A collaborative mixed reality feedback system to enhance the efficient recognition of composite data feeds.

Abstract

An augmented reality display system and method for use during surgical procedures are disclosed. [Solution] An imaging device captures real images of the surgical area during a surgical procedure and generates a first data feed. A sensor device generates a second data feed. An augmented reality device, including an augmented reality display, generates an augmented overlay based on the first and second data feeds. The augmented overlay includes a visual portion and a non-visual visual portion. A processor receives the first and second data feeds and combines them to generate the augmented overlay.

Description

[Technical Field]

[0001] (Cross-Reference to Related Applications) This application claims the benefit of U.S. Provisional Patent Application No. 63 / 174,674 entitled "HEADS UP DISPLAY" filed on April 14, 2021, and U.S. Provisional Patent Application No. 63 / 284,326 entitled "INTRAOPERATIVE DISPLAY FOR SURGICAL SYSTEMS" filed on November 30, 2021, under 35 U.S.C. § 119(e), and the disclosures of each of these are incorporated herein by reference in their entireties. [Background Art]

[0002] The present disclosure relates to apparatuses, systems, and methods for providing an augmented reality interactive experience during a surgical procedure. It would be desirable to provide an augmented reality interactive experience of a real-world environment where objects present in the real world are enhanced by overlaying computer-generated perceptual information across multiple sensory modalities, sometimes including vision, hearing, touch, somatosensation, and smell, during a surgical procedure. In the context of the present disclosure, images of the surgical field and surgical instruments and other objects appearing in the surgical field are enhanced by overlaying computer-generated visual, auditory, tactile, somatosensory, olfactory, or other sensory information onto a real-world image of the surgical field and instruments or other objects appearing in the surgical field. The images may be streamed in real time or may be still images.

[0003] Real-world surgical instruments include various surgical devices. Energy-based surgical devices include, but are not limited to, inter alia, radio frequency (RF)-based monopolar and bipolar electrosurgical instruments, ultrasonic surgical instruments, combinations of RF electrosurgical instruments and ultrasonic instruments, combinations of RF electrosurgical staplers and mechanical staplers. Surgical stapler devices are surgical instruments used for cutting and stapling tissue in a variety of surgical procedures including bariatric, thoracic, colorectal, gynecological, urological, and general surgery. [Overview of the project] [Means for solving the problem]

[0004] In various examples, this disclosure provides an augmented reality display system for use during surgical procedures. The augmented reality display system comprises an imaging device that captures real images of the surgical area during a surgical procedure and generates a first data feed. A sensor device generates a second data feed. An augmented reality device comprising an augmented reality display generates an augmented overlay based on the first and second data feeds. The augmented overlay includes a visual portion and a non-visual visual portion. A processor receives the first data feed, receives the second data feed, and combines the first and second data feeds to generate the augmented overlay.

[0005] In various examples, this disclosure provides a method for presenting an augmented reality overlay during a surgical procedure. According to the method, an imaging device captures a real image of the surgical area during a surgical procedure. The imaging device generates a first data feed based on the captured real image. A sensor device generates a second data feed. An augmented reality device, equipped with an augmented reality display, presents an augmented reality overlay based on the first and second data feeds. The augmented reality overlay includes a visual portion and a non-visual visual portion. [Brief explanation of the drawing]

[0006] The various embodiments described herein with respect to both configuration and operation methods, along with their further purposes and advantages, can be best understood by referring to the following description in conjunction with the accompanying drawings. [Figure 1] This is a block diagram of a computer-implemented interactive surgical system according to one aspect of the present disclosure. [Figure 2] This is a diagram of a surgical system used to perform surgical procedures in an operating room, according to one aspect of the present disclosure. [Figure 3] One aspect of the present disclosure is a visualization system, a robotic system, and a surgical hub paired with an intelligent instrument. [Figure 4] This figure shows a surgical data network, according to one aspect of the present disclosure, which includes a modular communication hub configured to connect modular devices located in one or more operating rooms of a medical facility, or any room within a medical facility equipped with specialized equipment for surgical procedures, to the cloud. [Figure 5] This figure shows a computer-implemented interactive surgical system according to one aspect of the present disclosure. [Figure 6] This figure shows a surgical hub, including multiple modules connected to a modular control tower, according to one aspect of the present disclosure. [Figure 7] This figure shows an augmented reality (AR) system, according to one aspect of the present disclosure, which includes an intermediate signal coupler located in the communication path between an imaging module and a surgical hub display. [Figure 8] This figure shows an augmented reality (AR) system, according to one aspect of the present disclosure, which includes an intermediate signal coupler located in the communication path between an imaging module and a surgical hub display. [Figure 9] This figure shows an augmented reality (AR) device worn by a surgeon to communicate data to a surgical hub, according to one aspect of the present disclosure. [Figure 10] This figure shows a system for augmenting surgical instrument information using an augmented reality display, according to one aspect of the present disclosure. [Figure 11] This is a system diagram of an operating room equipped with a surgical monitor having an intraoperative data display for the surgical area, according to one aspect of the present disclosure. [Figure 12] An aspect of the present disclosure is an expanded image of a live feed of a surgical area visualized through a laparoscopic camera during a minimally invasive surgical procedure, showing, as a tissue aspect, tissue that is inadequately captured between the jaws of a surgical instrument end effector. [Figure 13]An augmented image of a live feed of the surgical area visualized through a laparoscopic camera during a minimally invasive surgical procedure, as displayed on an intraoperative data display according to one aspect of the present disclosure. [Figure 14] This figure shows an augmented reality system, according to one aspect of the present disclosure, which includes an intermediate signal coupler located in the communication path between an imaging module and a surgical hub display. [Figure 15] This figure shows a method for presenting an extended overlay during a surgical procedure according to one aspect of the present disclosure. [Figure 16] This figure shows a timeline of a situational awareness surgical procedure according to one aspect of the present disclosure.

[0007] Throughout the drawings, corresponding reference numerals indicate corresponding parts. The examples described herein illustrate various disclosed embodiments in one form, and such examples should not be construed as limiting the scope thereof. [Modes for carrying out the invention]

[0008] The applicant of this application owns the following concurrently filed U.S. patent applications, the entirety of which is incorporated herein by reference: • U.S. Patent Application entitled "METHOD FOR INTRAOPERATIVE DISPLAY FOR SURGICAL SYSTEMS"; Agent Reference Number END9352USNP1 / 210120-1M • U.S. Patent Application entitled "Utilization of surgical data values ​​and situational awareness to control the overlay in surgical field view"; Agent reference number END9352USNP2 / 210120-2 • U.S. Patent Application entitled "Selective and adjustable mixed reality overlay insurgical field view"; Agent reference number END9352USNP3 / 210120-3 • U.S. Patent Application entitled "Risk based prioritization of display aspects in surgical field view"; Agent reference number END9352USNP4 / 210120-4 • U.S. Patent Application entitled "SYSTEMS AND METHODS FOR CONTROLLING SURGICAL DATA OVERLAY"; Agent Reference Number END9352USNP5 / 210120-5 U.S. Patent Application entitled "SYSTEMS AND METHODS FOR CHANGING DISPLAY OVERLAY OF SURGICAL FIELD VIEW BASED ON TRIGGERING EVENTS"; Agent Reference Number END9352USNP6 / 210120-6 • U.S. Patent Application entitled "CUSTOMIZATION OF OVERLAID DATA AND CONFIGURATION"; Agent Reference Number END9352USNP7 / 210120-7 U.S. Patent Application entitled "INDICATION OF THE COUPLE PAIR OF REMOTE CONTROLS WITH REMOTE DEVICES FUNCTIONS"; Agent Reference Number END9352USNP8 / 210120-8 U.S. Patent Application entitled "Cooperative Overlays of Interacting Instruments Which Resurface in Both Overlays Being Effected"; Agent Reference Number END9352USNP9 / 210120-9 U.S. Patent Application entitled "ANTICIPATION OF INTERACTIVE UTILIZATION OF COMMON DATA OVERLAYS BY DIFFERENT USERS"; Agent Reference Number END9352USNP10 / 210120-10 U.S. Patent Application entitled "MIXING DIRECTLY VISUALIZED WITH RENDERED ELEMENTS TO DISPLAY BLENDED ELEMENTS AND ACTIONS HAPPENING ON-SCREEN AND OFF-SCREEN"; Agent Reference Number END9352USNP11 / 210120-11 U.S. Patent Application entitled "SYSTEM AND METHOD FOR TRACKING A PORTION OF THE USER AS A PROXY FOR NON-MONITORED INSTRUMENT"; Agent Reference Number END9352USNP12 / 210120-12 U.S. Patent Application entitled "UTILIZING CONTEXTUAL PARAMETERS OF ONE OR MORE SURGICAL DEVICES TO PREDICT A FREQUENCY INTERVAL FOR DISPLAYING SURGICAL INFORMATION"; Agent Reference Number END9352USNP13 / 210120-13 U.S. Patent Application entitled "Cooperation Among Multiple Display Systems to Provide a Healthcare User Customized Information"; Agent Reference Number END9352USNP14 / 210120-14 • U.S. Patent Application entitled "INTRAOPERATIVE DISPLAY FOR SURGICAL SYSTEMS"; Agent Reference Number END9352USNP15 / 210120-15, and, U.S. Patent Application entitled "ADAPTATION AND ADJUSTABILITY OR OVERLAID INSTRUMENT INFORMATION FOR SURGICAL SYSTEMS"; Agent reference number END9352USNP16 / 210120-16.

[0009] The applicant of this application owns the following U.S. patent applications, the entirety of which is incorporated herein by reference: · U.S. Patent Application No. 16 / 209,423 (now U.S. Patent Application Publication No. 2019 / 0200981-A1) entitled "METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS", · U.S. Patent Application No. 16 / 209,453 (now U.S. Patent Application Publication No. 2019 / 0201046-A1) entitled "METHOD FOR CONTROLLING SMART ENERGY DEVICES".

[0010] Before describing various aspects of surgical instruments and generators in detail, it should be noted that the illustrative embodiments are not limited to the details of the construction and arrangement of the components illustrated in the accompanying drawings and description in application or use. The illustrative embodiments may be implemented in, incorporated into, or carried out or performed in various other aspects, variations, and modifications. Furthermore, unless otherwise expressly stated, the terms and expressions used herein are selected for the purpose of describing the illustrative embodiments for the convenience of the reader, and are not intended to limit the same. It should be further understood that one or more of the aspects, expressions of aspects, and / or embodiments described below may be combined with any one or more of the other aspects, expressions of aspects, and / or embodiments described below.

[0011] Various aspects are directed to on-screen displays for surgical systems for various energy- and surgical stapler-based medical devices. Energy-based medical devices include, but are not limited to, radio frequency (RF)-based monopolar and bipolar electrosurgical instruments, ultrasonic surgical instruments, combinations of RF electrosurgical instruments and ultrasonic instruments, combinations of RF electrosurgical staplers and mechanical staplers, among others. Surgical stapler devices include surgical staplers combined with electrosurgical devices and / or ultrasonic devices. Aspects of an ultrasonic surgical device may, for example, be configured to transect and / or coagulate tissue during a surgical procedure. Aspects of an electrosurgical device may, for example, be configured to transect, coagulate, seal, weld and / or desiccate tissue during a surgical procedure. Aspects of a surgical stapler device may be configured to transect and staple tissue during a surgical procedure, and in some aspects, the surgical stapler device may be configured to deliver RF energy to tissue during a surgical procedure. Electrosurgical devices are configured to deliver therapeutic and / or non-therapeutic RF energy to tissue. Elements of surgical staplers, electrosurgical devices, and ultrasonic devices may be used in combination in a single surgical instrument.

[0012] In various aspects, the present disclosure provides on-screen display of real-time information to the OR team during a surgical procedure. According to various aspects of the present disclosure, many new unique on-screen displays are provided for displaying various visual information feedback to the OR team on-screen. According to the present disclosure, the visual information may include one or more of various visual media with or without sound. Generally, visual information includes still photographs, moving photographs, video or audio recordings, graphic arts, visual aids, models, displays, visual presentation services, and support processes. The visual information may be communicated on any number of display options including, for example, a primary OR screen, the energy or surgical stapler device itself, a tablet, augmented reality glasses, among others.

