Powered surgical instrument with multi-stage tissue treatment

Abstract

A surgical instrument comprising an end effector including a first jaw, a second jaw, a staple cartridge, and at least one electrode, the surgical instrument further comprising a drive member, a motor assembly, and a control circuit, the control circuit configured to cause the at least one electrode to deliver therapeutic energy to tissue during a first stage of the surgical procedure, cause the motor assembly to move the drive member to deploy staples into tissue during a second stage of the surgical procedure, monitor a first tissue characteristic during the first stage and switch from the first stage to a second stage if at least one of two conditions is met, set parameters for the second stage based on at least one measurement of the tissue characteristic determined during the first stage, and monitor the second tissue characteristic during the second stage.

Description

[Technical Field]

[0001] The present invention relates to surgical instruments and to surgical stapling and severing instruments, and staple cartridges for use therewith, designed to staple and sever tissue in a variety of devices. Summary of the Invention [Means for solving the problem]

[0002] In one aspect, the present disclosure provides a surgical instrument including an end effector. The end effector includes a first jaw, a second jaw movable relative to the first jaw between an open configuration and a closed configuration to grasp tissue, a staple cartridge, and at least one electrode. The surgical instrument further includes a drive member, a motor assembly configured to generate a drive motion to move the drive member, and a control circuit. The control circuit is configured to cause the at least one electrode to deliver therapeutic energy to the tissue during a first phase of the surgical procedure, to cause the motor assembly to move the drive member to deploy staples from the staple cartridge into the tissue during a second phase of the surgical procedure, and to monitor a first tissue characteristic during the first phase of the surgical procedure. The control circuitry is further configured to switch from the first stage of the surgical procedure to the second stage of the surgical procedure when at least one of two conditions is met, the first of the two conditions being triggered by a first tissue characteristic reaching or exceeding a predetermined threshold value and the second of the two conditions being triggered by a first stage reaching or exceeding a predetermined threshold time. The control circuitry is further configured to set parameters of the second stage of the surgical procedure based on at least one measurement of the tissue characteristic determined during the first stage of the surgical procedure, and to monitor a second tissue characteristic during the second stage of the surgical procedure, the second tissue characteristic being different from the first tissue characteristic.

[0003] In another aspect, the present disclosure provides a surgical instrument including a first jaw and a second jaw, the first jaw being movable relative to the second jaw between an open configuration and a closed configuration to grasp tissue. The surgical instrument further includes an anvil, a staple cartridge, a channel configured to receive the staple cartridge, and an RF overlay pivotally connected to the channel, the RF overlay including at least one electrode. The surgical instrument further includes a drive member, a motor assembly configured to generate a drive motion to move the drive member, and a control circuit. The control circuit is configured to cause the at least one electrode to deliver therapeutic energy to the tissue during a first stage of the surgical procedure, to cause the motor assembly to move the drive member to deploy staples from the staple cartridge into the tissue during a second stage of the surgical procedure, and to monitor tissue characteristics during the first stage of the surgical procedure. The control circuit is further configured to switch from the first stage of the surgical procedure to the second stage of the surgical procedure based on at least one of a predetermined threshold value of the tissue characteristic and a predetermined threshold time for the first stage. The control circuitry is further configured to set parameters for a second stage of the surgical procedure based on at least one measurement of the tissue property determined during the first stage of the surgical procedure.

[0004] In another aspect, the present disclosure provides a surgical instrument including an end effector. The end effector includes a first jaw, a second jaw movable relative to the first jaw between an open configuration and a closed configuration to grasp tissue, and a staple cartridge. The staple cartridge includes a longitudinal slot and a row of staple cavities extending in successive treatment zones along the longitudinal slot. The end effector further includes electrode segments that individually reside in the successive treatment zones. The surgical instrument further includes a drive member, a motor assembly configured to generate a drive motion to move the drive member, and a control circuit. The control circuit is configured to deliver therapeutic energy to tissue within all of the successive treatment zones, cause the motor assembly to move the drive member to prompt staple deployment from the staple cartridge, and detect a parameter indicative of the progress of staple deployment from the staple cartridge within the successive treatment zones. The control circuit is further configured to sequentially stop the electrodes to sequentially capture delivery of therapeutic energy to tissue within the successive treatment zones based on the progress of staple deployment from the staple cartridge. [Brief explanation of the drawings]

[0005] The various features of the embodiments described herein, together with their advantages, may be understood by the following practice of the invention when taken in conjunction with the accompanying drawings, in which: [Figure 1] FIG. 1 is a schematic diagram of a surgical instrument according to at least one aspect of the present disclosure. [Figure 2] FIG. 2 is a partial perspective view of a jaw of the end effector of the surgical instrument of FIG. 1 and a staple cartridge for assembly therewith; [Figure 3] FIG. 2 is a cross-sectional view of the end effector of the surgical instrument of FIG. 1. [Figure 4] 2 is a cross-sectional view of tissue undergoing surgical treatment from the surgical instrument of FIG. 1. FIG. [Figure 5] FIG. 2 is a partial exploded view of an end effector for use with the surgical instrument of FIG. 1, according to at least one embodiment of the present disclosure. [Figure 6] FIG. 6 is a partial cross-sectional view of the end effector of FIG. 5 illustrating the channel assembled with a staple cartridge and radio frequency (RF) overlay in accordance with at least one embodiment of the present disclosure. [Figure 7] 6A-6C illustrate the process and mechanism for assembling the end effector of FIG. 5. [Figure 8] 6A-6C illustrate the process and mechanism for assembling the end effector of FIG. 5. [Figure 9] 6A-6C illustrate the process and mechanism for assembling the end effector of FIG. 5. [Figure 10] FIG. 1 is a process logic flow diagram illustrating a control program or logic configuration for performing a surgical procedure on tissue in accordance with at least one aspect of the present disclosure. [Figure 11] 11 is a graph showing an exemplary embodiment of the surgical procedure, which is the process of FIG. 10, on two tissues at different tissue compression rates. [Figure 12] FIG. 2 is a partial top view of a cartridge deck of a cartridge assembled with an end effector of the surgical instrument of FIG. 1; [Figure 13] FIG. 1 is a process logic flow diagram illustrating a control program or logic configuration for performing a surgical procedure on tissue in accordance with at least one aspect of the present disclosure. [Figure 14] 2 is a graph illustrating a sequence for deactivating electrode segments of the end effector of FIG. 1 in accordance with at least one embodiment of the present disclosure. [Figure 15] FIG. 1 is a process logic flow diagram illustrating a control program or logic configuration for performing a surgical procedure on tissue in accordance with at least one aspect of the present disclosure.

[0006] Corresponding reference characters indicate corresponding parts throughout the several views. The examples set forth herein illustrate, in one form, specific embodiments of the present invention, and such examples should not be construed as limiting the scope of the present invention in any way. DETAILED DESCRIPTION OF THE INVENTION

[0007] The applicant of the present application also owns the following U.S. patent applications, filed on even date herewith, each of which is incorporated herein by reference in its individual entirety: -U.S. Patent Application entitled "METHOD FOR TISSUE TREATMENT BY SURGICAL INSTRUMENT"; Attorney Docket No. END9291USNP1 / 200802-1M; -U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH INTERACTIVE FEATURES TO REMEDY INCIDENTAL SLED MOVEMENTS; Attorney Docket No. END9291USNP2 / 200802-2; -U.S. Patent Application entitled "SURGICAL INSTRUMENTS WITH SLED LOCATION DETECTION AND ADJUSTMENT FEATURES"; Attorney Docket No. END9291USNP3 / 200802-3; -U.S. Patent Application entitled SURGICAL INSTRUMENT WITH CARTRIDGE RELEASE MECHANISMS; Attorney Docket No. END9291USNP4 / 200802-4; -U.S. Patent Application entitled DUAL-SIDED REINFORCED RELOAD FOR SURGICAL INSTRUMENTS; Attorney Docket No. END9291USNP5 / 200802-5; -U.S. Patent Application entitled SURGICAL SYSTEMS WITH DETACHABLE SHAFT RELOAD DETECTION; Attorney Docket No. END9291USNP6 / 200802-6; -U.S. Patent Application entitled "SURGICAL INSTRUMENTS WITH ELECTRICAL CONNECTORS FOR POWER TRANSMISSION ACROSS STERILE BARRIER"; Attorney Docket No. END9291USNP7 / 200802-7; -U.S. Patent Application entitled "DEVICES AND METHODS OF MANAGING ENERGY DISSIPATED WITHIN STERILE BARRIERS OF SURGICAL INSTRUMENT HOUSINGS"; Attorney Docket No. END9291USNP8 / 200802-8; -U.S. Patent Application entitled "POWERED SURGICAL INSTRUMENTS WITH EXTERNAL CONNECTORS"; Attorney Docket No. END9291USNP9 / 200802-9; -U.S. Patent Application entitled "POWERED SURGICAL INSTRUMENTS WITH SMART RELOAD WITH SEPARATELY ATTACHABLE EXTERIORLY MOUNTED WIRING CONNECTIONS"; Attorney Docket No. END9291USNP10 / 200802-10; and No. 60 / 699,493, filed on Dec. 1, 2008. U.S. Patent Application entitled "POWERED SURGICAL INSTRUMENTS WITH COMMUNICATION INTERFACES THROUGH STERILE BARRIER"; Attorney Docket No. END9291USNP11 / 200802-11.

