Intelligent circular stitching instrument

Abstract

Disclosed is a surgical stapler, the surgical stapler comprising: an end effector configured to receive a staple cartridge; a trocar, the trocar being movable relative to the end effector; an anvil removably coupleable to the trocar, where the anvil is movable relative to the end effector based on movement of the trocar, and where the anvil is configured to apply a force to tissue positioned between the anvil and the end effector; a sensor configured to sense a position of the anvil relative to the end effector; a housing including a display; and a control circuit operably coupled to the sensor and the display, where the control circuit is configured to: interrogate the sensor to determine the position of the anvil; and displaying a representation of the determined position on the display.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims the benefit of priority under 35 U.S.C. 119(e) to U.S. Provisional Patent Application Serial No. 63 / 353,279, filed on June 17, 2022, entitled “SMART CIRCULAR STAPLERS,” the disclosure of which is incorporated herein by reference in its entirety. Background Art

[0003] The present disclosure relates to devices, systems, and methods for providing feedback to a user of a circular stapler during a surgical procedure. Summary of the invention

[0004] In various embodiments, a surgical stapler is disclosed, comprising: an end effector configured to receive a staple cartridge; a trocar that can move relative to the end effector; an anvil that can be removably coupled to the trocar; a sensor; a housing that includes a display; and a control circuit that can be operably coupled to the sensor and the display. The anvil can move relative to the end effector based on the movement of the trocar. The anvil is configured to apply force to tissue positioned between the anvil and the end effector. The sensor is configured to sense force. The control circuit is configured to interrogate the sensor to determine force and display a representation of the determined force on a display.

[0005] In various embodiments, a surgical stapler is disclosed, comprising: an end effector configured to receive a staple cartridge; a trocar that can move relative to the end effector; an anvil that can be removably coupled to the trocar; a sensor; a housing that includes a display; and a control circuit that is operably coupled to the sensor and the display. The anvil can move relative to the end effector based on the movement of the trocar. The sensor is configured to sense the position of the anvil relative to the end effector. The control circuit is configured to interrogate the sensor to determine the position of the anvil and display a representation of the determined position on the display.

[0006] In various embodiments, a surgical stapler is disclosed, comprising: an end effector configured to receive a staple cartridge; a trocar that can move relative to the end effector; an anvil that can be removably coupled to the trocar; a sensor; a housing that includes a display; and a control circuit that can be operably coupled to the sensor and the display. The anvil can move relative to the end effector based on the movement of the trocar. The anvil is configured to apply force to tissue positioned between the anvil and the end effector. The sensor is configured to sense the attachment of the anvil to the trocar. The control circuit is configured to interrogate the sensor to determine that the anvil is coupled to the trocar and to display on the display a representation that the anvil is coupled to the trocar. BRIEF DESCRIPTION OF THE DRAWINGS

[0007] The various aspects described herein, both as to surgical organization and method, together with further objects and advantages thereof, may best be understood by reference to the following description taken in conjunction with the following drawings.

[0008] Figure 1 is a block diagram of a computer-implemented interactive surgical system according to one aspect of the present disclosure.

[0009] Figure 2 A surgical system for performing a surgical procedure in an operating room according to one aspect of the present disclosure.

[0010] Figure 3 A surgical hub paired with a visualization system, a robotic system, and smart instruments according to one aspect of the present disclosure.

[0011] Figure 4 A surgical data network according to one aspect of the present disclosure is shown, the surgical data network including a modular communication hub configured to connect modular devices located in one or more operating rooms of a medical facility or any room in a medical facility specifically equipped for surgical operations to a cloud.

[0012] Figure 5 A computer-implemented interactive surgical system according to one aspect of the present disclosure is shown.

[0013] Figure 6 A surgical hub comprising multiple modules coupled to a modular control tower is shown according to one aspect of the present disclosure.

[0014] Figure 7 An augmented reality (AR) system according to one aspect of the present disclosure is shown, the system including an intermediate signal combiner positioned in a communication path between an imaging module and a surgical hub display.

[0015] Figure 8An augmented reality (AR) system according to one aspect of the present disclosure is shown, the system including an intermediate signal combiner positioned in a communication path between an imaging module and a surgical hub display.

[0016] Fig. 9 An augmented reality (AR) device worn by a surgeon to transmit data to a surgical hub is shown according to one aspect of the present disclosure.

[0017] Fig.10 A system for augmenting surgical instrument information using an augmented reality display according to one aspect of the present disclosure is shown.

[0018] Fig.11 A timeline of a situational awareness surgical procedure is shown in accordance with one aspect of the present disclosure.

[0019] Fig.12 A circular stapler according to at least one aspect of the present disclosure is shown.

[0020] Fig.13A A vertically oriented display indicating an anvil is out of range is shown in accordance with at least one aspect of the present disclosure.

[0021] Fig. 13B A diagram showing an anvil within range and ready to fire according to at least one aspect of the present disclosure is shown. Fig.13A Vertically oriented display.

[0022] Fig. 13C A horizontal orientation display indicating an anvil is out of range in accordance with at least one aspect of the present disclosure is shown.

[0023] Fig.13D A diagram showing an anvil within range and ready to fire according to at least one aspect of the present disclosure is shown. Fig. 13C Horizontally oriented display.

[0024] Fig.13E A display on a housing of a circular stapler according to at least one aspect of the present disclosure is shown.

[0025] Fig.14 and Fig.15 According to at least one aspect of the present disclosure, Fig.13A and Fig. 13B An example specific implementation of a display of.

[0026] Fig.16A A display indicating that an anvil is out of range is shown in accordance with at least one aspect of the present disclosure.

[0027] Fig. 16B A diagram showing an anvil within range and ready to fire according to at least one aspect of the present disclosure is shown. Fig.16A display.

[0028] FIG. 17A to FIG. 17F According to at least one aspect of the present disclosure, Fig.16A and Fig. 16B The various states of the display.

[0029] Figures 18 to 25 According to at least one aspect of the present disclosure, Fig.16A and Fig. 16B An example specific implementation of a display of.

[0030] Fig.26A A display indicating unacceptable staple gaps and a lack of force applied to tissue is shown in accordance with at least one aspect of the present disclosure.

[0031] Fig.26B FIG. 1 shows an indication of acceptable staple gaps and the amount of force applied to tissue according to at least one aspect of the present disclosure. Fig.26A display.

[0032] FIG. 27A to FIG. 27F According to at least one aspect of the present disclosure, Fig.26A and Fig.26B The various states of the display.

[0033] Figures 28 to 36 An example implementation of the display of FIG. 26 is shown in accordance with at least one aspect of the present disclosure.

[0034] Fig.37A A display is shown that indicates that an anvil is out of range and an unacceptable amount of force is being applied to tissue by the anvil in accordance with at least one aspect of the present disclosure.

[0035] Fig.37B A diagram showing an indication that the anvil is within range and an acceptable amount of force is being applied to tissue by the anvil according to at least one aspect of the present disclosure Fig.37A display.

[0036] FIG. 38A to FIG. 38F According to at least one aspect of the present disclosure, Fig.37A and Fig.37B The various states of the display.

[0037] Figure 39 to Figure 45 An example implementation of the display of FIG. 37 is shown in accordance with at least one aspect of the present disclosure.

[0038] Fig.46 A display is shown that indicates that an anvil is out of range and an unacceptable amount of force is being applied to tissue by the anvil in accordance with at least one aspect of the present disclosure.

[0039] FIG. 47A to FIG. 47F According to at least one aspect of the present disclosure, Fig.46 The various states of the display.

[0040] Fig.48 and Fig.49 According to at least one aspect of the present disclosure, Fig.46 An example specific implementation of a display of.

[0041] Corresponding reference characters indicate corresponding parts throughout the several views.The exemplifications described herein illustrate the various disclosed embodiments in one form, and such exemplifications should not be construed as limiting the scope of the invention in any way. DETAILED DESCRIPTION

[0042] The applicant of the present application owns the following U.S. patent application, the disclosure of which is incorporated herein by reference in its entirety:

[0043] U.S. patent application Ser. No. 17 / 688,589, filed on Mar. 7, 2022, and entitled “METHOD FOR INTRAOPERATIVE DISPLAY FOR SURGICAL SYSTEMS”

[0044] The applicant of the present application owns the following U.S. patent applications, the disclosures of each of which are incorporated herein by reference in their entirety:

[0045] U.S. Patent Application 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. US-2019-0200981-A1;

[0046] U.S. Patent Application No. 16 / 209,453, now U.S. Patent Publication No. US-2019-0201046-A1, entitled “METHOD FOR CONTROLLING SMART ENERGY DEVICES”; and

[0047] U.S. Provisional Patent Application No. 63 / 348,218, filed on June 2, 2022, entitled “CUSTOMIZATION, TROUBLESHOOTING, AND WIRELESS PAIRING TECHNIQUES FOR SURGICAL INSTRUMENTS”

[0048] Before describing in detail various aspects of the surgical device and generator, it should be noted that the application or use of the illustrative examples is not limited to the details of construction and arrangement of parts shown in the drawings and detailed description. The illustrative examples may be implemented alone or in combination with other aspects, variations and modifications, and may be practiced or performed in various ways. In addition, unless otherwise indicated, the terms and expressions used herein are selected for the convenience of the reader to describe the illustrative examples and are not for limiting purposes. Moreover, it should be understood that one or more of the aspects, expressions of aspects and / or examples described below may be combined with any one or more of the other aspects, expressions of aspects and / or examples described below.

[0049] Various aspects relate to screen displays of surgical systems for various energy-based and surgical stapler-based medical devices. Energy-based medical devices include, but are not limited to, radio frequency (RF)-based monopolar and bipolar electrosurgical instruments, ultrasonic surgical instruments, combined RF electrosurgical and ultrasonic instruments, combined RF electrosurgical and mechanical staplers, etc. The surgical stapler device includes a combined surgical stapler with an electrosurgical device and / or an ultrasonic device. The various aspects of the ultrasonic surgical device can be configured to, for example, cross-cut and / or coagulate tissue during surgery. The various aspects of the electrosurgical device can be configured to, for example, cross-cut, coagulate, scale, weld and / or dry tissue during surgery. The various aspects of the surgical stapler device can be configured to cross-cut and suture tissue during surgery, and in some aspects, the surgical stapler device can be configured to deliver RF energy to tissue during surgery. The electrosurgical device is configured to deliver therapeutic and / or non-therapeutic RF energy to tissue. The elements of the surgical stapler device, electrosurgical device and ultrasonic device can be used in combination in a single surgical instrument.

[0050] In various aspects, the present disclosure provides a screen display of real-time information to the OR team during a surgical procedure. According to various aspects of the present disclosure, many new and unique screen displays are provided to display various visual information feedback to the OR team on the screen. According to the present disclosure, the visual information may include one or more various visual media with or without sound. Generally speaking, the visual information includes still photography, film photography, video or audio recording, graphic art, visual aids, models, displays, visual presentation services and support processes. The visual information can be transmitted on any number of display options, such as, for example, the main OR screen, the energy or surgical stapler device itself, a tablet computer, augmented reality glasses, etc.

[0051] In various aspects, the present disclosure provides a large number of possible option lists to transmit visual information to the OR team in real time, without providing too much visual information to the OR team. For example, in various aspects, the present disclosure provides a screen display of visual information so that the surgeon or other members of the OR team can selectively activate the screen display, such as icons around screen options, to manage a large amount of visual information. One or a combination of various factors can be used to determine the active display, which may include the surgical device based on energy (e.g., electrosurgery, ultrasound) or based on machinery (e.g., suturer) in use, the risk associated with a given display, the experience degree of the surgeon, and the surgeon's choice, etc. In other aspects, visual information may include superimposed or overlapped into a large amount of data in the surgical field of view to manage visual information. In various aspects described below, including the overlapping images that require video analysis and tracking in order to appropriately superimpose data. In contrast to static icons, the visual information data transmitted in this way can provide additional useful visual information to the OR team in a more concise and easier to understand manner.

[0052] In various aspects, the present disclosure provides techniques for selectively activating screen displays, such as icons surrounding a screen, to manage visual information during a surgical procedure. In other aspects, the present disclosure provides techniques for determining an active display using one or a combination of various factors. In various aspects, techniques according to the present disclosure may include selecting an energy-based or mechanical-based surgical device to use as an active display, estimating the risks associated with a given display, leveraging the experience level of the surgeon or OR team making the selection, and the like.

[0053] In other aspects, the technology according to the present disclosure may include superimposing or overlapping a large amount of data onto the surgical field of view to manage visual information. The various display arrangements described in the present disclosure involve superimposing various visual representations of surgical data on the live stream of the surgical field of view. As used herein, the term superposition includes translucent superposition, partial superposition and / or mobile superposition. Graphic superposition may be in the form of transparent graphics, translucent graphics or opaque graphics, or a combination of transparent, translucent and opaque elements or effects. In addition, the overlay may be positioned on an object in the surgical field of view (such as, for example, an end effector and / or a key surgical structure) or at least partially positioned on it or positioned near it. Certain display arrangements may include changes in one or more display elements of the overlay, including changes in color, size, shape, display time, display position, display frequency, highlighting or a combination thereof based on changes in display priority values. The graphic overlay is rendered on top of the active display monitor to quickly and efficiently transmit important information to the OR team.

[0054] In other aspects, techniques according to the present disclosure may include the need to analyze video and tracked overlay images in order to appropriately overlay visual information data. In other aspects, techniques according to the present disclosure may include delivering rich visual information, rather than simple static icons, to provide additional visual information to the OR team in a more concise and easy to understand manner. In other aspects, visual overlays may be used in combination with audible and / or somatosensory overlays (such as thermal devices, chemical devices, and mechanical devices and combinations thereof).

[0055] The following description as a whole relates to devices, systems and methods for providing an augmented reality (AR) interactive experience during surgery. In this context, the surgical field of view and the images of surgical instruments and other objects appearing in the surgical field of view are enhanced by superimposing computer-generated visual, auditory, tactile, somatosensory, olfactory or other sensory information on the real-world image of the surgical field of view, the instruments and / or other objects appearing in the surgical field of view. The image can be streamed in real time, or it can be a still image. Augmented reality is a technology for rendering and displaying virtual or "enhanced" virtual objects, data or visual effects superimposed on a real environment. The real environment may include a surgical field of view. Virtual objects superimposed on the real environment can be represented as anchored or in a set position relative to one or more aspects of the real environment. In a non-limiting example, if the real-world object leaves the real environment field of view, the virtual object anchored to the real-world object will also leave the augmented reality field of view.

[0056] The various display arrangements described in the present disclosure relate to superimposing various visual representations of surgical data on a live stream of the surgical field of view. As used herein, the term superposition includes a translucent superposition, a partial superposition, and / or a moving superposition. In addition, the superposition layer may be positioned on or at least partially positioned on or near an object in the surgical field of view (such as, for example, an end effector and / or a key surgical structure). Certain display arrangements may include changes in one or more display elements of the superposition layer, including changes in color, size, shape, display time, display position, display frequency, highlighting, or a combination thereof based on changes in display priority values.

[0057] As described herein, AR is an enhanced version of the real physical world, achieved by using digital visual elements, sounds or other sensory stimulations delivered via technology. Virtual reality (VR) is a computer-generated environment with scenes and objects that look real, so that the user feels immersed in its surroundings. The environment is perceived by a device called a virtual reality headset or helmet. Mixed reality (MR) and AR are both considered immersive technologies, but they are not the same. MR is an extension of mixed reality, allowing real and virtual elements to interact in the environment. Although AR often adds digital elements to a real-time view using a camera, the MR experience combines elements of both AR and VR, in which the real world and digital objects interact.

[0058] In an AR environment, one or more computer-generated virtual objects may be displayed along with one or more real (i.e., so-called "real world") elements. For example, a real-time image or video of the surrounding environment may be displayed on a computer screen display along with one or more superimposed virtual objects. Such virtual objects may provide supplemental information about the environment or generally enhance the user's perception and engagement with the environment. Conversely, the real-time image or video of the surrounding environment may additionally or alternatively enhance the user's engagement with the virtual objects shown on the display.

