Surgical instruments with hover sensors and related methods

Abstract

A robotic surgical system, the robotic surgical system comprising: a robotic arm, the robotic arm comprising a distal end; a tool driver operatively coupled with the distal end of the robotic arm; a control unit; a surgical instrument, the surgical instrument comprising: an end effector configured to transmit treatment energy to tissue via a treatment energy cycle based on instructions from the control unit; and a tissue sensor configured to determine at least one tissue characteristic and to transmit the at least one tissue characteristic to the control unit, where the control unit is configured to modify a therapy energy cycle based on the at least one tissue characteristic; and a console, the console comprising: an activation switch configured to activate a therapy energy cycle; and a hover sensor configured to sense an object within the hover zone, where the hover sensor is configured to activate the tissue sensor to determine at least one tissue characteristic.

Description

Background Art

[0001] A variety of medical devices can be used in procedures performed by medical professionals and in applications in robotic-assisted surgery. In robotic-assisted surgery, a clinician can operate a master controller to remotely control the movement of such medical devices at the surgical site. The controller can be located a long distance from the patient (e.g., across the operating room, in a different room, or in a completely different building from the patient). Alternatively, the controller can be located very close to the patient in the operating room. In any case, the controller can include one or more input devices (such as foot pedals, joysticks, exoskeleton gloves, master manipulators, etc.) that are coupled to the medical device via a servo mechanism. In some scenarios, a servo motor moves the manipulator supporting the medical device based on the clinician's manipulation of the hand input device. During a medical procedure, a clinician can use a variety of medical devices via the robotic system, including ultrasonic scalpels, surgical staplers, tissue graspers, needle drivers, electrosurgical cauterization probes, etc. Each of these structures performs a function for the clinician, such as cutting tissue, coagulating tissue, holding or driving a needle, grasping a blood vessel, dissecting tissue, or cauterizing tissue.

[0002] Examples of robotic systems are described in the following patents: U.S. Patent No. 9,763,741, entitled “System for Robotic-Assisted Endolumenal Surgery and Related Methods,” published on September 19, 2017, the disclosure of which is incorporated herein by reference in its entirety; U.S. Patent No. 10,464,209, entitled “Robotic System with Indication of Boundary for Robotic Arm,” published on November 5, 2019, the disclosure of which is incorporated herein by reference in its entirety; U.S. Patent No. 10,667,875, entitled “Systems and Techniques for Providing Multiple Perspectives During Medical Procedures,” published on June 2, 2020, the disclosure of which is incorporated herein by reference in its entirety; and U.S. Patent No. 10,667,875, entitled “Systems and Techniques for Providing Multiple Perspectives During Medical Procedures,” published on September 8, 2020. No. 10,765,303, entitled “Systems and Methods for Displaying Estimated Location of Instrument,” published on November 10, 2020, the disclosure of which is incorporated herein by reference in its entirety; No. 10,827,913, entitled “Systems and Methods for Displaying Estimated Location of Instrument,” published on November 10, 2020, the disclosure of which is incorporated herein by reference in its entirety; No. 10,881,280, entitled “Manually and Robotically Controllable Medical Instruments,” published on January 5, 2021, the disclosure of which is incorporated herein by reference in its entirety; No. 10,898,277, entitled “Systems and Methods for Registration of Location Sensors,” published on January 26, 2012, the disclosure of which is incorporated herein by reference in its entirety; and No. 10,898,277, entitled “Systems and Methods for Registration of Location Sensors,” published on July 13, 2021, the disclosure of which is incorporated herein by reference in its entirety. No. 11,058,493, the disclosure of which is incorporated herein by reference in its entirety.

[0003] While several medical devices, systems, and methods have been made and used, it is believed that no one prior to the inventors has made or used the invention described in the appended claims. BRIEF DESCRIPTION OF THE DRAWINGS

[0004] The disclosed aspects will hereinafter be described with reference to the accompanying drawings, which are provided to illustrate and not to limit the disclosed aspects, wherein like reference numerals represent like elements.

[0005] Figure 1 depicts a perspective view of an example of a tabletop robotic system including a surgeon's console and multiple robotic arms;

[0006] Figure 2 Depicted are perspective views of an example robotic arm, an example tool driver, and an example surgical instrument, each configured to operate with Figure 1 Used in conjunction with a desktop robotic system;

[0007] Figure 3A Depicts Figure 2 an enlarged schematic perspective view of a tool driver and a surgical instrument;

[0008] Figure 3B Depicts something like Figure 3A a schematic perspective view of a tool driver of FIG, but with the surgical instrument removed to expose the rotary driver;

[0009] Figure 4 Depicts Figure 1 A schematic diagram of a surgeon's console comprising a control unit, a console, a display unit, and a foot control console;

[0010] Figure 5 Depicts Figure 4 A schematic diagram of a foot control console comprising an activation switch and a hover sensor having a hover zone;

[0011] Figure 6 Depicts Figure 2 a schematic diagram of a robotic surgical tool comprising an end effector including a pair of jaws and an electrical impedance spectroscopy (EIS) sensor, each jaw having a corresponding electrode surface, the end effector coupled to a robotic coupling via a shaft assembly, the robotic coupling coupled to a robotic arm;

[0012] Figure 7A Depicts Figure 6 An elevational side view of an end effector of with tissue between the pair of jaws in an open position;

[0013] Figure 7B Depicts Figure 6An elevational side view of an end effector of wherein a pair of jaws initially grasp tissue and an EIS sensor transmits subtherapeutic energy to the tissue;

[0014] Figure 7C Depicts Figure 6 An elevational side view of the end effector of FIG, wherein the pair of jaws further grasps the tissue and the electrode surface is activated;

[0015] Figure 8A Depicts Figure 4 An elevational side view of the foot control console with the operator's feet outside the hovering zone;

[0016] Figure 8B Depicts Figure 4 Elevation side view of the foot control console with the operator's foot in the hover zone and not pressed Figure 5 Activation switch;

[0017] Figure 8C Depicts Figure 4 Elevation side view of the foot control console with the operator's foot in the hovering area and pressing Figure 5 activation switch; and

[0018] Figure 9 Depicts Figure 6 The end effector and Figure 4 The surgeon console combines Figure 1 A flowchart of an exemplary use of a robotic system. DETAILED DESCRIPTION

[0019] I. Overview of Examples of Robotic Surgical Systems

[0020] Aspects of the present disclosure may be integrated into a robotically enabled medical system capable of performing a variety of medical procedures, including both minimally invasive (such as laparoscopy) and non-invasive (such as endoscopy) procedures. Among endoscopy procedures, the system may be capable of performing bronchoscopy, ureteroscopy, gastroscopy, etc.

