Tonal construction of energy modules for modular energy systems

Abstract

The present invention discloses an audio control system for a modular energy system. The audio control system may include a first controller and a second controller. The first controller may be configured to output an audio signal and an audio signal ID associated with the audio signal. The second controller may be coupled to the first controller and configured to receive the audio signal ID from the first controller and determine whether the audio signal ID corresponds to an expected audio signal ID.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims the benefit of U.S. non-provisional patent application serial number 16 / 562,159, filed on September 5, 2019, entitled “AUDIO TONE CONSTRUCTION FOR ANENERGY MODULE OF A MODULAR ENERGY SYSTEM,” the disclosure of which is incorporated herein by reference in its entirety.

[0003] This application also claims the benefit of U.S. Provisional Patent Application Serial No. 62 / 826,584, filed on March 29, 2019, entitled “MODULAR SURGICAL PLATFORMELECTRICAL ARCHITECTURE,” the disclosure of which is incorporated herein by reference in its entirety.

[0004] This application also claims the benefit of U.S. Provisional Patent Application Serial No. 62 / 826,587, filed on March 29, 2019, entitled “MODULAR ENERGY SYSTEM CONNECTIVITY,” the disclosure of which is incorporated herein by reference in its entirety.

[0005] This application also claims the benefit of U.S. Provisional Patent Application Serial No. 62 / 826,588, filed on March 29, 2019, entitled “MODULAR ENERGY SYSTEMINSTRUMENT COMMUNICATION TECHNIQUES,” the disclosure of which is incorporated herein by reference in its entirety.

[0006] This application also claims the benefit of U.S. Provisional Patent Application Serial No. 62 / 826,592, filed on March 29, 2019, entitled “MODULAR ENERGY DELIVERY SYSTEM,” the disclosure of which is incorporated herein by reference in its entirety. Background Art

[0007] The present disclosure relates to a variety of surgical systems, including modular electrosurgical systems and / or ultrasonic surgical systems. Simplified capital solutions are needed in operating rooms (ORs) because the OR is a tangled web of cords, devices, and people due to the number of different devices required to complete each surgical procedure. This is the reality of every OR in every market around the world. Capital equipment is the main culprit for creating clutter within the OR because most capital equipment performs one task or job, and each type of capital equipment requires the use of a unique technology or method and has a unique user interface. Therefore, there is an unmet consumer demand for capital equipment and other surgical technologies to be merged in order to reduce the equipment footprint within the OR, simplify the interface of the equipment, and improve the efficiency of the surgical staff during surgical procedures by reducing the number of devices that the surgical staff needs to interact with. Summary of the invention

[0008] In one general aspect, an audio control system for a modular energy system is provided. The audio control system may include: an audio output device; an amplifier coupled to the audio output device; and a control circuit, the control circuit including: a first controller coupled to the amplifier, the first controller configured to provide an audio signal and an audio signal ID associated with the audio signal to the amplifier; wherein the amplifier is configured to generate an audio output according to the audio signal; and a second controller coupled to the first controller, the second controller configured to: receive the audio signal ID from the first controller; and determine whether the audio signal ID corresponds to an expected audio signal ID.

[0009] In another general aspect, an audio control system for a modular energy system is provided. The audio control system may include: an audio output device; an amplifier coupled to the audio output device; and a control circuit coupled to the amplifier, the control circuit being configured to: retrieve a first audio file corresponding to a first function of the modular energy system, the first audio file encoding a first audio signal and a first ID; retrieve a second audio file corresponding to a second function of the modular energy system, the second audio file encoding a second audio signal and a second ID; wherein the first function and the second function are performed simultaneously by the modular energy system; combine representations of the first audio signal and the second audio signal to generate a third audio signal; combine the first ID and the second ID to generate a third ID; wherein the third ID is unique to the third audio signal; and provide the third audio signal and the third ID to the amplifier for generating an audio output according to the third audio signal.

[0010] In another general aspect, an audio control system for a modular energy system is provided. The audio control system may include: an audio output device; and a control circuit coupled to the audio output device, the control circuit configured to: cause the audio output device to emit a tone based on a function of the modular energy system, the tone including an audio signal encoding an identifier corresponding to the function; wherein the audio signal is at a frequency above a human hearing frequency threshold; receive the tone emitted by the audio output device; separate the audio signal from the tone; decode the identifier from the separated audio signal; and determine whether the decoded identifier corresponds to a stored identifier for the function. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] The various aspects described herein, both as to surgical organization and method, together with further objects and advantages thereof, may best be understood by reference to the following description taken in conjunction with the following drawings.

[0012] Figure 1 is a block diagram of a computer-implemented interactive surgical system according to at least one aspect of the present disclosure.

[0013] Figure 2 A surgical system for performing surgical procedures in an operating room according to at least one aspect of the present disclosure.

[0014] Figure 3 A surgical hub paired with a visualization system, a robotic system, and a smart instrument according to at least one aspect of the present disclosure.

[0015] Figure 4 is a partial perspective view of a surgical hub housing and a combination generator module slidably receivable in a drawer of the surgical hub housing according to at least one aspect of the present disclosure.

[0016] Figure 5 is a perspective view of a combination generator module having bipolar, ultrasonic and monopolar contacts and smoke evacuation components according to at least one aspect of the present disclosure.

[0017] Figure 6 A separate power bus attachment for multiple lateral docking ports of a lateral modular housing configured to receive multiple modules is shown in accordance with at least one aspect of the present disclosure.

[0018] Figure 7 A vertical modular housing configured to receive a plurality of modules according to at least one aspect of the present disclosure is shown.

[0019] Figure 8A surgical data network including a modular communication hub configured to enable connecting modular devices located in one or more operating rooms of a medical facility or any room in a medical facility dedicated to surgical operations to a cloud is shown in accordance with at least one aspect of the present disclosure.

[0020] Fig. 9 is a computer-implemented interactive surgical system according to at least one aspect of the present disclosure.

[0021] Fig.10 A surgical hub comprising multiple modules coupled to a modular control tower is shown in accordance with at least one aspect of the present disclosure.

[0022] Fig.11 An aspect of a universal serial bus (USB) hub device in accordance with at least one aspect of the present disclosure is shown.

[0023] Fig.12 A logic diagram of a control system for a surgical instrument or tool according to at least one aspect of the present disclosure is shown.

[0024] Fig.13 Control circuitry configured to control various aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure is shown.

[0025] Fig.14 Combinatorial logic circuits configured to control various aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure are shown.

[0026] Fig.15 A sequential 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.

[0027] Fig.16 A surgical instrument or tool including multiple motors that can be activated to perform various functions in accordance with at least one aspect of the present disclosure is shown.

[0028] Fig.17 is a schematic diagram of a robotic surgical instrument configured to operate the surgical tools described herein in accordance with at least one aspect of the present disclosure.

[0029] Fig.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.

[0030] Fig.19 is a schematic diagram of a surgical instrument configured to control various functions according to at least one aspect of the present disclosure.

[0031] Fig. 20A system according to at least one aspect of the present disclosure is configured to execute an adaptive ultrasonic blade control algorithm in a surgical data network including a modular communication hub.

[0032] Fig.21 An example of a generator according to at least one aspect of the present disclosure is shown.

[0033] Fig. 22 A surgical system according to at least one aspect of the present disclosure includes a generator and various surgical instruments that can be used therewith.

[0034] Fig.23 is a diagram of a situational awareness surgical system in accordance with at least one aspect of the present disclosure.

[0035] Fig.24 is a diagram of various modules and other components that can be combined to customize a modular energy system in accordance with at least one aspect of the present disclosure.

[0036] Fig.25A is a first exemplary modular energy system configuration according to at least one aspect of the present disclosure, comprising a head module and a display screen presenting a graphical user interface (GUI) for relaying information about modules connected to the head module.

[0037] Fig.25B A device mounted on a cart according to at least one aspect of the present disclosure Fig.25A The modular energy system shown in .

[0038] Fig.26A is a second exemplary modular energy system configuration according to at least one aspect of the present disclosure, comprising a head module, a display screen, an energy module, and an expansion energy module connected together and mounted to a cart.

[0039] Fig.26B is a third exemplary modular energy system configuration according to at least one aspect of the present disclosure, which is similar to Fig.25A The second configuration shown in , except that the head module does not contain a display screen.

[0040] Fig. 27 is a fourth exemplary modular energy system configuration according to at least one aspect of the present disclosure, comprising a head module, a display screen, an energy module, an expansion energy module, and a technology module connected together and mounted to a cart.

[0041] Fig.28 is a fifth exemplary modular energy system configuration according to at least one aspect of the present disclosure, comprising a head module, a display screen, an energy module, an extended energy module, a technology module, and a visualization module connected together and mounted to a cart.

[0042] Fig.29 is a diagram of a modular energy system including a communicatively connectable surgical platform in accordance with at least one aspect of the present disclosure.

[0043] Fig.30 is a perspective view of a head module of a modular energy system including a user interface according to at least one aspect of the present disclosure.

[0044] Fig.31 is a block diagram of an independent hub configuration of a modular energy system according to at least one aspect of the present disclosure.

[0045] Fig.32 is a block diagram of a hub configuration of a modular energy system integrated with a surgical control system according to at least one aspect of the present disclosure.

[0046] Fig.33 is a block diagram of a user interface module coupled to a communication module of a modular energy system according to at least one aspect of the present disclosure.

[0047] Fig.34 is a block diagram of an energy module of a modular energy system according to at least one aspect of the present disclosure.

[0048] Fig.35A and Fig.35B A block diagram of an energy module coupled to a head module of a modular energy system is shown, according to at least one aspect of the present disclosure.

[0049] Fig.36A and Fig.36B A header / user interface (UI) module (such as a ) for a modular energy system for a hub according to at least one aspect of the present disclosure is shown. Fig.33 Block diagram of the header module shown in FIG.

[0050] Fig.37 is an energy module (such as Figures 31 to 36B Block diagram of the energy module shown in .

[0051] Fig.38 is a block diagram of an audio control system for a modular energy system according to at least one aspect of the present disclosure.

[0052] Fig.39 is a block diagram of a technique for generating unique audio output in accordance with at least one aspect of the present disclosure.

[0053] Fig.40 is a block diagram of an audio control system for a modular energy system according to at least one aspect of the present disclosure.

[0054] Fig.41is a graph of audio level versus frequency of an audio signal according to at least one aspect of the present disclosure.

[0055] Fig.42 is a series of graphs illustrating a process for modulating a carrier wave to carry digital data in accordance with at least one aspect of the present disclosure.

[0056] Fig.43 is a graph of audio level versus time of an audio signal in accordance with at least one aspect of the present disclosure.

[0057] Fig.44 is a perspective view of a modular energy system configured to provide audiovisual feedback to a user according to at least one aspect of the present disclosure. DETAILED DESCRIPTION

[0058] The applicant of the present application owns the following U.S. patent applications filed concurrently herewith, the disclosures of each of these provisional patent applications are incorporated herein by reference in their entirety:

[0059] U.S. Patent Application Docket No. END9067USNP1 / 180679-1M, entitled “METHOD FOR CONSTRUCTING AND USING A MODULAR SURGICAL ENERGY SYSTEM WITH MULTIPLED EVICES”;

[0060] U.S. Patent Application Docket No. END9069USNP1 / 180681-1M, entitled “METHOD FOR ENERGY DISTRIBUTION IN A SURGICAL MODULAR ENERGY SYSTEM”;

[0061] U.S. Patent Application Docket No. END9069USNP2 / 180681-2, entitled “SURGICAL MODULARENERGY SYSTEM WITH A SEGMENTED BACKPLANE”;

[0062] U.S. Patent Application Docket No. END9069USNP3 / 180681-3, entitled “SURGICAL MODULARENERGY SYSTEM WITH FOOTER MODULE”;

[0063] U.S. Patent Application Docket No. END9069USNP4 / 180681-4, entitled “POWER AND COMMUNICATION MITIGATION ARRANGEMENT FOR MODULAR SURGICAL ENERGY SYSTEM”;

[0064] U.S. Patent Application Docket No. END9069USNP5 / 180681-5, entitled “MODULAR SURGICALENERGY SYSTEM WITH MODULE POSITIONAL AWARENESS SENSING WITH VOLTAGE DETECTION”;

[0065] U.S. Patent Application Docket No. END9069USNP6 / 180681-6, entitled “MODULAR SURGICALENERGY SYSTEM WITH MODULE POSITIONAL AWARENESS SENSING WITH TIME COUNTER”;

[0066] U.S. Patent Application Docket No. END9069USNP7 / 180681-7, entitled “MODULAR SURGICALENERGY SYSTEM WITH MODULE POSITIONAL AWARENESS WITH DIGITAL LOGIC”;

[0067] U.S. Patent Application Docket No. END9068USNP1 / 180680-1M, entitled “METHOD FOR CONTROLLING AN ENERGY MODULE OUTPUT”;

[0068] U.S. Patent Application Docket No. END9068USNP2 / 180680-2, entitled “ENERGY MODULE FORDRIVING MULTIPLE ENERGY MODALITIES”;

[0069] U.S. Patent Application Docket No. END9068USNP3 / 180680-3, entitled “GROUNDING ARRANGEMENT OF ENERGY MODULES”;

[0070] U.S. Patent Application Docket No. END9068USNP4 / 180680-4, entitled “BACKPLANE CONNECTOR DESIGN TO CONNECT STACKED ENERGY MODULES”;

[0071] U.S. Patent Application Docket No. END9068USNP5 / 180680-5, entitled “ENERGY MODULE FORDRIVING MULTIPLE ENERGY MODALITIES THROUGH A PORT”;

[0072] U.S. Patent Application Docket No. END9068USNP6 / 180680-6, entitled “SURGICALINSTRUMENT UTILIZING DRIVE SIGNAL TO POWER SECONDARY FUNCTION”;

[0073] U.S. Patent Application Docket No. END9038USNP1 / 180529-1M, entitled “METHOD FOR CONTROLLING A MODULAR ENERGY SYSTEM USER INTERFACE”;

[0074] U.S. Patent Application Docket No. END9038USNP2 / 180529-2, entitled “PASSIVE HEADER MODULE FOR A MODULAR ENERGY SYSTEM”;

[0075] U.S. Patent Application Docket No. END9038USNP3 / 180529-3, entitled “CONSOLIDATED USERINTERFACE FOR MODULAR ENERGY SYSTEM”;

[0076] U.S. Patent Application Docket No. END9038USNP4 / 180529-4, entitled “AUDIO TONE CONSTRUCTION FOR AN ENERGY MODULE OF A MODULAR ENERGY SYSTEM”;

[0077] U.S. Patent Application Docket No. END9038USNP5 / 180529-5, entitled “ADAPTABLY CONNECTABLE AND REASSIGNABLE SYSTEM ACCESSORIES FOR MODULAR ENERGY SYSTEM”;

[0078] U.S. Patent Application Docket No. END9070USNP1 / 180682-1M, entitled “METHOD FOR COMMUNICATING BETWEEN MODULES AND DEVICES IN A MODULAR SURGICAL SYSTEM”;

[0079] U.S. Patent Application Docket No. END9070USNP2 / 180682-2, entitled “FLEXIBLE HAND-SWITCH CIRCUIT”;

[0080] U.S. Patent Application Docket No. END9070USNP3 / 180682-3, entitled “FIRST AND SECOND COMMUNICATION PROTOCOL ARRANGEMENT FOR DRIVING PRIMARY AND SECONDARY DEVICESTHROUGH A SINGLE PORT”;

[0081] U.S. Patent Application Docket No. END9070USNP4 / 180682-4, entitled “FLEXIBLE NEUTRALELECTRODE”;

[0082] U.S. Patent Application Docket No. END9070USNP5 / 180682-5, entitled “SMART RETURN PADSENSING THROUGH MODULATION OF NEAR FIELD COMMUNICATION AND CONTACT QUALITY MONITORING SIGNALS”;

[0083] U.S. Patent Application Docket No. END9070USNP6 / 180682-6, entitled “AUTOMATICULTRASONIC ENERGY ACTIVATION CIRCUIT DESIGN FOR MODULAR SURGICAL SYSTEMS”;

[0084] U.S. Patent Application Docket No. END9070USNP7 / 180682-7, entitled “COORDINATED ENERGY OUTPUTS OF SEPARATE BUT CONNECTED MODULES”;

[0085] U.S. Patent Application Docket No. END9070USNP8 / 180682-8, entitled “MANAGING SIMULTANEOUS MONOPOLAR OUTPUTS USING DUTY CYCLE AND SYNCHRONIZATION”;

[0086] U.S. Patent Application Docket No. END9070USNP9 / 180682-9, entitled “PORT PRESENCEDETECTION SYSTEM FOR MODULAR ENERGY SYSTEM”;

[0087] U.S. Patent Application Docket No. END9070USNP10 / 180682-10, entitled “INSTRUMENT TRACKING ARRANGEMENT BASED ON REAL TIME CLOCK INFORMATION”;

[0088] U.S. Patent Application Docket No. END9070USNP11 / 180682-11, entitled “REGIONALLOCATION TRACKING OF COMPONENTS OF A MODULAR ENERGY SYSTEM”;

[0089] U.S. design patent application docket number END9212USDP1 / 190370D, entitled “ENERGY MODULE”;

[0090] U.S. design patent application docket number END9213USDP1 / 190371D, entitled “ENERGY MODULE MONOPOLAR PORT WITH FOURTH SOCKET AMONG THREE OTHER SOCKETS”;

[0091] U.S. design patent application docket number END9214USDP1 / 190372D, entitled “BACKPLANE CONNECTOR FOR ENERGY MODULE”; and

[0092] U.S. design patent application docket number END9215USDP1 / 190373D, entitled “ALERT SCREENFOR ENERGY MODULE.”

[0093] Before describing in detail various aspects of the surgical device and generator, it should be noted that the application or use of the illustrative examples is not limited to the details of construction and arrangement of components shown in the drawings and detailed description. The illustrative examples may be implemented alone or in combination with other aspects, variations and modifications, and may be practiced or performed in various ways. In addition, unless otherwise indicated, the terms and expressions used herein are selected for the convenience of the reader to describe the illustrative examples and are not for limiting purposes. 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.

[0094] Various aspects relate to improved ultrasonic surgical devices, electrosurgical devices, and generators for use therewith. Aspects of ultrasonic surgical devices can be configured for, for example, transecting and / or coagulating tissue during a surgical procedure. Aspects of electrosurgical devices can be configured for, for example, transecting, coagulating, targeting, welding, and / or desiccating tissue during a surgical procedure.

[0095] Surgical System Hardware

[0096] See also 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 coupled to a storage device 105). Each surgical system 102 includes at least one surgical hub 106 in communication with the cloud 104 that may include the remote server 113. In one example, as Figure 1 As shown in , the surgical system 102 includes a visualization system 108, a robotic system 110, and a handheld intelligent surgical instrument 112, which are configured to communicate with each other and / or with the hub 106. In some aspects, the surgical system 102 may include M number of hubs 106, N number of visualization systems 108, O number of robotic systems 110, and P number of handheld intelligent surgical instruments 112, where M, N, O, and P are integers greater than or equal to one.

[0097] Figure 2An example of a surgical system 102 is shown for performing a surgical procedure on a patient lying flat on an operating table 114 in a surgical operating room 116. A robotic system 110 is used as part of the surgical system 102 during a surgical procedure. The robotic system 110 includes a surgeon's console 118, a patient side cart 120 (surgical robot), and a surgical robotic hub 122. The patient side cart 120 can manipulate at least one removably coupled surgical tool 117 through a minimally invasive incision in the patient while the surgeon views the surgical site through the surgeon's console 118. Images of the surgical site can be obtained through a medical imaging device 124, which can be manipulated by the patient side cart 120 to orient the imaging device 124. The robotic hub 122 can be used to process images of the surgical site for subsequent display to the surgeon through the surgeon's console 118.

[0098] Other types of robotic systems may be readily adapted for use with the surgical system 102. Various examples of robotic systems and surgical tools suitable for use with the present disclosure are described in U.S. Provisional Patent Application Serial No. 62 / 611,339, filed on December 28, 2017, entitled “ROBOT ASSISTED SURGICAL PLATFORM,” the disclosure of which is incorporated herein by reference in its entirety.

[0099] Various examples of cloud-based analytics performed by cloud 104 and suitable for use in the present disclosure are described in U.S. Provisional Patent Application Serial No. 62 / 611,340, filed on December 28, 2017, entitled “CLOUD-BASED MEDICAL ANALYTICS,” the disclosure of which is incorporated herein by reference in its entirety.

[0100] In various aspects, 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.

[0101] The optical components of the imaging device 124 may include one or more illumination sources and / or one or more lenses. The one or more illumination sources may be directed to illuminate multiple portions of the surgical field. The one or more image sensors may receive light reflected or refracted from the surgical field, including light reflected or refracted from tissue and / or surgical instruments.

[0102] One or more illumination sources may be configured to radiate electromagnetic energy in the visible spectrum as well as in the invisible spectrum. The visible spectrum (sometimes referred to as the optical spectrum or the luminescence spectrum) is that portion of the electromagnetic spectrum that is visible to (i.e., detectable by) the human eye and may be referred to as visible light or simply light. A typical human eye will respond to wavelengths in the range of about 380 nm to about 750 nm in air.

[0103] The invisible spectrum (i.e., non-luminescent spectrum) is the portion of the electromagnetic spectrum below and above the visible spectrum (i.e., wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths greater than about 750 nm are longer than the red visible spectrum, and they become invisible infrared (IR), microwaves, and radio electromagnetic radiation. Wavelengths less than about 380 nm are shorter than the violet spectrum, and they become invisible ultraviolet, x-ray, and gamma-ray electromagnetic radiation.

[0104] In various aspects, the imaging device 124 is configured for use in minimally invasive procedures. Examples of imaging devices suitable for use in the present disclosure include, but are not limited to, arthroscopy, angioscope, bronchoscope, choledochoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophago-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngeal-renal endoscope, sigmoidoscope, thoracoscope, and hysteroscope.

[0105] In one aspect, the imaging device employs multispectral monitoring to discern topography and underlying structure. A multispectral image is an image that captures image data within a specific wavelength range across the electromagnetic spectrum. The wavelengths may be separated by filters or by using an instrument that is sensitive to specific wavelengths, including light from frequencies outside the visible light range, such as IR and ultraviolet. Spectral imaging may allow for 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” in U.S. Provisional Patent Application Serial No. 62 / 611,341, entitled “INTERACTIVE SURGICAL PLATFORM,” filed on December 28, 2017, the disclosure of which is incorporated herein by reference in its entirety. Multispectral monitoring may be a useful tool for repositioning the surgical field after completing the surgical task to perform one or more of the previously described tests on the treated tissue.

[0106] It is self-evident that during any surgery, the operating room and surgical equipment need to be strictly sterilized. The strict sanitation and sterilization conditions required in the "surgical room" (i.e., operating room or treatment room) require the highest possible sterility of all medical devices and equipment. Part of this sterilization process is the need to sterilize any material that contacts the patient or penetrates the sterile field, including imaging device 124 and its attachments and components. It should be understood that the sterile field can be considered as a designated area that is considered to be free of microorganisms, such as in a tray or in a sterile towel, or the sterile field can be considered as the area around the patient prepared for the surgical procedure. The sterile field can include properly dressed scrubbed team members, as well as all equipment and fixtures in the area.

[0107] 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 field, such as Figure 2 . In one aspect, the visualization system 108 includes interfaces for HL7, PACS, and EMR. Various components of the visualization system 108 are described in U.S. Provisional Patent Application Serial No. 62 / 611,341, entitled “INTERACTIVE SURGICAL PLATFORM,” filed on December 28, 2017, under the title “Advanced Imaging Acquisition Module,” the disclosure of which is incorporated herein by reference in its entirety.

[0108] like Figure 2 , the main display 119 is positioned in the sterile field to be visible to the operator at the operating table 114. In addition, the visualization tower 111 is positioned outside the sterile field. The visualization tower 111 includes a first non-sterile display 107 and a second non-sterile display 109 that are separated from each other. The visualization system 108 guided by the hub 106 is configured to be able to coordinate the flow of information to the operators inside and outside the sterile field using the displays 107, 109 and 119. For example, the hub 106 can enable the visualization system 108 to display a snapshot of the surgical site recorded by the imaging device 124 on the non-sterile display 107 or 109, while maintaining a real-time feed of the surgical site on the main display 119. The snapshot on the non-sterile display 107 or 109 can allow the non-sterile operator to, for example, perform diagnostic steps related to the surgical procedure.

[0109] In one aspect, the hub 106 is further configured to be able to route diagnostic input or feedback entered by a non-sterile operator at the visualization tower 111 to the primary display 119 within the sterile field, where it can be viewed by a sterile operator at the operating table. In one example, the input can be a modified form of a snapshot displayed on the non-sterile display 107 or 109, which can be routed to the primary display 119 via the hub 106.

[0110] See also Figure 2 , the surgical instrument 112 is used in a surgical procedure as part of the surgical system 102. The hub 106 is further configured to coordinate the flow of information to the display of the surgical instrument 112. For example, U.S. Provisional Patent Application Serial No. 62 / 611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed on December 28, 2017, the disclosure of which is incorporated herein by reference in its entirety. Diagnostic input or feedback entered by a non-sterile operator at the visualization tower 111 can be routed by the hub 106 to the surgical instrument display 115 within the sterile field, where the operator of the surgical instrument 112 can observe the input or feedback. For example, exemplary surgical instruments suitable for use with surgical system 102 are described under the heading “SURGICAL INSTRUMENT HARDWARE” in U.S. provisional patent application serial number 62 / 611,341, filed on December 28, 2017 (entitled “INTERACTIVE SURGICAL PLATFORM,” the disclosure of which is incorporated herein by reference in its entirety).

[0111] See now Figure 3 , the hub 106 is depicted as communicating with the visualization system 108, the robotic system 110, and the handheld intelligent surgical instrument 112. The hub 106 includes a hub display 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132, and a storage array 134. In certain aspects, as Figure 3 As shown in , the hub 106 also includes a smoke evacuation module 126 and / or a suction / rinsing module 128.

[0112] During surgical procedures, energy application to tissue for sealing and / or cutting is often associated with smoke evacuation, suction of excess fluid, and / or flushing of tissue. Fluid lines, power lines, and / or data lines from different sources often become tangled during surgical procedures. Valuable time can be lost in solving this problem during surgical procedures. Disconnecting a line may require disconnecting the line from its corresponding module, which may require resetting the module. The hub modular housing 136 provides a unified environment for managing power lines, data lines, and fluid lines, which reduces the frequency of tangling between such lines.

[0113] Aspects of the present disclosure provide a surgical hub for use in a surgical procedure involving application of energy to tissue at a surgical site. The surgical hub includes a hub housing and a combination generator module that can be slidably received in a docking base of the hub housing. The docking base includes data contacts and power contacts. The combination 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 seated in a single unit. In one aspect, the combination generator module also includes a smoke exhaust component for connecting the combination generator module to at least one energy delivery cable of a surgical instrument, at least one smoke exhaust component configured to be able to exhaust 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 exhaust component.

[0114] In one aspect, the fluid line is a first fluid line and the second fluid line extends from the remote surgical site to an aspiration and irrigation module slidably received in the hub housing. In one aspect, the hub housing includes a fluid interface.