[0059] Devices, systems, and methods in the context of the present disclosure enhance images received from one or more imaging devices during a surgical procedure. Imaging devices may include various endoscopes, AR devices, and / or cameras used during non-invasive and minimally invasive surgical procedures to provide images during open surgical procedures. Images may be streamed in real time, or may be still images. These devices, systems, and methods enhance images of a real-world surgical environment by superimposing representations of virtual objects or data and / or real objects on the real surgical environment, thereby providing an augmented reality interactive experience. The augmented reality experience may be viewed on a display and / or AR device that allows a user to view superimposed virtual objects on the real-world surgical environment. The display may be located in or away from the operating room. The AR device is worn on the head of a surgeon or other operating room personnel and typically includes two stereoscopic display lenses or screens, including one stereoscopic display lens or screen for each eye of the user. Natural light can pass through two transparent or translucent display lenses, making various aspects of the real environment visible, while also projecting light to make virtual objects visible to the user of the AR device.

[0060] Two or more displays and AR devices may be used in a coordinated manner, such as a first display or AR device controlling one or more additional displays or AR devices in a system with defined roles. For example, when activating a display or AR device, a user may select a role (e.g., a surgeon, a surgical assistant, a nurse, etc. during a surgical procedure) and the display or AR device may display information related to the role. For example, a surgical assistant may have a virtual representation of a displayed instrument that the surgeon needs when performing the next step of the surgical procedure. The surgeon's focus on the current step may see different displayed information than the surgical assistant.

[0061] Although there are many known screen displays and warnings, the present disclosure provides many new and unique augmented reality interactive experiences during surgical procedures. Such augmented reality interactive experiences include visual, auditory, tactile, somatosensory, olfactory, or other sensory feedback information to the surgical team inside or outside the operating room. Virtual feedback information superimposed on the real-world surgical environment can be provided to the operating room (OR) team, including personnel inside the OR, including but not limited to, for example, the surgeon, the surgeon's assistant, the scrubber, the anesthesiologist, and the circulating nurse. The virtual feedback information can be transmitted on any number of display options, such as the main OR screen display, AR device, energy or surgical stapler instrument, tablet computer, augmented reality glasses, device, etc.

[0062] Figure 1 A computer-implemented interactive surgical system 1 is shown, which includes one or more surgical systems 2 and a cloud-based system 4. The cloud-based system 4 may include a remote server 13 connected to a storage device 5. Each surgical system 2 includes at least one surgical hub 6 in communication with the cloud 4. For example, the surgical system 2 may include a visualization system 8, a robotic system 10, and a handheld intelligent surgical instrument 12, each of which is configured to be able to communicate with each other and / or with the hub 6. In some aspects, the surgical system 2 may include M hubs 6, N visualization systems 8, O robotic systems 10, and P handheld intelligent surgical instruments 12, where M, N, O, and P are integers greater than or equal to 1. The computer-implemented interactive surgical system 1 may be configured to be able to provide an augmented reality interactive experience during a surgical procedure as described herein.

[0063] Figure 2An example of a surgical system 2 is shown for performing a surgical procedure on a patient lying flat on an operating table 14 in a surgical operating room 16. A robotic system 10 is used as part of a surgical system 2 during a surgical procedure. The robotic system 10 includes a surgeon's console 18, a patient side cart 20 (surgical robot), and a surgical robot hub 22. The patient side cart 20 can manipulate at least one removably coupled surgical tool 17 through a minimally invasive incision in the patient's body while the surgeon observes the surgical site through the surgeon's console 18 or an augmented reality (AR) device 66 worn by the surgeon. Images of the surgical site for minimally invasive surgery (e.g., still images or real-time streaming live images) can be obtained through a medical imaging device 24. The patient side cart 20 can manipulate the imaging device 24 to orient the imaging device 24. Images of open surgical procedures can be obtained through a medical imaging device 96. The robotic hub 22 processes images of the surgical site for subsequent display on the surgeon's console 18 or the AR device 66 worn by the surgeon or to other personnel in the surgical operating room 16.

[0064] The optical components of the imaging device 24, 96 or AR device 66 may include one or more illumination sources and / or one or more lenses. The one or more illumination sources may be directed to illuminate multiple portions of the surgical field. One or more image sensors may receive light reflected or refracted from tissue and instruments in the surgical field.

[0065] In various aspects, the imaging device 24 is configured for use in minimally invasive surgery. Examples of imaging devices suitable for the present disclosure include, but are not limited to, arthroscopes, angioscopes, bronchoscopes, choledochoscopes, colonoscopes, cytoscopes, duodenoscopes, enteroscopes, esophago-duodenoscopes (gastroscopes), endoscopes, laryngoscopes, nasopharyngeal-renal endoscopes, sigmoidoscopes, thoracoscopes, and hysteroendoscopes. In various aspects, the imaging device 96 is configured for use in open (invasive) surgery.

[0066] In various aspects, the visualization system 8 includes one or more imaging sensors, one or more image processing units, one or more storage arrays, and one or more displays that are strategically arranged relative to the sterile field. In one aspect, the visualization system 8 includes interfaces for HL7, PACS, and EMR. In one aspect, the imaging device 24 can use multispectral monitoring to distinguish morphology and underlying structure. Multispectral images capture image data within a specific wavelength range on the electromagnetic spectrum. Wavelengths are separated by filters or instruments that are sensitive to specific wavelengths, and specific wavelengths include light from frequencies outside the visible light range, such as IR and ultraviolet. Spectral imaging can extract information that is invisible to the human eye. Multispectral monitoring can reposition the surgical field of view after completing the surgical task to perform tests on the treated tissue.

[0067] Figure 2 The primary display 19 is shown positioned in the sterile field to be visible to an operator at the operating table 14. The visualization tower 11 is positioned outside the sterile field and includes a first non-sterile display 7 and a second non-sterile display 9 facing away from each other. The visualization system 8, directed by the hub 6, is configured to be able to coordinate the flow of information to operators inside and outside the sterile field using the displays 7, 9, 19. For example, the hub 6 may enable the visualization system 8 to display an AR image of a surgical site recorded by an imaging device 24, 96 on the non-sterile displays 7, 9 or by an AR device 66, while maintaining a real-time feed of the surgical site on the primary display 19 or the AR device 66. For example, the non-sterile displays 7, 9 may allow a non-sterile operator to perform diagnostic steps associated with a surgical procedure.

[0068] Figure 3 A surgical hub 6 is shown in communication with a visualization system 8, a robotic system 10, and a handheld intelligent surgical instrument 12. The hub 6 includes a hub display 35, an imaging module 38, a generator module 40, a communication module 30, a processor module 32, a storage array 34, and an operating room mapping module 33. The hub 6 also includes a smoke evacuation module 26 and / or a suction / irrigation module 28. In various aspects, the imaging module 38 includes an AR device 66 and the processor module 32 includes an integrated video processor and an augmented reality modeler (e.g., Fig.10 ). The modular light source can be adapted for use with a variety of imaging devices. In various examples, multiple imaging devices can be placed at different locations in the surgical field of view to provide multiple views (e.g., non-invasive, minimally invasive, invasive, or open surgery). The imaging module 38 can be configured to be able to switch between imaging devices to provide the best view. In various aspects, the imaging module 38 can be configured to be able to integrate images from different imaging devices and provide an augmented reality interactive experience during a surgical procedure as described herein.

[0069] Figure 4 A surgical data network 51 is shown that includes a modular communication hub 53 configured to connect modular devices located in one or more operating rooms / rooms of a medical facility to a cloud-based system. The cloud 54 may include a remote server 63 (connected to a storage device 55) Figure 5). The modular communication hub 53 includes a network hub 57 and / or a network switch 59 that communicate with a network router 61. The modular communication hub 53 is connected to a local computer system 60 to process data. Modular devices 1a-1n located in an operating room may be connected to the modular communication hub 53. The network hub 57 and / or the network switch 59 may be connected to the network router 61 to connect the devices 1a-1n to the cloud 54 or the local computer system 60. Data associated with the devices 1a-1n may be transmitted to a cloud-based computer via a router for remote data processing and manipulation. The operating room devices 1a-1n may be connected to the modular communication hub 53 via a wired channel or a wireless channel. The surgical data network 51 environment may be used to provide an augmented reality interactive experience during a surgical procedure as described herein, and specifically to provide an augmented image in a surgical field of view to one or more remote displays 58.

[0070] Figure 5 A computer-implemented interactive surgical system 50 is shown. The computer-implemented interactive surgical system 50 is similar in many respects to the computer-implemented interactive surgical system 1. The computer-implemented interactive surgical system 50 includes one or more surgical systems 52 that are similar in many respects to the surgical system 2. Each surgical system 52 includes at least one surgical hub 56 that communicates with a cloud 54 that may include a remote server 63. In one aspect, the computer-implemented interactive surgical system 50 includes a modular control tower 23 that is connected to a plurality of operating room devices, such as, for example, smart surgical instruments, robots, and other computerized devices located in the operating room. Figure 6 As shown in FIG. , the modular control tower 23 includes a modular communication hub 53 coupled to a computer system 60 .

[0071] return Figure 5, the modular control tower 23 is coupled to the imaging module 38 (which is coupled to the endoscope 98), the generator module 27 (which is coupled to the energy device 99), the smoke evacuator module 76, the suction / irrigation module 78, the communication module 13, the processor module 15, the storage array 16, the smart device / instrument 21 (which is optionally coupled to the display 39), and the sensor module 29. The operating room devices are coupled to cloud computing resources such as the server 63, the data storage device 55, and the display 58 via the modular control tower 23. The robotic hub 72 may also be coupled to the modular control tower 23 and to the server 63, the data storage device 55, and the display 58. The devices / instruments 21, the visualization system 58, etc. may be coupled to the modular control tower 23 via wired or wireless communication standards or protocols, as described herein. The modular control tower 23 may be coupled to the hub display 65 (e.g., monitor, screen) to display the received augmented images, including the superimposed virtual objects in the real surgical field of view received from the imaging module 38, the device / instrument display 39, and / or other visualization systems 58. The hub display 65 may also display data received from devices connected to the modular control tower 23 in conjunction with graphics and overlay images.

[0072] Figure 6 A surgical hub 56 including multiple modules coupled to a modular control tower 23 is shown. The modular control tower 23 includes a modular communication hub 53 (e.g., a network connectivity device) and a computer system 60 to provide, for example, local processing, visualization, and imaging of enhanced surgical information. The modular communication hub 53 can be hierarchically configured to expand the number of modules (e.g., devices) that can be connected to the modular communication hub 53, and transmit data associated with the module to the computer system 60, cloud computing resources, or both. Each of the network hubs 57 / switches 59 in the modular communication hub 53 may include three downstream ports and one upstream port. The upstream network hub 57 / switch 59 is connected to the processor 31 to provide a communication connection with cloud computing resources and a local display 67. Communication with the cloud 54 can be performed via a wired or wireless communication channel.

[0073] The computer system 60 includes a processor 31 and a network interface 37. The processor 31 is coupled to a communication module 41, a storage device 45, a memory 46, a non-volatile memory 47 and an input / output interface 48 via a system bus. The system bus may be any of several types of bus structures including a memory bus or memory controller, a peripheral bus or external bus and / or a local bus using any of a variety of available bus architectures.

[0074] The processor 31 includes an augmented reality modeler (e.g., Fig.10) and may be implemented as a single-core or multi-core processor, such as those offered by Texas Instruments under the trade name ARM Cortex. In one aspect, the processor may be a commercially available LM4F230H5QR ARM Cortex-M4F processor core, such as Texas Instruments, which includes 256KB of single-cycle flash or other non-volatile memory (up to 40MHz) on-chip memory, a pre-fetch buffer for improved execution above 40MHz, 32KB of single-cycle sequential random access memory (SRAM), a 32KB MCU loaded with Internal read-only memory (ROM) for software, 2KB electrically erasable programmable read-only memory (EEPROM), and / or one or more pulse width modulation (PWM) modules, one or more quadrature encoder input (QEI) simulations, one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, details of which can be found in the product data sheet.

[0075] System memory includes volatile memory and non-volatile memory. The basic input / output system (BIOS), which contains basic routines such as transferring information between elements within the computer system during startup, is stored in non-volatile memory. For example, non-volatile memory may include ROM, programmable ROM (PROM), electrically programmable ROM (EPROM), EEPROM, or flash memory. Volatile memory includes random access memory (RAM) that acts as external cache memory. In addition, RAM is available in a variety of forms, such as SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDRSDRAM) enhanced SDRAM (ESDRAM), synchronous link DRAM (SLDRAM) and direct Rambus RAM (DRRAM).

[0076] Computer system 60 also includes removable / non-removable, volatile / non-volatile computer storage media, such as, for example, disk storage. Disk storage includes, but is not limited to, devices such as disk drives, floppy disk drives, tape drives, Jaz drives, Zip drives, LS-60 drives, flash memory cards, or memory sticks. In addition, disk storage devices may include storage media individually or in combination with other storage media, including but not limited to optical disk drives such as optical disk ROM devices (CD-ROM), optical disk recordable drives (CD-R drives), optical disk rewritable drives (CD-RW drives), or digital universal disk ROM drives (DVD-ROM). In order to facilitate the connection of the disk storage device to the system bus, a removable or non-removable interface may be used.

[0077] In various aspects, Figure 6 Computer system 60, Figures 4 to 6 The imaging module 38 and / or the visualization system 58 and / or the processor module 15 may include an image processor, an image processing engine, a graphics processing unit (GPU), a media processor, or any dedicated digital signal processor (DSP) for processing digital images. The image processor may employ parallel computing with single instruction, multiple data (SIMD) or multiple instructions, multiple data (MIMD) techniques to improve speed and efficiency. The digital image processing engine may perform a range of tasks. The image processor may be a system on a chip with a multi-core processor architecture.

[0078] Figure 7 An augmented reality system 263 is shown that includes an intermediate signal combiner 64 positioned in the communication path between the imaging module 38 and the surgical hub display 67. The signal combiner 64 combines audio and / or image data received from the imaging module 38 and / or the AR device 66. The surgical hub 56 receives the combined data from the combiner 64 and overlays the data provided to the display 67, on which the overlaid data is displayed. The imaging device 68 can be a digital video camera, and the audio device 69 can be a microphone. The signal combiner 64 can include a wireless heads-up display adapter to connect to the AR device 66 placed in the communication path of the display 67 to the console, thereby allowing the surgical hub 56 to overlay data on the display 67.

[0079] Figure 8 An augmented reality (AR) system is shown that includes an intermediate signal combiner positioned in a communication path between an imaging module and a surgical hub display. Figure 8 An AR device 66 worn by a surgeon 73 to transmit data to a surgical hub 56 is shown. The peripheral information of the AR device 66 does not include active video. Instead, the peripheral information only includes device settings or signals that do not have the same refresh rate requirements. The interaction can enhance the surgeon's 73 information based on a link to a preoperative computed tomography (CT) or other data linked in the surgical hub 56. The AR device 66 can identify structures, such as asking whether the instrument is contacting a nerve, vessel, or adhesion. The AR device 66 may include preoperative scan data, optical views, tissue interrogation characteristics obtained throughout the operation, and / or processing in the surgical hub 56 for providing answers. The surgeon 73 can dictate notes to the AR device 66 to be saved in the hub storage device 45 with the patient data for later use in reporting or follow-up.

[0080] The AR device 66 worn by the surgeon 73 is linked to the surgical hub 56 using audio and visual information to avoid the need for overlays and allow for customization of display information around the perimeter of the field of view. The AR device 66 provides signals from a device (e.g., an instrument), answers inquiries about device settings, or position information related to a video link to identify a quadrant or location. The AR device 66 has audio controls and audio feedback from the AR device 66. The AR device 66 is able to interact with all other systems in the operating room and has available feedback and interaction no matter where the surgeon 73 is looking. For example, the AR device 66 may receive commands and inquiries initiated by voice or gesture from the surgeon, and the AR device 66 may provide feedback in the form of one or more modalities including audio, visual, or tactile touch.

