one aspect, an imaging device includes a tubular housing including a plurality of channels. The first channel is configured to slidably receive a camera module, which may be configured to snap-fit engage with the first channel. The second channel is configured to slidably receive a light source module, which may be configured to snap-fit engage with the second channel. In another example, the camera module and/or the light source module may be rotated within their respective channels to a final position. Threaded engagement may be used instead of snap-fit engagement.

In various examples, multiple imaging devices are placed at different locations in a surgical field to provide multiple views. The imaging module 138 may be configured to be able to switch between imaging devices to provide an optimal view. In various aspects, the imaging module 138 may be configured to be able to integrate images from different imaging devices.

Various IMAGE PROCESSORs AND imaging devices suitable FOR use in the present disclosure are described in united states patent 7,995,045, published 8/9 of 2011, entitled COMBINED SBI AND conventional IMAGE PROCESSOR (COMBINED SBI AND related L IMAGE PROCESSOR), which is incorporated herein by reference in its entirety, furthermore, united states patent 7,982,776, 19 of 2011, entitled SBI MOTION ARTIFACT removal device AND method (SBI MOTION ARTIFACT removal mova L APPARATUS AND method), which is incorporated herein by reference in its entirety, describes various SYSTEMs FOR removing MOTION ARTIFACTs from IMAGE data, which is incorporated herein by reference in its entirety, such SYSTEMs may be integrated with imaging module 138. furthermore, united states patent publication 2011/0306840, published 12/15 of 2011, entitled controllable magnetic SOURCE FOR FIXTURE in-vivo device (20113545 AB LL TO filter into APPARATUS L APPARATUS), AND united states patent publication 2011/0306840, published 20148, published as contone FOR PERFORMING minimally invasive PROCEDUREs on each of the SYSTEM of 2011, which is incorporated herein by reference in its entirety as patent 493 3, which is published as patent publication No. patent No. 493 3.

Fig. 8 illustrates a surgical data network 201 including a modular communication hub 203, the modular communication hub 203 configured to enable connection of modular devices located in one or more operating rooms of a medical facility or any room in the medical facility specially equipped for surgical operations to a cloud-based system (e.g., a cloud 204 that may include a remote server 213 coupled to a storage device 205). In one aspect, modular communication hub 203 includes a network hub 207 and/or a network switch 209 that communicate with network routers. Modular communication hub 203 may also be coupled to local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 may be configured to be passive, intelligent, or switched. The passive surgical data network acts as a conduit for data, enabling it to be transferred from one device (or segment) to another device (or segment) as well as cloud computing resources. The intelligent surgical data network includes additional features to enable monitoring of traffic through the surgical data network and configuring each port in the hub 207 or network switch 209. The intelligent surgical data network may be referred to as a manageable hub or switch. The switching hub reads the destination address of each packet and then forwards the packet to the correct port.

The modular devices 1a-1n located in the operating room may be coupled to a modular communication hub 203. Network hub 207 and/or network switch 209 may be coupled to network router 211 to connect devices 1a-1n to cloud 204 or local computer system 210. Data associated with the devices 1a-1n may be transmitted via the router to the cloud-based computer for remote data processing and manipulation. Data associated with the devices 1a-1n may also be transmitted to the local computer system 210 for local data processing and manipulation. Modular devices 2a-2m located in the same operating room may also be coupled to the network switch 209. Network switch 209 may be coupled to network hub 207 and/or network router 211 to connect devices 2a-2m to cloud 204. Data associated with the devices 2a-2n may be transmitted via the network router 211 to the cloud 204 for data processing and manipulation. Data associated with the devices 2a-2m may also be transmitted to the local computer system 210 for local data processing and manipulation.

It should be understood that surgical data network 201 may be expanded by interconnecting multiple hubs 207 and/or multiple network switches 209 with multiple network routers 211. The modular communication hub 203 may be contained in a modular control tower configured to be able to house a plurality of devices 1a-1n/2a-2 m. Local computer system 210 may also be contained in a modular control tower. The modular communication hub 203 is connected to a display 212 to display images obtained by some of the devices 1a-1n/2a-2m, for example, during a surgical procedure. In various aspects, the devices 1a-1n/2a-2m may include, for example, various modules such as non-contact sensor modules in 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 array 134, a surgical device connected to a display, and/or other modular devices that may be connected to a modular communication hub 203 of a surgical data network 201.

In one aspect, the surgical data network 201 may include a combination of one or more network hubs, one or more network switches, and one or more network routers that connect the devices 1a-1n/2a-2m to the cloud. Any or all of the devices 1a-1n/2a-2m coupled to the network hub or network switch may collect data in real time and transmit the data into the cloud computer for data processing and manipulation. It should be appreciated that cloud computing relies on shared computing resources rather than using local servers or personal devices to process software applications. The term "cloud" may be used as a metaphor for "internet," although the term is not so limited. Accordingly, the term "cloud computing" may be used herein to refer to a "type of internet-based computing" in which different services (such as servers, memory, and applications) are delivered to modular communication hub 203 and/or computer system 210 located in a surgical room (e.g., a fixed, mobile, temporary, or live operating room or space) and devices connected to modular communication hub 203 and/or computer system 210 over the internet. The cloud infrastructure may be maintained by a cloud service provider. In this case, the cloud service provider may be an entity that coordinates the use and control of the devices 1a-1n/2a-2m located in one or more operating rooms. Cloud computing services can perform a large amount of computing based on data collected by smart surgical instruments, robots, and other computerized devices located in the operating room. The hub hardware enables multiple devices or connections to connect to a computer in communication with the cloud computing resources and memory.

Applying cloud computer data processing techniques to the data collected by the devices 1a-1n/2a-2m, the surgical data network provides improved surgical outcomes, reduced costs, and improved patient satisfaction. At least some of the devices 1a-1n/2a-2m may be employed to observe tissue conditions to assess leakage or perfusion of sealed tissue following a tissue sealing and cutting procedure. At least some of the devices 1a-1n/2a-2m may be employed to identify pathologies, such as the effects of disease, using cloud-based computing to examine data including images of body tissue samples for diagnostic purposes. This includes localization and edge confirmation of tissues and phenotypes. At least some of the devices 1a-1n/2a-2m may be employed to identify anatomical structures of the body using various sensors integrated with the imaging devices and techniques, such as overlaying images captured by multiple imaging devices. The data (including image data) collected by the devices 1a-1n/2a-2m may be transmitted to the cloud 204 or the local computer system 210 or both for data processing and manipulation, including image processing and manipulation. Such data analysis may further employ outcome analysis processing, and use of standardized methods may provide beneficial feedback to confirm or suggest modification of the behavior of the surgical treatment and surgeon.

In one implementation, the operating room devices 1a-1n may be connected to the modular communication hub 203 through a wired channel or a wireless channel, depending on the configuration of the devices 1a-1n to the network hub. In one aspect, hub 207 may be implemented as a local network broadcaster operating at the physical layer of the Open Systems Interconnection (OSI) model. The hub provides connectivity to devices 1a-1n located in the same operating room network. The hub 207 collects the data in the form of packets and transmits it to the router in half duplex mode. Hub 207 does not store any media access control/internet protocol (MAC/IP) used to transmit device data. Only one of the devices 1a-1n may transmit data through the hub 207 at a time. The hub 207 does not have routing tables or intelligence as to where to send information and broadcast all network data on each connection and to the remote server 213 (fig. 9) through the cloud 204. Hub 207 may detect basic network errors such as conflicts, but broadcasting all information to multiple ports may present a security risk and lead to bottlenecks.

In another implementation, the operating room devices 2a-2m may be connected to the network switch 209 via a wired channel or a wireless channel. Network switch 209 operates in the data link layer of the OSI model. The network switch 209 is a multicast device for connecting devices 2a-2m located in the same operating room to the network. Network switch 209 sends data in frames to network router 211 and operates in full duplex mode. Multiple devices 2a-2m may transmit data simultaneously through the network switch 209. The network switch 209 stores and uses the MAC addresses of the devices 2a-2m to transmit data.

Network hub 207 and/or network switch 209 are coupled to network router 211 to connect to cloud 204. Network router 211 operates in the network layer of the OSI model. Network router 211 creates a route for transmitting data packets received from network hub 207 and/or network switch 211 to the cloud-based computer resources for further processing and manipulation of data collected by any or all of devices 1a-1n/2a-2 m. Network router 211 may be employed to connect two or more different networks located at different locations, such as, for example, different operating rooms of the same medical facility or different networks located in different operating rooms of different medical facilities. Network router 211 sends data in packets to cloud 204 and operates in full duplex mode. Multiple devices may transmit data simultaneously. The network router 211 transmits data using the IP address.

In one example, hub 207 may be implemented as a USB hub, which allows multiple USB devices to be connected to a host. A USB hub may extend a single USB port to multiple tiers so that more ports are available for connecting devices to a host system computer. Hub 207 may include wired or wireless capabilities for receiving information over a wired channel or a wireless channel. In one aspect, a wireless USB short-range, high bandwidth wireless radio communication protocol may be used for communication between devices 1a-1n and devices 2a-2m located in an operating room.

In other examples, the operating room devices 1a-1n/2a-2m may communicate with the modular communication hub 203 via the Bluetooth wireless technology standard for exchanging data from stationary and mobile devices and constructing a Personal Area Network (PAN) over short distances (using short wavelength UHF radio waves of 2.4 to 2.485GHz in the ISM band). In other aspects, the operating room devices 1a-1n/2a-2m may communicate with the modular communication hub 203 via a variety of wireless or wired communication standards or protocols, including but not limited to Wi-Fi (IEEE 802.11 series), WiMAX (IEEE 802.16 series), IEEE 802.20, Long term evolution (L TE), and Ev-DO, HSPA +, HSDPA +, UPA +, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and their network derivatives, as well as any other wireless and wired protocols designated as 3G, 4G, 5G, and above.

The modular communication hub 203 may serve as a central connection for one or all of the operating room devices 1a-1n/2a-2m and handle a data type called a frame. The frames carry data generated by the devices 1a-1n/2a-2 m. When the modular communication hub 203 receives the frame, it is amplified and transmitted to the network router 211, which network router 211 transmits the data to the cloud computing resources using a plurality of wireless or wired communication standards or protocols as described herein.

Modular communication hub 203 may be used as a stand-alone device or connected to a compatible network hub and network switch to form a larger network. The modular communication hub 203 is generally easy to install, configure and maintain, making it a good option to network the operating room devices 1a-1n/2a-2 m.

Fig. 9 illustrates a computer-implemented interactive surgical system 200. The computer-implemented interactive surgical system 200 is similar in many respects to the computer-implemented interactive surgical system 100. For example, the computer-implemented interactive surgical system 200 includes one or more surgical systems 202 that are similar in many respects to the surgical system 102. Each surgical system 202 includes at least one surgical hub 206 in communication with a cloud 204, which may include a remote server 213. In one aspect, the computer-implemented interactive surgical system 200 includes a modular control tower 236, the modular control tower 236 being connected to a plurality of operating room devices, such as, for example, intelligent surgical instruments, robots, and other computerized devices located in an operating room. As shown in fig. 10, the modular control tower 236 includes a modular communication hub 203 coupled to the computer system 210. As shown in the example of fig. 9, the modular control tower 236 is coupled to an imaging module 238 coupled to an endoscope 239, a generator module 240 coupled to an energy device 241, a smoke ejector module 226, a suction/irrigation module 228, a communication module 230, a processor module 232, a storage array 234, an intelligent device/instrument 235 optionally coupled to a display 237, and a non-contact sensor module 242. The operating room devices are coupled to cloud computing resources and data storage via modular control tower 236. Robot hub 222 may also be connected to modular control tower 236 and cloud computing resources. The devices/instruments 235, visualization system 208, etc. may be coupled to the modular control tower 236 via wired or wireless communication standards or protocols, as described herein. The modular control tower 236 may be coupled to the hub display 215 (e.g., monitor, screen) to display and overlay images received from the imaging module, device/instrument display, and/or other visualization system 208. The hub display may also combine the image and the overlay image to display data received from devices connected to the modular control tower.

Fig. 10 shows the surgical hub 206 including a plurality of modules coupled to a modular control tower 236. The modular control tower 236 includes a modular communication hub 203 (e.g., a network connectivity device) and a computer system 210 to provide, for example, local processing, visualization, and imaging. As shown in fig. 10, the modular communication hub 203 may be connected in a hierarchical configuration to expand the number of modules (e.g., devices) that may be connected to the modular communication hub 203 and transmit data associated with the modules to the computer system 210, cloud computing resources, or both. As shown in fig. 10, each of the network hubs/switches in modular communication hub 203 includes three downstream ports and one upstream port. The upstream hub/switch is connected to the processor to provide a communication connection with the cloud computing resources and the local display 217. Communication with the cloud 204 may be through a wired or wireless communication channel.

The ultrasound-based non-contact sensor module scans the Operating Room by transmitting a burst of ultrasound waves and receiving echoes as they bounce off the enclosure of the Operating Room, as described under U.S. provisional patent application serial No. 62/611,341 entitled "Surgical interactive platform (INTERACTIVE SURGICA L P L ATFORM)" filed on 28.2017, 12.s., which is incorporated herein by reference in its entirety, entitled "Surgical Hub space perception in the Operating Room (Surgical Hub space operation Room)" wherein the sensor module is configured to be able to determine the size of the Operating Room and adjust the bluetooth paired distance limit.

Computer system 210 includes a processor 244 and a network interface 245, the processor 244 is coupled via a system bus to a communication module 247, storage 248, memory 249, non-volatile memory 250, and an input/output interface 251, the system bus can be any of several types of bus structure(s) including a memory bus or memory controller, a peripheral bus or external bus, and/or a local bus using any of a variety of available bus architectures including, but not limited to, 9-bit bus, Industrial Standard Architecture (ISA), mini-Charmel architecture (MSA), extended ISA (eisa), Intelligent Drive Electronics (IDE), VESA local bus (V L B), Peripheral Component Interconnect (PCI), USB, Advanced Graphics Port (AGP), personal computer memory card international association bus (PCMCIA), Small Computer System Interface (SCSI), or any other peripheral bus.

In one aspect, the processors may be on-chip memories available from, for example, Texas Instruments (Texas Instruments) L M4F230H5QR ARM Cortex-M4F processor cores including 256KB of single cycle flash memory or other non-volatile memory (up to 40MHZ), prefetch buffers for improved performance above 40MHz, 32KB of single cycle Sequence Random Access Memory (SRAM), loaded with memory such as ARM Cortex, or the likeSoftware internal Read Only Memory (ROM), 2KB Electrically Erasable Programmable Read Only Memory (EEPROM), and/or one or more Pulse Width Modulation (PWM) modules, one or more Quadrature Encoder Input (QEI) analog, one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, the details of which can be seen in the product data sheet.

In one aspect, the processor 244 may comprise a safety controller comprising two series controller-based controllers (such as TMS570 and RM4x), also known under the trade name Hercules ARM Cortex R4, also manufactured by Texas Instruments. The safety controller may be configured specifically for IEC 61508 and ISO26262 safety critical applications, etc., to provide advanced integrated safety features while delivering scalable performance, connectivity, and memory options.

For example, nonvolatile memory may include ROM, Programmable ROM (PROM), Electrically Programmable ROM (EPROM), EEPROM, or flash memory volatile memory includes Random Access Memory (RAM) which acts as external cache memory furthermore, RAM may be available in a variety of forms such as SRAM, Dynamic RAM (DRAM), Synchronous DRAM (SDRAM), Double Data Rate SDRAM (DDRSDRAM), Enhanced SDRAM (ESDRAM), synchronous link DRAM (S L) and Direct Rambus RAM (DRRAM).

The computer system 210 may also include removable/non-removable, volatile/nonvolatile computer storage media such as, for example, magnetic disk storage including, but not limited to, devices such as magnetic disk drives, floppy disk drives, tape drives, Jaz drives, Zip drives, L S-60 drives, flash memory cards, or memory sticks, hi addition, magnetic disk storage may include storage media separately or in combination with other storage media including, but not limited to, optical disk drives such as compact disk ROM devices (CD-ROMs), compact disk recordable drives (CD-R drives), compact disk rewritable drives (CD-RW drives), or digital versatile disk ROM drives (DVD-ROMs).

It is to be appreciated that the computer system 210 includes software that acts as an intermediary between users and the basic computer resources described in suitable operating environments. Such software includes an operating system. An operating system, which may be stored on disk storage, is used to control and allocate resources of the computer system. System applications utilize the operating system to manage resources through program modules and program data stored in system memory or on disk storage. It is to be appreciated that the various devices described herein can be implemented with various operating systems or combinations of operating systems.

A user enters commands or information into the computer system 210 through one or more input devices coupled to the I/O interface 251. Input devices include, but are not limited to, a pointing device such as a mouse, trackball, stylus, touch pad, keyboard, microphone, joystick, game pad, satellite dish, scanner, TV tuner card, digital camera, digital video camera, web camera, and the like. These and other input devices are connected to the processor through the system bus via one or more interface ports. The one or more interface ports include, for example, a serial port, a parallel port, a game port, and a USB. One or more output devices use the same type of port as one or more input devices. Thus, for example, a USB port may be used to provide input to a computer system and to output information from the computer system to an output device. Output adapters are provided to illustrate that there are some output devices (such as monitors, displays, speakers, and printers) that require special adapters among other output devices.

The computer system 210 may operate in a networked environment using logical connections to one or more remote computers, such as one or more cloud computers, or local computers, the one or more remote cloud computers may be personal computers, servers, routers, network PCs, workstations, microprocessor-based appliances, peer devices or other common network nodes and the like, and typically include many or all of the elements described relative to the computer system.

In various aspects, the computer system 210, imaging module 238, and/or visualization system 208 of fig. 10, and/or the processor module 232 of fig. 9-10 may include an image processor, an image processing engine, a media processor, or any dedicated Digital Signal Processor (DSP) for processing digital images. The image processor may employ parallel computing with single instruction, multiple data (SIMD) or multiple instruction, multiple data (MIMD) techniques to increase speed and efficiency. The digital image processing engine may perform a series of tasks. The image processor may be a system on a chip having a multi-core processor architecture.

The hardware/software necessary for connection to the network interface includes, for exemplary purposes only, internal and external technologies such as, modems including regular telephone grade modems, cable modems and DS L modems, ISDN adapters, and Ethernet cards.

Fig. 11 illustrates a functional block diagram of one aspect of a USB hub 300 device in accordance with at least one aspect of the present disclosure. In the illustrated aspect, the USB hub device 300 employs a TUSB2036 integrated circuit hub from texas instruments. The USB hub 300 is a CMOS device that provides an upstream USB transceiver port 302 and up to three downstream USB transceiver ports 304, 306, 308 according to the USB 2.0 specification. The upstream USB transceiver port 302 is a differential root data port that includes a differential data negative (DP0) input paired with a differential data positive (DM0) input. The three downstream USB transceiver ports 304, 306, 308 are differential data ports, where each port includes a differential data positive (DP1-DP3) output paired with a differential data negative (DM1-DM3) output.

The USB hub 300 device is implemented with a digital state machine rather than a microcontroller and does not require firmware programming. Fully compatible USB transceivers are integrated into the circuitry 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 devices and low-speed devices by automatically setting the slew rate according to the speed of the device attached to the port. The USB hub 300 device may be configured in a bus-powered mode or a self-powered mode and includes hub power logic 312 for managing power.

The USB hub 300 device includes a serial interface engine 310 (SIE). SIE 310 is the front end of the USB hub 300 hardware and handles most of the protocols described in section 8 of the USB specification. The SIE 310 typically includes signaling up to the transaction level. The processing functions thereof may include: packet identification, transaction ordering, SOP, EOP, RESET and RESUME signal detection/generation, clock/data separation, no return to zero inversion (NRZI) data encoding/decoding and digit stuffing, CRC generation and checking (token and data), packet id (pid) generation and checking/decoding, and/or serial-parallel/parallel-serial conversion. 310 receives a clock input 314 and is coupled to pause/resume logic and frame timer 316 circuitry and hub repeater circuitry 318 to control communications between the upstream USB transceiver port 302 and the downstream USB transceiver ports 304, 306, 308 through port logic circuitry 320, 322, 324. The SIE 310 is coupled to a command decoder 326 via interface logic to control commands from the serial EEPROM via a serial EEPROM interface 330.

In various aspects, the USB hub 300 may connect 127 functions configured in up to six logical layers (tiers) to a single computer. Further, the USB hub 300 may be connected to all external devices using a standardized four-wire cable that provides both communication and power distribution. The power configuration is a bus powered mode and a self-powered mode. The USB hub 300 may be configured to support four power management modes: bus-powered hubs with individual port power management or package port power management, and self-powered hubs with individual port power management or package port power management. In one aspect, the USB hub 300, upstream USB transceiver port 302, are plugged into the USB host controller using a USB cable, and downstream USB transceiver ports 304, 306, 308 are exposed for connection of USB compatible devices, or the like.

Surgical instrument hardware

Fig. 12 illustrates a logic diagram for a control system 470 for a surgical instrument or tool according to one or more aspects of the present disclosure. The system 470 includes control circuitry. The control circuit includes a microcontroller 461 that includes a processor 462 and a memory 468. For example, one or more of the sensors 472, 474, 476 provide real-time feedback to the processor 462. A motor 482 driven by a motor driver 492 is operatively coupled to the longitudinally movable displacement member to drive the clamp arm closure member. The tracking system 480 is configured to be able to determine the position of the longitudinally movable displacement member. The position information is provided to a processor 462, which processor 462 may be programmed or configured to be able to determine the position of the longitudinally movable drive member and the position of the closure member. Additional motors may be provided at the tool driver interface to control closure tube travel, shaft rotation, articulation, or gripper arm closure, or combinations thereof. The display 473 displays a variety of operating conditions of the instrument and may include touch screen functionality for data entry. The information displayed on the display 473 may be overlaid with the image acquired via the endoscopic imaging module.