[0115] Certain surgical procedures may require more than one energy type to be applied to tissue. One energy type may be more conducive to cutting tissue, while another different energy type may be more conducive to sealing tissue. For example, a bipolar generator may be used to seal tissue, while an ultrasonic generator may be used to cut sealed tissue. Aspects of the present disclosure provide a solution in which a hub modular housing 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the hub modular housing 136 is that it enables rapid removal and / or replacement of various modules.

[0116] Aspects of the present disclosure provide a modular surgical housing for use in surgical procedures involving application of energy to tissue. The modular surgical housing includes a first energy generator module configured to generate a first energy for application to tissue, and a first docking base including a first docking port, the first docking port including first data and power contacts, wherein the first energy generator module is slidably movable into electrical engagement 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,

[0117] Further describing the above, the modular surgical shell also includes a second energy generator module, which is configured to generate a second energy different from the first energy for application to tissue, and a second docking base, which includes a second docking port, the second docking port including second data and power contacts, wherein the second energy generator module is slidably movable into electrical engagement with the power and data contacts, and wherein the second energy generator is slidably movable out of electrical contact with the second power and data contacts.

[0118] Additionally, the modular surgical housing further includes a communication bus between the first docking port and the second docking port that is configured to facilitate communication between the first energy generator module and the second energy generator module.

[0119] See also Figures 3 to 7 , aspects of the present disclosure are presented as a hub modular housing 136 that allows modular integration of the generator module 140, the smoke evacuation module 126, and the suction / irrigation module 128. The hub modular housing 136 also facilitates interactive communication between the modules 140, 126, 128. Figure 5 As shown in , the generator module 140 may be a generator module having integrated monopolar components, bipolar components, and ultrasonic components supported in a single housing unit 139 that is slidably inserted into the hub modular housing 136. Figure 5 As shown in , the generator module 140 can be configured to be connected to a monopolar device 146, a bipolar device 147, and an ultrasonic device 148. Alternatively, the generator module 140 can include a series of monopolar generator modules, bipolar generator modules, and / or ultrasonic generator modules that interact through the hub modular housing 136. The hub modular housing 136 can be configured to facilitate the insertion of multiple generators and interactive communication between the generators docked into the hub modular housing 136 so that the generators will act as a single generator.

[0120] In one aspect, the hub modular housing 136 includes a modular power and communication backplane 149 having external and wireless communication connectors to enable removable attachment of the modules 140, 126, 128 and interactive communications therebetween.

[0121] In one aspect, the hub modular housing 136 includes a docking base or drawer 151 (also referred to herein as a drawer) that is configured to slidably receive the modules 140, 126, 128. Figure 4A partial perspective view of a surgical hub housing 136 and a combination generator module 145 that can be slidably received in a docking station 151 of the surgical hub housing 136 is shown. A docking port 152 having power and data contacts on the back 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 station 151 of the hub modular housing 136 when the combination generator module 145 is slid into place within the corresponding docking station 151 of the hub modular housing 136. In one aspect, the combination generator module 145 includes bipolar, ultrasonic and monopolar modules and a smoke evacuation module integrated together into a single housing unit 139, such as Figure 5 as shown in .

[0122] In various aspects, the smoke evacuation module 126 includes a fluid line 154 that delivers captured / collected smoke and / or fluid from the surgical site to, for example, the smoke evacuation module 126. Vacuum suction from the smoke evacuation module 126 can draw smoke into an opening of a common conduit at the surgical site. The common conduit coupled to the fluid line can be in the form of a flexible tube that terminates at the smoke evacuation module 126. The common conduit and the fluid line define a fluid path that extends toward the smoke evacuation module 126 received in the hub housing 136.

[0123] In various aspects, the suction / irrigation module 128 is coupled to a surgical tool including an aspiration fluid line and a suction fluid line. In one example, the aspiration fluid line and the suction fluid line are in the form of flexible tubes extending from the surgical site toward the suction / irrigation module 128. One or more drive systems can be configured to enable flushing of fluid to the surgical site and aspiration of fluid from the surgical site.

[0124] In one aspect, the surgical tool comprises a shaft having an end effector at its distal end and at least one energy treatment associated with the end effector, a suction tube, and a flushing tube. The suction tube may have an inlet at its distal end, and the suction tube extends through the shaft. Similarly, the suction tube may extend through the shaft and may have an inlet adjacent to an energy delivery tool. The energy delivery tool is configured to be able to deliver ultrasonic energy and / or RF energy to a surgical site, and is coupled to a generator module 140 by a cable initially extending through the shaft.

[0125] The irrigation tube may be in fluid communication with a fluid source, and the aspiration tube may be in fluid communication with a vacuum source. The fluid source and / or vacuum source may be seated in the suction / irrigation module 128. In one example, the fluid source and / or vacuum source may be seated in the hub housing 136 independently of the suction / irrigation module 128. In such examples, the fluid interface may be configured to connect the suction / irrigation module 128 to the fluid source and / or vacuum source.

[0126] In one aspect, the modules 140, 126, 128 and / or their corresponding docking stations on the hub modular housing 136 may include alignment features configured to align the docking ports of the modules to engage with their corresponding ports in the docking stations of the hub modular housing 136. For example, Figure 4 As shown in , the combination generator module 145 includes a side bracket 155 that is configured to be slidably engaged 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.

[0127] In some aspects, the drawers 151 of the hub modular housing 136 are the same or substantially the same size, and the size of the module is adjusted to be received in the drawer 151. For example, the side brackets 155 and / or 156 can be larger or smaller depending on the size of the module. In other aspects, the drawers 151 are different sizes and each is designed to accommodate a specific module.

[0128] Additionally, the contacts of a particular module may be keyed to engage the contacts of a particular drawer to avoid inserting a module into a drawer with mismatched contacts.

[0129] like Figure 4 As shown in , the docking port 150 of one drawer 151 can be coupled to the docking port 150 of another drawer 151 via a communication link 157 to facilitate interactive communication between modules seated in the hub modular housing 136. Alternatively or additionally, the docking port 150 of the hub modular housing 136 can facilitate wireless interactive communication between modules seated in the hub modular housing 136. Any suitable wireless communication can be employed, such as, for example, Air Titan-Bluetooth.

[0130] Figure 6 A single power bus attachment is shown for multiple lateral docking ports of a lateral modular housing 160 that is configured to receive multiple modules of a surgical hub 206. The lateral modular housing 160 is configured to receive and interconnect modules 161 laterally. The modules 161 are slidably inserted into docking bases 162 of the lateral modular housing 160 that include a bottom plate for interconnecting the modules 161. Figure 6 As shown in FIG, the modules 161 are arranged transversely in the transverse modular housing 160. Alternatively, the modules 161 may be arranged vertically in the transverse modular housing.

[0131] Figure 7A vertical modular housing 164 is shown that is configured to receive a plurality of modules 165 of a surgical hub 106. The modules 165 are slidably inserted into a docking station or drawer 167 of the vertical modular housing 164, which includes a bottom plate for interconnecting the modules 165. Although the drawers 167 of the vertical modular housing 164 are arranged vertically, in some cases, the vertical modular housing 164 may include drawers arranged horizontally. In addition, the modules 165 can interact with each other through the docking port of the vertical modular housing 164. Figure 7 In the example of , a display 177 is provided for displaying data related to the operation of the module 165. In addition, the vertical modular housing 164 includes a main module 178 that seats a plurality of sub-modules that are slidably received in the main module 178.

[0132] 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 is composed of a modular housing that can be equipped with a light source module and a camera module. The housing can be a disposable housing. In at least one example, the disposable housing is removably coupled to a reusable controller, a light source module, and a camera module. The light source module and / or the camera module can be selectively selected according to the type of surgical procedure. In one aspect, the camera module includes a CCD sensor. In another aspect, the camera module includes a CMOS sensor. In another aspect, the camera module is configured for scanning beam imaging. Similarly, the light source module can be configured to deliver white light or different light, depending on the surgical procedure.

[0133] During a surgical procedure, it may be inefficient to remove a surgical device from the surgical field and replace the surgical device with another surgical device that includes a different camera or a different light source. Temporarily losing sight of the surgical field may lead to undesirable consequences. The modular imaging device of the present disclosure is configured to allow mid-stream replacement of a light source module or a camera module during a surgical procedure without having to remove the imaging device from the surgical field.

[0134] In one aspect, an imaging device includes a tubular housing having a plurality of channels. A first channel is configured to slidably receive a camera module, which can be configured for snap-fit ​​engagement with the first channel. A second channel is configured to slidably receive a light source module, which can be configured for snap-fit ​​engagement with the second channel. In another example, the camera module and / or the light source module can be rotated within their respective channels to a final position. A threaded engagement can be used instead of a snap-fit ​​engagement.

[0135] In various examples, multiple imaging devices are placed at different locations in the surgical field to provide multiple views. The imaging module 138 can be configured to switch between imaging devices to provide the best view. In various aspects, the imaging module 138 can be configured to integrate images from different imaging devices.

[0136] Various image processors and imaging devices suitable for use with the present disclosure are described in U.S. Patent No. 7,995,045, entitled “COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR”, issued on August 9, 2011, which is incorporated herein by reference in its entirety. In addition, U.S. Patent No. 7,982,776, entitled “SBI MOTION ARTIFACT REMOVALAPPARATUS AND METHOD”, issued on July 19, 2011, describes various systems for removing motion artifacts from image data, which is incorporated herein by reference in its entirety. Such systems may be integrated with imaging module 138. In addition, U.S. Patent Application Publication No. 2011 / 0306840, published on December 15, 2011, entitled “CONTROLLABLE MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPARATUS,” and U.S. Patent Application Publication No. 2014 / 0243597, published on August 28, 2014, entitled “SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE,” each of which is incorporated herein by reference in its entirety.

[0137] Figure 8A surgical data network 201 is shown that includes a modular communication hub 203 that is configured to connect modular devices located in one or more operating rooms of a medical facility or any room in a medical facility that is specifically equipped for surgical operations to a cloud-based system (e.g., a cloud 204 that may include a remote server 213 coupled to a storage device 205). In one aspect, the modular communication hub 203 includes a network hub 207 and / or a network switch 209 that communicates 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 it to be transferred from one device (or segment) to another device (or segment) and cloud computing resources. An intelligent surgical data network includes additional features to enable monitoring of traffic through 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.

[0138] Modular devices 1a-1n located in an operating room may be coupled to a modular communication hub 203. A network hub 207 and / or a network switch 209 may be coupled to a network router 211 to connect devices 1a-1n to a cloud 204 or a local computer system 210. Data associated with devices 1a-1n may be transmitted to a cloud-based computer via a router for remote data processing and manipulation. Data associated with devices 1a-1n may also be transmitted to a local computer system 210 for local data processing and manipulation. Modular devices 2a-2m located in the same operating room may also be coupled to a network switch 209. A network switch 209 may be coupled to a network hub 207 and / or a network router 211 to connect devices 2a-2m to a cloud 204. Data associated with devices 2a-2n may be transmitted to a cloud 204 via a network router 211 for data processing and manipulation. Data associated with devices 2a-2m may also be transmitted to a local computer system 210 for local data processing and manipulation.

[0139] 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. The modular communication hub 203 can be included in a modular control tower that is configured to accommodate multiple devices 1a-1n / 2a-2m. A local computer system 210 can also be included in the modular control tower. The modular communication hub 203 is connected to a display 212 to display images obtained by some of the devices 1a-1n / 2a-2m during a surgical procedure, for example. In various aspects, 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 evacuation module 126, a suction / irrigation module 128, a communication module 130, a processor module 132, a storage array 134, a surgical device connected to a display, and / or a non-contact sensor module in other modular devices that can be connected to a modular communication hub 203 of a surgical data network 201.

[0140] In one aspect, the surgical data network 201 may include a combination of (one or more) network hubs, (one or more) network switches, and (one or more) network routers that connect the devices 1a-1n / 2a-2m to the cloud. Any or all of the devices 1a-1n / 2a-2m coupled to the network hub or network switch can 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" can be used as a metaphor for "Internet", although the term is not limited to this. Therefore, the term "cloud computing" can 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 a computer system 210 located in a surgical room (e.g., a fixed, mobile, temporary, or on-site operating room or space) and a device connected to the modular communication hub 203 and / or the computer system 210 via the Internet. The cloud infrastructure can be maintained by a cloud service provider. In this case, the cloud service provider may be an entity that coordinates the use and control of devices 1a-1n / 2a-2m located in one or more operating rooms. Cloud computing services may perform a large number of calculations based on data collected by smart 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.

[0141] Applying cloud computer data processing technology to the data collected by the devices 1a-1n / 2a-2m, the surgical data network provides improved surgical results, reduced costs and improved patient satisfaction. At least some of the devices 1a-1n / 2a-2m can be used to observe tissue status to evaluate leakage or perfusion of sealed tissue after tissue sealing and cutting procedures. At least some of the devices 1a-1n / 2a-2m can be used to identify pathology, such as the effects of disease, using cloud-based computing to examine data including images of body tissue samples for diagnostic purposes. This includes positioning and edge confirmation of tissues and phenotypes. At least some of the devices 1a-1n / 2a-2m can be used to identify the anatomical structures of the body using various sensors integrated with imaging devices and technologies (such as overlapping images captured by multiple imaging devices). The data (including image data) collected by the devices 1a-1n / 2a-2m can be transmitted to the cloud 204 or the local computer system 210 or both for data processing and manipulation, including image processing and manipulation. The data can be analyzed to improve surgical procedure outcomes by determining whether further treatment can be pursued, such as endoscopic interventions, emerging technologies, targeted radiation, targeted interventions, and precision robotic applications to tissue-specific sites and conditions. Such data analysis can be further processed using outcome analysis, and using standardized methods can provide helpful feedback to confirm surgical treatments and surgeon behavior, or suggest modifications to surgical treatments and surgeon behavior.

[0142] In one specific implementation, operating room devices 1a-1n may be connected to the modular communication hub 203 via a wired channel or a wireless channel, depending on the configuration of the devices 1a-1n to the network hub. In one aspect, the network hub 207 may be implemented as a local network broadcast device that operates on the physical layer of the open system interconnection (OSI) model. The network hub provides connections to devices 1a-1n located in the same operating room network. The network hub 207 collects data in the form of packets and sends it to a router in half-duplex mode. The network hub 207 does not store any media access control / Internet protocol (MAC / IP) for transmitting device data. Only one of the devices 1a-1n can send data through the network hub 207 at a time. The network hub 207 has no knowledge of where to send information and broadcasts all network data on each connection and to the remote server 213 ( Fig. 9 ) Routing tables or intelligence that 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.

[0143] In another specific implementation, the operating room devices 2a-2m can be connected to the network switch 209 through a wired channel or a wireless channel. The network switch 209 operates in the data link layer of the OSI model. The network switch 209 is a multicast device for connecting the devices 2a-2m located in the same operating room to the network. The network switch 209 sends data to the network router 211 in the form of a frame and operates in full-duplex mode. Multiple devices 2a-2m can send data simultaneously through the network switch 209. The network switch 209 stores and uses the MAC addresses of the devices 2a-2m to transmit data.

[0144] The network hub 207 and / or the network switch 209 are coupled to a network router 211 to connect to the cloud 204. The network router 211 operates in the network layer of the OSI model. The network router 211 generates routes for transmitting data packets received from the network hub 207 and / or the network switch 211 to cloud-based computer resources to further process and manipulate data collected by any or all of the devices 1a-1n / 2a-2m. The 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 located in different operating rooms in different medical facilities. The network router 211 sends data to the cloud 204 in the form of packets and operates in full-duplex mode. Multiple devices can send data simultaneously. The network router 211 uses IP addresses to transmit data.

[0145] In one example, the network hub 207 may be implemented as a USB hub that allows multiple USB devices to be connected to a host computer. The USB hub may expand a single USB port to multiple levels so that more ports are available to connect devices to a host system computer. The network hub 207 may include wired or wireless capabilities for receiving information through a wired channel or a wireless channel. In one aspect, a wireless USB short-range, high-bandwidth wireless radio communication protocol may be used for communication between devices 1a-1n and devices 2a-2m located in an operating room.

[0146] 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 fixed devices and motion devices over a short distance (using short wavelength UHF radio waves in the ISM band of 2.4 to 2.485 GHz) and building a personal area network (PAN). 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, Long Term Evolution (LTE) and Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and Ethernet derivatives thereof, and any other wireless and wired protocols designated as 3G, 4G, 5G and above. The computing module may include multiple communication modules. For example, the first communication module may be dedicated to shorter-range wireless communications such as Wi-Fi and Bluetooth, and the second communication module may be dedicated to longer-range wireless communications such as GPS, EDGE, GPRS, CDMA, WiMAX, LTE, Ev-DO, etc.

[0147] The modular communication hub 203 can serve as a central connection for one or all of the operating room devices 1a-1n / 2a-2m and handles data types called frames. The frames carry data generated by the devices 1a-1n / 2a-2m. When the modular communication hub 203 receives a frame, it is amplified and transmitted to the network router 211, which transmits the data to the cloud computing resources using multiple wireless or wired communication standards or protocols as described herein.

[0148] Modular communication hub 203 can be used as a standalone device or connected to compatible network hubs and network switches to form a larger network. Modular communication hub 203 is generally easy to install, configure and maintain, making it a good option for networking operating room devices 1a-1n / 2a-2m.

[0149] Fig. 9A computer-implemented interactive surgical system 200 is shown. The computer-implemented interactive surgical system 200 is similar in many respects to the computer-implemented interactive surgical system 100. For example, the computer-implemented interactive surgical system 200 includes one or more surgical systems 202 that are similar in many respects to the surgical system 102. Each surgical system 202 includes at least one surgical hub 206 that communicates with a cloud 204 that may include a remote server 213. In one aspect, the computer-implemented interactive surgical system 200 includes a modular control tower 236 that is connected to a plurality of operating room devices, such as, for example, smart surgical instruments, robots, and other computerized devices located in the operating room. Fig.10 As shown in FIG, modular control tower 236 includes modular communication hub 203 coupled to computer system 210. Fig. 9 As shown in the example of , the modular control tower 236 is coupled to an imaging module 238 (which is coupled to an endoscope 239), a generator module 240 coupled to an energy device 241, a smoke evacuator module 226, a suction / irrigation module 228, a communication module 230, a processor module 232, a storage array 234, a smart device / instrument 235 optionally coupled to a display 237, and a non-contact sensor module 242. The operating room devices are coupled to cloud computing resources and data storage via the modular control tower 236. The robotic hub 222 can also be connected to the modular control tower 236 and cloud computing resources. The devices / instruments 235, the visualization system 208, etc. can be coupled to the modular control tower 236 via wired or wireless communication standards or protocols, as described herein. The modular control tower 236 can be coupled to a hub display 215 (e.g., monitor, screen) to display and overlay images received from the imaging module, device / instrument display, and / or other visualization system 208. The hub display may also combine graphics and overlay images to display data received from devices connected to the modular control tower.

[0150] Fig.10 A surgical hub 206 is shown comprising a plurality of modules coupled to a modular control tower 236. The modular control tower 236 comprises a modular communication hub 203 (e.g., network connectivity means) and a computer system 210 to provide, for example, local processing, visualization, and imaging. Fig.10 As shown in , 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 the computer system 210, cloud computing resources, or both. Fig.10As shown in , 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 is connected to the processor to provide communication connections with cloud computing resources and local display 217. Communication with the cloud 204 can be carried out through wired or wireless communication channels.

[0151] The surgical hub 206 employs a non-contact sensor module 242 to measure the size of the operating room and generates a map of the surgical room using an ultrasound or laser-based non-contact measurement device. The ultrasound-based non-contact sensor module scans the operating room by transmitting a burst of ultrasound waves and receiving the echoes as they bounce off the walls of the operating room, as described in U.S. Provisional Patent Application Serial No. 62 / 611,341, entitled “INTERACTIVE SURGICAL PLATFORM,” filed on December 28, 2017, under the title “Surgical Hub Spatial Awareness Within an Operating Room,” which is incorporated herein by reference in its entirety, wherein the sensor module is configured to determine the size of the operating room and adjust the Bluetooth pairing distance limit. The laser-based non-contact sensor module scans the operating room by transmitting laser pulses, receiving laser pulses that bounce off the walls of the operating room, and comparing the phase of the transmitted pulses with the received pulses to determine the size of the operating room and adjust the Bluetooth pairing distance limit.

[0152] The computer system 210 includes a processor 244 and a network interface 245. The processor 244 is coupled to a communication module 247, a storage device 248, a memory 249, a non-volatile memory 250, and an input / output interface 251 via a system bus. The system bus may be any of several types of bus structures including a memory bus or memory controller, a peripheral bus or external bus, and / or a local bus using any of a variety of available bus architectures including, but not limited to, a 9-bit bus, Industry Standard Architecture (ISA), Micro Charmel Architecture (MSA), Extended ISA (EISA), Intelligent Drive Electronics (IDE), VESA Local Bus (VLB), Peripheral Component Interconnect (PCI), USB, Advanced Graphics Port (AGP), Personal Computer Memory Card International Association bus (PCMCIA), Small Computer System Interface (SCSI), or any other peripheral bus.

[0153] Controller 244 may be any single-core or multi-core processor, such as those offered by Texas Instruments under the trade name ARM Cortex. In one aspect, the processor may be a commercially available ARM Cortex-M4F processor core, such as the Texas Instruments LM4F230H5QR, which includes 256KB of single-cycle flash or other non-volatile memory (up to 40MHz) on-chip memory, a pre-fetch buffer for improved execution above 40MHz, 32KB of single-cycle sequential random access memory (SRAM), a CPU loaded with Internal read-only memory (ROM) for software, 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) simulations, one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, details of which can be found in the product data sheet.

[0154] In one aspect, the processor 244 may include a safety controller including two families based on controllers such as TMS570 and RM4x, known under the trade name Hercules ARM Cortex R4, also produced by Texas Instruments. The safety controller may be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while delivering scalable execution, connectivity, and memory options.

[0155] System memory includes volatile memory and non-volatile memory. The basic input / output system (BIOS), which contains basic routines such as transferring information between elements 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) that acts as external cache memory. In addition, RAM is available in a variety of forms, such as SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDRSDRAM) enhanced SDRAM (ESDRAM), synchronous link DRAM (SLDRAM), and direct Rambus RAM (DRRAM).

[0156] 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, tape drives, Jaz drives, Zip drives, LS-60 drives, flash memory cards, or memory sticks. In addition, disk storage may include storage media individually or in combination with other storage media, including, but not limited to, optical disk drives such as CD-ROM devices (CD-ROM), CD-recordable drives (CD-R drives), CD-RW drives, or digital universal disk ROM drives (DVD-ROM). In order to facilitate the connection of the disk storage device to the system bus, a removable or non-removable interface may be used.

[0157] It should be understood that the computer system 210 includes software that acts as an intermediary between a user and the basic computer resources described in a suitable operating environment. Such software includes an operating system. An operating system that can 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 disk storage devices. It should be understood that the various components described herein can be implemented with various operating systems or combinations of operating systems.

[0158] The user enters commands or information into the computer system 210 through (one or more) input devices coupled to the I / O interface 251. Input devices include, but are not limited to, pointing devices such as a mouse, a touch ball, a stylus, a touch pad, a keyboard, a microphone, a joystick, a game pad, a satellite dish, a scanner, a TV tuner card, a digital camera, a digital video camera, a web camera, and the like. These and other input devices are connected to the processor through the system bus via (one or more) interface ports. (One or more) interface ports include, for example, serial ports, parallel ports, game ports, and USB. (One or more) output devices use the same type of port as (one or more) 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 that there are some output devices (such as monitors, displays, speakers, and printers) that require special adapters among other output devices. Output adapters include, by way of example, but are not limited to, video and sound cards that provide connection means between output devices and the system bus. It should be noted that other devices or systems of devices such as (one or more) remote computers provide both input capabilities and output capabilities.

[0159] The computer system 210 can operate in a networked environment using a logical connection with one or more remote computers (such as (one or more) cloud computers) or local computers. (One or more) remote cloud computers can be personal computers, servers, routers, network PCs, workstations, microprocessor-based appliances, peer devices or other public network nodes, etc., and generally include many or all of the elements described relative to the computer system. For simplicity, only a memory storage device with (one or more) remote computers is shown. (One or more) remote computers are logically connected to the computer system through a network interface, and then physically connected via a communication connection. The network interface covers communication networks such as local area networks (LANs) and wide area networks (WANs). LAN technologies include fiber distributed data interface (FDDI), copper distributed data interface (CDDI), Ethernet / IEEE 802.3, token ring / IEEE 802.5, etc. WAN technologies include, but are not limited to, point-to-point links, circuit switching networks such as integrated services digital networks (ISDN) and their variants, packet switching networks, and digital subscriber lines (DSL).

[0160] In various aspects, Fig.10 computer system 210, imaging module 238 and / or visualization system 208, and / or Figures 9 and 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 instructions, 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.

[0161] The communication connection(s) refers to the hardware / software used to connect the network interface to the bus. Although the communication connections are shown for exemplary clarification within the computer system, they may also be located external to the computer system 210. The hardware / software necessary to connect to the network interface includes internal and external technologies such as modems, including conventional telephone grade modems, cable modems and DSL modems, ISDN adapters, and Ethernet cards for exemplary purposes only.

[0162] Fig.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 the TUSB2036 integrated circuit hub of Texas Instruments. The USB network hub 300 is a CMOS device that provides an upstream USB transceiver port 302 and up to three downstream USB transceiver ports 304, 306, 308 according to the USB 2.0 specification. The upstream USB transceiver port 302 is a differential root data port that includes a differential data negative (DP0) input paired with a differential data positive (DM0) input. The three downstream USB transceiver ports 304, 306, 308 are differential data ports, each of which includes a differential data positive (DP1-DP3) output paired with a differential data negative (DM1-DM3) output.

[0163] The USB network hub 300 device is implemented with a digital state machine rather than a microcontroller, and does not require firmware programming. A fully compatible USB transceiver is integrated into the circuit for the upstream USB transceiver port 302 and all downstream USB transceiver ports 304, 306, 308. The downstream USB transceiver ports 304, 306, 308 support both full-speed devices and low-speed devices by automatically setting the conversion rate according to the speed of the device attached to the port. The USB network hub 300 device can be configured to be in bus-powered mode or self-powered mode, and includes a hub power logic 312 for managing power.

[0164] 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 generally includes up to transaction-level signaling. The functions it handles 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 digit filling, 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 a pause / resume logic and frame timer 316 circuit and a hub repeater circuit 318 to control the communication between the upstream USB transceiver port 302 and the downstream USB transceiver port 304, 306, 308 through the port logic circuit 320, 322, 324. SIE 310 is coupled to command decoder 326 via interface logic to control commands from the serial EEPROM via serial EEPROM interface 330 .

[0165] In various aspects, the USB network hub 300 can connect 127 functions configured in up to six logical layers (hierarchies) to a single computer. In addition, the USB network hub 300 can be connected to all external devices using a standardized four-wire cable that provides both communication and power distribution. The power is configured as a bus-powered mode and a self-powered mode. 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 complete set of port power management, and a self-powered hub with individual port power management or a complete set of port power management. In one aspect, the USB network hub 300, the upstream USB transceiver port 302 is inserted into the USB host controller using a USB cable, and the downstream USB transceiver ports 304, 306, 308 are exposed for connecting USB compatible devices, etc.