[0008] The applicant of this application owns the following U.S. patent applications, filed December 4, 2018, the disclosures of each of which are incorporated herein by reference in their entirety: · U.S. Patent Application No. 16 / 209,385, entitled METHOD OF HUB COMMUNICATION, PROCESSING, STORAGE AND DISPLAY; ·U.S. Patent Application No. 16 / 209,395, entitled METHOD OF HUB COMMUNICATION; · U.S. Patent Application No. 16 / 209,403, entitled METHOD OF CLOUD BASED DATA ANALYTICS FOR USE WITH THE HUB; · U.S. Patent Application No. 16 / 209,407, entitled METHOD OF ROBOTIC HUB COMMUNICATION, DETECTION, AND CONTROL; · U.S. Patent Application No. 16 / 209,416, entitled METHOD OF HUB COMMUNICATION, PROCESSING, DISPLAY, AND CLOUD ANALYTICS; U.S. Patent Application No. 16 / 209,423, entitled "METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS"; · U.S. Patent Application No. 16 / 209,427, entitled "METHOD OF USING REINFORCED FLEXIBLE CIRCUITS WITH MULTIPLE SENSORS TO OPTIMIZE PERFORMANCE OF RADIO FREQUENCY DEVICES"; U.S. Patent Application No. 16 / 209,433, entitled "METHOD OF SENSING PARTICULATE FROM SMOKE EVACUATED FROM A PATIENT, ADJUSTING THE PUMP SPEED BASED ON THE SENSED INFORMATION, AND COMMUNICATING THE FUNCTIONAL PARAMETERS OF THE SYSTEM TO THE HUB"; · U.S. Patent Application No. 16 / 209,447, entitled METHOD FOR SMOKE EVACUATION FOR SURGICAL HUB; · U.S. Patent Application No. 16 / 209,453, entitled METHOD FOR CONTROLLING SMART ENERGY DEVICES; ·U.S. Patent Application No. 16 / 209,458, entitled METHOD FOR SMART ENERGY DEVICE INFRASTRUCTURE; · U.S. Patent Application No. 16 / 209,465, entitled METHOD FOR ADAPTIVE CONTROL SCHEMES FOR SURGICAL NETWORK CONTROL AND INTERACTION; · U.S. Patent Application No. 16 / 209,478, entitled "METHOD FOR SITUATIONAL AWARENESS FOR SURGICAL NETWORK OR SURGICAL NETWORK CONNECTED DEVICE CAPABLE OF ADJUSTING FUNCTION BASED ON A SENSED SITUATION OR USAGE"; U.S. Patent Application No. 16 / 209,490, entitled METHOD FOR FACILITY DATA COLLECTION AND INTERPRETATION; and · U.S. Patent Application No. 16 / 209,491, entitled METHOD FOR CIRCULAR STAPLER CONTROL ALGORITHM ADJUSTMENT BASED ON SITUATIONAL AWARENESS.

[0009] As described in the specification and illustrated in the accompanying drawings, numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments. Well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described herein. The reader will understand that the embodiments described and illustrated herein are non-limiting examples, and thus the specific structural and functional details disclosed herein may be representative and exemplary. Variations and modifications can be made thereto without departing from the scope of the claims.

[0010] Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein can be used in many surgical procedures and applications, including, for example, those associated with open surgical procedures. By proceeding through the Detailed Description section of this specification, the reader will further appreciate that the various instruments disclosed herein can be inserted into the body in any manner, such as through a natural opening, an incision or puncture made in tissue, etc. The working or end effector portions of these instruments can be inserted directly into the patient's body or through an access device having a working channel through which the end effector and elongate shaft of the surgical instrument can be advanced.

[0011] FIG. 1 illustrates a schematic diagram of a surgical instrument 750 configured to perform a surgical procedure on tissue to seal and / or cut the tissue. The surgical procedure includes at least two stages. In a first stage, therapeutic electrical energy is used to seal the tissue. In at least one example, the therapeutic electrical energy is RF energy. In a second stage, staples are deployed into the tissue and, optionally, a cutting member 721 (FIG. 2) cuts the tissue.

[0012] The surgical instrument 750 includes an end effector 752 with jaws 753. At least one of the jaws 753 is movable relative to the other jaws from an open configuration to a closed configuration to grasp tissue therebetween. As illustrated in FIG. 2, the end effector 752 includes at least one electrode 796 configured to deliver therapeutic electrical energy to tissue during a first phase of a surgical procedure. The end effector 752 further includes an anvil 766 and a staple cartridge 767 configured to cooperate to form deployable staples 742 ( FIG. 3 ) from the staple cartridge 767 into tissue during a second phase of the surgical procedure. The staples 742 are formed by anvil pockets 747 a, 747 b ( FIG. 4 ).

[0013] One of the jaws 753 of the end effector 752 includes a channel 744 configured to slidably receive a staple cartridge 767. In the illustrated example, the staple cartridge 767 is inserted into the channel 744 through a distal opening 755. The channel 744 and staple cartridge 767 include corresponding locking features 763, 768 that cooperate to reversibly lock the staple cartridge 767 and the channel in a locked configuration. In the illustrated example, the locking features 763, 768 are in the form of ramps and corresponding grooves. In other examples, the locking features 763, 768 can be in the form of protrusions, nubs, bulges, dimples, or any suitable protrusions and corresponding valleys, holes, or any suitable recesses. In certain examples, the protrusions can be in the form of biasing or spring members.

[0014] In the illustrated example, staple cartridge 767 includes two rows of staple cavities 757a, 757b on either side of a longitudinal slot 759 configured to accommodate the sliding movement of cutting member 721. Cutting member 721 is slidably advanced through longitudinal slot 759 to cut tissue grasped between jaws 753. In other examples, more or less than two rows of staple cavities can be disposed longitudinally along longitudinal slot 759.

[0015] Further to the above, channel 744 includes a ceiling or cover 740 including a longitudinal opening 741 configured to at least partially accommodate staple cavity rows 757 a, 757 b when staple cartridge 767 is assembled with channel 744. In the illustrated example, staple cartridge 767 includes a stepped deck 730 that elevates staple cavity rows 757 a, 757 b. Side walls 744 a, 744 b of channel 744 include narrowed portions configured to snuggly accommodate stepped deck 730 to ensure proper alignment of staple cavity rows 757 a, 757 b with longitudinal opening 741 defined in ceiling or cover 740.

[0016] In the illustrated example, at least one electrode 796 includes electrode segments 796a, 796b, 796c that define a partial perimeter around longitudinal opening 741. In the assembled configuration, as illustrated in FIG. 4, raised staple cavity rows 757a, 757b of stepped deck 730 extend longitudinally parallel or substantially parallel to electrode segments 796a, 796b, 796c that cooperate to define a tissue contacting surface. FIG. 3 illustrates tissue T including tissue portion T1 fastened by staples 742 from staple cavity row 757a and tissue portion T2 sealed by RF energy from electrode segment 796b. For example, in a second stage, tissue T is cut along plane P (perpendicular to the page) by cutting member 721 through longitudinal slot 759, driven, for example, by I-beam 720.

[0017] In the illustrated example, electrode segments 796a, 796b, 796c are disposed on or partially embedded in corresponding insulating segments 797a, 797b, 797c of insulating layer 797. Additionally, anvil 766 includes electrodes 731, 732 that are disposed on or partially embedded in corresponding insulating segments 733, 734. RF energy can flow from at least one electrode 796 to electrodes 731, 732 through tissue grasped between jaws 753.

[0018] To avoid the formation of unintentional shorts, electrodes 731, 732 are offset from electrode segments 797a, 797c, as illustrated in FIG. 4 . In other words, electrodes 731, 732 remain spaced apart from electrode segments 797a, 797c, respectively, in the closed configuration of the end effector, free of tissue. In the illustrated example, channel 744 is grounded, and at least one electrode 796 is an integral part of channel 744 with no moving parts. In at least one example, at least one electrode 796 is hardwired to channel 744, so that the electrical contact is not exposed to fluids that could cause a short. In the illustrated example, electrodes 731, 732 are isolated from anvil 766 by insulating segments 733, 734, respectively. In other examples, electrodes 731, 732 are integral with anvil 766. In such examples, anvil 766 is part of the return path for RF energy.

[0019] In the illustrated example, RF energy is configured to flow from at least one electrode 796 in a direction toward electrodes 731, 732. However, in other examples, end effector 752 can be configured to flow RF energy from electrodes 731, 732 in a direction toward at least one electrode 796.

