Method for compressing tissue within a suturing device and simultaneously displaying the position of the tissue within the jaws

Abstract

A method for compressing tissue during a surgical procedure is disclosed. The method includes obtaining a surgical instrument including an end effector, wherein the end effector includes a first jaw and a second jaw; establishing a communication path between the surgical instrument and a surgical hub; and inserting the surgical instrument into a surgical site. The method also includes compressing tissue between the first jaw and the second jaw; determining a position of the compressed tissue relative to at least one of the first jaw and the second jaw; transmitting the determined position of the compressed tissue to the surgical hub; and displaying the determined position of the compressed tissue on a visual feedback device.

Description

[0001] Cross-references to related applications

[0002] This application is entitled to U.S. Provisional Patent Application No. 62 / 773,778, filed November 30, 2018, entitled "METHOD FOR ADAPTIVE CONTROL SCHEMES FOR SURGICAL NETWORK CONTROL AND INTERACTION," filed November 30, 2018, entitled "METHOD FOR SITUATIONAL AWARENESS FOR SURGICAL NETWORK OR SURGICAL NETWORK CONNECTEDDEVICE CAPABLE OF ADJUSTING FUNCTION BASED ON A SENSED SITUATION OR USAGE," filed November 30, 2018, entitled "METHOD FOR FACILITYDATA COLLECTION AND Priority is claimed in U.S. Provisional Patent Application No. 62 / 773,741 entitled “Interpretation” and U.S. Provisional Patent Application No. 62 / 773,742 entitled “METHOD FOR CIRCULAR STAPLER CONTROL ALGORITHM ADJUSTMENTBASED ON SITUATIONAL AWARENESS”, filed November 30, 2018, the entire disclosure of each of these provisional patent applications of which is incorporated herein by reference.

[0003] This application also claims priority to U.S. Provisional Patent Application No. 62 / 750,529, filed October 25, 2018, entitled “METHOD FOR OPERATING A POWERED ARTICULATING MULTI-CLIP APPLIER”; U.S. Provisional Patent Application No. 62 / 750,539, filed October 25, 2018, entitled “SURGICAL CLIP APPLIER”; and U.S. Provisional Patent Application No. 62 / 750,555, filed October 25, 2018, entitled “SURGICAL CLIP APPLIER”, the entire disclosure of which is incorporated herein by reference.

[0004] This application also claims, pursuant to 35 U.S.C., 119(e), U.S. Provisional Patent Application 62 / 729,183, filed September 10, 2018, entitled “CONTROL FOR A SURGICAL NETWORK OR SURGICAL NETWORK CONNECTED DEVICETHAT ADJUSTS ITS FUNCTION BASED ON A SENSED SITUATION OR USAGE”; U.S. Provisional Patent Application 62 / 729,177, filed September 10, 2018, entitled “AUTOMATED DATA SCALING, ALIGNMENT, AND ORGANIZING BASED ON PREDEFINED PARAMETERS WITHIN A SURGICAL NETWORK FOR TRANSMISSION”; and U.S. Provisional Patent Application 62 / 729,177, filed September 10, 2018, entitled “INDIRECT COMMAND AND CONTROL OF A FIRST OPERATING ROOM SYSTEM THROUGH”. U.S. Provisional Patent Application 62 / 729,176, filed on September 10, 2018, entitled "Powered stapping device that is identifiable of adjudicating force, advance speed, and overall stroke of cutting member of the device based on a sensed parallel of firing or clapping," is titled "Powered stapping device that is identifiable of adjudicating force, advance speed, and overall stroke of cutting member of the device based on a sensed parallel of firing or clapping."U.S. Provisional Patent Application No. 62 / 729,184, filed September 10, 2018, entitled “POWERED SURGICAL TOOL WITH APREDEFINED ADJUSTABLE CONTROL ALGORITHM FOR CONTROLLING AT LEAST ONE ENDEFFECTOR PARAMETER AND A MEANS FOR LIMITING THE ADJUSTMENT”; U.S. Provisional Patent Application No. 62 / 729,182, filed September 10, 2018, entitled “SENSING THE PATIENT POSITION AND CONTACT UTILIZING THE MONO-POLAR RETURN PAD ELECTRODE TO PROVIDE SITUATIONAL AWARENESS TO THE HUB”; and U.S. Provisional Patent Application No. 62 / 729,182, filed September 10, 2018, entitled “SURGICAL NETWORK RECOMMENDATIONS FROM REAL TIME ANALYSIS OF PROCEDUREVARIABLES AGAINST A Priority is claimed in U.S. Provisional Patent Application 62 / 729,191, entitled “Baseline Highlighting Differences from the Optimal Solution”, filed September 10, 2018; U.S. Provisional Patent Application 62 / 729,195, entitled “Ultrasonice Nergy Device Which Varies Pressure Applied by Clamp Arm to Provide Threshold Control Pressure at a Cut Program Location”; and U.S. Provisional Patent Application 62 / 729,186, filed September 10, 2018, entitled “Wireles Pairing of a SURGICAL Device with an Other Device with a Sterile SURGICAL Field Based on the USAGE ANDSITUATIONAL AWARENESS OF Devices”, the entire disclosure of each of these provisional patent applications is incorporated herein by reference.

[0005] This application, pursuant to Title 35, Section 119(e) of the United States Code, also claims U.S. Provisional Patent Application No. 62 / 721,995, filed August 23, 2018, entitled “CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUELOCATION”; U.S. Provisional Patent Application No. 62 / 721,998, filed August 23, 2018, entitled “SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS”; U.S. Provisional Patent Application No. 62 / 721,999, filed August 23, 2018, entitled “INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING”; and U.S. Provisional Patent Application No. 62 / 721,999, filed August 23, 2018, entitled “BIPOLARCOMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON”. Priority is claimed in U.S. Provisional Patent Application No. 62 / 721,994 entitled “ENERGY MODALITY” and U.S. Provisional Patent Application No. 62 / 721,996 entitled “RADIOFREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS”, filed August 23, 2018, the entire disclosure of each of these provisional patent applications of which is incorporated herein by reference.

[0006] This patent application also claims priority to U.S. Provisional Patent Application No. 62 / 692,747, entitled “SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE,” filed June 30, 2018; U.S. Provisional Patent Application No. 62 / 692,748, entitled “SMART ENERGY ARCHITECTURE,” filed June 30, 2018; and U.S. Provisional Patent Application No. 62 / 692,768, entitled “SMART ENERGY DEVICES,” filed June 30, 2018, the entire disclosure of each of which is incorporated herein by reference.

[0007] This application also claims, pursuant to Title 35, Section 119(e) of the United States Code, U.S. Provisional Patent Application No. 62 / 691,228, filed June 28, 2018, entitled "Method of using reinforced flex circuits with multiple sensors with electrosurgical devices"; U.S. Provisional Patent Application No. 62 / 691,227, filed June 28, 2018, entitled "controlling a surgical instrument according to sensed closure parameters"; U.S. Provisional Patent Application No. 62 / 691,230, filed June 28, 2018, entitled "SURGICALINSTRUMENT HAVING A FLEXIBLE ELECTRODE"; U.S. Provisional Patent Application No. 62 / 691,219, filed June 28, 2018, entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL"; and U.S. Provisional Patent Application No. 62 / 691,219, filed June 28, 2018, entitled "COMMUNICATION OF Priority is claimed to U.S. Provisional Patent Application 62 / 691,257, entitled "SMOKEEVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM", U.S. Provisional Patent Application 62 / 691,262, entitled "SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE", filed June 28, 2018, and U.S. Provisional Patent Application 62 / 691,251, entitled "DUAL IN-SERIES LARGE AND SMALLDROPLET FILTERS", filed June 28, 2018, the entire disclosure of each of these provisional patent applications is incorporated herein by reference.

[0008] This application requests, pursuant to U.S. Provisional Patent Application No. 62 / 665,129 entitled "SURGICAL SUTURING SYSTEMS", filed May 1, 2018, entitled "SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS", filed May 1, 2018, entitled "SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS", filed May 1, 2018, entitled "SURGICAL INSTRUMENTS COMPRISING HANDLEARRANGEMENTS", filed May 1, 2018, entitled "SURGICAL INSTRUMENTS COMPRISING HANDLEARRANGEMENTS", filed May 1, 2018, entitled "MODULARSURGICAL INSTRUMENTS", filed May 1, 2018, entitled "SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS", filed May 1, 2018, entitled "SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS", filed May 1, 2018, entitled "SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS", filed May 1, 2018, entitled "SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS", filed May 1, 2018, entitled "SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS", filed May 1, 2018, entitled "SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS", filed May 1, 2018, entitled "SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS" The disclosures of each of the following provisional patent applications are incorporated herein by reference in their entirety: U.S. Provisional Patent Application No. 62 / 665,192 entitled “Dissectors” and U.S. Provisional Patent Application No. 62 / 665,134 entitled “SURGICAL CLIP APPLIER”, filed May 1, 2018.

[0009] This application also claims priority to U.S. Provisional Patent Application 62 / 659,900, filed April 19, 2018, entitled “METHOD OF HUB COMMUNICATION,” the entire disclosure of which is incorporated herein by reference.

[0010] This application also claims, pursuant to 35 U.S.C., 119(e), U.S. Provisional Patent Application No. 62 / 650,898, filed March 30, 2018, entitled “CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS”; U.S. Provisional Patent Application No. 62 / 650,887, filed March 30, 2018, entitled “SURGICAL SYSTEMS WITHOPTIMIZED SENSING CAPABILITIES”; U.S. Provisional Patent Application No. 62 / 650,882, filed March 30, 2018, entitled “SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM”; and U.S. Provisional Patent Application No. 62 / 650,882, filed March 30, 2018, entitled “SURGICAL SMOKE EVACUATION SENSING AND Priority is claimed in U.S. Provisional Patent Application No. 62 / 650,877, entitled “CONTROLS”, the full disclosure of each of which is incorporated herein by reference.

[0011] This application also claims, pursuant to Title 35, Section 119(e) of the United States Code, U.S. Provisional Patent Application No. 62 / 649,302, filed March 28, 2018, entitled “Interactive Surgical Systems with Encrypted Communications Capables”; U.S. Provisional Patent Application No. 62 / 649,294, filed March 28, 2018, entitled “Datastripping Method to Interrogate Patient Records and Create an Anoymized Record”; U.S. Provisional Patent Application No. 62 / 649,300, filed March 28, 2018, entitled “Surgical Humanisational Awarenless”; and U.S. Provisional Patent Application No. 62 / 649,300, filed March 28, 2018, entitled “Surgical Hub Spatial Awarenless to Determinine Devices in Operating”. U.S. Provisional Patent Application No. 62 / 649,309 entitled “THATER”, filed March 28, 2018; U.S. Provisional Patent Application No. 62 / 649,310 entitled “COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS”, filed March 28, 2018; U.S. Provisional Patent Application No. 62 / 649,291 entitled “USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT”, filed March 28, 2018; U.S. Provisional Patent Application No. 62 / 649,296 entitled “ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES”, filed March 28, 2018; and U.S. Provisional Patent Application No. 62 / 649,296 entitled “CLOUD-BASED MEDICALANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A”, filed March 28, 2018. U.S. Provisional Patent Application No. 62 / 649,333, filed on March 28, 2018, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES",327, U.S. Provisional Patent Application No. 62 / 649,315, filed March 28, 2018, entitled “DATA HANDLING AND PRIORITIZATION IN ACLOUD ANALYTICS NETWORK”; U.S. Provisional Patent Application No. 62 / 649,313, filed March 28, 2018, entitled “CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES”; U.S. Provisional Patent Application No. 62 / 649,320, filed March 28, 2018, entitled “DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”; and U.S. Provisional Patent Application No. 62 / 649,320, filed March 28, 2018, entitled “AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL”. The priority interests of U.S. Provisional Patent Application No. 62 / 649,307 entitled “PLTFORMS” and U.S. Provisional Patent Application No. 62 / 649,323 entitled “SENSING ARRANGEMENTS FORROBOT-ASSISTED SURGICAL PLATFORMS”, filed March 28, 2018, the entire disclosure of each of these provisional patent applications is incorporated herein by reference.

[0012] This application also claims priority to U.S. Provisional Patent Application No. 62 / 611,341, entitled “INTERACTIVE SURGICAL PLATFORM”, filed December 28, 2017; U.S. Provisional Patent Application No. 62 / 611,340, entitled “CLOUD-BASED MEDICAL ANALYTICS”, filed December 28, 2017; and U.S. Provisional Patent Application No. 62 / 611,339, entitled “ROBOT ASSISTED SURGICAL PLATFORM”, filed December 28, 2017, the entire disclosure of each of which is incorporated herein by reference. Background Technology

[0013] This disclosure relates to various surgical systems. Summary of the Invention

[0014] In one aspect, a method for compressing tissue during surgical procedures is provided. The method includes: obtaining a surgical instrument including an end effector, wherein the end effector includes a first jaw and a second jaw; establishing a communication path between the surgical instrument and a surgical hub; inserting the surgical instrument into a surgical site; compressing tissue between the first jaw and the second jaw; determining the position of the compressed tissue relative to at least one of the first jaw and the second jaw; transmitting the determined position of the compressed tissue to the surgical hub; and displaying the determined position of the compressed tissue on a visual feedback device.

[0015] In another aspect, a method for compressing tissue during surgical procedures. The method includes: inserting a surgical instrument including an end effector into a surgical site, wherein the end effector includes a first jaw and a second jaw; compressing tissue between the first jaw and the second jaw; determining the location of the compressed tissue within the surgical site; transmitting the determined location of the compressed tissue to a surgical hub; and displaying the determined location of the compressed tissue on a display.

[0016] In another aspect, a method for grasping tissue during surgical procedures. The method includes: obtaining a surgical instrument including an end effector, wherein the end effector includes a first jaw and a second jaw; establishing a communication path between the surgical instrument and a surgical hub; grasping tissue between the first jaw and the second jaw; determining the position of the grasped tissue relative to at least one of the first jaw and the second jaw; transmitting the determined position of the grasped tissue to the surgical hub; and displaying the determined position of the grasped tissue on a visual feedback display. Attached Figure Description

[0017] The features of each aspect are specifically described in the appended claims. However, the aspects (related to surgical tissues and methods) and their further purposes and advantages can be best understood by referring to the following description in conjunction with the accompanying drawings.

[0018] Figure 1 This is a block diagram of a computer-implemented interactive surgical system according to at least one aspect of the present disclosure.

[0019] Figure 2 A surgical system for performing surgical procedures in an operating room, according to at least one aspect of this disclosure.

[0020] Figure 3 A surgical hub for pairing with a visualization system, a robotic system, and a smart device, according to at least one aspect of this disclosure.

[0021] Figure 4A partial perspective view of a surgical hub housing and a combined generator module slidably housed in a drawer of the surgical hub housing, according to at least one aspect of this disclosure.

[0022] Figure 5 A perspective view of a combined generator module having bipolar, ultrasonic, and monopolar contacts and a smoke extraction component according to at least one aspect of this disclosure.

[0023] Figure 6 A separate power bus attachment is shown for a plurality of lateral docking ports of a lateral modular housing according to at least one aspect of the present disclosure, the lateral modular housing being configured to accommodate a plurality of modules.

[0024] Figure 7 A vertical modular housing configured to accommodate multiple modules is shown according to at least one aspect of this disclosure.

[0025] Figure 8 A surgical data network including a modular communication hub, according to at least one aspect of this disclosure, is shown. The modular communication hub is configured to connect modular devices located in one or more operating rooms of a medical facility or any room in a medical facility dedicated to surgical procedures to the cloud.

[0026] Figure 9 An interactive surgical system implemented by a computer according to at least one aspect of this disclosure.

[0027] Figure 10 A surgical hub comprising multiple modules coupled to a modular control tower is shown according to at least one aspect of this disclosure.

[0028] Figure 11 One aspect of a Universal Serial Bus (USB) network hub device according to at least one aspect of the present disclosure is shown.

[0029] Figure 12 A logic diagram of a control system for a surgical instrument or tool according to at least one aspect of this disclosure is shown.

[0030] Figure 13 A control circuit configured to control various aspects of a surgical instrument or tool, according to at least one aspect of this disclosure, is shown.

[0031] Figure 14 A combinational logic circuit configured to control various aspects of a surgical instrument or tool, according to at least one aspect of the present disclosure, is shown.

[0032] Figure 15 A timing logic circuit configured to control various aspects of a surgical instrument or tool, according to at least one aspect of the present disclosure, is shown.

[0033] Figure 16 A surgical instrument or tool comprising a plurality of motors is shown according to at least one aspect of the present disclosure, the motors being activating to perform various functions.

[0034] Figure 17 This is a schematic diagram of a robotic surgical instrument configured to operate the surgical tools described herein, according to at least one aspect of this disclosure.

[0035] Figure 18 A block diagram of a surgical instrument programmed to control distal translation of a displacement member, according to at least one aspect of the present disclosure, is shown.

[0036] Figure 19 This is a schematic diagram of a surgical instrument configured to control various functions according to at least one aspect of this disclosure.

[0037] Figure 20 A stroke length graph is provided to illustrate an example of a control system that modifies the stroke length of a clamping assembly based on the joint motion angle.

[0038] Figure 21 A positioning curve of a closed tube assembly is shown as an example of a control system that modifies the longitudinal position of a closed tube assembly based on joint motion angles.

[0039] Figure 22 To compare suturing methods that utilize controlled tissue compression with those that do not.

[0040] Figure 23 The force graph shown in Part A and the corresponding displacement graph shown in Part B are shown, wherein the force graph and the displacement graph have an x-axis that defines time, the y-axis of the displacement graph defines the travel displacement of the firing link, and the y-axis of the force graph defines the torque sensed on the motor that is configured to propel the firing link.

[0041] Figure 24 This is a schematic diagram of a tissue contact circuit that shows the completion of the circuit when a pair of spaced-apart contact plates come into contact with tissue.

[0042] Figure 25 A perspective view of a surgical instrument having interchangeable shaft assemblies operatively coupled thereto, according to at least one aspect of this disclosure.

[0043] Figure 26 For at least one aspect of this disclosure Figure 25 A breakdown and assembly diagram of a part of a surgical instrument.

[0044] Figure 27An exploded component view of the portions of an interchangeable shaft assembly according to at least one aspect of this disclosure.

[0045] Figure 28 For at least one aspect of this disclosure Figure 25 An exploded view of the end effector of a surgical instrument.

[0046] Figure 29A For at least one aspect of this disclosure Figure 25 A block diagram of the control circuit for a surgical instrument spanning two pages.

[0047] Figure 29B For at least one aspect of this disclosure Figure 25 A block diagram of the control circuit for a surgical instrument spanning two pages.

[0048] Figure 30 For at least one aspect of this disclosure Figure 25 A block diagram of the control circuitry for a surgical instrument, showing the interfaces between the handle assembly and the power assembly, and between the handle assembly and the interchangeable shaft assembly.

[0049] Figure 31 An exemplary medical device that may include one or more aspects of this disclosure is described.

[0050] Figure 32 An exemplary end effector of a medical device surrounding an organization is depicted according to one or more aspects of this disclosure.

[0051] Figure 33 An exemplary end effector of a medical device for compressing tissue according to one or more aspects of this disclosure is depicted.

[0052] Figure 34 An exemplary force is depicted by an end effector of a medical device for compressing tissue, according to one or more aspects of this disclosure.

[0053] Figure 35 Exemplary forces applied by an end effector of a medical device for compressing tissue, according to one or more aspects of this disclosure, are also depicted.

[0054] Figure 36 An exemplary tissue compression sensor system according to one or more aspects of this disclosure is described.

[0055] Figure 37 Exemplary tissue compression sensor systems according to one or more aspects of this disclosure are also described.

[0056] Figure 38 Exemplary tissue compression sensor systems according to one or more aspects of this disclosure are also described.

[0057] Figure 39 Also, there are exemplary circuit diagrams according to one or more aspects of this disclosure.

[0058] Figure 40 Also, there are exemplary circuit diagrams according to one or more aspects of this disclosure.

[0059] Figure 41 A graph depicting exemplary frequency modulation according to one or more aspects of this disclosure is provided.

[0060] Figure 42 A graph depicting a composite RF signal according to one or more aspects of this disclosure.

[0061] Figure 43 A graph depicting a filtered RF signal according to one or more aspects of this disclosure.

[0062] Figure 44 A perspective view of a surgical instrument with interchangeable shafts capable of joint movement.

[0063] Figure 45 This is a side view of the end of a surgical instrument.

[0064] Figures 46 to 50 To plot the gap size as it changes over time ( Figure 46 ), firing current varying with time ( Figure 47 Tissue compression over time () Figure 48 Anvil strain as a function of time Figure 49 ) and the triggering force that changes over time ( Figure 50 The curve graph of ).

[0065] Figure 51 To plot a curve showing how tissue compression changes with tissue displacement for normal tissue.

[0066] Figure 52 To plot the changes in tissue compression as tissue displacement occurs, thus distinguishing between normal and diseased tissue.

[0067] Figure 53 An embodiment of an end effector including a first sensor and a second sensor is shown.

[0068] Figure 54 To illustrate the use of based on from Figure 53 The diagram shows a logic diagram of one implementation of the process of adjusting the measurement results of the first sensor by using the input of the second sensor of the end effector shown.

[0069] Figure 55A logic diagram is shown for one embodiment of the process for determining the lookup table of the first sensor based on input from the second sensor.

[0070] Figure 56 A logic diagram is shown for one embodiment of the process of calibrating the first sensor in response to input from the second sensor.

[0071] Figure 57 A logic diagram illustrating one embodiment of a process for determining and displaying the thickness of a tissue segment held between the anvil and the cartridge of an end effector.

[0072] Figure 58 A logic diagram illustrating one embodiment of a process for determining and displaying the thickness of a tissue segment held between the anvil and the cartridge of an end effector.

[0073] Figure 59 A graph showing the adjusted Hall effect thickness measurement results compared to the unmodified Hall effect thickness measurement results.

[0074] Figure 60 An embodiment of an end effector including a first sensor and a second sensor is shown.

[0075] Figure 61 An embodiment of an end effector including a first sensor and multiple second sensors is shown.

[0076] Figure 62 A logic diagram is shown for one embodiment of a process for adjusting the measurement results of a first sensor in response to a plurality of second sensors.

[0077] Figure 63 An embodiment of a circuit configured to convert signals from a first sensor and a plurality of second sensors into digital signals that can be received by a processor is shown.

[0078] Figure 64 An embodiment of an end effector including multiple sensors is shown.

[0079] Figure 65 A logic diagram is shown for one implementation of a process for determining one or more tissue characteristics based on multiple sensors.

[0080] Figure 66 An embodiment of an end effector including multiple sensors coupled to a second jaw member is shown.

[0081] Figure 67 An embodiment of a staple cartridge comprising multiple sensors integrally formed therein is shown.

[0082] Figure 68 A logic diagram illustrating one embodiment of a process for determining one or more parameters of an tissue segment held within an end effector.

[0083] Figure 69 An embodiment of an end effector including multiple redundant sensors is shown.

[0084] Figure 70 A logic diagram is shown for one implementation of the process for selecting the most reliable output from multiple redundant sensors.

[0085] Figure 71 An embodiment of an end effector including a sensor is shown, the sensor including a specific sampling rate to limit or eliminate spurious signals.

[0086] Figure 72 A logic diagram illustrating one embodiment of the process for generating thickness measurements of a tissue segment positioned between the anvil and the cartridge of an end effector.

[0087] Figure 73 and Figure 74 An embodiment of an end effector including sensors for identifying different types of staple cartridges is shown.

[0088] Figure 75 One aspect of a segmented flexible circuit, according to at least one aspect of the present disclosure, configured to be fixedly attached to a jaw member of an end effector, is shown.

[0089] Figure 76 One aspect of a segmented flexible circuit, configured to be mounted to a jaw member of an end effector, is shown according to at least one aspect of the present disclosure.

[0090] Figure 77 An aspect of an end effector configured to measure the interstitial space GT according to at least one aspect of the present disclosure is shown.

[0091] Figure 78 An aspect of an end effector comprising segmented flexible circuitry according to at least one aspect of the present disclosure is shown.

[0092] Figure 79 At least one aspect of this disclosure is shown. Figure 78 The end effector shown in the figure has a jaw member that clamps tissue between the jaw member and the staple cartridge.

[0093] Figure 80A diagram of an absolute positioning system for a surgical instrument according to at least one aspect of the present disclosure, wherein the absolute positioning system includes a controlled motor drive circuit arrangement that includes a sensor arrangement.

[0094] Figure 81 A diagram of a position sensor according to at least one aspect of this disclosure, the position sensor comprising a magnetic rotational absolute positioning system.

[0095] Figure 82 This is a cross-sectional view of an end effector of a surgical instrument according to at least one aspect of the present disclosure, showing the stroke of a firing member relative to tissue held within the end effector.

[0096] Figure 83 The first graph of two closing force (FTC) curves (which depicts the forces applied to the closing member during the closing phase to close the thick and thin tissues) and the second graph of two firing force (FTF) curves (which depicts the forces applied to the firing member during the firing phase to fire through the thick and thin tissues).

[0097] Figure 84 As shown in the diagram of a control system according to at least one aspect of the present disclosure, the control system is configured to provide gradual closing of the closing member during the firing stroke as the firing member is advanced distally and engaged with the clamping arm, so as to reduce the closing force load on the closing member and reduce the firing force load on the firing member at a desired rate.

[0098] Figure 85 A proportional-integral-derivative (PID) controller feedback control system according to at least one aspect of this disclosure is shown.

[0099] Figure 86 A logic flowchart depicting a control program or logic configuration for determining the speed of a closing member, according to at least one aspect of this disclosure.

[0100] Figure 87 A timeline for describing the situational awareness of a surgical hub according to at least one aspect of this disclosure.

[0101] Figure 88 A block diagram of a surgical system configured to control surgical functions according to at least one aspect of the present disclosure is shown.

[0102] Figure 89 A block diagram of a situation-aware surgical system configured to control surgical functions according to at least one aspect of this disclosure is shown.

[0103] Figure 90A logic flowchart depicting a situation-aware algorithm for controlling surgical functions, according to at least one aspect of this disclosure.

[0104] Figure 91 A logic flowchart depicting an algorithm for controlling surgical functions, according to at least one aspect of this disclosure.

[0105] Figure 92 The illustration shows a portion of patient tissue comprising a tumor and a surgical margin defined relative to the tumor, according to at least one aspect of this disclosure.

[0106] Figure 93 A logic flowchart depicting a control program or logic configuration process for solving a device selection problem, according to at least one aspect of this disclosure.

[0107] Figure 94 A block diagram of a surgical system configured to determine the suitability of surgical instruments based on device parameters and sensed parameters, according to at least one aspect of the present disclosure, is shown.

[0108] Figure 95 A block diagram of a surgical instrument according to at least one aspect of this disclosure is shown.

[0109] Figure 96 A logic flowchart of a process for controlling a surgical instrument based on the integrity of the clamped tissue, according to at least one aspect of this disclosure, is shown.

[0110] Figure 97 A first graph depicting the force for closure of an exemplary firing end effector for a surgical instrument, according to at least one aspect of this disclosure, is shown as a function of time.

[0111] Figure 98 A second graph depicting the force for closure of an exemplary firing end effector for a surgical instrument, according to at least one aspect of this disclosure, is shown as a function of time.

[0112] Figure 99 A logic flowchart of a process for controlling a surgical instrument according to at least one aspect of the present disclosure based on the physiological type of the clamped tissue is shown.

[0113] Figure 100A A side front view of an end effector gripping a substance according to at least one aspect of the present disclosure is shown, wherein the end effector is in an initial contact position with the substance.

[0114] Figure 100B A side front view of an end effector gripping a substance according to at least one aspect of the present disclosure is shown, wherein the end effector is in a closed state.

[0115] Figure 101A A side front view of an end effector grasping a blood vessel according to at least one aspect of the present disclosure is shown, wherein the end effector is in an initial contact position with the blood vessel.

[0116] Figure 101B A side front view of an end effector grasping a blood vessel according to at least one aspect of the present disclosure is shown, wherein the end effector is in a closed state.

[0117] Figure 102 A first graph and a second graph, respectively depicting the force and closing speed of an exemplary firing end effector for closing a grasping surgical instrument, are shown according to at least one aspect of this disclosure, representing the changes over time.

[0118] Figure 103 A third and a fourth graph, respectively depicting the force and closure speed of an exemplary firing end actuator for closing a surgical instrument grasping a blood vessel, are shown according to at least one aspect of this disclosure, as a function of time.

[0119] Figure 104 A fifth graph depicting the force and closing speed of an exemplary firing end effector for a surgical instrument for closure as a function of time is shown, according to at least one aspect of this disclosure.

[0120] Figure 105 A fifth graph depicting the force and closing speed of an exemplary firing end effector for a surgical instrument for closure as a function of time is shown, according to at least one aspect of this disclosure.

[0121] Figure 106 A fifth graph depicting the force and closing speed of an exemplary firing end effector for a surgical instrument for closure as a function of time is shown, according to at least one aspect of this disclosure.

[0122] Figure 107 A graph depicting the change of impedance over time is shown according to at least one aspect of this disclosure to determine when the jaws of a surgical instrument contact tissue and / or a staple.

[0123] Figure 108 A first graph depicting various tissue closure thresholds for controlling end effector closure is shown according to at least one aspect of this disclosure.

[0124] Figure 109 A second graph depicting various tissue closure thresholds for controlling end effector closure is shown according to at least one aspect of this disclosure.

[0125] Figure 110A logic flowchart depicting a process for adjusting a control program or logic configuration for a closing rate algorithm, according to at least one aspect of this disclosure.