[0081] Fig. 9 A surgeon 73 wearing an AR device 66, a patient 74, and a camera 96 ​​may be included in an operating room 75. The AR device 66 worn by the surgeon 73 may be used to present virtual objects superimposed on a real-time image of the surgical field to the surgeon 73 through an augmented reality display 89 or a display 67 connected through a hub. The real-time image may include a portion of the surgical instrument 77. The virtual objects may not be visible to other people in the operating room 75 (e.g., a surgical assistant or nurse), even though they may also be wearing the AR device 66. Even if another person is viewing the operating room 75 using the AR device 66, that person may not see the virtual objects or be able to see the virtual objects in an augmented reality shared with the surgeon 73, or be able to see a modified version of the virtual objects (e.g., based on customization unique to the surgeon 73) or may see different virtual objects.

[0082] Virtual objects and / or data may be configured to appear on a portion of the surgical instrument 77 or in a surgical field captured by the imaging module 38, by the imaging device 68 during minimally invasive surgery, and / or by the camera 96 ​​during open surgery. In the illustrated example, the imaging module 38 is a laparoscopic camera that provides a real-time feed of the surgical field during minimally invasive surgery. The AR system may present virtual objects fixed to real objects without regard to the perspective of one or more observers of the AR system (e.g., surgeon 73). For example, a virtual object may be visible to an observer of the AR system inside the operating room 75, but not to an observer of the AR system outside the operating room 75. When the observer enters the operating room 75, the virtual object may be displayed to an observer outside the operating room 75. The augmented image may be displayed on the surgical hub display 67 or the augmented reality display 89.

[0083] The AR device 66 may include one or more screens or lenses, such as a single screen or two screens (e.g., one screen for each eye of the user). The screen may allow light to pass through the screen so that aspects of the real environment are visible when the virtual object is displayed. The virtual object may be made visible to the surgeon 73 by projecting light. The virtual object may appear to have a degree of transparency or may be opaque (i.e., occluding aspects of the real environment).

[0084] The AR system may be viewable to one or more observers and may include differences between views available to one or more observers while maintaining some aspects common between the views. For example, a heads-up display may change between two views, while virtual objects and / or data may be fixed to real objects or areas in both views. Various aspects may be changed between views, such as color, lighting, or other changes to an object, without changing the fixed position of at least one virtual object.

[0085] The user may view virtual objects and / or data presented in the AR system as opaque or as including a degree of transparency. In one example, the user may interact with the virtual object, such as by moving the virtual object from a first position to a second position. For example, the user may move the object with his own hand. This may be done virtually in the AR system by determining that the hand has moved to a position that coincides with or is adjacent to the object (e.g., using one or more cameras that may be mounted on the AR device 66, such as the AR device camera 79 or a separate camera 96, and which may be static or may be controlled to move) and causing the object to move in response. The virtual aspect may include a virtual representation of a real-world object or may include visual effects, such as lighting effects, etc. The AR system may include rules governing the behavior of virtual objects, such as subjecting virtual objects to gravity or friction, or may include other predefined rules that exclude real-world physical constraints (e.g., floating objects, perpetual motion, etc.). The AR device 66 may include a camera 79 located on the AR device 66 (not to be confused with the camera 96, separate from the AR device 66). The AR device camera 79 or the camera 96 ​​may include an infrared camera, an infrared filter, a visible light filter, multiple cameras, a depth camera, etc. The AR device 66 may project virtual items onto a representation of the real environment so that they may be viewed by the user.

[0086] The AR device 66 may be used in an operating room 75 during a surgical procedure, such as performed by a surgeon 73 on a patient 74. The AR device 66 may project or display virtual objects such as virtual objects during surgery to augment the surgeon's vision. The surgeon 73 may view the virtual objects using the AR device 66, a remote control for the AR device 66, or may interact with the virtual objects, such as "interacting" with the virtual objects using a hand or gestures recognized by a camera 79 of the AR device 66. The virtual objects may augment surgical tools, such as surgical instruments 77. For example, the virtual objects may appear (to the surgeon 73 viewing the virtual objects through the AR device 66) to be coupled to or held at a fixed distance from the surgical instruments 77. In another example, the virtual objects may be used to guide the surgical instruments 77 and may appear to be fixed to the patient 74. In some examples, the virtual objects may react to the movement of other virtual objects or real-world objects in the surgical field of view. For example, the virtual objects may be changed when the surgeon is manipulating a surgical instrument close to the virtual objects.

[0087] The augmented reality display system imaging device 38 captures a real image of the surgical area during the surgical procedure. The augmented reality display 89, 67 presents an overlay of the operational aspects of the surgical instrument 77 on the real image of the surgical area. The surgical instrument 77 includes a communication circuit system 231 to transmit the operational aspects and functional data from the surgical instrument 77 to the AR device 66 via the communication circuit system 233 on the AR device 66. Although the surgical instrument 77 and the AR device 66 are shown as performing RF wireless communication between the circuits 231, 233 as shown by arrows B, C, other communication technologies (e.g., wired, ultrasonic, infrared, etc.) may also be used. The overlay is related to the operational aspects of the active visualization of the surgical instrument 77. The overlay combines various aspects of the tissue interaction in the surgical field of view with the functional data from the surgical instrument 77. The processor portion of the AR device 66 is configured to receive the operational aspects and functional data from the surgical instrument 77, determine the overlay related to the operation of the surgical instrument 77, and combine the tissue aspects in the surgical field of view with the functional data from the surgical instrument 77. The augmented image indicates warnings about device performance considerations, warnings for incompatible use, and warnings about incomplete capture. Incompatible uses include tissue out of range conditions and tissue not properly balanced within the jaws of the end effector. Additional enhanced images provide indications of incidental events, including indications of tissue tension and indications of foreign body detection. Other enhanced images indicate device status overlays and instrument indications.

[0088] Fig.10A system 83 for augmenting an image of a surgical field of view with information using an AR display 89 is shown according to one aspect of the present disclosure. The system 83 can be used to perform the techniques described below, for example, by using a processor 85. The system 83 includes an aspect of an AR device 66 that can communicate with a database 93. The AR device 66 includes a processor 85, a memory 87, an AR display 89, and a camera 79. The AR device 66 may include a sensor 90, a speaker 91, and / or a haptic controller 92. The database 93 may include an image storage device 94 or a preoperative plan storage device 95.

[0089] The processor 85 of the AR device 66 includes an augmented reality modeler 86. The augmented reality modeler 86 can be used by the processor 85 to create an augmented reality environment. For example, the augmented reality modeler 86 can receive an image of an instrument in a surgical field of view, such as from a camera 79 or a sensor 90, and create an augmented reality environment to fit within the displayed image of the surgical field of view. In another example, physical objects and / or data can be superimposed on the surgical field of view and / or the surgical instrument image, and the augmented reality modeler 86 can use the physical objects and data to present an augmented reality display of virtual objects and / or data in the augmented reality environment. For example, the augmented reality modeler 86 can use or detect an instrument at a surgical site of a patient and present a virtual object and / or data on the surgical instrument and / or an image of the surgical site in the surgical field of view captured by the camera 79. The AR display 89 can display an AR environment superimposed on a real environment. The display 89 can use the AR device 66 to display virtual objects and / or data, such as a fixed position in the AR environment.

[0090] The AR device 66 may include a sensor 90, such as an infrared sensor. The camera 79 or sensor 90 may be used to detect movement, such as a gesture of a surgeon or other user, which the processor 85 may interpret as an attempted or intended interaction of the user with a virtual target. The processor 85 may identify objects in the real environment, such as by processing information received using the camera 79. In other aspects, the sensor 90 may be a tactile, auditory, chemical, or thermal sensor to generate corresponding signals that can be combined with various data feeds to create an enhanced environment. The sensor 90 may include binaural audio sensors (spatial sound), inertial measurement sensors (accelerometers, gyroscopes, magnetometers), environmental sensors, depth camera sensors, hand-eye tracking sensors, and voice command recognition capabilities.

[0091] For example, during a surgical procedure, the AR display 89 may present a virtual feature corresponding to a physical feature hidden by an anatomical aspect of the patient, such as within the surgical field of view, while allowing the surgical field of view to be viewed through the AR display 89. The virtual feature may have a virtual position or orientation corresponding to a first physical position or orientation of the physical feature. In one example, the virtual position or orientation of the virtual feature may include an offset from the first physical position or orientation of the physical feature. The offset may include a predetermined distance from the augmented reality display, a relative distance from the augmented reality display to the anatomical aspect, etc.

[0092] In one example, the AR device 66 can be a single AR device. In one aspect, the AR device 66 can be a HoloLens 2 AR device manufactured by Microsoft, Redmond, Wash. The AR device 66 includes goggles with lenses and binaural audio features (spatial sound), an inertial measurement device (accelerometer, gyroscope, magnetometer), environmental sensors, depth cameras and video cameras, hand-eye tracking, and voice command recognition capabilities. It provides an improved field of view with high resolution by using a reflector to guide a waveguide in front of the wearer's eyes. The image can be magnified by changing the angle of the reflector. It also provides eye tracking to identify the user and adjust the lens width for a specific user.

[0093] In another example, the AR device 66 may be a Snapchat Spectacles 3AR device. The AR device is capable of capturing paired images and recreating 3D depth maps, adding virtual effects, and replaying 3D videos. The AR device includes two HD cameras to capture 3D photos and videos at 60fps, while four built-in microphones record immersive high-fidelity audio. Images from the two cameras are combined to build a geometric map of the real world around the user, providing a new sense of depth perception. Photos and videos can be synchronized wirelessly to an external display device.

[0094] In yet another example, the AR device 66 may be Google's Glass 2 AR device, which provides inertial measurement (accelerometer, gyroscope, magnetometer) information superimposed on the lens (beyond the field of view) to supplement the information.

[0095] In another example, the AR device 66 can be Amazon's Echo Frames AR device. This AR device does not have a camera / display. The microphone and speaker are connected to Alexa. This AR device provides less functionality than a heads-up display.

[0096] In yet another example, the AR device 66 may be a Focals AR device from North (Google). The AR device provides push notifications / smart watch simulation; inertial measurement, screen overlay of information (weather, calendar, messages), voice control (Alexa) integration. The AR device provides basic head-up display functionality.

[0097] In another example, the AR device 66 may be a Nreal AR device. The AR device includes spatial sound, two environmental cameras, a photo camera, an IMU (accelerometer, gyroscope), an ambient light sensor, and a proximity sensor. Nebula projects application information on the lens.

[0098] In various other examples, AR device 66 can be any of the following commercially available AR devices: Magic Leap 1, Epson Moverio, Vuzix Blade AR, ZenFone AR, Microsoft AR glasses prototype, EyeTap, to produce light directly into the retina that is co-linear with ambient light. For example, a beam splitter makes the same light seen by the eye available for computer processing and overlay information. AR visualization systems include HUDs, contact lenses, glasses, virtual reality (VR) headsets, virtual retinal displays, operating room displays, and / or smart contact lenses (bionic lenses).

[0099] Multi-user interfaces for the AR device 66 include a virtual retinal display (such as a raster display drawn directly on the retina rather than on a screen in front of the eye), a smart TV, a smart phone, and / or a spatial display (such as the Sony Spatial Display System).

[0100] Other AR technologies may include, for example, AR capture devices and software applications, AR creation devices and software applications, and AR cloud devices and software applications. AR capture devices and software applications include, for example, Apple Polycam application Ubiquity 6 (Mirrorworld using Display.land app), where users can scan and obtain 3D images of the real world (to create 3D models). AR creation devices and software applications include, for example, Adobe Aero, Vuforia, ARToolKit, Google ARCore, Apple ARKit, MAXST, Aurasma, Zappar, Blippar. AR cloud devices and software applications include, for example, Facebook, Google (world geometry, object recognition, prediction data), Amazon AR cloud (business), Microsoft Azure, Samsung Project Whare, Niantic, Magic Leap.

[0101] Situational awareness refers to the ability of some aspects of a surgical system to determine or infer information related to a surgical procedure based on data received from a database and / or instrument. This information may include the type of surgery being performed, the type of tissue being operated on, or the body cavity being the subject of the surgery. Using contextual information related to the surgical procedure, a surgical system can, for example, improve the way in which the surgical system controls modular devices (e.g., robotic arms and / or robotic surgical tools) connected thereto, and provide contextual information or suggestions to the surgeon during the course of the surgical procedure.

[0102] Fig.11 A timeline of situational awareness surgery is shown. Fig.11A timeline 5200 of an exemplary surgical procedure is shown, along with contextual information that the surgical hub 5104 can derive from data received from a data source 5126 at each step of the surgical procedure. The timeline 5200 depicts typical steps that nurses, surgeons, and other medical personnel will take during a lung segment resection procedure, starting with setting up the operating room and ending with transferring the patient to a postoperative recovery room. The situational awareness surgical hub 5104 receives data from data sources 5126 throughout the surgical procedure, including data generated each time medical personnel utilize a modular device 5102 paired with the surgical hub 5104. The surgical hub 5104 can receive this data from the paired modular device 5102 and other data sources 5126, and continually derive inferences (i.e., contextual information) about the ongoing surgery as new data is received, such as which step of the surgery is being performed at any given time. The situational awareness system of the surgical hub 5104 can, for example, record data related to the procedure for generating a report, verify steps being taken by medical personnel, provide data or prompts that may be related to a particular surgical step (e.g., via a display screen), adjust the modular devices 5102 based on the context (e.g., activating a monitor, adjusting the FOV of a medical imaging device, or changing the energy level of an ultrasonic surgical instrument or an RF electrosurgical instrument), and take any other such actions described herein.

[0103] First 5202, hospital staff retrieves the patient's EMR from the hospital's EMR database. Based on the patient data selected in the EMR, the surgical hub 5104 determines that the surgery to be performed is a thoracic surgery.

[0104] Second 5204, the staff scans the incoming medical supplies for the surgery. The surgical hub 5104 cross-references the scanned supplies with a list of supplies utilized in various types of surgeries and confirms that the combination of supplies corresponds to a thoracic surgery. Additionally, the surgical hub 5104 can also determine that the surgery is not a wedge surgery (because the incoming supplies lack certain supplies required for a thoracic wedge surgery, or otherwise do not correspond to a thoracic wedge surgery).

[0105] Third, 5206, the medical personnel scans the patient belt via a scanner 5128 communicatively connected to the surgical hub 5104. The surgical hub 5104 can then confirm the identity of the patient based on the scanned data.

[0106] Fourth, 5208, the medical staff turns on auxiliary equipment. The auxiliary equipment utilized may vary depending on the type of surgical procedure and the technique to be used by the surgeon, but in this exemplary case, they include smoke evacuators, insufflators, and medical imaging devices. When activated, as part of its initialization process, the auxiliary equipment, which is a modular device 5102, can automatically pair with a surgical hub 5104 located in a specific vicinity of the modular device 5102. The surgical hub 5104 can then derive background information about the surgical procedure by detecting the type of modular device 5102 paired with it during this preoperative phase or initialization phase. In this specific example, the surgical hub 5104 determines that the surgical procedure is a VATS procedure based on this specific combination of paired modular devices 5102. Based on a combination of data from the patient's EMR, a list of medical supplies to be used in the surgery, and the type of modular device 5102 connected to the hub, the surgical hub 5104 can generally infer the specific surgery that the surgical team will perform. Once the surgical hub 5104 knows the specific procedure being performed, the surgical hub 5104 can retrieve the steps of the procedure from memory or the cloud and then cross-reference data it subsequently receives from connected data sources 5126 (e.g., modular devices 5102 and patient monitoring devices 5124) to infer the steps of the surgical procedure being performed by the surgical team.

[0107] Fifth 5210, staff attaches EKG electrodes and other patient monitoring devices 5124 to the patient. The EKG electrodes and other patient monitoring devices 5124 can be paired with the surgical hub 5104. As the surgical hub 5104 begins to receive data from the patient monitoring devices 5124, the surgical hub 5104 thus confirms that the patient is in the operating room.

