Multifunctional surgical cautery devices, systems and methods of use

Abstract

Surgical cauterization devices, systems, and methods of use may apply bipolar and / or sesquipole cauterization to target tissue via instruments with other primary surgical functions. The surgical cautery devices and systems may include one or more sensors configured to detect when a surgical cautery device is in use. The surgical cautery devices and systems may also include one or more sensors configured to detect a position of the surgical cautery device or instrument. The surgical cautery devices and systems may also include a processor and software capable of varying the current based on characteristics of the system. The devices and systems may also include adapters capable of allowing a plurality of surgical instruments to be inserted into or wirelessly connected to the system.

Description

[0001] Incorporation by reference into any priority application

[0002] This application claims priority to U.S. Provisional Patent Application No. 63 / 364,255 filed on May 5, 2022 and U.S. Provisional Patent Application No. 63 / 497,069 filed on April 19, 2023, both of which are incorporated herein by reference. Any and all applications claiming foreign or domestic priority identified in the Application Data Sheet filed with this application are hereby incorporated by reference pursuant to 37 CFR 1.57. Technical Field

[0003] Embodiments of the present application relate to surgical devices, systems, and methods of use, and more particularly, to multifunctional modular cautery devices, systems, and methods of use.

[0004] background

[0005] Endoscopic minimally invasive surgery relies on instruments to achieve hemostasis and surgical results comparable to traditional open surgical techniques through relatively small corridors or ports (e.g., nostrils or holes) in the patient's body. Conventionally used bipolar cautery forceps face difficulties in use when passing through the smaller corridors of such minimally invasive surgery. Currently used bipolar cautery instruments have limited mobility and visualization within the smaller corridors of minimally invasive surgery and are difficult to use due to the relatively poor depth perception and stereoscopic vision provided within these corridors. Summary of the invention

[0006] Minimally invasive and robotic surgical platforms are rapidly emerging in the field of surgical disciplines. Comparable to this is the development of new surgical instrument arrays, which attempt to integrate many surgical instruments into a given system, device, end effector or platform. U.S. Patents Nos. 9,033,974, 9,433,458 and 10,548,656 (incorporated herein by reference in their entirety) describe the use of multifunctional surgical systems that rely on standard surgical instruments including suction devices, microscissors, microgrippers, dissectors and curettes, and enhance each to provide bipolar or sesquipolar electrocautery between any two devices integrated into a standard RF surgical generator circuit. Embodiments of the present application relate to improvements that can be applied to these and other devices, systems and methods (including other surgical platforms) to improve intraoperative efficiency when using many surgical instruments.

[0007] In some embodiments, surgical cauterization devices, systems, and methods of use are described herein. The device relates to an improved method of applying bipolar and / or sesquipolar electrocautery to target tissue via a pair of instruments that retain other primary surgical functions. The device may include a first and a second element. The second element may be independently positioned relative to the first element. The first and second elements include a surgical assembly and may be capable of forming a circuit. The surgical assembly may be made of a conductive material such as stainless steel. Although various insulating surgical instruments may be incorporated into the system, exemplary surgical assemblies include cutting tools, rotating blades, grasping tools, micro-gripping forceps tools, annular curettes, dissectors or micro-dissectors, drills, ultrasonic tissue aspirators, micro-scissors tools, and suction cannulas. The surgical assembly is interchangeable and can therefore be used in any combination to provide cauterization applications and improve surgical efficiency. For example, when a surgical assembly is a suction cannula, it may be interchangeable with a cutting tool, a rotating blade, a grasping tool, a micro-scissors tool, a micro-gripping forceps tool, a dissector, a micro-dissector, or another suction cannula.

[0008] In many cases, the first and second elements are configured to contact a target tissue of a patient and, when the circuit is completed, deliver electrical energy to the target tissue. Typically, delivering electrical energy to the target tissue acts to cauterize the target tissue.

[0009] Typically, the tips of the first and second elements can be conductive, while a portion of the first and second elements is electrically insulated from the tips. The first element and the second element can access the target tissue through, for example, a conventional type of surgical opening in the patient's body, a single portal (e.g., an endoscopic or microsurgical portal), or multiple separate portals, and can be configured to be manipulated, for example, by a human surgeon and / or a robot.

[0010] Another exemplary device includes a conductive wire electrically connected to an electrically insulating element. The electrically insulating element may contain an electrically conductive surgical component. The surgical component may be capable of delivering electrical energy to a target tissue of a patient via the conductive wire.

[0011] An exemplary system consistent with embodiments of the present application includes an electrical energy source electrically coupled to the first element and the second element. The second element can be independently positioned relative to the first element. The first element and the second element can have a surgical assembly and can be capable of forming a circuit and delivering electrical energy from a source to a target tissue of a patient when the circuit is complete. The system can deliver, for example, cautery, sesquipolar cautery, and / or bipolar cautery.

[0012] Additional embodiments of the present application modify one or more of the surgical instruments described above or elsewhere in this application to provide one or more "smart tools."

[0013] In some embodiments, an electrosurgical system for manipulating and cauterizing target tissue may include: a plurality of surgical instruments, wherein each of the plurality of surgical instruments may include: a sensor configured to detect when the surgical instrument is in use; an accelerometer; and a surgical tool at a working end of the surgical instrument, wherein the surgical tool may be configured to deliver electrical energy to a target tissue site and perform additional functions in addition to delivering the electrical energy to the target tissue site; and an electrical energy source configured to be electrically coupled to the plurality of surgical instruments, the electrical energy source may include a controller, wherein the controller may be configured to: determine a distance between the working ends of at least two surgical instruments based on measurements from the accelerometer; calculate an impedance of the system based on the surgical tools and the target tissue; determine an appropriate current to deliver to the two working ends based on the calculation of the impedance; and deliver the determined appropriate current to the two working ends when the target tissue is located between the two working ends.

[0014] In some embodiments, the plurality of surgical instruments can include at least two surgical instruments that each include a different type of surgical tool.

[0015] In some embodiments, the plurality of surgical instruments includes six surgical instruments, each including a different type of surgical tool.

[0016] In some embodiments, the plurality of surgical instruments can include from two surgical instruments to six surgical instruments.

[0017] In some embodiments, the determined appropriate current may be based on a predetermined maximum voltage.

[0018] In some embodiments, the electrosurgical system can include an adapter, wherein the adapter can be configured to couple the plurality of surgical instruments to the source of electrical energy.

[0019] In some embodiments, the adapter may include the controller.