[0126] Figure 111 A perspective view of the end effector of a curved surgical suturing and cutting instrument comprising a predetermined region, according to at least one aspect of this disclosure, is shown.

[0127] Figure 112 At least one aspect of this disclosure is shown. Figure 111 The end effector of a curved surgical suture and cutting instrument straightens a local cross section, in which tissue is grasped by the end effector.

[0128] Figure 113 A perspective view of the end effector of a surgical suturing and cutting instrument comprising a predetermined region, according to at least one aspect of this disclosure, is shown.

[0129] Figure 114 An organization according to at least one aspect of this disclosure is shown disposed between the jaws of an end effector. Figure 111 The straightening of the local cross-section of the end actuator of the curved surgical suturing and cutting instrument.

[0130] Figure 115 An organization according to at least one aspect of this disclosure is shown disposed between the jaws of an end effector. Figure 111 The straightening of the local cross-section of the end actuator of the curved surgical suturing and cutting instrument.

[0131] Figure 116 An organization according to at least one aspect of this disclosure is shown disposed between the jaws of an end effector. Figure 111 The straightening of the local cross-section of the end actuator of the curved surgical suturing and cutting instrument.

[0132] Figure 117 It shows at least one aspect of the present disclosure. Figure 111 The end effector grips Figure 114 The organization.

[0133] Figure 118 It shows at least one aspect of the present disclosure. Figure 111 The end effector grips Figure 115 The organization.

[0134] Figure 119 It shows at least one aspect of the present disclosure. Figure 111 The end effector grips Figure 116 The organization.

[0135] Figure 120A logic flowchart is shown, according to at least one aspect of this disclosure, depicting a control program or logic configuration for identifying irregularities in tissue distribution within the end effector of a surgical instrument.

[0136] Figure 121 For representations in at least one aspect of this disclosure Figure 111 The graph shows the tissue impedance measurements at three predetermined regions of the end effector over time.

[0137] Figure 122 For the representation of at least one aspect of this disclosure Figure 114 The organization Figure 111 The curves showing the closing force of the end effector and the motor speed of the motor that achieves the closing of the end effector over time.

[0138] Figure 123 For the representation of at least one aspect of this disclosure Figure 115 The organization Figure 111 The curves showing the closing force of the end effector and the motor speed of the motor that achieves the closing of the end effector over time.

[0139] Figure 124 For the representation of at least one aspect of this disclosure Figure 116 The organization Figure 111 The curves showing the closing force of the end effector and the motor speed of the motor that achieves the closing of the end effector over time.

[0140] Figure 125 A control system for a surgical instrument according to at least one aspect of the present disclosure is shown.

[0141] Figure 126 A schematic diagram of a surgical instrument according to at least one aspect of the present disclosure is shown, the surgical instrument using a combination Figures 127 to 129 The benefits of the centering tools and techniques described are centered on the linear nail tangent.

[0142] Figures 127 to 129 The process of aligning the anvil cannula of a circular stapler with the staple overlap portion of a linear staple suture formed by a double-stitching technique, according to at least one aspect of this disclosure, is illustrated, wherein:

[0143] Figure 127 This illustrates that the anvil cannula needle of a circular suture device is not aligned with the overlapping portion of the staples in the linear staple suture formed by the double-stitch technique;

[0144] Figure 128 The anvil cannula of the circular suture device is shown to be aligned with the center of the overlap portion of the staples formed by the double-stitch technique; and

[0145] Figure 129 A centering tool is shown on a surgical suture display showing the staple overlap portion of a linear staple suture formed by a double-suture technique to be removed by a circular stapler, wherein the anvil cannula is not aligned with the staple overlap portion of the double-suture suture, as shown. Figure 127 As shown.

[0146] Figure 130 and Figure 131 The image shows a before-and-after image of a centering tool according to at least one aspect of this disclosure, wherein:

[0147] Figure 130 An image of the projected cutting path of the anvil cannula and circular blade before alignment is shown, with an image of a linear nail line around the target alignment loop on an image of the nail overlap presented on a surgical hub display.

[0148] Figure 131 Images of the projected cutting paths of the anvil cannula and circular blade after alignment are shown, with the target alignment ring surrounding the linear nail line on an image of the nail overlap presented on a surgical hub display.

[0149] Figures 132 to 134 The process of aligning the anvil cannula needle of a circular suture device with the center of the linear stapler according to at least one aspect of this disclosure is shown, wherein:

[0150] Figure 132 This shows that the center of the anvil sleeve needle and the linear staple wire are not aligned;

[0151] Figure 133 This shows the center alignment of the anvil sleeve needle with the linear staple wire;

[0152] Figure 134 A centering tool is shown on a surgical hub display of linear staples, where the anvil cannula is not aligned with the staple overlap portion of the double staple, as shown. Figure 132 As shown.

[0153] Figure 135 An image of a standard tracing field of view of a surgical procedure, such as a linear staple line cross section, displayed on a surgical hub monitor as observed via laparoscopy, according to at least one aspect of this disclosure.

[0154] Figure 136 According to at least one aspect of this disclosure, before the anvil cannula needle and circular blade of the circular stapler are aligned with the center of the linear stapler suture, Figure 135 The image shows the laser-assisted marking field of view of the surgical site.

[0155] Figure 137According to at least one aspect of this disclosure, after the anvil cannula needle and circular blade of the circular stapler are aligned with the center of the linear stapler suture, Figure 136 The image shows the laser-assisted marking field of view of the surgical site.

[0156] Figure 138 A partial perspective view of a circular stapler according to at least one aspect of the present disclosure is shown, illustrating a circular stapler cannula comprising a staple cartridge having four predetermined regions.

[0157] Figure 139 A partial perspective view of a circular stapler according to at least one aspect of the present disclosure is shown, illustrating a circular stapler cannula comprising a staple cartridge having eight predetermined regions.

[0158] Figure 140 This illustrates at least one aspect of the present disclosure, including on the left side, properly set to... Figure 138 The two tissues of the previously deployed staples on the staple cartridge, and the one on the right side including the staples correctly set to... Figure 138 The two organizations that previously deployed nails on the nail pod.

[0159] Figure 141 This illustrates at least one aspect of the present disclosure, including on the left side, properly set to... Figure 138 The organization of previously deployed staples on the staple cartridge, and on the right side including proper setting to... Figure 138 The organization of previously deployed nails on the nail pod.

[0160] Figure 142 The present disclosure illustrates at least one aspect of including correctly setting to Figure 139 The two organizations that previously deployed nails on the nail pod.

[0161] Figure 143 This illustrates at least one aspect of the present disclosure, including improper setting to Figure 139 The two organizations that previously deployed nails on the nail pod.

[0162] Figure 144 A graph depicting at least one aspect of this disclosure. Figure 142 The correct setting of the tissue impedance characteristics.

[0163] Figure 145 A graph depicting at least one aspect of this disclosure. Figure 143 The tissue impedance characteristics of the tissue are set incorrectly.

[0164] Figure 146 The present disclosure illustrates at least one aspect of including correctly setting to Figure 139The organization of previously deployed nails on the nail pod.

[0165] Figure 147 This illustrates at least one aspect of the present disclosure, including improper setting to Figure 139 The organization of previously deployed nails on the nail pod.

[0166] Figure 148 A graph depicting at least one aspect of this disclosure. Figure 146 The correct setting of the tissue impedance characteristics.

[0167] Figure 149 A graph depicting at least one aspect of this disclosure. Figure 147 The tissue impedance characteristics of the tissue are set incorrectly.

[0168] Figure 150 A logical flowchart of a process according to at least one aspect of this disclosure is shown, which depicts a control procedure or logical configuration for correctly positioning previously sutured tissue within an end effector.

[0169] Figure 151 An end effector extending from the axis of a surgical instrument in an open configuration, according to at least one aspect of this disclosure, is shown.

[0170] Figure 152 At least one aspect of this disclosure is shown. Figure 151 An end effector in which a blood vessel (BV) extends between the jaws of the end effector.

[0171] Figure 153 This illustrates an unorganized, closed configuration according to at least one aspect of the present disclosure. Figure 151 End effector.

[0172] Figure 154 At least one aspect of this disclosure is shown. Figure 151 An end effector in which tissue is gripped between the jaws of the end effector.

[0173] Figure 155 An end effector extending from the axis of a surgical instrument in an open configuration, according to at least one aspect of this disclosure, is shown.

[0174] Figure 156 This illustrates an unorganized, closed configuration according to at least one aspect of the present disclosure. Figure 151 End effector.

[0175] Figure 157 At least one aspect of this disclosure is shown. Figure 151An end effector in which tissue is gripped between the jaws of the end effector.

[0176] Figure 158 The image shows a tumor surrounded by healthy tissue according to at least one aspect of this disclosure, and a clearly defined border within the healthy tissue.

[0177] Figure 159 A graph showing the physiological parameters of an organization according to at least one aspect of this disclosure relative to the distance from the tumor.

[0178] Figure 160 The present disclosure provides a logical flowchart of a process according to at least one aspect of the present disclosure, which depicts a control procedure or logical configuration for assessing the proximity of an end effector of a surgical instrument to cancerous tissue.

[0179] Figure 161 A logic flowchart of a process according to at least one aspect of this disclosure is shown, which depicts a control procedure or logic configuration for assessing the proximity of an end effector to cancerous tissue.

[0180] Figure 162 An end effector of a surgical instrument according to at least one aspect of the present disclosure is shown.

[0181] Figure 163 A control system for a surgical instrument according to at least one aspect of the present disclosure is shown.

[0182] Figure 164 A proximity index is shown that associates sensor signals with proximity from an end effector according to at least one aspect of this disclosure.

[0183] Figure 165 The present disclosure provides a logical flowchart of a process according to at least one aspect of the present disclosure, which depicts a control program or logical configuration for determining the orientation of cancerous tissue relative to the end effector.

[0184] Figure 166 A top view of the end effector of a surgical instrument according to at least one aspect of this disclosure is shown.

[0185] Figure 167 A graph plotted over time representing a physiological parameter of an organization according to at least one aspect of this disclosure.

[0186] Figure 168 A partial view of the end effector of a surgical instrument according to at least one aspect of the present disclosure is shown.

[0187] Figure 169 A graph plotted over time representing a physiological parameter of an organization according to at least one aspect of this disclosure.

[0188] Figure 170 The present disclosure provides a logical flowchart of a process according to at least one aspect of the present disclosure, which depicts a control program or logical configuration for providing instructions for a cancer tissue navigation end effector.

[0189] Figure 171 The present disclosure provides a logical flowchart of a process according to at least one aspect of the present disclosure, which depicts a control program or logical configuration for providing instructions for a cancer tissue navigation end effector.

[0190] Figure 172 A graph plotted over time representing a physiological parameter of an organization according to at least one aspect of this disclosure.

[0191] Figure 173 A glucose sensor according to at least one aspect of the present disclosure is shown.

[0192] Figure 174 It shows Figure 173 An extended view of the glucose sensor.

[0193] Figure 175 A graph of current relative to potential is shown according to at least one aspect of this disclosure.

[0194] Figure 176 A graph showing the net current relative to glucose levels according to at least one aspect of this disclosure.

[0195] Figure 177 A perspective view of a pin cartridge including active elements and sensors according to at least one aspect of this disclosure is shown.

[0196] Figure 178 A block diagram of an active sensor assembly according to at least one aspect of this disclosure is shown.

[0197] Figure 179 A logical flowchart of a process for determining an organization type according to at least one aspect of this disclosure is shown.

[0198] Figure 180 A perspective view of a tank including a hydrophobic region according to at least one aspect of this disclosure is shown.

[0199] Figure 181 A perspective view of a container including a pair of data elements according to at least one aspect of this disclosure is shown.

[0200] Figure 182 A block diagram of a sensor assembly for detecting and / or receiving data from data elements associated with a warehouse, according to at least one aspect of this disclosure, is shown.

[0201] Figure 183 A logical flowchart of a process for resolving data identification conflicts according to at least one aspect of this disclosure is shown.

[0202] Figure 184 A block diagram of a circuit including a variable output sensor according to at least one aspect of the present disclosure is shown.

[0203] Figure 185 A logic flowchart of a process for controlling the output mode of a sensor according to at least one aspect of this disclosure is shown.

[0204] Figure 186 An end effector comprising a first sensor and a second sensor is shown according to at least one aspect of the present disclosure.

[0205] Figure 187 A perspective view of an end effector according to at least one aspect of the present disclosure is shown, wherein the anvil is in an open position and includes a plurality of light sources between the proximal and distal ends of the staple cartridge arranged on either side of the cartridge platform. Detailed Implementation

[0206] The applicant of this application owns the following U.S. patent applications filed on December 4, 2018, the disclosure of each of which is incorporated herein by reference in its entirety:

[0207] • The agent's case file number END8495USNP / 170727M, titled "METHOD OF HUB COMMUNICATION, PROCESSING, STORAGE AND DISPLAY";

[0208] • The agent's case file number, END8495USNP1 / 170727-1M, titled "METHOD OF HUB COMMUNICATION";

[0209] • The agent's case file number END8496USNP / 170728M, titled "METHOD OF CLOUD BASED DATA ANALYTICS FOR USE WITH THE HUB";

[0210] • The agent's case file number, END8497USNP / 170729M, is titled "Method of Robotic Hub Communication, Detection, and Control".

[0211] • The agent's case file number END8505USNP / 170772M, titled "METHOD OF HUB COMMUNICATION, PROCESSING, DISPLAY, AND CLOUDANALYTICS";

[0212] • The agent's case file number END8539USNP / 170752M, titled "METHOD OF USING REINFORCED FLEXIBLE CIRCUITS WITH MULTIPLESENSORS TO OPTIMIZE PERFORMANCE OF RADIO FREQUENCY DEVICES";

[0213] ·Attorney Docket No. END8540USNP / 170753M titled "Method Of Sensing Particulate From Smoke Evacuated From APatient,Adjusting The Pump Speed ​​Based On The Sensed Information,And Communicating The Functional Parameters Of The System To The Hub";

[0214] • The agent's case file number, END8541USNP / 170754M, is titled "METHOD FOR SMOKE EVACUATION FOR SURGICAL HUB".

[0215] • The agent's case file number for the titled "METHOD FOR CONTROLLING SMART ENERGY DEVICES" is END8558USNP1 / 180138-1M;

[0216] • The agent's case file number for the titled "METHOD FOR SMART ENERGY DEVICE INFRASTRUCTURE" is END8559USNP1 / 180141-1M;

[0217] • The agent's case file number END9011USNP1 / 180510-1M, titled "METHOD FOR ADAPTIVE CONTROL SCHEMES FOR SURGICAL NETWORKCONTROL AND INTERACTION";

[0218] • The agent's case file number END9015USNP1 / 180514-1M, titled "METHOD FOR SITUATIONAL AWARENESS FOR SURGICAL NETWORK OR SURGICAL NETWORK CONNECTED DEVICE CAPABLE OF ADJUSTING FUNCTION BASED ON ASENSED SITUATION OR USAGE";

[0219] • The agent's case file number END9017USNP1 / 180516-1M, titled "METHOD FOR FACILITY DATA COLLECTION AND INTERPRETATION"; and

[0220] • The agent's case file number END9033USNP1 / 180520-1M, titled "METHOD FOR CIRCULAR STAPLER CONTROL ALGORITHM ADJUSTMENTBASED ON SITUATIONAL AWARENESS".

[0221] The applicant of this application owns the following U.S. patent applications filed on November 6, 2018, the disclosure of each of which is incorporated herein by reference in its entirety:

[0222] • U.S. Patent Application No. 16 / 182,224 entitled “SURGICAL NETWORK, INSTRUMENT, AND CLOUD RESPONSES BASED ONVALIDATION OF RECEIVED DATASET AND AUTHENTICATION OF ITS SOURCE AND INTEGRITY”;

[0223] • U.S. Patent Application No. 16 / 182,230 entitled “SURGICAL SYSTEM FOR PRESENTING INFORMATION INTERPRETED FROM EXTERNAL DATA”;

[0224] • U.S. Patent Application No. 16 / 182,233 entitled “SURGICAL SYSTEMS WITH AUTONOMOUSLY ADJUSTABLE CONTROLPROGRAMS”;

[0225] • U.S. Patent Application 16 / 182,239, entitled “ADJUSTMENT OF DEVICE CONTROL PROGRAMS BASED ON STRATIFIED CONTEXTUAL DATA IN ADDITION TO THE DATA”;

[0226] • U.S. Patent Application No. 16 / 182,243 entitled “SURGICAL HUB AND MODULAR DEVICE RESPONSE ADJUSTMENT BASED ONSITUATIONAL AWARENESS”;

[0227] • U.S. Patent Application 16 / 182,248, entitled “DETECTION AND ESCALATION OF SECURITY RESPONSES OF SURGICALINSTRUMENTS TO INCREASING SEVERITY THREATS”;

[0228] • U.S. Patent Application No. 16 / 182,251 entitled “INTERACTIVE SURGICAL SYSTEM”;

[0229] • U.S. Patent Application 16 / 182,260 entitled “AUTOMATED DATA SCALING, ALIGNMENT, AND ORGANIZING BASED ON PREREDEFINED PARAMETERS WITHIN SURGICAL NETWORKS”;

[0230] • U.S. Patent Application 16 / 182,267 entitled “SENSING THE PATIENT POSITION AND CONTACT UTILIZING THE MONO-POLAR RETURN PAD ELECTRODE TO PROVIDE SITUATIONAL AWARENESS TO THE HUB”;

[0231] • U.S. Patent Application 16 / 182,249 entitled “POWERED SURGICAL TOOL WITH PREDEFINED ADJUSTABLE CONTROLALGORITHM FOR CONTROLLING END EFFECTOR PARAMETER”;

[0232] • U.S. Patent Application 16 / 182,246, entitled “ADJUSTMENTS BASED ON AIRBORNE PARTICLE PROPERTIES”;

[0233] • U.S. Patent Application No. 16 / 182,256 entitled “ADJUSTMENT OF A SURGICAL DEVICE FUNCTION BASED ONSITUATIONAL AWARENESS”;

[0234] • U.S. Patent Application No. 16 / 182,242 entitled “REAL-TIME ANALYSIS OF COMPREHENSIVE COST OF ALLINSTRUMENTATION USED IN SURGERY UTILIZING DATA FLUIDITY TO TRACK INSTRUMENTSTHROUGH STOCKING AND IN-HOUSE PROCESSES”;

[0235] • U.S. Patent Application 16 / 182,255, entitled “USAGE AND TECHNIQUE ANALYSIS OF SURGEON / STAFF PERFORMANCE AGAINST A BASELINE TO OPTIMIZE DEVICE UTILIZATION AND PERFORMANCE FOR BOTHCURRENT AND FUTURE PROCEDURES”;

[0236] • U.S. Patent Application 16 / 182,269 entitled “IMAGE CAPTURING OF THE AREAS OUTSIDE THE ABDOMEN TO IMPROVEPLACEMENT AND CONTROL OF A SURGICAL DEVICE IN USE”;

[0237] · U.S. patent application 16 / 182,278 titled "COMMUNICATION OF DATA WHERE A SURGICAL NETWORK IS USINGCONTEXT OF THE DATA AND REQUIREMENTS OF A RECEIVING SYSTEM / USER TO INFLUENCEINCLUSION OR LINKAGE OF DATA AND METADATA TO ESTABLISH CONTINUITY";

[0238] • U.S. Patent Application 16 / 182,290 entitled “SURGICAL NETWORK RECOMMENDATIONS FROM REAL TIME ANALYSIS OF PROCEDURE VARIABLES AGAINST A BASELINE HIGHLIGHTING DIFFERENCES FROM THEOPTIMAL SOLUTION”;

[0239] • U.S. Patent Application No. 16 / 182,232 entitled “CONTROL OF A SURGICAL SYSTEM THROUGH A SURGICAL BARRIER”;

[0240] • U.S. Patent Application 16 / 182,227 entitled “SURGICAL NETWORK DETERMINATION OF PRIORITIZATION OF COMMUNICATION, INTERACTION, OR PROCESSING BASED ON SYSTEM OR DEVICE NEEDS”;

[0241] • U.S. Patent Application 16 / 182,231 entitled “WIRELESS PAIRING OF A SURGICAL DEVICE WITH ANOTHER DEVICE WITHIN A STERILE SURGICAL FIELD BASED ON THE USAGE AND SITUATIONAL AWARENESS OF DEVICES”;

[0242] • U.S. Patent Application 16 / 182,229, entitled “ADJUSTMENT OF STAPLE HEIGHT OF AT LEAST ONE ROW OF STAPLESBASED ON THE SENSED TISSUE THICKNESS OR FORCE IN CLOSING”;

[0243] • U.S. Patent Application 16 / 182,234, entitled “STAPLING DEVICE WITH BOTH COMPULSORY AND DISCRETIONARY LOCKOUTS BASED ON SENSED PARAMETERS”;

[0244] • U.S. Patent Application 16 / 182,240 entitled “POWERED STAPLING DEVICE CONFIGURED TO ADJUST FORCE, ADVANCEMENT SPEED, AND OVERALL STROKE OF CUTTING MEMBER BASED ON SENSED PARAMETER OF FIRING OR CLAMPING”;

[0245] • U.S. Patent Application 16 / 182,235 entitled “VARIATION OF RADIO FREQUENCY AND ULTRASONIC POWER LEVEL INCOOPERATION WITH VARYING CLAMP ARM PRESSURE TO ACHIEVE PREDEFINED HEAT FLUXOR POWER APPLIED TO TISSUE”; and

[0246] • U.S. Patent Application 16 / 182,238 entitled “ULTRASONIC ENERGY DEVICE WHICH VARIES PRESSURE APPLIED BY CLAMP ARM TO PROVIDE THRESHOLD CONTROL PRESSURE AT A CUT PROGRESSIONLOCATION”.

[0247] The applicant of this application owns the following U.S. patent applications filed on October 26, 2018, the disclosure of each of which is incorporated herein by reference in its entirety:

[0248] • U.S. Patent Application No. 16 / 172,303 entitled “METHOD FOR OPERATING A POWERED ARTICULATING MULTI-CLIPAPPLIER”;

[0249] • U.S. Patent Application No. 16 / 172,130 entitled “CLIP APPLIER COMPRISING INTERCHANGEABLE CLIP RELOADS”;

[0250] • U.S. Patent Application No. 16 / 172,066 entitled “CLIP APPLIER COMPRISING A MOVABLE CLIP MAGAZINE”;

[0251] • U.S. Patent Application No. 16 / 172,078 entitled “Clip Applier Comprising a ROTATABLE CLIP MAGAZINE”;

[0252] • U.S. Patent Application No. 16 / 172,087 entitled “CLIP APPLIER COMPRISING CLIP ADVANCING SYSTEMS”;

[0253] • U.S. Patent Application No. 16 / 172,094 entitled “CLIP APPLIER COMPRISING A CLIP CRIMPING SYSTEM”;

[0254] • U.S. Patent Application No. 16 / 172,128 entitled “Clip Applier Comprising A Reciprocating CLIP Advancing Member”;

[0255] • U.S. Patent Application No. 16 / 172,168 entitled “Clip Applier Comprising a Motor Controller”;

[0256] • U.S. Patent Application No. 16 / 172,164 entitled “SURGICAL SYSTEM COMPRISING A SURGICAL TOOL AND A SURGICALHUB”;

[0257] • U.S. Patent Application No. 16 / 172,328, entitled “METHOD OF HUB COMMUNICATION WITH SURGICAL INSTRUMENT SYSTEMS”;

[0258] • U.S. Patent Application No. 16 / 172,280 entitled “METHOD FOR PRODUCING A SURGICAL INSTRUMENT COMPRISING ASMART ELECTRICAL SYSTEM”;

[0259] • U.S. Patent Application No. 16 / 172,219 entitled “METHOD OF HUB COMMUNICATION WITH SURGICAL INSTRUMENT SYSTEMS”;

[0260] • U.S. Patent Application No. 16 / 172,248 entitled “METHOD OF HUB COMMUNICATION WITH SURGICAL INSTRUMENT SYSTEMS”;

[0261] • U.S. Patent Application No. 16 / 172,198 entitled “METHOD OF HUB COMMUNICATION WITH SURGICAL INSTRUMENT SYSTEMS”; and

[0262] • U.S. Patent Application No. 16 / 172,155 entitled “METHOD OF HUB COMMUNICATION WITH SURGICAL INSTRUMENT SYSTEMS”.

[0263] The applicant of this application owns the following U.S. patent applications filed on August 28, 2018, the disclosure of each of which is incorporated herein by reference in its entirety:

[0264] • U.S. Patent Application No. 16 / 115,214 entitled “ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROLSYSTEM THEREFOR”;

[0265] • U.S. Patent Application No. 16 / 115,205 entitled “TEMPERATURE CONTROL OF ULTRASONIC END EFFECTOR AND CONTROLSYSTEM THEREFOR”;

[0266] • U.S. Patent Application 16 / 115,233 entitled “RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINE DELECTRICAL SIGNALS”;

[0267] • U.S. Patent Application No. 16 / 115,208 entitled “CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TOTISSUE LOCATION”;

[0268] • U.S. Patent Application 16 / 115,220, entitled “CONTROLLING ACTIVATION OF AN ULTRASONIC SURGICAL INSTRUMENT ACORDING TO THE PRESENCE OF TISSUE”;

[0269] • U.S. Patent Application 16 / 115,232 entitled “DETERMINING TISSUE COMPOSITION VIA AN ULTRASONIC SYSTEM”;

[0270] • U.S. Patent Application 16 / 115,239 entitled “Determining the State of an Ultrasonic Electromagnetic System According to Frequence Ship”;

[0271] • U.S. Patent Application 16 / 115,247 entitled “DETERMINING THE STATE OF AN ULTRASONIC END EFFECTOR”;

[0272] • U.S. Patent Application No. 16 / 115,211 entitled “SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS”;

[0273] • U.S. Patent Application 16 / 115,226 entitled “MECHANISMS FOR CONTROLLING DIFFERENT ELECTROMECHANICAL SYSTEMS OF AN ELECTROSURGICAL INSTRUMENT”;

[0274] • U.S. Patent Application No. 16 / 115,240, entitled “DETECTION OF END EFFECTOR EMERSION IN LIQUID”;

[0275] • U.S. Patent Application No. 16 / 115,249 entitled “Interruption of Energy Due to Inadvertent Capacitative Coupling”;

[0276] • U.S. Patent Application 16 / 115,256 entitled “INCREASING RADIO FREQUENCY TO CREATE PAD-LESS MONOPOLARLOOP”;

[0277] • U.S. Patent Application 16 / 115,223 entitled “BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTSPRESSURE BASED ON ENERGY MODALITY”; and

[0278] • U.S. Patent Application No. 16 / 115,238 entitled “ACTIVATION OF ENERGY DEVICES”.

[0279] The applicant of this application owns the following U.S. patent applications filed on August 24, 2018, the disclosure of each of which is incorporated herein by reference in its entirety:

[0280] • U.S. Patent Application 16 / 112,129 entitled “SURGICAL SUTURING INSTRUMENT CONFIGURED TO MANIPULATE TISSUEUSING MECHANICAL AND ELECTRICAL POWER”;

[0281] • U.S. Patent Application No. 16 / 112,155 entitled “SURGICAL SUTURING INSTRUMENT COMPRISING A CAPTURE WIDTHWHICH IS LARGER THAN TROCAR DIAMETER”;

[0282] • U.S. Patent Application No. 16 / 112,168 entitled “SURGICAL SUTURING INSTRUMENT COMPRISING A NON-CIRCULARNEEDLE”;

[0283] • U.S. Patent Application 16 / 112,180 entitled “ELECTRICAL POWER OUTPUT CONTROL BASED ON MECHANICAL FORCES”;

[0284] • U.S. Patent Application No. 16 / 112,193 entitled “REACTIVE ALGORITHM FOR SURGICAL SYSTEM”;

[0285] • U.S. Patent Application No. 16 / 112,099 entitled “SURGICAL INSTRUMENT COMPRISING AN ADAPTIVE ELECTRICAL SYSTEM”;

[0286] • U.S. Patent Application No. 16 / 112,112, entitled “CONTROL SYSTEM ARRANGEMENTS FOR A MODULAR SURGICALINSTRUMENT”;

[0287] • U.S. Patent Application 16 / 112,119 entitled “ADAPTIVE CONTROL PROGRAMS FOR A SURGICAL SYSTEM COMPRISING MORE THAN ONE TYPE OF CARTRIDGE”;

[0288] • U.S. Patent Application No. 16 / 112,097 entitled “SURGICAL INSTRUMENT SYSTEMS COMPRISING BATTERY ARRANGEMENTS”;

[0289] • U.S. Patent Application No. 16 / 112,109 entitled “SURGICAL INSTRUMENT SYSTEMS COMPRISING HANDLE ARRANGEMENTS”;

[0290] • U.S. Patent Application No. 16 / 112,114 entitled “SURGICAL INSTRUMENT SYSTEMS COMPRISING FEEDBACK MECHANISMS”;

[0291] • U.S. Patent Application No. 16 / 112,117 entitled “SURGICAL INSTRUMENT SYSTEMS COMPRISING LOCKOUT MECHANISMS”;

[0292] • U.S. Patent Application No. 16 / 112,095 entitled “SURGICAL INSTRUMENTS COMPRISING A LOCKABLE END EFFECTORSOCKET”;

[0293] • U.S. Patent Application No. 16 / 112,121 entitled “SURGICAL INSTRUMENTS COMPRISING A SHIFTING MECHANISM”;

[0294] • U.S. Patent Application No. 16 / 112,151 entitled “SURGICAL INSTRUMENTS COMPRISING A SYSTEM FOR ARTICULATION AND ROTATION COMPENSATION”;

[0295] • U.S. Patent Application No. 16 / 112,154 entitled “SURGICAL INSTRUMENTS COMPRISING A BIASED SHIFTING MECHANISM”;

[0296] • U.S. Patent Application 16 / 112,226 entitled “SURGICAL INSTRUMENTS COMPRISING AN ARTICULATION DRIVE THATPROVIDES FOR HIGH ARTICULATION ANGLES”;

[0297] • U.S. Patent Application No. 16 / 112,062 entitled “SURGICAL DISSECTORS AND MANUFACTURING TECHNIQUES”;

[0298] • U.S. Patent Application No. 16 / 112,098 entitled “SURGICAL DISSECTORS CONFIGURED TO APPLY MECHANICAL ANDELECTRICAL ENERGY”;

[0299] • U.S. Patent Application 16 / 112,237 entitled “SURGICAL CLIP APPLIER CONFIGURED TO STORE CLIPS IN A STOREDSTATE”;

[0300] • U.S. Patent Application No. 16 / 112,245 entitled “SURGICAL CLIP APPLIER COMPRISING AN EMPTY CLIP CARTRIDGELOCKOUT”;

[0301] • U.S. Patent Application No. 16 / 112,249 entitled “SURGICAL CLIP APPLIER COMPRISING AN AUTOMATIC CLIP FEEDING SYSTEM”;

[0302] • U.S. Patent Application No. 16 / 112,253 entitled “SURGICAL CLIP APPLIER COMPRISING ADAPTIVE FIRING CONTROL”; and

[0303] • U.S. Patent Application 16 / 112,257 entitled “SURGICAL CLIP APPLIER COMPRISING ADAPTIVE CONTROL INRESPONSE TO A STRAIN GAUGE CIRCUIT”.

