Suture reload detection and identification

Abstract

The invention is entitled Stapler Re-Load Detection and Identification. Surgical devices, systems, and related methods provide for automatic assessment of surgical instrument status. A surgical device is configured to staple tissue via a replaceable stapler cartridge. The surgical device includes a pusher member configured to articulate the stapler cartridge to deploy a staple. The surgical device includes an actuation mechanism that articulates the pusher member and a control unit configured to control operation of the actuation mechanism to attempt to move the pusher member from a first position to a second position subject to an output limit of the actuation mechanism and determine a property of the stapler cartridge based on an amount of movement of the pusher member achieved. The determined property can represent a type of stapler cartridge selected from different stapler cartridges, whether the stapler cartridge has been fired, or that no stapler cartridge is installed to the surgical device.

Description

[0001] This application is a divisional application. The original application was filed on September 8, 2017, with application number 201780053949.X (PCT / US2017 / 050747), and the invention title was "Detection and Identification of Stitcher Reloading".

[0002] Cross-references to related applications

[0003] This application claims the benefit of U.S. Provisional Application No. 62 / 385,649, filed September 9, 2016, the entire disclosure of which is incorporated herein by reference for all purposes. Background Technology

[0004] Minimally invasive surgical techniques aim to reduce the amount of foreign tissue damaged during diagnosis or surgery, thereby reducing patient recovery time, discomfort, and adverse side effects. Therefore, the use of minimally invasive surgical techniques can significantly shorten the average hospital stay for standard surgeries. Furthermore, minimally invasive surgery can reduce patient recovery time, patient discomfort, surgical side effects, and absence from work.

[0005] A common form of minimally invasive surgery is endoscopy, and a common form of endoscopy is laparoscopy, which is a minimally invasive examination and surgery within the abdominal cavity. In a standard laparoscopic procedure, the patient's abdomen is inflated, and a cannula is passed through a small incision (about half an inch or less) to provide an entry port for laparoscopic instruments.

[0006] Laparoscopic surgical instruments typically consist of an endoscope (e.g., a laparoscope) for viewing the surgical area and tools for working at the surgical site. The working tools are generally similar to those used in conventional (open) surgery, except that the working end or end effector of each tool is separated from its handle by an extension tube (also called, for example, an instrument shaft or spindle). End effectors may include, for example, clamps, grippers, scissors, suture devices, cauterization tools, linear cutters, or needle hubs.

[0007] To perform the surgical procedure, the surgeon inserts a working instrument through a cannula to the internal surgical site and manipulates it from the outside of the abdomen. The surgeon views the procedure on a monitor that displays images of the surgical site obtained through the endoscope. Similar endoscopic techniques are used for procedures such as arthroscopy, retroperitoneal laparoscopy, pelvicoscopy, nephroscopy, cystoscopy, proctoscopy, nasal endoscopic surgery, hysteroscopy, and urethroscopy.

[0008] Minimally invasive remote surgical robotic systems are being developed to increase surgeon flexibility when working at the surgical site and allow surgeons to operate on patients from remote locations (outside of sterile areas). In remote surgical systems, images of the surgical site are typically provided to the surgeon at a console. While viewing a three-dimensional image of the surgical site on a suitable observer or monitor, the surgeon performs the surgical procedure on the patient by manipulating the main inputs or controls of the console. Each of the main input devices controls the movement of servo-mechanically actuated / articulated surgical instruments. During the surgical procedure, the remote surgical system is capable of providing mechanical actuation and control of a variety of surgical instruments or tools having end effectors that perform various functions for the surgeon in response to manipulation of the main input devices (e.g., gripping or driving needles, grasping blood vessels, dissecting tissue, etc.).

[0009] Surgical clamping and cutting instruments (e.g., non-robotic linear clamping, suturing, and cutting devices, also known as surgical sutures; and electrosurgical vascular closure devices) have been used in many different surgical procedures. For example, surgical sutures can be used to remove cancerous or abnormal tissue from the gastrointestinal tract. Many known surgical clamping and cutting devices (including known surgical sutures) have opposing jaws for clamping tissue and a hinged blade for cutting the clamped tissue.

[0010] Many surgical clamping and cutting instruments include an end effector supported by an instrument shaft, to which a replaceable stapler cassette is mounted. The actuation mechanism articulates the stapler cassette to deploy / unploy staples from the cassette for suturing tissue clamped between the stapler cassette and the articulated claws of the end effector. Different types of staplers are available with different staple lengths suitable for different tissues to be sutured.

[0011] However, the use of replaceable stapler cassettes does introduce some additional problems. For example, a suitable stapler cassette with the correct staple length should be installed on the end effector before use. If a stapler cassette with an inappropriate staple length is incorrectly installed on the end effector, the tissue will be sutured with inappropriate staples if the error is not detected and corrected before suturing. As another example, if a previously used stapler cassette is not replaced with a suitable new one, the tissue sandwiched between the previously used stapler cassette and the articulated claw cannot be sutured due to the lack of staples to be deployed. Similar problems arise if no stapler cassette is installed on the end effector.

