Control program for modular combined energy plant

Abstract

A surgical instrument includes a housing, a shaft assembly, a processor, and a memory. The shaft assembly is replaceably connected to the housing. The surgical assembly includes an end effector. The memory is configured to store program instructions that, when executed from the memory, cause the processor to: send an electrical query signal to an attached shaft assembly; receive a response signal from the attached shaft assembly; cause a default function to be performed when the attached shaft assembly does not receive the response signal; determine an identifying characteristic of the attached shaft assembly as a result of the performance of the default function; and modify a control program based on the identifying characteristic of the attached shaft assembly.

Description

[0001] Cross Reference to Related Applications

[0002] This non-provisional application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application Serial No. 62 / 955,299, entitled “DEVICES AND SYSTEMS FOR ELECTROSURGERY,” filed December 30, 2019, the disclosure of which is incorporated by reference herein in its entirety. BACKGROUND

[0003] The present disclosure relates to surgical instruments designed to treat tissue, including but not limited to surgical instruments configured to both cut and fasten tissue. The surgical instruments can include electrosurgical instruments that are powered by a generator to effect tissue dissection, cutting, and / or coagulation during a surgical procedure. The surgical instruments can include instruments configured to cut tissue and sew tissue using surgical staples and / or fasteners. The surgical instruments can be configured for use in open surgical procedures, but can also be applied in other types of surgical procedures such as laparoscopic, endoscopic, and robotic-assisted procedures and can include end effectors that are articulatable relative to a shaft portion of the instrument to facilitate precise positioning within a patient. SUMMARY

[0004] In various embodiments, a surgical instrument is disclosed that includes a housing, a shaft assembly, a processor, and a memory. The shaft assembly is replaceably connected to the housing. The surgical assembly includes an end effector. The memory is configured to store program instructions that, when executed from the memory, cause the processor to: send an electrical query signal to an attached shaft assembly; receive a response signal from the attached shaft assembly; cause a default function to be performed when the attached shaft assembly does not receive the response signal; determine an identifying characteristic of the attached shaft assembly as a result of the performance of the default function; and modify a control program based on the identifying characteristic of the attached shaft assembly.

[0005] In various embodiments, a surgical instrument is disclosed that includes a housing, a shaft assembly, a processor, and a memory. The shaft assembly is replaceably connected to the housing. The surgical assembly includes an end effector. The memory is configured to store program instructions that, when executed from the memory, cause the processor to: send an electrical query signal to an attached shaft assembly; receive a response signal from the attached shaft assembly; cause a default function to be performed when the attached shaft assembly does not receive the response signal; determine an identifying characteristic of the attached shaft assembly as a result of the performance of the default function; and modify a control program based on the identifying characteristic of the attached shaft assembly.

[0006] In various embodiments, a surgical instrument is disclosed that includes a housing, a shaft assembly, a processor, and a memory. The shaft assembly is interchangeably coupled to the housing. The surgical assembly includes an end effector. The memory is configured to store program instructions that, when executed from the memory, cause the processor to: send an interrogation signal to the shaft assembly coupled to the housing; receive a response signal from the shaft assembly coupled to the housing; cause a default end effector function to be performed upon failing to discern the response signal; determine an identifying feature of the shaft assembly coupled to the housing as a result of the performance of the default end effector function; and modify a control program based on the identifying feature of the shaft assembly coupled to the housing. BRIEF DESCRIPTION OF DRAWINGS

[0007] The novel features of the various aspects are set forth with particularity in the appended claims. These aspects, together with their equivalents, can be best understood from the following description in conjunction with the accompanying drawings, in which:

[0008] Figure 1 An example of a generator for use with a surgical system is shown in accordance with at least one aspect of the present disclosure;

[0009] Figure 2 One form of a surgical system including a generator and an electrosurgical instrument that can be used with the generator is shown in accordance with at least one aspect of the present disclosure;

[0010] Figure 3 A block diagram of a surgical instrument or tool is shown in accordance with at least one aspect of the present disclosure;

[0011] Figure 4 is a perspective view of a surgical system including a surgical instrument and a display monitor in accordance with at least one embodiment, wherein the surgical instrument includes a display screen;

[0012] Figure 5 is a perspective view of a surgical system including a surgical instrument and a display monitor in accordance with at least one embodiment, wherein the surgical instrument includes a display screen; Figure 4 is a schematic diagram of a display screen of a surgical instrument and a corresponding view of a display monitor in accordance with at least one embodiment;

[0013] Figure 6 is a schematic diagram of a display screen of a surgical instrument and a corresponding view of a display monitor in accordance with at least one embodiment; Figure 4 is a schematic diagram of a display screen of a surgical instrument and a corresponding view of a display monitor in accordance with at least one embodiment;

[0014] Figure 7 is a schematic diagram of a display screen of a surgical instrument and a corresponding view of a display monitor in accordance with at least one embodiment; Figure 4 is a schematic diagram of a display screen of a surgical instrument and a corresponding view of a display monitor in accordance with at least one embodiment;

[0015] Figure 8 is a schematic diagram of a display screen of a surgical instrument and a corresponding view of a display monitor in accordance with at least one embodiment;Figure 4 schematic illustration of a display screen of a surgical instrument and a corresponding view of a display monitor;

[0016] Figure 9 is a schematic illustration of a display screen of a surgical instrument and a corresponding view of a display monitor in accordance with at least one embodiment; Figure 4 schematic illustration of a display screen of a surgical instrument and a corresponding view of a display monitor;

[0017] Figure 10 is a graphical depiction of a relationship between total effective energy delivered by one or more generators of a surgical system and a duty cycle from a motor of a smoke evacuator in accordance with at least one embodiment;

[0018] Figure 11 is a schematic illustration of a surgical system including a surgical hub, a combination electrosurgical instrument powered by a plurality of generators, a smoke evacuating system, and a display in accordance with at least one embodiment;

[0019] Figure 12 is a graphical depiction of a relationship between power provided by one or more generators of a surgical system over time and impedance of treated tissue over time in accordance with at least one embodiment;

[0020] Figure 13 is a schematic illustration of a communication pathway of a surgical system including a surgical hub, a smoke evacuating device, a surgical instrument, a first generator configured to supply power to a first operation of the surgical instrument, and a second generator configured to supply power to a second operation of the surgical instrument in accordance with at least one embodiment;

[0021] Figure 14 is a schematic illustration of a surgical system including a surgical hub and a plurality of robotic arms configured to receive tools thereon in accordance with at least one embodiment, wherein the surgical system includes an authentication module configured to permit the tools to be attached to and / or used with the surgical system;

[0022] Figure 15 is a schematic illustration of a surgical system positioned within a treatment room in accordance with at least one embodiment;

[0023] Figure 16 is a chart depicting various operational parameters and / or specifications of a surgical instrument at various stages of a surgical procedure in accordance with at least one embodiment;

[0024] Figure 17 is Figure 16 is a front view of a surgical instrument of

[0025] Figure 18 is Figure 16The image is shown as a front view of a surgical instrument that delivers bipolar and monopolar energy to patient tissue in a second time.

[0026] Figure 19 yes Figure 16 The image is shown as a front view of a surgical instrument that delivers monopolar energy to patient tissue at a fourth time.

[0027] Figure 20 yes Figure 16 Graphical representation of the various operating parameters and / or specifications of surgical instruments at each stage of surgical procedures;

[0028] Figure 21 It is a graphical representation of tissue impedance measured during the duration of a surgical procedure according to at least one embodiment;

[0029] Figure 22 It is a schematic diagram representing strain calculation according to at least one embodiment, wherein the applied strain is calculated using the gap defined between the jaws of the end effector when the end effector is in an open configuration;

[0030] Figure 23 It means Figure 22 A schematic diagram of strain calculation, in which the calculated applied strain exceeds the actual applied strain when the patient tissue is not in contact with or between the jaws of the end effector.

[0031] Figure 24 It is a schematic diagram representing the calculation of tissue impedance according to at least one embodiment, wherein tissue impedance is calculated using the gap defined between the jaws of the end effector when the jaws of the end effector contact the patient tissue located therebetween;

[0032] Figure 25 It is a graphical representation of the relationship between motor current and jaw gap over time according to at least one embodiment;

[0033] Figure 26 It is a schematic diagram of a network according to at least one embodiment, the network being formed by surgical instruments and cloud-based storage media;

[0034] Figure 27 It is based on Figure 26 A graphical representation of the relationship between the change in jaw gap determined by the network and the clamping current of the jaw motor;

[0035] Figure 28 It is based on Figure 26 A graphical representation of the relationship between generator power and time determined by the network;

[0036] Figure 29is a graphical representation of the relationship between the activation cycle of a surgical instrument according to at least one embodiment and the impedance measured when the end effector of the surgical instrument is in a closed configuration and no patient tissue is located therebetween;

[0037] Figure 30 is a graphical representation of the relationship between tissue conductivity, jaw aperture size, and jaw motor force during a jaw clamping cycle according to at least one embodiment; and

[0038] Figure 31 is a graphical representation of a user inputted jaw closure speed and a jaw closure speed based on the user input and monitored parameters according to at least one embodiment. DETAILED DESCRIPTION

[0039] Applicant of the present application owns the following U.S. Patent Applications that were filed on even date herewith and which are each herein incorporated by reference in their respective entireties:

[0040] • Attorney Docket No. END9234USNP1 / 190717-1M, entitled METHOD FOR AN ELECTROSURGICAL PROCEDURE;

[0041] • Attorney Docket No. END9234USNP2 / 190717-2, entitled ARTICULATABLE SURGICAL INSTRUMENT;

[0042] • Attorney Docket No. END9234USNP3 / 190717-3, entitled SURGICAL INSTRUMENT WITH JAW ALIGNMENT FEATURES;

[0043] • Attorney Docket No. END9234USNP4 / 190717-4, entitled SURGICAL INSTRUMENT WITH ROTATABLE AND ARTICULATABLE SURGICAL END EFFECTOR;

[0044] • Attorney Docket No. END9234USNP5 / 190717-5, entitled ELECTROSURGICAL INSTRUMENT WITH ASYNCHRONOUS ENERGIZING ELECTRODES;

[0045] • Attorney Docket No. END9234USNP6 / 190717-6, entitled ELECTROSURGICAL INSTRUMENT WITH ELECTRODES BIASING SUPPORT;

[0046] • Attorney Docket No. END9234USNP7 / 190717-7, entitled ELECTROSURGICAL INSTRUMENT WITH FLEXIBLE WIRING ASSEMBLIES;

[0047] • Attorney Docket No. END9234USNP8 / 190717-8, entitled ELECTROSURGICAL INSTRUMENT WITH VARIABLE CONTROL MECHANISMS;

[0048] • Attorney Docket No. END9234USNP9 / 190717-9, entitled ELECTROSURGICAL SYSTEMS WITH INTEGRATED AND EXTERNAL POWER SOURCES;

[0049] • Attorney Docket No. END9234USNP10 / 190717-10, entitled ELECTROSURGICAL INSTRUMENTS WITH ELECTRODES HAVING ENERGY FOCUSING FEATURES;

[0050] • Attorney Docket No. END9234USNP11 / 190717-11, entitled ELECTROSURGICAL INSTRUMENTS WITH ELECTRODES HAVING VARIABLE ENERGY DENSITIES;

[0051] • Attorney Docket No. END9234USNP12 / 190717-12, entitled ELECTROSURGICAL INSTRUMENT WITH MONOPOLAR AND BIPOLAR ENERGY CAPABILITIES;

[0052] • Attorney Docket No. END9234USNP13 / 190717-13, entitled ELECTROSURGICAL END EFFECTORS WITH THERMALLY INSULATIVE AND THERMALLY CONDUCTIVE PORTIONS;

[0053] • Attorney Docket No. END9234USNP14 / 190717-14, entitled ELECTROSURGICAL INSTRUMENT WITH ELECTRODES OPERABLE IN BIPOLAR AND MONOPOLAR MODES;

[0054] • Attorney Docket No. END9234USNP15 / 190717-15, entitled ELECTROSURGICAL INSTRUMENT FOR DELIVERING BLENDED ENERGY MODALITIES TO TISSUE;

[0055] • Attorney Docket No. END9234USNP16 / 190717-16, entitled CONTROL PROGRAM ADAPTATION BASED ON DEVICE STATUS AND USER INPUT; and

[0056] • Attorney Docket No. END9234USNP18 / 190717-18, entitled SURGICAL SYSTEM COMMUNICATION PATHWAYS.

[0057] Applicant of the present application owns the following U.S. Provisional Patent Applications that were filed on December 30, 2019, the disclosure of each of which is herein incorporated by reference in its entirety:

[0058] • U.S. Provisional Patent Application Serial No. 62 / 955,294, entitled USER INTERFACE FOR SURGICAL INSTRUMENT WITH COMBINATION ENERGY MODALITY END-EFFECTOR;

[0059] • U.S. Provisional Patent Application Serial No. 62 / 955,292, entitled COMBINATION ENERGY MODALITY END-EFFECTOR; and

[0060] • U.S. Provisional Patent Application Serial No. 62 / 955,306, entitled SURGICAL INSTRUMENT SYSTEMS.

[0061] The Applicant of the present application owns the following U.S. Patent Applications that are each herein incorporated by reference in their respective entireties:

[0062] • U.S. Patent Application Serial No. 16 / 209,395, entitled METHOD OF HUB COMMUNICATION, now U.S. Patent Application Publication No. 2019 / 0201136;

[0063] • U.S. Patent Application Serial No. 16 / 209,403, entitled METHOD OF CLOUD BASED DATA ANALYTICS FOR USE WITH THE HUB, now U.S. Patent Application Publication No. 2019 / 0206569;

[0064] • U.S. Patent Application Serial No. 16 / 209,407, entitled METHOD OF ROBOTIC HUB COMMUNICATION, DETECTION, AND CONTROL, now U.S. Patent Application Publication No. 2019 / 0201137;

[0065] • U.S. Patent Application Serial No. 16 / 209,416, entitled METHOD OF HUB COMMUNICATION, PROCESSING, DISPLAY, AND CLOUD ANALYTICS, now U.S. Patent Application Publication No. 2019 / 0206562;

[0066] • U.S. Patent Application Serial No. 16 / 209,423, entitled METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS, now U.S. Patent Application Publication No. 2019 / 0200981;

[0067] • U.S. Patent Application Serial No. 16 / 209,427, titled METHOD OF USING REINFORCED FLEXIBLE CIRCUITS WITH MULTIPLE SENSORS TO OPTIMIZE PERFORMANCE OF RADIO FREQUENCY DEVICES, now U.S. Patent Application Publication No. 2019 / 0208641;

[0068] • U.S. Patent Application Serial No. 16 / 209,433, titled METHOD OF SENSING PARTICULATE FROM SMOKE EVACUATED FROM A PATIENT, ADJUSTING THE PUMP SPEED BASED ON THE SENSED INFORMATION, AND COMMUNICATING THE FUNCTIONAL PARAMETERS OF THE SYSTEM TO THE HUB, now U.S. Patent Application Publication No. 2019 / 0201594;

[0069] • U.S. Patent Application Serial No. 16 / 209,447, titled METHOD FOR SMOKE EVACUATION FOR SURGICAL HUB, now U.S. Patent Application Publication No. 2019 / 0201045;

[0070] • U.S. Patent Application Serial No. 16 / 209,453, titled METHOD FOR CONTROLLING SMART ENERGY DEVICES, now U.S. Patent Application Publication No. 2019 / 0201046;

[0071] • U.S. Patent Application Serial No. 16 / 209,458, titled METHOD FOR SMART ENERGY DEVICE INFRASTRUCTURE, now U.S. Patent Application Publication No. 2019 / 0201047;

[0072] • U.S. Patent Application Serial No. 16 / 209,465, titled METHOD FOR ADAPTIVE CONTROL SCHEMES FOR SURGICAL NETWORK CONTROL AND INTERACTION, now U.S. Patent Application Publication No. 2019 / 0206563;

[0073] • U.S. Patent Application Serial No. 16 / 209,478, titled METHOD FOR SITUATIONAL AWARENESS FOR SURGICAL NETWORK OR SURGICAL NETWORK CONNECTED DEVICE CAPABLE OF ADJUSTING FUNCTION BASED ON A SENSED SITUATION OR USAGE, now U.S. Patent Application Publication No. 2019 / 0104919;

[0074] • U.S. Patent Application Serial No. 16 / 209,490, titled METHOD FOR FACILITY DATA COLLECTION AND INTERPRETATION, now U.S. Patent Application Publication No. 2019 / 0206564;

[0075] • U.S. Patent Application Serial No. 16 / 209,491, titled METHOD FOR CIRCULAR STAPLER CONTROL ALGORITHM ADJUSTMENT BASED ON SITUATIONAL AWARENESS, now U.S. Patent Application Publication No. 2019 / 0200998;

[0076] • U.S. Patent Application Serial No. 16 / 562,123, titled METHOD FOR CONSTRUCTING AND USING A MODULAR SURGICAL ENERGY SYSTEM WITH MULTIPLE DEVICES;

[0077] • U.S. Patent Application Serial No. 16 / 562,135, titled METHOD FOR CONTROLLING AN ENERGY MODULE OUTPUT;

[0078] • U.S. Patent Application Serial No. 16 / 562,144, titled METHOD FOR CONTROLLING A MODULAR ENERGY SYSTEM USER INTERFACE; and

[0079] • U.S. Patent Application Serial No. 16 / 562,125, titled METHOD FOR COMMUNICATING BETWEEN MODULES AND DEVICES IN A MODULAR SURGICAL SYSTEM.

[0080] Before the various aspects of the electrosurgical system are described in detail, it should be noted that the illustrative examples are not limited in application or use to the details of construction and arrangement of parts illustrated in the drawings and description. The illustrative examples can be implemented or incorporated in other aspects, variations and modifications and can be practiced or carried out in various ways. Further, unless otherwise indicated, the terms and expressions employed herein have been chosen for the purpose of describing the illustrative examples and are not to be taken in a limiting sense. Also, it is to be understood that one or more of the following-described aspects, expressions of aspects, and / or examples can be combined with any one or more of the other following-described aspects, expressions of aspects and / or examples.