In one aspect, the microprocessor 461 may be any single or multi-core processor, such as those known under the trade name ARM Cortex produced by Texas Instruments Inc. (Texas Instruments.) in one aspect, the microcontroller 461 may be an L M4F230H5QR ARM Cortex-M4F processor core available from, for example, Texas Instruments Inc. (Texas Instruments), which includes on-chip memory such as 256KB single cycle flash or other non-volatile memory (up to 40MHZ), a prefetch buffer for improving performance above 40MHz, 32KB single cycle SRAM, a prefetch buffer loaded with a memory that is loaded with 256KBInternal ROM of software, 2KB electrical EEPROM, one or more PWM modules, one or more QEI analog, one or more 12-bit ADCs with 12 analog input channels, the details of which can be seen in the product data sheet.

In one aspect, microcontroller 461 may comprise a safety controller comprising two controller-based families such as TMS570 and RM4x, also known under the trade name Hercules ARM Cortex R4, also manufactured by Texas Instruments. The safety controller may be configured specifically for IEC 61508 and ISO26262 safety critical applications, etc., to provide advanced integrated safety features while delivering scalable performance, connectivity, and memory options.

Microcontroller 461 may be programmed to perform various functions such as precisely controlling the speed AND position of the knife, articulation system, clamping arm, or combinations of the above in one aspect, microcontroller 461 includes processor 462 AND memory 468 electric motor 482 may be a brushed Direct Current (DC) motor having a gear box AND a mechanical link to the articulation or knife system in one aspect motor driver 492 may be a3941 available from Allegro Microsystems, Inc other motor drivers may be readily substituted FOR use in tracking system 480 that includes an absolute positioning system detailed description of which is published on 19.10.2017 under U.S. patent application publication No. SYSTEMS AND, control LL, a surgical stapling L STAP L, AND curttinggitrent, which is incorporated herein by reference in its entirety.

The microcontroller 461 may be programmed to provide precise control of the speed and position of the displacement member and the articulation system. The microcontroller 461 may be configured to be able to calculate a response in the software of the microcontroller 461. The calculated response is compared to the measured response of the actual system to obtain an "observed" response, which is used for the actual feedback decision. The observed response is a favorable tuning value that balances the smooth continuous nature of the simulated response with the measured response, which can detect external effects on the system.

In one aspect, the motor 482 can be controlled by a motor driver 492 and can be employed by a firing system of a surgical instrument or tool. In various forms, the motor 482 may be a brushed DC drive motor having a maximum rotational speed of about 25,000 RPM. In other arrangements, the motor 482 may comprise a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor driver 492 may comprise, for example, an H-bridge driver including a Field Effect Transistor (FET). The motor 482 may be powered by a power assembly releasably mounted to the handle assembly or tool housing for supplying control power to the surgical instrument or tool. The power assembly may include a battery, which may include a plurality of battery cells connected in series that may be used as a power source to provide power to a surgical instrument or tool. In some cases, the battery cells of the power assembly may be replaceable and/or rechargeable battery cells. In at least one example, the battery cell may be a lithium ion battery, which may be coupled to and separated from the power component.

The driver 492 may be a3941 available from Allegro Microsystems, Inc. A 3941492 is a full-bridge controller for use with an external N-channel power Metal Oxide Semiconductor Field Effect Transistor (MOSFET) specifically designed for inductive loads, such as brushed DC motors. Driver 492 includes a unique charge pump regulator that provides full (> 10V) gate drive for battery voltages as low as 7V and allows a3941 to operate with reduced gate drive as low as 5.5V. A bootstrap capacitor may be employed to provide the aforementioned battery supply voltage required for the N-channel MOSFET. The internal charge pump of the high-side drive allows for direct current (100% duty cycle) operation. The full bridge may be driven in fast decay mode or slow decay mode using diodes or synchronous rectification. In the slow decay mode, current recirculation may pass through either the high-side FET or the low-side FET. The power FET is protected from breakdown by a resistor adjustable dead time. The integral diagnostics provide an indication of undervoltage, overheating, and power bridge faults, and may be configured to protect the power MOSFETs under most short circuit conditions. Other motor drives can be readily substituted for use in tracking system 480, including an absolute positioning system.

The tracking system 480 includes a controlled motor drive circuit arrangement including a position sensor 472 according to one aspect of the present disclosure. The position sensor 472 for the absolute positioning system provides a unique position signal corresponding to the position of the displacement member. In one aspect, the displacement member represents a longitudinally movable drive member including a rack of drive teeth for meshing engagement with a corresponding drive gear of the gear reducer assembly. In other aspects, the displacement member represents a firing member that may be adapted and configured as a rack including drive teeth. In a further aspect, the displacement member represents a longitudinal displacement member for opening and closing the clamp arm, which may be adapted and configured as a rack comprising drive teeth. In other aspects, the displacement member represents a clamp arm closure member configured to be capable of closing and opening a clamp arm of a stapler, a clamp arm of an ultrasonic or electrosurgical device, or a combination thereof. Accordingly, as used herein, the term displacement member is used generically to refer to any movable member of a surgical instrument or tool (such as a drive member, a clamp arm, or any element that can be displaced). Thus, the absolute positioning system can in fact track the displacement of the gripping arm by tracking the linear displacement of the longitudinally movable drive member.

In various other aspects, the displacement member may be coupled to any position sensor 472 suitable for measuring linear displacement, thus, the longitudinally movable drive member, or the clamp arm, or a combination thereof, may be coupled to any suitable linear displacement sensor.

The electric motor 482 may include a rotatable shaft that operatively interfaces with a gear assembly mounted on the displacement member in meshing engagement with the set or rack of drive teeth. The sensor element may be operatively coupled to the gear assembly such that a single rotation of the position sensor 472 element corresponds to some linear longitudinal translation of the displacement member. The arrangement of the transmission and sensor may be connected to the linear actuator via a rack and pinion arrangement, or to the rotary actuator via a spur gear or other connection. The power source powers the absolute positioning system and the output indicator may display an output of the absolute positioning system. The displacement member represents a longitudinally movable drive member including a rack of drive teeth formed thereon for meshing engagement with a corresponding drive gear of the gear reducer assembly. The displacement member represents a longitudinally movable firing member for opening and closing the clamp arm.

A single rotation of the sensor element associated with the position sensor 472 is equivalent to a longitudinal linear displacement d of the displacement member₁Wherein d is₁Is the longitudinal linear distance that the displacement member moves from point "a" to point "b" after a single rotation of the sensor element coupled to the displacement member. The sensor arrangement may be connected via a gear reduction that causes the position sensor 472 to complete only one or more rotations for the full stroke of the displacement member. The position sensor 472 may complete multiple rotations for a full stroke of the displacement member.

A series of switches (where n is an integer greater than one) may be employed alone or in conjunction with the gear reduction to provide unique position signals for more than one rotation of the position sensor 472. The state of the switch is fed back to the microcontroller 461, which microcontroller 461 applies logic to determine a longitudinal linear displacement d corresponding to the displacement member₁+d₂+…d_nA unique position signal of. The output of the position sensor 472 is provided to a microcontroller 461. The position sensor 472 of the sensor arrangement may include a magnetic sensor, an analog rotation sensor (e.g., a potentiometer), an array of analog hall effect elements that output a unique combination of position signals or values.

Position sensor 472 may include any number of magnetic sensing elements, such as, for example, magnetic sensors that are classified according to whether they measure the total or vector component of the magnetic field. The techniques for producing the two types of magnetic sensors described above encompass a number of aspects of physics and electronics. Technologies for magnetic field sensing include search coils, flux gates, optical pumps, nuclear spins, superconducting quantum interferometers (SQUIDs), hall effects, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedances, magnetostrictive/piezoelectric composites, magnetodiodes, magnetotransistors, optical fibers, magneto-optical, and magnetic sensors based on micro-electromechanical systems, among others.

In one aspect, the position sensor 472 for the tracking system 480 including an absolute positioning system includes a magnetic rotating absolute positioning system the position sensor 472 may be implemented AS an AS5055EQFT monolithic magnetic rotating position sensor, available from australian Austria microelectronics (AG) the position sensor 472 interfaces with a microcontroller 461 to provide an absolute positioning system the position sensor 472 is a low voltage and low power device and includes four hall effect elements located in the area of the position sensor 472 on the magnet a high resolution ADC and an intelligent power management controller are also provided on the chip a coordinate rotation digital computer (dic) processor (also known AS the bitwise and Volder algorithms) is provided to perform simple and efficient algorithms to calculate hyperbolic and trigonometric functions that require only the addition, subtraction, displacement and table lookup operations angular position, alarm bit and magnetic field information to be transmitted to the microcontroller over a standard serial communication interface (such AS a Serial Peripheral Interface (SPI) 461) the position sensor provides 12 or 14 bit resolution the position sensor 472 may be provided in a qf 3585 mm package AS a small pin 5054.84.

The tracking system 480, which includes an absolute positioning system, may include AND/or may be programmed to implement a feedback controller, such as a PID, state feedback, AND ADAPTIVE controller, a power source converts the signal from the feedback controller into a physical input to the system, in this case a voltage, other examples include pwm OF voltage, current, AND force, one or more other sensors may be provided to measure physical parameters OF the physical system in addition to the position measured by the position sensor 472. in some aspects, one or more other sensors may include sensor arrangements such as those described in U.S. patent 9,345,481 entitled cartridge TISSUE THICKNESS sensor system (STAP L E CARTRIDGE TISSUE thcknes) issued on 24.2016, which is incorporated herein by reference in its entirety, AND U.S. patent application 2014/0263552 entitled cartridge TISSUE THICKNESS sensor system (STAP 2 TISSUE thknonsess) issued on 18.9.2014, which is incorporated herein by reference in its entirety, AND which is filed on 20.7, which is filed in full text FOR surgical TISSUE THICKNESS sensor system (STAP 2 TISSUE) AND calculates a response to a weighted response measurement system using a digital sensing algorithm FOR calculating a weighted response OF a system such as a weighted response to a system which calculates a response to a measurement OF a digital sensor system such as a system which calculates a weighted response to a system which is calculated by a weighted response OF a system, a system which is taken into account OF a system, a system FOR calculating a system, a system response OF a system, a system which calculates a system, a system which calculates a system which measures a system, a system which measures a response to calculate a system, a system which measures a response to calculate a system which measures a response to calculate a system, a system which measures a.

Thus, the absolute positioning system provides an absolute position of the displacement member upon power-up of the instrument, and does not retract or advance the displacement member to a reset (clear or home) position as may be required by conventional rotary encoders, which simply count the number of forward or backward steps taken by the motor 482 to infer the position of the device actuator, drive rod, knife, etc.

The sensor 474 (such as, for example, a strain gauge or a micro-strain gauge) is configured to measure one or more parameters of the end effector, such as, for example, the magnitude of the strain exerted on the anvil during a clamping operation, which may be indicative of the closing force applied to the anvil. The measured strain is converted to a digital signal and provided to the processor 462. Alternatively or in addition to sensor 474, sensor 476 (such as, for example, a load sensor) may measure the closing force applied by the closure drive system to an anvil in a stapler or clamping arm in an ultrasonic or electrosurgical instrument. The sensor 476 (such as, for example, a load sensor) may measure a firing force applied to a closure member coupled to a clamp arm of a surgical instrument or tool or a force applied by the clamp arm to tissue located in a jaw of an ultrasonic or electrosurgical instrument. Alternatively, a current sensor 478 may be employed to measure the current drawn by the motor 482. The displacement member may also be configured to be able to engage the clamp arm to open or close the clamp arm. The force sensor may be configured to measure a clamping force on the tissue. The force required to advance the displacement member may correspond to, for example, the current consumed by the motor 482. The measured force is converted to a digital signal and provided to the processor 462.

In one form, the strain gauge sensor 474 may be used to measure the force applied to tissue by the end effector. A strain gauge may be coupled to the end effector to measure the force on the tissue being treated by the end effector. The system for measuring force applied to tissue grasped by the end effector includes a strain gauge sensor 474, such as, for example, a micro-strain gauge, configured to be capable of measuring one or more parameters of, for example, the end effector. In one aspect, the strain gauge sensor 474 can measure the amplitude or magnitude of the strain applied to the jaw members of the end effector during a clamping operation, which can indicate tissue compression. The measured strain is converted to a digital signal and provided to the processor 462 of the microcontroller 461. Load sensor 476 may measure a force used to operate the knife member, for example, to cut tissue captured between the anvil and the staple cartridge. The load cell 476 may measure a force used to operate the clamp arm member, for example, to capture tissue between the clamp arm and the ultrasonic blade or to capture tissue between the clamp arm and the jaws of the electrosurgical instrument. A magnetic field sensor may be employed to measure the thickness of the trapped tissue. The measurements of the magnetic field sensors may also be converted to digital signals and provided to the processor 462.

The microcontroller 461 can use measurements of tissue compression, tissue thickness, and/or force required to close the end effector, as measured by the sensors 474, 476, respectively, to characterize selected positions of the firing member and/or corresponding values of the velocity of the firing member. In one example, the memory 468 may store techniques, formulas, and/or look-up tables that may be employed by the microcontroller 461 in the evaluation.

The control system 470 of the surgical instrument or tool may also include wired or wireless communication circuitry to communicate with the modular communication hub, as shown in fig. 8-11.

Fig. 13 illustrates a control circuit 500, the control circuit 500 configured to control aspects of a surgical instrument or tool according to an aspect of the present disclosure. The control circuitry 500 may be configured to enable the various processes described herein. The circuit 500 may include a microcontroller including one or more processors 502 (e.g., microprocessors, microcontrollers) coupled to at least one memory circuit 504. The memory circuitry 504 stores machine-executable instructions that, when executed by the processor 502, cause the processor 502 to execute machine instructions to implement the various processes described herein. The processor 502 may be any of a variety of single-core or multi-core processors known in the art. The memory circuit 504 may include volatile storage media and non-volatile storage media. Processor 502 may include an instruction processing unit 506 and an arithmetic unit 508. The instruction processing unit may be configured to be able to receive instructions from the memory circuit 504 of the present disclosure.

Fig. 14 illustrates a combinational logic circuit 510, the combinational logic circuit 510 configured to control aspects of a surgical instrument or tool according to an aspect of the present disclosure. The combinational logic circuit 510 may be configured to enable the various processes described herein. The combinational logic circuit 510 may include a finite state machine including combinational logic 512, the combinational logic 512 configured to receive data associated with a surgical instrument or tool at input 514, process the data through the combinational logic 512 and provide output 516.

Fig. 15 illustrates a sequential logic circuit 520 configured to control various aspects of a surgical instrument or tool according to one aspect of the present disclosure. Sequential logic circuitry 520 or combinational logic 522 may be configured to enable the various processes described herein. Sequential logic circuit 520 may comprise a finite state machine. Sequential logic circuitry 520 may include, for example, combinatorial logic 522, at least one memory circuit 524, and a clock 529. The at least one memory circuit 524 may store the current state of the finite state machine. In some cases, sequential logic circuit 520 may be synchronous or asynchronous. The combinational logic 522 is configured to receive data associated with a surgical instrument or tool from the inputs 526, process the data through the combinational logic 522, and provide the outputs 528. In other aspects, a circuit may comprise a combination of a processor (e.g., processor 502, fig. 13) and a finite state machine to implement the various processes herein. In other embodiments, the finite state machine may include a combination of combinational logic circuitry (e.g., combinational logic circuitry 510, FIG. 14) and sequential logic circuitry 520.

Fig. 16 illustrates a surgical instrument or tool including multiple motors that can be activated to perform various functions. In some cases, the first motor may be activated to perform a first function, the second motor may be activated to perform a second function, and the third motor may be activated to perform a third function. In some instances, multiple motors of the robotic surgical instrument 600 may be individually activated to cause firing, closing, and/or articulation motions in the end effector. Firing motions, closing motions, and/or articulation motions can be transmitted to the end effector, for example, by a shaft assembly.

In certain instances, a surgical instrument system or tool may include a firing motor 602. The firing motor 602 is operatively coupled to a firing motor drive assembly 604, which firing motor drive assembly 604 may be configured to transmit a firing motion generated by the motor 602 to the end effector, in particular for displacing the clamp arm closure member. The closure member may be retracted by reversing the direction of the motor 602, which also causes the gripper arms to open.

In some cases, the surgical instrument or tool may include a closure motor 603. The closure motor 603 may be operatively coupled to a closure motor drive assembly 605, the closure motor drive assembly 605 being configured to transmit the closure motions generated by the motor 603 to the end effector, in particular for displacing a closure tube to close the anvil and compress tissue between the anvil and the staple cartridge. The closure motor 603 can be operatively coupled to a closure motor drive assembly 605 configured to transmit the closure motions generated by the motor 603 to the end effector, in particular for displacing the closure tube to close the clamp arm and compress tissue between the clamp arm and the ultrasonic blade or jaw member of the electrosurgical device. The closing motion can transition, for example, the end effector from an open configuration to an approximated configuration to capture tissue. The end effector may be transitioned to the open position by reversing the direction of the motor 603.

In some cases, the surgical instrument or tool may include, for example, one or more articulation motors 606a, 606 b. The motors 606a, 606b can be operatively coupled to respective articulation motor drive assemblies 608a, 608b, which can be configured to transmit articulation motions generated by the motors 606a, 606b to the end effector. In some cases, the articulation can articulate the end effector relative to the shaft, for example.

As described above, a surgical instrument or tool may include multiple motors that may be configured to perform various independent functions. In some cases, multiple motors of a surgical instrument or tool may be activated individually or independently to perform one or more functions while other motors remain inactive. For example, the articulation motors 606a, 606b may be activated to articulate the end effector while the firing motor 602 remains inactive. Alternatively, the firing motor 602 may be activated to fire a plurality of staples and/or advance the cutting edge while the articulation motor 606 remains inactive. Further, the closure motor 603 may be activated simultaneously with the firing motor 602 to advance the closure tube or closure member distally, as described in more detail below.

In some instances, a surgical instrument or tool may include a common control module 610, which common control module 610 may be used with multiple motors of the surgical instrument or tool. In some cases, the common control module 610 may regulate one of the plurality of motors at a time. For example, the common control module 610 may be individually coupled to and decoupled from multiple motors of the surgical instrument. In some cases, multiple motors of a surgical instrument or tool may share one or more common control modules, such as common control module 610. In some instances, multiple motors of a surgical instrument or tool may independently and selectively engage a common control module 610. In some cases, the common control module 610 may switch from interfacing with one of the plurality of motors of the surgical instrument or tool to interfacing with another of the plurality of motors of the surgical instrument or tool.

In at least one example, the common control module 610 can be selectively switched between operatively engaging the articulation motors 606a, 606b and operatively engaging the firing motor 602 or the closure motor 603. In at least one example, as shown in fig. 16, the switch 614 may move or transition between a plurality of positions and/or states. In the first position 616, the switch 614 may electrically couple the common control module 610 to the firing motor 602; in a second position 617, the switch 614 may electrically couple the common control module 610 to the close motor 603; in the third position 618a, the switch 614 may electrically couple the common control module 610 to the first articulation motor 606 a; and in the fourth position 618b, the switch 614 may electrically couple the common control module 610 to, for example, the second articulation motor 606 b. In some instances, a single common control module 610 may be electrically coupled to the firing motor 602, the closure motor 603, and the articulation motors 606a, 606b simultaneously. In some cases, the switch 614 may be a mechanical switch, an electromechanical switch, a solid state switch, or any suitable switching mechanism.

Each of the motors 602, 603, 606a, 606b may include a torque sensor to measure the output torque on the shaft of the motor. The force on the end effector can be sensed in any conventional manner, such as by a force sensor on the outside of the jaws or by a torque sensor of a motor used to actuate the jaws.

In various instances, as shown in fig. 16, the common control module 610 may include a motor driver 626, which motor driver 626 may include one or more H-bridge FETs. The motor driver 626 may regulate power delivered from a power source 628 to the motors coupled to the common control module 610, for example, based on input from a microcontroller 620 ("controller"). In some cases, when the motors are coupled to the common control module 610, the microcontroller 620 may be employed, for example, to determine the current consumed by the motors, as described above.

In some cases, microcontroller 620 may include a microprocessor 622 ("processor") and one or more non-transitory computer-readable media or storage units 624 ("memory"). In some cases, memory 624 may store various program instructions that, when executed, may cause processor 622 to perform various functions and/or computations as described herein. In some cases, one or more of the memory units 624 may be coupled to the processor 622, for example. In various aspects, microcontroller 620 can communicate over a wired or wireless channel, or a combination thereof.

In some cases, power source 628 may be used, for example, to power microcontroller 620. In some cases, the power source 628 may include a battery (or "battery pack" or "power pack"), such as a lithium ion battery, for example. In some instances, the battery pack may be configured to be releasably mountable to the handle for powering the surgical instrument 600. A plurality of series-connected battery cells may be used as the power source 628. In some cases, the power source 628 may be replaceable and/or rechargeable, for example.

In various instances, the processor 622 may control a motor driver 626 to control the position, rotational direction, and/or speed of motors coupled to the common controller 610. In some cases, the processor 622 may signal the motor driver 626 to stop and/or disable the motors coupled to the common controller 610. It is to be understood that the term "processor" as used herein includes any suitable microprocessor, microcontroller, or other basic computing device that combines the functions of a computer's Central Processing Unit (CPU) on one integrated circuit or at most several integrated circuits. Processor 622 is a multipurpose programmable device that receives digital data as input, processes the input according to instructions stored in its memory, and then provides the result as output. Because the processor has internal memory, it is an example of sequential digital logic. The operands of the processor are numbers and symbols represented in a binary numerical system.