[0012] Therefore, there is a need for an improved surgical system, surgical apparatus, and related methods that can be configured to suture tissue, which, prior to use, checks whether a suitable stapler cassette is installed on the clamping and suturing surgical instruments. Preferably, the improved surgical system, surgical apparatus, and related methods check whether the stapler cassette is installed on the surgical instruments, whether the installed stapler cassette is new or has been fired, and the type of stapler cassette installed, to ensure that the installed stapler cassette has the appropriate staple length for the tissue to be sutured. Summary of the Invention

[0013] Improved surgical systems, surgical devices, and related methods are provided for configuring tissue suturing by checking the installation of a suitable suture cassette onto the surgical instrument before use. In many embodiments, the improved surgical systems, surgical devices, and related methods check whether the suture cassette is installed, whether the suture cassette is new or has been fired, and the type of suture cassette to ensure that a suture cassette with an appropriate suture length is installed. By verifying that a suitable unfired suture cassette is installed onto the surgical instrument before attempting to suture the tissue, inappropriate tissue suturing can be reduced.

[0014] Therefore, in one aspect, a method is provided for evaluating the operational state of a surgical instrument used to suture tissue via a replaceable stapler cassette. The method includes operating, under the control of a control unit, an actuation mechanism tractively coupled to a pusher member to attempt to move the pusher member from a first position to a second position subject to an output limit of the actuation mechanism. If the output limit of the actuation mechanism is exceeded during the attempt to move the pusher member from the first position to the second position, the movement of the pusher member is interrupted. The control unit determines a parameter representing the amount of movement of the pusher member achieved during the attempt to move the pusher member from the first position to the second position. Based on this parameter, the control unit determines the operational state of the surgical instrument associated with the replaceable stapler cassette.

[0015] In many embodiments, the method includes detecting whether no replaceable stapler cartridge has been installed on the surgical instrument. For example, in response to the pusher member reaching the second position during an attempt to move the pusher member from a first position to a second position, the control unit determining the operating state based on the parameters may include determining that no replaceable stapler cartridge has been installed on the surgical instrument.

[0016] In many embodiments, the method includes detecting whether a replaceable stapler cartridge is mounted to the surgical instrument. For example, in response to the pusher component stopping at a stop position due to exceeding the output limit of the actuation mechanism during an attempt to move the pusher component from a first position to a second position, determining the operating state by the control unit based on the parameters may include determining that the replaceable stapler cartridge is mounted to the surgical instrument.

[0017] In many embodiments, the method includes detecting whether a replaceable stapler cartridge mounted to a surgical instrument has been fired. For example, in response to a pusher member stopping at a stop position within an initial range of motion between a first and a second position due to exceeding the output limit of the actuation mechanism during an attempt to move the pusher member from a first position to a second position, the control unit determining the operating state based on the parameters may include determining that the replaceable stapler cartridge mounted to the surgical instrument has been fired.

[0018] In many embodiments, the method includes detecting whether a replaceable stapler cartridge mounted to a surgical instrument has not yet been fired. For example, in response to a pusher member stopping at a stop position outside the initial range of motion between the first and second positions due to exceeding the output limit of the actuation mechanism during an attempt to move the pusher member from a first position to a second position, the control unit determining the operating state based on the parameters may include determining that the replaceable stapler cartridge mounted to the surgical instrument has not yet been fired.

[0019] In many embodiments, the method includes determining the type of replaceable stapler cassette mounted to the surgical instrument. For example, in response to a pusher member stopping at a stop position outside the initial range of motion between the first and second positions due to exceeding the output limit of the actuation mechanism during an attempt to move the pusher member from a first position to a second position, the control unit determining the operating state based on the parameters may include determining the type of replaceable stapler cassette mounted to the surgical instrument from a variety of types of replaceable stapler cassettes.

[0020] In many embodiments, the method further includes operating an actuation mechanism to move the actuator member to a third position further away from the first position, subject to a second output limit of the actuation mechanism that is greater than the output limit of the actuation mechanism itself. Movement of the actuator member can be interrupted if the second output limit of the actuation mechanism is exceeded during an attempt to move the actuator member to the third position.

[0021] The method can include operating an actuation mechanism under the control of a control unit to position the pusher member at the first position before attempting to move the pusher member from the first position to the second position. For example, operating the actuation mechanism to position the pusher member at the first position before attempting to move the pusher member from the first position to the second position may include moving the pusher member away from the second position to contact a portion of a surgical instrument that is blocking further movement of the pusher member away from the second position.

[0022] The method can include constraining the staple pusher of the replaceable staple cassette with a body of the replaceable staple cassette. Constraining the staple pusher to the body can be used to: (a) position the staple pusher relative to the body of the replaceable staple cassette; and / or (b) suppress displacement of the staple pusher relative to the body of the replaceable staple cassette when the replaceable staple cassette contacts the pusher member during an attempt to move the pusher member from a first position to a second position.

[0023] In another aspect, a surgical system is provided that can be configured to suture tissue via a replaceable stapler cassette. The surgical system includes an end effector, a pusher member, an elongated shaft, a proximal chassis, a manipulator, an actuation mechanism, and a control unit. The end effector is configured to mount a replaceable stapler cassette to the end effector. The pusher member is configured to push a staple shuttle included in the replaceable stapler cassette to deploy staples from the replaceable stapler cassette. The end effector is mounted at the distal end of the elongated shaft. The proximal chassis supports the proximal end of the elongated shaft and includes an actuation input drivenly coupled to the pusher member. The proximal chassis can be mounted to the manipulator. The manipulator includes an actuation output configured to be drivenly coupled to the actuation input. The actuation mechanism is drivenly coupled to the actuation output. The control unit is configured to: (a) control the operation of the actuation mechanism to hinge the actuation output in order to attempt to move the pusher member from a first position to a second position under the constraint of the output limit of the actuation mechanism, wherein the movement of the pusher member is interrupted if the output limit of the actuation mechanism is exceeded; (b) determine a parameter representing the amount of movement of the pusher member achieved during the attempt to move the pusher member from the first position to the second position; and (c) determine the operating state of the surgical instrument associated with the replaceable stapler cartridge based on the parameter.