[0021] In addition to performing a wide range of procedures, the system can provide additional benefits, such as enhanced imaging and guidance to assist clinicians. Additionally, the system can provide clinicians with the ability to perform procedures from an ergonomic position without the need for awkward arm movements and positioning. Still further, the system can provide clinicians with the ability to perform procedures with improved ease of use, enabling one or more of the system's instruments to be controlled by a single user.

[0022] For illustrative purposes, various embodiments will be described below in conjunction with the accompanying drawings. It should be understood that many other specific implementations of the disclosed concepts are possible, and various advantages can be achieved using the disclosed specific implementations. Headings are included herein for reference and to help locate the various subsections. These headings are not intended to limit the scope of the concepts described therein. Such concepts may have applicability throughout the specification.

[0023] A. Example of a robot system platform

[0024] Figure 1 An example of a robotic surgical system (10) is illustrated. The robotic surgical system (10) includes a support structure (12) for supporting a platform (14) (shown as a "table" or "bed") above a floor and one or more robotic arms (16). The support structure (12) includes a base (18) and a column (20). The column (20) structurally supports the platform (14) and provides a path for vertical translation of the bracket. In some versions, the table base can be folded and stored when not in use. The column (20) of this example also includes an annular bracket (26) on which the robotic arms (16) are based. A surgeon's console (240) is coupled to the robotic surgical system (10).

[0025] The robotic arm (16) is shown as part of a table-mounted system, but in other configurations, the robotic arm (16) may be mounted on a cart, a ceiling or sidewall, or other suitable support surface. The robotic arm (16) is shown extending from the column (20) via a bracket (26). However, the robotic arm (16) may be coupled to the robotic surgical system (10) using a variety of suitable structures. Although the robotic arm (16) is shown in Figure 1 The robotic arms (16) are all shown positioned on one side of the patient, but other configurations may position the robotic arms (16) on either side of the patient, between the patient's legs, and / or in any other suitable location. In this example, the tool driver (22) is positioned at the distal end of the robotic arm (16). The tool driver (22) is operable to manipulate one or more surgical instruments (24), as will be described in more detail below.

[0026] The surgeon's console (240) includes a control unit (250), a hand control console (260), a display unit (270), and a foot control console (280). As will be described in more detail below, the surgeon can utilize the surgeon's console (240) to view appropriate data (e.g., a visual image of the surgical site, the current status of various system (10) components, etc.) and / or manipulate the robotic arm (16), tool driver (22), and / or surgical instrument (24) during a surgical procedure.

[0027] B. Examples of Robotic Arms, Tool Drivers, and Tools

[0028] Figure 2 Shown are examples of robotic arms (110), tool drivers (112), and surgical instruments (114) that may be incorporated into a robotic surgical system (10) in place of Figure 1 A robotic arm (16), a tool driver (22), and a surgical instrument (24) are shown. Additional examples of robotic arms, tool drivers, and surgical instruments are shown and described in U.S. Patent No. 10,166,082, entitled “System and Method for Controlling a Robotic Wrist,” issued January 1, 2019, the disclosure of which is incorporated herein by reference in its entirety.

[0029] like Figure 2 As shown, the robotic arm (110) includes a plurality of links (116) and a plurality of joints (118) for actuating the links (116) relative to each other. A tool driver (112) is attached to the distal end of the robotic arm (110). The tool driver (112) includes a cannula (120) that is coupled to the end of the tool driver (112) to receive and guide a surgical instrument (114). The surgical instrument (114) may include an endoscope, a laparoscope, a stapler, a grasper, an ultrasonic instrument, an RF electrosurgical instrument, or any other suitable type of instrument. The surgical instrument (114) is inserted into the patient's body via the cannula (120). The distal end of the surgical instrument (114) includes an end effector (122). The end effector (122) is configured to be able to interact with the patient (e.g., provide visualization, suturing, grasping, ultrasonic cutting and / or sealing, electrosurgical cutting and / or sealing, etc.).

[0030] The joints (118) of the robotic arm (110) can be actuated to selectively position and orient a tool driver (112) that actuates an end effector (122) for use in robotic surgery. The joints (118) can include various types, such as pitch joints or roll joints, which can substantially constrain the movement of adjacent links (116) relative to other links (116) about certain axes. Each joint (118) represents an independent degree of freedom available to the robotic arm (110). Multiple joints (118) result in multiple degrees of freedom, thereby allowing for "redundant" degrees of freedom. The redundant degrees of freedom allow the robotic arm (110) to position its corresponding end effector (122) at a specific position, orientation, and trajectory in space using links (116) and joint (118) angles at different positions. This allows the system to position and guide the surgical instrument (114) from a desired point in space while allowing the clinician to move the joint (118) to a clinically advantageous position away from the patient to enable greater access while avoiding collisions with the robotic arm (110).

[0031] Figure 3A and Figure 3B A tool driver (112) is shown with and without a tool driver adapter (124), which may also be referred to as a tool base. Figure 3A and Figure 3B As shown, the tool driver (112) can include a movable stage (126) and a bracket (128). The movable stage (126) includes a longitudinal track (130). The bracket (128) is slidably engaged with the longitudinal track (130). The movable stage (126) can be configured to be coupled to the distal end of the robotic arm (110) so that the joint movement of the robotic arm (110) positions and / or orients the tool driver (112) in space. The surgical instrument (114) includes a tool driver adapter (124) at the proximal end and, as described above, includes an end effector (122) at the distal end. The tool driver adapter (124) includes a handle (132) and a shaft assembly (134) extending distally from the handle (132).

[0032] The bracket (128) is configured to be coupled to the tool driver adapter (124). The bracket (128) can drive a set of joint movements of the end effector (122) and / or otherwise actuate the end effector (122), such as by a cable system or wire that is manipulated and controlled by an actuated driver. The bracket (128) can include actuated drivers of different configurations, including but not limited to motorized rotary axis drivers. The multiple rotary axis drivers can be arranged in any suitable manner. Figure 3BAs shown, the carriage (128) of this example includes six rotary drives (136a-f) arranged in two rows extending longitudinally along the base of the carriage (128). The rotary drives (136a-c) are arranged in a first row, which is longitudinally offset from a second row in which the rotary drives (136d-f) are arranged. This staggered arrangement of the rotary drives (136a-f) can reduce the width of the carriage (128), thereby providing a more compact form factor for the tool driver (112). However, the rotary drives (136a-f) can be provided in any other suitable arrangement. Furthermore, in addition to or in place of the rotary drives (136a-f), the carriage (128) can provide any other suitable type of drive output.

