Surgical instrument having tissue marking assembly - Patent Application 20070122997

Abstract

To provide a surgical instrument.SOLUTION: A surgical instrument includes an end effector and a marking assembly. The end effector includes a first jaw; a second jaw movable relative to the first jaw to grasp tissue therebetween; and a tissue-treatment mechanism configured to apply a tissue treatment to the tissue grasped between the first jaw and the second jaw. The marking assembly is configured to apply a distinct marking to the tissue unique to each tissue treatment application, wherein the distinct marking distinguishes the tissue treatment application from other tissue treatment applications.SELECTED DRAWING: Figure 30

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application No. 62 / 691,230, filed June 28, 2018, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE," the entire disclosure of which is incorporated herein by reference. This application claims priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application No. 62 / 691,228, filed June 28, 2018, entitled "A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES," the entire disclosure of which is incorporated herein by reference.

[0002] This application further contemplates the filing of U.S. Provisional Patent Application No. 62 / 650,887, filed March 30, 2018, entitled "SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES," U.S. Provisional Patent Application No. 62 / 650,877, filed March 30, 2018, entitled "SURGICAL SMOKE EVACUATION SENSING AND CONTROLS," U.S. Provisional Patent Application No. 62 / 650,882, filed March 30, 2018, entitled "SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM," and U.S. Provisional Patent Application No. 62 / 650,882, filed March 30, 2018, entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY," the disclosures of each of which are incorporated herein by reference in their entirety under 35 U.S.C. §119(e). This application claims the benefit of priority to U.S. Provisional Patent Application No. 62 / 650,898, filed March 30, 2018, entitled "PATENT ELEMENTS."

[0003] This application further claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application No. 62 / 640,417, filed March 8, 2018, entitled "TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR," and U.S. Provisional Patent Application No. 62 / 640,415, filed March 8, 2018, entitled "ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR," the disclosures of each of which are incorporated herein by reference in their entirety.

[0004] This application further claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application No. 62 / 611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed December 28, 2017; U.S. Provisional Patent Application No. 62 / 611,340, entitled "CLOUD-BASED MEDICAL ANALYTICS," filed December 28, 2017; and U.S. Provisional Patent Application No. 62 / 611,339, entitled "ROBOT ASSISTED SURGICAL PLATFORM," filed December 28, 2017, the disclosures of each of which are incorporated herein by reference in their entirety. [Background technology]

[0005] The present disclosure relates to various surgical systems. Summary of the Invention [Means for solving the problem]

[0006] A surgical instrument is disclosed. The surgical instrument includes an end effector and a marking assembly. The end effector includes a first jaw, a second jaw movable relative to the first jaw to grasp tissue between the first jaw, and a tissue processing mechanism configured to apply tissue processing to the tissue grasped between the first jaw and the second jaw. The marking assembly is configured to apply distinct markings to the tissue that are unique to each tissue processing application. The distinct markings distinguish the tissue processing application from other tissue processing applications.

[0007] A surgical instrument is disclosed. The surgical instrument includes an end effector, a marking assembly, and a control circuit. The end effector includes a first jaw, a second jaw movable relative to the first jaw to grasp tissue between the first jaw, and a tissue processing mechanism configured to apply a tissue processing to the tissue grasped between the first and second jaws. The control circuit is configured to receive a sensor signal indicative of the application of the tissue processing to the tissue and cause the marking assembly to apply a distinct marking to the tissue specific to the tissue processing application, the distinct marking distinguishing the tissue processing application from other tissue processing applications.

[0008] A surgical instrument is disclosed, the surgical instrument comprising an end effector including a first jaw, a second jaw movable relative to the first jaw to grasp tissue between the first jaw, and a tissue processing mechanism configured to apply tissue processing to tissue grasped between the first and second jaws. The surgical instrument further comprises means for applying distinct markings to the tissue unique to each tissue processing application, the distinct markings distinguishing the tissue processing application from other tissue processing applications. [Brief explanation of the drawings]

[0009] While the features of the various aspects are set forth with particularity in the appended claims, the various aspects, both as to organization and method of operation, together with further objects and advantages thereof, may best be understood by reference to the following description taken in conjunction with the accompanying drawings in which: [Figure 1] FIG. 1 is a block diagram of a computer-implemented interactive surgical system according to at least one aspect of the present disclosure. [Figure 2] 1 is a surgical system used to perform a surgical procedure in an operating room, according to at least one aspect of the present disclosure. [Figure 3] 1 is a surgical hub paired with a visualization system, a robotic system, and an intelligent instrument according to at least one aspect of the present disclosure. [Figure 4] FIG. 12 is a partial perspective view of a surgical hub housing and a combination generator module slidably receivable within a drawer of the surgical hub housing, according to at least one aspect of the present disclosure. [Figure 5] FIG. 1 is a perspective view of a combination generator module including bipolar, ultrasonic, and monopolar contacts and smoke evacuation components according to at least one embodiment of the present disclosure. [Figure 6] 10 illustrates individual power bus attachments for multiple lateral docking ports of a lateral modular housing configured to receive multiple modules, according to at least one embodiment of the present disclosure. [Figure 7] 1 illustrates a vertical modular housing configured to receive multiple modules, according to at least one embodiment of the present disclosure. [Figure 8] 1 illustrates a surgical data network comprising a modular communications 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 a cloud, in accordance with at least one embodiment of the present disclosure. [Figure 9] 1 illustrates a computer-implemented interactive surgical system according to at least one aspect of the present disclosure. [Figure 10]1 illustrates a surgical hub comprising multiple modules coupled to a modular control tower, according to at least one embodiment of the present disclosure. [Figure 11] 1 illustrates one embodiment of a Universal Serial Bus (USB) network hub device in accordance with at least one embodiment of the present disclosure. [Figure 12] 1 illustrates a logic diagram of a control system for a surgical instrument or tool, according to at least one aspect of the present disclosure. [Figure 13] 1 illustrates a control circuit configured to control aspects of a surgical instrument or tool, according to at least one aspect of the present disclosure. [Figure 14] 1 illustrates a combinational logic circuit configured to control aspects of a surgical instrument or tool, according to at least one aspect of the present disclosure. [Figure 15] 1 illustrates a sequential logic circuit configured to control aspects of a surgical instrument or tool, according to at least one aspect of the present disclosure. [Figure 16] 1 illustrates a surgical instrument or tool with multiple motors that can be activated to perform various functions, according to at least one aspect of the present disclosure. [Figure 17] FIG. 1 is a schematic diagram of a robotic surgical instrument configured to manipulate a surgical tool described herein, in accordance with at least one aspect of the present disclosure. [Figure 18] FIG. 1 shows a block diagram of a surgical instrument programmed to control distal translation of a displacement member, according to at least one aspect of the present disclosure. [Figure 19] FIG. 1 is a schematic diagram of a surgical instrument configured to control various functions, according to at least one aspect of the present disclosure. [Figure 20] FIG. 1 is a schematic diagram of a surgical instrument configured to control various functions, according to at least one aspect of the present disclosure. [Figure 21] FIG. 1 is a perspective view of a surgical instrument having an operably coupled interchangeable shaft assembly according to at least one embodiment of the present disclosure. [Figure 22]FIG. 22 is an exploded view of a portion of the surgical instrument of FIG. 21, in accordance with at least one embodiment of the present disclosure. [Figure 23] FIG. 1 is an exploded view of a portion of an interchangeable shaft assembly according to at least one aspect of the present disclosure. [Figure 24] FIG. 22 is an exploded view of the surgical instrument of FIG. 21 in accordance with at least one embodiment of the present disclosure. [Figure 25A] FIG. 22 is a block diagram of a control circuit for the surgical instrument of FIG. 21 spanning two views, in accordance with at least one embodiment of the present disclosure. [Figure 25B] FIG. 22 is a block diagram of a control circuit for the surgical instrument of FIG. 21 spanning two views, in accordance with at least one embodiment of the present disclosure. [Figure 26] FIG. 22 is a block diagram of a control circuit of the surgical instrument of FIG. 21 , showing the interface between the handle assembly and the power supply assembly, and the handle assembly and the interchangeable shaft assembly, in accordance with at least one embodiment of the present disclosure. [Figure 27] FIG. 1 is a process logic flow diagram illustrating a control program or logic configuration for marking tissue, in accordance with at least one aspect of the present disclosure. [Figure 28] 1 illustrates a jaw member of an end effector including a staple cartridge in accordance with at least one aspect of the present disclosure. [Figure 29] 1 illustrates a jaw member of an end effector of an ultrasonic surgical instrument according to at least one embodiment of the present disclosure. [Figure 30] 1 illustrates an end effector of a surgical stapling and severing instrument according to at least one aspect of the present disclosure. [Figure 31] 1 illustrates a control system for a surgical instrument according to at least one embodiment of the present disclosure. [Figure 32] 1 illustrates a tissue treatment applied to tissue to remove cancerous portions of the colon, according to at least one embodiment of the present disclosure. [Figure 33]1 is a graph illustrating clamping force (FTC) readings and firing force (FTF) readings of a powered surgical instrument during a surgical procedure and the corresponding communication rate of transmission of the readings to a surgical hub, where the readings and communication rate are plotted against time, in accordance with at least one aspect of the present disclosure. [Figure 34] 34 illustrates transmission rates of FTC and FTF data at four example points in the graph of FIG. 33, in accordance with at least one embodiment of the present disclosure. [Figure 35] FIG. 10 is a process logic flow diagram illustrating a control program or logic configuration for coordinating the transmission of data between a powered surgical tool and a surgical hub, in accordance with at least one aspect of the present disclosure. [Figure 36] FIG. 34 is a control system for the powered surgical tool of FIG. 33 according to at least one embodiment of the present disclosure. [Figure 37] FIG. 10 is a process logic flow diagram illustrating a control program or logic configuration for coordinating the transmission of data between a powered surgical tool and a surgical hub, in accordance with at least one aspect of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0010] The applicant of this application owns the following U.S. patent applications, filed June 29, 2018, the disclosures of which are incorporated herein by reference in their entirety: U.S. Patent Application No. __________, entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS"; Attorney Docket No. END8542USNP / 170755; U.S. Patent Application No. __________, entitled "CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS"; Attorney Docket No. END8543USNP / 170760; U.S. Patent Application No. __________, entitled "SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION"; Attorney Docket No. END8543USNP1 / 170760-1; U.S. Patent Application No. __________, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING"; Attorney Docket No. END8543USNP2 / 170760-2; U.S. Patent Application No. __________, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING"; Attorney Docket No. END8543USNP3 / 170760-3; U.S. Patent Application No. __________, entitled "SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES"; Attorney Docket No. END8543USNP4 / 170760-4; U.S. Patent Application No. __________, entitled "SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE"; Attorney Docket No. END8543USNP5 / 170760-5; U.S. Patent Application No. __________, entitled "SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES"; Attorney Docket No. END8543USNP6 / 170760-6; U.S. Patent Application No. __________, entitled "VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY"; Attorney Docket No. END8543USNP7 / 170760-7; U.S. Patent Application No. __________, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE"; Attorney Docket No. END8544USNP / 170761; U.S. Patent Application No. __________, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT"; Attorney Docket No. END8544USNP1 / 170761-1; U.S. Patent Application No. __________, entitled "SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES"; Attorney Docket No. END8544USNP3 / 170761-3; U.S. Patent Application No. __________, entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL"; Attorney Docket No. END8545USNP / 170762; U.S. Patent Application No. __________, entitled "SURGICAL EVACUATION SENSOR ARRANGEMENTS"; Attorney Docket No. END8545USNP1 / 170762-1; U.S. Patent Application No. __________, entitled "SURGICAL EVACUATION FLOW PATHS"; Attorney Docket No. END8545USNP2 / 170762-2; U.S. Patent Application No. __________, entitled "SURGICAL EVACUATION SENSING AND GENERATOR CONTROL"; Attorney Docket No. END8545USNP3 / 170762-3; U.S. Patent Application No. __________, entitled "SURGICAL EVACUATION SENSING AND DISPLAY"; Attorney Docket No. END8545USNP4 / 170762-4; U.S. Patent Application No. __________, entitled "COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM"; Attorney Docket No. END8546USNP / 170763; U.S. Patent Application No. __________, entitled "SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTROL CIRCUIT FOR INTERACTIVE SURGICAL PLATFORM"; Attorney Docket No. END8546USNP1 / 170763-1; U.S. Patent Application No. __________, entitled "SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE"; Attorney Docket No. END8547USNP / 170764; and U.S. Patent Application No. __________, entitled "DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS"; Attorney Docket No. END8548USNP / 170765.

[0011] The applicant of this application owns the following U.S. provisional patent applications, filed June 28, 2018, the disclosures of which are incorporated herein by reference in their entirety: U.S. Provisional Patent Application No. 62 / 691,228, entitled "A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES"; U.S. Provisional Patent Application No. 62 / 691,227, entitled "CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS"; · U.S. Provisional Patent Application No. 62 / 691,230, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE"; · U.S. Provisional Patent Application No. 62 / 691,219, entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL"; U.S. Provisional Patent Application No. 62 / 691,257, entitled "COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM"; U.S. Provisional Patent Application No. 62 / 691,262, entitled "SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE," and · U.S. Provisional Patent Application No. 62 / 691,251, entitled "DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS."

[0012] The applicant of this application owns the following U.S. patent applications, filed March 29, 2018, the disclosures of which are incorporated herein by reference in their entirety: · U.S. Patent Application No. 15 / 940,641, entitled "INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES"; · U.S. Patent Application No. 15 / 940,648, entitled "INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES"; · U.S. Patent Application No. 15 / 940,656, entitled "SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES"; U.S. Patent Application No. 15 / 940,666, entitled "SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS"; U.S. Patent Application No. 15 / 940,670, entitled "COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS"; · U.S. Patent Application No. 15 / 940,677, entitled "SURGICAL HUB CONTROL ARRANGEMENTS"; · U.S. Patent Application No. 15 / 940,632, entitled "DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD"; U.S. Patent Application No. 15 / 940,640, entitled "COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS"; U.S. Patent Application No. 15 / 940,645, entitled "SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT"; U.S. Patent Application No. 15 / 940,649, entitled "DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME"; · U.S. Patent Application No. 15 / 940,654, entitled "SURGICAL HUB SITUATIONAL AWARENESS"; · U.S. Patent Application No. 15 / 940,663, entitled "SURGICAL SYSTEM DISTRIBUTED PROCESSING"; · U.S. Patent Application No. 15 / 940,668, entitled "AGGREGATION AND REPORTING OF SURGICAL HUB DATA"; · U.S. Patent Application No. 15 / 940,671, entitled "SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER"; U.S. Patent Application No. 15 / 940,686, entitled "DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE"; · U.S. Patent Application No. 15 / 940,700, entitled "STERILE FIELD INTERACTIVE CONTROL DISPLAYS"; · U.S. Patent Application No. 15 / 940,629, entitled "COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS"; U.S. Patent Application No. 15 / 940,704, entitled "USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT"; U.S. Patent Application No. 15 / 940,722, entitled "CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY," and · U.S. Patent Application No. 15 / 940,742 entitled "DUAL CMOS ARRAY IMAGING."

[0013] The applicant of this application owns the following U.S. patent applications, filed March 29, 2018, the disclosures of which are incorporated herein by reference in their entirety: · U.S. Patent Application No. 15 / 940,636, entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES"; · U.S. Patent Application No. 15 / 940,653, entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS"; U.S. Patent Application No. 15 / 940,660, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER"; U.S. Patent Application No. 15 / 940,679, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET"; · U.S. Patent Application No. 15 / 940,694, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR MACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION"; U.S. Patent Application No. 15 / 940,634, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES"; U.S. Patent Application No. 15 / 940,706, entitled "DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK," and · U.S. Patent Application No. 15 / 940,675, entitled "CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES."

[0014] The applicant of this application owns the following U.S. patent applications, filed March 29, 2018, the disclosures of which are incorporated herein by reference in their entirety: · U.S. Patent Application No. 15 / 940,627, entitled "DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS"; · U.S. Patent Application No. 15 / 940,637, entitled "COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS"; · U.S. Patent Application No. 15 / 940,642, entitled "CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS"; · U.S. Patent Application No. 15 / 940,676, entitled "AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS"; · U.S. Patent Application No. 15 / 940,680, entitled "CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS"; · U.S. Patent Application No. 15 / 940,683, entitled "COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS"; U.S. Patent Application No. 15 / 940,690, entitled "DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS," and · U.S. Patent Application No. 15 / 940,711, entitled "SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS."

[0015] The applicant of this application owns the following U.S. provisional patent applications, filed March 28, 2018, the disclosures of which are incorporated herein by reference in their entirety: · U.S. Provisional Patent Application No. 62 / 649,302, entitled "INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES"; · U.S. Provisional Patent Application No. 62 / 649,294, entitled "DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD"; · U.S. Provisional Patent Application No. 62 / 649,300, entitled "SURGICAL HUB SITUATIONAL AWARENESS"; · U.S. Provisional Patent Application No. 62 / 649,309, entitled "SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER"; · U.S. Provisional Patent Application No. 62 / 649,310, entitled "COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS"; U.S. Provisional Patent Application No. 62 / 649,291, entitled "USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT"; · U.S. Provisional Patent Application No. 62 / 649,296, entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES"; U.S. Provisional Patent Application No. 62 / 649,333, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER"; U.S. Provisional Patent Application No. 62 / 649,327, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES"; · U.S. Provisional Patent Application No. 62 / 649,315, entitled "DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK"; U.S. Provisional Patent Application No. 62 / 649,313, entitled "CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES"; · U.S. Provisional Patent Application No. 62 / 649,320, entitled "DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS"; U.S. Provisional Patent Application No. 62 / 649,307, entitled "AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS," and · U.S. Provisional Patent Application No. 62 / 649,323, entitled "SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS."

[0016] The applicant of this application owns the following U.S. provisional patent applications, filed April 19, 2018, the disclosures of which are incorporated herein by reference in their entirety: · U.S. Provisional Patent Application No. 62 / 659,900, entitled "METHOD OF HUB COMMUNICATION."

[0017] The applicant of this application owns the following U.S. provisional patent applications, filed March 30, 2018, the disclosures of which are incorporated herein by reference in their entirety: · U.S. Provisional Patent Application No. 62 / 650,887, entitled "SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES"; · U.S. Provisional Patent Application No. 62 / 650,877, entitled "SURGICAL SMOKE EVACUATION SENSING AND CONTROLS"; U.S. Provisional Patent Application No. 62 / 650,882, entitled "SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM," and · U.S. Provisional Patent Application No. 62 / 650,898, entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS."

[0018] The applicant of this application owns the following U.S. provisional patent applications, filed March 8, 2018, the disclosures of each of which are incorporated herein by reference in their entirety: U.S. Provisional Patent Application No. 62 / 640,417, entitled "TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR," and · U.S. Provisional Patent Application No. 62 / 640,415, entitled "ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR."

[0019] The applicant of this application owns the following U.S. provisional patent applications, filed December 28, 2017, the disclosures of each of which are incorporated herein by reference in their entirety: · U.S. Provisional Patent Application No. 62 / 611,341, entitled "INTERACTIVE SURGICAL PLATFORM"; U.S. Provisional Patent Application No. 62 / 611,340, entitled "CLOUD-BASED MEDICAL ANALYTICS," and · U.S. Provisional Patent Application No. 62 / 611,339, entitled "ROBOT ASSISTED SURGICAL PLATFORM."

[0020] Before describing various aspects of the surgical devices and systems in detail, it should be noted that the illustrated embodiments are not limited in application or use to the details of construction and arrangement of parts shown in the accompanying drawings and description. The illustrative embodiments may be embodied in or incorporated into other aspects, variations, and modifications, and may be practiced or carried out in various ways. Furthermore, unless otherwise specified, the terms and phrases used herein have been chosen for the convenience of the reader for the purpose of describing the illustrative embodiments, and not for the purpose of limiting them. It should also be understood that one or more of the aspects, embodiment(s), and / or embodiments described below can be combined with any one or more of the other aspects, embodiment(s), and / or embodiments described below.

[0021] Aspects of the present disclosure present various surgical instruments utilized in cancer treatment that employ various sensors and algorithms to assess proximity to cancerous tissue and / or assist the user in navigating a safe distance away from cancerous tissue. The surgical instruments can be utilized alone or as components of a computer-implemented interactive surgical system.

[0022] 1 , a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (e.g., a cloud 104 that may include a remote server 113 coupled to a storage device 105). Each surgical system 102 includes at least one surgical hub 106 in communication with the cloud 104, which may include the remote server 113. In one embodiment, as shown in FIG. 1 , the surgical systems 102 include a visualization system 108, a robotic system 110, and a handheld intelligent surgical instrument 112 configured to communicate with each other and / or with the hub 106. In some aspects, the surgical system 102 may include M hubs 106, N visualization systems 108, O robotic systems 110, and P handheld intelligent surgical instruments 112, where M, N, O, and P are integers greater than or equal to 1.

[0023] FIG. 3 illustrates an example of a surgical system 102 used to perform a surgical procedure on a patient lying on an operating table 114 in a surgical operating room 116. One or more of the surgical instruments of the present disclosure can be implemented as robotic tools for use with a robotic system. A robotic system 110 is used as part of the surgical system 102 in a surgical procedure. The robotic system 110 includes a surgeon's console 118, a patient side cart 120 (surgical robot), and a surgical robot hub 122. The patient side cart 120 can manipulate at least one detachably coupled surgical tool 117 during minimally invasive incisions in the patient's body while the surgeon views the surgical site via the surgeon's console 118. Images of the surgical site can be acquired by a medical imaging device 124, which can be manipulated by the patient side cart 120 to orient the imaging device 124. The robotic hub 122 can be used to process images of the surgical site for subsequent display to the surgeon via the surgeon's console 118.

[0024] Other types of robotic systems can be readily adapted for use with surgical system 102. Various examples of robotic systems and surgical tools suitable for use with the present disclosure are described in U.S. Provisional Patent Application No. 62 / 611,339, filed December 28, 2017, entitled "ROBOT ASSISTED SURGICAL PLATFORM," the entire disclosure of which is incorporated herein by reference.

[0025] Various examples of cloud-based analytics performed by the cloud 104 and suitable for use with the present disclosure are described in U.S. Provisional Patent Application No. 62 / 611,340, entitled "CLOUD-BASED MEDICAL ANALYTICS," filed December 28, 2017, the entire disclosure of which is incorporated herein by reference.

[0026] In various embodiments, the image capture device 124 includes at least one image sensor and one or more optical components. Suitable image sensors include, but are not limited to, charge-coupled device (CCD) sensors and complementary metal-oxide semiconductor (CMOS) sensors.

[0027] The optical components of the imaging device 124 may include one or more illumination sources and / or one or more lenses. The one or more illumination sources may be directed to illuminate a portion of the surgical field. The one or more image sensors may receive light reflected or refracted from the surgical field, including light reflected or refracted from tissue and / or surgical instruments.

[0028] The one or more illumination sources can be configured to emit electromagnetic energy within the visible and invisible spectrum. The visible spectrum, sometimes called the optical spectrum or luminous spectrum, is the portion of the electromagnetic spectrum that is visible to (i.e., detectable by) the human eye and is sometimes called visible light, or simply light. The typical human eye responds to wavelengths in air between about 380 nm and about 750 nm.

[0029] The invisible spectrum (i.e., non-radiative spectrum) is the portion of the electromagnetic spectrum located below and above the visible spectrum (i.e., wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths above about 750 nm are longer than the red visible spectrum, which constitutes invisible infrared (IR), microwave, and radio electromagnetic radiation. Wavelengths below about 380 nm are shorter than the violet spectrum, which constitutes invisible ultraviolet, X-ray, and gamma-ray electromagnetic radiation.

[0030] In various aspects, the imaging device 124 is configured for use in minimally invasive surgery. Examples of imaging devices suitable for use with the present disclosure include, but are not limited to, arthroscopes, angioscopes, bronchoscopes, cholangioscopes, colonoscopes, cytoscopes, duodenoscopes, enteroscopes, esophagogastroduodenoscopes (gastroscopes), endoscopes, laryngoscopes, nasopharyngo-neproscopes, sigmoidoscopes, thoracoscopes, and ureteroscopes.