[0081] Various aspects relate to electrosurgical systems that include electrosurgical instruments that are powered by a generator to effect tissue dissection, cutting, and / or coagulation during a surgical procedure. In one aspect, these electrosurgical instruments can be configured for use in open surgical procedures, but can also be applied to other types of surgical procedures, such as laparoscopic, endoscopic, and robotic-assisted procedures.

[0082] As described in greater detail below, the electrosurgical instruments generally include a shaft having a distally mounted end effector (e.g., one or more electrodes). The end effector can be positioned against tissue such that electrical current is introduced into the tissue. The electrosurgical instruments can be configured for bipolar or monopolar operation. During bipolar operation, electrical current is introduced into and returned from the tissue by active and return electrodes of the end effector, respectively. During monopolar operation, electrical current is introduced into the tissue by an active electrode of the end effector and returned through a return electrode (e.g., a grounding pad) that is separately positioned on the patient’s body. The heat generated by the electrical current flowing through the tissue can form a hemostatic seal within and / or between the tissue and can thus be particularly suitable for sealing blood vessels, among other things.

[0083] Figure 1An example of a generator 900 configured to deliver multiple energy modalities to a surgical instrument is shown. The generator 900 provides RF signals and / or ultrasonic signals for energy delivery to a surgical instrument. The generator 900 includes at least one generator output that can deliver multiple energy modalities (e.g., ultrasonic, bipolar or monopolar RF, irreversible and / or reversible electroporation, and / or microwave energy, among others) through a single port, and these signals can be delivered to an end effector to treat tissue, either alone or simultaneously. The generator 900 includes a processor 902 coupled to a waveform generator 904. The processor 902 and the waveform generator 904 are configured to generate multiple signal waveforms based on information stored in a memory coupled to the processor 902, which is not shown for clarity of the present disclosure. Digital information associated with a waveform is provided to the waveform generator 904, which includes one or more DAC circuits to convert the digital input into an analog output. The analog output is fed to an amplifier 906 for signal conditioning and amplification. The conditioned and amplified output of the amplifier 906 is coupled to a power transformer 908. The signal is coupled through the power transformer 908 to the secondary side in the patient isolation side. A first signal of a first energy modality is provided to a surgical instrument between terminals labeled ENERGY1 and RETURN. A second signal of a second energy modality is coupled across a capacitor 910 and is provided to a surgical instrument between terminals labeled ENERGY2 and RETURN. It will be appreciated that more than two energy modalities can be output, and thus the subscript "n" can be used to designate that up to n ENERGY n terminals can be provided, where n is a positive integer greater than 1. It will also be appreciated that up to "n" return paths RETURN n may be provided without departing from the scope of the present disclosure.

[0084] The first voltage sense circuit 912 is coupled across the terminals labeled ENERGY1 and RETURN path to measure the output voltage between the two. The second voltage sense circuit 924 is coupled across the terminals labeled ENERGY2 and RETURN path to measure the output voltage between the two. As shown, the current sense circuit 914 is disposed in series with the RETURN leg of the secondary side of the power transformer 908 to measure the output current for either energy modality. If different return paths are provided for each energy modality, a separate current sense circuit should be provided in each return leg. The outputs of the first and second voltage sense circuits 912, 924 are provided to respective isolation transformers 928, 922, and the output of the current sense circuit 914 is provided to another isolation transformer 916. The outputs of the isolation transformers 916, 928, 922 on the primary side of the power transformer 908 (non-patient isolated side) are provided to one or more ADC circuits 926. The digitized outputs of the ADC circuits 926 are provided to the processor 902 for further processing and computation. The output voltage and current feedback information can be employed to regulate the output voltage and current provided to the surgical instrument, and to compute output impedance and other parameters. Input / output communication between the processor 902 and the patient isolated circuitry is provided through the interface circuit 920. Sensors can also be in electrical communication with the processor 902 through the interface circuit 920.

[0085] In one aspect, the impedance can be determined by the processor 902 by dividing the output of the first voltage sense circuit 912 coupled across the terminals labeled ENERGY1 / RETURN or the second voltage sense circuit 924 coupled across the terminals labeled ENERGY2 / RETURN by the output of the current sense circuit 914 disposed in series with the RETURN leg of the secondary side of the power transformer 908. The outputs of the first and second voltage sense circuits 912, 924 are provided to separate isolation transformers 928, 922, and the output of the current sense circuit 914 is provided to another isolation transformer 916. The digitized voltage and current sense measurements from the ADC circuits 926 are provided to the processor 902 for computation of impedance. For example, the first energy modality ENERGY1 can be RF monopolar energy, and the second energy modality ENERGY2 can be RF bipolar energy. However, other energy modalities include ultrasound energy, irreversible and / or reversible electroporation, and / or microwave energy, among others, in addition to bipolar and monopolar RF energy modalities. Also, although the illustrated example shows that a single return path RETURN can be provided for two or more energy modalities, in other aspects, multiple return paths RETURN can be provided for each energy modality ENERGY Figure 1 The illustrated example shows that a single return path RETURN can be provided for two or more energy modalities, but in other aspects, multiple return paths RETURN can be provided for each energy modality ENERGY n The illustrated example shows that a single return path RETURN can be provided for two or more energy modalities, but in other aspects, multiple return paths RETURN can be provided for each energy modality ENERGY n .

[0086] like Figure 1 As shown, 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 the end effector in one or more energy modes (such as ultrasound, bipolar or monopolar RF, irreversible and / or reversible electroporation and / or microwave energy, etc.) depending on the type of tissue treatment being performed. For example, the generator 900 may deliver energy with higher voltage and lower current to drive an ultrasound transducer, with lower voltage and higher current to drive an RF electrode for sealing tissue, or with a coagulation waveform for point coagulation using monopolar or bipolar RF electrosurgical electrodes. 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. In one example, the connection between the RF bipolar electrode and the output of the generator 900 would preferably be located between the outputs labeled ENERGY2 and RETURN. In the case of unipolar output, the preferred connection would be an active electrode (e.g., a pencil or other probe) to the ENERGY2 output and a suitable return pad connected to the RETURN output.

[0087] Additional details are disclosed in U.S. Patent Application Publication 2017 / 0086914, entitled “TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICALINSTRUMENTS”, published on March 30, 2017, the entire contents of which are incorporated herein by reference.

[0088] Figure 2 One form of a surgical system 1000 is shown, comprising a generator 1100 and various surgical instruments 1104, 1106, and 1108 that can be used with the generator, wherein surgical instrument 1104 is an ultrasonic surgical instrument, surgical instrument 1106 is an RF electrosurgical instrument, and multifunctional surgical instrument 1108 is a combined ultrasonic / RF electrosurgical instrument. The generator 1100 is configurable for use with a variety of surgical devices. Depending on the form, the generator 1100 may be configurable for use with different types of surgical instruments, including, for example, ultrasonic surgical instruments 1104, RF electrosurgical instruments 1106, and multifunctional surgical instruments 1108 that integrate RF energy and ultrasonic energy simultaneously delivered from the generator 1100. Although in Figure 2In the form shown, the generator 1100 is shown as being separate from the surgical instruments 1104, 1106, 1108, but in one form, the generator 1100 can be integrally formed with any of the surgical instruments 1104, 1106, 1108 to form an all-in-one surgical system. The generator 1100 includes input devices 1110 on the front panel of the generator 1100 console. The input devices 1110 can include any suitable device that generates signals suitable for programming the operation of the generator 1100. The generator 1100 can be configured for wired or wireless communication.

[0089] The generator 1100 is configured to drive a plurality of surgical instruments 1104, 1106, 1108. The first surgical instrument is an ultrasonic surgical instrument 1104 and includes a handpiece 1105 (HP), an ultrasonic transducer 1120, a shaft 1126, and an end effector 1122. The end effector 1122 includes an ultrasonic blade 1128 and 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 1137, 1134b, 1134c for energizing and driving the ultrasonic blade 1128 or other functions. The switch buttons 1137, 1134b, 1134c can be configured to energize the ultrasonic transducer 1120 with the generator 1100.

[0090] 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 clamp arms 1145, 1142b and returns through an electrical conductor portion of the shaft 1127. The electrodes are coupled to and energized by a bipolar energy source within the generator 1100. The handpiece 1107 includes a trigger 1145 for operating the clamp arms 1145, 1142b and an energy button 1135 for actuating an energy switch to energize the electrodes in the end effector 1124. The second surgical instrument 1106 can also be used with a return pad to deliver monopolar energy to tissue.

[0091] The generator 1100 is also configured to drive a multi-functional surgical instrument 1108. The multi-functional surgical instrument 1108 includes a handheld component 1109 (HP), a shaft 1129, and an end effector 1125. The end effector 1125 includes an ultrasonic scalpel 1149 and a clamping arm 1146. The ultrasonic scalpel 1149 is acoustically coupled to an ultrasonic transducer 1120. The handheld component 1109 includes a combination of a trigger 1147 for operating the clamping arm 1146 and switching buttons 11310, 1137b, 1137c for powering and driving the ultrasonic scalpel 1149 or other functions. The switching buttons 11310, 1137b, 1137c can be configured to power the ultrasonic transducer 1120 using the generator 1100 and the ultrasonic scalpel 1149 using a bipolar energy source also included in the generator 1100. Monopolar energy can be delivered to tissues in combination with bipolar energy or separately.

[0092] Generator 1100 is configurable for use with a variety of surgical devices. Depending on the form, generator 1100 can be configurable for use with different types of surgical instruments, including, for example, ultrasonic surgical instruments 1104, RF electrosurgical instruments 1106, and multifunctional surgical instruments 1108 that integrate RF energy and ultrasonic energy delivered simultaneously from generator 1100. Although in Figure 2 In one embodiment, generator 1100 is shown as independent of surgical instruments 1104, 1106, and 1108; however, in another embodiment, generator 1100 may be integrally formed with any of surgical instruments 1104, 1106, and 1108 to form an integrated surgical system. As discussed above, generator 1100 includes an input device 1110 located on the front panel of the generator 1100 control console. Input device 1110 may include any suitable means for generating signals suitable for programming the operation of generator 1100. Generator 1100 may also include one or more output devices 1112. Further aspects of generators and surgical instruments for digitally generating electrical signal waveforms are described in U.S. Patent Application Publication US-2017-0086914-A1, the entire contents of which are incorporated herein by reference.

[0093] Figure 3A schematic view of a surgical instrument or tool 600 is shown that includes a plurality of motor assemblies that can be activated to perform various functions. In the illustrated example, a closure motor assembly 610 can operate to transition an end effector between an open configuration and a closed configuration, and an articulation motor assembly 620 can operate to articulate the end effector relative to a shaft assembly. In certain instances, the plurality of motor assemblies can be individually activated to cause firing, closure, and / or articulation motions in the end effector. The firing, closure, and / or articulation motions can be transmitted to the end effector, for example, by the shaft assembly.

[0094] In certain instances, the closure motor assembly 610 includes a closure motor. The closure motor 603 can be operably coupled to a closure motor drive assembly 612, which can be configured to transmit closure motions generated by the motor to the end effector, specifically to displace a closure member into closure to transition the end effector into a closed configuration. These closure motions can transition, for example, the end effector from an open configuration to a closed configuration to capture tissue. The end effector can be transitioned to an open position by reversing the direction of the motor.

[0095] In certain instances, the articulation motor assembly 620 includes an articulation motor that is operably coupled to an articulation drive assembly 622, which can be configured to transmit articulation motions generated by the motor to the end effector. In certain instances, the articulation can articulate the end effector relative to the shaft, for example.

[0096] One or more of the motors of the surgical instrument 600 can include a torque sensor to measure the output torque on the shaft of the motor. The force on the end effector can be sensed in any conventional manner, such as by a force sensor on the outside of the jaws or by a torque sensor of the motor used to actuate the jaws.

[0097] In various instances, the motor assemblies 610, 620 include one or more motor drivers that can include one or more H-bridge FETs. These motor drivers can regulate the power transmitted from the power source 630 to the motor based on input from, for example, a microcontroller 640 (“controller”) of the control circuit 601. In certain instances, the microcontroller 640 can be used to determine, for example, the current consumed by the motor.

[0098] In certain instances, microcontroller 640 can include a microprocessor 642 ("processor") and one or more non-transitory computer-readable medium or memory units 644 ("memory"). In certain instances, memory 644 can store various program instructions, which when executed, can cause processor 642 to perform various functions and / or calculations described herein. In certain instances, one or more of memory units 644 can be coupled to processor 642, for example. In various aspects, microcontroller 640 can communicate over wired or wireless channels, or a combination thereof.

[0099] In certain instances, power source 630 can be used to supply power to microcontroller 640, for example. In certain instances, power source 630 can include a battery (or "battery pack" or "power pack"), such as a lithium ion battery, for example. In certain instances, the battery pack can be configured to be releasably mounted to the handle for supplying power to surgical instrument 600. A plurality of battery cells connected in series can be used as power source 630. In certain instances, power source 630 can be replaceable and / or rechargeable, for example.

[0100] In various instances, processor 642 can control the motor drives to control the position, direction of rotation, and / or speed of the motors of assemblies 610, 620. In certain instances, processor 642 can signal the motor drives to stop and / or deactivate the motors. It will be appreciated that the term "processor" as used herein includes any suitable microprocessor, microcontroller, or other base computing device that incorporates the functions of a computer's central processing unit (CPU) onto one integrated circuit or up to several integrated circuits. The processor 642 is a multipurpose, programmable device that accepts digital data as input, processes it according to instructions stored in its memory, and provides results as output. It is an example of sequential digital logic, as it has internal memory. The objects on which the processor operates are numbers and symbols that are represented in the binary numeral system.

[0101] In one instance, the processor 642 can be any single core or multi-core processor, such as those produced by Texas Instruments under the trade name ARM Cortex. In certain instances, the microcontroller 620 can be, for example, an LM4F230H5QR available from Texas Instruments. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core that includes: 256 KB single-cycle flash memory or other non-volatile memory (up to 40 MHz) of on-chip memory, a prefetch buffer for improved performance above 40 MHz, 32 KB single-cycle SRAM, an internal ROM loaded with the software, 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, one or more 12-bit ADCs with 12 analog input channels, and readily available other features. Other microcontrollers can be readily substituted for use with the surgical instrument 600. Accordingly, the present disclosure should not be limited to this context.

[0102] In certain instances, the memory 644 can include program instructions for controlling each of the motors of the surgical instrument 600. For example, the memory 644 can include program instructions for controlling a closure motor and an articulation motor. Such program instructions can cause the processor 642 to control the closure and articulation functions in accordance with inputs from the algorithm or control program of the surgical instrument 600.

[0103] In certain instances, one or more mechanisms and / or sensors, such as, for example, the sensor 645, can be used to alert the processor 642 of program instructions that should be used in a particular setting. For example, the sensor 645 can alert the processor 642 to use program instructions associated with causing the end effector to close and causing the end effector to articulate. In certain instances, the sensor 645 can include, for example, a position sensor that can be used to sense the position of the closure actuator. Thus, if the processor 642 receives a signal from the sensor 630 indicating the actuation of the closure actuator, the processor 642 can activate the motor of the closure drive assembly 620 using program instructions associated with causing the end effector to close.

[0104] In some examples, the motors can be brushless DC electric motors, and the respective motor drive signals can comprise PWM signals provided to one or more stator windings of the motors. Also, in some examples, the motor drivers can be omitted, and the control circuit 601 can generate the motor drive signals directly.

[0105] During various laparoscopic surgical procedures, it is common practice to insert the surgical end effector portion of a surgical instrument through a trocar needle that has been installed in the abdominal wall of a patient to access a surgical site located inside the patient's abdomen. In its simplest form, a trocar needle is a pen-like instrument having a sharp triangular point at one end that is typically used within a hollow tube called a cannula to form an opening into the body through which the surgical end effector can be introduced. This arrangement forms an access port into a body cavity through which the surgical end effector can be inserted. The cannula inner diameter of the trocar needle necessarily limits the size of the end effector and drive support shaft of a surgical instrument that can be inserted through the trocar needle.

[0106] Regardless of the particular type of surgical procedure being performed, once the surgical end effector has been inserted into the patient through the trocar cannula, it is often necessary to move the surgical end effector relative to the shaft assembly located within the trocar cannula in order to properly position the surgical end effector relative to the tissue or organ to be treated. This movement or positioning of the surgical end effector relative to the portion of the shaft that remains within the trocar cannula is commonly referred to as "articulation" of the surgical end effector. Various articulation joints have been developed to attach the surgical end effector to the associated shaft in order to facilitate such articulation of the surgical end effector. As would be expected, in many surgical procedures, it is desirable to employ a surgical end effector having as large an articulation range as possible.

[0107] Due to the size constraints imposed by the trocar cannula, the size of the articulation joint components must be set to be freely insertable through the trocar cannula. These size constraints also limit the size and composition of various drive members and components that are operably engaged with the motors and / or other control systems supported in a housing, which can be hand-held or part of a larger automated system. In many cases, these drive members must be operably threaded through the articulation joint to operably couple to or engage with the surgical end effector. For example, one such drive member is often used to apply articulation control motions to the surgical end effector. During use, the articulation drive member can be de-actuated to position the surgical end effector in a non-articulated position to facilitate insertion of the surgical end effector through the trocar needle, and subsequently actuated to articulate the surgical end effector to a desired position once the surgical end effector has been introduced into the patient.

[0108] Accordingly, the aforementioned size constraints present many challenges to developing articulation systems that can achieve desired ranges of articulation while still accommodating various different drive systems necessary to accommodate various features of the operating surgical end effector. Moreover, once the surgical end effector has been placed in a desired articulation position, the articulation system and articulation joint must be able to hold the surgical end effector in that position during actuation of the end effector and completion of the surgical procedure. Such articulation joint arrangements must also be able to withstand external forces experienced by the end effector during use.