[0013] In various embodiments, this disclosure provides a list of many potential options for communicating visual information to an OR team in real time without overwhelming the OR team with too much visual information. For example, in various embodiments, this disclosure provides on-screen displays of visual information that enable a surgeon, or other member of the OR team, to selectively activate on-screen displays, such as icons surrounding screen options, to manage the rich visual information. One or a combination of factors may be used to determine the active display, and these may include, among other things, the energy-based (e.g., electrosurgery, ultrasound) or machine-based (e.g., stapler) surgical device in use, the estimated risk associated with a given display, the surgeon's level of experience, and the surgeon's choice. In other embodiments, the visual information may include rich data overlaid or superimposed on the surgical field to manage the visual information. In various embodiments described below, this includes superimposed images that require video analysis and tracking to properly overlay the data. Visual information data thus communicated can provide additional useful visual information to the OR team in a more concise and understandable way, in contrast to static icons.

[0014] In various embodiments, the Disclosure provides techniques for selectively activating on-screen displays, such as icons surrounding a screen, to manage visual information during a surgical procedure. In other embodiments, the Disclosure provides techniques for determining an active display using one or a combination of factors. In various embodiments, the techniques provided by the Disclosure may include, among other things, selecting an energy-based or machine-based surgical device to be used as the active display, estimating the risks associated with a given display, and utilizing the experience level of the surgeon or OR team making the selection.

[0015] In other embodiments, the techniques described herein may include overlaying or superimposing rich data onto the surgical field for the purpose of managing visual information. Several display arrangements described herein involve overlaying various visual representations of surgical data onto a live stream of the surgical field. As used herein, the term overlay includes translucent overlays, partial overlays, and / or moving overlays. Graphical overlays may take the form of transparent graphics, translucent graphics, or opaque graphics, or combinations of transparent, translucent, and opaque elements or effects. Furthermore, overlays may be positioned on, or at least partially on or near, objects in the surgical field, such as end effectors and / or important surgical structures. A particular display arrangement may include changes in one or more display elements of the overlay, including changes in color, size, shape, display time, display location, display frequency, highlighting, or combinations thereof, based on a change in display priority value. Graphical overlays are rendered on an active display monitor to quickly and efficiently communicate critical information to the OR team.

[0016] In other embodiments, the technology provided by the Disclosure may include superimposing images that require video analysis and tracking in order to appropriately overlay visual information data. In other embodiments, the technology provided by the Disclosure may include communicating rich visual information, as opposed to simple static icons, to provide additional visual information to the OR team in a more concise and easily understandable manner. In other embodiments, the visual overlay may be used in combination with auditory and / or somatosensory overlays, e.g., thermal, chemical, and mechanical devices, and combinations thereof.

[0017] The following description generally pertains to devices, systems, and methods for providing augmented reality (AR) interactive experiences during surgical procedures. In this context, images of the surgical field and surgical instruments and other objects appearing in the surgical field are enhanced by overlaying computer-generated visual, auditory, tactile, somatosensory, olfactory, or other sensory information onto the real-world images of the surgical field, instruments, and / or other objects appearing in the surgical field. The images may be streamed in real time or they may be still images. Augmented reality is a technique for rendering and displaying virtual or "augmented" virtual objects, data, or visual effects that are overlaid on a real environment. The real environment may include the surgical field. Virtual objects overlaid on a real environment may be represented at fixed or set positions relative to one or more aspects of the real environment. In non-limiting examples, if a real-world object moves out of the field of view of the real environment, the virtual object fixed to the real-world object also moves out of the field of view of augmented reality.

[0018] Some of the display arrangements described herein involve overlaying various visual representations of surgical data onto a live stream of the surgical field. As used herein, the term overlay includes translucent overlays, partial overlays, and / or moving overlays. Furthermore, overlays may be placed on, or at least partially on or near, objects in the surgical field, such as end effectors and / or important surgical structures. A particular display arrangement may include changes in one or more display elements of the overlay, including changes in color, size, shape, display time, display location, display frequency, highlighting, or combinations thereof, based on a change in display priority value.

[0019] As described herein, AR is an extended version of the real physical world achieved through the use of digital visual elements, sounds, or other sensory stimuli delivered via technology. Virtual reality (VR) is a computer-generated environment with scenes and objects that appear real, making the user feel immersed in them. This environment is perceived through a device known as a virtual reality headset or helmet. While both mixed reality (MR) and AR are considered immersive technologies, they are not the same. MR is an extension of mixed reality that allows real and virtual elements to interact within an environment. AR often adds digital elements to a live view by using a camera, while an MR experience combines elements of both AR and VR, where real-world and digital objects interact.

[0020] In an AR environment, one or more computer-generated virtual objects may be displayed alongside one or more real-world (i.e., so-called "real-world") elements. For example, real-time images or videos of the surrounding environment may be displayed on a computer screen display along with one or more overlay virtual objects. Such virtual objects can provide supplementary information about the environment or, in general, enhance the user's perception and engagement with the environment. Conversely, real-time images or videos of the surrounding environment can, in addition or alternatively, enhance the user's engagement with the virtual objects displayed on the display.

[0021] Apparatus, systems, and methods in the context of this disclosure enhance images received from one or more imaging devices during surgical procedures. Imaging devices may include various scopes used during non-invasive and minimally invasive surgical procedures, AR devices, and / or cameras that provide images during incisional surgical procedures. Images may be streamed in real time or still images. Apparatus, systems, and methods provide an augmented reality interactive experience by enhancing images of a real-world surgical environment by overlaying representations of virtual objects or data and / or real objects onto the real-world surgical environment. The augmented reality experience may be viewed on a display and / or AR device that allows the user to view virtual objects overlaid on the real-world surgical environment. The display may be located in the operating room or located away from the operating room. The AR device is worn on the head of a surgeon or other operating room personnel and typically includes two stereoscopic display lenses or screens, one for each eye of the user. Natural light can pass through the two transparent or translucent display lenses so that aspects of the real environment are visible, while projecting light to make virtual objects visible to the user of the AR device.

[0022] Two or more displays and AR devices may be used in conjunction with a first display or AR device that controls one or more additional displays or AR devices in a system having defined roles. For example, when activating a display or AR device, the user may select a role (e.g., a surgeon, surgical assistant, nurse, etc. during a surgical procedure), and the display or AR device may display information related to that role. For example, a surgical assistant may have the display show virtual representations of instruments that the surgeon needs to use for the next step in the surgical procedure. The surgeon's focus on the current step may differ from the information displayed by the surgical assistant.

[0023] While many known on-screen displays and alerts exist, this disclosure provides many novel and unique augmented reality interactive experiences during surgical procedures. Such augmented reality interactive experiences include visual, auditory, tactile, somatosensory, olfactory, or other sensory feedback information to the surgical team inside or outside the operating room. Virtual feedback information overlaid on the real-world surgical environment may be provided to the operating room (OR) team, including, but not limited to, personnel within the OR, such as the surgical surgeon, surgical assistants, scrub wearers, anesthesiologists, and circulating nurses. The virtual feedback information can be communicated on any number of display options, such as primary OR screen displays, AR devices, energy or surgical staplers, tablets, augmented reality glasses, and other devices.

[0024] Figure 1 shows a computer-implemented interactive surgical system 1 comprising one or more surgical systems 2 and a cloud-based system 4. The cloud-based system 4 may include a remote server 13 connected to remote storage 5. Each surgical system 2 comprises at least one surgical hub 6 that communicates with the cloud 4. For example, a surgical system 2 may comprise a visualization system 8, a robotic system 10, and a handheld intelligent surgical instrument 12, each configured to communicate with each other and / or with the hub 6. In some embodiments, a surgical system 2 may comprise M hubs 6, N visualization systems 8, O robotic systems 10, and P handheld intelligent surgical instruments 12, where M, N, O, and P are integers of 1 or more. The computer-implemented interactive surgical system 1 may be configured to provide an augmented reality interactive experience during surgical procedures, as described herein.

[0025] Figure 2 shows an example of a surgical system 2 for performing a surgical procedure on a patient lying on an operating table 14 in a surgical operating room 16. A robotic system 10 is used as part of the surgical system 2 in the surgical procedure. The robotic system 10 includes a surgeon's console 18, a patient-side cart 20 (surgical robot), and a surgical robot hub 22. The patient-side cart 20 allows the surgeon to operate at least one detachably connected surgical tool 17 through a minimally invasive incision in the patient's body while viewing the surgical site through the surgeon's console 18 or an augmented reality (AR) device 66 worn by the surgeon. Images of the surgical site during the minimally invasive procedure (e.g., still or live images streamed in real time) can be acquired by a medical imaging device 24. The patient-side cart 20 can operate the imaging device 24 to orient it. Images of the incision surgical procedure can be acquired by a medical imaging device 96. The robot hub 22 processes images of the surgical site for subsequent display on the surgeon's console 18, or on an AR device 66 worn by the surgeon or another person in the surgical room 16.

[0026] The optical components of the imaging device 24, 96, or AR device 66 may include one or more illumination sources and / or one or more lenses. One or more illumination sources may be directed to illuminate a portion of the surgical field. One or more image sensors may receive light reflected or refracted from tissues and instruments in the surgical field.

[0027] In various embodiments, the imaging device 24 is configured for use in minimally invasive surgical procedures. Examples of imaging devices suitable for use with this disclosure include, but are not limited to, arthroscopes, angioscopes, bronchoscopes, cholangioscopies, colonoscopes, cystoscopes, duodenoscopes, intestinaloscopes, esophagogastroduodenoscopes (gastroscopy), endoscopes, laryngoscopes, nasopharyngolaryngoscopes, sigmoidoscopy, thoracoscopy, and ureteroscopes. In various embodiments, the imaging device 96 is configured for use in incisional (invasive) surgical procedures.

[0028] In various embodiments, the visualization system 8 comprises one or more imaging sensors strategically positioned relative to the sterile field, one or more image processing devices, one or more storage arrays, and one or more displays. In one embodiment, the visualization system 8 includes interfaces for HL7, PACS, and EMR. In one embodiment, the imaging device 24 may employ multispectral monitoring to distinguish between topography and underlying structures. Multispectral imaging captures image data within a specific wavelength range in the electromagnetic spectrum. Wavelengths are separated by filters or by instruments sensitive to specific wavelengths, including frequencies beyond the visible light range, e.g., IR and ultraviolet light. Spectral imaging can extract information invisible to the human eye. Multispectral monitoring allows the surgical field to be repositioned after the surgical task for performing tests on the treated tissue is completed.

[0029] Figure 2 shows a primary display 19 positioned in the sterile field for the operator on the operating table 14 to see. The visualization tower 11 includes a first non-sterile display 7 and a second non-sterile display 9 positioned outside the sterile field and facing opposite directions from each other. The visualization system 8, guided by the hub 6, is configured to utilize displays 7, 9, and 19 to coordinate the flow of information to operators inside and outside the sterile field. For example, the hub 6 can cause the visualization system 8 to display AR images of the surgical site recorded by imaging devices 24 and 96 through the non-sterile displays 7, 9, or AR device 66, while maintaining live video of the surgical site on the primary display 19 or AR device 66. The non-sterile displays 7 and 9 can, for example, enable non-sterile operators to perform diagnostic steps related to the surgical procedure.

[0030] Figure 3 shows a hub 6 that communicates with a visualization system 8, a robotic system 10, and handheld intelligent surgical instruments 12. The hub 6 includes a hub display 35, an imaging module 38, a generator module 40, a communication module 30, a processor module 32, a storage array 34, and an operating room mapping module 33. The hub 6 further includes a smoke extraction module 26 and / or a suction / irrigation module 28. In various embodiments, the imaging module 38 includes an AR device 66, and the processor module 32 includes an integrated video processor and an augmented reality modeler (e.g., as shown in Figure 10). The modular light source can be adapted for use with various imaging devices. In various examples, multiple imaging devices can be positioned at different locations in the surgical field to provide multiple views (e.g., non-invasive, minimally invasive, invasive, or incisional surgical procedures). The imaging module 38 can be configured to switch between imaging devices to provide the optimal view. In various embodiments, the imaging module 38 can be configured to integrate images from different imaging devices and provide an augmented reality interactive experience during surgical procedures as described herein.

[0031] Figure 4 shows a surgical data network 51 including a modular communication hub 53 configured to connect modular devices located in one or more operating rooms / surgery sites of a medical facility to a cloud-based system. The cloud 54 may include a remote server 63 (Figure 5) connected to a storage device 55. The modular communication hub 53 includes a network hub 57 and / or a network switch 59 that communicate with a network router 61. The modular communication hub 53 is connected to a local computer system 60 for data processing. The modular devices 1a-1n in the operating room may be connected to the modular communication hub 53. The network hub 57 and / or the network switch 59 are connected to the network router 61 so that the devices 1a-1n can connect to the cloud 54 or the local computer system 60. Data associated with the devices 1a-1n may be transferred to a cloud-based computer via the router for remote data processing and manipulation. The operating room devices 1a-1n may be connected to the modular communication hub 53 via a wired channel or a wireless channel. The surgical data network environment 51 may be employed, as described herein, to provide an augmented reality interactive experience during a surgical procedure, in particular to provide augmented images of the surgical field to one or more remote displays 58.