[0304] The applicant of this application owns the following U.S. patent applications filed on June 29, 2018, the disclosure of each of which is incorporated herein by reference in its entirety:

[0305] • U.S. Patent Application No. 16 / 024,090, entitled “CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAYELEMENTS”;

[0306] • U.S. Patent Application No. 16 / 024,057 entitled “CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSEDCLOSURE PARAMETERS”;

[0307] • U.S. Patent Application No. 16 / 024,067 entitled “SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION”;

[0308] • U.S. Patent Application No. 16 / 024,075 entitled “SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING”;

[0309] • U.S. Patent Application No. 16 / 024,083 entitled “SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING”;

[0310] • U.S. Patent Application No. 16 / 024,094 entitled “SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUEDISTRIBUTION IRREGULARITIES”;

[0311] • U.S. Patent Application No. 16 / 024,138 entitled “SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TOCANCEROUS TISSUE”;

[0312] • U.S. Patent Application No. 16 / 024,150 entitled “SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES”;

[0313] • U.S. Patent Application No. 16 / 024,160 entitled “VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY”;

[0314] • U.S. Patent Application No. 16 / 024,124 entitled “SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE”;

[0315] • U.S. Patent Application No. 16 / 024,132 entitled “SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT”;

[0316] • U.S. Patent Application No. 16 / 024,141, entitled “SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY”;

[0317] • U.S. Patent Application No. 16 / 024,162 entitled “SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSIONCAPABILITIES”;

[0318] • U.S. Patent Application No. 16 / 024,066 entitled “SURGICAL EVACUATION SENSING AND MOTOR CONTROL”;

[0319] • U.S. Patent Application No. 16 / 024,096 entitled “SURGICAL EVACUATION SENSOR ARRANGEMENTS”;

[0320] • U.S. Patent Application No. 16 / 024,116 entitled “SURGICAL EVACUATION FLOW PATHS”;

[0321] • U.S. Patent Application No. 16 / 024,149 entitled “SURGICAL EVACUATION SENSING AND GENERATOR CONTROL”;

[0322] • U.S. Patent Application No. 16 / 024,180 entitled “SURGICAL EVACUATION SENSING AND DISPLAY”;

[0323] • U.S. Patent Application No. 16 / 024,245 entitled “COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUBOR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM”;

[0324] • U.S. Patent Application No. 16 / 024,258 entitled “SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTROLCIRCUIT FOR INTERACTIVE SURGICAL PLATFORM”;

[0325] • U.S. Patent Application 16 / 024,265 entitled “SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FORCOMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE”; and

[0326] • U.S. Patent Application No. 16 / 024,273 entitled “DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS”.

[0327] The applicant of this patent application owns the following U.S. patent applications filed on March 29, 2018, the disclosures of each of which are incorporated herein by reference in their entirety:

[0328] • U.S. Patent Application No. 15 / 940,641, entitled “Interactive Surgical Systems with Encrypted Communication Capacities”;

[0329] • U.S. Patent Application No. 15 / 940,648, entitled “Interactive Surgical Systems with Condition Handling of Devices and Data Capacities”;

[0330] • U.S. Patent Application No. 15 / 940,656 entitled “SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES”;

[0331] • U.S. Patent Application No. 15 / 940,666, entitled “SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS”;

[0332] • U.S. Patent Application No. 15 / 940,670, entitled “COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS”;

[0333] • U.S. Patent Application No. 15 / 940,677 entitled “SURGICAL HUB CONTROL ARRANGEMENTS”;

[0334] • U.S. Patent Application 15 / 940,632 entitled “DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD”;

[0335] • U.S. Patent Application 15 / 940,640, entitled “COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS”;

[0336] • U.S. Patent Application No. 15 / 940,645 entitled “Self-descripting data packets generated at an instrumentation”;

[0337] • U.S. Patent Application No. 15 / 940,649, entitled “DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME”;

[0338] • U.S. Patent Application No. 15 / 940,654 entitled “SURGICAL HUB SITUATIONAL AWARENESS”;

[0339] • U.S. Patent Application No. 15 / 940,663 entitled “SURGICAL SYSTEM DISTRIBUTED PROCESSING”;

[0340] • U.S. Patent Application No. 15 / 940,668 entitled “AGGREGATION AND REPORTING OF SURGICAL HUB DATA”;

[0341] • U.S. Patent Application No. 15 / 940,671 entitled “SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES INOPERATING THEATER”;

[0342] • U.S. Patent Application No. 15 / 940,686 entitled “DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEARSTAPLE LINE”;

[0343] • U.S. Patent Application No. 15 / 940,700 entitled “STERILE FIELD INTERACTIVE CONTROL DISPLAYS”;

[0344] • U.S. Patent Application No. 15 / 940,629 entitled “COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS”;

[0345] • U.S. Patent Application No. 15 / 940,704 entitled “USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TODETERMINE PROPERTIES OF BACK SCATTERED LIGHT”;

[0346] • U.S. Patent Application No. 15 / 940,722 entitled “Characterization of Tissue Irregularities Through the Use of Mono-Chromatic Light Refraction”;

[0347] • U.S. Patent Application No. 15 / 940,742 entitled “DUAL CMOS ARRAY IMAGING”;

[0348] • U.S. Patent Application No. 15 / 940,636 entitled “ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES”;

[0349] • U.S. Patent Application No. 15 / 940,653 entitled “ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS”;

[0350] • U.S. Patent Application No. 15 / 940,660, entitled “CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER”;

[0351] • U.S. Patent Application No. 15 / 940,679 entitled “CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGETRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET”;

[0352] • U.S. Patent Application No. 15 / 940,694 entitled “CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION”;

[0353] • U.S. Patent Application No. 15 / 940,634 entitled “CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES”;

[0354] • U.S. Patent Application No. 15 / 940,706 entitled “DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICSNETWORK”;

[0355] • U.S. Patent Application No. 15 / 940,675 entitled “CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES”;

[0356] • U.S. Patent Application No. 15 / 940,627 entitled “DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”;

[0357] • U.S. Patent Application No. 15 / 940,637 entitled “COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICALPLATFORMS”;

[0358] • U.S. Patent Application No. 15 / 940,642 entitled “CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”;

[0359] • U.S. Patent Application No. 15 / 940,676 entitled “AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICALPLATFORMS”;

[0360] • U.S. Patent Application No. 15 / 940,680, entitled “CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”;

[0361] • U.S. Patent Application No. 15 / 940,683 entitled “COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICALPLATFORMS”;

[0362] • U.S. Patent Application No. 15 / 940,690, entitled “DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”; and

[0363] • U.S. Patent Application No. 15 / 940,711 entitled “SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”.

[0364] The applicant of this patent application owns the following U.S. provisional patent applications filed on March 8, 2018, the disclosure of each of which is incorporated herein by reference in its entirety:

[0365] • U.S. Provisional Patent Application No. 62 / 640,417 entitled “TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEMTHEREFOR”; and

[0366] • U.S. Provisional Patent Application No. 62 / 640,415 entitled “ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROLSYSTEM THEREFOR”.

[0367] Before detailing the various aspects of the surgical apparatus and generator, it should be noted that the application or use of the exemplary examples is not limited to the details of the configuration and arrangement of the components shown in the accompanying drawings and detailed embodiments. The exemplary examples may be implemented alone or in combination with other aspects, variations, and modifications, and may be practiced or performed in a variety of ways. Furthermore, unless otherwise specified, the terminology and expressions used herein are chosen for the convenience of the reader in describing exemplary embodiments and are not intended to be restrictive. Moreover, it should be understood that one or more of the aspects, expressions of aspects and / or examples described below may be combined with any one or more of the other aspects, expressions of aspects and / or examples described below.

[0368] Before detailing the various aspects of the surgical apparatus and generator, it should be noted that the application or use of the exemplary examples is not limited to the details of the configuration and arrangement of the components shown in the accompanying drawings and detailed embodiments. The exemplary examples may be implemented alone or in combination with other aspects, variations, and modifications, and may be practiced or performed in a variety of ways. Furthermore, unless otherwise specified, the terminology and expressions used herein are chosen for the convenience of the reader in describing exemplary embodiments and are not intended to be restrictive. Moreover, it should be understood that one or more of the aspects, expressions of aspects and / or examples described below may be combined with any one or more of the other aspects, expressions of aspects and / or examples described below.

[0369] Certain exemplary aspects will now be described to provide a full understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed in this invention. One or more examples of these aspects are illustrated in the accompanying drawings. It will be understood by those skilled in the art that the devices and methods particularly described and illustrated in the drawings are non-limiting exemplary aspects, and that the scope of the various aspects is defined only by the claims. Features shown or described in conjunction with one exemplary aspect may be combined with features of other aspects. Such modifications and variations are intended to be included within the scope of the claims.

[0370] See Figure 1 The computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (e.g., a cloud 104 that may include a remote server 113 connected to a storage device 105). Each surgical system 102 includes at least one surgical hub 106 that communicates with the cloud 104, which may include the remote server 113. In one example, such as Figure 1As shown, the surgical system 102 includes a visualization system 108, a robotic system 110, and handheld intelligent surgical instruments 112, which are configured to communicate with each other and / or with a hub 106. In some aspects, the surgical system 102 may include M hubs 106, N visualization systems 108, O robotic systems 110, and P handheld intelligent surgical instruments 112, where M, N, O, and P are integers greater than or equal to one.

[0371] Figure 3 An example of a surgical system 102 for performing surgery on a patient lying supine on an operating table 114 in an operating room 116 is shown. A robotic system 110 is used as part of the surgical system 102 during the surgery. The robotic system 110 includes a surgeon's console 118, a patient-side trolley 120 (surgical robot), and a surgical robot hub 122. While the surgeon views the surgical site through the surgeon's console 118, the patient-side trolley 120 can manipulate at least one removably coupled surgical tool 117 through a minimally invasive incision within the patient's body. Images of the surgical site can be obtained via a medical imaging device 124, which can be manipulated by the patient-side trolley 120 to orient the imaging device 124. The robot hub 122 can be used to process the images of the surgical site for subsequent display to the surgeon via the surgeon's console 118.

[0372] Other types of robotic systems can be readily adapted for use with surgical system 102. Various examples of robotic systems and surgical tools suitable for use with this disclosure are described in U.S. Provisional Patent Application Serial No. 62 / 611,339, filed December 28, 2017, entitled “ROBOT ASSISTED SURGICAL PLATFORM,” the entire disclosure of which is incorporated herein by reference.

[0373] Various examples of cloud-based analytics performed by Cloud 104 and applicable to this disclosure are described in U.S. Provisional Patent Application Serial No. 62 / 611,340, filed December 28, 2017, entitled “CLOUD-BASED MEDICAL ANALYTICS,” the entire disclosure of which is incorporated herein by reference.

[0374] In various respects, the imaging device 124 includes at least one image sensor and one or more optical components. Suitable image sensors include, but are not limited to, charge-coupled device (CCD) sensors and complementary metal-oxide-semiconductor (CMOS) sensors.

[0375] The optical components 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 multiple portions of the surgical site. One or more image sensors may receive light reflected or refracted from the surgical site, including light reflected or refracted from tissue and / or surgical instruments.

[0376] One or more illumination sources can 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 emission spectrum) is the portion of the electromagnetic spectrum that is visible to the human eye (i.e., detectable by it) and can be called visible light or simple light. The typical human eye responds to wavelengths in air from about 380 nm to about 750 nm.

[0377] 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 approximately 380 nm and above approximately 750 nm). The invisible spectrum is undetectable to the human eye. Wavelengths greater than approximately 750 nm are longer than the red visible spectrum and become invisible infrared (IR), microwave, and radio electromagnetic radiation. Wavelengths less than approximately 380 nm are shorter than the violet spectrum and become invisible ultraviolet, X-ray, and gamma-ray electromagnetic radiation.

[0378] In various respects, the imaging device 124 is configured for use in minimally invasive surgery. Examples of imaging devices suitable for use in this disclosure include, but are not limited to, arthroscopes, angioscopes, bronchoscopes, cholangioscopes, colonoscopes, cytoscopes, duodenoscopes, colonoscopes, esophagoduodenoscopes (gastroscopes), endoscopes, laryngoscopes, nasopharyngeal-renal endoscopes, sigmoidoscopes, thoracoscopes, and hysteroscopes.

[0379] In one aspect, imaging devices employ multispectral monitoring to discriminate morphology and underlying structures. A multispectral image is an image that captures image data across a specific wavelength range of the electromagnetic spectrum. Wavelengths can be separated by filters or by using instruments sensitive to specific wavelengths, including light from frequencies outside the visible light range, such as IR and ultraviolet. Spectral imaging allows the extraction of additional information that the human eye fails to capture with its red, green, and blue receptors. The use of multispectral imaging is described in more detail under the title “Advanced Imaging Acquisition Module” of U.S. Provisional Patent Application Serial No. 62 / 611,341, filed December 28, 2017, entitled “INTERACTIVE SURGICAL PLATFORM,” the entire disclosure of which is incorporated herein by reference. After completing a surgical task to perform one or more of the previously described tests on treated tissue, multispectral monitoring can be a useful tool for repositioning the surgical site.

[0380] It goes without saying that rigorous sterilization of the operating room and surgical equipment is required during any surgical procedure. The stringent hygienic and sterilization conditions required in the “surgical room” (i.e., operating room or treatment room) necessitate the highest possible sterility of all medical devices and equipment. Part of this sterilization process requires the sterilization of any material that comes into contact with the patient or penetrates the sterile area, including the imaging device 124 and its attachments and components. It should be understood that a sterile area can be considered a designated area deemed free of microorganisms, such as within a tray or sterile towel, or can be considered the area around the patient prepared for surgical procedures. A sterile area may include properly dressed scrubbed team members, as well as all equipment and fixtures within that area.

[0381] 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 relative to the sterile area, such as... Figure 2 As shown in the figure. In one aspect, the visualization system 108 includes interfaces for HL7, PACS, and EMR. Various components of the visualization system 108 are described under the title “Advanced Imaging Acquisition Module” of U.S. Provisional Patent Application Serial No. 62 / 611,341, filed December 28, 2017, entitled “INTERACTIVE SURGICAL PLATFORM”, the entire disclosure of which is incorporated herein by reference.

[0382] like Figure 2 As shown, the main display 119 is positioned within the sterile area for visibility to the operator at the operating table 114. Furthermore, a visualization tower 111 is positioned outside the sterile area. The visualization tower 111 includes a first non-sterile display 107 and a second non-sterile display 109 positioned opposite each other. A visualization system 108, guided by a hub 106, is configured to utilize displays 107, 109, and 119 to coordinate information flow to operators both inside and outside the sterile area. For example, the hub 106 allows the visualization system 108 to display snapshots of the surgical site recorded by the imaging device 124 on the non-sterile displays 107 or 109 while maintaining a real-time feed of the surgical site on the main display 119. The snapshots on the non-sterile displays 107 or 109 may allow a non-sterile operator to perform diagnostic steps related to the surgical procedure, for example.

[0383] In one aspect, hub 106 is further configured to route diagnostic inputs or feedback entered by a non-sterile operator at visualization tower 111 to a main display 119 within a sterile area, which can be viewed by a sterile operator at a workbench. In one example, the input may be a modified form of a snapshot displayed on non-sterile displays 107 or 109, which can be routed to the main display 119 via hub 106.

[0384] See Figure 2 Surgical instrument 112 is used in surgical procedures as part of surgical system 102. Hub 106 is further configured to coordinate the flow of information to the display of surgical instrument 112. For example, the disclosure of U.S. Provisional Patent Application Serial No. 62 / 611,341, filed December 28, 2017, entitled “Interactive Surgical Platform,” is incorporated herein by reference in its entirety. Diagnostic input or feedback entered by a non-aseptic operator at visualization tower 111 can be routed by hub 106 to surgical instrument display 115 within the aseptic area, where the operator of surgical instrument 112 can observe the input or feedback. An exemplary surgical instrument suitable for surgical system 102 is described in U.S. Provisional Patent Application Serial No. 62 / 611,341, filed December 28, 2017, entitled “Interactive Surgical Platform,” under the title “Surgical Instrument Hardware,” the disclosure of which is incorporated herein by reference in its entirety.

[0385] See now Figure 3 Hub 106 is depicted as communicating with visualization system 108, robotic system 110, and handheld intelligent surgical instruments 112. Hub 106 includes hub display 135, imaging module 138, generator module 140, communication module 130, processor module 132, and storage array 134. In some aspects, such as Figure 3 As shown, hub 106 also includes a smoke extraction module 126 and / or a suction / flushing module 128.

[0386] During surgical procedures, the application of energy to tissue for sealing and / or cutting is often associated with fumigation, aspiration of excess fluid, and / or tissue flushing. Fluid lines, power lines, and / or data lines from different sources often become entangled during surgery. Resolving this issue during surgery can result in lost valuable time. Disconnecting lines may require disconnecting them from their respective modules, which may necessitate module reset. The hub modular housing 136 provides a unified environment for managing power lines, data lines, and fluid lines, reducing the frequency of entanglement between such lines.

[0387] Various aspects of this disclosure provide a surgical hub for surgical procedures involving the application of energy to tissue at a surgical site. The surgical hub includes a hub housing and a combined generator module slidably housed in a docking base within the hub housing. The docking base includes data contacts and power contacts. The combined generator module includes two or more of an ultrasonic energy generator component, a bipolar RF energy generator component, and a monopolar RF energy generator component, all housed in a single unit. In one aspect, the combined generator module further includes a smoke extraction device, at least one energy delivery cable for connecting the combined generator module to surgical instruments, at least one smoke extraction device configured to extract smoke, fluid, and / or particles generated by applying therapeutic energy to tissue, and a fluid line extending from a remote surgical site to the smoke extraction device.

[0388] In one aspect, the fluid line is a first fluid line, and the second fluid line extends from a remote surgical site to a suction and flushing module slidably housed within a hub housing. In another aspect, the hub housing includes a fluid interface.

[0389] Some surgical procedures may require the application of more than one type of energy to tissue. One type of energy may be more advantageous for cutting tissue, while another different type of energy may be more advantageous for sealing tissue. For example, a bipolar generator can be used to seal tissue, while an ultrasonic generator can be used to cut sealed tissue. Aspects of this disclosure provide a solution in which a hub modular housing 136 is configured to accommodate different generators and facilitate interactive communication between them. One advantage of the hub modular housing 136 is the ability to quickly remove and / or replace various modules.

[0390] This disclosure provides a modular surgical housing for use in surgical procedures involving the 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 base including a first docking port including first data and power contacts, wherein the first energy generator module is slidably movable to electrically engage with the power and data contacts, and wherein the first energy generator module is slidably movable out of electrical engagement with the first power and data contacts.

[0391] Further describing the above, the modular surgical housing also 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 base including a second docking port including second data and power contacts, wherein the second energy generator module is slidably movable to electrically engage 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.

[0392] In addition, the modular surgical housing also includes a communication bus between the first docking port and the second docking port, which is configured to facilitate communication between the first energy generator module and the second energy generator module.

[0393] See Figure 3-7 Various aspects of this disclosure are presented as a hub modular housing 136, which allows for modular integration of the generator module 140, the smoke extraction module 126, and the suction / flushing module 128. The hub modular housing 136 also facilitates interactive communication between modules 140, 126, and 128. Figure 5 As shown, generator module 140 may be a generator module with integrated monopolar, bipolar, and ultrasonic devices, which are supported in a single housing unit 139 that is slidably inserted into hub modular housing 136. Figure 5 As shown, generator module 140 can be configured to connect to monopolar device 146, bipolar device 147, and ultrasonic device 148. Alternatively, generator module 140 may include a series of monopolar generator modules, bipolar generator modules, and / or ultrasonic generator modules that interact via hub modular housing 136. Hub modular housing 136 can be configured to facilitate the insertion of multiple generators and interactive communication between generators connected to hub modular housing 136, such that a generator functions as a single generator.

[0394] In one aspect, the hub modular housing 136 includes a modular power and communication baseplate 149 with external and wireless communication connectors to enable removable attachments to modules 140, 126, 128 and interactive communication between them.

[0395] In one aspect, the hub modular housing 136 includes a mating base or drawer 151 (also referred to herein as a drawer) configured to slidably accommodate modules 140, 126, 128. Figure 4 A partial perspective view of a surgical hub housing 136 and a combination generator module 145 slidably housed within a docking base 151 of the surgical hub housing 136 is shown. A docking port 152, having power and data contacts on the rear side of the combination generator module 145, is configured to engage the corresponding docking port 150 with the power and data contacts of the corresponding docking base 151 of the hub modular housing 136 when the combination generator module 145 slides into the appropriate position within the corresponding docking base 151 of the hub modular housing 136. In one aspect, the combination generator module 145 includes bipolar, ultrasonic, and monopolar modules, as well as a smoke extraction module, all integrated together into a single housing unit 139. Figure 5 As shown in the image.

[0396] In various respects, the smoke extraction module 126 includes a fluid line 154 that delivers captured / collected smoke and / or fluid from the surgical site to, for example, the smoke extraction module 126. Vacuum suction originating from the smoke extraction module 126 may draw smoke into an opening of a common conduit at the surgical site. The common conduit coupled to the fluid line may be in the form of a flexible tube terminated at the smoke extraction module 126. The common conduit and the fluid line define a fluid path extending toward the smoke extraction module 126 housed within a hub housing 136.

[0397] In various ways, the aspiration / irrigation module 128 is coupled to a surgical instrument that includes an aspiration fluid line and an 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 aspiration / irrigation module 128. One or more drive systems may be configured to enable the flow of fluid to be flushed to and from the surgical site.

[0398] In one aspect, the surgical tool includes a shaft having an end effector at its distal end and at least one energy treatment associated with the end effector, an aspiration tube, and an irrigation tube. The aspiration tube may have an inlet at its distal end and extends through the shaft. Similarly, the aspiration tube may extend through the shaft and may have an inlet adjacent to the energy delivery tool. The energy delivery tool is configured to deliver ultrasound energy and / or RF energy to a surgical site and is coupled to a generator module 140 via a cable initially extending through the shaft.

[0399] The flushing tube may be in fluid communication with a fluid source, and the suction tube may be in fluid communication with a vacuum source. The fluid source and / or vacuum source may be housed within the suction / fluiding module 128. In one example, the fluid source and / or vacuum source may be housed independently of the suction / fluiding module 128 within the hub housing 136. In such examples, a fluid interface enables the suction / fluiding module 128 to be connected to the fluid source and / or vacuum source.

[0400] In one aspect, modules 140, 126, 128 and / or their corresponding mating bases on the hub modular housing 136 may include alignment features configured to align the mating ports of the modules to engage with their corresponding ports in the mating bases of the hub modular housing 136. For example, as Figure 4 As shown, the combination generator module 145 includes a side bracket 155 configured to slidably engage with a corresponding bracket 156 of a corresponding docking base 151 of the hub modular housing 136. The bracket cooperates to guide the docking port contacts of the combination generator module 145 to electrically engage with the docking port contacts of the hub modular housing 136.

[0401] In some respects, the drawers 151 of the hub modular housing 136 are the same or substantially the same size, and the size of the modules is adjusted to accommodate them in the drawers 151. For example, the side supports 155 and / or 156 may be larger or smaller depending on the size of the module. In other respects, the drawers 151 vary in size and are each designed to accommodate a specific module.

[0402] In addition, the contacts of a specific module can be keyed to engage with the contacts of a specific drawer, thus preventing the module from being inserted into a drawer with mismatched contacts.

[0403] like Figure 4 As shown, the docking port 150 of one drawer 151 can be connected to the docking port 150 of another drawer 151 via a communication link 157 to facilitate interactive communication between modules housed in the hub modular housing 136. Alternatively or additionally, the docking port 150 of the hub modular housing 136 may facilitate wireless interactive communication between modules housed in the hub modular housing 136. Any suitable wireless communication, such as, for example, Air Titan-Bluetooth, can be used.

[0404] Figure 6Individual power bus attachments are shown for multiple lateral docking ports of a lateral modular housing 160 configured to accommodate multiple modules of a surgical hub 206. The lateral modular housing 160 is configured to laterally accommodate and interconnect modules 161. Modules 161 are slidably inserted into docking bases 162 of the lateral modular housing 160, which includes a base plate for interconnecting modules 161. Figure 6 As shown, module 161 is arranged laterally in the transverse modular housing 160. Alternatively, module 161 may be arranged vertically in the transverse modular housing.

[0405] Figure 7 A vertical modular housing 164 is shown, configured to receive multiple modules 165 of a surgical hub 106. Modules 165 are slidably inserted into mating bases or drawers 167 of the vertical modular housing 164, which includes a base plate for interconnecting the modules 165. Although the drawers 167 of the vertical modular housing 164 are vertically arranged, in some cases, the vertical modular housing 164 may include laterally arranged drawers. Furthermore, the modules 165 can interact with each other through mating ports of the vertical modular housing 164. Figure 7 In the example, a display 177 is provided for displaying data related to the operation of module 165. Furthermore, the vertical modular housing 164 includes a main module 178, which is slidably received within a plurality of sub-modules.

[0406] In various aspects, the imaging module 138 includes an integrated video processor and a modular light source, and is suitable for use with various imaging devices. In one aspect, the imaging device comprises a modular housing capable of housing 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 a reusable controller, light source module, and camera module. The light source module and / or camera module may be selectively chosen depending on 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 yet another aspect, the camera module is configured for scanning beam imaging. Similarly, the light source module may be configured to deliver white light or different types of light, depending on the surgical procedure.

[0407] Removing surgical devices from the surgical site during surgery and replacing them with another surgical device, including one with a different camera or a different light source, can be inefficient. Temporary loss of sight of the surgical site can lead to undesirable consequences. The modular imaging apparatus of this disclosure is configured to allow for mid-operative replacement of the light source module or camera module during surgery without having to remove the imaging device from the surgical site.

[0408] In one aspect, the imaging apparatus includes a tubular housing comprising multiple channels. A first channel is configured to slidably receive a camera module, which may be configured for snap-fit ​​engagement with the first channel. A second channel is configured to slidably receive a light source module, which may be configured for snap-fit ​​engagement with the second channel. In another example, the camera module and / or the light source module may be rotated to a final position within their respective channels. Threaded engagement may be used instead of snap-fit ​​engagement.

[0409] In various examples, multiple imaging devices are placed at different locations within the surgical site to provide multiple views. Imaging module 138 can be configured to switch between imaging devices to provide the optimal view. In various respects, imaging module 138 can be configured to integrate images from different imaging devices.

[0410] Various image processors and imaging apparatuses applicable to this disclosure are described in U.S. Patent No. 7,995,045, entitled "COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR," published August 9, 2011, the entire contents of which are incorporated herein by reference. Furthermore, U.S. Patent No. 7,982,776, entitled "SBI MOTION ARTIFACT REMOVAL APPARATUS AND METHOD," published July 19, 2011, describes various systems for removing motion artifacts from image data, the entire contents of which are incorporated herein by reference. Such systems can be integrated with imaging module 138. In addition, the disclosures of U.S. Patent Application Publication No. 2011 / 0306840, entitled “CONTROLLABLE MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPARATUS”, published on December 15, 2011, and U.S. Patent Application Publication No. 2014 / 0243597, entitled “SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE”, published on August 28, 2014, are incorporated herein by reference in their entirety.

[0411] Figure 8A surgical data network 201 is illustrated, including a modular communication hub 203 configured to connect modular units located in one or more operating rooms within a medical facility, or any room in a medical facility specifically equipped for surgical procedures, to a cloud-based system (e.g., a cloud 204 that may include a remote server 213 connected to storage device 205). In one aspect, the modular communication hub 203 includes a network hub 207 and / or a network switch 209 communicating with a network router. The modular communication hub 203 may also be coupled to a local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 may be configured as passive, intelligent, or switched. A passive surgical data network acts as a conduit for data, enabling its transfer from one device (or segment) to another and to cloud computing resources. An intelligent surgical data network includes additional features to enable monitoring of traffic across the surgical data network and configuration of each port in the network hub 207 or network switch 209. An 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.