In one example, the processor 622 may be anyIn some cases, microcontroller 620 may be, for example, L M4F230H5QR, available from Texas Instruments (Texas Instruments). in at least one example, Texas Instruments L M4F230H5QR is an ARM Cortex-M4F processor core that includes on-chip memory of 256KB single-cycle flash or other non-volatile memory (up to 40MHZ), a prefetch buffer for improving performance above 40MHz, a 32KB single-cycle SRAM, a processor loaded with ARM core, such as those manufactured by Texas Instruments under the trade name ARM CortexInternal ROM of software, EEPROM of 2KB, one or more PWM modules, one or more QEI analog, one or more 12-bit ADCs with 12 analog input channels, and other features readily available. Other microcontrollers could be readily substituted for use with module 4410. Accordingly, the present disclosure should not be limited to this context.

In some cases, the memory 624 may include program instructions for controlling each of the motors of the surgical instrument 600, which may be coupled to the common controller 610. For example, the memory 624 may include program instructions for controlling the firing motor 602, the closure motor 603, and the articulation motors 606a, 606 b. Such program instructions may cause the processor 622 to control firing, closure, and articulation functions in accordance with input from an algorithm or control program of the surgical instrument or tool.

In some cases, one or more mechanisms and/or sensors, such as sensor 630, may be used to alert processor 622 of program instructions that should be used in a particular setting. For example, the sensor 630 may alert the processor 622 to use program instructions associated with firing, closing, and articulating the end effector. In some cases, sensor 630 may include, for example, a position sensor that may be used to sense the position of switch 614. Thus, the processor 622 can use program instructions associated with firing a closure member coupled to a clamp arm of the end effector when the switch 614 is detected in the first position 616, for example, by the sensor 630; the processor 622 can use the program instructions associated with closing the anvil when the switch 614 is in the second position 617, for example, as detected by the sensor 630; and the processor 622 may use the program instructions associated with articulating the end effector when the switch 614 is in the third position 618a or the fourth position 618b, for example, as detected by the sensor 630.

Fig. 17 is a schematic illustration of a robotic surgical instrument 700 configured to operate a surgical tool described herein, according to one aspect of the present disclosure. The robotic surgical instrument 700 may be programmed or configured to control distal/proximal translation of the displacement member, distal/proximal displacement of the closure tube, shaft rotation, and articulation with single or multiple articulation drive links. In one aspect, the surgical instrument 700 can be programmed or configured to control the firing member, the closure member, the shaft member, or one or more articulation members individually, or in combinations thereof. The surgical instrument 700 includes a control circuit 710, the control circuit 710 configured to control a motor driven firing member, a closure member, a shaft member, or one or more articulation members, or a combination thereof.

In one aspect, the robotic surgical instrument 700 includes a control circuit 710, the control circuit 710 configured to control the clamp arm 716 and closure member 714 portions of the end effector 702, the ultrasonic blade 718 coupled to an ultrasonic transducer 719 excited by an ultrasonic generator 721, the shaft 740, and one or more articulation members 742a, 742b via a plurality of motors 704a-704 e. The position sensor 734 may be configured to provide position feedback of the closure member 714 to the control circuit 710. The other sensors 738 may be configured to provide feedback to the control circuit 710. The timer/counter 731 provides timing and count information to the control circuit 710. An energy source 712 may be provided to operate the motors 704a-704e, and a current sensor 736 provides motor current feedback to the control circuit 710. The motors 704a-704e may be operated individually by the control circuit 710 in open loop or closed loop feedback control.

In one aspect, control circuit 710 may include one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause the one or more processors to perform one or more tasks. In one aspect, the timer/counter 731 provides an output signal, such as a elapsed time or a digital count, to the control circuit 710 to correlate the position of the closure member 714 as determined by the position sensor 734 with the output of the timer/counter 731 so that the control circuit 710 can determine the position of the closure member 714 at a particular time (t) relative to a starting position or at a time (t) when the closure member 714 is at a particular position relative to a starting position. The timer/counter 731 may be configured to be able to measure elapsed time, count or time external events.

In one aspect, the control circuit 710 can be programmed to control the function of the end effector 702 based on one or more tissue conditions. Control circuit 710 may be programmed to sense a tissue condition, such as thickness, directly or indirectly, as described herein. The control circuit 710 may be programmed to select a firing control program or a closing control program based on tissue conditions. The firing control routine may describe distal movement of the displacement member. Different firing control programs may be selected to better address different tissue conditions. For example, when thicker tissue is present, the control circuit 710 may be programmed to translate the displacement member at a lower speed and/or at a lower power. When thinner tissue is present, the control circuit 710 may be programmed to translate the displacement member at a higher speed and/or at a higher power. The closure control program can control the closure force applied to the tissue by the clamp arms 716. Other control programs control the rotation of the shaft 740 and the articulation members 742a, 742 b.

In one aspect, the control circuit 710 may generate a motor set point signal. The motor set point signals may be provided to various motor controllers 708a-708 e. The motor controllers 708a-708e may include one or more circuits configured to provide motor drive signals to the motors 704a-704e to drive the motors 704a-704e, as described herein. In some examples, the motors 704a-704e may be brushed DC electric motors. For example, the speeds of the motors 704a-704e may be proportional to the respective motor drive signals. In some examples, the motors 704a-704e can be brushless DC motors, and the respective motor drive signals can include PWM signals provided to one or more stator windings of the motors 704a-704 e. Also, in some examples, the motor controllers 708a-708e may be omitted and the control circuit 710 may generate the motor drive signals directly.

In some examples, the control circuit 710 may initially operate each of the motors 704a-704e in an open loop configuration for a first open loop portion of the stroke of the displacement member. Based on the response of the robotic surgical instrument 700 during the open-loop portion of the stroke, the control circuit 710 may select a firing control program in a closed-loop configuration. The response of the instrument may include the translation distance of the displacement member during the open loop portion, the time elapsed during the open loop portion, the energy provided to one of the motors 704a-704e during the open loop portion, the sum of the pulse widths of the motor drive signals, and so forth. After the open loop portion, the control circuit 710 may implement the selected firing control routine for a second portion of the displacement member stroke. For example, during the closed-loop portion of the stroke, the control circuit 710 may modulate one of the motors 704a-704e based on translation data that describes the position of the displacement member in a closed-loop manner to translate the displacement member at a constant speed.

In one aspect, the motors 704a-704e may receive power from an energy source 712. The energy source 712 may be a DC power source driven by a main alternating current power source, a battery, an ultracapacitor, or any other suitable energy source. The motors 704a-704e may be mechanically coupled to separate movable mechanical elements, such as the closure member 714, the clamp arm 716, the shaft 740, the articulation 742a, and the articulation 742b, via respective transmissions 706a-706 e. The actuators 706a-706e may include one or more gears or other linkage devices to couple the motors 704a-704e to the movable mechanical elements. The position sensor 734 may sense the position of the closure member 714. The position sensor 734 may be or include any type of sensor capable of generating position data indicative of the position of the closure member 714. In some examples, the position sensor 734 may include an encoder configured to provide a series of pulses to the control circuit 710 as the closure member 714 is translated distally and proximally. The control circuit 710 may track the pulses to determine the position of the closure member 714. Other suitable position sensors may be used, including, for example, proximity sensors. Other types of position sensors may provide other signals indicative of the movement of the closure member 714. Also, in some examples, position sensor 734 may be omitted. Where the motors 704a-704e are stepper motors, the control circuit 710 may track the position of the closure member 714 by aggregating the number and direction of steps that the motor 704 has been instructed to perform. The position sensor 734 may be located in the end effector 702 or at any other portion of the instrument. The output of each of the motors 704a-704e includes a torque sensor 744a-744e for sensing force and has an encoder for sensing rotation of the drive shaft.

In one aspect, the control circuit 710 is configured to drive a closure member 714 portion of a firing member, such as the end effector 702. The control circuit 710 provides a motor set point to the motor control 708a, which provides a drive signal to the motor 704 a. The output shaft of motor 704a is coupled to a torque sensor 744 a. The torque sensor 744a is coupled to the transmission 706a, which transmission 706a is coupled to the closure member 714. The transmission 706a includes movable mechanical elements, such as rotating elements and firing members, to control the distal and proximal movement of the closure member 714 along the longitudinal axis of the end effector 702. In one aspect, the motor 704a may be coupled to a knife gear assembly that includes a knife gear reduction set that includes a first knife drive gear and a second knife drive gear. The torque sensor 744a provides a firing force feedback signal to the control circuit 710. The firing force signal represents the force required to fire or displace the closure member 714. The position sensor 734 may be configured to provide the position of the closure member 714 along the firing stroke or the position of the firing member as a feedback signal to the control circuit 710. The end effector 702 may include an additional sensor 738 configured to provide a feedback signal to the control circuit 710. When ready for use, the control circuit 710 may provide a firing signal to the motor control 708 a. In response to the firing signal, the motor 704a can drive the firing member distally along the longitudinal axis of the end effector 702 from a proximal stroke start position to an end of stroke position distal of the stroke start position. As the closure member 714 translates distally, the clamp arm 716 closes toward the ultrasonic blade 718.

In one aspect, the control circuit 710 is configured to drive a closure member, such as a clamp arm 716 portion of the end effector 702. The control circuit 710 provides a motor set point to the motor control 708b, which motor control 708b provides a drive signal to the motor 704 b. The output shaft of motor 704b is coupled to a torque sensor 744 b. The torque sensor 744b is coupled to the transmission 706b coupled to the clamp arm 716. The actuator 706b includes movable mechanical elements, such as rotating elements and closing members, to control the movement of the clamp arms 716 from the open and closed positions. In one aspect, the motor 704b is coupled to a closure gear assembly that includes a closure reduction gear set supported in meshing engagement with a closure spur gear. The torque sensor 744b provides a closing force feedback signal to the control circuit 710. The closing force feedback signal is representative of the closing force applied to the clamp arm 716. The position sensor 734 may be configured to provide the position of the closure member as a feedback signal to the control circuit 710. An additional sensor 738 in the end effector 702 may provide a closing force feedback signal to the control circuit 710. Pivotable clamp arm 716 is positioned opposite ultrasonic blade 718. When ready for use, the control circuit 710 may provide a close signal to the motor control 708 b. In response to the closure signal, the motor 704b advances the closure member to grasp tissue between the clamp arm 716 and the ultrasonic blade 718.

In one aspect, the control circuit 710 is configured to rotate a shaft member, such as the shaft 740, to rotate the end effector 702. The control circuit 710 provides a motor set point to the motor control 708c, which motor control 708c provides a drive signal to the motor 704 c. The output shaft of motor 704c is coupled to a torque sensor 744 c. Torque sensor 744c is coupled to transmission 706c, which is coupled to shaft 740. Actuator 706c includes a movable mechanical element, such as a rotating element, to control rotation of shaft 740 more than 360 ° clockwise or counterclockwise. In one aspect, the motor 704c is coupled to a rotary transmission assembly that includes a tube gear section formed on (or attached to) the proximal end of the proximal closure tube for operative engagement by a rotary gear assembly operatively supported on the tool mounting plate. The torque sensor 744c provides a rotational force feedback signal to the control circuit 710. The rotational force feedback signal represents the rotational force applied to the shaft 740. The position sensor 734 may be configured to provide the position of the closure member as a feedback signal to the control circuit 710. An additional sensor 738, such as a shaft encoder, may provide the control circuit 710 with the rotational position of the shaft 740.

In one aspect, the control circuit 710 is configured to articulate the end effector 702. The control circuit 710 provides a motor set point to the motor control 708d, which motor control 708d provides a drive signal to the motor 704 d. The output of the motor 704d is coupled to a torque sensor 744 d. The torque sensor 744d is coupled to the transmission 706d that is coupled to the articulation member 742 a. The transmission 706d includes mechanical elements, such as articulation elements, that are movable to control the + -65 deg. articulation of the end effector 702. In one aspect, the motor 704d is coupled to an articulation nut that is rotatably journaled on the proximal end portion of the distal spine and rotatably driven thereon by an articulation gear assembly. The torque sensor 744d provides an articulation force feedback signal to the control circuit 710. The articulation force feedback signal represents the articulation force applied to the end effector 702. A sensor 738, such as an articulation encoder, may provide the control circuit 710 with the articulated position of the end effector 702.

In another aspect, the articulation function of the robotic surgical system 700 may include two articulation members or links 742a, 742 b. These articulation members 742a, 742b are driven by separate disks on the robotic interface (rack) that are driven by the two motors 708d, 708 e. When a separate firing motor 704a is provided, each of the articulation links 742a, 742b can be driven antagonistic to the other link to provide resistance holding motion and load to the head when the head is not moving and to provide articulation when the head is articulating. When the head is rotated, the articulation members 742a, 742b are attached to the head at a fixed radius. Thus, the mechanical advantage of the push-pull link changes as the head rotates. This variation in mechanical advantage may be more apparent for other articulation link drive systems.

In one aspect, one or more of the motors 704a-704e can include a brushed DC motor having a gearbox and a mechanical link to a firing member, a closure member, or an articulation member. Another example includes electric motors 704a-704e that operate movable mechanical elements such as displacement members, articulation links, closure tubes, and shafts. External influences are unmeasured, unpredictable effects of things such as tissue, surrounding body and friction on the physical system. Such external influences may be referred to as drag forces, which act against one of the electric motors 704a-704 e. External influences such as drag forces may cause the operation of the physical system to deviate from the desired operation of the physical system.

In one aspect, position sensor 734 may be implemented as an absolute positioning system. In one aspect, the position sensor 734 may include a magnetic rotary absolute positioning system implemented AS an AS5055EQFT monolithic magnetic rotary position sensor, available from Austria microelectronics, australia, AG. Position sensor 734 interfaces with controller 710 to provide an absolute positioning system. The location may include a hall effect element located above the magnet and coupled to a CORDIC processor, also known as a bitwise method and a Volder algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only an addition operation, a subtraction operation, a digit shift operation, and a table lookup operation.

In one aspect, the control circuit 710 may be in communication with one or more sensors 738. The sensors 738 can be positioned on the end effector 702 and adapted to operate with the robotic surgical instrument 700 to measure various derivative parameters such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensors 738 may include magnetic sensors, magnetic field sensors, strain gauges, load sensors, pressure sensors, force sensors, torque sensors, inductive sensors such as eddy current sensors, resistive sensors, capacitive sensors, optical sensors, and/or any other suitable sensors for measuring one or more parameters of the end effector 702. The sensors 738 may include one or more sensors. A sensor 738 may be located on the clamp arm 716 to determine tissue location using segmented electrodes. The torque sensors 744a-744e may be configured to be able to sense forces such as firing forces, closing forces, and/or articulation forces, among others. Thus, the control circuit 710 may sense (1) the closure load experienced by the distal closure tube and its position, (2) the firing member at the rack and its position, (3) the portion of the ultrasonic blade 718 that has tissue thereon, and (4) the load and position on the two articulation bars.

In one aspect, the one or more sensors 738 may include a strain gauge, such as a micro-strain gauge, configured to be able to measure a magnitude of strain in the clamp arm 716 during a clamping condition. The strain gauge provides an electrical signal whose magnitude varies with the magnitude of the strain. Sensor 738 may include a pressure sensor configured to detect pressure generated by the presence of compressed tissue between clamp arm 716 and ultrasonic blade 718. Sensor 738 may be configured to detect the impedance of a tissue section located between clamp arm 716 and ultrasonic blade 718, which is indicative of the thickness and/or degree of filling of tissue located therebetween.

In one aspect, the sensors 738 may be implemented as one or more limit switches, electromechanical devices, solid state switches, Hall effect devices, Magnetoresistive (MR) devices, Giant Magnetoresistive (GMR) devices, magnetometers, and the like. In other implementations, the sensor 738 may be implemented as a solid state switch that operates under the influence of light, such as an optical sensor, an IR sensor, an ultraviolet sensor, and so forth. Also, the switch may be a solid state device, such as a transistor (e.g., FET, junction FET, MOSFET, bipolar transistor, etc.). In other implementations, the sensors 738 may include a non-conductor switch, an ultrasonic switch, an accelerometer, an inertial sensor, and so forth.

In one aspect, the sensor 738 may be configured to measure the force exerted on the clamp arm 716 by the closure drive system. For example, one or more sensors 738 may be located at the point of interaction between the closure tube and the clamp arm 716 to detect the closing force applied to the clamp arm 716 by the closure tube. The force exerted on clamp arm 716 may be indicative of tissue compression experienced by a section of tissue captured between clamp arm 716 and ultrasonic blade 718. One or more sensors 738 may be positioned at various interaction points along the closure drive system to detect the closure force applied to the clamp arm 716 by the closure drive system. The one or more sensors 738 may be sampled in real time by a processor of the control circuit 710 during a clamping operation. The control circuit 710 receives real-time sample measurements to provide and analyze time-based information and evaluates the closing force applied to the gripping arm 716 in real-time.

In one aspect, a current sensor 736 may be used to measure the current consumed by each of the motors 704a-704 e. the force required to advance any of the movable mechanical elements (such as the closure member 714) corresponds to the current consumed by one of the motors 704a-704 e. the force is converted to a digital signal and provided to the processor 710. the control circuit 710 may be configured to simulate the response of the actual system of the INSTRUMENT in the software of the controller.

Fig. 18 illustrates a schematic view of a surgical instrument 750 configured to control distal translation of a displacement member according to one aspect of the present disclosure. In one aspect, the surgical instrument 750 is programmed to control distal translation of a displacement member, such as the closure member 764. The surgical instrument 750 includes an end effector 752, which end effector 752 may include a clamp arm 766, a closure member 764, and an ultrasonic blade 768 coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

The position, movement, displacement, and/or translation of a linear displacement member, such as the closure member 764, may be measured by an absolute positioning system, sensor arrangement, and position sensor 784. Since the closure member 764 is coupled to the longitudinally movable drive member, the position of the closure member 764 can be determined by measuring the position of the longitudinally movable drive member with the position sensor 784. Thus, in the following description, the position, displacement, and/or translation of the closure member 764 may be achieved by the position sensor 784 described herein. The control circuit 760 may be programmed to control the translation of a displacement member, such as the closure member 764. In some examples, the control circuitry 760 may include one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause the one or more processors to control the displacement member (e.g., the closure member 764) in the manner described. In one aspect, the timer/counter 781 provides an output signal, such as a elapsed time or a digital count, to the control circuit 760 to correlate the position of the closure member 764, as determined by the position sensor 784, with the output of the timer/counter 781 so that the control circuit 760 can determine the position of the closure member 764 at a particular time (t) relative to the starting position. The timer/counter 781 may be configured to be able to measure elapsed time, count or time external events.

The control circuit 760 may generate a motor set point signal 772. The motor set point signal 772 may be provided to the motor controller 758. The motor controller 758 may include one or more circuits configured to provide a motor drive signal 774 to the motor 754 to drive the motor 754, as described herein. In some examples, the motor 754 may be a brushed DC electric motor. For example, the speed of motor 754 may be proportional to motor drive signal 774. In some examples, the motor 754 may be a brushless DC electric motor, and the motor drive signals 774 may include PWM signals provided to one or more stator windings of the motor 754. Also, in some examples, the motor controller 758 may be omitted and the control circuitry 760 may generate the motor drive signal 774 directly.

The motor 754 may receive power from an energy source 762. The energy source 762 may be or include a battery, a supercapacitor, or any other suitable energy source. The motor 754 may be mechanically coupled to the closure member 764 via a transmission 756. The transmission 756 can include one or more gears or other linkage devices to couple the motor 754 to the closure member 764. The position sensor 784 may sense the position of the closure member 764. The position sensor 784 may be or include any type of sensor capable of generating position data indicative of the position of the closure member 764. In some examples, the position sensor 784 may include an encoder configured to provide a series of pulses to the control circuit 760 as the closure member 764 is translated distally and proximally. The control circuit 760 may track the pulses to determine the position of the closure member 764. Other suitable position sensors may be used, including, for example, proximity sensors. Other types of position sensors may provide other signals indicative of the motion of the closure member 764. Also, in some examples, position sensor 784 may be omitted. In the case where the motor 754 is a stepper motor, the control circuit 760 may track the position of the closure member 764 by aggregating the number and direction of steps that the motor 754 has been instructed to perform. The position sensor 784 may be located in the end effector 752 or at any other portion of the instrument.

The control circuitry 760 may be in communication with one or more sensors 788. The sensors 788 may be positioned on the end effector 752 and adapted to operate with the surgical instrument 750 to measure various derivative parameters such as gap distance and time, tissue compression and time, and anvil strain and time. The sensors 788 may include, for example, magnetic sensors, magnetic field sensors, strain gauges, pressure sensors, force sensors, inductive sensors (such as eddy current sensors), resistive sensors, capacitive sensors, optical sensors, and/or any other suitable sensors for measuring one or more parameters of the end effector 752. The sensor 788 may include one or more sensors.

In certain instances, the one or more sensors 788 may include a strain gauge, such as a micro-strain gauge, configured to be capable of measuring a magnitude of strain in the clamp arm 766 during a clamping condition. The strain gauge provides an electrical signal whose magnitude varies with the magnitude of the strain. The sensor 788 may comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the clamp arm 766 and the ultrasonic blade 768. The sensor 788 may be configured to detect an impedance of a section of tissue located between the clamp arm 766 and the ultrasonic blade 768, which impedance is indicative of a thickness and/or degree of filling of the tissue located therebetween.

The sensor 788 may be configured to measure the force exerted by the closure drive system on the clamp arm 766. For example, one or more sensors 788 may be located at the point of interaction between the closure tube and the clamp arm 766 to detect the closing force applied by the closure tube to the clamp arm 766. The force exerted on the clamp arm 766 may be representative of the tissue compression experienced by a section of tissue captured between the clamp arm 766 and the ultrasonic blade 768. One or more sensors 788 may be positioned at various interaction points along the closure drive system to detect the closure force applied by the closure drive system to the clamp arm 766. The one or more sensors 788 may be sampled in real time by the processor of the control circuitry 760 during the clamping operation. The control circuitry 760 receives real-time sample measurements to provide and analyze time-based information and evaluates the closing force applied to the gripping arm 766 in real-time.