[0024] In many embodiments, the surgical system is configured to detect whether a replaceable stapler cartridge has been installed into the surgical instrument. For example, the control unit may be configured to determine that no replaceable stapler cartridge has been installed into the surgical instrument in response to the pusher member reaching the second position during an attempt to move the pusher member from a first position to a second position.

[0025] In many embodiments, the surgical system is configured to detect whether a replaceable stapler cartridge is installed on the surgical instrument. For example, the control unit may be configured to determine that a replaceable stapler cartridge is installed on the surgical instrument in response to the pusher member stopping at a stop position due to exceeding the output limit of the actuation mechanism during an attempt to move the pusher member from a first position to a second position.

[0026] In many embodiments, the surgical system is configured to detect whether a replaceable stapler cartridge mounted to a surgical instrument has been fired. For example, the control unit may be configured to determine that a replaceable stapler cartridge mounted to a surgical instrument has been fired in response to a stop position being within an initial range of motion between a first position and a second position.

[0027] In many embodiments, the surgical system is configured to detect whether a replaceable stapler cartridge mounted to the surgical instrument has not yet been fired. For example, the control unit may be configured to determine that the replaceable stapler cartridge mounted to the surgical instrument has not been fired in response to a stop position being outside the initial range of motion between a first position and a second position.

[0028] In many embodiments, the surgical system is configured to detect the type of replaceable stapler cassette that is mounted to the surgical instrument. For example, the control unit may be configured to determine the type of replaceable stapler cassette mounted to the surgical instrument based on parameters from a variety of replaceable stapler cassette types.

[0029] In many embodiments of the surgical system, the actuation mechanism is operatively subject to a second output limit of the actuation mechanism that is greater than the output limit of the actuation mechanism. For example, the control unit may be configured to operate the actuation mechanism to move the actuator member to a third position further away from the first position than the second position, subject to a second output limit of the actuation mechanism that is greater than the output limit of the actuation mechanism, wherein the movement of the actuator member is interrupted if the second output limit of the actuation mechanism is exceeded.

[0030] In many embodiments of the surgical system, the control unit is configured to operate an actuation mechanism to position the pusher member at the first position before attempting to move the pusher member from the first position to the second position. For example, the control unit may be configured to operate the actuation mechanism to move the pusher member away from the second position to contact a portion of a surgical instrument that prevents further movement of the pusher member away from the second position, thereby positioning the pusher member at the first position.

[0031] In many embodiments of the surgical system, the replaceable stapler cartridge includes a staple shuttle and a body that constrains the staple shuttle. For example, the staple shuttle can be constrained via the body to: (a) position the staple shuttle relative to the body of the replaceable stapler cartridge; and / or (b) suppress displacement of the staple shuttle relative to the body of the replaceable stapler cartridge when the replaceable stapler cartridge contacts the pusher member during an attempt to move the pusher member from a first position to a second position.

[0032] In another aspect, a surgical system is provided, configured to suture tissue via a replaceable stapler cassette. The surgical apparatus includes an end effector, a pusher assembly, an actuation mechanism, and a control unit. The end effector is configured to mount the replaceable stapler cassette to the end effector. The pusher assembly is configured to hinge the replaceable stapler cassette to deploy staples from the replaceable stapler cassette. The actuation mechanism is operatively coupled to the pusher assembly. The control unit is configured to: (a) control the operation of the actuation mechanism to attempt to move the pusher member from a first position to a second position under the constraint of the output limit of the actuation mechanism, wherein the movement of the pusher member is interrupted if the output limit of the actuation mechanism is exceeded; and (b) determine the properties of the suture cassette based on the amount of movement of the pusher member achieved during the attempt to move the pusher member from the first position to the second position, the determined properties of the suture cassette indicating: (1) the type of suture cassette selected from a variety of suture cassette types; (2) whether the suture cassette has been fired; or (3) no suture cassette is mounted on the end effector.

[0033] To gain a more complete understanding of the nature and advantages of this invention, reference should be made to the following detailed description and accompanying drawings. Other aspects, objects, and advantages of the invention will become apparent from the following drawings and detailed description. Attached Figure Description

[0034] Figure 1 This is a plan view of a minimally invasive robotic surgical system for performing surgery, according to many embodiments.

[0035] Figure 2 This is a perspective view of a surgeon's console for a robotic surgical system, according to many embodiments.

[0036] Figure 3 This is a perspective view of an electronic trolley for a robotic surgical system according to many embodiments.

[0037] Figure 4 A robotic surgical system according to many embodiments is illustrated schematically.

[0038] Figure 5A This is a front view of a patient-side trolley (surgical robot) of a robotic surgical system according to many embodiments.

[0039] Figure 5B This is a front view of a robotic surgical tool according to many embodiments.

[0040] Figure 6 This is a perspective view of a robotic surgical tool including an end effector with opposing grippers, according to many embodiments.

[0041] Figure 7This is a cross-sectional side view of the end effector of a surgical instrument having a mounted stapler cartridge, according to many embodiments.

[0042] Figure 8 yes Figure 7 A top view of the main body of the sewing machine staple box.

[0043] Figure 9 This is a partial cross-sectional side view of a stapler box with relatively long staples according to many embodiments.

[0044] Figure 10 This is a partial cross-sectional side view of a stapler cassette with relatively short staples according to many embodiments.