[0032] Figure 5 shows a computer-implemented interactive surgical system 50. The computer-implemented interactive surgical system 50 is similar in many respects to the computer-implemented interactive surgical system 1. The computer-implemented interactive surgical system 50 includes one or more surgical systems 52 that are similar in many respects to surgical system 2. Each surgical system 52 includes at least one surgical hub 56 that communicates with a cloud 54 which may include a remote server 63. In one embodiment, the computer-implemented interactive surgical system 50 includes a modular control tower 23 connected to a plurality of surgical site devices, such as intelligent surgical instruments, robots, and other computerized devices located in the operating room. As shown in Figure 6, the modular control tower 23 includes a modular communication hub 53 connected to a computer system 60.

[0033] Returning to Figure 5, the modular control tower 23 is connected to an imaging module 38 connected to an endoscope 98, a generator module 27 connected to an energy device 99, a fume exhaust module 76, a suction / irrigation module 78, a communication module 13, a processor module 15, a storage array 16, and optionally smart devices / instruments 21 and sensor modules 29 connected to a display 39. Surgical site devices are connected to cloud computing resources such as a server 63, data storage 55, and a display 58 via the modular control tower 23. The robot hub 72 may also be connected to the modular control tower 23, as well as the server 63, data storage 55, and display 58. In particular, the devices / instruments 21 and the visualization system 58 may be connected to the modular control tower 23 via wired or wireless communication standards or protocols as described herein. The modular control tower 23 may be connected to a hub display 65 (e.g., a monitor, screen) to display received augmented images, including overlaid virtual objects on the real surgical world, received from the imaging module 38, device / instrument display 39, and / or other visualization systems 58. The hub display 65 may also display data received from devices connected to the modular control tower 23, along with the images and overlay images.

[0034] Figure 6 shows a surgical hub 56 including multiple modules connected to a modular control tower 23. The modular control tower 23 includes a modular communication hub 53, such as a network connectivity device, and a computer system 60 for local processing, visualization, and imaging of augmented surgical information. The modular communication hub 53 is connected in a hierarchical configuration to expand the number of modules (e.g., devices) that may be connected to the modular communication hub 53, and data associated with the modules may be transferred to the computer system 60, cloud computing resources, or both. Each of the network hubs / switches 57 / 59 within the modular communication hub 53 may include three downstream ports and one upstream port. The upstream network hubs / switches 57, 59 are connected to the processor 31 to provide communication connectivity to cloud computing resources and local displays 67. Communication to the cloud 54 can be done via either a wired communication channel or a wireless communication channel.

[0035] The computer system 60 includes a processor 31 and a network interface 37. The processor 31 is connected via a system bus to a communication module 41, storage 45, memory 46, non-volatile memory 47, and an input / output interface 48. The system bus may be any of several types of bus structures, including a memory bus or memory controller, a peripheral bus or external bus, and / or a local bus, using various available bus architectures.

[0036] The processor 31 may include an augmented reality modeler (e.g., as shown in Figure 10) and may be implemented as a single-core or multi-core processor, such as one known by the trademark name ARM Cortex by Texas Instruments. In one embodiment, the processor may be, for example, the LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments. This processor core includes on-chip memory of 256KB single-cycle flash memory or other non-volatile memory with a maximum frequency of 40MHz, a prefetch buffer for improving performance beyond 40MHz, 32KB single-cycle serial random access memory (SRAM), internal read-only memory (ROM) with StellarisWare® software, 2KB electrically erasable programmable read-only memory (EEPROM), and / or one or more pulse-width modulation (PWM) modules, one or more quadrature encoder input (QEI) analogs, and one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels. Further details are available in the product datasheet.

[0037] System memory includes volatile and non-volatile memory. The Basic Input / Output System (BIOS), which contains basic routines for transferring information between elements within the computer system during startup, is stored in non-volatile memory. For example, non-volatile memory may include ROM, programmable ROM (PROM), electrically programmable ROM (EPROM), EEPROM, or flash memory. Volatile memory may include random access memory (RAM), which functions as external cache memory. Furthermore, RAM is available in many forms, such as SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), sync-link DRAM (SLDRAM), and direct rhombus RAM (DRRAM).

[0038] The computer system 60 also includes removable / non-removable volatile / non-volatile computer storage media, such as disk storage. Examples of disk storage devices include, but are not limited to, magnetic disk drives, floppy disk drives, tape drives, Jaz drives, Zip drives, LS-60 drives, flash memory cards, or memory sticks. In addition, the disk storage device may include the above-mentioned storage media independently or in combination with other storage media. Examples of other storage media include, but are not limited to, optical disk drives such as compact disk ROM devices (CD-ROMs), compact disk recordable drives (CD-R drives), compact disk rewritable drives (CD-RW drives), or digital multi-purpose disk ROM drives (DVD-ROMs). Removable or non-removable interfaces may be used to facilitate connection of the disk storage device to the system bus.

[0039] In various embodiments, the computer system 60 in Figure 6, the imaging module 38 in Figures 4 to 6, and / or the visualization system 58, and / or the processor module 15 may include an image processor, an image processing engine, an image processing unit (GPU), a media processor, or any dedicated digital signal processor (DSP) used for processing digital images. The image processor can increase speed and efficiency using parallel computing with single-instruction multiple data (SIMD) or multiple-instruction multiple data (MIMD) techniques. The digital image processing engine can perform a variety of tasks. The image processor may be a system on a chip with a multi-core processor architecture.

[0040] Figure 7 shows an augmented reality system 263 that includes an intermediate signal coupler 64 located in the communication path between the imaging module 38 and the surgical hub display 67. The signal coupler 64 combines audio and / or image data received from the imaging module 38 and / or the AR device 66. The surgical hub 56 receives the combined data from the coupler 64, overlays the provided data onto the display 67, and displays the overlaid data. The imaging device 68 may be a digital video camera, and the audio device 69 may be a microphone. The signal coupler 64 may include a wireless head-up display adapter for coupling to the AR device 66 located in the communication path of the display 67 to a console that enables the surgical hub 56 to overlay data onto the display 67.

[0041] Figure 8 shows an augmented reality (AR) system including an intermediate signal coupler positioned in the communication path between the imaging module and the surgical hub display. Figure 8 shows an AR device 66 worn by the surgeon 73 to communicate data to the surgical hub 56. Peripheral information of the AR device 66 does not include active images. Rather, peripheral information includes only signals that do not have the same requirements for device settings or refresh rate. The interaction may extend the surgeon 73's information based on links with preoperative computed tomography (CT) or other data linked within the surgical hub 56. The AR device 66 can identify structures and, for example, ask whether an instrument is touching a nerve, blood vessel, or adhesion. The AR device 66 may include processing in the surgical hub 56 used to provide preoperative scan data, optical views, tissue examination characteristics acquired throughout the procedure, and / or answers. The surgeon 73 may write notes on the AR device 66 so that they are stored in the hub storage 45 along with patient data for later use in reporting or follow-up.

[0042] The AR device 66, worn by the surgeon 73, links to the surgical hub 56 using auditory and visual information to avoid the need for overlays, and allows customization of information displayed around the periphery of the field of view. The AR device 66 provides signals from devices (e.g., instruments) and answers queries regarding location information linked with video to identify device settings or quadrants or locations. The AR device 66 has voice control and voice feedback from the AR device 66. The AR device 66 can interact with other systems in the operating room and can have available feedback and interaction wherever the surgeon 73 looks. For example, the AR device 66 may receive voice or gesture start commands and queries from the surgeon, and the AR device 66 may provide feedback in the form of one or more modalities, including voice, visual, or haptic touch.

[0043] Figure 9 shows a surgeon 73 and a patient 74 wearing AR devices 66, and may include a camera 96 ​​in the operating room 75. The AR device 66 worn by the surgeon 73 may be used to present virtual objects overlaid on a real-time image of the surgical field to the surgeon 73 through an augmented reality display 89 or through a hub-connected display 67. The real-time image may include parts of surgical instruments 77. The virtual objects may not be visible to others in the operating room 75 (e.g., surgical assistants or nurses), but they may also wear AR devices 66. Even if another person is viewing the operating room 75 using an AR device 66, that person may not be able to see the virtual objects, or may be able to see the virtual objects in augmented reality shared with the surgeon 73, or may be able to see modified versions of the virtual objects (e.g., according to customization specific to the surgeon 73), or may see different virtual objects.

[0044] Virtual objects and / or data may be configured to appear on a portion of the surgical instrument 77 or within the surgical field captured by the imaging module 38, the imaging device 68 during minimally invasive surgical procedures, and / or the camera 96 ​​during incisional surgical procedures. In the illustrated example, the imaging module 38 is a laparoscopic camera that provides live video of the surgical area during minimally invasive surgical procedures. The AR system may present virtual objects fixed to real objects regardless of the viewpoint of one or more viewers of the AR system (e.g., the surgeon 73). For example, virtual objects may be visible to viewers of the AR system inside the operating room 75, but not visible to viewers of the AR system outside the operating room 75. Virtual objects may be displayed to viewers outside the operating room 75 when a viewer enters the operating room 75. Augmented images may be displayed on the surgical hub display 67 or the augmented reality display 89.

[0045] The AR device 66 may include one or more screens or lenses, such as a single screen or two screens (e.g., one for each user's eye). The screens may allow light to pass through them so that aspects of the real environment are visible while virtual objects are being displayed. Virtual objects may become visible to the surgeon 73 by projecting light. Virtual objects may appear to have some degree of transparency or may be opaque (i.e., blocking aspects of the real environment).

[0046] An AR system may be visible to one or more viewers and may include differences between views available to one or more viewers, while maintaining some common aspects between views. For example, a heads-up display may change between two views, but virtual objects and / or data may be fixed to real objects or areas in both views. Aspects such as the color, lighting, or other changes of an object may occur between views without changing the fixed position of at least one virtual object.

[0047] Users can view virtual objects and / or data presented within the AR system as opaque or with a certain level of transparency. For example, a user can interact with a virtual object by moving it from a first position to a second position. For instance, a user may move an object with their own hand. This may be done virtually in the AR system by determining that the hand has moved to a position adjacent to or adjacent to the object (using one or more cameras, which may be mounted on the AR device 66, such as AR device camera 79 or a separate camera 96, and which may be static or controlled to move) and moving the object accordingly. The virtual form may include a virtual representation of a real-world object, or it may include visual effects such as lighting effects. The AR system may include rules to govern the behavior of the virtual object, such as exposing the virtual object to gravity or friction, or it may include other predefined rules that negate real-world physical constraints (e.g., floating objects, perpetual motion, etc.). The AR device 66 may include a camera 79 (which should not be confused with a separate camera 96). The AR device camera 79 or camera 96 ​​may include an infrared camera, an infrared filter, a visible light filter, multiple cameras, a depth camera, etc. The AR device 66 may project virtual items onto a representation of the real environment that the user can see.

[0048] The AR device 66 may be used, for example, in an operating room 75 during a surgical procedure performed on a patient 74 by a surgeon 73. The AR device 66 may project or display virtual objects, such as virtual objects during the surgical procedure, to extend the surgeon's vision. The surgeon 73 may view the virtual objects using the AR device 66, a remote controller for the AR device 66, or interact with the virtual objects by using their hands to “interact” with the virtual objects or gestures recognized by the camera 79 of the AR device 66, for example. The virtual objects can extend surgical tools, such as surgical instruments 77. For example, the virtual object may appear to be connected to the surgical instrument 77 (to the surgeon 73 viewing the virtual object through the AR device 66), or to remain at a fixed distance from the surgical instrument 77. In another example, the virtual object may be used to guide the surgical instrument 77 and may appear to be fixed to the patient 74. In certain examples, the virtual object may react to the movement of other virtual or real-world objects in the surgical field. For example, a virtual object may be modified when a surgeon is manipulating a surgical instrument in close proximity to the virtual object.