[0020] In some embodiments, the electrosurgical system can include a first adapter and a second adapter, wherein the first adapter can be configured to couple a first plurality of surgical instruments to the electrical energy source and the second adapter can be configured to couple a second plurality of surgical instruments to the electrical energy source.

[0021] In some embodiments, the first plurality of surgical instruments can include surgical instruments configured for use with the right hand, and the second plurality of surgical instruments can include surgical instruments configured for use with the left hand.

[0022] In some embodiments, the first adapter and the second adapter can each include multiple first halves of the inductive charger, and each of the multiple surgical instruments can include a battery and a second half of the inductive charger, and each of the multiple surgical instruments can wirelessly communicate with the first adapter and the second adapter, and when the multiple first halves of the inductive charger are coupled to at least one of the second halves of the inductive charger, the electrical energy source can charge at least one of the batteries.

[0023] In some embodiments, each of the plurality of instruments can include a light source configured to illuminate the tissue.

[0024] In some embodiments, the light source can be a light emitting diode.

[0025] In some embodiments, the light source can be configured to illuminate an optical fluorescent agent or a surgical dye.

[0026] In some embodiments, the controller may be configured to deliver the determined appropriate current to the plurality of instruments in use when the distance between the working ends of the plurality of instruments is less than a cut-off distance.

[0027] In some embodiments, the cut-off distance may be 5 mm.

[0028] In some embodiments, the controller can be configured to determine the type of the target tissue based on the impedance of the target tissue.

[0029] In some embodiments, the controller may use electrochemical impedance spectroscopy (EIS) to determine the type of target tissue.

[0030] In some embodiments, the controller may include artificial intelligence and / or machine learning algorithms.

[0031] In some embodiments, the plurality of surgical instruments can each be insulated.

[0032] In some embodiments, the sensor may be a pressure sensor.

[0033] In some embodiments, the plurality of surgical instruments can each include a different surgical tool, and wherein the controller can be configured to automatically detect each different surgical tool.

[0034] In some embodiments, the source of electrical energy may include a memory, and the controller may determine the appropriate current to deliver to the two working ends based on information stored in the memory.

[0035] In some embodiments, an electrosurgical system for manipulating and cauterizing target tissue may include: a plurality of surgical instruments, each of which may include: at least one sensor; and a surgical tool at a working end of the surgical instrument, wherein the surgical tool may be configured to deliver electrical energy to a target tissue site and perform additional functions in addition to delivering the electrical energy to the target tissue site; and an electrical energy source configured to be electrically coupled to the plurality of surgical instruments, the electrical energy source including a controller, wherein the controller is configured to determine desired operating conditions based on a size, shape, or type of surgical instrument coupled to the electrical energy source and / or based on information received from the at least one sensor.

[0036] In some embodiments, the at least one sensor may include an accelerometer and / or a gyroscope.

[0037] In some embodiments, the at least one sensor can be configured to detect when the surgical instrument is in use.

[0038] In some embodiments, the electrosurgical system can include an adapter, wherein the adapter can be configured to couple the plurality of surgical instruments to the source of electrical energy.

[0039] In some embodiments, the adapter may include the controller.

[0040] BRIEF DESCRIPTION OF THE DRAWINGS

[0041] Embodiments of the present application are illustrated by way of example and not limitation in the figures of the accompanying drawings, in which:

[0042] Figure 1 An exemplary surgical system is depicted;

[0043] FIG. 2A to FIG. 2D depicting exemplary first and / or second elements;

[0044] Figure 2E Various exemplary surgical assemblies are depicted;

[0045] FIG. 3A to FIG. 3C Various exemplary groups of surgical components consistent with embodiments of the present application are depicted;

[0046] Figure 4 An exemplary use of the first and second elements is shown; and

[0047] Figure 5 An exemplary surgical system incorporating a pair of adapters and a plurality of surgical instruments is shown.

[0048] Figure 6An exemplary surgical system is shown wherein components are categorized by handedness.

[0049] Figure 7 A set of surgical components for use with embodiments of the present application is shown.

[0050] Detailed Description

[0051] Certain embodiments of electrosurgical devices, systems, and methods

[0052] Electrosurgical devices apply high frequency current to biological target tissue to cut, coagulate or desiccate the target tissue or at least a portion of the target tissue. Electrosurgical devices use a generator (e.g., a power supply or waveform generator) and a handpiece including one or more electrodes. Electrosurgical techniques are used, for example, in dermatology, gynecology, cardiac, plastic surgery, ophthalmology, spine, otolaryngology (ENT), maxillofacial surgery, orthopedics, urology, neurological and general surgery, and in some dental procedures.

[0053] One of the benefits of modern endoscopic surgery is the ability to work through two or more portals with a two-handed and / or robotic approach. Rather than limiting the size and mobility of the cautery device to one portal, one embodiment of the current surgical system proposes a novel electrocautery technique in which the two separate "electrodes" of the system are also independent insulated modular devices with their own functional purposes (e.g., microgrippers, suction cannulas, microscissors, dissectors, microdissectors, etc.). These dual or multi-functional components of the cautery system can manipulate the target tissue with better mobility and visualization, independently transmit reverse current from one electrode to another to achieve a sesquipolar or bipolar cautery effect from one electrode to another (depending on, for example, the size and surface area of ​​the conductive electrode surfaces), and / or retrieve data or information from the two tips, such as the electrical impedance of the target tissue. Certain embodiments of the present application have two separate electrodes that have dual functions as one or more other surgical devices, rather than functional bifurcation near the tip of the forceps as proposed in current models of endoscopic bipolar forceps. The two electrodes diverge outside the patient's body rather than in the surgical cavity, and are connected to each other and to a power source by wiring so that the reverse high-frequency current is appropriately transmitted to the contacted target tissue. Each functional electrode / element of the electrocautery device can be insulated relative to the surgical component so that the current will be selectively transmitted only from one surgical component to another surgical component. The modular device can be connected or disconnected with, for example, standard wires such as a bipolar electrocautery generator used with a power source, and can be used in various combinations (e.g., a suction cannula and microscissors or micro-gripping forceps and microscissors). The current can be activated by any conventionally available means (e.g., using a foot pedal in a manner similar to existing bipolar devices).