[0020] When staple cartridge 767 is assembled with channel 744, nose 769 of staple cartridge 767 extends beyond distal opening 755, while the remainder of staple cartridge 767 is received within channel 744. Additionally, staple cartridge 767 includes a cartridge release latch 765 configured to disengage locking mechanisms 763, 768 to permit removal of staple cartridge 767 from channel 744.

[0021] 5 and 6 illustrate an end effector 852 that is similar in many respects to end effector 752. End effector 852 may be utilized with surgical instrument 750 in place of end effector 752. Like end effector 752, end effector 852 includes jaws configured to grasp tissue for performing a surgical procedure on the tissue during the first and second procedure stages.

[0022] Further, end effector 852 includes an anvil 866 and a channel 844 configured to releasably retain a staple cartridge 867. An RF overlay 890 is pivotally coupled to channel 844. Figures 7-9 illustrate a process and mechanism for attaching and detaching RF overlay 890 to and from staple cartridge 867 while staple cartridge 867 is retained in channel 844.

[0023] 6, staple cartridge 867, similar to staple cartridge 767, includes a stepped deck 830 with raised staple cavity rows 857a, 857b and an insulating recessed region 831 configured to releasably retain RF overlay 890. In an assembled configuration, staple cavity rows 857a, 857b and at least one electrode 896 of RF overlay 890 cooperate to define a tissue contacting surface, as illustrated in FIG.

[0024] Further, staple cavity rows 857a, 857b and electrode segments 896a, 896b of at least one electrode 896 extend longitudinally parallel, or at least substantially parallel, on either side of a longitudinal slot 859 cooperatively defined by RF overlay 890 and staple cartridge 867 while staple cartridge 867 is retained within channel 844. In the illustrated example, drive member 751 terminates in an I-beam 720 including a cutting member 721 movable through longitudinal slot 859 to cut tissue grasped between the jaws of end effector 852, similar to that described in connection with end effector 752.

[0025] In the illustrated example, the RF overlay 890 includes two body portions 897a, 897c that have a U-shape and extend longitudinally parallel, or at least substantially parallel. The body portions 897a, 897c are separated by a longitudinal opening 841 defined in the RF overlay 890. A distal arcuate portion 897b connects the body portions 897a, 897c. The longitudinal opening 841 facilitates translation of the cutting member 721 relative to the RF overlay 890. The at least one electrode 896 also includes a U-shape and is disposed on or at least partially embedded in the portions 897a, 897b, 897c. In certain examples, the at least one electrode 896 includes electrodes 896a, 896b, 896c that can be connected to the RF energy source 762. Other electrode shapes and configurations for the RF overlay 890 are contemplated by the present disclosure.

[0026] In the illustrated example, the overlay 890 includes a pivot 891 extending laterally from a proximal portion of the RF overlay 890. The pivot 893 is received in a corresponding pivot hole 843 defined in a sidewall of the channel 844. The overlay 890 is rotatable about an axis extending through the pivot hole 891 between an unlocked configuration ( FIG. 7 ) and a locked configuration ( FIG. 8 ). In the illustrated example, the anvil 866 pivots the RF overlay 890 toward the staple cartridge 867. The anvil 866 allows the staple cartridge 867 to snap into the channel 844 and the RF overlay 890 to snap into the staple cartridge 867.

[0027] Further, staple cartridge 867 includes a latch mechanism 860 including a latch member 861 and a biasing member 862 configured to maintain latch member 861 in the first position, as illustrated in FIG. 8. In the illustrated example, RF overlay includes a distal protrusion 898 configured to be captured by latch member 861 in the locked configuration.

[0028] 9 , sled 863 can be moved by drive member 751 to disengage latch member 861 from distal protrusion 898. In the illustrated example, sled 863 urges latch member 861 distally toward the end of the sled firing stroke, which depresses biasing member 862 to release distal protrusion 898 from latch member 861. The spent staple cartridge 867 can then be withdrawn from channel 844 and replaced with an unused staple cartridge 867. RF overlay 890 can then be moved by anvil 866 into locking engagement with the unused staple cartridge 867.

[0029] 1 , the control circuit 760 may be programmed to control one or more functions of the surgical instrument 750, such as, for example, closing the end effector 752, activating at least one electrode, and / or firing a staple cartridge. The control circuit 760 may, in some examples, comprise one or more of a microcontroller, a microprocessor, or other suitable processor for executing instructions that cause the one or more processors to control one or more functions of the surgical instrument 750. In one aspect, the timer / counter 781 provides an output signal, such as an elapsed time or a digital count, to the control circuit 760. The timer / counter 781 may be configured to measure elapsed time, count an external event, or time an external event.

[0030] The control circuit 760 can generate a motor set point signal 772. The motor set point signal 772 can be provided to a motor controller 758. The motor controller 758 can include one or more circuits configured to provide a motor drive signal 774 to the motor 754 to drive the motor 754, as described herein. In some examples, the motor 754 can be a brushed DC electric motor. For example, the speed of the motor 754 can be proportional to the motor drive signal 774. In some examples, the motor 754 can be a brushless DC electric motor, and the motor drive signal 774 can include a PWM signal provided to one or more stator windings of the motor 754. Similarly, in some examples, the motor controller 758 can be omitted, and the control circuit 760 can directly generate the motor drive signal 774.

[0031] Motor 754 may receive power from energy source 762. Energy source 762 may be or may include a battery, a supercapacitor, or any other suitable energy source. Motor 754 may be mechanically coupled to drive member 751 via transmission 756. Transmission 756 may include one or more gears or other coupling components to couple motor 754 to drive member 751.

[0032] Further to the above, RF energy source 762 is coupled to the end effector (e.g., end effector 752 (FIG. 2), 852 (FIG. 5)) and applied to the RF electrode (e.g., electrode 796 (FIG. 2), 896 (FIG. 5)) or electrodes of the end effector. In at least one example, anvil 766 is fabricated at least in part from a conductive metal and may be used as a return path for the electrosurgical RF current. Control circuit 760 controls the delivery of RF energy to RF electrode 796 or RF electrode 896.

[0033] Additional 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.

[0034] 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.

[0035] 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, 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. 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 788 may include a non-electrical conductor-containing switch, an ultrasonic switch, an accelerometer, and an inertial sensor, among others. The sensor 788 may include one or more sensors.

[0036] The control circuitry 760 can be configured to simulate the response of the actual system of the instrument in the controller software. The drive member 751 can move one or more elements in the end effector 752 at or near a target velocity. The surgical instrument 750 can include a feedback controller, which can be one of any feedback controller, including, for example, but not limited to, a PID, state feedback, LQR, and / or adaptive controller. The surgical instrument 750 can include a power supply for converting signals from the feedback controller into physical input values, such as, for example, case voltage, PWM voltage, frequency modulated voltage, current, torque, and / or force.

[0037] As described in more detail above, various example embodiments are directed to a surgical instrument 750 comprising an end effector 752 or 852 having motorized sealing and cutting instruments. In various examples, the surgical instrument 750 may include a control circuit 760 that is programmed to control the distal translation of the drive member 751 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 control program based on the tissue condition. The control program can dictate the distal movement of the drive member 751. Different control programs may be selected to better treat different tissue conditions. For example, when thicker tissue is present, the control circuit 760 may be programmed to translate the drive member 751 at a slower speed and / or with less power. When thicker tissue is present, control circuitry 760 may be programmed to translate drive member 751 at a higher speed and / or with a higher power.

[0038] 10 is a logic flow diagram of a process 900 illustrating a control program or logic configuration for performing a surgical procedure on tissue. In certain examples, the process 900 is performed using, for example, the surgical instrument 750. In certain examples, the process 900 is performed, or at least in part, using, for example, the control circuitry 760. In the illustrated example, the process 900 includes applying 901 a first stage of the surgical procedure to tissue grasped by the surgical instrument 750. In certain examples, the process 901 includes switching 903 from the first stage of the surgical procedure to a second stage of the surgical procedure based on at least one of a predetermined threshold value of a tissue characteristic and a predetermined threshold time for the first stage.

[0039] In the illustrated example, if a characteristic of the tissue being treated equals or exceeds a predetermined threshold (902), process 901 switches to a second stage of the surgical procedure (903). Process 904 also switches to a second stage of the surgical procedure (903) if a threshold application time for the first stage is reached (904) before the characteristic of the tissue being treated reaches the predetermined threshold. Thus, process 900 can switch from a first stage of the surgical procedure to a second stage of the surgical procedure if at least one of two conditions is met. The first condition is triggered by reaching or exceeding a predetermined threshold for the first tissue characteristic, and the second condition is triggered by reaching or exceeding a predetermined threshold time for the first stage.