A current sensor 786 may be used to measure the current drawn by the motor 754. The force required to advance the closure member 764 may correspond to, for example, the current consumed by the motor 754. The force is converted to a digital signal and provided to the control circuit 760.

The surgical instrument 750 may include a feedback controller, which may be one of any feedback controllers including, but not limited to, for example, a PID, status feedback, L QR, and/or an adaptive controller.

The actual drive system of the surgical instrument 750 is configured to drive the displacement, cutting or closure member 764 through a brushed DC motor having a gearbox and mechanical link to the articulation and/or knife system. Another example is an electric motor 754 that operates a displacement member and articulation driver, such as an interchangeable shaft assembly. External influences are unmeasured, unpredictable effects of things such as tissue, surrounding body and friction on the physical system. This external influence may be referred to as a drag force acting opposite the electric motor 754. External influences such as drag forces may cause the operation of the physical system to deviate from the desired operation of the physical system.

Various example aspects relate to a surgical instrument 750 including an end effector 752 having a motorized surgical sealing and cutting implementation. For example, the motor 754 can drive the displacement member distally and proximally along a longitudinal axis of the end effector 752. The end effector 752 may include a pivotable clamp arm 766, and when configured for use, the ultrasonic blade 768 is positioned opposite the clamp arm 766. The clinician may grasp tissue between the clamp arm 766 and the ultrasonic blade 768, as described herein. When the instrument 750 is ready for use, the clinician may provide a firing signal, for example, by depressing a trigger of the instrument 750. In response to the firing signal, the motor 754 may drive the displacement member distally along the longitudinal axis of the end effector 752 from a proximal stroke start position to an end of stroke position distal to the stroke start position. The closure member 764, having a cutting element positioned at the distal end, may cut tissue between the ultrasonic blade 768 and the clamp arm 766 as the displacement member is translated distally.

In various examples, the surgical instrument 750 can include a control circuit 760, the control circuit 760 programmed to control distal translation of a displacement member (such as the closure member 764) based on one or more tissue conditions. Control circuit 760 may be programmed to sense a tissue condition, such as thickness, directly or indirectly, as described herein. The control circuit 760 may be programmed to select a control program based on tissue conditions. The control program may describe distal movement of the displacement member. Different control programs may be selected to better address different tissue conditions. For example, when thicker tissue is present, the control circuit 760 may be programmed to translate the displacement member at a lower speed and/or at a lower power. When thinner tissue is present, the control circuit 760 may be programmed to translate the displacement member at a higher speed and/or at a higher power.

In some examples, the control circuit 760 may initially operate the motor 754 in an open loop configuration FOR a first open loop portion OF travel OF the displacement member based on a response OF the INSTRUMENT 750 during the open loop portion OF travel, the control circuit 760 may select a firing control program, the response OF the INSTRUMENT may include a translation distance OF the displacement member during the open loop portion, a time elapsed during the open loop portion, an energy provided to the motor 754 during the open loop portion, a sum OF pulse widths OF motor drive signals, and so on.

Fig. 19 is a schematic view of a surgical instrument 790 configured to control various functions in accordance with an aspect of the present disclosure. In one aspect, the surgical instrument 790 is programmed to control distal translation of a displacement member, such as the closure member 764. The surgical instrument 790 includes an end effector 792 that may include a clamp arm 766, a closure member 764, and an ultrasonic blade 768 that may be interchanged with or work in conjunction with one or more RF electrodes 796 (shown in phantom). The ultrasonic blade 768 is coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

In one aspect, the sensor 788 can be implemented as a limit switch, an electromechanical device, a solid state switch, a hall effect device, an MR device, a GMR device, a magnetometer, or the like. In other implementations, the sensor 638 may be implemented as a solid state switch that operates under the influence of light, such as an optical sensor, an IR sensor, an ultraviolet sensor, and so forth. Also, the switch may be a solid state device, such as a transistor (e.g., FET, junction FET, MOSFET, bipolar transistor, etc.). In other implementations, the sensors 788 may include a non-conductor switch, an ultrasonic switch, an accelerometer, an inertial sensor, and so forth.

In one aspect, the position sensor 784 may be implemented AS an absolute positioning system including a monolithic magnetic rotary position sensor implemented AS5055EQFT, available from austria microelectronics, AG, australia. Position sensor 784 may interface with controller 760 to provide an absolute positioning system. The location may include a hall effect element located above the magnet and coupled to a CORDIC processor, also known as a bitwise method and a Volder algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only an addition operation, a subtraction operation, a digit shift operation, and a table lookup operation.

In some examples, the position sensor 784 may be omitted. In the case where the motor 754 is a stepper motor, the control circuit 760 may track the position of the closure member 764 by aggregating the number and direction of steps the motor has been instructed to perform. The position sensor 784 may be located in the end effector 792 or at any other portion of the instrument.

The control circuitry 760 may be in communication with one or more sensors 788. The sensors 788 may be positioned on the end effector 792 and adapted to operate with the surgical instrument 790 to measure various derivative parameters such as gap distance and time, tissue compression and time, and anvil strain and time. The sensor 788 may include, for example, a magnetic sensor, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor (such as an eddy current sensor), a resistive sensor, a capacitive sensor, an optical sensor, and/or any other suitable sensor for measuring one or more parameters of the end effector 792. The sensor 788 may include one or more sensors.

An RF energy source 794 is coupled to the end effector 792 and, when an RF electrode 796 is disposed in the end effector 792 to operate in place of or in conjunction with the ultrasonic blade 768, the RF energy source 794 is applied to the RF electrode 796. For example, the ultrasonic blade is made of a conductive metal and can be used as a return path for electrosurgical RF current. Control circuitry 760 controls the delivery of RF energy to RF electrode 796.

Additional details are disclosed in U.S. patent application serial No. 15/636,096 filed on 28.6.2017, entitled surgical SYSTEM coupleable with a staple cartridge and a RADIO FREQUENCY cartridge and METHOD OF use thereof (SURGICA L SYSTEM COUP L AB L E WITHSTAP L E CARTRIDGE AND RADIO FREQUENCY resonance CARTRIDGE, AND METHOD OF USING SAME), which is incorporated herein by reference in its entirety.

Generator hardware

Adaptive ultrasonic blade control algorithm

In various aspects, the smart ultrasonic energy device may include an adaptive algorithm for controlling the operation of the ultrasonic blade. In one aspect, the ultrasonic blade adaptive control algorithm is configured to identify tissue type and adjust device parameters. In one aspect, the ultrasonic blade control algorithm is configured to be capable of parameterizing tissue type. The following sections of the present disclosure describe an algorithm for detecting the collagen/elasticity ratio of tissue to tune the amplitude of the distal tip of an ultrasonic blade. Various aspects of a smart ultrasonic energy device are described herein in connection with, for example, fig. 1-94. Accordingly, the following description of the adaptive ultrasonic blade control algorithm should be read in conjunction with fig. 1-94 and the description associated therewith.

Tissue type identification and device parameter adjustment

In certain surgical procedures, it is desirable to employ an adaptive ultrasonic blade control algorithm. In one aspect, an adaptive ultrasonic blade control algorithm may be employed to adjust parameters of an ultrasonic device based on the type of tissue in contact with the ultrasonic blade. In one aspect, parameters of the ultrasonic device can be adjusted based on the position of tissue within the jaws of the ultrasonic end effector (e.g., the position of tissue between the clamp arm and the ultrasonic blade). The impedance of the ultrasound transducer can be used to distinguish the percentage of tissue in the distal or proximal end of the end effector. The response of the ultrasound device may be based on the tissue type or compressibility of the tissue. In another aspect, parameters of the ultrasound device may be adjusted based on the identified tissue type or parameterization. For example, the mechanical displacement amplitude of the distal tip of the ultrasonic blade may be tuned based on the ratio of collagen to elastin tissue detected during the tissue identification process. The ratio of collagen to elastin tissue can be detected using a variety of techniques, including Infrared (IR) surface reflectance and specific radiance. The force applied to the tissue by the clamp arm and/or the stroke of the clamp arm creates the gap and compression. Electrical continuity across the electrode-equipped jaws may be employed to determine the percentage of jaw coverage by tissue.

Fig. 20 is a system 800 configured to execute an adaptive ultrasonic blade control algorithm in a surgical data network including a modular communication hub, according to at least one aspect of the present disclosure. In one aspect, the generator module 240 is configured to be capable of executing one or more adaptive ultrasonic blade control algorithms 802 as described herein with reference to fig. 53-105. In another aspect, device/instrument 235 is configured to be capable of executing one or more adaptive ultrasonic blade control algorithms 804 as described herein with reference to fig. 53-105. In another aspect, both device/instrument 235 and device/instrument 235 are configured to be capable of executing adaptive ultrasonic blade control algorithms 802, 804 as described herein with reference to fig. 53-105.

The generator module 240 may include a patient isolation stage in communication with a non-isolation stage via a power transformer. The secondary winding of the power transformer is contained in an isolation stage and may include a tapped configuration (e.g., a center-tapped or non-center-tapped configuration) to define a drive signal output for delivering drive signals to different surgical instruments, such as, for example, ultrasonic surgical instruments, RF electrosurgical instruments, and multi-functional surgical instruments including ultrasonic energy modes and RF energy modes that can be delivered separately or simultaneously. In particular, the drive signal output may output an ultrasonic drive signal (e.g., a 420V Root Mean Square (RMS) drive signal) to the ultrasonic surgical instrument 241, and the drive signal output may output an RF electrosurgical drive signal (e.g., a 100V RMS drive signal) to the RF electrosurgical instrument 241. Aspects of the generator module 240 are described herein with reference to fig. 21-28B.

The generator module 240 or the device/instrument 235, or both, are coupled to a modular control tower 236, which modular control tower 236 is connected to a plurality of operating room devices, such as, for example, intelligent surgical instruments, robots, and other computerized devices located in the operating room, as described with reference to fig. 8-11, for example.

Fig. 21 shows an example of a generator 900, which is one form of a generator configured to be coupled to an ultrasonic instrument and further configured to execute an adaptive ultrasonic blade control algorithm in a surgical data network including a modular communication hub, as shown in fig. 20. The generator 900 is configured to deliver a plurality of energy modalities to the surgical instrument. The generator 900 provides RF and ultrasonic signals for delivering energy to the surgical instrument independently or simultaneously. The RF signal and the ultrasound signal may be provided separately or in combination, and may be provided simultaneously. As described above, at least one generator output may deliver multiple energy modalities (e.g., ultrasound, bipolar or monopolar RF, irreversible and/or reversible electroporation, and/or microwave energy, etc.) through a single port, and these signals may be delivered separately or simultaneously to the end effector to treat tissue. The generator 900 includes a processor 902 coupled to a waveform generator 904. The processor 902 and waveform generator 904 are configured to be capable of generating various signal waveforms based on information stored in a memory coupled to the processor 902, which memory is not shown for clarity of the present disclosure. Digital information associated with the waveform is provided to a waveform generator 904, which waveform generator 904 includes one or more DAC circuits to convert a digital input to an analog output. The analog output is fed to an amplifier 1106 for signal conditioning and amplification. Amplification ofThe regulated and amplified output of the stage 906 is coupled to a power transformer 908. The signal is coupled to the secondary side of the patient isolation side through a power transformer 908. A first signal of a first ENERGY mode is provided to a first ENERGY mode labeled ENERGY₁And a terminal of the RETURN. A second signal of a second ENERGY mode is coupled across capacitor 910 and provided to a second terminal labeled ENERGY₂And a terminal of the RETURN. It will be appreciated that more than two ENERGY modes may be output, and thus the subscript "n" may be used to specify that up to n ENERGY may be provided_nA terminal, wherein n is a positive integer greater than 1. It should also be understood that up to n RETURN paths RETURN may be provided without departing from the scope of this disclosure_n。

First voltage sensing circuit 912 is coupled to a first voltage sense circuit labeled ENERGY₁And across the terminals of the RETURN path to measure the output voltage therebetween. A second voltage sense circuit 924 is coupled to the output terminal labeled ENERGY₂And across the terminals of the RETURN path to measure the output voltage therebetween. As shown, a current sensing circuit 914 is placed in series with the RETURN leg on the secondary side of the power transformer 908 to measure the output current of either energy mode. If a different return path is provided for each energy modality, a separate current sensing circuit should be provided in each return branch. The outputs of the first 912 and second 924 voltage sensing circuits are provided to respective isolation transformers 916, 922 and the output of the current sensing circuit 914 is provided to another isolation transformer 918. The output of the isolation transformers 916, 928, 922 on the primary side of the power transformer 908 (not the patient isolation side) is provided to one or more ADC circuits 926. The digitized output of the ADC circuit 926 is provided to the processor 902 for further processing and computation. Output voltage and output current feedback information may be employed to adjust the output voltage and current provided to the surgical instrument and calculate parameters such as output impedance. Input/output communication between the processor 902 and the patient isolation circuitry is provided through an interface circuit 920. The sensors may also be in electrical communication with the processor 902 through an interface 920.

In one aspect, the impedance may be passed by the processor 902Will couple at a frequency denoted as ENERGY₁First voltage sense circuit 912 coupled across terminals of/RETURN or otherwise labeled ENERGY₂The output of the second voltage sense circuit 924 across the terminals of the/RETURN is divided by the output of the current sense circuit 914 arranged in series with the RETURN leg on the secondary side of the power transformer 908. The outputs of the first 912 and second 924 voltage sensing circuits are provided to separate isolation transformers 916, 922 and the output of the current sensing circuit 914 is provided to another isolation transformer 916. The digitized voltage and current sense measurements from the ADC circuit 926 are provided to the processor 902 for use in calculating the impedance. For example, the first ENERGY modality ENERGY₁May be ultrasonic ENERGY and the second ENERGY modality ENERGY₂May be RF energy. However, in addition to ultrasound and bipolar or monopolar RF energy modalities, other energy modalities include irreversible and/or reversible electroporation and/or microwave energy, among others. Also, while the example shown in fig. 21 shows that a single RETURN path RETURN may be provided for two or more ENERGY modalities, in other aspects, a single RETURN path RETURN may be provided for each ENERGY modality ENERGY_nProviding multiple RETURN paths RETURN_n. Thus, as described herein, the ultrasound transducer impedance may be measured by dividing the output of the first voltage sensing circuit 912 by the output of the current sensing circuit 914, and the tissue impedance may be measured by dividing the output of the second voltage sensing circuit 924 by the output of the current sensing circuit 914.

As shown in fig. 21, the generator 900 including at least one output port may include a power transformer 908 having a single output and multiple taps to provide power to the end effector in the form of one or more energy modalities (such as ultrasound, bipolar or monopolar RF, irreversible and/or reversible electroporation, and/or microwave energy, etc.), for example, depending on the type of tissue treatment being performed. For example, the generator 900 may deliver energy with higher voltages and lower currents to drive an ultrasound transducer, with lower voltages and higher currents to drive an RF electrode for sealing tissue, or with a coagulation waveform for using monopolar or bipolar RF electrosurgical electrodes. The output waveform from the generator 900 can be manipulated, cutOr filtered to provide a frequency to an end effector of the surgical instrument. The connection of the ultrasonic transducer to the output of the generator 900 will preferably be at what is labelled ENERGY₁And the output of RETURN, as shown in fig. 21. In one example, the connection of the RF bipolar electrode to the output of generator 900 will preferably be at what is labeled ENERGY₂And the output of RETURN. In the case of a unipolar output, the preferred connection would be an active electrode (e.g. a light cone (pencil) or other probe) to ENERGY₂The sum of the outputs is connected to a suitable RETURN pad of the RETURN output.

Additional details are disclosed in U.S. patent application publication 2017/0086914, entitled technique FOR OPERATING a GENERATOR AND housing instrument FOR digitally generating electrical signal WAVEFORMS (TECHNIQUES FOR OPERATING GENERATITOR FOR DIGITA LL YGENERATING E L ECTRICA L SIGNA L WAVEFORMS AND SURGICA L INSTRUMENTS), published on 3/30/2017, which is incorporated herein by reference in its entirety.

As used throughout this specification, the term "wireless" and its derivatives may be used to describe circuits, devices, systems, methods, techniques, communication channels, etc., that may communicate data through a non-solid medium using modulated electromagnetic radiation, the term does not imply that the associated organization does not contain any wires, although in some aspects they may not.

As used herein, a processor or processing unit is an electronic circuit that performs operations on some external data source, typically a memory or some other data stream. The term is used herein to refer to a central processing unit (cpu) in one or more systems, especially systems on a chip (SoC), that combine multiple specialized "processors".

As used herein, a system-on-chip or system-on-chip (SoC or SoC) is an integrated circuit (also referred to as an "IC" or "chip") that integrates all of the devices of a computer or other electronic system. It may contain digital, analog, mixed signal, and often radio frequency functions-all on a single substrate. The SoC integrates a microcontroller (or microprocessor) with advanced peripherals such as a Graphics Processing Unit (GPU), Wi-Fi modules, or coprocessors. The SoC may or may not contain built-in memory.

As used herein, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuitry and memory. The microcontroller (or MCU of the microcontroller unit) may be implemented as a small computer on a single integrated circuit. It may be similar to a SoC; the SoC may include a microcontroller as one of its devices. Microcontrollers may include one or more Core Processing Units (CPUs) as well as memory and programmable input/output peripherals. Program memory in the form of ferroelectric RAM, NOR flash memory or OTP ROM as well as a small amount of RAM are often included on the chip. In contrast to microprocessors used in personal computers or other general-purpose applications composed of various discrete chips, microcontrollers may be used in embedded applications.

As used herein, the term controller or microcontroller may be a stand-alone IC or chip device that interfaces with peripheral devices. This may be a link between two components of a computer or a controller on an external device for managing the operation of (and connection to) the device.

In one aspect, the processor may be, for example, the L M4F230H5QR ARMCortex-M4F processor core available from Texas Instruments (Texas Instruments) that includes 256KB of single cycle flash memory or other non-volatile memory (up to 256 KB) of a single cycle flash memory or other non-volatile memory (up to as many as possible)40MHZ), a prefetch buffer for performance improvement over 40MHZ, a 32KB single cycle Serial Random Access Memory (SRAM), a load with a loadInternal Read Only Memory (ROM) in software, Electrically Erasable Programmable Read Only Memory (EEPROM) in 2KB, one or more Pulse Width Modulation (PWM) modules, one or more Quadrature Encoder Input (QEI) analog, one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, and other features readily available.

In one example, the processor may include a safety controller that includes two series based controllers, such as TMS570 and RM4x, also available from Texas Instruments under the trade name Hercules ARMCortex R4. The safety controller may be configured specifically for IEC 61508 and ISO26262 safety critical applications, etc., to provide advanced integrated safety features while delivering scalable performance, connectivity, and memory options.

The modular device includes modules (as described in connection with fig. 3 and 9) that can be housed within a surgical hub and surgical devices or instruments that can be connected to the various modules for connection or mating with a corresponding surgical hub. Modular devices include, for example, smart surgical instruments, medical imaging devices, suction/irrigation devices, smoke ejectors, energy generators, respirators, insufflators, and displays. The modular devices described herein may be controlled by a control algorithm. The control algorithms may be executed on the modular devices themselves, on a surgical hub paired with a particular modular device, or on both the modular devices and the surgical hub (e.g., via a distributed computing architecture). In some examples, the control algorithm of the modular device controls the device based on data sensed by the modular device itself (i.e., by sensors in, on, or connected to the modular device). This data may be related to the patient being operated on (e.g., tissue characteristics or insufflation pressure) or the modular device itself (e.g., rate at which the knife is advanced, motor current, or energy level). For example, the control algorithm of a surgical stapling and severing instrument may control the rate at which the motor of the instrument drives its knife through tissue based on the resistance encountered by the knife as it advances.

Fig. 22 illustrates one form of a surgical system 1000 including a generator 1100 and various surgical instruments 1104, 1106, 1108 that may be used therewith, wherein the surgical instrument 1104 is an ultrasonic surgical instrument, the surgical instrument 1106 is an RF electrosurgical instrument, and the multifunctional surgical instrument 1108 is a combination ultrasonic/RF electrosurgical instrument. The generator 1100 may be configured for use with a variety of surgical devices. According to various forms, the generator 1100 may be configurable for use with different types of surgical instruments including, for example, an ultrasonic surgical instrument 1104, an RF electrosurgical instrument 1106, and a multifunctional surgical instrument 1108 that integrates RF energy and ultrasonic energy delivered simultaneously from the generator 1100. Although in the form of fig. 22, the generator 1100 is shown separate from the surgical instruments 1104, 1106, 1108, in one form, the generator 1100 may be integrally formed with any of the surgical instruments 1104, 1106, 1108 to form an integrated surgical system. The generator 1100 includes an input device 1110 located on the front panel of the console of the generator 1100. Input device 1110 may include any suitable device that generates signals suitable for programming the operation of generator 1100. The generator 1100 may be configured for wired or wireless communication.

The generator 1100 is configured to drive a plurality of surgical instruments 1104, 1106, 1108. The first surgical instrument is an ultrasonic surgical instrument 1104 and includes a handpiece 1105(HP), an ultrasonic transducer 1120, a shaft 1126, and an end effector 1122. The end effector 1122 includes an ultrasonic blade 1128 and a clamp arm 1140 acoustically coupled to an ultrasonic transducer 1120. The handpiece 1105 includes a combination of a trigger 1143 for operating the clamp arm 1140 and toggle buttons 1134a, 1134b, 1134c for energizing the ultrasonic blade 1128 and driving the ultrasonic blade 1128 or other functions. Toggle buttons 1134a, 1134b, 1134c may be configured to enable the generator 1100 to power the ultrasound transducer 1120.

