Control program for modular combination energy devices

Abstract

A surgical instrument is disclosed that includes a housing, a shaft assembly, a processor, and a memory. The shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions that, when executed from the memory, cause the processor to: send an electrical interrogation signal to an attached shaft assembly; receive a response signal from the attached shaft assembly; perform a default function when the response signal is not received by the attached shaft assembly; determine an identifying characteristic of the attached shaft assembly as a result of performing the default function; and modify a control program based on the identifying characteristic of the attached shaft assembly.

Description

[Technical Field]

[0001] (Cross-reference of related applications) This application claims the benefit of U.S. Provisional Patent Application No. 62 / 955,299, filed December 30, 2019, titled “DEVICES AND SYSTEMS FOR ELECTROSURGERY,” under Section 119 of the U.S. Patent Act, and the entirety of this disclosure is incorporated herein by reference. [Background technology]

[0002] The present invention relates to surgical instruments designed to treat tissue, including but not limited to surgical instruments configured to cut and fasten tissue. Surgical instruments may include electrosurgical instruments powered by a generator to produce tissue dissection, cutting, and / or coagulation during a surgical procedure. Surgical instruments may include instruments configured to cut and staple tissue using surgical staples and / or fasteners. Surgical instruments may be configured for use in open surgery but have applications in other types of surgery such as laparoscopy, endoscopic, and robot-assisted procedures, and may include articulated end effectors relative to the shaft portion of the instrument to facilitate precise positioning within the patient. [Overview of the project] [Means for solving the problem]

[0003] In various embodiments, surgical instruments are disclosed, comprising a housing, a shaft assembly, a processor, and a memory. The shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions, and when a program instruction is executed from the memory, it causes the processor to: send an electrical calling signal to a mounted shaft assembly; receive a response signal from the mounted shaft assembly; perform a default function if no response signal is received by the mounted shaft assembly; determine the identification characteristics of the mounted shaft assembly as a result of performing the default function; and modify the control program based on the identification characteristics of the mounted shaft assembly.

[0004] In various embodiments, surgical instruments are disclosed, comprising a housing, a shaft assembly, a processor, and a memory. The shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions, and when program instructions are executed from the memory, it causes the processor to transmit variable call communications to an attached shaft assembly, determine the capabilities of the attached shaft assembly based on the response to the variable call communications, and modify a control program based on the determined capabilities of the attached shaft assembly.

[0005] In various embodiments, surgical instruments are disclosed, comprising a housing, a shaft assembly, a processor, and a memory. The shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions, and when a program instruction is executed from the memory, it causes the processor to: send a call signal to the shaft assembly connected to the housing; receive a response signal from the shaft assembly connected to the housing; perform a default end effector function if no response signal is recognized; determine the identification characteristics of the shaft assembly connected to the housing as a result of performing the default end effector function; and modify the control program based on the identification characteristics of the shaft assembly connected to the housing. [Brief explanation of the drawing]