[0108] Sixth, 5212, the medical personnel induces anesthesia in the patient. The surgical hub 5104 may infer that the patient is under anesthesia based on data from the modular device 5102 and / or the patient monitoring device 5124 (including EKG data, blood pressure data, ventilator data, or a combination thereof). Upon completion of the sixth step 5212, the preoperative portion of the lung segmentectomy surgery is completed and the surgical portion begins.

[0109] Seventh, 5214, collapse a lung of the patient undergoing surgery (while ventilation is switched to the contralateral lung). The surgical hub 5104 can infer from the ventilator data that the patient's lung has collapsed. The surgical hub 5104 can infer that the surgical portion of the surgery has begun because it can compare the detection of the patient's lung collapsing to the expected steps of the surgery (which can be previously accessed or retrieved) and determine that collapsing the lung is a surgical step in this particular surgery.

[0110] Eighth, 5216, a medical imaging device 5108 (e.g., an endoscope) is inserted and video from the medical imaging device is started. The surgical hub 5104 receives medical imaging device data (i.e., still image data or real-time live streaming video) through its connection to the medical imaging device. After receiving the medical imaging device data, the surgical hub 5104 can determine that the laparoscopic portion of the surgical procedure has begun. Additionally, the surgical hub 5104 can determine that the particular procedure being performed is a segmentectomy, rather than a lobectomy (note that the surgical hub 5104 has already ruled out wedge procedures based on data received at the second step 5204 of the procedure). From the medical imaging device 124 ( Figure 2 ) data can be used to determine contextual information related to the type of procedure being performed in a number of different ways, including by determining the angle of the visualization orientation of the medical imaging device relative to the patient's anatomy, monitoring the number of medical imaging devices utilized (i.e., activated and paired with the surgical hub 5104), and monitoring the type of visualization devices utilized.

[0111] For example, a technique for performing a VATS lobectomy places a camera in the lower anterior corner of the patient's thorax above the diaphragm, while a technique for performing a VATS segmentectomy places the camera in an anterior intercostal position relative to the segmental fissure. For example, using pattern recognition or machine learning techniques, a situational awareness system can be trained to identify the positioning of a medical imaging device based on visualization of the patient's anatomy. As another example, a technique for performing a VATS lobectomy utilizes a single medical imaging device, while another technique for performing a VATS segmentectomy utilizes multiple cameras. As another example, a technique for performing a VATS segmentectomy utilizes an infrared light source (which can be communicatively connected to a surgical hub as part of a visualization system) to visualize a segmental fissure that is not used in a VATS pulmonary resection. By tracking any or all of this data from the medical imaging device 5108, the surgical hub 5104 can therefore determine the specific type of surgical procedure being performed and / or the technique used for a particular type of surgical procedure.

[0112] Ninth 5218, the surgical team begins the dissection step of the procedure. The surgical hub 5104 may infer that the surgeon is in the process of dissecting to mobilize the patient's lungs because it receives data from the RF generator or ultrasonic generator indicating that energy instruments are being fired. The surgical hub 5104 may cross-reference the received data with the retrieved steps of the surgical procedure to determine that the energy instruments fired at this point in the method (i.e., after the previously discussed surgical steps are completed) correspond to the dissection step.

[0113] Tenth 5220, the surgical team proceeds to the ligation step of the procedure. The surgical hub 5104 can infer that the surgeon is ligating the artery and vein because it receives data from the surgical stapling and cutting instrument indicating that the instrument is being fired. Similar to the previous step, the surgical hub 5104 can derive this inference by cross-referencing the receipt of data from the surgical stapling and cutting instrument with the retrieval step in the method.

[0114] Eleventh 5222, perform the segmented resection portion of the procedure. The surgical hub 5104 infers that the surgeon is transecting soft tissue based on data from the surgical instrument, including data from the staple cartridge. The cartridge data may correspond to the size or type of staple fired by the instrument. The cartridge data may indicate the type of tissue being stapled and / or transected for different types of staples employed in different types of tissue. The type of staple fired is for soft tissue or other tissue types to enable the surgical hub 5104 to infer that a segmented resection procedure is being performed.

[0115] Twelve 5224, perform a node dissection step. The surgical hub 5104 can infer that the surgical team is dissecting a node and performing a leak test based on data received from the generator indicating that an RF or ultrasonic instrument is being fired. For this particular operation, the use of an RF or ultrasonic instrument after transecting the soft tissue corresponds to a node dissection step, which allows the surgical hub 5104 to make this inference. It should be noted that the surgeon regularly switches back and forth between surgical stapling / cutting instruments and surgical energy (i.e., RF or ultrasonic) instruments depending on the specific steps in the operation because different instruments are better suited for specific tasks. Therefore, the specific sequence in which the stapling / cutting instruments and surgical energy instruments are used can indicate the steps of the operation that the surgeon is performing. At the completion of the twelfth step 5224, the incision is closed and the postoperative portion of the operation begins.

[0116] Thirteenth, 5226, reverse the patient's anesthesia. For example, the surgical hub 5104 may infer based on ventilator data (ie, the patient's breathing rate begins to increase) that the patient is waking up from anesthesia.

[0117] Finally, at fourteenth 5228, the medical staff removes the various patient monitoring devices 5124 from the patient. Thus, the surgical hub 5104 may infer that the patient is being transferred to a recovery room when the hub loses the EKG, BP, and other data from the patient monitoring devices 5124. The surgical hub 5104 may determine or infer when each step of a given surgical procedure occurs based on data received from the various data sources 5126 communicatively coupled to the surgical hub 5104.

[0118] In addition to using patient data from the EMR database to infer the type of surgical procedure to be performed, such as Fig.11As shown in the first step 5202 of the timeline 5200 shown in , the situational awareness surgical hub 5104 can also utilize patient data to generate control adjustments for the paired modular device 5102.

[0119] Reference now Fig.12 , a circular stapler 1000 is provided according to at least one aspect of the present disclosure. The circular stapler 1000 includes a housing 1002, a shaft 1004 extending from the housing 1002, and an end effector 1006 extending from the shaft 1004. In various embodiments, the housing 1002 includes a handle grasped by a user of the circular stapler 1000. The end effector 1006 is sized to receive a staple cartridge 1007 therein, the staple cartridge including staples that can be deployed from the staple cartridge 1007 into tissue. In various embodiments, the staple cartridge 1007 includes a cartridge body, an annular array of staple cavities defined in the cartridge body, and staples removably stored in the annular array of staple cavities. The circular stapler 1000 also includes a firing drive configured to drive staples from the staple cavities into tissue and drive a knife into the stapled tissue based on actuation of a firing trigger 1008 on the housing 1002. The housing 1002 also includes a safety 1010 that is configured to prevent unintentional actuation of the firing trigger 1008 by engaging the firing trigger 1008 until the safety 1010 is manually moved away from the firing trigger 1008 .

[0120] The circular stapler 1000 also includes a trocar 1012 sized and configured to be coupled to an anvil shaft 1014 of anvil 1016. In some embodiments, the trocar 1012 can be manually extended and retracted relative to the end effector 1006 by a manual adjustment knob or a rotary actuator 1013 on the proximal end of the housing 1002. In some embodiments, the trocar 1012 can be extended and retracted relative to the end effector 1006 by a motor drive system. The trocar 1012 includes a band 1018 thereon for providing visual feedback about the trocar 1012, such as a visual indication of the position of the trocar 1012, or for visually determining whether the anvil 1016 is coupled to the trocar 1012, as described below.

[0121] In operation, the trocar 1012 is inserted into the anvil shaft 1014 until the locking spring 1020 of the anvil 1016 locks onto the trocar 1012, thereby releasably coupling the anvil 1016 to the trocar 1012. In one aspect, the anvil 1016 is coupled to the trocar 1012 by grasping the gripping area 1022 of the anvil 1016 with a grasping tool and moving the anvil 1016 toward the trocar 1012, as in Fig.191018. In the coupled state, the anvil shaft 1014 covers the band 1018, thereby providing the user with visual confirmation that the anvil 1016 is coupled to the trocar 1012. Once the anvil 1016 is coupled to the trocar 1012, the user can adjust the position of the anvil 1016 relative to the staple cartridge 1007. For example, in some embodiments, the user can move / rotate the manually adjustable knob 1013 on the housing 1002, which moves the trocar 1012 and, therefore, the anvil 1016. The user can rotate the knob 1013 in a first direction to move the anvil 1016 toward the staple cartridge 1007 and the end effector 1006 through the trocar 1012 to capture tissue between the anvil 1016 and the staple cartridge 1007. Similarly, the user can rotate the knob 1013 in a second direction opposite to the first direction to move the anvil 1016 away from the staple cartridge 1007 and the end effector 1006 through the trocar 1012. Other embodiments are contemplated in which the user adjusts the position of the anvil 1016 relative to the staple cartridge 1007 using the motor drive system mentioned above.

[0122] Once the user is satisfied with the position of the anvil 1016, the user can move the safety device 1010 to disengage from the firing trigger 1008 and actuate the firing trigger 1008. Based on the actuation of the firing trigger 1008, the firing drive drives the nail from the nail magazine 1007 through the tissue captured between the anvil 1016 and the nail magazine 1007 and enters the nail pit 1009 defined in the anvil 1016 to form the nail. In addition, the knife cuts the suture tissue based on the actuation of the firing trigger. In many cases, the circular stapler 1000 includes a display 1030 to provide visual feedback to the user, as will be described in more detail below.

[0123] In various embodiments, the rotary actuator 1013 includes a sensor 1040 that is configured to sense various parameters associated with the circular stapler 1000. In some embodiments, the sensor 1040 senses the rotational movement of the rotary actuator 1013, which indicates the longitudinal position of the trocar 1012 and the anvil 1016 relative to the end effector 1006. In various embodiments, the sensor 1040 senses the torque applied by the user to the rotary actuator 1013, which indicates the force applied by the anvil 1016 to the tissue captured between the anvil 1016 and the end effector 1006.

[0124] In various embodiments, the trocar 1012 includes a sensor 1042 that is configured to sense various parameters associated with the circular stapler 1000. In some embodiments, the sensor 1042 senses the longitudinal position of the trocar 1012 relative to the end effector 1006, and therefore senses the relative position of the anvil 1016 relative to the end effector 1006. In various embodiments, the sensor 1042 senses the force experienced by the trocar 1012, which is indicative of the force applied by the anvil 1016 to the tissue captured between the anvil 1016 and the end effector 1006. In some embodiments, the sensor 1042 senses when the anvil 1016 is connected to the trocar 1012.

[0125] In various embodiments, the anvil 1016 includes a sensor 1044 that is configured to sense various parameters associated with the circular stapler 1000. In some embodiments, the sensor 1044 senses when the anvil 1016 has been connected to the trocar 1012. In some embodiments, the anvil 1016 senses its position relative to the end effector. In some embodiments, the anvil 1016 senses the force applied to the tissue captured between the anvil 1016 and the end effector 1006.

[0126] In various embodiments, the circular stapler also includes a control system 1050 that is configured to control various aspects of the circular stapler 1000. In some embodiments, the control system 1030 is in wired or wireless communication with the various sensors 1040, 1042, 1044 and can interrogate the sensors 1040, 1042, 1044 to determine what is being sensed. Based on the determination, the control system 1050 controls various aspects of the circular stapler 1000. In some embodiments, based on the determination, the control system adjusts the display 1030. For example, based on the determination, the control system 1050 displays a representation of the determined parameter on the display 1030, as will be described in more detail below.

[0127] Various other circular staplers are described in U.S. Patent Nos. 8,066,167; 8,353,438; 8,672,207; 8,801,734; 8,801,735; 8,827,903; 8,622,275; 8,899,466; 8,978,955; 9,033,204; 9,113,883; 9,125,654; 10,426,476; 10,980,538; 11,284,890; 10,675,021; 10,682,136, which are hereby incorporated by reference in their entirety.

[0128] Implementation A: Indicator Position Feedback

[0129] Fig.13A and Fig. 13B A display 1100 for providing visual feedback to a user of a circular stapler according to at least one aspect of the present disclosure is shown. In various embodiments, the display 1100 is incorporated into the housing 1002 of the circular stapler 1000. In various embodiments, the display 1100 is shown on the display 1030. In various other embodiments, the display 1100 is visually displayed on a display such as display 7, display 9, display 19, within a display of the surgeon's console 18, on the AR device 66, or in any other suitable location described herein that is configured to convey visual information to the user. In various embodiments, the display 1100 is operably communicated with a control system (such as control system 1030) that controls various aspects of the display 1100, as described herein. In various embodiments, the control system includes a processor and a memory storing instructions executable by the processor. In various embodiments, the control system is any suitable controller, control circuit, hub, etc. described herein.

[0130] Display 1100 provides visual feedback to the user indicating the position of an anvil, such as anvil 1016, relative to a staple cartridge, such as staple cartridge 1007. In various embodiments, display 1100 includes a vertically extending bar 1102 defining an acceptable zone 1104 and unacceptable zones 1106, 1108 surrounding the acceptable zone 1104. Fig.13A As shown in , the unacceptable zone 1106 and the acceptable zone 1104 are separated by a threshold boundary 1114 visible to the user. Similarly, the unacceptable zone 1108 and the acceptable zone 1104 are separated by a threshold boundary 1116 visible to the user. In one aspect, the acceptable zone 1104 corresponds to the position of the anvil relative to the nail magazine suitable for firing nails from the nail magazine. In one aspect, the unacceptable zone 1106 corresponds to the position of the anvil that is too far away from the nail magazine (such as exceeding the threshold limit) and is therefore not suitable for firing nails from the nail magazine. In one aspect, the unacceptable zone 1108 corresponds to the position of the anvil that is too close to the nail magazine (such as below the threshold limit) and is therefore not suitable for firing nails from the nail magazine. In various embodiments, the size of the zones 1104, 1106, 1108 is predefined, stored in the memory, and can be retrieved by the control system. Various other embodiments are envisioned, in which the size of the zones 1104, 1106, 1108 and the position of the threshold boundaries 1114, 1116 are set by the user at the user interface.

[0131] In some embodiments, when the anvil is initially coupled to the trocar of the surgical instrument, the control system detects the attachment of the anvil and generates an indicator 1110 on the display 1100 to identify the position on the bar 1102. Fig.13AAs shown in , when the anvil is initially attached, the control system detects the position of the anvil and the position indicator 1110 in the unacceptable zone 1106 because the detected position of the anvil is too far from the nail magazine. The control system uses any suitable sensor, detector, etc. to detect the attachment of the anvil, as described elsewhere herein. In various embodiments, the control system uses an anvil connectivity sensor (such as sensor 1044) integrated with the anvil to detect the attachment of the anvil. Therefore, as an example, the control system communicates with various sensors (such as force sensors and / or position sensors) in the anvil so that the control circuit can receive, process and / or wirelessly transmit data from the anvil sensor to other devices in the OR to display to the user. The indicator 1110 pointing to the unacceptable zone 1106 indicates to the user that the anvil is positioned too far from the nail magazine, that is, "out of range", and the anvil should be moved closer to the nail magazine, such as using a manual retraction knob 1013 or a motorized system on the housing. When the anvil is in one of the unacceptable zones 1106, 1108, a portion 1112 of the strip 1102 is displayed or illuminated in a first color (such as gray) to indicate that the stapler is not ready to fire. In some embodiments, the control system prevents actuation of the firing drive to deploy staples from the staple cartridge 1007 based on a determination that the indicator 1110 is positioned in one of the unacceptable zones 1106, 1108.