[0033] II. Examples of Surgical Instruments with Hover Sensors

[0034] A. Overview of the Surgeon's Console

[0035] Figure 4 Shown Figure 1 The surgeon's console (240) is a device that allows the surgeon to view appropriate data (e.g., a visual image of the surgical site, the current status of various system (10) components, etc.) and / or manipulate the robotic arm (16), tool driver (22), and / or surgical instrument (24) during a surgical procedure. The surgeon's console (240) includes a control unit (250), a console (260), a display unit (270), and a foot control console (280).

[0036] The control unit (250) may include a processor, memory, storage device, and / or any other suitable components capable of receiving data from, storing data, processing data, and transmitting data to appropriate components of the robotic surgical system (10). Figure 4 As shown, the control unit (250) is in communication with the console (260), the display unit (270), and the foot control console (280). The control unit (250) is also in communication with the tool driver (112) so that the control unit (250) can receive information from the consoles (260, 280) and transmit such data appropriately to the tool driver (112) to manipulate and control the corresponding surgical instrument (114) according to the description herein. Although the control unit (250) in the current example is associated with the surgeon's console (240), this is merely optional. The control unit (250) can be associated with any other suitable component or combination of components, which will be apparent to those skilled in the art based on the teachings herein.

[0037] The control unit (250) may also communicate with other suitable components of the surgical instrument (114) or other suitable components of the robotic surgical system (10). For example, the control unit (250) may communicate with various sensors of the surgical instrument (114) so ​​that the control unit (250) may activate the sensors and / or obtain suitable data from the sensors during exemplary use as described herein. The control unit (250) may also receive and / or process data from suitable components of the surgical system (10) and transmit such data to the display unit (270), which may then visually display the data for viewing by the surgeon.

[0038] The console (260) can communicate with the control unit (250) and can be in the form of an input device or a combination of input devices that can receive instructions from an operator and transmit these instructions to the control unit (250). The console (260) can serve as an interface between the control unit (250) and the operator, so that the operator can manipulate the console (260) to transmit appropriate data associated with such manipulation to the control unit (250). The console (260) can be used to assist the control unit (250) in controlling the tool driver (112) to appropriately utilize the corresponding surgical instrument (114) according to the description herein. For example, the console (260) can be used to instruct the tool driver (112) to move the end effector (122) of the surgical instrument (114) to appropriately manipulate tissue according to the description herein. The console (260) can be in the form of a keyboard, a joystick, a camera, a computer mouse, or any other device capable of receiving instructions from an operator and transmitting the instructions to the control unit (250), which will be apparent to those skilled in the art based on the teachings herein.

[0039] The display unit (270) may include a display or monitor capable of displaying appropriate data to the operator; such as a video image of the surgical site, parameters of the robotic surgical system (10), etc. The display unit (270) may display information related to the patient and the status of appropriate components of the robotic arm (110) and surgical instrument (114). As discussed later, the display unit (270) may indicate the end effector (310) during exemplary use according to the description herein (see Figure 6 ) status.

[0040] B. Example of a foot control console with hover sensors for sub-therapeutic energy delivery

[0041] Go to Figure 5, the foot control console (280) can be used to appropriately manipulate and control the surgical instrument (114). For example, the foot control console (280) includes at least one activation switch (282). Although one activation switch (282) is shown, two or more activation switches (282) can be utilized, as will be apparent to one skilled in the art based on the teachings herein. The activation switch (282) can include a pedal that, when pressed by an operator, initiates a therapeutic energy delivery cycle.

[0042] For example, in the case where the surgical instrument (114) includes an end effector (122) configured to deliver RF energy, the operator can press the pedal of the activation switch (282) so that the control unit (250) instructs the surgical instrument (114) to deliver therapeutic energy in the form of RF energy to the tissue. As another example, in the case where the surgical instrument (114) includes an end effector (122) configured to deliver ultrasonic energy to the tissue via an acoustic waveguide and an ultrasonic scalpel, the operator can press the pedal of the activation switch (282) so that the control unit (250) instructs the surgical instrument (114) to deliver ultrasonic energy to the tissue. As yet another example, in the case where the surgical instrument (114) includes an end effector (122) configured to grasp, cut, and suture tissue, the operator can press the pedal of the activation switch (282) so that the control unit (250) initiates a firing cycle to cut and suture tissue.

[0043] In some cases, before delivering therapeutic energy to tissue, it may be desirable to obtain information about the characteristics of such tissue. For example, it may be desirable to obtain information about the density of the tissue, the type of tissue, or other suitable characteristics, which will be apparent to those skilled in the art based on the teachings herein. In addition, it may be desirable to modify the therapeutic energy delivery cycle in response to the determined characteristics of such tissue, thereby providing a customizable therapeutic result in response to the determined characteristics of the tissue. For example, in the case where a particular type of tissue is detected, the control unit (250) may modify the predetermined energy delivery cycle to increase / decrease the energy level applied to the tissue compared to the case where another type of tissue is detected. As another example, the control unit (250) may modify the length and / or cycle frequency of energy delivered to the tissue. As yet another example, in the case where a pair of jaws grasp tissue, the control unit (250) may instruct the tool driver (112) to modify the grasping force applied to the tissue before initiating the therapeutic energy delivery cycle.

[0044] However, accumulating tissue characteristic data after pressing the activation switch (282) and subsequently modifying the energy delivery cycle may undesirably increase the amount of time for each therapeutic energy delivery cycle. Therefore, it may be desirable to accumulate such tissue characteristic data and significantly modify the energy delivery cycle before the surgeon physically presses the activation switch (282), but in anticipation of doing so.