[0054] When compared to conventional techniques, embodiments of the present application provide enhanced mobility and visualization when cauterizing surgical targets by, for example, allowing two or more elements with surgical components to approach target tissue from different depths, angles, and / or entrances. Each surgical component can have independent, interchangeable and / or functional properties (i.e., cutting, grasping, dissecting, suction, probing, etc.), thereby allowing surgeons to manipulate the target tissue in an effective manner when cauterizing delicate surgical target tissue. In addition, according to the present invention, the size of the surgical opening (i.e., entrance) in the patient's body only needs to accommodate one surgical component, which in many cases is smaller than the cautery forceps used traditionally, and can be as small as 1 mm or less in some examples.

[0055] Embodiments of the present application further allow surgeons to perform surgical procedures and cauterize with the same surgical assembly, thereby reducing the need to remove the surgical device from the patient and subsequently insert a separate cauterization device. Thus, the use of these embodiments improves surgical efficiency and potentially reduces the risk of infection or damage to surrounding anatomical structures that may be caused by repeated removal and insertion of the device.

[0056] Embodiments of the present application are described in more detail with respect to the exemplary embodiments depicted in the figures accompanying this patent application. For example, Figure 1 An exemplary surgical system 100 consistent with some embodiments is depicted. The surgical system 100 can include a power source 150, a power cord 155, and an activation device 160. The power source 150 can be coupled to the first element 110 and the second element 120 via an electrical connector 145 (e.g., a banana clip) electrically coupled to the conductive wire 130. The power source 150 can be any device capable of supplying electrical energy or current to the first element 110 and the second element 120 when the user selects the activation device 160. The activation device 160 can be any conventionally available means for initiating the delivery of power to the first element 110 and / or the second element 120, including but not limited to a foot pedal, a button, or a dial. In some embodiments, the amount of power delivered to the first and / or second elements 110 and 120 can be controlled by operating the activation device 160 (e.g., twisting the dial) so that the maximum power level or a portion thereof is delivered to the first element and / or the second element 110 and 120.

[0057] The first and second elements 110 and 120 can be configured to deliver electrical energy 165 from the power source 150 to the contact or target portion of tissue in the patient via the surgical assembly 115 and / or 125. Exemplary target tissues include small blood vessels that need to be cauterized, tumors, or other unwanted tissues to be removed from the patient. The first and second elements 110 and 120 can be configured to be manipulated by a human surgeon and / or a robot, and in some cases, can be configured for single or multiple access surgeries with a microscope or endoscope. In some embodiments, a portion of the first and second elements 110 and 120, respectively, other than the first and second surgical assemblies 115 and 125, can be covered in an electrical insulator 135 or can be insulated in other ways. In this way, only the surgical assembly 115 and / or 125 can deliver electrical energy from the power source 150 to the contacted tissue. Electrical insulator 135 may be any suitable electrically insulating material, including but not limited to plastic, vinyl, epoxy, parylene, or ceramic, and may enable a surgeon to grasp and / or hold first and second elements 110 and 120, for example, with grasper 140. First and / or second elements 110 and 120 and surgical components 115 and / or 125 may be disposable (i.e., for one-time use) or reusable (i.e., capable of multiple uses).

[0058] In some cases, first and second surgical components 115 and 125 can be configured similarly to each other in shape and size, and in some cases, can include a matched pair of components. In other cases, first surgical component 115 can be configured to perform a first function other than conducting electricity, and second surgical component 125 can be configured to perform a second function other than conducting electricity. For example, first surgical component 115 can be configured to be operable by a robot, while second surgical component 125 can be configured to be operable by a human surgeon. In addition, one or both of surgical components 115 and / or 125 can include one or more controls (not shown) that enable an operator of the surgical component (e.g., a human surgeon or a robot) to control the operation of the surgical component.

[0059] The first and second elements 110 and 120 and / or the first and second surgical assemblies 115 and 125 can be configured to be independently positionable by a human surgeon and / or a robot. In this manner, for example, movement of the first element 110 does not affect the position of the second element 120. Likewise, in some cases, movement of the first surgical assembly 115 may not affect the position or function of the second surgical assembly 125. In this manner, the first and second elements 110 and 120 and / or the first and second surgical assemblies 115 and 125 can be independently moved within and / or before entering a patient to, for example, contact target tissue from different angles or different portals within a patient and / or perform different functions (other than power delivery) on target tissue within a patient.

[0060] In some embodiments, the first and second components 110 and 120 can be interchanged with other components by any known method. For example, by unplugging the electrical connector 145 coupled to the first or second component 110 or 120 from the power supply 150 and plugging another electrical connector (not shown) electrically coupled to another component (not shown) and compatible with the power supply 150 into the power supply 150, the first and / or second components 110 and / or 120 can be interchanged at the power supply 150. In this manner, for example, Figure 2A The microscissor elements 110 / 120 depicted in (described below) may be used in conjunction with Figure 2D (as shown below) depicted suction cannula elements 110 / 120 interchangeable. Additionally or alternatively, surgical components 115 and / or 125 may be interchangeable with other surgical components by any conventionally available means, including but not limited to unscrewing or otherwise separating surgical components 115 and / or 125 from first and / or second elements 110 and 120. For example, surgical components 115 or 125 may be removed from elements 110 or 120, respectively, and another surgical component may be attached to first element 110 or second element 120.

[0061] FIG. 2A to FIG. 2D Exemplary first and / or second elements 110 / 120 are depicted. Figure 2A In the embodiment, the first and / or second element 110 / 120 is configured as a microscissor tool, wherein the grasper 140 is embodied as a scissor handle, the shaft of the microscissor tool is encased in an insulator 135, and the surgical assembly 115 / 125 is a conductive microscissor set. Figure 2B In the embodiment, the first and / or second element 110 / 120 is also configured as a microscissor tool, wherein the entire first and / or second element 110 / 120 except for the surgical component 115 / 125 is covered by the insulator 135. Figure 2C In the embodiment, the first and / or second element 110 / 120 is configured as a probe, wherein the surgical component 115 / 125 is a surgical probe. Figure 2C The first and / or second element 110 / 120 may further include a handle 170. Figure 2D In the embodiment, the first and / or second element 110 / 120 is configured as a suction tool, wherein the surgical component 115 / 125 is a suction cannula. Figure 2E Various exemplary surgical components 115 / 125 are depicted, wherein surgical component 115A / 125A is a suction cannula, surgical component 115B / 125B is a grasper, surgical component 115C / 125C is a set of microscissors, and surgical component 115D / 125D is a probe.