[0109] Throughout the course of a particular surgical procedure, various modes of one or more surgical devices are often used. For example, a communication pathway extending between a surgical device and a centralized surgical hub can improve the efficiency and success rate of a surgical procedure. In various instances, each surgical device within a surgical system includes a display that communicates the presence and / or operational status of other surgical devices within the surgical system. The surgical hub can use information received through the communication pathway to assess compatibility of surgical devices used together, assess compatibility of surgical devices used during a particular surgical procedure, and / or optimize operational parameters of the surgical devices. As described in greater detail herein, operational parameters of the one or more surgical devices can be optimized based on, for example, patient demographics, a particular surgical procedure, and / or detected environmental conditions such as tissue thickness.

[0110] Figures 4 to 9 A partitioned display system is shown. The partitioned display communicates various generator and / or surgical device parameters between the display 27010 of the handheld surgical instrument 27000 and the main monitor display 27100. Figure 4 An example of the display 27010 of the handheld surgical instrument 27000 is depicted. In various instances, the display 27010 includes a touch-sensitive graphical user interface that is capable of receiving user input. The display 27010 includes various settings and / or modes that allow the user to customize the information and / or images shown on the display 27010 at any given time.

[0111] The surgical instrument 27000 is in communication with a primary display monitor 27100. The primary display monitor 27100 includes a larger screen than the display 27010 of the surgical instrument 27000. In various instances, the primary display monitor 27100 displays the same information and / or images as the display 27010 of the surgical instrument 27000. In other instances, the primary display monitor 27100 displays different information and / or images than the display 27010 of the surgical instrument 27000. In various instances, the primary display monitor 27100 includes a touch-sensitive graphical user interface that is capable of receiving user inputs. Similar to the display 27010 of the surgical instrument 27000, the primary display monitor 27100 includes various settings and / or modes that allow the user to customize the information and / or images shown on the primary display monitor 27100 at any given time. As described in greater detail herein, a selected mode on the primary display monitor 27100 can change the mode of the display 27010 on the surgical instrument 27000, and vice versa. In other words, the primary display monitor 27100 and the surgical instrument display 27010 work together to most effectively communicate selected operating parameters to the user.

[0112] The depicted handheld surgical instrument 27000 includes a combined electrosurgical functionality, wherein the surgical instrument 27000 includes an end effector that includes a first jaw and a second jaw. The first jaw and the second jaw include electrodes disposed thereon. The electrosurgical instrument 27000 includes one or more power generators configured to supply power to the electrodes to energize the electrodes. More specifically, energy delivery to patient tissue supported between the first jaw and the second jaw is achieved by energizing the electrodes configured to deliver energy in monopolar mode, bipolar mode, and / or a combined mode. The combined mode is configured to deliver alternating or mixed bipolar and monopolar energy. In at least one embodiment, the at least one power generator includes a battery, a rechargeable battery, a disposable battery, and / or combinations thereof. Various details regarding the operation of the first generator and the second generator are described in greater detail in the following patent application: U.S. Patent Application Serial No. 16 / 562,123, titled “METHOD FOR CONSTRUCTING AND USING A MODULAR SURGICAL ENERGY SYSTEM WITH MULTIPLE DEVICES,” filed September 5, 2019, which is hereby incorporated by reference in its entirety.

[0113] The display 27010 of the surgical instrument 27000 and the main display monitor 27100 include partitioned displays to convey many operational parameters to the user. The partitioned displays are configured to be selectively segmented. In other words, the user can select the operational parameters to be displayed and / or the display location of the selected operational parameters. This customization minimizes distraction by eliminating unnecessary and / or unwanted information, while allowing the user to efficiently observe the information needed and / or desired to control the surgical instrument 27000 and / or perform the surgical procedure. The display 27010 of the surgical instrument 27000 includes a first portion 27012 in which a particular mode of power level is displayed. The display 27010 of the surgical instrument 27000 also includes a second portion 27014 in which the mode in which the surgical instrument 27000 is operating and / or the type of energy that the surgical instrument 27000 is delivering is identified or otherwise conveyed.

[0114] Similarly, the main display monitor 27100 includes a segmented display; however, in various instances, the images displayed on the display monitor 27100 can overlay one another. A center portion 27110 of the main display monitor 27100 streams a real-time feed and / or a static image of the surgical site to the operating room. The real-time feed and / or image of the surgical site is captured by a suitably positioned camera, such as an endoscope. A menu selection portion 27130 of the main display monitor 27100 prompts and / or otherwise allows the user to select the mode in which the main display monitor 27100 is operating and / or the information that the user wishes to see on the main display monitor 27100. A device status portion 27120 of the main display monitor 27100 conveys information similar to the first portion 27012 of the surgical instrument display 27010. In various instances, the device status portion 27120 is further divided into multiple sections. For example, a first portion 27122 is configured to convey operational parameters reflective of the bipolar mode. Such operational parameters can be specific and / or general. A specific operational parameter may, for example, reflect the power level of the bipolar mode. A general operational parameter may, for example, indicate whether the bipolar mode is active or inactive. A second portion 27124 is configured to convey operational parameters reflective of the monopolar mode. Such operational parameters can be specific and / or general. A specific operational parameter may, for example, reflect the power level of the monopolar mode. A general operational parameter may, for example, indicate whether the monopolar mode is active or inactive. A third portion 27126 is configured to convey operational parameters reflective of the smoke evacuation system. Such operational parameters can be specific and / or general. A specific operational parameter may, for example, reflect the power level of the smoke evacuation system. A general operational parameter may, for example, indicate whether the smoke evacuation system is active or inactive.

[0115] Referring now to Figures 5 to 9, the display 27010 of the surgical instrument 27000 is shown alongside the corresponding display on the main display monitor 27100. As described in greater detail herein, when the user changes the power level on the handheld surgical instrument 27000, such power level change is reflected on the main display monitor 27100. For example, as shown in Figure 5 the generator running in bipolar mode is currently operating at a power level of 80 watts, as indicated in the device status portion 27120 of the main display monitor 27100 and the first and second portions 27012, 27014 of the surgical instrument display 27010. More specifically, the first portion 27012 of the surgical instrument display 27010 represents the output of the generator, while the second portion 27014 of the surgical instrument display 27010 represents the mode and / or type of energy. Similarly, the device status portion 27120 of the main display monitor 27100 indicates that the generator is running the bipolar energy mode at a power level of 80 watts and that the generator is running the monopolar energy mode at a power level of zero watts. Upon receiving a command to increase the power output of the generator running in bipolar mode to 100 watts, the surgical instrument display 27010 and the main display monitor 27100 change accordingly as shown in Figure 6 More specifically, the first portion 27012 of the surgical instrument display 27010 now represents a power level of 100 watts, and the device status portion 27120 of the main display monitor 27100 now indicates that the generator is running the bipolar mode at a power level of 100 watts. The main display monitor 27100 continues to indicate that the monopolar energy mode is running at a power level of zero watts; however, the main display monitor 27100 also indicates that the smoke detection system has been activated to 20% 27126 due to the detection of smoke within the surgical site and / or the increase in power level of the surgical instrument.

[0116] Figures 7 to 9 the display 27010 of the surgical instrument 27000 and the corresponding main display monitor 27100 when a combination of both bipolar and monopolar energy is being delivered to the patient tissue. Figure 7 The first portion 27012' of the surgical instrument display 27010 in total power mode is shown. As shown on the main display monitor 27100, the bipolar energy mode 27122 is running at a power level of 60 watts, and the monopolar energy mode 27124 is running at a power level of 60 watts. However, a combined and / or total power level of 120 watts is represented on the first portion 27012' of the surgical instrument display 27010. The main display monitor 27100 also indicates that the smoke detection system has been activated to 50% 27126 due to the detection of smoke within the surgical site and / or the increase in power level of the surgical instrument. As Figure 8As shown, the user can wish to see separate power levels for bipolar and monopolar modes on the first portion 27012" of the surgical instrument display 27010 and the total power level on the device status portion 27122' of the primary display monitor 27100. In other words, Figure 8 the information shown on the display in Figure 7 the display shown is reversed. The primary display monitor 27100 also indicates that the smoke detection system has been activated to 73% 27126 due to detection of smoke within the surgical site and / or a change in the power level of the bipolar and / or monopolar modes. Figure 9 the pair of displays shown in Figure 8 the pair of displays shown; however, the user has selected to remove the indication of the operational level of the smoke detection system from the primary display monitor 27100.

[0117] As discussed in greater detail herein, the surgical instrument display 27010 and / or the primary display monitor 27100 can comprise a touch-sensitive graphical user interface. In various instances, the surgical instrument display 27010 is used to control the content displayed on the surgical instrument display 27010 and not the content displayed on the primary display monitor 27100. In other instances, the primary display monitor 27100 is used to control the content displayed on the surgical instrument display 27010 and not the content displayed on the primary display monitor 27100. In various instances, each display is configured to control the content displayed on its own display. In various instances, each display within the surgical system is configured to cooperatively control the content displayed on the other displays within the surgical system.

[0118] In various instances, the surgical system comprises an electrosurgical device and a smoke evacuation system. As discussed in greater detail herein, the electrosurgical device is configured to deliver energy to patient tissue supported between the jaws of an end effector by energizing electrodes. These electrodes are configured to deliver energy in monopolar mode, bipolar mode, and / or a combined mode with alternating or mixed bipolar and monopolar energy. In various instances, a first generator is configured to control the bipolar energy modality and a second generator is configured to control the monopolar energy modality. A third generator is configured to control the smoke evacuation system. Various details regarding the operation of the first and second generators are described in greater detail in the following patent application: U.S. Patent Application Serial No. 16 / 562,123, titled “METHOD FOR CONSTRUCTING AND USING A MODULAR SURGICAL ENERGY SYSTEM WITH MULTIPLE DEVICES,” filed September 5, 2019, which is hereby incorporated by reference in its entirety.

[0119] Figure 10 is a graphical representation 27200 that depicts the proportional relationship between the duty cycle of the smoke evacuator and the total effective energy delivered to the patient tissue. Time 27210 is represented along the x-axis, while power (W) 27220a and the duty cycle of the smoke evacuator (%) 27220b are represented along the y-axis. The total effective energy is represented in the following three aspects: (1) bipolar therapy 27230; (2) monopolar therapy 27240; and (3) combined energy 27250. The percentage of the smoke evacuator duty cycle is represented in the following two aspects: (1) in response to combined energy 27260; and (2) in response to bipolar therapy only 27270. For example, at time to, no power is delivered to the patient tissue and the smoke evacuator is inactive. At time ti, bipolar therapy 27230 is delivered at a first power level Pi. At time ti, bipolar therapy 27230 is the only energy delivered to the patient tissue. As the power increases to Pi during the time period to-ti, the smoke evacuator is activated. At time ti, a first percentage Si of the smoke evacuator duty cycle is utilized.

[0120] At time t2, the power level of bipolar therapy 27230 is increased, and monopolar therapy 27240 has begun to be delivered. At time t3, bipolar therapy 27230 is decreased, while monopolar therapy 27240 is increased. Overall, combined energy 27250 remains substantially the same from t2 to t3. At time t3, combined energy 27250 is delivered at a third power level P3, which is higher than the first power level Pi delivered at time ti. As the power increases to P3 during the time period ti-t3, the percentage of the smoke evacuator duty cycle also increases. At time t3, a third percentage S3 of the smoke evacuator duty cycle is utilized. The third percentage S3 is greater than the first percentage Si. At time t4, the delivery of bipolar therapy 27230 has ceased, and the only energy delivered to the patient tissue is obtained through monopolar therapy 27240. Notably, at time t4, monopolar therapy 27240 delivers energy to the patient tissue at a highest level P4 of monopolar therapy delivered during the entire surgical procedure. Thus, as the delivered energy P4 at time t4 is greater than the delivered energy P3 at time t3, the percentage of the smoke evacuator duty cycle also increases. At time t4, a fourth percentage S4 of the smoke evacuator duty cycle is utilized. The fourth percentage S4 is greater than the third percentage S3 and the first percentage Si.

[0121] Figure 10The graphical representation shows bipolar energy 27230 delivered at different levels at all different time points of a surgical procedure. Such time points can correspond to a tissue sealing period in which the surgical hub commands the smoke evacuation system to increase or decrease its operating level in response to the current bipolar power level. Upon completion of the tissue sealing period, monopolar energy can be applied for a defined period of time to cut patient tissue. When cutting patient tissue, the surgical hub can command the smoke evacuation system to increase its operating level, for example, based on an increase in the energy being applied to cut the tissue, as such an increase in the energy being applied typically corresponds to an increase in smoke generated by the burning tissue. During a particular surgical procedure, the surgical hub is aware of predefined time points of energy delivery and power level changes. These predefined time points can vary, for example, based on the type of particular surgical procedure to be performed. Any detected changes in the type of energy being applied and / or the level of energy being applied can trigger a response by different components of the surgical system.

[0122] Similar to the surgical system described with respect to Figure 10 FIG. 1, Figure 11 The surgical system 27700 depicted in FIG. 27 includes an electrosurgical instrument 27710 in communication with a surgical hub. The electrosurgical instrument 27710 is configured to deliver energy to patient tissue supported between the jaws of an end effector via an electrode configured to deliver energy in monopolar, bipolar, and / or combined modes. The electrosurgical instrument 27710 is configured to apply alternating or mixed bipolar and monopolar energy to patient tissue when in the combined mode. The surgical system 27700 further includes a first generator 27720 configured to control the monopolar energy modality, and a second generator 27730 configured to control the bipolar energy modality. A display screen 27750 is located within the surgical theater in a position within the user’s field of view. In various instances, the electrosurgical instrument 27710 includes a display located thereon. The instrument display and / or the display screen 27750 within the surgical theater indicates the applied power level when the second generator 27730 causes bipolar energy to be delivered to the patient tissue. In various instances, the smoke evacuation level of the smoke evacuation system is indicated on the display, where the smoke evacuation level is based on the energy level and / or energy type being applied. As discussed in greater detail herein, the display is configured to update the displayed or otherwise communicated operating parameters when the first generator 27720 causes monopolar energy to be delivered to the patient tissue and / or the second generator 27730 causes a reduced amount of bipolar energy to be delivered to the patient tissue. As the power level changes during the surgical procedure, such changes are communicated to the surgical hub. In response, the surgical hub is configured to automatically or without external cues alter the smoke evacuation level to compensate for changes in the energy level and / or energy type being applied to the patient tissue.

[0123] At least one of the instrument displays and the display screen 27750 includes a touch-sensitive graphical user interface configured to receive user input. The user can select the information to be displayed, the display location of the selected information on a particular display, and / or the display within the surgical system where the desired information is displayed. In various instances, the surgical system 27700 further includes one or more cameras located within the operating room. The one or more cameras are configured to monitor the movements of the user and / or devices of the surgical system. The one or more cameras can transmit any detected movements to the surgical hub, where the surgical hub recognizes that the detected movements correspond to predetermined commands. For example, when a user waves an arm, the camera can detect. A memory within the surgical hub correlates the arm waving to the user’s desire to clear all operating parameters from the display, such that the only information remaining on the display is a live feed and / or images of the surgical site. Exemplary commands that can be associated with particular user and / or instrument movements include adjusting the position of a display, adjusting the view of a display, adjusting the information presented on a display, adjusting the location of the displayed information on a particular display, adjusting the size of the displayed information, controlling the power level of a generator, and / or controlling operating parameters of various surgical instruments of the surgical system.

[0124] As discussed with respect to the surgical system 27700, the electrosurgical instrument 27710 includes a combination of electrical modalities. The monopolar modality of the electrosurgical instrument is run by the first generator 27720, while the bipolar modality is run by the second generator 27730. Monopolar energy is delivered to patient tissue to make an incision, or otherwise cut the treated tissue. Bipolar energy is delivered to the tissue prior to cutting the patient tissue in order to seal and / or cauterize the target tissue. Figure 12 A graphical representation 27300 of the power level (watts) of the first generator and the second generator 27320a with respect to time (t) 27310 is shown. The power level is represented in two ways: (1) the first generator 27340; and (2) the second generator 27330. The graphical representation 27300 also depicts the relationship of the tissue impedance (ohms) 27320b with respect to time (t) 27310. The tissue impedance is represented in two ways: (1) in response to delivered monopolar energy 27345; and (2) in response to delivered bipolar energy 27335.

[0125] As the power level of the second generator 27330 increases from zero, bipolar energy is delivered to the patient tissue. The impedance of the patient tissue increases in response to the application of the bipolar energy 27335. Notably, the impedance of the patient tissue continues to increase for a certain amount of time even after the power level of the second generator 27330 begins to decrease. In other words, without the delivery of monopolar energy to cut the patient tissue, the impedance of the tissue sealed by the bipolar energy 27335 eventually decreases after the power level of the second generator 27330 decreases; however, the impedance of the tissue does not necessarily decrease immediately in such cases. At time ti, the power level of the first generator 27340 increases, thereby cutting the tissue by delivering monopolar energy to the patient tissue. The impedance of the patient tissue also increases in response to the application of the monopolar energy 27345. Notably, as the tissue is cut and the power level of the first generator 27340 decreases, the impedance of the patient tissue exponentially increases.

[0126] Figure 13 An algorithm 27400 for controlling various components of a surgical system is depicted. The surgical system includes a surgical instrument configured to perform an intended surgical function. In various instances, the surgical instrument is handheld and includes a handle. A user is configured to operate various modes of the surgical instrument through input elements on the handle. As described in greater detail herein, the surgical instrument includes a first generator configured to supply power to a monopolar modality, and a second generator configured to supply power to a bipolar modality. The surgical system also includes a smoke evacuation system configured to remove smoke and / or other unwanted particulates from a surgical procedure site. The surgical instrument and / or the smoke evacuation system are in signal communication with a surgical hub, wherein the surgical hub is configured to coordinate appropriate responses of components of the surgical system in response to user input on the surgical instrument, the smoke evacuation system, and / or another component within the surgical system.