[0040] In certain examples, the tissue characteristic determined in the first stage is tissue impedance. Various mechanisms for monitoring tissue impedance are disclosed in U.S. Patent Application Publication No. 20170000553, entitled SURGICAL SYSTEM WITH USER ADAPTABLE TECHNIQUES EMPLOYING MULTIPLE ENERGY MODALITIES BASED ON TISSUE PARAMETERS, filed June 9, 2016, and incorporated herein by reference in its entirety. In at least one example, tissue impedance is determined based on current passed through the tissue by the RF energy source 762. A current sensor can measure the current passing through the tissue based on a preset voltage value. Alternatively, a voltage sensor can measure the voltage between the electrode 796, or alternatively, the electrode 896, and the return electrode based on a preset current value. Tissue impedance can be determined based on the current value and the voltage value.

[0041] Further to the above, the first and second stages are different. In at least one example, the first stage includes electrical sealing of the tissue, while the second stage includes mechanical sealing and, optionally, mechanical cutting of the tissue. In at least one example, the first stage includes applying therapeutic RF energy to the tissue, while the second stage includes stapling the tissue via staples from a staple cartridge. In certain examples, the second stage is applied after the first stage is completed. In other cases, the second stage is set before the first stage is completed. In other cases, the second stage and the first stage are separated by a predetermined waiting time. In certain examples, the waiting time is based on tissue characteristics determined during the first stage.

[0042] Additionally, the process 900 includes setting (905) parameters for the second stage based on at least one measurement of the tissue characteristic determined in the first stage. In certain examples, the at least one measurement is measured at the beginning of the first stage of the surgical procedure or at the end of the first stage of the surgical procedure. In other examples, the at least one measurement includes multiple measurements of the first tissue characteristic measured during the first stage of the surgical procedure. In one example, the parameters for the second stage are set based on an average value of the multiple measurements of the first tissue characteristic measured during the first stage of the surgical procedure.

[0043] In various embodiments, the second stage parameter is, for example, the drive speed of the motor controller 758. In certain embodiments, the second stage parameter is, for example, the speed of the drive member 751. The drive speed can be an initial drive speed. In certain examples, the drive speed is, for example, the speed of the I-beam 720 in a predetermined initial zone of the firing path.

[0044] The process 900 may further include monitoring 906 a second tissue characteristic, different from the first tissue characteristic, during a second stage of the surgical procedure. In certain examples, the second tissue characteristic is tissue compression. The sensor 788 may be configured to measure a force applied to the jaws by the drive member 751 of the drive system 761 of the surgical instrument 750. The force applied to the jaws may represent tissue compression experienced by a tissue section grasped by the jaws. One or more sensors 788 may be positioned at various interaction points along the drive system 761 ( FIG. 1 ) to detect closing and / or firing forces applied by the drive system 761 to an end effector (e.g., end effector 752, 852). The one or more sensors 788 may be sampled in real time during the surgical procedure, including the closing / firing operations by the control circuit 760. The control circuitry 760 receives and analyzes real-time sample measurements to provide time-based information for real-time assessment of closing / firing forces applied to the end effector 752 during a surgical procedure.

[0045] In one form, the one or more sensors 788 include, for example, a strain gauge sensor that 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. In at least one example, the strain gauge sensor is a micro strain gauge configured to measure one or more parameters of the end effector. In one aspect, the strain gauge sensor can measure the amplitude or magnitude of strain on the jaw members of the end effector during a surgical procedure, which can indicate tissue compression. The measured strain is converted into a digital signal and provided to the control circuit 760. In certain examples, the sensor 788 can comprise a load sensor configured to detect a load generated by the presence of compressed tissue between the jaws of the end effector.

[0046] In certain examples, a current sensor 786 can be used to measure the current drawn by the motor 754. The force required to advance the drive member 751 corresponds to the current drawn by the motor 754. The force is converted to a digital signal and provided to the control circuit 760. The current drawn by the motor 754 can represent tissue compression.

[0047] 11 is a graph 500 displaying an example implementation of the surgical procedure of process 900 for two tissues having different tissue compressibility. The less compressible tissue is represented by the dashed line, while the more compressible tissue is represented by the solid line. Graph 500 tracks tissue impedance (Z), I-beam force (F), and I-beam travel distance (δ) versus time (t). As RF energy is applied to the tissue in the first phase of the surgical procedure, tissue impedance (Z) reaches a minimum (Z at t, Z at t). 0’ In Z 0’ ), the minimum value of which depends in part on the compressibility of the tissue. With further application of RF energy, the minimum tissue impedance is maintained. t 1’ , t1, the tissue impedance begins to rise towards a predetermined maximum tissue impedance threshold (Zmax).

[0048] The increase in tissue impedance is faster in highly compressible tissue than in less compressible tissue. In the illustrated example, the end of the first phase occurs at t 2’ For less compressible tissue, however, the end of the first stage is determined by reaching a predetermined maximum threshold of tissue impedance (Zmax) at t2. Therefore, the switch from the first stage to the second stage (903) occurs more quickly at t2 than for less compressible tissue at t2. 2’ In this case, the more compressible the tissue, the faster the compression.

[0049] In the illustrated example, the end of the first phase triggers activation of motor 754, thereby initiating a second phase of the surgical procedure. The second phase of the surgical procedure includes firing a staple cartridge (e.g., staple cartridge 767, 867) by activating motor 754 to deploy staples from rows of staple cavities into tissue. The staples are formed against anvil pockets of an anvil (e.g., anvil 766, 866). For highly compressible tissue, activation of motor 754 is triggered by reaching a predetermined maximum tissue impedance threshold (Zmax) in the first phase. However, for less compressible tissue, activation of motor 754 is triggered by reaching a maximum first phase time threshold (Δt'max) at time t2.

[0050] In addition to the above, for the second phase, different initial I-beam or motor drive velocities V', V (slope of lines 501, 511) may be used to determine the end point of the first phase (t'), as determined by reaching a predetermined maximum threshold of tissue impedance (Zmax) or by reaching a maximum time threshold (Δt'max). 2’ , t2). In another example, the initial I-beam or motor drive speeds V0′, V0 (slope of lines 501, 511) for the second stage can be determined based on tissue impedance readings at the start (Z1′, Z1) of the first stage. In yet another example, the initial I-beam or motor drive speeds V0′, V0 (slope of lines 501, 511) for the second stage can be determined based on multiple tissue impedance readings at various points in the first stage. For example, an average value of multiple tissue impedance readings at various points in the first stage can be used to determine the initial I-beam or motor drive speed for the second stage.

[0051] In various examples, the control circuitry 760 includes a microcontroller with a storage medium and a processor. The storage medium may be in the form of a memory unit that stores a database, formula, or look-up table that can be utilized by the processor to determine an initial I-beam or motor drive speed for the second stage based on tissue impedance readings of the first stage. In certain examples, the initial I-beam or motor drive speed is an initial steady-state speed after an initial ramping segment to reach the initial steady-state speed. In certain examples, the initial I-beam or motor drive speed is a target initial speed set by the processor based on tissue impedance readings of the first stage.

[0052] 11 , as described in more detail above, process 900 may include monitoring tissue compression (906) during the second stage and making adjustments to the I-beam or motor drive speed based on the detected tissue compression. In the illustrated example, control circuit 760 is configured to maintain the I-beam force within a predetermined force threshold range (Fmin-Fmax). The I-beam force in the example of less compressible tissue reaches a predetermined maximum I-beam force (Fmax) (521) at t3, which triggers control circuit 760 to adjust the I-beam or motor drive speed. In the illustrated example, control circuit 760 adjusts the drive speed from an initial drive speed V0 (slope of line 511) to a drive speed V1 (slope of line 512) that is less than the initial drive speed V0. The reduction in drive speed at t3 reduces the I-beam force to a level less than the predetermined maximum I-beam force (Fmax).

[0053] Conversely, at t4, the I-beam force in the less compressible tissue example reaches (522) a predetermined minimum I-beam force (F), which triggers control circuit 760 to adjust the drive speed of the I-beam or motor. In the illustrated example, control circuit 760 adjusts the drive speed from drive speed V1 (slope of line 512) to a drive speed V2 (slope of line 513) greater than drive speed V1. The increase in drive speed at t4 increases the I-beam force to a level greater than the predetermined minimum I-beam force (F) while remaining within the predetermined force threshold range (F-F).

[0054] In addition to adjusting the drive speed based on the I-beam force, the control circuit 760 can also make adjustments to the drive speed based on tissue impedance readings determined within the second stage. In certain examples, tissue impedance is monitored in the second stage by passing a non-therapeutic or therapeutic current through the tissue and measuring the tissue impedance based on the non-therapeutic or therapeutic current. In certain examples, adjustments to the drive speed based on tissue impedance readings within the second stage are made while maintaining the I-beam force within a predetermined force threshold range (Fmin-Fmax). Thus, in such examples, the control circuit 760 is configured to make a first adjustment to the drive speed based on tissue compression and a second adjustment to the drive speed based on tissue impedance.