[0006] Novel features in various embodiments are specifically described in the attached "Claims." However, the embodiments described, both in terms of configuration and operation, can be best understood by referring to the following description together with the attached drawings. [Figure 1] An example of a generator for use with a surgical system, according to at least one aspect of this disclosure, is shown. [Figure 2] This disclosure illustrates one form of a surgical system comprising a generator and an electrosurgical instrument usable with the generator, according to at least one aspect of this disclosure. [Figure 3] A schematic diagram of a surgical instrument or tool according to at least one aspect of this disclosure is shown. [Figure 4] This is a perspective view of a surgical system comprising surgical instruments and a display monitor, wherein the surgical instruments include a display screen according to at least one embodiment. [Figure 5] This is a schematic diagram of the display screen and corresponding view of the display monitor of the surgical instrument shown in Figure 4, according to at least one embodiment. [Figure 6]Schematic diagram of a display screen of a surgical instrument and a corresponding view of a display monitor according to at least one embodiment, as shown in FIG. 4. [Figure 7] Schematic diagram of a display screen of a surgical instrument and a corresponding view of a display monitor according to at least one embodiment, as shown in FIG. 4. [Figure 8] Schematic diagram of a display screen of a surgical instrument and a corresponding view of a display monitor according to at least one embodiment, as shown in FIG. 4. [Figure 9] Schematic diagram of a display screen of a surgical instrument and a corresponding view of a display monitor according to at least one embodiment, as shown in FIG. 4. [Figure 10] Graphic depiction of the relationship between the total effective energy delivered by one or more generators of a surgical system according to at least one embodiment and the duty cycle of a motor from a smoke evacuator. [Figure 11] Schematic diagram of a surgical system according to at least one embodiment, comprising a surgical hub, a combined electrosurgical instrument powered by a plurality of generators, a smoke evacuation system, and a display. [Figure 12] Graphic depiction of the relationship between the power supplied over time by one or more generators of a surgical system according to at least one embodiment and the impedance of the treated tissue over time. [Figure 13] Schematic diagram of a communication path having a surgical system according to at least one embodiment, the surgical system comprising a surgical hub, a smoke evacuation device, a surgical instrument, a first generator configured to power a first operation of the surgical instrument, and a second generator configured to power a second operation of the surgical instrument. [Figure 14] Schematic diagram of a surgical system according to at least one embodiment, comprising a surgical hub and a plurality of robotic arms configured to receive tools thereon, the surgical system comprising an authentication module configured to approve tools for attachment to and / or use with the surgical system. [Figure 15] This is a schematic diagram of a surgical system located in a treatment room, according to at least one embodiment. [Figure 16] This is a chart showing various operating parameters and / or specifications of surgical instruments at various stages of a surgical procedure, according to at least one embodiment. [Figure 17] Figure 16 is an elevation view of the surgical instrument, shown during the first time when bipolar energy is delivered to the patient tissue. [Figure 18] Figure 16 is an elevation view of the surgical instrument, showing the second time period during which bipolar and unipolar energy is delivered to the patient tissue. [Figure 19] Figure 16 is an elevation view of the surgical instrument, shown in the fourth time, when unipolar energy is delivered to the patient tissue. [Figure 20] Figure 16 is a graphical representation of various operating parameters and / or specifications of surgical instruments at various stages of surgical procedures. [Figure 21] This is a graphical representation of tissue impedance measured over the duration of a surgical procedure, according to at least one embodiment. [Figure 22] A schematic diagram illustrating strain calculation according to at least one embodiment, in which the applied strain is calculated using the gap defined between the jaws of the end effector when the end effector is in an open configuration. [Figure 23] Figure 22 is a schematic diagram representing the strain calculation, and the calculated applied strain overestimates the actual applied strain because the patient tissue is positioned without contact between the jaws of the end effector. [Figure 24] This is a schematic diagram illustrating tissue impedance calculation according to at least one embodiment, where the tissue impedance is calculated using the gap defined between the jaws of the end effector when the jaws of the end effector are in contact with patient tissue positioned between them. [Figure 25] This is a graphical representation of the relationship between motor current and jaw gap over time, according to at least one embodiment. [Figure 26] This is a schematic diagram of a network formed by surgical instruments and a cloud-based storage medium, according to at least one embodiment. [Figure 27] Figure 26 is a graphical representation of the relationship between the jaw gap change and the jaw motor clamping current, determined from the network. [Figure 28] Figure 26 is a graphical representation of the relationship between generator powers over time, determined from the network. [Figure 29] This is a graphical representation of the relationship between the activation cycle of a surgical instrument and the measured impedance when the end effector of the surgical instrument is in a closed configuration with no patient tissue positioned between them, according to at least one embodiment. [Figure 30] This is a graphical representation of the relationship between structural conductance, jaw opening dimension, and jaw motor force during the jaw clamp stroke, according to at least one embodiment. [Figure 31] This is a graphical representation of the jaw closing speed based on user input, and the jaw closing speed based on user input and monitored parameters, according to at least one embodiment. [Modes for carrying out the invention]