[0127] As Figure 13As shown, the control algorithm 27400 begins when a user changes 27410 the mode of the surgical instrument. For example, the user can wish to increase the power level of the first generator to cut patient tissue. As another example, the user can wish for the surgical instrument to seal and / or cut patient tissue. In any case, the surgical instrument then communicates 27412, 27414 the user input to the first and second generators, respectively. The surgical instrument also communicates 27415 the user input to the surgical hub. After the surgical hub is informed 27420 of the desired increase in monopolar energy, the surgical hub is configured to command 27425 the second generator to supply and / or apply an appropriate power level. Upon receiving the communication 27412 from the surgical instrument, the first generator increases 27440 the waveform in preparation to cut patient tissue. Upon receiving the communication 27414 from the surgical instrument and the command 27425 from the surgical hub, the second generator increases 27450 the power level associated with the bipolar modality in preparation to seal patient tissue after the cut is performed. The second generator can then communicate 27455 its readiness status to the first generator. The first generator can then begin cutting 27442 patient tissue. In other words, the surgical hub prevents the monopolar electrode from being energized until the bipolar electrode has been energized to prevent cutting tissue that has not been cauterized and / or sealed. The surgical hub is further configured to command 27426 the smoke evacuation system to increase the motor rate in response to the increase in power levels of the first and second generators. After the smoke evacuation system increases 27430 its motor rate, the smoke evacuation system is configured to maintain a communication line with the surgical hub, the surgical instrument, and / or the first and second generators throughout the duration of the surgical procedure. For example, the smoke evacuation system is configured to continuously communicate 27435 the current motor rate to the surgical hub. In such cases, the smoke evacuation system communicates its current motor rate to the surgical hub every minute or every two minutes; however, the smoke evacuation system can communicate its current motor rate at any suitable frequency. Upon the surgical instrument completing the desired tissue cut, the user can again provide input on the instrument handle to decrease the power level of the first generator and / or end the control algorithm 27400. In various cases, the control algorithm 27400 is configured to automatically decrease the power level of the first generator after a predetermined period of time corresponding to the completion of the tissue cut. With the control algorithm 27400, the surgical hub can, for example, coordinate operating parameters of components of the surgical system to facilitate the performance of an efficient and / or effective surgical procedure.

[0128] Many surgical devices, tools, and / or replaceable components are typically used during a particular surgical procedure. Various systems are disclosed herein that, among other things, facilitate the storage of devices and / or components used during a particular procedure within an operating room, minimize operator error, and / or minimize delays during a surgical procedure. The systems described herein use, among other things, artificial intelligence and machine learning developed over the course of one or more surgical procedures to increase the efficiency of surgical procedures.

[0129] Figure 14 Various components of an example surgical system 27500 are shown. During a particular surgical procedure, a patient lies on an operating table or any suitable surgical surface 27510. In various instances, the particular procedure is performed at least partially using a surgical robot. The surgical robot includes one or more robotic arms 27520. Each robotic arm 27520 is configured to receive a tool component 27590. The tool components 27590 are configured to cooperate with one another to perform and / or assist a clinician in performing the particular surgical procedure. The tool components can include, for example, surgical stapling and / or tissue cutting tool components, tissue grasping tool components, and / or electrosurgical tool components. The tool components can include other distinguishing features such as, for example, size, manufacturer, date of manufacture, number of prior uses, and / or expiration date.

[0130] The surgical system 27500 also includes a surgical hub 27530. Various surgical hubs are described in U.S. Patent Application Serial No. 16 / 209,395, titled METHOD OF HUB COMMUNICATION, filed December 4, 2018, which is hereby incorporated by reference in its entirety. The surgical hub 27530 includes a memory 27535 that stores a combination of various suitable or otherwise appropriate tool components 27590 to be used during the particular procedure. In other words, the memory 27535 of the surgical hub 27530 includes a library of stored information that can be used to indicate which tool components 27590 are appropriate to utilize during a selected procedure.

[0131] Prior to performing a desired surgical procedure, a clinician can notify or otherwise communicate details related to the desired surgical procedure and / or the patient to the surgical hub 27530. For example, such details can include, e.g., an identification of the surgical procedure, an identification of the clinician performing the surgical procedure, and / or a biometric profile of the patient. The surgical hub 27530 is then configured to utilize one or more of the communicated details to assess and / or determine which tool components 27950 are necessary and / or suitable for performing the desired surgical procedure. In various instances, the surgical hub 27530 is configured to assess which modes of each tool component 27950 are suitable for performing the desired surgical procedure on the particular patient.

[0132] As shown in Figure 14 four robotic arms 27250 are attached to the surgical table 27510. Three tool components 27590 are connected to three corresponding robotic arms 27250, leaving one robotic arm free to receive an additional tool component. A plurality of unique tool components 27560, 27570, 27580 are shown stored on a mobile stand 27550 within the operating room. As described above, the types and / or functions of the tool components 27560, 27570, 27580 can be different. In such instances, the surgical hub 27530 assesses the available tool components 27560, 27570, 27580 and identifies suitable tool components for attachment to the surgical robot. For example, suitable tool components are identified based on one or more factors, such as which tool types and / or functions the surgical robot still needs and / or which tool components have completed a predetermined tool component pairing associated with, e.g., the desired surgical procedure. In various instances, for example, the surgical robot includes a memory that stores predetermined tool component pairings based on particular surgical procedures and / or particular patient demographics. In such instances, the surgical robot is able to identify suitable tool components for attachment to the surgical robot based on the identification of the tool components that have already been attached.

[0133] In other instances, the tool components 27560, 27570, 27580 include the same types and / or functions; however, the tool components 27560, 27570, 27580 include at least one other distinguishing feature, such as, e.g., a difference in size, manufacturer, expiration date, and / or number of prior uses. The surgical hub 27530 assesses the profile of each available tool component 27560, 27570, 27580 and identifies suitable tool components based on which features are compatible with the profiles of the other selected and / or attached tool components 27590.

[0134] As shown in Figure 14As shown, each tool component 27560, 27570, 27580 includes a QR code 27565, 27575, 27585 at any suitable location thereon, where each QR code contains an information profile representative of the tool component to which the QR code is coupled. The user scans and / or reads the QR codes 27565, 27575, 27585 using any suitable scanning tool 27540. The scanning tool 27540 then communicates the QR code and / or the information contained within the QR code to the surgical hub 27530. In instances where the QR code itself is communicated by the scanning tool 27540 to the surgical hub 27530, the processor of the surgical hub 27530 is configured to decipher the information profile contained by the received QR code. While the depicted embodiment includes QR codes, the tool components can include, for example, any suitable memory device, such as a bar code, an RFID tag, and / or a memory chip.

[0135] The surgical hub 27530 is configured to alert the user when a tool component is not acceptable and / or is not desirably used during a surgical procedure. Such alerts can be communicated through various forms of feedback, including, for example, haptic feedback, audible feedback, and / or visual feedback. In at least one instance, the feedback includes audio feedback, and the surgical system 27500 can include a speaker that emits a sound, such as, for example, a beep, when an error is detected. In certain instances, the feedback includes visual feedback, and the tool component can include a light emitting diode (LED) that, for example, flashes when an error is detected. In certain instances, visual feedback can be communicated to the user through an alert presented on a display monitor within the clinician’s field of view. In various instances, the feedback includes haptic feedback, and a component of the surgical system 27500 can include an electric motor that includes an eccentric element that vibrates when an error is detected. The alert can be specific or general. For example, the alert can specifically indicate that a QR code on a tool component cannot be detected, or the alert can specifically indicate that the QR code includes an information profile representative of an incompatible and / or defective tool component.

[0136] For example, a user attempts to attach a first tool component 27560 to an available robotic arm 27590 of a surgical robot. Prior to attaching the first tool component 27560 to the robotic arm 27590, the scanning tool 27540 scans a QR code 27565 displayed on the first tool component 27560. The scanning tool 27540 communicates the QR code 27565 and / or the information contained within the QR code 27565 to the surgical hub 27530. The surgical hub 27530 compares the information contained within the QR code 27565 to a stored list of acceptable tool components associated with a particular surgical procedure and / or a stored list of acceptable tool components that are compatible with the tool components currently attached to the surgical robot. In this case, the surgical hub 27530 is unable to identify and / or locate the first tool component 27560 within its memory 27535. As a result, the first tool component 27560 is not recommended for use with the surgical robot and / or the first tool component is not suitable for use with the surgical robot. As discussed above, the surgical hub 27530 is configured to alert the clinician that the first tool component 27560 is incompatible with the surgical robot and / or the particular surgical procedure. In various instances, the surgical system 27500 can prevent the first tool component 27560 from being attached to the surgical system by mechanical and / or electrical lockouts, for example. Such attachment lockouts prevent the clinician from missing and / or simply ignoring the alert issued by the surgical system 27500. In other words, the attachment lockouts require the clinician to take a positive step to override the error communicated by the surgical system 27500. In such instances, an override can be activated to allow the clinician to override any system lockouts and utilize the operational functionality of the first tool component 27560. In various instances, when the first tool component 27560 is identified as incompatible with the surgical robot for use therewith, the override is not available in order to prevent the clinician from utilizing the functionality of the first tool component 27560.

[0137] Similarly, the user attempts to attach a second tool component 27570 to an available robotic arm 27590 of a surgical robot. Prior to attaching the second tool component 27570 to the robotic arm 27590, the scanning tool 27540 scans the QR code 27575 displayed on the second tool component 27570. The scanning tool 27540 communicates the QR code 27575 and / or the information contained within the QR code 27575 to the surgical hub 27530. The surgical hub 27530 compares the information contained within the QR code 27575 to a stored list of acceptable tool components associated with the particular surgical procedure and / or a stored list of acceptable tool components that are compatible with the tool components currently attached to the surgical robot. In this case, the surgical hub 27530 is unable to identify and / or locate the second tool component 27570 within its memory 27535. As such, the second tool component 27570 is not recommended for use with the surgical robot and / or the second tool component is not suitable for use with the surgical robot. As discussed above, the surgical hub 27530 is configured to alert the clinician that the second tool component 27570 is incompatible with the surgical robot and / or the particular surgical procedure. In various instances, the surgical system 27500 can prevent the second tool component 27570 from being attached to the surgical system. This attachment lockout prevents the clinician from missing and / or simply ignoring the alert issued by the surgical system 27500. In other words, this attachment lockout requires the clinician to take a positive step to override the error communicated by the surgical system 27500. In such instances, an override can be activated to allow the clinician to override any system lockout and utilize the operational functionality of the second tool component 27570. In various instances, when the second tool component 27570 is identified as incompatible with the surgical robot for use therewith, the override is not available in order to prevent the clinician from utilizing the functionality of the second tool component 27570.

[0138] The user attempts to attach the third tool component 27580 to an available robotic arm 27590 of the surgical robot. Prior to attaching the third tool component 27580 to the robotic arm 27590, the scanning tool 27540 scans the QR code 27585 displayed on the third tool component 27580. The scanning tool 27540 communicates the QR code 27585 and / or the information contained within the QR code 27585 to the surgical hub 27530. The surgical hub 27530 compares the information contained within the QR code 27585 to a stored list of acceptable tool components associated with the particular surgical procedure and / or a stored list of acceptable tool components that are compatible with the tool components currently attached to the surgical robot. In this case, the surgical hub 27530 successfully identifies and / or locates the third tool component 27580 within its memory 27535. It is then determined that the third tool component 27580 is suitable for use with the surgical robot during the particular surgical procedure and / or for use with the other attached tool components. In various instances, the surgical hub 27530 is configured to alert the clinician that the third tool component 27580 is compatible with the surgical robot. In other instances, the surgical system 27500 simply does not prevent the third tool component 27580 from being attached to the available robotic arm 27590.

[0139] In various instances, the memory 27535 of the surgical hub 27530 is configured to store a QR code associated with each tool component used during a particular surgical procedure. The surgical hub 27530 can then analyze the collected information to form observations and / or conclusions regarding factors such as, for example, the efficiency and / or effectiveness of particular tool components and / or multiple tool components during a surgical procedure. The surgical hub 27530 can then use the observations and / or conclusions to select and / or recommend which tool components to utilize during future surgical procedures.

[0140] Figure 15 A surgical system 27600 is depicted that includes one or more cameras configured to assist a clinician in performing an efficient and / or successful surgical procedure. Similar to the surgical system 27500, the surgical system 27600 includes an operating table 27610 or any suitable operative surface. The surgical system 27600 also includes a surgical hub 27650 and a device tower 27660. Various surgical hubs are described in U.S. Patent Application Serial No. 16 / 209,395, titled METHOD OF HUB COMMUNICATION, filed December 4, 2018, which is hereby incorporated by reference in its entirety.

[0141] The surgical system 27600 also includes a camera system comprising one or more cameras 27640 located at various locations throughout the operating room. In the depicted embodiment, two cameras 27640 are located in opposite corners of the operating room; however, the cameras 27640 can be positioned and / or oriented to allow the cameras 27640 to collaboratively capture the operating room in an unobstructed manner at any suitable location. Artificial intelligence protocols detect and / or identify various devices, equipment, and / or personnel within the operating room and their corresponding locations and / or orientations.

[0142] Camera 27640 of the camera system communicates with surgical hub 27650. In other words, real-time feeds from camera 27640 can be transmitted to surgical hub 27650 for processing and analysis. Through analysis of the material collected by camera 27640, surgical hub 27650 is able to maintain a real-time inventory of devices, equipment, and / or personnel in the operating room, and / or monitor and / or control interactions between detected devices, equipment, and / or personnel. Using the images and / or data collected by the camera system, surgical hub 27650 is configured to: be informed of the identification of detected devices, alert clinicians about compatibility issues with detected devices, and / or control various components of surgical system 27600 based on the presence and / or operation of detected devices. Surgical hub 27650 is configured to: compare any detected devices to determine compatibility between devices during a particular surgical procedure, facilitate collaboration between two devices that tend to work together, and / or facilitate collaboration between two devices based on their sensing and / or control operations.

[0143] like Figure 15 As shown, anesthesia cart 27670 and preparation table 27620 are located in the operating room. Preparation table 27620 is configured to support various surgical instruments and / or devices in a manner that makes them easily accessible for use during surgery. For example, such surgical instruments and / or devices may include replaceable staple cartridges or shaft assemblies of different sizes, which include end effectors of different sizes and / or functions. In the depicted embodiment, preparation table 27620 supports first device 27630a, second device 27630b, and third device 27630c.

[0144] The camera 27640 is configured to detect identifying information about devices, equipment, and / or personnel located within the operating room. For example, the camera 27640 can capture a serial number printed on a visible portion of each device 27630a, 27630b, 27630c, such as on the packaging of the device. In various instances, the packaging includes a QR code printed thereon that contains information about the device contained within the packaging. The QR code is captured by the camera 27640 and communicated to the surgical hub 27650 for analysis and identification of the staple cartridge.

[0145] Such an identification system can function, for example, during a surgical procedure in which a surgical stapling instrument includes an end effector in which a 60 mm staple cartridge is configured to be seated within the end effector. For example, a camera 27640 within the operating room is configured to capture the presence of the surgical stapling instrument in the form of a live video feed and / or a still image. The camera 27640 then communicates the captured image to the surgical hub 27650. The surgical hub 27650 is configured to identify the surgical stapling instrument based on the image received from the camera 27640. In instances in which the surgical hub 27650 knows the surgical procedure to be performed, the surgical hub 27650 can alert the clinician as to whether the identified surgical stapling instrument is appropriate. For example, knowing that a 45 mm staple cartridge is associated with a particular surgical procedure, the surgical hub 27650 can alert the clinician that the detected surgical stapling instrument is inappropriate because the end effector of the detected surgical stapling instrument is configured to receive a 60 mm staple cartridge.

[0146] The surgical hub 27650 includes a memory 27655 in which technical requirements and / or specifications associated with various devices are stored. For example, the memory 27655 of the surgical hub 27650 recognizes that the surgical stapling instrument described above is configured to receive a 60 mm staple cartridge. In various instances, the memory 27655 can also recognize a particular brand of 60 mm staple cartridge that is compatible with the surgical stapling instrument. In various instances, for example, the camera 27640 can capture the presence of a replaceable staple cartridge in the form of a live video feed and / or a still image. The camera 27640 then communicates the captured image to the surgical hub 27650. The surgical hub 27650 is configured to identify characteristics of the replaceable staple cartridge based on the image received from the camera 27640. Such characteristics include, for example, size, brand, and / or manufacturing lot. As discussed in greater detail herein, the alert can be specific or general. In instances in which the camera 27640 captures the presence of packaging containing a replaceable 45 mm staple cartridge, the surgical hub 27650 is configured to alert the clinician that an incompatible staple cartridge has been mistakenly stored within the room. Such an alert can prevent, for example, a malfunction of the surgical instrument, injury to the patient, and / or a loss of valuable time during the surgical procedure.

[0147] As discussed above, the camera system is configured to facilitate the surgical hub 27650 coordinating devices detected within the operating room. In various instances, a combination energy device and a smoke evacuation system are detected by the camera system. The combination energy device is configured to apply both bipolar energy and monopolar energy to patient tissue. For example, when the camera system and / or the surgical hub 27650 detects activation of the combination energy device, presence of the combination energy device at a location proximate to the patient, and / or presence of smoke within the operating room, the surgical hub 27650 is configured to direct the generator to enable the smoke evacuation system.

[0148] The surgical instrument can utilize a measurable or otherwise detectable feature of the end effector to confirm a particular stage of the surgical procedure and / or control various operational parameters of the surgical instrument. Such a feature can include, for example, a distance between jaws of the end effector. The memory of the surgical instrument and / or the surgical hub includes stored information that correlates a particular jaw gap distance to a particular stage of the surgical procedure. For example, when a distance between the jaws is measured to be between 0.030 inches to 0.500 inches, the surgical instrument and / or the surgical hub confirms that the end effector is delivering bipolar energy to patient tissue. In other instances, when a distance between the jaws is measured to be between 0.030 inches to 0.500 inches, the surgical instrument and / or the surgical hub activates the generator, thereby initiating delivery of bipolar energy to patient tissue. In other words, detection of a feature of the surgical instrument and / or contact with patient tissue can be used by the surgical instrument and / or the surgical hub in order to confirm and / or adjust operation of the surgical instrument.