[0045] As described above, the foot control console (280) is in communication with the control unit (250). The foot control console (280) includes an activation switch (282) and a hover sensor (284). The activation switch (282) can be manipulated by an operator (such as the operator's foot). The foot control console (280) can be positioned so that the operator can use the foot control console (280) and the control unit (260) simultaneously. In some examples, the activation switch (282) includes an active position and an inactive position, such as having a hold switch or a momentary switch. When in the active position, the activation switch (282) is operable to signal the control unit (250) to activate the end effector (such as Figures 6 to 7C The present invention also provides a method for the surgeon to control the end effector (310) of the robotic arm (110) to deliver a therapeutic energy to the surgical site. Thus, during exemplary use, the surgeon may utilize the consoles (260, 280) to manipulate the end effector operatively attached to the robotic arm (110) to properly engage tissue at the surgical site. Once the tissue at the surgical site is properly engaged by the end effector, the surgeon may depress the activation switch (282) to initiate the therapeutic energy delivery cycle.

[0046] The foot control console (280) also includes a hover sensor (284) associated with the activation switch (282). The hover sensor (284) is in operative communication with the control unit (250). During exemplary use, the hover sensor (284) is configured to generate a hover zone (286) that is proximate to the activation switch (282). The hover sensor (284) is configured to detect and / or identify an object within the hover zone (286) and transmit the detection to the control unit (250). Specifically, the size of the hover zone (286) is appropriately set to detect when the surgeon intends to press the activation switch (282) to initiate a therapeutic energy delivery cycle. The hover sensor (284) can include any suitable components, which will be apparent to those skilled in the art based on the teachings herein. As will be described in more detail below, the control unit (250) can initiate a sub-therapeutic energy cycle in response to the hover sensor (284) detecting that the surgeon's foot is within the hover zone (286). Such sub-therapeutic energy cycles may determine appropriate tissue characteristics such that the control unit (250) may appropriately modify the energy delivery cycle as described herein.

[0047] In one example, the hover sensor (284) can be positioned above the activation switch (282) such that a hover zone (286) is projected to cover the area between the activation switch (282) and the hover sensor (284). In an alternative example, the hover sensor (284) can be positioned adjacent to or within a portion of the activation switch (282) and include a hover zone (286) capable of detecting objects directly above and / or near the activation switch (282). The hover sensor (284) can be positioned in any suitable location, as will be apparent to one skilled in the art in view of the teachings herein. The hover zone (286) can include any suitable dimensions, as will be apparent to one skilled in the art in view of the teachings herein.

[0048] The hover sensor (284) can be capable of detecting nearby objects by using a proximity component, an infrared component, a mechanical component, a laser detection component, or any other component reasonably capable of detecting objects within the hover zone (286). In one embodiment, the operator enters the hover zone (286) before being able to contact the activation switch (282). The console (260), the display unit (270), and / or the foot control console (280) can communicate with the control unit (250) and each other in wired or wireless communication.

[0049] C. Examples of Surgical Instruments with Subtherapeutic Energy Delivery

[0050] Figure 6 An example of a surgical instrument (300) coupled to a robotic arm (302) via a robotic coupling (304) is shown. The surgical instrument (300), robotic coupling (304), and robotic arm (302) can be substantially similar to the surgical instrument (114), tool driver adapter (124), and robotic arm (110) described above, with differences described in detail below. Thus, the robotic arm (302) and surgical instrument (300) can be readily incorporated into a robotic surgical system (10) to replace the robotic arm (110) and surgical instrument (114), respectively, described above.

[0051] In the present example, the surgical instrument (300) includes an end effector (310) that is coupled to the robotic coupling (304) via a shaft assembly (334). The shaft assembly (334) can be substantially similar to the shaft assembly (134) described above, with the differences being described in detail herein. The end effector (310) includes a pair of jaws (320) operable to grasp and clamp tissue between each jaw (320). Specifically, the jaws (320) can be operably coupled to the robotic coupling 304 such that a suitable rotational drive (not shown) of the robotic arm (302) can be engaged in an open configuration (see FIG. Figures 6 to 7A ) and various closed configurations (see Figures 7B to 7C ) between the jaws (320). The rotational drive (not shown) of the robotic arm (302) can be substantially similar to the rotational drives (136a, 136b, 136c, 136d, 136e, 136f) described above. Thus, the surgeon can control the position of the jaws (320) using the surgeon console (240) as described herein.

[0052] In the current example, each jaw (320) includes an electrode (325). The electrode (325) is configured to be capable of applying therapeutic energy in the form of RF energy to tissue grasped between the jaws (320) in a closed configuration. In the present example, each jaw (320) includes a corresponding electrode (325) so that the electrode (325) is capable of conducting bipolar RF energy through the tissue between the jaws (320). In some examples, a single jaw (320) includes more than one electrode (325). Alternatively, or optionally, only one jaw (320) may include an electrode (325), or only one electrode (325) may be capable of applying RF energy to tissue in a monopolar setting. According to the description herein, the electrode (325) can be appropriately activated to deliver therapeutic energy in response to the surgeon pressing the activation switch (282). While in the present example, the end effector (310) includes a pair of jaws (320) and an electrode (325) configured to apply therapeutic energy to tissue, the end effector (310) may include any other suitable component for delivering therapeutic energy to tissue, as will be apparent to one skilled in the art in light of the teachings herein. For example, the end effector (310) may include a clamping arm and an ultrasonic blade configured to apply therapeutic energy in the form of ultrasonic energy. As another example, the end effector (310) may include a suturing assembly configured to grasp tissue and apply therapeutic energy in the form of severing and suturing the grasped tissue.

[0053] The end effector (310) may also include a sub-therapeutic tissue sensor, such as an electrical impedance spectroscopy (EIS) sensor (330) capable of sensing the electrical impedance of the tissue. The EIS sensor (330) is in communication with the control unit (250) of the surgeon's console (240), such that the sensor (330) is configured to transmit appropriate data to the control unit (250). As will be described in more detail below, the EIS sensor (330) may be configured to transmit appropriate data to the control unit (250) via the hover sensor 284 (see Figure 5) is activated upon detecting the presence of at least a portion of the surgeon's foot within the hovering zone (286). Once activated, the EIS sensor (330) is configured to deliver sub-therapeutic energy to the grasped tissue, thereby acquiring impedance measurements and / or other suitable data on the tissue, as will be apparent to those skilled in the art in view of the teachings herein.