[0045] Figure 11 According to many embodiments Figure 7 A top view of the proximal portion of the main body of the stapler cartridge, showing a pawl feature that engages with the staple push shuttle to control the starting position of the stapler cartridge push shuttle.

[0046] Figure 12 The nominal positional relationship between the pusher component of an end effector and the staple pusher shuttle of a first type of stapler cassette is shown according to many embodiments.

[0047] Figure 13 The nominal positional relationship between the pusher component of the end effector according to many embodiments and the suture needle shuttle of the second type of suture needle box is shown.

[0048] Figure 14 The nominal positional relationship between the pusher component of the end effector and the staple pusher shuttle of the third type of stapler cassette is shown according to many embodiments.

[0049] Figure 15 The nominal positional relationship between the pusher component of the end effector and the staple pusher shuttle of the fourth type of stapler cassette is shown according to many embodiments.

[0050] Figure 16 The nominal positional relationship between the pusher component of the end effector and the staple pusher shuttle of the fifth type of stapler cassette is shown according to many embodiments.

[0051] Figure 17 The nominal positional relationship between the pusher component of the end effector and the blocking spring clip of the stitcher cassette is shown according to many embodiments.

[0052] Figure 18 This is a simplified block diagram of the actions of a method for evaluating the operational status of surgical instruments used for suturing tissue, according to many embodiments. Detailed Implementation

[0053] In the following description, various embodiments of the invention will be described. Specific configurations and details are set forth for illustrative purposes to provide a thorough understanding of the embodiments. However, it will be apparent to those skilled in the art that the invention can be practiced without these specific details. Furthermore, well-known features may be omitted or simplified so as not to obscure the described embodiments.

[0054] Minimally invasive robotic surgical system

[0055] Referring now to the accompanying drawings, in which the same reference numerals indicate the same parts in several views. Figure 1 This is a plan view of a minimally invasive robotic surgical (MIRS) system 10, typically used to perform minimally invasive diagnostic or surgical procedures on a patient 12 lying on an operating table 14. The system can include a surgeon's console 16 used by a surgeon 18 during the procedure. One or more assistants 20 may also participate in the procedure. The MIRS system 10 may also include a patient-side trolley 22 (surgical robot) and an electronic trolley 24. While the surgeon 18 views the surgical site via the console 16, the patient-side trolley 22 can manipulate at least one removably coupled tool assembly 26 (hereinafter referred to as "tool") through a minimally invasive incision in the patient 12's body. Images of the surgical site can be obtained via an endoscope 28 (such as a stereoscopic endoscope), which can be manipulated by the patient-side trolley 22 to orient the endoscope 28. The electronic trolley 24 can be used to process the images of the surgical site for subsequent display to the surgeon 18 via the surgeon's console 16. The number of surgical tools 26 used at one time will typically depend on the diagnostic or surgical procedure and space constraints within the operating room, as well as other factors. If it is necessary to replace one or more of the tools 26 in use during the procedure, the assistant 20 may remove the tool 26 from the patient-side trolley 22 and replace it with another tool 26 from the tray 30 in the operating room.

[0056] Figure 2 This is a perspective view of the surgeon's console 16. The surgeon's console 16 includes a left-eye display 32 and a right-eye display 34 for presenting the surgeon 18 with a coordinated stereoscopic view of the surgical site, enabling depth perception. The console 16 also includes one or more input controls 36, which in turn cause the patient-side trolley 22 ( Figure 1 (As shown) manipulate one or more tools. Input control device 36 can provide the associated tool 26 (as shown) Figure 1The same degrees of freedom (as shown in the diagram) are used to provide the surgeon with a remote presentation or sensation that integrates the input control device 36 with the tool 26, so that the surgeon has a strong awareness of direct control over the tool 26. For this purpose, position, force, and tactile feedback sensors (not shown) can be used to transmit the position, force, and tactile sensation from the tool 26 back to the surgeon's hand via the input control device 36.

[0057] The surgeon's console 16 is typically located in the same room as the patient, allowing the surgeon to directly monitor the procedure, be physically present if necessary, and speak directly with assistants rather than via telephone or other communication media. However, the surgeon may be located in a different room, a completely different building, or another remote location far from the patient, thus allowing for remote surgical procedures.

[0058] Figure 3 This is a perspective view of the electronic trolley 24. The electronic trolley 24 can be coupled to the endoscope 28 and can include a processor to process the captured images for subsequent display to the surgeon, such as on a surgeon's console, or on another suitable display, locally and / or remotely. For example, in the case of using a stereoscopic endoscope, the electronic trolley 24 can process the captured images to present the surgeon with a coordinated stereoscopic image of the surgical site. Such coordination can include alignment between relative images and can include adjusting the stereoscopic working distance of the stereoscopic endoscope. As another example, image processing can include compensating for imaging errors of the image capture device, such as optical aberrations, using previously determined camera calibration parameters.

[0059] Figure 4 A robotic surgical system 50 (such as...) is schematically shown. Figure 1 The MIRS system 10). As described above, the surgeon's console 52 (such as...) Figure 1 The surgeon's console 16) can be used by the surgeon to control the patient-side trolley (surgical robot) 54 (such as...) during minimally invasive procedures. Figure 1 The patient-side trolley 22). The patient-side trolley 54 is capable of using imaging devices such as stereoscopic endoscopes to capture images of the procedure site and output the captured images to an electronic trolley 56 (such as...). Figure 1(Electronic trolley 24 in the image). As described above, the electronic trolley 56 can process captured images in various ways before any subsequent display. For example, the electronic trolley 56 can overlay the captured images with a virtual control interface before displaying the combined images to the surgeon via the surgeon's console 56. The patient-side trolley 54 can output captured images for processing outside the electronic trolley 56. For example, the patient-side trolley 54 can output captured images to a processor 58, which can be used to process the captured images. Images can also be processed in combination with the electronic trolley 56 and the processor 58, which can be coupled together to process captured images jointly, sequentially, and / or in a combined manner of joint and sequential processing. One or more separate displays 60 can also be coupled to the processor 58 and / or the electronic trolley 56 for local and / or remote display of images (such as images of process sites or other relevant images).