[0149] Figure 16 includes a chart depicting various operational parameters and / or specifications of the surgical instrument corresponding to various stages of the surgical procedure. Similar to the surgical instrument described in greater detail herein, Figures 17 to 19The surgical instrument 27000 depicted in the middle includes a combined electrosurgical functionality, where the surgical instrument includes an end effector that includes a first jaw 27810 and a second jaw 27820. At least one of the first jaw 27810 and the second jaw 27820 is movable relative to the other, and the end effector is configurable between an open configuration and a closed configuration. The first jaw 27810 includes a first tissue support and / or tissue contact surface 27815, and the second jaw 27820 includes a second tissue support and / or tissue contact surface 27825. The first jaw 27810 and the second jaw 27810 include electrodes disposed thereon. The electrosurgical instrument 27000 includes one or more power generators configured to supply power to the electrodes to energize the electrodes. More particularly, energy delivery to patient tissue supported between the first jaw and the second jaw is achieved by the electrodes configured to deliver energy in monopolar mode, bipolar mode, and / or a combined mode. Alternating or hybrid bipolar and monopolar energy is configured to be delivered in the combined mode. In at least one embodiment, the at least one power generator includes a battery, a rechargeable battery, a disposable battery, and / or combinations thereof.

[0150] The end effector 27800 is used to perform various end effector functions during a surgical procedure. At an initial time tO, the end effector 27800 is not in contact with patient tissue T t0 . Accordingly, the electrodes of the end effector 27800 do not deliver any energy. At the initial time tO, the patient tissue T t0 is in a relaxed, uncompressed state. The end effector 27800 is shown in an open configuration. In the open configuration, the distance dO between the first tissue support surface 27815 and the second tissue support surface 27825 spans any distance from 0.500 inches to 0.700 inches. In other words, when the end effector 27800 is in the open configuration, the tissue support surfaces 27815, 27825 are separated from each other by a maximum distance dO of 0.500 inches to 0.700 inches.

[0151] At a first time tl, the jaws 27810, 27820 of the end effector 27800 begin to come into contact with patient tissue T t1 . As the end effector 27800 moves from the open configuration toward the closed configuration, at least a portion of the patient tissue T t1 is positioned between the jaws 27810, 27820 of the end effector 27800. As the jaws 27810, 27820 move toward the closed configuration, the tissue T t1 is compressed between the two jaws. At time tl, the end effector 27800 is configured to deliver energy to the patient tissue T t1Bipolar energy is delivered. For example, the application of bipolar energy allows the end effector 27800 to feather through parenchymal cells. At time T1, the end effector 27800 is in a partially closed configuration. At time t1, a first distance d1 between the first tissue support surface 27815 and the second tissue support surface 27825 spans any distance between 0.030 inches and 0.500 inches. In other words, when the end effector delivers bipolar energy to the patient tissue at time t1... t1 When delivering bipolar energy, the tissue support surfaces 27815 and 27825 are separated into a maximum first distance d1 of 0.030 inches to 0.500 inches. Figure 17 The jaws 27810 and 27820 of the end effector 27800 are shown to be directed at the patient tissue T at the first time t1. t1 A detailed description of the delivery of bipolar energy.

[0152] At the second time t2, the jaws 27810 and 27820 of the end effector 27800 remain in contact with the patient tissue T. t2 Contact. Patient tissue T t2 At least a portion of it is located between the jaws 27810 and 27820 of the end effector 27800. At time t2, the end effector 27800 is configured to deliver a force to the patient tissue T. t2 Delivering a combination of bipolar and monopolar energy. The application of bipolar and monopolar energy allows the end effector 27800 to deliver T-cell energy to the patient tissue. t2 Heating occurs. At time t2, the end effector 27800 is in a partially closed configuration; however, compared to the end effector 27800 at time t1, the distal end effector 27800 at time t2 is closer to a fully closed configuration. More specifically, at time t2, the second distance d2 between the first tissue support surface 27815 and the second tissue support surface 27825 spans any distance between 0.010 inches and 0.030 inches. In other words, when the end effector propels the patient tissue T at time t2... t2 When delivering bipolar and unipolar energy, the tissue support surfaces 27815 and 27825 are separated by a maximum second distance d2 of 0.010 inches to 0.030 inches. Figure 18 The jaws 27810 and 27820 of the end effector 27800 are shown to be directed at the patient tissue T at the second time t2. t2 Detailed description of the delivery of bipolar and unipolar energy.

[0153] At the third time t3, the jaws 27810 and 27820 of the end effector 27800 remain in contact with the patient tissue T. t3 Contact. Patient tissue T t3at least a portion of the patient tissue T t3 a combination of bipolar energy and monopolar energy. The continued application of bipolar energy and monopolar energy allows the end effector 27800 to seal the patient tissue T t3 At time t3, the end effector 27800 is in a partially closed and / or a fully closed configuration. In other words, the distal end effector 27800 at time t3 is in a fully closed configuration and / or closer to a fully closed configuration as compared to the end effector 27800 at time t2. More specifically, at time t3, the third distance d3 between the first tissue support surface 27815 and the second tissue support surface 27825 spans any distance from 0.003 inches to 0.010 inches. In other words, when the end effector is delivering bipolar energy and monopolar energy to the patient tissue T t3 The tissue support surfaces 27815, 27825 are separated by a maximum third distance d3 of 0.003 inches to 0.100 inches when delivering bipolar energy and monopolar energy. Figure 18 A detailed depiction of the end effector 27800 jaws 27810, 27820 delivering bipolar energy and monopolar energy to the patient tissue at a third time t3 is also shown.

[0154] At a fourth time t4, the jaws 27810, 27820 of the end effector 27800 remain in contact with the patient tissue T t4 . At least a portion of the patient tissue T t4 is positioned between the jaws 27810, 27820 of the end effector 27800. At time t4, the end effector 27800 is configured to deliver monopolar energy to the patient tissue T t4 . The application of monopolar energy allows the end effector 27800 to cut the patient tissue T t4 At time t4, the end effector 27800 is in a partially closed and / or a fully closed configuration. In other words, the distal end effector 27800 at time t4 is in a fully closed configuration and / or closer to a fully closed configuration as compared to the end effector 27800 at time t2. More specifically, at time t4, the fourth distance d4 between the first tissue support surface 27815 and the second tissue support surface 27825 spans any distance from 0.003 inches to 0.010 inches. In other words, when the end effector is delivering monopolar energy to the patient tissue T t4 The tissue support surfaces 27815, 27825 are separated by a maximum fourth distance d4 of 0.003 inches to 0.010 inches when delivering monopolar energy. Figure 19The jaws 27810 and 27820 of the end effector 27800 are shown to be directed at the patient tissue T at the fourth time t4. t4 A detailed description of the delivery of unipolar energy.

[0155] Figure 20 The curve graph 27900 shown illustrates... Figures 16 to 19 The relationship between various operating parameters and / or specifications of surgical instruments and time. Surgical instruments and / or surgical hubs can utilize the depicted relationships to confirm the correct functioning of surgical instruments during surgical procedures and / or to operate and / or adjust various functions of surgical instruments in response to one or more measured parameters. The graph shows: (1) the change of power (W) 27920a of the generator controlling the surgical instrument in bipolar mode 27930 over time 27910; (2) the change of power (W) 27920a of the generator controlling the surgical instrument in unipolar mode 27935 over time 27910; (3) the change of distance between the jaws of the end effector 27920b over time 27940; (4) the change of force (F) 27920c of the jaw motor over time 27910; and (5) the change of speed (V) 27920d of the jaw motor over time 27910 27960.

[0156] At time t0, the electrodes of the end effector are not delivering energy to the patient tissue, and the end effector is not yet in contact with the patient tissue. Since the end effector is in the open configuration, the distance 27920b between the jaws of the end effector is maximum at time t0. The clamping force 27950 of the jaws is minimum from time t0 to time t1 because the end effector experiences almost no resistance from the patient tissue as it moves from the open configuration to the closed configuration. From time t1 to time t2, the jaws of the end effector continue to approach the patient tissue, during which time the end effector begins to deliver bipolar energy 27930. The distance between the jaws of the end effector is shorter at time t1 than at time t0. From time t1 to time t2, the jaw motor speed 27960 begins to decrease as the clamping force of the end effector jaws 27950 begins to increase.

[0157] As relative to Figures 16 to 29The combination of monopolar energy 27935 and bipolar energy 27930 is delivered to the patient tissue from time t2 to time t3. During this time period, the jaws of the end effector continue to approximate around the patient tissue. The distance between the jaws of the end effector is shorter at time t2 than at time ti. The particular distance between the jaws of the end effector at time t2 indicates to the surgical instrument and / or the surgical hub that the tissue warming phase of the surgical procedure has been reached and that the combination of monopolar energy and bipolar energy should and / or is being delivered to the patient tissue. From time t2 to time t3, the jaw motor speed continues to decrease and is less than the speed of the jaw motor at ti. The force required to clamp the jaws increases abruptly between time t2 to time t3, thereby confirming to the surgical instrument and / or the surgical hub that the combination of monopolar energy and bipolar energy is being delivered to the patient tissue.

[0158] The delivery of monopolar energy and bipolar energy to the patient tissue continues and the patient tissue is sealed from time t3 to time t4. As the end effector reaches its fully closed configuration at time t3, the force to clamp the jaws also reaches a maximum; however, the force to clamp the jaws remains steady between time t3 to time t4. The power level at which the generator delivers monopolar energy increases between time t3 to time t4, while the power level at which the generator delivers bipolar energy decreases between time t3 to time t4. Finally, between time t4 to time t5, monopolar energy is the only energy delivered for cutting the patient tissue. The force to clamp the jaws of the end effector can vary as the patient tissue is cut. In the event that the force to clamp the jaws decreases from the steady state level at which it remains between time t3 to time t4, a high efficiency and / or effective tissue cut is recognized by the surgical instrument and / or the surgical hub. In the event that the force to clamp the jaws increases from the steady state level at which it remains between time t3 to time t4, a low efficiency and / or ineffective tissue cut is recognized by the surgical instrument and / or the surgical hub. In such instances, an error can be communicated to the user.

[0159] In various instances, the clamping operation of the jaws of the end effector can be adjusted based on a detected characteristic of the patient tissue in contact. In various instances, the detected characteristic includes tissue thickness and / or tissue type. For example, the operation can be adjusted based on a detected patient tissue thickness, such as a range of gap distance between the jaws during a jaw closure stroke, a load threshold, a rate of jaw closure, a current limit applied during a jaw closure stroke, and / or a wait time between a jaw closure stroke and delivery of energy. In various instances, the detected characteristic of the patient tissue in contact can be used to adjust tissue weld parameters. More specifically, for example, the detected characteristic can be used to adjust a multi-frequency scan of impedance sensing, a balance and / or sequence of energy modalities, an energy delivery level, an impedance shut-off level, and / or a wait time between two energy level adjustments.

[0160] As discussed in greater detail above, the surgical instrument and / or the surgical hub can utilize the measured tissue characteristic to control and / or adjust operational parameters of the surgical instrument. For example, when patient tissue is positioned between the jaws of the end effector, the tissue impedance can be detected. Detection of the tissue impedance alerts the surgical instrument and / or the surgical hub that the jaws of the end effector are in contact with and / or in the vicinity of the patient tissue. Referring now to Figure 21 FIG. 28, a graph 28000 illustrates tissue impedance 28020 calculated over time 28010. When the jaws of the end effector are not in contact with patient tissue, the tissue impedance 28030a is infinite. When the jaws of the end effector are clamped around patient tissue positioned therebetween, the patient tissue is in contact with both jaws. In such instances, the tissue impedance 28030b is measurable. The ability to measure the tissue impedance indicates to the surgical instrument and / or the surgical hub that the patient tissue is properly positioned between the jaws of the end effector. For example, the surgical instrument and / or the surgical hub can then initiate an operation, such as applying bipolar energy and / or monopolar energy to the patient tissue.

[0161] In various instances, the surgical instrument and / or the surgical hub can utilize the magnitude of the detected tissue impedance to determine a stage of the surgical procedure. For example, as shown in Figure 21 FIG. 28, after initial contact between the jaws of the end effector and the patient tissue, the tissue impedance 28030b is measured to be at a first level. The surgical instrument can then begin to deliver bipolar energy to the patient tissue. Upon the detected tissue impedance 28030b increasing to and / or above a first predetermined level, the surgical instrument begins to deliver a combination of bipolar energy and monopolar energy to the patient tissue to warm the patient tissue and / or form a seal. As the detected tissue impedance 28030b continues to increase, the tissue impedance 28030b reaches and / or exceeds a second predetermined level, at which point the surgical instrument ceases delivery of the bipolar energy while continuing to deliver the monopolar energy to cut the patient tissue. Finally, when the patient tissue is no longer positioned between the jaws of the end effector after completion of the cut, the tissue impedance reaches an infinite level. In such instances, the surgical instrument and / or the surgical hub can cease delivery of the monopolar energy.

[0162] In various instances, strain can be a metric utilized to adjust operational parameters of the surgical instrument, such as the clamping mechanism. However, for an accurate estimation of the compressive strain, contact between the jaws of the end effector and the patient tissue is desirable. As discussed in greater detail with reference to Figure 21 As discussed in greater detail above, the surgical instrument and / or the surgical hub can utilize the measured tissue characteristic to control and / or adjust operational parameters of the surgical instrument. For example, when patient tissue is positioned between the jaws of the end effector, the tissue impedance can be detected. Detection of the tissue impedance alerts the surgical instrument and / or the surgical hub that the jaws of the end effector are in contact with and / or in the vicinity of the patient tissue. Referring now to Figure 22An end effector 28100 is shown, including a first jaw 28110 and a second jaw 28120, wherein the end effector is in an open configuration. In the open configuration, a gap is defined between the first jaw 28110 and the second jaw 28120. The jaws 28110 and 28120 of the end effector 28100 are configured to receive patient tissue therebetween. At an initial time t0, the patient tissue T A,0 Located between the first jaw 28110 and the second jaw 28120. It is noteworthy that the patient tissue T... A,0 It contacts the first jaw 28110 and the second jaw 28120. In other words, the patient tissue T... A,0 The thickness is greater than or equal to the gap. When at least one of the first jaws 28110 and the second jaws 28120 moves toward each other, the patient tissue is compressed and a gap is defined between the first jaws 28110 and the second jaws 28120. Decrease. Patient tissue T A,1 It is shown as being compressed between the first jaw 28110 and the second jaw 28120 at time t1. It can be used... Figure 22 The equation shown is used to calculate the compressive strain. Because the patient tissue T... A,0 At time t0, the jaws 28110 and 28120 of the end effector 28100 come into contact, so the applied strain is accurately calculated.

[0163] Figure 23 It shows the open configuration. Figure 22 End effector 28100. In the open configuration, a gap is defined between the first jaw 28110 and the second jaw 28120. The jaws 28110 and 28120 of the end effector 28100 are configured to receive patient tissue therebetween. At an initial time t0, the patient tissue T B,0 Located between the first jaw 28110 and the second jaw 28120. However, unlike patient tissue T... A,0 Patient tissue T B,0 It does not contact either the first jaw 28110 or the second jaw 28120. In other words, the patient tissue T... B,0 The thickness is less than or equal to the gap. When at least one of the first jaws 28110 and the second jaws 28120 moves toward each other, the gap defined between the first jaws 28110 and the second jaws 28120 Decrease. Patient tissue T B,1 It is shown as being compressed and / or in contact with the first and second jaws 28110 between time t1. It can be used...Figure 23 The compression strain is calculated using the equation shown; however, the calculated compression strain will be overestimated because the patient tissue T B,0 At time t0, the patient tissue T

[0164] As described above, by calculating the compression strain using the gap defined between the first jaw and the second jaw of the end effector when the end effector is in the open configuration, an accurate calculation is only produced when the patient tissue is in contact with both jaws of the end effector at the initial time t0. Therefore, it is undesirable to use the standard gap defined between the first jaw and the second jaw of the end effector when the end effector is in the open configuration. Rather, when calculating the compression strain, the gap defined between the first jaw and the second jaw of the end effector when the patient tissue initially contacts both jaws should be used. In Figure 24 The end effector is shown in the open configuration 28150. Notably, the patient tissue T is not in contact with both of the end effector jaws 28110, 28120. Therefore, the size and / or gauge of the end effector in this configuration 28150 should not be used to calculate the compression strain. As at least one of the first jaw 28110 and the second jaw 28120 continues to move toward one another, a gap G C,0 is defined between the first jaw 28110 and the second jaw 28120. C,0 Notably, the patient tissue T C,0 is in contact with both the first jaw 28110 and the second jaw 28120. In other words, the thickness of the patient tissue T As at least one of the first jaw 28110 and the second jaw 28120 continues to move toward one another, the patient tissue is compressed and the gap G defined between the first jaw 28110 and the second jaw 28120 decreases. The patient tissue T C,1 is shown compressed between the first jaw 28110 and the second jaw 28120 at time t1. The compression strain can be calculated using the equation shown. Figure 24 As the patient tissue T C,0 is in contact with the jaws 28110, 28120 of the end effector 28100 at time t0, and the gap G defined between the first jaw 28110 and the second jaw 28120 at the point in time of initial tissue contact is implemented, the applied strain is accurately calculated.

[0165] The motor control program for a combined electrosurgical instrument can utilize detected tissue stability as input. The surgical instrument can determine tissue stability by detecting the compression rate and / or measuring the creep of patient tissue compressed between the end effector jaws. The control program can be modified to adjust the waiting time between end effector functions, define when additional tissue stability determinations are performed, and / or adjust the jaw clamping rate based on the determined tissue stability.