[0062] In some embodiments, the first and second surgical components can be similar or different from each other. For example, FIG. 3A to FIG. 3C Various exemplary sets of surgical components 115 and 125 provided by various embodiments of the present invention are depicted. Figure 3A As depicted, first and second surgical components 115B and 125B are configured as grasping elements that enable a surgeon to grasp and manipulate target tissue as well as cauterize the target tissue. Figure 3B and Figure 3C As shown, surgical components 115 and 125 are configured differently from each other. Figure 3B In the depicted embodiment, surgical component 115A is configured as a suction device, and surgical component 115B is configured as a grasping component. Thus, a surgeon utilizing the first and second elements 110 and 120 of this embodiment will be able to grasp target tissue, aspirate material (e.g., blood, bone, and / or target tissue) from a patient, and cauterize target tissue while, for example, aspirating smoke generated by the cauterization to improve visualization. Figure 3C In the depicted embodiment, surgical component 115B is configured as a grasping tool, and surgical component 115C is configured as a microscissor tool. Thus, a surgeon utilizing the first and second elements 110 and 120 of this embodiment will be able to grasp, cut, and cauterize target tissue without the need to remove or insert any additional devices.

[0063] Figure 4An exemplary use of the first and second elements 110 and 120 is shown after inserting two entrances of the patient to contact the target tissue 405. In this embodiment, the first element 110 is inserted into the first entrance in the right nostril of the patient, and the second element 120 is inserted into the second entrance in the left nostril of the patient. In this way, the first and second elements can approach the target tissue 405 from different angles and can move independently of each other. After the first and second elements 110 and 120 are inserted into the first and second entrances in the patient's body, the delivery of electricity can be started by the user selecting the activation device 160 of the power supply 150 to form a circuit. After activation, electrical energy can be delivered to the first and / or second elements 110 and / or 120, and when the surgical components 115 and 125 are in contact with the target tissue, electrical energy 165 can be delivered to the target tissue, thereby cauterizing the target tissue. The same application can be used for multi-entry surgery in the abdomen, chest or any other surgical site, where one or more entry entrances or channels are used.

[0064] Further improvements to improve intraoperative efficiency

[0065] As further described below, the above described devices, systems and methods may further include one or more improvements to improve surgical efficiency and ease of use in the operating environment. Figures 1 to 4 These further improvements are described with respect to the devices, systems and methods of the present invention, but these improvements may also be applied to other devices, systems and methods.

[0066] like Figure 5 As shown, in some embodiments, a surgical instrument such as the first element 110 and / or the second element 120 may include at least one sensor 175. The at least one sensor 175 may include a pressure sensor, a capacitive touch sensor, or other sensor configured to detect whether a human surgeon or a robot is holding the first element 110 and / or the second element 120. The at least one sensor 175 may be coupled to the grasper 140 or the electrical insulator 135, or the handle or other location on the surgical instrument.

[0067] In some embodiments, the system 100 may include a hub, referred to herein as a power supply 150, but it should be understood that the power supply 150 or hub may include more components and features beyond just powering. In some embodiments, the hub or power supply 150 may include one or more processors or controllers 151. At least one sensor 175 may be configured to communicate with the one or more processors or controllers 151 via a connection 156 such as a wired or wireless connection. The one or more processors or controllers 151 may control the flow of electrical energy 165 to the first and second elements 110 and 120 and / or surgical components 115 and 125 positioned at the working ends of the first and second elements 110 and 120. For example, in one embodiment, when at least one sensor 175 detects that a human surgeon or a robot is holding and / or moving the first and / or second elements 110 and 120, the power supply 150 may deliver electrical energy 165 to the first and second elements 110 and 120. In another embodiment, when the user selects to activate the device 160, the power source 150 can deliver power only to the first and second elements 110 and 120 that are detected to be in use by the at least one sensor 175. In some embodiments, the power source 150 can include an RF generator 153. The RF generator 153 can be configured to generate electrical energy 165 or current that is delivered to the target tissue 405.

[0068] In some embodiments, surgical instruments such as the first and second elements 110 and 120 may also each include at least one position or motion sensor 195, such as an accelerometer, a gyroscope, an inertial measurement unit (IMU), or other similar sensor. The position or motion sensor 195 may be configured to send element position or motion data to one or more processors or controllers 151. The one or more processors or controllers 151 may receive the element position or motion data from the position or motion sensor 195 and determine the position or related information of the first and second elements 110 and 120 relative to each other. The one or more processors or controllers 151 may be able to use the element position data or related information to determine the distance between the surgical components 115 and 125. In some embodiments, the one or more processors or controllers 151 of the power supply 150 may include a stereoscopic navigation processor to determine the position of the first and second elements 110 and 120.

[0069] In some embodiments, one or more processors or controllers 151 can communicate with at least one position or motion sensor 195 to detect or determine whether a human surgeon or a robot is holding the first element 110 and / or the second element 120. In some embodiments, one or more processors can communicate with at least one position or motion sensor 195 to detect or determine which of the first element 110 and / or the second element 120 is being used by a human surgeon or a robot.

[0070] In some embodiments, one or more processors or controllers 151 can control the amount of electrical energy 165 or current delivered by the power source 150 to the target tissue 405. The amount of electrical energy 165 or current delivered by the power source 150 to the target tissue 405 can depend on the size, shape, and / or type of surgical components 115 and 125 in use, the impedance of the target tissue 405 such as bone, nerve, blood vessel, etc., and / or the distance between the surgical components 115 and 125. In some embodiments, a human surgeon can input the type of target tissue 405 via a user interface. In some embodiments, one or more processors or controllers 151 can communicate with the surgical components 115 and 125 to determine the impedance of the target tissue 405 and / or the system 100. In these embodiments, the one or more processors or controllers 151 can use feedback from the surgical components 115 and 125 to calculate the impedance of the system 100. The system 100 can be configured to detect the type of the target tissue 405 based on the calculated impedance of the target tissue 405. The one or more processors or controllers 151 may dynamically adjust the amount of electrical energy 165 , voltage, and / or current supplied to the surgical components 115 and 125 in real time or substantially real time based on the calculated impedance of the target tissue 405 .

[0071] In some embodiments, the one or more processors or controllers 151 can adjust the amount of current supplied to the surgical components 115 and 125 in real time or approximately real time. The one or more processors or controllers 151 can use a feedback loop from the surgical components 115 and 125 to determine the amount of current delivered to the target tissue 405. When the system detects an impedance associated with certain tissues, the one or more processors or controllers 151 can cut off the current. In some embodiments, the certain tissues can be bone, a tumor such as a brain tumor, or a nerve. In some embodiments, the one or more processors or controllers 151 can include an algorithm that is configured to control the amount of current delivered to the tissue based on the detected tissue impedance.