[0060] Figure 5A and Figure 5B Patient-side trolley 22 and surgical instruments 62 are shown separately. Surgical instrument 62 is an example of surgical instrument 26. The patient-side trolley 22 shown provides manipulation of the three surgical instruments 26 and imaging devices 28 (such as a stereoscopic endoscope for capturing images of the site of the procedure). Maneuvering is provided by a robotic mechanism with multiple robotic joints. Imaging devices 28 and surgical instruments 26 can be positioned and manipulated through an incision in the patient's body such that the kinematic remote center is maintained at the incision to minimize the incision size. Images of the surgical site can include images of the surgical instruments 26 when their distal ends are positioned within the field of view of imaging devices 28.

[0061] Figure 6 A surgical instrument 70 is shown, comprising a proximal chassis 72, an instrument shaft 74, and a distal actuator 76 with a claw 78 capable of being hinged to clamp patient tissue. The proximal chassis includes an input connector configured to engage and be driven by a corresponding output connector of a patient-side trolley 22. The input connector is drivably connected to a drive shaft disposed within the instrument shaft 74. The drive shaft is drivably connected to the end effector 76.

[0062] Automatic assessment of stapler cartridge status

[0063] Figure 7This is a cross-sectional side view of an end effector 76 of a surgical instrument having a mounted staple cassette 84 according to many embodiments. The staple cassette 84 is replaceable, for example, by removing a used staple cassette from the end effector 76 and installing a new staple cassette into the end effector 76. The end effector 76 includes a hinged anvil 86 configured to form the free end of a staple deployed from the staple cassette 84 and through tissue sandwiched between the staple cassette 84 and the anvil 86. The staple cassette 84 includes a staple cassette body 88 for receiving staples and a staple pusher 90, which is distally hinged along the staple cassette body 88 for pushing staples out of the staple cassette body 88 to pass through and suture tissue sandwiched between the staple cassette body 88 and the anvil 86. The staple pusher 90 has an inclined portion 92 that is aligned with an inclined staple pusher 94 (e.g., Figure 9 and Figure 10 (As shown) engagement, with movement relative to the suture needle shuttle 90, laterally ejects the suture needle pusher and suture needle from the suture needle holder body 88. The end effector 76 includes a pusher member 96 operably coupled to the actuation mechanism via a push rod 98. An initial distal hinge of the pusher member 96 allows it to contact the suture needle shuttle 90. A further distal hinge of the pusher member 96 allows it to distally push the suture needle shuttle 90 along the suture needle holder body 88, thereby forcing the suture needle away from the suture needle holder body 88. The pusher member 96 is movable between a proximal limit position where it contacts a portion of the end effector but not the suture needle shuttle 90, and a position where it contacts the suture needle shuttle 90. As described herein, the distance between the proximal limit position and the position where the pusher member 96 initially contacts the suture needle shuttle 90 can vary depending on the length of the suture needle in the installed suture needle cartridge 84 and can be used to detect which type of suture needle cartridge 84 is installed on the end effector 76.

[0064] Figure 8 This is a top view of an embodiment of the stapler cassette body 88. The stapler cassette body 88 has an array of staple receiving holes 100 in which staples and associated staple pushers are housed and deployed from the staple receiving holes 100 via a staple pusher shuttle 90, which is hinged distally along the stapler cassette body 88. The stapler cassette body 88 also has a central guide channel 102 and side guide channels 104, which receive and guide complementary shape features of the staple pusher shuttle 90 during distal hinge along the stapler cassette body 88. The central guide channel 102 also receives the pusher member 96 during distal hinge along the stapler cassette body 88.

[0065] In many embodiments, the initial position of the staple pusher 90 along the stapler cassette body 88 is variable and serves to identify the type of stapler cassette being installed (e.g., the staple length of the installed stapler cassette). Specifically, for shorter staples, the staple pusher 90 may be positioned more distally along the stapler cassette body 88 compared to longer staples because the staple pusher for the shorter staples does not interact with the distal portion of the inclined portion 92 of the staple pusher 90. For example, as Figure 9 As shown, the initial position of the staple pusher 90 must be proximal enough to allow the distal portion of the inclined section 92 to interact with the nearest staple pusher 94 for the longest staple. In contrast, as Figure 10 As shown, with Figure 9 Compared to the longer suture staples shown, the initial position of the suture staple pusher 90 can be further distal for the shorter suture staples because the suture staple pusher 94 can be positioned closer to the top of the suture staple holder 88, thereby accommodating the distal portion of the suture staple pusher 90 below the nearest suture staple pusher 94.

[0066] Figure 11 This is a top view of the proximal portion of an embodiment of the stapler cartridge body 88. The side guide channel 104 has a pawl feature 106 that engages with a pawl feature of a complementary shape to that of the staple pusher 90 to control the initial position of the staple pusher 90 along the stapler cartridge body 88. In many embodiments, the pawl feature 106 is used to position the staple pusher 90 at a corresponding known position along the stapler cartridge body 88 for each type of stapler cartridge 84, wherein each type of stapler cartridge 84 has a corresponding staple length. The stapler cartridge body 88 also has a reusable stop spring clip mounting area 108, shaped to receive and support a reusable stop spring clip 110. Figures 12 to 17 (as shown in the image).