[0166] Surgical Instrument Hardware

[0167] Fig.12 A logic diagram of a control system 470 of a surgical instrument or tool according to one or more aspects of the present disclosure is shown. The system 470 includes a control circuit. The control circuit includes a microcontroller 461, which includes a processor 462 and a memory 468. For example, one or more of the sensors 472, 474, 476 provide real-time feedback to the processor 462. A motor 482 driven by a motor driver 492 is operably coupled to a longitudinally movable displacement member to drive a clamp arm closing member. The tracking system 480 is configured to be able to determine the position of the longitudinally movable displacement member. The position information is provided to the processor 462, which can be programmed or configured to be able to determine the position of the longitudinally movable drive member and the position of the closing member. Additional motors can be provided at the tool driver interface to control the closure tube travel, shaft rotation, joint movement, or clamp arm closure, or a combination of the above. The display 473 displays a variety of operating conditions of the instrument and may include a touch screen function for data input. The information displayed on the display 473 may be superimposed with an image acquired via an endoscopic imaging module.

[0168] In one aspect, the microprocessor 461 can be any single-core or multi-core processor, such as those known under the trade name ARM Cortex produced by Texas Instruments. In one aspect, the microcontroller 461 can be a LM4F230H5QR ARM Cortex-M4F processor core available from, for example, Texas Instruments, which includes 256KB of single-cycle flash or other non-volatile memory (up to 40MHz) on-chip memory, a pre-fetch buffer for improved performance above 40MHz, 32KB of single-cycle SRAM, a CPU loaded with Internal ROM for software, 2KB electrical EEPROM, one or more PWM modules, one or more QEI analog, one or more 12-bit ADC with 12 analog input channels, details of which can be found in the product data sheet.

[0169] In one aspect, the microcontroller 461 may include a safety controller including two families based on controllers such as TMS570 and RM4x, known under the trade name Hercules ARM Cortex R4 also produced by Texas Instruments. The safety controller may be configured specifically for IEC 61508 and ISO26262 safety critical applications, among others, to provide advanced integrated safety features while delivering scalable execution, connectivity, and memory options.

[0170] Microcontroller 461 can be programmed to perform various functions, such as accurately controlling the speed and position of a knife, an articulation system, a clamping arm, or a combination thereof. In one aspect, microcontroller 461 includes processor 462 and memory 468. Electric motor 482 can be a brushed DC (DC) motor having a gearbox and a mechanical link to an articulation or knife system. In one aspect, motor driver 492 can be an A3941 available from Allegro Microsystems, Inc. Other motor drivers can be easily replaced for use in tracking system 480 including 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 A SURGICAL STAPLING AND CUTTING INSTRUMENT" published on October 19, 2017, which is incorporated herein by reference in its entirety.

[0171] The microcontroller 461 can be programmed to provide precise control of the speed and position of the displacement member and articulation system. The microcontroller 461 can be configured to be able to calculate the response in the software of the microcontroller 461. The calculated response is compared with the measured response of the actual system to obtain the "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.

[0172] In one aspect, the motor 482 can be controlled by a motor driver 492 and can be adopted by the firing system of a surgical instrument or tool. In various forms, the motor 482 can be a brushed DC drive motor with a maximum rotation speed of about 25,000 RPM. In other arrangements, the motor 482 can include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor driver 492 can include, for example, an H-bridge driver including a field effect transistor (FET). The motor 482 can be supplied with power by a power assembly that can be releasably mounted to a handle assembly or a tool housing for supplying control power to a surgical instrument or tool. The power assembly can include a battery that can include a plurality of battery cells connected in series that can be used as a power source to provide power to a surgical instrument or tool. In some cases, the battery cell of the power assembly can be a replaceable and / or rechargeable battery cell. In at least one example, the battery cell can be a lithium-ion battery that can be coupled to the power assembly and can be separated from the power assembly.

[0173] Driver 492 may be an A3941 available from Allegro Microsystems, Inc. A3941 492 is a full-bridge controller for use with external N-channel power metal oxide semiconductor field effect transistors (MOSFETs) specifically designed for inductive loads such as brushed DC motors. Driver 492 includes a unique charge pump regulator that provides full (>10V) gate drive for battery voltages as low as 7V and allows the A3941 to operate at reduced gate drive as low as 5.5V. A bootstrap capacitor may be used to provide the above-mentioned battery supply voltage required for the N-channel MOSFET. The internal charge pump of the high-side driver allows DC (100% duty cycle) operation. A diode or synchronous rectification may be used to drive the full bridge in fast decay mode or slow decay mode. In slow decay mode, current recirculation may pass through the high-side FET or the low-side FET. The power FET is protected from breakdown by a resistor-adjustable dead time. Comprehensive diagnostics provide indication of undervoltage, overtemperature, and power bridge faults, and can be configured to protect the power MOSFETs under most short circuit conditions.Other motor drivers can be easily substituted for use in tracking system 480 including an absolute positioning system.

[0174] Tracking system 480 includes a controlled motor drive circuit arrangement including position sensor 472 according to one aspect of the present disclosure. Position sensor 472 for absolute positioning system provides a unique position signal corresponding to the position of displacement member. In one aspect, displacement member represents a longitudinally movable drive member, which includes a rack of drive teeth for meshing engagement with a corresponding drive gear of a gear reducer assembly. In other aspects, displacement member represents a firing member, which can be adapted and configured to include a rack of drive teeth. In another aspect, displacement member represents a longitudinal displacement member for opening and closing clamping arms, which can be adapted and configured to include a rack of drive teeth. In other aspects, displacement member represents a clamping arm closing member, which is configured to close and open the clamping arm of a stapler, the clamping arm of an ultrasonic or electrosurgical device, or a combination of the above. Therefore, 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, a clamping arm, or any element that can be displaced). Therefore, the absolute positioning system can actually track the displacement of the clamping arm by tracking the linear displacement of the longitudinally movable drive member. In other aspects, the absolute positioning system can be configured to track the position of the clamping arm during closing or opening. In various other aspects, the displacement member can be coupled to any position sensor 472 suitable for measuring linear displacement. Therefore, the longitudinally movable drive member, or the clamping arm, or a combination thereof can be coupled to any suitable linear displacement sensor. The linear displacement sensor may include a contact displacement sensor or a non-contact displacement sensor. The linear displacement sensor may include a linear variable differential transformer (LVDT), a differential variable reluctance transducer (DVRT), a sliding potentiometer, a magnetic sensing system including a movable magnet and a series of linearly arranged Hall effect sensors, a magnetic sensing system including a fixed magnet and a series of movable linearly arranged Hall effect sensors, an optical sensing system including a movable light source and a series of linearly arranged photodiodes or photodetectors, an optical sensing system including a fixed light source and a series of movable linearly arranged photodiodes or photodetectors, or any combination thereof.

[0175] The electric motor 482 may include a rotatable shaft operably interfaced with a gear assembly that is mounted on the displacement member in meshing engagement with a set or rack of drive teeth. The sensor element may be operably coupled to the gear assembly so that a single rotation of the position sensor 472 element corresponds to some linear longitudinal translation of the displacement member. The arrangement of the transmission and sensor may be connected to a linear actuator via a rack and pinion arrangement, or to a rotary actuator via a spur gear or other connection. The power source supplies power to the absolute positioning system, and the output indicator may display the output of the absolute positioning system. The displacement member represents a longitudinally movable drive member that includes a rack of drive teeth formed thereon for meshing engagement with a corresponding drive gear of the gear reducer assembly. The displacement member represents a longitudinally movable firing member for opening and closing the clamping arm.

[0176] A single rotation of the sensor element associated with the position sensor 472 is equivalent to a longitudinal linear displacement of the displacement member d1, 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 coupled to the displacement member. The sensor arrangement may be connected via a gear reduction that enables the position sensor 472 to complete only one or more rotations for a full stroke of the displacement member. The position sensor 472 may complete multiple rotations for a full stroke of the displacement member.

[0177] A series of switches (where n is an integer greater than one) may be employed alone or in conjunction with gear reduction to provide unique position signals for more than one rotation of the position sensor 472. The state of the switches is fed back to the microcontroller 461, which applies logic to determine the longitudinal linear displacement d1+d2+…d corresponding to the displacement member. n The output of the position sensor 472 is provided to the microcontroller 461. The position sensor 472 of the sensor arrangement may include a magnetic sensor, an analog rotation sensor (such as a potentiometer), an array of analog Hall effect elements that output a unique combination of position signals or values.

[0178] Position sensor 472 may include any number of magnetic sensing elements, such as, for example, magnetic sensors classified according to whether they measure the total magnetic field or the vector component of the magnetic field. The technologies used to produce the above two types of magnetic sensors cover many aspects of physics and electronics. Technologies for magnetic field sensing include probe coils, fluxgates, optical pumps, nuclear spins, superconducting quantum interference devices (SQUIDs), Hall effects, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive / piezoelectric composites, magnetosensitive diodes, magnetosensitive transistors, optical fibers, magneto-optics, and magnetic sensors based on micro-electromechanical systems, among others.

[0179] In one aspect, the position sensor 472 for the tracking system 480 including the absolute positioning system includes a magnetic rotation absolute positioning system. The position sensor 472 can be implemented as an AS5055EQFT monolithic magnetic rotation position sensor, which can be purchased from Austria Microsystems, AG. The position sensor 472 interacts with the microcontroller 461 to provide an absolute positioning system. The position sensor 472 is a low voltage and low power component and includes four Hall effect elements in the area of ​​the position sensor 472 located above the magnet. A high resolution ADC and an intelligent power management controller are also provided on the chip. A coordinate rotation digital computer (CORDIC) processor (also known as the bitwise method and Volder algorithm) is provided to perform a simple and efficient algorithm to calculate hyperbolic and trigonometric functions, which only requires addition, subtraction, digit shift 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 may be an AS5055 chip provided in a small QFN 16-pin 4×4×0.85 mm package.

[0180] The tracking system 480 including the absolute positioning system may include and / or may be programmed to implement a feedback controller such as a PID, state feedback, and an adaptive controller. The power source converts the signal from the feedback controller into a physical input to the system: in this case, a voltage. Other examples include PWM of voltage, current, and force. In addition to the position measured by the position sensor 472, one or more other sensors may be provided to measure a physical parameter 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,” issued on May 24, 2016, which is incorporated herein by reference in its entirety; U.S. Patent Application Publication 2014 / 0263552, entitled “STAPLE CARTRIDGETISSUE THICKNESS SENSOR SYSTEM,” published on September 18, 2014, which is incorporated herein by reference in its entirety; 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 on June 20, 2017, which is incorporated herein by reference in its entirety. In a digital signal processing system, the absolute positioning system is coupled to a digital data acquisition system, where the output of the absolute positioning system will have a finite resolution and sampling frequency. The absolute positioning system may include comparison and combination circuits to combine the calculated response with the measured response using an algorithm (such as weighted average and theoretical control loop) that 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.

[0181] Thus, the absolute positioning system provides the absolute position of the displacement member when the instrument is powered on, and does not retract or advance the displacement member to a reset (zero or home) position as may be required with conventional rotary encoders, which simply count the number of forward or backward steps taken by the motor 482 to infer the position of the device actuator, drive rod, knife, etc.

[0182] The sensor 474 (such as, for example, a strain gauge or a micro strain gauge) is configured to measure one or more parameters of the end effector, such as, for example, the magnitude of the strain applied to the anvil during the clamping operation, which can indicate the closing force applied to the anvil. The measured strain is converted into a digital signal and provided to the processor 462. Alternatively or in addition to the sensor 474, the sensor 476 (such as, for example, a load sensor) can measure the closing force of the anvil in the stapler or clamping arm applied by the closed drive system to the ultrasonic or electrosurgical instrument. The sensor 476 (such as, for example, a load sensor) can measure the firing force applied to the closing member of the clamping arm coupled to the surgical instrument or tool or the force applied by the clamping arm to the tissue in the jaws of the ultrasonic or electrosurgical instrument. Alternatively, a current sensor 478 can be used to measure the current consumed by the motor 482. The displacement member can also be configured to engage the clamping arm to open or close the clamping arm. The force sensor can be configured to measure the clamping force on the tissue. The force required to advance the displacement member may correspond to, for example, the current consumed by the motor 482. The measured force is converted into a digital signal and provided to the processor 462.

[0183] In one form, a strain gauge sensor 474 can be used to measure the force applied to the tissue by the end effector. A strain gauge can be coupled to the end effector to measure the force on the tissue processed by the end effector. A system for measuring the force applied to the tissue grasped by the end effector includes a strain gauge sensor 474, such as, for example, a micro strain gauge, which is configured to measure, for example, one or more parameters of the end effector. In one aspect, the strain gauge sensor 474 can measure the amplitude or magnitude of the strain applied to the jaw member of the end effector during the clamping operation, which can indicate tissue compression. The measured strain is converted into a digital signal and provided to the processor 462 of the microcontroller 461. The load sensor 476 can measure the force used to operate the knife element, for example, to cut the tissue captured between the anvil and the nail magazine. The load sensor 476 can measure the force used to operate the clamp arm element, for example, to capture the tissue between the clamp arm and the ultrasonic knife or the tissue between the clamp arm and the jaws of the electrosurgical instrument. A magnetic field sensor can be used to measure the thickness of the captured tissue. The measurement value of the magnetic field sensor can also be converted into a digital signal and provided to the processor 462.

[0184] The microcontroller 461 can characterize the selected position of the firing member and / or the corresponding value of the velocity of the firing member using the measured values ​​of tissue compression, tissue thickness, and / or the force required to close the end effector measured by the sensors 474, 476, respectively. In one embodiment, the memory 468 can store techniques, formulas, and / or lookup tables that can be used by the microcontroller 461 in the evaluation.

[0185] The control system 470 of the surgical instrument or tool may also include wired or wireless communication circuitry to communicate with the modular communication hub, such as Figures 8 to 11 as shown in .

[0186] Fig.13 A control circuit 500 configured to control various aspects of a surgical instrument or tool according to one aspect of the present disclosure is shown. The control circuit 500 may be configured to implement the various methods described herein. The control circuit 500 may include a microcontroller including one or more processors 502 (e.g., microprocessors, microcontrollers) coupled to at least one memory circuit 504. The memory circuit 504 stores machine executable instructions that, when executed by the processor 502, cause the processor 502 to execute machine instructions to implement the various processes described herein. The processor 502 may be any of a variety of single-core or multi-core processors known in the art. The memory circuit 504 may include a volatile storage medium and a non-volatile storage medium. The processor 502 may include an instruction processing unit 506 and an operation unit 508. The instruction processing unit may be configured to receive instructions from the memory circuit 504 of the present disclosure.

[0187] Fig.14 Combinatorial logic circuit 510 is shown, which is configured to control various aspects of a surgical instrument or tool according to one aspect of the present disclosure. Combinatorial logic circuit 510 can be configured to implement various methods described herein. Combinatorial logic circuit 510 may include a finite state machine, which includes a combinatorial logic component 512, which is configured to receive data associated with a surgical instrument or tool at an input 514, process the data through the combinatorial logic component 512, and provide an output 516.

[0188] Fig.15 A sequential logic circuit 520 is shown that is configured to control various aspects of a surgical instrument or tool according to one aspect of the present disclosure. The sequential logic circuit 520 or the combinational logic component 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, a combinational logic component 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 a surgical instrument or tool from an 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., a processor 502, Fig.13) and a finite state machine to implement the various methods herein. In other aspects, the finite state machine may include a combinational logic circuit (e.g., combinational logic circuit 510, Fig.14 ) and a sequential logic circuit 520.

[0189] Fig.16 A surgical instrument or tool is shown that includes multiple motors that can be activated to perform various functions. In some cases, a first motor can be activated to perform a first function, a second motor can be activated to perform a second function, and a third motor can be activated to perform a third function. In some cases, multiple motors of the robotic surgical instrument 600 can be individually activated to cause a firing motion, a closing motion, and / or an articulation motion in an end effector. The firing motion, the closing motion, and / or the articulation motion can be transmitted to the end effector, for example, via a shaft assembly.

[0190] In some cases, the surgical instrument system or tool may include a firing motor 602. The firing motor 602 may be operably coupled to a firing motor drive assembly 604, which may be configured to transmit the firing motion generated by the motor 602 to the end effector, specifically for displacing the clamp arm closure member. The closure member may be retracted by reversing the direction of the motor 602, which also causes the clamp arm to open.

[0191] In some cases, the surgical instrument or tool may include a closing motor 603. The closing motor 603 may be operably coupled to a closing motor drive assembly 605, which is configured to be able to transmit the closing motion generated by the motor 603 to the end effector, specifically for displacing the closing tube to close the anvil and compressing the tissue between the anvil and the staple cartridge. The closing motor 603 may be operably coupled to a closing motor drive assembly 605, which is configured to be able to transmit the closing motion generated by the motor 603 to the end effector, specifically for displacing the closing tube to close the clamping arm and compressing the tissue between the clamping arm and the ultrasonic blade or jaw member of the electrosurgical device. The closing motion may, for example, cause the end effector to transition from an open configuration to a close configuration to capture tissue. The end effector may be transitioned to an open position by reversing the direction of the motor 603.

[0192] In some cases, the surgical instrument or tool may include, for example, one or more articulation motors 606a, 606b. The motors 606a, 606b may be operably coupled to respective articulation motor drive assemblies 608a, 608b, which may be configured to transmit the articulation generated by the motors 606a, 606b to the end effector. In some cases, the articulation may cause the end effector to articulate relative to an axis, for example.

[0193] As described above, surgical instruments or tools may include multiple motors that may be configured to perform various independent functions. In some cases, multiple motors of surgical instruments or tools may be individually or independently activated to perform one or more functions, while other motors remain inactive. For example, articulation motors 606a, 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 nails and / or advance the cutting edge, while articulation motor 606 remains inactive. In addition, closing motor 603 may be activated simultaneously with firing motor 602 to advance the closing tube or closing member toward the distal side, as described in more detail below.

[0194] In some cases, a surgical instrument or tool 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 can be individually coupled to multiple motors of the surgical instrument and can be separated from the multiple motors of the surgical instrument. In some cases, multiple motors of the surgical instrument or tool can 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 can independently and selectively engage the common control module 610. In some cases, the common control module 610 can switch from interfacing with one of the multiple motors of the surgical instrument or tool to interfacing with another of the multiple motors of the surgical instrument or tool.

[0195] In at least one example, the common control module 610 can selectively switch between operably engaging the articulation motors 606a, 606b and operably engaging the firing motor 602 or the closing motor 603. Fig.16 As shown in , the switch 614 can move or change between multiple positions and / or states. In the first position 616, the switch 614 can electrically couple the common control module 610 to the firing motor 602; in the second position 617, the switch 614 can electrically couple the common control module 610 to the closing motor 603; in the third position 618a, the switch 614 can electrically couple the common control module 610 to the first joint motion motor 606a; and in the fourth position 618b, the switch 614 can electrically couple the common control module 610 to, for example, the second joint motion motor 606b. In some cases, a separate common control module 610 can be electrically coupled to the firing motor 602, the closing motor 603, and the joint motion motors 606a, 606b at the same time. In some cases, the switch 614 can be a mechanical switch, an electromechanical switch, a solid-state switch, or any suitable switch mechanism.

[0196] Each of the motors 602, 603, 606a, 606b may include a torque sensor to measure the output torque on the shaft of the motor. The force on the end effector may 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.

[0197] In various cases, such as Fig.16 As shown in , 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 modulate the power transmitted from a power source 628 to a motor coupled to the common control module 610, for example, based on input from a microcontroller 620 ("controller"). In some cases, when a 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.

[0198] In some cases, microcontroller 620 may include a microprocessor 622 ("processor") and one or more non-transitory computer-readable media or storage units 624 ("memory"). In some cases, memory 624 may store various program instructions that, when executed, may cause processor 622 to perform a number of functions and / or calculations described herein. In some cases, one or more of memory units 624 may be coupled to processor 622, for example. In various aspects, microcontroller 620 may communicate via wired or wireless channels, or a combination thereof.

[0199] In some cases, the power source 628 may be used, for example, to supply power to the microcontroller 620. In some cases, the power source 628 may include a battery (or "battery pack" or "power pack"), such as a lithium-ion battery, for example. In some cases, the battery pack may be configured to be releasably mounted to the handle for supplying power to the surgical instrument 600. A plurality of battery cells connected in series may be used as the power source 628. In some cases, the power source 628 may be, for example, replaceable and / or rechargeable.

[0200] In various cases, the processor 622 may control the motor driver 626 to control the position, rotation direction, and / or speed of the motor coupled to the common controller 610. In some cases, the processor 622 may signal the motor driver 626 to stop and / or deactivate the motor coupled to the 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 functions of the central processing unit (CPU) of a computer on an integrated circuit or at most several integrated circuits. The processor 622 is a multi-purpose programmable device that receives digital data as input, processes the input according to instructions stored in its memory, and then provides a result as output. Because the processor has internal memory, it is an example of sequential digital logic. The operating objects of the processor are numbers and symbols represented in the binary number system.

[0201] In one case, the processor 622 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex produced by Texas Instruments. In some cases, the microcontroller 620 may 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 core that includes: 256KB of single-cycle flash or other non-volatile memory (up to 40MHz) on-chip memory, a pre-fetch buffer for improved performance above 40MHz, 32KB of single-cycle SRAM, a CPU loaded with The 4410 includes an internal ROM for software, 2KB of EEPROM, one or more PWM modules, one or more QEI simulations, one or more 12-bit ADCs with 12 analog input channels, and other features readily available. Other microcontrollers can be easily substituted for use with module 4410. Therefore, the present disclosure should not be limited to this context.

[0202] In some cases, the memory 624 may include program instructions for controlling each of the motors of the surgical instrument 600 that may be coupled to the common controller 610. For example, the memory 624 may include program instructions for controlling the firing motor 602, the closing motor 603, and the articulation motors 606a, 606b. Such program instructions may enable the processor 622 to control the firing, closing, and articulation functions based on input from an algorithm or control program of the surgical instrument or tool.

[0203] In some cases, one or more mechanisms and / or sensors, such as sensor 630, can be used to alert processor 622 of 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 the end effector. In some cases, sensor 630 can include, for example, a position sensor that can be used to sense the position of switch 614. Thus, processor 622 can use program instructions associated with firing a closing member of a clamping arm coupled to an end effector when, for example, sensor 630 detects that switch 614 is in first position 616; processor 622 can use program instructions associated with closing anvil when, for example, sensor 630 detects that switch 614 is in second position 617; and processor 622 can use program instructions associated with articulating the end effector when, for example, sensor 630 detects that switch 614 is in third position 618a or fourth position 618b.

[0204] Fig.17 7 is a schematic diagram of a robotic surgical instrument 700 configured to operate the surgical tools described herein according to one aspect of the present 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, shaft rotation, and articulation with a single or multiple articulation drive links. In one aspect, the surgical instrument 700 can be programmed or configured to individually control a firing member, a closure member, an axis member, or one or more articulation members, or a combination thereof. The surgical instrument 700 includes a control circuit 710 that is configured to control a motor-driven firing member, a closure member, an axis member, or one or more articulation members, or a combination thereof.

[0205] In one aspect, the robotic surgical instrument 700 includes a control circuit 710 configured to control the clamping arm 716 and the closing member 714 portion of the end effector 702, the ultrasonic blade 718 coupled to the ultrasonic transducer 719 excited by the ultrasonic generator 721, the shaft 740, and one or more joint motion members 742a, 742b via a plurality of motors 704a-704e. The position sensor 734 may be configured to provide position feedback of the closing member 714 to the control circuit 710. Other sensors 738 may be configured to provide feedback to the control circuit 710. The timer / counter 731 provides timing and counting information to the control circuit 710. An energy source 712 may be provided to operate the motors 704a-704e, and a current sensor 736 provides motor current feedback to the control circuit 710. The motors 704a-704e may be operated individually in open-loop or closed-loop feedback control by the control circuit 710.

[0206] In one aspect, the control circuit 710 may include one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause the one or more processors to perform one or more tasks. In one aspect, the timer / counter 731 provides an output signal to the control circuit 710, such as an elapsed time or a digital count, to correlate the position of the closing member 714 as determined by the position sensor 734 with the output of the timer / counter 731, so that the control circuit 710 can determine the position of the closing member 714 at a specific time (t) relative to the starting position or the time (t) when the closing member 714 is in a specific position relative to the starting position. The timer / counter 731 can be configured to measure the elapsed time, count external events, or time external events.

[0207] In one aspect, the control circuit 710 can be programmed to control the function of the end effector 702 based on one or more tissue conditions. The control circuit 710 can be programmed to sense tissue conditions, such as thickness, directly or indirectly, as described herein. The control circuit 710 can be programmed to select a firing control program or a closing control program based on the 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, the control circuit 710 can be programmed to translate the displacement member at a lower speed and / or at a lower power. When thinner tissue is present, the control circuit 710 can be programmed to translate the displacement member at a higher speed and / or at a higher power. The closing control program can control the closing force applied to the tissue by the clamping arm 716. Other control programs control the rotation of the shaft 740 and the articulation members 742a, 742b.

[0208] In one aspect, the control circuit 710 may generate a motor set point signal. The motor set point signal may be provided to various motor controllers 708a-708e. The motor controllers 708a-708e may include one or more circuits configured to provide motor drive signals to the motors 704a-704e to drive the motors 704a-704e as described herein. In some examples, the motors 704a-704e may be brushed DC electric motors. For example, the speed of the motors 704a-704e may be proportional to the corresponding motor drive signals. In some examples, the motors 704a-704e may be brushless DC motors, and the corresponding motor drive signals may include PWM signals provided to one or more stator windings of the motors 704a-704e. Moreover, in some examples, the motor controllers 708a-708e may be omitted, and the control circuit 710 may directly generate the motor drive signals.

[0209] In some examples, the control circuit 710 may initially operate each of the motors 704a-704e in an open-loop configuration for a first open-loop portion of the displacement member's travel. Based on the response of the robotic surgical instrument 700 during the open-loop portion of the travel, the control circuit 710 may select a firing control program in a closed-loop configuration. The response of the instrument may include the translation distance of the displacement member during the open-loop portion, the time elapsed during the open-loop portion, the energy provided to one of the motors 704a-704e during the open-loop portion, the sum of the pulse widths of the motor drive signals, etc. After the open-loop portion, the control circuit 710 may implement the selected firing control program for a second portion of the displacement member's travel. For example, during the closed-loop portion of the travel, the control circuit 710 may modulate one of the motors 704a-704e based on the translation data describing the position of the displacement member in a closed-loop manner to cause the displacement member to translate at a constant speed.

[0210] In one aspect, the motors 704a-704e may receive power from the energy source 712. The energy source 712 may be a DC power source driven by a main AC power source, a battery, a supercapacitor, or any other suitable energy source. The motors 704a-704e may be mechanically coupled to separate movable mechanical elements, such as the closing member 714, the clamping arm 716, the shaft 740, the articulation 742a, and the articulation 742b, via corresponding transmissions 706a-706e. The transmissions 706a-706e may include one or more gears or other connecting rod components to couple the motors 704a-704e to the movable mechanical elements. The position sensor 734 may sense the position of the closing member 714. The position sensor 734 may be or include any type of sensor capable of generating position data indicating the position of the closing member 714. In some examples, the position sensor 734 may include an encoder configured to provide a series of pulses to the control circuit 710 when the closing member 714 is translated toward the distal side and toward the proximal side. The control circuit 710 can track the pulses to determine the position of the closing member 714. Other suitable position sensors can be used, including, for example, proximity sensors. Other types of position sensors can provide other signals indicating the movement of the closing member 714. Moreover, in some examples, the position sensor 734 can be omitted. In the case where the motors 704a-704e are stepper motors, the control circuit 710 can track the position of the closing member 714 by gathering the number and direction of the steps that the motor 704 has been instructed to perform. The position sensor 734 can be located in the end effector 702 or at any other part of the instrument. The output of each of the motors 704a-704e includes a torque sensor 744a-744e for sensing force, and has an encoder for sensing the rotation of the drive shaft.