[0132] When the display 1100 indicates that the anvil is in the unacceptable zone 1106, the user can use the retraction knob 1013 or the motorized system to move the anvil toward the nail magazine (via the cannula needle). When the user retracts the anvil, the control system detects the movement of the anvil (using any number of position sensors described elsewhere in this article, etc.) to move the indicator 1110 along the strip 1102 relative to the zones 1104, 1106, and 1108 to visually convey to the user that the anvil is approaching the acceptable zone 1104. In various embodiments, the circular stapler includes a rotational position sensor (such as sensor 1040) that measures the rotation of the retraction knob 1013 to determine the position of the anvil relative to the nail magazine. In various embodiments, the circular stapler includes a linear position sensor (such as sensor 1042) to measure the movement of various components of the stapler (such as the cannula needle itself) to determine the position of the anvil relative to the nail magazine. Once the indicator 1110 has reached the acceptable zone 1104, indicating that the circular stapler is in a "ready to fire" state ( Fig. 13B), the control system causes portion 1112 of strip 1102 to illuminate or display in a second color (such as green) different from the first color, thereby indicating to the user that the anvil is within the receptive zone 1104 and the stapler can be fired. In various other embodiments, the control system actuates a tactile feedback module to notify the user that the anvil is within the receptive zone 1104. In various other embodiments, the control system actuates an auditory module to provide auditory feedback to notify the user that the anvil is within the receptive zone 1104. In various embodiments, the circular stapler includes a lockout that prevents the user from actuating the firing drive unless the control system determines that the anvil is within the receptive zone 1104.

[0133] Fig. 13C and Fig.13D Another display 1120 for providing visual feedback to a user of a circular stapler in accordance with at least one aspect of the present disclosure is shown. Display 1120 is substantially the same as display 1100, except that display 1120 includes a horizontally extending bar 1152 instead of vertically extending bar 1102. The use of horizontally extending bar 1152 utilizes more area of ​​display 1120 when compared to vertically extending bar 1102, which can make it easier to track the position of an indicator along bar 1152.

[0134] Fig.13E Another display 1130 for providing visual feedback to a user of a circular stapler according to at least one aspect of the present disclosure is shown. The display 1130 includes a vertically extending bar 1132, an indicator 1134 that visually indicates the position of the anvil relative to the staple cartridge, a first feedback portion 1136 that surrounds at least a portion of the bar 1132, and a second feedback portion 1138. In one aspect, the first feedback portion 1136 is displayed or illuminated in a first color (such as gray) when the anvil is in an unacceptable zone for firing similar to the unacceptable zones 1106, 1108, and is displayed or illuminated in a second color (such as green) when the anvil is in an acceptable zone for firing similar to the acceptable zone 1104. In one aspect, the second feedback portion 1138 is a visual cue (such as a check mark or any other suitable symbol) that is displayed or illuminated in a first color (such as gray) when the anvil is in one of the unacceptable zones for firing, and is displayed or illuminated in a second color (such as green) when the anvil is in the acceptable zone for firing. Other embodiments are contemplated in which the second feedback portion 1138 is not illuminated when the anvil is within the unacceptable zone for firing and is illuminated when the anvil is within the acceptable zone for firing. Fig.13EIn the embodiment shown in , the control system detects that the anvil is within the acceptance zone, so the control system controls the first feedback portion 1136 to illuminate in the second color and controls the second feedback portion 1138 to illuminate the check mark in the second color.

[0135] Fig.14 and Fig.15 An example implementation of a display 1100 is shown. Display 1100 is displayed on a display, such as any number of displays described elsewhere herein. Fig.14 In the embodiment of the present invention, the anvil and the trocar are not yet coupled, so the display 1100 defaults to displaying the indicator 1110 within the unacceptable zone 1106. In various other embodiments, when the anvil is not coupled to the trocar, the indicator 1110 is not present on the display 1100, thereby indicating to the user that the anvil is not yet coupled to the trocar. In various other embodiments, when the anvil is not coupled to the trocar, the display 1100 provides any number of textual or visual feedback to indicate that the anvil is not coupled to the trocar, such as Fig.17A or Fig.46 As shown in A. Fig.15 , the anvil has been connected to the cannula needle and the anvil has been moved relative to the staple cartridge into an acceptable firing range, so the control system controls the indicator 1110 to point into the acceptable zone 1104 and illuminates portion 1112 as green, thereby indicating to the user that the stapler is ready to fire.

[0136] Implementation B: Graphical Position Feedback

[0137] Fig.16A and Fig. 16B A display 1400 for providing visual feedback to a user of a circular stapler according to at least one aspect of the present disclosure is shown. In various cases, the display 1400 is incorporated into the housing 1002 of the circular stapler 1000. In various embodiments, the display 1400 is shown on the display 1030. In various other embodiments, the display 1400 is visually displayed on a display such as display 7, display 9, display 19, within a display of the surgeon's console 18, on the AR device 66, or in any other suitable location described herein that is configured to convey visual information to the user. In various embodiments, the display 1400 is operably communicated with a control system (such as control system 1030) that controls various aspects of the display 1400, as described herein. In various embodiments, the control system includes a processor and a memory storing instructions executable by the processor. In various embodiments, the control system is any suitable controller, control circuit, hub, etc. described herein.

[0138] Display 1400 provides visual feedback to the user indicating the position of an anvil (such as anvil 1016) relative to a staple cartridge (such as staple cartridge 1007). In one aspect, display 1400 is similar to display 1100. In various embodiments, display 1400 is a graphical feedback mechanism that includes a movable indicator 1410 as a graphical depiction of an anvil and an indicator 1411 as a graphical depiction of a staple cartridge. In one aspect, indicator 1410 includes an indicator line 1412 as a graphical representation of the tissue contact surface of the anvil. Display 1400 also includes an acceptable zone 1404 defined by threshold boundaries 1403 and threshold boundaries 1405, both of which are visible to the user. In one aspect, acceptable zone 1404 corresponds to a position of an anvil relative to a staple cartridge suitable for firing staples from the staple cartridge. In one aspect, threshold boundary 1403 is aligned with a boundary of indicator 1411. Other embodiments are contemplated in which threshold boundary 1403 deviates from the boundary of indicator 1411. In some embodiments, the size of the acceptable zone 1404 and the positions of the threshold boundaries 1403, 1405 are predefined, stored in a memory, and can be retrieved by the control system. Various other embodiments are contemplated in which the size of the acceptable zone 1404 and the positions of the threshold boundaries 1403, 1405 are set by the user at the user interface.

[0139] In some embodiments, when the anvil is initially connected to the trocar of the surgical instrument, an indicator 1410 on the display 1400 indicates that the anvil is outside the acceptable zone 1404 and in the unacceptable zone 1406. The control system detects the attachment of the anvil using any suitable sensor, detector, etc., as described elsewhere herein. In various embodiments, the control system detects the attachment of the anvil using an anvil connectivity sensor (such as sensor 1044) integrated with the anvil. Thus, as an example, the control system communicates with various sensors (such as force sensors and / or position sensors) within the anvil so that the control circuit can receive, process and / or wirelessly transmit data from the anvil sensor to other devices in the OR for display to the user. In one aspect, when the anvil is not connected to the trocar, the control system displays or illuminates the indicator line 1412 in a first color (such as gray), and when the anvil is connected to the trocar, the control system displays or illuminates the indicator line 1412 in a second color (such as orange) different from the first color. When the indicator line 1412 of the indicator 1410 is in the unacceptable zone 1406 ( Fig.16A), this indicates to the user that the anvil is positioned too far from the staple cartridge, i.e., "out of range," and that the anvil should be moved closer to the staple cartridge, such as with a manual retraction knob 1013 or a motorized system. When the anvil is within the unacceptable zone 1406, the control system illuminates a portion 1414 of the display 1400 in a first color, such as gray. In various embodiments, the size of portion 1414 is defined by boundary lines 1403, 1405. In some embodiments, the control system prevents actuation of the firing drive to deploy staples from the staple cartridge 1007 based on a determination that the indicator line 1412 is positioned within the unacceptable zone 1406.

[0140] When the display 1400 indicates that the anvil is in the unacceptable zone 1406, the user can use the retraction knob 1013 or the motorized system to move the anvil toward the nail magazine (via the cannula needle). When the user retracts the anvil, the control system detects the movement of the anvil (using any number of position sensors described elsewhere in this article, etc.) so that the indicator 1410 thus moves the indicator line 1412 toward the indicator 1411 to visually convey to the user that the anvil is approaching the acceptable zone 1404. In various embodiments, the circular stapler includes a rotational position sensor (such as sensor 1040) that measures the rotation of the retraction knob 1013 to determine the position of the anvil relative to the nail magazine. In various embodiments, the circular stapler includes a linear position sensor (such as sensor 1042) to measure the movement of various components of the stapler (such as the cannula needle itself) to determine the position of the anvil relative to the nail magazine. Once the indicator line 1412 reaches or crosses the threshold boundary 1405, the anvil is indicated to have reached the acceptable zone 1404 ( Fig. 16B ), the control system illuminates portion 1414 in a second color (such as green) different from the first color, thereby indicating to the user that the anvil is within the receptacle zone 1404 and the stapler is therefore ready to fire.

[0141] FIG. 17A to FIG. 17F Various states of the display 1400 are shown to visually convey information to the user. The states of the display 1400 include when the anvil is not attached to the trocar ( Fig.17A ), when the anvil is initially attached to the trocar ( Fig. 17B ), when the anvil moves toward the nail magazine ( Fig. 17C ), when the user has reached the desired position of the anvil and the countdown is initiated to allow the tissue to relax before firing the staple cartridge ( Fig.17D ), when the circular stapler is fired ( Fig.17E ), and when the firing is complete ( Fig.17F ). In one aspect, Fig.17DThe countdown in is initiated by the user by providing an input to the control system indicating that the anvil is in the desired position and the user desires to fire the stapler. In various embodiments, the input includes a button on the housing (such as housing 1002) of the actuating circular stapler. In various embodiments, the input includes moving a safety device such as safety device 1010 to disengage from a firing trigger such as firing trigger 1008 of the circular stapler.

[0142] In one aspect, as in Fig. 17B and Fig. 17C As can be seen in FIG. 14, the display 1400 also includes a feedback portion 1420 defined on the upper and lower boundaries of the receptive zone 1404. When the anvil is not moving relative to the staple cartridge ( Fig. 17B ), the feedback portion 1420 is illuminated by the control system in a color (such as green) and a first brightness, or is not illuminated at all. When the anvil moves relative to the nail magazine ( Fig. 17C ), the feedback portion 1420 is illuminated by the control system in a color (such as green) and a second brightness greater than the first brightness, or in an embodiment where the feedback portion 1420 is not illuminated when the anvil is stationary. Thus, the feedback portion 1420 provides visual feedback as to whether the anvil is moving.

[0143] In one aspect, the control system displays or illuminates portion 1414 of display 1400 in a first color (e.g., green) and at a first brightness, thereby indicating to the user that the anvil is within the receptacle zone 1404 but is not fired ( Fig.17D and 17F ). When the stapler is fired ( Fig.17E ), the control system displays or illuminates portion 1414 in a first color and a second brightness greater than the first brightness, thereby indicating that the stapler has fired ( Fig.17E ). In addition, when the anvil is not within the receiving area 1404 ( Fig. 17C ), the control system displays or illuminates portion 1414 in a second color (such as gray), or does not illuminate portion 1414 at all ( Fig.17A In some embodiments, when the stapler is not fired, the control system displays or illuminates portion 1422 of display 1400 in a first color (such as gray) to indicate to the user that the stapler is not fired ( FIG. 17A to FIG. 17D and Fig.17F ). When the stapler is fired ( Fig.17E ), the control system displays or illuminates portion 1422 in a second color (such as white) different from the first color to indicate to the user that the stapler has fired. Therefore, portion 1422 provides another visual indicator of when the stapler has fired.

[0144] In some embodiments, such as in Fig.17AAs can be seen in FIG. 14 , when the anvil is not attached to the trocar, various or all of the displays 1400 are not illuminated, thereby indicating to the user that the anvil is not attached to the trocar. Fig. 17B ), the control system displays or illuminates various portions of display 1400 to visually communicate to the user that the anvil is connected to the trocar. In one aspect, when the anvil is not connected to the trocar, the control system displays or illuminates the border of the graphical representation 1410 of the anvil in a first color (such as gray), or does not illuminate the border of the graphical representation 1410 of the anvil at all. In one aspect, when the anvil is not connected to the trocar, the control system displays or illuminates the feedback portion 1420 in a first color (such as gray), or does not illuminate the feedback portion 1420 at all. In one aspect, when the anvil is not connected to the trocar, the control system displays or illuminates the indicator line 1412 in a first color (such as gray), or does not illuminate the indicator line 1412 at all. When the anvil is connected to the trocar ( Fig. 17B ), the border of the graphical representation 1410 of the anvil is illuminated in a color (such as white), the feedback portion 1420 is illuminated in a color and a first brightness, as described above, and the indicator line 1412 is illuminated in a first color (such as orange), as described above. Thus, the display 1400 provides the user with many visual cues of the status of the surgical stapler.

[0145] In various embodiments, the display 1400 displays notifications 1424, 1426, 1428 that provide text information to the user. In one aspect, when the countdown has been initiated, the control system causes the display 1400 to display notification 1424 ( Fig.17D ). Notification 1424 includes a bar that visually shows the time remaining in the countdown. In one aspect, when the stapler fires, the control system causes the display 1400 to display notification 1426 ( Fig.17E In one aspect, when the firing is complete, the control system causes the display 1400 to display a notification 1438 ( Fig.17F ).

[0146] Figures 18 to 25 An example implementation of display 1400 is shown. Display 1400 is displayed on a display, such as any number of displays described elsewhere herein. Fig.18 The anvil is not yet coupled to the trocar, so the display 1400 shows Fig.17A status. Fig.19 The grasping tool is shown moving the anvil toward the trocar but not yet coupled to the trocar, so the display 1400 shows Fig.17A status. Fig. 20 The anvil is shown coupled to the trocar, so the display 1400 shows Fig. 17B status. Fig.21 The anvil is shown having moved into the receptacle zone 1404 . Fig. 22 The display 1400 shows that the anvil has reached the desired position and the countdown has started to allow the tissue to relax before firing. Fig.17D status. Fig.23 The stapler is shown in a firing ready state after the countdown is over. Fig.23 As can be seen, the control system causes the display 1400 to display a notification 1430 indicating that the device is ready to fire. Fig.24 The stapler is shown fired, so the display 1400 shows Fig.17E status. Fig.25 The stapler has completed firing, so the display 1400 shows Fig.17F status.

[0147] Implementation C: Numerical gap and force feedback

[0148] Fig.26A and Fig.26B A display 1500 for providing visual feedback to a user of a circular stapler according to at least one aspect of the present disclosure is shown. In various embodiments, the display 1500 is incorporated into the housing 1002 of the circular stapler 1000. In various embodiments, the display 1500 is shown on the display 1030. In various other embodiments, the display 1500 is visually displayed on a display such as display 7, display 9, display 19, within a display of the surgeon's console 18, on the AR device 66, or in any other suitable location described herein that is configured to convey visual information to the user. In various embodiments, the display 1500 is operably communicated with a control system (such as control system 1030) that controls various aspects of the display 1500, as described herein. In various embodiments, the control system includes a processor and a memory storing instructions executable by the processor. In various embodiments, the control system is any suitable controller, control circuit, hub, etc. described herein.

[0149] In one aspect, the display 1500 includes a first feedback portion 1502, a second feedback portion 1504, and a third feedback portion 1506. In one aspect, the first feedback portion 1502 provides a gap distance between the anvil and the staple cartridge in numerical terms. In various embodiments, the gap distance is determined in any suitable manner known in the art, such as using a position sensor, a Hall effect sensor, an encoder incorporated into the manual adjustment knob 1013, an optical feedback sensor, or any other suitable sensor described elsewhere herein. In various embodiments, the circular stapler includes a rotary position sensor (such as sensor 1040) that measures the rotation of the retraction knob 1013 to determine the position of the anvil relative to the staple cartridge. In various embodiments, the circular stapler includes a linear position sensor (such as sensor 1042) to measure the movement of various components of the stapler (such as the trocar itself) to determine the position of the anvil relative to the staple cartridge.