[0067] Figures 12 to 16 The diagram illustrates the corresponding nominal positional relationships between the pusher member 96 (located proximally to contact a portion of the end effector 76) and the suture pusher shuttle 90 for five different types of suture cassettes, each having five different suture lengths. In many embodiments, the pusher member 96 is hinged to measure an initial distance between the pusher member 96 and the suture pusher shuttle 90, and this measured initial distance is evaluated to determine the type of suture cassette to be mounted to the end effector 76. Figures 12 to 16Also shown is a reusable stop spring clip 110 in a pre-use configuration in which a portion of a staple pusher 90 is disposed between the reusable stop spring clips 110 to separate the reusable stop spring clips 110, thereby accommodating the distal hinge of a pusher member 96 between the reusable stop spring clips 110 to push the staple pusher 90 distally to deploy the staple.

[0068] Figure 12 A first type of suture staple box 84-1 with the longest staple length is shown. Figure 12 In the diagram, the staple shuttle 90-1 is shown positioned at an initial location and fixed relative to the staple cassette body 88-1 via engagement between a pawl feature 106 on the staple cassette body 88-1 and a pawl feature of complementary shape to the interface of the staple shuttle 90-1. In the first type of staple cassette 84-1, the pusher member 96 is positioned at a first nominal distance (x1) from the staple shuttle 90-1.

[0069] Figure 13 The second type of stapler cassette 84-2 is shown, which has a larger size than the one shown in the original text. Figure 12 The first type of suture staple box 84-1 shown has a shorter staple length. Figure 13 In the diagram, the staple shuttle 90-2 is shown positioned initially and fixed relative to the staple cassette body 88-2 via engagement between the pawl feature 106 of the staple cassette body 88-2 and the pawl feature of the staple shuttle 90-2, which are complementary in shape to the interface of the staple shuttle 90-2. In the second type of staple cassette, the pusher member 96 is positioned at a second nominal distance (x2) from the staple shuttle 90-2. The second nominal distance (x2) is appropriately larger than the first nominal distance (x1) so that the first type of staple cassette 84-1 and the second type of staple cassette 84-2 can be reliably distinguished based on the initial distance measured between the pusher member 96 and the staple shuttle 90-2.

[0070] Figure 14 The third type of stapler cassette 84-3 is shown, which has a larger... Figure 13 The second type of suture cassette 84-2 shown has a shorter suture staple length. Figure 14In this design, the staple shuttle 90-3 is shown positioned initially and fixed relative to the staple cassette body 88-3 via engagement between the pawl feature 106 of the staple cassette body 88-3 and the pawl feature of the staple shuttle 90-3, which are complementary in shape to the interface of the staple shuttle 90-3. In the third type of staple cassette, the pusher member 96 is positioned at a third nominal distance (x3) from the staple shuttle 90-3. The third nominal distance (x3) is appropriately larger than the second nominal distance (x2) so that the second type of staple cassette 84-2 and the third type of staple cassette 84-3 can be reliably distinguished based on the initial distance measured between the pusher member 96 and the staple shuttle 90-3.

[0071] Figure 15 The fourth type of stapler cassette 84-4 is shown, which has a larger... Figure 14 The third type of suture cassette 84-3 shown has a shorter suture staple length. Figure 15 In this design, the staple shuttle 90-4 is shown positioned initially and fixed relative to the staple cassette body 88-4 via engagement between the pawl feature 106 of the staple cassette body 88-4 and the pawl feature of the staple shuttle 90-4, which are complementary in shape to the interface of the staple shuttle 90-4. In the fourth type of staple cassette, the pusher member 96 is positioned at a fourth nominal distance (x4) from the staple shuttle 90-4. The fourth nominal distance (x4) is appropriately larger than the third nominal distance (x3) such that the third type of staple cassette 84-3 and the fourth type of staple cassette 84-4 can be reliably distinguished based on the initial distance measured between the pusher member 96 and the staple shuttle 90-4.

[0072] Figure 16 The fifth type of stapler cassette 84-5 is shown, which has a larger... Figure 15 The fourth type of suture staple box 84-4 shown has a shorter staple length. Figure 16 In this design, the staple shuttle 90-5 is shown positioned initially and fixed relative to the staple cassette body 88-5 via engagement between the pawl feature 106 of the staple cassette body 88-5 and the pawl feature of the staple shuttle 90-5, which are complementary in shape to the interface of the staple shuttle 90-5. In the fifth type of staple cassette, the pusher member 96 is positioned at a fifth nominal distance (x5) from the staple shuttle 90-5. This fifth nominal distance (x5) is greater than the fourth nominal distance (x4) by a suitable distance, such that the fourth type of staple cassette 84-4 and the fifth type of staple cassette 84-5 can be reliably distinguished based on the initial distance measured between the pusher member 96 and the staple shuttle 90-5.