[0031] In one aspect, the imaging device uses multispectral monitoring to distinguish between topography and underlying structures. Multispectral imaging captures image data within specific wavelength ranges across the electromagnetic spectrum. Wavelengths can be separated by filters or by using instruments sensitive to specific wavelengths of light, including frequencies beyond the visible light range, e.g., IR and ultraviolet light. Spectral imaging can enable the extraction of additional information that the human eye cannot capture with its red, green, and blue receptors. The use of multispectral imaging is described in detail in the "Advanced Imaging Acquisition Module" section of U.S. Provisional Patent Application No. 62 / 611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed December 28, 2017, the entire disclosure of which is incorporated herein by reference. Multispectral monitoring can be a useful tool for repositioning the surgical field after a surgical procedure is completed to perform one or more of the above-mentioned tests on the treated tissue.

[0032] It is self-evident that any surgical procedure requires rigorous sterilization of the operating room and surgical instruments. The strict hygiene and sterilization conditions required in the "surgical theater," i.e., operating room or procedure room, require the utmost sterility of all medical devices and equipment. Part of that sterilization process is the need to sterilize everything that comes into contact with the patient or enters the sterile field, including the imaging device 124 and its accessories and components. It will be understood that the sterile field may be considered a specific area deemed free of microorganisms, such as in a tray or on a sterile towel, or the sterile field may be considered the area immediately surrounding the patient as he or she is prepared for the surgical procedure. The sterile field may include cleaned team members in appropriate clothing and all equipment and fixtures within the area.

[0033] In various aspects, the visualization system 108 includes one or more imaging sensors strategically positioned relative to the sterile field, one or more image processing units, one or more storage arrays, and one or more displays, as shown in FIGURE 2. In one aspect, the visualization system 108 includes HL7, PACS, and EMR interfaces. The various components of the visualization system 108 are described in the "Advanced Imaging Acquisition Module" section of U.S. Provisional Patent Application No. 62 / 611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed December 28, 2017, the entire disclosure of which is incorporated herein by reference.

[0034] As shown in FIG. 2 , primary display 119 is positioned within the sterile field so as to be visible to an operator positioned at operating table 114. In addition, visualization tower 111 is positioned outside the sterile field. Visualization tower 111 includes first non-sterile display 107 and second non-sterile display 109 facing away from each other. Visualization system 108, guided by hub 106, is configured to coordinate information flow to operators inside and outside the sterile field using displays 107, 109, and 119. For example, hub 106 can cause visualization system 108 to maintain a live video of the surgical site on primary display 119 while displaying snapshots of the surgical site recorded by imager 124 on non-sterile display 107 or 109. The snapshots on non-sterile display 107 or 109 can, for example, enable a non-sterile operator to perform diagnostic steps related to the surgical procedure.

[0035] In one aspect, the hub 106 is also configured to send diagnostic input or feedback entered by a non-sterile operator located in the sterile field at the visualization tower 111 to the primary display 119 in the sterile field for viewing by a sterile operator located at the operating table. In one example, the input may be in the form of a correction to a snapshot displayed on the non-sterile display 107 or 109 that can be sent by the hub 106 to the primary display 119.

[0036] 2 , a surgical instrument 112 is used as part of the surgical system 102 in a surgical procedure. The hub 106 is also configured to coordinate information flow to the display of the surgical instrument 112, as described, for example, in U.S. Provisional Patent Application No. 62 / 611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," the entire disclosure of which is incorporated herein by reference. Diagnostic input or feedback entered by a non-sterile operator at the visualization tower 111 may be sent by the hub 106 to the surgical instrument display 115 within the sterile field, where the diagnostic input or feedback may be viewed by the operator of the surgical instrument 112. Exemplary surgical instruments suitable for use with the surgical system 102 are described, for example, in the section entitled "Surgical Instrument Hardware" and in U.S. Provisional Patent Application No. 62 / 611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," the entire disclosure of which is incorporated herein by reference.

[0037] 3, hub 106 is shown in communication with visualization system 108, robotic system 110, and handheld intelligent surgical instrument 112. Hub 106 includes a hub display 135, an imaging module 138, a generator module 140, a communications module 130, a processor module 132, and a storage array 134. In certain embodiments, as shown in FIG. 3, hub 106 further includes a smoke evacuation module 126 and / or a suction / irrigation module 128.

[0038] During a surgical procedure, the application of energy to tissue for sealing and / or cutting is commonly accompanied by smoke evacuation, aspiration of excess fluid, and / or irrigation of tissue. Fluid, power, and / or data lines from different sources often become tangled during a surgical procedure. Addressing this issue can result in valuable time being lost during a surgical procedure. Untangling the lines may require unplugging them from their corresponding modules, which may require resetting the modules. The hub's modular housing 136 provides a unified environment for managing power, data, and fluid lines, reducing the frequency of such line tangles.

[0039] Aspects of the present disclosure present a surgical hub for use in surgical procedures involving the application of energy to tissue at a surgical site. The surgical hub includes a hub housing and a combination generator module slidably receivable within a docking station of the hub housing. The docking station includes data and power contacts. The combination generator module includes two or more of an ultrasonic energy generator component, a bipolar radio frequency (RF) energy generator component, and a monopolar RF energy generator component housed within a single unit. In one aspect, the combination generator module further includes a smoke evacuation component, at least one energy delivery cable for connecting the combination generator module to a surgical instrument, at least one smoke evacuation component configured to evacuate smoke, fluid, and / or particulates generated by the application of therapeutic energy to tissue, and a fluid line extending from the remote surgical site to the smoke evacuation component.

[0040] In one aspect, the fluid line is a first fluid line and a second fluid line extends from the remote surgical site to an aspiration and irrigation module slidably received within the hub housing. In one aspect, the hub housing comprises a fluid interface.

[0041] Certain surgical procedures may require the application of two or more energy types to tissue. One energy type may be more beneficial for cutting tissue, while another, different energy type may be more beneficial for sealing tissue. For example, a bipolar generator may be used to seal tissue, while an ultrasonic generator may be used to cut the sealed tissue. Aspects of the present disclosure present a solution in which the hub's modular housing 136 is configured to house various generators and facilitate bidirectional communication between them. One advantage of the hub's modular housing 136 is that it allows for quick removal and / or replacement of various modules.

[0042] Aspects of the present disclosure present a modular surgical housing for use in a surgical procedure involving the application of energy to tissue, the modular surgical housing including a first energy generator module configured to generate a first energy for application to tissue, and a first docking station including a first docking port including first data and power contacts, the first energy generator module slidably movable into electrical engagement with the power and data contacts and the first energy generator module slidably movable out of electrical engagement with the first power and data contacts.

[0043] Further to the above, the modular surgical housing further includes a second energy generator module configured to generate a second energy for application to tissue, different from the first energy, and a second docking station including a second docking port including second data and power contacts, wherein the second energy generator module is slidably movable into electrical engagement with the power and data contacts and the second energy generator module is slidably movable out of electrical engagement with the second power and data contacts.

[0044] Additionally, the modular surgical housing further includes a communication bus between the first docking port and the second docking port configured to facilitate communication between the first energy generator module and the second energy generator module.

[0045] 3-7, aspects of the present disclosure are presented relating to a hub modular housing 136 that allows for modular integration of a generator module 140, a smoke evacuation module 126, and a suction / irrigation module 128. The hub modular housing 136 further facilitates bidirectional communication between the modules 140, 126, and 128. As shown in FIG. 5, the generator module 140 may be a generator module that includes integrated monopolar, bipolar, and ultrasonic components supported within a single housing unit 139 that is slidably insertable into the hub modular housing 136. As shown in FIG. 5, the generator module 140 may be configured to connect to a monopolar device 146, a bipolar device 147, and an ultrasonic device 148. Alternatively, the generator module 140 may include a series of monopolar, bipolar, and / or ultrasonic generator modules that interact via the hub modular housing 136. The hub modular housing 136 may be configured to facilitate the insertion of multiple generators and bidirectional communication between the generators docked to the hub modular housing 136 so that the multiple generators function as a single generator.

[0046] As described in more detail below, one or more of the monopolar device 146, the bipolar device 147, and the ultrasound device 148 may be equipped with sensors and algorithms to assess proximity to cancerous tissue and / or assist the user in navigating a safe distance away from the cancerous tissue.

[0047] In one aspect, the hub's modular housing 136 includes a modular power and communication backplane 149 with external and wireless communication headers to allow removable attachment of the modules 140, 126, 128 and bidirectional communication therebetween.

[0048] In one aspect, the hub modular housing 136 includes a docking station or drawer 151, also referred to herein as a drawer, configured to slidably receive the modules 140, 126, 128. Figure 4 shows a partial perspective view of the surgical hub housing 136 and a combination generator module 145 slidably receiveable in the docking station 151 of the surgical hub housing 136. A docking port 152 having power and data contacts on the rear side of the combination generator module 145 is configured to engage the corresponding docking port 150 with the power and data contacts of the corresponding docking station 151 of the hub modular housing 136 when the combination generator module 145 is slid into position within the corresponding docking station 151 of the hub modular housing 136. In one aspect, the combination generator module 145 includes bipolar, ultrasonic, and monopolar modules and a smoke evacuation module integrated together with a single housing unit 139, as shown in Figure 5.

[0049] In various aspects, the smoke evacuation module 126 includes fluid lines 154 that transport captured / collected smoke and / or fluids away from the surgical site, for example, to the smoke evacuation module 126. Vacuum suction generated from the smoke evacuation module 126 can draw the smoke into openings in utility conduits at the surgical site. Utility conduits coupled to the fluid lines may be in the form of flexible tubing that terminates at the smoke evacuation module 126. The utility conduits and fluid lines define a fluid pathway that extends toward the smoke evacuation module 126, which is received within the hub housing 136.

[0050] In various aspects, the aspiration / irrigation module 128 is coupled to a surgical tool that includes aspiration and suction fluid lines. In one embodiment, the aspiration and suction fluid lines are in the form of flexible tubing that extends from the surgical site toward the aspiration / irrigation module 128. One or more drive systems can be configured to drive the irrigation and suction of fluids to and from the surgical site.

[0051] In one aspect, the surgical tool includes a shaft having an end effector at its distal end, at least one energy treatment unit associated with the end effector, a suction tube, and an irrigation tube. The suction tube can have an inlet port at its distal end, and the suction tube extends through the shaft. Similarly, the irrigation tube can extend through the shaft and have an inlet port proximate to the energy delivery instrument. The energy delivery instrument is configured to deliver ultrasonic and / or RF energy to the surgical site and is initially coupled to the generator module 140 by a cable extending through the shaft.

[0052] The irrigation tubing can be in fluid communication with a fluid source, and the suction tubing can be in fluid communication with a vacuum source. The fluid source and / or vacuum source can be housed within aspiration / irrigation module 128. In one embodiment, the fluid source and / or vacuum source can be housed within hub housing 136 separate from aspiration / irrigation module 128. In such an embodiment, a fluid interface can be configured to connect aspiration / irrigation module 128 to the fluid source and / or vacuum source.

[0053] In one aspect, the modules 140, 126, 128 and / or their corresponding docking stations on the hub modular housing 136 may include alignment features configured to align the docking ports of the modules into engagement with their counterparts in the docking stations of the hub modular housing 136. For example, as shown in FIG. 4 , the combination generator module 145 includes side brackets 155 configured to slidably engage with corresponding brackets 156 of the corresponding docking stations 151 of the hub modular housing 136. The brackets cooperate to guide the docking port contacts of the combination generator module 145 into electrical engagement with the docking port contacts of the hub modular housing 136.

[0054] In some embodiments, the drawers 151 of the hub's modular housing 136 are the same or substantially the same size, and the modules are sized to be received within the drawers 151. For example, the side brackets 155 and / or 156 may be larger or smaller depending on the size of the module. In other embodiments, the drawers 151 are different sizes, each designed to accommodate a specific module.

[0055] Additionally, to prevent inserting a module into a drawer with incompatible contacts, the contacts on a particular module may be keyed to engage with the contacts on a particular drawer.

[0056] 4, the docking port 150 of one drawer 151 may be coupled to the docking port 150 of another drawer 151 via a communication link 157 to facilitate two-way communication between modules housed within the hub modular housing 136. Alternatively, or in addition, the docking port 150 of the hub modular housing 136 may facilitate wireless two-way communication between modules housed within the hub modular housing 136. Any suitable wireless communication may be used, such as, for example, Air Titan-Bluetooth.

[0057] FIG. 6 illustrates individual power bus attachments of multiple lateral docking ports of a lateral modular housing 160 configured to receive multiple modules of a surgical hub 206. The lateral modular housing 160 is configured to laterally receive and interconnect modules 161. The modules 161 are slidably inserted into docking stations 162 of the lateral modular housing 160, which include a backplane for interconnecting the modules 161. As shown in FIG. 6, the modules 161 are arranged laterally within the lateral modular housing 160. Alternatively, the modules 161 may be arranged vertically within the lateral modular housing.

[0058] FIG. 7 illustrates a vertical modular housing 164 configured to receive multiple modules 165 of a surgical hub 106. The modules 165 are slidably inserted into a docking station or drawer 167 of the vertical modular housing 164, which includes a backplane for interconnecting the modules 165. While the drawer 167 of the vertical modular housing 164 is vertically oriented, in certain cases the vertical modular housing 164 may include a horizontally oriented drawer. Additionally, the modules 165 may interact with each other via docking ports in the vertical modular housing 164. In the embodiment of FIG. 7, a display 177 is provided for displaying data related to the operation of the modules 165. Additionally, the vertical modular housing 164 includes a master module 178 that houses multiple sub-modules that are slidably received within the master module 178.

[0059] In various aspects, the imaging module 138 includes a built-in video processor and a modular light source and is adapted for use with various imaging devices. In one aspect, the imaging device is configured with a modular housing that can be assembled with a light source module and a camera module. The housing may be a disposable housing. In at least one embodiment, the disposable housing is removably coupled to a reusable controller, light source module, and camera module. The light source module and / or camera module can be selectively selected depending on the type of surgical procedure. In one aspect, the camera module includes a CCD sensor. In another aspect, the camera module includes a CMOS sensor. In another aspect, the camera module is configured for imaging of a scanned beam. Similarly, the light source module can be configured to deliver white light or a different light depending on the surgical procedure.

[0060] During a surgical procedure, it can be inefficient to remove a surgical device from the surgical field and replace it with another surgical device containing a different camera or a different light source. Temporarily losing view of the surgical field can have undesirable consequences. The modular imaging device of the present disclosure is configured to allow for replacement of a light source module or camera module midstream during a surgical procedure without having to remove the imaging device from the surgical field.

[0061] In one aspect, the imaging device includes a tubular housing including a plurality of channels. A first channel is configured to slidably receive a camera module that can be configured for snap-fit ​​engagement with the first channel. A second channel is configured to slidably receive a light source module that can be configured for snap-fit ​​engagement with the second channel. In another embodiment, the camera module and / or the light source module can be rotated to a final position within their corresponding channels. A threaded engagement may be employed instead of a snap-fit ​​engagement.

[0062] In various embodiments, multiple imaging devices are positioned at different locations within the surgical field to provide multiple fields of view. The imaging module 138 can be configured to switch between the imaging devices to provide the optimal field of view. In various aspects, the imaging module 138 can be configured to integrate images from the different imaging devices.

[0063] Various image processors and imaging devices suitable for use with the present disclosure are described in U.S. Patent No. 7,995,045, issued August 9, 2011, entitled "COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR," which is incorporated herein by reference in its entirety. Additionally, U.S. Patent No. 7,982,776, issued July 19, 2011, entitled "SBI MOTION ARTIFACT REMOVAL APPARATUS AND METHOD," which is incorporated herein by reference in its entirety, describes various systems for removing motion artifacts from image data. Such systems may be integrated with imaging module 138. Additionally, U.S. Patent Application Publication No. 2011 / 0306840, published December 15, 2011, entitled "CONTROLLABLE MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPARATUS," and U.S. Patent Application Publication No. 2014 / 0243597, published August 28, 2014, entitled "SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE," are hereby incorporated by reference in their entirety.

[0064] FIG. 8 illustrates a surgical data network 201 comprising a modular communications hub 203 configured to connect modular devices located in one or more operating rooms in a medical facility, or any room within a medical facility equipped for surgical procedures, to a cloud-based system (e.g., a cloud 204 that may include a remote server 213 coupled to a storage device 205). In one aspect, the modular communications hub 203 comprises a network hub 207 and / or a network switch 209 in communication with a network router. The modular communications hub 203 can further be coupled to a local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 may be configured as passive, intelligent, or switched. A passive surgical data network acts as a conduit for data, allowing data to travel from one device (or segment) to another device (or segment) and to cloud computing resources. An intelligent surgical data network includes additional features that allow traffic to pass through the monitored surgical data network, configuring each port in the network hub 207 or network switch 209. An intelligent surgical data network can be referred to as a manageable hub or switch. A switching hub reads the destination address of each packet and then forwards the packet to the correct port.

[0065] Modular devices 1a-1n located in an operating room may be coupled to a modular communication hub 203. A network hub 207 and / or a network switch 209 may be coupled to a network router 211 to connect devices 1a-1n to the cloud 204 or a local computer system 210. Data associated with devices 1a-1n may be transferred to a cloud-based computer via the router for remote data processing and manipulation. Data associated with devices 1a-1n may also be transferred to the local computer system 210 for local data processing and manipulation. Modular devices 2a-2m located in the same operating room may also be coupled to the network switch 209. The network switch 209 may be coupled to the network hub 207 and / or a network router 211 to connect devices 2a-2m to the cloud 204. Data associated with devices 2a-2n may be transferred to the cloud 204 via the network router 211 for data processing and manipulation. Data associated with devices 2a-2m may also be transferred to the local computer system 210 for local data processing and manipulation.

[0066] It will be appreciated that surgical data network 201 may be expanded by interconnecting multiple network hubs 207 and / or multiple network switches 209 with multiple network routers 211. Modular communications hub 203 may be housed within a modular control tower configured to receive multiple devices 1a-1n / 2a-2m. A local computer system 210 may also be housed in the modular control tower. Modular communications hub 203 is connected to a display 212 to display images acquired by some of devices 1a-1n / 2a-2m, for example, during a surgical procedure. In various embodiments, devices 1a-1n / 2a-2m may include various modules such as, for example, an imaging module 138 coupled to an endoscope, a generator module 140 coupled to an energy-based surgical device, a smoke evacuation module 126, a suction / irrigation module 128, a communications module 130, a processor module 132, a storage array 134, a surgical device coupled to a display, and / or a non-contact sensor module, among other modular devices that may be connected to a modular communications hub 203 of a surgical data network 201.

[0067] In one aspect, the surgical data network 201 may include a combination of network hub(s), network switch(es), and network router(s) that connect the devices 1a-1n / 2a-2m to the cloud. Any one or all of the devices 1a-1n / 2a-2m coupled to the network hub or network switch can collect data in real time and transfer the data to a cloud computer for data processing and manipulation. It will be understood that cloud computing relies on shared computing resources rather than having local servers or personal devices to handle software applications. While the term "cloud" may be used as a metaphor for the "Internet," the term is not so limited. Accordingly, the term "cloud computing" may be used herein to refer to a type of internet-based computing in which various services, such as servers, storage, and applications, are delivered to a modular communications hub 203 and / or computer system 210 located at a surgical site (e.g., a fixed, mobile, temporary, or on-site operating room or space) and to devices connected to the modular communications hub 203 and / or computer system 210 via the internet. The cloud infrastructure may be maintained by a cloud service provider. In this context, a cloud service provider may be an entity that coordinates the use and control of devices 1a-1n / 2a-2m located in one or more operating rooms. The cloud computing service may perform numerous calculations based on data collected by smart surgical instruments, robots, and other computerized devices located in the operating room. The hub hardware allows multiple devices or connections to connect to a computer that communicates with cloud computing resources and storage.

[0068] By applying cloud computer data processing technology to data collected by the devices 1a-1n / 2a-2m, the surgical data network provides improved surgical outcomes, reduced costs, and improved patient satisfaction. At least some of the devices 1a-1n / 2a-2m can be used to observe tissue status and evaluate leakage or perfusion of sealed tissue after tissue sealing and cutting procedures. Using cloud-based computing, at least some of the devices 1a-1n / 2a-2m can be used to diagnostically examine data, including images of bodily tissue samples, to identify pathologies, such as the effects of disease. This includes tissue and phenotypic localization and margin confirmation. At least some of the devices 1a-1n / 2a-2m can be used to identify bodily anatomical structures using various sensors integrated with the imaging devices and techniques such as overlaying images captured by multiple imaging devices. Data collected by the devices 1a-1n / 2a-2m, including image data, can be transferred to the cloud 204 or a local computer system 210, or both, for data processing and manipulation, including image processing and manipulation. The data can be analyzed to improve the outcome of the surgical procedure by determining whether further treatments can be performed, such as endoscopic interventions, emerging technologies, targeted radiation, targeted interventions, and the application of precision robotics to tissue-specific sites and conditions. Such data analysis may further employ prognostic analysis processes, and using a standardized approach can provide useful feedback to either confirm or suggest modifications to surgical treatments and surgeon performance.

[0069] In one implementation, operating room devices 1a-1n may be connected to the modular communications hub 203 via wired or wireless channels, depending on the configuration of the devices 1a-1n relative to the network hub. In one embodiment, the network hub 207 may be implemented as a local network broadcasting device operating on the physical layer of the Open Systems Interconnection (OSI) model. The network hub provides connectivity to devices 1a-1n located within the same operating room network. The network hub 207 collects data in the form of packets and sends them to a router in half-duplex mode. The network hub 207 does not store any Media Access Control / Internet Protocol (MAC / IP) protocols for transferring device data. Only one of the devices 1a-1n can transmit data through the network hub 207 at a time. The network hub 207 does not have a routing table or intelligence regarding where to send the information; it broadcasts all network data across each connection and to a remote server 213 (FIG. 9) on the cloud 204. Although network hub 207 can detect basic network errors such as collisions, broadcasting all information to multiple ports can pose a security risk and cause bottlenecks.

[0070] In another implementation, the operating room devices 2a-2m may be connected to the network switch 209 via a wired or wireless channel. The network switch 209 functions within the data link layer of the OSI model. The network switch 209 is a multicast device for connecting the devices 2a-2m located in the same operating room to the network. The network switch 209 transmits data in the form of frames to the network router 211 and functions in full-duplex mode. Multiple devices 2a-2m can transmit data simultaneously through the network switch 209. The network switch 209 stores and uses the MAC addresses of the devices 2a-2m to forward data.

[0071] The network hub 207 and / or the network switch 209 are coupled to a network router 211 for connection to the cloud 204. The network router 211 functions within the network layer of the OSI model. The network router 211 creates a path for transmitting data packets received from the network hub 207 and / or the network switch 211 to cloud-based computer resources for further processing and manipulation of data collected by any one or all of the devices 1a-1n / 2a-2m. The network router 211 may be used to connect two or more different networks located in different locations, such as different operating rooms in the same medical facility or different operating rooms in different medical facilities. The network router 211 transmits data in the form of packets to the cloud 204 and functions in full-duplex mode. Multiple devices can transmit data simultaneously. The network router 211 uses IP addresses to forward data.

[0072] In one embodiment, the network hub 207 may be implemented as a USB hub that allows multiple USB devices to be connected to a host computer. The USB hub can expand a single USB port into several tiers so that more ports are available for connecting devices to the host system computer. The network hub 207 may include wired or wireless capabilities for receiving information via wired or wireless channels. In one aspect, a wireless USB short-range, high-bandwidth wireless communication protocol may be used for communication between the devices 1a-1n and 2a-2m located in the operating room.