[0072] In some embodiments, the algorithm may include artificial intelligence (AI) and / or machine learning (ML). The algorithm may use AI and / or ML to determine the type of target tissue 405 (i.e., provide a tissue diagnosis) based on the calculated impedance of the target tissue 405. For example, the target tissue may contain an abnormal impedance level, and the algorithm may determine that the type of target tissue 405 is cancerous tissue. In some embodiments, the algorithm may determine the type of target tissue 405 in real time or substantially real time.

[0073] In some embodiments, one or more processors or controllers 151 and / or algorithms may be configured to use electrochemical impedance spectroscopy (EIS) to calculate the impedance of the target tissue 405 and / or determine the type of the target tissue 405. In some embodiments, the electrical energy 165 or current may include direct current (DC). In some embodiments, the electrical energy 165 or current may include alternating current (AC). One or more processors or controllers 151 and / or algorithms may apply AC to the target tissue 405 for a period of time. One or more processors or controllers 151 and / or algorithms may modify, change or adjust the frequency of AC for a period of time. In some embodiments, one or more processors or controllers 151 and / or algorithms may apply high-frequency AC to the target tissue 405 for a period of time and reduce the frequency of AC. In some embodiments, one or more processors or controllers 151 and / or algorithms may apply low-frequency AC to the target tissue 405 for a period of time and increase the frequency of AC. In some embodiments, the frequency of AC can include about 1Hz, about 10Hz, about 100Hz, about 1kHz, about 10kHz, about 20kHz, about 50kHz, about 100kHz, about 150kHz, about 200kHz, about 300kHz, about 400kHz, about 500kHz, about 600kHz, about 700kHz, about 800kHz, about 900kHz, about 1MHz, about 10MHz, about 20MHz, about 30MHz, about 40MHz, about 50MHz, about 60MHz, about 70MHz, about 80MHz, about 90MHz, about 100MHz, about 500MHz, about 1000MHz and / or the frequency of any value between the aforementioned values. In some embodiments, the frequency of AC can include a frequency greater than 1000MHz. In some embodiments, the frequency of AC can include a frequency less than 1Hz. In some embodiments, the frequency of AC can include a frequency of about 1kHz to about 500kHz. In some embodiments, the frequency of AC can include a frequency of about 50kHz to about 150kHz.

[0074] In some embodiments, one or more processors or controllers 151 and / or algorithms can determine or measure the magnitude and / or phase angle of impedance, or spectral readings. In some embodiments, one or more processors or controllers 151 and / or algorithms can automatically determine the type of target tissue 405 based on the magnitude and / or phase angle of impedance, or spectral readings.

[0075] In some embodiments, the algorithm may use AI and / or ML to automatically determine the size, shape, and / or type of surgical components 115 and 125 in use, the distance between surgical components 115 and 125, and / or the impedance of system 100. The algorithm may determine the size, shape, and / or type of surgical components 115 and 125 in use, the distance between surgical components 115 and 125, and / or the impedance of system 100 in real time or substantially real time.

[0076] In some embodiments, the algorithm may use AI and / or ML to adjust and / or regulate the amount of electrical energy 165, voltage, and / or current supplied to the surgical components 115 and 125 and / or the target tissue 405. The algorithm may adjust and / or regulate the amount of electrical energy 165, voltage, and / or current supplied to the surgical components 115 and 125 and / or the target tissue 405 in real time or substantially real time. In some embodiments, the algorithm may adjust and / or regulate the amount of electrical energy 165, voltage, and / or current supplied to the surgical components 115 and 125 and / or the target tissue 405 based on the amount of time that the electrical energy 165, voltage, and / or current has been supplied to the surgical components 115 and 125 and / or the target tissue 405 (i.e., the firing duration).

[0077] In some embodiments, a human surgeon may input the type of surgical component 115 and 125 currently being used into the power supply 150. In other embodiments, the power supply 150 may automatically detect and determine the type of surgical component currently being used. In these embodiments, the surgical components 115 and 125 may include a memory 180 configured to store information related to the type of surgical component. In some embodiments, the information may include the type of surgical component, the size of the surgical component, or any other information related to the surgical components 115 and 125.

[0078] The power supply 150 can have predetermined impedances associated with different sizes and / or shapes of different types of surgical components 115 and 125 stored in the memory 152. In some embodiments, the memory 180 of the first and second elements 110 and 120 can be configured to store predetermined impedances associated with the size, shape, and / or type of surgical components 115 and 125, respectively. The first and second elements 110 and 120 can be configured to send or transmit the predetermined impedance associated with the size, shape, and / or type of surgical components 115 and 125 to one or more processors or controllers 151 of the power supply 150 when the at least one sensor 175 detects that the first and second elements 110 and 120 are in use. In some embodiments, the power supply 150 can detect the type and / or size and shape of each of the surgical components 115 and 125 connected to the system 100, whether or not the surgical components 115 and 125 are currently in use. In some embodiments, a human surgeon can input a predetermined maximum voltage into the power supply 150 via a user interface. The one or more processors or controllers 151 may determine the appropriate current to deliver to the target tissue 405 based on the predetermined maximum voltage and the impedance of the system 100. In some embodiments, the one or more processors or controllers 151 may send current to the surgical components 115 and 125 in use.

[0079] In some embodiments, the one or more processors or controllers 151 can compare information received from at least one position or motion sensor 195 of the first and second elements 110 and 120 and / or surgical components 115 and 125 to determine the impedance of the target tissue 405 or system 100, the type of target tissue 405, and / or the distance between the surgical components 115 and 125. In some embodiments, the one or more processors or controllers 151 can compare the impedance of the target tissue 405 or system 100, the type of target tissue 405, and / or the distance between the surgical components 115 and 125 to data or information stored in the memory 180 to determine and / or set a threshold or limit on the amount of electrical energy 165, voltage, and / or current that the power source 150 can deliver to the surgical components 115 and 125 and / or the target tissue 405.

[0080] In some embodiments, the one or more processors or controllers 151 can interrupt the flow of electrical energy 165 or current when the distance between surgical components 115 and 125 is longer than a predetermined cutoff distance. In some embodiments, the cutoff distance can include a distance of about 1 mm, about 2 mm, about 3 mm, about 4 mm, about 5 mm, about 10 mm, about 15 mm, about 20 mm, and / or any other value between the foregoing values.