[0055] In certain examples, adjustments to the drive speed during the second stage can be based on the rate of change of tissue impedance. As the I-beam advances distally, tissue compression causes a change in tissue impedance over time. In the illustrated example, control circuit 760 adjusts the rate of change of tissue impedance (ΔZ1 / Δt1), e.g., the slope of line 531, over time (e.g., over period t 2’ -t 3’ ) is determined by monitoring changes in tissue impedance.

[0056] If the control circuit 760 determines that the rate of change of tissue impedance has exceeded a predetermined threshold range, the control circuit 760 can adjust the drive speed to return the rate of change of tissue impedance to a value within the predetermined threshold range. For example, the drive speed can be adjusted from an initial drive speed V', which is the slope of line 501, to a drive speed V', which is the slope of line 502, thereby adjusting the rate of change of tissue impedance from (ΔZ / Δt), which is the slope of line 531, to (ΔZ / Δt), which is the slope of line 532.

[0057] In certain examples, the rate of change of tissue impedance in the second stage is utilized as a feedback indicator for adjusting the drive speed. Adjusting the drive speed can result in a change in the rate of change of tissue impedance. In the illustrated example, the slopes of lines 541, 542, and 543 correspond to the slopes of lines 511, 512, and 513, for example. Thus, control circuit 760 can be configured to verify changes made to the drive speed setting, for example, by monitoring the rate of change of tissue impedance.

[0058] 11 , the second phase of the surgical procedure involves firing the staple cartridge (e.g., staple cartridge 767, 867) by deploying staples from the rows of staple cavities into the tissue. The staples are formed against the anvil pockets of the anvil (e.g., anvil 766, 866). As the staples are deployed and formed in stages, the I-beam force fluctuates within a predetermined force threshold range (Fmin-Fmax). As described above, the control circuit 760 is configured to maintain the I-beam force within the predetermined force threshold range (Fmin-Fmax) by making adjustments to the drive speed. Toward the end of the second phase, after the staple deployment and formation are complete, the I-beam force quickly drops to a minimum, which corresponds to the tissue impedance curve (e.g., t5, t6). 5’), which can be detected by control circuit 760 based on tissue impedance readings. In response, control circuit 760 further adjusts the drive speed (e.g., the slope of lines 503, 514) to terminate the second phase.

[0059] 12, a top view of cartridge deck 630 is shown. Cartridge deck 630 is similar in many respects to other cartridge decks disclosed elsewhere herein, such as cartridge decks 730 and 830. For example, cartridge deck 630 includes two rows of staple cavities 657a and 657b on either side of longitudinal slot 659. Additionally, cartridge deck 630 also includes electrode segments 696a, 696c, and 696e and electrode segments 696b, 696d, and 696f on either side of longitudinal slot 659.

[0060] In the illustrated example, staple cavity rows 657a, 657b are closer to longitudinal slot 659 than electrode segments 696a-696f. However, in other arrangements, staple cavity rows 657a, 657b can be further from longitudinal slot 659 than electrode segments 696a-696f. In various examples, cartridge deck 630 may include more or less than two staple cavity rows and / or more or less than six electrode segments.

[0061] In certain examples, cartridge deck 630 can be implemented using an end effector similar in many respects to end effector 752 (FIG. 2). In such examples, electrode segments 696a-696f can be integrated with channel 744 (FIG. 2), for example. Cartridge deck 630 can be formed by inserting a staple cartridge including staple cavity rows 657a, 657b into the distal end of channel 744.

[0062] In other examples, cartridge deck 630 may be implemented using an end effector that is similar in many respects to end effector 852 ( FIG. 5 ). In such examples, electrode segments 696 a-696 f may be integrated into an RF overlay that is similar in many respects to RF overlay 890. Further, as detailed by the assembly process described in connection with FIGS. 7-9 , cartridge deck 630 may be formed by inserting a staple cartridge including staple cavity rows 657 a, 657 b into channel 844 and pivoting RF overlay including electrode segments 696 a-696 f toward channel 844 into locking engagement with the staple cartridge.

[0063] In addition to the above, the cartridge deck 630 can form a tissue contacting surface 631 for grasping tissue, for example, in cooperation with the anvil 766 and in response to a drive motion generated, for example, by the motor 754 of the surgical instrument 750. Furthermore, the electrode segments 696 a-696 f can be electrically coupled to an RF energy source 762, which can selectively transmit RF energy to tissue grasped between the tissue contacting surface 631 of the cartridge deck 630 and the anvil 766. The control circuitry 760 can cause the RF energy source 762 to selectively energize and de-energize, or activate and deactivate, the electrode segments 696 a-696 f in a predetermined sequence to deliver therapeutic RF energy to the grasped tissue.

[0064] In the illustrated example, the electrode segments 696a-696f are arranged in two rows on either side of the longitudinal slot 659. The electrode segments in each row reside in distinct, successive treatment zones, for example, a proximal zone (Zone 1), an intermediate zone (Zone 2), and a distal zone (Zone 3). In other examples, more or less than three, for example, two, four, five, and / or different size treatment zones are contemplated.

[0065] In the illustrated example, the electrode segments 696a-696f are arranged in pairs in each of the consecutive treatment zones. A pair of electrode segments (e.g., electrode segments 695a, 696b) is located on either side of the longitudinal slot 659. In other examples, the electrode segments in consecutive treatment zones can be lined up on one side of the longitudinal slot 659. In other examples, the electrode segments in consecutive treatment zones can alternate, with a first electrode segment present in a first treatment zone on one side of the longitudinal slot 659 and a second electrode segment present in a second treatment zone distal or proximal to the first treatment zone on the other side of the longitudinal slot 659.

[0066] In the illustrated example, the electrode segments 696a-696f vary in size. Specifically, the electrode segments 696c, 696d in the intermediate zone are smaller in size than the electrode segments 696a, 696b, 696e, 696f in the proximal and distal zones. In other examples, electrode segments having different or the same sizes are contemplated. In one example, the aligned electrode segments may include a gradually increasing size in the proximal or distal direction.

[0067] In the illustrated example, the electrode segments in different treatment zones are spaced apart and can be individually activated or deactivated in a predetermined sequence. In at least one example, each electrode segment or pair of electrode segments in a treatment zone is separately coupled to an RF energy source, thereby enabling the RF energy source 762 to selectively energize and deenergize, or activate and deactivate, the electrode segments 696a-696f in a predetermined sequence to selectively deliver therapeutic RF energy to the grasped tissue in a predetermined zone-treatment sequence, as discussed in more detail below.

[0068] In addition to the RF energy, staples from staple cavity rows 657a, 657b are deployed within the tissue. The staples are formed against the anvil pockets of an anvil (e.g., anvils 766, 866). The staples are sequentially deployed by a sled driven by I-beam 720 and advanced from the proximal end 632 to the distal end 634 of cartridge deck 630. Advancement of the sled through I-beam 720 is powered by a drive motion generated, for example, by motor 754 and transmitted to I-beam 720 by drive member 751.

[0069] 14 and 15 are logic flow diagrams of processes 600, 650 illustrating a control program or logic configuration for performing a surgical procedure on tissue. In one form, processes 600, 650 are performed by a surgical instrument 750 while armed with an end effector including, for example, a cartridge deck 630 (FIG. 12). Tissue is grasped, for example, between a tissue contacting surface 631 of a staple cartridge 667 on the cartridge deck 630 and an anvil 766 (FIG. 1).

[0070] The process 600, 650 includes simultaneously delivering 601 therapeutic energy to all tissue in the sequential treatment zones. The process 600, 650 further includes driving 602 the motor 754 to sequentially deploy staples from the staple cartridge 667 in the sequential treatment zones that exist between the proximal end 632 and the distal end 634 of the cartridge deck 630.

[0071] Process 600 includes detecting (609) a parameter indicative of the progress of staple deployment from the staple cartridge in the successive treatment zones, and sequentially stopping (610) electrode segments 696a-696f to sequentially interrupt delivery of therapeutic energy to tissue in the successive treatment zones based on the progress of staple deployment from the staple cartridge.

[0072] 15 and graph 680 of FIG. 13 , process 650 continues to deliver therapeutic RF energy to zone 1, zone 2, and zone 3 until certain conditions are met. When staple deployment in zone 1 is detected to be complete (603), process 650 stops delivering therapeutic RF energy to zone 1 (604) while continuing to deliver therapeutic RF energy to zones 2 and 3. Next, when staple deployment in zone 2 is detected to be complete (605), process 650 stops delivering therapeutic RF energy to zone 2 (606) while continuing to deliver therapeutic RF energy to zone 3. Finally, when staple deployment in zone 3 is detected to be complete (607), process 650 stops delivering therapeutic RF energy to zone 3 (608).

[0073] In certain examples, the parameter indicative of staple deployment progress is a distance-based parameter or a position-based parameter. In such examples, control circuitry 760 is configured to implement a predetermined sequence of deactivation of electrode segments 696a-696f based on the staple deployment progress, as detected based on distance and / or position readings received from one or more sensors 788.