[0412] Modular devices 1a-1n located in the operating room can be connected to a modular communication hub 203. A network hub 207 and / or a network switch 209 can be connected to a network router 211 to connect devices 1a-1n to the cloud 204 or a local computer system 210. Data associated with devices 1a-1n can be transmitted via the router to a cloud-based computer for remote data processing and manipulation. Data associated with devices 1a-1n can 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 can also be connected to a network switch 209. The network switch 209 can be connected to a network hub 207 and / or a network router 211 to connect devices 2a-2m to the cloud 204. Data associated with devices 2a-2n can be transmitted via the network router 211 to the cloud 204 for data processing and manipulation. Data associated with devices 2a-2m can also be transmitted to the local computer system 210 for local data processing and manipulation.

[0413] It should be understood that the surgical data network 201 can be expanded by interconnecting multiple network hubs 207 and / or multiple network switches 209 with multiple network routers 211. A modular communication hub 203 may be included in a modular control tower configured to accommodate multiple devices 1a-1n / 2a-2m. A local computer system 210 may also be included in the modular control tower. The modular communication hub 203 is connected to a display 212 to display images, for example, acquired by some of the devices 1a-1n / 2a-2m during surgical procedures. In various aspects, the devices 1a-1n / 2a-2m may include, for example, various modules such as an imaging module 138 coupled to an endoscope, a generator module 140 coupled to an energy-based surgical device, a smoke extraction module 126, a suction / rinsing module 128, a communication module 130, a processor module 132, a storage array 134, a surgical device coupled to a display, and / or other modular devices such as a modular communication hub 203 that may be coupled to a surgical data network 201, and non-contact sensor modules.

[0414] 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 connecting devices 1a-1n / 2a-2m to the cloud. Any or all of the devices 1a-1n / 2a-2m connected to the network hubs or network switches may collect data in real time and transmit the data to the cloud computer for data processing and manipulation. It should be understood 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 “the Internet,” although the term is not limited thereto. Therefore, the term “cloud computing” may be used herein to refer to “a type of Internet-based computing” in which different services (such as servers, storage, and applications) are delivered to a modular communication hub 203 and / or computer system 210 located in a surgical room (e.g., a fixed, mobile, temporary, or on-site operating room or space) and to devices connected to the modular communication hub 203 and / or computer system 210 via the Internet. The cloud infrastructure may be maintained by a cloud service provider. In this context, the cloud service provider can be an entity that coordinates the use and control of devices 1a-1n / 2a-2m located in one or more operating rooms. Cloud computing services can perform extensive computations based on data collected by intelligent surgical instruments, robots, and other computerized devices located in the operating room. Hub hardware enables multiple devices or connections to connect to a computer that communicates with cloud computing resources and storage.

[0415] Cloud computing data processing technology is applied to the data collected by devices 1a-1n / 2a-2m, and the surgical data network provides improved surgical outcomes, reduced costs, and improved patient satisfaction. At least some of devices 1a-1n / 2a-2m can be used to observe tissue condition to assess leakage or perfusion of sealed tissue after tissue sealing and cutting procedures. At least some of devices 1a-1n / 2a-2m can be used to identify pathologies, such as the impact of disease, using cloud-based computing to examine data including images of body tissue samples for diagnostic purposes. This includes the localization and edge confirmation of tissues and phenotypes. At least some of devices 1a-1n / 2a-2m can be used to identify anatomical structures of the body using various sensors integrated with imaging devices and techniques, such as overlaying images captured by multiple imaging devices. Data collected by devices 1a-1n / 2a-2m (including image data) can be transferred to cloud 204 or local computer system 210, or both, for data processing and manipulation, including image processing and manipulation. Analyzable data can be used to improve surgical outcomes by determining whether further treatment can be carried out (such as endoscopic interventions, emerging technologies, targeted radiation, targeted interventions, and the application of precise robotics to tissue-specific sites and conditions). Such data analysis can be further processed using outcome analysis, and the use of standardized methods can provide beneficial feedback to validate surgical treatment and surgeon behavior, or to suggest modifications to surgical treatment and surgeon behavior.

[0416] In one specific implementation, operating room devices 1a-1n can be connected to modular communication hub 203 via wired or wireless channels, depending on the configuration of devices 1a-1n to the network hub. In one aspect, network hub 207 can be implemented as a local network broadcasting device operating at the physical layer of the Open Systems Interconnection (OSI) model. This network hub provides connectivity to devices 1a-1n located within the same operating room network. Network hub 207 collects data in packet form and transmits it to a router in half-duplex mode. Network hub 207 does not store any Media Access Control / Internet Protocol (MAC / IP) data for transmitting device data. Only one of devices 1a-1n can transmit data through network hub 207 at a time. Network hub 207 does not specify where to send information and broadcasts all network data on each connection, nor does it transmit data to a remote server 213 via cloud 204. Figure 9 The routing table or intelligence broadcasts all network data. The network hub 207 can detect basic network errors such as collisions, but broadcasting all information to multiple ports can pose security risks and cause bottlenecks.

[0417] In another specific implementation, operating room devices 2a-2m can be connected to network switch 209 via a wired or wireless channel. Network switch 209 operates at the data link layer of the OSI model. Network switch 209 is a multicast device used to connect devices 2a-2m located in the same operating room to the network. Network switch 209 sends data to network router 211 in frame form and operates in full-duplex mode. Multiple devices 2a-2m can simultaneously send data through network switch 209. Network switch 209 stores and uses the MAC addresses of devices 2a-2m for data transmission.

[0418] Network hub 207 and / or network switch 209 are connected to network router 211 to connect to cloud 204. Network router 211 operates at the network layer of the OSI model. Network router 211 creates routes for data packets received from network hub 207 and / or network switch 211 to cloud-based computing resources for further processing and manipulation of data collected by any or all of devices 1a-1n / 2a-2m. Network router 211 can be used to connect two or more different networks located in different locations, such as, for example, different operating rooms in the same medical facility or different networks in different operating rooms in different medical facilities. Network router 211 sends data to cloud 204 in packet form and operates in full-duplex mode. Multiple devices can send data simultaneously. Network router 211 uses IP addresses to transmit data.

[0419] In one example, network hub 207 can be implemented as a USB hub, allowing multiple USB devices to connect to a host. A USB hub can extend a single USB port to multiple tiers, providing more ports for connecting devices to a host system computer. Network hub 207 may include wired or wireless capabilities for receiving information via wired or wireless channels. In one aspect, a wireless USB short-range, high-bandwidth wireless radio communication protocol can be used for communication between devices 1a-1n and devices 2a-2m located in an operating room.

[0420] In other examples, the operating room devices 1a-1n / 2a-2m can communicate with the modular communication hub 203 via the Bluetooth wireless technology standard for exchanging data from stationary and moving devices over short distances (using short-wavelength UHF radio waves in the ISM band from 2.4 to 2.485 GHz) and constructing personal area networks (PANs). In other aspects, the operating room devices 1a-1n / 2a-2m can 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, LTE and Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and their Ethernet derivatives, and any other wireless and wired protocols specified as 3G, 4G, 5G, and above. The computing module may include multiple communication modules. For example, the first communication module can be dedicated to short-range wireless communication such as Wi-Fi and Bluetooth, and the second communication module can be dedicated to long-range wireless communication such as GPS, EDGE, GPRS, CDMA, WiMAX, LTE, Ev-DO, etc.

[0421] Modular communication hub 203 can be used as the central connection for one or all of the operating room devices 1a-1n / 2a-2m and processes a data type called a frame. A frame carries data generated by device 1a-1n / 2a-2m. When modular communication hub 203 receives a frame, it is amplified and transmitted to network router 211, which transmits the data to cloud computing resources using multiple wireless or wired communication standards or protocols as described herein.

[0422] The modular communication hub 203 can be used as a standalone unit or connected to compatible network hubs and network switches to form a larger network. The modular communication hub 203 is generally easy to install, construct, and maintain, making it a good option for networking operating room units 1a-1n / 2a-2m.

[0423] Figure 9An interactive surgical system 200 implemented by a computer is illustrated. The interactive surgical system 200 implemented by a computer is similar in many respects to the interactive surgical system 100 implemented by a computer. For example, the interactive surgical system 200 implemented by a computer includes one or more surgical systems 202 that are similar in many respects to surgical system 102. Each surgical system 202 includes at least one surgical hub 206 communicating with a cloud 204 that may include a remote server 213. In one aspect, the interactive surgical system 200 implemented by a computer includes a modular control tower 236 connected to multiple operating room devices, such as, for example, intelligent surgical instruments, robots, and other computerized devices located in the operating room. Figure 10 As shown, the modular control tower 236 includes a modular communication hub 203 connected to the computer system 210. (As illustrated...) Figure 9 As illustrated in the example, 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 fume extractor module 226, a suction / flushing 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. Operating room equipment is coupled to cloud computing resources and data storage via the modular control tower 236. A robotic hub 222 may also be connected to the modular control tower 236 and cloud computing resources. Devices / instruments 235, visualization systems 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 a hub display 215 (e.g., a monitor, a screen) to display and overlay images received from the imaging module, device / instrument display, and / or other visualization systems 208. The hub display can also combine images and overlays to display data received from devices connected to the modular control tower.

[0424] Figure 10 A surgical hub 206 is shown, comprising multiple 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. Figure 10 As shown, the modular communication hub 203 can be hierarchically configured to expand the number of modules (e.g., devices) that can be connected to the modular communication hub 203 and transmit data associated with the modules to computer system 210, cloud computing resources, or both. Figure 10As shown, each of the network hubs / switches in the modular communication hub 203 includes three downstream ports and one upstream port. The upstream network hub / switch connects to the processor to provide communication connectivity with cloud computing resources and the local display 217. Communication with the cloud 204 can be made via wired or wireless communication channels.

[0425] Surgical hub 206 employs a non-contact sensor module 242 to measure the dimensions of the operating room and uses ultrasonic or laser-based non-contact measuring devices to generate a mapping of the operating room. The ultrasonic-based non-contact sensor module scans the operating room by emitting a burst of ultrasonic waves and receiving the echoes as they bounce off the walls of the operating room, as described in the title “Surgical Hub Spatial Awareness Within an Operating Room” of U.S. Provisional Patent Application Serial No. 62 / 611,341, filed December 28, 2017, entitled “INTERACTIVE SURGICAL PLATFORM,” the entire contents of which are incorporated herein by reference. In this application, the sensor module is configured to determine the size of the operating room and adjust Bluetooth pairing distance limits. The laser-based non-contact sensor module scans the operating room by emitting laser pulses, receiving laser pulses bouncing off the walls of the operating room, and comparing the phase of the emitted pulses with the received pulses to determine the dimensions of the operating room and adjust Bluetooth pairing distance limits.

[0426] Computer system 210 includes processor 244 and network interface 245. Processor 244 is connected via system bus to communication module 247, storage device 248, memory 249, non-volatile memory 250, and input / output interface 251. The system bus can be any of several types of bus architectures, including memory bus or memory controller, peripheral bus or external bus, and / or local bus using any of the various available bus architectures, including but not limited to 9-bit bus, Industry Standard Architecture (ISA), Micro Charmel Architecture (MSA), Extended ISA (EISA), Intelligent Drive Electronics (IDE), VESA Local Bus (VLB), Peripheral Device Interconnect (PCI), USB, Advanced Graphics Port (AGP), PCMCIA, Small Computer System Interface (SCSI), or any other peripheral bus.

[0427] The controller 244 can be any single-core or multi-core processor, such as those commercially available from Texas Instruments under the name ARM Cortex. In one aspect, the processor can be, for example, a Texas Instruments LM4F230H5QR ARM Cortex-M4F processor core, which includes 256KB of single-cycle flash memory or other non-volatile memory (up to 40MHz) on-chip memory, a prefetch buffer for improving execution above 40MHz, 32KB of single-cycle sequential random access memory (SRAM), and loaded with… The software includes an internal read-only memory (ROM), a 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 modules, and one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, details of which can be found in the product datasheet.

[0428] In one aspect, the processor 244 may include a safety controller comprising two controller-based series (such as the TMS570 and RM4x), also known as the Hercules ARM Cortex R4, manufactured by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety-critical applications, etc., to provide advanced integrated safety features while delivering scalable execution, connectivity, and memory options.

[0429] System memory includes volatile and non-volatile memory. The Basic Input / Output System (BIOS), which contains basic routines such as transferring information between components within the computer system during startup, is stored in non-volatile memory. For example, non-volatile 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 an external cache memory. Furthermore, RAM can be available in various forms, such as SRAM, Dynamic RAM (DRAM), Synchronous DRAM (SDRAM), Double Data Rate SDRAM (DDRSDRAM), Enhanced SDRAM (ESDRAM), Synchronous Link DRAM (SLDRAM), and Direct Rambus RAM (DRRAM).

[0430] Computer system 210 also includes removable / non-removable, volatile / non-volatile computer storage media, such as, for example, disk storage. Disk storage includes, but is not limited to, devices such as disk drives, floppy disk drives, magnetic tape drives, Jaz drives, Zip drives, LS-60 drives, flash memory cards, or memory modules. Furthermore, disk storage may include storage media, alone or in combination with other storage media, including, but not limited to, optical disc drives such as optical disc ROM devices (CD-ROM), optical disc recordable drives (CD-R drives), optical disc rewritable drives (CD-RW drives), or digital universal disk ROM drives (DVD-ROM). Removable or non-removable interfaces may be used to facilitate the connection of the disk storage device to the system bus.

[0431] It should be understood that computer system 210 includes software that acts as an intermediary between the user and basic computer resources described in a suitable operating environment. Such software includes an operating system. An operating system, which may be stored on a disk storage device, is used to control and allocate the 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 a disk storage device. It should be understood that the various components described herein can be implemented using various operating systems or combinations of operating systems.

[0432] Users input commands or information into computer system 210 through one or more input devices connected to I / O interface 251. Input devices include, but are not limited to, pointing devices such as mice, ballpoint pens, styluses, touchpads, keyboards, microphones, joysticks, game pads, satellite dishes, scanners, TV tuner cards, digital cameras, digital video cameras, and format cameras. These and other input devices are connected to the processor via the system bus through one or more interface ports. The interface ports include, for example, serial ports, parallel ports, game ports, and USB ports. Output devices use the same type of port as the input devices. Thus, for example, a USB port can be used to provide input to the computer system and output information from the computer system to an output device. Output adapters are provided to illustrate the existence of some output devices (such as monitors, displays, speakers, and printers) that require special adapters. Output adapters, by way of example, include, but are not limited to, video and sound cards that provide a connection between the output device and the system bus. It should be noted that other devices or devices such as one or more remote computers provide both input and output capabilities.

[0433] Computer system 210 can operate in a networked environment using logical connections to one or more remote computers (such as one or more cloud computers) or a local computer. The one or more remote cloud computers may be personal computers, servers, routers, network PCs, workstations, microprocessor-based appliances, peer-to-peer devices, or other public network nodes, and typically include many or all of the elements described relative to the computer system. For simplicity, only memory storage devices with one or more remote computers are shown. The one or more remote computers are logically connected to the computer system via a network interface and then physically connected via a communication connection. The network interface encompasses communication networks such as local area networks (LANs) and wide area networks (WANs). LAN technologies include Fiber Distributed Data Interface (FDDI), Copper Distributed Data Interface (CDDI), Ethernet / IEEE 802.3, Token Ring / IEEE 802.5, etc. WAN technologies include, but are not limited to, point-to-point links, circuit-switched networks such as Integrated Services Digital Network (ISDN) and its variants, packet-switched networks, and Digital Subscriber Line (DSL).

[0434] In various aspects, Figure 10 The computer system 210, the imaging module 238 and / or the visualization system 208, and / or Figure 9-10 The processor module 232 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 improve speed and efficiency. The digital image processing engine may perform a range of tasks. The image processor may be a system-on-a-chip with a multi-core processor architecture.

[0435] One or more communication connections refer to the hardware / software used to connect a network interface to a bus. While communication connections are shown for illustrative clarification within a computer system, they may also be located outside of computer system 210. The hardware / software necessary to connect to the network interface, for illustrative purposes only, includes internal and external technologies such as modems, including conventional telephone-grade modems, cable modems and DSL modems, ISDN adapters, and Ethernet cards.

[0436] Figure 11A functional block diagram of one aspect of a USB network hub 300 device according to at least one aspect of the present disclosure is shown. In the illustrated aspect, the USB network hub device 300 employs a TUSB2036 integrated circuit hub from Texas Instruments. The USB network hub 300 is a CMOS device providing an upstream USB transceiver port 302 and up to three downstream USB transceiver ports 304, 306, and 308 according to the USB 2.0 specification. The upstream USB transceiver port 302 is a differential root data port, which includes a differential data negative (DP0) input paired with a differential data positive (DM0) input. The three downstream USB transceiver ports 304, 306, and 308 are differential data ports, wherein each port includes a differential data positive (DP1-DP3) output paired with a differential data negative (DM1-DM3) output.

[0437] The USB network hub 300 device is implemented using a digital state machine instead of a microcontroller and requires no 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, and 308. Downstream USB transceiver ports 304, 306, and 308 support both full-speed and low-speed devices by automatically setting the slewing rate based on the speed of the device attached to the port. The USB network hub 300 device can be configured to operate in bus-powered or self-powered mode and includes hub power logic 312 for power management.

[0438] The USB network hub 300 device includes a Serial Interface Engine 310 (SIE). The SIE 310 is the front-end of the USB network hub 300 hardware and handles most of the protocols described in Chapter 8 of the USB specification. The SIE 310 typically includes signaling up to the transaction level. Its processing functions may include: packet identification, transaction ordering, SOP, EOP, RESET, and RESUME signal detection / generation, clock / data separation, non-return-to-zero inversion (NRZI) data encoding / decoding and bit stuffing, CRC generation and verification (token and data), packet ID (PID) generation and verification / decoding, and / or serial-to-parallel / parallel-to-serial conversion. The 310 receives a clock input 314 and is coupled to pause / resume logic and frame timer 316 circuitry, as well as hub repeater circuitry 318, to control communication between upstream USB transceiver port 302 and downstream USB transceiver ports 304, 306, and 308 via port logic circuitry 320, 322, and 324. SIE 310 is connected to command decoder 326 via interface logic to control commands from serial EEPROM via serial EEPROM interface 330.

[0439] In various aspects, the USB network hub 300 can connect 127 functions, configured across up to six logical layers (hierarchies), to a single computer. Furthermore, the USB network hub 300 can connect to all external devices using a standardized four-wire cable that provides both communication and power distribution. Power configurations include bus-powered and self-powered modes. The USB network hub 300 can be configured to support four power management modes: a bus-powered hub with individual port power management or a suite of port power management, and a self-powered hub with individual port power management or a suite of port power management. In one aspect, the USB network hub 300, upstream USB transceiver port 302, is plugged into a USB host controller using a USB cable, and downstream USB transceiver ports 304, 306, and 308 are exposed for connecting USB-compatible devices, etc.

[0440] Surgical instrument hardware

[0441] Figure 12 A logic diagram of a control system 470 for a surgical instrument or tool according to one or more aspects of this disclosure is shown. System 470 includes control circuitry. The control circuitry includes a microcontroller 461, which includes a processor 462 and a memory 468. For example, one or more of sensors 472, 474, and 476 provide real-time feedback to processor 462. A motor 482, driven by a motor driver 492, is operatively coupled to a longitudinally movable displacement member to drive an I-beam blade element. A tracking system 480 is configured to determine the position of the longitudinally movable displacement member. Position information is provided to processor 462, which can be programmed or configured to determine the position of the longitudinally movable drive member and the positions of the firing member, firing lever, and I-beam blade element. An additional motor may be located at the tool driver interface to control I-beam firing, tube closure travel, shaft rotation, and joint movement. A display 473 displays various operating conditions of the instrument and may include touchscreen functionality for data input. Information displayed on display 473 may be overlaid with images acquired via an endoscopic imaging module.

[0442] In one aspect, the microprocessor 461 can be any single-core or multi-core processor, such as those known to be manufactured by Texas Instruments under the trade name ARM Cortex. In another aspect, the microcontroller 461 can be an LM4F230H5QR ARM Cortex-M4F processor core from, for example, Texas Instruments, which includes 256KB of single-cycle flash memory or other non-volatile memory (up to 40MHz) on-chip memory, a prefetch buffer for improving performance above 40MHz, 32KB of single-cycle SRAM, and loaded with… The software includes an internal ROM, a 2KB electrical EEPROM, one or more PWM modules, one or more QEI analog modules, and one or more 12-bit ADCs with 12 analog input channels. Details can be found in the product datasheet.

[0443] In one aspect, the microcontroller 461 may include a safety controller comprising two controller-based series (such as the TMS570 and RM4x), also known by trade name Hercules ARM Cortex R4, manufactured by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO26262 safety-critical applications, etc., to provide advanced integrated safety features while delivering scalable execution, connectivity, and memory options.

[0444] The controller 461 can be programmed to perform various functions, such as precise control of the speed and position of the blade and joint motion systems. In one aspect, the microcontroller 461 includes a processor 462 and a memory 468. The electric motor 482 may be a brushed direct current (DC) motor having a gearbox and a mechanical link to the joint motion or blade system. In one aspect, the motor driver 492 may be an A3941 available from Allegro Microsystems, Inc. Other motor drivers may be readily replaced for use in a tracking system 480 that includes an absolute positioning system. A detailed description of the absolute positioning system is described in U.S. Patent Application Publication 2017 / 0296213, entitled “SYSTEMS AND METHODS FOR CONTROLLING ASURGICAL STAPLING AND CUTTING INSTRUMENT,” published October 19, 2017, the entire contents of which are incorporated herein by reference.

[0445] The microcontroller 461 can be programmed to provide precise control over the velocity and position of displacement components and articulated motion systems. The microcontroller 461 can be configured to calculate the response in its software. The calculated response is compared to the measured response of the actual system to obtain an "observed" response, which is used for actual feedback decisions. 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 influences on the system.

[0446] In one aspect, motor 482 may be controlled by motor driver 492 and may be employed by a firing system of a surgical instrument or tool. In various forms, motor 482 may be a brushed DC drive motor having a maximum rotational speed of approximately 25,000 RPM. In other arrangements, motor 482 may include a brushless motor, cordless motor, synchronous motor, stepper motor, or any other suitable electric motor. Motor driver 492 may include, for example, an H-bridge driver including a field-effect transistor (FET). 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 comprising multiple battery cells connected in series and capable of serving as a power source to power the surgical instrument or tool. In some cases, the battery cells of the power assembly may be replaceable and / or rechargeable. In at least one example, the battery cells may be lithium-ion batteries that are both coupled to and decoupled from the power assembly.

[0447] The driver 492 is available as the A3941 from Allegro Microsystems, Inc. The A3941 492 is a full-bridge controller designed for use with external N-channel power metal-oxide-semiconductor field-effect transistors (MOSFETs) specifically designed for inductive loads such as brushed DC motors. The driver 492 includes a unique charge pump regulator that provides full (>10V) gate drive for battery voltages as low as 7V and allows the A3941 to operate with reduced gate drive voltages as low as 5.5V. A bootstrap capacitor can be used to provide the aforementioned battery supply voltage required for the N-channel MOSFETs. The internal charge pump of the high-side drive allows DC (100% duty cycle) operation. The full bridge can be driven in fast decay or slow decay mode using diodes or synchronous rectification. In slow decay mode, current recirculation can pass through either the high-side or low-side FETs. Resistor-adjustable no-load time protection prevents the power FETs from breakdown. The overall diagnostics provide indications of undervoltage, overheating, and power bridge faults, and can be configured to protect the power MOSFETs under most short-circuit conditions. Other motor drivers can be easily replaced for use in the tracking system 480, which includes an absolute positioning system.

[0448] The tracking system 480 includes a controlled motor drive circuit arrangement including a position sensor 472, according to at least one aspect of this disclosure. The position sensor 472, used in the absolute positioning system, provides a unique position signal corresponding to the position of a displacement member. In one aspect, the displacement member represents a longitudinally movable drive member including a rack with drive teeth for meshing with a corresponding drive gear of a gear reducer assembly. In another aspect, the displacement member represents a firing member that can be adapted and configured to include a rack with drive teeth. In yet another aspect, the displacement member represents a firing lever or an I-beam, each of which can be adapted and configured to include a rack with drive teeth. Thus, as used herein, the term displacement member is generally used to refer to any movable member of a surgical instrument or tool, such as a drive member, firing member, firing lever, I-beam, or any element capable of displacement. In one aspect, the longitudinally movable drive member is coupled to the firing member, firing lever, and I-beam. Therefore, the absolute positioning system can effectively track the linear displacement of the I-beam by tracking the linear displacement of the longitudinally movable drive member. In various other respects, the displacement member can be coupled to any position sensor 472 suitable for measuring linear displacement. Therefore, a longitudinally movable drive member, firing member, firing rod, or I-beam, or combinations thereof, can be coupled to any suitable linear displacement sensor. The linear displacement sensor can include contact or non-contact displacement sensors. The linear displacement sensor can include a linearly variable differential transformer (LVDT), a differential variable magnetoresistive transducer (DVRT), a sliding potentiometer, a magnetic sensing system comprising a movable magnet and a series of linearly arranged Hall effect sensors, a magnetic sensing system comprising a fixed magnet and a series of linearly arranged Hall effect sensors, an optical sensing system comprising a movable light source and a series of linearly arranged photodiodes or photodetectors, an optical sensing system comprising a fixed light source and a series of linearly arranged photodiodes or photodetectors, or any combination thereof.

[0449] The electric motor 482 may include a rotatable shaft operably coupled to a gear assembly, which is mounted on a displacement member in meshing with a set of drive teeth or a rack. A sensor element may be operably coupled to the gear assembly such that a single rotation of the position sensor 472 corresponds to some linear longitudinal translation of the displacement member. The transmission and sensor may be arranged to connect to a linear actuator via a rack and pinion arrangement, or to a rotary actuator via spur gears or other connections. A power source supplies power to the absolute positioning system, and an output indicator displays the output of the absolute positioning system. The displacement member represents a longitudinally movable drive member including a rack with drive teeth formed thereon for meshing with a corresponding drive gear in a gear reducer assembly. The displacement member also represents a longitudinally movable firing member, firing lever, I-beam, or a combination thereof.

[0450] A single rotation of the sensor element associated with position sensor 472 is equivalent to a longitudinal linear displacement d1 of the displacement member, where d1 is the longitudinal linear distance the displacement member moves from point "a" to point "b" after a single rotation of the sensor element connected to the displacement member. The sensor arrangement can be connected via a gear reduction mechanism, which allows position sensor 472 to complete only one or more rotations over the full stroke of the displacement member. Position sensor 472 can also complete multiple rotations over the full stroke of the displacement member.

[0451] A series of switches (where n is an integer greater than one) can be used individually or in combination with gear reduction to provide unique position signals for more than one rotation of position sensor 472. The states of the switches are fed back to microcontroller 461, which applies logic to determine unique position signals corresponding to longitudinal linear displacements d1+d2+…dn of the displacement member. The output of position sensor 472 is provided to microcontroller 461. Position sensor 472 in this sensor arrangement may include magnetic sensors, analog rotation sensors (such as potentiometers), or an array of analog Hall effect elements that output unique combinations of position signals or values.

[0452] Position sensor 472 may include any number of magnetic sensing elements, such as magnetic sensors classified, for example, according to whether they measure the total magnetic field or vector components of a magnetic field. The techniques used to generate the two types of magnetic sensors described above encompass multiple aspects of physics and electronics. Techniques for magnetic field sensing include probe coils, fluxgate magnetogates, optical pumps, nuclear swirl, superconducting quantum interference devices (SQUIDs), the Hall effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoresistance, magnetostrictive / piezoelectric composites, magnetodiodes, magnetotransistors, optical fibers, magnetooptics, and microelectromechanical systems (MEMS)-based magnetic sensors, among others.

[0453] In one aspect, the position sensor 472 used in the tracking system 480, which includes an absolute positioning system, comprises a magnetic rotary absolute positioning system. The position sensor 472 can be implemented as an AS5055EQFT monolithic magnetic rotary position sensor, available from Austria Microsystems, AG. The position sensor 472 interfaces with a microcontroller 461 to provide the absolute positioning system. The position sensor 472 is a low-voltage and low-power component and includes four Hall effect elements located in the region of the position sensor 472 above the magnet. A high-resolution ADC and a smart power management controller are also provided on-chip. A coordinate rotating digital computer (CORDIC) processor (also known as the bitwise and Volder algorithm) is provided to perform simple and efficient algorithms to calculate hyperbolic and trigonometric functions, requiring only addition, subtraction, digital displacement, and table lookup operations. Angular position, alarm bit, and magnetic field information are transmitted to the microcontroller 461 via a standard serial communication interface, such as a Serial Peripheral Interface (SPI) interface. The position sensor 472 provides 12 or 14-bit resolution. The position sensor 472 is available as an AS5055 chip in a small QFN 16-pin 4×4×0.85mm package.

[0454] The tracking system 480, including the absolute positioning system, may include and / or 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 for voltage, current, and force. In addition to the position measured by the position sensor 472, one or more other sensors may be provided to measure the physical parameters of the physical system. In some aspects, one or more other sensors may include sensor arrangements such as those described in U.S. Patent 9,345,481, entitled “STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM,” published May 24, 2016, the entire contents of which are incorporated herein by reference; U.S. Patent Application Publication 2014 / 0263552, entitled “STAPLE CARTRIDGETISSUE THICKNESS SENSOR SYSTEM,” published September 18, 2014, the entire contents of which are incorporated herein by reference; and U.S. Patent Application Serial No. 15 / 628,175, entitled “TECHNIQUES FOR ADAPTIVE CONTROLOF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT,” filed June 20, 2017, the entire contents of which are incorporated herein by reference. In digital signal processing systems, absolute positioning systems are coupled to digital data acquisition systems, where the output of the absolute positioning system will have finite resolution and sampling frequency. The absolute positioning system may include comparison and combination circuitry to combine the calculated response with the measured response using algorithms such as weighted averaging and theoretical control loops. This algorithm drives the calculated response toward the measured response. The calculated response of the physical system takes into account characteristics such as mass, inertia, viscous friction, inductance, and resistance to predict the state and output of the physical system by knowing the input.