The generator 1100 is further configured to drive a second surgical instrument 1106. The second surgical instrument 1106 is an RF electrosurgical instrument and includes a hand piece 1107(HP), a shaft 1127, and an end effector 1124. The end effector 1124 includes electrodes in the clamp arms 1142a, 1142b and returns through the electrical conductor portion of the shaft 1127. These electrodes are coupled to and powered by a bipolar energy source within the generator 1100. The handpiece 1107 includes a trigger 1145 for operating the clamp arms 1142a, 1142b and an energy button 1135 for actuating an energy switch to energize the electrodes in the end effector 1124.

The generator 1100 is further configured to drive a multi-function surgical instrument 1108. The multifunctional surgical instrument 1108 includes a hand piece 1109(HP), a shaft 1129, and an end effector 1125. The end effector 1125 includes an ultrasonic blade 1149 and a clamp arm 1146. The ultrasonic blade 1149 is acoustically coupled to the ultrasonic transducer 1120. The handpiece 1109 includes a combination of a trigger 1147 for operating the clamp arm 1146 and switch buttons 1137a, 1137b, 1137c for energizing the ultrasonic blade 1149 and driving the ultrasonic blade 1149 or other functions. The toggle buttons 1137a, 1137b, 1137c may be configured to enable the generator 1100 to power the ultrasonic transducer 1120, and the bipolar energy source also contained within the generator 1100 to power the ultrasonic blade 1149.

The generator 1100 may be configured for use with a variety of surgical devices. According to various forms, the generator 1100 may be configurable for use with different types of surgical instruments including, for example, an ultrasonic surgical instrument 1104, an RF electrosurgical instrument 1106, and a multifunctional surgical instrument 1108 that integrates RF energy and ultrasonic energy delivered simultaneously from the generator 1100. Although in the form of fig. 22, the generator 1100 is shown separate from the surgical instruments 1104, 1106, 1108, in another form, the generator 1100 may be integrally formed with any of the surgical instruments 1104, 1106, 1108 to form an integrated surgical system. As discussed above, the generator 1100 includes an input device 1110 located on the front panel of the console of the generator 1100. Input device 1110 may include any suitable device that generates signals suitable for programming the operation of generator 1100. The generator 1100 may also include one or more output devices 1112. Additional aspects of generators and surgical instruments for digitally generating electrical signal waveforms are described in U.S. patent publication US-2017-0086914-A1, which is incorporated herein by reference in its entirety.

Fig. 23 is an end effector 1122 of an example ultrasonic device 1104 in accordance with at least one aspect of the present disclosure. The end effector 1122 may include a blade 1128, which blade 1128 may be coupled to an ultrasonic transducer 1120 via a waveguide. When driven by the ultrasonic transducer 1120, the blade 1128 may vibrate and, when in contact with tissue, may cut and/or coagulate the tissue, as described herein. According to various aspects, and as shown in fig. 23, the end effector 1122 may further comprise a clamp arm 1140 which may be configured to act in cooperation with a blade 1128 of the end effector 1122. With the blade 1128, the clamp arm 1140 can include a set of jaws. The clamp arm 1140 may be pivotally connected at a distal end of the shaft 1126 of the instrument portion 1104. Clamp arm 1140 can comprise a clamp arm tissue pad 1163, and clamp arm tissue pad 1163 can be formed fromOr other suitable low friction material. A pad 1163 may be mounted for cooperation with the knife 1128, wherein pivotal movement of the clamp arm 1140 positions the clamp pad 1163 generally parallel to and in contact with the blade 1128. With this arrangement, tissue to be clamped can be grasped between the tissue pad 1163 and the blade 1128. Tissue pad 1163 may have a serrated configuration including a plurality of axially spaced proximally extending gripping teeth 1161 to cooperate with blade 1128 to enhance the grip of tissue. The clamp arm 1140 may be transitioned from the open position shown in fig. 23 to the closed position (where the clamp arm 1140 is in contact with or proximate to the blade 1128) in any suitable manner. For example, the handpiece 1105 can include a jaw closure trigger. When actuated by the clinician, the jaw closure trigger may pivot the clamp arm 1140 in any suitable manner.

The generator 1100 may be activated to provide a drive signal to the transducer 1120 in any suitable manner. For example, the generator 1100 can include a foot switch 1430 (fig. 24), the foot switch 1430 being coupled to the generator 1100 via a foot switch cable 1432. The clinician may activate the ultrasonic transducer 1120, and thereby the ultrasonic transducer 1120 and the blade 1128, by depressing the foot switch 1430. In addition, or in lieu of the foot switch 1430, some aspects of the apparatus 1104 may utilize one or more switches positioned on the handpiece 1105 that, when activated, may cause the generator 1100 to activate the transducer 1120. In one aspect, for example, the one or more switches can include a pair of toggle buttons 1134a, 1134b, 1134c (fig. 22), e.g., to determine the operating mode of device 1104. When the toggle button 1134a is depressed, for example, the ultrasonic generator 1100 may provide a maximum drive signal to the transducer 1120, causing it to produce a maximum ultrasonic energy output. Depressing the toggle button 1134b may cause the ultrasound generator 1100 to provide a user selectable drive signal to the ultrasound transducer 1120, causing it to produce an ultrasound energy output that is less than a maximum value. Additionally or alternatively, the device 1104 may include a second switch to, for example, indicate the position of a jaw closure trigger for operating the jaws via the clamp arm 1140 of the end effector 1122. Further, in some aspects, the sonicator 1100 may be activated based on the position of the jaw closure trigger (e.g., ultrasonic energy may be applied when the clinician depresses the jaw closure trigger to close the jaws via the clamp arm 1140).

Additionally or alternatively, the one or more switches can include a toggle button 1134c, which toggle button 1134c, when depressed, causes generator 1100 to provide a pulsed output (fig. 22). The pulses may be provided, for example, at any suitable frequency and grouping. In certain aspects, for example, the power level of the pulse may be the power level associated with the toggle buttons 1134a, 1134b (maximum, less than maximum).

It should be appreciated that the device 1104 may include any combination of toggle buttons 1134a, 1134b, 1134c (FIG. 22). For example, the device 1104 may be configured with only two toggle buttons: a toggle button 1134a for producing a maximum ultrasonic energy output and a toggle button 1134c for producing a pulsed output at or below a maximum power level. Thus, the drive signal output configuration of generator 1100 may be five continuous signals, or any discrete number of single pulse signals (1, 2, 3, 4, or 5). In certain aspects, a particular drive signal configuration may be controlled, for example, based on an EEPROM setting and/or one or more user power level selections in generator 1100.

In some aspects, an on/off switch may be provided in place of toggle button 1134c (FIG. 22). For example, the device 1104 may include a toggle button 1134a and a dual toggle button 1134b for producing a continuous output at a maximum power level. In the first detent position, the switch button 1134b may produce a continuous output at less than the maximum power level, and in the second detent position, the switch button 1134b may produce a pulsed output (e.g., at or less than the maximum power level, depending on the EEPROM setting).

In some aspects, the RF electrosurgical end effector 1124, 1125 (fig. 22) can also include a pair of electrodes. The electrodes may be in communication with the generator 1100, for example, via a cable. The electrodes may be used, for example, to measure the impedance of a tissue bite existing between the clamping arms 1142a, 1146 and the blades 1142b, 1149. Generator 1100 may provide a signal (e.g., a non-therapeutic signal) to the electrodes. For example, the impedance of tissue occlusion can be found by monitoring the current, voltage, etc. of the signal.

In various aspects, the generator 1100 may include several separate functional elements, such as modules and/or blocks, as shown in the illustrations of the surgical system 1000 of fig. 24, 22. Different functional elements or modules may be configured to drive different kinds of surgical devices 1104, 1106, 1108. For example, the ultrasonic generator module may drive an ultrasonic device, such as ultrasonic surgical device 1104. The electrosurgical/RF generator module may drive an electrosurgical device 1106. For example, the modules may generate respective drive signals for driving the surgical devices 1104, 1106, 1108. In various aspects, the ultrasonic generator module and/or the electrosurgical/RF generator module can each be integrally formed with the generator 1100. Alternatively, one or more of the modules may be provided as a separate circuit module electrically coupled to the generator 1100. (the module is shown in phantom to illustrate this portion.) furthermore, in some aspects, the electrosurgical/RF generator module may be integrally formed with the ultrasonic generator module, or vice versa.

According to the aspects, the ultrasonic generator module may generate one or more drive signals of a particular voltage, current, and frequency (e.g., 55, 500 cycles per second or Hz). The one or more drive signals may be provided to ultrasound device 1104, in particular transducer 1120, which may operate, for example, as described above. In one aspect, the generator 1100 may be configured to generate drive signals of specific voltage, current, and/or frequency output signals that may be modified in terms of high resolution, accuracy, and reproducibility.

According to the aspects, the electrosurgical/RF generator module may generate one or more drive signals having an output power sufficient to perform bipolar electrosurgery using Radio Frequency (RF) energy. In a bipolar electrosurgical application, the drive signal may be provided to, for example, an electrode of the electrosurgical device 1106, as described above. Accordingly, the generator 1100 may be configured for therapeutic purposes by applying electrical energy to tissue sufficient to treat the tissue (e.g., coagulate, cauterize, tissue weld, etc.).

Generator 1100 may include an input device 2150 located, for example, on a front panel of a console of generator 1100 (fig. 27B). Input device 2150 may include any suitable device that generates signals suitable for programming the operation of generator 1100. In operation, a user may program or otherwise control the operation of generator 1100 using input device 2150. The input device 2150 can include any suitable device that generates signals that can be used by the generator (e.g., by one or more processors included in the generator) to control the operation of the generator 1100 (e.g., the operation of the ultrasound generator module and/or the electrosurgical/RF generator module). In various aspects, the input device 2150 includes one or more of the following: buttons, switches, thumbwheels, keyboards, keypads, touch screen monitors, pointing devices, remote connections to general purpose or special purpose computers. In other aspects, the input device 2150 can comprise a suitable user interface, such as one or more user interface screens displayed on a touch screen monitor, for example. Thus, through the input device 2150, a user may set or program various operating parameters of the generator, such as, for example, the current (I), voltage (V), frequency (f), and/or period (T) of one or more drive signals generated by the ultrasound generator module and/or the electrosurgical/RF generator module.

The generator 1100 may also include an input device 2140 (FIG. 27B) located, for example, on a front panel of the generator 1100 console, the output device 2140 includes one or more devices for providing sensory feedback to the user, such devices may include, for example, visual feedback devices (e.g., L CD display screen, L ED indicator), audio feedback devices (e.g., speaker, buzzer), or tactile feedback devices (e.g., haptic actuators).

Further, while various aspects may be described in terms of modules and/or blocks for ease of illustration, such modules and/or blocks may be implemented by one or more hardware devices (e.g., processors, Digital Signal Processors (DSPs), programmable logic devices (P L D), Application Specific Integrated Circuits (ASICs), circuits, registers) and/or software devices (e.g., programs, subroutines, logic), and/or a combination of hardware and software devices.

In one aspect, the ultrasonic generator driver module and the electrosurgical/RF driver module 1110 (fig. 22) can include one or more embedded applications implemented as firmware, software, hardware, or any combination thereof. The modules may include various executable modules such as software, programs, data, drivers, Application Program Interfaces (APIs), and so forth. The firmware may be stored in a non-volatile memory (NVM), such as a bit-mask read-only memory (ROM) or flash memory. In various implementations, storing firmware in ROM may protect flash memory. NVM may include other types of memory including, for example, programmable rom (prom), erasable programmable rom (eprom), electrically erasable programmable rom (eeprom), or battery backed Random Access Memory (RAM) (such as dynamic RAM (dram), double data rate dram (ddram), and/or synchronous dram (sdram)).

In one aspect, the modules include hardware devices implemented as a processor for executing program instructions for monitoring various measurable characteristics of the devices 1104, 1106, 1108 and generating corresponding output drive signals for operating the devices 1104, 1106, 1108 in aspects in which the generator 1100 is used in conjunction with the device 1104, the drive signals may drive the ultrasonic transducer 1120 in a cutting and/or coagulation mode of operation, electrical characteristics of the device 1104 and/or tissue may be measured and used to control aspects of operation of the generator 1100 and/or may be provided as feedback to a user in aspects in which the generator 1100 is used in conjunction with the device 1106, the drive signals may supply electrical energy (e.g., RF energy) to the end effector 1124 in a cutting, coagulation and/or dehydration mode, electrical characteristics of the device 1106 and/or tissue may be measured and used to control aspects of operation of the generator 1100 and/or may be provided as feedback to a user.

An electromechanical ultrasound system includes an ultrasound transducer, a waveguide, and an ultrasound blade. The electromechanical ultrasound system has an initial resonant frequency defined by the physical characteristics of the ultrasound transducer, the waveguide, and the ultrasonic blade. The ultrasonic transducer being excited by an alternating voltage V_g(t) Signal and Current I_g(t) the resonant frequency of the signal is equal to the electromechanical ultrasound system. When the ultrasonic electromechanical system is at resonance, the voltage V_g(t) Signal and Current I_g(t) the phase difference between the signals is zero. In other words, at resonance, the inductive impedance is equal to the capacitive impedance. As the ultrasonic blade heats up, the compliance of the ultrasonic blade (modeled as an equivalent capacitance) causes the resonant frequency of the electromechanical ultrasonic system to shift. As a result, the inductive impedance is no longer equal to the capacitive impedance, resulting in a mismatch between the drive frequency and the resonant frequency of the electromechanical ultrasound system. The system now operates "off-resonance". The mismatch between the drive frequency and the resonant frequency is manifested as a voltage V applied to the ultrasonic transducer_g(t) signalAnd current I_g(t) phase difference between the signals. The generator electronics can easily monitor the voltage V_g(t) and current I_g(t) the phase difference between the signals and the drive frequency can be continuously adjusted until the phase difference is again zero. At this point, the new drive frequency is equal to the new resonant frequency of the electromechanical ultrasound system. The change in phase and/or frequency can be used as an indirect measure of the temperature of the ultrasonic blade.

As shown in fig. 25, the electromechanical properties of the ultrasound transducer can be modeled as an equivalent circuit comprising a first branch with a static capacitance and a second "dynamic" branch with series-connected inductance, resistance and capacitance defining the electromechanical properties of the resonator. The known ultrasonic generator may comprise a tuning inductor for detuning the static capacitance at the resonance frequency, such that substantially all of the driving signal current of the generator flows into the dynamic branch. Thus, by using a tuning inductor, the generator's drive signal current is representative of the dynamic branch current, and thus the generator is able to control its drive signal to maintain the resonant frequency of the ultrasound transducer. The tuning inductor may also transform the phase impedance map of the ultrasonic transducer to improve the frequency locking capability of the generator. However, the tuning inductor must be matched to the particular static capacitance of the ultrasound transducer at the operating resonant frequency. In other words, different ultrasonic transducers with different static capacitances require different tuning inductors.

FIG. 25 illustrates an equivalent circuit 1500 for an ultrasonic transducer, such as ultrasonic transducer 1120, according to one aspect the circuit 1500 includes a series-connected inductor L having electromechanical properties defining a resonator_s、Resistance R_sAnd a capacitor C_sAnd a first "dynamic" branch C having a static capacitance₀. Can be driven at a voltage V_g(t) receiving a drive current I from a generator_g(t) wherein the dynamic current I_m(t) flows through the first branch and a current I_g(t)-I_m(t) flows through the capacitive branch. Can be controlled by properly controlling I_g(t) and V_g(t) to enable control of the electromechanical properties of the ultrasound transducer. As described above, knownThe generator architecture may include a tuned inductor L in a parallel resonant circuit_t(shown in dashed lines in fig. 25), the tuning inductor is used to couple the static capacitance C₀Tuned to the resonance frequency so that substantially the current output I of the generator_gAll of (t) flow through the dynamic leg. In this way, by controlling the generator current output I_g(t) to realize the dynamic branch current I_m(t) control however, inductor L is tuned_tStatic capacitance C to ultrasonic transducer₀Are specific and different ultrasonic transducers with different static capacitances require different tuned inductors L_tIn addition, because inductor L is tuned_tAt a single resonant frequency with a static capacitance C₀So that the dynamic branch current I is only guaranteed at this frequency_m(t) precise control. As the frequency shifts downward with transducer temperature, precise control of the dynamic branch current is compromised.

Various aspects of the generator 1100 may not rely on tuning the inductor L_tTo monitor the dynamic branch current I_m(t) of (d). Rather, the generator 1100 may use a static capacitance C between applications of power for a particular ultrasonic surgical device 1104₀Along with drive signal voltage and current feedback data to determine dynamic branch current I on a dynamic travel basis (e.g., in real time)_mThe value of (t). Thus, such aspects of the generator 1100 can provide virtual tuning to simulate a tuned system or static capacitance C at any frequency₀Is resonant, rather than only at the static capacitance C₀Is resonant at a single resonant frequency as indicated by the nominal value of (a).

Fig. 26 is a simplified block diagram of an aspect of a generator 1100 that provides inductorless tuning, as described above, among other benefits. Fig. 27A-27C illustrate an architecture of the generator 1100 of fig. 26, according to one aspect. Referring to fig. 26, generator 1100 may include a patient isolation stage 1520 in communication with a non-isolation stage 1540 via a power transformer 1560. Secondary winding 1580 of power transformer 1560 is included in isolation stage 1520 and may include a tapped configuration (e.g., a center-tapped or non-center-tapped configuration) to define drive signal outputs 1600a, 1600b, 1600c for outputting drive signals to different surgical devices, such as, for example, ultrasonic surgical device 1104 and electrosurgical device 1106. In particular, drive signal outputs 1600a, 1600b, 1600c may output a drive signal (e.g., a 420V RMS drive signal) to ultrasonic surgical device 1104, and drive signal outputs 1600a, 1600b, 1600c may output a drive signal (e.g., a 100V RMS drive signal) to electrosurgical device 1106, with output 1060b corresponding to a center tap of power transformer 1560. Non-isolated stage 1540 may include a power amplifier 1620 having an output connected to a primary winding 1640 of a power transformer 1560. In certain aspects, the power amplifier 1620 may comprise a push-pull amplifier, for example. Non-isolation stage 1540 may further include a programmable logic device 1660, where programmable logic device 1660 is used to supply a digital output to a digital-to-analog converter (DAC)1680, and where the digital-to-analog converter 1680 in turn supplies a corresponding analog signal to the input of power amplifier 1620. In certain aspects, the programmable logic device 1660 may comprise a Field Programmable Gate Array (FPGA), for example. As a result of controlling the input of power amplifier 1620 via DAC1680, programmable logic device 1660 may thus control any of a plurality of parameters (e.g., frequency, waveform shape, waveform amplitude) of the drive signals present at drive signal outputs 1600a, 1600b, 1600 c. In certain aspects and as described below, programmable logic device 1660 in conjunction with a processor (e.g., processor 1740 described below) can implement a plurality of Digital Signal Processing (DSP) based algorithms and/or other control algorithms to control parameters of the drive signals output by generator 1100.

Power may be supplied to the power rails of power amplifier 1620 by switch-mode regulator 1700. In certain aspects, the switch mode regulator 1700 may comprise, for example, an adjustable buck regulator. As described above, non-isolation stage 1540 may further include a processor 1740, which processor 1740 in one aspect may include a DSP processor such as ADSP-21469 arc DSP, available from Analog Devices, Norwood, Mass, for example. In certain aspects, processor 1740 may control the operation of switch-mode power converter 1700 in response to voltage feedback data received by processor 1740 from power amplifier 1620 via analog-to-digital converter (ADC) 1760. In one aspect, for example, processor 1740 can receive as input via ADC 1760 a waveform envelope of a signal (e.g., an RF signal) being amplified by power amplifier 1620. Processor 1740 may then control switch-mode regulator 1700 (e.g., via a Pulse Width Modulation (PWM) output) so that the rail voltage supplied to power amplifier 1620 tracks the waveform envelope of the amplified signal. By dynamically modulating the rail voltage of the power amplifier 1620 based on the waveform envelope, the efficiency of the power amplifier 1620 may be significantly increased relative to a fixed rail voltage amplifier scheme. The processor 1740 may be configured for wired or wireless communication.

In certain aspects and as discussed in more detail in connection with fig. 28A-28B, programmable logic device 1660 in conjunction with processor 1740 may implement a Direct Digital Synthesizer (DDS) control scheme to control the waveform shape, frequency, and/or amplitude of the drive signal output by generator 1100. in one aspect, programmable logic device 1660 may implement DDS control algorithm 2680 (fig. 28A) by retrieving (recall) waveform samples stored in a dynamically updated look-up table (L UT), such as RAM L UT which may be embedded in an FPGA. the control algorithm may be particularly useful in ultrasound applications where an ultrasound transducer such as ultrasound transducer 1120 may be driven by a pure sinusoidal current at its resonant frequency.

The non-isolation stage 1540 may further include an ADC 1780 and an ADC 1800 coupled to the output of the power transformer 1560 via respective isolation transformers 1820, 1840 for sampling the voltage and current, respectively, of the drive signal output by the generator 1100. in some aspects, the ADCs 1780, 1800 may be configured to be capable of sampling at high speed (e.g., 80Msps) to enable oversampling of the drive signal. in one aspect, the sampling speed of the ADCs 1780, 1800 may enable oversampling of about 200X (as a function of frequency) of the drive signal.