[0049] The augmented reality display system imaging device 38 captures real images of the surgical area during surgical procedures. The augmented reality displays 89 and 67 present an overlay of the operating modes of the surgical instrument 77 onto the real images of the surgical area. The surgical instrument 77 includes a communication circuit 231 for communicating operating mode and functional data from the surgical instrument 77 to the AR device 66 via a communication circuit 233 on the AR device 66. The surgical instrument 77 and the AR device 66 are shown in RF wireless communication between circuits 231 and 233, as indicated by arrows B and C, but other communication technologies (e.g., wired, ultrasonic, infrared, etc.) may be employed. The overlay relates to the operating modes of the surgical instrument 77 that are actively visualized. The overlay combines the modes of tissue interaction in the surgical area with functional data from the surgical instrument 77. The processor portion of the AR device 66 is configured to receive operating mode and functional data from the surgical instrument 77, determine overlays related to the operation of the surgical instrument 77, and combine the tissue characteristics within the surgical area with the functional data from the surgical instrument 77. The augmented images display alerts regarding device performance considerations, non-conformity use, and incomplete capture. Non-conformity use includes out-of-range tissue conditions and tissue improperly balanced within the jaws of the end effector. Additional augmented images provide indications of incidental events, including indications of tissue tension and foreign body detection. Other augmented images display device status overlays and instrument indications.

[0050] Figure 10 shows a system 83 for augmenting images of the surgical field with information using an AR display 89, according to at least one aspect of the present disclosure. The system 83 may be used to perform the techniques described below, for example, by using a processor 85. The system 83 includes one aspect of an AR device 66 that can communicate with a database 93. The AR device 66 includes a processor 85, memory 87, an AR display 89, and a camera 79. The AR device 66 may also include a sensor 90, a speaker 91, and / or a haptic controller 92. The database 93 may include image storage 94 or preoperative planning storage 95.

[0051] The processor 85 of the AR device 66 includes an augmented reality modeler 86. The augmented reality modeler 86 may be used by the processor 85 to create an augmented reality environment. For example, the augmented reality modeler 86 may receive images of instruments in the surgical field from a camera 79 or sensor 90, etc., and create an augmented reality environment that fits within the displayed image of the surgical field. In another example, physical objects and / or data may be overlaid on the surgical field and / or surgical instrument images, and the augmented reality modeler 86 may use the physical objects and data to present an augmented reality display of virtual objects and / or data within the augmented reality environment. For example, the augmented reality modeler 86 may use or detect instruments at the patient's surgical site and present virtual objects and / or data on the surgical instruments, and / or images of the surgical site in the surgical field captured by the camera 79. The AR display 89 may display the AR environment overlaid on the real environment. The display 89 can use the AR device 66, which is located in a fixed position, etc., within the AR environment, to show virtual objects and / or data.

[0052] The AR device 66 may include sensors 90 such as infrared sensors. The camera 79 or sensor 90 may be used to detect movements such as gestures by a surgeon or other user, which may be interpreted by the processor 85 as attempted or intended interactions by the user with a virtual target. The processor 85 can identify objects in the real environment by processing information received using the camera 79, for example. In other embodiments, sensor 90 may be a tactile sensor, audible sensor, chemical sensor, or thermal sensor to generate corresponding signals that can be combined with various data feeds to create an augmented environment. Sensor 90 may include binaural audio sensors (spatial sound), inertial measurement (accelerometer, gyroscope, magnetometer) sensors, environmental sensors, depth camera sensors, hand and eye-tracking sensors, and voice command recognition capabilities.

[0053] The AR display 89 may, for example, during a surgical procedure, allow the surgical field to be viewed through the AR display 89, while presenting virtual features within the surgical field that correspond to physical features hidden by the patient's anatomical features. The virtual features may have a virtual position or orientation that corresponds to a first physical position or orientation of the physical features. In one example, the virtual position or orientation of the virtual features may include an offset from the first physical position or orientation of the physical features. The offset may include a predetermined distance from the augmented reality display, a relative distance from the augmented reality display to the anatomical features, and so on.

[0054] In one example, the AR device 66 may be an individual AR device. In one embodiment, the AR device 66 may be a HoloLens 2 AR device manufactured by Microsoft in Redmond, Washington. This AR device 66 includes a visor with lenses and binaural audio features (spatial sound), inertial measurements (accelerometer, gyroscope, magnetometer), environmental sensors, a depth camera, a video camera, hand and eye tracking, and voice command recognition capabilities. It provides a high-resolution, improved field of view by using mirrors to orient waveguides in front of the wearer's eyes. The image can be magnified by changing the angle of the mirrors. It also provides eye tracking to recognize the user and adjust the lens width for a particular user.

[0055] In another example, AR device 66 could be the Snapchat Spectacles 3 AR device. This AR device offers the ability to capture paired images, recreate 3D depth mapping, add virtual effects, and play 3D videos. The AR device includes two HD cameras for capturing 3D photos and videos at 60fps, while four built-in microphones record immersive high-fidelity audio. Images from both cameras are combined to construct a geometric map of the real world around the user, providing a new sense of depth perception. Photos and videos can be wirelessly synchronized to an external display device.

[0056] In yet another example, AR device 66 could be Google's Glass 2 AR device. This AR device provides inertial measurement (accelerometer, gyroscope, magnetometer) information overlaid on the lens (outside the field of view) to supplement the information.

[0057] In another example, AR device 66 could be Amazon's Echo Frames AR device. This AR device does not have a camera / display. The microphone and speaker are linked to Alexa. This AR device has fewer features than a head-up display.

[0058] In yet another example, AR device 66 could be the Focals AR device by North (Google). This AR device provides a notification pusher / smartwatch analog, inertial measurement, screen overlays for information (weather, calendar, messages), and voice control (Alexa) integration. This AR device also provides basic head-up display functionality.

[0059] In another example, AR device 66 could be an Nreal AR device. This AR device includes spatial sound, two ambient cameras, a photographic camera, an IMU (accelerometer, gyroscope), an ambient light sensor, and proximity sensor functions. Nebula projects application information onto the lens.

[0060] In various other examples, the AR device 66 may be any one of the following commercially available AR devices, namely Magic Leap 1, Epson Moverio, Vuzix Blade AR, ZenFone AR, Microsoft AR glasses prototype, or EyeTap, which create light collinear with the ambient light directly onto the retina. A beam splitter makes the same visible light available to a computer, for example, to process and overlay information. The AR visualization system may include a HUD, contact lenses, glasses, virtual reality (VR) headset, virtual retinal display, intraoperative display, and / or smart contact lenses (bionic lenses).

[0061] The multi-user interface for the AR device 66 includes a virtual retinal display such as a raster display that draws directly onto the retina rather than on a screen in front of the eyes, a smart TV, a smartphone, and / or a spatial display such as the Sony Spatial Display System.

[0062] Other AR technologies may include, for example, AR capture devices and software applications, AR creation devices and software applications, and AR cloud devices and software applications. AR capture devices and software applications include, for example, the Apple Polycam app and Ubiquity 6 (Mirrorworld using the Display.land app), which allow users to scan and acquire 3D images of the real world (to create 3D models). AR creation devices and software applications include, for example, Adobe Aero, Vuforia, ARToolKit, Google ARCore, Apple ARKit, MAXST, Aurasma, Zappar, and Blippar. AR cloud devices and software applications include, for example, Facebook, Google (world geometry, object recognition, predictive data), Amazon AR Cloud (commerce), Microsoft Azure, Samsung Project Whare, Niantic, and Magic Leap.

[0063] One aspect of the following disclosure describes various overlays of operating modes or functions of surgical instruments onto a live video stream of the surgical area visualized through the surgical field of a laparoscopic camera during minimally invasive surgical procedures. The overlays relate to one of the operating modes of the surgical instruments and devices that are actively visualized. The overlays combine modes of tissue / organ interaction with functional data received from the surgical instruments used in the surgical procedure. The surgical instruments may include grippers, clamps, staplers, ultrasound, RF, or any combination of these instruments. With respect to grippers and clamps, aspects of tissue parameters may include incomplete tissue capture, along with the state or size of the clamp. With respect to surgical staplers, aspects of tissue parameters may include tissue capture location, tissue compression, clamping, or sufficient firing of the surgical stapler. With respect to advanced energy devices such as ultrasound or RF devices, aspects of tissue parameters may include impedance, cauterization state, and size of bleeding, and aspects of instrument function may include, for example, energy level, timing, and clamping pressure. The augmented images shown in Figures 11 to 13 below can be viewed on a local display, a remote display, and / or an AR device, as described above in relation to Figures 1 to 10. While the augmented images are described as being visualized through a laparoscopic camera during minimally invasive surgical procedures, the images may also be captured during non-invasive and invasive (e.g., open) surgical procedures, without limiting the scope of this disclosure in this context. These embodiments are described below.

[0064] Figures 11-13 show various augmented images visualized through a laparoscopy camera during minimally invasive surgical procedures. The augmented reality display system is used during surgical procedures. The augmented reality display system comprises an imaging device for capturing real images of the surgical area during surgical procedures, an augmented reality display for presenting overlays of the operating modes of surgical instruments on the real images of the surgical area, and a processor. The overlays relate to the operating modes of the surgical instruments that are actively visualized. The overlays combine the modes of tissue interaction in the surgical area with functional data from the surgical instruments. The processor is configured to receive operating mode and functional data from the surgical instruments, determine overlays related to the operation of the surgical instruments, and combine the modes of tissue in the surgical area with functional data from the surgical instruments. The augmented images display alerts regarding device performance considerations, non-conformity use, and incomplete capture. Non-conformity use includes out-of-range tissue conditions and tissue improperly balanced within the jaws of the end effector. Additional augmented images provide indications of incidental events, including indications of tissue tension and foreign body detection. Other augmented images show device status overlays and instrument indications.

[0065] Figures 11-13 also illustrate functional overlays of key instrument behaviors or parameters to clearly represent the behaviors of surgical staplers, energy devices, or their interactions. In one embodiment, the overlaid data is adjusted by the behavior detected by the surgical hub to modify the overlay from information detected by the source instrument, simply to add context. In another embodiment, the display may be adjusted or modified by the user, resulting in modifications to the behavior of the monitored surgical instrument as well.

[0066] Figures 11-13 illustrate an intraoperative display system for use during surgical procedures. The system comprises a surgical monitor with an intraoperative data display of the surgical area. An advanced energy generator is connected to an advanced energy surgical instrument. The advanced energy surgical instrument uses radio frequency (RF) energy and ultrasonic energy during surgical procedures on the patient. A surgical hub is connected to the advanced energy generator and the surgical monitor. The surgical hub provides a live feed of the surgical area to the surgical monitor for displaying a live feed of the surgical area via the intraoperative data display. The intraoperative data display shows a view of the surgical area including the advanced energy surgical instrument grasping the tissue and a panel overlay displaying information specific to the advanced energy surgical instrument.

[0067] In one embodiment, the intraoperative data display shows the end effector of a surgical instrument grasping tissue, and a panel overlay displaying case information, system notifications, or a device panel, or any combination thereof, overlaid on the live surgical feed. The position, opacity, size, and placement of the panel overlay are customizable. The panel overlay is configured to be turned on / off individually or as a group. The panel overlay is further configured to change dynamically to indicate state changes such as device startup or power level adjustment. The panel overlay displays an Optimal Device Performance (ODP) guide image or other Instructions for Use (IFU) / information sources.

[0068] In various embodiments, a panel overlay may include at least one of the following: capital equipment, generators, injectors, fume extractors, electronic health records, laparoscopes, computers, surgical devices, wired and wireless connected devices, surgeon profile preferences that can be stored, retrieved, or edited, or any combination thereof. A panel overlay may include case information, including at least one of the following: patient name, surgeon name, case time, or instrument activation, or any combination thereof. A panel overlay may include system notifications, including at least one of the following: connected device status, minor error alerts, medium error alerts, or major error alerts, or any combination thereof. A panel overlay may include information associated with surgical instruments connected to the system to provide advanced hemostasis. A panel overlay may include a visible patient panel overlay. A panel overlay may include a device panel overlay, including at least one of the following: device name, device settings, or device supplemental features, or any combination thereof. A panel overlay may include multiple panel overlays in a stacked configuration. A panel overlay may include multiple panel overlays in an extended configuration. The panel overlay may display display device troubleshooting information. The panel overlay may display at least one of the following: alerts, warnings, device information, or device characteristics, or any combination thereof.

[0069] In another embodiment, the intraoperative data display includes a secondary configurable panel. The secondary configurable panel dynamically changes based on a selected customized laparoscopic overlay field displayed within the surgical field of the live surgical feed area of ​​the intraoperative data display. The customized laparoscopic overlay field comprises at least one of a bottom edge panel, a left upper corner panel, an upper central panel, or a lateral edge panel, or any combination thereof.