[0054] As described above, the EIS sensor (330) is configured to transmit impedance readings and / or data to the control unit (250). The control unit (250) can utilize the data from the EIS sensor (330) to determine the type and / or density of the grasped tissue, the state of the grasped tissue, and / or other suitable characteristics of the grasped tissue, as will be apparent to those skilled in the art in view of the teachings herein. Furthermore, in response to the determined characteristics of the grasped tissue, the control unit (250) can modify the process of delivering therapeutic energy to the tissue to better accommodate the determined tissue characteristics. For example, the control unit (250) can modify the grasping force applied by the jaws (320) to the tissue, the intensity of the therapeutic energy to be delivered to the tissue, the frequency and / or duration of the therapeutic energy to be delivered to the tissue, and / or any other suitable modifications, as will be apparent to those skilled in the art in view of the teachings herein. While in the present example, the subtherapeutic tissue sensor comprises an EIS sensor (330), any other suitable sensor configured to provide suitable data about tissue may be utilized, as will be apparent to those skilled in the art in view of the teachings herein.

[0055] The EIS sensor (330) can be located at any suitable location on the end effector (310) that is configured to acquire suitable data about the tissue. The EIS sensor (330) can be located along either jaw (320) or can be located proximal to the jaw (320). The EIS sensor (330) can be located near the electrode (325) and also at a sufficient distance so as not to be damaged when the electrode (325) is activated with RF energy. Alternatively, the EIS sensor (330) can be incorporated into a portion of the electrode (325) or around the electrode (325) so that the EIS sensor (330) is located near the tissue in contact with the electrode (325). In examples where the electrode (325) is not used, the EIS sensor (330) can be placed at a suitable location so as not to interfere with the therapeutic energy delivered to the tissue.

[0056] D. Exemplary Use of a Foot Control Console with Hover Sensor and a Surgical Instrument with Subtherapeutic Energy Delivery use

[0057] 7A to 8CAn exemplary use of a robotic surgical system (10) with a surgical instrument (300) and a foot control console (280) is shown to acquire tissue properties via an EIS sensor (330) and potentially modify delivered therapeutic energy to accommodate the measured tissue properties.

[0058] Once the end effector (310) is properly positioned within the patient as described herein, the surgeon may initiate grasping (415) of the tissue using the appropriate portion of the console (260, 280). Figure 7A As best shown, the end effector (310) can be actuated so that the jaws (320) are in an open configuration. With the jaws (320) in the open configuration, the end effector (310) can be positioned so that tissue is interposed between the pair of jaws (320). When in the open configuration, the tissue may not be secured by the end effector (310) so as to allow the end effector (310) to engage different portions of the tissue. The operator can visually confirm, such as through an endoscope, that the tissue intended for grasping is properly positioned between the pair of jaws (320) in the open configuration. Figure 7A At the moment shown, the surgeon may not be ready to apply therapeutic energy to the tissue as described herein. Figure 8A As best shown, the surgeon's foot may be neither adjacent to the activation switch (282) nor within the hovering zone (286). In the event that the operator is outside of the hovering zone (286), the control unit (250) does not activate the EIS sensor (330) as described herein, so that sub-therapeutic energy is not applied.

[0059] Next, if Figure 7B As shown, the end effector (310) is actuated from an open configuration toward a first closed configuration, thereby grasping tissue in preparation for applying therapeutic energy. When in the first closed configuration, the jaws (320) are properly engaged with the tissue, enabling the EIS sensor (330) to transmit sub-therapeutic energy to the tissue, thereby detecting the electrical impedance of the tissue. The electrode (325) can also be properly contacted with the tissue and can deliver therapeutic energy to the tissue in the form of RF energy.

[0060] like Figure 8B As shown, with the jaws (320) grasping tissue in the first closed position, the surgeon can hover his foot over the activation switch (282) and within the hovering zone (286) in anticipation of pressing the activation switch (282) to appropriately activate the electrode (325) as described herein. In the event that the hovering sensor (284) detects the foot within the hovering zone (286), the hovering sensor (284) sends a confirmation signal to the control unit (250) to enable the EIS sensor (330) to deliver sub-therapeutic energy waves in the form of impedance sensing of the tissue, as described herein. Figure 7B shown.

[0061] The control unit (250) can analyze the data provided by the EIS sensor (330) to determine tissue characteristics. In some cases, the tissue characteristics can be determined by the EIS sensor (330) data falling within a predetermined range or threshold. In addition, once the activation switch (282) is appropriately pressed, the control unit (250) can modify the clamping force provided by the jaws (320) and / or the therapeutic energy to be delivered to the tissue. The intensity, duration, frequency, or any other suitable modification of the therapeutic energy can be made in response to the determined tissue characteristics. In some cases, the control unit (250) can also determine the state of the tissue and communicate the state to the operator by reporting the state on the display unit (270).

[0062] Figure 7C The end effector (310) is shown modifying the clamping force of the jaws (320) in response to tissue characteristics determined by the control unit (250). It should be understood that such modification of the clamping force can be performed before or after the surgeon presses the activation switch (282) as described herein. In the current example, the end effector (310) moves the jaws (320) into a second closed configuration. In the second closed configuration, the jaws (320) apply a greater closing force to the tissue. The control unit (250) can transition the end effector (310) from the first closed configuration to the second closed configuration based on readings from the EIS sensor (330). Although in the current example, the jaws (320) are actuated to be closer together based on readings from the EIS sensor (330), in some examples, based on the determined tissue characteristics, the jaws (320) can be actuated to be slightly open based on readings from the EIS sensor (330) so that the jaws (320) apply less clamping force to the tissue. Thus, the closing force applied by jaws (320) to tissue may be customized based on tissue characteristics determined by control unit (250) and sensor (330).

[0063] like Figure 8C As shown, once the surgeon is ready to apply therapeutic energy to the tissue, the surgeon can press the activation switch (282). In response, the control unit (250) can instruct the jaws (320) to actuate into a desired closed configuration suitable for activating the electrodes (325) to apply therapeutic energy to the grasped tissue. Additionally, the control unit (250) can instruct the electrodes (325) to apply such therapeutic energy to the grasped tissue.

[0064] It should be understood that because the EIS sensor (330) is activated in response to the hover sensor (284) detecting the presence of the foot, the sensor (330) and the control unit (250) can obtain and utilize the above-mentioned tissue characteristic data and make the above-mentioned treatment energy modifications before the surgeon presses the activation switch (282). Therefore, in some cases, the tissue characteristic data and subsequent modifications can be made before the surgeon presses the activation switch (282); this can allow for customizable treatment energy delivery based on tissue characteristics without undesirably extending the amount of time between pressing the activation switch (282) and completing the treatment energy delivery cycle.