[0007] The applicant of this application also owns the following U.S. patent applications filed on the same day as this application, each of which is incorporated herein by reference in its entirety. Agent's case number END9234USNP1 / 190717-1M, title of invention "METHOD FOR AN ELECTROSURGICAL PROCEDURE", Agent's case reference number END9234USNP2 / 190717-2, title of invention "ARTICULATABLE SURGICAL INSTRUMENT", Agent's case reference number END9234USNP3 / 190717-3, title of invention "SURGICAL INSTRUMENT WITH JAW ALIGNMENT FEATURES", • Agent's case reference number END9234USNP4 / 190717-4, title of invention "SURGICAL INSTRUMENT WITH ROTATABLE AND ARTICULATABLE SURGICAL END EFFECTOR", Agent's case reference number END9234USNP5 / 190717-5, title of invention "ELECTROSURGICAL INSTRUMENT WITH ASYNCHRONOUS ENERGIZING ELECTRODES", • Agent's case reference number END9234USNP6 / 190717-6, title of invention "ELECTROSURGICAL INSTRUMENT WITH ELECTRODES BIASING SUPPORT", Agent's case reference number END9234USNP7 / 190717-7, title of invention "ELECTROSURGICAL INSTRUMENT WITH FLEXIBLE WIRING ASSEMBLIES", Agent's case reference number END9234USNP8 / 190717-8, title of invention "ELECTROSURGICAL INSTRUMENT WITH VARIABLE CONTROL MECHANISMS", Agent's case reference number END9234USNP9 / 190717-9, title of invention "ELECTROSURGICAL SYSTEMS WITH INTEGRATED AND EXTERNAL POWER SOURCES", Agent's case reference number END9234USNP10 / 190717-10, title of invention "ELECTROSURGICAL INSTRUMENTS WITH ELECTRODES HAVING ENERGY FOCUSING FEATURES", Agent's case reference number END9234USNP11 / 190717-11, title of invention "ELECTROSURGICAL INSTRUMENTS WITH ELECTRODES HAVING VARIABLE ENERGY DENSITIES", Agent's case reference number END9234USNP12 / 190717-12, title of invention "ELECTROSURGICAL INSTRUMENT WITH MONOPOLAR AND BIPOLAR ENERGY CAPABILITIES", Agent's case reference number END9234USNP13 / 190717-13, title of invention "ELECTROSURGICAL END EFFECTORS WITH THERMALLY INSULATIVE AND THERMALLY CONDUCTIVE PORTIONS", Agent's case reference number END9234USNP14 / 190717-14, title of invention "ELECTROSURGICAL INSTRUMENT WITH ELECTRODES OPERABLE IN BIPOLAR AND MONOPOLAR MODES", Agent's case reference number END9234USNP15 / 190717-15, title of invention "ELECTROSURGICAL INSTRUMENT FOR DELIVERING BLENDED ENERGY MODALITIES TO TISSUE", • Agent's case reference number END9234USNP16 / 190717-16, title of invention "CONTROL PROGRAM ADAPTATION BASED ON DEVICE STATUS AND USER INPUT", and Agent's case reference number END9234USNP18 / 190717-18, title of invention "SURGICAL SYSTEM COMMUNICATION PATHWAYS".

[0008] The applicant of this application owns the following U.S. provisional patent applications filed December 30, 2019, the entirety of which is incorporated herein by reference: • U.S. Provisional Patent Application No. 62 / 955,294, Title of Invention: "USER INTERFACE FOR SURGICAL INSTRUMENT WITH COMBINATION ENERGY MODALITY END-EFFECTOR" • U.S. Provisional Patent Application No. 62 / 955,292, Title of Invention "COMBINATION ENERGY MODALITY END-EFFECTOR", and • U.S. Provisional Patent Application No. 62 / 955,306, Title of Invention: "SURGICAL INSTRUMENT SYSTEMS".