[0081] In some embodiments, such as Figure 5 As shown, the system 100 may include at least one adapter 502. The at least one adapter 502 may be coupled to the power source 150 and may include one or more ports 504. The one or more ports 504 may be designed to electrically couple the first and / or second components 110 and 120 to the at least one adapter 502 via the connector 156. The at least one adapter 502 may be configured to electrically couple any number of components to the power source 150. The adapter 502 may include one or more processors or controllers 151 configured to control whether the first and second components 110 and 120 deliver power 165.

[0082] In some embodiments, the system 100 includes one or more adapters 502 configured to electrically couple the first and second components 110 and 120 to the power source 150. In some embodiments, such as Figure 6 As shown, the first adapter 502A can be configured to receive the element used by the human surgeon with the right hand, and the second adapter 502B can be configured to receive the element used by the human surgeon with the left hand. The first adapter 502A can be configured to act as an anode, and the second adapter 502B can be configured to act as a cathode, or vice versa. Having a separate anode and cathode allows the system 100 to transmit energy consistently between two separate surgical assemblies. In some embodiments, an adapter 502 can be configured to receive the element used by the human surgeon with the right hand and the element used by the human surgeon with the left hand. In some embodiments, the system 100 can automatically detect which hand the surgeon uses the element, or the surgeon can input which hand each element will use into at least one adapter 502 and / or the power supply 150 based on the operation performed.

[0083] In some embodiments, the one or more adapters 502 may include one or more inductive coils. The first and second components 110 and 120 may include one or more inductive coils and one or more batteries 185. In some embodiments, the one or more inductive coils of the one or more adapters 502 may include a first half of an inductive charger, and each of the one or more inductive coils of the first and second components 110 and 120 may include a second half of an inductive charger. Each of the one or more inductive coils of the one or more adapters 502 may include a first half of an inductive charger, and each of the one or more inductive coils of the first and second components 110 and 120 may include a second half of an inductive charger. In these embodiments, the one or more inductive coils of the one or more adapters 502 may charge the one or more batteries 185 of the first and second components 110 and 120. In these embodiments, the first and second components 110 and 120 may include a transceiver, and the one or more adapters 502 may include a transceiver. The connection 156 between the first and second components 110 and 120 and the one or more adapters 502 may include a wireless connection between a transceiver of the first and second components 110 and 120 and a transceiver of the one or more adapters 502, so that the first and second components 110 and 120 can wirelessly communicate with the one or more adapters 502 via the transceiver.

[0084] In some embodiments, one or more adapters 502 may include one or more processors or controllers 151, RF generators 153, and / or suction devices, and may perform any of the functions performed by the power supply 150 above.

[0085] In some embodiments, one or more adapters 502 may be used to retrofit the system 100 into an existing power source 150 , which may not include features of the system 100 .

[0086] In some embodiments, the first and second elements 110 and 120 may include one or more light sources or lamps 190. One or more lamps 190 may be configured to illuminate the first and second surgical components 115 and 125 to improve the visibility of the human surgeon when the human surgeon performs the operation. In some embodiments, one or more lamps 190 may be configured to generate wavelengths of light. The wavelength of light may include the wavelength of white light. In some embodiments, the wavelength of light generated by one or more lamps 190 may be selected based on the optical fluorescent agent or surgical dye used in the operation. For example, the optical fluorescent agent or surgical dye may include fluorescein, indocyanine green, 5-ALA / protoporphyrin IX and / or any other optical fluorescent agent or surgical dye. When the human surgeon performs the operation, the wavelength of light generated by one or more lamps 190 may illuminate or improve the visibility of the optical fluorescent agent or surgical dye for the human surgeon.

[0087] In some embodiments, the first and second elements 110 and 120 may include an ultrasonic aspirator handpiece. In some embodiments, at least one of the first and second elements 110 and 120 may include a suction or irrigation device. In some embodiments, at least one of the first and second elements 110 and 120 may include an episiotomy mechanical suction device.

[0088] In some embodiments, the system 100 can use machine learning and / or artificial intelligence to learn the preferences of a human surgeon over time. The preferences of a human surgeon can include a combination of surgical components used together, the hand used by the surgeon to hold certain surgical components, and / or a predetermined maximum voltage preference based on surgical components used by the human surgeon.

[0089] It should be understood that although system 100 is described as having first and second elements 110 and 120, system can include more elements. In some embodiments, system 100 can include three elements, four elements, five elements, six elements or more elements. In some embodiments, system 100 can include two to six elements. In some embodiments, system 100 can include elements configured for a specific group of specific operations or surgical subspecialties. The elements of this group are generally used for specific operations or surgical subspecialties. For example, the elements of the first group can include elements generally used for the first operation, and the elements of the second group can include elements generally used for the second operation.

[0090] like Figure 5As shown, in one embodiment, the first element 110 can include a live suction and the second element 120 can include a live scissors, a live grasper, or a live dissector. In this embodiment, one or more lights 190 of the first element 110 and / or the second element 120 can include a light emitting diode (LED) and / or LED lighting. The first and second elements 110 and 120 can be used by a human surgeon or a robot to manipulate a target lesion or target tissue 405. The system 100 can use co-navigation to determine the position of the first and second elements 110 and 120.

[0091] like Figure 6 As shown, the system 100 may include first and second components 110 and 120 for use by a right-handed surgeon and a left-handed surgeon. Figure 6 1 and 120, but the surgeon's right hand and the surgeon's left hand can use any first and second elements 110 and 120. In some embodiments, the hand using the elements can be the same hand throughout the surgery, or the hand using the elements can be changed during the surgery.

[0092] In some embodiments, the first element 110 may include a suction tool and a grasping tool. The second element 120 may include scissors, a dissector, a grasper, and a curette. In some embodiments, the system 100 may be customized, individualized, or modular to allow a human surgeon to select which elements to use for a particular operation.

[0093] Figure 7 Examples of surgical assemblies or surgical instruments that may be used with the system 100 are shown. Examples of surgical assemblies or surgical instruments that may be used with the system 100 may include a first micrograsper 702, a suction tool 704, a suction tool and dissector 706, microscissors 708, a second micrograsper 710, and / or a dissector 712. The first micrograsper 702 may include a pistol grip 702A. The microscissors 708 and the second micrograsper 710 may include clamping grips 708A, 710A.

[0094] Example

[0095] In an example embodiment, the hub of the system as described above can include a processing unit with multiple ports for multiple surgical instruments, which can be relayed to create a functional two-way circuit. The hub can include up to six ports or more. Multiple surgical instruments can be inserted into the system. When inserted, the system can identify each surgical instrument. The hub can be an intermediate unit between multiple other inputs including an RF generator, a suction device, and a stereotactic navigation processor. The stereotactic navigation processor can determine the position of the instrument tip based on the actuator and the camera array that visualizes the instrument.