In certain aspects, voltage and current feedback data may be used to control the frequency and/or amplitude (e.g., current amplitude) of the drive signal. In one aspect, for example, voltage and current feedback data may be used to determine an impedance phase, such as a phase difference between voltage and current drive signals. The frequency of the drive signal may then be controlled to minimize or reduce the difference between the determined impedance phase and the impedance phase set point (e.g., 0 °), thereby minimizing or reducing the effects of harmonic distortion and correspondingly improving impedance phase measurement accuracy. The determination of the phase impedance and frequency control signals may be implemented in processor 1740, for example, where the frequency control signals are supplied as inputs to a DDS control algorithm implemented by programmable logic device 1660.

The impedance phase may be determined by fourier analysis. In one aspect, the generator voltage V may be determined using a Fast Fourier Transform (FFT) or a Discrete Fourier Transform (DFT) as follows_g(t) drive signal and generator current I_g(t) phase difference between drive signals:

evaluating the fourier transform at sinusoidal frequencies yields:

other methods include weighted least squares estimation, kalman filtering, and space vector based techniques. For example, almost all processing in the FFT or DFT techniques may be performed in the digital domain with the aid of, for example, a 2-channel high speed ADC 1780, 1800. In one technique, digital signal samples of the voltage signal and the current signal are fourier transformed with an FFT or DFT. The phase angle at any point in time can be calculated by the following formula

WhereinIs a phase angle, f is a frequency, t is a time, andis the phase at t-0.

For determining the voltage V_g(t) Signal and Current I_g(t) another technique for phase difference between signals is the zero crossing method and produces very accurate results. For voltages V having the same frequency_g(t) Signal and Current I_g(t) signal, voltage signal V_g(t) the start of each negative-to-positive zero crossing trigger pulse, and the current signal I_gEach negative to positive zero crossing of (t) triggers the end of a pulse. The result is a pulse train having a pulse width proportional to the phase angle between the voltage signal and the current signal. In one aspect, the pulse train may be passed through an averaging filter to obtain a measure of the phase difference. In addition, if the positive to negative zero point cross is also in a similar mannerUsing, and averaging the results, any effects of DC and harmonic components can be reduced. In one implementation, the analog voltage V_g(t) Signal and Current I_g(t) the signal is converted to a digital signal which is high if the analog signal is positive and low if the analog signal is negative. High precision phase estimation requires sharp transitions between high and low values. In one aspect, Schmitt triggers and RC stabilization networks may be employed to convert analog signals to digital signals. In other aspects, edge-triggered RS flip-flops (flip-flops) and ancillary circuits may be employed. In yet another aspect, the zero crossing technique may employ exclusive or (XOR) gates.

Other techniques for determining the phase difference between the voltage and current signals include L issajous plots and monitoring of the images, methods such as the three volt method, the cross-coil method, the vector voltmeter, and the vector impedance method, and the use of phase-standard instruments, phase-locked loops, and "phase measurements" (Peter O 'Shea, 2000CRC Press LL C, < http:// www.engnetbase.com >) as by Peter O' Shea, 2000CRC Press, Inc. < http:// www.engnetbase.com), which are incorporated herein by reference.

In certain aspects, control of the current amplitude may be accomplished by a control algorithm in processor 1740, such as, for example, a proportional-integral-derivative (PID) control algorithm.

Non-isolated stage 1540 may further include a processor 1900 for providing User Interface (UI) functionality, among other things. In one aspect, processor 1900 may include, for example, an Atmel AT91 SAM9263 processor with an ARM 926EJ-S core available from Atmel Corporation, San Jose, Calif., of San Jose, Calif. Examples of UI functions supported by the processor 1900 may include audible and visual user feedback, communication with peripheral devices (e.g., via a Universal Serial Bus (USB) interface), communication with the foot switch 1430, communication with an input device 2150 (e.g., a touch screen display), and communication with an output device 2140 (e.g., a speaker). Processor 1900 may communicate with processor 1740 and a programmable logic device (e.g., via a Serial Peripheral Interface (SPI) bus). Although the processor 1900 may primarily support UI functions, in some aspects it may also cooperate with the processor 1740 to achieve risk mitigation. For example, processor 1900 may be programmed to monitor various aspects of user input and/or other input (e.g., touch screen input 2150, foot pedal 1430 input, temperature sensor input 2160) and disable the drive output of generator 1100 when an error condition is detected.

In certain aspects, processor 1740 (fig. 26, 27A) and processor 1900 (fig. 26, 27B) may determine and monitor an operating state of generator 1100. With respect to processor 1740, the operational state of generator 1100 may, for example, indicate to processor 1740 which control and/or diagnostic processes are being implemented. For processor 1900, the operational state of generator 1100 may, for example, indicate which elements of a user interface (e.g., display screen, sound) are presented to the user. Processors 1740, 1900 may independently maintain the current operating state of generator 1100 and identify and evaluate possible transitions of the current operating state. Processor 1740 may serve as a master in this relationship and determine when transitions between operating states may occur. The processor 1900 may note valid transitions between operating states and may verify that a particular transition is appropriate. For example, when processor 1740 instructs processor 1900 to transition to a particular state, processor 1900 may verify that the requested transition is valid. In the event that processor 1900 determines that the requested inter-state transition is invalid, processor 1900 may cause generator 1100 to enter a failure mode.

Non-isolated stage 1540 may further include a controller 1960 (fig. 26, 27B) for monitoring input device 2150 (e.g., capacitive touch sensor, capacitive touch screen for turning generator 1100 on and off). In certain aspects, the controller 1960 can include at least one processor and/or other controller device that communicates with the processor 1900. In one aspect, for example, the controller 1960 can include a processor (e.g., a Mega 1688 bit controller available from Atmel corporation) configured to be capable of monitoring user input provided via one or more capacitive touch sensors. In one aspect, the controller 1960 can include a touchscreen controller (e.g., a QT5480 touchscreen controller available from Atmel corporation (Atemel)) to control and manage the acquisition of touch data from a capacitive touchscreen.

In certain aspects, the controller 1960 may continue to receive operating power (e.g., via a line from a power source of the generator 1100, such as the power source 2110 (fig. 26) discussed below) when the generator 1100 is in a "power off state. In this way, controller 1960 may continue to monitor input device 2150 (e.g., a capacitive touch sensor located on the front panel of generator 1100) for turning generator 1100 on and off. When the generator 1100 is in the "power off" state, if activation of the user "on/off input device 2150 is detected, the controller 1960 can wake up the power source (e.g., enable operation of one or more DC/DC voltage converters 2130 (fig. 26) of the power source 2110). Controller 1960 can begin a sequence that transitions generator 1100 to a "power on" state. Conversely, when generator 1100 is in a "power on" state, if activation of "on/off input device 2150 is detected, controller 1960 may begin a sequence that transitions generator 1100 to a" power off "state. In certain aspects, for example, controller 1960 may report activation of "on/off input device 2150 to processor 1900, which in turn implements the desired sequence of processes to transition generator 1100 to a" power off "state. In such aspects, the controller 1960 may not have the independent ability to remove power from the generator 1100 after the "power off" state has been established.

In certain aspects, the controller 1960 can cause the generator 1100 to provide audible or other sensory feedback for alerting a user that a "power on" or "power off sequence has begun. This alert may be provided at the beginning of a "power on" or "power off" sequence and before the beginning of other processes associated with that sequence.

In certain aspects, the isolation stage 1520 may include instrument interface circuitry 1980 to provide a communication interface, for example, between control circuitry of the surgical device (e.g., control circuitry including a handpiece switch) and devices of the non-isolation stage 1540 (such as, for example, programmable logic device 1660, processor 1740, and/or processor 1900). The instrument interface circuit 1980 may exchange information with devices of the non-isolated stage 1540 via a communication link that maintains a suitable degree of electrical isolation between the stages 1520, 1540, such as, for example, an Infrared (IR) based communication link. For example, instrument interface circuit 1980 may be supplied with power using a low drop-out voltage regulator powered by an isolation transformer, which is driven from non-isolated stage 1540.

In one aspect, the instrument interface circuit 1980 may include a programmable logic device 2000 in communication with a signal conditioning circuit 2020 (fig. 26 and 27C). The signal conditioning circuit 2020 may be configured to receive a periodic signal (e.g., a 2kHz square wave) from the programmable logic circuit 2000 to generate a bipolar interrogation signal having the same frequency. For example, the interrogation signal may be generated using a bipolar current source fed by a differential amplifier. The interrogation signal may be sent to the surgical device control circuit (e.g., by using a conductive pair in a cable connecting the generator 1100 to the surgical device) and monitored to determine the state or configuration of the control circuit. For example, the control circuit may include a plurality of switches, resistors, and/or diodes to modify one or more characteristics (e.g., amplitude, correction) of the interrogation signal such that the state or configuration of the control circuit may be uniquely discerned based on the one or more characteristics. In one aspect, for example, the signal conditioning circuit 2020 may include an ADC for generating samples of a voltage signal that appears in the input of the control circuit as a result of an interrogation signal passing through the control circuit. Programmable logic device 2000 (or a device of non-isolation stage 1540) may then determine the state or configuration of the control circuit based on the ADC samples.

In one aspect, the instrument interface circuit 1980 may include a first data circuit interface 2040 to enable the exchange of information between the programmable logic device 2000 (or other elements of the instrument interface circuit 1980) and a first data circuit disposed in or otherwise associated with the surgical device. In certain aspects, for example, the first data circuit 2060 may be provided in a cable integrally attached to the surgical device handpiece or provided in an adapter for interfacing a particular surgical device type or model with the generator 1100. In certain aspects, the first data circuit may include a non-volatile storage device, such as an electrically erasable programmable read-only memory (EEPROM) device. In certain aspects and referring again to fig. 26, the first data circuit interface 2040 may be implemented separately from the programmable logic device 2000 and include suitable circuitry (e.g., discrete logic devices, processors) to enable communication between the programmable logic device 2000 and the first data circuit. In other aspects, the first data circuit interface 2040 may be integral to the logic device 2000.

In certain aspects, the first data circuit 2060 may store information relating to the particular surgical device associated. Such information may include, for example, a model number, a serial number, a number of operations in which the surgical device has been used, and/or any other type of information. This information may be read by instrument interface circuitry 1980 (e.g., by programmable logic device 2000), transmitted to devices of non-isolation stage 1540 (e.g., to programmable logic device 1660, processor 1740, and/or processor 1900), presented to a user via output device 2140, and/or to control functions or operations of generator 1100. Additionally, any type of information may be sent to the first data circuit 2060 via the first data circuit interface 2040 (e.g., using the programmable logic device 2000) for storage therein. Such information may include, for example, the updated number of operations in which the surgical device is used and/or the date and/or time of its use.

As previously discussed, the surgical instrument is detachable from the handpiece (e.g., the instrument 1106 is detachable from the handpiece 1107) to facilitate instrument interchangeability and/or disposability. In such cases, the ability of the known generator to identify the particular instrument configuration used and to optimize the control and diagnostic procedures accordingly may be limited. However, from a compatibility perspective, solving this problem by adding readable data circuitry to the surgical device instrument is problematic. For example, designing a surgical device to remain backward compatible with a generator lacking the requisite data reading functionality may be impractical due to, for example, different signal schemes, design complexity, and cost. Other aspects of the instrument address these issues by using a data circuit that can be economically implemented in existing surgical instruments with minimal design changes to maintain compatibility of the surgical device with current generator platforms.

In addition, aspects of the generator 1100 may be configured to communicate with a second data circuit contained in an instrument (e.g., instruments 1104, 1106, or 1108) of the surgical device.

In certain aspects, the second data circuit and the second data circuit interface 2100 may be configured to enable communication between the programmable logic device 2000 and the second data circuit without providing additional conductors for this (e.g., dedicated conductors of a cable connecting the handpiece to the generator 1100). In one aspect, information may be transmitted to and from the second data circuit using a single bus communication scheme implemented on an existing cable, such as one of the conductors used to transmit interrogation signals from signal conditioning circuit 2020 to control circuitry in the handpiece, for example. In this way, design changes or modifications to the surgical device that may otherwise be necessary may be minimized or reduced. Furthermore, because different types of communication may be implemented on a common physical channel (with or without band splitting), the presence of the second data circuit may be "invisible" to generators that do not have the requisite data reading functionality, thus enabling backwards compatibility of surgical device instruments.

In certain aspects, the isolation stage 1520 may include at least one blocking capacitor 2960-1 (fig. 27C) that is connected to the drive signal output 1600b to prevent DC current from flowing to the patient. For example, the signal blocking capacitor may be required to comply with medical regulations or standards. While relatively few errors occur in single capacitor designs, such errors can have undesirable consequences. In one aspect, a second blocking capacitor 2960-2 may be provided in series with the blocking capacitor 2960-1, wherein current leakage from a point between the blocking capacitors 2960-1, 2960-2 is detected by, for example, the ADC 2980 for sampling the voltage induced by the leakage current. The sample may be received by programmable logic device 2000, for example. Based on the change in leakage current (as indicated by the voltage samples in the aspect of FIG. 26), the generator 1100 may determine when at least one of the blocking capacitors 2960-1, 2960-2 fails. Thus, the aspect of fig. 26 has benefits over a single capacitor design with a single point of failure.

In certain aspects, the non-isolated stage 1540 may include a power source 2110 for outputting DC power at appropriate voltages and currents. The power source may comprise, for example, a 400W power source for outputting a system voltage of 48 VDC. As described above, the power source 2110 may further include one or more DC/DC voltage converters 2130 for receiving the output of the power source to produce a DC output at the voltage and current required by the various devices of the generator 1100. As described above in connection with controller 1960, one or more of DC/DC voltage converters 2130 may receive input from controller 1960 when controller 1960 detects a user activation of "on/off input device 2150 to enable operation of DC/DC voltage converter 2130 or to wake up DC/DC voltage converter 2130.

Fig. 28A-28B illustrate certain functional and structural aspects of an aspect of the generator 1100. Feedback indicative of the current and voltage output from the secondary winding 1580 of the power transformer 1560 is received by the ADCs 1780, 1800, respectively. As shown, ADCs 1780, 1800 may be implemented as 2-channel ADCs, and the feedback signal may be sampled at high speed (e.g., 80Msps) to allow oversampling (e.g., approximately 200x oversampling) of the drive signal. The current feedback signal and the voltage feedback signal may be appropriately conditioned (e.g., amplified, filtered) in the analog domain prior to processing by the ADC 1780, 1800. Current and voltage feedback samples from ADCs 1780, 1800 may be individually buffered and then multiplexed or interleaved into a single data stream within block 2120 of programmable logic device 1660. In the aspect of fig. 28A-28B, programmable logic device 1660 comprises an FPGA.

The multiplexed current and voltage feedback samples may be received by a Parallel Data Acquisition Port (PDAP) implemented within block 2144 of processor 1740 the PDAP may comprise a packaging unit for implementing any of a variety of methods for associating the multiplexed feedback samples with memory addresses.

Block 2200 of processor 1740 may implement a predistortion algorithm for predistorting or modifying L UT samples stored in programmable logic device 1660 on a dynamic marching basis, the predistortion of L UT samples may compensate for various sources of distortion present in the output drive circuitry of generator 1100, as described above, the predistorted L UT samples, when processed by the drive circuitry, will thus cause the drive signal to have a desired waveform shape (e.g., sinusoidal shape) to optimally drive the ultrasound transducer.

At block 2220 of the predistortion algorithm, the current through the dynamic branch of the ultrasound transducer is determined. May be based on, for example, current and voltage feedback samples stored at memory location 2180 (which, when properly calibrated, may represent I in the model of FIG. 25 discussed above_gAnd V_g) Static capacitance C of ultrasonic transducer_oMay be determined for each set of stored current and voltage feedback samples associated with L UT samples.

The method may further include the step of comparing each dynamic branch current sample determined at block 2220 to a sample of a desired current waveform shape at block 2240 of a predistortion algorithm to determine a difference or sample amplitude error between the compared samples for this determination, the samples of the desired current waveform shape may be supplied, for example, from waveform shape L UT2260, the waveform shape L UT2260 containing amplitude samples for one cycle of the desired current waveform shape.

Each value of the sample amplitude error determined at block 2240 is transmitted to L UT of programmable logic device 1660 (shown at block 2280 in fig. 28A) along with an indication of its associated L UT address, based on the value of the sample amplitude error and its associated address (and, optionally, the previously received value of the sample amplitude error for the same L UT address), L UT2280 (or other control block of programmable logic device 1660) may pre-distort or modify the value of the L UT sample stored at the L UT address such that the sample amplitude error is reduced or minimized, it should be understood that such pre-distortion or modification of each L UT sample in an iterative manner over the entire L UT address range will result in the waveform shape of the generator's output current matching or conforming to the desired current waveform shape represented by the samples of waveform shape L UT 2260.

The current and voltage amplitude measurements, power measurements, and impedance measurements may be determined at block 2300 of processor 1740 based on current and voltage feedback samples stored at memory location 2180. Prior to determining these quantities, the feedback samples may be appropriately scaled and, in some aspects, processed through a suitable filter 2320 to remove noise generated by, for example, the data acquisition process and induced harmonic components. Thus, the filtered voltage and current samples may substantially represent the fundamental frequency of the generator's drive output signal. In certain aspects, the filter 2320 may be a Finite Impulse Response (FIR) filter applied to the frequency domain. Such aspects may use a Fast Fourier Transform (FFT) of the output drive signal current and voltage signals. In some aspects, the resulting frequency spectrum may be used to provide additional generator functionality. In one aspect, for example, the ratio of the second order harmonic component and/or the third order harmonic component relative to the fundamental frequency component may be used as a diagnostic indicator.

At block 2340 (fig. 28B), a Root Mean Square (RMS) calculation may be applied to current feedback samples representing a sample size of the drive signal for an integer cycle to generate a measurement I representing the drive signal output current_rms。

At block 2360, a Root Mean Square (RMS) calculation may be applied to the voltage feedback samples representing a sample size of the drive signal for an integer cycle to determine a measurement V representing the output voltage of the drive signal_rms。

At block 2380, the current and voltage feedback samples may be multiplied point-by-point and the samples representing the integer-cycle drive signal may be averaged to determine a measure of true output power Pr of the generator.

At block 2400, a measure P of the apparent output power of the generator_aCan be determined as the product V_rms·I_rms。

At block 2420, the measured value of the load resistance value Z_mCan be determined as a quotient V_rms/I_rms。

In certain aspects, the amount I determined at blocks 2340, 2360, 2380, 2400, and 2420_rms、V_rms、P_r、P_aAnd Z_mCan be used by the generator 1100 to implement any of a number of control and/or diagnostic processes. In certain aspects, any of these quantities may be communicated to a user via, for example, output device 2140 integral to generator 1100 or output device 2140 connected to generator 1100 through a suitable communication interface (e.g., a USB interface). For example, various diagnostic procedures may include, but are not limited to, handpiece integrity, instrument attachment integrity, instrument overload, approaching instrument overload, frequency lock failure, over current condition, over power condition, voltage sensing failure, current sensing failure, audio indication failure, visual indication failure, short circuit condition, power delivery failure, or blocking capacitor failure.

Block 2440 of processor 1740 may implement a phase control algorithm for determining and controlling the impedance phase of an electrical load (e.g., an ultrasound transducer) driven by generator 1100. As described above, by controlling the frequency of the drive signal to minimize or reduce the difference between the determined impedance phase and the impedance phase set point (e.g., 0 °), the effects of harmonic distortion may be minimized or reduced and the accuracy of the phase measurement increased.

The phase control algorithm receives as inputs the current and voltage feedback samples stored in memory location 2180. Before using the feedback samples in the phase control algorithm, the feedback samples may be appropriately scaled and processed in some respects by a suitable filter 2460 (which may be the same as filter 2320) to remove noise generated by, for example, the data acquisition process and induced harmonic components. Thus, the filtered voltage and current samples may substantially represent the fundamental frequency of the generator's drive output signal.

The current through the dynamic branch of the ultrasound transducer is determined at block 2480 of the phase control algorithm, which may be the same as the determination described above in connection with block 2220 of the predistortion algorithm, thus, for each set of stored current and voltage feedback samples associated with L UT samples, the output of block 2480 may be a dynamic branch current sample.

At block 2500 of the phase control algorithm, the impedance phase is determined based on the synchronous input of the dynamic branch current samples and the corresponding voltage feedback samples determined at block 2480. In certain aspects, the impedance phase is determined as an average of the impedance phase measured at the rising edge of the waveform and the impedance phase measured at the falling edge of the waveform.

At block 2520 of the phase control algorithm, the impedance phase value determined at block 2220 is compared to the phase set point 2540 to determine a difference or phase error between the compared values.

At block 2560 (fig. 28A) of the phase control algorithm, a frequency output for controlling the frequency of the drive signal is determined based on the value of the phase error determined at block 2520 and the impedance magnitude determined at block 2420. The value of the frequency output may be continuously adjusted by the block 2560 and transmitted to the DDS control block 2680 (discussed below) in order to maintain the impedance phase determined at block 2500 at a phase set point (e.g., zero phase error). In certain aspects, the impedance phase may be adjusted to a 0 ° phase setpoint. In this way, any harmonic distortion will be centered around the peak of the voltage waveform, thereby enhancing the accuracy of the phase impedance determination.

Block 2580 of processor 1740 may implement an algorithm for modulating the current amplitude of the drive signal in order to control the drive signal current, voltage, and power according to user-specified set points or according to requirements specified by other processes or algorithms implemented by the generator 1100. control of these quantities may be implemented, for example, by scaling L UT samples in L UT2280 and/or by adjusting the full-scale output voltage of DAC1680 (which supplies input to power amplifier 1620) via DAC 1860. Block 2600 (which may be implemented as a PID controller) may receive as input current feedback samples (which may be appropriately scaled and filtered) from memory location 2180_dThe values are compared to determine whether the drive signal supplies the necessary current. In terms of driving signal current as a control variable, current demand I_dCan be controlled by current set point 2620A (I)_sp) And directly specifying. For example, the RMS value of the current feedback data (as determined in block 2340) may be compared to a user-specified RMS current set point I_spA comparison is made to determine the appropriate controller action. For example, if the current feedback data indicates that the RMS value is less than the current set point I_spThen L UT scaled and/or full-scaled output voltages of DAC1680 may be adjusted by block 2600 such that the drive signal current increases_spAt this time, block 2600 can adjust L UT scaled and/or full-scaled output voltages of DAC1680 to reduce drive signal current.