[0074] The distance can be, for example, the distance traveled by the drive member 751 or I-beam 720 advancing the sled through the successive treatment zones. Similarly, the position can be the position of the I-beam 720 or the sled driven by the I-beam 720 with respect to the successive treatment zones. In certain examples, detecting that the I-beam 720 has transitioned from the proximal zone to the distal zone triggers the control circuit 760 to intercept delivery of therapeutic RF energy to the proximal zone.

[0075] In various embodiments, the one or more sensors 788 may include, for example, a position sensor configured to detect the position of the drive member 751 and / or the I-beam 720. The position sensor may be or include any type of sensor capable of generating position data indicative of the position of the drive member 751 and / or the I-beam 720. In some examples, the position sensor may include an encoder configured to provide a series of pulses to the control circuitry 760 as the drive member 751 and / or the I-beam 720 translates distally and proximally. The control circuitry 760 can track the pulses to determine the position of the drive member 751 and / or the I-beam 720. 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 drive member 751 and / or the I-beam 720.

[0076] In certain examples, if motor 754 is a stepper motor, control circuitry 760 can track the position of drive member 751 by summing the number and direction of steps that motor 754 is commanded to take. Thus, in such examples, a parameter indicative of staple deployment progress can be based on the number and direction of steps that motor 754 is commanded to take.

[0077] The position sensor may be located in the end effector 752 or in any other portion of the instrument. Additionally, a detailed description of an absolute positioning system for use with surgical instrument 750 is described 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.

[0078] In certain examples, the parameter indicative of staple deployment progress is a time-based parameter. The control circuitry 760 can evaluate the staple deployment progress using, for example, a timer / counter 781. The control circuitry 760 can simultaneously start the timer / counter 781 and activate the motor 754 (FIG. 1). The control circuitry 760 uses the time elapsed since activation of the motor 754, as detected by the timer / counter 781, to evaluate the staple deployment progress based on, for example, a technique, a formula, a database, and / or a look-up table stored in a memory unit.

[0079] In certain instances, the parameter indicative of staple deployment progress is a tissue impedance-based parameter or a force-based parameter. In certain instances, the parameter indicative of staple deployment progress is based on tissue thickness, for example.

[0080] Measurements of tissue compression, tissue impedance, tissue thickness, and / or force required to close the end effector on the tissue measured by sensor 788 can be used by the microcontroller of control circuit 760 to, for example, assess the progress of staple deployment. In one example, the microcontroller can include memory that stores techniques, formulas, formulas, databases, and / or lookup tables that can be used by the microcontroller to assess the progress of staple deployment based on readings from sensor 788.

[0081] The surgical tool systems described herein are operated by electric motors; however, the surgical tool systems described herein may be driven in any suitable manner. In certain examples, the motors disclosed herein may comprise one or more portions of a robotically controlled system. For example, U.S. Patent Application No. 13 / 118,241 (now U.S. Patent No. 9,072,535), entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, discloses several examples of robotic surgical tool systems in more detail, the entire disclosure of which is incorporated herein by reference. International Publication No. 2017 / 083125, published May 18, 2017, entitled "STAPLER WITH COMPOSITE CARDAN AND SCREW DRIVE"; International Publication No. 2017 / 083126, published May 18, 2017, entitled "STAPLE PUSHER WITH LOST MOTION BETWEEN RAMPS"; International Publication No. 2015 / 153642, published October 8, 2015, entitled "SURGICAL INSTRUMENT WITH SHIFTABLE TRANSMISSION"; U.S. Patent Application Publication No. 2017 / 0265954, filed March 17, 2017, entitled "STAPLER WITH CABLE-DRIVEN ADVANCEABLE CLAMPING ELEMENT AND DUAL DISTAL PULLEYS"; and U.S. Patent Application Publication No. 2017 / 0265954, filed March 17, 2017, entitled "STAPLER WITH CABLE-DRIVEN ADVANCEABLE CLAMPING ELEMENT AND DUAL DISTAL PULLEYS." The disclosures of U.S. Patent Application Publication No. 2017 / 0265865, entitled PULLEY, filed February 15, 2017, and U.S. Patent Application Publication No. 2017 / 0290586, entitled STAPLING CARTRIDGE, filed March 29, 2017, are incorporated herein by reference in their entireties.

[0082] While the surgical tool systems described herein have been described in connection with the placement and deformation of staples, the embodiments described herein are not so limited. Various embodiments are contemplated that place fasteners other than staples, such as clamps or tacks. Additionally, various embodiments are contemplated that utilize any suitable means for sealing tissue. For example, end effectors according to various embodiments can include electrodes configured to heat and seal tissue. Similarly, for example, end effectors according to certain embodiments can apply vibrational energy to seal tissue. [Example]

[0083] Various aspects of the subject matter described herein are illustrated in the following numbered examples.

[0084] Example 1 - A surgical instrument comprising an end effector. The end effector comprises a first jaw, a second jaw movable relative to the first jaw between an open configuration and a closed configuration to grasp tissue, a staple cartridge, and at least one electrode. The surgical instrument further comprises a drive member, a motor assembly configured to generate a drive motion to move the drive member, and a control circuit. The control circuit is configured to cause the at least one electrode to deliver therapeutic energy to the tissue during a first phase of the surgical procedure, to cause the motor assembly to move the drive member to deploy staples from the staple cartridge into the tissue during a second phase of the surgical procedure, and to monitor a first tissue characteristic during the first phase of the surgical procedure. The control circuitry is further configured to switch from the first stage of the surgical procedure to the second stage of the surgical procedure when at least one of two conditions is met, the first of the two conditions being triggered by a first tissue characteristic reaching or exceeding a predetermined threshold and the second of the two conditions being triggered by a first stage reaching or exceeding a predetermined threshold time. The control circuitry is further configured to set parameters of the second stage of the surgical procedure based on at least one measurement of the tissue characteristic determined during the first stage of the surgical procedure and to monitor a second tissue characteristic during the second stage of the surgical procedure, the second tissue characteristic being different from the first tissue characteristic.

[0085] Example 2 - The surgical instrument of Example 1, wherein the parameter of the second stage is a drive speed of the motor assembly.

[0086] Example 3 - The surgical instrument of Examples 1 or 2, wherein the first tissue property is tissue impedance.

[0087] Example 4 - The surgical instrument of Examples 1, 2 or 3, wherein at least one measurement is taken at the beginning of a first stage of a surgical procedure or at the end of a first stage of a surgical procedure.

[0088] Example 5 - The surgical instrument of Examples 1, 2 or 3, wherein at least one measurement comprises a plurality of measurements of a first tissue property measured during a first stage of the surgical procedure.

[0089] Example 6 - The surgical instrument of Examples 1, 2, 3, 4 or 5, wherein the first jaw comprises a channel configured to slidably receive a staple cartridge.

[0090] Example 7 - The surgical instrument of Examples 1, 2, 3, 4, 5 or 6, wherein the channel comprises a cover and at least one electrode is integral with the cover.

[0091] Example 8 - A surgical instrument described in Example 1, 2, 3, 4, 5, 6 or 7, wherein the cover has a longitudinal opening configured to allow at least one electrode and a cartridge deck of the staple cartridge to cooperate to define a tissue contact surface while the staple cartridge is held in the channel.

[0092] Example 9 - A surgical instrument as described in Examples 1, 2, 3, 4, 5, 6, 7 or 8, wherein the control circuit is further configured to cause the generator to adjust the level of therapeutic energy delivered through at least one electrode based on the first tissue characteristic.

[0093] Example 10 - A surgical instrument comprising a first jaw and a second jaw, the first jaw being movable relative to the second jaw between an open configuration and a closed configuration to grasp tissue. The surgical instrument further comprises an anvil, a staple cartridge, a channel configured to receive the staple cartridge, and an RF overlay pivotally connected to the channel, the RF overlay comprising at least one electrode. The surgical instrument further comprises a drive member, a motor assembly configured to generate a drive motion to move the drive member, and a control circuit. The control circuit is configured to cause the at least one electrode to deliver therapeutic energy to the tissue during a first stage of the surgical procedure, to cause the motor assembly to move the drive member to deploy staples from the staple cartridge into the tissue during a second stage of the surgical procedure, and to monitor tissue characteristics during the first stage of the surgical procedure. The control circuit is further configured to switch from the first stage of the surgical procedure to the second stage of the surgical procedure based on at least one of a predetermined threshold value of the tissue characteristic and a predetermined threshold time for the first stage. The control circuitry is further configured to set parameters for a second stage of the surgical procedure based on at least one measurement of the tissue property determined during the first stage of the surgical procedure.

[0094] Example 11 - The surgical instrument of Example 10, wherein the parameter of the second stage is a drive speed of the motor assembly.

[0095] Example 12 - The surgical instrument of Example 10 or 11, wherein the tissue property is tissue impedance.

[0096] Example 13 - The surgical instrument of Examples 10, 11 or 12, wherein at least one measurement is taken at the beginning of a first stage of a surgical procedure or at the end of a first stage of a surgical procedure.