[0065] In some cases, the surgeon may not wait for the sensor (330) and control unit (250) to properly acquire tissue information and make subsequent modifications as described herein. For example, in some cases, the surgeon may press the activation switch (282) without hovering over the activation switch (282) long enough for the sensor (330) and control unit (250) to make the above-mentioned determinations and modifications. In such cases, the end effector (310) can be activated with a predetermined treatment energy delivery cycle and the jaws (320) in a predetermined closed configuration. Thus, if desired, the surgeon can bypass the modification process initiated by hovering the foot within the hovering zone (286).

[0066] Figure 9 A flowchart (400) is shown that demonstrates an exemplary use of a robotic surgical system (10) having a surgical instrument (300) and a foot control console (280) to acquire tissue characteristics via an EIS sensor (330) and potentially modify therapeutic energy delivery to accommodate the measured tissue characteristics. First, the surgical instrument (300) can be operatively attached (405) to a robotic arm (302) as described herein. The surgical instrument (300) can be attached (405) to the robotic arm (302) via a robotic coupling (304) such that appropriate components of the end effector (310) communicate with the control unit (250).

[0067] Once in communication, the robotic surgical system (10) may initiate (410) itself with a series of checks and operations to ensure readiness for operation. For example, the robotic surgical system (10) may identify the type of surgical instrument (300) attached (405) to the robotic arm (302). Once properly identified, initiation (410) may include loading appropriate operating parameters to ensure that the control unit (250) properly controls the end effector (310) as described herein. Additionally, initiation (410) may include ensuring electrical continuity between the control unit (250) and various electrically controlled components of the end effector (310), such as the electrodes (325) and the EIS sensor (330). Initiating the surgical instrument (300) to be suitable for use with the robotic surgical system (10) may include any other suitable process, which will be apparent to one skilled in the art in light of the teachings herein.

[0068] Next, once the surgical system (10) is activated (410) and ready for exemplary use, the surgical instrument (300) is inserted into the patient via a cannula (not shown), which can be substantially similar to the cannula (120) described above. The distal end of the surgical instrument (300), including the end effector (310), is appropriately positioned (412) within the patient such that the end effector (310) is adjacent to the target anatomical structure. As described herein, the positioning (412) of the end effector (310) can be controlled using the surgeon's console (240). Thus, the surgeon can visually confirm the proper placement of the end effector using the display unit (270).

[0069] Next, the surgeon can control the end effector (310) to appropriately grasp (415) the tissue as described herein. With the tissue grasped (415), the surgeon can prepare to apply therapeutic energy to the tissue such that the surgeon hovers his or her foot over the activation switch (282), thereby triggering (420) the hover sensor (284). As described above, the surgeon can choose to utilize a sub-therapeutic energy course or choose to press the activation switch before the sub-therapeutic energy course is completed. Thus, the surgeon can confirm the use (425) of the sensor (230) by maintaining his or her foot within the hover zone (288), or choose to bypass the use of the sensor (230) by pressing (450) the activation switch (282) before the sub-therapeutic energy course is completed.

[0070] If the surgeon confirms the use (425) of the sub-therapeutic energy course, the control unit (250) may begin (430) the sub-therapeutic course and instruct activation of the EIS sensor (330) as described herein. Next, the control unit (250) may analyze (435) the tissue results provided by the sensor (430) and update (440) the robot output (such as modifying the therapeutic energy delivery or clamping force) in response to such analysis (435). Optionally, the control unit (250) may report the results (445) via the display unit (270).

[0071] Next, the surgeon may press (450) the activation switch (232) to deliver therapeutic energy (460) as described herein. Where the clamping force provided by the jaws (320) changes after the activation switch (232) is pressed, the jaws (320) may then transition (455) to the determined closed position. It should be understood that if the surgeon bypasses the sub-therapeutic sensing process, pressing (450) the activation switch (232) activates a predetermined therapeutic energy delivery (460) (i.e., a therapeutic energy delivery cycle that is not based on the tissue characteristic results provided by the sensor (330) and the control unit (250)). However, if the surgeon does not bypass the sub-therapeutic sensing process, pressing (450) the activation switch (232) activates a customized therapeutic energy delivery (460) that utilizes the tissue characteristic results provided by the sensor (330) and the control unit (250). In some cases, a surgeon may complete a sub-therapeutic energy course as described herein and still decide to disregard the results and activate a therapeutic energy cycle that is not based on the determined tissue properties.

[0072] III. Combined Examples

[0073] The following examples relate to various non-exhaustive ways in which the teachings herein may be combined or applied. The following examples are not intended to limit the scope of any claims that may be made at any time in this patent application or subsequent submissions of this patent application. It is not intended to make a disclaimer. The following examples are provided for illustrative purposes only. It is envisioned that the various teachings herein may be arranged and applied in a variety of other ways. It is also envisioned that some variations may omit certain features mentioned in the following examples. Therefore, any of the aspects or features mentioned below should not be considered decisive unless otherwise expressly indicated as such by the inventor or a successor with an interest in the inventor at a later date. If any claim set forth in this patent application or subsequent submissions related to this patent application includes additional features other than those mentioned below, these additional features should not be assumed to be added for any reason related to patentability.

[0074] Example 1

[0075] A robotic surgical system, comprising: a robotic arm including a distal end; a tool driver operatively coupled to the distal end of the robotic arm; a control unit; a surgical instrument comprising: an end effector configured to transmit therapeutic energy to tissue via a therapeutic energy cycle based on instructions from the control unit; and a tissue sensor configured to determine at least one tissue characteristic and transmit the at least one tissue characteristic to the control unit, wherein the control unit is configured to modify the therapeutic energy cycle based on the at least one tissue characteristic; and a console comprising: an activation switch configured to activate the therapeutic energy cycle of the end effector; and a hover sensor configured to sense an object within a hovering zone proximate to the activation switch, wherein the hover sensor is configured to activate the tissue sensor to determine the at least one tissue characteristic in response to sensing the object within the hovering zone.

[0076] Example 2

[0077] The robotic surgical system according to any one or more of the preceding embodiments, wherein the tissue sensor comprises an electrical impedance sensing device configured to determine the electrical impedance of the tissue.

[0078] Example 3

[0079] The robotic surgical system according to any one or more of the preceding embodiments, wherein the console comprises a foot-controlled console, wherein the hovering sensor is configured to sense an operator's foot.

[0080] Example 4

[0081] The robotic surgical system according to any one or more of the foregoing embodiments, wherein the hovering zone is positioned at least above the activation switch, and the foot control console is configured to enable the operator to enter the hovering zone before the activation switch can activate the therapeutic energy cycle of the end effector.