[0070] Figure 11 is a system diagram 3000 of an operating room equipped with a surgical monitor having an intraoperative data display 3002 for the surgical area. An advanced energy generator 3004 is connected to a surgical hub 3006 and an advanced energy surgical instrument 3008. The advanced energy surgical instrument 3008 uses RF energy and ultrasonic energy during surgical procedures on a patient 3010. The surgical hub 3006 provides a live feed 3014 of the surgical area displayed by the intraoperative data display 3002. The intraoperative data display 3002 displays a view of the surgical area including the advanced energy surgical instrument 3008 grasping tissue and a panel overlay 3012 that displays information specific to the advanced energy surgical instrument 3008.

[0071] Figure 12 is an expanded image 300 of a live feed of the surgical area 324 visualized through a laparoscopic camera during a minimally invasive surgical procedure, showing tissue 322 poorly captured between the jaws 318 of the surgical instrument end effector 320 as a tissue morphology. The laparoscopic view 302 of the surgical area 324 shows the surgical instrument end effector 320 grasping the tissue 322 with the jaws 318 of the end effector 320. The expanded image 300 shows a graphical alert overlay 304 superimposed on the image of the surgical area 324 to show the tissue 322 poorly captured relative to the end of the cut at the jaws 318 of the end effector 320.

[0072] The extended image 300 also includes a first sub-image 308 showing a graphic image 306 of a general anatomical structure superimposed on or adjacent to the surgical field 302, and a reference frame 310 of the actual anatomical structure superimposed on or adjacent to the surgical field 302. The extended image 300 also includes a second sub-image 312 showing the type of surgical instrument in use, the energy level if applicable, and the current surgical procedure. The second sub-image 312 may be superimposed on or adjacent to the surgical field 302. The extended image 300 shows an ultrasonic surgical instrument being used in a surgical procedure at an energy level set to a maximum of 5 to achieve a high degree of hemostasis. The graphic image 316 of the surgical instrument is shown superimposed on the graphic image 314 of the incomplete tissue capture alert overlay 304. Thus, the extended image 300 provides several virtual objects to notify the OR team of inadequately captured tissue 322 at the end of the cut. The superimposed incomplete tissue capture alert overlay 304 is applicable to energy-based surgical instruments and surgical staplers, among others.

[0073] Figure 13 is an augmented image 3120 of a live feed of the surgical area visualized through a laparoscopy camera during a minimally invasive surgical procedure, displayed on the intraoperative data display 3122. At least one aspect of this disclosure shows a screen having an end effector 3108 of a surgical instrument 3008 for grasping tissue 3110 and a visible patient panel overlay 3124. The visible patient panel overlay 3124 may require additional applications to display content. The intraoperative data display 3122 also displays a case information panel overlay 3102 and a device panel overlay 3106. In the illustrated example, the system notification panel overlay 3104 is hidden.

[0074] The following description provides alternative or collaborative augmented reality communication for providing surgeons or other OR personnel with an intuitive or data-dense feed of information. In one aspect, the disclosure provides a mixed reality, augmented reality, and / or augmented reality feedback system and method that works together to increase the efficient perception of a complex data feed. In one aspect, first and second augmented data feeds are provided, and at least one of the first or second data feeds generates an overlay that is not part of a visual display. In another aspect, the visual display portion of the data feed or overlay may include a plurality of augmented reality display systems operating in series with each other or arranged independently. In another aspect, the non-visual communication of data may be by the user alone or in combination of auditory, somatosensory, tactile, chemical perception (including smell), or thermal perception. The disclosure hereby describes collaborative augmented reality, mixed reality, or AR communication that includes a collaborative combination of one or more audible and / or somatosensory overlays working together with one or more visual overlays. Each of these collaborative overlays is described below.

[0075] Figure 14 shows an augmented reality system 5400 that includes an intermediate signal coupler 64 located in the communication path between the imaging module 38 and the surgical hub display 67. The signal coupler 64 couples the sensor and / or image data received from the imaging module 38 and / or the AR device 66. The surgical hub 56 receives the coupled data from the coupler 64, overlays the provided data onto the display 67, and displays the overlaid data. The AR device 66 couples the data feeds from the imaging device 68 and the sensor device 5402. The coupled data feed can be provided from the AR device 66 to the coupler 64 for further overlay with the data feed from the imaging module 38. In one embodiment, the visual portion of the augmented overlay includes a plurality of collaborative image displays. In one embodiment, the plurality of collaborative image displays function in series with each other. In another embodiment, the plurality of collaborative image displays are arranged independently. In various embodiments, the data feed can be provided by the sensor 90, speaker 91, and haptic controller 92 portions of the AR device 66.

[0076] The imaging device 68 may be a digital video camera. The signal coupler 64 may include a wireless head-up display adapter for coupling to an AR device 66 located in the communication path of the display 67 to a console that enables the surgical hub 56 to overlay data onto the display 67. In various embodiments, the AR device 66 may display a combination of images, audible sounds, and / or somatosensory signals from the imaging module 38, the imaging device 68, and / or the sensor device 5402 in the form of an overlay as part of a view provided to the surgeon as described below. In various embodiments, the display 67 may display a combination of images, audible sounds, and / or somatosensory signals from the imaging module 38, the imaging device 68, and / or the sensor device 5402 in the form of an overlay as part of a view generally provided to the OR as described below. In one embodiment, the sensor device 5402 may be coupled to the AR device 66 via a filter 5404. In another embodiment, an amplifier 5406 may be placed between the filter 5404 and the AR device 66 to amplify the signal from the sensor device 5402.

[0077] The sensor device 5402 may be an audio device, a somatosensory device, and / or a combination thereof. Somatosensory devices include, but are not limited to, thermal, chemical, and mechanical devices, as described below. In one embodiment, the sensor device 5402 may be configured to sense various audible input signals, such as, among other things, voice 5408, biomarkers 5410, and heartbeat / rhythm 5412. The audible signals may be filtered by filter 5404 and amplified by amplifier 5406. In one embodiment, a surgeon 73 or other OR personnel may receive stimulus input from various somatosensory stimuli, such as thermal stimuli 5414, chemical stimuli 5416, and mechanical stimuli 5418. The audible input may be overlaid with images received from imaging device 68 and / or imaging module 38. Similarly, somatosensory stimulus input may be overlaid with images received from imaging device 68 and / or imaging module 38. Audible and somatosensory overlays may be displayed on the AR device 66 and / or display 67.

[0078] In one embodiment, the disclosure provides an audible overlay based on an audible signal generated by a sensor device 5402. The audible signal may be filtered by, for example, a filter 5404 to exclude or amplify certain OR audio from others, and amplified by an amplifier 5405. Filtering may increase or decrease the attention of the overlay to control the magnitude of the user's attention to the overlay. In one embodiment, the sensor device 5402 receives voice commands and converts the voice commands into electrical signals. In one embodiment, the sensor device 5402 includes a voice-to-text converter. Filter 5404 may be configured to filter specific commands to an OR assistant, such as positioning a manual handle up / down or left / right to assist a surgeon 73 in a robot console. In another embodiment, filtering or amplification may be based on keywords that the surgeon 73 may speak during a surgical procedure.

[0079] The audible overlay provides an alternative method to help verify where the surgeon 73 is positioned in the procedure plan. For example, if the augmented reality system 5400 knows that the next step in a surgical procedure requires a grasper to move an organ for access, when the surgeon utters the word "grasper," the augmented reality system 5400 can verify that the surgeon 73 and the surgical procedure are properly tracked. This additional control may be needed when the surgeon 73 deviates slightly from the initial surgical procedure. For example, if the surgeon 73 requests a surgical instrument such as a surgical stapler, the augmented reality system 5400 recognizes the word "surgical stapler" or simply "stapler" and adjusts the surgeon 73's main screen 67 or AR device 66 with a specific combination of visual and audible overlays for the placement and firing of the digitally connected surgical instrument. The augmented reality system 5400 further performs pre-use checks of the surgical instrument and communications before the surgeon 73 fires the surgical instrument. The volume of the audible overlay portion may be increased or decreased based on the severity of the situation. The augmented reality system 5400 may be configured to lower the volume of all background noise (e.g., radio, telephone, etc.) if the current surgical procedure is deemed critical or high-risk. If it is discovered that a particular user is hearing impaired, the augmented reality system 5400 may respond by increasing the volume or adjusting the pitch to help the surgeon 73 hear clearly.

[0080] In another embodiment, surgical procedure-specific filtering can be used to separate speech into specific surgical procedures. This type of filtering may be determined based on a risk-benefit analysis and an assessment of the historical risk of a particular surgical procedure. For example, if a particular surgical procedure is a cholecystectomy, the need for the surgeon 73 to adjust to the patient's heart rate and blood pressure is relatively low. Assuming a low risk of complications during surgery, coupled with a short surgical procedure time, the augmented reality system 5400 may conclude, after the risk assessment calculation, that there is no reason for the surgeon 73 to require an audible overlay. However, the surgeon 73 can disable the augmented reality system 5400 which commands the presence of an audible overlay and other collaborative overlays.

[0081] In another embodiment, the audible overlay may include overlaying audibly correlated feedback onto specific patient biomarker 5410 data. The biomarker 5410 data may be the patient's heartbeat, and the corresponding audible overlay of the patient's heartbeat allows the surgeon 73 to hear the patient's heart as if using a stethoscope. Overlays of sensed nerve stimulation may be employed to determine nerve proximity and overload. This can be done by increasing or decreasing both the volume and frequency of the audible overlay, allowing the surgeon 73 to correlate the location of the electrical device with important nerves.

[0082] In yet another embodiment, the audible overlay may include overlaying a predetermined heartbeat / rhythm 5412 so as to enable the surgeon to synchronize with the physical response. The heartbeat / rhythm 5412 can further be synchronized with a key rhythm away from the surgical procedure or the patient. Audible indication of undesirable tissue contact from a robotic surgical device outside the surgical field.

[0083] In one embodiment, the Disclosure provides a somatosensory overlay based on one or more somatosensory signals detected by either a sensor device 5402 or a surgeon 73. In some embodiments, the somatosensory signals may be received by, for example, the sensor device 5402, filtered by a filter 5404, and amplified by an amplifier 5406. The somatosensory signals may be employed as a somatosensory overlay in cooperation with either an audible overlay and / or an image overlay as described herein.

[0084] In one embodiment, somatosensory signals may be thermal signals received by the surgeon 73 to directly stimulate specific thermoreceptors, or other non-specialized sensory receptors, or receptive parts of sensory neurons, which encode absolute and relative changes in temperature, primarily within a harmless range. Temperature changes in the surgical instrument handle or part of the handle allow the surgical instrument handle to be used as a substitute for the temperature of the relevant components of the surgical instrument. For example, seeing also Figure 9, in a particular electric surgical stapler 77, the motor and gearbox are located within the handle of the surgical stapler 77. This is the same area that the surgeon 73 uses to hold and operate the surgical stapler 77. This area becomes hotter when the surgical stapler 77 is in use. The temperature is directly related to the work that the surgical stapler 77 needs to perform during the surgical procedure. The surgeon 73 can sense this temperature rise during the surgical procedure. The surgeon 73 can use this physical temperature data input as a substitute for how the surgical instrument 77 is operating and will continue to operate. If the handle becomes too hot to grip, it is a clear indication that the surgical instrument 77 is being operated beyond normal use. Motor overheating reduces the system's optimal performance, and this reduction can directly affect the outcome of surgical procedures. For example, a surgical stapler may be unable to cut / staple the tissue within the clamped jaws, thereby complicating the surgical procedure.

[0085] In another embodiment, somatosensory signals may stimulate specific chemoreceptors that primarily respond to chemical stimuli in the OR environment. These may also be perceived by the surgeon's 73 sense of taste and smell, for example, the surgeon 73 may smell a burning electronic device and indicate the result and, if necessary, turn off surgical instruments. In some embodiments, somatosensory signals may be detected by a sensor device 5402 and subsequently used in conjunction with either an audible overlay and / or an image overlay to generate a somatosensory overlay.

[0086] In another embodiment, somatosensory signals may stimulate certain mechanoreceptors, among other things, that respond primarily to tactile, tactile, or vibratory stimuli. In one embodiment, mechanical vibrations of a surgical instrument may be detected by either the surgeon 73 or the sensor device 5402. The sensed mechanical vibrations may be used by the augmented reality system 5400 to indicate that the current movement or direction of the surgical instrument 77 is causing a corresponding suboptimal result and therefore requires correction. The augmented reality system 5400 may be configured to indicate that the drive was "out of normal" at the end of the current drive / cutting stroke. This may indicate that the clamping force of the jaws of the surgical stapler 77 was out of range, or that the firing force was higher than expected. These conditions may be indicated by a series of tactile buzzers to distinguish between different indications. In one example, vibrations at the end of the stroke of the surgical stapler 77 may indicate that the surgical stapler 77 cannot move any further in the indicated direction. In another example, vibrations in the handle may indicate that the “high-temperature blade” of an energy-based surgical instrument is making contact with secondary tissue and thus attempting to avoid critical structures. Certain types of vibrations may indicate that the robotic arm is in its maximum extension state. The augmented reality system 5400 may be configured to provide a sequence of tactile pulses to alert the surgeon 73 that the maximum value has been reached.