[0073] In another embodiment, the operating room devices 1a-1n / 2a-2m can communicate with the modular communications hub 203 via the Bluetooth wireless technology standard to exchange data over short distances from fixed and mobile devices (using short-wavelength UHF radio waves in the 2.4-2.485 GHz ISM band) and to establish a personal area network (PAN). In another aspect, the operating room devices 1a-1n / 2a-2m can communicate with the modular communications hub 203 via numerous wireless or wired communications standards or protocols, including, but not limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, Long Term Evolution (LTE), and Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and their Ethernet derivatives, as well as any other wireless or wired protocols designated 3G, 4G, 5G, and beyond. The computing module may include multiple communication modules, for example, a first communication module may be dedicated to short-range wireless communication such as Wi-Fi and Bluetooth, and a second communication module may be dedicated to long-range wireless communication such as GPS, EDGE, GPRS, CDMA, WiMAX, LTE, and Ev-DO.

[0074] The modular communications hub 203 can act as a central connection for one or all of the operating room devices 1a-1n / 2a-2m and handles data types known as frames. Frames carry data generated by the devices 1a-1n / 2a-2m. Once the frames are received by the modular communications hub 203, they are amplified and transmitted to the network router 211, which forwards this data to cloud computing resources using any number of wireless or wired communications standards or protocols described herein.

[0075] The modular communications hub 203 may be used as a stand-alone device or may be connected to compatible network hubs and network switches to form a larger network. The modular communications hub 203 is generally easy to install, configure, and maintain, making the modular communications hub 203 a good choice for networking the operating room devices 1a-1n / 2a-2m.

[0076] FIG. 9 illustrates a computer-implemented interactive surgical system 200. The computer-implemented interactive surgical system 200 is similar in many respects to the computer-implemented interactive surgical system 100. For example, the computer-implemented interactive surgical system 200 includes one or more surgical systems 202 that are similar in many respects to the surgical system 102. Each surgical system 202 includes at least one surgical hub 206 that communicates with a cloud 204, which may include a remote server 213. In one aspect, the computer-implemented interactive surgical system 200 includes a modular control tower 236 connected to multiple operating room devices, such as, for example, intelligent surgical instruments, robots, and other computerized devices located in the operating room. As shown in FIG. 10, the modular control tower 236 includes a modular communication hub 203 coupled to the computer system 210. As illustrated in the embodiment of FIG. 9 , modular control tower 236 is coupled to imaging module 238 coupled to endoscope 239, generator module 240 coupled to energy device 241, smoke evacuation module 226, suction / irrigation module 228, communications module 230, processor module 232, storage array 234, smart device / instrument 235 optionally coupled to display 237, and non-contact sensor module 242. Operating room equipment is coupled to cloud computing resources and data storage via modular control tower 236. Robotic hub 222 may also be connected to modular control tower 236 and cloud computing resources. Device / instrument 235, visualization system 208, among other devices, may be coupled to modular control tower 236 via wired or wireless communication standards or protocols described herein. Modular control tower 236 may be coupled to hub display 215 (e.g., monitor, screen) for displaying and overlaying images received from imaging module, device / instrument display, and / or other visualization system 208. The hub display may also display data received from devices connected to the modular control tower along with images and overlay images.

[0077] FIG. 10 illustrates a surgical hub 206 comprising multiple modules coupled to a modular control tower 236. The modular control tower 236 comprises a modular communications hub 203, e.g., a network-connected device, and a computer system 210, e.g., for providing local processing, visualization, and imaging. As shown in FIG. 10, the modular communications hubs 203 can be connected in a hierarchical configuration to expand the number of modules (e.g., devices) that can be connected to the modular communications hub 203 and transfer data associated with the modules to the computer system 210, cloud computing resources, or both. As shown in FIG. 10, each of the network hubs / switches in the modular communications hub 203 includes three downstream ports and one upstream port. The upstream network hub / switch is connected to a processor to provide communications connectivity to cloud computing resources and a local display 217. Communications to the cloud 204 can occur via either wired or wireless communication channels.

[0078] The surgical hub 206 uses a non-contact sensor module 242 to measure the dimensions of the operating room and generate a map of the surgical site using either an ultrasound or laser-based non-contact measurement device. As described in the section titled "Surgical Hub Spatial Awareness Within an Operating Room" in U.S. Provisional Patent Application No. 62 / 611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," which is incorporated herein by reference in its entirety, an ultrasound-based non-contact sensor module scans the operating room by transmitting bursts of ultrasound and receiving echoes when the bursts of ultrasound reflect off the exterior walls of the operating room, where the sensor module is configured to determine the size of the operating room and adjust the Bluetooth pairing distance limit. A laser-based non-contact sensor module scans the operating room by, for example, transmitting laser light pulses, receiving laser light pulses that reflect off the exterior walls of the operating room, and comparing the phase of the transmitted pulses with the received pulses to determine the size of the operating room and adjust the Bluetooth pairing distance limit.

[0079] Computer system 210 includes a processor 244 and a network interface 245. Processor 244 is coupled to a communications module 247, storage 248, memory 249, non-volatile memory 250, and input / output interface 251 via a system bus. The system bus may be any of several types of bus structure(s), including a memory bus or memory controller, a peripheral bus or external bus, and / or a local bus using any of a variety of bus architectures, including, but not limited to, a 9-bit bus, Industry Standard Architecture (ISA), Micro Channel Architecture (MSA), Enhanced ISA (EISA), Intelligent Drive Electronics (IDE), VESA Local Bus (VLB), Peripheral Component Interconnect (PCI), USB, Advanced Graphics Port (AGP), Personal Computer Memory Card International Association bus (PCMCIA), Small Computer System Interface (SCSI), or any other proprietary bus.

[0080] Processor 244 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex manufactured by Texas Instruments. In one aspect, the processor may be an LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, including, for example, 256 KB of on-chip memory of single-cycle flash memory or other non-volatile memory up to 40 MHz, a prefetch buffer to improve performance above 40 MHz, 32 KB of single-cycle serial random access memory (SRAM), internal read-only memory (ROM) loaded with StellarisWare® software, 2 KB of 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, one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, details of which are available in the product datasheet.

[0081] In one embodiment, processor 244 may include a safety controller, including two controller families such as the TMS570 and RM4x, also known under the trade name Hercules ARM Cortex R4, manufactured by Texas Instruments. The safety controller may be specifically configured for IEC 61508 and ISO 26262 safety limit applications, among others, to provide advanced integrated safety mechanisms while offering scalable performance, connectivity, and memory options.

[0082] System memory includes both volatile and nonvolatile memory. The basic input / output system (BIOS), containing the basic routines for transferring information between elements within a computer system, such as during start-up, is stored in nonvolatile memory. For example, nonvolatile memory may include ROM, programmable ROM (PROM), electrically programmable ROM (EPROM), EEPROM, or flash memory. Volatile memory includes random access memory (RAM), which acts as external cache memory. RAM is available in many forms, including static RAM (SRAM), dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), sync link DRAM (SLDRAM), and direct RAM (DRRAM).

[0083] The computer system 210 also includes removable / non-removable, volatile / non-volatile computer storage media, such as disk storage. Disk storage includes, but is not limited to, devices such as magnetic disk drives, floppy disk drives, tape drives, Jaz drives, Zip drives, LS-60 drives, flash memory cards, or memory sticks. In addition, disk storage can include storage media independently or in combination with other storage media, including, but not limited to, optical disk drives such as compact disk read-only memory drives (CD-ROMs), compact disk recordable drives (CD-R drives), compact disk rewritable drives (CD-RW drives), or digital versatile disk read-only memory drives (DVD-ROMs). Removable or non-removable interfaces may be used to facilitate connection of disk storage devices to the system bus.

[0084] It should be understood that computer system 210 includes software that acts as an intermediary between users and the basic computer resources described in a suitable operating environment. Such software includes an operating system. The operating system, which may be stored on disk storage, functions to control and allocate resources of the computer system. System applications leverage resource management by the operating system through program modules and program data stored either in system memory or on disk storage. It should be understood that the various components described herein can be implemented with various operating systems or combinations of operating systems.

[0085] A user inputs commands or information into the computer system 210 through input device(s) coupled to the I / O interface 251. Input devices include, but are not limited to, pointing devices such as a mouse, trackball, stylus, or touchpad; keyboards; microphones; joysticks; gamepads; satellite dishes; scanners; TV tuner cards; digital cameras; digital video cameras; webcams; and the like. These and other input devices connect to the processor through the system bus via interface port(s). Interface port(s) include, for example, serial ports, parallel ports, game ports, and USB. Output device(s) use some of the same types of ports as the input device(s). Thus, for example, a USB port may be used to provide input to the computer system and to output information from the computer system to an output device. Output adapters are provided to illustrate that there are some output devices, such as monitors, displays, speakers, and printers, among other output devices, that require special adapters. Output adapters include, by way of example and not limitation, video and sound cards, which provide a means of connection between an output device and the system bus. It should be noted that other devices and / or systems of devices, such as remote computer(s), provide both input and output capabilities.

[0086] The computer system 210 can operate in a networked environment using logical connections to one or more remote or local computers, such as cloud computer(s). The remote cloud computer(s) may be personal computers, servers, routers, network PCs, workstations, microprocessor-based appliances, peer devices, or other common network nodes, and typically include many or all of the elements described with respect to a computer system. For simplicity, only memory storage devices are shown along with the remote computer(s). The remote computer(s) are logically connected to the computer system through a network interface and are subsequently physically connected via a communications connection. Network interfaces encompass communication networks such as local area networks (LANs) and wide area networks (WANs). LAN technologies include Fiber Distributed Data Interface (FDDI), Copper Distributed Data Interface (CDDI), Ethernet / IEEE 802.3, Token Ring / IEEE 802.5, and the like. WAN technologies include, but are not limited to, point-to-point links, circuit-switched networks such as Integrated Services Digital Networks (ISDN) and its variants, packet-switched networks, and Digital Subscriber Lines (DSL).

[0087] In various aspects, the computer system 210 of FIG. 10 , the imaging module 238 of FIGS. 9 and 10 , and / or the visualization system 208, and / or the processor module 232 may include an image processor, an image processing engine, a media processor, or any dedicated digital signal processor (DSP) used to process digital images. The image processor may use parallel computing using single instruction, multiple data (SIMD) or multiple instruction, multiple data (MIMD) techniques to increase speed and efficiency. The digital image processing engine may perform a variety of tasks. The image processor may be a system on a chip (SoC) with a multi-core processor architecture.

[0088] The communications connection(s) refer to the hardware / software used to connect the network interface to the bus. While the communications connections are shown internal to the computer system for clarity of illustration, the communications connections may also be external to computer system 210. By way of example only, the hardware / software required to connect to the network interface may include internal and external technologies such as modems, including regular telephone-grade modems, cable modems, and DSL modems, ISDN adapters, and Ethernet cards.

[0089] FIG. 11 shows a functional block diagram of one embodiment of a USB network hub 300 device in accordance with at least one embodiment of the present disclosure. In the illustrated embodiment, the USB network hub device 300 employs a Texas Instruments TUSB2036 integrated circuit hub. The USB network hub 300 is a CMOS device that conforms to the USB 2.0 standard and provides an upstream USB transmit / receive port 302 and up to three downstream USB transmit / receive ports 304, 306, and 308. The upstream USB transmit / receive port 302 is a differential routed data port that includes a differential data minus (DM0) input paired with a differential data plus (DP0) input. The three downstream USB transmit / receive ports 304, 306, and 308 are differential data ports, each including a differential data plus (DP1-DP3) output paired with a differential data minus (DM1-DM3) output.

[0090] The USB network hub 300 device is implemented with a digital state machine instead of a microcontroller and does not require firmware programming. Fully compliant USB transceivers are integrated into the circuitry of the upstream USB transmit / receive port 302 and all downstream USB transmit / receive ports 304, 306, and 308. The downstream USB transmit / receive ports 304, 306, and 308 support both full-speed and low-speed devices by automatically setting the slew rate depending on the speed of the device attached to the port. The USB network hub 300 device may be configured in either bus-powered or self-powered mode and includes hub power logic 312 to manage power.

[0091] The USB network hub 300 device includes a serial interface engine (SIE) 310. The SIE 310 is the front end of the USB network hub 300 hardware and handles most of the protocol described in Chapter 8 of the USB Specification. The SIE 310 typically understands signaling down to the transaction level. Functions it handles may include packet recognition, transaction reordering, SOP, EOP, RESET, and RESUME signal detection / generation, clock / data separation, non-return-to-zero inverted (NRZI) data encoding / decoding and bit stuffing, CRC generation and checking (token and data), packet ID (PID) generation and checking / decoding, and / or serial-to-parallel / parallel-to-serial conversion. The SIE 310 receives a clock input 314 and is coupled to suspend / resume logic and frame timer 316 and hub repeater circuits 318 to control communication between the upstream USB transmit / receive port 302 and downstream USB transmit / receive ports 304, 306, and 308 via port logic circuits 320, 322, and 324. The SIE 310 is coupled to a command decoder 326 via interface logic for controlling commands from a serial EEPROM via a serial EEPROM interface 330 .

[0092] In various embodiments, the USB network hub 300 can connect 127 functions organized into up to six logical layers (hierarchies) to a single computer. Furthermore, the USB network hub 300 can connect to all peripheral devices using a standardized four-wire cable that provides both communication and power distribution. Power configurations include bus-powered mode and self-powered mode. The USB network hub 300 may be configured to support four modes of power management: a bus-powered hub with either individual or ganged port power management, and a self-powered hub with either individual or ganged port power management. In one embodiment, using a USB cable, the USB network hub 300, the upstream USB transmit / receive port 302 is plugged into a USB host controller, and the downstream USB transmit / receive ports 304, 306, and 308 are exposed for connecting USB-compatible devices.

[0093] Surgical Instrument Hardware FIG. 12 shows a logic diagram of a surgical instrument or tool control system 470 according to one or more embodiments of the present disclosure. The control system 470 includes a microcontroller 461 with a processor 462 and a memory 468. For example, one or more of sensors 472, 474, 476 provide real-time feedback to the processor 462. A motor 482, driven by a motor driver 492, operably couples a longitudinally movable displacement member to drive the I-beam knife element. A tracking system 480 is configured to determine the position of the longitudinally movable displacement member. The position information is provided to the processor 462, which may be programmed or configured to determine the position of the longitudinally movable drive member, as well as the positions of the firing member, firing bar, and I-beam knife element. Additional motors may be provided to the tool driver interface to control I-beam firing, closure tube movement, shaft rotation, and articulation. A display 473 displays various operating conditions of the instrument and may include touchscreen functionality for data entry. Information displayed on the display 473 can be overlaid with images acquired via the endoscopic imaging module.

[0094] In one embodiment, microcontroller 461 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex manufactured by Texas Instruments. In one embodiment, main microcontroller 461 may be, for example, an LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, including on-chip memory of 256 KB of single-cycle flash memory or other non-volatile memory up to 40 MHz, a prefetch buffer to improve performance above 40 MHz, 32 KB of single-cycle SRAM, internal ROM with StellarisWare® software, 2 KB of EEPROM, one or more PWM modules, one or more QEI analog, and / or one or more 12-bit ADCs with 12 analog input channels, details of which are available in the product datasheet.

[0095] In one embodiment, the microcontroller 461 may include a safety controller, which includes two controller families such as the TMS570 and RM4x, also known under the trade name Hercules ARM Cortex R4, manufactured by Texas Instruments. The safety controller may be specifically configured for IEC 61508 and ISO 26262 safety limit applications, among others, to provide advanced integrated safety mechanisms while offering scalable performance, connectivity, and memory options.

[0096] The microcontroller 461 may be programmed to perform various functions, such as providing precise control over the speed and position of the knife and articulation system. In one embodiment, the microcontroller 461 includes a processor 462 and memory 468. The electric motor 482 may be a brushed direct current (DC) motor with a gearbox and mechanical linkage to the articulation or knife system. In one embodiment, the motor driver 492 may be an A3941 available from Allegro Microsystems, Inc. Other motor drivers may be easily substituted for use in the tracking system 480 with an absolute positioning system. A detailed description of the absolute positioning system is provided in U.S. Patent Application Publication No. 2017 / 0296213, published October 19, 2017, entitled "SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT," which is incorporated herein by reference in its entirety.

[0097] The microcontroller 461 may be programmed to provide precise control over the velocity and position of the displacement members and articulation system. The microcontroller 461 may be configured to calculate a response within the microcontroller 461 software. The calculated response is compared to the measured response of the actual system to obtain an "observed" response, which is used to determine the actual feedback. The observed response is a suitably adjusted value that balances the smooth, continuous nature of the simulated response with the measured response, which can detect external influences on the system.

[0098] In one aspect, the motor 482 may be controlled by a motor driver 492 and may be used by the surgical instrument or tool firing system. In various configurations, the motor 482 may be a brushed DC drive motor having a maximum rotational speed of, for example, about 25,000 RPM. In another configuration, the motor 482 may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor driver 492 may include, for example, an H-bridge driver including field effect transistors (FETs). The motor 482 may be powered by a power supply assembly releasably attached to the handle assembly or tool housing to provide control power to the surgical instrument or tool. The power supply assembly may include a battery, which may include multiple battery cells connected in series, that may be used as a power source to power the surgical instrument or tool. Under certain circumstances, the battery cells of the power supply assembly may be replaceable and / or rechargeable. In at least one example, the battery cells may be lithium-ion (LI) batteries, which may be connectable to and separable from the power supply assembly.

[0099] The motor driver 492 may be the A3941, available from Allegro Microsystems, Inc. The A3941 492 is a full-bridge controller for use with external N-channel power metal-oxide semiconductor field-effect transistors (MOSFETs), specifically designed for inductive loads such as brushed DC motors. The driver 492 includes an intrinsic charge-pump regulator that provides full (>10V) gate drive for battery voltages up to 7V, allowing the A3941 to operate with reduced gate drive down to 5.5V. A bootstrap capacitor may be used to provide the required battery supply voltage above the N-channel MOSFET. An internal charge pump for the high-side drive allows DC (100% duty cycle) operation. The full-bridge can be driven in fast or slow decay mode using diode or synchronous rectification. In slow decay mode, current recirculation is possible through either the high-side or low-side FET. The power FETs are protected from shoot-through by a resistor-adjustable dead time. Integrated diagnostics indicate undervoltage, overtemperature, and power bridge faults and can be configured to protect the power MOSFETs under most short circuit conditions. Other motor drivers can be easily substituted for use in tracking system 480 with an absolute positioning system.

[0100] The tracking system 480 includes controlled motor drive circuitry including a position sensor 472 according to at least one embodiment of the present disclosure. The position sensor 472 for the absolute positioning system provides a unique position signal corresponding to the position of the displacement member. In one embodiment, the displacement member represents a longitudinally movable drive member including a rack of drive teeth for meshing engagement with a corresponding drive gear of a gear reducer assembly. In another embodiment, the displacement member represents a firing member that may be adapted and configured to include a rack of drive teeth. In yet another embodiment, the displacement member represents a firing bar or an I-beam, each of which may be adapted and configured to include a rack of drive teeth. Accordingly, as used herein, the term displacement member is used to collectively refer to any movable member of a surgical instrument, such as a drive member, firing member, firing bar, I-beam, or any element that can be displaced. In one embodiment, the longitudinally movable drive member is coupled to the firing member, firing bar, and I-beam. Thus, the absolute positioning system can, in effect, track the linear displacement of the I-beam by tracking the linear displacement of the longitudinally movable drive member. In various other aspects, the displacement member may be coupled to any position sensor 472 suitable for measuring linear displacement. Thus, the longitudinally movable drive member, firing member, firing bar, or I-beam, or combinations thereof, may be coupled to any suitable linear displacement sensor. The linear displacement sensor may include a contact or non-contact displacement sensor.The linear displacement sensors may include linear variable differential transformers (LVDTs), differential variable reluctance transducers (DVRTs), slide potentiometers, magnetic sensing systems with a movable magnet and a series of linearly arranged Hall effect sensors, magnetic sensing systems with a fixed magnet and a series of movable linearly arranged Hall effect sensors, optical detection systems with a movable light source and a series of linearly arranged photodiodes or photodetectors, optical detection systems with a fixed light source and a series of movable linearly arranged photodiodes or photodetectors, or any combination thereof.

[0101] The electric motor 482 may include a rotatable shaft operably interfaced with a gear assembly mounted in meshing engagement with a set or rack of drive teeth on the displacement member. The sensor element may be operably coupled to the gear assembly such that one rotation of the position sensor 472 element corresponds to some linear longitudinal translation of the displacement member. The gearing and sensor mechanism may be connected to a linear actuator by a rack and pinion mechanism or to a rotary actuator by a spur gear or other connection. A power source provides power to the absolute positioning system, and an output indicator may display the output of the absolute positioning system. The displacement member represents a longitudinally movable drive member with a rack of drive teeth formed thereon for meshing engagement with a corresponding drive gear of a gear reducer assembly. The displacement member may represent a longitudinally movable firing member, a firing bar, an I-beam, or a combination thereof.

[0102] One revolution of the sensor element associated with position sensor 472 corresponds to a linear longitudinal displacement d1 of the displacement member, where d1 is the linear longitudinal distance traveled by the displacement member from point "a" to point "b" after one revolution of the sensor element coupled to the displacement member. The sensor mechanism may be connected via a gear reduction that results in the position sensor 472 completing one or more revolutions relative to the full stroke of the displacement member. The position sensor 472 may complete multiple revolutions relative to the full stroke of the displacement member.

[0103] A series of switches (where n is an integer greater than 1) may be used alone or in combination with gear reduction to provide a unique position signal for two or more revolutions of the position sensor 472. The states of the switches are fed back to the microcontroller 461, which applies logic to determine a unique position signal corresponding to the longitudinal linear displacement d1+d2+...dn of the displacement member. The output of the position sensor 472 is provided to the microcontroller 461. The position sensor 472 of the sensor mechanism may comprise a magnetic sensor, an analog rotation sensor such as a potentiometer, or an array of analog Hall effect elements that output a unique combination of position signals or values.

[0104] Position sensor 472 may comprise any number of magnetic sensing elements, such as magnetic sensors classified based on whether they measure the total magnetic field or vector components of a magnetic field. The technologies used to produce both types of magnetic sensors involve many aspects of physics and electronics. Technologies used to sense magnetic fields include search coils, fluxgates, optical pumping, nuclear precession, SQUIDs, Hall effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive / piezoelectric composites, magnetodiodes, magnetotransistors, fiber optics, magneto-optics, and microelectromechanical systems-based magnetic sensors, among others.

[0105] In one aspect, the position sensor 472 of the tracking system 480 with an absolute positioning system comprises a magnetic rotary absolute positioning system. The position sensor 472 may be implemented as an AS5055EQFT single-chip magnetic rotary position sensor available from Austria Microsystems, AG. The position sensor 472 works in conjunction with the microcontroller 461 to provide the absolute positioning system. The position sensor 472 is a low-voltage, low-power component and includes four Hall-effect elements in the area of ​​the position sensor 472 located above the magnet. Additionally, a high-resolution ADC and a smart power management controller are provided on-chip. A Coordinate Rotation Digital Computer (CORDIC) processor, also known as the digit-by-digit method and Volder's algorithm, is provided to implement simple and efficient algorithms for calculating hyperbolic and trigonometric functions, requiring only addition, subtraction, bit shifting, and table lookup operations. Angular position, alarm bits, and magnetic field information are transmitted to the microcontroller 461 via a standard serial communications interface, such as a serial peripheral interface (SPI) interface. The position sensor 472 provides 12-bit or 14-bit resolution and may be an AS5055 chip provided in a small QFN 16-pin 4x4x0.85mm package.

[0106] A tracking system 480 comprising an absolute positioning system may comprise and / or be programmed to implement a feedback controller, such as a PID, state feedback, and adaptive controller. A power supply converts the signal from the feedback controller into a physical input to the system, in this case a voltage. Other examples include PWM of voltage, current, and force. In addition to the position measured by position sensor 472, other sensor(s) may be provided to measure physical parameters of the physical system. In some embodiments, the other sensor(s) may include sensor mechanisms such as those described in U.S. Pat. No. 9,345,481, issued May 24, 2016, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM," which is incorporated herein by reference in its entirety; U.S. Patent Application Publication No. 2014 / 0263552, published September 18, 2014, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM," which is incorporated herein by reference in its entirety; and U.S. Patent Application No. 15 / 628,175, filed June 20, 2017, entitled "TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT," which is incorporated herein by reference in its entirety. In a digital signal processing system, the absolute positioning system is coupled to a digital data acquisition system, where the output of the absolute positioning system has a finite resolution and sampling frequency. The absolute positioning system may include comparison and combination circuitry to combine the calculated response with the measured response using algorithms such as weighted averages and theoretical control loops that drive the calculated response towards the measured response. The calculated response of the physical system takes into account properties such as mass, inertia, viscous friction, and induced resistance in order to predict what the state and output of the physical system will be given knowledge of the input.