[0073] Figure 17This diagram illustrates the nominal positional relationship between the pusher member 96 (located proximal to contact a portion of the end effector 76) and the reusable stop spring clip 110 when the previously used suture cassette (84-in use) is installed onto the end effector 76. Figure 17 In the process, because the stapler cassette (84-used) was previously used, the stapler pusher member 90 has been hinged distally, thus no longer keeping the reusable stop spring clip 110 separated, causing the reusable stop spring clip 110 to have been released from... Figures 12 to 16 The pre-use configuration shown in each of the examples is reconfigured to Figure 17 The post-use configuration is shown. In the post-use configuration, the reusable stop spring clip 110 prevents the pusher member 96 from hinged distally. When a previously used stapler cartridge (84-used) is installed in the end effector, the pusher member 96 is set in the post-use configuration at a post-use nominal distance (x0) from the reusable stop spring clip 110. The post-use nominal distance (x0) is appropriately smaller than the first nominal distance (x1) so that the previously used stapler cartridge (84-used) and the first type of stapler cartridge 84-1 can be reliably distinguished based on the initial distance measured between the pusher member 96 and the stapler pusher shuttle 90-1 or the reusable stop spring clip 110.

[0074] In many embodiments, the systems, apparatus, and methods described herein include detecting when no stapler cassette is installed to the end effector. When no stapler cassette is installed to the end effector, due to the absence of an installed stapler cassette, the pusher member 96 (positioned proximally to contact a portion of the end effector 76) undergoes an initial distal hinge (from proximal positioning to contact a portion of the end effector 76) without contact with the reusable stop spring clip 110 or the stapler pusher shuttle 90. Therefore, when the pusher member 96 has been hinged to a distance equal to or greater than the distance of the missing stapler cassette (xm), it can be determined that no stapler cassette is installed to the end effector 76. The distance of the missing stapler cassette (xm) can be appropriately larger than the fifth nominal distance (x5) to reliably distinguish between the missing stapler cassette and the fifth type of stapler cassette 84-5.

[0075] Figure 18 This is a simplified block diagram of the operation of a method 200 for evaluating the operational status of surgical instruments used for suturing tissue, according to many embodiments. Although method 200 is described herein with respect to the surgical system and surgical apparatus described herein, method 200 can be practiced using any suitable surgical system or surgical apparatus.

[0076] In action 200, the actuation mechanism is operated to position the pusher member 96 at a known first position. Any suitable known first position can be used. For example, in many embodiments, the actuation mechanism is operated to retract the pusher member 96 proximally to contact the portion of the end effector 76 where the stapler cartridge 84 is mounted. The actuation mechanism can then be operated to hinge the pusher member 96 distally from the known first position to measure the distance from the known first position to the stapler shuttle 90 or the reusable stop spring clip 110 for evaluating the operational status of the surgical instrument. As another example, the actuation mechanism can be operated to hinge the pusher member 96 distally to contact the stapler shuttle 90 or the reusable stop spring clip 110. The actuation mechanism can then be operated to retract the pusher member 96 proximally to measure the distance from the known first position to the position where the pusher member 96 contacts a portion of the end effector 76 for evaluating the operational status of the surgical instrument based on the distance the pusher member 96 has been hinged through. The first position can also be located at any suitable known distance from a portion of the end effector 76, the stitching shuttle 90, or the reusable stop spring clip 110.

[0077] In action 204, the operation of the actuation mechanism is restricted to prevent accidental displacement of the staple pusher 90. For example, in many embodiments, the actuation mechanism is operated such that only a limited force is applied to the pusher member 96 via the actuation rod 98, such that the pusher member 96 cannot apply sufficient force to the staple pusher 90 to disengage the staple pusher 90 from the pawl feature 106 of the stapler cassette body 88.

[0078] In action 206, the actuation mechanism is operated to move the pusher member 96 from a first position to a second position. Further movement of the pusher member 96 away from the first position is inhibited due to contact with a portion of the surgical instrument mounted to or deviating from the stapler cassette 84. In many embodiments, the actuation mechanism is monitored to determine operating parameters of the actuation mechanism representing the amount of movement of the pusher member 96 from the first position to the second position.

[0079] In action 208, the attributes of the stapler cassette 84 are selected based on the amount of movement of the pusher member 96 from the first position to the second position. For example, the attributes of the stapler cassette 84 can be selected based on the operating parameters of the actuation mechanism that represent the amount of movement of the pusher member 96 from the first position to the second position. The selected attribute of the stapler cassette 84 can be the type of stapler cassette (e.g., the staple length of the cassette), whether the stapler cassette has been used, or whether no stapler cassette has been installed on the end effector.

[0080] Other variations are within the spirit of the invention. For example, while five different types of stapler cassettes are described herein, any suitable number of stapler cassette types may be used, including fewer and more than the five types described. Therefore, although the invention is readily adaptable to various modifications and alternative constructions, certain illustrated embodiments are shown in the accompanying drawings and have been described in detail above. However, it should be understood that the invention is not intended to be limited to the specific forms or forms disclosed, but rather, its purpose is to cover all modifications, alternative constructions, and equivalents falling within the spirit and scope of the invention as defined in the appended claims.

[0081] Unless otherwise stated herein or obviously contradicted by the context, the terms “a / an” and “the” and similar indicators used in the context of describing the invention (particularly in the context of the following claims) should be interpreted to cover both singular and plural. Unless otherwise indicated, the terms “comprising,” “having,” “including,” and “containing” should be interpreted as open-ended terms (i.e., meaning “including but not limited to”). The term “connected” should be interpreted as partially or wholly included, attached to, or combined, even with some intermediate elements. Unless otherwise stated herein, the description of numerical ranges herein is intended only as a shorthand method of individually referencing each individual value falling within that range, and each individual value is incorporated into this specification as if it were individually described herein. Unless otherwise stated herein or obviously contradicted by the context, all methods described herein can be performed in any suitable order. Unless otherwise claimed, the use of any and all examples or exemplary language (e.g., “such as”) provided herein is intended only to better illustrate embodiments of the invention and does not constitute a limitation on the scope of the invention. No language in this specification should be construed as indicating any unclaimed element that is essential to the practice of this invention.