[0211] In one aspect, the control circuit 710 is configured to drive a firing member such as a closing member 714 portion of the end effector 702. The control circuit 710 provides a motor set point to a motor control 708a, which provides a drive signal to the motor 704a. The output shaft of the motor 704a is coupled to a torque sensor 744a. The torque sensor 744a is coupled to a transmission 706a, which is coupled to the closing member 714. The transmission 706a includes a movable mechanical element such as a rotating element and a firing member to control the movement of the closing member 714 along the longitudinal axis of the end effector 702 to the distal and proximal sides. In one aspect, the motor 704a can be coupled to a knife gear assembly, which includes a knife gear reduction group, and the knife gear reduction group includes a first knife drive gear and a second knife drive gear. The torque sensor 744a provides a firing force feedback signal to the control circuit 710. The firing force signal represents the force required to fire or displace the closing member 714. The position sensor 734 can be configured to provide the position of the closing member 714 along the firing stroke or the position of the firing member as a feedback signal to the control circuit 710. The end effector 702 may include an additional sensor 738 configured to provide a feedback signal to the control circuit 710. When ready for use, the control circuit 710 can provide a firing signal to the motor control 708a. In response to the firing signal, the motor 704a can drive the firing member from the proximal stroke start position to the distal end of the stroke start position along the longitudinal axis of the end effector 702. When the closing member 714 is translated toward the distal side, the clamping arm 716 is closed toward the ultrasonic blade 718.

[0212] In one aspect, the control circuit 710 is configured to drive a closing member, such as the clamping arm 716 portion of the end effector 702. The control circuit 710 provides a motor set point to the motor control 708b, which provides a drive signal to the motor 704b. The output shaft of the motor 704b is coupled to a torque sensor 744b. The torque sensor 744b is coupled to a transmission 706b coupled to the clamping arm 716. The transmission 706b includes a movable mechanical element such as a rotating element and a closing member to control the movement of the clamping arm 716 from an open position and a closed position. In one aspect, the motor 704b is coupled to a closing gear assembly, which includes a closing reduction gear set supported to mesh with a closing spur gear. The torque sensor 744b provides a closing force feedback signal to the control circuit 710. The closing force feedback signal represents the closing force applied to the clamping arm 716. The position sensor 734 can be configured to provide the position of the closing member as a feedback signal to the control circuit 710. The additional sensor 738 in the end effector 702 can provide a closing force feedback signal to the control circuit 710. The pivotable clamp arm 716 is positioned opposite the ultrasonic blade 718. When ready for use, the control circuit 710 can provide a closing signal to the motor control 708b. In response to the closing signal, the motor 704b advances the closing member to grasp the tissue between the clamp arm 716 and the ultrasonic blade 718.

[0213] In one aspect, the control circuit 710 is configured to enable a shaft member such as shaft 740 to rotate so that the end effector 702 rotates. The control circuit 710 provides a motor set point to a motor control 708c, which provides a drive signal to the motor 704c. The output shaft of the motor 704c is coupled to a torque sensor 744c. The torque sensor 744c is coupled to a transmission 706c coupled to the shaft 740. The transmission 706c includes a movable mechanical element such as a rotating element to control the shaft 740 to rotate up to 360° and more than 360° clockwise or counterclockwise. In one aspect, the motor 704c is coupled to a rotary transmission assembly, which includes a tube gear section formed on (or attached to) the proximal end of the proximal closure tube to be operably engaged by a rotary gear assembly operably supported on a tool mounting plate. The torque sensor 744c provides a rotational force feedback signal to the control circuit 710. The rotational force feedback signal represents the rotational force applied to the shaft 740. The position sensor 734 may be configured to provide the position of the closing member as a feedback signal to the control circuit 710. An additional sensor 738, such as a shaft encoder, may provide the rotational position of the shaft 740 to the control circuit 710.

[0214] In one aspect, the control circuit 710 is configured to enable the end effector 702 to articulate. The control circuit 710 provides a motor set point to a motor control 708d, which provides a drive signal to the motor 704d. The output of the motor 704d is coupled to a torque sensor 744d. The torque sensor 744d is coupled to a transmission 706d coupled to the articulation member 742a. ​​The transmission 706d includes a movable mechanical element such as an articulation element to control the articulation of the end effector 702 ± 65°. In one aspect, the motor 704d is coupled to an articulation nut that is rotatably journaled on the proximal end portion of the distal spine and rotatably driven thereon by an articulation gear assembly. The torque sensor 744d provides an articulation force feedback signal to the control circuit 710. The articulation force feedback signal represents the articulation force applied to the end effector 702. A sensor 738 , such as an articulation encoder, may provide the articulation position of the end effector 702 to the control circuit 710 .

[0215] On the other hand, the joint motion function of the robotic surgical system 700 may include two joint motion components or connecting rods 742a, 742b. These joint motion components 742a, 742b are driven by a separate disk on the robot interface (rack), and the separate disk is driven by two motors 708d, 708e. When a separate firing motor 704a is provided, each of the joint motion connecting rods 742a, 742b can be driven in an antagonistic manner relative to another connecting rod so as to provide resistance to the head to maintain motion and load when the head is not moving, and to provide joint motion when the head is articulated. When the head rotates, the joint motion components 742a, 742b are attached to the head with a fixed radius. Therefore, when the head rotates, the mechanical advantage of the push-pull connecting rod changes. This change in mechanical advantage can be more obvious for other joint motion connecting rod drive systems.

[0216] In one aspect, one or more motors 704a-704e may include a brushed DC motor with a gearbox and a mechanical link with a firing member, a closing member, or an articulation member. Another example includes an electric motor 704a-704e that operates a movable mechanical element such as a displacement member, an articulation link, a closing tube, and an axis. External influences are unmeasured, unpredictable effects of things such as tissue, surrounding body, and friction on a physical system. Such external influences may be referred to as drag, which acts relative to one of the electric motors 704a-704e. External influences such as drag may cause the operation of a physical system to deviate from the desired operation of the physical system.

[0217] In one aspect, the position sensor 734 can be implemented as an absolute positioning system. In one aspect, the position sensor 734 can include a magnetic rotation absolute positioning system implemented as an AS5055EQFT monolithic magnetic rotation position sensor, which can be purchased from Austria Microsystems, AG. The position sensor 734 can interact with the control circuit 710 to provide an absolute positioning system. The position can include a Hall effect element located above the magnet and coupled to a CORDIC processor, which is also known as a bit-by-bit method and Volder algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions, which only require addition operations, subtraction operations, digit shift operations, and table lookup operations.

[0218] In one aspect, the control circuit 710 can communicate with one or more sensors 738. The sensor 738 can be positioned on the end effector 702 and is adapted to operate with the robotic surgical instrument 700 to measure various derived parameters, such as gap distance and time, tissue compression and time, and anvil strain and time. The sensor 738 can include a magnetic sensor, a magnetic field sensor, a strain gauge, a load sensor, a pressure sensor, a force sensor, a torque sensor, an inductive sensor such as an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor, and / or any other suitable sensor for measuring one or more parameters of the end effector 702. The sensor 738 can include one or more sensors. The sensor 738 can be located on the clamping arm 716 to determine tissue position using segmented electrodes. The torque sensors 744a-744e can be configured to sense forces such as firing force, closing force, and / or joint motion force, etc. Thus, the control circuit 710 can sense (1) the closure load experienced by the distal closure tube and its position, (2) the firing member at the rack and its position, (3) the portion of the ultrasonic blade 718 on which the tissue is located, and (4) the loads and positions on the two articulation rods.

[0219] In one aspect, one or more sensors 738 may include a strain gauge, such as a micro strain gauge, which is configured to measure the magnitude of the strain in the clamping arm 716 during the clamping condition. The strain gauge provides an electrical signal whose amplitude varies with the magnitude of the strain. The sensor 738 may include a pressure sensor configured to detect the pressure generated by the presence of compressed tissue between the clamping arm 716 and the ultrasonic blade 718. The sensor 738 may be configured to detect the impedance of the tissue section between the clamping arm 716 and the ultrasonic blade 718, which indicates the thickness and / or filling degree of the tissue located therebetween.

[0220] In one aspect, the sensor 738 may be implemented as one or more limit switches, electromechanical devices, solid-state switches, Hall effect devices, magnetoresistive (MR) devices, giant magnetoresistive (GMR) devices, magnetometers, and the like. In other implementations, the sensor 738 may be implemented as a solid-state switch that operates under the influence of light, such as an optical sensor, an IR sensor, an ultraviolet sensor, and the like. Likewise, the switch may be a solid-state device, such as a transistor (e.g., a FET, a junction FET, a MOSFET, a bipolar transistor, and the like). In other implementations, the sensor 738 may include a non-electrically conductive switch, an ultrasonic switch, an accelerometer, an inertial sensor, and the like.

[0221] In one aspect, the sensor 738 may be configured to measure the force applied by the closure drive system to the clamp arm 716. For example, one or more sensors 738 may be located at the interaction point between the closure tube and the clamp arm 716 to detect the closing force applied by the closure tube to the clamp arm 716. The force applied to the clamp arm 716 may represent the tissue compression experienced by the tissue segment captured between the clamp arm 716 and the ultrasonic blade 718. One or more sensors 738 may be positioned at various interaction points along the closure drive system to detect the closing force applied by the closure drive system to the clamp arm 716. One or more sensors 738 may be sampled in real time by the processor of the control circuit 710 during the clamping operation. The control circuit 710 receives real-time sample measurements to provide and analyze time-based information and evaluate the closing force applied to the clamp arm 716 in real time.

[0222] In one aspect, the current sensor 736 can be used to measure the current consumed by each of the motors 704a-704e. The force required to propel any one of the movable mechanical elements (such as the closing member 714) corresponds to the current consumed by one of the motors 704a-704e. The force is converted into a digital signal and provided to the control circuit 710. The control circuit 710 can be configured to simulate the response of the actual system of the instrument in the software of the controller. The displacement member can be actuated to move the closing member 714 in the end effector 702 at a target speed or close to the target speed. The robotic surgical system 700 may include a feedback controller, which may be one of any feedback controllers, including but not limited to, for example, PID, state feedback, linear square (LQR) and / or adaptive controllers. The robotic surgical instrument 700 may include a power source to, for example, convert a signal from the feedback controller into a physical input, such as a housing voltage, a PWM voltage, a frequency modulated voltage, a current, a torque and / or a force. Additional details are disclosed in U.S. patent application serial number 15 / 636,829, filed on June 29, 2017, entitled “CLOSED LOOP VELOCITY CONTROLTECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT,” which is incorporated herein by reference in its entirety.

[0223] Fig.18 A schematic diagram of a surgical instrument 750 configured to control distal translation of a displacement member according to 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 a closure member 764. The surgical instrument 750 includes an end effector 752, which may include a clamp arm 766, a closure member 764, and an ultrasonic blade 768 coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

[0224] The position, movement, displacement and / or translation of a linear displacement member such as the closing member 764 can be measured by an absolute positioning system, a sensor arrangement and a position sensor 784. Since the closing member 764 is coupled to a longitudinally movable drive member, the position of the closing member 764 can be determined by measuring the position of the longitudinally movable drive member using the position sensor 784. Therefore, in the following description, the position, displacement and / or translation of the closing member 764 can be achieved by the position sensor 784 described herein. The control circuit 760 can be programmed to control the translation of a displacement member such as the closing member 764. In some examples, the control circuit 760 may include one or more microcontrollers, microprocessors or other suitable processors for executing instructions that cause the one or more processors to control the displacement member (e.g., the closing member 764) in the manner described. In one aspect, the timer / counter 781 provides an output signal, such as an elapsed time or a digital count, to the control circuit 760 to correlate the position of the closing member 764 as determined by the position sensor 784 with the output of the timer / counter 781 so that the control circuit 760 can determine the position of the closing member 764 at a particular time (t) relative to the starting position. The timer / counter 781 can be configured to be able to measure elapsed time, count external events, or time external events.

[0225] The control circuit 760 may generate a motor set point signal 772. The motor set point signal 772 may be provided to the motor controller 758. The motor controller 758 may include one or more circuits configured to provide a motor drive signal 774 to the motor 754 to drive the motor 754 as described herein. In some examples, the motor 754 may be a brushed DC electric motor. For example, the speed of the motor 754 may be proportional to the motor drive signal 774. In some examples, the 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 the motor 754. Moreover, in some examples, the motor controller 758 may be omitted, and the control circuit 760 may directly generate the motor drive signal 774.

[0226] The motor 754 may receive power from the energy source 762. The energy source 762 may be or include a battery, a supercapacitor, or any other suitable energy source. The motor 754 may be mechanically coupled to the closing member 764 via the transmission 756. The transmission 756 may include one or more gears or other connecting rod components to couple the motor 754 to the closing member 764. The position sensor 784 may sense the position of the closing member 764. The position sensor 784 may be or include any type of sensor capable of generating position data indicating the position of the closing member 764. In some examples, the position sensor 784 may include an encoder configured to provide a series of pulses to the control circuit 760 when the closing member 764 is translated toward the distal side and toward the proximal side. The control circuit 760 may track the pulses to determine the position of the closing member 764. Other suitable position sensors may be used, including, for example, proximity sensors. Other types of position sensors may provide other signals indicating the movement of the closing member 764. Moreover, in some examples, the position sensor 784 may be omitted. Where motor 754 is a stepper motor, control circuit 760 may track the position of closure member 764 by gathering the number and direction of steps that motor 754 has been instructed to perform. Position sensor 784 may be located in end effector 752 or at any other portion of the instrument.

[0227] The control circuit 760 may communicate with one or more sensors 788. The sensor 788 may be positioned on the end effector 752 and adapted to operate with the surgical instrument 750 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensor 788 may include a magnetic sensor, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor (such as an eddy current sensor), a resistive sensor, a capacitive sensor, an optical sensor, and / or any other suitable sensor for measuring one or more parameters of the end effector 752. The sensor 788 may include one or more sensors.

[0228] In some cases, one or more sensors 788 may include a strain gauge, such as a micro strain gauge, which is configured to measure the magnitude of the strain in the clamping arm 766 during the clamping condition. The strain gauge provides an electrical signal whose amplitude varies with the magnitude of the strain. The sensor 788 may include a pressure sensor configured to detect the pressure generated by the presence of compressed tissue between the clamping arm 766 and the ultrasonic blade 768. The sensor 788 may be configured to detect the impedance of the tissue section between the clamping arm 766 and the ultrasonic blade 768, which indicates the thickness and / or filling degree of the tissue located therebetween.

[0229] The sensor 788 may be configured to measure the force applied by the closure drive system to the clamp arm 766. For example, one or more sensors 788 may be located at the interaction point between the closure tube and the clamp arm 766 to detect the closing force applied by the closure tube to the clamp arm 766. The force applied to the clamp arm 766 may represent the tissue compression experienced by the tissue segment captured between the clamp arm 766 and the ultrasonic blade 768. One or more sensors 788 may be positioned at various interaction points along the closure drive system to detect the closing force applied by the closure drive system to the clamp arm 766. One or more sensors 788 may be sampled in real time by the processor of the control circuit 760 during the clamping operation. The control circuit 760 receives real-time sample measurements to provide and analyze time-based information and evaluate the closing force applied to the clamp arm 766 in real time.

[0230] The current sensor 786 may be used to measure the current consumed by the motor 754. The force required to advance the closure member 764 may correspond to, for example, the current consumed by the motor 754. The force is converted into a digital signal and provided to the control circuit 760.

[0231] The control circuit 760 can be configured to simulate the response of the actual system of the instrument in the software of the controller. The displacement member can be actuated to move the closing member 764 in the end effector 752 at a target speed or close to the target speed. The surgical instrument 750 may include a feedback controller, which may be one of any feedback controllers, including but not limited to, for example, PID, state feedback, LQR and / or adaptive controllers. The surgical instrument 750 may include a power source to, for example, convert a signal from the feedback controller into a physical input, such as a housing voltage, a PWM voltage, a frequency modulated voltage, a current, a torque and / or a force.

[0232] The actual drive system of the surgical instrument 750 is configured to be able to drive the displacement member, cutting member or closing member 764 through a brushed DC motor with a gear box and a mechanical link to the articulation and / or knife system. Another example is an electric motor 754 that operates the displacement member and articulation drive of, for example, an interchangeable shaft assembly. External influences are the unmeasured, unpredictable effects of things such as tissue, surrounding body, and friction on the physical system. Such external influences can be referred to as drag forces that act in opposition to the electric motor 754. External influences such as drag forces can cause the operation of the physical system to deviate from the desired operation of the physical system.

[0233] Various example aspects relate to a surgical instrument 750, which includes an end effector 752 with a motor-driven surgical sealing and cutting embodiment. 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 clamping arm 766, and when configured for use, an ultrasonic blade 768 is positioned relative to the clamping arm 766. The clinician can grasp the tissue between the clamping arm 766 and the ultrasonic blade 768, as described herein. When the instrument 750 is ready to be used, the clinician can provide a firing signal, for example, by pressing the trigger of the instrument 750. In response to the firing signal, the motor 754 can drive the displacement member from the proximal stroke start position distally along the longitudinal axis of the end effector 752 to the stroke end position distal to the stroke start position. When the displacement member is translated distally, a closing member 764 having a cutting element positioned at the distal end can cut the tissue between the ultrasonic blade 768 and the clamping arm 766.

[0234] In various examples, the surgical instrument 750 may include a control circuit 760 that is programmed to control the distal translation of a displacement member, such as a closure member 764, based on one or more tissue conditions. The control circuit 760 may be programmed to sense tissue conditions, such as thickness, directly or indirectly, as described herein. The control circuit 760 may be programmed to select a control program based on the tissue conditions. The control program may describe the distal movement of the displacement member. Different control programs may be selected to better handle different tissue conditions. For example, when thicker tissue is present, the control circuit 760 may be programmed to translate the displacement member at a lower speed and / or at a lower power. When thinner tissue is present, the control circuit 760 may be programmed to translate the displacement member at a higher speed and / or at a higher power.

[0235] In some examples, the control circuit 760 may initially operate the motor 754 in an open-loop configuration for a first open-loop portion of the displacement member's travel. Based on the response of the instrument 750 during the open-loop portion of the travel, the control circuit 760 may select a firing control program. The response of the instrument may include the distance the displacement member was translated during the open-loop portion, the time elapsed during the open-loop portion, the energy provided to the motor 754 during the open-loop portion, the sum of the pulse widths of the motor drive signal, etc. After the open-loop portion, the control circuit 760 may implement the selected firing control program for a second portion of the displacement member's travel. For example, during the closed-loop portion of the travel, the control circuit 760 may modulate the motor 754 based on the translation 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 number 15 / 720,852, filed on September 29, 2017, entitled “SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT,” which is incorporated herein by reference in its entirety.

[0236] Fig.19 790 is a schematic diagram of a surgical instrument 790 configured to control various functions according to one aspect of the present disclosure. In one aspect, the surgical instrument 790 is programmed to control the distal translation of a displacement member such as a closure member 764. The surgical instrument 790 includes an end effector 792, which may include a clamping arm 766, a closure member 764, and an ultrasonic blade 768, which may be interchangeable with or work in conjunction with one or more RF electrodes 796 (shown in dotted lines). The ultrasonic blade 768 is coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

[0237] In one aspect, the sensor 788 may be implemented as a limit switch, an electromechanical device, a solid-state switch, a Hall effect device, an MR device, a GMR device, a magnetometer, and the like. In other implementations, the sensor 638 may be implemented as a solid-state switch that operates under the influence of light, such as an optical sensor, an IR sensor, an ultraviolet sensor, and the like. Likewise, the switch may be a solid-state device, such as a transistor (e.g., a FET, a junction FET, a MOSFET, a bipolar transistor, and the like). In other implementations, the sensor 788 may include a non-electrical conductor switch, an ultrasonic switch, an accelerometer, an inertial sensor, and the like.

[0238] In one aspect, the position sensor 784 can be implemented as an absolute positioning system including a monolithic magnetic rotary position sensor implemented as an AS5055EQFT, available from Austria Microsystems, AG. The position sensor 784 can interact with the control circuit 760 to provide an absolute positioning system. The position can include a Hall effect element located above a magnet and coupled to a CORDIC processor, which is also known as a bitwise method and Volder algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions, which only require addition operations, subtraction operations, bit shift operations, and table lookup operations.

[0239] In some examples, the position sensor 784 may be omitted. Where the motor 754 is a stepper motor, the control circuit 760 may track the position of the closure member 764 by gathering the number and direction of steps the motor has been instructed to perform. The position sensor 784 may be located in the end effector 792 or at any other portion of the instrument.

[0240] The control circuit 760 may communicate with one or more sensors 788. The sensor 788 may be positioned on the end effector 792 and adapted to operate with the surgical instrument 790 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensor 788 may include a magnetic sensor, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor (such as an eddy current sensor), a resistive sensor, a capacitive sensor, an optical sensor, and / or any other suitable sensor for measuring one or more parameters of the end effector 792. The sensor 788 may include one or more sensors.

[0241] The RF energy source 794 is coupled to the end effector 792 and is applied to the RF electrode 796 when the RF electrode 796 is disposed in the end effector 792 to replace the ultrasonic blade 768 or to work in conjunction with the ultrasonic blade 768. For example, the ultrasonic blade is made of a conductive metal and can be used as a return path for the electrosurgical RF current. The control circuit 760 controls the delivery of RF energy to the RF electrode 796.

[0242] Additional details are disclosed in U.S. patent application serial number 15 / 636,096, filed on June 28, 2017, entitled “SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME,” which is incorporated herein by reference in its entirety.

[0243] Generator Hardware

[0244] In various aspects, the intelligent ultrasonic energy device may include an adaptive algorithm for controlling the operation of the ultrasonic scalpel. In one aspect, the ultrasonic scalpel adaptive control algorithm is configured to be able to identify tissue types and adjust device parameters. In one aspect, the ultrasonic scalpel control algorithm is configured to be able to parameterize tissue types. The following section of the present disclosure describes an algorithm for detecting the collagen / elasticity ratio of tissue to tune the amplitude of the distal end of the ultrasonic scalpel. This article is combined with, for example, Figures 12 to 19 Therefore, the following description of the adaptive ultrasonic knife control algorithm should be combined with Figures 12 to 19 and the description associated with it.

[0245] In certain surgical procedures, it is desirable to use an adaptive ultrasonic blade control algorithm. In one aspect, an adaptive ultrasonic blade control algorithm can be used to adjust the parameters of an ultrasonic device based on the type of tissue in contact with the ultrasonic blade. In one aspect, the parameters of the ultrasonic device can be adjusted based on the position of the tissue in the jaws of the ultrasonic end effector (e.g., the position of the tissue between the clamping arm and the ultrasonic blade). The impedance of the ultrasonic transducer can be used to distinguish the percentage of tissue in the distal end or proximal end of the end effector. The response of the ultrasonic device can be based on the tissue type or the compressibility of the tissue. On the other hand, the parameters of the ultrasonic device can be adjusted based on the identified tissue type or parameterization. For example, the mechanical displacement amplitude of the distal end of the ultrasonic blade can be tuned based on the ratio of collagen to elastin tissue detected during the tissue identification process. The ratio of collagen to elastin tissue can be detected using a variety of techniques, including infrared (IR) surface reflectivity and specific emissivity. The force applied to the tissue by the clamping arm and / or the stroke of the clamping arm to produce gaps and compression. The electrical continuity across the jaws equipped with electrodes can be used to determine the percentage of the jaws covered by tissue.

[0246] Fig. 20A system 800 is configured to be capable of executing an adaptive ultrasonic blade control algorithm in a surgical data network including a modular communication hub according to at least one aspect of the present disclosure. In one aspect, the generator module 240 is configured to be capable of executing an adaptive ultrasonic blade control algorithm 802. In another aspect, the device / instrument 235 is configured to be capable of executing an adaptive ultrasonic blade control algorithm 804. In another aspect, both the generator module 240 and the device / instrument 235 are configured to be capable of executing the adaptive ultrasonic blade control algorithms 802, 804.

[0247] The generator module 240 may include a patient isolation stage that communicates with a non-isolated stage via a power transformer. The secondary winding of the power transformer is contained in the isolation stage and may include a tap configuration (e.g., a center tap or a non-center tap configuration) to define a drive signal output that is used to deliver the drive signal to different surgical instruments, such as, for example, ultrasonic surgical instruments, RF electrosurgical instruments, and multifunctional surgical instruments that include ultrasonic energy modes and RF energy modes that can be delivered separately or simultaneously. Specifically, the drive signal output may output an ultrasonic drive signal (e.g., a 420V root mean square (RMS) drive signal) to an ultrasonic surgical instrument 241, and the drive signal output may output an RF electrosurgical drive signal (e.g., a 100V RMS drive signal) to the RF electrosurgical instrument 241. Reference herein Figure 21 to Figure 22 Various aspects of the generator module 240 are described.

[0248] The generator module 240 or the device / instrument 235 or both are coupled to a modular control tower 236 that is connected to a plurality of operating room devices, such as, for example, intelligent surgical instruments, robots, and other computerized devices located in the operating room, as described, for example, with reference to Figures 8 to 11 described.

[0249] Fig.21 An example of a generator 900 is shown, which is a form of a generator that is configured to be coupled to an ultrasonic instrument and is further configured to execute an adaptive ultrasonic blade control algorithm in a surgical data network including a modular communication hub, such as Fig. 20As shown in . Generator 900 is configured to be able to deliver multiple energy modes to surgical instruments. Generator 900 provides RF signals and ultrasonic signals for independently or simultaneously delivering energy to surgical instruments. RF signals and ultrasonic signals can be provided separately or in combination, and can be provided simultaneously. As described above, at least one generator output can deliver multiple energy modes (e.g., ultrasound, bipolar or monopolar RF, irreversible and / or reversible electroporation and / or microwave energy, etc.) through a single port, and these signals can be delivered to the end effector separately or simultaneously to treat tissue. Generator 900 includes a processor 902 coupled to a waveform generator 904. Processor 902 and waveform generator 904 are configured to be able to generate multiple signal waveforms based on information stored in a memory coupled to processor 902, and the memory is not shown for clarity of this disclosure. Digital information associated with the waveform is provided to waveform generator 904, which includes one or more DAC circuits to convert digital input into analog output. The analog output is fed to amplifier 1106 for signal conditioning and amplification. The conditioned and amplified output of amplifier 906 is coupled to a power transformer 908. The signal is coupled to a secondary side in the patient isolation side through power transformer 908. A first signal of a first energy mode is provided to a surgical instrument between terminals labeled ENERGY1 and RETURN. A second signal of a second energy mode is coupled across capacitor 910 and provided to a surgical instrument between terminals labeled ENERGY2 and RETURN. It should be understood that more than two energy modes may be output, and thus the subscript "n" may be used to specify that up to n ENERGY modes may be provided. n terminals, where n is a positive integer greater than 1. It should also be understood that up to n return paths RETURN may be provided without departing from the scope of the present disclosure. n .