[0082] Example 5

[0083] The robotic surgical system according to any one or more of the preceding embodiments, wherein the end effector comprises an electrode configured to deliver RF energy.

[0084] Example 6

[0085] The robotic surgical system according to any one or more of the foregoing embodiments, wherein the end effector comprises a pair of jaws configured to grasp tissue, wherein the control unit is configured to modify the grasping force of the pair of jaws based on the at least one tissue characteristic.

[0086] Example 7

[0087] The robotic surgical system according to any one or more of the preceding embodiments, wherein at least one jaw of the pair of jaws comprises an electrode.

[0088] Example 8

[0089] The robotic surgical system according to any one or more of the preceding embodiments, wherein the electrode is configured to ablate tissue.

[0090] Example 9

[0091] The robotic surgical system according to any one or more of the preceding embodiments, wherein the surgical instrument includes a robotic interface configured to be selectively coupled to the tool driver.

[0092] Example 10

[0093] The robotic surgical system according to any one or more of the preceding embodiments, wherein the surgical instrument includes a shaft assembly extending proximally from the end effector.

[0094] Example 11

[0095] According to any one or more of the preceding embodiments, the robotic surgical system further comprises a display unit, wherein the display unit is configured to transmit the at least one tissue characteristic determined by the tissue sensor.

[0096] Example 12

[0097] The robotic surgical system according to any one or more of the preceding embodiments, wherein the surgical instrument is removably coupled to the robotic arm.

[0098] Example 13

[0099] The robotic surgical system according to any one or more of the preceding embodiments, wherein the control unit is configured to be capable of modifying the intensity of the treatment energy cycling based on the at least one tissue characteristic.

[0100] Example 14

[0101] The robotic surgical system according to any one or more of the preceding embodiments, wherein the control unit is configured to be capable of modifying the duration of the treatment energy cycle based on the at least one tissue characteristic.

[0102] Example 15

[0103] The robotic surgical system according to any one or more of the preceding embodiments, wherein the control unit is configured to modify the frequency of the treatment energy cycling based on the at least one tissue characteristic.

[0104] Example 16

[0105] The robotic surgical system according to any one or more of the preceding embodiments, wherein the control unit is associated with the console.

[0106] Example 17

[0107] A surgeon's console comprising: a control unit; a console configured to receive commands from an operator and transmit the commands to the control unit; a robotic arm in communication with the control unit; a surgical instrument configured to be selectively coupled to the robotic arm, the surgical instrument comprising an end effector configured to deliver therapeutic energy to tissue, the end effector comprising: a pair of jaws configured to grasp tissue with adjustable compression; and a tissue sensor configured to determine at least one group of tissue characteristic and transmitting the at least one tissue characteristic to the control unit, wherein the control unit is configured to modify the adjustable compression of the pair of jaws in response to the at least one tissue characteristic; and a foot control console that communicates with the console and includes: an activation switch, the activation switch configured to activate the end effector using therapeutic energy; and a hover sensor, the hover sensor configured to sense an object in a hovering zone proximate to the activation switch, wherein the hover sensor is configured to activate the tissue sensor to determine the at least one tissue characteristic in response to sensing the object in the hovering zone.

[0108] Example 18

[0109] A method of activating an end effector, the method comprising: receiving an indication from a hover sensor that an object has entered a hover zone defined by the hover sensor and positioned proximate to an activation switch; in response to receiving the indication from the hover sensor, instructing a tissue sensor to determine at least one tissue characteristic of tissue adjacent to the tissue sensor; modifying a first therapeutic energy into a second therapeutic energy to be delivered to the tissue using the at least one tissue characteristic; and receiving an indication that the activation switch has been pressed; and activating the end effector using the second therapeutic energy modified based on the at least one tissue characteristic.

[0110] Example 19

[0111] A method according to embodiment 18, wherein the at least one tissue characteristic comprises electrical impedance.

[0112] Example 20

[0113] A method according to embodiment 18, wherein the hover zone is positioned at least above the activation switch.

[0114] IV. Miscellaneous

[0115] For clarity of disclosure, the terms "proximal" and "distal" are defined herein relative to a surgeon or other operator grasping a surgical instrument having a distal surgical end effector. The term "proximal" refers to a position of an element closer to the surgeon or other operator, and the term "distal" refers to a position of an element closer to the surgical end effector of the surgical instrument and further away from the surgeon or other operator.

[0116] It should be noted that, as used herein, the term "coupled" or other variations of the word coupled can indicate an indirect connection or a direct connection. For example, if a first component is "coupled" to a second component, the first component can be indirectly connected to the second component via another component or directly connected to the second component.

[0117] The methods disclosed herein include one or more steps or actions for implementing the described methods. Method steps and / or actions may be interchangeable with one another without departing from the scope of the claims. In other words, unless a specific order of steps or actions is required for the proper operation of the method being described, the order and / or use of specific steps and / or actions may be modified without departing from the scope of the claims.

[0118] As used herein, the term "plurality" means two or more. For example, a plurality of components refers to two or more components.

[0119] It should be understood that any type of device described herein may also include various other features in addition to or in place of those described above. By way of example only, any device herein may also include one or more of the various features disclosed in any of the various references incorporated herein by reference. Various suitable ways in which such teachings can be combined will be apparent to those skilled in the art.

[0120] Although the examples herein are primarily described in the context of uterine manipulator instruments, it should be understood that the various teachings herein can be readily applied to a variety of other types of devices. By way of example only, the various teachings herein can be readily applied to other types of surgical instruments, including tissue graspers, tissue retrieval capsule deployment instruments, surgical staplers, surgical clip appliers, ultrasonic surgical instruments, and the like. It should also be understood that the teachings herein can be readily applied to any of the instruments described in any of the references cited herein, such that the teachings herein can be readily combined with the teachings of any of the references cited herein in a variety of ways. Other types of instruments that can incorporate the teachings herein will be readily apparent to those skilled in the art.

[0121] It should be understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. described herein. Therefore, the above teachings, expressions, embodiments, examples, etc. should not be considered in isolation from each other. Various suitable ways in which the teachings herein can be combined will be apparent to those skilled in the art with reference to the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.

[0122] It should be understood that any patent, patent publication, or other public material, whether in whole or in part, allegedly incorporated herein by reference is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions or other public material set forth in this disclosure. Accordingly, and to the extent necessary, the disclosure expressly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, allegedly incorporated herein by reference that conflicts with existing definitions or other public material set forth herein will be incorporated only to the extent that no conflict arises between the incorporated material and the existing public material.