[0087] In another embodiment, the mechanoreceptor may respond to variations in the operating force threshold of the surgical stapler. Variations in the operating force provide the user with feedback that it is undesirable to operate the surgical stapler 77 at that particular time. For example, while initially clamping the jaws of the surgical stapler 77 into the tissue, the surgeon 73 can physically feel how tightly they are clamping the tissue within the jaws. This direct physical input, along with the sensor reading displaying the “measured” value, provides two different inputs to this value.

[0088] In another embodiment, a mechanoreceptor may respond to an expandable stimulating element to indicate that it is undesirable to use its control. The expandable portion may be not merely a column or cleat, but an expandable pattern that provides a different “feel.” For example, the knife of a surgical stapler 77 is partially expanded, and the surgeon 73 attempts to release the closure system, and the expandable element is activated on the release button to indicate that it cannot be operated at this time or in this sequence. The expandable portion may be not merely a column or cleat, but an expandable pattern that provides a different “feel.”

[0089] In another embodiment, a mechanoreceptor may, in response to force feedback, disable or prohibit an action from being performed. For example, when a surgeon 73 attempts to fire a surgical stapler 77, the surgical hub detects a foreign object currently located within the jaws. Then, when the surgeon 73 attempts to pull the firing trigger, the device pushes the trigger back, making it impossible for the surgeon to press the trigger down.

[0090] In another embodiment, a combination of multiple somatosensory outputs may be used simultaneously to communicate interrelated data feeds. Those skilled in the art will understand the need to distinguish between two distinct indicators, both having the same standard feedback mode. In one embodiment, one system feedback may indicate that another system is unavailable based on its status. In another embodiment, a backlit LED may be placed within the control unit to indicate a lack of function. The LED should be configured to clearly indicate two distinct faults or conditions. Furthermore, the LED system may be configured to resolve conflicts between multiple similar indicators operating simultaneously. Force sensing may be provided to the OR assistant when inserting a circular stapler or rectal sizer.

[0091] In another embodiment, a display 67 within the OR may be used to indicate a fault or display. The overlay is displayed without interfering with the key display information. In one embodiment, the overlay information is displayed around the boundary surrounding the main display 67 to reduce interference and can change color along with the organization's identification information.

[0092] In another embodiment, somatosensory overlays may include alternative feedback for device interactions based on tactile feedback of AR devices, such as notification of instrument collision, impending inattentive tissue contact, high-temperature instrument contact with adjacent tissue, heated gloves combined with vibration to ensure output is clearly transmitted, and / or completion of high-energy device cycles. Yu et al. (Nature 575, 473-479; 2019) describe wearable skin-integrated technologies that can adhere to the skin and vibrate. These devices include 1.4 g, 12-18 mm sized actuators that are wirelessly powered and controlled.

[0093] In another embodiment, the somatosensory overlay may include visual feedback. Visual feedback somatosensory overlays may be used to indicate the completion of a high-energy device cycle, a system misfit, and a device unusable in its current configuration. Additional overlays may include audible feedback via a speaker. Safety overlays may be provided for handheld and robotic surgical instruments.

[0094] Figure 15 shows a method 5500 for presenting an augmented reality overlay during a surgical procedure. Referring also to Figures 10 and 14, according to method 5500, an imaging device 68 captures real images of the surgical area during a surgical procedure (5502). A first data feed is generated based on the captured real images (5504). The first data feed is provided to an AR device 66. A sensor device 5402 generates a second data feed (5506). The second data feed is also provided to the AR device 66. The AR device 66, equipped with an augmented reality display 89, presents an augmented reality overlay based on the first and second data feeds (5508). The augmented overlay includes a visual portion and a non-visual visual portion.

[0095] In one embodiment, according to method 5500, the sensor device 5402 may receive tactile, audible, chemical, or thermal signals from one or more sources such as sound 5408, biomarker 5410, heartbeat / rhythm 5412, thermal stimulus 5414, chemical stimulus 5416, or mechanical stimulus 5418. The tactile, audible, chemical, or thermal signals, or any combination thereof, are coupled to the non-visual portion of the extended overlay.

[0096] In one embodiment, according to method 5500, the filter 5404 can filter the signal received by the sensor device 5402. The amplifier 5406 amplifies the filtered signal.

[0097] In one embodiment, according to method 5500, a display 67 connected to the AR device 66 displays an augmented overlay. An imaging module 38 generates a third data feed, which is coupled with the augmented overlay, and the coupled augmented overlay is displayed on the display 67. A coupler 64 couples the third data feed with the augmented overlay. A surgical hub 56 communicates the augmented overlay to the display 67.

[0098] Situational awareness is the ability of several embodiments of a surgical system to determine or infer information related to a surgical procedure from data received from a database and / or instruments. This information may include the type of procedure being performed, the type of tissue being operated on, or the body cavity being treated. Contextual information regarding a surgical procedure can improve a surgical system, for example, by controlling modular devices connected to it (e.g., robotic arms and / or robotic surgical tools) and providing contextualized information or suggestions to the surgeon during the course of the surgical procedure.

[0099] Figure 16 shows a timeline of a situation-aware surgical procedure. Figure 71 shows an exemplary surgical procedure timeline 5200 and contextual information that the surgical hub 5104 can derive from data received from data source 5126 at each step of the surgical procedure. Timeline 5200 shows typical steps that nurses, surgeons, and other healthcare professionals might take during a lung segmentectomy procedure, starting with setting up the operating room and ending with transferring the patient to the postoperative recovery room. Throughout the surgical procedure, the situation-aware surgical hub 5104 receives data from data source 5126, including data generated each time healthcare professionals use the modular device 5102 paired with the surgical hub 5104. By receiving this data from the paired modular device 5102 and other data sources 5126, the surgical hub 5104 can continuously derive estimations (i.e., contextual information) about the ongoing procedure as new data is received, such as which step of the procedure is being performed at any given time. The situational awareness system of the surgical hub 5104 can, for example, record data relating to a procedure to generate a report, verify the steps being taken by a healthcare professional, provide data or prompts that may be relevant to a particular procedure step (e.g., via a display screen), adjust the modular device 5102 based on context (e.g., activate a monitor, adjust the FOV of a medical imaging device, or change the energy level of an ultrasonic surgical instrument or an RF electrosurgical instrument), and perform any other such actions as described above.

[0100] In the first step 5202, hospital staff retrieve the patient's EMR from the hospital's EMR database. Based on the patient data selected in the EMR, the surgical hub 5104 determines that the procedure to be performed is a thoracic surgery.

[0101] In the second 5204, staff scan incoming medical supplies for a procedure. The surgical hub 5104 cross-references the scanned supplies with a list of supplies used in various types of procedures to confirm that the mixture of supplies corresponds to a thoracic procedure. Furthermore, the surgical hub 5104 can also determine that the procedure is not a wedge resection (because the incoming supplies either do not contain specific supplies required for a thoracic wedge resection or are otherwise not corresponding to a thoracic wedge resection).

[0102] In the third 5206, a healthcare worker scans the patient band via a scanner 5128 that is communicably connected to a surgical hub 5104. The surgical hub 5104 can then verify the patient's identity based on the scanned data.

[0103] In the fourth part of 5208, a medical professional turns on the assistive device. The assistive devices used may vary depending on the type of surgical procedure and the techniques used by the surgeon, but in this exemplary case, they include a fume exhauster, an air inlet, and a medical imaging device. Once activated, the assistive device, which is a modular device 5102, can automatically pair with a surgical hub 5104 located within a specific vicinity of the modular device 5102 as part of its initialization process. The surgical hub 5104 can then derive contextual information about the surgical procedure by detecting the type of modular device 5102 paired with it during this pre-operative or initialization phase. In this particular embodiment, the surgical hub 5104 determines that the surgical procedure is a VATS surgery based on this particular combination of paired modular devices 5102. Based on the combination of data from the patient's EMR, a list of medical supplies used in the procedure, and the type of modular device 5102 connected to the hub, the surgical hub 5104 can roughly estimate the specific procedure performed by the surgical team. Once the surgical hub 5104 knows what particular procedure is being performed, it can then read the steps of that procedure from memory or the cloud, and then cross-reference the data subsequently received from connected data sources 5126 (e.g., modular device 5102 and patient monitoring device 5124) to estimate which steps of the surgical procedure the surgical team is performing.

[0104] In step 5210, the staff attaches the EKG electrode and other patient monitoring devices 5124 to the patient. The EKG electrode and other patient monitoring devices 5124 can be paired with the surgical hub 5104. Once the surgical hub 5104 begins receiving data from the patient monitoring devices 5124, the surgical hub 5104 confirms that the patient is in the operating room.

[0105] In step 6, 5212, medical personnel induce anesthesia in the patient. The surgical hub 5104 can infer that the patient is under anesthesia based on data from modular devices 5102 and / or patient monitoring devices 5124, including, for example, EKG data, blood pressure data, ventilator data or a combination thereof. Once step 6, 5212 is completed, the preoperative portion of the lung segmentectomy is complete and the surgical portion commences.

[0106] In section 7 of 5214, the lung of the patient being operated on collapses (while ventilation is switched to the contralateral lung). The surgical hub 5104 can infer from the ventilator data that the patient's lung has collapsed. The surgical hub 5104 can compare the detection of the patient's lung collapse with the expected steps of the procedure (which can be accessed or read in advance), so it can infer that the surgical portion of the procedure has begun and determine that collapsing the lung is the first surgical step in this particular procedure.

[0107] In step 8, 5216, a medical imaging device 5108 (e.g., a scope) is inserted, and video footage from the medical imaging device is initiated. The surgical hub 5104 receives medical imaging device data (i.e., still image data or real-time live-streaming video) through its connection to the medical imaging device. Upon receiving the medical imaging device data, the surgical hub 5104 can determine that the laparoscopic portion of the surgical procedure has commenced. Furthermore, the surgical hub 5104 can determine that the particular procedure being performed is a segmentectomy, as opposed to a lobectomy (note that wedge resection has not been taken into consideration by the surgical hub 5104 based on the data received in step 2 of the procedure, 5204). Using data from the medical imaging device 124 (Figure 2), contextual information regarding the type of procedure being performed can be determined in various ways, for example, by determining the angle of the medical imaging device directed towards the visualization of the patient's anatomical structure, by monitoring the number of medical imaging devices being used (i.e., activated and paired with the surgical hub 5104), and by monitoring the type of visualization device being used.

[0108] For example, one technique for performing VATS lobectomy positions the camera above the diaphragm in the anteroinferior corner of the patient's thoracic cavity, while another technique for performing VATS segmentectomy positions the camera in an anterior intercostal position relative to the segmental fissure. The situational awareness system can be trained, for example, using pattern recognition or machine learning techniques, to recognize the position of the medical imaging device according to the visualization of the patient's anatomical structure. As another example, one technique for performing VATS lobectomy utilizes a single medical imaging device, while another technique for performing VATS segmentectomy utilizes multiple cameras. As yet another example, one technique for performing VATS segmentectomy utilizes an infrared light source (which can be communicably connected to a surgical hub as part of the visualization system) to visualize the segmental fissure, which is not used in VATS lobectomy. By tracking any or all of this data from the medical imaging device 5108, the surgical hub 5104 can determine the specific type of surgical procedure being performed and / or the technique being used for that specific type of surgical procedure.

[0109] In Section 9, 5218, the surgical team initiates the incision step of the procedure. The surgical hub 5104 receives data from an RF or ultrasound generator indicating that an energy instrument is being emitted, and can therefore infer that the surgeon is in the process of incising and separating the patient's lung. The surgical hub 5104 can cross-reference the received data with the read-out steps of the surgical procedure to determine that the energy instrument being emitted at this point in the process (i.e., after the completion of the procedure steps described above) corresponds to the incision step.

[0110] In the tenth step 5220, the surgical team proceeds to the ligation step of the procedure. The surgical hub 5104 receives data from the surgical stapling and cutting instruments indicating that instruments are being fired, and can therefore infer that the surgeon is ligating arteries and veins. As in the previous step, the surgical hub 5104 can derive this inference by cross-referencing the data received from the surgical stapling and cutting instruments with the steps in the read-out process.