[0107] The absolute positioning system provides the absolute position of the displacement member upon powering up of the instrument without retracting or advancing the displacement member to a reset (zero or home) position, as may be required with conventional rotary encoders that simply count the number of steps taken by the motor 482 forward or backward to estimate the position of the device actuator, drive bar, knife, etc.

[0108] Sensor 474, such as a strain gauge or micro-strain gauge, is configured to measure one or more parameters of the end effector, such as the amplitude of strain exerted on the anvil during clamping, which can be indicative of the closure force applied to the anvil. The measured strain is converted to a digital signal and provided to processor 462. Alternatively or in addition to sensor 474, a sensor 476, such as a load sensor, can measure the closure force applied to the anvil by the closure drive system. For example, sensor 476, such as a load sensor, can measure the firing force applied to the I-beam during the firing stroke of the surgical instrument or tool. The I-beam is configured to engage a wedge-shaped sled, which is configured to cam the staple driver upward and drive the staples into deforming contact with the anvil. The I-beam also includes a sharp cutting edge that can be used to cut tissue as the I-beam is advanced distally by the firing bar. Alternatively, a current sensor 478 can be used to measure current draw by motor 482. The force required to advance the firing member may correspond, for example, to the current drawn by motor 482. The measured force is converted to a digital signal and provided to processor 462.

[0109] In one form, a strain gauge sensor 474 can be used to measure the force applied to tissue by the end effector. A strain gauge can be coupled to the end effector to measure the force applied by the end effector to the tissue being treated. A system for measuring the force applied to tissue grasped by the end effector includes a strain gauge sensor 474, such as a micro-strain gauge configured to measure one or more parameters of the end effector. In one aspect, the strain gauge sensor 474 can measure the amplitude or magnitude of strain exerted on the jaw members of the end effector during a grasping operation, which can indicate tissue compression. The measured strain is converted to a digital signal and provided to the processor 462 of the microcontroller 461. The load sensor 476 can measure the force used to manipulate the knife element, for example, to cut tissue captured between the anvil and the staple cartridge. A magnetic field sensor can be used to measure the thickness of the captured tissue. The magnetic field sensor measurements can also be converted to a digital signal and provided to the processor 462.

[0110] Measurements of tissue compression, tissue thickness, and / or force required to close the end effector on the tissue, measured by sensors 474, 476, respectively, can be used by microcontroller 461 to characterize a selected position of the firing member and / or a corresponding value of firing member velocity. In one example, memory 468 can store techniques, equations, and / or look-up tables that can be used by microcontroller 461 during the evaluation.

[0111] The surgical instrument or tool control system 470 may also include wired or wireless communication circuitry for communicating with a modular communications hub as shown in Figures 8-11.

[0112] FIG. 13 illustrates a control circuit 500 configured to control aspects of a surgical instrument or tool according to at least one embodiment of the present disclosure. The control circuit 500 can be configured to implement various processes described herein. The control circuit 500 can include a microcontroller including one or more processors 502 (e.g., microprocessors, microcontrollers) coupled to at least one memory circuit 504. The memory circuit 504 stores machine-executable instructions that, when executed by the processor 502, cause the processor 502 to execute the machine instructions to implement the various processes described herein. The processor 502 can be any one of a number of single- or multi-core processors known in the art. The memory circuit 504 can include volatile and non-volatile storage media. The processor 502 can include an instruction processing unit 506 and an arithmetic unit 508. The instruction processing unit can be configured to receive instructions from the memory circuit 504 of the present disclosure.

[0113] 14 illustrates a combinational logic circuit 510 configured to control aspects of a surgical instrument or tool in accordance with at least one embodiment of the present disclosure. The combinational logic circuit 510 can be configured to implement various processes described herein. The combinational logic circuit 510 can include a finite state machine including combinational logic 512 configured to receive data associated with the surgical instrument or tool at an input 514, process the data through the combinational logic 512, and provide an output 516.

[0114] FIG. 15 illustrates a sequential logic circuit 520 configured to control aspects of a surgical instrument or tool in accordance with at least one embodiment of the present disclosure. The sequential logic circuit 520 or the combinatorial logic 522 can be configured to implement various processes described herein. The sequential logic circuit 520 may include a finite state machine. The sequential logic circuit 520 may include, for example, combinatorial logic 522, at least one memory circuit 524, and a clock 529. The at least one memory circuit 524 can store the current state of the finite state machine. In certain examples, the sequential logic circuit 520 may be synchronous or asynchronous. The combinatorial logic 522 is configured to receive data associated with the surgical instrument or tool from an input 526, process the data through the combinatorial logic 522, and provide an output 528. In other embodiments, a circuit may include a combination of a processor (e.g., processor 502 of FIG. 13 ) and a finite state machine that implements various processes herein. In other aspects, the finite state machine may include a combination of combinational logic (eg, combinational logic 510 of FIG. 14) and sequential logic 520.

[0115] 16 illustrates a surgical instrument or tool with multiple motors that can be activated to perform various functions. In certain examples, a first motor can be activated to perform a first function, a second motor can be activated to perform a second function, a third motor can be activated to perform a third function, a fourth motor can be activated to perform a fourth function, and so on. In certain examples, the motors of the robotic surgical instrument 600 can be individually activated to produce firing, closing, and / or articulation motions in the end effector. The firing, closing, and / or articulation motions can be transmitted to the end effector via, for example, a shaft assembly.

[0116] In certain examples, the surgical instrument system or tool may include a firing motor 602. The firing motor 602 may be operably coupled to a firing motor drive assembly 604, which may be configured to transfer the firing motion generated by the motor 602 to the end effector, particularly to displace an I-beam element. In certain examples, the firing motion generated by the motor 602 may, for example, deploy staples from a staple cartridge into tissue captured by the end effector and / or advance a cutting blade of the I-beam element to cut the captured tissue. The I-beam element may be retracted by reversing the direction of the motor 602.

[0117] In certain examples, the surgical instrument or tool may include a closure motor 603. The closure motor 603 may be operatively coupled to a closure motor drive assembly 605, which may be configured to transmit the closure motion generated by the motor 603 to the end effector, specifically to displace a closure tube to close the anvil and compress tissue between the anvil and the staple cartridge. The closure motion may, for example, transition the end effector from an open configuration to an approximated configuration to capture tissue. The end effector may be transitioned to the open position by reversing the direction of the motor 603.

[0118] In certain examples, a surgical instrument or tool may include, for example, one or more articulation motors 606 a, 606 b. The motors 606 a, 606 b may be operatively coupled to corresponding articulation motor drive assemblies 608 a, 608 b, which may be configured to transfer articulation motion generated by the motors 606 a, 606 b to an end effector. In certain examples, the articulation motion may, for example, cause the end effector to articulate relative to the shaft.

[0119] As described above, a surgical instrument or tool may include multiple motors that can be configured to perform various independent functions. In certain examples, multiple motors of a surgical instrument or tool can be independently or separately activated to perform one or more functions while other motors remain stopped. For example, articulation motors 606 a, 606 b can be activated to articulate the end effector while firing motor 602 remains stopped. Alternatively, firing motor 602 can be activated to fire multiple staples and / or advance a cutting edge while articulation motor 606 is stopped. Additionally, closure motor 603 can be activated simultaneously with firing motor 602 to distally advance a closure tube and I-beam element, as described in more detail herein below.

[0120] In certain examples, a surgical instrument or tool may include a common control module 610 that can be used with multiple motors of the surgical instrument or tool. In certain examples, the common control module 610 can accommodate one of the multiple motors at a time. For example, the common control module 610 may be capable of individually coupling and decoupling multiple motors of a robotic surgical instrument. In certain examples, the multiple motors of a surgical instrument or tool may share one or more common control modules, such as the common control module 610. In certain examples, the multiple motors of a surgical instrument or tool can be independently and selectively engaged with the common control module 610. In certain examples, the common control module 610 can be selectively switched from coupling with one of the multiple motors of the surgical instrument or tool to coupling with another of the multiple motors of the surgical instrument or tool.

[0121] In at least one example, the common control module 610 can be selectively switched between operative engagement with the articulation motors 606 a, 606 b and operative engagement with either the firing motor 602 or the closure motor 603. In at least one embodiment, as shown in FIGURE 16 , the switch 614 can be moved or transitioned between multiple positions and / or states. For example, in a first position 616, the switch 614 can electrically couple the common control module 610 to the firing motor 602, in a second position 617, the switch 614 can electrically couple the common control module 610 to the closure motor 603, in a third position 618 a, the switch 614 can electrically couple the common control module 610 to the first articulation motor 606 a, and in a fourth position 618 b, the switch 614 can electrically couple the common control module 610 to the second articulation motor 606 b. In certain examples, a separate common control module 610 may be electrically coupled to the firing motor 602, the closing motor 603, and the articulation motors 606 a, 606 b at the same time. In certain examples, the switch 614 may be a mechanical switch, an electromechanical switch, a solid-state switch, or any suitable switching mechanism.

[0122] Each of the motors 602, 603, 606a, 606b may be equipped with a torque sensor to measure the output torque on the shaft of the motor. The force on the end effector may be sensed in any conventional manner, such as by a force sensor outside the jaws or by a torque sensor on the motor that actuates the jaws.

[0123] 16, common control module 610 may include a motor driver 626, which may include one or more H-bridge FETs. Motor driver 626 may modulate power transferred from a power supply 628 to a motor coupled to common control module 610, for example, based on input from a microcontroller 620 ("controller"). In certain examples, as described above, for example, microcontroller 620 may be used to determine the current drawn by a motor while the motor is coupled to common control module 610.

[0124] In particular examples, microcontroller 620 may include a microprocessor 622 ("processor") and one or more non-transitory computer-readable media or memory units 624 ("memory"). In particular examples, memory 624 may store various program instructions that, when executed, cause processor 622 to perform multiple functions and / or calculations described herein. In particular examples, one or more of memory units 624 may be coupled to processor 622, for example.

[0125] In certain examples, power supply 628 may be used to, for example, power microcontroller 620. In certain examples, power supply 628 may include a battery (or "battery pack" or "power pack"), such as, for example, an LI battery. In certain examples, the battery pack may be configured to releasably attach to the handle to power surgical instrument 600. Multiple battery cells connected in series may be used as power supply 628. In certain examples, power supply 628 may be, for example, replaceable and / or rechargeable.

[0126] In various examples, the processor 622 can control the motor drivers 626 to control the position, direction of rotation, and / or speed of the motors coupled to the common control module 610. In certain examples, the processor 622 can signal the motor drivers 626 to stop and / or disable the motors coupled to the common control module 610. The term "processor," as used herein, should be understood to include any suitable microprocessor, microcontroller, or other basic computing device that integrates the functionality of a computer's central processing unit (CPU) on one integrated circuit or up to a few integrated circuits. A processor is a general-purpose, programmable device that accepts digital data as input, processes that data according to instructions stored in memory, and provides the results as output. Because it has internal memory, it is an example of sequential digital logic. A processor operates on numbers and symbols represented in the binary system.

[0127] In one example, processor 622 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex manufactured by Texas Instruments. In a particular example, microcontroller 620 may be, for example, the LM 4F230H5QR available from Texas Instruments. In at least one embodiment, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core that includes, among other characteristics readily available in the product datasheet, 256 KB of on-chip memory of single-cycle flash memory or other non-volatile memory up to 40 MHz, a prefetch buffer to improve performance above 40 MHz, 32 KB of single-cycle SRAM, internal ROM loaded with StellarisWare® software, 2 KB of EEPROM, one or more PWM modules, one or more QEI analog, one or more 12-bit ADCs with 12 analog input channels. Other microcontrollers may be readily substituted for use with module 4410. Accordingly, the present disclosure should not be limited in this context.

[0128] In certain examples, memory 624 may include program instructions for controlling each of the motors of the surgical instrument 600 that are connectable to the common control module 610. For example, memory 624 may include program instructions for controlling the firing motor 602, the closing motor 603, and the articulation motors 606 a, 606 b. Such program instructions may cause processor 622 to control the firing, closing, and articulation functions according to inputs from algorithms or control programs of the surgical instruments or tools.

[0129] In certain examples, one or more mechanisms and / or sensors, such as, for example, sensor 630, can be used to alert processor 622 to program instructions to use in a particular setting. For example, sensor 630 can alert processor 622 to use program instructions associated with firing, closing, and articulating the end effector. In certain examples, sensor 630 can include, for example, a position sensor that can be used to sense the position of switch 614. Thus, for example, processor 622 can use program instructions associated with firing an I-beam of the end effector when it detects, for example, via sensor 630, that switch 614 is in first position 616; processor 622 can use program instructions associated with closing an anvil when it detects, for example, that switch 614 is in second position 617 via sensor 630; and processor 622 can use program instructions associated with articulating the end effector when it detects, for example, via sensor 630, that switch 614 is in third position 618a or fourth position 618b.

[0130] 17 is a schematic diagram of a robotic surgical instrument 700 configured to manipulate a surgical tool described herein, according to at least one embodiment of the present disclosure. The robotic surgical instrument 700 may be programmed or configured to control distal / proximal translation of a displacement member, distal / proximal displacement of an obturator tube, shaft rotation, and articulation using either single or multiple articulation drive couplings. In one embodiment, the surgical instrument 700 may be programmed or configured to individually control a firing member, a closure member, a shaft member, or one or more articulating members. The surgical instrument 700 includes a control circuit 710 configured to control a motor-driven firing member, a closure member, a shaft member, and / or one or more articulating members.

[0131] In one aspect, the robotic surgical instrument 700 includes a control circuit 710 configured to control the anvil 716 and I-beam 714 (including the sharp cutting blade) portions of the end effector 702, the removable staple cartridge 718, the shaft 740, and one or more articulating members 742a, 742b via multiple motors 704a-704e. A position sensor 734 may be configured to provide position feedback of the I-beam 714 to the control circuit 710. Other sensors 738 may be configured to provide feedback to the control circuit 710. A timer / counter 731 provides timing and counting information to the control circuit 710. An energy source 712 may be provided to operate the motors 704a-704e, and a current sensor 736 provides motor current feedback to the control circuit 710. The motors 704a-704e can be individually operated by the control circuit 710 in open-loop or closed-loop feedback control.

[0132] In one aspect, control circuitry 710 may comprise one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause a processor or processors to perform one or more tasks. In one aspect, timer / counter 731 provides an output signal, such as an elapsed time or digital count, to control circuitry 710 to correlate the position of I-beam 714 determined by position sensor 734 with the output of timer / counter 731 so that control circuitry 710 can determine the position of I-beam 714 at a particular time (t) relative to a starting position or time (t) when I-beam 714 is at a particular position relative to the starting position. Timer / counter 731 may be configured to measure elapsed time, count external events, or time an external event.

[0133] In one aspect, the control circuit 710 may be programmed to control the function of the end effector 702 based on one or more tissue conditions. The control circuit 710 may be programmed to sense tissue conditions, such as thickness, either directly or indirectly, as described herein. The control circuit 710 may be programmed to select a firing control program or a closure control program based on the tissue condition. The firing control program can describe the distal movement of the displacement member. Different firing control programs can be selected to better handle different tissue conditions. For example, when thicker tissue is present, the control circuit 710 may be programmed to translate the displacement member at a slower speed and / or with lower power. When thinner tissue is present, the control circuit 710 may be programmed to translate the displacement member at a higher speed and / or with higher power. The closure control program may control the closure force applied to the tissue by the anvil 716. Other control programs control the rotation of the shaft 740 and articulating members 742a, 742b.

[0134] In one aspect, the control circuit 710 can generate motor setpoint signals. The motor setpoint signals may be provided to various motor controllers 708a-708e. The motor controllers 708a-708e may include one or more circuits configured to provide motor drive signals to the motors 704a-704e to drive the motors 704a-704e, as described herein. In some embodiments, the motors 704a-704e may be brushed DC electric motors. For example, the speed of the motors 704a-704e may be proportional to the respective motor drive signals. In some embodiments, the motors 704a-704e may be brushless DC electric motors, and the respective motor drive signals may include PWM signals provided to one or more stator windings of the motors 704a-704e. Also, in some embodiments, the motor controllers 708a-708e may be omitted, and the control circuit 710 may directly generate the motor drive signals.

[0135] In one aspect, the control circuit 710 may initially operate each of the motors 704a-704e in an open-loop configuration for a first open-loop portion of the displacement member's stroke. Based on the response of the robotic surgical instrument 700 during the open-loop portion of the stroke, the control circuit 710 may select a firing control program for a closed-loop configuration. The instrument response may include the translation distance of the displacement member during the open-loop portion, the time elapsed during the open-loop portion, the energy provided to one of the motors 704a-704e during the open-loop portion, the total pulse width of the motor drive signal, etc. After the open-loop portion, the control circuit 710 may implement the selected firing control program for a second portion of the displacement member's stroke. For example, during the closed-loop portion of the stroke, the control circuit 710 may modulate one of the motors 704a-704e in a closed-loop manner based on translation data describing the position of the displacement member to translate the displacement member at a constant velocity.

[0136] In one aspect, the motors 704a-704e can receive power from an energy source 712. The energy source 712 can be a DC power supply driven by a mains AC power supply, a battery, a supercapacitor, or any other suitable energy source. The motors 704a-704e can be mechanically coupled to respective movable mechanical elements, such as the I-beam 714, the anvil 716, the shaft 740, the articulation 742a, and the articulation 742b, via respective transmissions 706a-706e. The transmissions 706a-706e can include one or more gears or other coupling components for coupling the motors 704a-704e to the movable mechanical elements. The position sensor 734 can sense the position of the I-beam 714. The position sensor 734 can be or include any type of sensor capable of generating position data indicative of the position of the I-beam 714. In some examples, the position sensor 734 may include an encoder configured to provide a series of pulses to the control circuitry 710 as the I-beam 714 translates distally and proximally. The control circuitry 710 may track the pulses to determine the position of the I-beam 714. Other suitable position sensors may be used, including, for example, a proximity sensor. Other types of position sensors may provide other signals indicative of the movement of the I-beam 714. Also, in some embodiments, the position sensor 734 may be omitted. If any of the motors 704a-704e are stepper motors, the control circuitry 710 may track the position of the I-beam 714 by summing the number and direction of steps the motor 704 is commanded to take. The position sensor 734 may be located within the end effector 702 or any other portion of the instrument. The output of each of the motors 704a-704e includes a torque sensor 744a-744e for sensing force and has an encoder for sensing rotation of the drive shaft.

[0137] In one aspect, the control circuit 710 is configured to drive a firing member, such as the I-beam 714 portion of the end effector 702. The control circuit 710 provides motor settings to a motor controller 708a, which provides a drive signal to the motor 704a. The output shaft of the motor 704a is coupled to a torque sensor 744a. The torque sensor 744a is coupled to a transmission 706a, which is coupled to the I-beam 714. The transmission 706a includes a moving mechanical element, such as a rotating element and a firing member, to control the movement of the I-beam 714 distally and proximally along the longitudinal axis of the end effector 702. In one aspect, the motor 704a may be coupled to a knife gear assembly including a knife gear reduction set including a first knife drive gear and a second knife drive gear. The torque sensor 744a provides a firing force feedback signal to the control circuit 710. The firing force signal represents the force required to fire or displace the I-beam 714. The position sensor 734 may be configured to provide a position of the I-beam 714 or the firing member along the firing stroke as a feedback signal to the control circuit 710. The end effector 702 may include an additional sensor 738 configured to provide a feedback signal to the control circuit 710. When ready for use, the control circuit 710 can provide a firing signal to the motor control 708a. In response to the firing signal, the motor 704a can drive the firing member distally along the longitudinal axis of the end effector 702 from a proximal start-of-stroke position to an end-of-stroke position distal to the start-of-stroke position. As the firing member translates distally, the I-beam 714, with a cutting element positioned at its distal end, advances distally to cut tissue located between the staple cartridge 718 and the anvil 716.

[0138] In one aspect, the control circuit 710 is configured to drive a closure member, such as the anvil 716 portion of the end effector 702. The control circuit 710 provides a motor set point to a motor controller 708b, which provides a drive signal to a motor 704b. The output shaft of the motor 704b is coupled to a torque sensor 744b. The torque sensor 744b is coupled to a transmission 706b, which is coupled to the anvil 716. The transmission 706b includes a movable mechanical element, such as a rotating element and a closure member, for controlling movement of the anvil 716 from open and closed positions. In one aspect, the motor 704b is coupled to a closure gear assembly including a closure reduction gear set supported in meshing engagement with a closure spur gear. The torque sensor 744b provides a closure force feedback signal to the control circuit 710. The closure force feedback signal is indicative of the closure force applied to the anvil 716. The position sensor 734 may be configured to provide the position of the closure member as a feedback signal to the control circuit 710. An additional sensor 738 in the end effector 702 can provide a closure force feedback signal to the control circuit 710. The pivotable anvil 716 is positioned opposite the staple cartridge 718. When ready for use, the control circuit 710 can provide a closure signal to the motor control 708b. In response to the closure signal, the motor 704b advances the closure member to grasp tissue between the clamp arm 716 and the staple cartridge 718.

[0139] In one aspect, the control circuit 710 is configured to rotate a shaft member, such as the shaft 740, to rotate the end effector 702. The control circuit 710 provides a motor setpoint to a motor controller 708c, which provides a drive signal to the motor 704c. The output shaft of the motor 704c is coupled to a torque sensor 744c. The torque sensor 744c is coupled to a transmission 706c, which is coupled to the shaft 740. The transmission 706c includes a movable mechanical element, such as a rotating element, to control the clockwise or counterclockwise rotation of the shaft 740 up to and beyond 360 degrees. In one aspect, the motor 704c is coupled to a rotational transmission assembly including a tubular gear segment formed on (or attached to) the proximal end of the proximal closure tube for operably engaging with a rotary gear assembly operably supported on the tool mounting plate. The torque sensor 744c provides a rotational force feedback signal to the control circuit 710. The rotational force feedback signal is indicative of the rotational force applied to the shaft 740. The position sensor 734 may be configured to provide the position of the closure member as a feedback signal to the control circuit 710. An additional sensor 738, such as a shaft encoder, may provide the rotational position of the shaft 740 to the control circuit 710.

[0140] In one aspect, the control circuit 710 is configured to articulate the end effector 702. The control circuit 710 provides a motor set point to a motor controller 708d, which provides a drive signal to the motor 704d. The output shaft of the motor 704d is coupled to a torque sensor 744d. The torque sensor 744d is coupled to a transmission 706d, which is coupled to the articulation member 742a. ​​The transmission 706d includes a movable mechanical element, such as an articulation element, for controlling ±65 degrees of articulation of the end effector 702. In one aspect, the motor 704d is coupled to an articulation nut, which is rotatably journaled on a proximal end portion of the distal spine portion and rotatably driven by an articulation gear assembly on the proximal end portion of the distal spine portion. The torque sensor 744d provides an articulation force feedback signal to the control circuit 710. The articulation force feedback signal is indicative of the articulation force applied to the end effector 702. A sensor 738 , such as an articulation encoder, may provide the articulation position of the end effector 702 to the control circuit 710 .

[0141] In another embodiment, the articulation function of the robotic surgical system 700 may include two articulation members, or linkages, 742a, 742b. These articulation members 742a, 742b are driven by separate disks on a robot interface (rack) driven by two motors 708d, 708e. When a separate firing motor 704a is provided, each of the articulation linkages 742a, 742b may be driven antagonistically relative to the other linkage to provide resistive holding motion and load to the head when the head is not moving, and to provide articulation motion when the head is articulating. The articulation members 742a, 742b are attached to the head at a fixed radius as the head rotates. Therefore, as the head rotates, the mechanical efficiency of the push-pull linkage changes. This change in mechanical efficiency may be more pronounced with other articulation linkage drive systems.