In terms of driving signal voltage as a control variable, current demand I_dMay be based, for example, on maintaining the load impedance magnitude Z measured at block 2420_mGiven a desired voltage set point 2620B (V)_sp) The required current is indirectly specified (e.g. I)_d＝V_sp/Z_m). Similarly, in terms of driving signal power as a control variable, current demand I_dMay be based, for example, on the voltage V measured at block 2360_rmsGiven a desired setpoint 2620C (P)_sp) The required current is indirectly specified (e.g. I)_d＝P_sp/V_rms)。

Block 2680 (fig. 28A) may implement a DDS control algorithm for controlling the drive signal by retrieving L UT samples stored in L UT 2280. in some aspects, the DDS control algorithm may be a digitally controlled oscillator (NCO) algorithm for generating samples of a waveform at a fixed clock rate using a point (memory location) -skip technique.

Block 2700 of processor 1740 may implement a switch-mode converter control algorithm for dynamically modulating a rail voltage of power amplifier 1620 based on a waveform envelope of an amplified signal to improve efficiency of power amplifier 1620. In certain aspects, characteristics of the waveform envelope may be determined by monitoring one or more signals contained in the power amplifier 1620. In one aspect, for example, the characteristics of the waveform envelope may be determined by monitoring a minimum value of a drain voltage (e.g., a MOSFET drain voltage) modulated according to the envelope of the amplified signal. The minimum voltage signal may be generated, for example, by a voltage minimum detector coupled to the drain voltage. The minimum voltage signal may be sampled by the ADC 1760 with the output minimum voltage sample being received at block 2720 of the switch mode converter control algorithm. Based on the value of the minimum voltage sample, block 2740 may control the PWM signal output by PWM generator 2760, which PWM generator 2760 in turn controls the rail voltage supplied to power amplifier 1620 by switch-mode regulator 1700. In certain aspects, the mains voltage may be modulated according to the waveform envelope characterized by the minimum voltage sample, as long as the value of the minimum voltage sample is less than the minimum target 2780 input into block 2720. For example, block 2740 may result in supplying a low rail voltage to power amplifier 1620 when the minimum voltage samples indicate a low envelope power level, where the full rail voltage is supplied only when the minimum voltage samples indicate a maximum envelope power level. When the minimum voltage sample falls below the minimum target 2780, block 2740 may keep the rail voltage at a minimum value suitable to ensure proper operation of power amplifier 1620.

Limiting capacitive coupling and its effects

Aspects of the present disclosure are directed to a surgical instrument having improved device capabilities for reducing undesirable operational side effects. In particular, the surgical instrument may include means for limiting capacitive coupling to improve monopolar isolation for use independently or with another advanced energy mode. Capacitive coupling typically occurs when there is an energy transfer between the nodes caused by an electric field. During surgery, capacitive coupling may occur when two or more powered surgical instruments are used in or around a patient. While capacitive coupling may be desirable in some situations because the add-on device may be inductively powered by capacitive coupling, the consequences of capacitive coupling that may occur accidentally during surgery or around the patient may often be extremely detrimental. Parasitic or accidental capacitive coupling may occur at unknown or unpredictable locations, resulting in energy being applied to unintended areas. When the patient is under anesthesia and fails to provide any response, the parasitic capacitive coupling may burn the patient, which the surgeon is not even aware of. It is therefore desirable to limit parasitic or accidental capacitive coupling in surgical instruments and during general surgery.

In some aspects, a system comprising a surgical instrument and a generator can be configured to interrupt transmission of energy from the generator to the surgical instrument when a capacitive coupling has been detected. In these cases, one or more safety fuses, sensors, controllers, and/or algorithms may be in place to automatically trigger the interruption of the generator. An alarm may be issued, including audio signals, vibration, and visual messages, to inform the surgical team to interrupt the generator due to the detection of capacitive coupling.

In some aspects, the system includes means for detecting that a capacitive coupling event has occurred. For example, an algorithm that includes input from one or more sensors for detecting events around the system may apply situational awareness and other programming means to infer that capacitive coupling is occurring somewhere within the system and react accordingly. A situational aware system means that the system can be configured to be able to predict what may happen based on current environmental and system data, and determine that current conditions follow a pattern that causes a predictable next step. For example, the system may apply situational awareness in the context of treating capacitive coupling events by recalling instances in surgical procedures where locations of various sensor data are similar are detected. The sensor data may indicate an increase in current at two particular locations along the closed loop electrosurgical system that indicates a high likelihood that a capacitive coupling event is imminent based on prior data of a similarly located surgical procedure.

In some aspects, the surgical instrument may be structurally modified to limit the occurrence of capacitive coupling or otherwise reduce collateral damage caused by capacitive coupling. For example, additional insulation strategically placed in or around the surgical instrument may help limit capacitive coupling from occurring. In other instances, the end effector of a surgical instrument may include improved structures that reduce the occurrence of current displacement, such as rounding the end of the end effector or specifically shaping the blade of the end effector to behave more like a monopolar blade, while still acting as a bipolar device.

In some aspects, the system may include passive means for mitigating or limiting the effects of capacitive coupling. For example, the system may include leads that may shunt energy to a neutral node through conductive passive components. Generally, any or all of these aspects may be combined or included in a single system to address challenges presented by multiple electronic components that are susceptible to capacitive coupling during patient surgery.

Fig. 29 provides a diagram illustrating an example system 134000 having an apparatus for detecting capacitive coupling in accordance with at least one aspect of the present disclosure. The system 134000 includes a monopolar ESU generator 134002 electrically coupled to a surgical instrument 134008. The surgical instrument 134008 is used to perform a surgical procedure on a patient, where patient tissue 134016 is shown to represent a surgical site of the patient undergoing the surgical procedure. The surgical instrument 134008 may include a means for applying electrosurgical or ultrasonic energy to an end effector, and in some cases may include a blade and/or a pair of jaws to grasp or clamp on tissue. The energy supplied by the ESU generator 134002 can contact the patient through the end effector via any of a variety of possible components of the end effector. At least a portion of the patient may rest on a return path Pad 134014, such as a Smart Megasoft Pad^TMFor example, the return path pad is configured to divert excess energy away from the patient when the surgical instrument 134008 contacts the patient and applies electrosurgical energy.

Because of the multiple power sources in the vicinity of the patient, parasitic capacitive coupling is always present and there is always a risk of injury to the patient during the surgical procedure. Because it is not desirable for the patient to express any response during surgery, if unknown or unpredictable capacitive coupling occurs, the patient may therefore experience burns in unintended places. Generally, energy anomalies such as capacitive coupling should be minimized or otherwise corrected to improve patient safety. To limit capacitive coupling or other types of energy anomalies from occurring, a number of smart sensors or monitors, such as CT1(134006), CT2(134010), and CT3(134012) smart sensors, may be integrated into the electrosurgical system as indicators to determine whether excess or induced energy is radiating outside of the power source or sources. As shown in fig. 29, the smart sensors CT1(134006), CT2(134010), and CT3(134012) are placed at possible locations where energy can sense radiation. The sensor or monitor may be configured to be able to detect capacitance, and if placed at a strategic location within the system, the reading of the capacitance may suggest that a capacitance leak is occurring in the vicinity of the sensor or monitor. In conjunction with knowledge of other sensors near the system or throughout the system that are not indicating capacitance readings, it can be inferred that a capacitance leak is occurring near the sensor or monitor that is providing the positive indication. Other sensors may be used, such as capacitive leakage monitors or detectors. These sensors may be configured to be able to provide an alarm, such as lighting or delivering noise or ultimately transmitting a signal to a display monitor. Additionally, the monopolar ESU 134002 can be configured to automatically trigger an energy interrupt to prevent any further capacitive coupling from occurring.

In some aspects, the neutral electrode 134004 may be included in a monopolar ESU 1340002 and may be electrically coupled to a return path pad 134014, such as a Smart MegasoftFor example as another solution to reduce capacitive coupling. When the electrosurgical instrument 134008 contacts the patient, the patient is contacting the return path pad 134014, and the pad is conductively connected to the neutral electrode 134004, energy may conductively reach the neutral node 134004. Accordingly, energy may be transferred from the monopolar ESU 134002 or the surgical instrument 134008 to the neutral node 134004, thereby reducing the occurrence of capacitive coupling.

In some aspects, a cloud analysis system communicatively coupled to a monopolar ESU, such as through a medical hub, can be configured to be able to employ situational awareness that can help predict when capacitive coupling is likely to occur during a surgical procedure. The cloud analysis system and/or medical hub may utilize capacitive coupling algorithms to monitor the incidence of energy flowing through the surgical system, and based on prior data regarding the energy status in the system for similarly situated procedures, it may be inferred that capacitive coupling is likely to occur if no further action is taken. For example, during a surgical procedure that involves a prescribed method of how the surgical instrument is used during a particular step in the surgical procedure and how much power should be employed, the cloud analysis module may extract this information from previous surgical procedures and note that capacitive coupling is more likely to occur after the particular step in the surgical procedure. In monitoring steps in a surgical procedure, the cloud analysis system may deliver an alert that this is likely to cause capacitive coupling when the same or very similar energy profile occurs during or before the expected step that tends to induce capacitive coupling. The surgeon may be provided with the option of reducing the peak voltage in the surgical instrument 134008 or interrupting power generation through the monopolar ESU 134002, or the cloud analysis module may automatically cause the medical hub to take these actions. This may lead to the possibility of eliminating the capacitive coupling before it has had a chance to occur, or at least may limit any unintended effects due to the temporary occurrence of capacitive coupling.

In some aspects, a surgical instrument as shown in fig. 29 can include structural means for reducing or preventing capacitive coupling. For example, insulation in the shaft of the surgical instrument 134008 may reduce the occurrence of inductance. In other instances, the monopolar lead connecting the monopolar ESU 134002 to the surgical instrument 134008 can be shielded. As another example, there may be intermittent interrupted plastic elements within the shaft to prevent capacitive coupling from transmitting long distances within the shaft. Other insulator type elements may be used to achieve a similar effect. In some aspects, the monopolar wires electrically connecting the surgical instrument 134008 to the generator 134002 may be shielded to also reduce the occurrence of capacitive coupling.

In some aspects, the structure of the end effector can be modified to reduce the effects of capacitive coupling when the end effector is in contact with a patient. For example, the jaws of the end effector may be designed such that only one side of each jaw is used to deliver energy, thereby causing the end effector to function like a monopolar blade, while still being functionally configured as a bipolar device. In one example of this, the end or tip of the end effector may be shaped like a duckbill, with rounded ends to reduce any voltage peaks that may arise from a sharp tip. The direction of energy in the end effector may still be directed to the area or point of the duckbill end, but any excess energy dissipation may be blunted by the duckbill end. As another example, the blade may be configured to be slightly thicker on one side, such as having a triangular cross-sectional area, and have a thin upstanding upper blade element on the opposite side. This may allow any energy delivered to the blade to be focused to a point, which may help the surgical instrument function like a monopolar blade, while still being a bipolar device. In this way, the energy will not be dissipated, which will make the surgical instrument more susceptible to causing capacitive coupling. As a final example, the jaws of the surgical instrument may have electrodes placed on the inside of the end effector, allowing the outside of the end effector to act like a shield to prevent capacitive coupling from occurring. The electrodes may still be placed sufficiently to contact the patient's tissue during surgery while shielding one or more edges of the end effector from energy dissipation outside the focused surgical field.

Fig. 30 is a logic flow diagram 134100 depicting a control program or logic configuration of an exemplary method for limiting the effects of capacitive coupling in the disclosed surgical system, in accordance with some aspects. This exemplary method may be consistent with the description above regarding several enumerated means for limiting capacitive coupling or mitigating the effects thereof during a surgical procedure using one or more surgical instruments.

As shown in the above example and consistent therewith, the method 134100 may begin with the surgical system being configured to monitor 134102 energy generation. For example, multiple sensors may be strategically placed at potentially vulnerable points that are more likely to leak energy that could lead to capacitive coupling. These sensors may be configured to be able to deliver an alarm when an energy anomaly occurs.

Continuing, a sensor or other detection device may detect 134104 a voltage anomaly, such as a voltage peak or voltage spike, at one or more locations along the surgical system, which is generally not desired to generate such energy. The system may be configured to be able to infer that these conditions may cause parasitic capacitive coupling, possibly burning the patient without any alarm and without the knowledge of the surgical team. As a result, an alarm or message may be delivered indicating the occurrence of an energy anomaly and a capacitive coupling hazard.

In some aspects, situational awareness may also be used to predict 134106 when capacitive coupling is more likely to occur during the routine course of a surgical procedure. Situational awareness can be used to review past types or situations of similar surgical procedures to identify which variables may be present in determining when capacitive coupling occurs. If certain steps in the protocol are more likely to cause capacitive coupling, the system can predict these conditions by specifically monitoring the sensors at these times and/or taking proactive measures to reduce the occurrence of capacitive coupling.

If capacitive coupling is detected or deemed imminent based on the above-described method 134100 performed by the surgical system, according to some aspects, the action taken to reduce, eliminate, or mitigate the effects of the capacitive coupling may include automatically interrupting 134108 the energy generation at the monopolar energy generator. It should be noted that some surgical procedure loss may temporarily occur when this interruption is enabled, but in any case it is of utmost importance to prevent unintended damage to the patient. After a brief interruption, the surgery may continue as planned.

The relationship between the energy of the output and the energy of the input is measured, the parasitic leakage is used to improve pad contact or turn off power, the generator knows how much current it generates and how much output energy it is measuring.

In thatIncreasing frequency in the presence of capacitive coupling

In some aspects, the presence of parasitic capacitive coupling may be exploited to perform energy coagulation or energy cauterization. In some cases, it may be desirable to increase the energy generation of the electrosurgical instrument to drive the monopolar circuit through the patient's body to ground. Though in many cases through a conductive return pad (such as a Smart Megasoft)134014, see fig. 29) to complete a unipolar circuit, but in some cases, the pad may be defective or worn,such that pad 134014 is not sufficiently conductive to draw current of an electrosurgical instrument (e.g., 134008) through the patient's body. In such cases, the current may lack sufficient grounding for energy to propagate, effectively causing the patient's body to act like a short circuit. This may render electrosurgery ineffective because the energy delivered by the surgical instrument 134008 does not pass through the patient's tissue and, therefore, does not heat the tissue as intended. A similar situation may occur when there is no return pad at all. That is, without a conductive return pad such as a Smart Megasoft134014 there may not be a ground available to connect to the patient while providing a wide conductive return path. This may also cause the patient to act like a short circuit when energy from the surgical instrument is applied to the patient.

To accommodate these situations, in some aspects, the unipolar energy generation may be increased to very high frequencies, such as 500Khz to 3-4Mhz, to take advantage of parasitic patient leakage for pad-less electrosurgery (or electrosurgery with insufficient conductivity in the pad). By increasing the alternating current frequency, the parasitic leakage current will increase. Stronger leakage currents can then radiate more efficiently through the patient's body. After reaching through the patient's body, the capacitively coupled leakage current may be more efficiently radiatively coupled to the ground state, which may, as a result, efficiently drive current radiation into another object acting as a ground. For example, if the AC frequency is high enough, current leakage may reach the single-pole generator ground terminal. This will help to eliminate the short circuit effect of the patient so that energy coagulation can occur. Thus, in the presence of non-pad systems or systems with poor conductivity in the pad, it may be desirable to increase current leakage to take advantage of the higher leakage return that can be used to complete a unipolar circuit. That is, in some cases, the return path may be formed by radiation current leakage due to capacitive coupling. To help ensure that the radiation return path reaches the ground plane, the energy of the surgical instrument may be increased to very high frequencies.

In some cases, a poorly conducting return pad may be intentionally connected to ground, a mesa or nearest support surface, while a return connector on the generator may also be connected to ground. This diverts the circuit so that it flows through the radiation return path rather than having any energy try to travel through the poorly conducting return pad and back to the generator (which could cause burning to the patient).

It should be noted that when a pad system is present, and the pad provides sufficient conductivity under the patient, a typical unipolar circuit driving current through the body and into the return pad may be the preferred method. In these cases, it may be useful to establish an isolation barrier for an externally connected power source, such as the energy generator 134002 (see fig. 29). Alternatively, a battery powered instrument may be a more desirable system for reducing leakage current, which would help isolate the energy path through the conductive return pad.

In some aspects, a surgical system can include a detection circuit configured to determine a volume of a return path pad. Rather than attempting to rely on a poorly conducting return path pad or no pad at all, the detection circuit may then provide information as to whether it is better to complete the circuit with radiation current leakage. The detection circuit can measure the amount of conductivity in the return path pad. If the measurement of conductivity meets a predetermined threshold, the system may determine that the return path pad may be used to perform a surgical procedure and provide a return path for monopolar energy. If the conductivity is below the threshold, the detection circuit can be configured to be able to send a signal to the system, such as at a processor of a surgical hub or monopolar generator, that the frequency of monopolar energy should be significantly increased and the return path pad should be eliminated or at least disregarded. Increasing the frequency will then complete the unipolar circuit by creating a radiated return path.

In some aspects, the unipolar generator may include one or more control circuits coupled to the one or more sensors, the one or more control circuits configured to enable a determination of whether the current leakage has reached a ground terminal of the unipolar generator. The sensor in combination with the detection and control circuitry of the unipolar generator may be used to create a closed feedback loop system that may automatically adjust the frequency based on high leakage current to create an adequate return path. For example, the detection circuit may determine whether there is sufficient conductivity in the return path pad. If not, the control circuit of the unipolar generator may cause energy generation to increase the AC frequency. The sensor at the monopole generator may continuously monitor whether any radiation current leakage has reached the ground terminal of the monopole generator based on the increased frequency. The control circuit may gradually increase the frequency until it is detected that the radiation current leakage has reached the ground terminal. Thus, if it is determined that there is no return path pad or insufficient conductivity in the pad, the surgical system may rely on a predetermined frequency threshold, or may use a closed feedback system to find a sufficiently high frequency at which a return path can be created by radiative coupling.

Fig. 31 is a logic flow diagram 134200 depicting a control program or logic configuration of an exemplary method that may be performed by a surgical system utilizing monopolar energy generation to determine whether to utilize parasitic capacitive coupling. Consistent with the above description, a detection circuit that is part of the surgical system may be configured to measure 134202 a conductivity level in a return path of a monopolar electrosurgical set. The return path may be initially determined through a conductive pad, such as Soft MegasoftOr other return path conductive pad. In some cases, the conductivity in the pad may provide poor conductivity. In other cases, there may be no pad present as part of the surgical setup. This may result in the patient's body acting as a short circuit to the monopolar circuit, which will reduce or eliminate the effectiveness of attempting to apply monopolar energy to the surgical site of the patient.

The detection circuit may determine 134204 that the measured value of conductivity falls below a predetermined threshold, indicating that the conductivity level in the return path is sufficiently poor to prevent completion of the unipolar circuit. As a result, the surgical system may cause the generator to increase 134206 current leakage by increasing the frequency of the alternating current in the monopolar generator. The surgical system may alternatively utilize radiation current leakage to create the return path. As the frequency increases, the current leakage will also increase, increasing the range over which the radiation leakage current reaches the ground plane and completes the circuit. Thus, by increasing the frequency, the poor conductivity of the return path pad or even no pad at all can be overridden. In some cases, the leakage increase may be determined based on a closed feedback sensor system that may adjust the frequency until it is determined that the radiation current leakage has reached a ground terminal at the monopole generator.

In some aspects, the surgical system may also provide instructions to isolate 134208 any return path pads and attach the return connector of the unipolar generator to ground. These measures can be taken to eliminate other alternative return paths that may inadvertently cause burns in undesired patient locations.

Situation awareness

Referring now to fig. 32, a timeline 5200 depicting situational awareness of a hub, such as the surgical hub 106 or 206, is shown. The time axis 5200 is illustrative of a surgical procedure and background information that the surgical hub 106, 206 may derive from data received from the data source at each step in the surgical procedure. The time axis 5200 depicts typical steps that nurses, surgeons, and other medical personnel will take during a lung segment resection procedure, starting from the establishment of an operating room and ending with the transfer of the patient to a post-operative recovery room.

The situation aware surgical hub 106, 206 receives data from data sources throughout the course of a surgical procedure, including data generated each time a medical professional utilizes a modular device paired with the surgical hub 106, 206. The surgical hub 106, 206 may receive this data from the paired modular devices and other data sources, and continually derive inferences about the ongoing procedure (i.e., background information) as new data is received, such as which step of the procedure is performed at any given time. The situational awareness system of the surgical hub 106, 206 can, for example, record data related to the procedure used to generate the report, verify that the medical personnel are taking steps, provide data or prompts that may be related to particular procedure steps (e.g., via a display screen), adjust the modular device based on context (e.g., activate a monitor, adjust a field of view (FOV) of a medical imaging device, or change an energy level of an ultrasonic surgical instrument or RF electrosurgical instrument), and take any other such actions described above.

As a first step 5202 in the exemplary procedure, the hospital staff retrieves the patient's EMR from the hospital's EMR database. Based on the selected patient data in the EMR, the surgical hub 106, 206 determines that the procedure to be performed is a chest procedure.