[0166] like Figure 25 As shown, the end effector 28250 includes a first jaw 28254 and a second jaw 28256, wherein at least one of the first jaw 28254 and the second jaw 28256 is configured to move toward each other, and wherein the patient tissue T is configured to be located between the first jaw and the second jaw. Figure 25 A schematic diagram is provided showing the various positions of the first jaw 28254 and the second jaw 28256 relative to the patient tissue T during the jaw clamping stroke. The gap 28220a defined between the jaws of the end effector and the motor current 28220b required to clamp the jaws of the end effector vary with time 28210, at least in part, due to tissue stability measurements. The initial slope S0 corresponds to the change in the jaw gap 28230 from the time when the jaws are fully open to the time point when there is initial contact between the jaws and the patient tissue T. The resulting motor current 28240 remains low when there is no tissue contact until the end effector jaws contact the patient tissue T. The surgical system is configured to monitor the current 28220b over time 28210 to identify when the current slope flattens, i.e., when the tissue is stable. When the current slope flattens, the surgical system is configured to acquire the difference between the peak current at the time of initial contact between the end effector and the tissue and the time when the current flattens. In other words, when the waiting time expires, the jaws are able to continue clamping the tissue within them, where the waiting time is defined by the time it takes for the tissue compression to stabilize. Creep in the motor current drives the next stage of motor current and speed to achieve the desired jaw gap or level of tissue compression. The creep measurement is repeated to drive the next stage of motor current and speed until the final jaw gap or level of tissue compression is achieved.

[0167] In addition to sensing parameters associated with the clamping stroke of the jaws, surgical systems can monitor other functions to adjust and / or refine the operating parameters of surgical instruments. For example, a surgical system can monitor the orientation of the surgical instrument relative to the user and / or patient, the impedance of tissue located between the jaws of the end effector to determine tissue location and / or tissue composition, the patient's grounding level, and / or leakage current. Leakage current can be monitored to determine secondary leakage from other devices and / or to generate parasitic energy output via capacitive coupling.

[0168] In various instances, the surgical instrument is configured to modify instrument and / or generator settings and / or control programs using local unsupervised machine learning. In such instances, the surgical instrument can update and / or adjust local functional behavior based on a summary and / or collection of data from various surgical procedures performed with the same surgical instrument. Such functional behavior can be adjusted based on previous use cases and / or preferences of a particular user and / or hospital. In such instances, the control program of the surgical instrument recognizes the same user and automatically modifies the default program with the recognized user’s preferences. The surgical instrument can be updated by receiving regional and / or global updates and / or improvements to the displayed information and / or control programs of digital enablement through interaction with a non-local server.

[0169] In various instances, the surgical instrument is configured to modify instrument and / or generator settings and / or control programs using global collections of instrument operating parameters and / or surgical procedure outcomes. The global surgical system is configured to collect data regarding relevant and / or impactful instrument parameters such as, for example, outcomes, complications, comorbidities, surgical instrument costs, instrument utilization, procedure duration, procedural data, and / or patient data. The global surgical system is further configured to collect data regarding generator operating data such as, for example, impedance curves, power levels, energy modalities, event annotations, and / or adverse events. The global surgical system is further configured to collect data regarding smart device operating parameters such as, for example, clamp times, tissue pressures, wait times, usage counts, patient time on table, battery levels, motor currents, and / or actuation strokes. The global surgical system is configured to adjust default control programs and / or update existing control programs based on detected operating parameters. In this way, each surgical instrument within the global surgical system can perform the most effective and / or efficient surgical procedures possible.

[0170] Figure 26A network 28300 of surgical instruments 28310 in communication with a cloud-based storage medium 28320 is shown. The cloud-based storage medium 28320 is configured to receive data related to operating parameters from surgical instruments 28310 that are collected over many surgical procedures. This data is used by the cloud-based storage medium 28320 to optimize control programs to achieve efficient and / or desired results. The cloud-based storage medium 28320 is further configured to analyze all collected data in random batches 28340. The results of the analysis from random batches 28340 can further be used to redefine control programs. For example, data collected within batch A can represent a significantly different wear curve. It can then be possible to draw a conclusion from this data that the instrument wears faster by adjusting power, for example, rather than clamp current. The cloud-based storage medium 28320 is configured to communicate this finding and / or conclusion with the surgical instruments. The surgical instruments can then maximize the life of the instrument by adjusting clamp current rather than power, and / or the surgical system can alert the clinician of the finding.

[0171] Figure 26 A network 28300 of surgical instruments 28310 in communication with a cloud-based storage medium 28320 is shown. The cloud-based storage medium 28320 is configured to receive data related to operating parameters from surgical instruments 28310 that are collected over many surgical procedures. This data is used by the cloud-based storage medium 28320 to optimize control programs to achieve efficient and / or desired results. The cloud-based storage medium 28320 is further configured to analyze all collected data in random batches 28340. The results of the analysis from random batches 28340 can further be used to redefine control programs. For example, data collected within batch A can represent a significantly different wear curve. It can then be possible to draw a conclusion from this data that the instrument wears faster by adjusting power, for example, rather than clamp current. The cloud-based storage medium 28320 is configured to communicate this finding and / or conclusion with the surgical instruments. The surgical instruments can then maximize the life of the instrument by adjusting clamp current rather than power, and / or the surgical system can alert the clinician of the finding.

[0172] The information collected by the cloud-based storage medium 28320 from the network 28300 of surgical instruments 28310 is presented in graphical form in FIGS. 1 1-13. Figure 27 and 28 More particularly, Figure 27A relationship between a gap 28430 defined between jaws of an end effector (which changes over time from a point in time of initial tissue contact during a surgical procedure) and a jaw motor clamp current 28440 is shown. The number of times a particular end effector has reached a fully clamped state during a jaw clamping stroke affects the amount of force required to clamp a tissue of the same thickness. For example, the jaws of an end effector can clamp to a greater extent with less current for 1-10 times 28430a the end effector is fully clamped compared to 10-15 times 28430b the end effector is fully clamped. Further, the jaws of an end effector can clamp to a greater extent with less current for 10-15 times 28430b the end effector is fully clamped compared to 16-20 times 28430c the end effector is fully clamped. Finally, clamping a tissue of the same thickness to the same fully clamped gap requires more force and thus more current as the surgical instrument continues to be used. The collected information from the surgical instrument 28310 and the cloud-based storage medium 28320 can be used to modify the control program to perform a more efficient and / or timely jaw clamping stroke.

[0173] The current required to clamp a tissue of the same thickness by achieving the same fully clamped gap between the jaws of an end effector is used to set a motor current threshold for the generator. As shown, Figure 28 for an end effector that has reached a fully clamped state less than 10 times, the motor current threshold is lower because less current is required to achieve the fully clamped state. Thus, the control program sets the threshold generator power lower for newer end effectors compared to the threshold generator power for older end effectors. If the same generator power is used in an older end effector as is used in a newer end effector, the tissue can not be clamped and / or compressed sufficiently between the jaws of the end effector. If the same generator power is used in a newer end effector as is used in an older end effector, the tissue and / or the instrument can be damaged because the tissue can be over-compressed by the jaws of the end effector.

[0174] In various instances, a surgical system includes modular components. For example, a surgical system includes a surgical robot that includes robot arms, where the robot arms are configured to receive tools having different capabilities thereon. For example, a control program of the surgical system is modified based on a type of modular accessory, such as a tool connected to a surgical robot arm. In other instances, a surgical system includes a hand-held surgical instrument that is configured to receive different and / or replaceable end effectors thereon. The hand-held surgical instrument is configured to identify an attached end effector and modify a control program based on a determined identity of the end effector prior to performing an intended surgical function.

[0175] The surgical system is configured to identify the attached modular component using adaptive and / or intelligent interrogation techniques. In various instances, the surgical system uses a combination of electrical interrogation and mechanical actuation interrogation to determine the capacity and / or capability of the attached component. The response to the interrogation can be recorded and / or compared to information stored within the memory of the surgical system to establish baseline operating parameters associated with the identified modular accessory. In various instances, the established baseline parameters are stored within the memory of the surgical system for use in future identification of the same or similar modular accessory.

[0176] In various instances, an electrical interrogation signal is transmitted from the handle of the surgical instrument to the attached modular component, where the electrical interrogation signal is transmitted to determine the identity, operating parameters, and / or status of the attached modular component. The attached modular component is configured to transmit a response signal having identifying information. In various instances, a response to the interrogation signal is not received and / or the response signal includes unidentifiable information. In such instances, the surgical instrument can execute a default function in order to assess the capability of the attached modular component. The default function is defined by conservative operating parameters. In other words, the default operating parameters used during execution of the default function are defined to a particular level in order to avoid causing damage to the surgical instrument and / or the attached modular component, causing harm to the patient, and / or causing harm to the user. The surgical instrument is configured to utilize the results of the default function to set operating procedures specific to the attached modular component.

[0177] For example, the surgical instrument can execute a tissue cutting stroke, where a cutting member traverses the attached end effector from a proximal position toward a distal position. In instances where the surgical instrument is unable to identify the attached end effector, the surgical instrument is configured to execute the tissue cutting stroke using default operating parameters. With the position of the cutting member within the end effector at the end of the tissue cutting stroke, the surgical instrument can determine the length of the tissue cutting stroke associated with the attached end effector and / or suitable for completion with the attached end effector. The surgical instrument is configured to record the distal-most position of the cutting member in order to set additional operating parameters associated with the attached end effector. Such additional operating parameters include, for example, the speed of the cutting element and / or the length of the end effector during the tissue cutting stroke.

[0178] The default function can also be used to determine one and / or more current states of the attached modular component. For example, the default function can be executed to determine whether the attached end effector is articulated and / or the extent to which the attached end effector is articulated. The surgical instrument is then configured to adjust the control program accordingly. When the end effector is articulated across a range of articulation angles, the length of the cutting stroke changes. In other words, the length of the cutting stroke is different when the end effector is in an articulated state as compared to when the end effector is in an unarticulated state. The surgical instrument is configured to update the control program to execute a cutting stroke that spans the length associated with the last detected full stroke. The surgical instrument is further configured to use the length of the last completed cutting stroke to determine whether the full length of the cutting stroke is achieved and / or completed with the current control program when the end effector is articulated as compared to when the end effector is unarticulated.

[0179] In various instances, the surgical system can perform intelligent assessments of characteristics of the attached component. Such characteristics include, for example, tissue pad wear, extent of accessory use, and / or operating conditions of the accessory. In other words, the surgical system is configured to assess the functionality and / or condition of the attached component. Upon detecting a characteristic of the attached modular component, the control program for operating the surgical system is adjusted accordingly.

[0180] The surgical instrument includes one or more tissue pads located on the jaws of the end effector. As is known, tissue pads are generally susceptible to wearing and tearing over time, for example, due to frictional engagement with the blade when no tissue is present therebetween. For example, the surgical instrument is configured to determine the extent of tissue pad wear by analyzing the remaining tissue pad thickness and / or stiffness. With the determined state of the tissue pad, the surgical instrument adjusts the control program accordingly. For example, the control program can alter the applied pressure and / or power level of the surgical instrument based on the determined state of the tissue pad. In various instances, in response to a detected thickness of the tissue pad that is less than a threshold thickness, the processor of the surgical instrument can automatically reduce the power level of the surgical instrument.

[0181] The surgical instrument includes combined electrosurgical functions, wherein the surgical instrument includes an end effector comprising a first jaw and a second jaw. At least one of the first jaw and the second jaw is configured to move toward each other to switch the end effector between an open configuration and a closed configuration. The first jaw and the second jaw include electrodes disposed thereon. The electrosurgical instrument includes one or more power generators configured to supply power to the electrodes to power them. The surgical instrument can assess the degree of charring and / or tissue contamination on one or more end effector jaws by measuring impedance when the end effector is in a closed configuration and no patient tissue is present therebetween. A predetermined impedance can be stored in the memory of the surgical instrument, wherein if the impedance exceeds a predetermined threshold, the jaw includes an undesirable level of charring and / or tissue contamination thereon. As discussed in more detail herein, an alert can be issued to the user upon detection of an undesirable level of charring. In various cases, the processor of the surgical instrument and / or surgical hub can automatically adjust operating parameters in response to the detected closed jaw impedance. For example, such operating parameters include power level, applied pressure level, and / or advanced tissue cutting parameters.

[0182] like Figure 29 As shown, the graphical representation 28500 illustrates the relationship 28530 between the measured impedance 28250 and multiple activation cycles 28510. Before any energy activation (n=0 activation), the baseline impedance is measured and recorded in memory. As discussed above, the impedance is measured when the end effector of the surgical instrument is in a closed configuration and no patient tissue is present therein. The surgical instrument and / or surgical hub prompts the user to change the end effector to a closed configuration in order to measure the closed jaw impedance. For example, such prompts can be delivered at predefined activation intervals (such as n=5, 10, 15, etc.). As carbonization and / or tissue contamination accumulates on the jaws of the end effector, the impedance increases. At a level equal to and / or higher than a first predetermined level 28540, the surgical instrument and / or surgical hub is configured to alert the user to this carbonization accumulation and suggest that the user clean the end effector. At a level equal to and / or higher than a second predetermined level 28550, surgical instruments and / or surgical hubs can prevent the user from using various operational functions of the surgical instruments before the end effector is cleaned. Assuming the measured impedance has been reduced to an acceptable level, the operational lock can be removed after cleaning the end effector.

[0183] As discussed above, the surgical hub and / or surgical instrument are configured to alert the user when a predetermined impedance is met and / or exceeded. This alert can be communicated through various forms of feedback, including, for example, tactile feedback, audio feedback, and / or visual feedback. In at least one instance, the feedback includes audio feedback, and the surgical instrument can include a speaker that emits a sound such as, for example, a beep when an error is detected. In certain instances, the feedback includes visual feedback, and the surgical instrument can include a light emitting diode (LED) that, for example, flashes when an error is detected. In certain instances, visual feedback can be communicated to the user through an alert presented on a display monitor within the user’s field of view. In various instances, the feedback includes tactile feedback, and the surgical instrument can include an electric motor that includes an eccentric element that vibrates when an error is detected. The alert can be specific or general. For example, the alert can specifically indicate that the closure jaw impedance exceeds a predetermined level, or the alert can specifically indicate the measured impedance.

[0184] In various instances, the surgical instrument and / or surgical hub are configured to detect parameters such as integrated shaft stretch, damage, and / or tolerance stack-up to compensate for functional parameter operation of the motorized actuator. The surgical instrument is configured to alert the user when the detected parameters of the attached end effector and / or shaft approach and / or are outside of a desired operating range specific to the attached components. In addition to alerting the user, in various instances, operation of the surgical instrument is prevented when it is detected that the surgical instrument cannot operate within the adjusted predefined envelope. The surgical instrument and / or surgical hub include an override, where the user is allowed to override the lock under certain predefined conditions. Such predefined conditions include: an emergency, the surgical instrument is currently in use during a surgical procedure where the surgical instrument cannot be used without causing harm to the patient, and a one-time override allows the user to decide on their own to use the surgical instrument once more. In various instances, the override is also used to allow the user to perform secondary end effector functions that are not related to the primary end effector function. For example, if the surgical instrument prevents the jaws of the end effector from articulating, the user can activate the override to allow the surgical instrument to articulate the end effector.

[0185] The surgical system can adjust a control program configured to operate the surgical instrument in response to detected instrument actuation parameters, energy generator parameters, and / or user inputs. The determined state of the surgical instrument is used in conjunction with the user inputs to adjust the control program. For example, the determined state of the surgical instrument can include whether the end effector is in its open configuration, whether the end effector is in its closed configuration, and / or whether tissue impedance is detectable. The determined state of the surgical instrument can include more than one detected characteristic. For example, the determined state of the surgical instrument can be assessed using a combination of two or more measurements, a series of ordered operations, and / or an interpretation made based on a familiar user input usage scenario. For example, the control program is configured to adjust various functions of the surgical instrument such as power levels, step-up or step-down in power, and / or various motor control parameters.

[0186] The surgical system includes a surgical instrument that includes a combined electrosurgical function, where the surgical instrument includes an end effector that includes a first jaw and a second jaw having electrodes disposed thereon. The electrosurgical instrument includes one or more power generators configured to supply power to the electrodes to energize the electrodes. More specifically, energy delivery to patient tissue supported between the first and second jaws is achieved through the electrodes configured to deliver energy in monopolar mode, bipolar mode, and / or a combined mode having alternating or mixed bipolar and monopolar energy. As described in greater detail herein, the surgical system can adjust the energy power activation level of the one or more generators based on various monitored parameters of the surgical instrument.

[0187] The surgical system is configured to adjust energy power activation based on instrument monitoring parameters. In various instances, the surgical system can monitor a sequence of activation of various surgical instrument functions. The surgical system can then automatically adjust various operational parameters based on the activation of the surgical instrument functions. For example, the surgical system can monitor activation of a rotation and / or articulation control and prevent the surgical instrument from being able to deliver energy to patient tissue while such secondary non-clamp control is in use.

[0188] In various instances, for example, the surgical system can adjust the instrument power level to compensate for a detected operational parameter such as a deficient battery and / or motor drive power level. For example, detecting a deficient battery and / or motor drive power level can indicate to the surgical system that the clamp strength of the end effector is compromised and / or impaired resulting in undesirable control of patient tissue located therebetween.

[0189] A surgical system can record operating parameters of surgical instruments during use that are associated with a specific intended function. The surgical system can then use these recorded operating parameters to adjust the energy power level and / or the surgical instrument mode, for example, when it recognizes that a specific intended function is being performed. In other words, the surgical system can automatically adjust the energy power level and / or the surgical instrument mode using stored preferred operating parameters when the desired function of the surgical instrument is recognized, and / or the surgical instrument can adjust the energy power level and / or the surgical instrument mode to support and complement the desired function. For example, the surgical system can supplement a detected lateral load on an axis by applying monopolar power, since the detected lateral load on the axis is typically due to grinding anatomy with the end effector in its closed configuration. The surgical system decides to apply monopolar power because it knows, through prior procedures and / or through information stored in memory, that monopolar power results in improved anatomy. In various cases, the surgical system is configured to apply monopolar power proportionally to the increase in detected lateral load.