[0142] In one aspect, one or more of the motors 704a-704e may comprise a brushed DC motor with a gearbox and a mechanical linkage to the firing member, closure member, or articulation member. Another example includes electric motors 704a-704e that operate moving mechanical elements such as displacement members, articulation links, closure tubes, and shafts. External influences are the unmeasured and unpredictable effects of things like tissue, surroundings, and friction on a physical system. Such external influences are sometimes referred to as obstacles that act against one of the electric motors 704a-704e. External influences, such as obstacles, can cause the operation of a physical system to deviate from the desired operation of the physical system.

[0143] In one embodiment, the position sensor 734 may be implemented as an absolute positioning system. In one embodiment, the position sensor 734 may comprise a magnetic rotary absolute positioning system implemented as an AS5055EQFT single-chip magnetic rotary position sensor available from Austria Microsystems, AG. The position sensor 734 can interface with the control circuit 710 to provide the absolute positioning system. The position sensor may include multiple Hall effect elements positioned above a magnet and coupled to a CORDIC processor, also known as the digit-by-digit method and the Boulder algorithm, which implements simple and efficient algorithms for calculating hyperbolic and trigonometric functions, requiring only addition, subtraction, bit shifting, and table lookup operations.

[0144] In one aspect, the control circuit 710 may be in communication with one or more sensors 738. The sensors 738 may be positioned on the end effector 702 and adapted to operate with the robotic surgical instrument 700 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensors 738 may include magnetic sensors, magnetic field sensors, strain gauges, load cells, pressure sensors, force sensors, torque sensors, inductive sensors such as eddy current sensors, resistive sensors, capacitive sensors, optical sensors, and / or any other suitable sensors for measuring one or more parameters of the end effector 702. The sensors 738 may include one or more sensors. The sensors 738 may be positioned on the deck of the staple cartridge 718 to determine the position of the tissue using split electrodes. The torque sensors 744a-744e may be configured to sense forces, such as firing force, closure force, and / or articulation force, among others. Thus, the control circuit 710 can sense (1) the closure load experienced by the distal closure tube and its position, (2) the firing member in the rack and its position, (3) which portion of the staple cartridge 718 has tissue thereon, and (4) the load and position on both articulation rods.

[0145] In one aspect, the one or more sensors 738 may comprise a strain gauge, such as a micro-strain gauge, configured to measure the magnitude of strain in the anvil 716 during the clamping state. The strain gauge provides an electrical signal whose amplitude varies with the magnitude of strain. The sensor 738 may comprise a pressure sensor configured to detect pressure generated by the presence of compressed tissue between the anvil 716 and the staple cartridge 718. The sensor 738 may be configured to detect the impedance of the tissue portion located between the anvil 716 and the staple cartridge 718, which impedance is indicative of the thickness and / or fullness of the tissue located therebetween.

[0146] In one aspect, the sensor 738 may be implemented as one or more limit switches, electromechanical devices, solid-state switches, Hall effect devices, magnetoresistive (MR) devices, giant magnetoresistive (GMR) devices, and magnetometers, among others. In other implementations, the sensor 738 may be implemented as a solid-state switch that operates under the influence of light, such as a light sensor, an IR sensor, and an ultraviolet sensor, among others. Furthermore, the switch may be a solid-state device such as a transistor (e.g., FET, junction FET, MOSFET, bipolar, etc.). In other implementations, the sensor 738 may include a non-conductor-containing switch, an ultrasonic switch, an accelerometer, and an inertial sensor, among others.

[0147] In one aspect, the sensor 738 can be configured to measure the force exerted by the closure drive system on the anvil 716. For example, one or more sensors 738 can be located at an interaction point between a closure tube and the anvil 716 to detect the closure force applied to the anvil 716 by the closure tube. The force exerted against the anvil 716 can be representative of tissue compression experienced by tissue portions captured between the anvil 716 and the staple cartridge 718. One or more sensors 738 can be positioned at various interaction points along the closure drive system to detect the closure force applied to the anvil 716 by the closure drive system. The one or more sensors 738 can be sampled in real time during clamping by a processor in the control circuitry 710. The control circuitry 710 receives the real-time sampled measurements to provide and analyze time-based information to assess the closure force applied to the anvil 716 in real time.

[0148] In one aspect, a current sensor 736 can be used to measure the current drawn by each of the motors 704a-704e. The force required to advance any of the moving mechanical elements, such as the I-beam 714, corresponds to the current drawn by one of the motors 704a-704e. The force is converted to a digital signal and provided to the control circuit 710. The control circuit 710 can be configured to simulate the response of the actual system of the instrument in the controller software. The displacement member can be actuated to move the I-beam 714 in the end effector 702 at or near a target velocity. The robotic surgical instrument 700 can include a feedback controller, which can be any one of any feedback controllers, including, but not limited to, a PID, a state feedback, a linear quadratic (LQR), and / or an adaptive controller. The robotic surgical instrument 700 can include a power supply for converting a signal from the feedback controller into a physical input, such as, for example, a case voltage, a PWM voltage, a frequency modulated voltage, a current, a torque, and / or a force. Further details are disclosed in U.S. Patent Application No. 15 / 636,829, filed June 29, 2017, entitled "CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT," which is incorporated herein by reference in its entirety.

[0149] 18 shows a block diagram of a surgical instrument 750 programmed to control the distal translation of a displacement member, in accordance with at least one embodiment of the present disclosure. In one embodiment, the surgical instrument 750 is programmed to control the distal translation of a displacement member, such as an I-beam 764. The surgical instrument 750 includes an anvil 766, an I-beam 764 (including a sharp cutting blade), and an end effector 752 that may include a removable staple cartridge 768.

[0150] The position, movement, displacement, and / or translation of a linear displacement member, such as I-beam 764, can be measured by an absolute positioning system, a sensor mechanism, and a position sensor 784. Because I-beam 764 is coupled to a longitudinally movable drive member, the position of I-beam 764 can be determined by measuring the position of the longitudinally movable drive member using position sensor 784. Accordingly, in the following description, the position, displacement, and / or translation of I-beam 764 may be achieved by position sensor 784 as described herein. Control circuitry 760 may be programmed to control the translation of a displacement member, such as I-beam 764. In some embodiments, control circuitry 760 may comprise one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause a processor or processors to control a displacement member, e.g., I-beam 764, in the manner described. In one aspect, timer / counter 781 provides an output signal, such as elapsed time or a digital count, to control circuitry 760 to correlate the position of I-beam 764 determined by position sensor 784 with the output of timer / counter 781 so that control circuitry 760 can determine the position of I-beam 764 at a particular time (t) relative to a starting position. Timer / counter 781 may be configured to measure elapsed time, count external events, or measure the time of external events.

[0151] Control circuit 760 may generate a motor setpoint signal 772. Motor setpoint signal 772 may be provided to motor controller 758. Motor controller 758 may include one or more circuits configured to provide a motor drive signal 774 to motor 754 to drive motor 754, as described herein. In some embodiments, motor 754 may be a brushed DC electric motor. For example, the speed of motor 754 may be proportional to motor drive signal 774. In some examples, motor 754 may be a brushless DC electric motor, and motor drive signal 774 may include a PWM signal provided to one or more stator windings of motor 754. Also, in some embodiments, motor controller 758 may be omitted, and control circuit 760 may directly generate motor drive signal 774.

[0152] The motor 754 can receive power from an energy source 762. The energy source 762 can be or can include a battery, a supercapacitor, or any other suitable energy source. The motor 754 can be mechanically coupled to the I-beam 764 via a transmission 756. The transmission 756 can include one or more gears or other coupling components to couple the motor 754 to the I-beam 764. The position sensor 784 can sense the position of the I-beam 764. The position sensor 784 can be or can include any type of sensor capable of generating position data indicative of the position of the I-beam 764. In some examples, the position sensor 784 can include an encoder configured to provide a series of pulses to the control circuitry 760 as the I-beam 764 translates distally and proximally. The control circuitry 760 can track the pulses to determine the position of the I-beam 764. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals indicative of the movement of the I-beam 764. Also, in some embodiments, position sensor 784 may be omitted. If motor 754 is a stepper motor, control circuit 760 can track the position of I-beam 764 by summing the number and direction of steps motor 754 is commanded to take. Position sensor 784 can be located in end effector 752 or in any other part of the instrument.

[0153] The control circuitry 760 may be in communication with one or more sensors 788. The sensors 788 may be positioned on the end effector 752 and adapted to operate with the surgical instrument 750 to measure various derived parameters such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensors 788 may include magnetic sensors, magnetic field sensors, strain gauges, pressure sensors, force sensors, inductive sensors such as eddy current sensors, resistive sensors, capacitive sensors, optical sensors, and / or any other suitable sensors for measuring one or more parameters of the end effector 752. The sensors 788 may include one or more sensors.

[0154] The one or more sensors 788 may comprise a strain gauge, such as a micro-strain gauge, configured to measure the magnitude of strain in the anvil 766 during clamping. The strain gauge provides an electrical signal whose amplitude varies with the magnitude of strain. The sensor 788 may comprise a pressure sensor configured to detect pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The sensor 788 may be configured to detect the impedance of the tissue portion located between the anvil 766 and the staple cartridge 768, which impedance is indicative of the thickness and / or fullness of the tissue located therebetween.

[0155] The sensor 788 may be configured to measure the force exerted on the anvil 766 by the closure drive system. For example, one or more sensors 788 may be located at an interaction point between a closure tube and the anvil 766 to detect the closure force applied to the anvil 766 by the closure tube. The force exerted against the anvil 766 may be representative of tissue compression experienced by tissue portions captured between the anvil 766 and the staple cartridge 768. One or more sensors 788 may be positioned at various interaction points along the closure drive system to detect the closure force applied to the anvil 766 by the closure drive system. The one or more sensors 788 may be sampled in real time during clamping by a processor in the control circuitry 760. The control circuitry 760 receives the real-time sampled measurements to provide and analyze time-based information to assess the closure force applied to the anvil 766 in real time.

[0156] A current sensor 786 can be used to measure the current drawn by motor 754. The force required to advance I-beam 764 corresponds to the current drawn by motor 754. The force is converted to a digital signal and provided to control circuit 760.

[0157] The control circuitry 760 can be configured to simulate the response of the actual system of the instrument in the controller software. The displacement member can be actuated to move the I-beam 764 in the end effector 752 at or near a target velocity. The surgical instrument 750 can include a feedback controller, which can be any one of any feedback controller, including, but not limited to, a PID, a state feedback, an LQR, and / or an adaptive controller. The surgical instrument 750 can include a power supply for converting a signal from the feedback controller into a physical input, such as, for example, a case voltage, a PWM voltage, a frequency modulated voltage, a current, a torque, and / or a force.

[0158] The actual drive system of the surgical instrument 750 is configured to drive the displacement member, cutting member, or I-beam 764 via a brushed DC motor with a gearbox and mechanical linkage to the articulation and / or knife system. Another example is an electric motor 754 operating, for example, a displacement member and articulation driver of an interchangeable shaft assembly. External influences are the unmeasured and unpredictable effects of things like tissue, surroundings, and friction on a physical system. These external influences are sometimes referred to as obstacles that act against the electric motor 754. External influences, such as obstacles, can cause the operation of a physical system to deviate from the desired operation of the physical system.

[0159] Various exemplary embodiments are directed to a surgical instrument 750 including an end effector 752 having a motor-driven surgical stapling and cutting means. For example, a motor 754 may drive a displacement member distally and proximally along a longitudinal axis of the end effector 752. The end effector 752 may include a pivotable anvil 766 and, when configured for use, a staple cartridge 768 disposed opposite the anvil 766. A clinician may grasp tissue between the anvil 766 and the staple cartridge 768 as described herein. When the instrument 750 is ready to be used, the clinician may provide a firing signal, for example, by depressing a trigger of the instrument 750. In response to the firing signal, the motor 754 can drive the displacement member distally along the longitudinal axis of the end effector 752 from a proximal start-of-stroke position to an end-of-stroke position distal to the start-of-stroke position. As the displacement member translates distally, an I-beam 764 having a cutting element disposed at its distal end can cut tissue between the staple cartridge 768 and the anvil 766 .

[0160] In various embodiments, the surgical instrument 750 may include a control circuit 760 programmed to control the distal translation of a displacement member, such as an I-beam 764, based on one or more tissue conditions. The control circuit 760 may be programmed to sense tissue conditions, such as thickness, either directly or indirectly, as described herein. The control circuit 760 may be programmed to select a firing control program based on the tissue condition. The firing control program may describe the distal movement of the displacement member. Different firing control programs may be selected to better handle different tissue conditions. For example, when thicker tissue is present, the control circuit 760 may be programmed to translate the displacement member at a slower speed and / or with lower power. When thinner tissue is present, the control circuit 760 may be programmed to translate the displacement member at a higher speed and / or with higher power.

[0161] In some embodiments, the control circuit 760 may initially operate the motor 754 in an open-loop configuration for a first open-loop portion of the displacement member stroke. Based on the response of the surgical instrument 750 during the open-loop portion of the stroke, the control circuit 760 may select a firing control program. The instrument response may include the translation distance of the displacement member during the open-loop portion, the time elapsed during the open-loop portion, the energy provided to the motor 754 during the open-loop portion, the total pulse width of the motor drive signal, etc. After the open-loop portion, the control circuit 760 may implement the selected firing control program for a second portion of the displacement member stroke. For example, during the closed-loop portion of the stroke, the control circuit 760 may modulate the motor 754 in a closed-loop manner based on translation data describing the position of the displacement member to translate the displacement member at a constant velocity. Further details are disclosed in U.S. Patent Application No. 15 / 720,852, filed September 29, 2017, entitled "SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT," which is incorporated herein by reference in its entirety.

[0162] 19 is a schematic illustration of a surgical instrument 790 configured to control various functions, in accordance with at least one embodiment of the present disclosure. In one embodiment, the surgical instrument 790 is programmed to control the distal translation of a displacement member, such as an I-beam 764. The surgical instrument 790 includes an end effector 792 that may include an anvil 766, an I-beam 764, and a removable staple cartridge 768 that may be replaced with an RF cartridge 796 (shown in dashed lines).

[0163] In one aspect, the sensor 788 may be implemented as a limit switch, an electromechanical device, a solid-state switch, a Hall effect device, an MR device, a GMR device, and a magnetometer, among others. In other implementations, the sensor 788 may be a solid-state switch that operates under the influence of light, such as a light sensor, an IR sensor, an ultraviolet sensor, among others. Additionally, the switch may be a solid-state device such as a transistor (e.g., FET, junction FET, MOSFET, bipolar, etc.). In other implementations, the sensor 788 may include a non-conductor-containing switch, an ultrasonic switch, an accelerometer, and an inertial sensor, among others.

[0164] In one aspect, position sensor 784 may be implemented as an absolute positioning system comprising a magnetic rotary absolute positioning system implemented as an AS5055EQFT single-chip magnetic rotary position sensor available from Austria Microsystems, AG. Position sensor 784 can provide an absolute positioning system in conjunction with control circuit 760. The position sensor may include multiple Hall effect elements positioned above a magnet and coupled to a CORDIC processor, also known as the digit-by-digit method and Boulder algorithm, which implements simple and efficient algorithms for calculating hyperbolic and trigonometric functions, requiring only addition, subtraction, bit shifting, and table lookup operations.

[0165] In one aspect, I-beam 764 may be implemented as a knife member comprising a knife body operably supporting a tissue-cutting blade thereon and may further include anvil engagement tabs or features and track engagement features or feet. In one aspect, staple cartridge 768 may be implemented as a standard (mechanical) surgical fastener cartridge. In one aspect, RF cartridge 796 may be implemented as an RF cartridge. These and other sensor configurations are described in commonly owned U.S. Patent Application No. 15 / 628,175, filed June 20, 2017, entitled "TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT," which is incorporated by reference herein in its entirety.

[0166] The position, movement, displacement, and / or translation of a linear displacement member, such as I-beam 764, can be measured by an absolute positioning system, sensor arrangement, and position sensor, represented as position sensor 784. Because I-beam 764 is coupled to a longitudinally movable drive member, the position of I-beam 764 can be determined by measuring the position of the longitudinally movable drive member using position sensor 784. Accordingly, in the following description, the position, displacement, and / or translation of I-beam 764 may be achieved by position sensor 784 as described herein. Control circuitry 760 may be programmed to control the translation of a displacement member, such as I-beam 764, as described herein. In some embodiments, control circuitry 760 may comprise one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause a processor or processors to control a displacement member, e.g., I-beam 764, in the manner described. In one aspect, timer / counter 781 provides an output signal, such as elapsed time or a digital count, to control circuitry 760 to correlate the position of I-beam 764 determined by position sensor 784 with the output of timer / counter 781 so that control circuitry 760 can determine the position of I-beam 764 at a particular time (t) relative to a starting position. Timer / counter 781 may be configured to measure elapsed time, count external events, or measure the time of external events.

[0167] Control circuit 760 may generate a motor setpoint signal 772. Motor setpoint signal 772 may be provided to motor controller 758. Motor controller 758 may include one or more circuits configured to provide a motor drive signal 774 to motor 754 to drive motor 754, as described herein. In some embodiments, motor 754 may be a brushed DC electric motor. For example, the speed of motor 754 may be proportional to motor drive signal 774. In some examples, motor 754 may be a brushless DC electric motor, and motor drive signal 774 may include a PWM signal provided to one or more stator windings of motor 754. Also, in some embodiments, motor controller 758 may be omitted, and control circuit 760 may directly generate motor drive signal 774.

[0168] The motor 754 can receive power from an energy source 762. The energy source 762 can be or can include a battery, a supercapacitor, or any other suitable energy source. The motor 754 can be mechanically coupled to the I-beam 764 via a transmission 756. The transmission 756 can include one or more gears or other coupling components to couple the motor 754 to the I-beam 764. The position sensor 784 can sense the position of the I-beam 764. The position sensor 784 can be or can include any type of sensor capable of generating position data indicative of the position of the I-beam 764. In some examples, the position sensor 784 can include an encoder configured to provide a series of pulses to the control circuitry 760 as the I-beam 764 translates distally and proximally. The control circuitry 760 can track the pulses to determine the position of the I-beam 764. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals indicative of the movement of the I-beam 764. Also, in some embodiments, position sensor 784 may be omitted. If motor 754 is a stepper motor, control circuit 760 can track the position of I-beam 764 by summing the number and direction of steps the motor is commanded to take. Position sensor 784 can be located in end effector 792 or any other part of the instrument.

[0169] The control circuitry 760 may be in communication with one or more sensors 788. The sensors 788 may be positioned on the end effector 792 and adapted to operate with the surgical instrument 790 to measure various derived parameters such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensors 788 may include magnetic sensors, magnetic field sensors, strain gauges, pressure sensors, force sensors, inductive sensors such as eddy current sensors, resistive sensors, capacitive sensors, optical sensors, and / or any other suitable sensors for measuring one or more parameters of the end effector 792. The sensors 788 may include one or more sensors.

[0170] The one or more sensors 788 may comprise a strain gauge, such as a micro-strain gauge, configured to measure the magnitude of strain in the anvil 766 during clamping. The strain gauge provides an electrical signal whose amplitude varies with the magnitude of strain. The sensor 788 may comprise a pressure sensor configured to detect pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The sensor 788 may be configured to detect the impedance of the tissue portion located between the anvil 766 and the staple cartridge 768, which impedance is indicative of the thickness and / or fullness of the tissue located therebetween.

[0171] The sensor 788 may be configured to measure the force exerted on the anvil 766 by the closure drive system. For example, one or more sensors 788 may be located at an interaction point between a closure tube and the anvil 766 to detect the closure force applied to the anvil 766 by the closure tube. The force exerted against the anvil 766 may be representative of tissue compression experienced by tissue portions captured between the anvil 766 and the staple cartridge 768. One or more sensors 788 may be positioned at various interaction points along the closure drive system to detect the closure force applied to the anvil 766 by the closure drive system. The one or more sensors 788 may be sampled in real time during clamping by a processor portion of the control circuitry 760. The control circuitry 760 receives the real-time sampled measurements to provide and analyze time-based information to assess the closure force applied to the anvil 766 in real time.

[0172] A current sensor 786 can be used to measure the current drawn by motor 754. The force required to advance I-beam 764 corresponds to the current drawn by motor 754. The force is converted to a digital signal and provided to control circuit 760.

[0173] An RF energy source 794 is coupled to the end effector 792 and is applied to the RF cartridge 796 when the RF cartridge 796 is loaded into the end effector 792 in place of the staple cartridge 768. The control circuitry 760 controls the delivery of RF energy to the RF cartridge 796.

[0174] Further details are disclosed in U.S. Patent Application No. 15 / 636,096, filed June 28, 2017, entitled "SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME," which is incorporated herein by reference in its entirety.

[0175] 20 is a schematic diagram of a surgical instrument 791 that is similar in many respects to surgical instrument 790. Surgical instrument 791 includes an end effector 769 that includes a first jaw 765 and a second jaw 767. End effector 769 is configured to transition from an open configuration to a closed configuration. First jaw 765 and second jaw 767 are close together in the closed configuration. In one aspect, tissue grasped by end effector 769 in the closed configuration is treated with ultrasonic energy generated by energy source 795. In another aspect, tissue grasped by end effector 769 in the closed configuration is treated with RF energy generated by energy source 795 or a separate RF energy source.

[0176] In one aspect, a closure tube 773 (shown in dashed lines) can transition the end effector 769 into the closed configuration. A motor 754 can be mechanically coupled to the closure tube 773 via a transmission 756 to transmit the closing motion to the end effector 769. Alternatively, the closure tube 773 can be manually moved to transition the end effector 769 between the open and closed configurations. In one aspect, an I-beam 771 (shown in dashed lines), which is similar to the I-beam 764, can transition the end effector 769 into the closed configuration. A motor 754 can be mechanically coupled to the I-beam 771 via a transmission 756 to transmit the closing motion to the end effector 769. Alternatively, the I-beam 771 can be manually moved to transition the end effector 769 between the open and closed configurations. A position sensor 784 can sense the position of the I-beam 771 and / or the closure tube 773.

[0177] 21-24 illustrate a motorized surgical instrument 150010 for cutting and fastening, which may or may not be reusable. In the illustrated embodiment, the surgical instrument 150010 includes a housing 150012 with a handle assembly 150014 configured to be grasped, manipulated, and actuated by a clinician. The housing 150012 is configured to be operably attached to an interchangeable shaft assembly 150200, to which an end effector 150300 configured to perform one or more surgical tasks or procedures is operably coupled. In accordance with the present disclosure, various forms of interchangeable shaft assemblies may be effectively used in connection with robotically controlled surgical systems. Accordingly, the term "housing" can encompass a housing or similar portion of a robotic system that houses or operably supports at least one drive system configured to generate and apply at least one control motion that can be utilized to actuate the interchangeable shaft assembly. The term "frame" may also refer to a portion of a handheld surgical instrument. The term "frame" may also refer to a portion of a robotically controlled surgical instrument and / or a portion of a robotic system that may be used to operatively control a surgical instrument. The interchangeable shaft assembly may be used with various robotic systems, instruments, components, and methods disclosed in U.S. Patent No. 9,072,535, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS," which is incorporated herein by reference in its entirety.

[0178] 21 is a perspective view of a surgical instrument 150010 having an operably coupled interchangeable shaft assembly 150200 in accordance with at least one embodiment of the present disclosure. The housing 150012 includes an end effector 150300 having a surgical cutting and fastening device configured therein to operably support a surgical staple cartridge 150304. The housing 150012 can be configured for use in connection with an interchangeable shaft assembly, which includes end effectors adapted to support various sizes and types of staple cartridges and has various shaft lengths, sizes, and types. The housing 150012 can be used with various interchangeable shaft assemblies, which include assemblies configured to apply other forms of motion and energy, such as RF energy, ultrasonic energy, and / or motion, to end effector configurations adapted for use in connection with various surgical applications and procedures. The end effector, shaft assembly, handle, surgical instrument, and / or surgical instrument system may utilize any suitable fasteners to fasten tissue. For example, a fastener cartridge having a plurality of fasteners removably stored therein may be removably inserted into and / or attached to the end effector of the shaft assembly.