[0150] In one aspect, the second feedback portion 1504 is a visual indicator of whether the anvil is within an acceptable zone for firing. In one aspect, the second feedback portion 1504 can be in a first state ( Fig.26A ) or the second state ( Fig.26B ), in the first state, the second feedback portion 1504 depicts a circle filled with a first color (such as gray), and in the second state, the second feedback portion 1504 depicts a symbol (such as a check mark) and / or a second color (such as green) different from the first color, thereby indicating that the anvil is in an acceptable zone for firing a surgical stapler. In various cases, the second feedback portion 1504 depicts a first state when the anvil is in an unacceptable zone, thereby indicating to the user that the anvil is not in a suitable position for firing a stapler. In some embodiments, the control system prevents actuation of the firing drive to deploy staples from the staple cartridge 1007 based on determining that the second feedback portion 1504 is in the first state.

[0151] In one aspect, the third feedback portion 1506 is a numerical representation of the amount of force that the anvil applies to the tissue positioned between the anvil and the staple cartridge. In various embodiments, the force is determined in any suitable manner known in the art, such as using a force sensor, a strain gauge or any other suitable sensor, as described elsewhere herein. In various embodiments, a torque sensor is integrated with the knob 1013 of a circular stapler to measure the torque applied by the user. In various embodiments, the force sensor is integrated with the inner shaft of the drive trocar of the stapler, or is integrated in the trocar itself, for measuring the force experienced by the shaft. In various embodiments, the anvil includes a force sensor for measuring the force applied to the tissue. In one aspect, the control system utilizes an anvil connectivity sensor (such as sensor 1044) integrated with the anvil to communicate with the anvil so that the control system can inquire about the force sensor and receive data from the force sensor.

[0152] FIG. 27A to FIG. 27F Various states of the display 1500 are shown to visually convey information to the user. The states of the display 1500 include when the anvil is not attached to the trocar ( Fig.27A ), when the anvil is attached to the trocar ( Fig.27B ), when the anvil is within an acceptable zone for firing the stapler (as indicated by the second feedback portion 1504 ( Fig.27C )), when the user has reached the desired position of the anvil and the countdown is initiated to allow the tissue to relax before firing the staple cartridge ( Fig.27D ), when the circular stapler is fired ( Fig.27E ), and when the firing is complete ( Fig.27F ).

[0153] In one aspect, when the stapler is unfired, the control system causes portion 1522 of display 1500 to illuminate in a first color, such as gray, to indicate to the user that the stapler is unfired ( FIG. 27A to FIG. 27D and Fig.27F ), or not illuminate portion 1522 at all. When the stapler is fired ( Fig.27E ), the control system illuminates portion 1522 in a second color (such as white) to indicate to the user that the stapler has fired.

[0154] In various embodiments, the display 1500 displays notifications 1524, 1526, 1528, 1530 that provide textual information to the user. In one aspect, the control system causes the display 1500 to display a notification 1524 ( Fig.27B ). In various embodiments, the control system uses sensors described elsewhere herein to detect that the anvil has been attached to the trocar. In one aspect, when the countdown has been initiated, the control system causes the display 1500 to display a notification 1526 ( Fig.27D ). Notification 1526 also includes a bar visually showing the time remaining in the countdown. In one aspect, when the stapler is fired, the control system causes the display 1500 to display notification 1528 ( Fig.27E In one aspect, when the firing has been completed, the control system causes the display 1500 to display a notification 1530 ( Fig.27F ).

[0155] Figures 28 to 36 An example implementation of display 1500 is shown. Display 1500 is displayed on a display, such as any number of displays described elsewhere herein. Fig.28 The anvil is not yet coupled to the trocar, so the display 1500 shows Fig.27A status. Fig.29The grasping tool is shown moving the anvil toward the trocar but not yet coupled to the trocar, so the display 1500 shows Fig.27A status. Fig.30 The anvil is shown coupled to the trocar, so the display 1500 shows Fig.27B status. Fig.31 The anvil is shown moved relative to the staple cartridge but is not yet within the acceptable zone, as indicated by the second feedback portion 1504 . Fig.32 The anvil has reached an acceptable zone for firing, as indicated by the second feedback portion 1504, and thus the display 1500 displays Fig.27C status. Fig.33 The display 1500 shows that the anvil has reached the desired position and the countdown has started to allow the tissue to relax before firing. Fig.27D status. Fig.34 The stapler is shown in a firing ready state. Fig.34 As can be seen, the control system causes the display 1500 to display a notification 1532 indicating that the device is ready to fire. Fig.35 The stapler is shown fired, so the display 1500 shows Fig.27E status. Fig.36 The stapler has completed firing, so the display 1500 shows Fig.27F status.

[0156] Implementation D: Graphic gap and force feedback

[0157] Fig.37A and Fig.37B A display 1600 for providing visual feedback to a user of a circular stapler according to at least one aspect of the present disclosure is shown. In various cases, the display 1600 is incorporated into the housing 1002 of the circular stapler 1000. In various embodiments, the display 1600 is shown on the display 1030. In various other embodiments, the display 1600 is visually displayed on a display such as display 7, display 9, display 19, within a display of the surgeon's console 18, on the AR device 66, or in any other suitable location described herein that is configured to convey visual information to the user. In various embodiments, the display 1600 is operably communicated with a control system (such as control system 1030) that controls various aspects of the display 1600, as described herein. In various embodiments, the control system includes a processor and a memory storing instructions executable by the processor. In various embodiments, the control system is any suitable controller, control circuit, hub, etc. described herein.

[0158] Display 1600 provides visual feedback to the user indicating the position of the anvil relative to the staple cartridge and the force applied to the tissue captured by the anvil and the staple cartridge. In various embodiments, display 1600 includes a first feedback portion 1610 and a second feedback portion 1620. In one aspect, the first feedback portion 1610 provides visual feedback about the relative positioning between the anvil (such as anvil 1016) and the staple cartridge (such as staple cartridge 1007). The first feedback portion 1610 includes a strip 1612 defining an acceptable zone 1614 and unacceptable zones 1616, 1618 surrounding the acceptable zone 1614. The unacceptable zone 1616 and the acceptable zone 1614 are separated by a threshold boundary 1615 visible to the user. Similarly, the unacceptable zone 1618 and the acceptable zone 1614 are separated by a threshold boundary 1617 visible to the user. In one aspect, the acceptable zone 1614 corresponds to the position of the anvil relative to the staple cartridge suitable for firing staples from the staple cartridge. In one aspect, the unacceptable zone 1616 corresponds to a position of the anvil that is too far from the nail magazine (such as exceeding a threshold limit) and is therefore not suitable for firing nails from the nail magazine. In one aspect, the unacceptable zone 1618 corresponds to a position of the anvil that is too close to the nail magazine (such as below a threshold limit) and is therefore not suitable for firing nails from the nail magazine. In various embodiments, the size of the zones 1614, 1616, 1618 and the position of the threshold boundaries 1615, 1617 are predefined, stored in a memory, and can be retrieved by a control system. Various other embodiments are contemplated in which the size of the zones 1614, 1616, 1618 and the position of the threshold boundaries 1615, 1617 are set by a user at a user interface.

[0159] The first feedback portion 1610 also includes an indicator 1619 that moves along the strip 1612 to visually show which of the zones 1614, 1616, 1618 the anvil is positioned in, as determined by the control system. As described elsewhere herein, the position of the anvil is detected by the control system using any suitable sensor, etc. In various embodiments, the circular stapler includes a rotational position sensor (such as sensor 1040) that measures the rotation of the retraction knob 1013 to determine the position of the anvil relative to the staple cartridge. In various embodiments, the circular stapler includes a linear position sensor (such as sensor 1042) to measure the movement of various components of the stapler (such as the trocar itself) to determine the position of the anvil relative to the staple cartridge. Using the determined position, the control system controls the position of the indicator 1619 along the strip 1612 to visually show which zone 1614, 1616, 1618 the anvil is located in.

[0160] In some embodiments, when the anvil is initially coupled to the trocar of the surgical instrument, the control system detects the attachment of the anvil and causes the indicator 1619 on the first feedback portion 1610 to point to a position on the bar 1612 to indicate that the anvil is within the unacceptable zone 1616, such as Fig.37A In various embodiments, the control system detects the attachment of the anvil using any suitable sensor, detector, etc., as described elsewhere herein. In various embodiments, the control system detects the attachment of the anvil using an anvil connectivity sensor (such as sensor 1044) integrated with the anvil. Therefore, as an example, the control system can communicate with various sensors (such as force sensors and / or position sensors) in the anvil so that the control circuit can receive, process and / or wirelessly transmit data from the anvil sensor to other devices in the OR to display to the user. The indicator 1619 positioned in the unacceptable zone 1616 indicates to the user that the anvil is positioned too far from the staple cartridge, that is, "out of range", and the anvil should be moved closer to the staple cartridge, such as using the manual retraction knob 1013 or motorized system on the housing. When the anvil is in one of the unacceptable zones 1616, 1618, the control system displays or illuminates the portion 1613 of the strip 1612 in a first color (such as gray) to indicate that the stapler is not ready to fire. In various other embodiments, when the anvil is within one of the unacceptable zones 1616, 1618, portion 1613 of strip 1612 is not illuminated to indicate that the stapler is not ready to fire. In some cases, the size of portion 1613 is defined by boundaries 1615, 1617. In some embodiments, the control system prevents actuation of the firing drive to deploy staples from staple cartridge 1007 based on a determination that indicator 1619 is positioned within one of the unacceptable zones 1616, 1618.

[0161] When the control system indicates that the anvil is within the unacceptable zone 1616 using indicator 1619, the user can use the retraction knob 1013 or the motorized system to move the anvil toward the staple cartridge (via the trocar). As the user retracts the anvil, the control system detects the movement of the anvil and moves indicator 1619 along strip 1612 to visually communicate to the user that the anvil is approaching the acceptable zone 1614. Once indicator 1619 has reached the acceptable zone 1614 ( Fig.37B ), the control system displays or illuminates portion 1613 of bar 1612 in a second color (such as green) different from the first color, thereby indicating to the user that the anvil is within the receptacle area 1614 and the stapler can be fired.

[0162] As mentioned above, the display 1600 also includes a second feedback portion 1620. In one aspect, the second feedback portion 1620 provides visual feedback on the amount of force applied to the tissue positioned between the anvil and the staple cartridge. The second feedback portion 1620 includes a bar 1622 defining an acceptable zone 1624 and unacceptable zones 1626, 1628 surrounding the acceptable zone 1624. The unacceptable zone 1626 is separated from the acceptable zone 1624 by a threshold boundary 1625 visible to the user. Similarly, the unacceptable zone 1628 is separated from the acceptable zone 1624 by a threshold boundary 1627 visible to the user. In one aspect, the acceptable zone 1624 corresponds to a force suitable for firing a staple from the staple cartridge. In one aspect, the unacceptable zone 1626 corresponds to a too low force (such as below a threshold limit), and is therefore unacceptable for firing a staple. For example, the anvil may not apply enough force to the tissue to enable the staple to be properly formed and sealed to the tissue. In one aspect, unacceptable zone 1628 corresponds to a force that is too high (such as exceeding a threshold limit) and is therefore unacceptable for firing a nail. For example, anvil may apply excessive force to tissue, thereby possibly damaging tissue.

[0163] In various embodiments, the sizes of the zones 1624, 1626, 1628 and the locations of the threshold boundaries 1625, 1627 are predefined, stored in memory, and retrievable by the control system. Various other embodiments are contemplated in which the sizes of the zones 1624, 1626, 1628 and the locations of the threshold boundaries 1625, 1627 are set by the user at the user interface.

[0164] Second feedback portion 1620 also includes indicator 1629, which moves along strip 1622 to visually show how much force is applied to the nail via zone 1624, 1626, 1628. As described elsewhere herein, the force applied to the tissue is detected by the control system using any suitable sensor, such as using a force sensor, a strain gauge or any other suitable device for sensing force, as described elsewhere herein. In various embodiments, a torque sensor is integrated with the knob 1013 of the circular stapler to measure the torque applied by the user. In various embodiments, the force sensor is integrated with the inner shaft of the drive trocar of the stapler, or is integrated in the trocar itself, for measuring the force experienced by the shaft. In various embodiments, anvil includes a force sensor for measuring the force applied to the tissue. In one aspect, the control system communicates with the anvil using an anvil connectivity sensor (such as sensor 1044) integrated with the anvil, so that the control system can inquire about the force sensor and receive data from the force sensor. Using the determined forces, the control system controls the position of the indicator 1629 to visually illustrate within which force zone 1624 , 1626 , 1628 the indicator 1629 is positioned.

[0165] In some embodiments, when the anvil is initially coupled to the trocar of the surgical instrument, the control system detects that the anvil has not yet applied force to the tissue and thus causes the indicator 1629 on the second feedback portion 1620 to point to the unacceptable zone 1616, such as Fig.37A . Indicator 1629 pointing to unacceptable zone 1626 indicates to the user that the anvil should be moved closer to the staple cartridge to apply additional force to the tissue, such as by using a manual retraction knob 1013 or a motorized system on the housing. When the anvil is in one of unacceptable zones 1626, 1628, the portion 1623 of strip 1622 is displayed or illuminated with a first color (such as gray) to indicate that the stapler is not ready to fire. In some cases, the size of portion 1623 is limited by borders 1625, 1627. In some embodiments, the control system prevents the actuation of the firing drive to deploy staples from staple cartridge 1007 based on the determination that indicator 1629 is positioned in one of unacceptable zones 1626, 1628.

[0166] When second feedback portion 1620 indicates, via indicator 1629 positioned within unacceptable zone 1626, that too little force is being applied to the tissue, the user can utilize retraction knob 1013 to move the anvil toward the staple cartridge (via the trocar) to apply additional force to the tissue. As the user retracts the anvil, the control system detects the increase in force (using any number of force sensors, etc., as described elsewhere herein) to cause indicator 1629 to move along strip 1622 to visually communicate to the user that the force applied to the tissue is approaching acceptable zone 1624. Once indicator 1629 has reached acceptable zone 1624 ( Fig.37B ), portion 1623 of strip 1622 is displayed or illuminated in a second color (such as green) that is different from the first color, thereby indicating to the user that a sufficient amount of force is being applied to the tissue so that the stapler can be fired.

[0167] FIG. 38A to FIG. 38F Various states of the display 1600 are shown to visually convey information to the user. The states of the display 1600 include when the anvil is not attached to the trocar ( Fig.38A ), when the anvil is attached to the trocar ( Fig.38B ), when the position of the anvil is within the acceptable zone for firing the stapler but the force applied to the tissue is not within the acceptable zone for firing ( Fig.38C ), when the user has reached the desired position of the anvil, sufficient force has been applied to the tissue and a countdown is initiated to allow the tissue to relax before firing the staple cartridge ( Fig.38D ), when the circular stapler is fired ( Fig.38E ), and when the firing is complete ( Fig.38F ).

[0168] like Fig.38AAs shown in , before the anvil 1016 is attached to the cannula needle 1012, the control system controls the display 1600 to enter a first state to visually indicate to the user that the anvil 1016 is not attached to the cannula needle 1012, as determined by the anvil connectivity sensor described elsewhere herein. Upon detecting that the anvil 1016 is connected to the cannula needle 1012 (as an example, via the connectivity sensor), the control system transitions the display 1600 to a second state to indicate to the user that the anvil 1016 is attached to the cannula needle 1012. For example, in some embodiments, in the second state, the control system may display a visual indication of the position of the anvil 1016 relative to the staple cartridge 1017 and / or a visual indication of the force that the anvil 1016 is applying to the tissue, as described elsewhere herein and also as described herein. Fig.38B Thus, the control system does not provide visual feedback regarding the various sensed parameters until the control system detects that the anvil 1016 is attached to the trocar 1012.

[0169] In one aspect, when the stapler is not fired, the control system causes portion 1632 of display 1600 to illuminate in a first color, such as gray, to indicate to the user that the stapler is not fired ( FIG. 38A to FIG. 38D and Fig.38F ). When the stapler is fired ( Fig.38E ), the control system illuminates portion 1632 in a second color (such as white) different from the first color to indicate to the user that the stapler has fired.