[0250] The first voltage sensing circuit 912 is coupled to both ends of the terminals marked as ENERGY1 and RETURN paths to measure the output voltage therebetween. The second voltage sensing circuit 924 is coupled to both ends of the terminals marked as ENERGY2 and RETURN paths to measure the output voltage therebetween. As shown, the current sensing circuit 914 is arranged in series with the RETURN branch on the secondary side of the power transformer 908 to measure the output current of any energy mode. If a different return path is provided for each energy mode, a separate current sensing circuit should be provided in each return branch. The outputs of the first voltage sensing circuit 912 and the second voltage sensing circuit 924 are provided to the corresponding isolation transformers 916, 922, and the output of the current sensing circuit 914 is provided to another isolation transformer 918. The outputs of the isolation transformers 916, 928, 922 on the primary side of the power transformer 908 (non-patient isolation side) are provided to one or more ADC circuits 926. The digitized output of the ADC circuit 926 is provided to the processor 902 for further processing and calculation. The output voltage and output current feedback information can be used to adjust the output voltage and current provided to the surgical instrument and calculate parameters such as output impedance. Input / output communication between the processor 902 and the patient isolation circuit is provided through the interface circuit 920. The sensor can also be in electrical communication with the processor 902 through the interface circuit 920.

[0251] In one aspect, the impedance may be determined by the processor 902 by dividing the output of a first voltage sensing circuit 912 coupled across terminals labeled ENERGY1 / RETURN or a second voltage sensing circuit 924 coupled across terminals labeled ENERGY2 / RETURN by the output of a current sensing circuit 914 disposed in series with the RETURN branch of the secondary side of the power transformer 908. The outputs of the first voltage sensing circuit 912 and the second voltage sensing circuit 924 are provided to separate isolation transformers 916, 922, and the output of the current sensing circuit 914 is provided to another isolation transformer 916. The digitized voltage and current sense measurements from the ADC circuit 926 are provided to the processor 902 for calculating the impedance. For example, the first energy modality ENERGY1 may be ultrasonic energy, and the second energy modality ENERGY2 may be RF energy. However, in addition to ultrasonic and bipolar or monopolar RF energy modalities, other energy modalities include irreversible and / or reversible electroporation and / or microwave energy, among others. Furthermore, although Fig.21 The example shown in FIG. 1 shows that a single return path RETURN may be provided for two or more energy modes, but in other aspects, a single return path RETURN may be provided for each energy mode ENERGY n Provide multiple return paths RETURN nThus, as described herein, ultrasound transducer impedance may be measured by dividing the output of the first voltage sensing circuit 912 by the output of the current sensing circuit 914 , and tissue impedance may be measured by dividing the output of the second voltage sensing circuit 924 by the output of the current sensing circuit 914 .

[0252] like Fig.21 As shown in , a generator 900 including at least one output port may include a power transformer 908 having a single output and multiple taps to provide power to an end effector in the form of one or more energy modalities (such as ultrasound, bipolar or monopolar RF, irreversible and / or reversible electroporation, and / or microwave energy, etc.), for example, depending on the type of tissue treatment being performed. For example, the generator 900 may deliver energy with a higher voltage and lower current to drive an ultrasonic transducer, deliver energy with a lower voltage and higher current to drive an RF electrode for sealing tissue, or deliver energy with a coagulation waveform for spot coagulation using a monopolar or bipolar RF electrosurgical electrode. The output waveform from the generator 900 may be manipulated, switched, or filtered to provide a frequency to the end effector of the surgical instrument. The connection of the ultrasonic transducer to the output of the generator 900 will preferably be located between the outputs labeled ENERGY1 and RETURN, as shown in FIG. Fig.21 In one example, the connection of the RF bipolar electrodes to the generator 900 output will preferably be between the outputs labeled ENERGY2 and RETURN. In the case of a monopolar output, the preferred connection would be an active electrode (e.g., pencil or other probe) to the ENERGY2 output and a suitable return pad connected to the RETURN output.

[0253] Additional details are disclosed in U.S. Patent Application Publication No. 2017 / 0086914, published on March 30, 2017, entitled “TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICALINSTRUMENTS,” which is incorporated herein by reference in its entirety.

[0254] As used throughout this specification, the term "wireless" and its derivatives may be used to describe circuits, devices, systems, methods, techniques, communication channels, etc. that can transmit data through a non-solid medium using modulated electromagnetic radiation. The term does not mean that the associated device does not contain any wires, although in some aspects they may not. The communication module may implement any of a variety of wireless or wired communication standards or protocols, including but not limited to Wi-Fi (IEEE 802.11 series), WiMAX (IEEE 802.16 series), IEEE 802.20, Long Term Evolution (LTE), Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, Bluetooth, and its Ethernet derivatives, and any other wireless and wired protocols designated as 3G, 4G, 5G and above. The computing module may include multiple communication modules. For example, the first communication module may be dedicated to shorter range wireless communications such as Wi-Fi and Bluetooth, and the second communication module may be dedicated to longer range wireless communications such as GPS, EDGE, GPRS, CDMA, WiMAX, LTE, Ev-DO, etc.

[0255] As used herein, a processor or processing unit is an electronic circuit that performs operations on some external data source (usually memory or some other data stream). The term is used herein to refer to a central processing unit (central processing unit) in one or more systems (especially system-on-chip (SoC)) that combine multiple specialized "processors".

[0256] As used herein, a system on a chip or system on a chip (SoC or SOC) is an integrated circuit (also referred to as an "IC" or "chip") that integrates all the components of a computer or other electronic system. It may include digital, analog, mixed signal, and often radio frequency functions - all on a single substrate. A SoC integrates a microcontroller (or microprocessor) with advanced peripherals such as a graphics processing unit (GPU), a Wi-Fi module, or a coprocessor. A SoC may or may not include built-in memory.

[0257] As used herein, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuits and memory. A microcontroller (or MCU for a microcontroller unit) can be implemented as a small computer on a single integrated circuit. It can be similar to a SoC; an SoC may include a microcontroller as one of its components. A microcontroller may include one or more core processing units (CPUs) as well as memory and programmable input / output peripherals. Program memory in the form of ferroelectric RAM, NOR flash memory, or OTP ROM, as well as a small amount of RAM, is also often included on the chip. Compared to microprocessors used in personal computers or other general-purpose applications consisting of various discrete chips, microcontrollers can be used for embedded applications.

[0258] As used herein, the term controller or microcontroller may be a stand-alone IC or chip device that interfaces with peripheral devices. This may be a link between the two components of a computer or a controller on an external device that manages the operation of the device (and the connection to the device).

[0259] Any of the processors or microcontrollers described herein may be any single-core or multi-core processor, such as those offered by Texas Instruments under the trade name ARM Cortex. In one aspect, the processor may be, for example, the LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, which includes: 256KB of single-cycle flash or other non-volatile memory (up to 40MHz) on-chip memory, a pre-fetch buffer for improving performance above 40MHz, 32KB of single-cycle serial random access memory (SRAM), a 32KB MCU loaded with Internal read-only memory (ROM) for software, 2KB of electrically erasable programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder input (QEI) simulations, one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, and other features that are readily available.

[0260] In one example, the processor may include a safety controller including two families based on controllers such as the TMS570 and RM4x also offered by Texas Instruments under the trade name Hercules ARM Cortex R4. The safety controller may be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while delivering scalable execution, connectivity, and memory options.

[0261] The modular device includes a module that can be received in a surgical hub (such as a combination of Figure 3 and Fig. 9The invention relates to a surgical device or instrument that can be connected to various modules so as to be connected or paired with a corresponding surgical hub. Modular devices include, for example, intelligent surgical instruments, medical imaging devices, suction / irrigation devices, smoke evacuators, energy generators, ventilators, insufflators, and displays. The modular devices described herein can be controlled by control algorithms. The control algorithm can be executed on the modular device itself, on a surgical hub paired with a specific modular device, or on both the modular device and the surgical hub (e.g., via a distributed computing architecture). In some examples, the control algorithm of the modular device controls the device based on data sensed by the modular device itself (i.e., by sensors in, on, or connected to the modular device). The data can be related to the patient being operated on (e.g., tissue properties or insufflation pressure) or the modular device itself (e.g., the rate at which the knife is advanced, the motor current, or the energy level). For example, the control algorithm of a surgical suturing and cutting instrument can control the rate at which the motor of the instrument drives its knife through the tissue according to the resistance encountered by the knife as it advances.

[0262] Fig. 22 One form of a surgical system 1000 is shown that includes a generator 1100 and various surgical instruments 1104, 1106, 1108 that can be used therewith, wherein the surgical instrument 1104 is an ultrasonic surgical instrument, the surgical instrument 1106 is an RF electrosurgical instrument, and the multifunctional surgical instrument 1108 is a combination ultrasonic / RF electrosurgical instrument. The generator 1100 may be configurable for use with a variety of surgical devices. According to various forms, the generator 1100 may be configurable for use with different surgical instruments of different types, including, for example, an ultrasonic surgical instrument 1104, an RF electrosurgical instrument 1106, and a multifunctional surgical instrument 1108 that integrates simultaneous delivery of RF energy and ultrasonic energy from the generator 1100. Although in Fig. 22 In one form, the generator 1100 is shown as being separate from the surgical instruments 1104, 1106, 1108, but in one form, the generator 1100 may be integrally formed with any of the surgical instruments 1104, 1106, 1108 to form an integrated surgical system. The generator 1100 includes an input device 1110 located on a front panel of the console of the generator 1100. The input device 1110 may include any suitable device that generates signals suitable for programming the operation of the generator 1100. The generator 1100 may be configured for wired or wireless communication.

[0263] The generator 1100 is configured to be able to drive a plurality of surgical instruments 1104, 1106, 1108. The first surgical instrument is an ultrasonic surgical instrument 1104 and includes a handpiece 1105 (HP), an ultrasonic transducer 1120, a shaft 1126, and an end effector 1122. The end effector 1122 includes an ultrasonic blade 1128 and a clamp arm 1140 acoustically coupled to the ultrasonic transducer 1120. The handpiece 1105 includes a trigger 1143 for operating the clamp arm 1140 and a combination of switch buttons 1134a, 1134b, 1134c for energizing the ultrasonic blade 1128 and driving the ultrasonic blade or other functions. The switch buttons 1134a, 1134b, 1134c can be configured to be able to energize the ultrasonic transducer 1120 with the generator 1100.

[0264] The generator 1100 is also configured to drive a second surgical instrument 1106. The second surgical instrument 1106 is an RF electrosurgical instrument and includes a handpiece 1107 (HP), a shaft 1127, and an end effector 1124. The end effector 1124 includes electrodes in the clamping arms 1142a, 1142b and returns through the electrical conductor portion of the shaft 1127. These electrodes are coupled to and powered by a bipolar energy source within the generator 1100. The handpiece 1107 includes a trigger 1145 for operating the clamping arms 1142a, 1142b and an energy button 1135 for actuating an energy switch to power the electrodes in the end effector 1124.

[0265] The generator 1100 is also configured to be able to drive a multifunctional surgical instrument 1108. The multifunctional surgical instrument 1108 includes a handpiece 1109 (HP), a shaft 1129, and an end effector 1125. The end effector 1125 includes an ultrasonic blade 1149 and a clamp arm 1146. The ultrasonic blade 1149 is acoustically coupled to the ultrasonic transducer 1120. The handpiece 1109 includes a trigger 1147 for operating the clamp arm 1146 and a combination of switch buttons 1137a, 1137b, 1137c for energizing the ultrasonic blade 1149 and driving the ultrasonic blade or other functions. The switch buttons 1137a, 1137b, 1137c can be configured to be able to energize the ultrasonic transducer 1120 with the generator 1100, and to energize the ultrasonic blade 1149 with a bipolar energy source also included in the generator 1100.

[0266] The generator 1100 may be configurable for use with a variety of surgical devices. According to various forms, the generator 1100 may be configurable for use with different surgical instruments of different types, including, for example, an ultrasonic surgical instrument 1104, an RF electrosurgical instrument 1106, and a multi-function surgical instrument 1108 that integrates simultaneous delivery of RF energy and ultrasonic energy from the generator 1100. Fig. 22In one form, the generator 1100 is shown as being independent of the surgical instruments 1104, 1106, 1108, but in another form, the generator 1100 may be integrally formed with any of the surgical instruments 1104, 1106, 1108 to form an integrated surgical system. As discussed above, the generator 1100 includes an input device 1110 located on the front panel of the generator 1100 console. The input device 1110 may include any suitable device that generates a signal suitable for programming the operation of the generator 1100. The generator 1100 may also include one or more output devices 1112. Additional aspects of generators and surgical instruments for digitally generating electrical signal waveforms are described in U.S. Patent Publication US-2017-0086914-A1, which is incorporated herein by reference in its entirety.

[0267] Situational Awareness

[0268] Although a "smart" device including a control algorithm responsive to sensed data may be an improvement over a "dumb" device that operates without regard to the sensed data, some sensed data may be incomplete or uncertain when considered in isolation, i.e., without the context of the type of surgical procedure being performed or the type of tissue being operated on. Without knowing the context of the procedure (e.g., knowing the type of tissue being operated on or the type of procedure being performed), the control algorithm may incorrectly or suboptimally control the modular device given a specific sensed data without context. For example, the best way to control a control algorithm for a surgical instrument in response to a specific sensed parameter may vary depending on the specific type of tissue being operated on. This is due to the fact that different tissue types have different properties (e.g., tear resistance) and therefore respond differently to actions taken by a surgical instrument. Therefore, it may be desirable for a surgical instrument to take different actions even when sensing the same measured value for a specific parameter. As a specific example, the best way to control a surgical suturing and cutting instrument in response to the instrument sensing an unexpectedly high force used to close its end effector will vary depending on whether the tissue type is easy to tear or tear-resistant. For tissue that is prone to tearing (such as lung tissue), the control algorithm of the instrument will optimally gradually reduce the motor speed in response to the unexpectedly high force used to close, thereby avoiding tearing the tissue. For tissue that is resistant to tearing (such as stomach tissue), the control algorithm of the instrument will optimally gradually increase the motor speed in response to the unexpectedly high force used to close, thereby ensuring that the end effector is properly clamped on the tissue. Without knowing whether lung tissue or stomach tissue has been clamped, the control algorithm may make suboptimal decisions.

[0269] One solution utilizes a surgical hub that includes a system that is configured to be able to derive information about the surgical procedure being performed based on data received from various data sources, and then control the paired modular devices accordingly. In other words, the surgical hub is configured to be able to infer information about the surgical procedure from the received data, and then control the modular devices paired with the surgical hub based on the context of the inferred surgical procedure. Fig.23 A diagram of a situational awareness surgical system 5100 is shown in accordance with at least one aspect of the present disclosure. In some examples, data sources 5126 include, for example, modular devices 5102 (which may include sensors configured to detect parameters associated with a patient and / or the modular devices themselves), databases 5122 (e.g., an EMR database containing patient records), and patient monitoring devices 5124 (e.g., a blood pressure (BP) monitor and an electrocardiogram (EKG) monitor). The surgical hub 5104 may be configured to be able to derive contextual information related to a surgical procedure from the data, for example, based on a particular combination (or combinations) of the received data or a particular order in which the data is received from the data sources 5126. The contextual information inferred from the received data may include, for example, the type of surgical procedure being performed, the particular steps of the surgical procedure being performed by the surgeon, the type of tissue being operated on, or the body cavity that is the subject of the procedure. This ability of some aspects of the surgical hub 5104 to derive or infer information related to a surgical procedure from the received data may be referred to as "situational awareness." In one example, the surgical hub 5104 may incorporate a situational awareness system, which is hardware and / or programming associated with the surgical hub 5104 that derives contextual information related to the surgical procedure from the received data.

[0270] The situational awareness system of the surgical hub 5104 can be configured to be able to derive context information from data received from the data source 5126 in a variety of different ways. In one example, the situational awareness system includes a pattern recognition system or a machine learning system (e.g., an artificial neural network) that has been trained on training data to associate various inputs (e.g., data from the database 5122, the patient monitoring device 5124, and / or the modular devices 5102) with corresponding context information about the surgical procedure. In other words, the machine learning system can be trained to accurately derive context information about the surgical procedure from the provided input. In another example, the situational awareness system may include a lookup table that stores pre-characterized context information about the surgical procedure associated with one or more inputs (or input ranges) corresponding to the context information. In response to a query using one or more inputs, the lookup table may return corresponding context information that the situational awareness system uses to control the modular devices 5102. In one example, the context information received by the situational awareness system of the surgical hub 5104 is associated with a specific control adjustment or a set of control adjustments for one or more modular devices 5102. In another example, the situational awareness system includes an additional machine learning system, lookup table, or other such system that generates or retrieves one or more control adjustments for one or more modular devices 5102 when context information is provided as input.

[0271] The surgical hub 5104 incorporating a situational awareness system provides numerous benefits to the surgical system 5100. One benefit includes improved interpretation of sensed and collected data, which in turn improves processing accuracy and / or use of the data during the course of a surgical procedure. Returning to the previous example, the situational awareness surgical hub 5104 can determine the type of tissue being operated on; thus, when an unexpectedly high force is detected for the end effector of a closing surgical instrument, the situational awareness surgical hub 5104 can appropriately ramp up or ramp down the motor speed of the surgical instrument for the tissue type.

[0272] As another example, the type of tissue being operated on can affect the adjustment of the compression rate and load threshold of the surgical stapling and cutting instrument for a specific tissue gap measurement value. The situational awareness surgical hub 5104 can infer whether the surgical procedure being performed is a thoracic procedure or an abdominal procedure, thereby allowing the surgical hub 5104 to determine whether the tissue clamped by the end effector of the surgical stapling and cutting instrument is lung tissue (for thoracic procedures) or stomach tissue (for abdominal procedures). The surgical hub 5104 can then appropriately adjust the compression rate and load threshold of the surgical stapling and cutting instrument for the type of tissue.

[0273] As yet another example, the type of body cavity being operated on during an insufflation procedure can affect the function of the smoke evacuator. The situational awareness surgical hub 5104 can determine whether the surgical site is under pressure (by determining that the surgical protocol is utilizing insufflation) and determine the type of procedure. Since one type of procedure is typically performed in a particular body cavity, the surgical hub 5104 can then control the motor rate of the smoke evacuator appropriately for the body cavity in which the procedure is being performed. Thus, the situational awareness surgical hub 5104 can provide consistent smoke evacuation for both thoracic and abdominal procedures.

[0274] As yet another example, the type of procedure being performed may affect the optimal energy level at which an ultrasonic surgical instrument or a radio frequency (RF) electrosurgical instrument operates. For example, an arthroscopic procedure requires a higher energy level because the end effector of the ultrasonic surgical instrument or the RF electrosurgical instrument is immersed in a fluid. The situational awareness surgical hub 5104 may determine whether the surgical procedure is an arthroscopic procedure. The surgical hub 5104 may then adjust the RF power level or ultrasonic amplitude (i.e., "energy level") of the generator to compensate for the fluid-filled environment. Relatedly, the type of tissue being operated on may affect the optimal energy level at which an ultrasonic surgical instrument or an RF electrosurgical instrument operates. The situational awareness surgical hub 5104 may determine the type of surgical procedure being performed, and then customize the energy level of the ultrasonic surgical instrument or the RF electrosurgical instrument, respectively, according to the expected tissue profile of the surgical procedure. In addition, the situational awareness surgical hub 5104 may be configured to be able to adjust the energy level of the ultrasonic surgical instrument or the RF electrosurgical instrument during the entire surgical procedure rather than just on a procedure-by-procedure basis. The situational awareness surgical hub 5104 can determine the step of a surgical procedure that is being performed or is subsequently to be performed, and then update the control algorithm for the generator and / or ultrasonic surgical instrument or RF electrosurgical instrument to set the energy level at a value appropriate for the expected tissue type based on the surgical procedure step.

[0275] As yet another example, data may be extracted from additional data sources 5126 to improve conclusions extracted by the surgical hub 5104 from one data source 5126. The situational awareness surgical hub 5104 may augment the data it receives from the modular devices 5102 with contextual information about the surgical procedure that has been constructed from other data sources 5126. For example, the situational awareness surgical hub 5104 may be configured to be able to determine whether hemostasis has occurred (i.e., whether bleeding at a surgical site has stopped) based on video or image data received from a medical imaging device. However, in some cases, the video or image data may be inconclusive. Therefore, in one example, the surgical hub 5104 may be further configured to be able to combine physiological measurements (e.g., blood pressure sensed by a BP monitor communicatively coupled to the surgical hub 5104) with visual or image data of hemostasis (e.g., from a medical imaging device 124 communicatively coupled to the surgical hub 5104) Figure 2 )) to determine the integrity of the suture or tissue weld. In other words, the situational awareness system of the surgical hub 5104 can consider physiological measurement data to provide additional context when analyzing visualization data. Additional context can be useful when the visualization data itself may be uncertain or incomplete.

[0276] Another benefit includes actively and automatically controlling the paired modular devices 5102 according to the specific steps of the surgical procedure being performed to reduce the number of times medical personnel need to interact with or control the surgical system 5100 during the course of the surgical procedure. For example, if the situational awareness surgical hub 5104 determines that a subsequent step of the procedure requires the use of an RF electrosurgical instrument, it can actively activate the generator connected to the instrument. Actively activating the energy source allows the instrument to be ready for use as soon as the previous steps of the procedure are completed.

[0277] As another example, the situational awareness surgical hub 5104 may determine whether the current or subsequent steps of the surgical procedure require a different view or degree of magnification on the display based on the feature(s) that the surgeon anticipates needing to view at the surgical site. The surgical hub 5104 may then proactively change the displayed view (e.g., provided by a medical imaging device for the visualization system 108) accordingly, such that the display is automatically adjusted throughout the surgical procedure.

[0278] As yet another example, the situational awareness surgical hub 5104 can determine which step of a surgical procedure is being performed or will be performed subsequently and whether specific data or comparisons between data are required for that step of the surgical procedure. The surgical hub 5104 can be configured to automatically call up data screens based on the step of the surgical procedure being performed without having to wait for the surgeon to request that specific information.

[0279] Another benefit includes checking for errors during the setup of a surgical procedure or during the course of a surgical procedure. For example, the situational awareness surgical hub 5104 can determine whether the operating room is correctly or optimally set up for the surgical procedure to be performed. The surgical hub 5104 can be configured to determine the type of surgical procedure being performed, retrieve the corresponding list, product location, or setup requirements (e.g., from a memory), and then compare the current operating room layout with the standard layout for the type of surgical procedure being performed determined by the surgical hub 5104. In one example, the surgical hub 5104 can be configured to be able to compare a list of items for a procedure (e.g., scanned by a scanner) and / or a list of devices paired with the surgical hub 5104 with a suggested or expected list of items and / or devices for a given surgical procedure. The surgical hub 5104 can be configured to be able to provide an alarm indicating that a specific modular device 5102, a patient monitoring device 5124, and / or other surgical items are missing if there is any discontinuity between the lists. In one example, the surgical hub 5104 can be configured to determine the relative distance or position of the modular device 5102 and the patient monitoring device 5124, for example, via a proximity sensor. The surgical hub 5104 can compare the relative position of the devices to a suggested or expected layout for a particular surgical procedure. The surgical hub 5104 can be configured to provide an alert indicating that the current layout for the surgical procedure deviates from the suggested layout if there is any discontinuity between the layouts.

[0280] As another example, the situational awareness surgical hub 5104 may determine whether a surgeon (or other medical personnel) is making an error or otherwise deviating from an expected course of action during the course of a surgical procedure. For example, the surgical hub 5104 may be configured to determine the type of surgical procedure being performed, retrieve a corresponding list of steps or order of equipment use (e.g., from memory), and then compare the steps being performed or the equipment being used during the course of the surgical procedure to the expected steps or equipment determined by the surgical hub 5104 for the type of surgical procedure being performed. In one example, the surgical hub 5104 may be configured to provide an alert indicating that an unexpected action is being performed or an unexpected device is being utilized at a particular step in a surgical procedure.

[0281] In general, the situational awareness system for the surgical hub 5104 improves surgical procedure outcomes by adjusting surgical instruments (and other modular devices 5102) to the specific context of each surgical procedure (such as adjusting for different tissue types) and validating actions during the surgical procedure. The situational awareness system also improves the surgeon's efficiency in performing surgical procedures by automatically suggesting next steps, providing data, and adjusting displays and other modular devices 5102 in the operating room based on the specific context of the procedure.

[0282] Modular energy system

[0283] Due to the number of devices required to perform surgical procedures, ORs in every part of the world are a tangled web of cords, devices, and people. Surgical capital equipment is often a major factor in this problem, as most surgical capital equipment performs a single, specialized task. Due to its specialized nature, and the fact that surgeons need to use multiple different types of devices during the course of a single surgical procedure, an OR may be forced to keep two or even more surgical capital equipment (such as energy generators) on hand. Each of these surgical capital equipment must be plugged into a power source separately and can be connected to one or more other devices that pass between OR personnel, thereby generating a tangle of cords that must be navigated. Another problem faced in modern ORs is that each of these specialized surgical capital equipment has its own user interface and must be controlled independently of other devices in the OR. This creates complexity in correctly controlling multiple different devices connected to each other, and forces users to be trained and memorize different types of user interfaces (in addition to changing between each capital equipment, it can also be changed based on the task or surgical procedure being performed). This cumbersome, complex process may require more personnel to be placed in the OR, and may be dangerous if multiple devices cannot be correctly controlled in series with each other. Therefore, reducing the surgical capital equipment footprint within the OR by consolidating surgical capital equipment technologies into a single system that can flexibly meet the surgeon's needs will simplify the user experience, reduce clutter in the OR, and prevent the difficulties and dangers associated with controlling multiple capital devices simultaneously. In addition, making such systems scalable or customizable will allow new technologies to be conveniently incorporated into existing surgical systems, eliminating the need to replace the entire surgical system or require OR personnel to learn a new user interface or device control for each new technology.

[0284] like Figures 1 to 11 As described above, the surgical hub 106 can be configured to interchangeably receive a variety of modules, which in turn can interact with surgical devices (e.g., surgical instruments or smoke evacuators) or provide various other functions (e.g., communication). In one aspect, the surgical hub 106 can be embodied as a modular energy system 2000 that combines Figures 24 to 30 . The modular energy system 2000 may include a plurality of different modules 2001 that can be connected together in a stacked configuration. In one aspect, the modules 2001 can be physically and communicatively coupled together when stacked or otherwise connected together to form a single component. In addition, the modules 2001 can be interchangeably connected together in different combinations or arrangements. In one aspect, each of the modules 2001 can include a consistent or universal array of connectors disposed along its upper and lower surfaces, thereby allowing any module 2001 to be connected to another module 2001 in any arrangement (except that, in some aspects, a particular module type (such as a head module 2002) can be configured to be used, for example, as the topmost module in a stack. In alternative aspects, the modular energy system 2000 may include a housing configured to receive and retain the modules 2001, such as Figure 3 and Figure 4 The modular energy system 2000 may also include a variety of different components or accessories that can also be connected to the module 2001 or otherwise associated with the module. In another aspect, the modular energy system 2000 may be embodied as a generator module 140, 240 ( Figure 3 and Fig.10 ). In yet another aspect, the modular energy system 2000 can be a distinct system from the surgical hub 106. In such aspects, the modular energy system 2000 can be communicatively coupled to the surgical hub 206 for transmitting and / or receiving data therebetween.