[0179] The handle assembly 150014 may include a pair of interconnectable handle housing segments 150016, 150018, which may be interconnected by screws, snap mechanisms, adhesives, etc. The handle housing segments 150016, 150018 cooperate to form a pistol grip portion 150019 that may be grasped and manipulated by a clinician. The handle assembly 150014 operably supports a plurality of drive systems, the drive systems configured to generate and apply controlled motions to corresponding portions of interchangeable shaft assemblies operably attached to the handle assembly. A display may be provided below the cover 150045.

[0180] FIG. 22 is an exploded view of a portion of the surgical instrument 150010 of FIG. 21 , in accordance with at least one embodiment of the present disclosure. The handle assembly 150014 may include a frame 150020 that operably supports multiple drive systems. The frame 150020 may operably support a “first,” or closure drive system 150030, which may apply closing and opening motions to the interchangeable shaft assembly 150200. The closure drive system 150030 may include an actuator, such as a closure trigger 150032, pivotally supported by the frame 150020. The closure trigger 150032 is pivotally coupled to the handle assembly 150014 by a pivot pin 150033, allowing the closure trigger 150032 to be operated by a clinician. When a clinician grasps the pistol grip portion 150019 of the handle assembly 150014, the closure trigger 150032 can pivot from a starting or "unactuated" position to an "actuated" position, more specifically to a fully compressed or fully actuated position.

[0181] The handle assembly 150014 and frame 150020 may operably support a firing drive system 150080 configured to apply a firing motion to a corresponding portion of an interchangeable shaft assembly attached thereto. The firing drive system 150080 may employ an electric motor 150082 mounted in the pistol grip portion 150019 of the handle assembly 150014. The electric motor 150082 may be a brushed DC motor having a maximum rotational speed of, for example, approximately 25,000 RPM. In other configurations, the motor may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The electric motor 150082 may be powered by a power source 150090, which may include a removable power pack 150092. The removable power pack 150092 may include a proximal housing portion 150094 configured to attach to a distal housing portion 150096. The proximal housing portion 150094 and the distal housing portion 150096 are configured to operably support a plurality of batteries 150098 therein. Each of the batteries 150098 may include, for example, an LI or other suitable battery. The distal housing portion 150096 is configured to be removably and operably attached to a control circuit board 150100, which is operably coupled to the electric motor 150082. Several batteries 150098 connected in series can power the surgical instrument 150010. The power source 150090 may be replaceable and / or rechargeable. A display 150043, located below a cover 150045, is electrically coupled to the control circuit board 150100. The cover 150045 may be removed to expose the display 150043.

[0182] The electric motor 150082 may include a rotatable shaft (not shown) that operably interfaces with a gear reducer assembly 150084 that is mounted in meshing engagement with a set or rack of drive teeth 150122 on the longitudinally movable drive member 150120. The longitudinally movable drive member 150120 has a rack of drive teeth 150122 formed thereon for meshing engagement with a corresponding drive gear 150086 of the gear reducer assembly 150084.

[0183] In use, the voltage polarity provided by the power source 150090 causes the electric motor 150082 to operate in a clockwise direction, while the voltage polarity applied to the electric motor by the battery can be reversed to cause the electric motor 150082 to operate in a counterclockwise direction. When the electric motor 150082 is rotated in one direction, the longitudinally movable drive member 150120 is driven axially in a distal direction "DD." When the electric motor 150082 is driven in the opposite rotational direction, the longitudinally movable drive member 150120 is driven axially in a proximal direction "PD." The handle assembly 150014 can include a switch that can be configured to reverse the polarity applied to the electric motor 150082 by the power source 150090. The handle assembly 150014 can include a sensor configured to detect the position of the longitudinally movable drive member 150120 and / or the direction in which the longitudinally movable drive member 150120 is being moved.

[0184] Actuation of the electric motor 150082 may be controlled by a firing trigger 150130 that is pivotally supported on the handle assembly 150014. The firing trigger 150130 may pivot between an inactivated position and an activated position.

[0185] 21 , the interchangeable shaft assembly 150200 includes an end effector 150300 having an elongated channel 150302 configured to operably support a surgical staple cartridge 150304 therein. The end effector 150300 may include an anvil 150306 pivotally supported relative to the elongated channel 150302. The interchangeable shaft assembly 150200 may include an articulation joint 150270. The configuration and operation of the end effector 150300 and the articulation joint 150270 are described in U.S. Patent Application Publication No. 2014 / 0263541, entitled "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK," which is incorporated herein by reference in its entirety. The interchangeable shaft assembly 150200 may include a proximal housing or nozzle 150201 comprised of nozzle portions 150202, 150203. The interchangeable shaft assembly 150200 may include a closure tube 150260 extending along the shaft axis SA, which may be utilized to close and / or open the anvil 150306 of the end effector 150300.

[0186] 21 , in response to actuation of the closure trigger 150032, for example, the anvil 150306 is closed by translating the closure tube 150260 in a distal direction (direction "DD") in the manner described in the above-referenced U.S. Patent Application Publication No. 2014 / 0263541. The anvil 150306 is opened by translating the closure tube 150260 in a proximal direction. In the anvil open position, the closure tube 150260 is moved to its proximal position.

[0187] 23 is another exploded view of a portion of the interchangeable shaft assembly 150200 in accordance with at least one embodiment of the present disclosure. The interchangeable shaft assembly 150200 may include a firing member 150220 supported for axial movement within the spine 150210. The firing member 150220 includes an intermediate firing shaft 150222 configured to attach to a distal cutting portion or knife bar 150280. The firing member 150220 may also be referred to as a "second shaft" or "second shaft assembly." The intermediate firing shaft 150222 may include a longitudinal slot 150223 at its distal end configured to receive a tab 150284 on the proximal end 150282 of the knife bar 150280. The longitudinal slot 150223 and the proximal end 150282 may be configured to allow relative movement therebetween and may include a slip joint 150286. The slip joint 150286 can allow the intermediate firing shaft 150222 of the firing member 150220 to articulate the end effector 150300 about the articulation joint 150270 without moving, or at least substantially moving, the knife bar 150280. Once the end effector 150300 is properly oriented, the intermediate firing shaft 150222 can be advanced distally until the proximal sidewall of the longitudinal slot 150223 contacts the tab 150284, advancing the knife bar 150280 and firing a staple cartridge located within the channel 150302. The spine 150210 has an elongated opening or window 150213 therein to facilitate assembly and insertion of the intermediate firing shaft 150222 into the spine 150210. Once the intermediate firing shaft 150222 is inserted, the top frame segment 150215 may be engaged with the shaft frame 150212 to enclose the intermediate firing shaft 150222 and the knife bar 150280. Operation of the firing member 150220 can be found in U.S. Patent Application Publication No. 2014 / 0263541. The spine 150210 can be configured to slidably support the firing member 150220 and a closure tube 150260 that extends around the spine 150210.The spine 150210 may slidably support an articulation driver 150230 .

[0188] The interchangeable shaft assembly 150200 may include a clutch assembly 150400 configured to selectively and removably couple the articulation driver 150230 to the firing member 150220. The clutch assembly 150400 includes a locking collar or locking sleeve 150402 positioned about the firing member 150220 that may be rotated between an engaged position, in which the locking sleeve 150402 couples the articulation driver 150230 to the firing member 150220, and a disengaged position, in which the articulation driver 150230 is not operably coupled to the firing member 150220. When the locking sleeve 150402 is in its engaged position, distal movement of the firing member 150220 may move the articulation driver 150230 distally, and correspondingly, proximal movement of the firing member 150220 may move the articulation driver 150230 proximally. When the locking sleeve 150402 is in its disengaged position, movement of the firing member 150220 is not transmitted to the articulation driver 150230, such that the firing member 150220 can be moved independently of the articulation driver 150230. The nozzle 150201 can be used to operatively engage and disengage the articulation drive system and the firing drive system in various ways as described in U.S. Patent Application Publication No. 2014 / 0263541.

[0189] The interchangeable shaft assembly 150200 can include a slip ring assembly 150600, which can be configured, for example, to transfer power and / or communicate signals to and / or from the end effector 150300. The slip ring assembly 150600 can include a proximal connector flange 150604 and a distal connector flange 150601 disposed within slots defined in the nozzle portions 150202, 150203. The proximal connector flange 150604 can include a first surface, and the distal connector flange 150601 can include a second surface disposed adjacent to and movable relative to the first surface. The distal connector flange 150601 can rotate relative to the proximal connector flange 150604 about the shaft axis SA-SA (FIG. 21). The proximal connector flange 150604 can include a plurality of concentric, or at least substantially concentric, conductors 150602 defined in a first surface thereof. The connector 150607 can be mounted proximally to the distal connector flange 150601 and can have a plurality of contacts, each contact corresponding to and in electrical contact with one of the conductors 150602. Such a configuration allows the proximal connector flange 150604 and the distal connector flange 150601 to rotate relative to each other while maintaining electrical contact therebetween. The proximal connector flange 150604 can include an electrical connector 150606 that can, for example, place the conductors 150602 in signal communication with a shaft circuit board. In at least one instance, a wire harness including multiple conductors can extend between the electrical connector 150606 and the shaft circuit board. The electrical connector 150606 can extend proximally through a connector opening defined in the chassis mounting flange. U.S. Patent Application Publication No. 2014 / 0263551, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM," is incorporated herein by reference in its entirety.U.S. Patent Application Publication No. 2014 / 0263552, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM," is incorporated herein by reference in its entirety. Further details regarding the slip ring assembly 150600 can be found in U.S. Patent Application Publication No. 2014 / 0263541.

[0190] The interchangeable shaft assembly 150200 may include a proximal portion fixably attached to the handle assembly 150014 and a distal portion rotatable about a longitudinal axis. The rotatable distal shaft portion may be rotated relative to the proximal portion about the slip ring assembly 150600. The distal connector flange 150601 of the slip ring assembly 150600 may be positioned within the rotatable distal shaft portion.

[0191] 24 is an exploded view of one embodiment of the end effector 150300 of the surgical instrument 150010 of FIG. 21 , in accordance with at least one embodiment of the present disclosure. The end effector 150300 may include an anvil 150306 and a surgical staple cartridge 150304. The anvil 150306 may be coupled to an elongated channel 150302. An aperture 150199 can be defined within the elongated channel 150302 to receive a pin 150152 extending from the anvil 150306, allowing the anvil 150306 to pivot from an open position to a closed position relative to the elongated channel 150302 and the surgical staple cartridge 150304. A firing bar 150172 is configured to translate longitudinally into the end effector 150300. The firing bar 150172 may be constructed from one solid piece or may include a laminate material, including a stack of steel plates. The firing bar 150172 includes an I-beam 150178 and a cutting edge 150182 at its distal end. The distally protruding end of the firing bar 150172 may be attached to the I-beam 150178 to help space the anvil 150306 from the surgical staple cartridge 150304 disposed within the elongated channel 150302 when the anvil 150306 is in the closed position. The I-beam 150178 may include a sharp cutting edge 150182 for severing tissue as the I-beam 150178 is advanced distally by the firing bar 150172. In operation, the I-beam 150178 may fire the surgical staple cartridge 150304. The surgical staple cartridge 150304 can include a shaped cartridge body 150194 that holds a plurality of staples 150191 mounted on staple drivers 150192 within corresponding upwardly opening staple cavities 150195. The wedge-shaped sled 150190 is driven distally by the I-beam 150178 and slides on a cartridge tray 150196 of the surgical staple cartridge 150304.While the cutting edge 150182 of the I-beam 150178 cuts the clamped tissue, the wedge-shaped sled 150190 cams the staple driver 150192 upward, expelling and deforming the staples 150191 into contact with the anvil 150306.

[0192] The I-beam 150178 can include an upper pin 150180 that engages the anvil 150306 during firing. The I-beam 150178 can include a center pin 150184 and a bottom foot 150186 to engage the cartridge body 150194, the cartridge tray 150196, and a portion of the elongated channel 150302. When the surgical staple cartridge 150304 is positioned within the elongated channel 150302, the slot 150193 defined in the cartridge body 150194 can align with the longitudinal slot 150197 defined in the cartridge tray 150196 and the slot 150189 defined in the elongated channel 150302. In use, the I-beam 150178 can slide through the aligned longitudinal slots 150193, 150197, and 150189, and as shown in FIG. 24, the bottom foot 150186 of the I-beam 150178 can engage with a groove running along the bottom surface of the elongated channel 150302 along the length of the slot 150189, the central pin 150184 can engage with the top surface of the cartridge tray 150196 along the length of the longitudinal slot 150197, and the upper pin 150180 can engage with the anvil 150306. The I-beam 150178 can space or limit the relative movement between the anvil 150306 and the surgical staple cartridge 150304 as the firing bar 150172 advances distally to fire staples from the surgical staple cartridge 150304 and / or cut tissue captured between the anvil 150306 and the surgical staple cartridge 150304. The firing bar 150172 and I-beam 150178 can be retracted proximally, which allows the anvil 150306 to open and release the two stapled and cut tissue portions.

[0193] 25A and 25B are block diagrams of a control circuit 150700 of the surgical instrument 150010 of FIG. 21 , spanning two views, in accordance with at least one embodiment of the present disclosure. Referring primarily to FIGS. 25A and 25B , the handle assembly 150702 can include a motor 150714, which can be controlled by a motor driver 150715 and used by the firing system of the surgical instrument 150010. In various forms, the motor 150714 can be a brushed DC drive motor having a maximum rotational speed of approximately 25,000 RPM. In other configurations, the motor 150714 can include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor driver 150715 can include, for example, an H-bridge driver including a FET 150719. The motor 150714 may be powered by a power supply assembly 150706 releasably attached to the handle assembly 150200 to provide control power to the surgical instrument 150010. The power supply assembly 150706 may include a battery, which may include multiple battery cells connected in series, that may be used as a power source to power the surgical instrument 150010. Under certain circumstances, the battery cells of the power supply assembly 150706 may be replaceable and / or rechargeable. In at least one example, the battery cells may be LI batteries that may be separately connectable to the power supply assembly 150706.

[0194] The shaft assembly 150704 may include a shaft assembly controller 150722 that is capable of communicating with the safety controller and power management controller 150716 via the interface while the shaft assembly 150704 and power supply assembly 150706 are coupled to the handle assembly 150702. For example, the interface may include a first interface portion 150725 that may include one or more electrical connectors for mating engagement with corresponding shaft assembly electrical connectors, and a second interface portion 150727 that may include one or more electrical connectors for mating engagement with corresponding power supply assembly electrical connectors, to enable electrical communication between the shaft assembly controller 150722 and the power management controller 150716 while the shaft assembly 150704 and power supply assembly 150706 are coupled to the handle assembly 150702. One or more communication signals may be transmitted via the interface to transmit one or more power requirements of the attached and replaceable shaft assembly 150704 to the power management controller 150716. In response, the power management controller may modulate the power output of the batteries of the power supply assembly 150706, as described in further detail below, according to the power requirements of the attached shaft assembly 150704. The connector may include a switch that may be activated following mechanical interlocking engagement of the handle assembly 150702 with the shaft assembly 150704 and / or the power supply assembly 150706 to enable electrical communication between the shaft assembly controller 150722 and the power management controller 150716.

[0195] The interface may facilitate transmission of one or more such communication signals between the power management controller 150716 and the shaft assembly controller 150722, for example, by routing the communication signals through a main controller 150717 housed in the handle assembly 150702. Under other circumstances, the interface may facilitate direct line communication between the power management controller 150716 and the shaft assembly controller 150722 via the handle assembly 150702 while the shaft assembly 150704 and the power supply assembly 150706 are coupled to the handle assembly 150702.

[0196] Main controller 150717 may be any single-core or multi-core processor, such as those known by Texas Instruments under the trademark ARM Cortex. In one aspect, main controller 150717 may be, for example, an LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, including 256 KB of on-chip memory of single-cycle flash memory or other non-volatile memory up to 40 MHz, a prefetch buffer to improve performance above 40 MHz, 32 KB of single-cycle SRAM, internal ROM with StellarisWare® software, 2 KB of EEPROM, one or more PWM modules, one or more QEI analog, or one or more 12-bit ADCs with 12 analog input channels, details of which are available in the product datasheet.

[0197] The safety controller may be a safety controller platform with two controller base families, such as the TMS570 and RM4x, also known by Texas Instruments under the trademark Hercules ARM Cortex R4. The safety controller may be configured specifically for IEC 61508 and ISO 26262 safety limit applications, among others, to provide advanced integrated safety mechanisms while offering scalable performance, connectivity, and memory options.

[0198] The power supply assembly 150706 may include power management circuitry, which may include a power management controller 150716, a power modulator 150738, and a current sensor circuit 150736. The power management circuitry may be configured to modulate the power output of the battery based on the power requirements of the shaft assembly 150704 while the shaft assembly 150704 and the power supply assembly 150706 are coupled to the handle assembly 150702. For example, the power management controller 150716 may be programmed to control the power modulator 150738 of the power output of the power supply assembly 150706, and the current sensor circuit 150736 may be used to monitor the power output of the power supply assembly 150706 to provide feedback to the power management controller 150716 regarding the power output of the battery so that the power management controller 150716 can adjust the power output of the power supply assembly 150706 to maintain the desired output. The power management controller 150716 and / or the shaft assembly controller 150722 may each include one or more processors and / or memory units capable of storing multiple software modules.

[0199] The surgical instrument 150010 (FIGS. 21-24) can include an output device 150742, which can include a device for providing sensory feedback to the user. Such devices can include, for example, a visual feedback device (e.g., a liquid crystal display (LCD) screen, LED indicator), an audible feedback device (e.g., a speaker, a buzzer), or a tactile feedback device (e.g., a tactile actuator). Under certain circumstances, the output device 150742 can include a display 150743, which can be included in the handle assembly 150702. The shaft assembly controller 150722 and / or the power management controller 150716 can provide feedback to a user of the surgical instrument 150010 via the output device 150742. An interface can be configured to connect the shaft assembly controller 150722 and / or the power management controller 150716 to the output device 150742. The output device 150742 can alternatively be integrated with the power supply assembly 150706. In such a situation, while the shaft assembly 150704 is coupled to the handle assembly 150702, communication between the output device 150742 and the shaft assembly controller 150722 can be achieved via an interface.

[0200] The control circuit 150700 includes circuit segments configured to control the operation of the powered surgical tool 150010. The safety controller segment (segment 1) includes a safety controller and a main controller 150717 segment (segment 2). The safety controller and / or main controller 150717 are configured to interact with one or more additional circuit segments, such as an acceleration segment, a display segment, a shaft segment, an encoder segment, a motor segment, and a power segment. Each of the circuit segments may be coupled to the safety controller and / or main controller 150717. The main controller 150717 is also coupled to flash memory. The main controller 150717 also includes a serial communication interface. The main controller 150717 includes multiple inputs, for example, coupled to one or more circuit segments, a battery, and / or multiple switches. The segmented circuits may be implemented by any suitable circuitry, such as, for example, a printed circuit board assembly (PCBA) within the powered surgical tool 150010. The term processor, as used herein, should be understood to include any microprocessor, processor, one or more controllers, or other basic computing device that incorporates the functionality of a computer's CPU onto a single integrated circuit or up to several integrated circuits. Main controller 150717 is a general-purpose programmable device that accepts digital data as input, processes that data according to instructions stored in memory, and provides results as output. Because it has internal memory, it is an example of sequential digital logic. Control circuit 150700 may be configured to implement one or more of the processes described herein.

[0201] The acceleration segment (segment 3) comprises an accelerometer. The accelerometer is configured to detect movement or acceleration of the powered surgical tool 150010. Input from the accelerometer may be used to transition in and out of sleep mode, identify the orientation of the powered surgical tool, and / or identify when the surgical tool has been dropped. In some examples, the acceleration segment is coupled to the safety controller and / or the main controller 150717.

[0202] The display segment (segment 4) includes a display connector coupled to the main controller 150717. The display connector couples the main controller 150717 to a display through one or more integrated circuit drivers for the display. The integrated circuit drivers for the display may be integrated with the display and / or located separately from the display. The display may include any suitable display, such as, for example, an organic light emitting diode (OLED) display, an LCD, and / or any other suitable display. In some examples, the display segment is coupled to a safety controller.

[0203] The shaft segment (segment 5) includes controls for an interchangeable shaft assembly 150200 ( FIGS. 21 and 23 ) coupled to the surgical instrument 150010 ( FIGS. 21-24 ) and / or one or more controls for an end effector 150300 coupled to the interchangeable shaft assembly 150200. The shaft segment includes a shaft connector configured to couple the main controller 150717 to a shaft PCBA. The shaft PCBA includes a low-power microcontroller having ferroelectric random access memory (FRAM), an articulation switch, a shaft release Hall effect switch, and a shaft PCBA EEPROM. The shaft PCBA EEPROM includes one or more parameters, routines, and / or programs specific to the interchangeable shaft assembly 150200 and / or the shaft PCBA. The shaft PCBA may be coupled to the interchangeable shaft assembly 150200 and / or may be integral with the surgical instrument 150010. In some examples, the shaft segment includes a second shaft EEPROM that contains a plurality of algorithms, routines, parameters, and / or other data corresponding to one or more shaft assemblies 150200 and / or end effectors 150300 that may be associated with the powered surgical instrument 150010.

[0204] The position encoder segment (segment 6) comprises one or more magnetic angular rotary position encoders configured to identify the rotational position of the motor 150714, interchangeable shaft assembly 150200 (FIGS. 21 and 23), and / or end effector 150300 of the surgical instrument 150010 (FIGS. 21-24). In some examples, the magnetic angular rotary position encoders may be coupled to the safety controller and / or the main controller 150717.

[0205] The motor circuit segment (segment 7) includes a motor 150714 configured to control the movement of the powered surgical tool 150010 (FIGS. 21-24). The motor 150714 is coupled to the main microcontroller processor 150717 by an H-bridge driver, which includes one or more H-bridge FETs and a motor controller. The H-bridge driver is also coupled to the safety controller. A motor current sensor is coupled in series with the motor to measure the motor's current draw. The motor current sensor is in signal communication with the main controller 150717 and / or the safety controller. In some examples, the motor 150714 is coupled to a motor electromagnetic interference (EMI) filter.

[0206] The motor controller controls the first motor flag and the second motor flag to indicate the status and position of the motor 150714 to the main controller 150717. The main controller 150717 provides a PWM high signal, a PWM low signal, a direction signal, a synchronization signal, and a motor reset signal to the motor controller via a buffer. The power segments are configured to provide segment voltages to each of the circuit segments.

[0207] The power segment (segment 8) includes a battery coupled to the safety controller, the main controller 150717, and an additional circuit segment. The battery is coupled to the segmented circuitry by a battery connector and a current sensor. The current sensor is configured to measure the total current drawn by the segmented circuitry. In some examples, one or more voltage converters are configured to provide a predetermined voltage value to one or more circuit segments. For example, in some examples, the segmented circuitry may include a 3.3V voltage converter and / or a 5V voltage converter. The boost converter is configured to provide a boost voltage up to a predetermined amount, such as up to 13V. The boost converter is configured to provide additional voltage and / or current during power-intensive operations and prevent brownouts or low-power conditions.

[0208] A plurality of switches are coupled to the safety controller and / or main controller 150717. The switches may be configured to control the operation of the segmented circuit, the surgical instrument 150010 (FIGS. 21-24), and / or indicate the status of the surgical instrument 150010. The emergency escape door switch and the emergency escape Hall effect switch are configured to indicate the status of the emergency escape door. A plurality of articulation switches, for example, a left articulation left switch, a left articulation right switch, a left articulation center switch, a right articulation left switch, a right articulation right switch, and a right articulation center switch, are configured to control the articulation of the interchangeable shaft assembly 150200 (FIGS. 21 and 23) and / or the end effector 150300 (FIGS. 21-24). The left reversal switch and the right reversal switch are coupled to the main controller 150717. The left side switches, including a left side articulation left switch, a left side articulation right switch, a left side articulation center switch, and a left side reversing switch, are coupled by a left side flexible connector to the main controller 150717. The right side switches, including a right side articulation left switch, a right side articulation right switch, a right side articulation center switch, and a right side reversing switch, are coupled by a right side flexible connector to the main controller 150717. The fire switch, clamp release switch, and shaft engagement switch are coupled to the main controller 150717.