In a second step 5204, the staff scans the incoming medical supply for the procedure. The surgical hub 106, 206 cross-references the scanned supplies with a list of supplies used in various types of protocols and confirms that the supplied mix corresponds to a chest protocol. In addition, the surgical hub 106, 206 is also able to determine that the procedure is not a wedge procedure (because the incoming supplies lack some of the supplies required for the chest wedge procedure, or otherwise do not correspond to the chest wedge procedure).

In a third step 5206, medical personnel scan the patient belt via a scanner communicatively coupled to the surgical hub hubs 106, 206. The surgical hub 106, 206 may then confirm the identity of the patient based on the scanned data.

Fourth, the medical staff opens the ancillary equipment 5208. The ancillary equipment utilized may vary depending on the type of surgical procedure and the technique to be used by the surgeon, but in this exemplary case they include smoke ejectors, insufflators, and medical imaging devices. When activated, the auxiliary device as a modular device may be automatically paired with a surgical hub 106, 206 located in a specific vicinity of the modular device as part of its initialization process. The surgical hub 106, 206 may then derive contextual information about the surgical procedure by detecting the type of modular device with which it is paired during the pre-operative or initialization phase. In this particular example, the surgical hub 106, 206 determines that the surgical procedure is a VATS procedure based on this particular combination of paired modular devices. Based on the combination of data from the patient's EMR, the list of medical supplies used in the procedure, and the type of modular device connected to the hub, the surgical hub 106, 206 can generally infer the specific procedure that the surgical team will perform. Once the surgical hub 106, 206 knows what specific procedure is being performed, the surgical hub 106, 206 may retrieve the steps of the procedure from memory or cloud and then cross-reference the data it subsequently receives from the connected data sources (e.g., modular devices and patient monitoring devices) to infer what steps of the surgical procedure are being performed by the surgical team.

In a fifth step 5210, the staff member attaches EKG electrodes and other patient monitoring devices to the patient. EKG electrodes and other patient monitoring devices can be paired with the surgical hubs 106, 206. When the surgical hub 106, 206 begins to receive data from the patient monitoring device, the surgical hub 106, 206 thus confirms that the patient is in the operating room.

Sixth step 5212, the medical personnel induce anesthesia in the patient. The surgical hub 106, 206 may infer that the patient is under anesthesia based on data from the modular device and/or the patient monitoring device, including, for example, EKG data, blood pressure data, ventilator data, or a combination thereof. Upon completion of the sixth step 5212, the pre-operative portion of the lung segmentation resection procedure is completed and the surgical portion begins.

In a seventh step 5214, the patient's lungs being operated on are collapsed (while ventilation is switched to the contralateral lungs). For example, the surgical hub 106, 206 may infer from the ventilator data that the patient's lungs have collapsed. The surgical hub 106, 206 may infer that the surgical portion of the procedure has begun because it may compare the detection of the patient's lung collapse to the expected steps of the procedure (which may have been previously visited or retrieved) to determine that collapsing the lungs is the surgical step in that particular procedure.

In an eighth step 5216, a medical imaging device (e.g., an endoscope) is inserted and video from the medical imaging device is initiated. The surgical hub 106, 206 receives medical imaging device data (i.e., video or image data) through its connection to the medical imaging device. After receiving the medical imaging device data, the surgical hub 106, 206 may determine that a laparoscopic portion of the surgical procedure has begun. In addition, the surgical hub 106, 206 may determine that the particular procedure being performed is a segmental resection, rather than a leaf resection (note that the wedge procedure has been excluded based on the data received by the surgical hub 106, 206 at the second step 5204 of the procedure). Data from the medical imaging device 124 (fig. 2) may be used to determine contextual information relating to the type of procedure being performed in a number of different ways, including by determining the angle of visualization orientation of the medical imaging device relative to the patient anatomy, monitoring the number of medical imaging devices utilized (i.e., activated and paired with the surgical hub 106, 206), and monitoring the type of visualization devices utilized. For example, one technique for performing a VATS lobectomy places the camera in the lower anterior corner of the patient's chest above the septum, while one technique for performing a VATS segmental resection places the camera in an anterior intercostal location relative to the segmental cleft. For example, using pattern recognition or machine learning techniques, the situational awareness system may be trained to recognize the positioning of the medical imaging device from a visualization of the patient's anatomy. As another example, one technique for performing a VATS lobectomy utilizes a single medical imaging device, while another technique for performing a VATS segmental resection utilizes multiple cameras. As another example, one technique for performing VATS segmental resection utilizes an infrared light source (which may be communicatively coupled to a surgical hub as part of a visualization system) to visualize segmental fissures that are not used in VATS pulmonary resection. By tracking any or all of this data from the medical imaging device, the surgical hub 106, 206 can thus determine the specific type of surgical procedure being performed and/or the technique being used for a particular type of surgical procedure.

Ninth step 5218, the surgical team begins the dissection step of the procedure. The surgical hub 106, 206 may infer that the surgeon is dissecting to mobilize the patient's lungs because it receives data from the RF generator or ultrasound generator indicating that the energy instrument is being fired. The surgical hub 106, 206 may intersect the received data with the retrieved steps of the surgical procedure to determine that the energy instrument fired at that point in the procedure (i.e., after completion of the previously discussed procedure steps) corresponds to an anatomical step. In some cases, the energy instrument may be an energy tool mounted to a robotic arm of a robotic surgical system.

In a tenth step 5220, the surgical team continues with the ligation step of the procedure. The surgical hub 106, 206 may infer that the surgeon is ligating arteries and veins because it receives data from the surgical stapling and severing instrument indicating that the instrument is being fired. Similar to the previous steps, the surgical hub 106, 206 may deduce the inference by cross-referencing the receipt of data from the surgical stapling and severing instrument with the retrieval steps in the procedure. In some cases, the surgical instrument may be a surgical tool mounted to a robotic arm of a robotic surgical system.

An eleventh step 5222, a segmental resection portion of the procedure is performed. The surgical hub 106, 206 may infer that the surgeon is transecting soft tissue based on data from the surgical stapling and severing instrument, including data from its cartridge. The cartridge data may correspond to, for example, the size or type of staples fired by the instrument. Since different types of staples are used for different types of tissue, the cartridge data can indicate the type of tissue being stapled and/or transected. In this case, the type of staple fired is for soft tissue (or other similar tissue type), which allows the surgical hub 106, 206 to infer that a segmental resection portion of the procedure is in progress.

In a twelfth step 5224, a node dissection step is performed. The surgical hub 106, 206 may infer that the surgical team is dissecting a node and performing a leak test based on data received from the generator indicating that the RF or ultrasonic instrument is being fired. For this particular procedure, the RF or ultrasound instruments used after transecting soft tissue correspond to a node dissection step that allows the surgical hub 106, 206 to make such inferences. It should be noted that the surgeon periodically switches back and forth between the surgical stapling/severing instrument and the surgical energy (i.e., RF or ultrasonic) instrument according to specific steps in the procedure, as different instruments are better suited to the particular task. Thus, the particular sequence in which the stapling/severing instrument and the surgical energy instrument are used may indicate the steps of the procedure being performed by the surgeon. Further, in some cases, robotic implements may be used for one or more steps in a surgical procedure, and/or hand-held surgical instruments may be used for one or more steps in a surgical procedure. One or more surgeons may alternate and/or may use the device simultaneously, for example, between a robotic tool and a hand-held surgical instrument. Upon completion of the twelfth step 5224, the incision is closed and the post-operative portion of the procedure begins.

A thirteenth step 5226, reverse anesthetizing the patient. For example, the surgical hub 106, 206 may infer that the patient is waking up from anesthesia based on, for example, ventilator data (i.e., the patient's breathing rate begins to increase).

Finally, a fourteenth step 5228 is for the medical personnel to remove various patient monitoring devices from the patient. Thus, when the hub loses EKG, BP, and other data from the patient monitoring device, the surgical hub 106, 206 may infer that the patient is being transferred to a recovery room. As can be seen from the description of the exemplary procedure, the surgical hub 106, 206 may determine or infer when each step of a given surgical procedure occurs from data received from various data sources communicatively coupled to the surgical hub 106, 206.

Situational awareness is further described in U.S. provisional patent application serial No. 62/611,341 entitled interactive surgical platform (INTERACTIVE SURGICA L P L ATFORM), filed on 28.12.2017, which is incorporated herein by reference in its entirety in some cases, operation of robotic surgical systems, including the various robotic surgical systems disclosed herein, may be controlled by the hubs 106, 206 based on their situational awareness and/or feedback from their devices and/or based on information from the cloud 102.

While several forms have been illustrated and described, it is not the intention of the applicants to restrict or limit the scope of the appended claims to such detail. Numerous modifications, changes, variations, substitutions, combinations, and equivalents of these forms can be made without departing from the scope of the present disclosure, and will occur to those skilled in the art. Further, the structure of each element associated with the described forms may alternatively be described as a means for providing the function performed by the element. In addition, where materials for certain components are disclosed, other materials may also be used. It is, therefore, to be understood that the foregoing detailed description and appended claims are intended to cover all such modifications, combinations and variations as fall within the scope of the disclosed forms of the invention. It is intended that the following claims cover all such modifications, changes, variations, substitutions, modifications, and equivalents.

The foregoing detailed description has set forth various forms of the devices and/or methods via the use of block diagrams, flowcharts, and/or examples. Insofar as such block diagrams, flowcharts, and/or examples contain one or more functions and/or operations, it will be understood by those within the art that each function and/or operation within such block diagrams, flowcharts, or examples can be implemented, individually and/or collectively, by a wide range of hardware, software, firmware, or virtually any combination thereof. Those skilled in the art will recognize that some aspects of the forms disclosed herein, in whole or in part, can be equivalently implemented in integrated circuits, as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or as virtually any combination thereof, and that designing the electronic circuitry and/or writing the code for the software and or hardware would be well within the skill of one of skill in the art in light of this disclosure. In addition, those skilled in the art will appreciate that the mechanisms of the subject matter described herein are capable of being distributed as one or more program products in a variety of forms, and that an exemplary form of the subject matter described herein applies regardless of the particular type of signal bearing media used to actually carry out the distribution.

The instructions for programming logic to perform the various disclosed aspects may be stored within a memory within the system, such as a Dynamic Random Access Memory (DRAM), cache, flash memory, or other memory. Further, the instructions may be distributed via a network or through other computer readable media. Thus, a machine-readable medium may include a mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), but is not limited to, floppy diskettes, optical disks, read-only memories (CD-ROMs), magneto-optical disks, read-only memories (ROMs), Random Access Memories (RAMs), erasable programmable read-only memories (EPROMs), electrically erasable programmable read-only memories (EEPROMs), magnetic or optical cards, flash memory, or a tangible, machine-readable storage device used in transmitting information over the internet via electrical, optical, acoustical or other forms of propagated signals (e.g., carrier waves, infrared signals, digital signals, etc.). Thus, a non-transitory computer-readable medium includes any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a form readable by a machine (e.g., a computer).

As used throughout this specification, the term "wireless" and its derivatives may be used to describe circuits, devices, systems, methods, techniques, communication channels, etc., that may communicate data through a non-solid medium using modulated electromagnetic radiation, the term does not imply that the associated organization does not contain any wires, although in some aspects they may not.

As used herein in any aspect, the term "control circuitry" may refer to, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor comprising one or more separate instruction processing cores, processing units, processors, microcontrollers, microcontroller units, controllers, Digital Signal Processors (DSPs), programmable logic devices (P L D), programmable logic arrays (P L a), Field Programmable Gate Arrays (FPGAs)), state machine circuitry, firmware storing instructions executed by programmable circuitry, and any combination thereof.

As used herein, a processor or processing unit is an electronic circuit that performs operations on some external data source, typically a memory or some other data stream. The term is used herein to refer to a central processing unit (cpu) in one or more systems, especially systems on a chip (SoC), that combine multiple specialized "processors".

As used herein, a system-on-chip or system-on-chip (SoC or SoC) is an integrated circuit (also referred to as an "IC" or "chip") that integrates all of the devices of a computer or other electronic system. It may contain digital, analog, mixed signal, and often radio frequency functions-all on a single substrate. The SoC integrates a microcontroller (or microprocessor) with advanced peripherals such as a Graphics Processing Unit (GPU), Wi-Fi modules, or coprocessors. The SoC may or may not contain built-in memory.

As used herein, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuitry and memory. The microcontroller (or MCU of the microcontroller unit) may be implemented as a small computer on a single integrated circuit. It may be similar to a SoC; the SoC may include a microcontroller as one of its devices. Microcontrollers may include one or more Core Processing Units (CPUs) as well as memory and programmable input/output peripherals. Program memory in the form of ferroelectric RAM, NOR flash memory or OTP ROM as well as a small amount of RAM are often included on the chip. In contrast to microprocessors used in personal computers or other general-purpose applications composed of various discrete chips, microcontrollers may be used in embedded applications.

As used herein, the term controller or microcontroller may be a stand-alone IC or chip device that interfaces with peripheral devices. This may be a link between two components of a computer or a controller on an external device for managing the operation of (and connection to) the device.

In one aspect, the processor may be an on-chip memory such as L M4F230H5QR ARMCortex-M4F processor core available from Texas Instruments, which includes 256KB of single cycle flash memory or other non-volatile memory (up to 40MHZ), a prefetch buffer to improve performance beyond 40MHz, 32KB of single cycle Serial Random Access Memory (SRAM) loaded with 32KB, a processor such as those provided by Texas Instruments under the trade name ARM CortexInternal Read Only Memory (ROM) in software, Electrically Erasable Programmable Read Only Memory (EEPROM) in 2KB, one or more Pulse Width Modulation (PWM) modules, one or more Quadrature Encoder Input (QEI) analog, one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, and other features readily available.

In one example, the processor may include a safety controller that includes two series based controllers, such as TMS570 and RM4x, also available from Texas Instruments under the trade name Hercules ARMCortex R4. The safety controller may be configured specifically for IEC 61508 and ISO 26262 safety critical applications, etc., to provide advanced integrated safety features while delivering scalable performance, connectivity, and memory options.

As used in any aspect herein, the term "logic" may refer to an application, software, firmware, and/or circuitry configured to be capable of performing any of the foregoing operations. The software may be embodied as a software package, code, instructions, instruction sets, and/or data recorded on a non-transitory computer-readable storage medium. Firmware may be embodied as code, instructions or instruction sets and/or data that are hard-coded (e.g., non-volatile) in a memory device.

As used in any aspect herein, the terms "device," "system," "module," and the like can refer to a computer-related entity, either hardware, a combination of hardware and software, or software in execution.

An "algorithm," as used in any aspect herein, is a self-consistent sequence of steps leading to a desired result, wherein "step" refers to the manipulation of physical quantities and/or logical states which may (but are not necessarily) take the form of electrical or magnetic signals capable of being stored, transferred, combined, compared, and otherwise manipulated. And are used to refer to these signals as bits, values, elements, symbols, characters, terms, numbers, or the like. These and similar terms may be associated with the appropriate physical quantities and are merely convenient labels applied to these quantities and/or conditions.

The communication devices may be capable of communicating with each other using a frame relay communication protocol, the frame relay communication protocol may be capable of communicating with each other using an international telephone and telephone negotiation committee (CCITT) and/or a standard promulgated by the American National Standards Institute (ANSI), the transceivers may be capable of communicating with each other using an Asynchronous Transfer Mode (ATM) communication protocol, the ATM communication protocol may be capable of communicating with each other using a packet switched network, the communication devices may be capable of communicating with each other using a selected packet switched network communication protocol, one exemplary communication protocol may include an Ethernet communication protocol that may allow communication using the Transmission control protocol/Internet protocol (TCP/IP), the Ethernet protocol may conform to or be compatible with the Ethernet standard entitled "IEEE 802.3 standard" promulgated by the institute of Electrical and electronics Engineers 12 and/or a higher version of the standard.

Unless specifically stated otherwise as apparent from the above discussion, it is appreciated that throughout the above disclosure, discussions utilizing terms such as "processing," "computing," "calculating," "determining," "displaying" or the like, refer to the action and processes of a computer system, or similar electronic computing device, that manipulates and transforms data represented as physical (electronic) quantities within the computer system's registers and memories into other data similarly represented as physical quantities within the computer system memories or registers or other such information storage, transmission or display devices.

One or more components may be referred to herein as "configured to be able," "configurable to be able," "operable," "adapted/adaptable," "able," "conformable/conformable," or the like. Those skilled in the art will recognize that "configured to be able to" may generally encompass components in an active state and/or components in an inactive state and/or components in a standby state unless the context indicates otherwise.

The terms "proximal" and "distal" are used herein with respect to a clinician manipulating a handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician and the term "distal" refers to the portion located away from the clinician. It will also be appreciated that for simplicity and clarity, spatial terms such as "vertical," "horizontal," "up," "down," "left," and "right" may be used herein in connection with the figures. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

The modular device includes modules (as described in connection with fig. 3 and 9) that can be housed within a surgical hub and surgical devices or instruments that can be connected to the various modules for connection or mating with a corresponding surgical hub. Modular devices include, for example, smart surgical instruments, medical imaging devices, suction/irrigation devices, smoke ejectors, energy generators, respirators, insufflators, and displays. The modular devices described herein may be controlled by a control algorithm. The control algorithms may be executed on the modular devices themselves, on a surgical hub paired with a particular modular device, or on both the modular devices and the surgical hub (e.g., via a distributed computing architecture). In some examples, the control algorithm of the modular device controls the device based on data sensed by the modular device itself (i.e., by sensors in, on, or connected to the modular device). This data may be related to the patient being operated on (e.g., tissue characteristics or insufflation pressure) or the modular device itself (e.g., rate at which the knife is advanced, motor current, or energy level). For example, the control algorithm of a surgical stapling and severing instrument may control the rate at which the motor of the instrument drives its knife through tissue based on the resistance encountered by the knife as it advances.

Those skilled in the art will recognize that, in general, terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are generally intended as "open" terms (e.g., the term "including" should be interpreted as "including but not limited to," the term "having" should be interpreted as "having at least," the term "includes" should be interpreted as "includes but is not limited to," etc.). It will be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases "at least one" and "one or more" to introduce claims. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles "a" or "an" limits any particular claim containing such introduced claim recitation to claims containing only one such recitation, even when the same claim includes the introductory phrases "one or more" or "at least one" and indefinite articles such as "a" or "an" (e.g., "a" and/or "an" should typically be interpreted to mean "at least one" or "one or more"); this also applies to the use of definite articles used to introduce claim recitations.

In addition, even if a specific number of an introduced claim recitation is explicitly recited, those skilled in the art will recognize that such recitation should typically be interpreted to mean at least the recited number (e.g., the bare recitation of "two recitations," without other modifiers, typically means at least two recitations, or two or more recitations). Further, in those instances where a convention analogous to "at least one of A, B and C, etc." is used, in general such a construction is intended to have a meaning that one of ordinary skill in the art would understand the convention (e.g., "a system having at least one of A, B and C" would include, but not be limited to, systems having a alone, B alone, C, A and B together alone, a and C together, B and C together, and/or A, B and C together, etc.). In those instances where a convention analogous to "A, B or at least one of C, etc." is used, in general such a construction is intended to have a meaning that one of skill in the art would understand the convention (e.g., "a system having at least one of A, B or C" would include but not be limited to systems having a alone, B alone, C, A and B together alone, a and C together, B and C together, and/or A, B and C together, etc.). It will also be understood by those within the art that, in general, disjunctive words and/or phrases having two or more alternative terms, whether appearing in the detailed description, claims, or drawings, should be understood to encompass the possibility of including one of the terms, either of the terms, or both terms, unless the context indicates otherwise. For example, the phrase "a or B" will generally be understood to include the possibility of "a" or "B" or "a and B".

Those skilled in the art will appreciate from the appended claims that the operations recited therein may generally be performed in any order. In addition, while the various operational flow diagrams are presented in one or more sequences, it should be understood that the various operations may be performed in other sequences than those shown, or may be performed concurrently. Examples of such alternative orderings may include overlapping, interleaved, interrupted, reordered, incremental, preliminary, complementary, simultaneous, reverse, or other altered orderings, unless context dictates otherwise. Furthermore, unless the context dictates otherwise, terms like "responsive," "related," or other past adjectives are generally not intended to exclude such variations.

It is worthy to note that any reference to "an aspect," "an example" means that a particular feature, structure, or characteristic described in connection with the aspect is included in at least one aspect. Thus, the appearances of the phrases "in one aspect," "in an example" in various places throughout this specification are not necessarily all referring to the same aspect. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more aspects.

Any patent applications, patents, non-patent publications or other published materials mentioned in this specification and/or listed in any application data sheet are herein incorporated by reference, to the extent that the incorporated materials are not inconsistent herewith. Thus, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.

In summary, a number of benefits resulting from employing the concepts described herein have been described. The foregoing detailed description of one or more forms has been presented for purposes of illustration and description. It 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. The form or forms selected and described are to be illustrative of the principles and practical applications to thereby enable one of ordinary skill in the art to utilize the form or forms and various modifications as are suited to the particular use contemplated. The claims as filed herewith are intended to define the full scope.

Various aspects of the subject matter described herein are set forth in the following numbered examples:

example 1: a surgical system, comprising: a monopolar energy generator; a surgical instrument electrically coupled to a monopolar energy generator comprising an electrode and configured to transmit electrosurgical energy through the electrode to tissue of a patient at a surgical site; at least one detection circuit configured to be capable of: measuring an amount of electrical conduction in a return path of the electrosurgical energy; determining that the amount of conductivity in the return path falls below a predetermined threshold; and transmitting a signal to cause the monopolar generator to increase current leakage in the surgical system by increasing the frequency of the alternating current in the generation of the electrosurgical energy; wherein the monopolar energy generator comprises a sensor configured to be able to determine that a monopolar energy circuit is complete by detecting that the current leakage has reached a ground terminal in the monopolar energy generator.