[0285] The modular energy system 2000 can be assembled from a variety of different modules 2001, some examples of which are shown in Fig.24. Each of the different types of modules 2001 may provide different functions, thereby allowing the modular energy system 2000 to be assembled into different configurations to customize the functions and capabilities of the modular energy system 2000 by customizing the modules 2001 included in each modular energy system 2000. The modules 2001 of the modular energy system 2000 may include, for example, a head module 2002 (which may include a display screen 2006), an energy module 2004, a technology module 2040, and a visualization module 2042. In the illustrated aspect, the head module 2002 is configured to be able to be used as the top or uppermost module in the modular energy system stack, and thus may not contain connectors along its top surface. On the other hand, the head module 2002 may be configured to be able to be positioned at the bottom or lowermost module in the modular energy system stack, and thus may not contain connectors along its bottom surface. On yet another aspect, the head module 2002 may be configured to be able to be positioned at an intermediate position in the modular energy system stack, and thus may include connectors along both its bottom and top surfaces. The head module 2002 may be configured to control system-level settings for each module 2001 and components connected thereto through physical controls 2011 on the head module and / or a graphical user interface (GUI) 2008 presented on a display screen 2006. Such settings may include activation of the modular energy system 2000, the amount of alarms, foot switch settings, setting icons, the appearance or configuration of the user interface, the surgeon profile logged into the modular energy system 2000, and / or the type of surgical procedure being performed. The head module 2002 may also be configured to provide communications, processing, and / or power to the modules 2001 connected to the head module 2002. The energy module 2004 (which may also be referred to as a generator module 140, 240 ( Figure 3 and Fig.10 )) can be configured to generate one or more energy modes for driving an electrosurgical instrument and / or an ultrasonic surgical instrument connected to the energy module, such as the above-mentioned Fig.21 900 shown in . The technology module 2040 can be configured to provide additional or expanded control algorithms (e.g., electrosurgical control algorithms or ultrasonic control algorithms for controlling the energy output of the energy module 2004). The visualization module 2042 can be configured to interact with a visualization device (i.e., an observation device) and thereby enhance visualization capabilities.

[0286] The modular energy system 2000 may also include a variety of accessories 2029 that can be connected to the module 2001 for controlling its functions or otherwise configured to work in conjunction with the modular energy system 2000. The accessories 2029 may include, for example, a single-pedal foot switch 2032, a dual-pedal foot switch 2034, and a cart 2030 for supporting the modular energy system 2000 thereon. The foot switches 2032, 2034 may be configured to control, for example, the activation or function of a particular energy modality output by the energy module 2004.

[0287] By utilizing modular components, the depicted modular energy system 2000 provides a surgical platform that is optimized with the availability of technology and can be customized to the needs of the facility and / or surgeon. In addition, the modular energy system 2000 supports combination devices (e.g., dual electrosurgical and ultrasonic energy generators) and supports software-driven algorithms for customizing tissue effects. Furthermore, the surgical system architecture reduces capital footprint by combining multiple technologies critical to surgery into a single system.

[0288] The various modular components that can be used in conjunction with the modular energy system 2000 may include a monopolar energy generator, a bipolar energy generator, a dual electrosurgical / ultrasonic energy generator, a display screen, and various other modules and / or other components, some of which are also described above in conjunction with Figures 1 to 11 Described.

[0289] See now Fig.25A In some aspects, the head module 2002 may include a display screen 2006 that presents a GUI 2008 for relaying information about the modules 2001 connected to the head module 2002. In some aspects, the GUI 2008 of the display screen 2006 may provide a consolidated control point for all modules 2001 that make up a particular configuration of the modular energy system 2000. Fig.30Various aspects of the GUI 2008 are discussed in greater detail. In alternative aspects, the head module 2002 may not include the display screen 2006, or the display screen 2006 may be removably connected to the housing 2010 of the head module 2002. In such aspects, the head module 2002 can be communicatively coupled to an external system that is configured to display information generated by the modules 2001 of the modular energy system 2000. For example, in a robotic surgical application, the modular energy system 2000 can be communicatively coupled to a robotic cart or robotic console that is configured to display information generated by the modular energy system 2000 to an operator of the robotic surgical system. For another example, the modular energy system 2000 can be communicatively coupled to a mobile display that can be carried or secured to surgical staff for viewing. In yet another example, the modular energy system 2000 can be communicatively coupled to a surgical hub 2100 or another computer system that can include a display 2104, such as Fig.29 In aspects utilizing a user interface that is separate from or otherwise distinct from the modular energy system 2000, the user interface may be wirelessly connected to the modular energy system 2000 as a whole or one or more of its modules 2001 such that the user interface may display information from the connected modules 2001 thereon.

[0290] Still see Fig.25A , the energy module 2004 may include a port assembly 2012 that includes a plurality of different ports configured to deliver different energy modalities to corresponding surgical instruments that may be connected thereto. Figures 24 to 30 In the particular aspect shown in FIG. 2 , the port assembly 2012 includes a bipolar port 2014, a first monopolar port 2016a, a second monopolar port 2018b, a neutral electrode port 2018 (to which a monopolar return pad can be connected), and a combination energy port 2020. However, this particular combination of ports is for illustrative purposes only, and alternative combinations of ports and / or energy modalities are possible for the port assembly 2012.

[0291] As described above, the modular energy system 2000 can be assembled into different configurations. In addition, different configurations of the modular energy system 2000 can also be used for different surgical procedure types and / or different tasks. For example, Fig.25A and Fig.25B A first exemplary configuration of a modular energy system 2000 is shown, which includes a head module 2002 (including a display screen 2006) and an energy module 2004 connected together. Such a configuration may be suitable for use in, for example, laparoscopic and open surgical procedures.

[0292] Fig.26AA second exemplary configuration of the modular energy system 2000 is shown, which includes a head module 2002 (including a display screen 2006), a first energy module 2004a, and a second energy module 2004b connected together. By stacking two energy modules 2004a, 2004b, the modular energy system 2000 can provide a pair of port assemblies 2012a, 2012b for expanding the array of energy modalities that the modular energy system 2000 can deliver from the first configuration. The second configuration of the modular energy system 2000 can thus accommodate more than one bipolar / monopolar electrosurgical instrument, more than two bipolar / monopolar electrosurgical instruments, etc. Such a configuration may be suitable for particularly complex laparoscopic and open surgical procedures. Fig.26B A third exemplary configuration is shown that is similar to the second configuration, except that the head module 2002 does not include a display screen 2006. This configuration may be suitable for robotic surgical applications or mobile display applications, as described above.

[0293] Fig. 27 A fourth exemplary configuration of a modular energy system 2000 is shown, which includes a head module 2002 (including a display screen 2006), a first energy module 2004a, a second energy module 2004b, and a technology module 2040 connected together. Such a configuration may be suitable for surgical applications where particularly complex or computationally intensive control algorithms are required. Alternatively, the technology module 2040 may be a newly released module that supplements or expands the capabilities of a previously released module (such as the energy module 2004).

[0294] Fig.28 A fifth exemplary configuration of a modular energy system 2000 is shown, which includes a head module 2002 (including a display screen 2006), a first energy module 2004a, a second energy module 2004b, a technology module 2040, and a visualization module 2042 connected together. Such a configuration can be adapted for endoscopic procedures by providing a dedicated surgical display 2044 for relaying a video feed from a scope coupled to the visualization module 2042. It should be noted that FIG. 25A to FIG. 29 The configurations shown in are merely to illustrate various concepts of the modular energy system 2000 and should not be construed as limiting the modular energy system 2000 to the specific aforementioned configurations.

[0295] As described above, the modular energy system 2000 can be communicatively coupled to external systems, such as Fig.29. Such external systems may include a display screen 2104 for displaying a visual feed from an endoscope (or a camera or another such visualization device) and / or data from the modular energy system 2000. Such external systems may also include a computer system 2102 for performing calculations or otherwise analyzing data generated or provided by the modular energy system 2000, controlling a function or mode of the modular energy system 2000, and / or relaying data to a cloud computing system or another computer system. Such external systems may also coordinate multiple modular energy systems 2000 and / or other surgical systems (e.g., such as in combination with a plurality of modular energy systems 2000). Figure 1 and Figure 2 Actions between the visualization system 108 and / or the robotic system 110).

[0296] See now Fig.30 , in some aspects, the head module 2002 may include or support a display 2006 configured to display a GUI 2008, as described above. The display screen 2006 may include a touch screen for receiving input from a user in addition to displaying information. The controls displayed on the GUI 2008 may correspond to the modules 2001 connected to the head module 2002. In some aspects, different portions or areas of the GUI 2008 may correspond to specific modules 2001. For example, a first portion or area of ​​the GUI 2008 may correspond to a first module, and a second portion or area of ​​the GUI 2008 may correspond to a second module. As different and / or additional modules 2001 are connected to the modular energy system stack, the GUI 2008 may be adjusted to accommodate different and / or additional controls for each newly added module 2001 or to remove controls for each module 2001 that is removed. Each portion of the display corresponding to a specific module connected to the head module 2002 may display controls, data, user prompts, and / or other information corresponding to that module. For example, in Fig.302, a first or upper portion 2052 of the depicted GUI 2008 displays controls and data associated with an energy module 2004 connected to the head module 2002. Specifically, the first portion 2052 of the GUI 2008 for the energy module 2004 provides a first widget 2056a corresponding to the bipolar port 2014, a second widget 2056b corresponding to the first monopolar port 2016a, a third widget 2056c corresponding to the second monopolar port 2016b, and a fourth widget 2056d corresponding to the combined energy port 2020. Each of these widgets 2056a-d provides data related to its corresponding port of the port assembly 2012 and controls for controlling the mode and other features of the energy modality delivered by the energy module 2004 through the corresponding port of the port assembly 2012. For example, the desktop widgets 2056a-d can be configured to display the power level of a surgical instrument connected to the corresponding port, change the operating mode of the surgical instrument connected to the corresponding port (e.g., changing the surgical instrument from a first power level to a second power level and / or changing a monopolar surgical instrument from a "spray" mode to a "mixed" mode), and so on.

[0297] In one aspect, the head module 2002 may include various physical controls 2011 in addition to or in lieu of the GUI 2008. Such physical controls 2011 may include, for example, a power button that controls the activation of each module 2001 connected to the head module 2002 in the modular energy system 2000. Alternatively, the power button may be displayed as part of the GUI 2008. Thus, the head module 2002 may be used as a single point of contact, and each individual module 2001 making up the modular energy system 2000 need not be individually activated and deactivated.

[0298] In one aspect, the head module 2002 may display still images, videos, animations, and / or information associated with the surgical module 2001 configuring the modular energy system 2000 or a surgical device communicatively coupled to the modular energy system 2000. The still images and / or videos displayed by the head module 2002 may be received from an endoscope or another visualization device communicatively coupled to the modular energy system 2000. The animations and / or information of the GUI 2008 may be overlaid on or displayed adjacent to the images or video feed.

[0299] In one aspect, modules 2001 other than head module 2002 can be configured to similarly relay information to a user. For example, energy module 2004 can include light assemblies 2015 disposed around each port of port assembly 2012. Light assembly 2015 can be configured to relay information about a port to a user based on its color or state (e.g., flashing). For example, light assembly 2015 can change from a first color to a second color when a plug is fully seated in a corresponding port. In one aspect, the color or state of light assembly 2015 can be controlled by head module 2002. For example, head module 2002 can cause light assembly 2015 of each port to display a color corresponding to the color display of the port on GUI 2008.

[0300] Fig.31 is a block diagram of an independent hub configuration of a modular energy system 3000 according to at least one aspect of the present disclosure, and Fig.32 is a block diagram of a hub configuration of a modular energy system 3000 integrated with a surgical control system 3010 in accordance with at least one aspect of the present disclosure. Fig.31 and 32 As shown, the modular energy system 3000 can be used as a standalone unit or integrated with a surgical control system 3010 that controls one or more surgical hub units and / or receives data from one or more surgical hub units. Figure 31 to Figure 32 In the example shown in , the integrated head / UI module 3002 of the modular energy system 3000 includes a head module and a UI module integrated together as a single module. In other aspects, the head module and the UI module can be provided as separate components that are communicatively coupled via a data bus 3008.

[0301] like Fig.31 As shown in , an example of a stand-alone modular energy system 3000 includes an integrated head module / user interface (UI) module 3002 coupled to an energy module 3004. Power and data are transmitted between the integrated head / UI module 3002 and the energy module 3004 via a power interface 3006 and a data interface 3008. For example, the integrated head / UI module 3002 can transmit various commands to the energy module 3004 via the data interface 3008. Such commands can be based on user input from the UI. For another example, power can be transmitted to the energy module 3004 via the power interface 3006.

[0302] exist Fig.32 In the embodiment, the surgical hub configuration includes a modular energy system 3000 integrated with a control system 3010 and an interface system 3022 for managing data and power transmission to and / or from the modular energy system 3000, among other things. Fig.32The modular energy system shown includes an integrated head module / UI module 3002, a first energy module 3004, and a second energy module 3012. In one example, a data transmission path is established between a system control unit 3024 of a control system 3010 and the second energy module 3012 through the first energy module 3004 and the head / UI module 3002 via a data interface 3008. In addition, a power path extends between the integrated head / UI module 3002 and the second energy module 3012 through the first energy module 3004 via a power interface 3006. In other words, in one aspect, the first energy module 3004 is configured to be able to be used as a power interface and a data interface between the second energy module 3012 and the integrated head / UI module 3002 via a power interface 3006 and a data interface 3008. This arrangement allows the modular energy system 3000 to be expanded by seamlessly connecting additional energy modules to energy modules 3004, 3012 that are already connected to the integrated head / UI module 3002, without the need for a dedicated power interface and energy interface within the integrated head / UI module 3002.

[0303] The system control unit 3024 (which may be referred to herein as a control circuit, control logic component, microprocessor, microcontroller, logic component, or FPGA, or various combinations thereof) is coupled to the system interface 3022 via an energy interface 3026 and an instrument communication interface 3028. The system interface 3022 is coupled to the first energy module 3004 via a first energy interface 3014 and a first instrument communication interface 3016. The system interface 3022 is coupled to the second energy module 3012 via a second energy interface 3018 and a second instrument communication interface 3020. When additional modules (such as additional energy modules) are stacked in the modular energy system 3000, additional energy interfaces and communication interfaces are provided between the system interface 3022 and the additional modules.

[0304] As described in more detail below, the energy modules 3004, 3012 can be connected to the hub and can be configured to generate electrosurgical energy (e.g., bipolar or monopolar), ultrasonic energy, or a combination thereof for a variety of energy surgical instruments (referred to herein as "advanced energy" modules). In general, the energy modules 3004, 3012 include a hardware / software interface, an ultrasonic controller, an advanced energy RF controller, a bipolar RF controller, and control algorithms executed by the controllers that receive outputs from the controllers and control the operation of the various energy modules 3004, 3012 accordingly. In various aspects of the present disclosure, the controllers described herein can be implemented as control circuits, control logic components, microprocessors, microcontrollers, logic components, or FPGAs, or various combinations thereof.

[0305] Figure 33 to Figure 35 is a block diagram of various modular energy systems connected together to form a hub according to at least one aspect of the present disclosure. Figure 33 to Figure 3 5 shows various diagrams (e.g., circuit or control diagrams) of a hub module. According to at least one aspect of the present disclosure, a modular energy system 3000 includes a plurality of energy modules 3004 ( Fig.34 )、3012(FIG. 35)、header module 3150(FIG. 35)、UI module 3030( Fig.33 ) and communication module 3032 ( Fig.33 ). The UI module 3030 includes a touch screen 3046 that displays various relevant information and various user controls for controlling one or more parameters of the modular energy system 3000. The UI module 3030 is attached to the top head module 3150, but is received separately so that it can be manipulated independently of the head module 3150. For example, the UI module 3030 can be picked up and / or reattached to the head module 3150 by a user. Additionally or alternatively, the UI module 3030 can be slightly moved relative to the head module 3150 to adjust its position and / or orientation. For example, the UI module 3030 can be tilted and / or rotated relative to the head module 3150.

[0306] In some aspects, the various hub modules may include light guides around the physical ports to communicate instrument status and also connect on-screen elements to the corresponding instruments. Light guides are one example of lighting technology that can be used to alert a user to the status of a surgical instrument attached / connected to a physical port. In one aspect, a physical port is illuminated with a specific light to guide a user to connect a surgical instrument to the physical port. In another example, a physical port is illuminated with a specific light to alert a user to an error associated with an existing connection of a surgical instrument.

[0307] Go to Fig.33 , a block diagram of a user interface (UI) module 3030 coupled to a communication module 3032 via a pass-through hub connector 3034 according to at least one aspect of the present disclosure is shown. The UI module 3030 is provided as a separate component from the header module 3150 (shown in FIG. 35 ) and can be communicatively coupled to the header module 3150, for example, via the communication module 3032. In one aspect, the UI module 3030 may include a UI processor 3040 that is configured to be able to present instruction visualizations and behaviors received from other connected modules, as well as perform other centralized UI functions, such as system configuration (e.g., language selection, module association, etc.). The UI processor 3040 can be, for example, a processor or system on module (SOM) running a framework such as Qt, .NET WPF, a web server, etc.

[0308] In the illustrated example, the UI module 3030 includes a touch screen 3046, a liquid crystal display 3048 (LCD), and an audio output 3052 (e.g., a speaker, a buzzer). The UI processor 3040 is configured to receive touch screen input from a touch controller 3044 coupled between the touch screen 3046 and the UI processor 3040. The UI processor 3040 is configured to output visual information to the LCD display 3048 and output audio information to the audio output 3052 via an audio amplifier 3050. The UI processor 3040 is configured to interface to the communication module 3032 via a switch 3042 coupled to the through-hub connector 3034 to receive data, process data, and forward data from a source device to a target device, and control data communication between them. DC power is provided to the UI module 3030 via a DC / DC converter module 3054. The DC power is delivered to the communication module 3032 via the power bus 3006 through the through-hub connector 3034. The data is passed through the data bus 3008 to the communication module 3032 through the pass-through hub connector 3034. The switches 3042, 3056 receive the data, process the data, and forward the data from the source device to the destination device.

[0309] Continue to see Fig.33 , the communication module 3032 and various surgical hubs and / or surgical systems may include a gateway 3058 that is configured to shuttle selected traffic (i.e., data) between two different networks (e.g., an internal network and / or a hospital network) running different protocols. The communication module 3032 includes a first through-hub connector 3036 that couples the communication module 3032 to other modules. In the illustrated example, the communication module 3032 is coupled to the UI module 3030. The communication module 3032 is configured to be able to be coupled to other modules (e.g., an energy module) via a second through-hub connector 3038 to couple the communication module 3032 to other modules via a switch 3056 disposed between the first through-hub connector 3036 and the second through-hub connector 3038 to receive data, process data and forward data from a source device to a target device, and control data communications between them. The switch 3056 is also coupled to the gateway 3058 to transmit information between the external communication port and the UI module 3030 and other connected modules. The gateway 3058 may be coupled to various communication modules, such as an Ethernet module 3060, a universal serial bus (USB) module 3062, a WiFi module 3064, and a Bluetooth module 3066, etc., for communicating with a hospital or other local network. The communication module may be a physical board located within the communication module 3032, or may be a port coupled to a remote communication board.

[0310] In some aspects, all modules (ie, detachable hardware) are controlled by a single UI module 3030 disposed on or integral with the head module. Figure 35 illustrates a separate head module 3150 to which the UI module 3030 may be attached. Fig.31 , Fig.32 and FIG. 36 shows the integrated header / UI module 3002. Now return to Fig.33 In various aspects, the system provides a simpler way to control and monitor multiple devices simultaneously by combining all modules into a single responsive UI module 3002. This approach significantly reduces the footprint and complexity in the operating room (OR).

[0311] Go to Fig.34 , shows a block diagram of an energy module 3004 according to at least one aspect of the present disclosure. Communication module 3032 ( Fig.33 ) is coupled to the energy module 3004 via the second through-hub connector 3038 of the communication module 3032 and the first through-hub connector 3074 of the energy module 3004. The energy module 3004 can be coupled to other modules, such as the second energy module 3012 shown in FIG. 35, via the second through-hub connector 3078. Return to Fig.34 The switch 3076 disposed between the first through-hub connector 3074 and the second through-hub connector 3078 receives data, processes data and forwards data from the source device to the target device, and controls data communication therebetween. Data is received and transmitted via the data bus 3008. The energy module 3032 includes a controller 3082 to control various communication and processing functions of the energy module 3004.

[0312] DC power is received and transmitted by the energy module 3004 through the power bus 3006. The power bus 3006 is coupled to the DC / DC converter module 3138 to supply power to the adjustable regulators 3084, 3107 and the isolated DC / DC converter ports 3096, 3112, 3132.

[0313] In one aspect, the energy module 3004 may include an ultrasonic broadband amplifier 3086, which in one aspect may be a linear class H amplifier capable of generating arbitrary waveforms and driving harmonic transducers at low total harmonic distortion (THD) levels. The ultrasonic broadband amplifier 3086 is fed by a step-down adjustable regulator 3084 to maximize efficiency and is controlled by a controller 3082, which may be implemented as a digital signal processor (DSP), for example, via a direct digital synthesizer (DDS). For example, the DDS may be embedded in a DSP or implemented in a field programmable gate array (FPGA). The controller 3082 controls the ultrasonic broadband amplifier 3086 via a digital-to-analog converter 3106 (DAC). The output of the ultrasonic broadband amplifier 3086 is fed to an ultrasonic power transformer 3088, which is coupled to the ultrasonic energy output portion of the advanced energy receiver 3100. Ultrasonic voltage (V) and current (I) feedback (FB) signals that can be used to calculate ultrasonic impedance are fed back to the controller 3082 via an ultrasonic VI FB transformer 3092 through the input portion of the advanced energy receiver 3100. The ultrasonic voltage and current feedback signals are routed back to the controller 3082 via an analog-to-digital converter 3102 (A / D). An isolated DC / DC converter port 3096, which receives DC power from the power bus 3006, and a medium bandwidth data port 3098 are also coupled to the controller 3082 via the advanced energy receiver 3100.

[0314] In one aspect, the energy module 3004 may include a broadband RF power amplifier 3108, which in one aspect may be a linear class H amplifier capable of generating arbitrary waveforms and driving RF loads at a range of output frequencies. The broadband RF power amplifier 3108 is fed by an adjustable buck regulator 3107 to maximize efficiency and is controlled by a controller 3082, which may be implemented as a DSP via a DDS. For example, the DDS may be embedded in a DSP or implemented in an FPGA. The controller 3082 controls the broadband RF amplifier 3086 via a DAC 3122. The output of the broadband RF power amplifier 3108 may be fed through an RF selection relay 3124. The RF selection relay 3124 is configured to receive the output signal of the broadband RF power amplifier 3108 and selectively transmit it to various other components of the energy module 3004. In one aspect, the output signal of the broadband RF power amplifier 3108 may be fed to an RF power transformer 3110 via an RF selection relay 3124, which is coupled to the RF output portion of a bipolar RF energy receiver 3118. Bipolar RF voltage (V) and current (I) feedback (FB) signals that can be used to calculate RF impedance are fed back to the controller 3082 through the input section of the bipolar RF energy receiver 3118 via the RF VI FB transformer 3114. The RF voltage and current feedback signals are routed back to the controller 3082 through the A / D 3120. An isolated DC / DC converter port 3112, which receives DC power from the power bus 3006, and a low bandwidth data port 3116 are also coupled to the controller 3082 through the bipolar RF energy receiver 3118.

[0315] As described above, in one aspect, the energy module 3004 may include an RF select relay 3124 driven by a controller 3082 (e.g., an FPGA) with a rated coil current for actuation, and may also be set to a lower holding current via pulse width modulation (PWM) to limit steady-state power dissipation. Switching of the RF select relay 3124 is accomplished using a force-directed (safety) relay, and the state of the contact state is sensed by the controller 3082 to mitigate any single fault condition. In one aspect, the RF select relay 3124 is configured to be capable of being in a first state, wherein an output RF signal received from an RF source such as a broadband RF power amplifier 3108 is transmitted to a first component of the energy module 3004, such as an RF power transformer 3110 of a bipolar energy receiver 3118. In a second aspect, the RF select relay 3124 is configured to be capable of being in a second state, wherein an output RF signal received from an RF source such as a broadband RF power amplifier 3108 is transmitted to a second component, such as an RF power transformer 3128 of a monopolar energy receiver 3136, as described in more detail below. In general terms, the RF selection relay 3124 is configured to be drivable by the controller 3082 to switch between multiple states (such as a first state and a second state) to transmit the output RF signal received from the RF power amplifier 3108 between different energy receivers of the energy module 3004.

[0316] As described above, the output of the broadband RF power amplifier 3108 may also be fed to the broadband RF power transformer 3128 of the RF monopolar receiver 3136 through the RF select relay 3124. The monopolar RF voltage (V) and current (I) feedback (FB) signals, which may be used to calculate the RF impedance, are fed back to the controller 3082 through the input section of the monopolar RF energy receiver 3136 via the RF VI FB transformer 3130. The RF voltage and current feedback signals are routed back to the controller 3082 through the A / D 3126. An isolated DC / DC converter port 3132, which receives DC power from the power bus 3006, and a low bandwidth data port 3134 are also coupled to the controller 3082 through the monopolar RF energy receiver 3136.

[0317] The output of the broadband RF power amplifier 3108 may also be fed to the broadband RF power transformer 3090 of the advanced energy receiver 3100 through the RF select relay 3124. RF voltage (V) and current (I) feedback (FB) signals, which may be used to calculate RF impedance, are fed back to the controller 3082 through the input section of the advanced energy receiver 3100 via the RF VI FB transformer 3094. The RF voltage and current feedback signals are routed back to the controller 3082 through the A / D 3104.

[0318] 35 is a block diagram of a second energy module 3012 coupled to a head module 3150 according to at least one aspect of the present disclosure. Fig.34 35 is coupled to the second energy module 3012 shown in FIG. 35 by coupling the second through-hub connector 3078 of the first energy module 3004 to the first through-hub connector 3074 of the second energy module 3012. In one aspect, the second energy module 3012 can be an energy module similar to the first energy module 3004, as shown in FIG. 35. In another aspect, the second energy module 2012 can be a different energy module than the first energy module, such as shown in more detail in FIG. Fig.37 Adding the second energy module 3012 to the first energy module 3004 adds functionality to the modular energy system 3000.

[0319] The second energy module 3012 is coupled to the head module 3150 by connecting the through-hub connector 3078 to the through-hub connector 3152 of the head module 3150. In one aspect, the head module 3150 may include a head processor 3158 configured to manage a power button function 3166, software upgrades performed by an upgrade USB module 3162, system time management, and a gateway to an external network (i.e., a hospital or cloud) via an Ethernet module 3164 that can run different protocols. Data is received by the head module 3150 through the through-hub connector 3152. The head processor 3158 is also coupled to a switch 3160 to receive data, process data, and forward data from a source device to a target device, and control data communications therebetween. The head processor 3158 is also coupled to an OTS power source 3156, which is coupled to the main power input module 3154.

[0320] FIG. 36 is a block diagram of a device for use with a hub (such as Fig.33 1 and 1 . The head / UI module 3002 includes a head power module 3172, a head wireless module 3174, a head USB module 3176, a head audio / screen module 3178, a head network module 3180 (e.g., Ethernet), a backplane connector 3182, a head standby processor module 3184, and a head foot switch module 3186. These functional modules interact to provide the head / UI 3002 functions. The head / UI controller 3170 controls each functional module and the communication between them, including safety critical control logic modules 3230, 3232 coupled between the head / UI controller 3170 and an isolated communication module 3234 coupled to the head foot switch module 3186. A safety coprocessor 3188 is coupled to the head / UI controller 3170.