[0209] The switches may be implemented using any suitable mechanical, electromechanical, or solid-state switches in any combination. For example, the switches may be limit switches operated by the movement of a component associated with the surgical instrument 150010 (FIGS. 21-24) or the presence of an object. Such switches may be used to control various functions associated with the surgical instrument 150010. A limit switch is an electromechanical device consisting of an actuator mechanically coupled to a set of contacts. When an object contacts the actuator, the device operates the contacts to create or break an electrical connection. Due to their ruggedness, ease of installation, and reliable operation, limit switches are used in a variety of applications and environments. Limit switches can determine the presence, absence, passage, placement, and end of movement of an object. In other implementations, the switches may be solid-state switches that operate under the influence of a magnetic field, such as Hall effect devices, MR devices, GMR devices, and magnetometers, among others. In other implementations, the switches may be solid-state switches that operate under the influence of light, such as light sensors, IR sensors, and UV sensors, among others. Additionally, the switches may be solid state devices such as transistors (e.g., FETs, junction FETs, MOSFETs, bipolar, etc.) Other switches may include wireless switches, ultrasonic switches, accelerometers, and inertial sensors, among others.

[0210] 26 is another block diagram of the control circuit 150700 of the surgical instrument of FIG. 21 , showing an interface between the handle assembly 150702 and the power supply assembly 150706, and an interface between the handle assembly 150702 and the interchangeable shaft assembly 150704, in accordance with at least one embodiment of the present disclosure. The handle assembly 150702 can include a main controller 150717, a shaft assembly connector 150726, and a power supply assembly connector 150730. The power supply assembly 150706 can include a power supply assembly connector 150732, a power management circuit 150734, which can include a power management controller 150716, a power modulator 150738, and a current sensor circuit 150736. The shaft assembly connectors 150730, 150732 form an interface 150727. While the interchangeable shaft assembly 150704 and the power supply assembly 150706 are coupled to the handle assembly 150702, the power management circuit 150734 can be configured to modulate the power output of the battery 150707 based on the power requirements of the interchangeable shaft assembly 150704. For example, the power management controller 150716 can be programmed to control a power modulator 150738 of the power output of the power supply assembly 150706, and the current sensor circuit 150736 can be used to monitor the power output of the power supply assembly 150706 to provide feedback to the power management controller 150716 regarding the power output of the battery 150707 so that the power management controller 150716 can adjust the power output of the power supply assembly 150706 to maintain the desired output. The shaft assembly 150704 includes a shaft processor 150720 coupled to a non-volatile memory 150721 and a shaft assembly connector 150728, electrically coupling the shaft assembly 150704 to the handle assembly 150702. The shaft assembly connectors 150726, 150728 form an interface 150725.The main controller 150717, the shaft processor 150720, and / or the power management controller 150716 may be configured to implement one or more of the processes described herein.

[0211] The surgical instrument 150010 (FIGS. 21-24) can include an output device 150742 that provides sensory feedback to the user. Such devices may include visual feedback devices (e.g., LCD display screen, LED indicators), audible feedback devices (e.g., speakers, buzzers), or tactile feedback devices (e.g., tactile actuators). Under certain circumstances, the output device 150742 can include a display 150743 that can be included on the handle assembly 150702. The shaft assembly controller 150722 and / or the power management controller 150716 can provide feedback to a user of the surgical instrument 150010 via the output device 150742. The interface 150727 can be configured to connect the shaft assembly controller 150722 and / or the power management controller 150716 to the output device 150742. The output device 150742 can be integrated with the power supply assembly 150706. While the interchangeable shaft assembly 150704 is coupled to the handle assembly 150702, communication between the output device 150742 and the shaft assembly controller 150722 can be achieved via the interface 150725.

[0212] tissue marking In various surgical procedures, surgical instruments seal tissue by applying energy or deploying staples into the tissue. Surgical instruments may also cut or sever the sealed tissue. In surgical procedures, one or more surgical instruments may be applied to several separate tissue portions of the tissue being processed when the tissue size is larger than the maximum tissue size that can be handled by the surgical instrument in a single application. If a leak occurs in one of the processed tissue portions, it can be difficult to identify the associated surgical instrument or its component, such as a staple cartridge. Without such identification, it becomes difficult to determine the cause of the leak.

[0213] Aspects of the present disclosure provide a surgical instrument including an end effector configured to apply tissue processing to tissue. The end effector includes a first jaw, a second jaw movable relative to the first jaw to grasp tissue therebetween, and a tissue processing mechanism configured to apply tissue processing to tissue grasped between the first and second jaws. Additionally, the surgical instrument includes a marking assembly configured to apply distinct markings to the tissue unique to each tissue processing application, the distinct markings distinguishing the tissue processing application from other tissue processing applications performed by the surgical instrument or other surgical instruments.

[0214] In various aspects, the tissue processing mechanism comprises a staple cartridge configured to apply the tissue processing application by deploying staples into tissue grasped by the end effector. In other aspects, the tissue processing mechanism comprises an energy device configured to apply the tissue processing application by delivering therapeutic energy to tissue grasped by the end effector. The energy delivered by the energy device can be in the form of, for example, RF energy or ultrasonic energy.

[0215] In various aspects, the tissue processing mechanism comprises a transecting member movable to apply the tissue processing application by severing the grasped tissue. One or both of the jaws of the end effector may include a longitudinal slot configured to accommodate the transecting member. The transecting member may include a cutting edge at its distal portion.

[0216] 27 shows a logic flow diagram of a process 31010 illustrating a control program or logic configuration for marking tissue processed by an end effector of a surgical instrument, in accordance with at least one embodiment of the present disclosure. In one embodiment, the process 31010 is performed by control circuitry 500 (FIG. 13), as described in more detail below. In another embodiment, the process 31010 may be performed by combinational logic circuitry 510 (FIG. 14). In yet another embodiment, the process 31010 may be performed by sequential logic circuitry 520 (FIG. 15).

[0217] In the example of FIGS. 28-31, tissue is treated by the end effector 31000 of the surgical stapling and severing instrument 31006 and marked by the marking assembly 31020 of the control system 31470.

[0218] The surgical instrument 31006 is similar in many respects to the surgical instrument 150010. For example, the end effector 31000 and control system 31470 are similar in many respects to the end effector 150300 and control circuit 470 (FIG. 12), respectively. Components of the surgical instrument 31006 that are similar to the above-described components of the surgical instrument 150010 will not be repeated here for the sake of brevity.

[0219] The end effector 31000 includes a first jaw 31001 and a second jaw 31002 extending from the interchangeable shaft assembly 150200. The end effector 31000 further includes an anvil defined in the first jaw 31001 and a staple cartridge 31005 defined in the second jaw 31002. At least one of the first jaw 31001 and the second jaw 31002 is movable relative to one another to transition the end effector 26000 between an open configuration and a closed configuration to grasp tissue between the anvil and the staple cartridge 31005. In operation, tissue processing with the surgical instrument 31006 involves deploying staples from the staple cartridge 26005 into grasped tissue with a firing member. The deployed staples are deformed by the anvil. In various embodiments, tissue can also be processed by cutting using a cutting member that is movable relative to a longitudinal slot 31007 defined in at least one of the first jaw 31001 and the second jaw 31002.

[0220] In various embodiments, a surgical instrument according to the present disclosure may include an end effector that processes tissue by applying RF energy or ultrasonic energy to the tissue. In various embodiments, the surgical instrument 26010 may be a handheld surgical instrument. Alternatively, the surgical instrument 26010 may be incorporated into a robotic system as a component of a robotic arm. This application is the subject of U.S. Provisional Patent Application No. 62 / 611,339, filed December 28, 2017, the entire contents of which are incorporated herein by reference.

[0221] 27, process 31010 includes receiving a sensor signal indicative of a tissue treatment application 31011. If a tissue treatment has been applied to the tissue or is being applied to the tissue as determined based on the received sensor signal 31012, a distinct marking is applied to the tissue 31013. The distinct marking is unique to the tissue treatment application and can be utilized to distinguish the tissue treatment application from other tissue treatment applications.

[0222] In various aspects, and referring to FIG. 31 , the process 31010 may be performed by a control system 31470 of the surgical instrument 31006. The control system 31470 is similar in many respects to the control system 470 ( FIG. 12 ). For example, the control system 31470 includes a control circuit having a microcontroller 470. A number of sensors 472, 474, 476, 31473 provide various sensor signals to the microcontroller 470. One or more of such sensor signals can be analyzed, alone or in combination with other sensor signals, to determine whether a tissue treatment has been or is being applied to the tissue. The control system 31470 further includes a marking assembly 31020 in communication with the microcontroller 470. After determining that a tissue treatment has been or is being applied to the tissue, the microcontroller 470 causes the marking assembly 31020 to mark the tissue.

[0223] In various examples, the marking of tissue by the marking assembly 31020 may be triggered by input from an operator of the surgical instrument 31006, which may be delivered via a user interface such as the display 473. Alternatively, or in addition, the marking of tissue may be triggered by one or more sensor signals.

[0224] In one example, tissue marking can be triggered by a reading from a strain gauge sensor 474, which can be used to measure the force applied to tissue grasped by the end effector 31000. When the microcontroller 461 receives a sensor signal from the sensor 474 that exceeds a predetermined threshold, indicating that tissue is being grasped by the end effector 31000, the microcontroller 461 can cause the marking assembly 31020 to mark the tissue.

[0225] In one embodiment, a reading from the activation sensor 31473, which can be used to detect the deployment of staples or the application of energy to tissue, can trigger tissue marking. Upon receiving a sensor signal from the sensor 31473 above a predetermined threshold, the microcontroller 461 can instruct the marking assembly 31020 to mark tissue.

[0226] 28 and 30, the marking assembly 31020 includes two marking applicators 31021, 31022 disposed on the second jaw 31002. More specifically, the applicator 31021 is disposed on the proximal portion 31008 of the staple cartridge 31005 assembled with the second jaw 31002, while the applicator 31022 is disposed on the distal portion 31009 of the staple cartridge 31005. In other configurations, more or less than two applicators can be disposed on one or more jaws of the end effector to apply markings to tissue processed by the end effector.

[0227] Each of the applicators 31021, 31022 includes markers 31023 arranged in a predetermined pattern. As shown in FIG. 31 , the markers 31023 of the applicators 31021, 31022 are arranged in three rows. Also, the applicators 31021, 31022 include the same number and arrangement of markers 31023. However, in certain examples, the markers of an applicator can be arranged in any suitable arrangement. Different applicators may include the same or different marker arrangements. In certain examples, all of the markers of an applicator are activated to generate a tissue marking. In other examples, only some of the markers of an applicator are activated to generate a tissue marking. Activation of the markers can be controlled by the microcontroller 461 to achieve a predetermined marking.

[0228] In various examples, the markers 31023 can be configured to apply their individual marks with the same intensity. Alternatively, the markers 31023 can be configured to apply their individual marks with different intensities. The intensities of the marks can be controlled by the microcontroller 461 to achieve a predetermined marking.

[0229] 28, the applicators 31021, 31022 are disposed on the proximal and distal portions 31008, 31009, respectively, of the second jaw 31002. This configuration allows the applicators 31021, 31022 to apply their markings proximal and distal to the tissue processing, which can assist in identifying the start and end of the tissue processing.

[0230] In various examples, one or more of the markings are detectable through stimulation by at least one of a light source, a radiation source, and an illumination source. In certain examples, the marker 31023 is configured to apply one or more fluorescent materials to the tissue such that the markings are visible only in the presence of a light source outside the visible spectrum. In other words, the markings fluoresce under an applied light source outside the visible spectrum.

[0231] In certain examples, the marker 31023 is configured to use an IR-readable ink formula in generating the markings. The ink formula can be based on light absorption and reflection in the IR. As shown in FIG. 32, the marker 31023 can be configured to generate unique IR ink markings 31035, 31037.

[0232] In certain examples, the markers 31023 are in the form of electrodes that can be selectively activated by the microcontroller 461 to generate markings. The microcontroller 461 can control the intensity of each mark by controlling the activation time of the electrode. The longer the electrode is activated, the greater the intensity of the mark. Divisions can be introduced into the electrode to leave distinctive markings. In certain examples, the markers 31023 can comprise an RF electrode that includes an array of microelectrodes configured to weld distinct, optically distinguishable markings for each tissue processing application.

[0233] 29 and 32, the eight tissue segments were subjected to eight treatments performed by the end effector 31030 of the surgical instrument 31036. FIG. 3 shows the jaws 31002 of the end effector 31030. In each of the eight treatments, the end effector 31030 grasped the tissue segment, sealed the tissue segment, and cut the tissue segment. As shown in FIG. 32, the treatments were applied in a specific order to separate the cancerous portion of the colon from the adjacent tissue T. A marking assembly 31033, including applicators 31031, 31032, applied a separate tissue marking to each tissue segment for each treatment.

[0234] The surgical instrument 31036 is similar in many respects to the surgical instruments 31006, 150010. For example, the end effector 31000 is similar in many respects to the end effector 31000, 150300. Components of the surgical instrument 31036 that are similar to the above-described components of the surgical instruments 31006, 150010 will not be repeated here for the sake of brevity.

[0235] 29, the applicators 31031, 31032 are positioned at the proximal portion 31009 of the second jaw 31034 on either side 31038, 31039 of the transected path defined by the longitudinal slot 31007 along the longitudinal axis LA. In this configuration, each side of the transected tissue receives a separate marking.

[0236] In various examples, as shown in FIG. 32 , the markings can be made in an order such that a series of marks from one use to the next provides distinct markings for successive treatments. This allows for unique markings between treatments in addition to the markings associated with each treatment. In other words, markings associated with related treatments may include a common identifier in addition to their unique identifiers. Treatments can be related in a surgical procedure or by being fired sequentially by a single surgical instrument.

[0237] In various aspects, surgical instruments of the present disclosure, such as surgical instruments 26010, 31006, 310036, for example, are communicatively coupled to a surgical hub (e.g., surgical hub 106 (FIGS. 2, 3), 206 (FIG. 10)) via wired and / or wireless communication channels. Data collected by such surgical instruments can be transmitted to surgical hub 106, 206, which can further transmit the data to a cloud-based system (e.g., cloud-based system 104, 204) for further analysis.

[0238] In addition to the above, the visualization system (e.g., visualization system 108 (FIG. 3), 208 (FIG. 9)) can record frames of marked tissue for subsequent identification after the surgical instrument has been removed from the surgical site. Data from the surgical instrument and frames recorded by the visualization system can be transmitted to a surgical hub, which can timestamp and / or correlate the data received from both sources. Data can also be transferred to a cloud-based system for additional analysis.

[0239] This process can be useful when analyzing failures. For example, as shown in FIG. 32 , a leak 31039 occurred during the seventh tissue procedure. A distinct marking on the seventh tissue procedure recorded by the visualization system helps identify the surgical instrument performing the seventh procedure. Thus, the operational data 31040 for the seventh procedure can be examined and compared with operational data 31042 for the same surgical instrument in the same environment that resulted in the successful application of the same procedure. As described above, the markings for a single surgical procedure or the markings generated by a single surgical instrument may include a common identifier that allows for a quick comparison of the operational data 31040 and the operational data 31042.

[0240] In the example of Figure 32, operational data from the first tissue processing application, which resulted in a successful seal, is compared to operational data from the seventh tissue processing application, in which a leak occurred. Comparing the two data sets reveals that the leak was caused by an abnormal drop in clamping force, which can be addressed in subsequent tissue processing attempts using the same or similar surgical instrument. In other examples, operational data from surgical instruments associated with failures is compared to preset criteria.

[0241] In certain examples, the failure analysis described above can be performed by the surgical hub in real time during the surgical procedure. Leak detection and tissue marking interpretation can be performed by various image processing techniques. The surgeon can be guided back to the surgical site with the surgical hub by using dot-by-dot analysis techniques to identify anatomical landmarks and the unique variable shading of the tissue. In certain examples, landmarks can be identified and acquired by observing hot spots in the tissue after energy application.

[0242] Data Transmission Prioritization Various data may be collected and / or generated by a powered surgical instrument during a surgical procedure. For example, a powered surgical stapling and severing instrument may collect, among other things, clamping force (FTC) readings and firing force (FTF) readings, which may be transmitted to a surgical hub, which further transmits the data to a cloud-based system for further processing. The communication path between the powered surgical instrument and the surgical hub has a predetermined bandwidth. Similarly, the communication path between the surgical hub and the cloud-based system also has a predetermined bandwidth. In certain instances, various environmental interferences may further limit such bandwidth. Furthermore, various data sources may compete for the limited bandwidth.

[0243] During a surgical procedure, the surgical hub can react to the received data by adjusting various parameters in its control in real time. Depending on the surgical procedure being performed, certain data sources and / or surgical activities may be more important than others. Transmitting data without consideration of its importance may interfere with the operation of the surgical hub and its ability to make timely decisions. Similarly, delays in data transmission due to bandwidth limitations may interfere with the operation of the surgical hub and its ability to make timely decisions.

[0244] In various embodiments, the surgical system 32002 is used in a surgical procedure. The surgical system 32002 includes a surgical hub (e.g., surgical hub 106 (FIGS. 3, 4, 36), surgical hub 206 (FIG. 10)), a powered surgical instrument (e.g., device / instrument 235 (FIG. 9), surgical instrument 32235 (FIG. 36)), and a communications module 32004 (FIG. 36). The communications module 32004 includes a shift / register 32005 and a transceiver 32007.

[0245] 35 shows a logic flow diagram of a process 32000 illustrating a control program or logic configuration for coordinating the transmission of data between a powered surgical instrument 32235 and a surgical hub (e.g., surgical hub 106 (FIGS. 3, 4, 36), surgical hub 206 (FIG. 10)) in accordance with at least one embodiment of the present disclosure. The process 32000 includes receiving first data related to a first surgical activity of a surgical procedure (32006), receiving second data related to a second surgical activity of the surgical procedure (32008), selecting a transmission rate for transmitting the first data and the second data between the powered surgical instrument 32235 and the surgical hub 106 based on at least one characteristic of at least one of the first surgical activity and the second surgical activity (32010), and transmitting the first data and the second data between the powered surgical instrument and the surgical hub at the selected transmission rate (32012).

[0246] In at least one example, the process 32000 selects or adjusts a transmission rate for transmitting the first data and the second data between the powered surgical instrument 32235 and the surgical hub 106 based on at least one characteristic of at least one of the first surgical activity and the second surgical activity and the available bandwidth. The communications module 32004 can determine the available bandwidth, which may change over time based on various factors such as, for example, interference and other environmental factors.

[0247] Figure 36 shows a control system 32470 of a surgical instrument 32235 that may be used to implement the process of Figure 35. The control system 32470 is similar in many respects to control system 470 (Figure 12). In various aspects, the process 32000 may be implemented by a communications module 32004 of the surgical instrument 32235 that includes a microcontroller 461 coupled to sensors 472, 474, 476, as shown in Figure 36.

[0248] In various aspects, the first data can be received from a first source and the second data can be received from a second source different from the first source. The first source and / or the second source can be, for example, any of sensors 472, 474, 476.

[0249] In various aspects, the surgical instrument 32235 is similar in many respects to surgical instruments 235 (FIG. 9), 150010 (FIG. 25). For example, like surgical instrument 150010, the surgical instrument 32235 includes an end effector 150300 that is transitionable from an open configuration, as shown in FIG. 25, to a closed configuration to grasp tissue in a first surgical activity. A motor 482 (FIG. 36) may drive the transition of the end effector 150300 between the open and closed configurations. In certain examples, the first data represents the force required for the FTC of the end effector 150300 over time, as shown in FIG. 33.

[0250] In various embodiments, the surgical instrument 32235 includes a displacement member (e.g., the drive member 150120 of FIG. 26) that is movable in a second surgical activity to deploy / fire staples into tissue grasped by the end effector 150300. In certain examples, the second data represents the FTF of the end effector 150300 over time, as shown in FIG.

[0251] Figure 33 is a graph showing FTC and FTF readings of a powered surgical instrument 32235 during a surgical procedure plotted against time (t). The corresponding transmission rates of the FTC and FTF readings to the surgical hub 106 are also plotted against time (t). In the example of Figures 33 and 34, sensors 472, 474, 476 include an ideal sampling rate of 30 samples per second. The sampling rate is the rate at which readings are taken.

[0252] The communication channel between the powered surgical instrument 32235 and the surgical hub 106 includes a first bandwidth capable of transmitting up to 25 megabits per second, corresponding to a maximum of 62 samples transmitted per second. The first bandwidth is reduced to a second bandwidth at time t=t2 due to environmental interference in the operating room. The second bandwidth is capable of transmitting up to 20 megabits per second, corresponding to a maximum of 48 samples per second. Figure 34 also lists the actual FTC and FTF samples transmitted per second at four exemplary time points (t1, t2, t3, t4) selected for illustrative purposes.

[0253] 33 and 34, a first surgical activity represented by FTC data begins at time t=0, while a second surgical activity represented by FTF data begins at time t=t3. The first surgical activity also reaches a maximum FTC at t=t1, which defines an important characteristic of the first surgical activity. Therefore, it is desirable to prioritize transmission of FTC data associated with the first surgical activity over FTF data associated with the second surgical activity until time t=t3. As shown at t=t1, which corresponds to the maximum FTC value, FTC data is transmitted at an optimal transmission rate corresponding to 30 samples per second, but no FTF data is transmitted during this initial phase.

[0254] In addition to the above, a negative change in bandwidth or maximum available transmission rate occurs at t=ta and is sensed by the communications module 32004. In response, the transmission rate of the FTC data is reduced to a transmission rate corresponding to 26 samples per second, as shown at t=t2, to accommodate the negative change caused by the environmental interference. In various examples, the first data and the second data are transmitted over a communications channel established between the powered surgical instrument 32235 and the surgical hub 106, and the communications module 32004 adjusts the transmission rate of at least one of the first data and the second data in response to the change in bandwidth of the communications channel.

[0255] 34 and 35, since the FTF data transmission rate is already 0 samples per second, only the FTC data transmission rate is reduced from 30 samples per second to 26 samples per second. In other examples, as described in more detail below, an ongoing prioritization scheme established based on at least one characteristic of the first surgical activity and the second surgical activity can affect the effect of a negative change in bandwidth on the transmission rate of the first data and / or the second data.

[0256] At t=t3, the FTF data and FTC data become equally relevant. However, due to reduced bandwidth or the maximum available transmission rate, only 48 samples per second can be transmitted. Therefore, the transmission rates of the FTC data and FTF data are adjusted to be equal at 24 samples per second. In other words, the transmission rates of the FTC data and FTF data are adjusted to accommodate the increased relevance of the FTF data and any adverse changes in bandwidth or maximum available transmission rate.

[0257] Further to the above, as the FTF data ramps upward and the FTC data becomes smaller and smaller, the FTF data may be prioritized over the FTC data. Thus, the transmission rate of the FTF data may be increased, and the transmission rate of the FTC data may be decreased for the remainder of the second surgical activity. In other words, the communications module 32004 may adjust the transmission rate for transmitting the first data and the second data between the powered surgical instrument and the surgical hub based on certain characteristics of at least one of the first surgical activity and the second surgical activity.

[0258] At t=t4, an abnormal FTF is detected when the FTF exceeds a predetermined threshold. To investigate the abnormal FTF, the communication module 32004 responds by decreasing the FTC transmission rate to 8 samples per second while increasing the FTF data transmission rate to 40 samples per second. In other words, the communication module 32004 responds to the detected abnormal FTF data by adjusting the transmission rate to prioritize transmission of FTF data over FTC data.

[0259] 37 shows a logic flow diagram of a process 32100 illustrating a control program or logic configuration for coordinating the transmission of data between a powered surgical instrument 32235 and a surgical hub (e.g., surgical hub 106 (FIGS. 3, 4, 36), surgical hub 206 (FIG. 10)) in accordance with at least one embodiment of the present disclosure. The process 32100 includes receiving first data related to a first surgical activity of the surgical procedure (32106), receiving second data related to a second surgical activity of the surgical procedure (32108), and transmitting the first data and the second data between the powered surgical instrument 32235 and the surgical hub 106 (32112).