[0097] Example 14 - The surgical instrument of Example 10, 11 or 12, wherein at least one measurement comprises a plurality of measurements of tissue properties measured during a first stage of the surgical procedure.

[0098] Example 15 - The surgical instrument of Examples 10, 11, 12, 13 or 14, wherein the anvil is configured to pivot the RF overlay into locking engagement with the staple cartridge in the channel.

[0099] Example 16 - The surgical instrument of Examples 10, 11, 12, 13, 14 or 15, wherein the staple cartridge comprises a cartridge deck including a recessed area configured to releasably retain an RF overlay.

[0100] Example 17 - The surgical instrument of Example 10, wherein the staple cartridge comprises a latch member configured to lockingly engage a distal portion of the staple cartridge.

[0101] Example 18 - A surgical instrument comprising an end effector. The end effector comprises a first jaw, a second jaw movable relative to the first jaw between an open configuration and a closed configuration to grasp tissue, and a staple cartridge. The staple cartridge comprises a longitudinal slot and a row of staple cavities extending in successive treatment zones along the longitudinal slot. The end effector further comprises electrode segments individually present in the successive treatment zones. The surgical instrument further comprises a drive member, a motor assembly configured to generate a drive motion to move the drive member, and a control circuit. The control circuit is configured to deliver therapeutic energy to tissue in all of the successive treatment zones, cause the motor assembly to move the drive member to encourage staple deployment from the staple cartridge, and detect a parameter indicative of progress of staple deployment from the staple cartridge within the successive treatment zones. The control circuit is further configured to sequentially stop the electrodes and sequentially interrupt delivery of therapeutic energy to tissue within the successive treatment zones based on progress of staple deployment from the staple cartridge.

[0102] Example 19 - The surgical instrument of Example 18, wherein the electrode segments include a proximal electrode segment present in a proximal treatment zone of the successive treatment zones and a distal electrode segment present in a distal treatment zone of the successive treatment zones. Completion of staple deployment from the staple cartridge in the proximal treatment zone is detected to cause the control circuit to stop the proximal electrode segment.

[0103] Example 20 - The surgical instrument of Example 19, wherein detection of completion of staple deployment from the staple cartridge in the distal treatment zone causes the control circuit to stop the distal electrode segment.

[0104] While several embodiments have been shown and described, it is not the applicant's intention to restrict or limit the scope of the appended claims to such details. Numerous modifications, variations, changes, substitutions, combinations, and equivalents of these embodiments may be implemented and will occur to those skilled in the art without departing from the scope of the present disclosure. Furthermore, the structure of each element associated with the described embodiments can alternatively be described as a means for providing the function performed by that element. Similarly, although materials are disclosed with respect to particular components, other materials may be used. It is therefore to be understood that the above description and the appended claims are intended to cover all such modifications, combinations, and variations as fall within the scope of the disclosed embodiments. The appended claims are intended to cover all such modifications, variations, changes, substitutions, modifications, and equivalents.

[0105] The above detailed description has set forth various aspects of devices and / or processes via the use of block diagrams, flow diagrams, and / or examples. To the extent that such block diagrams, flow diagrams, 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, flow diagrams, and / or examples can be individually and / or collectively implemented by a variety 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. Additionally, 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 applies regardless of the particular type of signal-bearing medium used to actually effect the distribution.

[0106] The instructions used to program the logic to implement various disclosed aspects may be stored in system memory, such as dynamic random access memory (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, compact disks, read-only memories (CD-ROMs), magneto-optical disks, read-only memories (ROMs), random access memories (RAMs), erasable programmable read-only memories (EPROMs), electrically erasable programmable read-only memories (EEPROMs), magnetic or optical cards, flash memories, 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, infrared signals, digital signals, etc.). 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).

[0107] 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 digital signal processor (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, collectively or individually, can be embodied as circuitry that forms part of a larger system, such as, for example, an integrated circuit (IC), an application specific integrated circuit (ASIC), a system on a chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, a smartphone, etc. Thus, as used herein, "control circuitry" includes, but is not limited to, electrical circuitry having at least one discrete electrical circuit, electrical circuitry having at least one integrated circuit, electrical circuitry having at least one application-specific integrated circuit, electrical circuitry forming a general-purpose computing device configured by a computer program (e.g., a general-purpose computer configured by a computer program that at least partially executes the processes and / or apparatus described herein, or a microprocessor configured by a computer program that at least partially executes the processes and / or apparatus described herein), electrical circuitry forming a memory device (e.g., a form of random access memory), and / or electrical circuitry forming a communications device (e.g., a modem, a communications switch, or an optical-to-electrical facility). 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.

[0108] As used in any aspect of this specification, 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 in a memory device, and / or hard-coded (e.g., non-volatile) data.

[0109] When 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.

[0110] 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 manipulations of physical quantities and / or logical states, which may, but need not, take the form of electrical or magnetic signals capable of being stored, transferred, combined, compared, and otherwise manipulated. 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.

[0111] 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.

[0112] Unless expressly specified otherwise, as will be apparent from the foregoing disclosure, discussions throughout the foregoing disclosure using terms such as "processing," "computing," "calculating," "determining," "displaying," and the like will be understood to refer to the actions 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 other such information storage, transmission, or display device.

[0113] 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 components and / or inactive components and / or standby components, unless the context requires otherwise.

[0114] 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," "up," and "down" 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.

[0115] 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,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). 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, 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 statement, 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.

[0116] Additionally, 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 any other modifiers, generally means at least two items, or more than two 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, etc.). 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, etc.). Furthermore, one of ordinary skill in the art will understand that any disjunctive word and / or phrase presenting two or more alternative terms should typically be understood, whether in the specification, claims, or drawings, to contemplate the possibility of including one of those terms, either of those terms, or both of those terms, unless the context requires otherwise. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "A and B."

[0117] 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 a sequence, it should be understood that the various operations may be performed in orders other than those shown, or may be performed 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.

[0118] 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.

[0119] As used herein, unless otherwise indicated, the term "about" or "approximately" as used in this disclosure refers to an acceptable error for a particular value as determined by one of ordinary skill in the art, which depends in part on how the value is measured or determined. In certain embodiments, the term "about" or "approximately" refers to 1, 2, 3, or 4 standard deviations. In certain embodiments, the term "about" or "approximately" refers to within 50%, 20%, 15%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, or 0.05% of a given value or range.

[0120] As used herein, unless otherwise indicated, all numerical parameters should be understood in all instances to be preceded and modified by the term "about," given the inherent variability of the underlying measurement methods used to determine the numerical value of such parameters. At the very least, and not as an attempt to limit the application of the doctrine of equivalents to the scope of the claims, each numerical parameter set forth herein should at least be construed in light of the number of reported significant digits and by applying ordinary rounding techniques.

[0121] Additionally, any numerical range recited herein includes all subranges subsumed within the recited range. For example, a range of "1 to 10" includes all subranges between (and including) the recited minimum of 1 and the recited maximum of 10, i.e., all subranges having a minimum of 1 or more and a maximum of 10 or less. Similarly, all ranges recited herein include the endpoints of the recited range. For example, a range of "1 to 10" includes the endpoints 1 and 10. Every maximum numerical limit recited herein is intended to include every subsumed lower numerical limit, and every minimum numerical limit recited herein is intended to include every subsumed higher numerical limit. Accordingly, applicants reserve the right to amend this specification, including the claims, to include every explicitly recited subrange that falls within the explicitly recited range. All such ranges are inherently set forth herein.

[0122] 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 material, or portions thereof, that is said to be incorporated herein by reference but that conflicts with current definitions, views, or other disclosure material set forth herein shall be incorporated only to the extent that no conflict arises between the incorporated material and the current disclosure material.

[0123] 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 were chosen and described to illustrate the principles and practical applications, thereby enabling those skilled in the art to utilize various embodiments, with various modifications, as suited to the particular use contemplated. It is intended that the claims presented herewith define the overall scope.

[0124] [Embodiment] (1) A surgical instrument, An end effector, First Joe and a second jaw movable relative to the first jaw between an open configuration and a closed configuration to grasp tissue; a staple cartridge; at least one electrode; an end effector comprising: A drive member; a motor assembly configured to generate a drive motion to move the drive member; A control circuit comprising: causing the at least one electrode to deliver therapeutic energy to the tissue during a first stage of a surgical procedure; causing the motor assembly to move the drive member to deploy staples from the staple cartridge into the tissue during a second stage of the surgical procedure; monitoring a first tissue characteristic during the first stage of the surgical procedure; switching from the first stage of the surgical procedure to the second stage of the surgical procedure when at least one of two conditions is met, a first of the two conditions being triggered by a predetermined threshold of the first tissue characteristic being reached or exceeded, and a second of the two conditions being triggered by a predetermined threshold time of the first stage being reached or exceeded; setting parameters for the second stage of the surgical procedure based on at least one measurement of the tissue property determined during the first stage of the surgical procedure; monitoring a second tissue characteristic during the second stage of the surgical procedure, the second tissue characteristic being different from the first tissue characteristic; a control circuit configured to: A surgical instrument comprising: (2) A surgical instrument according to embodiment 1, wherein the parameter of the second stage is the drive speed of the motor assembly. (3) A surgical instrument according to embodiment 2, wherein the first tissue characteristic is tissue impedance. (4) The surgical instrument of embodiment 3, wherein the at least one measurement is measured at the start of the first stage of the surgical procedure or at the end of the first stage of the surgical procedure. (5) The surgical instrument of embodiment 3, wherein the at least one measurement value comprises a plurality of measurements of the first tissue property measured during the first stage of the surgical procedure.