[0009] The applicant of this application owns the following U.S. patent applications, the disclosures of which are incorporated herein by reference in their entirety. • U.S. Patent Application No. 16 / 209,395, Title of Invention: "METHOD OF HUB COMMUNICATION" (currently U.S. Patent Application Publication No. 2019 / 0201136), • U.S. Patent Application No. 16 / 209,403, Title of Invention: "METHOD OF CLOUD BASED DATA ANALYTICS FOR USE WITH THE HUB" (currently U.S. Patent Application Publication No. 2019 / 0206569), • U.S. Patent Application No. 16 / 209,407, Title of Invention: "METHOD OF ROBOTIC HUB COMMUNICATION, DETECTION, AND CONTROL" (currently U.S. Patent Application Publication No. 2019 / 0201137) • U.S. Patent Application No. 16 / 209,416, Title of Invention: "METHOD OF HUB COMMUNICATION, PROCESSING, DISPLAY, AND CLOUD ANALYTICS" (currently U.S. Patent Application Publication No. 2019 / 0206562), • U.S. Patent Application No. 16 / 209,423, Title of Invention: "Method of Compressing Tissue Within a Stapling Device and Simultaneously Displaying the Location of the Tissue Within the Jaws" (currently U.S. Patent Publication No. 2019 / 0200981) • U.S. Patent Application No. 16 / 209,427, Title of Invention: "Method of Using Reinforced Flexible Circuits with Multiple Sensors to Optimize Performance of Radio Frequency Devices" (currently U.S. Patent Publication No. 2019 / 0208641), • U.S. Patent Application No. 16 / 209,433, Title of Invention: "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" (currently U.S. Patent Application Publication No. 2019 / 0201594). • U.S. Patent Application No. 16 / 209,447, Title of Invention: "METHOD FOR SMOKE EVACUATION FOR SURGICAL HUB" (currently U.S. Patent Application Publication No. 2019 / 0201045), • U.S. Patent Application No. 16 / 209,453, Title of Invention: "METHOD FOR CONTROLLING SMART ENERGY DEVICES" (currently U.S. Patent Application Publication No. 2019 / 0201046), • U.S. Patent Application No. 16 / 209,458, Title of Invention: "METHOD FOR SMART ENERGY DEVICE INFRASTRUCTURE" (currently U.S. Patent Application Publication No. 2019 / 0201047), • U.S. Patent Application No. 16 / 209,465, Title of Invention: "METHOD FOR ADAPTIVE CONTROL SCHEMES FOR SURGICAL NETWORK CONTROL AND INTERACTION" (currently U.S. Patent Publication No. 2019 / 0206563), • U.S. Patent Application No. 16 / 209,478, Title of Invention: "Method for Situational Awarenesse for Surgical Network or Surgical Network Connected Device Capable of Adjusting Function Based on a Sensed Situation or Usage" (currently U.S. Patent Application Publication No. 2019 / 0104919), • U.S. Patent Application No. 16 / 209,490, Title of Invention: "METHOD FOR FACILITY DATA COLLECTION AND INTERPRETATION" (currently U.S. Patent Publication No. 2019 / 0206564), • U.S. Patent Application No. 16 / 209,491, Title of Invention: "Method for Circular Stapler Control Algorithm Adjustment Based on Situational Awareness" (currently U.S. Patent Application Publication No. 2019 / 0200998), U.S. Patent Application No. 16 / 562,123, Title of Invention: "Method for Construction and Using a Modular Surgical Energy System with Multiple Devices" U.S. Patent Application No. 16 / 562,135, Title of Invention: "Method for Controlling an Energy Module Output," • U.S. Patent Application No. 16 / 562,144, Title of Invention: "METHOD FOR CONTROLLING A MODULAR ENERGY SYSTEM USER INTERFACE", and U.S. Patent Application No. 16 / 562,125, Title of Invention: "Method for Communicating Between Modules and Devices in a Modular Surgical System."

[0010] Before describing in detail the various embodiments of the electrosurgical system, it should be noted that the exemplary embodiments are not limited in their application or use to the structural and arrangement details of the components shown in the accompanying drawings and specification. The exemplary embodiments may be implemented or incorporated into other embodiments, variations, and modifications, and may be implemented or performed in a variety of ways. Furthermore, unless otherwise specified, the terms and expressions used herein have been selected for the purpose of describing the exemplary embodiments for the convenience of the reader and are not intended to limit them. Furthermore, it should be understood that one or more embodiments, expressions of embodiments, and / or embodiments described below may be combined with any one or more other embodiments, expressions of embodiments, and / or embodiments described below.

[0011] Various embodiments include electrosurgical systems that include electrosurgical instruments powered by a generator to produce tissue dissection, cutting, and / or coagulation during surgical procedures. While electrosurgical instruments may be configured for use in open surgery, they also have applications in other types of surgery, such as laparoscopic, endoscopic, and robot-assisted procedures.

[0012] As will be described in more detail below, electrosurgical instruments generally include a shaft having distally mounted end-effectors (e.g., one or more electrodes). The end-effectors can be positioned relative to the tissue so that current is introduced into the tissue. Electrosurgical instruments can be configured for bipolar or unipolar operation. In bipolar operation, current is introduced into the tissue by the active electrode of the end-effector and returned from the tissue by the return electrode of the end-effector. In unipolar operation, current is introduced into the tissue by the active electrode of the end-effector and returned via a return electrode (e.g., a grounding pad) separately located on the patient's body. The heat generated by the current flowing through the tissue can form hemostatic seals within and / or between tissues, and can therefore be particularly useful, for example, for sealing blood vessels.