[0123] The patterns described above can be designed to be discarded after a single use, or they can be designed to be used multiple times. In either case or both cases, these patterns can be repaired to be reused after at least one use. Repair can include any combination of the following steps: disassembling the device, then cleaning or replacing specific parts and subsequently reassembling. Specifically, the device of some patterns can be disassembled, and any number of specific parts or parts of the device can be selectively replaced or removed in any combination. When cleaning and / or replacing specific parts, some patterns of the device can be reassembled at the repair facility or reassembled by the operator before the procedure is about to be carried out for subsequent use. Those skilled in the art will appreciate that the repair of the device can utilize multiple technologies to disassemble, clean / replace and reassemble. The use of such technology and the repair device of gained are all within the scope of the present application.

[0124] By way of example only, the devices described herein can be sterilized before and / or after the procedure. In one sterilization technique, the device is placed in a closed and sealed container, such as a plastic bag or a TYVEK bag. The container and device can then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation can kill bacteria on the device and in the container. The sterilized device can then be stored in a sterile container for later use. The device can also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.

[0125] Various embodiments of the present invention have been shown and described, and further improvements to the methods and systems described herein may be achieved by appropriate modifications by those skilled in the art without departing from the scope of the present invention. Several such possible modifications have been mentioned, and other modifications will be apparent to those skilled in the art. For example, the embodiments, implementations, geometries, materials, dimensions, ratios, steps, etc. discussed above are illustrative and not required. Accordingly, the scope of the present invention should be considered in light of the following claims and should be understood not to be limited to the details of structure and operation shown and described in the specification and drawings.

Claims

1. A robotic surgical system, comprising: (a) a robotic arm comprising a distal end; (b) a tool driver operatively coupled to the distal end of the robotic arm; (c) a control unit; (d) a surgical instrument comprising: (i) an end effector configured to deliver therapeutic energy to tissue via a therapeutic energy cycle based on instructions from the control unit; and (ii) a tissue sensor configured to determine at least one tissue characteristic and transmit the at least one tissue characteristic to the control unit, wherein the control unit is configured to modify the therapeutic energy cycle based on the at least one tissue characteristic; and (e) a control console, the control console comprising: (i) an activation switch configured to activate the therapeutic energy cycle of the end effector; and (ii) a hover sensor configured to sense an object within a hover zone proximate to the activation switch, wherein the hover sensor is configured to activate the tissue sensor to determine the at least one tissue characteristic in response to sensing the object within the hover zone.

2. The robotic surgical system according to claim 1, wherein: The tissue sensor comprises an electrical impedance sensing device configured to determine the electrical impedance of the tissue.

3. The robotic surgical system according to claim 1 or claim 2, wherein: The console includes a foot control console, wherein the hover sensor is configured to sense an operator's foot.

4. The robotic surgical system according to claim 3, wherein: The hovering zone is positioned at least above the activation switch, and the foot control console is configured to allow the operator to enter the hovering zone before the activation switch can activate the therapeutic energy cycle of the end effector.

5. A robotic surgical system according to any preceding claim, wherein: The end effector includes an electrode configured to deliver RF energy.

6. A robotic surgical system according to any preceding claim, wherein: The end effector includes a pair of jaws configured to grasp tissue, wherein the control unit is configured to modify a grasping force of the pair of jaws based on the at least one tissue characteristic.

7. The robotic surgical system according to claim 6, wherein: At least one jaw of the pair of jaws includes an electrode.

8. The robotic surgical system according to claim 7, wherein: The electrodes are configured to ablate tissue.

9. A robotic surgical system according to any preceding claim, wherein: The surgical instrument includes a robotic interface configured to be selectively couplable with the tool driver.

10. The robotic surgical system according to claim 9, wherein: The surgical instrument includes a shaft assembly extending proximally from the end effector.

11. The robotic surgical system according to any preceding claim, further comprising a display unit, wherein The display unit is configured to communicate the at least one tissue characteristic determined by the tissue sensor.

12. A robotic surgical system according to any preceding claim, wherein: The surgical instrument is removably coupled to the robotic arm.

13. A robotic surgical system according to any preceding claim, wherein: The control unit is configured to modify the intensity of the therapeutic energy cycling based on the at least one tissue characteristic.

14. A robotic surgical system according to any preceding claim, wherein: The control unit is configured to modify the duration of the therapeutic energy cycle based on the at least one tissue characteristic.

15. A robotic surgical system according to any preceding claim, wherein: The control unit is configured to modify the frequency of the therapeutic energy cycles based on the at least one tissue characteristic.

16. A robotic surgical system according to any preceding claim, wherein: The control unit is associated with the console.

17. A surgeon's console, comprising: (a) a control unit; (b) a console configured to receive commands from an operator and transmit the commands to the control unit; (c) a robotic arm in communication with the control unit; (d) a surgical instrument configured to be selectively coupled to the robotic arm, the surgical instrument comprising an end effector configured to deliver therapeutic energy to tissue, the end effector comprising: (i) a pair of jaws configured to grasp tissue with adjustable compression; and (ii) a tissue sensor configured to determine at least one tissue characteristic and transmit the at least one tissue characteristic to the control unit, wherein the control unit is configured to modify the adjustable compression of the pair of jaws in response to the at least one tissue characteristic; and (d) a foot control console in communication with the console and comprising: (i) an activation switch configured to activate the end effector with therapeutic energy; and (ii) a hover sensor configured to sense an object within a hover zone proximate to the activation switch, wherein the hover sensor is configured to activate the tissue sensor to determine the at least one tissue characteristic in response to sensing the object within the hover zone.

18. A method of activating an end effector, the method comprising: (i) receiving an indication from a hover sensor that an object has entered a hover zone defined by the hover sensor and located proximate to an activation switch; (ii) in response to receiving the indication from the hover sensor, instructing a tissue sensor to determine at least one tissue characteristic of tissue adjacent to the tissue sensor; (iii) modifying the first treatment energy into a second treatment energy to be delivered to the tissue using the at least one tissue characteristic; as well as (iv) receiving an indication that an activation switch has been pressed; as well as (v) activating the end effector with the second treatment energy modified based on the at least one tissue characteristic.

19. The method according to claim 18, wherein The at least one tissue characteristic includes electrical impedance.

20. The method according to claim 18 or claim 19, wherein The hover zone is positioned at least above the activation switch.

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