[0455] Therefore, the absolute positioning system provides the absolute position of the displacement member when the instrument is powered on, without causing the displacement member to retract or advance to a reset (zero or home position) position as required by conventional rotary encoders, which only count the number of forward or backward steps taken by motor 482 to infer the position of the device actuator, drive bar, knife, etc.

[0456] Sensor 474 (such as, for example, a strain gauge or microstrain gauge) is configured to measure one or more parameters of the end effector, such as, for example, the amplitude of the strain applied to the anvil during clamping operation, which can indicate the closing force applied to the anvil. The measured strain is converted into a digital signal and provided to processor 462. Alternatively, or in addition to sensor 474, sensor 476 (such as a load sensor) can measure the closing force applied to the anvil by the closing drive system. Sensor 476, such as a load sensor, can measure the firing force applied to the I-beam during the firing stroke of a surgical instrument or tool. The I-beam is configured to engage a wedge-shaped slider configured to cause the staple driver to cam upward to push the staple into deformable contact with the anvil. The I-beam also includes a sharp cutting edge that can be used to cut tissue when the I-beam is advanced distally by the firing lever. Alternatively, a current sensor 478 can be used to measure the current consumed by motor 482. The force required to propel the firing mechanism can correspond to, for example, the current consumed by the motor 482. The measured force is converted into a digital signal and provided to the processor 462.

[0457] In one embodiment, strain gauge sensor 474 can be used to measure the force applied to tissue by an end effector. A strain gauge can be coupled to the end effector to measure the force on the tissue being handled by the end effector. A system for measuring the force applied to tissue gripped by the end effector includes strain gauge sensor 474, such as a micro-strain gauge, configured to measure one or more parameters of, for example, the end effector. In one aspect, strain gauge sensor 474 can measure the amplitude or magnitude of the strain applied to the jaw members of the end effector during clamping operations, which can indicate tissue compression. The measured strain is converted into a digital signal and provided to processor 462 of microcontroller 461. Load sensor 476 can measure the force used to operate the blade element, for example, to cut tissue captured between the anvil and the cartridge. A magnetic field sensor can be used to measure the thickness of the captured tissue. The measurements from the magnetic field sensor can also be converted into digital signals and provided to processor 462.

[0458] The microcontroller 461 can characterize the selected position of the firing member and / or the velocity of the firing member using measurements of tissue compression, tissue thickness, and / or the force required for the closed end effector, respectively, measured by sensors 474 and 476. In one case, the memory 468 can store techniques, formulas, and / or lookup tables that can be used by the microcontroller 461 in the evaluation.

[0459] The control system 470 for surgical instruments or tools may also include wired or wireless communication circuitry for communicating with a modular communication hub, such as... Figures 8 to 11 As shown in the image.

[0460] Figure 13A control circuit 500, configured to control aspects of a surgical instrument or tool according to at least one aspect of the present disclosure, is shown. The control circuit 500 may be configured to perform the various processes described herein. The control circuit 500 may include a microcontroller comprising one or more processors 502 (e.g., microprocessor, microcontroller) coupled to at least one memory circuit 504. The memory circuit 504 stores machine-executable instructions that, when executed by the processor 502, cause the processor 502 to execute machine instructions to perform 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 and non-volatile storage media. The processor 502 may include an instruction processing unit 506 and an arithmetic unit 508. The instruction processing unit may be configured to receive instructions from the memory circuit 504 of the present disclosure.

[0461] Figure 14 A combinational logic circuit 510, configured to control aspects of a surgical instrument or tool according to at least one aspect of the present disclosure, is shown. The combinational logic circuit 510 may be configured to implement the various processes described herein. The combinational logic circuit 510 may include a finite state machine including combinational logic 512 configured to receive data associated with the surgical instrument or tool at input 514, process the data via combinational logic 512, and provide an output 516.

[0462] Figure 15 A sequential logic circuit 520, configured to control aspects of a surgical instrument or tool according to at least one aspect of this disclosure, is shown. The sequential logic circuit 520 or combinational logic 522 may be configured to implement the various processes described herein. The sequential logic circuit 520 may include a finite state machine. The sequential logic circuit 520 may include, for example, combinational 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, the sequential logic circuit 520 may be synchronous or asynchronous. The combinational logic 522 is configured to receive data associated with the surgical instrument or tool from input 526, process the data through the combinational logic 522, and provide an output 528. In other aspects, the circuit may include a processor (e.g., processor 502, ...). Figure 13 A combination of finite state machines and combination logic circuits can be used to implement the various processes described herein. In other respects, the finite state machine may include combinational logic circuits (e.g., combinational logic circuit 510, ...). Figure 14 The combination of ) and sequential logic circuit 520.

[0463] Figure 16A surgical instrument or tool is illustrated, comprising multiple motors that can be activated to perform various functions. In some cases, a first motor may be activated to perform a first function, a second motor may be activated to perform a second function, and a third motor may be activated to perform a third function. In other cases, the multiple motors of the robotic surgical instrument 600 may be individually activated to cause firing motion, closing motion, and / or articulation motion in the end effector. The firing motion, closing motion, and / or articulation motion may be transmitted to the end effector, for example, via a shaft assembly.

[0464] In some cases, 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 may be configured to transmit the firing motion generated by the motor 602 to an end effector, specifically for displacing an I-beam element. In some cases, the firing motion generated by the motor 602 may, for example, deploy a staple from a staple cartridge into tissue captured by the end effector and / or advance the cutting edge of the I-beam element to cut the captured tissue. The I-beam element may be retracted by reversing the direction of the motor 602.

[0465] In some cases, surgical instruments or tools may include a closure motor 603. The closure motor 603 may be operatively coupled to a closure motor drive assembly 605, which is configured to transmit the closing motion generated by the motor 603 to an end effector, specifically for displacing the closure tube to close the anvil and compress tissue between the anvil and the cartridge. The closing motion may cause, for example, the end effector to change from an open configuration to a proximity configuration to capture tissue. The end effector may be changed to an open position by reversing the direction of the motor 603.

[0466] In some cases, surgical instruments or tools may include, for example, one or more articulated motors 606a, 606b. Motors 606a, 606b may be operatively coupled to corresponding articulated motor drive assemblies 608a, 608b, which may be configured to transmit joint motion generated by motors 606a, 606b to an end effector. In some cases, the joint motion may cause the end effector to articulate relative to an axis, for example.

[0467] As described above, surgical instruments or tools may include multiple motors 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, articulation motors 606a and 606b may be activated to articulate the end effector, while firing motor 602 remains inactive. Alternatively, firing motor 602 may be activated to fire multiple pins and / or advance the cutting edge, while articulation motor 606 remains inactive. Furthermore, closure motor 603 may be activated simultaneously with firing motor 602 to advance the closure tube and I-beam element distally, as described in more detail below.

[0468] In some cases, surgical instruments or tools may include a common control module 610 that can be used with multiple motors of the surgical instrument or tool. In some cases, the common control module 610 can adjust one of the multiple motors at a time. For example, the common control module 610 may be individually coupled to multiple motors of the surgical instrument and may be detached from the multiple motors of the surgical instrument. In some cases, multiple motors of the surgical instrument or tool may share one or more common control modules such as the common control module 610. In some cases, multiple motors of the surgical instrument or tool may independently and selectively engage the common control module 610. In some cases, the common control module 610 may switch from engagement with one of the multiple motors of the surgical instrument or tool to engagement with another of the multiple motors of the surgical instrument or tool.

[0469] In at least one example, the common control module 610 can selectively switch between operably engaging joint motion motors 606a, 606b and operably engaging firing motor 602 or closing motor 603. In at least one example, as... Figure 16 As shown, switch 614 can move or change between multiple positions and / or states. In a first position 616, switch 614 can electrically connect common control module 610 to firing motor 602; in a second position 617, switch 614 can electrically connect common control module 610 to closing motor 603; in a third position 618a, switch 614 can electrically connect common control module 610 to first articulated motor 606a; and in a fourth position 618b, switch 614 can electrically connect common control module 610 to, for example, second articulated motor 606b. In some cases, a single common control module 610 can be electrically connected simultaneously to firing motor 602, closing motor 603, and articulated motors 606a, 606b. In some cases, switch 614 can be a mechanical switch, electromechanical switch, solid-state switch, or any suitable switching mechanism.

[0470] Each of motors 602, 603, 606a, and 606b may include a torque sensor to measure the output torque on the motor shaft. 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 the motor used to actuate the jaws.

[0471] In various situations, such as Figure 16 As shown, the common control module 610 may include a motor driver 626, which may include one or more H-bridge FETs. The motor driver 626 may, for example, modulate the power transmitted from the power source 628 to the motor coupled to the common control module 610 based on inputs obtained from the microcontroller 620 (“controller”). In some cases, when the motor is coupled to the common control module 610, the microcontroller 620 may be used, for example, to determine the current consumed by the motor, as described above.

[0472] In some cases, the 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, the memory 624 may store various program instructions that, when executed, cause the processor 622 to perform the various functions and / or calculations described herein. In some cases, one or more of the memory units 624 may, for example, be coupled to the processor 622.

[0473] In some cases, power source 628 may be used, for example, to power microcontroller 620. In some cases, power source 628 may include a battery (or “battery pack” or “power pack”), such as a lithium-ion battery, for example. In some cases, the battery pack may be configured to be releasably mounted to the handle for powering surgical instrument 600. Multiple battery cells connected in series may be used as power source 628. In some cases, power source 628 may be, for example, replaceable and / or rechargeable.

[0474] In various situations, processor 622 can control motor driver 626 to control the position, direction of rotation, and / or speed of the motor coupled to common controller 610. In some cases, processor 622 can signal motor driver 626 to stop and / or deactivate the motor coupled to common controller 610. It should be understood that the term "processor" as used herein includes any suitable microprocessor, microcontroller, or other basic computing device that combines the functionality of a computer's central processing unit (CPU) on one or at most a few integrated circuits. A processor is a versatile 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 processors have internal memory, they are examples of sequential digital logic. The objects of operation of a processor are numbers and symbols represented in a binary number system.

[0475] In one scenario, the processor 622 can be any single-core or multi-core processor, such as those known to be manufactured by Texas Instruments under the trade name ARM Cortex. In some cases, the microcontroller 620 can be, for example, the LM 4F230H5QR available from Texas Instruments. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor chip that includes: 256KB of single-cycle flash memory or other non-volatile memory (up to 40MHz) on-chip memory, a prefetch buffer for improving performance above 40MHz, 32KB of single-cycle SRAM, and a... The software includes internal ROM, 2KB EEPROM, one or more PWM modules, one or more QEI emulations, one or more 12-bit ADCs with 12 analog input channels, and other readily available features. Other microcontrollers can be easily substituted for use with module 4410. Therefore, this disclosure should not be limited to this context.

[0476] In some cases, memory 624 may include program instructions for controlling each of the motors in the surgical instrument 600, which can be coupled to a common controller 610. For example, memory 624 may include program instructions for controlling the firing motor 602, the closing motor 603, and the joint movement motors 606a, 606b. Such program instructions enable processor 622 to control the firing, closing, and joint movement functions based on inputs from an algorithm or control program from the surgical instrument or tool.

[0477] In some cases, one or more mechanisms and / or sensors, such as sensor 630, can be used to alert processor 622 to program instructions that should be used in a particular setting. For example, sensor 630 can alert processor 622 to use program instructions associated with firing, closing, and articulating end effectors. In some cases, sensor 630 may include, for example, a position sensor that can be used to sense the position of switch 614. Thus, processor 622 may use program instructions associated with firing the I-beam of the end effector, for example, when sensor 630 detects that switch 614 is in a first position 616; processor 622 may use program instructions associated with closing the anvil, for example, when sensor 630 detects that switch 614 is in a second position 617; and processor 622 may use program instructions associated with articulating the end effector, for example, when sensor 630 detects that switch 614 is in a third position 618a or a fourth position 618b.

[0478] Figure 17 This is a schematic diagram of a robotic surgical instrument 700 configured to operate the surgical tools described herein, according to at least one aspect of this disclosure. The robotic surgical instrument 700 can be programmed or configured to control distal / proximal translation of a displacement member, distal / proximal displacement of a closure tube, axis rotation, and joint movements of links having one or more articulated motion drives. In one aspect, the surgical instrument 700 can be programmed or configured to individually control a firing member, a closure member, an axis member, and / or one or more articulated motion members. The surgical instrument 700 includes a control circuit 710 configured to control the motor-driven firing member, closure member, axis member, and / or one or more articulated motion members.

[0479] In one aspect, the robotic surgical instrument 700 includes a control circuit 710 configured to control the anvil 716 and I-beam 714 (including a sharp cutting edge) portion of the end effector 702 via multiple motors 704a-704e, enabling the removal of a staple cartridge 718, a shaft 740, and one or more articulated components 742a, 742b. A position sensor 734 is configured to provide position feedback of the I-beam 714 to the control circuit 710. Other sensors 738 are configured to provide feedback to the control circuit 710. A timer / counter 731 provides timing and counting information to the control circuit 710. A power source 712 can 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 can be operated individually by the control circuit 710 in open-loop or closed-loop feedback control.

[0480] In one aspect, the control circuitry 710 may include one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause one or more processors to perform one or more tasks. In one aspect, a timer / counter 731 provides an output signal, such as elapsed time or a digital count, to the control circuitry 710 to correlate the position of the I-beam 714, as determined by the position sensor 734, with the output of the timer / counter 731, such that the control circuitry 710 can determine the position of the I-beam 714 relative to a starting position at a specific time (t) or the time (t) when the I-beam 714 is at a specific position relative to the starting position. The timer / counter 731 may be configured to measure elapsed time, count external events, or time external events.

[0481] In one aspect, control circuitry 710 can be programmed to control the function of end effector 702 based on one or more tissue conditions. Control circuitry 710 can be programmed to sense tissue conditions, such as thickness, directly or indirectly, as described herein. Control circuitry 710 can be programmed to select a firing control program or a closing control program based on tissue conditions. The firing control program can describe the distal movement of the displacement member. Different firing control programs can be selected to better handle different tissue conditions. For example, when thicker tissue is present, control circuitry 710 can be programmed to translate the displacement member at a lower speed and / or with lower power. When thinner tissue is present, control circuitry 710 can be programmed to translate the displacement member at a higher speed and / or with higher power. The closing control program can control the closing force applied to the tissue by anvil 716. Other control programs control the rotation of shaft 740 and articulated motion members 742a, 742b.

[0482] In one aspect, control circuitry 710 can generate a motor setpoint signal. This motor setpoint signal can be provided to various motor controllers 708a-708e. Motor controllers 708a-708e may include one or more circuits configured to provide motor drive signals to motors 704a-704e to drive them, as described herein. In some examples, motors 704a-704e may be brushed DC motors. For example, the speed of motors 704a-704e may be proportional to the corresponding motor drive signal. In some examples, motors 704a-704e may be brushless DC motors, and the corresponding motor drive signal may include PWM signals provided to one or more stator windings of motors 704a-704e. Furthermore, in some examples, motor controllers 708a-708e may be omitted, and control circuitry 710 may directly generate the motor drive signal.

[0483] In some examples, control circuitry 710 may initially operate each of motors 704a-704e in an open-loop configuration for a first open-loop portion of the displacement member's stroke. Based on the response of the robotic surgical instrument 700 during the open-loop portion of the stroke, control circuitry 710 may select a firing control program in a closed-loop configuration. The instrument's response may include the translational distance of the displacement member during the open-loop portion, the time elapsed during the open-loop portion, the energy supplied to one of the motors 704a-704e during the open-loop portion, the sum of the pulse widths of the motor drive signals, etc. After the open-loop portion, control circuitry 710 may implement the selected firing control program for a second portion of the displacement member's stroke. For example, during the closed-loop portion of the stroke, control circuitry 710 may modulate one of the motors 704a-704e based on translational data describing the position of the displacement member in a closed-loop manner to cause the displacement member to translate at a constant speed.

[0484] In one aspect, motors 704a-704e may receive power from energy source 712. Energy source 712 may be a DC power source driven by a main AC power source, battery, supercapacitor, or any other suitable energy source. Motors 704a-704e may be mechanically coupled to individual movable mechanical elements, such as I-beam 714, anvil 716, shaft 740, articulation 742a, and articulation 742b, via corresponding transmissions 706a-706e. Transmissions 706a-706e may include one or more gears or other linkage components to couple motors 704a-704e to the movable mechanical elements. Position sensor 734 may sense the position of I-beam 714. Position sensor 734 may be or include any type of sensor capable of generating position data indicating the position of I-beam 714. In some examples, position sensor 734 may include an encoder configured to provide a series of pulses to control circuitry 710 as I-beam 714 translates distally and proximally. Control circuit 710 can track pulses to determine the position of I-beam 714. Other suitable position sensors can be used, including, for example, proximity sensors. Other types of position sensors can provide additional signals indicating the movement of I-beam 714. Moreover, in some examples, position sensor 734 can be omitted. If any of the motors 704a-704e is a stepper motor, control circuit 710 can track the position of I-beam 714 by aggregating the number and direction of steps that motor 704 has been commanded to perform. Position sensor 734 can be located in end effector 702 or any other part of the apparatus. The output of each of motors 704a-704e includes torque sensors 744a-744e for sensing force and has an encoder for sensing the rotation of the drive shaft.

[0485] In one aspect, control circuitry 710 is configured to drive a firing element, such as an I-beam 714 portion of end effector 702. Control circuitry 710 provides a motor setpoint to motor control 708a, which in turn provides a drive signal to motor 704a. The output shaft of motor 704a is coupled to torque sensor 744a. Torque sensor 744a is coupled to a transmission 706a connected to I-beam 714. Transmission 706a includes movable mechanical elements, such as rotating elements and firing elements, to control the movement of I-beam 714 along the longitudinal axis of end effector 702 towards the distal and proximal sides. In one aspect, motor 704a may be coupled to a cutter gear assembly including a cutter gear reduction set comprising a first cutter drive gear and a second cutter drive gear. Torque sensor 744a provides firing force feedback signal to control circuitry 710. The firing force signal represents the force required to fire or displace I-beam 714. Position sensor 734 may be configured to provide the position of I-beam 714 along the firing stroke or the position of the firing member as a feedback signal to control circuit 710. End effector 702 may include an additional sensor 738 configured to provide a feedback signal to control circuit 710. When ready for use, control circuit 710 may provide a firing signal to motor control 708a. In response to the firing signal, motor 704a may drive the firing member along the longitudinal axis of end effector 702 from a proximal stroke start position toward a stroke end position distal to the stroke start position. As the firing member translates distally, I-beam 714, having a cutting element positioned at the distal end, advances distally to cut tissue located between staple cartridge 718 and anvil 716.

[0486] In one aspect, control circuitry 710 is configured to drive a closing member, such as the anvil 716 portion of end effector 702. Control circuitry 710 provides a motor setpoint to motor control 708b, which in turn provides a drive signal to motor 704b. The output shaft of motor 704b is coupled to torque sensor 744b. Torque sensor 744b is coupled to a transmission 706b coupled to anvil 716. Transmission 706b includes movable mechanical elements, such as rotating elements and a closing member, to control the movement of anvil 716 from an open position and a closed position. In one aspect, motor 704b is coupled to a closing gear assembly, which includes a set of closing reduction gears supported for meshing with a closing spur gear. Torque sensor 744b provides a closing force feedback signal to control circuitry 710. The closing force feedback signal represents the closing force applied to anvil 716. Position sensor 734 may be configured to provide the position of the closing member as a feedback signal to control circuitry 710. An additional sensor 738 in the end effector 702 provides a closing force feedback signal to the control circuit 710. The pivotable anvil 716 is positioned opposite the staple cartridge 718. When ready for use, the control circuit 710 provides a closing signal to the motor control 708b. In response to the closing signal, the motor 704b advances the closing member to grip the tissue between the anvil 716 and the staple cartridge 718.

[0487] In one aspect, control circuitry 710 is configured to rotate a shaft component, such as shaft 740, to rotate end effector 702. Control circuitry 710 provides a motor setpoint to motor control 708c, which in turn provides a drive signal to motor 704c. The output shaft of motor 704c is coupled to torque sensor 744c. Torque sensor 744c is coupled to a transmission 706c coupled to shaft 740. Transmission 706c includes movable mechanical elements, such as rotating elements, to control shaft 740 to rotate clockwise or counterclockwise up to 360° and beyond. In one aspect, motor 704c is coupled to a rotary transmission assembly including a tube gear section formed on (or attached to) the proximal end of a proximal closed tube to be operably engaged by a rotary gear assembly operably supported on a tool mounting plate. Torque sensor 744c provides a rotational force feedback signal to control circuitry 710. The rotational force feedback signal represents the rotational force applied to shaft 740. Position sensor 734 can be configured to provide the position of the closed member as a feedback signal to control circuit 710. Additional sensor 738, such as a shaft encoder, can provide the rotational position of shaft 740 to control circuit 710.

[0488] In one aspect, control circuitry 710 is configured to enable articulation of end effector 702. Control circuitry 710 provides a motor setpoint to motor control 708d, which in turn provides a drive signal to motor 704d. The output of motor 704d is coupled to torque sensor 744d. Torque sensor 744d is coupled to transmission 706d, which is coupled to articulation member 742a. ​​Transmission 706d includes movable mechanical elements, such as articulation elements, to control articulation of end effector 702 ±65°. In one aspect, motor 704d is coupled to articulation nut, which is rotatably journaled on the proximal end portion of the distal ridge and rotatably driven thereon by articulation gear assembly. Torque sensor 744d provides articulation force feedback signal to control circuitry 710. The articulation force feedback signal represents the articulation force applied to end effector 702. Sensor 738 (such as a joint motion encoder) can provide the control circuit 710 with the joint position of end effector 702.

[0489] On the other hand, the articulation function of the robotic surgical system 700 may include two articulated components or links 742a, 742b. These articulated components 742a, 742b are driven by separate discs on a robot interface (rack), which are driven by two motors 708d, 708e. When a separate firing motor 704a is provided, each of the articulated links 742a, 742b can be antagonically driven relative to the other link to provide resistance to the head to maintain motion and load when the head is not moving, and to provide articulation when the head is performing articulation. When the head rotates, the articulated components 742a, 742b are attached to the head with a fixed radius. Therefore, the mechanical advantages of the push-pull linkage change when the head rotates. This change in mechanical advantages may be more pronounced for other articulated link drive systems.

[0490] In one aspect, one or more motors 704a-704e may include a brushed DC motor with a gearbox and a mechanical link to a firing member, a closing member, or a jointed motion member. Another example includes an electric motor 704a-704e that operates movable mechanical elements such as displacement members, jointed motion links, closing tubes, and shafts. External influences are unmeasured and unpredictable effects of things such as tissues, the surrounding body, and friction on a physical system. Such external influences may be referred to as drag forces, which are an action relative to one of the electric motors 704a-704e. External influences such as drag forces can cause the operation of the physical system to deviate from the desired operation of the physical system.

[0491] In one aspect, the position sensor 734 can be implemented as an absolute positioning system. In another 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 Microsystems, AG. The position sensor 734 may be interfaced with control circuitry 710 to provide an absolute positioning system. The position may include a Hall effect element located above the magnet and coupled to a CORDIC processor, also known for bitwise methods and Volder algorithms, provided to implement simple and efficient algorithms for calculating hyperbolic and trigonometric functions requiring only addition, subtraction, digital displacement, and table lookup operations.

[0492] In one aspect, control circuitry 710 may communicate with one or more sensors 738. Sensors 738 may be positioned on end effector 702 and adapted to operate with robotic surgical instruments 700 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. 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 end effector 702. Sensors 738 may include one or more sensors. Sensors 738 may be located on the staple cartridge 718 platform to determine tissue location using segmented electrodes. Torque sensors 744a-744e may be configured to sense forces such as striking force, closing force, and / or joint motion forces. Therefore, the control circuit 710 can sense (1) the closing load experienced by the distal closing tube and its position, (2) the firing member at the rack and its position, (3) the tissue portion above the pin cartridge 718, and (4) the load and position on the two articulated rods.

[0493] In one aspect, one or more sensors 738 may include strain gauges such as microstrain gauges configured to measure the magnitude of strain in the anvil 716 during clamping conditions. The strain gauge provides an electrical signal whose amplitude varies with the strain value. Sensor 738 may include a pressure sensor configured to detect pressure generated by the presence of compressed tissue between the anvil 716 and the staple cartridge 718. Sensor 738 may be configured to detect the impedance of a tissue segment located between the anvil 716 and the staple cartridge 718, the impedance indicating the thickness and / or integrity of the tissue located between the anvil and the staple cartridge.

[0494] In one embodiment, sensor 738 can be implemented as one or more limit switches, electromechanical devices, solid-state switches, Hall effect devices, magnetoresistive (MR) devices, giant magnetoresistive (GMR) devices, magnetometers, etc. In other embodiments, sensor 738 can 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, etc. Similarly, the switch can be a solid-state device, such as a transistor (e.g., a FET, a junction FET, a MOSFET, a bipolar transistor, etc.). In other embodiments, sensor 738 can include a conductorless switch, an ultrasonic switch, an accelerometer, and an inertial sensor, etc.

[0495] In one aspect, sensor 738 may be configured to measure the force applied to anvil 716 by the closure drive system. For example, one or more sensors 738 may be located at the interaction point between the closure tube and anvil 716 to detect the closure force applied to anvil 716 by the closure tube. The force applied to anvil 716 may represent the tissue compression experienced by the tissue segment captured between anvil 716 and staple cartridge 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 anvil 716 by the closure drive system. One or more sensors 738 may be sampled in real time by the processor of control circuitry 710 during clamping operations. Control circuitry 710 receives real-time sample measurements to provide and analyze time-based information and to evaluate the closure force applied to anvil 716 in real time.

[0496] In one aspect, current sensor 736 can be used to measure the current consumed by each of motors 704a-704e. The force required to propel any of the movable mechanical elements (such as I-beam 714) corresponds to the current consumed by one of motors 704a-704e. The force is converted into a digital signal and provided to control circuitry 710. Control circuitry 710 can be configured to simulate the actual system response of the instrument in the controller's software. Actuable displacement members can move I-beam 714 in end effector 702 at or near a target speed. Robotic surgical system 700 may include a feedback controller, which may be one of any feedback controllers, including but not limited to, PID, state feedback, linear squared (LQR), and / or adaptive controllers. Robotic surgical instrument 700 may include a power source to, for example, convert signals from the feedback controller into physical inputs, such as housing voltage, PWM voltage, frequency-modulated voltage, current, torque, and / or force. Additional details are disclosed in U.S. Patent Application Serial No. 15 / 636,829, filed June 29, 2017, entitled “CLOSED LOOP VELOCITY CONTROL TECHNIQUESFOR ROBOTIC SURGICAL INSTRUMENT”, the entire contents of which are incorporated herein by reference.

[0497] Figure 18 A block diagram of a surgical instrument 750 programmed to control distal translation of a displacement member according to at least one aspect of the present disclosure is shown. In one aspect, the surgical instrument 750 is programmed to control distal translation of a displacement member such as an I-beam 764. The surgical instrument 750 includes an end effector 752, which may include an anvil 766, an I-beam 764 (including a sharp cutting edge), and a removable staple cartridge 768.

[0498] The position, movement, displacement, and / or translation of a linear displacement member, such as I-beam 764, can be measured using an absolute positioning system, a sensor arrangement, and position sensor 784. Since I-beam 764 is coupled to a longitudinally movable drive member, the position of I-beam 764 can be determined by measuring the position of the longitudinally movable drive member using position sensor 784. Therefore, in the following description, the position, displacement, and / or translation of I-beam 764 can be achieved using position sensor 784 as described herein. Control circuitry 760 can be programmed to control the translation of the displacement member, such as I-beam 764. In some examples, control circuitry 760 may include one or more microcontrollers, microprocessors, or other suitable processors for executing instructions to cause one or more processors to control the displacement member (e.g., I-beam 764) in the manner described. In one aspect, timer / counter 781 provides an output signal, such as elapsed time or digital count, to control circuitry 760 to correlate the position of I-beam 764, as determined by position sensor 784, with the output of timer / counter 781, so that control circuitry 760 can determine the position of I-beam 764 relative to its starting position at a specific time (t). Timer / counter 781 can be configured to measure elapsed time, count external events, or time external events.

[0499] Control circuitry 760 generates a motor setpoint signal 772. The motor setpoint signal 772 can be provided to a motor controller 758. Motor controller 758 may include one or more circuits configured to provide a motor drive signal 774 to drive motor 754, as described herein. In some examples, motor 754 may be a brushed DC electric motor. For example, the speed of motor 754 may be proportional to the motor drive signal 774. In some examples, motor 754 may be a brushless DC electric motor, and the motor drive signal 774 may include a PWM signal provided to one or more stator windings of motor 754. Furthermore, in some examples, motor controller 758 may be omitted, and control circuitry 760 may directly generate the motor drive signal 774.