[0321] The head power module 3172 includes a main power input module 3190 coupled to an OTS power source unit 3192 (PSU). Low voltage DC (e.g., 5V) standby power is provided from the OTS PSU 3192 to the head / UI module 3002 and other modules via a low voltage power bus 3198. High voltage DC (e.g., 60V) is provided from the OTS PSU 3192 to the head / UI module 3002 via a high voltage bus 3200. A high voltage DC / DC converter module 3196 and an isolated DC / DC converter module 3236 are provided. The standby processor 3204 of the head / standby module 3184 provides a PSU / enable signal 3202 to the OTS PSU 3192.

[0322] The head wireless module 3174 includes a WiFi module 3212 and a Bluetooth module 3214. Both the WiFi module 3212 and the Bluetooth module 3214 are coupled to the head / UI controller 3170. The Bluetooth module 3214 is used to connect devices without using cables, and the Wi-Fi module 3212 provides high-speed access to networks such as the Internet and can be used to create a wireless network that can link multiple devices, such as multiple energy modules or other modules and surgical instruments and other devices located in an operating room. Bluetooth is a wireless technology standard for exchanging data within a short distance (such as less than 30 feet).

[0323] The head USB module 3176 includes a USB port 3216 coupled to the head / UI controller 3170. The USB module 3176 provides a standard cable connection interface for modules and other electronic devices through short-range digital data communication. The USB module 3176 allows modules including USB devices to connect to a USB cable and transfer digital data through the USB cable.

[0324] The head audio / screen module 3178 includes a touch screen 3220 coupled to a touch controller 3218. The touch controller 3218 is coupled to the head / UI controller 3170 to read input from the touch screen 3220. The head / UI controller 3170 drives the LCD display 3224 through the display / port video output signal 3222. The head / UI controller 3170 is coupled to an audio amplifier 3226 to drive one or more speakers 3228.

[0325] In one aspect, the head / UI module 3002 provides a touch screen 3220 user interface that is configured to enable control of a control or module connected to the head module 3002 in the modular energy system 3000. The touch screen 3220 can be used to maintain a single access point for a user to adjust all modules connected within the modular energy system 3000. Additional hardware modules (e.g., smoke evacuation modules) can appear at the bottom of the user interface LCD display 3224 when they are connected to the head / UI module 3002, and can disappear from the user interface LCD display 3224 when they are disconnected from the head / UI module 3002.

[0326] In addition, the user touch screen 3220 may provide access to settings for the modules attached to the modular energy system 3000. In addition, the user interface LCD display 3224 arrangement may be configured to be able to change depending on the number and type of modules connected to the head / UI module 3002. For example, a first user interface may be displayed on the LCD display 3224 for a first application in which one energy module and one smoke evacuation module are connected to the head / UI module 3002, and a second user interface may be displayed on the LCD display 3224 for a second application in which two energy modules are connected to the head / UI module 3002. In addition, the user interface may change its display on the LCD display 3224 as modules are connected and disconnected from the modular energy system 3000.

[0327] In one aspect, the head / UI module 3002 provides a user interface LCD display 3224 that is configured to be able to display coloring corresponding to port lighting on the LCD display. In one aspect, the coloring of the instrument panel and the LED light around its corresponding port will be the same or otherwise correspond to each other. Each color can, for example, convey a unique meaning. In this way, the user will be able to quickly assess the instrument involved in the indication and the nature of the indication. In addition, the indication about the instrument can be represented by changing the color of the LED light lining around its corresponding port and the coloring of its module. Further, messages on the screen and hardware / software port alignment can also be used to convey that action must be taken on the hardware rather than the interface. In various aspects, all other instruments can be used when an alarm occurs on other instruments. This allows the user to quickly assess the instrument involved in the indication and the nature of the indication.

[0328] In one aspect, the head / UI module 3002 provides a user interface screen that is configured to be displayed on the LCD display 3224 to present the procedure options to the user. In one aspect, the user interface can be configured to present a series of options to the user (which can be arranged, for example, from broad to specific). After each selection is made, the modular energy system 3000 presents the next level until all selections are completed. These settings can be managed locally and transferred via an auxiliary device (such as a USB thumb drive). Alternatively, these settings can be managed via a portal and automatically distributed to all connected systems in the hospital.

[0329] The procedure options may include, for example, a list of factory preset options categorized by specialty, procedure, and procedure type. Upon completion of the user selection, the head module may be configured to set any connected instrument to the factory preset settings for that particular procedure. The procedure options may also include, for example, a list of surgeons, followed by specialty, procedure, and type. Once the user completes the selection, the system may suggest instruments preferred by the surgeon and set the settings for those instruments according to the surgeon's preferences (i.e., a profile associated with each surgeon that stores the surgeon's preferences).

[0330] In one aspect, the header / UI module 3002 provides a user interface screen that is configured to display key instrument settings on the LCD display 3224. In one aspect, each instrument panel displayed on the LCD display 3224 of the user interface corresponds in position and content to an instrument plugged into the modular energy system 3000. When a user taps on a panel, it may expand to display additional settings and options for that particular instrument, and the rest of the screen may, for example, be dimmed or otherwise de-emphasized.

[0331] In one aspect, the head / UI module 3002 provides an instrument settings panel of the user interface that is configured to include / display controls that are unique to the instrument and allow the user to increase or decrease the intensity of its output, toggle certain functions, pair it with system accessories such as a foot switch connected to the head foot switch module 3186, access advanced instrument settings, and find additional information about the instrument. In one aspect, the user can tap / select the "Advanced Settings" control to expand the advanced settings drawer displayed on the user interface LCD display 3224. In one aspect, the user can then tap / select the icon at the upper right corner of the instrument settings panel or tap anywhere outside the panel, and the panel will then shrink to its initial state. In these aspects, the user interface is configured to be able to display only the most critical instrument settings, such as power level and power mode, on the ready / home screen of each instrument panel on the LCD display 3224. This is to maximize the size and readability of the system from a distance. In some aspects, the panel and the settings therein can be scaled proportionally with the number of instruments connected to the system to further improve readability. As more instruments are connected, the panel scales proportionally to accommodate a larger amount of information.

[0332] The head network module 3180 includes a plurality of network interfaces 3264, 3266, 3268 (e.g., Ethernet) to network connect the head / UI module 3002 to other modules of the modular energy system 3000. In the illustrated example, one network interface 3264 may be a third party network interface, another network interface 3266 may be a hospital network interface, and yet another network interface 3268 may be located on the backplane network interface connector 3182.

[0333] The head standby processor module 3184 includes a standby processor 3204 coupled to an on / off switch 3210. The standby processor 3204 performs an electrical continuity test by checking to see if current is flowing in the continuity loop 3206. The continuity test is performed by applying a small voltage across the continuity loop 3206. A serial bus 3208 couples the standby processor 3204 to the backplane connector 3182.

[0334] The head foot switch module 3186 includes a controller 3240 coupled to a plurality of analog foot switch ports 3254, 3256, 3258 through a plurality of corresponding presence / ID and switch status modules 3242, 3244, 3246, respectively. The controller 3240 is also coupled to an accessory port 3260 via the presence / ID and switch status module 3248 and the transceiver module 3250. The accessory port 3260 is supplied with power by the accessory power module 3252. The controller 3240 is coupled to the head / UI controller 3170 via an isolated communication module 3234 and a first safety critical control module 3230 and a second safety critical control module 3232. The head foot switch module 3186 also includes a DC / DC converter module 3238.

[0335] In one aspect, the head / UI module 3002 provides a user interface screen that is configured to be displayed on the LCD display 3224 for controlling a foot switch connected to any of the simulated foot switch ports 3254, 3256, 3258. In some aspects, when a user inserts a non-manually activated instrument into any of the simulated foot switch ports 3254, 3256, 3258, the instrument panel appears at a warning icon next to the foot switch icon. The instrument settings may be, for example, grayed out because the instrument cannot be activated without the foot switch.

[0336] When the user inserts a foot switch into any of the simulated foot switch ports 3254, 3256, 3258, a pop-up window appears indicating that the foot switch has been assigned to the instrument. The foot switch icon indicates that the foot switch has been inserted and assigned to the instrument. The user can then tap / select the icon to assign, reallocate, unassign, or otherwise change the settings associated with the foot switch. In these aspects, the system is configured to automatically assign foot switches to non-manually activated instruments using a logic component that can also assign a single-pedal foot switch or a dual-pedal foot switch to the appropriate instrument. If the user wants to manually assign / reallocate a foot switch, there are two processes available.

[0337] In one aspect, the head / UI module 3002 provides a global foot switch button. Once the user taps the global foot switch icon (located in the upper right of the user interface LCD display 3224), the foot switch assignment overlay appears and the contents in the instrument module are dimmed. If not assigned to an instrument, a (e.g., photo-realistic) representation of each attached foot switch (dual pedal or single pedal) appears at the bottom, or appears on the corresponding instrument panel. Thus, the user can drag and drop these illustrations into and out of the framed icons in the foot switch assignment overlay to assign, unassign, and reassign foot switches to their respective instruments.

[0338] In one aspect, in accordance with at least one aspect of the present disclosure, the head / UI module 3002 provides a user interface screen displayed on the LCD display 3224 indicating automatic assignment of a foot switch. As described above, the modular energy system 3000 can be configured to automatically assign a foot switch to an instrument that has not been manually activated. In some aspects, the head / UI module 3002 can be configured to associate a color displayed on the user interface LCD display 3224 with a light on the module itself as a method of tracking a physical port with a user interface element.

[0339] In one aspect, the head / UI module 3002 may be configured to depict various applications of the user interface with varying numbers of modules connected to the modular energy system 3000. In various aspects, the overall layout or scale of the user interface elements displayed on the LCD display 3224 may be based on the number and type of instruments inserted into the head / UI module 3002. These scalable graphics may provide a method to utilize more of the screen for better visualization.

[0340] In one aspect, the head / UI module 3002 may be configured to be able to show a user interface screen on the LCD display 3224 to indicate which ports of the modules connected to the modular energy system 3000 are active. In some aspects, the head / UI module 3002 may be configured to be able to show active ports and inactive ports by highlighting active ports and dimming inactive ports. In one aspect, the ports can be represented by colors when active (e.g., monopolar tissue cutting is represented by yellow, monopolar tissue coagulation is represented by blue, bipolar tissue cutting is represented by blue, advanced energy tissue cutting is represented by warm white, etc.). In addition, the displayed color will match the color of the light guide around the port. Coloring can also indicate that the user cannot change the settings of other instruments when the instrument is activated. For example, the head / UI module 3002 may be configured to be able to show the bipolar port, monopolar port, and ultrasonic port of the first energy module as active, and the monopolar port of the second energy module as equally active.

[0341] In one aspect, the header / UI module 3002 may be configured to be able to show a user interface screen on the LCD display 3224 to display a global settings menu. In one aspect, the header / UI module 3002 may be configured to be able to display a menu on the LCD display 3224 to control global settings across any module connected to the modular energy system 3000. The global settings menu may, for example, always be displayed in a consistent location (e.g., always available in the upper right corner of the home screen).

[0342] In one aspect, the head / UI module 3002 may be configured to show a user interface screen on the LCD display 3224 that is configured to prevent settings from being changed while a surgical instrument is in use. In one example, the head / UI module 3002 may be configured to prevent settings from being changed via a displayed menu when a connected instrument is activated. The user interface screen may include, for example, an area (e.g., upper left corner) reserved for indicating instrument activation when a settings menu is opened. In one aspect, the user has turned on the bipolar setting when monopolar coagulation is activated. In one aspect, the settings menu may be used once activation is complete. In one aspect, the head / UI module 3002 may be configured to never overlay any menus or other information on a dedicated area for indicating key instrument information in order to keep key information displayed.

[0343] In one aspect, the head / UI module 3002 can be configured to display a user interface screen configured to display an instrument error on the LCD display 3224. In one aspect, the instrument error warning can be displayed on the instrument panel itself, allowing the user to continue using other instruments while the nurse troubleshoots the error. This allows the user to continue the surgical procedure without having to stop the surgical procedure to debug the instrument.

[0344] In one aspect, the head / UI module 3002 can be configured to display a user interface screen on the LCD display 3224 to display different modes or settings that can be used for various instruments. In various aspects, the head / UI module 3002 can be configured to display a settings menu suitable for the type or application of the surgical instrument connected to the stack / hub. Each settings menu can provide options for different power levels, energy delivery profiles, etc. suitable for a particular instrument type. In one aspect, the head / UI module 3002 can be configured to display different modes that can be used for bipolar, monopolar cutting, and monopolar coagulation applications.

[0345] In one aspect, the head / UI module 3002 can be configured to display a user interface screen on the LCD display 3224 to display pre-selected settings. In one aspect, the head / UI module 3002 can be configured to receive a selection of an instrument / device setting before an instrument is inserted so that the modular energy system 3000 is ready before the patient enters the operating room. In one aspect, the user can simply click on a port and then change the setting for that port. In the aspect shown, the selected port appears to fade out to indicate that the setting is set, but no instrument is inserted into the port.

[0346] Fig.37 is an energy module 3270 (such as Fig.31 , Fig.32 , Fig.34 35 ). Energy module 3270 is configured to be coupled to head module, head / UI module and other energy modules via a first through-hub connector 3272 and a second through-hub connector 3276. A switch 3076 disposed between the first through-hub connector 3272 and the second through-hub connector 3276 receives data, processes data and forwards data from a source device to a target device, and controls data communication therebetween. Data is received and transmitted via a data bus 3008. Energy module 3270 includes a controller 3082 to control various communications and processing functions of energy module 3270.

[0347] DC power is received and transmitted by the energy module 3270 through the power bus 3006. The power bus 3006 is coupled to the DC / DC converter module 3138 to supply power to the adjustable regulators 3084, 3107 and the isolated DC / DC converter ports 3096, 3112, 3132.

[0348] In one aspect, the energy module 3270 may include an ultrasonic broadband amplifier 3086, which in one aspect may be a linear class H amplifier capable of generating arbitrary waveforms and driving harmonic transducers at low total harmonic distortion (THD) levels. The ultrasonic broadband amplifier 3086 is fed by a step-down adjustable regulator 3084 to maximize efficiency and is controlled by a controller 3082, which may be implemented as a digital signal processor (DSP), for example, via a direct digital synthesizer (DDS). For example, the DDS may be embedded in a DSP or implemented in a field programmable gate array (FPGA). The controller 3082 controls the ultrasonic broadband amplifier 3086 via a digital-to-analog converter 3106 (DAC). The output of the ultrasonic broadband amplifier 3086 is fed to an ultrasonic power transformer 3088, which is coupled to the ultrasonic energy output portion of the advanced energy receiver 3100. Ultrasonic voltage (V) and current (I) feedback (FB) signals that can be used to calculate ultrasonic impedance are fed back to the controller 3082 via an ultrasonic VI FB transformer 3092 through the input portion of the advanced energy receiver 3100. The ultrasonic voltage and current feedback signals are routed back to the controller 3082 through the analog multiplexer 3280 and the dual analog-to-digital converter 3278 (A / D). In one aspect, the dual A / D 3278 has a sampling rate of 80MSPS. An isolated DC / DC converter port 3096, which receives DC power from the power bus 3006, and a medium bandwidth data port 3098 are also coupled to the controller 3082 through the advanced energy receiver 3100.

[0349] In one aspect, the energy module 3270 may include a plurality of broadband RF power amplifiers 3108, 3286, 3288, etc., each of which may be a linear class H amplifier capable of generating arbitrary waveforms and driving RF loads at a range of output frequencies. Each of the broadband RF power amplifiers 3108, 3286, 3288 is fed by an adjustable buck regulator 3107 to maximize efficiency and is controlled by a controller 3082, which may be implemented as a DSP via a DDS. For example, the DDS may be embedded in a DSP or implemented in an FPGA. The controller 3082 controls the first broadband RF power amplifier 3108 via a DAC 3122.

[0350] and Fig.34 Unlike the energy modules 3004 and 3012 shown and described in FIG. 35 , the energy module 3270 does not include an RF select relay configured to receive an RF output signal from the adjustable buck regulator 3107. Fig.34Unlike the energy modules 3004 and 3012 shown and described in FIG. 35 , the energy module 3270 includes multiple broadband RF power amplifiers 3108, 3286, 3288 instead of a single RF power amplifier. In one aspect, the adjustable buck regulator 3107 can be switched between multiple states, wherein the adjustable buck regulator 3107 outputs the output RF signal to one of the multiple broadband RF power amplifiers 3108, 3286, 3288 connected to the adjustable buck regulator. The controller 3082 is configured to be able to switch the adjustable buck regulator 3107 between multiple states. In a first state, the controller drives the adjustable buck regulator 3107 to output the RF energy signal to the first broadband RF power amplifier 3108. In a second state, the controller drives the adjustable buck regulator 3107 to output the RF energy signal to the second broadband RF power amplifier 3286. In the third state, the controller drives the adjustable buck regulator 3107 to output the RF energy signal to the third broadband RF power amplifier 3288 .

[0351] The output of the first broadband RF power amplifier 3108 may be fed to an RF power transformer 3090, which is coupled to the RF output section of the advanced energy receiver 3100. RF voltage (V) and current (I) feedback (FB) signals, which may be used to calculate RF impedance, are fed back to the controller 3082 via the RF VI FB transformer 3094 through the input section of the advanced energy receiver 3100. The RF voltage and current feedback signals are routed back to the controller 3082 through the RF VI FB transformer 3094, which is coupled to an analog multiplexer 3284 and a dual A / D 3282 coupled to the controller 3082. In one aspect, the dual A / D 3282 has a sampling rate of 80MSPS.

[0352] The output of the second RF broadband power amplifier 3286 is fed through the RF power transformer 3128 of the RF monopolar receiver 3136. Monopolar RF voltage (V) and current (I) feedback (FB) signals, which can be used to calculate RF impedance, are fed back to the controller 3082 through the input section of the monopolar RF energy receiver 3136 via the RF VI FB transformer 3130. The RF voltage and current feedback signals are routed back to the controller 3082 through the analog multiplexer 3284 and the dual A / D 3282. An isolated DC / DC converter port 3132, which receives DC power from the power bus 3006, and a low bandwidth data port 3134 are also coupled to the controller 3082 through the monopolar RF energy receiver 3136.

[0353] The output of the third RF broadband power amplifier 3288 is fed through the RF power transformer 3110 of the bipolar RF receiver 3118. Bipolar RF voltage (V) and current (I) feedback (FB) signals, which can be used to calculate RF impedance, are fed back to the controller 3082 through the input section of the bipolar RF energy receiver 3118 via the RF VI FB transformer 3114. The RF voltage and current feedback signals are routed back to the controller 3082 through the analog multiplexer 3280 and the dual A / D 3278. An isolated DC / DC converter port 3112, which receives DC power from the power bus 3006, and a low bandwidth data port 3116 are also coupled to the controller 3082 through the bipolar RF energy receiver 3118.

[0354] The contact monitor 3290 is coupled to the NE receiver 3292. Power is fed from the monopole receiver 3136 to the NE receiver 3292.

[0355] In one aspect, reference Figure 31 to Figure 37 , the modular energy system 3000 may be configured to detect the presence of an instrument in a receiver 3100, 3118, 3136 via a photointerrupter, magnetic sensor, or other non-contact sensor integrated into the receiver 3100, 3118, 3136. This approach prevents the necessity to assign dedicated presence pins on the MTD connector to a single purpose, and instead allows the MTD signal pins 6-9 to have multi-purpose functionality while continuously monitoring for instrument presence.

[0356] In one aspect, reference Figure 31 to Figure 37 , the modules of the modular energy system 3000 may include an optical link that allows high speed communication (10Mb / s to 50Mb / s) across the patient isolation boundary. This link will carry device communications, suppression signals (monitors, etc.), and low bandwidth runtime data. In some aspects, the optical link will not contain real-time sampling data that can be performed on the non-isolated side.

[0357] In one aspect, reference Figure 31 to Figure 37 , a module of the modular energy system 3000 may include a multi-function circuit block that can: (i) read a presence resistor value via an A / D and current source, (ii) communicate with a conventional instrument via a manual switch Q protocol, (iii) communicate with an instrument via a local bus single wire protocol, and (iv) communicate with a CAN FD enabled surgical instrument. When a surgical instrument is properly identified by the energy generator module, the associated pin functions and communication circuits are enabled, while other unused functions are disabled and set to a high impedance state.

[0358] In one aspect, reference Figure 31 to Figure 37, the modules of the modular energy system 3000 may include an amplifier pulse / stimulation / auxiliary DC amplifier. This is a flexible use amplifier based on a full-bridge output and includes functional isolation. This allows its differential output to reference any output connection on the applied part (except for the unipolar active electrode in some aspects). The amplifier output can be a small signal linear (pulse / excitation) with a waveform drive provided by a DAC or a square wave drive with medium output power for DC applications (such as DC motors, lighting, FET drivers, etc.). The output voltage and current are sensed using functionally isolated voltage and current feedback to provide accurate impedance and power measurements to the FPGA. Paired with a CAN FD-enabled instrument, this output can provide a motor / motion control drive, while position or velocity feedback is provided by the CAN FD interface for closed-loop control.

[0359] Modular Energy System Audio Technology

[0360] Conventional surgical capital equipment can be designed to provide audiovisual feedback to the user when the surgical instrument driven thereby is activated or otherwise used. For example, the surgical capital equipment can be configured to output auditory feedback when the surgical instrument is powered, so as to ensure that the surgical staff knows that the surgical instrument has been activated. In a specific implementation, this can take the form of a tone, which is emitted by the capital equipment when the electrosurgical instrument and / or ultrasonic surgical instrument connected to the capital equipment is powered. For conventional surgical capital equipment, when there are multiple different capital equipments that are effectively used in the OR, these activation tones can be distinguished from each other, even when the tones are very similar to each other, because the capital equipment is located at different locations in the OR. Since the capital equipment that generates the tones is located at different locations, this inherently produces different acoustic effects for each of the tones, thereby allowing the tones to be distinguished from each other. However, as described above under the title modular energy system, the modular energy system described herein is designed to replace different surgical capital equipments and provide a single consolidation system for driving all surgical instruments used during surgical procedures. This may create problems with audio feedback because the different energy modules are located at a single location within the OR (i.e., in a modular energy system stack), and therefore, it may be difficult for a user to distinguish the same or similar tones emitted from the modules because the tones no longer originate from different locations within the OR. Therefore, there is a need for modular energy systems to implement various techniques to modulate audio feedback and / or generate unique audio feedback based on the configuration of the modular energy system and other factors.

[0361] In one general aspect, a modular energy system can include at least two energy modules, each of which can include multiple (e.g., four) ports. The modular energy system can be configured to be able to construct a unique audio signal for each port based on the number, type, and operating state of the connected modules. In one aspect, the signal can be constructed by modulating at least two separate signals.

[0362] In one aspect, a modular energy system (e.g., Figures 24 to 37 The modular energy system of the present invention can be configured to employ an audio control system that is configured to generate the tones played by the modular energy system and to confirm that the correct tone is being played for a given function performed by the modular energy system. By ensuring that it outputs the correct tone for each given function, the control system can prevent incorrect audio feedback from being provided to surgical staff and other users during the course of a surgical procedure.

[0363] For example, Fig.38 1 is a block diagram of an audio control system 12500 for a modular energy system. The audio control system 12500 may include a control circuit 12502, which in turn may include an audio output controller 12506 and an audio auxiliary controller 12504. The audio output controller 12506 may be configured to generate an audio signal, which may include a digital audio signal, which is provided to an audio amplifier 12508 (e.g., a 12S digital-to-analog (DAC) Class D stereo amplifier) ​​for output by one or more audio output devices 12514a-b (e.g., speakers). The audio auxiliary controller 12504 is further coupled to the audio output controller 12506 via circuit connections 12507a-b, such that the audio auxiliary controller 12504 receives the audio signal from the audio output controller 12506 before the audio output devices 12514a-b emit the audio signal. In one aspect, the audio signal output by the audio output controller 12506 may include a segment that includes or represents an audio signal identifier (ID) that uniquely identifies a particular tone to which the audio signal corresponds. The audio signal output by the audio output controller 12506 may be generated from, for example, an audio file that includes an audio signal ID.

[0364] Thus, the audio auxiliary controller 12504 may receive a signal output by the audio output controller 12506 via the circuit connections 12507a-b, the signal including an audio signal ID embedded therein. The audio signal ID, which may be embedded in an extra bit of the digital audio signal output by the audio output controller 12506, may be used to confirm that the audio output controller 12506 is outputting the appropriate signal to the audio amplifier 12508 (i.e., the audio output controller 12506 is attempting to play the appropriate tone). In one aspect, the audio auxiliary controller 12504 may be configured to be able to compare the audio signal from the digital audio signal output by the audio output controller 12506 with the expected audio signal. In another aspect, the audio auxiliary controller 12504 may be configured to be able to compare the audio signal ID from the audio output controller 12506 with the expected audio signal ID to determine whether the audio output controller 12506 is outputting the correct signal. In an alternative aspect, the audio auxiliary controller 12504 can be configured to compare the entirety of the output audio signal or a portion of the output audio signal used by the audio amplifier 12508 to produce the tone to an expected audio signal to determine if the audio output controller 12506 is outputting the correct signal. The expected audio signal and / or audio signal ID can be determined by the audio auxiliary controller 12506 through autonomous knowledge of the modular energy system state or other processes, and the audio auxiliary controller 12506 compares the actual output audio signal and / or signal ID received to the expected audio signal and / or audio signal ID.

[0365] The audio control system 12500 may also include one or more LC filters 12510a-b coupled to the current shunts 12512a-b and the audio output devices 12514a-b. In addition, the audio control system 12500 may include current sense amplifiers 12516a-b coupled to the current shunts 12512a-b and comparators 12518a-b coupled to the current sense amplifiers 12516a-b. The outputs of the comparators 12518a-b are coupled to the audio auxiliary controller 12504.

[0366] Thus, the audio auxiliary controller 12504 may receive a current measurement signal of an audio signal output by the audio amplifier 12508 via the current shunts 12512a-b and associated components. In one aspect, the audio auxiliary controller 12504 may be configured to compare the current measurement signal to a threshold value for determining whether the audio amplifier output is within an expected intensity range. By determining whether the audio amplifier output is within an expected intensity range, the audio auxiliary controller 12504 may confirm that the audio amplifier 12508 is operating at a sufficient level (i.e., driving sufficient power to the audio output devices 12514a-b) and / or may confirm that the audio output devices 12514a-b are operating properly and / or are properly connected (i.e., the audio output devices 12514a-b are connected to the audio amplifier 12508 based on the absence of open circuits or short circuits).

[0367] In one aspect, the audio auxiliary controller 12504 may be configured to further or alternatively compare the direct output of the audio output controller 12506 with the output fed to the audio output devices 21514a-b to confirm that the audio output devices 21514a-b are outputting the correct tones based on the generated audio signals.