[0096] Surgeons typically use certain surgical instruments with their right or left hand, depending on which hand is the surgeon's dominant hand. For example, a right-handed surgeon may use a suction device with his left hand and scissors with his right hand. An adapter can take advantage of this preferred use of instruments to facilitate the completion of an electrical circuit. An adapter can include separate inputs for the anode and cathode of the circuit. By having separate inputs, an adapter can allow two separate instruments to be used in unison to transfer energy between the two tips of a surgical instrument.

[0097] The surgical instrument may include an accelerometer and a pressure sensor on the handle. The processing unit may use the accelerometer and / or pressure sensor to detect when the surgeon is using the surgical instrument. The processing unit may only activate the instrument that the surgeon is using as determined by the accelerometer and / or pressure sensor. The processor may shut down the unused surgical instruments. By using a combination of pre-approved or pre-selected instruments to complete the circuit, the circuit may use a computational understanding of when the circuit is complete. The adapter eliminates the step of the surgeon inserting or removing the instrument each time he decides to use a different surgical instrument, thereby improving workflow and efficiency.

[0098] The system can use electrode feedback from the tip of the smart tool (including actuator position, impedance or resistance, and / or any physiological stimulus) to calculate information including the distance between the tips of the two surgical instruments in use, the surface area or size of the surgical instruments in use, and / or the impedance of the intervening tissue. The system can use the information to determine the desired operating conditions, implement safety mechanisms, set limits or thresholds on the amount of thermal energy delivered to the target tissue or the tip of the surgical instrument, increase the amount of thermal energy delivered to the target tissue, or allow the tips of the surgical instruments to meet via separate entry points. For example, the processing unit can use the measured impedance between the two tips of the surgical instrument to deliver a predetermined current or maintain a predetermined maximum voltage between the two tips of the surgical instrument or within the system to reduce and / or safely limit the amount of thermal or electrical energy delivered to the intervening surgical tissue in a bipolar or sesquipolar system. The system can compare the distance between the tips of two surgical instruments in use, the surface area or size of the surgical instruments in use, and / or the impedance of the intervening tissue to information or data stored in memory to determine desired operating conditions, implement safety mechanisms, set limits or thresholds on the amount of thermal energy delivered to the target tissue or the tips of the surgical instruments, increase the amount of thermal energy delivered to the target tissue, or allow the tips of the surgical instruments to meet via separate entry points.

[0099] The processing unit of the system may include artificial intelligence (AT) or machine learning (ML). The processing unit may automatically identify or determine the type of intervening tissue based on the impedance of the intervening tissue. The processing unit may use electrochemical impedance spectroscopy (EIS) to calculate the impedance of the intervening tissue and / or determine the type of the intervening tissue. The processing unit may determine the magnitude and / or phase angle of the impedance of the intervening tissue, or a spectral reading to identify or determine the type of the intervening tissue. The processing unit may identify or determine the type of the intervening tissue in real time or substantially real time.

[0100] For example, the subject technology is shown according to the various aspects described above. The present disclosure is provided to enable any person skilled in the art to practice the various aspects described herein. The present disclosure provides various examples of the subject technology, and the subject technology is not limited to these examples. Various modifications to these aspects will be apparent to those skilled in the art, and the general principles defined herein may be applied to other aspects.

[0101] Unless otherwise specified, reference to an element in the singular does not mean "one and only one," but "one or more." Unless otherwise specified, the term "some" means one or more. The masculine gender (e.g., his) includes the feminine and neuter gender (e.g., her and its) and vice versa. Headings and subheadings, if any, are used for convenience only and do not limit the invention.

[0102] The word "exemplary" is used herein to mean "serving as an example or illustration." Any aspect or design described herein as "exemplary" is not necessarily to be construed as preferred or advantageous over other aspects or designs. In one aspect, the various alternative configurations and operations described herein may be considered at least equivalent.

[0103] As used herein, the phrase "at least one" preceding a list of items (where the term "or" separates any of the items) modifies the entire list, rather than each item of the list. The phrase "at least one" does not require selection of at least one item; rather, the phrase allows for a meaning that includes at least one of any one of the items, and / or at least one of any combination of the items, and / or at least one of each of the items. As an example, the phrase "at least one of A, B, or C" may mean: only A, only B, or only C; or any combination of A, B, and C.

[0104] Phrases such as "aspects" do not mean that such aspects are essential to the subject technology, or that such aspects apply to all configurations of the subject technology. Disclosures related to aspects may apply to all configurations, or one or more configurations. An aspect may provide one or more examples. Phrases such as aspects may refer to one or more aspects, and vice versa. Phrases such as "implementations" do not mean that such implementations are essential to the subject technology, or that such implementations apply to all configurations of the subject technology. Disclosures related to implementations may apply to all implementations, or one or more implementations. An implementation may provide one or more examples. Phrases such as implementations may refer to one or more implementations, and vice versa. Phrases such as "configurations" do not mean that such configurations are essential to the subject technology, or that such configurations apply to all configurations of the subject technology. Disclosures related to configurations may apply to all configurations, or one or more configurations. A configuration may provide one or more examples. Phrases such as configurations may refer to one or more configurations, and vice versa.

[0105] In one aspect, unless otherwise indicated, all measurements, values, levels, positions, sizes, dimensions and other specifications set forth in this specification (including the appended claims) are approximate and not exact. In one aspect, they are intended to have a reasonable range that is consistent with the functions to which they are related and the customary practices in the art to which they belong.

[0106] It should be understood that some or all of the steps, operations or processes may be performed automatically without user intervention. The method claims may be provided to present elements of the various steps, operations or processes in a sample order, and are not meant to be limited to the specific order or hierarchy presented.

[0107] All structural and functional equivalents of the elements throughout the various aspects described in this disclosure that are known or will subsequently be known to those of ordinary skill in the art are expressly incorporated herein by reference and are intended to be covered by the appended claims. In addition, nothing disclosed herein is intended to be dedicated to the public, regardless of whether such disclosure is explicitly stated in the claims. Unless an element is explicitly stated using the phrase "means for...", or in the case of a method, an element is stated using the phrase "step for...", no claim element should be interpreted according to the provisions of 35 U.S.C. §112 (f). In addition, to the extent that the terms "include", "have", etc. are used, such terms are intended to be included in a manner similar to the way the term "comprise" is interpreted when used as a transitional word in a claim.