[0260] Further to the above, if an anomaly is detected (32109), the process 32100 adjusts (32110) the transmission rate for transmitting the first data and the second data between the powered surgical instrument 32235 and the surgical hub 106 to prioritize the transmission of data containing the anomaly. As mentioned above, the anomaly according to process 32109 may be exceeding a predetermined threshold.

[0261] In various aspects, the communications module 32004 sets a preferred or preferred communications process configuration to ensure low-speed data flow and high-speed connectivity while still allowing prioritization of low-speed bandwidth data when prioritization of low-speed bandwidth data is a higher priority. [Example]

[0262] Various aspects of the subject matter described herein are illustrated in the following numbered examples.

[0263] Example 1 - A surgical instrument is disclosed. The surgical instrument includes an end effector and a marking assembly. The end effector includes a first jaw, a second jaw movable relative to the first jaw to grasp tissue therebetween, and a tissue processing mechanism configured to apply tissue processing to tissue grasped between the first and second jaws. The marking assembly is configured to apply distinct markings to the tissue that are unique to each tissue processing application. The distinct markings distinguish the tissue processing application from other tissue processing applications.

[0264] Example 2 - The surgical instrument of Example 1, wherein the end effector includes a cutting member configured to transect tissue, and the marking assembly is configured to form a discrete marking adjacent to a transverse incision line defined in the tissue by the cutting member.

[0265] Example 3 - A surgical instrument as described in any one of Examples 1 and 2, wherein the distinct markings are visible only in the presence of a light source outside the visible spectrum.

[0266] Example 4 - The surgical instrument of any one of Examples 1-3, wherein the distinct markings are configured to fluoresce under an applied light source outside the visible spectrum.

[0267] Example 5 - A surgical instrument according to any one of Examples 1-4, wherein the distinct markings are detectable through stimulation by at least one of a light source, a radiation source, and an illumination source.

[0268] Example 6 - The surgical instrument of any one of Examples 1-5, wherein the tissue processing mechanism comprises a staple cartridge configured to deploy staples within tissue in a tissue processing application.

[0269] Example 7 - The surgical instrument of any one of Examples 1-6, wherein the tissue processing mechanism comprises an electrode configured to deliver therapeutic energy to tissue in a tissue processing application.

[0270] Example 8 - The surgical instrument of any one of Examples 1-7, wherein the tissue processing mechanism comprises a transecting member movable to transect tissue in a tissue processing application.

[0271] Example 9 - The surgical instrument of any one of Examples 1-8, wherein application of tissue processing by the tissue processing mechanism triggers application of a distinct marking to the tissue by the marking assembly.

[0272] Example 10 - The surgical instrument of any one of Examples 1-9, wherein the marking assembly comprises a plurality of spaced apart applicators.

[0273] Example 11 - The surgical instrument of Example 10, wherein the plurality of applicators comprises a proximal applicator and a distal applicator.

[0274] Example 12 - A surgical instrument described in any one of Examples 10 and 11, wherein the end effector has a longitudinal slot, a first applicator on a first side of the longitudinal slot, and a second applicator on a second side opposite the first side of the longitudinal slot.

[0275] Example 13 - A surgical instrument is disclosed. The surgical instrument includes an end effector, a marking assembly, and a control circuit. The end effector includes a first jaw, a second jaw movable relative to the first jaw to grasp tissue therebetween, and a tissue processing mechanism configured to apply a tissue processing to the tissue grasped between the first and second jaws. The control circuit is configured to receive a sensor signal indicative of the application of the tissue processing to the tissue and cause the marking assembly to apply a distinct marking to the tissue specific to the tissue processing application, the distinct marking distinguishing the tissue processing application from other tissue processing applications.

[0276] Example 14 - A surgical instrument as described in Example 13, wherein the end effector includes a cutting member configured to transect tissue, and the marking assembly is configured to form a separate marking adjacent to a transverse incision line defined in the tissue by the cutting member.

[0277] Example 15 - The surgical instrument of any one of Examples 13 and 14, wherein the distinct marking is visible only in the presence of a light source outside the visible spectrum.

[0278] Example 16 - The surgical instrument of any one of Examples 13-15, wherein the distinct markings are configured to fluoresce under an applied light source outside the visible spectrum.

[0279] Example 17 - A surgical instrument described in any one of Examples 13-16, wherein the distinct marking is detectable through stimulation by at least one of a light source, a radiation source, and an illumination source.

[0280] Example 18 - A surgical instrument according to any one of Examples 13-17, wherein application of tissue processing by the tissue processing mechanism triggers application of a distinct marking to the tissue by the marking assembly.

[0281] Example 19 - The surgical instrument of any one of Examples 13-18, wherein the marking assembly comprises a plurality of spaced apart applicators.

[0282] Example 20 - A surgical instrument is disclosed. The surgical instrument comprises an end effector including a first jaw, a second jaw movable relative to the first jaw to grasp tissue therebetween, and a tissue processing mechanism configured to apply tissue processing to tissue grasped between the first and second jaws. The surgical instrument further comprises means for applying distinct markings to the tissue that are unique to each tissue processing application, the distinct markings distinguishing the tissue processing application from other tissue processing applications.

[0283] In various aspects, the communication channel established by the communication module between the surgical hub and the powered surgical instrument is a wireless communication channel. Examples of suitable wireless communication between the surgical instrument and the surgical hub are described elsewhere in this disclosure. In other examples, the communication channel established by the communication module between the surgical hub and the powered surgical instrument is a wired communication channel. In various aspects, as noted above, communication over such communication channel(s) is prioritized by the importance of the data being communicated, rather than by overall bandwidth.

[0284] In various aspects, communications between the surgical hub and the powered surgical tool are encrypted communications to prevent interception or modification of data within the system as it powers up, assigns identification numbers, or communicates within the system itself.

[0285] The above detailed description has set forth various aspects of devices and / or processes via the use of block diagrams, flowcharts, and / or examples. To the extent that such block diagrams, flowcharts, and / or examples 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 examples can be individually and / or collectively implemented by various forms of hardware, software, firmware, or virtually any combination thereof. Those skilled in the art will understand that all or a portion of some aspects of the embodiments disclosed herein can be equivalently implemented on an integrated circuit as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or virtually any combination thereof, and that designing circuitry and / or writing software and / or firmware code is within the skill of those skilled in the art in light of this disclosure. Furthermore, those skilled in the art will appreciate that the subject matter described herein may be distributed as one or more program products in a variety of forms, and that the particular form of the subject matter described herein will be used regardless of the particular type of signal-bearing medium used to actually effect the distribution.

[0286] The instructions used to program the logic to execute the various disclosed aspects may be stored in system memory, such as DRAM, cache, flash memory, or other storage. Additionally, the 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), including, but not limited to, floppy diskettes, optical disks, CD-ROMs, magneto-optical disks, ROM, RAM, EPROM, EEPROM, magnetic or optical cards, flash memory, or tangible machine-readable storage used for transmitting information via the Internet via electrical, optical, acoustic, or other forms of propagated signals (e.g., carrier waves, IR signals, digital signals). Thus, non-transitory computer-readable media include any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a form readable by a machine (e.g., a computer).

[0287] The term "control circuitry," as used in any aspect of the present specification, can refer to, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor including one or more individual instruction processing cores, a processing unit, a processor, a microcontroller, a microcontroller unit, a controller, a DSP, a programmable logic device (PLD), a programmable logic array (PLA), or a field programmable gate array (FPGA)), a state machine circuit, firmware that stores instructions executed by the programmable circuitry, and any combination thereof. Control circuitry may be embodied, collectively or individually, as circuitry that forms part of a larger system, e.g., an integrated circuit, an application specific integrated circuit (ASIC), an SoC, a desktop computer, a laptop computer, a tablet computer, a server, or a smartphone. Thus, as used herein, "control circuitry" includes, but is not limited to, electrical circuitry having at least one individual electrical circuit, electrical circuitry having at least one integrated circuit, electrical circuitry having at least one ASIC, electrical circuitry forming a general-purpose computing device configured with a computer program (e.g., a general-purpose computer configured with a computer program that at least partially executes the processes and / or apparatus described herein, or a microprocessor configured with a computer program that at least partially executes the processes and / or apparatus described herein), electrical circuitry forming a memory device (e.g., in the form of RAM), and / or electrical circuitry forming a communications device (e.g., a modem, a communications switch, or an opto-electrical device). Those skilled in the art will recognize that the subject matter described herein may be implemented in analog or digital form, or some combination thereof.

[0288] As used in any aspect herein, the term "logic" may refer to an application, software, firmware, and / or circuitry configured to perform any of the operations described above. Software may be embodied as a software package, code, instructions, instruction sets, and / or data recorded on a non-transitory computer-readable storage medium. Firmware may be embodied as code, instructions, or instruction sets and / or hard-coded (e.g., non-volatile) data in a memory device.

[0289] As used in any aspect of this specification, the terms "component," "system," "module," etc. may refer to a computer-related entity that is either hardware, a combination of hardware and software, software, or software in execution.

[0290] As used in any aspect of this specification, an "algorithm" refers to a self-consistent sequence of steps leading to a desired result, and the "steps" refer to the manipulation of physical quantities and / or logical states, which may, but need not, take the form of electrical or magnetic signals capable of being stored, transferred, combined, compared, and otherwise manipulated. It is common practice to refer to these signals as bits, values, elements, symbols, characters, terms, numbers, or the like. These and similar terms may be associated with the appropriate physical quantities or are merely convenient labels applied to these quantities and / or states.

[0291] The network may include a packet-switched network. The communication devices may communicate with each other using a selected packet-switched network communication protocol. One exemplary communication protocol may include an Ethernet communication protocol, which may enable communication using Transmission Control Protocol / Internet Protocol (TCP / IP). The Ethernet protocol may conform to or be compatible with the Ethernet standard published by the Institute of Electrical and Electronics Engineers (IEEE), entitled "IEEE 802.3 Standard," December 2008, and / or later versions of this standard. Alternatively or additionally, the communication devices may communicate with each other using an X.25 communication protocol. The X.25 communication protocol may conform to or be compatible with standards promulgated by the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, the communication devices may communicate with each other using a frame relay communication protocol. The frame relay communication protocol may conform to or be compatible with standards promulgated by the Consultative Committee for International Telegraph and Telephone (CCITT) and / or the American National Standards Institute (ANSI). Alternatively or additionally, the transceivers may be capable of communicating with each other using an Asynchronous Transfer Mode (ATM) communication protocol. The ATM communication protocol may conform to or be compatible with the ATM standard published in August 2001 by the ATM Forum entitled "ATM-MPLS Network Interworking 2.0" and / or later versions of this standard. Of course, different and / or later-developed connection-oriented network communication protocols are equally contemplated herein.

[0292] Unless expressly specified otherwise, as will be apparent from the foregoing disclosure, discussions throughout the foregoing disclosure using terms such as "processing," "calculating," "computing," "determining," "displaying," and the like will be understood to refer to the operations and processing of a computer system or similar electronic computing device that manipulates and transforms data represented as physical (electronic) quantities in the computer system's registers and memory into other data similarly represented as physical quantities in the computer system's memory or registers or such information storage, transmission, or display device.

[0293] One or more components may be referred to herein as being "configured to," "configurable to," "operable / operative to," "adaptable," "capable to," "conformable / conformed to," etc. Those skilled in the art will understand that "configured to" may generally encompass active and / or inactive and / or standby components, unless the context requires otherwise.

[0294] The terms "proximal" and "distal" are used herein with reference to a clinician manipulating the handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician, and the term "distal" refers to the portion located away from the clinician. It will be further understood that for convenience and clarity, spatial terms such as "vertical," "horizontal," "above," and "below" may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.

[0295] Those skilled in the art will understand that the terms used herein generally, and in the appended claims in particular (e.g., the body of the appended claims), are generally intended as "open" terms (e.g., the term "including" should be interpreted as "including but not limited to," the term "having" should be interpreted as "having at least," and the term "includes" should be interpreted as "includes but is not limited to"). Furthermore, those skilled in the art will understand that where a specific number is intended in an introduced claim recitation, such intention will be clearly recited in the claim, and that, in the absence of such recitation, no such intention exists. For example, as an aid to understanding, the appended claims below 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 construed as suggesting that when a claim is introduced by the indefinite article "a" or "an," any particular claim containing such introduced claim language is limited to claims containing only one such recitation, 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" (e.g., "a" and / or "an" should normally be construed to mean "at least one" or "one or more"). The same applies when a definite article is used to introduce a claim.

[0296] Furthermore, even when a specific number is explicitly stated in an introduced claim, those skilled in the art will recognize that such a statement should typically be interpreted to mean at least the recited number (e.g., a statement simply stating "two items" without other modifiers generally means at least two items, or two or more items). Furthermore, when notation similar to "at least one of A, B, and C, etc." is used, such syntax is generally intended in the sense that one skilled in the art would understand the notation (e.g., "a system having at least one of A, B, and 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). When notation similar to "at least one of A, B, or C, etc." is used, such syntax is generally intended in the sense that one of ordinary skill in the art would understand the notation (e.g., "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, one of ordinary skill in the art will understand that any disjunctive word and / or phrase that typically presents two or more alternative terms should be understood to contemplate the possibility of including one of those terms, either of those terms, or both of those terms, unless the context requires otherwise, whether in the specification, claims, or drawings. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "A and B."

[0297] With respect to the appended claims, those skilled in the art will understand that the recited operations herein generally can be performed in any order. Also, while flow diagrams of various operations are shown in sequence(s), it should be understood that various operations may occur in orders other than those illustrated, or may occur simultaneously. Examples of such alternative orderings may include overlapping, interleaved, interrupted, reordered, incremental, preliminary, additional, simultaneous, reverse, or other different orderings, unless the context requires otherwise. Furthermore, terms such as "responsive to," "related to," or other past-tense adjectives are generally not intended to exclude such variations, unless the context requires otherwise.

[0298] It is worth noting that any reference to "one embodiment," "embodiment," "exemplary," "one example," etc. means that a particular feature, structure, or characteristic described in connection with that embodiment is included in at least one embodiment. Thus, the appearances of the phrases "in one embodiment," "in an embodiment," "exemplary," and "in one example" in various places throughout this specification do not necessarily all refer to the same embodiment. Furthermore, particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments.

[0299] 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 the incorporated material is not inconsistent with this specification. As such, and to the extent necessary, the disclosure material explicitly set forth herein shall supersede any conflicting statements incorporated herein by reference. Any content, or portions thereof, that conflicts with current definitions, opinions, or other disclosure material set forth herein shall be incorporated herein by reference, but only to the extent that there is no conflict between the referenced content and the current disclosure material.

[0300] In summary, many benefits have been described that result from using the concepts described herein. The foregoing description of one or more embodiments has been presented for purposes of illustration and description. It is not intended to be exhaustive or to be limited to the precise form disclosed. Modifications or variations are possible in light of the above teachings. The one or more embodiments have been selected and described to illustrate the principles and practical applications, thereby enabling those skilled in the art to utilize various embodiments, with various modifications, as suitable for the particular use contemplated. It is intended that the claims presented herewith define the overall scope.

[0301] [Embodiment] (1) A surgical instrument, An end effector, First Joe and a second jaw movable relative to the first jaw to grasp tissue therebetween; an end effector including a tissue processing mechanism configured to apply a tissue process to tissue grasped between the first jaw and the second jaw; a marking assembly configured to apply a distinct marking to the tissue that is unique to each tissue processing application, the distinct marking distinguishing the tissue processing application from other tissue processing applications. (2) The surgical instrument of embodiment 1, wherein the end effector includes a cutting member configured to transect tissue, and the marking assembly is configured to form the separate marking adjacent to a transverse incision line defined in the tissue by the cutting member. (3) The surgical instrument of claim 1, wherein the distinct markings are visible only in the presence of a light source outside the visible spectrum. (4) The surgical instrument of claim 1, wherein the distinct markings are configured to fluoresce under an applied light source outside the visible spectrum. (5) The surgical instrument of embodiment 1, wherein the distinct markings are detectable through stimulation by at least one of a light source, a radiation source, and an illumination source.

[0302] (6) The surgical instrument of embodiment 1, wherein the tissue processing mechanism comprises a staple cartridge configured to place staples within the tissue in the tissue processing application. (7) The surgical instrument of embodiment 1, wherein the tissue processing mechanism comprises an electrode configured to deliver therapeutic energy to the tissue in the tissue processing application. (8) The surgical instrument of embodiment 1, wherein the tissue processing mechanism comprises a transecting member movable to transect the tissue in the tissue processing application. (9) The surgical instrument of embodiment 1, wherein application of the tissue treatment by the tissue treatment mechanism triggers application of the separate marking to the tissue by the marking assembly. (10) The surgical instrument of claim 1, wherein the marking assembly includes a plurality of spaced apart applicators.

[0303] (11) The plurality of applicators a proximal applicator; and 11. The surgical instrument of embodiment 10, comprising: a distal applicator. (12) The end effector includes a longitudinal slot, and the plurality of applicators include: a first applicator on a first side of the longitudinal slot; a second applicator on a second side of the longitudinal slot opposite the first side. (13) A surgical instrument, An end effector, First Joe and a second jaw movable relative to the first jaw to grasp tissue therebetween; an end effector including a tissue processing mechanism configured to apply a tissue process to tissue grasped between the first jaw and the second jaw; a marking assembly; A control circuit comprising: receiving a sensor signal indicative of application of a tissue treatment to the tissue; a control circuit configured to cause the marking assembly to apply a distinct marking to the tissue that is specific to the tissue processing application, the distinct marking distinguishing the tissue processing application from other tissue processing applications. (14) The surgical instrument of claim 13, wherein the end effector includes a cutting member configured to transect tissue, and the marking assembly is configured to form the discrete marking adjacent a transverse incision line defined in the tissue by the cutting member. 15. The surgical instrument of claim 13, wherein the distinct markings are visible only in the presence of a light source outside the visible spectrum.

[0304] (16) The surgical instrument of claim 13, wherein the distinct markings are configured to fluoresce under an applied light source outside the visible spectrum. (17) The surgical instrument of embodiment 13, wherein the distinct markings are detectable through stimulation by at least one of a light source, a radiation source, and an illumination source. (18) The surgical instrument of claim 13, wherein application of the tissue treatment by the tissue treatment mechanism triggers application of the separate marking to the tissue by the marking assembly. (19) The surgical instrument of claim 13, wherein the marking assembly includes a plurality of spaced apart applicators. (20) A surgical instrument, An end effector, First Joe and a second jaw movable relative to the first jaw to grasp tissue therebetween; an end effector including a tissue processing mechanism configured to apply a tissue process to tissue grasped between the first jaw and the second jaw; and means for applying a distinct marking to the tissue that is unique to each tissue processing application, the distinct marking distinguishing the tissue processing application from other tissue processing applications.

Claims

1. A surgical instrument comprising: An end effector, The first Joe, a second jaw movable relative to the first jaw to grasp tissue therebetween; an end effector including a tissue processing mechanism configured to apply tissue processing to the tissue grasped between the first jaw and the second jaw during a surgical procedure; a marking assembly; a sensor for detecting application of the tissue treatment to the tissue; A control circuit comprising: analyzing a sensor signal from the sensor to determine whether the tissue treatment has been or is being applied to the tissue; after determining that the tissue processing application to the tissue has been performed or that the tissue processing application to the tissue is being performed, causing the marking assembly to apply a separate marking to the tissue specific to each of the tissue processing applications, wherein the separate markings applied to the tissue specific to each of the tissue processing applications vary in marking form between individual tissue processing applications of each of the tissue processing applications; wherein the distinct markings distinguish one of the tissue processing applications from other tissue processing applications performed during the surgical procedure; and The marking assembly includes a plurality of markers, the marking assembly having a state in which all of the markers are activated to generate tissue markings and a state in which only some of the markers are activated to generate tissue markings, the tissue markings in one of the states being markings specific to one of the tissue processing applications that are readable by a user of the surgical instrument or decipherable by image processing technology, and the tissue markings in the other of the states being markings specific to the other of the tissue processing applications that are readable by the user or decipherable by image processing technology.

2. 2. The surgical instrument of claim 1, wherein the end effector includes a cutting member configured to transect tissue, and the marking assembly is configured to form the discrete marking adjacent a transverse incision line defined in the tissue by the cutting member.

3. The surgical instrument of claim 1 , wherein the distinct markings are visible only in the presence of a light source outside the visible spectrum.

4. The surgical instrument of claim 1 , wherein the distinct markings are configured to fluoresce under an applied light source outside the visible spectrum.

5. The surgical instrument of claim 1 , wherein the distinct markings are detectable through stimulation by at least one of a light source, a radiation source, and an illumination source.

6. The surgical instrument of claim 1 , wherein the tissue processing mechanism comprises a staple cartridge configured to place staples within the tissue in the tissue processing application.

7. The surgical instrument of claim 1 , wherein the tissue processing mechanism comprises an electrode configured to deliver therapeutic energy to the tissue in the tissue processing application.

8. The surgical instrument of claim 1 , wherein the tissue processing mechanism comprises a transecting member movable to transect the tissue in the tissue processing application.

9. The surgical instrument of claim 1 , wherein application of the tissue treatment by the tissue treatment mechanism triggers application of the separate marking to the tissue by the marking assembly.

10. The surgical instrument of claim 1 , wherein the marking assembly includes a plurality of spaced apart applicators, each of the plurality of spaced apart applicators adapted to apply the distinct marking to the tissue.

11. the plurality of spaced apart applicators: a proximal applicator; and A distal applicator.

12. the end effector includes a longitudinal slot, and the plurality of spaced apart applicators include: a first applicator on a first side of the longitudinal slot; a second applicator on a second side of the longitudinal slot opposite the first side.

13. The surgical instrument of claim 1 , wherein the surgical procedure includes applying energy to the tissue grasped by the end effector for sealing and / or cutting.

14. The surgical instrument of claim 1 , wherein the tissue processing mechanism is configured to apply the tissue processing application by deploying staples within the tissue grasped by the end effector.

15. The surgical instrument of claim 1 , wherein the tissue processing mechanism is configured to apply the tissue processing application by transecting the tissue grasped by the end effector.

16. 2. The surgical instrument of claim 1, wherein the control circuit is configured to cause the marking assembly to mark the tissue upon receiving a signal from a strain gauge sensor for measuring a force applied to the tissue grasped by the end effector indicating the force exceeds a predetermined threshold.

17. 10. The surgical instrument of claim 1, wherein the control circuitry is configured to cause the marking assembly to mark the tissue upon receiving a signal from a sensor to detect deployment of staples or application of energy to the tissue.

18. A surgical instrument comprising: An end effector, The first Joe, a second jaw movable relative to the first jaw to grasp tissue therebetween; an end effector including a tissue processing mechanism configured to apply tissue processing to the tissue grasped between the first jaw and the second jaw during a surgical procedure; a marking assembly; a sensor for detecting application of the tissue treatment to the tissue; A control circuit comprising: analyzing a sensor signal from the sensor to determine whether the tissue treatment has been or is being applied to the tissue; after determining that the tissue processing application to the tissue has been performed or that the tissue processing application to the tissue is being performed, causing the marking assembly to apply a separate marking to the tissue specific to each of the tissue processing applications, wherein the separate markings applied to the tissue specific to each of the tissue processing applications vary in marking form between individual tissue processing applications of each of the tissue processing applications; wherein the distinct markings distinguish one of the tissue processing applications from other tissue processing applications performed during the surgical procedure; and A surgical instrument, wherein the marking assembly includes markers in the form of electrodes that can be selectively activated to produce the markings, and the control circuit is configured to control the intensity of each of the markings by controlling the active time of the electrodes, the longer the electrodes are activated the greater the intensity of the markings, and the markings are readable by a user of the surgical instrument or decipherable by image processing techniques.

19. The surgical instrument of claim 10, wherein the plurality of spaced apart applicators are configured to place the markings in different marker sequences.

20. The surgical instrument of claim 1 , wherein the plurality of markers are individually operable to apply the distinct predetermined markings to the tissue specific to each of the tissue treatment applications.

21. The surgical instrument of claim 1 , wherein the image processing interpretation is performed in a visualization system external to the surgical instrument.

22. The surgical instrument of claim 21 , wherein the surgical instrument is communicatively coupled to the visualization system.

Images