[0013] Figure 1 shows an example of a generator 900 configured to deliver multiple energy modalities to surgical instruments. The generator 900 provides RF signals and / or ultrasonic signals for delivering energy to surgical instruments. The generator 900 includes at least one generator output unit that can deliver multiple energy modalities (e.g., ultrasonic energy, bipolar RF energy or unipolar RF energy, irreversible electroporation and / or reversible electroporation, and / or microwave energy) through a single port, and these signals can be delivered individually or simultaneously to end effectors for treating tissue. The generator 900 includes a processor 902 coupled to a waveform generator 904. The processor 902 and waveform generator 904 are configured to generate various signal waveforms based on information stored in a memory coupled to the processor 902, which is not shown for clarity of disclosure. Digital information associated with the waveforms is provided to the waveform generator 904, which includes one or more DAC circuits to convert the digital input to an analog output. The analog output is supplied to amplifier 906 for signal conditioning and amplification. The conditioned and amplified output of amplifier 906 is coupled to power transformer 908. The signal is coupled across power transformer 908 to the secondary side on the patient isolation side. The first signal of the first energy modality is supplied to the surgical instrument between terminals labeled ENERGY1 and RETURN. The second signal of the second energy modality is coupled across capacitor 910 and supplied to the surgical instrument between terminals labeled ENERGY2 and RETURN. Three or more energy modalities may be output, and therefore the subscript "n" indicates up to n ENERGY n This can be used to indicate that terminals may be provided, and it will be understood that n is a positive integer greater than or equal to 2. A maximum of "n" return paths. n However, it will be understood that such information may be provided without exceeding the scope of this disclosure.

[0014] The first voltage sensing circuit 912 is connected across terminals labeled ENERGY1 and RETURN paths to measure the output voltage between them. The second voltage sensing circuit 924 is connected across terminals labeled ENERGY2 and RETURN paths to measure the output voltage between them. The current sensing circuit 914 is connected in series with the RETURN section on the secondary side of the indicated power transformer 908 to measure the output current of any of the energy modalities. If different return paths are provided for each energy modality, a separate current sensing circuit must be provided for each return section. The outputs of the first voltage sensing circuit 912 and the second voltage sensing circuit 924 are supplied to isolation transformers 928 and 922, respectively, and the output of the current sensing circuit 914 is supplied to another isolation transformer 916. The outputs of the isolation transformers 916, 928, and 922 on the primary side (non-patient isolation side) of the power transformer 908 are supplied to one or more ADC circuits 926. The digitized output of the ADC circuit 926 is provided to the processor 902 for further processing and calculations. Feedback information on the output voltage and output current can be used to calculate parameters such as output impedance in order to adjust the output voltage and current supplied to the surgical instrument. Input / output communication between the processor 902 and the patient isolation circuit is provided via the interface circuit 920. Sensors may also communicate electrically with the processor 902 via the interface circuit 920.

[0015] In one embodiment, the impedance can be determined by the processor 902 by dividing the output of either a first voltage sensing circuit 912 connected across terminals labeled ENERGY1 / RETURN or a second voltage sensing circuit 924 connected across terminals labeled ENERGY2 / RETURN by the output of a current sensing circuit 914 arranged in series with the RETURN section on the secondary side of a power transformer 908. The outputs of the first voltage sensing circuit 912 and the second voltage sensing circuit 924 are supplied to separate isolation transformers 928 and 922, and the output of the current sensing circuit 914 is supplied to another isolation transformer 916. Digitized voltage and current sensing measurements from the ADC circuit 926 are supplied to the processor 902 to calculate the impedance. As an example, the first energy modality ENERGY1 may be RF unipolar energy, and the second energy modality ENERGY2 may be RF bipolar energy. Nevertheless, in addition to bipolar and unipolar RF energy modalities, other energy modalities include, among others, ultrasonic energy, irreversible electroporation and / or reversible electroporation, and / or microwave energy. Furthermore, while the example shown in Figure 1 illustrates that a single return path (RETURN) may be provided to two or more energy modalities, in other embodiments, multiple return paths (RETURN) may be provided. n However, each energy modality ENERGY n It can be provided to.