[0190] Surgical systems can adjust control programs configured to operate surgical instruments in response to detected end effector parameters. For example... Figure 30 As shown, surgical instruments can automatically modify the gap clamping control program using measured tissue conductivity. For example, tissue conductivity is measured at two frequencies, such as 50 kHz and 5 MHz. Low-frequency conductivity (GE) is driven by extracellular fluid, while high-frequency conductivity (GI) is driven by intracellular fluid. For example, intracellular fluid levels change when cells are damaged. The end effector can be configured in both open and closed configurations. Therefore, when the end effector is actuated from its open configuration toward its closed configuration, the jaws of the end effector compress the tissue located therebetween. During tissue compression, changes in conductivity between the two frequencies can be detected and / or recorded. The surgical system is configured to adjust the control program based on the ratio of low-frequency conductivity (GE) to high-frequency conductivity (GI) to control the clamping compression of the end effector. The surgical system adjusts the control program until it approaches discrete, predetermined points and / or inflection points, whereby these predetermined points and / or inflection points indicate that cell damage may be nearby.

[0191] More specifically, Figure 30is a graphical representation 29000 of the relationship between measured tissue conductivity 29100, the ratio of low frequency conductivity to high frequency conductivity 29200, the size of the jaw aperture 29300, and the jaw motor force 29400 over the duration of the jaw clamping stroke 29010. At the beginning of the jaw clamping stroke, the measured tissue conductivity is at its lowest because the jaws of the end effector initially make contact with the patient tissue, and the jaw aperture 29300 is at its maximum when the end effector is in its open configuration. The jaw motor force is low at the beginning of the jaw clamping stroke due at least in part to the small amount of electrical resistance provided from the tissue located between the jaws to the jaws. The low frequency conductivity 29110 increases prior to compression but after contact between the patient tissue and the jaws of the end effector, which indicates the presence of extracellular fluid within the captured tissue. Similarly, the high energy conductivity 29120 increases prior to compression but after contact between the patient tissue and the jaws of the end effector, which indicates the presence of intracellular fluid.

[0192] As the end effector begins to move toward its closed configuration, the jaws of the end effector begin to clamp the tissue located therebetween, and thus the jaw aperture 29300 continues to decrease. The jaws begin to compress the tissue; however, it is undesirable for the patient tissue to be sealed by the surgical instrument before the liquid begins to be expelled from the compressed tissue. The jaw motor force continues to increase during the jaw clamping stroke as the captured tissue removes increased resistance to the end effector jaws.

[0193] After the initial expulsion of extracellular fluid causes the low frequency conductivity (GE) 29110 to decrease, the low frequency conductivity (GE) 29110 remains relatively constant during the jaw clamping stroke. The high frequency conductivity (GI) 29120 remains relatively constant during the jaw clamping stroke until after the patient tissue is sealed. As the tissue continues to be compressed after sealing is complete, intracellular tissue damage occurs and intracellular fluid is expelled. At this point, the high frequency conductivity 29120 decreases, resulting in the ratio of low frequency conductivity to high frequency conductivity 29210 peaking. A tissue damage threshold 29220 is predetermined as the peak in the ratio of low frequency conductivity to high frequency conductivity 29210 reaches and / or exceeds the tissue damage threshold 29220, the surgical system alerts the user and / or automatically prompts the surgical system to modify the operating parameters. At this point, the surgical system is configured to modify the control program to stop urging the jaws of the end effector toward the closed configuration of the end effector and / or begin urging the jaws of the end effector back toward the open configuration of the end effector. In various instances, the surgical system is configured to modify the control program to decrease the jaw clamping force. This adjustment to the control program prevents additional tissue damage.

[0194] The surgical system is configured to modify a control program based on cooperative dual inputs. More specifically, the surgical system can change a motor actuation rate based on user input and predefined settings. For example, the greater the force a user applies to a handle control, the faster the motor is actuated to trigger the system. In various instances, a handle control can be used to communicate different commands to the surgical system depending on the context of use of the surgical system. More specifically, the surgical system can monitor and / or record specific user inputs. The specific user inputs can be analyzed for length, duration, and / or any suitable characteristic that can be used to differentiate the inputs. For example, a handle of a surgical instrument can include a trigger, where the trigger is configured to control shaft rotation. In various instances, faster actuation of the trigger corresponds to an increase in the rate of shaft rotation; however, the maximum force (current) threshold of the motor remains constant. In other instances, faster actuation of the trigger corresponds to an increase in the force applied, while the rotation speed threshold remains unchanged. This control can be further differentiated by shaft rotation speed, which increases based on the duration the user actuates the trigger, while force is based on the rate at which the trigger is actuated.

[0195] In various instances, the motor actuation control is based on a combination of predefined settings and detection of instrument operating parameters and / or user control parameters. Figure 31 is a graphical representation 29500 of the relationship between actual jaw closure velocity 29520 and trigger velocity 29510 indicated by user input. The jaw closure velocity 29520 resulting from the corresponding user input 29510 alone is represented by a first line 29530. As the user input trigger velocity 29510 increases, the jaw closure velocity 29520 also increases. This relationship 29530 is determined without considering any additional parameters. The jaw closure velocity 29520 resulting from the corresponding user input 29510 and the determination of thick tissue located between the jaws of an end effector is represented by a second line 29540. As the user input trigger velocity 29510 increases, the jaw closure velocity 29520 also increases; however, the jaw closure velocity 29520 is less than the jaw closure velocity if only the user input trigger velocity is considered. The additional consideration— tissue thickness— slows the jaw closure velocity in order to prevent, for example, damage to patient tissue and / or the surgical instrument.

[0196] A surgical system includes many components. For example, a surgical system includes many handheld surgical instruments, a surgical hub, and a surgical robot. In various instances, each component of the surgical system communicates with other components and can issue commands, and / or can alter control programs based on at least one monitored parameter and / or user input. The surgical system includes a means for determining which system is in charge and which system makes partial operational decisions. This designation can change based on situational awareness, predetermined occurrences, and / or exceeding a threshold. In various instances, a command protocol can be established within the surgical system to indicate the type of commands each component is able to issue and / or to which components the issuing component can direct commands within the surgical system.

[0197] The command protocol can use predefined thresholds to determine when to authorize a transfer of control. For example, a surgical system includes a generator and a handheld surgical instrument, including various controls therein. At the beginning of a surgical procedure, initially the generator is in control and the generator adjusts power based on a detected impedance. The generator uses the detected impedance and / or the current power level to command a pressure control within the handle of the surgical instrument to follow a particular pressure demand. At some time during the surgical procedure, a lower impedance threshold is exceeded, which indicates that the generator algorithm has detected an electrical short. The generator passes control to the pressure control within the handle by instructing the pressure control to determine whether tissue is still between the jaws of the end effector. The pressure control is then able to determine an appropriate tissue compression and can communicate information - which power level and / or energy modality is most appropriate for the detected tissue.

[0198] The control protocol can be determined based on a consensus reached by a plurality of the components within the surgical system. For example, three components within the surgical system detect a first value related to a monitored parameter, while two components within the surgical system detect a second value related to the same monitored parameter, where the first value and the second value are different. The group of three components includes more components than the group of two components, and thus the first value of the monitored parameter control is more. Each component within the surgical system can be assigned a position within a hierarchy. The hierarchy can be established based on the reliability of a particular component and / or the capabilities of a particular component. A first component detects a first value related to a monitored parameter and a second component detects a second value related to the same monitored parameter, where the first value and the second value are different. Within the hierarchy of the surgical system, the second component is “higher ranked” than the first component, and thus the second value of the monitored parameter detected by the second component control is higher ranked.

[0199] Various aspects of the subject matter described herein are set out in the following embodiments:

[0200] Set of Embodiments 1

[0201] Example 1 - A surgical system comprising a surgical instrument, a generator configured to supply power to an end effector, and a processor configured to execute a control program to operate the surgical system. The surgical instrument comprises the end effector comprising a first jaw and a second jaw. At least one of the first jaw and the second jaw moves relative to one another between an open position and a closed position. Tissue is configured to be located between the first jaw and the second jaw. The processor is configured to detect a first parameter of the surgical system, detect at least one user input, and modify the control program in response to the detected first parameter and the at least one user input.

[0202] Example 2 - The surgical system of Example 1, wherein the control program is configured to control a power level of the generator.

[0203] Example 3 - The surgical system of Example 1 or 2, wherein the control program is configured to control a motor, wherein the motor is configured to move the end effector between the open configuration and the closed configuration.

[0204] Example 4 - The surgical system of Example 3, wherein the control program is configured to control the motor by a motor control parameter, and wherein the control program is configured to adjust the motor control parameter in response to the detected first parameter and the detected user input.

[0205] Example 5 - The surgical system of Example 1, 2, 3, or 4, wherein the first parameter comprises an instrument actuation parameter.

[0206] Example 6 - The surgical system of Example 1, 2, 3, 4, or 5, wherein the first parameter comprises a generator operation parameter.

[0207] Example 7 - The surgical system of Example 1, 2, 3, 4, 5, or 6, wherein the first parameter comprises a status of the end effector.

[0208] Example 8 - The surgical system of Example 1, 2, 3, 4, 5, 6, or 7, wherein the first parameter indicates whether the end effector is in the open configuration or the closed configuration.

[0209] Example 9 - The surgical system of Example 1, 2, 3, 4, 5, 6, or 7, wherein the first parameter indicates whether the tissue is located between the first jaw and the second jaw.

[0210] Example 10 - The surgical system of Examples 1, 2, 3, 4, 5, 6, 7, 8, or 9, wherein the surgical instrument is in operational control, and wherein the generator is a default master control system.

[0211] Example 11 - The surgical system of Examples 1, 2, 3, 4, 5, 6, 7, 8, or 9, wherein the control program is configured to cause the generator to be in operational control and the surgical instrument to be the master control system in response to the detected first parameter and the detected user input.

[0212] Example 12 - The surgical system of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11, wherein the first parameter comprises a combination of two measurements.

[0213] Example 13 - The surgical system of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12, wherein the surgical system further comprises a trigger configured to receive the user input, wherein the processor is configured to interpret a plurality of user inputs received by the trigger, wherein each user input comprises a different meaning based on situational use.

[0214] Example 14 - A surgical system comprising a surgical instrument, a generator configured to supply power to the surgical instrument, and a processor configured to run a control program to operate the surgical system. The processor is configured to: detect a status of the surgical instrument, detect at least one user input, and adjust the control program in response to the detected status of the surgical instrument and the at least one user input.

[0215] Example 15 - The surgical system of Example 14, wherein the surgical instrument comprises an end effector, wherein the end effector is configurable in an open configuration and a closed configuration, and wherein the status of the surgical instrument corresponds to whether the end effector is in the open configuration or the closed configuration.

[0216] Example 16 - The surgical system of Examples 14 or 15, wherein the surgical instrument comprises an end effector, wherein the end effector is configurable in an open configuration and a closed configuration, and wherein the status of the surgical instrument corresponds to whether patient tissue is positioned between the first jaw and the second jaw.

[0217] Example 17 - The surgical system of Examples 14, 15, or 16, wherein the surgical system further comprises an input member configured to receive the user input, wherein the processor is configured to interpret a plurality of user inputs received by the input member, wherein each received user input comprises a different meaning based on situational use of the surgical system.

[0218] Example 18 - A surgical system comprising a surgical instrument, a generator configured to supply power to an end effector, and a processor configured to execute a control program to operate the surgical system. The surgical instrument comprises the end effector comprising a first jaw and a second jaw. At least one of the first jaw and the second jaw moves relative to one another between an open position and a closed position. Tissue is configured to be located between the first jaw and the second jaw. The processor is configured to: detect a first parameter of the surgical instrument, detect a second parameter of the generator, detect at least one user input, and modify the control program in response to the detected first parameter, the detected second parameter, and the at least one user input.

[0219] Example 19 - The surgical system of Example 18, wherein the first parameter of the surgical instrument corresponds to whether the end effector is in the open configuration or the closed configuration and whether patient tissue is located between the first jaw and the second jaw.

[0220] Example 20 - The surgical system of Examples 18 or 19, wherein the surgical instrument further comprises an input member configured to receive the user input, wherein the processor is configured to interpret a plurality of user inputs received by the input member, wherein each received user input comprises a different meaning based on situational use of the surgical instrument within the surgical system.

[0221] Set of Embodiments 2

[0222] Example 1 - A surgical instrument comprising a housing, a shaft assembly, a processor, and a memory. The shaft assembly is replaceably connected to the housing. The surgical assembly comprises an end effector. The memory is configured to store program instructions that, when executed from the memory, cause the processor to: send an electrical query signal to an attached shaft assembly; receive a response signal from the attached shaft assembly; cause a default function to be executed when the attached shaft assembly does not receive a response signal; determine an identifying characteristic of the attached shaft assembly as a result of the execution of the default function; and modify a control program based on the identifying characteristic of the attached shaft assembly.

[0223] Example 2 - The surgical instrument of Example 1, wherein the identifying feature comprises a remaining capacity of the attached shaft assembly.

[0224] Example 3 - The surgical instrument of Example 1 or 2, wherein the identifying feature comprises a performance level of the attached shaft assembly.

[0225] Example 4 - The surgical instrument of Example 1, 2, or 3, wherein the identifying feature is different for attached shaft assemblies having different capabilities.

[0226] Example 5 - The surgical instrument of Example 1, 2, 3, or 4, wherein the memory comprises a lookup table comprising operating parameters corresponding to particular shaft assemblies, wherein the processor utilizes the received response signal to identify the attached shaft assembly within the lookup table, and wherein the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.

[0227] Example 6 - The surgical instrument of Example 1, 2, 3, 4, or 5, wherein the memory further comprises program instructions that, when executed, cause the processor to store the modified control program in the memory.

[0228] Example 7 - A surgical instrument comprising a housing, a shaft assembly, a processor, and a memory. The shaft assembly is replaceably connected to the housing. The surgical assembly comprises an end effector. The memory is configured to store program instructions that, when executed from the memory, cause the processor to: send a variable query communication to an attached shaft assembly, determine a capability of the attached shaft assembly based on a response to the variable query communication, and modify a control program based on the determined capability of the attached shaft assembly.

[0229] Example 8 - The surgical instrument of Example 7, wherein the variable query communication comprises an electrical query signal and a physical actuation of the surgical instrument.

[0230] Example 9 - The surgical instrument of Example 7 or 8, wherein the physical actuation of the surgical instrument is monitored to determine a functional capability of the attached shaft assembly.

[0231] Example 10 - The surgical instrument of Example 7, 8, or 9, wherein the determined capability relates to a remaining capacity of the shaft assembly.

[0232] Example 11 - The surgical instrument of Example 7, 8, 9, or 10, wherein the determined capability relates to a performance level of the shaft assembly.

[0233] Example 12 - The surgical instrument of Examples 7, 8, 9, 10, or 11, wherein the capability to be determined differs based on the shaft assembly connected.

[0234] Example 13 - The surgical instrument of Examples 7, 8, 9, 10, 11, or 12, wherein the memory further comprises program instructions that, when executed, cause the processor to store the modified control program and the determined shaft assembly capability in the memory.

[0235] Example 14 - A surgical instrument comprising a housing, a shaft assembly, a processor, and a memory. The shaft assembly is interchangeably coupled to the housing. The surgical assembly comprises an end effector. The memory is configured to store program instructions that, when executed from the memory, cause the processor to: send an inquiry signal to the shaft assembly coupled to the housing; receive a response signal from the shaft assembly coupled to the housing; cause a default end effector function to be executed upon failure to recognize a response signal; determine an identifying characteristic of the shaft assembly coupled to the housing as a result of the execution of the default end effector function; and modify a control program based on the identifying characteristic of the shaft assembly coupled to the housing.

[0236] Example 15 - The surgical instrument of Example 14, wherein the processor fails to recognize the response signal because the processor does not receive the response signal.

[0237] Example 16 - The surgical instrument of Examples 14 or 15, wherein the identifying characteristic comprises a remaining capacity of the shaft assembly coupled to the housing.

[0238] Example 17 - The surgical instrument of Examples 14, 15, or 16, wherein the identifying characteristic comprises a performance level of the shaft assembly coupled to the housing.

[0239] Example 18 - The surgical instrument of Examples 14, 15, 16, or 17, wherein the determined characteristic can differ based on the shaft assembly interchangeably coupled to the housing.

[0240] Example 19 - The surgical instrument of Examples 14, 15, 16, 17, or 18, wherein the memory comprises a lookup table comprising operating parameters corresponding to particular shaft assemblies, wherein the processor utilizes the received response signal to identify the shaft assembly coupled to the housing within the lookup table, and wherein the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.

[0241] Example 20 - The surgical instrument of Example 14, 15, 16, 17, 18, or 19, wherein the memory further comprises program instructions that, when executed, cause the processor to store the modified control program in the memory.

[0242] Set of Embodiments 3

[0243] Example 1 - A surgical system comprising a surgical hub, a surgical instrument, a generator configured to power an end effector; and a smoke evacuation system configured to remove smoke from a surgical procedure site. The surgical instrument comprises the end effector. Control commands are communicated directly from the surgical hub to the surgical instrument. The surgical instrument is configured to communicate the control commands received from the surgical hub to the generator and the smoke evacuation system in a daisy chain fashion.

[0244] Example 2 - The surgical system of Example 1, wherein the surgical instrument is configured to modify the control commands with parameters detected by the surgical instrument.

[0245] Example 3 - The surgical system of Example 2, wherein the surgical instrument is configured to communicate the modified control commands to the generator.

[0246] Example 4 - The surgical system of Example 2 or 3, wherein an operating parameter of the generator is controlled by the modified control commands.