[0111] In the eleventh step 5222, the segmental resection portion of the procedure is performed. The surgical hub 5104 estimates that the surgeon has transversely incised parenchymal tissue, based on data from surgical instruments, including data from a staple cartridge. Cartridge data may correspond, for example, to the size or type of staples fired by the instrument. Cartridge data may indicate the type of tissue being stapled and / or transversely incised, for different types of staples used for different types of tissue. The type of staples fired is used for parenchymal tissue or other similar tissue types, and the surgical hub 5104 can estimate that a segmental resection procedure has been performed.

[0112] Next, in the twelfth step 5224, the nodule incision step is performed. Based on the data received from the generator indicating that an RF or ultrasonic instrument is being emitted, the surgical hub 5104 can infer that the surgical team is incising the nodule and performing a leak test. In this particular procedure, the RF or ultrasonic instrument used after the parenchymal tissue has been transversely incised corresponds to the nodule incision step, thereby enabling the surgical hub 5104 to make this inference. Note that the surgeon will periodically switch between surgical stapling / cutting instruments and surgical energy (i.e., RF or ultrasonic) instruments depending on the specific step in the procedure, as different instruments are better suited to specific tasks. Thus, the specific sequence in which stapling / cutting instruments and surgical energy instruments are used can indicate which step of the procedure the surgeon is performing. Once the twelfth step 5224 is completed, the incision is closed and the postoperative portion of the procedure begins.

[0113] In the 13th step 5226, the patient is de-anesthetized. The surgical hub 5104 can estimate that the patient is waking from anesthesia, for example, based on ventilator data (i.e., the patient's respiratory rate begins to increase).

[0114] Finally, in the 14th step 5228, the healthcare worker removes the various patient monitoring devices 5124 from the patient. Thus, the surgical hub 5104 can infer that the patient has been transferred to the recovery room when the hub loses EKG, BP, and other data from the patient monitoring devices 5124. Based on the data received from various data sources 5126 that are communicably connected to the surgical hub 5104, the surgical hub 5104 can determine or infer when each step of a given surgical procedure is occurring.

[0115] As shown in the first step 5202 of the timeline 5200 shown in Figure 16, in addition to using patient data from the EMR database(s) to estimate the type of surgical procedure to be performed, the patient data can also be used by the situation-aware surgical hub 5104 to generate control adjustments for the paired modular device 5102.

[0116] Various additional aspects of the subject matter described herein are illustrated in the following numbered examples.

[0117] Example 1: An augmented reality display system for use during surgical procedures, comprising: an imaging device that captures real images of a surgical area during a surgical procedure and generates a first data feed; a sensor device that generates a second data feed; an augmented reality device that generates an augmented overlay including a visual portion and a non-visual portion based on the first data feed and the second data feed; and a processor that generates a first data feed, receives a second data feed, and combines the first data feed and the second data feed to generate an augmented overlay.

[0118] Example 2: The augmented reality display system according to Example 1, wherein the visual portion of the augmented overlay comprises multiple collaborative image displays.

[0119] Example 3: The augmented reality display system according to Example 2, wherein multiple collaborative image displays function in series with respect to one another.

[0120] Example 4: An augmented reality display system according to any one of Examples 2-3, wherein multiple collaborative image displays are independently positioned.

[0121] Example 5: An augmented reality display system according to any one of Examples 1 to 4, wherein the non-visual portion of the augmented overlay is tactile, audible, chemical, thermal, or any combination thereof.

[0122] Example 6: An augmented reality display system according to any one of Examples 1 to 4, comprising a filter between a sensor device and an augmented reality device.

[0123] Example 7: The augmented reality display system according to Example 6, further comprising an amplifier between the filter and the augmented reality device.

[0124] Example 8: An augmented reality display system according to any one of Examples 1 to 7, comprising a sensor, speaker, or haptic controller, or a combination thereof, which generates a data feed for the non-visual portion of the augmented overlay.

[0125] Example 9: An augmented reality display system according to any one of Examples 1 to 8, comprising a display connected to an augmented reality device.

[0126] Example 10: An augmented reality display system according to Example 9, comprising an imaging module that generates a third data feed, the third data feed being coupled with an augmented overlay and displayed on a display.

[0127] Example 11: The augmented reality display system according to Example 10, further comprising a coupler for coupling a third data feed with an augmented overlay.

[0128] Example 12: The augmented reality display system according to Example 11, further comprising a surgical hub between the coupling device and the display, the surgical hub communicating the augmented overlay to the display.

[0129] Example 13: A method for presenting an augmented overlay during a surgical procedure, comprising: capturing a real image of the surgical area during the surgical procedure using an imaging device; generating a first data feed based on the captured real image using the imaging device; generating a second data feed using a sensor device; and presenting an augmented reality overlay, including a visual portion and a non-visual portion, based on the first and second data feeds using an augmented reality device equipped with an augmented reality display.

[0130] Example 14: The method according to Example 13, comprising receiving a tactile signal, an audible signal, a chemical signal, or a thermal signal, or any combination thereof, from a sensor device, and coupling the tactile signal, an audible signal, a chemical signal, or a thermal signal, or any combination thereof, to the non-visual portion of an extended overlay.

[0131] Example 15: The method according to any one of Examples 13 to 14, comprising filtering the signal received by the sensor device using a filter.

[0132] Example 16: The method according to Example 15, comprising amplifying the filtered signal with an amplifier.

[0133] Example 17: The method according to any one of Examples 13 to 17, comprising displaying an augmented overlay on a display connected to an augmented reality device.

[0134] Example 18: The method according to Example 17, comprising generating a third data feed using an imaging module, combining the third data feed with an extended overlay, and displaying the combined extended overlay on a display.

[0135] Example 19: The method according to Example 18, comprising combining a third data feed with an extended overlay using a coupler.

[0136] Example 20: The method according to Example 19, comprising communicating an extended overlay to a display via a surgical hub.

[0137] While several forms have been shown and described, it is not the applicant's intention to limit or restrict the attached claims to such details. Many modifications, variations, alterations, substitutions, combinations, and equivalents of these forms can be implemented and will be conceived by those skilled in the art without departing from the scope of this disclosure. Furthermore, the structure of each element related to the described form can be alternatively described as a means for providing the function performed by that element. Also, while materials are disclosed with respect to specific components, other materials may be used. Therefore, it should be understood that the above description and the attached claims are intended to cover all such modifications, combinations, and variations as being included within the scope of the disclosed forms. The attached claims are intended to cover all such modifications, variations, alterations, substitutions, alterations, and equivalents.

[0138] The detailed descriptions above have described various forms of apparatus and / or processes using block diagrams, flowcharts and / or embodiments. To the extent that such block diagrams, flowcharts and / or embodiments include one or more functions and / or operations, it will be understood by those skilled in the art that each function and / or operation included in such block diagrams, flowcharts and / or embodiments can be individually and / or collectively implemented by various hardware, software, firmware, or virtually any combination thereof. Those skilled in the art will understand that some or all of the forms disclosed herein can be equivalently implemented on integrated circuits as one or more computer programs running on one or more computers (e.g., one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., one or more programs running on one or more microprocessors), as firmware, or substantially any combination thereof, and that designing circuits and / or writing software and / or firmware code falls within the scope of the skills of those skilled in the art in light of this disclosure. Furthermore, as will be understood by those skilled in the art, the mechanisms of the subject matter described herein can be distributed in various forms as one or more program products, and the specific forms of the subject matter described herein are applicable regardless of the particular type of signal carrier medium used to actually carry out the distribution.

[0139] Instructions used to program logic to implement various disclosed embodiments may be stored in system memory such as dynamic random access memory (DRAM), cache, flash memory, or other storage. Furthermore, instructions may be distributed over a network or by other computer-readable media. Thus, machine-readable media may include any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), but are not limited to floppy diskettes, optical disks, compact disks, read-only memory (CD-ROMs), and magneto-optical disks, read-only memory (ROMs), random access memory (RAMs), erasable programmable read-only memory (EPROMs), electrically erasable programmable read-only memory (EEPROMs), magnetic or optical cards, flash memory, or tangible machine-readable storage used for transmitting information over the Internet via electrical, optical, acoustic, or other forms of propagated signals (e.g., carrier waves, infrared signals, digital signals, etc.). Thus, non-temporary computer-readable media may include any type of tangible machine-readable media suitable for storing or transmitting electronic instructions or information in a form readable by a machine (e.g., a computer).

[0140] When used in any aspect of this specification, the term “control circuit” can mean, for example, hardwired circuits, programmable circuits (e.g., computer processors, processing units, processors, microcontrollers, microcontroller units, controllers, digital signal processors (DSPs), programmable logic devices (PLDs), programmable logic arrays (PLAs), or field-programmable gate arrays (FPGAs) including one or more individual instruction processing cores), state-machine circuits, firmware that stores instructions executed by programmable circuits, and any combination thereof. Control circuits can be embodied collectively or individually as circuits that form part of a larger system, such as an integrated circuit (IC), an application-specific integrated circuit (ASIC), a system-on-a-chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, or a smartphone. Accordingly, as used herein, “control circuit” includes, but is not limited to, an electrical circuit having at least one separate electrical circuit, an electrical circuit having at least one integrated circuit, an electrical circuit having at least one application-specific integrated circuit, an electrical circuit forming a general-purpose computing device configured by a computer program (e.g., a general-purpose computer configured by a computer program that performs at least partially the processes and / or devices described herein, or a microprocessor configured by a computer program that performs at least partially the processes and / or devices described herein), an electrical circuit forming a memory device (e.g., in the form of random access memory), and / or an electrical circuit forming a communication device (e.g., a modem, a communication switch, or an optical-electric installation). Those skilled in the art will recognize that the subject matter described herein may be implemented in analog form, digital form, or some combination thereof.

[0141] When used in any aspect of this specification, the term “logic” may mean an application, software, firmware, and / or circuit configured to perform any of the operations described above. Software may be embodied as software packages, code, instructions, instruction sets, and / or data recorded on a non-temporary computer-readable storage medium. Firmware may be embodied as code, instructions, or instruction sets, and / or hardcoded (e.g., non-volatile) data in a memory device.

[0142] When used in any aspect of this specification, the terms “component,” “system,” “module,” etc., may refer to a control circuit, a computer-related entity, hardware, a combination of hardware and software, software, or running software.

[0143] Where used in any aspect of this specification, “algorithm” means a self-consistent sequence of steps leading to a desired result, and “step” means the manipulation of physical quantities and / or logical states that can take the form of electrical or magnetic signals, which are not necessarily required but can be stored, transferred, combined, compared, and otherwise manipulated. These signals are commonly referred to as bits, values, elements, symbols, characters, terms, numbers, etc. These and similar terms may be associated with appropriate physical quantities, or simply are convenient labels applied to these quantities and / or states.

[0144] A packet-switched network is one example of a network. Communication devices can communicate with each other using a selected packet-switched network communication protocol. One exemplary communication protocol is the Ethernet communication protocol, which can enable communication using the Transmission Control Protocol / Internet Protocol (TCP / IP). The Ethernet protocol may conform to or be compatible with the "IEEE 802.3 Standard" published in December 2008 by the Institute of Electrical and Electronics Engineers (IEEE), and / or later versions of the Ethernet standard. Alternatively or additionally, communication devices can communicate with each other using the X.25 communication protocol. The X.25 communication protocol may conform to or be compatible with standards published by the International Telecommunication Union - Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, communication devices can communicate with each other using the Frame Relay communication protocol. The Frame Relay communication protocol conforms to or may be compatible with standards published by the Consultative Committee for International Telegraph and Telephone (CCITT) and / or the American National Standards Institute (ANSI). Alternatively or additionally, transceivers may communicate with each other using the Asynchronous Transfer Mode (ATM) communication protocol. The ATM communication protocol conforms to or may be compatible with the ATM standard and / or later versions of this standard, published by the ATM Forum in August 2001 under the title "ATM-MPLS Network Interworking 2.0". Naturally, different and / or later developed connection-oriented network communication protocols are equally construed herein.

[0145] Unless otherwise explicitly stated, as is evident from the foregoing disclosures, any use of terms such as “processing,” “computing,” “calculating,” “determining,” and “displaying” throughout the foregoing disclosures will be understood to refer to the actions and processes of a computer system or similar electronic computing device that manipulate and convert data represented as physical (electronic) quantities in the registers and memory of a computer system into other data similarly represented as physical quantities in the memory or registers of a computer system or other such information storage, transmission, or display device.

[0146] One or more components may be referred to herein as “configured to,” “configurable to,” “operable / operative to,” “adapted / adaptable,” “able to,” “conformable / conformed to,” and so on. Those skilled in the art will understand that “configured to” generally encompasses active components and / or inactive components and / or standby components, unless the context should interpret it otherwise.