[0108] The title, background, brief description of the drawings and claims of the present disclosure are incorporated herein into the present disclosure and are provided as illustrative examples of the present disclosure, rather than as restrictive descriptions. It should be understood at the time of submission that they will not be used to limit the scope or meaning of the claims. In addition, in the detailed description, it can be seen that the description provides illustrative examples, and for the purpose of streamlining the present disclosure, the various features are grouped together in various embodiments. This method of disclosure should not be interpreted as reflecting the intention that the subject matter claimed for protection requires more features than the features explicitly recited in any claim. On the contrary, as reflected in the attached claims, the subject matter of the invention lies in less than all the features of a single disclosed configuration or operation. The attached claims are incorporated into the detailed description here, with each claim independently representing a subject matter claimed for protection separately.

[0109] The claims are not intended to be limited to the aspects described herein, but are to be accorded the full scope consistent with the language of the claims and to encompass all legal equivalents. Nevertheless, no claims are intended to include subject matter that does not comply with the requirements of 35 U.S.C. §101, 102, or 103, nor should they be interpreted in such a manner.

Claims

1. An electrosurgical system for manipulating and cauterizing target tissue, comprising: A plurality of surgical instruments, wherein each of the plurality of surgical instruments comprises: a sensor configured to detect when the surgical instrument is in use; Accelerometer; and a surgical tool at a working end of the surgical instrument, wherein the surgical tool is configured to deliver electrical energy to a target tissue site and to perform additional functions in addition to delivering the electrical energy to the target tissue site; and an electrical energy source configured to be electrically coupled to the plurality of surgical instruments, the electrical energy source comprising a controller, wherein the controller is configured to: determining a distance between working ends of at least two surgical instruments based on measurements from the accelerometer; calculating an impedance of the system based on the surgical tool and the target tissue; determining appropriate currents to be delivered to the two working ends based on the impedance calculation; and When the target tissue is located between the two working ends, the determined appropriate current is delivered to the two working ends.

2. An electrosurgical system as described in claim 1, wherein the plurality of surgical instruments includes at least two surgical instruments each including a different type of surgical tool.

3. An electrosurgical system as described in claim 1, wherein the plurality of surgical instruments includes six surgical instruments each including a different type of surgical tool.

4. An electrosurgical system as described in claim 1, wherein the plurality of surgical instruments includes two surgical instruments to six surgical instruments.

5. The electrosurgical system of claim 1, the determined appropriate current being based on a predetermined maximum voltage.

6. The electrosurgical system of claim 1, further comprising an adapter, wherein the adapter is configured to couple the plurality of surgical instruments to the source of electrical energy.

7. An electrosurgical system as described in claim 6, wherein the adapter includes the controller.

8. The electrosurgical system of claim 1 , further comprising a first adapter and a second adapter, wherein the first adapter is configured to couple a first plurality of surgical instruments to the electrical energy source, and the second adapter is configured to couple a second plurality of surgical instruments to the electrical energy source.

9. An electrosurgical system as described in Claim 8, wherein the first plurality of surgical instruments includes surgical instruments configured for use with the right hand, and the second plurality of surgical instruments includes surgical instruments configured for use with the left hand.

10. The electrosurgical system of claim 8, wherein the first adapter and the second adapter each comprise a plurality of first halves of an inductive charger, and each of the plurality of surgical instruments comprises a battery and a second half of the inductive charger, and wherein each of the plurality of surgical instruments wirelessly communicates with the first adapter and the second adapter, and wherein the electrical energy source charges at least one of the batteries when the plurality of first halves of the inductive charger are coupled to at least one of the second halves of the inductive charger.

11. An electrosurgical system as described in Claim 1, wherein each of the plurality of instruments includes a light source configured to illuminate the tissue.

12. An electrosurgical system as described in Claim 11, wherein the light source is a light emitting diode.

13. The electrosurgical system of claim 11, wherein the light source is configured to illuminate an optical fluorescent agent or a surgical dye.

14. The electrosurgical system of claim 1, wherein the controller is configured to deliver the determined appropriate current to the plurality of instruments in use when the distance between the working ends of the plurality of instruments is less than a cut-off distance.

15. An electrosurgical system as described in Claim 14, wherein the cut-off distance is 5 mm.

16. An electrosurgical system as described in Claim 1, wherein the controller is configured to determine the type of the target tissue based on the impedance of the target tissue.

17. An electrosurgical system as described in claim 16, wherein the controller uses electrochemical impedance spectroscopy (EIS) to determine the type of the target tissue.

18. The electrosurgical system of claim 16, wherein the controller comprises an artificial intelligence and / or machine learning algorithm.

19. An electrosurgical system as described in Claim 1, wherein each of the plurality of surgical instruments is insulated.

20. An electrosurgical system as described in Claim 1, wherein the sensor is a pressure sensor.

21. An electrosurgical system as described in Claim 1, wherein each of the plurality of surgical instruments comprises a different surgical tool, and wherein the controller is configured to automatically detect each different surgical tool.

22. An electrosurgical system as described in claim 1, wherein the source of electrical energy includes a memory, and wherein the controller is configured to determine the appropriate current to deliver to the two working ends based on information stored in the memory.

23. An electrosurgical system for manipulating and cauterizing target tissue, comprising: A plurality of surgical instruments, wherein each of the plurality of surgical instruments comprises: at least one sensor; and a surgical tool at a working end of the surgical instrument, wherein the surgical tool is configured to deliver electrical energy to a target tissue site and to perform additional functions in addition to delivering the electrical energy to the target tissue site; and An electrical energy source configured to be electrically coupled to the plurality of surgical instruments, the electrical energy source comprising a controller, wherein the controller is configured to determine desired operating conditions based on a size, shape or type of surgical instruments coupled to the electrical energy source and / or based on information received from the at least one sensor.

24. An electrosurgical system as described in Claim 23, wherein the at least one sensor comprises an accelerometer and / or a gyroscope.

25. An electrosurgical system as described in Claim 24, wherein the at least one sensor is configured to detect when the surgical instrument is in use.

26. The electrosurgical system of claim 23, further comprising an adapter, wherein the adapter is configured to couple the plurality of surgical instruments to the source of electrical energy.

27. An electrosurgical system as described in Claim 26, wherein the adapter includes the controller.

28. An electrosurgical system comprising one or more of the features described above.

29. An electrosurgical instrument comprising one or more of the features described above.

30. A method of performing surgery comprising one or more of the features described above.

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