[0247] Example 5 - The surgical system of Example 2, 3, or 4, wherein the generator is configured to alter the modified control commands with second parameters detected by the generator.

[0248] Example 6 - The surgical system of Example 2, 3, 4, or 5, wherein the surgical instrument is configured to communicate the modified control commands to the surgical hub, and wherein the surgical hub is configured to communicate the modified control commands to the generator.

[0249] Example 7 - The surgical system of Example 1, wherein the surgical instrument detects a first parameter of the surgical instrument, wherein the surgical instrument is configured to communicate the detected first parameter to the generator, and wherein the generator is configured to modify the control commands with the first parameter.

[0250] Example 8 - The surgical system of Example 1, wherein the surgical instrument detects a first parameter of the surgical instrument, wherein the surgical instrument is configured to communicate the detected first parameter to the generator, wherein the generator detects a second parameter, and wherein the generator is configured to modify the control command with the first parameter and the second parameter.

[0251] Example 9 - The surgical system of Examples 1, 2, 3, 4, 5, 6, 7, or 8, further comprising a display screen configured to display a real-time feed of a surgical site and a first operational parameter of the surgical instrument.

[0252] Example 10 - The surgical system of Example 9, wherein the surgical instrument further comprises an instrument display configured to display a second operational parameter of the surgical instrument, and wherein the first operational parameter is the same as the second operational parameter.

[0253] Example 11 - The surgical system of Example 9, wherein the surgical instrument further comprises an instrument display configured to display a second operational parameter of the surgical instrument, and wherein the first operational parameter is different than the second operational parameter.

[0254] Example 12 - The surgical system of Examples 9, 10, or 11, wherein the display screen is further configured to display an operational parameter of the generator.

[0255] Example 13 - A surgical system comprising a surgical hub, a surgical instrument, a generator configured to power an end effector, and a smoke evacuation system configured to remove smoke from a surgical site. The surgical instrument comprises the end effector. Control commands are communicated directly from the surgical hub to the surgical instrument. The surgical instrument is configured to communicate the control commands received from the surgical hub to the generator and the smoke evacuation system.

[0256] Example 14 - The surgical system of Example 13, wherein the surgical instrument is configured to daisy chain the control commands received from the surgical hub to the generator and the smoke evacuation system.

[0257] Example 15 - A surgical system comprising a surgical hub, a first surgical instrument, a first generator configured to power a first end effector, and a second surgical instrument. The first surgical instrument comprises the first end effector. Control commands are communicated directly from the surgical hub to the first surgical instrument. The first surgical instrument is configured to communicate the control commands received from the surgical hub to the first generator and the second surgical instrument in daisy chain fashion.

[0258] Example 16 - The surgical system of Example 15, wherein the first surgical instrument is configured to modify the control commands with a first parameter detected by the first surgical instrument.

[0259] Example 17 - The surgical system of Example 16, wherein the first surgical instrument is configured to communicate the modified control commands to the second surgical instrument.

[0260] Example 18 - The surgical system of Example 17, wherein the second surgical instrument is configured to alter the modified control commands with a second parameter detected by the second surgical instrument, and wherein the second surgical instrument is configured to communicate the altered control commands to the first surgical instrument.

[0261] Example 19 - The surgical system of Example 15, wherein the first surgical instrument is configured to detect a first parameter, wherein the second surgical instrument is configured to detect a second parameter, wherein the second surgical instrument is configured to communicate the detected second parameter to the first surgical instrument, and wherein the first surgical instrument is configured to modify the control commands with the first parameter detected by the first surgical instrument and the second parameter detected by the second surgical instrument.

[0262] Example 20 - The surgical system of Examples 15, 16, 17, 18, or 19, wherein the second surgical instrument comprises a smoke evacuation system configured to remove smoke from a surgical procedure site.

[0263] Although a number of forms have been exemplified and described, the scope of the appended claims is not intended to be limited to the particular forms disclosed. Many modifications, variations, changes, substitutions, combinations, and equivalents will occur to those skilled in the art upon reading this disclosure and may be made without departing from the scope of the disclosure. Additionally, alternative forms will occur to practitioners of the art. For instance, the structural description of each element associated with the forms described can alternatively be described as a means for providing the function performed by the element. Furthermore, where materials are disclosed for certain components, other materials may

[0264] The detailed description set forth above exemplifies and describes various forms of apparatus and / or methods. As such, the terms "exemplary" and "in one form" used throughout this disclosure are used merely for purposes of explanation and / or illustration. They are not intended to limit the scope of the appended claims in any way. Although a number of forms have been exemplified and described, the scope of the appended claims is not intended to be limited to the particular forms disclosed. Many modifications, variations, changes, substitutions, combinations, and equivalents will occur to those skilled in the art upon reading this disclosure and may be made without departing from the scope of the disclosure. Additionally, alternative forms will occur to practitioners of the art. For instance, the structural description of each element associated with the forms described can alternatively be described as a means for providing the function performed by the element. Furthermore, where materials are disclosed for certain components, other materials may

[0265] Instructions for programming logic to perform various disclosed aspects can be stored within memory in the system, such as dynamic random access memory (DRAM), cache, flash memory, or other memory. Furthermore, instructions can be received via a network or by way of other computer-readable media. Thus, a machine-readable medium can include any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), but is not limited to, soft disks, optical disks, magnetic disks, Read Only Memory (ROM), Random Access Memory (RAM), erasable programmable read only memory (EPROM), electrically erasable programmable read only memory (EEPROM), magnetic cards or optical cards, flash memory, or tangible, machine-readable storage now known or later developed that is appropriate for the job at hand, using electrical, optical, acoustical or other form of propagated signals (e.g., carrier waves, infrared signals, digital signals, etc.) in the Internet. Accordingly, non-transitory computer-readable media include all tangible, machine-readable media appropriate for storing or transmitting electronic instructions or information in a form readable by a machine (e.g., a computer).

[0266] As used herein in any aspect, the term "control circuitry" can refer to, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor including one or more individual instruction processing cores, processing units, processors, microcontrollers, microcontroller units, controllers, digital signal processors (DSPs), programmable logic devices (PLD), programmable logic arrays (PLA), field programmable gate arrays (FPGA)), state machine circuitry, firmware that stores instructions executed by programmable circuitry, and any combination thereof. The control circuitry can be implemented, in whole or in part, as circuitry that forms a part of a larger system, such as an integrated circuit (IC), an application-specific integrated circuit (ASIC), a system-on-chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, a smart phone, etc. As used herein, "control circuitry" includes, but is not limited to, electronic circuitry with one or more discrete components, electronic circuitry with one or more integrated circuits, electronic circuitry with one or more application-specific integrated circuits, electronic circuitry forming a general-purpose computing device configured by a computer program (e.g., a general-purpose computer configured by computer program instructions to implement, at least in part, the methods described herein and / or a microprocessor configured by computer program instructions to implement, at least in part, the methods described herein), electronic circuitry forming a memory device (e.g., forming a random access memory), and / or electronic circuitry forming a communications device (e.g., a modem, a communications switch, or an opto-electronic device). Those skilled in the art will recognize that the subject matter described herein can be implemented in analog or digital form, or some combination thereof.

[0267] As used in any aspect herein, the term “logic” can refer to an application program, software, firmware, and / or circuitry configured to perform any of the aforementioned operations. Software can be embodied as a software package, code, instructions, instruction sets, and / or data recorded in one or more non-transitory computer-readable storage media. Firmware can be embodied as code, instructions, or instruction sets and / or data that are hard-coded (e.g., nonvolatile) in memory devices.

[0268] As used in any aspect herein, the terms “component,” “system,” “module” and the like can refer to a computer-related entity, either hardware, a combination of hardware and software, software, or software in execution.

[0269] As used in any aspect herein, “algorithm” refers to a self-consistent sequence of steps leading to a desired result, where a “step” refers to a manipulation of physical quantities and / or logic states, which may, but need not, take the form of electrical or magnetic signals, that may, but need not, be stored, transferred, combined, compared, and otherwise manipulated in a manner that is consistent with the nature of the physical quantities and / or logic states. Commonly, these quantities take the form of bits, values, elements, symbols, characters, terms, numbers, and the like. These and similar terms can be associated with the appropriate physical quantities and are merely convenient labels applied to these quantities.

[0270] The network can include a packet-switched network. The communication devices can be capable of communicating with each other using a selected packet-switched network communication protocol. One example communication protocol can include an Ethernet communication protocol that can be capable of allowing communication using the Transmission Control Protocol / Internet Protocol (TCP / IP). The Ethernet protocol can conform to or be compatible with the Ethernet standard entitled “IEEE 802.3 Standard” published by the Institute of Electrical and Electronics Engineers (IEEE) in December 2008 and / or later versions of this standard. Alternatively or additionally, the communication devices can be capable of communicating with each other using an X.25 communication protocol. The X.25 communication protocol can conform to or be compatible with standards published by the International Telecommunication Union Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, the communication devices can be capable of communicating with each other using a Frame Relay communication protocol. The Frame Relay communication protocol can conform to or be compatible with standards published by the Consultative Committee International Telegraph and Telephone (CCITT) and / or the American National Standards Institute (ANSI). Alternatively or additionally, the transceivers can be capable of communicating with each other using an Asynchronous Transfer Mode (ATM) communication protocol. The ATM communication protocol can conform to or be compatible with the ATM standard entitled “ATM-MPLS Network Interworking 2.0” published by the ATM Forum in August 2001 and / or later versions of this standard. Of course, different and / or later-developed connection-oriented network communication protocols are likewise contemplated herein.

[0271] Unless specifically stated otherwise as apparent from the above disclosure, it is appreciated that, throughout the foregoing disclosure, the use of terms such as "processing," "computing," "calculating," "determining," "displaying," or the like, can refer to the action and processes of a computer system, or similar electronic

[0272] One or more components can be referred to herein as "configured to," "configurable to," "operable / operative to," "adapted to / adaptable to," "capable of," "adapted to adaptably," etc. Those skilled in the art will recognize that "configured to" can generally include active- state components and / or inactive-state components and / or pending-state components unless context clearly dictates otherwise.

[0273] The terms "proximal" and "distal" are used herein with respect to a clinician manipulating a handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician, and the term "distal" refers to the portion positioned away from the clinician. It will also be appreciated that, for conciseness and clarity, spatial terms such as "vertical," "horizontal," "up," and "down," can be used herein with respect to the accompanying drawings. However, surgical instruments are employed in many orientations and positions, and the terms are not intended to be limiting and / or absolute.

[0274] Those skilled in the art will recognize that, in general, the terms used herein, and particularly in the appended claims (e.g., in the text of the appended claims) are intended to be "open" terms (e.g., the terms "including" and "including but not limited to", the terms "has" and "having" are intended to be interpreted as "including at least" ; the term "including" should be interpreted as "including without limitation"; etc.). Those skilled in the art will also recognize that, where specific numbers can be mentioned in the claims, such intent can be expressed if desired, and in the absence of such a recitation, no such intent is present. For example, to aid in understanding, the following appended claims can contain the use of the introductory phrases "at least one" and "one or more" to introduce claim recitations. However, the use of such phrases is not to be taken as implying that the use of indefinite articles such as "a" or "an" prior to the recitations of a claim is to be limited to claims containing only one such recitation, even when the same claim includes the introductory phrases "one or more" or "at least one" and the indefinite article such as "a" or "an" (e.g., "a" and / or "an" should generally be interpreted to mean "at least one" or "one or more"), and the same holds true for the use of the definite article prior to the recitations of a claim.

[0275] Furthermore, even when a specific number of claims is explicitly stated, those skilled in the art should recognize that such a statement should generally be interpreted as referring to at least the number stated (e.g., in the absence of other modifiers, a bare statement of "two statements" generally means at least two statements, or two or more statements). Moreover, in cases where conventions such as "at least one of A, B, and C" are used, such constructions are generally intended to have a meaning that those skilled in the art will understand (e.g., "a system having at least one of A, B, and C" will include, but is not limited to, systems having only A, only B, only C, A and B together, A and C together, B and C together, and / or A, B, and C together, etc.). In cases where conventions such as "at least one of A, B, or C" are used, such constructions are generally intended to have a meaning that those skilled in the art will understand (e.g., "a system having at least one of A, B, or C" should include, but is not limited to, systems having only A, only B, only C, A and B together, A and C together, B and C together, and / or A, B, and C together, etc.). Those skilled in the art should also understand that, generally, unless the context otherwise indicates, any transitional words and / or phrases presenting two or more alternative terms in the detailed description, claims, or drawings should be understood to cover the possibility of including one of the terms, any one of the terms, or both of the terms. For example, the phrase "A or B" will generally be understood to include the possibility of "A" or "B" or "A and B".

[0276] With respect to the appended claims, those skilled in the art will understand that the operations described herein can generally be performed in any order. Furthermore, although various operation flowcharts are shown in one or more sequences, it should be understood that the various operations may be performed in other orders than those shown, or may be performed simultaneously. Unless the context otherwise requires, examples of such alternative orderings may include overlapping, interleaving, interruption, reordering, incremental, preparatory, supplementary, simultaneous, reverse, or other altered orderings. Moreover, unless the context otherwise requires, terms such as “in response to,” “related,” or other past tense adjectives are generally not intended to exclude such variations.

[0277] It is worth noting that any reference to "one aspect," "one aspect," "one example," or "one example" means that the specific feature, structure, or characteristic described in connection with said aspect is included in at least one aspect. Therefore, the phrases "in one aspect," "in one aspect," "in one example," and "in one example" appearing in various places throughout the specification do not necessarily refer to the same aspect. Furthermore, specific features, structures, or characteristics may be combined in one or more aspects in any suitable manner.

[0278] In this specification, unless otherwise indicated, the term "about" or "approximately," as used in the disclosure, means an acceptable error for a particular value as determined by one of ordinary skill in the art, which depends in part on how the value is measured or determined. In certain embodiments, the term "about" or "approximately" means within 1, 2, 3, or 4 standard deviations. In certain embodiments, the term "about" or "approximately" means within 50%, 20%, 15%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, or 0.05% of a given value or range.

[0279] In this specification, unless otherwise indicated, all numerical values are to be understood as being modified in all instances by the term "about" or are to be interpreted in a manner consistent with that term. In the context of the present specification, the term "about" or "approximately" means that a value is within 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, or 0.1% of the stated value (or range of values), in light of the number of reported significant digits and by applying ordinary rounding techniques.

[0280] Any numerical range recited herein includes all sub-ranges of the same numerical precision subsumed within the recited range. For example, a range of "1 to 10" includes all sub-ranges between (and including) the recited minimum value of 1 and the recited maximum value of 10, that is, having a minimum value equal to or greater than 1 and a maximum value equal to or less than 10. In addition, all ranges recited herein include the endpoints of the range in their entirety. For example, the range "1 to 10" includes the endpoints 1 and 10. Any maximum numerical limitation recited in this specification is intended to include all lower numerical limitations subsumed therein and any minimum numerical limitation recited in this specification is intended to include all higher numerical limitations subsumed therein. Accordingly, Applicant reserves the right to amend this specification, including the claims, to expressly recite any sub-range included in the ranges expressly recited in this specification. All such ranges are inherently described in this specification.

[0281] Any patent application, patent, non-patent publication, or other disclosure material referred to in this specification is hereby incorporated by reference, to the extent that the incorporated material is not inconsistent with this specification, only to the extent necessary for that purpose, and only to the extent that the incorporated material is not otherwise inconsistent with the prior art. Thus, and to the extent necessary, the disclosure herein supersedes any contradictory or otherwise inconsistent material in the documents, or parts thereof, that are cited herein. Any material, or portion thereof, that is said to be incorporated by reference in this specification, but which contradicts the present definition, statement, or other disclosure material set forth in this specification, is only incorporated to the extent that it is consistent with this specification and its present definition, statement, or other disclosure material.

[0282] In general, numerous benefits have been described which result from the techniques described herein. The foregoing specific embodiments have been presented for purposes of illustration and description. They are not intended to be exhaustive of or to limit the application to the precise forms disclosed. Modifications and variations are possible in light of the above teachings or can be acquired from practice of the application. One or more forms have been chosen and described expressed in one or more specific forms chosen for the convenience of the reader. The one or more forms are not intended to limit the scope of the application which is defined by the claims submitted herewith.

Claims

1. A surgical instrument comprising: a housing; a shaft assembly replaceably connected to the housing, wherein the shaft assembly comprises an end effector; a processor; and a memory configured to store program instructions that, when executed from the memory, cause the processor to: send a variable query communication to an attached shaft assembly; determine a capability of the attached shaft assembly based on a response to the variable query communication; and modify a control program based on the determined capability of the attached shaft assembly; wherein the variable query communication comprises an electrical query signal of the surgical instrument and a physical actuation; wherein i) the end effector comprises a cutting member and the capability of the attached shaft assembly comprises an identification, operating parameters, and / or a current state of the attached shaft assembly, wherein the physical actuation of the surgical instrument comprises performing a tissue cutting stroke in which the cutting member traverses the end effector from a proximal position toward a distal position and no patient tissue is disposed in the end effector, and the capability of the attached shaft assembly is determined by determining a length of the tissue cutting stroke, or ii) the end effector comprises a first jaw and a second jaw, wherein the first and second jaws comprise energizable electrodes disposed thereon, wherein at least one of the first and second jaws is configured to move toward the other of the first and second jaws to configure the end effector between an open configuration and a closed configuration, wherein the capability of the attached shaft assembly comprises a degree of charring and / or tissue contamination on one or more of the first and second jaws, wherein the physical actuation of the surgical instrument comprises configuring the end effector between the open configuration and the closed configuration, and the capability of the attached shaft assembly is determined by measuring an impedance when the end effector is in the closed configuration and no patient tissue is disposed therebetween.

2. The surgical instrument of claim 1, wherein the capability to be determined differs based on the connected shaft assembly.

3. The surgical instrument of claim 1, wherein the memory further comprises program instructions that, when executed, cause the processor to store the modified control program and the determined shaft assembly capability in the memory. ​ ​

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