[0500] Motor 754 may receive power from energy source 762. Energy source 762 may be or include a battery, supercapacitor, or any other suitable energy source. Motor 754 may be mechanically coupled to I-beam 764 via transmission 756. Transmission 756 may include one or more gears or other linkage components for coupling motor 754 to I-beam 764. Position sensor 784 may sense the position of I-beam 764. Position sensor 784 may be or include any type of sensor capable of generating position data indicating the position of I-beam 764. In some examples, position sensor 784 may include an encoder configured to provide a series of pulses to control circuitry 760 as I-beam 764 translates distally and proximally. Control circuitry 760 may track the pulses to determine the position of I-beam 764. Other suitable position sensors may be used, including, for example, proximity sensors. Other types of position sensors may provide additional signals indicating the movement of I-beam 764. Moreover, in some examples, position sensor 784 may be omitted. When motor 754 is a stepper motor, control circuitry 760 can track the position of I-beam 764 by the number and direction of steps that the aggregating motor 754 has been instructed to perform. Position sensor 784 may be located in end effector 752 or at any other part of the apparatus.

[0501] Control circuitry 760 may communicate with one or more sensors 788. Sensors 788 may be positioned on end effector 752 and adapted to operate with surgical instruments 750 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. 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 end effector 752. Sensors 788 may include one or more sensors.

[0502] One or more sensors 788 may include strain gauges such as microstrain gauges, configured to measure the magnitude of strain in the anvil 766 during clamping conditions. The strain gauge provides an electrical signal whose amplitude varies with the strain value. Sensors 788 may include pressure sensors configured to detect pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. Sensors 788 may be configured to detect the impedance of a tissue segment located between the anvil 766 and the staple cartridge 768, the impedance indicating the thickness and / or integrity of the tissue located between the anvil and the staple cartridge.

[0503] Sensor 788 may be configured to measure the force applied to the anvil 766 by the closure drive system. For example, one or more sensors 788 may be located at the interaction point between the closure tube and the anvil 766 to detect the closure force applied to the anvil 766 by the closure tube. The force applied to the anvil 766 may represent the tissue compression experienced by the tissue segment captured between the anvil 766 and the staple cartridge 768. One or more sensors 788 may be positioned at various interaction points along the closure drive system to detect the closure force applied to the anvil 766 by the closure drive system. One or more sensors 788 may be sampled in real time by the processor of the control circuitry 760 during clamping operations. The control circuitry 760 receives real-time sample measurements to provide and analyze time-based information and to evaluate the closure force applied to the anvil 766 in real time.

[0504] The current sensor 786 can be used to measure the current consumed by the motor 754. The force required to propel the I-beam 764 corresponds to the current consumed by the motor 754. The force is converted into a digital signal and provided to the control circuit 760.

[0505] The control circuit 760 can be configured to simulate the actual system response of the instrument in the controller's software. An actuable displacement member causes the I-beam 764 in the end effector 752 to move at or near a target speed. The surgical instrument 750 may include a feedback controller, which can be one of any feedback controller, including but not limited to, PID, state feedback, LQR, and / or adaptive controllers. The surgical instrument 750 may include a power source to, for example, convert signals from the feedback controller into physical inputs such as housing voltage, PWM voltage, frequency-modulated voltage, current, torque, and / or force.

[0506] The actual drive system of the surgical instrument 750 is configured to drive the displacement member, cutting member, or I-beam 764 via a brushed DC motor having a gearbox and a mechanical connection to the joint movement and / or knife system. Another example is an electric motor 754 that operates, for example, a displacement member and a joint movement actuator with interchangeable shaft assemblies. External influences are unmeasured and unpredictable effects of things such as tissue, the surrounding body, and friction on a physical system. Such external influences can be referred to as drag forces acting in opposition to the electric motor 754. External influences such as drag forces can cause the operation of the physical system to deviate from its desired operation.

[0507] Various exemplary aspects relate to a surgical instrument 750, which includes an end effector 752 with a motor-driven surgical suturing and cutting tool. For example, a motor 754 can drive a displacement member distally and proximally along the longitudinal axis of the end effector 752. The end effector 752 may include a pivotable anvil 766, and a staple cartridge 768 is positioned opposite the anvil 766 when configured for use. A clinician can hold tissue between the anvil 766 and the staple cartridge 768, as described herein. When ready to use the instrument 750, the clinician can provide a firing signal, for example, by pressing a trigger of the instrument 750. In response to the firing signal, the motor 754 can drive the displacement member distally along the longitudinal axis of the end effector 752 from a proximal stroke start position to a stroke end position distal to the stroke start position. As the displacement member translates distally, an I-beam 764 with a cutting element positioned at the distal end can cut the tissue between the staple cartridge 768 and the anvil 766.

[0508] In various examples, the surgical instrument 750 may include control circuitry 760 programmed to control the distal translation of a displacement member (such as I-beam 764) based on one or more tissue conditions. Control circuitry 760 may be programmed to sense tissue conditions, such as thickness, directly or indirectly, as described herein. Control circuitry 760 may be programmed to select a firing control program based on tissue conditions. The firing control program may describe the distal movement of the displacement member. Different firing control programs may be selected to better handle different tissue conditions. For example, when thicker tissue is present, control circuitry 760 may be programmed to translate the displacement member at a lower speed and / or with lower power. When thinner tissue is present, control circuitry 760 may be programmed to translate the displacement member at a higher speed and / or with higher power.

[0509] In some examples, control circuitry 760 may initially operate motor 754 in an open-loop configuration for a first open-loop portion of the displacement member's stroke. Based on the response of instrument 750 during the open-loop portion of the stroke, control circuitry 760 may select a firing control program. The instrument's response may include the translational distance of the displacement member during the open-loop portion, the time elapsed during the open-loop portion, the energy supplied to motor 754 during the open-loop portion, the sum of the pulse widths of the motor drive signals, etc. After the open-loop portion, control circuitry 760 may implement the selected firing control program for a second portion of the displacement member's stroke. For example, during the closed-loop portion of the stroke, control circuitry 760 may modulate motor 754 based on translational data describing the position of the displacement member in a closed-loop manner to cause the displacement member to translate at a constant speed. Additional details are disclosed in U.S. Patent Application Serial No. 15 / 720,852, filed on September 29, 2017, entitled “SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT”, the entire contents of which are incorporated herein by reference.

[0510] Figure 19 This is a schematic diagram of a surgical instrument 790 configured to control various functions according to at least one aspect of the present disclosure. In one aspect, the surgical instrument 790 is programmed to control distal translation of a displacement member such as an I-beam 764. The surgical instrument 790 includes an end effector 792, which may include an anvil 766, the I-beam 764, and a removable staple cartridge 768, which is interchangeable with an RF cartridge 796 (shown in dashed lines).

[0511] In one embodiment, sensor 788 can be implemented as a limit switch, electromechanical device, solid-state switch, Hall effect device, MR device, GMR device, magnetometer, etc. In other embodiments, sensor 638 can be implemented as a solid-state switch that operates under the influence of light, such as an optical sensor, IR sensor, ultraviolet sensor, etc. Similarly, the switch can be a solid-state device, such as a transistor (e.g., FET, junction FET, MOSFET, bipolar transistor, etc.). In other embodiments, sensor 788 can include a conductorless switch, ultrasonic switch, accelerometer, and inertial sensor, etc.

[0512] In one aspect, the position sensor 784 can be implemented as an absolute positioning system comprising an AS5055EQFT monolithic magnetic rotary position sensor, available from Austria Microsystems, AG. The position sensor 784 can be interfaced with control circuitry 760 to provide the absolute positioning system. Position may include a Hall effect element located above the magnet and coupled to a CORDIC processor, also known for bitwise methods and Volder algorithms, provided to implement simple and efficient algorithms for calculating hyperbolic and trigonometric functions requiring only addition, subtraction, digital displacement, and table lookup operations.

[0513] In one aspect, the I-beam 764 may be implemented as a blade member including a blade body on which a tissue cutting blade is operatively supported, and the I-beam may further include an anvil engagement tab or feature and a channel engagement feature or foot. In one aspect, the staple cartridge 768 may be implemented as a standard (mechanical) surgical fastener cartridge. In one aspect, the RF cartridge 796 may be implemented as an RF cartridge. These and other sensor arrangements are described in U.S. Patent Application Serial No. 15 / 628,175, filed June 20, 2017, entitled “TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT,” the entire contents of which are incorporated herein by reference.

[0514] The position, movement, displacement, and / or translation of a linear displacement member, such as I-beam 764, can be measured using an absolute positioning system, a sensor arrangement, and a position sensor represented as position sensor 784. Since I-beam 764 is coupled to a longitudinally movable drive member, the position of I-beam 764 can be determined by measuring the position of the longitudinally movable drive member using position sensor 784. Therefore, in the following description, the position, displacement, and / or translation of I-beam 764 can be achieved using position sensor 784 as described herein. Control circuitry 760 can be programmed to control the translation of displacement members, such as I-beam 764, as described herein. In some examples, control circuitry 760 may include one or more microcontrollers, microprocessors, or other suitable processors for executing instructions to cause one or more processors to control the displacement member (e.g., I-beam 764) in the manner described herein. In one aspect, timer / counter 781 provides an output signal, such as elapsed time or digital count, to control circuitry 760 to correlate the position of I-beam 764, as determined by position sensor 784, with the output of timer / counter 781, so that control circuitry 760 can determine the position of I-beam 764 relative to its starting position at a specific time (t). Timer / counter 781 can be configured to measure elapsed time, count external events, or time external events.

[0515] Control circuitry 760 generates a motor setpoint signal 772. The motor setpoint signal 772 can be provided to a motor controller 758. Motor controller 758 may include one or more circuits configured to provide a motor drive signal 774 to drive motor 754, as described herein. In some examples, motor 754 may be a brushed DC electric motor. For example, the speed of motor 754 may be proportional to the motor drive signal 774. In some examples, motor 754 may be a brushless DC electric motor, and the motor drive signal 774 may include a PWM signal provided to one or more stator windings of motor 754. Furthermore, in some examples, motor controller 758 may be omitted, and control circuitry 760 may directly generate the motor drive signal 774.

[0516] Motor 754 may receive power from energy source 762. Energy source 762 may be or include a battery, supercapacitor, or any other suitable energy source. Motor 754 may be mechanically coupled to I-beam 764 via transmission 756. Transmission 756 may include one or more gears or other linkage components for coupling motor 754 to I-beam 764. Position sensor 784 may sense the position of I-beam 764. Position sensor 784 may be or include any type of sensor capable of generating position data indicating the position of I-beam 764. In some examples, position sensor 784 may include an encoder configured to provide a series of pulses to control circuitry 760 as I-beam 764 translates distally and proximally. Control circuitry 760 may track the pulses to determine the position of I-beam 764. Other suitable position sensors may be used, including, for example, proximity sensors. Other types of position sensors may provide additional signals indicating the movement of I-beam 764. Moreover, in some examples, position sensor 784 may be omitted. If motor 754 is a stepper motor, control circuitry 760 can track the position of I-beam 764 by aggregating the number and direction of steps that the motor has been instructed to perform. Position sensor 784 may be located in end effector 792 or at any other part of the apparatus.

[0517] Control circuitry 760 may communicate with one or more sensors 788. Sensors 788 may be positioned on end effector 792 and adapted to operate with surgical instruments 790 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. 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 end effector 792. Sensors 788 may include one or more sensors.

[0518] One or more sensors 788 may include strain gauges such as microstrain gauges, configured to measure the magnitude of strain in the anvil 766 during clamping conditions. The strain gauge provides an electrical signal whose amplitude varies with the strain value. Sensors 788 may include pressure sensors configured to detect pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. Sensors 788 may be configured to detect the impedance of a tissue segment located between the anvil 766 and the staple cartridge 768, the impedance indicating the thickness and / or integrity of the tissue located between the anvil and the staple cartridge.

[0519] Sensor 788 may be configured to measure the force applied to the anvil 766 by the closure drive system. For example, one or more sensors 788 may be located at the interaction point between the closure tube and the anvil 766 to detect the closure force applied to the anvil 766 by the closure tube. The force applied to the anvil 766 may represent the tissue compression experienced by the tissue segment captured between the anvil 766 and the staple cartridge 768. One or more sensors 788 may be positioned at various interaction points along the closure drive system to detect the closure force applied to the anvil 766 by the closure drive system. One or more sensors 788 may be sampled in real time by the processor portion of the control circuitry 760 during clamping operations. The control circuitry 760 receives real-time sample measurements to provide and analyze time-based information and to evaluate the closure force applied to the anvil 766 in real time.

[0520] The current sensor 786 can be used to measure the current consumed by the motor 754. The force required to propel the I-beam 764 corresponds to the current consumed by the motor 754. The force is converted into a digital signal and provided to the control circuit 760.

[0521] When the RF cartridge 796 is loaded into the end effector 792 in place of the staple cartridge 768, the RF power source 794 is connected to the end effector 792 and applied to the RF cartridge 796. The control circuit 760 controls the delivery of RF power to the RF cartridge 796.

[0522] Additional details are disclosed in U.S. Patent Application Serial No. 15 / 636,096, filed on June 28, 2017, entitled “SURGICAL SYSTEM COUPLABLE WITHSTAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME”, the entire contents of which are incorporated herein by reference.

[0523] Figure 20 A stroke length curve 20740 is shown, illustrating how a control system can modify the stroke length of the closure tube assembly based on a joint motion angle θ. Such modification of the stroke length involves shortening the stroke length to a compensating stroke length (e.g., defined along the y-axis) as the joint angle θ increases (e.g., defined along the x-axis). The compensating stroke length defines the distance the closure tube assembly travels in the distal direction to close the jaws of the end effector; this compensated stroke length depends on the joint motion angle θ and prevents excessive travel of the closure tube assembly from damaging the surgical device.

[0524] For example, as shown in stroke length curve 20740, the stroke length of the closing tube assembly closing the jaws is approximately 0.250 inches when the end effector is not articulating, while the compensated stroke length is approximately 0.242 inches when the articulation angle θ is approximately 60 degrees. Such measurements are provided by way of example only and may include various angles and corresponding stroke lengths as well as compensated stroke lengths without departing from the scope of this disclosure. Furthermore, the relationship between the articulation angle θ and the compensated stroke length is non-linear, and the rate of decrease in the compensated stroke length increases with increasing articulation angle. For example, the decrease in compensated stroke length between 45 and 60 degrees of articulation is greater than the decrease between 0 and 15 degrees of articulation. While using this method, the control system adjusts the stroke length based on the articulation angle θ to prevent damage to the surgical device (e.g., locking the distal end of the closing tube assembly in a distal position), it still allows the distal closing tube to advance during articulation, thereby potentially closing the jaws at least partially.

[0525] Figure 21 A positioning curve 20750 for the closure assembly is shown, illustrating one aspect of how the control system modifies the longitudinal position of the closure assembly based on a joint motion angle θ. This modification of the longitudinal position of the closure assembly involves retracting the closure assembly proximally a compensation distance (e.g., defined along the y-axis) based on the joint motion angle θ (e.g., defined along the x-axis) when the end effector performs joint motion. This compensation distance retracts the closure assembly proximally to prevent distal closure tube from advancing distally, thereby holding the jaws in the open position during joint motion. By retracting the closure assembly proximally a compensation distance during joint motion, the closure assembly can travel a stroke length from the proximal retracted position to close the jaws upon activation of the closure assembly.

[0526] For example, as shown in the closure tube assembly positioning curve 20750, the compensation distance is zero when the end effector is not articulating, and approximately 0.008 inches when the articulation angle θ is approximately 60 degrees. In this example, the closure tube assembly retracts 0.008 inches of compensation distance during articulation. Therefore, to close the jaws, the closure tube assembly can advance the stroke length from this retracted position. Such measurements are provided for illustrative purposes only and may include any of a variety of angles and corresponding compensation distances without departing from the scope of this disclosure. Figure 21 As shown, the relationship between the joint motion angle θ and the compensation distance is non-linear, and the rate of increase in the compensation distance increases with the increase of the joint motion angle θ. For example, the increase in compensation distance between 45 degrees and 60 degrees is greater than the increase in compensation distance between 0 degrees and 15 degrees.

[0527] When clamping patient tissue, the force and tissue applied by the clamping device (e.g., a linear suture device) can reach unacceptably high levels. For example, when a constant closure rate is used, the force can become high enough to cause excessive trauma to the clamped tissue and can cause deformation within the clamping device, making it impossible to maintain acceptable tissue spacing throughout the suture path. Figure 22 This diagram illustrates the power applied to the tissue during compression at a constant anvil closure rate (i.e., without controlled tissue compression (CTC)) and the power applied to the tissue during compression at a variable anvil closure rate (i.e., with CTC). The adjustable closure rate controls tissue compression such that the power applied to the tissue remains constant for a portion of the compression. When using a variable anvil closure rate, according to... Figure 22 The peak power applied to the tissue is much lower. Based on the applied power, the force (or a force-related or proportional parameter) applied by the surgical device can be calculated. In this regard, the power can be limited so that the force applied by the surgical device (e.g., by the jaws of a linear stapler) does not exceed the yield force or pressure that would cause the jaws to open, such that when in the fully closed position, the tissue gap is not within acceptable limits along the entire suture length. For example, the jaws should be parallel or sufficiently close to parallel so that the tissue gap remains within acceptable or target limits for all staple positions along the entire length of the jaws. Furthermore, limiting the applied power avoids or at least minimizes trauma or damage to the tissue.

[0528] exist Figure 22 In this case, the total energy applied in the method without using CTC is the same as the total energy applied in the method using CTC, that is, Figure 22 The areas under the power curves are the same or substantially the same. However, the power distributions utilized differ significantly because the peak power in the example using CTC is much lower compared to the example without CTC.

[0529] In the example using CTC, power limiting is achieved by slowing down the shutdown rate, as shown in line 20760. It should be noted that the compression time B' is longer than the shutdown time B. Figure 22 As shown, the apparatus and method providing a constant closure rate (i.e., without CTC) achieve the same 50 psi compression force at the same 1 mm tissue gap as the apparatus and method providing a variable closure rate (i.e., using CTC). While the apparatus and method providing a constant closure rate can achieve compression force at the desired tissue gap in a shorter time compared to the apparatus and method using a variable closure rate, this produces a peak in the power applied to the tissue, such as... Figure 22As shown. In contrast, using the exemplary aspect shown in CTC begins by slowing the closure rate to limit the amount of power applied to the tissue below a certain level. By limiting the power applied to the tissue, tissue trauma can be minimized relative to systems and methods that do not use CTC.

[0530] Figure 22 The additional examples are further described in U.S. Patent 8,499,992, filed June 1, 2012, entitled “DEVICE AND METHOD FORCONTROLLING COMPRESSION OF TISSUE”, published August 6, 2013, the entire disclosure of which is incorporated herein by reference.

[0531] In some aspects, the control system may include multiple predefined force thresholds that help the control system determine the position of the electron beam and / or the joint motion angle of the firing axis and, based on such determination, appropriately control at least one motor. For example, the force thresholds may vary depending on the travel length of the firing rod configured to translate the firing axis, and such force thresholds may be compared with measured torque of one or more motors communicating with the control system. The comparison of the measured torque with the force thresholds provides the control system with a reliable way to determine the position of the electron beam and / or the joint motion of the end effector. This allows the control system to appropriately control one or more motors (e.g., reduce or stop torsional loads) to ensure proper firing of the firing assembly and joint motion of the end effector, as well as to prevent damage to the system, as will be described in more detail below.

[0532] Figure 23A force-displacement graph 20800 is shown, which includes the measured force in Part A related to the measured displacement in Part B. Both Part A and Part B have x-axis defining time (e.g., seconds). The y-axis of Part B defines the travel displacement of the firing link (e.g., in millimeters), and the y-axis of Part A defines the force applied to the firing rod, thereby advancing the firing shaft. As shown in Part A, the travel of the firing rod within a first joint movement range 20902 (e.g., the first approximately 12 mm of travel) causes the end effector to articulate. For example, at the 12 mm displacement position, the end effector is fully articulated to the right and mechanically cannot articulate further. Due to being in full articulation, the torque on the motor will increase, and the control system can sense that the peak joint movement force 20802 exceeds a predefined joint movement threshold 20804, as shown in Part A. The control system may include more than one predefined joint movement threshold 20804 for sensing more than one maximum joint movement direction (e.g., left joint movement and right joint movement). After the control system detects a joint motion force peak 20802 that exceeds a predetermined joint motion threshold 20804, the control system can reduce or stop the actuation of the motor, thereby protecting at least the motor from damage.

[0533] After the firing lever advances beyond the range of motion 20902, a displacement mechanism within the surgical stapler can cause further distal travel of the firing lever, resulting in distal travel of the firing axis. For example, as shown in Section B, travel between approximately 12 mm and 70 mm can advance the electron beam along the firing stroke 20904 and cut tissue trapped between the jaws; however, other travel lengths are also within the scope of this disclosure. In this example, the maximum firing stroke position 20906 of the electron beam occurs at 70 mm of travel. At this point, the electron beam or blade abuts the distal end of the magazine or jaws, thereby increasing the torque on the motor and causing the control system to sense a blade travel force peak 20806 as shown in Section A. As shown in Section A, the control system may include the ends of a motor threshold 20808 and a blade travel threshold 20810, which branches from the motor threshold 20808 and decreases (e.g., non-linearly) as the electron beam approaches the maximum firing stroke position 20906.

[0534] The control system can be configured to monitor sensed motor torque during at least the last portion of the distal stroke 20907 of the electron beam (e.g., the last 10% of the firing stroke 904) before the electron beam reaches the maximum firing stroke position 20906. While monitoring along this last portion of the distal stroke 20907, the control system can reduce the motor torque, thereby reducing the load on the electron beam. This can protect the surgical stapler (including the electron beam) from damage by reducing the load on the electron beam as it approaches the maximum firing stroke position 20906, thereby reducing the impact of the electron beam on the distal end of the magazine or jaws. As described above, such impacts can generate a blade travel force peak 20806, which may exceed a blade travel threshold 20810 but not a motor threshold 20808, thus preventing damage to the motor. Therefore, the control system can stop motor actuation after the peak feed force 20806 exceeds the feed threshold 20810 and before the peak feed force 20806 exceeds the motor threshold 20808, thereby protecting the motor from damage. Furthermore, the gradual decrease in the feed threshold 20810 prevents the control system from initially deducing that the electron beam has reached the maximum firing stroke position 20906.

[0535] After the control system detects that the peak feed force 20806 exceeds the feed threshold 20810, the control system can confirm the position of the electron beam (e.g., at a 70 mm displacement and / or at the end of the firing stroke 20904) and can retract the firing lever based on such a known displacement position to reset the electron beam at the nearest side position 20908 (e.g., 0 mm displacement). At the nearest side position 20908, the control system can sense a peak feed force 20812 exceeding a predefined feed retraction threshold 20814, as shown in Section A. At this point, if necessary, the control system can recalibrate and associate the position of the electron beam with the original position, where subsequent advance of the firing link in the distal direction (e.g., approximately 12 mm) will cause the shifter to disengage the electron beam from the firing lever. Once disengaged, travel of the firing lever within the joint range of motion 20902 will again cause joint movement of the end effector.

[0536] Therefore, the control system can sense the torque on the motor that controls the movement of the firing lever and compare such sensed torque with multiple thresholds to determine the position of the electron beam or the joint movement angle of the end effector, thereby appropriately controlling the motor to prevent damage to the motor and confirming the positioning of the firing lever and / or the electron beam.

[0537] As described above, the tissue contact or pressure sensor determines when the jaw member initially contacts the tissue "T". This allows the surgeon to determine the initial thickness and / or the thickness of the tissue "T" before clamping. In any of the above-described surgical instruments, such as Figure 24As shown, the contact between the jaw member and the tissue "T" closes the previously disconnected sensing circuit "SC" by establishing contact with a pair of opposing plates "P1, P2" disposed on the jaw member. The contact sensor may also include a force-sensitive transducer that determines the amount of force applied to the sensor, which can be assumed to be the same as the amount of force applied to the tissue "T". This force applied to the tissue can then be converted into a certain amount of tissue compression. The force sensor measures the amount of compression experienced by the tissue and provides the surgeon with information about the force applied to the tissue "T". Excessive tissue compression can have negative effects on the tissue "T" being operated on. For example, excessive compression of the tissue "T" can lead to tissue necrosis and, in some surgeries, suture failure. Information about the pressure applied to the tissue "T" allows the surgeon to better determine whether excessive pressure has been applied to the tissue "T".

[0538] Any of the contact sensors disclosed herein may include, but is not limited to, electrical contacts placed on the inner surface of a jaw that close a previously disconnected sensing circuit upon contact with tissue. The contact sensor may also include a force-sensitive transducer that detects when the clamped tissue first resists compression. The force transducer may include, but is not limited to, piezoelectric elements, piezoresistive elements, metal film or semiconductor strain gauges, inductive pressure sensors, capacitive pressure sensors, and potentiometric pressure transducers that use a Bourdon tube, capsule, or bellows to drive an arc brush arm on a resistive element.

[0539] In one aspect, any of the aforementioned surgical instruments may include one or more piezoelectric elements to detect pressure changes occurring on the jaw members. A piezoelectric element is a bidirectional transducer that converts stress into an electric potential. The element may be made of metallized quartz or ceramic. In operation, when stress is applied to the crystal, the charge distribution of the material changes, resulting in a voltage generated across the entire material. The piezoelectric element can be used to indicate when any one or both of the jaw members come into contact with the tissue “T” and the amount of pressure applied to the tissue “T” after contact is established.

[0540] In one aspect, any of the aforementioned surgical instruments may include or be provided with one or more metal strain gauges, which are placed within or on a portion of the body of the surgical instrument. The metal strain gauge operates on the principle that the resistance of a material depends on its length, width, and thickness. Therefore, when the material of the metal strain gauge undergoes strain, the resistance of the material changes. Thus, a resistor made of such material, incorporated into a circuit, will convert strain into a change in electrical signal. Advantageously, the strain gauge may be placed on the surgical instrument such that pressure applied to the tissue affects the strain gauge.

[0541] Alternatively, one or more semiconductor strain gauges can be used in a manner similar to the metal strain gauges described above, but with a different transduction mode. In operation, the resistivity of the material changes as the lattice structure of the semiconductor strain gauge deforms due to applied stress. This phenomenon is known as the piezoresistive effect.

[0542] On the other hand, any of the aforementioned surgical instruments may include or be provided with one or more inductive pressure sensors to convert pressure or force into motion of sensing elements relative to each other. This motion of the sensing elements relative to each other changes the overall inductance or inductive coupling. A capacitive pressure transducer similarly converts pressure or force into motion of capacitive elements relative to each other, thereby changing the total capacitance.

[0543] In another aspect, any of the aforementioned surgical instruments may include or be provided with one or more capacitive pressure transducers to convert pressure or force into movement of capacitive elements relative to each other, thereby changing the total capacitance.

[0544] In one aspect, any of the aforementioned surgical instruments may include or be provided with one or more mechanical pressure transducers to convert pressure or force into motion. In use, the motion of the mechanical element deflects a pointer or dial on a measuring instrument. This motion of the pointer or dial may represent pressure or force applied to tissue “T”. Examples of mechanical elements include, but are not limited to, Bourdon tubes, capsules, or bellows. By way of example, the mechanical element may be coupled to other measuring and / or sensing elements such as a potentiometer pressure transducer. In this example, the mechanical element is coupled to an arc brush on a variable resistor. In use, pressure or force can be converted into mechanical motion that deflects the arc brush on the potentiometer, thereby changing the resistance to reflect the applied pressure or force.

[0545] The combination of the above aspects, especially the combination of gap and tissue contact sensors, provides surgeons with feedback and / or real-time information about the condition of the surgical site and / or target tissue "T". For example, information about the initial thickness of the tissue "T" can guide the surgeon to select an appropriate staple size; information about the clamping thickness of the tissue "T" can let the surgeon know whether the selected staple will be properly shaped; information related to the initial thickness and clamping thickness of the tissue "T" can be used to determine the amount of compression or strain on the tissue "T"; and information related to the strain on the tissue "T" can be used to avoid compressing the tissue to excessive strain values ​​and / or avoid suturing tissue that has already undergone excessive strain.

[0546] Additionally, force sensors can be used to provide surgeons with the amount of pressure applied to the tissue. Surgeons can use this information to avoid applying excessive pressure to the tissue "T" or to avoid suturing a tissue "T" that has already undergone excessive strain.

[0547] Figure 24 The additional examples are further described in U.S. Patent 8,181,839 entitled “SURGICAL INSTRUMENT EMPLOYING SENSORS”, filed June 27, 2011, published May 5, 2012, the entire disclosure of which is incorporated herein by reference.

[0548] Certain aspects are shown and described to provide an understanding of the structure, function, manufacture, and use of the disclosed apparatus and methods. Features shown or described in one example may be combined with features in other examples, and modifications and variations may be made within the scope of this disclosure.

[0549] The terms “proximal” and “distal” are used relative to the clinician manipulating the handle of a surgical instrument, where “proximal” refers to the portion closer to the clinician and “distal” refers to the portion farther from the clinician. For convenience, the spatial terms “vertical,” “horizontal,” “upward,” and “downward” used relative to figures are not intended to be restrictive and / or absolute, as surgical instruments can be used in many orientations and positions.

[0550] Exemplary devices and methods for performing laparoscopic and minimally invasive surgical procedures are provided. However, such devices and methods can be used in other surgical procedures and applications, including, for example, open surgery. Surgical instruments can be inserted through natural orifices or through incisions or puncture holes formed in tissue. The working portion or end effector portion of the instrument can be inserted directly into the body or through an access device having a working channel through which the end effector and elongated shaft of the surgical instrument can be advanced.