[0016] As shown in Figure 1, the generator 900, having at least one output port, may include a power transformer 908 having a single output section and multiple taps to supply power to an end effector in the form of one or more energy modalities, such as, in particular, ultrasonic energy, bipolar RF energy or unipolar RF energy, irreversible electroporation and / or reversible electroporation, and / or microwave energy, depending on the type of tissue treatment being performed. For example, the generator 900 may deliver high-voltage, low-current energy to drive an ultrasonic transducer, low-voltage, high-current energy to drive an RF electrode to seal tissue, or energy with a coagulation waveform for spot coagulation using either a unipolar RF electrosurgical electrode or a bipolar RF electrosurgical electrode. The output waveform from the generator 900 may be induced, switched, or filtered to supply frequencies to the end effector of a surgical instrument. In one example, the connection to the output section of the RF bipolar electrode generator 900 would preferably be located between the output section labeled ENERGY2 and RETURN. In the case of a unipolar output, the preferred connection would be an active electrode (e.g., a pencil-type or other probe) to a suitable return pad connected to the ENERGY2 output section and the RETURN output section.

[0017] Further details are disclosed in U.S. Patent Application Publication No. 2017 / 0086914, published on March 30, 2017, entitled "TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS," which is incorporated herein by reference in its entirety.

[0018] Figure 2 shows one embodiment of a surgical system 1000 comprising a generator 1100 and various surgical instruments 1104, 1106, and 1108 that can be used with it, wherein surgical instrument 1104 is an ultrasonic surgical instrument, surgical instrument 1106 is an RF electrosurgical instrument, and multifunctional surgical instrument 1108 is a combined ultrasonic / RF electrosurgical instrument. The generator 1100 can be configured for use with various surgical instruments. In various embodiments, the generator 1100 may be configured for use with different types of surgical devices, including, for example, the ultrasonic surgical instrument 1104, the RF electrosurgical instrument 1106, and the multifunctional surgical instrument 1108 that integrates RF and ultrasonic energy delivered simultaneously from the generator 1100. In the embodiment shown in Figure 2, the generator 1100 is shown separately from the surgical instruments 1104, 1106, and 1108. However, in one embodiment, the generator 1100 may be integrally formed with any of the surgical instruments 1104, 1106, and 1108 to form an integrated surgical system. The generator 1100 includes an input device 1110 located on the front panel of the generator 1100's console. The input device 1110 may include any suitable device for generating signals suitable for programming the operation of the generator 1100. The generator 1100 may be configured for wired or wireless communication.

[0019] The generator 1100 is configured to drive several surgical instruments 1104, 1106, and 1108. The first surgical instrument is an ultrasonic surgical instrument 1104, which comprises a handpiece 1105 (HP), an ultrasonic transducer 1120, a shaft 1126, and an end effector 1122. The end effector 1122 comprises an ultrasonic blade 1128 acoustically coupled to the ultrasonic transducer 1120 and a clamp arm 1140. The handpiece 1105 comprises a trigger 1143 for operating the clamp arm 1140 and a combination of toggle buttons 1137, 1134b, and 1134c for supplying energy to and driving the ultrasonic blade 1128 or other functions. The toggle buttons 1137, 1134b, and 1134c can be configured to supply energy to the ultrasonic transducer 1120 using the generator 1100.

[0020] The generator 1100 is also configured to drive a second surgical instrument 1106. The second surgical instrument 1106 is an RF electrosurgical instrument comprising a handpiece 1107 (HP), a shaft 1127, and an end effector 1124. The end effector 1124 has electrodes in clamp arms 1145, 1142b that return through the electrically conductive portion of the shaft 1127. The electrodes are connected to a bipolar energy source in the generator 1100 and are supplied with energy by the bipolar energy source. The handpiece 1107 comprises a trigger 1145 for operating the clamp arms 1145, 1142b and an energy button 1135 for activating an energy switch to supply energy to the electrodes in the end effector 1124. The second surgical instrument 1106 can also be used with a return pad to deliver unipolar energy to tissue.