[0170] In various embodiments, the display 1600 displays notifications 1634, 1636, 1638 that provide text information to the user. In one aspect, the control system causes the display 1600 to display a notification 1634 ( Fig.38D ). In various embodiments, notification 1634 also includes a bar visually showing the remaining time in the countdown. In one aspect, when the stapler is fired, the control system causes the display 1600 to display notification 1636 ( Fig.38E In one aspect, when the firing has been completed, the control system causes the display 1600 to display a notification 1638 ( Fig.38F ).

[0171] Figure 39 to Figure 45 An example implementation of display 1600 is shown. Display 1600 is displayed on a display, such as any number of displays described elsewhere herein. Fig.39 The anvil is not yet coupled to the trocar, so the display 1600 shows Fig.38A status. Fig.40 The anvil is shown coupled to the trocar, so the display 1600 shows Fig.38B status. Fig.41The anvil is shown to have reached an acceptable zone for firing (as indicated by the first feedback portion 1610) and an acceptable force zone for firing (as indicated by the second feedback portion 1620). Fig.42 The countdown is shown to have been initiated to allow the tissue to relax before firing, so the display 1600 shows Fig.38D status. Fig.43 The stapler is shown in a firing ready state after the countdown is completed. Fig.43 As can be seen, the control system causes the display 1600 to display a notification 1640 indicating that the device is ready to fire. Fig.44 The stapler is shown fired, so the display 1600 shows Fig.38E status. Fig.45 The stapler has completed firing, so the display 1600 shows Fig.38F status.

[0172] Implementation E: Graphic Gap and Graphic Force Feedback

[0173] Fig.46 A display 1700 for providing visual feedback to a user of a circular stapler according to at least one aspect of the present disclosure is shown. In various embodiments, the display 1700 is incorporated into the housing 1002 of the circular stapler 1000. In various embodiments, the display 1700 is shown on the display 1030. In various other embodiments, the display 1100 is visually displayed on a display such as display 7, display 9, display 19, within a display of the surgeon's console 18, on the AR device 66, or in any other suitable location described herein that is configured to convey visual information to the user. In various embodiments, the display 1700 is operably communicated with a control system (such as control system 1030) that controls various aspects of the display 1700, as described herein. In various embodiments, the control system includes a processor and a memory storing instructions executable by the processor. In various embodiments, the control system is any suitable controller, control circuit, hub, etc. described herein. In one aspect, the display 1700 is similar to the display 1600.

[0174] In one aspect, the first feedback portion 1702 is similar to the display 1400. The first feedback portion 1702 provides a graphical visual feedback to the user indicating the position of the anvil relative to the staple cartridge. In various embodiments, the first feedback portion 1702 is a graphical feedback mechanism that includes a movable indicator 1710 as a graphical depiction of the anvil and an indicator 1711 as a graphical depiction of the staple cartridge. In one aspect, the indicator 1710 includes an indicator line 1712 as a graphical representation of the tissue contact surface of the anvil. The first feedback portion 1702 also includes an acceptable zone 1714 defined by a threshold boundary 1713 and a threshold boundary 1715, both of which are visible to the user. In one aspect, the acceptable zone 1714 corresponds to a position of the anvil relative to the staple cartridge suitable for firing staples from the staple cartridge. In one aspect, the threshold boundary 1715 is aligned with the boundary of the indicator 1711. Other embodiments are contemplated in which the threshold boundary 1715 deviates from the boundary of the indicator 1711. In various embodiments, the size of the acceptable zone 1714 and the positions of the threshold boundaries 1713, 1715 are predefined, stored in a memory, and retrievable by a control system. Various other embodiments are contemplated in which the size of the acceptable zone 1714 and the positions of the threshold boundaries 1713, 1715 are set by a user at a user interface.

[0175] In some embodiments, when the anvil is initially connected to the trocar of the surgical instrument, the indicator 1710 on the first feedback portion 1702 indicates that the anvil is outside the acceptable zone 1714 and in the unacceptable zone 1716. In various embodiments, the control system detects the attachment of the anvil using any suitable sensor, detector, etc., as described elsewhere herein. In various embodiments, the control system detects the attachment of the anvil using an anvil connectivity sensor (such as sensor 1044) integrated with the anvil. Thus, as an example, the control system can communicate with various sensors (such as force sensors and / or position sensors) within the anvil so that the control circuit can receive, process and / or wirelessly transmit data from the anvil sensor to other devices in the OR for display to the user. In one aspect, when the anvil is not connected to the trocar, the control system displays or illuminates the indicator line 1712 in a first color (such as gray), and when the anvil is connected to the trocar, the control system displays or illuminates the indicator line 1712 in a second color (such as orange) different from the first color. When the indicator line 1712 of the indicator 1710 is in the unacceptable zone 1716, this indicates to the user that the anvil is positioned too far from the nail magazine, that is, "out of range", and the anvil should be moved closer to the nail magazine, such as using a manual retraction knob 1013 on the housing or a motorized drive system. When the anvil is in the unacceptable zone 1716, the control system illuminates the portion 1719 with a first color (such as gray). In various embodiments, the size of the portion 1719 is defined by the boundary lines 1713, 1715. In some embodiments, the control system prevents the actuation of the firing drive to deploy nails from the nail magazine 1007 based on the determination that the indicator line 1712 is positioned in the unacceptable zone 1716.

[0176] When the first feedback portion 1702 indicates that the anvil is in the unacceptable zone 1716, the user can use the retraction knob 1013 or the motorized system to move the anvil toward the staple cartridge (via the trocar). When the user retracts the anvil, the control system detects the movement of the anvil (using any number of position sensors described elsewhere herein, etc.) so that the indicator 1710 thus moves the indicator line 1712 toward the indicator 1711 to visually convey to the user that the anvil is approaching the acceptable zone 1714. In various embodiments, the circular stapler includes a rotational position sensor (such as sensor 1040) that measures the rotation of the retraction knob 1013 to determine the position of the anvil relative to the staple cartridge. In various embodiments, the circular stapler includes a linear position sensor (such as sensor 1042) to measure the movement of various components of the stapler (such as the trocar itself) to determine the position of the anvil relative to the staple cartridge. Once indicator line 1712 reaches or crosses threshold boundary 1713, indicating that the anvil has reached receptive zone 1714, the control system illuminates portion 1719 in a second color, such as green, that is different from the first color, thereby indicating to the user that the anvil is within receptive zone 1714 and the stapler can be fired.

[0177] As mentioned above, the display 1700 also includes a second feedback portion 1720. In one aspect, the second feedback portion 1720 provides visual feedback on the amount of force applied to the tissue positioned between the anvil and the staple cartridge. The second feedback portion includes a bar 1722 defining an acceptable zone 1724 and unacceptable zones 1726, 1728 surrounding the acceptable zone 1724. The unacceptable zone 1726 is separated from the acceptable zone 1724 by a threshold boundary 1725 visible to the user. Similarly, the unacceptable zone 1728 is separated from the acceptable zone 1724 by a threshold boundary 1727 visible to the user. In one aspect, the acceptable zone 1724 corresponds to a force suitable for firing a staple from the staple cartridge. In one aspect, the unacceptable zone 1726 corresponds to a too low force (such as below a threshold limit), and is therefore unacceptable for firing a staple. For example, the anvil may not apply enough force to the tissue to enable the staple to be properly formed and sealed to the tissue. In one aspect, unacceptable zone 1728 corresponds to too high a force (such as exceeding a threshold limit), and is therefore unacceptable for firing a nail. For example, an anvil may apply too much force to the tissue, and thus may damage the tissue. In various embodiments, the size of zones 1724, 1726, 1728 and the position of threshold boundaries 1725, 1727 are predefined, stored in a memory, and can be retrieved by a control system. Various other embodiments are contemplated, in which the size of zones 1724, 1726, 1728 and the position of threshold boundaries 1725, 1727 are set by a user at a user interface.

[0178] Second feedback portion 1720 also includes indicator 1729, which moves along strip 1722 to visually show how much force is applied to tissue via zones 1724, 1726, 1728. In various embodiments, force is determined in any suitable manner known in the art, such as utilizing a force sensor, a strain gauge, or utilizing any other suitable sensor for sensing force, as described elsewhere herein. In various embodiments, a torque sensor is integrated with the knob 1013 of a circular stapler to measure the torque applied by a user. In various embodiments, a force sensor is integrated with the inner shaft of the drive trocar of the stapler, or is integrated in the trocar itself, for measuring the force experienced by the shaft. In various embodiments, anvil includes a force sensor for measuring the force applied to tissue. In one aspect, a control system can communicate with anvil using an anvil connectivity sensor (such as sensor 1044) integrated with anvil, so that a control system can inquire about the force sensor and receive data from the force sensor. Using the determined forces, the control system controls the position of the indicator 1729 to visually illustrate within which force zone 1724 , 1726 , 1728 the indicator 1729 is positioned.

[0179] In some embodiments, when the anvil is initially coupled to the trocar of the surgical instrument, the control system detects that the anvil has not yet applied force to the tissue and thus positions the indicator 1729 on the second feedback portion 1720 within the unacceptable zone 1726, such as Fig.46 . Indicator 1729 pointing to unacceptable zone 1726 indicates to the user that the anvil should be moved closer to the staple cartridge to apply additional force to the tissue, such as by using the manual retraction knob 1013 or a motorized system on the housing. When the anvil is in one of the unacceptable zones 1726, 1728, the portion 1723 of strip 1722 is displayed or illuminated with a first color (such as gray) to indicate that the stapler is not ready to fire. In some cases, the size of portion 1723 is limited by threshold boundaries 1725, 1727. In some embodiments, the control system prevents the actuation of the firing drive to deploy staples from the staple cartridge 1007 based on the determination that the indicator 1729 is positioned in one of the unacceptable zones 1726, 1728.

[0180] When the second feedback portion 1704 indicates that too little force is being applied to the tissue by an indicator 1729 positioned within the unacceptable zone 1726, the user can use the retraction knob 1013 to move the anvil toward the staple cartridge (via the trocar) to apply additional force to the tissue. When the user retracts the anvil, the control system detects an increase in force (using any number of force sensors, etc. as described elsewhere herein) to move the indicator 1729 along the strip 1722 to visually communicate to the user that the force applied to the tissue is approaching the acceptable zone 1724. Once the indicator 1729 has reached the acceptable zone 1724, a portion 1723 of the strip 1722 is displayed or illuminated in a second color (such as green) that is different from the first color, thereby indicating to the user that a sufficient amount of force is being applied to the tissue and the stapler can be fired.

[0181] FIG. 47A to FIG. 47F Various states of the display 1700 are shown to visually convey information to the user. The states of the display 1700 include when the anvil is not attached to the trocar ( Fig.47A ), when the anvil is attached to the trocar ( Fig.47B ), when the position of the anvil moves toward the acceptable zone 1724 but is still within the unacceptable zone 1726 and the force applied to the tissue is within the unacceptable zone 1728, i.e., too much force is applied ( Fig.47C ), when the user has reached the desired position of the anvil, sufficient force has been applied to the tissue and a countdown is initiated to allow the tissue to relax before firing the staple cartridge ( Fig.47D ), when the circular stapler is fired ( Fig.47E ), and when the firing is complete ( Fig.46 F).

[0182] In one aspect, when the stapler is not fired, the control system causes portion 1732 of display 1700 to illuminate in a first color, such as gray, to indicate to the user that the stapler is not fired ( FIG. 47A to FIG. 47D and Fig.47F ). When the stapler is fired ( Fig.47E ), the control system illuminates portion 1732 in a second color (such as white) different from the first color to indicate to the user that the stapler has fired.

[0183] In various embodiments, the display 1700 displays notifications 1734, 1736, 1738 that provide text information to the user. In one aspect, the control system causes the display 1700 to display a notification 1734 ( Fig.47D ). Notification 1734 also includes a bar visually showing the time remaining in the countdown. In one aspect, when the stapler fires, the control system causes the display 1700 to display notification 1736 ( Fig.47EIn one aspect, when the firing has been completed, the control system causes the display 1700 to display a notification 1738 ( Fig.47F ).

[0184] Fig.48 and Fig.49 An example implementation of display 1700 is shown. Display 1700 is displayed on a display, such as any number of displays described elsewhere herein. Fig.48 The anvil is not yet coupled to the trocar, so the display 1700 shows Fig.47B In other cases, when the anvil has not yet been coupled to the trocar, the display 1700 may display Fig.47A status. Fig.49 The anvil is shown to have reached an acceptable zone for firing (as indicated by first feedback portion 1702) and an acceptable force zone for firing (as indicated by second feedback portion 1704).

[0185] Although multiple forms have been illustrated and described, it is not the intention of the applicant to restrict or limit the scope of the appended claims to such details. Without departing from the scope of this disclosure, many modifications, variations, changes, substitutions, combinations and equivalents to these forms can be realized, and those skilled in the art will think of many modifications, variations, changes, substitutions, combinations and equivalents to these forms. In addition, alternatively, the structure of each element associated with the described form can be described as a device for providing the function performed by the element. In addition, in the case of disclosing materials for certain parts, other materials can also be used. Therefore, it should be understood that the above-mentioned specific embodiments and the appended claims are intended to cover all such modifications, combinations and variations within the scope of the forms disclosed by the present invention. The appended claims are intended to cover all such modifications, variations, changes, substitutions, modifications and equivalents.

[0186] The above specific embodiments have been described in various forms of devices and / or methods using block diagrams, logic diagrams and / or examples. As long as such block diagrams, logic diagrams and / or examples contain one or more functions and / or operations, those skilled in the art will understand that each function and / or operation in such block diagrams, logic diagrams and / or examples can be implemented individually and / or collectively by a variety of hardware, software, firmware or any combination thereof. Those skilled in the art will recognize that some aspects of the forms disclosed herein can be implemented equivalently in integrated circuits as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or as any combination thereof in whole or in part, and according to the present disclosure, designing circuits and / or writing software and / or hardware codes will be within the technical scope of those skilled in the art. In addition, those skilled in the art will recognize that the mechanisms of the subject matter described herein can be distributed as one or more program products in a variety of forms, and that the illustrative forms of the subject matter described herein are applicable regardless of the specific type of signal-bearing medium used to actually distribute.

[0187] Instructions for programming logic to perform various disclosed aspects may be stored in a memory in the system, such as a dynamic random access memory (DRAM), a cache, a flash memory, or other memory. In addition, the instructions may be distributed via a network or by other computer-readable media. Therefore, a machine-readable medium may include any mechanism for storing or transmitting information in a machine (e.g., computer) readable form, but is not limited to a floppy disk, an optical disk, a compact disk read-only memory (CD-ROM), and a magneto-optical disk, a read-only memory (ROM), a random access memory (RAM), an erasable programmable read-only memory (EPROM), an electrically erasable programmable read-only memory (EEPROM), a magnetic card or an optical card, a flash memory, or a tangible, machine-readable storage device used when transmitting information on the Internet via an electrical signal, an optical signal, an acoustic signal, or other form of propagation signal (e.g., a carrier wave, an infrared signal, a digital signal, etc.). Therefore, a non-transitory computer-readable medium includes any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a machine (e.g., computer) readable form.

[0188] As used in any aspect of this document, the term "control circuitry" or "control system" may refer to, for example, hard-wired circuitry, programmable circuitry (e.g., a computer processor including one or more separate instruction processing cores, a processing unit, a processor, a microcontroller, a microcontroller unit, a controller, a digital signal processor (DSP), a programmable logic device (PLD), a programmable logic array (PLA), a field programmable gate array (FPGA)), a state machine circuitry, firmware that stores instructions executed by the programmable circuitry, and any combination thereof. The control circuitry may be implemented collectively or individually as circuitry that forms part of a larger system, such as an integrated circuit (IC), an application specific integrated circuit (ASIC), a system on a chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, a smart phone, etc. Thus, as used herein, "control circuitry" includes, but is not limited to, electronic circuitry having at least one discrete circuit, electronic circuitry having at least one integrated circuit, electronic circuitry having at least one application specific integrated circuit, electronic circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program to at least partially implement the methods and / or devices described herein, or a microprocessor configured by a computer program to at least partially implement the methods and / or devices described herein), electronic circuitry forming a memory device (e.g., forming a random access memory), and / or electronic circuitry forming a communication device (e.g., a modem, a communication switch, or an optoelectronic device). Those skilled in the art will recognize that the subject matter described herein may be implemented in analog or digital form, or some combination thereof.