[0551] Figures 25 to 28A motor-driven surgical instrument 150010 for cutting and fastening is depicted, which may be reusable or non-reusable. In an illustrative example, the surgical instrument 150010 includes a housing 150012 that includes a handle assembly 150014 configured to be grasped, manipulated, and actuated by a clinician. The housing 150012 is configured to be operatively attached to an interchangeable shaft assembly 150200 having an end effector 150300 operatively coupled thereto, the end effector being configured to perform one or more surgical tasks or procedures. According to this disclosure, various forms of interchangeable shaft assemblies can be effectively employed in conjunction with robot-controlled surgical systems. The term "housing" may encompass the housing or similar portion of a robotic system that houses or otherwise operatively supports at least one drive system configured to generate and apply at least one controlled motion that can be used to actuate the interchangeable shaft assembly. The term "frame" may refer to a portion of a handheld surgical instrument. The term "frame" can also refer to a portion of a robot-controlled surgical instrument and / or a portion of a robotic system that can be used to operatively control a surgical instrument. Interchangeable axis assemblies can be used with various robotic systems, instruments, components, and methods disclosed in U.S. Patent 9,072,535 entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS," the entire contents of which are incorporated herein by reference.

[0552] Figure 25 This is a perspective view of a surgical instrument 150010 having an interchangeable shaft assembly 150200 operatively coupled thereto according to at least one aspect of the present disclosure. The housing 150012 includes an end effector 150300 comprising a surgical cutting and fastening device configured to operatively support a surgical cartridge 150304 therein. The housing 150012 can be configured for use in conjunction with an interchangeable shaft assembly including an end effector adapted to support cartridges of different sizes and types, having different shaft lengths, dimensions, and types. The housing 150012 can be used with a variety of interchangeable shaft assemblies, including assemblies configured to apply other forms of motion and energy (such as radio frequency (RF) energy, ultrasonic energy, and / or motion) to an end effector arrangement adapted for use in conjunction with a variety of surgical applications and procedures. The end effector, shaft assembly, handle, surgical instrument, and / or surgical instrument system can utilize any suitable one or more fasteners to fasten tissue. For example, a fastener magazine, which includes multiple fasteners removably stored therein, can be removably inserted into and / or attached to the end actuator of the shaft assembly.

[0553] The handle assembly 150014 may include a pair of interconnected handle housing segments 150016 and 150018, which are interconnected by screws, snap-fit ​​features, adhesives, etc. The handle housing segments 150016 and 150018 cooperate to form a pistol-style grip 150019 that can be grasped and manipulated by a clinician. The handle assembly 150014 operatively supports multiple drive systems configured to generate and apply control movements to corresponding portions of interchangeable shaft assemblies operatively attached thereto. A display may be disposed below a cover 150045.

[0554] Figure 26 For at least one aspect of this disclosure Figure 25 An exploded assembly view of a portion of the surgical instrument 150010. The handle assembly 150014 may include a frame 150020 operatively supporting multiple actuation systems. The frame 150020 operatively supports a “first” or closure actuation system 150030, which applies closing and opening movements to an interchangeable shaft assembly 150200. The closure actuation system 150030 may include an actuator, such as a closure trigger 150032 pivotally supported by the frame 150020. The closure trigger 150032 is pivotally coupled to the handle assembly 150014 via a pivot pin 150033, allowing the closure trigger 150032 to be manipulated by a clinician. When a clinician grasps the pistol grip 150019 of the handle assembly 150014, the closing trigger 150032 can pivot from the activated or "unactivated" position to the "activated" position and more specifically to the fully compressed or fully activated position.

[0555] The handle assembly 150014 and frame 150020 operably support a firing drive system 150080, which is configured to apply firing motion to corresponding portions of interchangeable shaft assemblies attached thereto. The firing drive system 150080 may employ an electric motor 150082 located in a pistol grip portion 150019 of the handle assembly 150014. The electric motor 150082 may be a DC brushed motor having a maximum rotational speed of, for example, about 25,000 RPM. In other configurations, the motor may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The electric motor 150082 may be powered by a power source 150090, which may include a removable power supply assembly 150092. The removable power supply assembly 150092 may include a proximal housing portion 150094 configured to attach to a distal housing portion 150096. The proximal housing portion 150094 and the distal housing portion 150096 are configured to operably support a plurality of batteries 150098 therein. Each battery 150098 may comprise, for example, a lithium-ion (Li) or other suitable battery. The distal housing portion 150096 is configured for removable operability to attach to a control circuit board 150100 operably coupled to an electric motor 150082. The plurality of batteries 150098 connected in series can power a surgical instrument 150010. The power source 150090 may be replaceable and / or rechargeable. A display 150043 located beneath a cover 150045 is electrically coupled to the control circuit board 150100. The cover 150045 is removable to expose the display 150043.

[0556] The electric motor 150082 may include a rotatable shaft (not shown) operatively coupled to a gear reducer assembly 150084, which is mounted to engage with a set or rack of drive teeth 150122 on a longitudinally movable drive member 150120. The longitudinally movable drive member 150120 has a rack with drive teeth 150122 formed thereon for engaging with a corresponding drive gear 150086 of the gear reducer assembly 150084.

[0557] In use, the voltage polarity provided by power source 150090 can operate electric motor 150082 in a clockwise direction, wherein the voltage polarity applied to electric motor by battery can be reversed to operate electric motor 150082 in a counterclockwise direction. When electric motor 150082 rotates in one direction, longitudinally movable drive member 150120 will be axially driven in the distal direction "DD". When electric motor 150082 is driven in the opposite direction of rotation, longitudinally movable drive member 150120 will be axially driven in the proximal direction "PD". Handle assembly 150014 may include a switch that can be configured to reverse the polarity applied to electric motor 150082 by power source 150090. Handle assembly 150014 may include a sensor configured to detect the position of longitudinally movable drive member 150120 and / or the direction of movement of longitudinally movable drive member 150120.

[0558] The actuation of the electric motor 150082 can be controlled by a trigger 150130 that is pivotally supported on the handle assembly 150014. The trigger 150130 can pivot between an unactuated position and an actuated position.

[0559] Go back to Figure 25 The interchangeable shaft assembly 150200 includes an end effector 150300, which includes an elongated channel 150302 configured to operably support a surgical cartridge 150304 therein. The end effector 150300 may include an anvil 150306, which is pivotally supported relative to the elongated channel 150302. The interchangeable shaft assembly 150200 may include an articulation joint 150270. The construction and operation of the end effector 150300 and the articulation joint 150270 are described in U.S. Patent Application Publication 2014 / 0263541 entitled “ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK”, the entire contents of which are incorporated herein by reference. The interchangeable shaft assembly 150200 may include a proximal housing or nozzle 150201, which is formed by nozzle portions 150202 and 150203. The interchangeable shaft assembly 150200 may include a closing tube 150260 extending along the shaft axis SA that can be used to close and / or open the anvil 150306 of the end actuator 150300.

[0560] Go back to Figure 25The closing tube 150260 is translated distally (in the direction "DD") to close the anvil 150306, for example, in response to the actuation of the closing trigger 150032, in the manner described in the aforementioned reference, U.S. Patent Application Publication 2014 / 0263541. The anvil 150306 is opened by translating the closing tube 150260 proximally. In the anvil open position, the closing tube 150260 moves to the proximal position.

[0561] Figure 27 This is another exploded component view of a portion of an interchangeable shaft assembly 150200 according to at least one aspect of the present disclosure. The interchangeable shaft assembly 150200 may include a firing member 150220 supported for axial travel within a spine 150210. The firing member 150220 includes an intermediate firing shaft 150222 configured to attach to a distal cutting portion or shank 150280. The firing member 150220 may be referred to as a “second shaft” and / or a “second shaft assembly.” The intermediate firing shaft 150222 may include a longitudinal slot 150223 in its distal end, configured to receive a tab 150284 on the proximal end 150282 of the shank 150280. The longitudinal slot 150223 and the proximal end 150282 may be configured to allow relative movement between them and may include a sliding joint 150286. The sliding joint 150286 allows the intermediate firing shaft 150222 of the firing member 150220 to articulate the end effector 150300 about the articulated joint 150270 without moving or at least substantially without moving the shank 150280. Once the end effector 150300 is properly oriented, the intermediate firing shaft 150222 can be advanced distally until the proximal sidewall of the longitudinal slot 150223 contacts the insert 150284 to advance the shank 150280 and fire the cartridge positioned within the channel 150302. The ridge 150210 has an elongated opening or window 150213 therein to facilitate the assembly and insertion of the intermediate firing shaft 150222 into the ridge 150210. Once the intermediate firing shaft 150222 has been inserted into the ridge, the top frame segment 150215 can engage with the shaft frame 150212 to enclose the intermediate firing shaft 150222 and the blade shank 150280 therein. Operation of the firing member 150220 is described in U.S. Patent Application Publication 2014 / 0263541. The ridge 150210 can be configured to slidably support the firing member 150220 and the closed tube 150260 extending around the ridge 150210. The ridge 150210 can slidably support the articulated motion actuator 150230.

[0562] Interchangeable shaft assembly 150200 may include clutch assembly 150400 configured to selectively and releasably engage articulated actuator 150230 to firing member 150220. Clutch assembly 150400 includes a locking bushing or locking sleeve 150402 positioned around firing member 150220, wherein locking sleeve 150402 is rotatable between an engaged position and a disengaged position, in which the locking sleeve 150402 engages articulated actuator 150230 to firing member 150220, and in the disengaged position, articulated actuator 150230 is not operatively engaged with firing member 150220. When the locking sleeve 150402 is in the engaged position, distal movement of the firing member 150220 causes distal movement of the articulated actuator 150230; and correspondingly, proximal movement of the firing member 150220 causes proximal movement of the articulated actuator 150230. When the locking sleeve 150402 is in the disengaged position, movement of the firing member 150220 is not transmitted to the articulated actuator 150230; and therefore, the firing member 150220 can move independently of the articulated actuator 150230. The nozzle 150201 can be used to operatively engage and disengage the articulated actuator system from the firing actuator system in various manners described in U.S. Patent Application Publication 2014 / 0263541.

[0563] Interchangeable shaft assembly 150200 may include slip ring assembly 150600, which may be configured to, for example, conduct power to and / or from end effector 150300, and / or transmit signals to and / or from end effector 150300. Slip ring assembly 150600 may include a proximal connector flange 150604 and a distal connector flange 150601 positioned within slots defined in nozzle portions 150202, 150203. Proximal connector flange 150604 may include a first face, and distal connector flange 150601 may include a second face positioned adjacent to and movable relative to the first face. Distal connector flange 150601 may be positioned around shaft axis SA-SA ( Figure 25The connector 150607 is rotatable relative to the proximal connector flange 150604. The proximal connector flange 150604 may include a plurality of concentric or at least substantially concentric conductors 150602 defined on its first surface. The connector 150607 may be mounted on the proximal side of the distal connector flange 150601 and may have a plurality of contacts, each corresponding to and electrically contacting one of the conductors 150602. This arrangement allows relative rotation between the two flanges while maintaining electrical contact between the proximal connector flange 150604 and the distal connector flange 150601. The proximal connector flange 150604 may include an electrical connector 150606 that enables, for example, signal communication between the conductors 150602 and the shaft circuit board. In at least one embodiment, a wire harness comprising a plurality of conductors may extend between the electrical connector 150606 and the shaft circuit board. The electrical connector 150606 may extend proximally through a connector opening defined in a chassis mounting flange. The full text of U.S. Patent Application Publication 2014 / 0263551, entitled “STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM,” is incorporated herein by reference. The full text of U.S. Patent Application Publication 2014 / 0263552, entitled “STAPLE CARTRIDGE TISSUETHICKNESS SENSOR SYSTEM,” is incorporated herein by reference. Further details regarding the slip ring assembly 150600 can be found in U.S. Patent Application Publication 2014 / 0263541.

[0564] The interchangeable shaft assembly 150200 may include a proximal portion that can be securely mounted to the shank assembly 150014, and a distal portion that can rotate about a longitudinal axis. The rotatable distal shaft portion is rotatable about the slip ring assembly 150600 relative to the proximal portion. The distal connector flange 150601 of the slip ring assembly 150600 may be positioned within the rotatable distal shaft portion.

[0565] Figure 28 For at least one aspect of this disclosure Figure 25An exploded view of one side of the end effector 150300 of the surgical instrument 150010. The end effector 150300 may include an anvil 150306 and a surgical cartridge 150304. The anvil 150306 may be coupled to an elongated channel 150302. A hole 150199 may be defined in the elongated channel 150302 to receive a pin 150152 extending from the anvil 150306 to allow the anvil 150306 to pivot relative to the elongated channel 150302 and the surgical cartridge 150304 from an open position to a closed position. A firing lever 150172 is configured to be longitudinally translatable into the end effector 150300. The firing lever 150172 may be composed of a solid portion or may include a laminated material comprising stacks of steel plates. The firing lever 150172 includes an I-beam 150178 and a cutting blade 150182 at its distal end. The distally projecting end of the firing lever 150172 may be attached to the I-beam 150178 to help space the anvil 150306 from the surgical cartridge 150304 positioned in the elongated channel 150302 when the anvil 150306 is in the closed position. The I-beam 150178 may include a sharp cutting blade 150182 that cuts tissue when the I-beam 150178 is advanced distally through the firing lever 150172. In operation, the I-beam 150178 may fire the surgical cartridge 150304. The surgical staple cartridge 150304 may include a molded cartridge body 150194 that holds a plurality of staples 150191 disposed on staple actuators 150192 located in corresponding upwardly opening staple cavities 150195. A wedge-shaped slider 150190 is driven distally by an I-beam 150178 to slide on a cartridge tray 150196 of the surgical staple cartridge 150304. The wedge-shaped slider 150190 causes the staple actuators 150192 to cam upward to expel the staples 150191 into deformable contact with the anvil 150306, while the cutting edge 150182 of the I-beam 150178 cuts the clamped tissue.

[0566] The I-beam 150178 may include an upper pin 150180 that engages with an anvil 150306 during firing. The I-beam 150178 may include an intermediate pin 150184 and a bottom base 150186 that engage with portions of the cartridge body 150194, the cartridge tray 150196, and the elongated channel 150302. When the surgical cartridge 150304 is positioned within the elongated channel 150302, a slot 150193 defined in the cartridge body 150194 may align with a longitudinal slot 150197 defined in the cartridge tray 150196 and a slot 150189 defined in the elongated channel 150302. In use, the I-beam 150178 may slide through the aligned longitudinal slots 150193, 150197, and 150189, wherein, as Figure 28As shown, the bottom base 150186 of the I-beam 150178 can engage with a groove extending along the length of the slot 150189 and a groove extending along the bottom surface of the elongated channel 150302; the intermediate pin 150184 can engage with the top surface of the cartridge tray 150196 along the length of the longitudinal slot 150197; and the upper pin 150180 can engage with the anvil 150306. When the firing lever 150172 is advanced distally to fire staples from the surgical cartridge 150304 and / or cut into tissue captured between the anvil 150306 and the surgical cartridge 150304, the I-beam 150178 can isolate or restrict relative movement between the anvil 150306 and the surgical cartridge 150304. The firing lever 150172 and the I-beam 150178 can retract proximally, thereby allowing the anvil 150306 to be opened to release the two sutured and cut tissue portions.

[0567] Figure 29A and Figure 29B For at least one aspect of this disclosure Figure 25 A block diagram of the control circuit 150700 for the surgical instrument 150010, which spans two pages. See also: Figure 29A and Figure 29B The handle assembly 150702 may include a motor 150714, which may be controlled by a motor driver 150715 and may be used by the firing system of the surgical instrument 150010. In various forms, the motor 150714 may be a brushed DC motor with a maximum rotational speed of approximately 25,000 RPM. In other arrangements, the motor 150714 may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor driver 150715 may include, for example, an H-bridge driver including a field-effect transistor (FET) 150719. The motor 150714 may be powered by a power assembly 150706, which is releasably mounted to the handle assembly 150200, for supplying control power to the surgical instrument 150010. The power assembly 150706 may include a battery comprising multiple battery cells connected in series and capable of serving as a power source to power the surgical instrument 150010. In some cases, the battery cell of power component 150706 may be replaceable and / or rechargeable. In at least one example, the battery cell may be a lithium-ion battery detachably connected to power component 150706.

[0568] Shaft assembly 150704 may include shaft assembly controller 150722, which can communicate with a safety controller and a power management controller 150716 via an interface when shaft assembly 150704 and power assembly 150706 are coupled to shank assembly 150702. For example, the interface may include a first interface portion 150725 and a second interface portion 150727, wherein the first interface portion may include one or more electrical connectors for engaging with a corresponding shaft assembly electrical connector, and the second interface portion may include one or more electrical connectors for engaging with a corresponding power assembly electrical connector, thereby allowing electrical communication between shaft assembly controller 150722 and power management controller 150716 when shaft assembly 150704 and power assembly 150706 are coupled to shank assembly 150702. One or more communication signals can be transmitted via the interface to convey one or more power requirements of the attached interchangeable shaft assembly 150704 to power management controller 150716. In response, the power management controller can adjust the power output of the battery in the power assembly 150706 according to the power requirements of the attached shaft assembly 150704, as described in more detail below. Connectors may include switches that can be activated after the shank assembly 150702 is mechanically engaged with the shaft assembly 150704 and / or the power assembly 150706 to allow electrical communication between the shaft assembly controller 150722 and the power management controller 150716.

[0569] For example, the interface routes one or more communication signals through the main controller 150717 located in the handle assembly 150702, thereby facilitating the transmission of such communication signals between the power management controller 150716 and the shaft assembly controller 150722. In other cases, when the shaft assembly 150704 and the power assembly 150706 are coupled to the handle assembly 150702, the interface may facilitate a direct communication line between the power management controller 150716 and the shaft assembly controller 150722 passing through the handle assembly 150702.

[0570] The main controller 150717 can be any single-core or multi-core processor, such as those commercially available as ARM Cortex processors from Texas Instruments. In one aspect, the main controller 150717 can be, for example, an LM4F230H5QR ARM Cortex-M4F processor core from Texas Instruments, which includes: 256KB of single-cycle flash memory or other non-volatile memory (up to 40MHz) on-chip memory, a prefetch buffer for improving performance by more than 40MHz, 32KB of single-cycle serial random access memory (SRAM), and a prefetch buffer loaded with… The software includes an internal read-only memory (ROM), 2KB of electrically erasable programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder input (QEI) analog modules, and one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, details of which can be found in the product datasheet.

[0571] Safety controllers can be safety controller platforms comprising two controller-based series (such as the TMS570 and RM4x, also known to be manufactured by Texas Instruments and traded as the Hercules ARM Cortex R4). Safety controllers can be configured specifically for IEC 61508 and ISO 26262 safety-critical applications, etc., to provide advanced integrated safety features while delivering scalable execution, connectivity, and memory options.

[0572] Power component 150706 may include power management circuitry, which may include a power management controller 150716, a power modulator 150738, and a current sensing circuit 150736. When shaft assembly 150704 and power component 150706 are coupled to handle assembly 150702, the power management circuitry can be configured to adjust the battery's power output based on the power requirements of shaft assembly 150704. Power management controller 150716 can be programmed to control power modulator 150738 to adjust the power output of power component 150706. Current sensing circuit 150736 can be used to monitor the power output of power component 150706 to provide feedback to power management controller 150716 related to the battery's power output, enabling power management controller 150716 to adjust the power output of power component 150706 to maintain a desired output. The power management controller 150716 and / or the shaft assembly controller 150722 may each include one or more processors and / or memory units capable of storing multiple software modules.

[0573] Surgical Instruments 150010 ( Figures 25-28The device may include an output device 150742, which may include means for providing sensory feedback to a user. Such means may include, for example, visual feedback devices (e.g., LCD display, LED indicator), audio feedback devices (e.g., speaker, buzzer), or haptic feedback devices (e.g., haptic actuator). In some cases, the output device 150742 may include a display 150743, which may be included in the handle assembly 150702. The shaft assembly controller 150722 and / or the power management controller 150716 may provide feedback to the user of the surgical instrument 150010 via the output device 150742. An interface may be configured to connect the shaft assembly controller 150722 and / or the power management controller 150716 to the output device 150742. Alternatively, the output device 150742 may be integrated with the power assembly 150706. In such cases, when the shaft assembly 150704 is connected to the shank assembly 150702, communication between the output device 150742 and the shaft assembly controller 150722 can be achieved through an interface.

[0574] The control circuitry 150700 includes circuit segments configured to control the operation of the electric surgical instrument 150010. A safety controller segment (segment 1) includes a safety controller and a main controller segment (segment 2). The safety controller and / or the main controller 150717 is configured to interact with one or more additional circuit segments, such as an acceleration segment, a display segment, a shaft segment, an encoder segment, a motor segment, and a power segment. Each of the circuit segments can be coupled to the safety controller and / or the main controller 150717. The main controller 150717 is also coupled to a flash memory. The main controller 150717 also includes a serial communication interface. The main controller 150717 includes multiple inputs coupled to, for example, one or more circuit segments, a battery, and / or multiple switches. The segmented circuitry can be implemented using any suitable circuitry, such as a printed circuit board assembly (PCBA) within the electric surgical instrument 150010. It should be understood that the term "processor" as used herein includes any microprocessor, processor, microcontroller, controller, or other basic computing device that combines the functionality of a computer's central processing unit (CPU) onto one or more integrated circuits. The main controller 150717 is a versatile programmable device that receives digital data as input, processes the input according to instructions stored in its memory, and provides results as output. Because the processor has internal memory, it is an example of sequential digital logic. The control circuitry 150700 can be configured to implement one or more of the processes described herein.

[0575] The acceleration segment (segment 3) includes an accelerometer. The accelerometer is configured to detect the motion or acceleration of the electrically operated surgical instrument 150010. Input from the accelerometer can be used, for example, to switch to and from sleep mode to other modes, to identify the orientation of the electrically operated surgical instrument, and / or to identify when the surgical instrument has been placed. In some examples, the acceleration segment is coupled to a safety controller and / or a main controller 150717.

[0576] The display segment (segment 4) includes a display connector that connects to the main controller 150717. The display connector connects the main controller 150717 to the display via one or more integrated circuit drivers for the display. The integrated circuit drivers for the display may be integrated with the display and / or may be located separately from the display. The display may include any suitable display, such as an organic light-emitting diode (OLED) display, a liquid crystal display (LCD), and / or any other suitable display. In some examples, the display segment is connected to a security controller.

[0577] The shaft segment (segment 5) includes sections for coupling to surgical instruments 150010. Figures 25 to 28 Interchangeable shaft assembly 150200 Figure 25 and Figure 27 The shaft segment includes controls for the interchangeable shaft assembly 150200 and / or one or more controls for coupling to the end effector 150300 of the interchangeable shaft assembly 150200. The shaft segment includes a shaft connector configured to couple a main controller 150717 to the shaft PCBA. The shaft PCBA includes a low-power microcontroller with ferroelectric random access memory (FRAM), articulated motion switches, shaft release Hall effect switches, and a shaft PCBA EEPROM. The shaft PCBA EEPROM includes one or more parameters, routines, and / or programs specific to the interchangeable shaft assembly 150200 and / or the shaft PCBA. The shaft PCBA can be coupled to the interchangeable shaft assembly 150200 and / or integrated with the surgical instrument 150010. In some examples, the shaft segment includes a second shaft EEPROM. The second shaft EEPROM includes multiple algorithms, routines, parameters, and / or other data corresponding to one or more shaft assemblies 150200 and / or end effectors 150300 that can be interfacing with the electric surgical instrument 150010.

[0578] The position encoder segment (segment 6) includes one or more magnetic angular rotary position encoders. The one or more magnetic angular rotary position encoders are configured to identify surgical instruments 150010 ( Figures 25 to 28 Motor 150714, interchangeable shaft assembly 150200 Figure 25 and Figure 27The rotational position of the 150300 and / or the end effector 150300. In some examples, the magnetic angular rotary position encoder may be coupled to the safety controller and / or the main controller 150717.

[0579] The motor circuit segment (segment 7) includes components configured to control the electric surgical instrument 150010. Figures 25 to 28 The motor 150714 is a moving part of the motor. The motor 150714 is connected to the main microcontroller processor 150717 via an H-bridge driver including one or more H-bridge field-effect transistors (FETs) and a motor controller. The H-bridge driver is also connected to a safety controller. A motor current sensor is connected in series with the motor to measure its current consumption. The motor current sensor communicates with the main controller 150717 and / or the safety controller. In some examples, the motor 150714 is connected to a motor electromagnetic interference (EMI) filter.

[0580] The motor controller controls the first and second motor markers to indicate the status and position of the motor 150714 to the main controller 150717. The main controller 150717 provides the motor controller with a pulse width modulation (PWM) high signal, a PWM low signal, a direction signal, a synchronization signal, and a motor reset signal via a buffer. The power segment is configured to provide segment voltage to each of the circuit segments.

[0581] The power segment (segment 8) includes a battery connected to the safety controller, the main controller 150717, and the additional circuit segment. The battery is connected to the segment circuit via a battery connector and a current sensor. The current sensor is configured to measure the total current consumption of the segment circuit. In some examples, one or more voltage converters are configured to provide a predetermined voltage value to one or more circuit segments. For example, in some examples, the segment circuit may include a 3.3V voltage converter and / or a 5V voltage converter. A boost converter is configured to provide a boost voltage up to a predetermined amount (e.g., up to 13V). The boost converter is configured to provide additional voltage and / or current during power-intensive operation and is capable of preventing voltage drop conditions or low-power conditions.

[0582] Multiple switches are connected to the safety controller and / or the main controller 150717. These switches can be configured to control surgical instruments 150010. Figures 25 to 28The operation of the segmented circuit, and / or indication of the status of the surgical instrument 150010. An emergency door switch and a Hall effect switch are configured to indicate the status of the emergency door. Multiple joint motion switches (such as left-to-left joint motion switch, left-to-right joint motion switch, left-to-center joint motion switch, right-to-left joint motion switch, right-to-right joint motion switch, and right-to-center joint motion switch) are configured to control the interchangeable shaft assembly 150200 (…). Figure 25 and Figure 27 ) and / or end effector 150300 ( Figure 25 and Figure 28 The joint movement of the shaft is controlled by a left-side reversing switch and a right-side reversing switch. The left-side switches (including the left-to-left joint movement switch, the left-to-right joint movement switch, the left-to-center joint movement switch, and the left-side reversing switch) are connected to the main controller 150717 via a left flexible connector. The right-side switches (including the right-to-left joint movement switch, the right-to-right joint movement switch, the right-to-center joint movement switch, and the right-side reversing switch) are connected to the main controller 150717 via a right flexible connector. The trigger switch, the clamp release switch, and the shaft engagement switch are connected to the main controller 150717.

[0583] Any suitable mechanical, electromechanical, or solid-state switch can be combined in any way to achieve multiple switches. For example, the switch can be used with surgical instruments 150010 ( Figures 25 to 28 Limit switches are limit switches operated by the movement of associated components or the presence of an object. Such switches can be used to control various functions associated with surgical instruments 150010. A limit switch is an electromechanical device consisting of an actuator mechanically connected to a set of contacts. When an object comes into contact with the actuator, the device actuates the contacts to form or disconnect an electrical connection. Limit switches are durable, easy to install, and reliable in operation, making them suitable for a variety of applications and environments. Limit switches can determine the presence or absence of an object, its passage, its positioning, and the end of its travel. In other embodiments, the switch can be a solid-state switch that operates under the influence of a magnetic field, such as a Hall effect device, a magnetoresistive (MR) device, a giant magnetoresistive (GMR) device, a magnetometer, etc. In other embodiments, the switch can be a solid-state switch that operates under the influence of light, such as an optical sensor, an infrared sensor, an ultraviolet sensor, and others. Similarly, the switch can be a solid-state device, such as a transistor (e.g., a FET, a junction FET, a metal-oxide-semiconductor FET (MOSFET), a bipolar transistor, etc.). Other switches may include wireless switches, ultrasonic switches, accelerometers, inertial sensors, and others.

[0584] Figure 30 For at least one aspect of this disclosure Figure 25Another block diagram of the control circuitry 150700 for a surgical instrument shows the interfaces between the handle assembly 150702 and the power assembly 150706, and between the handle assembly 150702 and the interchangeable shaft assembly 150704. The handle assembly 150702 may include a main controller 150717, a shaft assembly connector 150726, and a power assembly connector 150730. The power assembly 150706 may include a power assembly connector 150732 and a power management circuit 150734, which may include a power management controller 150716, a power modulator 150738, and a current sensing circuit 150736. Shaft assembly connectors 150730 and 150732 form interface 150727. The power management circuit 150734 can be configured to adjust the power output of the battery 150707 based on the power requirements of the interchangeable shaft assembly 150704 when the interchangeable shaft assembly 150704 and the power assembly 150706 are coupled to the handle assembly 150702. The power management controller 150716 can be programmed to control the power modulator 150738 to adjust the power output of the power assembly 150706, and the current sensing circuit 150736 can be used to monitor the power output of the power assembly 150706 to provide feedback to the power management controller 150716 related to the power output of the battery 150707, so that the power management controller 150716 can adjust the power output of the power assembly 150706 to maintain ideal output. Shaft assembly 150704 includes shaft processor 150720, which is coupled to non-volatile memory 150721 and shaft assembly connector 150728 to electrically connect shaft assembly 150704 to shank assembly 150702. Shaft assembly connectors 150726 and 150728 form interface 150725. Main controller 150717, shaft processor 150720, and / or power management controller 150716 may be configured to implement one or more of the processes described herein.