[0082] This document describes preferred embodiments of the invention, including the best mode known to the inventors for carrying out the invention. Variations of those preferred embodiments will become apparent to those skilled in the art upon reading the foregoing description. The inventors expect those skilled in the art to appropriately employ such variations, and the inventors desire that the invention be practiced in ways other than those specifically described herein. Therefore, the invention includes all modifications and equivalents of the subject matter described in the appended claims as permitted by applicable law. Furthermore, unless otherwise stated herein or the context clearly contradicts it, the invention covers any combination of the foregoing elements with all possible variations.

[0083] All references cited in this article (including publications, patent applications and patents) are incorporated herein by reference to the same extent that each reference is individually and specifically cited and fully elaborated in this article.

Claims

1. A system comprising: A manipulator configured to have an instrument mounted thereon, the instrument including an end effector configured to mount a staple cartridge to the end effector, and a pusher member configured to hinge a staple pusher shuttle in the staple cartridge to deploy staples from the staple cartridge; An actuating mechanism, which is drivably connected to the actuator component; and The control unit is configured as follows: Operate the actuation mechanism to move the pusher member from a first position to a second position, wherein the pusher member contacts a portion of the suture cassette or a portion of the end effector; Based on the operating parameters of the actuation mechanism, the amount of movement of the pusher component from the first position to the second position is determined; as well as Based on the amount of movement, determine the operating state of the instrument associated with the stapler cartridge; The operation state is selected from the group consisting of the following items: The type of stapler cassette is selected from the various types of stapler cassettes; Whether the stapler cartridge has been fired; and No stapler box was installed on the end effector.

2. The system of claim 1, wherein the portion of the stapler cartridge is a staple pusher or a reusable blocking clip.

3. The system of claim 1, wherein further movement of the pusher member is inhibited due to contact between the pusher member and the portion of the suture cassette or the portion of the end effector.

4. The system of claim 1, wherein the force limitation restricts the amount of force that the actuation mechanism can apply, preventing the pusher member from disengaging from the portion of the suture cassette.

5. The system according to any one of claims 1 to 4, wherein the control unit is further configured to determine that the stapler cartridge is mounted to the end effector based on the amount of movement corresponding to a nominal distance associated with the stapler cartridge type.

6. The system according to any one of claims 1 to 4, wherein the control unit is further configured to determine the type of the stapler cassette based on the amount of movement corresponding to a nominal distance associated with the corresponding stapler cassette type.

7. The system according to any one of claims 1 to 4, wherein the control unit is further configured to determine that the stapler cartridge mounted to the end effector has been fired in response to the amount of movement being less than a nominal distance associated with all stapler cartridge types.

8. The system according to any one of claims 1 to 4, wherein the control unit is further configured to operate the actuation mechanism to position the pusher member in the first position before operating the actuation mechanism to move the pusher member from the first position to the second position.

9. The system of claim 8, wherein the control unit is further configured to operate the actuation mechanism to move the pusher member away from the second position and into contact with a portion of the instrument, the portion of the instrument preventing the pusher member from moving further away from the second position, so as to position the pusher member in the first position.

10. The system according to any one of claims 1 to 4, wherein the control unit is further configured to determine that no stapler cartridge is installed to the end effector when the amount of movement of the pusher member is equal to or greater than the missing staple cartridge distance before reaching the second position.

11. A control unit for evaluating the operational status of an instrument associated with a stapler cartridge, wherein the control unit is configured to: An actuation mechanism is drivenly coupled to the actuator component of the instrument to move the actuator component from a first position to a second position, in which the actuator component contacts a portion of a stapler cartridge mounted to the end effector of the instrument or a portion of the end effector; Based on the operating state of the actuation mechanism, the amount of movement of the pusher component from the first position to the second position is determined; as well as Based on the amount of movement, determine the operating state of the instrument associated with the stapler cartridge; The operation state is selected from the group consisting of the following items: The type of stapler cassette is selected from the various types of stapler cassettes; Whether the stapler cartridge has been fired; and No stapler box was installed on the end effector.

12. The control unit of claim 11, wherein said portion of the stapler cartridge is a staple pusher or a reusable blocking clip.

13. The control unit of claim 11, wherein further movement of the pusher member is suppressed due to contact between the pusher member and the portion of the suture cassette or the portion of the end effector.

14. The control unit of claim 11, wherein force limitation restricts the amount of force that the actuation mechanism can apply, preventing the pusher member from disengaging from the portion of the suture cassette.

15. The control unit according to any one of claims 11 to 14, wherein the control unit is further configured to: Based on the amount of movement corresponding to a nominal distance associated with the stapler cartridge type, the installation of the stapler cartridge to the end effector is determined; or The type of the stapler cassette is determined based on the amount of movement corresponding to a nominal distance associated with the corresponding stapler cassette type; or In response to the movement being less than the nominal distance associated with all stapler cartridge types, it is determined that the stapler cartridge mounted on the end effector has been fired.

16. The control unit according to any one of claims 11 to 14, wherein the control unit is further configured to operate the actuation mechanism to position the pusher member in the first position before operating the actuation mechanism to move the pusher member from the first position to the second position.

17. The control unit according to any one of claims 11 to 14, wherein the control unit is further configured to determine that no stapler cassette is installed to the end effector when the amount of movement of the pusher member is equal to or greater than the missing stapler cassette distance before reaching the second position.

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