[0147] The terms “proximal” and “distal” are used herein in reference to the clinician operating the handle portion of a surgical instrument. “Proximal” refers to the part closest to the clinician, and “distal” refers to the part further away from the clinician. For convenience and clarity, spatial terms such as “vertical,” “horizontal,” “up,” and “down” may be used herein in reference to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be restrictive and / or absolute.

[0148] Those skilled in the art will generally understand that the terms used herein, and especially in the appended claims (e.g., the text of the appended claims), are generally intended to be "open" terms (for example, the term "including" should be interpreted as "including but not limited to," the term "having" should be interpreted as "having at least," and the term "includes" should be interpreted as "includes but is not limited to"). Furthermore, those skilled in the art will understand that if a particular number is intended in an introduced claim recitation, such intent is clearly stated in the claim, and if such statement is not present, such intent does not exist. For example, to aid understanding, subsequent appended claims may include the introductory phrases "at least one" and "one or more" to introduce the claim recitation. However, the use of such phrases should not be interpreted as suggesting that any particular claim containing such introduced claim description is limited to claims containing only one such description, even if the same claim contains an introductory phrase such as "one or more" or "at least one" and the indefinite article "a" or "an" (for example, "a" and / or "an" should generally be interpreted as meaning "at least one" or "one or more"). The same applies when introducing a claim description using a definite article.

[0149] In addition, even if a specific number is explicitly stated in the introduced claim, it will be recognized by those skilled in the art that such a statement should typically be interpreted as meaning at least the number stated (for example, if there is a statement that is simply “two descriptions” without any other modifiers, it generally means at least two descriptions, or two or more descriptions). Furthermore, when a notation similar to “at least one of A, B, and C, etc.” is used, such a notation is generally intended to be understood in a way that those skilled in the art will understand (for example, “a system having at least one of A, B, and C” is not limited to systems having only A, only B, only C, both A and B, both A and C, both B and C and / or all of A, B and C, etc.). When expressions similar to "at least one of A, B, or C" are used, such expressions are generally intended to be understood in a way that a person skilled in the art would understand (for example, "a system having at least one of A, B, or C" includes, but is not limited to, systems having only A, only B, only C, both A and B, both A and C, both B and C, and / or all of A, B, and C). Furthermore, a person skilled in the art will understand that, typically, any disjunctive word and / or phrase representing two or more selective terms should be understood, whether in the specification, claims, or drawings, as intended to include the possibility of including one of those terms, any of those terms, or both of those terms, unless the context requires a different interpretation. For example, the phrase "A or B" will typically be understood to include the possibility of "A" or "B" or "A and B".

[0150] With respect to the attached claims, those skilled in the art will understand that the operations cited herein may generally be performed in any order. Furthermore, while various operations are shown in sequence(s), it should be understood that the operations may be performed in any order other than those shown, or simultaneously. Examples of such alternative orderings may include repetition, alternation, interruption, reordering, augmentation, preliminary, additional, simultaneous, reverse, or other different orderings, unless the context should imply otherwise. Moreover, terms such as “responsive to,” “related to,” or other past tense adjectives are generally not intended to exclude such variations, unless the context should imply otherwise.

[0151] It is worth noting that any reference to “one aspect,” “aspect,” “example,” or “example” means that the specific feature, structure, or characteristic described in relation to that aspect is included in at least one aspect. Therefore, the phrases “in one aspect,” “in aspect,” “example,” and “example” found in various places throughout this specification do not necessarily all refer to the same aspect. Furthermore, specific features, structures, or characteristics can be combined in any preferred manner in one or more aspects.

[0152] Any patent application, patent, non-patent publication, or other disclosure material referenced herein and / or listed in any application data sheet is incorporated herein by reference to the extent that the incorporated material does not conflict with this Specified. Disclosures expressly stated herein, both in themselves and to the extent required, shall supersede any conflicting statements incorporated herein by reference. Any material, or any part thereof, that is referred to as being incorporated herein by reference but conflicts with current definitions, views, or other disclosures contained herein shall be incorporated only to the extent that there is no conflict between the incorporated material and the current disclosures.

[0153] In summary, the numerous benefits that can be obtained as a result of using the concepts described herein have been described. The above descriptions of one or more forms are presented for illustrative and explanatory purposes only. They are not intended to be comprehensive or to be limited to the exact forms disclosed. Modifications or variations are possible in light of the above teachings. One or more forms have been selected and described to illustrate the principle and practical applications, thereby enabling a person skilled in the art to utilize the various forms, along with various modifications, for specific conceivable uses. The claims presented herein are intended to define the overall scope.

[0154] [Implementation Method] (1) An augmented reality display system for use during surgical procedures, An imaging device that captures real images of the surgical area during the aforementioned surgical procedure and generates a first data feed, A sensor device that generates a second data feed, An augmented reality device comprising an augmented reality display that generates an augmented overlay including a visual portion and a non-visual visual portion based on the first data feed and the second data feed, It is a processor, Upon receiving the first data feed, Upon receiving the second data feed, An augmented reality display system comprising: a processor that combines the first data feed and the second data feed to generate the augmented overlay. (2) The augmented reality display system according to Embodiment 1, wherein the visual portion of the augmented overlay comprises a plurality of collaborative image displays. (3) The augmented reality display system according to Embodiment 2, wherein the plurality of collaborative image displays function in series with respect to one another. (4) The augmented reality display system according to Embodiment 2, wherein the plurality of collaborative image displays are independently located. (5) The augmented reality display system according to Embodiment 1, wherein the non-visual portion of the augmented overlay is tactile, audible, chemical, thermal, or any combination thereof.

[0155] (6) The augmented reality display system according to Embodiment 1, further comprising a filter between the sensor device and the augmented reality device. (7) The augmented reality display system according to embodiment 6, further comprising an amplifier between the filter and the augmented reality device. (8) The augmented reality display system according to Embodiment 1, wherein the augmented reality device comprises a sensor, speaker, or haptic controller, or a combination thereof, which generates a data feed for the non-visual portion of the augmented overlay. (9) The augmented reality display system according to Embodiment 1, comprising a display connected to the augmented reality device. (10) An augmented reality display system according to Embodiment 9, comprising an imaging module that generates a third data feed, the third data feed being coupled with the augmented overlay and displayed on the display.

[0156] (11) The augmented reality display system according to embodiment 10, comprising a coupler for coupling the third data feed with the augmented overlay. (12) The augmented reality display system according to embodiment 11, comprising a surgical hub between the coupler and the display, the surgical hub communicating the augmented overlay to the display. (13) A method for presenting an expanded overlay during a surgical procedure, The imaging device captures real images of the surgical area during the surgical procedure, The imaging device generates a first data feed based on the captured real image, The sensor device generates a second data feed, A method comprising presenting an augmented reality overlay, including a visual portion and a non-visual visual portion, based on a first data feed and a second data feed, using an augmented reality device equipped with an augmented reality display. (14) From the sensor device, Tactile signals, Audible signals, Chemical signal, or Receiving thermal signals, The method according to Embodiment 13, comprising coupling the tactile signal, the audible signal, the chemical signal, or the thermal signal, or any combination thereof, to the non-visual portion of the extended overlay. (15) The method according to Embodiment 13, comprising filtering the signal received by the sensor device with a filter.

[0157] (16) The method according to Embodiment 15, comprising amplifying the filtered signal with an amplifier. (17) The method according to Embodiment 13, which includes displaying the augmented overlay on a display connected to the augmented reality device. (18) The imaging module generates a third data feed, The third data feed is combined with the extended overlay, The method according to Embodiment 17, comprising displaying the combined extended overlay on the display. (19) The method of Embodiment 18, comprising coupling the third data feed with the extended overlay using a coupler. (20) The method according to embodiment 19, comprising communicating the extended overlay to the display via a surgical hub.

Claims

1. An augmented reality (AR) device for use during surgical procedures, wherein the AR device is It is a processor, The imaging device receives a first data feed containing real images of the surgical area during the surgical procedure, Receiving a second data feed from a sensor device, the detection data including functional data related to the function of a surgical instrument, Generating AR content based on the first and second data feeds, wherein generating the AR content based on the first and second data feeds includes generating the AR content based on the functional data relating to the function of the surgical instrument, and the AR content includes alerts relating to at least one of the performance of the surgical instrument or the improper use of the surgical instrument. The AR content is to be output, wherein the AR content includes a visual portion and a non-visual portion. An AR device equipped with a processor configured to perform the following.

2. The AR device according to claim 1, wherein the non-visual portion of the AR content is one or more of the following: tactile or audible.

3. The AR device according to claim 1, wherein the processor is further configured to filter the detection data.

4. The AR device according to claim 1, wherein the processor is further configured to amplify the detection data.

5. The AR device according to claim 1, wherein the AR device includes a sensor, a speaker, a haptic controller, or a combination thereof, for generating the non-visual portion of the AR content.

6. The AR device according to claim 1, wherein the non-visual portion of the AR content includes chemical AR content.

7. The AR device according to claim 1, wherein the non-visual portion of the AR content includes thermal AR content.

8. The processor is further configured to filter the detection data based on at least one of the keywords spoken by the user or the risk assessment of the surgical procedure. The AR device according to claim 1, wherein generating the AR content based on the first and second data feeds includes generating the AR content based on the filtered detection data.

9. A method for presenting augmented reality (AR) content during a surgical procedure, wherein the method is: The processor receives a first data feed from the imaging device, which includes a real image of the surgical area during the surgical procedure. The processor receives a second data feed containing detection data from the sensor device. The processor filters the detection data based on at least one of the keywords spoken by the user or the risk assessment of the surgical procedure. The processor generates AR content based on the first and second data feeds, and generating the AR content based on the first and second data feeds includes generating the AR content based on the filtered detection data. The processor outputs the AR content, and the AR content includes a visual portion and a non-visual portion. Methods that include...

10. The aforementioned method, The processor receives one or more of the tactile signals or audible signals, The processor generates the non-visual portion of the AR content based on one or more of the haptic signals or the audible signals, The method according to claim 9, further comprising:

11. The method according to claim 9, further comprising the processor amplifying the detected data.

12. The aforementioned method, The processor generates a third data feed, wherein the actual image of the surgical region is a first actual image, and the third data feed includes a second actual image of the surgical region from a different viewpoint than the first actual image. The processor combines the third data feed with the AR content to generate composite AR content. Displaying the aforementioned composite AR content, The method according to claim 9, including the method described in claim 9.

13. The method according to claim 9, wherein the AR content includes chemical AR content.

14. The method according to claim 9, wherein the AR content includes thermal AR content.

15. The detection data includes functional data related to the function of surgical instruments. The processor generating the AR content based on the first and second data feeds includes the processor generating the AR content based on the functional data relating to the function of the surgical instrument, The method according to claim 9, wherein the AR content includes an alert relating to at least one of the performance of the surgical instrument or the improper use of the surgical instrument.

16. The detection data includes functional data related to the function of surgical instruments. The processor generating the AR content based on the first and second data feeds includes the processor generating the AR content based on the functional data relating to the function of the surgical instrument, The method according to claim 9, wherein the AR content includes at least one indication of tissue tension generated by the surgical instrument or detection of a foreign body within a threshold distance from the surgical instrument.

17. It is an augmented reality (AR) device, It is a processor, The imaging device receives a first data feed containing real images of the surgical area during the surgical procedure, Receiving a second data feed from a sensor device, the detection data including functional data related to the function of a surgical instrument, Generating AR content based on the first and second data feeds, wherein generating the AR content based on the first and second data feeds includes generating the AR content based on the functional data relating to the function of the surgical instrument, and the AR content includes at least one indication of tissue tension generated by the surgical instrument or detection of a foreign body within a threshold distance from the surgical instrument. Outputting the aforementioned AR content, An AR device equipped with a processor configured to perform the following.

18. The processor is further configured to filter the detection data based on at least one of the keywords spoken by the user or the risk assessment of the surgical procedure. The AR device according to claim 17, wherein generating the AR content based on the first and second data feeds includes generating the AR content based on the filtered detection data.

19. The AR device according to claim 17, wherein the AR content includes one or more of haptic AR content, audible AR content, chemical AR content, or thermal AR content.

20. The aforementioned processor, The method involves generating a third data feed, wherein the actual image of the surgical region is the first actual image, and the third data feed includes a second actual image of the surgical region from a different viewpoint than the first actual image. The third data feed is combined with the AR content to generate composite AR content, Displaying the aforementioned composite AR content, The AR device according to claim 17, further configured to perform the following:

Images