[0368] In yet another aspect, the audio auxiliary controller 12504 may be configured to be able to identify a specific tone being output via the audio output device 21514a-b based on the current measurement signal received from the current shunt 12512a-b and associated components. Thus, the audio auxiliary controller 12504 may be configured to be able to determine whether the tone determined via the current measurement signal is appropriate for a given situation or modular energy system state. For example, the audio auxiliary controller 12504 may be configured to be able to determine whether the correct activation tone is being played via the audio output device 21514a-b when the device is activated / powered. Thus, the audio auxiliary controller 12504 can ensure that the tone is appropriate and that the audio amplifier 12508 is operating properly.

[0369] Because modular energy systems (e.g. Figures 24 to 37A modular energy system) may include an energy module that can simultaneously power multiple devices and the activation or powering of each device may have a unique tone associated with it, so the modular energy system may output multiple overlapping tones in some cases. In addition, the modular energy system may also output other tones associated with an alarm or message provided to the user, which may overlap with other tones being output by the modular energy system. Due to the close proximity between the energy module of the modular energy system and other audio emission modules (which is attributed to the characteristics of its stacked configuration), these overlapping tones may potentially interfere with each other or be difficult to distinguish each other auditorily for the user. In one aspect, the modular energy system may be configured to generate a unique audio output when the modular energy system is performing multiple audio emission functions. In other words, the modular energy system may be configured to generate a single unique audio output, rather than multiple overlapping audio outputs. Therefore, the modular energy system can ensure that all auditory feedback provided is easily distinguished by the user. In another aspect, a unique audio output can be generated based on a specific combination of tones that would otherwise be output in an overlapping manner.

[0370] In one aspect, each audio file representing a tone output by a modular energy system may include an embedded ID that is unique to the audio file. The function of the modular energy system to which the audio file to be output may be assigned when the function is formed may include, for example, powering or activating a specific instrument type or providing a specific type of alarm or message. Each different surgical instrument that can be driven by the modular energy system and the alarm / message that can be provided by the modular energy system may have a different tone associated with it so as to provide the user with confirmation auditory feedback about each separate function type being performed by the modular energy system. In one aspect, each audio file may include a first series of bits (e.g., 16 bits) of a digital audio signal representing a tone and a second series of bits (e.g., 8 bits) representing a header or ID of the tone. When it is determined that a specific function is being performed by a modular energy system, the audio output controller 12506 may be configured to be able to retrieve the appropriate audio file corresponding to the function, and then transmit the bit sequence including the digital audio signal and the associated ID to the amplifier 12508 (ignoring the ID bit when generating the output audio waveform). Thus, the audio auxiliary controller 12504 can be configured to read the output of the audio amplifier 12508 and ensure that the embedded ID corresponds to the appropriate audio file corresponding to the specific function being performed by the modular energy system, as generally described above. The embedded audio file ID can also be used in the process of generating a unique tone from a combination of individual audio files.

[0371] In one aspect, the audio control system 12500 can be configured to generate a unique tone based on a specific combination of tones of functions being simultaneously performed by the modular energy system. Fig.39is a diagram of techniques used to generate unique audio output. Fig.39 The technology implemented can be, for example, Fig.38 The control circuit 12502 of the audio control system 12500 in the embodiment of the present invention is executed. In one aspect, the control circuit 12502 can be configured to generate a unique tone from a combination of the individual tones output by the audio control system 12500 to replace the individual tones, and provide a unique ID for confirming that the appropriate tone is being generated and output based on the input individual tones.

[0372] In one aspect, the audio file ID can be selected so that the sum of the given values ​​of any one of the IDs in a set of IDs is not equal to any one of the IDs in a set of IDs. In other words, the ID can be selected so that the sum of the given values ​​of the IDs is a unique value obtained from the selected ID. One method for generating a list of such IDs is by considering each possible ID value from the lowest permissible ID to the highest permissible ID. Specifically, each alternative ID can be added to the list of valid IDs only in the following cases: (i) it is not equal to the sum of the combination of existing valid IDs, and (ii) when added to the existing valid ID (or the sum of the combination of existing IDs), the result is also not equal to the sum of other existing valid IDs or combinations of IDs. The method ensures that any value is a unique single ID itself or a unique sum of a combination of IDs, wherein the set of each constituent ID is precisely known. The method can be implemented as a set of steps, a closed form, an algorithmic mathematical expression, etc. Ensuring that each combination of IDs is unique compared to other combinations of IDs and the value of the ID itself allows the control circuit 12502 to distinguish each specific combination of tones generated by the audio control system 12500, and thereby verifies that the modular energy system is playing the correct tones for any combination of functions. For example, if two tones are combined together, the IDs may include 1, 3, 7, 15, 25, 41, 61, 89, etc. As can be seen in this example, the sum of any pair of IDs is a unique value. If three or more tones are mixed or combined together, different IDs may be selected because the values ​​of the IDs added together affect which specific values ​​may be added together to produce a unique value. Table 1 below provides an approximation of a number of unique tone ID values ​​that may be generated based on the number of bits used for the audio file ID.

[0373] Table 1

[0374] ID digits Maximum value of unique two-tone combination Maximum value of a unique three-tone combination 8 15 7 16 137 52 20 388 145 24 647 393

[0375] Thus, the control circuit 12502 may retrieve a first audio file represented by the first graph element 12550 and a second audio file represented by the second graph element 12552. Each of the audio files includes a portion corresponding to a digital audio signal (i.e., "Audio 1" and "Audio 2"). In this particular example, the digital audio signal is 16 bits, but this is merely an example, and the audio portion is not limited to any particular number of bits. In an alternative aspect, instead of the audio portion representing a digital audio signal that is then fed to the amplifier 12508 for output, the audio portion may represent a unique value or ID corresponding to a tone that can be retrieved from memory by the control circuit 12502. In addition, each of the audio files includes a portion corresponding to an ID associated with each of the tones (i.e., "ID 1" and "ID 2"). In this particular example, the header or ID is 8 bits, but this is again merely an example, and the ID portion is not limited to any particular number of bits (and in fact, Table 1 above provides examples of IDs that are alternatively 16, 20, or 24 bits).

[0376] Thus, the control circuit 12502 may sum the IDs obtained from the retrieved audio files (e.g., using binary addition) to generate a combined ID (i.e., “ID 1 + ID 2”). In addition, the control circuit 12502 may sum the audio portions obtained from the retrieved audio files (e.g., using binary addition) and then apply the scale factor represented by the third graph element 12554 to generate a unique output tone (i.e., “(Audio 1 + Audio 2) * Scale”). The concatenated combined audio and ID portions are represented by the fourth graph element 12556.

[0377] Thus, the audio output controller 12506 may be configured to be able to transmit the bit sequence of the concatenated combined audio and ID portions represented by the fourth graph element 12556 and generated using the above-described techniques to the amplifier 12508 (ignoring the ID bits when generating the output audio waveform). Thus, the audio auxiliary controller 12504 may be configured to be able to read the output of the audio output controller 12506 and ensure that the embedded ID corresponds to the combined ID of the audio files that generated the audio output. Because the audio file IDs are preselected so that each combination of IDs produces a corresponding ID that is unique to that particular combination, the audio auxiliary controller 12504 may compare the output generated by the audio output controller 12506 with the summed IDs from the appropriate audio files and ensure that the output of the audio output controller 12506 is correct for the particular combination of tones.

[0378] It should be noted that while shown and described in the context of combining two separate tones to output a unique tone and ID Fig.39The technique shown in , however, should not be construed as limited to a combination of two tones. As mentioned above, the technique is also equally applicable to a combination of three or more individual tones to generate a unique tone and ID. In addition, Fig.39 The techniques shown may be pre-generated or performed during runtime.

[0379] In one aspect, a modular energy system (e.g., Figures 24 to 37 A modular energy system) may be configured to generate an audio output that is distinguishable by an electronic system based on an identifier signal embedded within a non-audible range of the generated audio output. Thus, the modular energy system may be configured to be able to confirm that the modular energy system is playing the correct tone for a given action it is performing by isolating the identifier signal embedded within the audio output and comparing it to the correct identifier for the action. Alternatively, other systems in the vicinity of the modular energy system may be configured to be able to determine the action that the modular energy system is performing based on the identifier signal embedded within its audio output. Furthermore, the identifier signal may be embedded within a non-audible frequency range so that the auditory characteristics of the tone are not altered.

[0380] For example, Fig.40 1 is a block diagram of an audio control system 12600 for a modular energy system according to at least one aspect of the present disclosure. The audio control system 12600 includes a controller 12602 (eg, a control circuit or processor) coupled to an audio output device 12605. See further Fig.41 , which is a graph of audio level (e.g., sound intensity level that can be measured in dB) represented by the vertical axis 12652 and the frequency of the audio signal represented by the horizontal axis 12654, the controller 12602 can be configured to cause the audio output device 12605 to output an audible acoustic signal 12658, which is implemented as a tone or sound emitted based on a specific function or action taken by the modular energy system (e.g., energizing a surgical instrument). The audible acoustic signal 12658 can vary depending on the function of the modular energy system, the number and type of other tones output by the modular energy system, and various other factors, as described above. The audible acoustic signal 12658 can be output at a frequency f c The frequency f is the end point of the change within a specific frequency range. c The controller 12602 may be further configured to embed an identifier acoustic signal 12660 within the audio output having a frequency or frequency range above the hearing frequency threshold 12656 (e.g., 20 kHz). The center or fundamental frequency of the identifier acoustic signal 12660 may be located at a frequency f i At this frequency f iMay be above the auditory frequency threshold of human hearing 12656, as noted above.

[0381] In one aspect, the identifier acoustic signal 12660 may be implemented as a digital signal encoding data, such as an identifier code indicating a function performed by the modular energy system. The identifier acoustic signal 12660 may be implemented as a digital signal using a variety of different techniques. For example, Fig.42 12700, 12702, 12704 are a series of graphs 12700, 12702, 12704 representing a process for modulating a carrier wave 12712 to carry digital data. In each of the graphs 12700, 12702, 12704, the vertical axis 12706 represents the signal amplitude and the horizontal axis 12708 represents time. It should be noted that the values ​​of the vertical axis 12706 and the horizontal axis 12708 represent relative values ​​and are provided for illustrative purposes only. The first graph 12700 represents a digital signal 12710 that can be output by the controller 12602. In this example, the digital signal 12710 represents an 8-bit identifier having a value of "01010110". Therefore, the value can represent an identifier code that is unique to the action or function performed by the modular energy system. Each different action or function can be assigned a different identifier so that they can be uniquely distinguished by the modular energy system or an external system. In addition, the second graph 12702 represents a digital signal that can be at the above-mentioned frequency f i The carrier signal 12712 at frequency f can thus be modulated to encode the identifier represented by the digital signal 12710, thereby generating the modulated signal 12714 shown in the third graph 12704. i The modulation signal 12714 at may encode the identifier. In one aspect, this signal modulation technique may be performed "dynamically" by the audio control system 12600. In another aspect, the modulation signal 12714 may be pre-embedded within a file (e.g., a .wav file) for the tone, such that the modulation signal 12714 is output by the modular energy system at any time the tone file is played.

[0382] See again Fig.40 , the audio control system 12600 may further include a bandpass filter 12606 coupled to the current shunt 12604, which couples the controller 12602 to the audio output device 12605. The bandpass filter 12606 may be configured to enable the frequency f of the identifier acoustic signal 12660 to i A specific range of (i.e., f i -x to f i+y), where x and y are selected based on the desired tuning of the bandpass filter 12606. Thus, the bandpass filter 12606 may pass the modulated signal 12714 for further processing. The audio control system 12600 may also include a peak detection circuit 12608 and an auxiliary controller 12610, which are configured to detect the peak amplitude of the modulated signal 12714 for each specific time interval and thereby decode the modulated signal 12714 to determine the encoded identifier. In one aspect, the auxiliary controller 12610 may be further configured to determine the function performed by the modular energy system that is outputting the acoustic signal, compare the decoded identifier with the stored identifier assigned to the function, and then determine whether the decoded identifier corresponds to the stored identifier. If the values ​​do not correspond, this may indicate that the modular energy system and / or the audio control system 12600 is causing an incorrect tone to be output for a given modular energy system function. The auxiliary controller 12610 may then output a user warning (e.g., via the UI 2050 ( Fig.30 )), causing the controller 12602 to change the tone output via the audio output device 12605 and / or take another corrective action. Conversely, if the values ​​do correspond, this may indicate that the modular energy system and / or the audio control system 12600 is causing the correct tone to be output for a given modular energy system function. Therefore, corrective action is not necessary and the second controller 12610 does not take any corrective action. This process may be beneficial because it embeds an identifier within the audio output generated by the modular energy system without changing the auditory characteristics of the output, and a large number of digital identifiers may be encoded within the audio output (e.g., 2^n identifiers, where n is the number of bits in the digital signal 12710).

[0383] In one aspect, a modular energy system (e.g., Figures 24 to 37 The modular energy system of the invention can be configured to modulate the generated tone to have different audio levels at different times of the tone. This can be used, for example, to make the generated tone have a higher audio level at the beginning of the tone to help the user auditorily distinguish between multiple different tones activated in close proximity to each other or a continuous tone and a newly activated tone. For example, Fig.43 12750 is a graph of an audio level (e.g., a sound intensity level that can be measured in dB) of an audio signal 12755 represented by a vertical axis 12752 and time represented by a horizontal axis 12754. The audio signal 12755 can be represented by Fig.38 The audio control system 12500 shown, Fig.40 The audio control system 12600 shown or any other such control system may be generated.

[0384] In the illustrated embodiment, the control system causes the audio level of the audio signal 12755 to increase 12756 dramatically to a peak level 12757 during an initial time period from the initial activation point of the audio signal 12755 to t1. Thereafter, the control system causes the audio level to decay 12758 from time t1 to time t2 to a sustained level 12760, which is then maintained from time t2 to time t3. At time t3, when the modular energy system completes the function associated with the audio signal 12755 or the audio signal 12755 is otherwise completed, the control system then causes the audio level of the audio signal 12755 to decay 12762 to zero at time t4. For example, the control system may determine that a surgical instrument connected to the modular energy system has been activated, retrieve an appropriate audio file for a given surgical instrument type, and then cause a tone encoded by the audio file to be output at a higher audio level during an initial time period before decaying to a standard or sustained level of the tone. When the instrument is no longer activated, the control system may stop playing the tone (i.e., the audio level of the earpiece will decay to zero, such as Fig.43 12760). By causing the audio signal 12755 to reach a peak 12757 at a value higher than the sustained level 12760 during the initial time period, the control system can thus allow the user to audibly distinguish between different tones output by modular energy systems that are in close proximity to each other, because it produces a particularly recognizable initial portion of the tone that coincides with the activation of the function associated with the tone. Thus, the user can distinguish which tone corresponds to which function based on the sequence in which the user hears the initial portions of the tone. In addition, the user can distinguish between a newly activated tone and a sustained tone based on the different audio levels of the initial portions of the newly activated tone and the sustained tone.

[0385] In one aspect, an example of a modular energy system 12800 is shown in Fig.44In the embodiment of the present invention, the modular energy system can be configured to provide both audio feedback and visual feedback in coordination with each other. As described above, the modular energy system 12800 may include a head module 12808, which can be connected to one or more energy modules 12810 or other module types. The head module 12808 and the energy module 12810 can be configured to provide various types of visual feedback. For example, the head module 12808 can support or be associated with a display screen 12802, which can then display a UI 12804. The UI 12804 can then be configured to provide various information or alarms as feedback to the user, such as "check return electrode" alarms 12806a, 12806b. In addition, the energy module 12810 can include light pipe elements 12814a-e arranged around its ports 12812a-e, which can be configured to light up in various colors, flash in a specific pattern or sequence, or take other actions to convert information to the user. In one aspect, the modular energy system 12800 may be configured to generate a tone or audio signal in coordination with a UI alert, visual feedback provided by the light pipe elements 12814a-e, or other visual feedback provided by the modular energy system 12800. For example, the head module 12808 and / or the energy module 12810 may be configured to determine when visual feedback is provided, and thus cause an appropriate tone to be generated by the modular energy system 12800. The generated tone may be generated or modulated by any of the techniques described above. For example, when a "check return electrode" alert 12806a, 12806b is being displayed on the UI 12804 and / or the light pipes 12814b-d of the monopolar ports 12812b-c and the neutral electrode port 12812d is displaying an alert color indicating that there is an error in the return electrode, the modular energy system 12800 may be configured to output a "check return electrode" tone accordingly. Additionally, the "check return electrode" tone can be unique and, therefore, capable of being audibly distinguished by a user from other tones output by the modular energy system 12800 for other functions or alarms.

[0386] Example

[0387] Various aspects of the subject matter described herein are set forth in the following numbered examples:

[0388] Embodiment 1. An audio control system for a modular energy system, the audio control system comprising: an audio output device; an amplifier, the amplifier coupled to the audio output device; and a control circuit, the control circuit comprising: a first controller, the first controller coupled to the amplifier, the first controller being configured to provide an audio signal and an audio signal ID associated with the audio signal to the amplifier; wherein the amplifier is configured to generate an audio output based on the audio signal; and a second controller, the second controller coupled to the first controller, the second controller being configured to: receive the audio signal ID from the first controller; and determine whether the audio signal ID corresponds to an expected audio signal ID.

[0389] Embodiment 2. The audio control system of Embodiment 1, wherein the audio signal corresponds to a function performed by the modular energy system.

[0390] Embodiment 3. An audio control system according to Embodiment 2, wherein the function includes activation of a surgical instrument connected to the modular energy system.

[0391] Embodiment 4. The audio control system of Embodiment 2, wherein the functionality includes an alarm provided by the modular energy system.

[0392] Embodiment 5. The audio control system of any one of embodiments 1 to 4, wherein the second controller is further configured to: receive an amplifier output of the amplifier; and determine whether the amplifier output is within an expected output range of the amplifier.

[0393] Embodiment 6. The audio control system according to embodiment 5 further includes: a current shunt, which couples the amplifier to the audio output device; and a current sensing amplifier, which couples the second controller to the amplifier via the current shunt; wherein the amplifier output includes a signal representation of the audio output from the amplifier via the current shunt and the current sensing amplifier.

[0394] Embodiment 7. An audio control system for a modular energy system, the audio control system comprising: an audio output device; an amplifier, the amplifier coupled to the audio output device; and a control circuit, the control circuit coupled to the amplifier, the control circuit being configured to be able to: retrieve a first audio file corresponding to a first function of the modular energy system, the first audio file encoding a first audio signal and a first ID; retrieve a second audio file corresponding to a second function of the modular energy system, the second audio file encoding a second audio signal and a second ID; wherein the first function and the second function are performed simultaneously by the modular energy system; combine representations of the first audio signal and the second audio signal to generate a third audio signal; combine the first ID and the second ID to generate a third ID; wherein the third ID is unique to the third audio signal; and provide the third audio signal and the third ID to the amplifier for generating an audio output based on the third audio signal.

[0395] Embodiment 8. An audio control system according to Embodiment 7, wherein the control circuit comprises: a first controller, the first controller being configured to provide the third audio signal and the third ID to the amplifier; and a second controller, the second controller being coupled to the first controller, the second controller being configured to: receive the third ID from the first controller; and determine whether the third ID is consistent with the expected audio signal ID.

[0396] Embodiment 9. An audio control system according to embodiment 7 or 8, wherein the control circuit includes: a first controller, the first controller is coupled to the amplifier; and a second controller, the second controller is coupled to the first controller, and the second controller is configured to be able to: receive the amplifier output of the amplifier; and determine whether the amplifier output is within the expected output range of the amplifier.

[0397] Embodiment 10. The audio control system according to embodiment 9 further includes: a current shunt, which couples the amplifier to the audio output device; and a current sensing amplifier, which couples the second controller to the amplifier via the current shunt; wherein the amplifier output includes a signal representation of the audio output from the amplifier via the current shunt and the current sensing amplifier.

[0398] Embodiment 11. An audio control system according to any one of Embodiments 7 to 10, wherein: the first function includes a first activation of a first surgical instrument connected to the modular energy system; and the second function includes a second activation of a second surgical instrument connected to the modular energy system.

[0399] Embodiment 12. An audio control system according to any one of Embodiments 7 to 11, wherein: the first function includes activation of a surgical instrument connected to the modular energy system; and the second function includes an alarm provided by the modular energy system.

[0400] Embodiment 13. An audio control system according to any one of Embodiments 7 to 12, wherein the first ID and the second ID are selected from a group of IDs, wherein the sum of the numerical values ​​of any one of the IDs in the group of IDs is not equal to any one of the IDs in the group of IDs.

[0401] Embodiment 14. An audio control system according to any one of Embodiments 7 to 13, wherein the control circuit is configured to be able to: sum the representations of the first audio signal and the second audio signal; and apply a scaling factor to the sum to generate the third audio signal.

[0402] Embodiment 15. An audio control system for a modular energy system, the audio control system comprising: an audio output device; and a control circuit, the control circuit being coupled to the audio output device, the control circuit being configured to: cause the audio output device to emit a tone based on a function of the modular energy system, the tone comprising an audio signal encoding an identifier corresponding to the function; wherein the audio signal is at a frequency above a human hearing frequency threshold; receive the tone emitted by the audio output device; separate the audio signal from the tone; decode the identifier from the separated audio signal; and determine whether the decoded identifier corresponds to a stored identifier of the function.

[0403] Embodiment 16. An audio control system according to embodiment 15, wherein the control circuit includes: a bandpass filter, which is configured to separate the audio signal from the tone; a peak detection circuit, which is configured to determine the peak of the separated audio signal; and an auxiliary controller, which is configured to: decode the identifier from the audio signal; and determine whether the decoded identifier corresponds to the stored identifier of the function.

[0404] Embodiment 17. An audio control system according to Embodiment 15 or 16, wherein the function includes activation of a surgical instrument connected to the modular energy system.

[0405] Embodiment 18. The audio control system of any one of Embodiments 15 to 17, wherein the functionality includes an alarm provided by the modular energy system.

[0406] Embodiment 19. The audio control system of any one of Embodiments 15 to 18, wherein the audio signal comprises a modulated carrier signal encoding a digital signal corresponding to the identifier.

[0407] Although multiple forms have been illustrated and described, it is not the intention of the applicant to restrict or limit the scope of the appended claims to such details. Without departing from the scope of the present disclosure, many modifications, variations, changes, substitutions, combinations and equivalents to these forms can be realized, and those skilled in the art will think of many modifications, variations, changes, substitutions, combinations and equivalents to these forms. In addition, alternatively, the structure of each element associated with the described form can be described as a device for providing the function performed by the element. In addition, in the case of disclosing materials for certain parts, other materials can also be used. Therefore, it should be understood that the above-mentioned specific embodiments and the appended claims are intended to cover all such modifications, combinations and variations within the scope of the forms disclosed by the present invention. The appended claims are intended to cover all such modifications, variations, changes, substitutions, modifications and equivalents.

[0408] The above specific embodiments have been described in various forms of devices and / or methods using block diagrams, flow charts and / or examples. As long as such block diagrams, flow charts and / or examples contain one or more functions and / or operations, those skilled in the art will understand that each function and / or operation in such block diagrams, flow charts and / or examples can be implemented individually and / or collectively by a variety of hardware, software, firmware or any combination thereof. Those skilled in the art will recognize that some aspects of the forms disclosed herein can be implemented equivalently in integrated circuits as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or as any combination thereof, in whole or in part, and according to the present disclosure, designing circuit systems and / or writing software and / or hardware codes will be within the technical scope of those skilled in the art. In addition, those skilled in the art will recognize that the mechanisms of the subject matter described herein can be distributed as one or more program products in a variety of forms, and the illustrative forms of the subject matter described herein are applicable, regardless of the specific type of signal-bearing medium used to actually distribute.

[0409] Instructions for programming logic to perform various disclosed aspects may be stored in a memory in the system, such as a dynamic random access memory (DRAM), a cache, a flash memory, or other memory. In addition, the instructions may be distributed via a network or by other computer-readable media. Therefore, a machine-readable medium may include any mechanism for storing or transmitting information in a machine (e.g., computer) readable form, but is not limited to a floppy disk, an optical disk, a compact disk read-only memory (CD-ROM), and a magneto-optical disk, a read-only memory (ROM), a random access memory (RAM), an erasable programmable read-only memory (EPROM), an electrically erasable programmable read-only memory (EEPROM), a magnetic card or an optical card, a flash memory, or a tangible, machine-readable storage device used when transmitting information on the Internet via an electrical signal, an optical signal, an acoustic signal, or other form of propagation signal (e.g., a carrier wave, an infrared signal, a digital signal, etc.). Therefore, a non-transitory computer-readable medium includes any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a machine (e.g., computer) readable form.

[0410] As used in any aspect of this document, the term "control circuitry" may refer to, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor including one or more separate instruction processing cores, a processing unit, a processor, a microcontroller, a microcontroller unit, a controller, a digital signal processor (DSP), a programmable logic device (PLD), a programmable logic array (PLA), a field programmable gate array (FPGA)), state machine circuitry, firmware that stores instructions executed by the programmable circuitry, and any combination thereof. The control circuitry may be implemented collectively or individually as circuitry that forms part of a larger system, such as an integrated circuit (IC), an application specific integrated circuit (ASIC), a system on a chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, a smart phone, etc. Thus, as used herein, "control circuitry" includes, but is not limited to, electronic circuitry having at least one discrete circuit, electronic circuitry having at least one integrated circuit, electronic circuitry having at least one application specific integrated circuit, electronic circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program to at least partially implement the methods and / or devices described herein, or a microprocessor configured by a computer program to at least partially implement the methods and / or devices described herein), electronic circuitry forming a memory device (e.g., forming a random access memory), and / or electronic circuitry forming a communication device (e.g., a modem, a communication switch, or an optoelectronic device). Those skilled in the art will recognize that the subject matter described herein may be implemented in analog or digital form, or some combination thereof.

[0411] As used in any aspect of this document, the term "logic" may refer to an application, software, firmware, and / or circuitry configured to perform any of the foregoing operations. Software may be embodied as a software package, code, instructions, instruction sets, and / or data recorded on a non-transitory computer-readable storage medium. Firmware may be embodied as code, instructions, instruction sets, and / or data hard-coded (e.g., non-volatile) in a memory device.

[0412] As used in any aspect of this document, the terms "component," "system," "module" and the like may refer to a comput...

Claims

1. An audio control system for a modular energy system, the audio control system comprising: Audio output device; an amplifier coupled to the audio output device; as well as A control circuit, the control circuit comprising: a first controller coupled to the amplifier, the first controller being configured to provide an audio signal and an audio signal ID associated with the audio signal to the amplifier; wherein the amplifier is configured to generate an audio output based on the audio signal; as well as A second controller, the second controller is coupled to the first controller, the second controller is configured to: receiving the audio signal ID from the first controller; and A determination is made as to whether the audio signal ID corresponds to an expected audio signal ID.

2. The audio control system according to claim 1, wherein: The audio signal corresponds to a function performed by the modular energy system.

3. The audio control system according to claim 2, wherein: The function includes activation of a surgical instrument connected to the modular energy system.

4. The audio control system according to claim 2, wherein: The functionality includes alarms provided by the modular energy system.

5. The audio control system according to claim 1, wherein: The second controller is further configured to: receiving an output of the amplifier; and A determination is made as to whether the output of the amplifier is within an expected output range of the amplifier.

6. The audio control system of claim 5, further comprising: a current shunt coupling the amplifier to the audio output device; as well as a current sense amplifier coupling the second controller to the amplifier via the current shunt; Wherein the output of the amplifier comprises a signal representative of the audio output from the amplifier via the current shunt and the current sense amplifier.

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