[0125] (6) The surgical instrument of claim 1, wherein the first jaw includes a channel configured to slidably receive the staple cartridge. (7) The surgical instrument of embodiment 6, wherein the channel comprises a cover and the at least one electrode is integrated with the cover. (8) The surgical instrument of embodiment 7, wherein the cover has a longitudinal opening configured to allow the at least one electrode and a cartridge deck of the staple cartridge to cooperate to define a tissue contact surface while the staple cartridge is retained in the channel. (9) The surgical instrument of claim 1, wherein the control circuitry is further configured to cause the generator to adjust a level of the therapeutic energy delivered through the at least one electrode based on the first tissue characteristic. (10) A surgical instrument, First Joe and a second jaw, the first jaw being movable relative to the second jaw between an open configuration and a closed configuration to grasp tissue; Anvil and a staple cartridge; a channel configured to receive the staple cartridge; an RF overlay pivotally connected to the channel, the RF overlay comprising at least one electrode; A drive member; a motor assembly configured to generate a drive motion to move the drive member; A control circuit comprising: causing the at least one electrode to deliver therapeutic energy to the tissue during a first stage of a surgical procedure; causing the motor assembly to move the drive member to deploy staples from the staple cartridge into the tissue during a second stage of the surgical procedure; monitoring tissue characteristics during the first stage of the surgical procedure; switching from the first stage of the surgical procedure to the second stage of the surgical procedure based on at least one of a predetermined threshold value of the tissue characteristic and a predetermined threshold time of the first stage; setting parameters for the second stage of the surgical procedure based on at least one measurement of the tissue property determined during the first stage of the surgical procedure; a control circuit configured to: A surgical instrument comprising:

[0126] (11) The surgical instrument of claim 10, wherein the parameter of the second stage is a drive speed of the motor assembly. (12) The surgical instrument of claim 11, wherein the tissue characteristic is tissue impedance. (13) The surgical instrument of embodiment 12, wherein the at least one measurement is taken at the beginning of the first stage of the surgical procedure or at the end of the first stage of the surgical procedure. (14) The surgical instrument of embodiment 12, wherein the at least one measurement value comprises a plurality of measurements of the tissue property measured during the first stage of the surgical procedure. (15) The surgical instrument of claim 10, wherein the anvil is configured to pivot the RF overlay into locking engagement with the staple cartridge in the channel.

[0127] (16) The surgical instrument of claim 15, wherein the staple cartridge comprises a cartridge deck including a recessed area configured to releasably retain the RF overlay. (17) The surgical instrument of claim 10, wherein the staple cartridge comprises a latch member configured to lockingly engage a distal portion of the RF overlay. (18) A surgical instrument, An end effector, First Joe and a second jaw movable relative to the first jaw between an open configuration and a closed configuration to grasp tissue; A staple cartridge comprising: a longitudinal slot; and a row of staple cavities extending in a continuous treatment zone along said longitudinal slot; a staple cartridge comprising: Electrode segments individually present in the continuous treatment zone; an end effector comprising: A drive member; a motor assembly configured to generate a drive motion to move the drive member; A control circuit comprising: delivering therapeutic energy to the tissue in all of the successive treatment zones; causing the motor assembly to move the drive member to encourage deployment of staples from the staple cartridge; detecting a parameter indicative of the progress of staple deployment from the staple cartridge in the sequential treatment zone; sequentially stopping the electrodes to sequentially interrupt the delivery of the therapeutic energy to the tissue within the successive treatment zones based on the progress of the staple deployment from the staple cartridge; a control circuit configured to: A surgical instrument comprising: (19) The electrode segment is a proximal electrode segment in a proximal treatment zone of the continuous treatment zone; a distal electrode segment present in a distal treatment zone of the continuous treatment zones, the distal electrode segment causing the control circuit to stop the proximal electrode segment upon detection of completion of staple deployment from the staple cartridge in the proximal treatment zone; 19. The surgical instrument of embodiment 18, comprising: (20) The surgical instrument of embodiment 19, wherein detection of completion of staple deployment from the staple cartridge in the distal treatment zone causes the control circuit to stop the distal electrode segment.

Claims

1. A surgical instrument comprising: An end effector, The first Joe, a second jaw movable relative to the first jaw between an open configuration and a closed configuration to grasp tissue; a staple cartridge; at least one electrode; an end effector comprising: A drive member; a motor assembly configured to generate a drive motion to move the drive member; A control circuit comprising: causing the at least one electrode to deliver therapeutic energy to the tissue during a first stage of a surgical procedure; causing the motor assembly to move the drive member to deploy staples from the staple cartridge into the tissue during a second stage of the surgical procedure; monitoring a first tissue characteristic during the first stage of the surgical procedure; switching from the first stage of the surgical procedure to the second stage of the surgical procedure when at least one of two conditions is met, the first of the two conditions being triggered by the first tissue characteristic reaching or exceeding a predetermined threshold value and the second of the two conditions being triggered by the first stage reaching or exceeding a predetermined threshold time; setting parameters for the second stage of the surgical procedure based on at least one measurement of the first tissue property determined during the first stage of the surgical procedure; monitoring a second tissue characteristic during the second stage of the surgical procedure, the second tissue characteristic being different from the first tissue characteristic; a control circuit configured to: Equipped with A surgical instrument, wherein the parameter of the second stage is a drive speed of the motor assembly or a movement speed of the drive member.

2. The surgical instrument of claim 1 , wherein the first tissue property is tissue impedance.

3. The surgical instrument of claim 2 , wherein the at least one measurement is taken at the beginning of the first stage of the surgical procedure or at the end of the first stage of the surgical procedure.

4. The surgical instrument of claim 2 , wherein the at least one measurement comprises a plurality of measurements of the first tissue property measured during the first stage of the surgical procedure.

5. The surgical instrument of claim 1 , wherein the first jaw includes a channel configured to slidably receive the staple cartridge.

6. The surgical instrument of claim 5 , wherein the channel includes a cover, and the at least one electrode is integral with the cover.

7. 7. The surgical instrument of claim 6, wherein the cover comprises a longitudinal opening configured to allow the at least one electrode and a cartridge deck of the staple cartridge to cooperate to define a tissue contacting surface while the staple cartridge is retained in the channel.

8. Further comprising a generator, 10. The surgical instrument of claim 1, wherein the control circuitry is further configured to cause the generator to adjust a level of the treatment energy delivered through the at least one electrode based on the first tissue characteristic.

9. A surgical instrument comprising: The first Joe, a second jaw, the first jaw being movable relative to the second jaw between an open configuration and a closed configuration to grasp tissue; Anvil and a staple cartridge; a channel configured to receive the staple cartridge; an RF overlay pivotally connected to the channel, the RF overlay comprising at least one electrode; A drive member; a motor assembly configured to generate a drive motion to move the drive member; A control circuit comprising: causing the at least one electrode to deliver therapeutic energy to the tissue during a first stage of a surgical procedure; causing the motor assembly to move the drive member to deploy staples from the staple cartridge into the tissue during a second stage of the surgical procedure; monitoring tissue characteristics during the first stage of the surgical procedure; switching from the first stage of the surgical procedure to the second stage of the surgical procedure based on at least one of a predetermined threshold value of the tissue characteristic and a predetermined threshold time of the first stage; setting parameters for the second stage of the surgical procedure based on at least one measurement of the tissue property determined during the first stage of the surgical procedure; a control circuit configured to: Equipped with A surgical instrument, wherein the parameter of the second stage is a drive speed of the motor assembly or a movement speed of the drive member.

10. The surgical instrument of claim 9, wherein the tissue property is tissue impedance.

11. The surgical instrument of claim 10 , wherein the at least one measurement is taken at the beginning of the first stage of the surgical procedure or at the end of the first stage of the surgical procedure.

12. The surgical instrument of claim 10, wherein the at least one measurement comprises a plurality of measurements of the tissue property measured during the first stage of the surgical procedure.

13. The surgical instrument of claim 9, wherein the anvil is configured to pivot the RF overlay into locking engagement with the staple cartridge in the channel.

14. The surgical instrument of claim 13, wherein the staple cartridge comprises a cartridge deck including a recessed area configured to releasably retain the RF overlay.

15. The surgical instrument of claim 9, wherein the staple cartridge comprises a latch member configured to lockingly engage a distal portion of the RF overlay.

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