[0189] As used in any aspect of this document, the term "logic" may refer to an application, software, firmware, and / or circuitry configured to perform any of the foregoing operations. Software may be embodied as a software package, code, instructions, instruction sets, and / or data recorded on a non-transitory computer-readable storage medium. Firmware may be embodied as code, instructions, instruction sets, and / or data hard-coded (e.g., non-volatile) in a memory device.

[0190] As used in any aspect herein, the terms "component," "system," "module" and the like may refer to a control circuit, a computer-related entity, hardware, a combination of hardware and software, software, or software in execution.

[0191] As used in any aspect herein, an "algorithm" refers to a self-consistent sequence of steps leading to a desired result, wherein the "steps" refer to manipulations of physical quantities and / or logical states which may (but need not) take the form of electrical or magnetic signals capable of being stored, transferred, combined, compared, and otherwise manipulated. References to such signals are often made to bits, values, elements, symbols, characters, terms, numbers, and the like. These and similar terms may be associated with the appropriate physical quantities and are merely convenient labels applied to such quantities and / or states.

[0192] Unless otherwise expressly indicated in the above disclosure, it is understood that discussions using terms such as "processing," "computing," "calculating," "determining," and "displaying" in the above disclosure refer to the actions and processes of a computer system or similar electronic computing device that manipulates data represented as physical (electronic) quantities within the computer system's registers and memories and transforms it into other data similarly represented as physical quantities within the computer system's memories or registers or other such information storage, transmission, or display devices.

[0193] One or more components may be referred to herein as "configured to be able to", "configurable to be able to", "operable / operably", "suitable / adaptable to", "able to", "conformable / conform to", etc. Those skilled in the art will recognize that, unless the context indicates otherwise, "configured to be able to" may generally cover components in an active state and / or components in an inactive state and / or components in a standby state.

[0194] The terms "proximal" and "distal" are used herein relative to a clinician manipulating the 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 should also be understood that for brevity and clarity, spatial terms such as "vertical," "horizontal," "upper," and "lower" may be used herein in conjunction with the accompanying drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.

[0195] Those skilled in the art will recognize that, in general, the terms used herein, and in particular in the appended claims (e.g., the body of the appended claims), are generally intended to be "open" terms (e.g., the term "including" should be interpreted as "including but not limited to", the term "having" should be interpreted as "having at least", the term "comprising" should be interpreted as "including but not limited to", etc.). Those skilled in the art will also understand that if a specific number of an introduced claim recitation is intended, such intent will be explicitly stated in the claim, and in the absence of such recitation, no such intent is present. For example, to aid understanding, the following appended claims may contain use of the introductory phrases "at least one" and "one or more" to introduce claims. However, the use of such phrases should not be construed as implying that the introduction of a claim recitation by the indefinite article "a" or "an" limits any particular claim containing such introduced claim recitation to claims containing only one such recitation, even when the same claim includes the introductory phrases "one or more" or "at least one" and an indefinite article such as "a" or "an" (e.g., "a" and / or "an" should generally be interpreted as meaning "at least one" or "one or more"); this also applies to the use of definite articles used to introduce claim recitations.

[0196] In addition, even if a specific number of claim recitations is explicitly recited, those skilled in the art will recognize that such recitation should generally be interpreted to mean at least the recited number (e.g., a bare recitation of "two recitations" without other modifiers generally means at least two recitations, or two or more recitations). In addition, in those cases where a convention similar to "at least one of A, B, and C, etc." is used, generally, such construction is intended to have the meaning that those skilled in the art will understand the convention (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 those cases where a convention similar to "at least one of A, B, or C, etc." is used, generally, such construction is intended to have the meaning that those skilled in the art will understand the convention (e.g., "a system having at least one of A, B, or 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.). Those skilled in the art will also understand that, generally, unless the context indicates otherwise, transitional words and / or phrases presenting two or more alternative terms in the detailed description, claims, or drawings should be understood to include 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".

[0197] For the appended claims, those skilled in the art will appreciate that the operations described therein may generally be performed in any order. In addition, although various operational flow charts are presented in one or more sequences, it should be understood that the various operations may be performed in other orders than the order shown, or the various operations may be performed simultaneously. Unless the context otherwise dictates, examples of such alternative orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplementary, simultaneous, reverse, or other altered orderings. In addition, unless the context otherwise dictates, terms such as "responsive to," "related to," or other past tense adjectives are generally not intended to exclude such variants.

[0198] It is worth mentioning that any reference to "one aspect", "an aspect", "an example", or "an example" means that the specific features, structures, or characteristics described in conjunction with the aspect are included in at least one aspect. Therefore, the phrases "in one aspect", "in an aspect", "in an example", or "in an example" appearing in various places throughout the specification do not necessarily refer to the same aspect. In addition, specific features, structures, or characteristics may be combined in any suitable manner in one or more aspects.

[0199] Any patent application, patent, non-patent publication or other public material referred to in this specification and / or listed in any Application Data Sheet is incorporated herein by reference to the extent that the incorporated material is inconsistent herewith. Therefore, and to the extent necessary, the disclosure explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material or portion thereof that is allegedly incorporated herein by reference but conflicts with existing definitions, statements or other public material set forth herein will be incorporated only to the extent that there is no conflict between the incorporated material and the existing public material.

[0200] In summary, many of the benefits resulting from the use of the concepts described herein have been described. For purposes of illustration and description, one or more of the above specific embodiments have been provided. These specific embodiments are not intended to be exhaustive or limited to the precise forms disclosed by the invention. The invention may be modified or varied in accordance with the above teachings. The one or more forms selected and described are intended to illustrate the principles and practical applications so that one of ordinary skill in the art can utilize various forms and various modifications suitable for the intended specific use. The claims submitted herewith are intended to define the full scope.

[0201] The following is a non-exhaustive list of embodiments that may or may not be claimed.

[0202] 1. A surgical stapler, comprising:

[0203] an end effector configured to receive a staple cartridge;

[0204] a trocar movable relative to the end effector;

[0205] an anvil removably coupleable to the trocar, wherein the anvil is movable relative to the end effector based on movement of the trocar, and wherein the anvil is configured to apply a force to tissue positioned between the anvil and the end effector;

[0206] a sensor configured to sense the force;

[0207] a housing including a display; and

[0208] a control circuit operably coupled to the sensor and the display, wherein the control circuit is configured to:

[0209] interrogating the sensor to determine the force; and

[0210] A representation of the determined force is displayed on the display.

[0211] 2. The surgical stapler of embodiment 1, wherein the housing comprises a rotary actuator configured to enable movement of the trocar relative to the end effector, and wherein the rotary actuator comprises the sensor.

[0212] 3. A surgical stapler according to embodiment 1, wherein the trocar includes the sensor.

[0213] 4. A surgical stapler according to embodiment 1, wherein the housing includes a handle.

[0214] 5. A surgical stapler according to embodiment 1, wherein the representation includes a numerical representation.

[0215] 6. The surgical stapler of embodiment 1, wherein the display comprises a feedback portion, the feedback portion comprising:

[0216] Article, which defines:

[0217] an unacceptable region corresponding to unacceptable forces for firing staples from the staple cartridge; and

[0218] an acceptable region corresponding to an acceptable force for firing staples from the staple cartridge; and

[0219] An indicator is movable along the strip, wherein the determined representation of force comprises a position of the indicator along the strip.

[0220] 7. The surgical stapler of embodiment 6, wherein the strip defines a portion, and wherein the control circuit is further configured to:

[0221] displaying a first color in the portion based on the indicator indicating that the determined force is within the unacceptable zone; and

[0222] Based on the indicator indicating that the determined force is within the acceptable zone, a second color is displayed in the portion.

[0223] 8. A surgical stapler, comprising:

[0224] an end effector configured to receive a staple cartridge;

[0225] a trocar movable relative to the end effector;

[0226] an anvil removably coupleable to the trocar, wherein the anvil is movable relative to the end effector based on movement of the trocar;

[0227] a sensor configured to sense a position of the anvil relative to the end effector;

[0228] a housing including a display; and

[0229] A control circuit operatively coupled to the sensor and the display

[0230] The device, wherein the control circuit is configured to:

[0231] interrogating the sensor to determine the position of the anvil; and

[0232] A representation of the determined position is displayed on the display.

[0233] 9. The surgical stapler of embodiment 8, wherein the housing comprises a rotary actuator configured to enable movement of the trocar relative to the end effector, and wherein the rotary actuator comprises the sensor.

[0234] 10. The surgical stapler of embodiment 8, wherein the trocar comprises the sensor.

[0235] 11. The surgical stapler of embodiment 8, wherein the housing comprises a handle.

[0236] 12. A surgical stapler according to embodiment 8, wherein the representation includes a numerical representation.

[0237] 13. The surgical stapler of embodiment 8, wherein the display comprises a feedback portion, the feedback portion comprising:

[0238] Article, which defines:

[0239] an unacceptable zone corresponding to a position of the anvil that is unacceptable for firing staples from the staple cartridge; and

[0240] an acceptable zone corresponding to a position of the anvil that is acceptable for firing staples from the staple cartridge; and

[0241] An indicator is movable along the bar, wherein the representation of the determined position includes the position of the indicator along the bar.

[0242] 14. The surgical stapler of embodiment 13, wherein the strip defines a portion, and wherein the control circuit is further configured to:

[0243] displaying a first color in the portion based on the indicator indicating that the determined position is within the unacceptable zone; and

[0244] Based on the indicator indicating that the determined position is within the acceptable zone, a second color is displayed in the portion.

[0245] 15. A surgical stapler, comprising:

[0246] an end effector configured to receive a staple cartridge;

[0247] a trocar movable relative to the end effector;

[0248] an anvil removably coupleable to the trocar, wherein the anvil is movable relative to the end effector based on movement of the trocar, and wherein the anvil is configured to apply a force to tissue positioned between the anvil and the end effector;

[0249] a sensor configured to sense attachment of the anvil to the trocar;

[0250] a housing including a display; and

[0251] A control circuit operatively coupled to the sensor and the display

[0252] The device, wherein the control circuit is configured to:

[0253] interrogating the sensor to determine that the anvil is coupled to the trocar; and displaying on the display a representation that the anvil is coupled to the trocar. 16. The surgical stapler of embodiment 15, wherein the display is configurable

[0254] The following states:

[0255] a first state in which the display indicates that no anvil is coupled to the trocar; and

[0256] a second state in which the display indicates that the anvil is coupled to the trocar;

[0257] Wherein, the representing comprises transitioning the display to the second state.

[0258] 17. The surgical stapler of embodiment 16, wherein the surgical stapler further comprises a sensor configured to sense the force, and wherein the control circuit is further configured to:

[0259] interrogating the sensor to determine the force; and

[0260] In the second state of the display, a representation of the determined force is displayed on the display.

[0261] 18. The surgical stapler of embodiment 16, wherein the surgical stapler further comprises a sensor configured to sense a position of the anvil relative to the end effector, and wherein the control circuit is further configured to:

[0262] interrogating the sensor to determine the position of the anvil; and

[0263] In the second state of the display, a representation of the determined position is displayed on the display.

[0264] 19. The surgical stapler of embodiment 15, wherein the housing comprises a handle.

Claims

1. A surgical stapler (1000), comprising: an end effector (1006) configured to receive a staple cartridge (1007); a trocar (1012) movable relative to the end effector; an anvil (1016) removably coupleable to the trocar, wherein the anvil is movable relative to the end effector based on movement of the trocar, and wherein the anvil is configured to apply a force to tissue positioned between the anvil and the end effector; a sensor (1040, 1042, 1044) configured to sense a position of the anvil relative to the end effector; a housing (1002) comprising a display (1030); and A control circuit (1050) operably coupled to the sensor and the display, wherein the control circuit is configured to: interrogating the sensor to determine the position of the anvil; and A representation of the determined position is displayed on the display.

2. The surgical stapler according to claim 1, wherein: The housing includes a rotary actuator (1013) configured to enable movement of the trocar relative to the end effector, and wherein the rotary actuator includes the sensor.

3. The surgical stapler according to claim 1 or claim 2, wherein: The trocar includes the sensor.

4. A surgical stapler according to any preceding claim, wherein: The representation includes a numerical representation (1502).

5. A surgical stapler according to any preceding claim, wherein: The display includes a feedback portion (1102, 1152, 1610, 1702), the feedback portion including: an unacceptable zone (1106, 1108, 1406, 1616, 1618, 1716), the unacceptable zone corresponding to a position of the anvil that is unacceptable for firing staples from the staple cartridge; an acceptable zone (1102, 1404, 1614, 1714) corresponding to a position of the anvil that is acceptable for firing staples from the staple cartridge; and An indicator (1110, 1134, 1410, 1619, 1712) that is movable relative to the unacceptable zone and the acceptable zone, wherein the representation of the determined position includes the position of the indicator relative to the unacceptable zone and the acceptable zone.

6. The surgical stapler according to claim 5, wherein: The feedback portion defines a portion (1112, 1136, 1138, 1412, 1414, 1420, 1504, 1613, 1719), and wherein the control circuit is further configured to: displaying a first color in the portion based on the indicator indicating that the determined position is within the unacceptable zone; and Based on the indicator indicating that the determined position is within the acceptable zone, a second color is displayed in the portion.

7. The surgical stapler according to any of the preceding claims, further comprising a second sensor (1040, 1042, 1044) configured to sense the force, and wherein: The control circuit is configured to: interrogating the second sensor to determine the force; as well as A representation of the determined force is displayed on the display.

8. A surgical stapler according to any preceding claim, wherein: The housing includes a rotary actuator (1013) configured to enable movement of the trocar relative to the end effector, and wherein the rotary actuator includes the sensor.

9. A surgical stapler according to any preceding claim, wherein: The trocar includes the sensor.

10. The surgical stapler according to any preceding claim, wherein: The representation includes a numerical representation (1506).

11. A surgical stapler according to any preceding claim, wherein: The display includes a feedback portion (1620, 1720), the feedback portion including: an unacceptable zone (1626, 1628, 1726, 1728) corresponding to unacceptable forces for firing staples from the staple cartridge; an acceptable zone (1624, 1724) corresponding to an acceptable force for firing staples from the staple cartridge; and An indicator (1629, 1729) that is movable relative to the unacceptable zone and the acceptable zone, wherein the representation of the determined force includes the position of the indicator relative to the unacceptable zone and the acceptable zone.

12. The surgical stapler according to claim 11, wherein: The feedback portion defines a portion (1613, 1723), and wherein the control circuit is further configured to: displaying a first color in the portion based on the indicator indicating that the determined force is within the unacceptable zone; and Based on the indicator indicating that the determined force is within the acceptable zone, a second color is displayed in the portion.

13. The surgical stapler according to any preceding claim, further comprising a second sensor (1042, 1044) configured to sense attachment of the anvil to the trocar, and wherein: The control circuit is configured to: interrogating the second sensor to determine that the anvil is coupled to the trocar; and A representation of the anvil coupled to the trocar is displayed on the display.

14. The surgical stapler according to claim 13, wherein: The display can be configured in the following states: a first state in which the display indicates that no anvil is coupled to the trocar; as well as a second state in which the display indicates that the anvil is coupled to the trocar; Wherein, the representing comprises transitioning the display to the second state.

15. The surgical stapler according to claim 14, wherein: The surgical stapler further comprises a third sensor (1040, 1042, 1044) configured to sense the force, and wherein the control circuit is further configured to: interrogating the sensor to determine the force; and In the second state of the display, a representation of the determined force is displayed on the display.

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