[0585] Surgical Instruments 150010 ( Figures 25 to 28The device may include an output device 150742 for providing sensory feedback to a user. Such a device may include visual feedback devices (e.g., an LCD display, LED indicators), auditory feedback devices (e.g., a speaker, a buzzer), or haptic feedback devices (e.g., a haptic actuator). In some cases, the output device 150742 may include a display 150743, which may be included in the handle assembly 150702. The shaft assembly controller 150722 and / or the power management controller 150716 may provide feedback to the user of the surgical instrument 150010 via the output device 150742. An interface 150727 may be configured to connect the shaft assembly controller 150722 and / or the power management controller 150716 to the output device 150742. The output device 150742 may be integrated with the power assembly 150706. When the interchangeable shaft assembly 150704 is coupled to the handle assembly 150702, communication between the output device 150742 and the shaft assembly controller 150722 can be achieved through interface 150725. (The description of the control of surgical instrument 150010 is also included.) Figures 25 to 28 ) control circuit 150700 ( Figure 29A , Figure 29B and Figure 6 Following this, this disclosure now turns to surgical instruments 150010 ( Figures 25 to 28 Various configurations of the control circuit 150700.

[0586] See Figure 31 The surgical stapler 151000 may include a handle portion 151002, a shaft portion 151004, and an end effector portion 151006. The surgical stapler 151000 is similarly constructed and configured for combination. Figure 25 The motor-driven surgical cutting and fastening instrument 150010 is described. Therefore, for convenience and clarity, details of its operation and construction will not be repeated here. The end effector 151006 can be used to compress, cut, or suture tissue. See now. Figure 32 Before performing compression, cutting, or suturing, the physician can position the end effector 151030 around the tissue 151032. For example... Figure 32 As shown, compression should not be applied to the tissue when preparing to use the end effector. See now. Figure 33 By engaging with the handle of a surgical suture device (e.g., handle 151002), a physician can use the end effector 151030 to compress tissue 151032. In one aspect, tissue 151032 can be compressed to its maximum threshold, such as... Figure 33 As shown.

[0587] See Figure 34Various forces can be applied to tissue 151032 via end effector 151030. For example, when tissue 151032 is compressed between anvil 151034 and channel frame 151036 of end effector 151030, vertical forces F1 and F2 can be applied via anvil and channel frame. See now. Figure 35 When tissue 151032 is compressed by end effector 151030, various diagonal and / or lateral forces can also be applied to the tissue. For example, force F3 can be applied. To operate a medical device such as surgical stapler 151000, it is desirable to sense or calculate various forms of compression applied to the tissue by the end effector. For example, vertical or lateral compression is known to allow the end effector to perform staple operations more precisely or accurately, or to inform the operator of the surgical stapler, enabling more correct or safe use of the surgical stapler.

[0588] Compression through tissue 151032 can be determined based on its impedance. The impedance Z of tissue 151032 can increase or decrease at various compression levels. The impedance Z of tissue 151032 can be determined at various compression levels by applying a voltage V and a current I to tissue 151032. For example, the impedance Z can be calculated by dividing the applied voltage V by the current I.

[0589] See now Figure 36 In one aspect, the RF electrode 151038 may be positioned on the end effector 151030 (e.g., on the cartridge, blade, or channel frame of the end effector 151030). Furthermore, the electrical contact 151040 may be positioned on the anvil 151034 of the end effector 151030. In another aspect, the electrical contact may be positioned on the channel frame of the end effector. When tissue 151032 is compressed between the anvil 151034 and, for example, the channel frame 151036 of the end effector 151030, the impedance Z of the tissue 151032 changes. The vertical tissue compression 151042 caused by the end effector 151030 can be measured as a function of the impedance Z of the tissue 151032.

[0590] See now Figure 37 In one aspect, when positioning the RF electrode 151038, the electrical contact 151044 can be positioned on the opposite end of the anvil 151034 of the end effector 151030. When tissue 151032 is compressed between the anvil 151034 of the end effector 151030 and, for example, the channel frame 151036, the impedance Z of tissue 151032 changes. The lateral tissue compression 151046 caused by the end effector 151030 can be measured as a function of the impedance Z of tissue 151032.

[0591] See now Figure 38In one aspect, electrical contact 151050 may be positioned on anvil 151034, and electrical contact 151052 may be positioned on the opposite end of end effector 151030 at channel frame 151036. RF electrode 151048 may be positioned laterally to the center of end effector 151030. When tissue 151032 is compressed between anvil 151034 of end effector 151030 and, for example, channel frame 151036, the impedance Z of tissue 151032 changes. Lateral compression 151054 or angular compression 151056 on either side of RF electrode 151048 may be caused by end effector 151030 and may be measured as a function of different impedance Z of tissue 151032 based on the relative positioning of RF electrode 151048 and electrical contacts 151050 and 151052.

[0592] See now Figure 39 Frequency generator 151222 can receive power or current from power source 151221 and can supply one or more RF signals to one or more RF electrodes 151224. As described above, the one or more RF electrodes can be positioned at various locations or components on the end effector or surgical stapler, such as the staple cartridge or channel frame. One or more electrical contacts, such as electrical contacts 151226 or 151228, can be positioned on the channel frame or anvil of the end effector. Furthermore, one or more filters (such as filters 151230 or 151232) can be communicatively coupled to electrical contacts 151226 or 151228. Filters 151230 and 151232 can filter the one or more RF signals supplied by frequency generator 151222 before engaging a single return path 151234. The voltage V and current I associated with one or more RF signals can be used to calculate the impedance Z associated with a tissue that may be compressed and / or communicatively coupled between one or more RF electrodes 151224 and electrical contacts 151226 or 151228.

[0593] See still Figure 39Various components of the tissue compression sensor system described herein can be located in the handle 151236 of the surgical suture. For example, as shown in circuit diagram 151220a, a frequency generator 151222 can be located in the handle 151236 and receive power from a power source 151221. Additionally, currents I1 and I2 can be measured on the return paths corresponding to electrical contacts 151228 and 151226. Impedances Z1 and Z2 can be calculated using a voltage V applied between the supply and return paths. Z1 can correspond to the impedance of tissue compressed and / or communicatively connected between one or more of the RF electrodes 151224 and electrical contacts 151228. Furthermore, Z2 can correspond to the impedance of tissue compressed and / or communicatively connected between one or more of the RF electrodes 151224 and electrical contacts 151226. Impedances Z1 and Z2 corresponding to different compression levels of tissue compressed by the end effector can be calculated using the formulas Z1 = V / I1 and Z2 = V / I2.

[0594] See now Figure 40 One or more aspects of this disclosure are described in circuit diagram 151250. In one embodiment, a power source at the handle 151252 of the surgical stapler can provide power to a frequency generator 151254. The frequency generator 151254 can generate one or more RF signals. The one or more RF signals can be multiplexed or superimposed at a multiplexer 151256, which can be located in the shaft 151258 of the surgical stapler. In this way, two or more RF signals can be superimposed (or, for example, nested or modulated together) and transmitted to the end effector. The one or more RF signals can power one or more RF electrodes 151260 at the end effector 151262 of the surgical stapler (e.g., positioned in the staple cartridge). Tissue (not shown) can be compressed and / or communicatively coupled between one or more of the RF electrodes 151260 and one or more electrical contacts. For example, the tissue may be compressed and / or communicatively coupled between one or more RF electrodes 151260 and electrical contacts 151264 located in the channel frame of the end effector 151262 or electrical contacts 151266 located in the anvil of the end effector 151262. A filter 151268 may be communicatively coupled to electrical contacts 151264, and a filter 151270 may be communicatively coupled to electrical contacts 151266.

[0595] The voltage V and current I associated with one or more RF signals can be used to calculate the impedance Z associated with tissue that can be compressed between a staple cartridge (and communicatively coupled to one or more RF electrodes 151260) and a channel frame or anvil (and communicatively coupled to one or more of electrical contacts 151264 or 151266).

[0596] In one aspect, the various components of the tissue compression sensor system described herein may be located within the shaft 151258 of the surgical suture. For example, as shown in circuit diagram 151250 (and except for the frequency generator 151254), the impedance calculator 151272, controller 151274, non-volatile memory 151276, and communication channel 151278 may be located within the shaft 151258. In one example, the frequency generator 151254, impedance calculator 151272, controller 151274, non-volatile memory 151276, and communication channel 151278 may be positioned on a circuit board within the shaft 151258.

[0597] Two or more RF signals can return via electrical contacts on a common path. Furthermore, the two or more RF signals can be filtered before being coupled on the common path to distinguish the individual tissue impedances represented by the two or more RF signals. Currents I1 and I2 can be measured on the return paths corresponding to electrical contacts 151264 and 151266. Impedances Z1 and Z2 can be calculated using a voltage V applied between the supply and return paths. Z1 can correspond to the impedance of tissue compressed and / or communicatively connected between one or more of the RF electrodes 151260 and electrical contacts 151264. Similarly, Z2 can correspond to the impedance of tissue compressed and / or communicatively connected between one or more of the RF electrodes 151260 and electrical contacts 151266. The impedances Z1 and Z2 corresponding to different compressions of tissue compressed by end effector 151262 can be calculated using the formulas Z1 = V / I1 and Z2 = V / I2. In this example, impedances Z1 and Z2 can be calculated using impedance calculator 151272. Impedances Z1 and Z2 can be used to calculate various levels of tissue compression.

[0598] See now Figure 41 Frequency curve 151290 is shown. Frequency curve 151290 illustrates the frequency modulation of two nested RF signals. As described above, the two RF signals can be nested before reaching the RF electrodes at the end effector. For example, an RF signal with frequency 1 and an RF signal with frequency 2 can be nested together. Now see Figure 42 The resulting nested RF signal is shown in frequency curve 151300. The composite signal shown in frequency curve 151300 comprises the two RF signals from the composite frequency curve 151290. Now see Figure 43 Frequency curve 151400 is shown. Frequency curve 151400 shows the RF signal with frequency 1 and frequency 2 after being filtered (through, for example, filters 151268 and 151270). The resulting RF signal can be used for separate impedance calculations or measurements on the return path, as described above.

[0599] In one aspect, filters 151268 and 151270 can be high-Q filters, allowing for a narrow filter range (e.g., Q = 10). Q can be defined by the center frequency (Wo) / bandwidth (BW), where Q = Wo / BW. In one example, frequency 1 could be 150 kHz, and frequency 2 could be 300 kHz. A feasible impedance measurement range could be 100 kHz to 20 MHz. In various examples, other sophisticated techniques such as correlation, quadrature detection, etc., can be used to separate RF signals.

[0600] Using one or more of the techniques and features described herein, a single energized electrode on a staple cartridge or an isolator of an end effector can be used to perform multiple tissue compression measurements simultaneously. If two or more RF signals are superimposed or multiplexed (or nested or modulated), they can be transmitted down a single power side of the end effector and can return at the channel frame or the anvil of the end effector. If filters are built into the anvil and channel contacts before the anvil and channel contacts engage to a common return path, tissue impedance represented by the two paths can be distinguished. This provides a measure of vertical versus lateral tissue compression. This method can also provide proximal and distal tissue compression depending on the placement of the filters and the location of the metal loop. The frequency generator and signal processor can be located on one or more chips on a circuit board or subboard (which may already be present in the surgical stapler).

[0601] In one aspect, this disclosure provides an apparatus 150010 configured to have various sensing systems (in combination) Figures 25 to 30 (As described above). Therefore, for convenience and clarity, details regarding operation and construction will not be repeated here. In one aspect, the sensing system includes a viscoelastic / rate-of-change sensing system to monitor blade acceleration, rate of change of impedance, and rate of change of tissue contact. In one example, the rate of change of blade acceleration can be used as a measure of tissue type. In another example, the rate of change of impedance can be measured using a pulse sensor and can be used as a measure of compressibility. Finally, a sensor based on blade firing rate can be used to measure the rate of change of tissue contact to measure tissue flow.

[0602] The rate of change of a sensed parameter, or, to put it another way, how long it takes for a tissue parameter to reach an asymptotic steady-state value, is itself a separate measurement and may be more valuable than the sensed parameter from which it is derived. To enhance the measurement of tissue parameters, such as the time required to wait for a predetermined quantity before taking a measurement, this disclosure provides a novel technique for employing measurements derived from this, such as the rate of change of a tissue parameter.

[0603] Derivative techniques or rate of change measurements become most useful, and it should be understood that no single measurement can be used alone to significantly improve pin formation. Combinations of multiple measurements make the measurements effective. In the case of tissue gaps, knowing how much of the jaw is covered by tissue is helpful to correlate gap measurements. Rate of change measurements of impedance can be combined with strain measurements in the anvil to correlate the forces and pressures applied to the tissue between the jaw components (such as the anvil and the pin cartridge) gripping the end effector. Endoscopic surgical devices can use rate of change measurements to determine tissue type rather than just tissue compression. Although stomach and lung tissues sometimes have similar thicknesses, and even similar compressibility characteristics when lung tissue is calcified, instruments can differentiate these tissue types by using a combination of measurements such as gap, compression, applied force, tissue contact area, rate of change of compression, or rate of change of gap. If any one of these measurements is used alone, endoscopic surgical devices may struggle to distinguish one tissue type from another. Rate of change of compression can also help the device determine whether the tissue is “normal” or whether some abnormality is present. It is necessary not only to measure how much time has elapsed, but also to measure the changes in the sensor signal and determine the derivatives of the signal, which will provide another measurement so that the endoscopic surgical device can measure the signal. Information on the rate of change can also be used to determine when steady state is reached to signal the next step in the process. For example, after tissue has been gripped between the jaws of an end effector (such as an anvil and cartridge), an indicator or trigger for initiating the firing mechanism can be activated when tissue compression reaches steady state (e.g., approximately 15 seconds).

[0604] This article also provides methods, apparatus, and systems for time-dependent assessment of sensor data to determine the stability, creep, and viscoelastic characteristics of tissues during surgical instrument manipulation. Surgical instruments, such as Figure 25 The suture device shown may include various sensors for measuring operational parameters such as jaw gap size or distance, firing current, tissue compression, amount of jaws covered by tissue, anvil strain, and triggering force. These sensed measurements are important for the automated control of surgical instruments and for providing feedback to clinicians.

[0605] A combination can be adopted Figures 30 to 49 The examples shown are used to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. A current sensor connected in series with battery 2308 can be used to monitor motor current.

[0606] Now go to Figure 44 It describes a reusable or non-reusable motor-driven surgical cutting and fastening instrument 151310. The motor-driven surgical cutting and fastening instrument 151310 is similarly constructed and equipped for use in conjunction with… Figures 25 to 30The motor-driven surgical cutting and fastening instrument 150010 is described above. Figure 44 In the example shown, instrument 151310 includes a housing 151312 that includes a handle assembly 151314 configured to be grasped, manipulated, and actuated by a clinician. Housing 151312 is configured for operatively attaching to an interchangeable shaft assembly 151500 having a surgical end effector 151600 operatively coupled thereto, the surgical end effector being configured to perform one or more surgical tasks or procedures. Motor-driven surgical cutting and fastening instruments 151310 are similarly configured and equipped for combination. Figures 25 to 30 For the sake of convenience and clarity, the details of operation and construction of the motor-driven surgical cutting and fastening instrument 150010 will not be repeated here.

[0607] Figure 44 The depicted housing 151312 is shown in conjunction with an interchangeable shaft assembly 151500, which includes an end effector 151600 comprising a surgical cutting and fastening device configured to operably support a surgical cartridge 151304 therein. The housing 151312 can be configured for use with interchangeable shaft assemblies including end effectors adapted to support cartridges of different sizes and types, having different shaft lengths, sizes, and types, etc. Additionally, the housing 151312 is also effectively used with a variety of other interchangeable shaft assemblies, including those configured to apply other forms of motion and energy (such as radio frequency (RF) energy, ultrasonic energy, and / or motion) to end effector arrangements suitable for use with various surgical applications and procedures. Furthermore, the end effector, shaft assembly, handle, surgical instrument, and / or surgical instrument system can be secured to tissue using any suitable fastener. For example, a fastener magazine, which includes multiple fasteners removably stored therein, can be removably inserted into and / or attached to the end actuator of the shaft assembly.

[0608] Figure 44 A surgical instrument 151310 to which an interchangeable shaft assembly 151500 is operatively coupled is shown. In the illustrated arrangement, the handle housing forms a pistol-like grip 151319 that can be grasped and manipulated by a clinician. A handle assembly 151314 operatively supports a plurality of drive systems configured to generate and apply various controlled movements to corresponding portions of the interchangeable shaft assembly operatively attached thereto. A trigger 151332 is operatively associated with the pistol-like grip for controlling these various controlled movements.

[0609] See also Figure 44The interchangeable shaft assembly 151500 includes a surgical end effector 151600, which includes an elongated channel 151302 configured to operably support a staple cartridge 151304 therein. The end effector 151600 may also include an anvil 151306, which is pivotally supported relative to the elongated channel 151302.

[0610] The inventors have discovered that, for controlling surgical instruments (such as...) Figure 44 (As illustrated in the instrument), derived parameters can be even more useful than the one or more sensing parameters upon which they are based. Non-limiting examples of derived parameters include the rate of change of a sensing parameter (e.g., jaw gap distance) and the length of time elapsed before a tissue parameter reaches its asymptotic steady-state value (e.g., 15 seconds). Derived parameters, such as rates of change, are particularly useful because they significantly improve measurement accuracy and also provide information directly from the sensing parameter. For example, the rate of change of impedance (i.e., tissue compression) can be combined with strain in the anvil to correlate compression and force, allowing a microcontroller to determine tissue type rather than just the amount of tissue compression. This example is merely illustrative, and any derived parameter can be combined with one or more sensing parameters to provide more accurate information about tissue type (e.g., stomach vs. lung), tissue health (calcified vs. normal), and the operational status of the surgical device (e.g., clamping completion). Different tissues have unique viscoelasticity and unique rates of change, making these and other parameters discussed herein useful markers for monitoring and automatically adjusting surgical procedures.

[0611] Figure 46 An exemplary graph illustrating the change in gap distance over time is provided, where the gap is the interval between the jaws occupied by the clamped tissue. The vertical (y) axis represents distance, and the horizontal (x) axis represents time. See also: Figure 44 and Figure 45 The gap distance 151340 is the distance between the anvil 151306 and the elongated channel 151302 of the end effector. In the open jaw position, at time zero, the gap 151340 between the anvil 151306 and the elongated member is at its maximum distance. The width of the gap 151340 decreases as the anvil 151306 closes, such as during tissue clamping. The rate of change of the gap distance can vary because tissues have non-uniform elasticity. For example, some tissue types may initially exhibit rapid compression, resulting in a faster rate of change. However, as the tissue is continuously compressed, the viscoelasticity of the tissue can reduce the rate of change until the tissue can no longer be compressed, at which point the gap distance will remain substantially constant. As the tissue is compressed between the anvil 151306 and the staple cartridge 151304 of the end effector 151340, the gap decreases over time. Figures 31 to 43One or more sensors described, such as 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, may be adapted and configured to measure the gap distance "d" between the anvil 151306 and the staple cartridge 151304 as a function of time "t". Figure 46 The graph represents the distance "d" as a function of time "t". Figure 46 The slope of the curve shown is given by slope = Δd / Δt.

[0612] Figure 47 An exemplary graph illustrating the firing current of the end effector jaws is shown. The vertical (y) axis represents current, and the horizontal (x) axis represents time. As described herein, in conjunction with Figure 25 As shown and described, surgical instruments and / or their microcontrollers may include current sensors that detect the current used during various operations, such as clamping, cutting, and / or suturing tissue. For example, when tissue resistance increases, the instrument's motor may require more current to clamp, cut, and / or suture tissue. Similarly, if resistance is low, the motor may require less current to clamp, cut, and / or suture tissue. Therefore, the firing current can be used as an approximation of tissue resistance. The sensed current can be used alone or, more preferably, in combination with other measurements to provide feedback about the target tissue. See still Figure 47 During some procedures (such as suturing), the firing current is initially high at time zero but decreases over time. During other device operations, the current can increase over time if the motor consumes more current to overcome a gradually increasing mechanical load. Furthermore, the rate of change of the firing current can be used as an indicator of tissue transition from one state to another. Therefore, the firing current, and especially the rate of change of the firing current, can be used to monitor device operation. When the scalpel cuts through tissue, the firing current decreases over time. If the tissue being cut is affected by tissue characteristics or the scalpel 151305 (… Figure 45 The rate of change of the firing current can vary by providing more or less resistance to adjust the sharpness of the blade. When cutting conditions change, the work done by the motor changes, thus altering the firing current over time. When the blade 151305 is firing, a current sensor can be used to measure the firing current as it changes over time. Figure 47 This is represented graphically. For example, a current sensor can be used to monitor the motor current. The current sensor can be adapted and configured to measure the motor firing current "i" as it changes over time "t", such as... Figure 47 The value is represented graphically. The rate of change of the firing current "i" with time "t" is... Figure 47 The slope of the curve shown is given by slope = Δi / Δt.

[0613] Figure 48 This is an exemplary graph showing the change of impedance over time. The vertical (y) axis represents impedance, and the horizontal (x) axis represents time. The impedance is low at zero time, but increases over time as tissue pressure increases under manipulation (e.g., clamping and suturing). The rate of change varies over time because the tissue between the anvil 151306 and the staple cartridge 151304 of the end effector 151340 is cut by the blade or sealed with RF energy between electrodes located between the anvil 151306 and the staple cartridge 151304 of the end effector 151340. For example, the impedance increases as the tissue is cut, and reaches infinity when the tissue is completely cut by the blade. Additionally, if the end effector 151340 includes electrodes coupled to an RF energy source, the impedance of the tissue increases as energy is delivered through the tissue between the anvil 151306 and the staple cartridge 151304 of the end effector 151340. The impedance increases as the energy passing through the tissue dries the tissue by evaporating moisture in the tissue. Ultimately, when the appropriate amount of energy is delivered to the tissue, the impedance increases to very high values ​​or infinity when the tissue is severed. Furthermore, as... Figure 48 As shown, different tissues may possess unique compressibility characteristics that distinguish them, such as compression rate. Tissue impedance can be measured by driving a subtherapeutic radiofrequency current through the tissue held between the first jaw member 9014 and the second jaw member 9016. One or more electrodes may be positioned on either or both of the anvil 151306 and the staple cartridge 151304. The tissue compression / impedance of the tissue between the anvil 151306 and the staple cartridge 151304 over time can be measured, such as... Figure 48 It is represented graphically. Combined with... Figures 31 to 43 The aforementioned sensors, such as 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, may be adapted and configured to measure tissue compressibility / resistance. The sensors may be adapted and configured to measure tissue impedance "Z" as a function of time "t", such as... Figure 48 It is represented graphically in Chinese.

[0614] Figure 49 It is anvil 151306 ( Figure 44 , Figure 45 An exemplary curve showing strain versus time. The vertical (y) axis represents strain, and the horizontal (x) axis represents time. During suturing, for example, the strain of the anvil 151306 is initially high, but decreases as the tissue reaches a steady state, and a smaller pressure is applied to the anvil 151306. The rate of change of strain of the anvil 151306 can be determined by the position of the anvil 151306 and the staple cartridge 151304. Figure 44 , Figure 45Pressure sensors or strain gauges on either or both of these components are used to measure the pressure or strain applied to the tissue held between the anvil 151306 and the staple cartridge 151304. The strain of the anvil 151306 over time can be measured, such as... Figure 49 The expression is graphical. The rate of change of strain "S" with time "t" is... Figure 49 The slope of the curve shown is given by slope = ΔS / Δt.

[0615] Figure 50 This is an exemplary graph showing how the trigger force changes over time. The vertical (y) axis represents the trigger force, and the horizontal (x) axis represents time. In some examples, the trigger force is progressive to provide tactile feedback to the clinician. Therefore, at time zero, trigger 151320 ( Figure 44 The pressure can be at its lowest point, and the trigger pressure can be increased until the operation is completed (e.g., clamping, cutting, or suturing). This can be achieved by positioning the instrument 151310 ( Figure 44 The pressure sensor or strain gauge on the trigger 151302 of the shank 151319 measures the rate of change of the triggering force to measure the driving force of the drive tool 151305. Figure 45 The force required to grasp the tissue between the anvil 151306 and the staple cartridge 151304. The force of the trigger 151332 over time can be measured, such as... Figure 50 The change rate of the strain triggering force "F" with time "t" is represented graphically. Figure 50 The slope of the curve shown is given by slope = ΔF / Δt.

[0616] For example, even though stomach and lung tissues can have similar thicknesses, these tissues can be distinguished, and if lung tissue is calcified, these tissues can have similar compressibility properties. Stomach and lung tissues can be differentiated by analyzing jaw gap distance, tissue compression, applied force, tissue contact area, rate of compression change, and rate of change of jaw gap. For example, Figure 51A graph showing tissue pressure “P” versus tissue displacement for various tissues is presented. The vertical (y) axis represents tissue pressure, and the horizontal (x) axis represents tissue displacement. When tissue pressure reaches a predetermined threshold (such as 50 psi to 100 psi), the amount of tissue displacement and the rate of tissue displacement before reaching the threshold can be used to distinguish tissues. For example, vascular tissue reaches the predetermined pressure threshold with less tissue displacement and a faster rate of change than colon, lung, or stomach tissue. Furthermore, the rate of change (tissue pressure divided by displacement) of vascular tissue is almost asymptotic at the 50 psi to 100 psi threshold, while the rate of change of colon, lung, and stomach tissue is not asymptotic at the 50 psi to 100 psi threshold. It should be understood that any pressure threshold can be used, such as between 1 psi and 1000 psi, more preferably between 10 psi and 500 psi, and even more preferably between 50 psi and 100 psi. In addition, multiple thresholds or progressive thresholds can be used to provide further resolution for tissue types with similar viscoelasticity.

[0617] The rate of change in compression can also enable microcontrollers to determine whether tissue is "normal" or whether there are abnormalities, such as calcification. For example, see... Figure 52 The compression curve of calcified lung tissue follows a different curve than that of normal lung tissue. Therefore, tissue displacement and the rate of change of tissue displacement can be used to diagnose and / or differentiate calcified lung tissue from normal lung tissue.

[0618] Furthermore, some sensed measurements can benefit from additional sensory input. For example, regarding jaw gap, knowing how much of the jaw is covered by tissue makes gap measurements more useful and accurate. If only a small portion of the jaw is covered by tissue, tissue compression may appear smaller than if the entire jaw is covered. Therefore, the amount of jaw coverage can be taken into account by the microcontroller when analyzing tissue compression and other sensed parameters.

[0619] In some cases, the actual time elapsed can also be an important parameter. Measuring how much time has elapsed, along with the sensed parameters and de...

Claims

1. A surgical system, comprising a surgical instrument and a surgical hub, wherein the surgical instrument further comprises: a communication path between the surgical instrument and the surgical hub, wherein the surgical hub includes a visual feedback device, and wherein the surgical instrument includes an end effector, the end effector including a first jaw and a second jaw, the second jaw being movable between an open position and a closed position relative to the first jaw, wherein the surgical instrument is configured to be insertable into a surgical site, wherein the second jaw is movable to a first position between the open position and the closed position to contact tissue positioned between the first jaw and the second jaw, Wherein, the surgical instrument is configured to: determining an extent of contact between tissue and the end effector when in the first position; setting a closing rate of the end effector based on the determined degree of contact; transmitting the determined degree of contact to the surgical hub, the surgical hub being configured to display the determined degree of contact on the visual feedback device, The surgical instrument comprises a motor, a control circuit and one or more sensors, the control circuit being configured to determine the degree of tissue contact based on a ratio of sensors that have detected the presence of tissue to sensors that have not detected the presence of tissue, the surgical instrument being configured to characterize the tissue type of the clamped tissue based on the degree of tissue contact against the surfaces of the first jaw and the second jaw and the relative positions of the first jaw and the second jaw at the initial contact point with the tissue, the surgical instrument being further configured to control the motor to affect the closing rate of the first jaw and the second jaw and to correspondingly affect the adjustment threshold of the detected tissue type.

2. The surgical system of claim 1, wherein: A series of impedance sensors are included for determining the degree of contact.

3. The surgical system of claim 2, wherein: The impedance sensor is positioned along the first jaw of the surgical instrument.

4. The surgical system of claim 2, wherein: Each of the impedance sensors is configured to determine whether tissue is positioned against the impedance sensor to determine the degree of contact.

5. The surgical system of claim 1, wherein: A series of photoacoustic sensors are included for determining the degree of contact.

6. The surgical system of claim 1, wherein: A thin film coating is included to determine the degree of contact.

7. A surgical system, comprising a surgical instrument and a surgical hub, in, A communication path is established between the surgical instrument and a surgical hub, wherein the surgical hub includes a visual feedback display, and wherein the surgical instrument includes an end effector including a first jaw and a second jaw; wherein tissue is grasped between the first jaw and the second jaw; The surgical instrument is constructed as follows: determining an extent of contact between the grasped tissue and the end effector; setting a closing rate of the end effector based on the determined degree of contact; transmitting the determined degree of contact to the surgical hub; The surgical hub is configured to: display the determined contact level on the visual feedback display, wherein the surgical instrument includes a motor, a control circuit, and one or more sensors, the control circuit being configured to determine the degree of tissue contact based on a ratio of sensors that have detected the presence of tissue to sensors that have not detected the presence of tissue, In which, the surgical instrument is configured to characterize the tissue type of the clamped tissue based on the degree of tissue contact against the surfaces of the first jaw and the second jaw and the relative positions of the first jaw and the second jaw at the initial contact point with the tissue, and the surgical instrument is also configured to control the motor to affect the closing rate of the first jaw and the second jaw, and correspondingly affect the adjustment threshold of the detected tissue type.

8. The surgical system of claim 7, wherein: The surgical system is configured to determine the degree of contact using a plurality of impedance sensors.

9. The surgical system of claim 8, wherein: The impedance sensor is configured to be able to determine whether tissue is positioned against the impedance sensor to determine the degree of contact.

10. The surgical system of claim 7, wherein: The surgical system is configured to determine the degree of contact using a plurality of photoacoustic sensors.

11. The surgical system of claim 7, wherein: The surgical system is configured to also use a thin film coating to determine the degree of contact.

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