[0021] The generator 1100 is also configured to drive a multifunctional surgical instrument 1108. The multifunctional surgical instrument 1108 comprises a handpiece 1109 (HP), a shaft 1129, and an end effector 1125. The end effector 1125 comprises an ultrasonic blade 1149 and a clamp arm 1146. The ultrasonic blade 1149 is acoustically coupled to an ultrasonic transducer 1120. The handpiece 1109 comprises a trigger 1147 for operating the clamp arm 1146 and a combination of toggle buttons 11310, 1137b, and 1137c for supplying energy to and driving the ultrasonic blade 1149 or other functions. The toggle buttons 11310, 1137b, and 1137c can be configured to supply energy to the ultrasonic transducer 1120 using the generator 1100, and similarly to supply energy to the ultrasonic blade 1149 using a bipolar energy source housed within the generator 1100. Unipolar energy can be delivered to the tissue in combination with or separately from bipolar energy.

[0022] The generator 1100 can be configured for use with various surgical instruments. In various forms, the generator 1100 may be configured for use with different types of surgical instruments, including, for example, an ultrasonic surgical instrument 1104, an RF electrosurgical instrument 1106, and a multifunctional surgical instrument 1108 that integrates RF and ultrasonic energy delivered simultaneously from the generator 1100. In the embodiment of Figure 2, the generator 1100 is shown separately from the surgical instruments 1104, 1106, and 1108, but in another embodiment, the generator 1100 may be formed integrally with any one of the surgical instruments 1104, 1106, and 1108 to form an integrated surgical system. As discussed above, the generator 1100 includes an input device 1110 located on the front panel of the generator 1100's console. The input device 1110 may include any suitable device that generates signals suitable for programming the operation of the generator 1100. The generator 1100 may also comprise one or more output devices 1112. Further embodiments of generators for digitally generating electrical signal waveforms, and surgical instruments, are described in U.S. Patent Application Publication US-2017-0086914-A1, which is incorporated herein by reference in whole.

[0023] Figure 3 shows a schematic diagram of a surgical instrument or tool 600 comprising multiple motor assemblies that can be activated to perform various functions. In the illustrated example, the closing motor assembly 610 is operable to transition the end effector between an open configuration and a closed configuration, and the articulation motor assembly 620 is operable to articulate the end effector relative to the shaft assembly. In a particular example, the multiple motor assemblies can be activated individually to produce firing, closing, and / or articulation motions in the end effector. The firing, closing, and / or articulation motions can be transmitted to the end effector, for example, via the shaft assembly.

[0024] In a particular example, the closing motor assembly 610 includes a closing motor. The closing motor 603 may be operably coupled to a closing motor drive assembly 612, which may be configured to transmit a closing motion generated by the motor to the end effector in order to displace a closing member and move the end effector into a closed configuration. The closing motion allows, for example, the end effector to move from an open configuration to a closed configuration to capture tissue. The end effector may be moved to an open position by reversing the direction of the motor.

[0025] In a particular example, the articular motion motor assembly 620 includes an articular motion motor operably coupled to an articular motion drive assembly 622, which can be configured to transmit the articular motion generated by the motor to an end effector. In a particular example, the articular motion can, for example, cause the end effector to articulate relative to a shaft.

[0026] One or more of the motors of the surgical instrument 600 may be equipped with a torque sensor for measuring the output torque relative to the motor shaft. The force on the end effector may be sensed by any conventional method, such as by a force sensor on the outside of the jaws or by a torque sensor on the motor that actsuates the jaws.

[0027] In various examples, the motor assemblies 610, 620 include one or more motor drivers, which may comprise one or more H-bridge FETs. The motor drivers may modulate the power transmitted from the power supply 630 to the motor based, for example, on input from the microcontroller 640 ("controller") of the control circuit 601. In certain examples, the microcontroller 640 may be used, for example, to determine the current drawn by the motor.

[0028] In certain examples, the microcontroller 640 may include a microprocessor 642 ("processor") and one or more non-temporary computer-readable media or memory units 644 ("memory"). In certain examples, the memory 644 may store various program instructions, which, when executed, can cause the processor 642 to perform some of the functions and / or calculations described herein. In certain examples, one or more of the memory units 644 may be connected to the processor 642, for example. In various embodiments, the microcontroller 640 may communicate via wired channels, wireless channels, or a combination thereof.

[0029] In certain examples, the power supply 630 can be used to power, for example, a microcontroller 640. In certain examples, the power supply 630 may comprise a battery (or "battery pack" or "power pack"), such as a lithium-ion battery. In certain examples, the battery pack may be configured to be removably attached to a handle in order to power a surgical instrument 600. Multiple battery cells connected in series may be used as the power supply 630. In certain examples, the power supply 630 may be, for example, replaceable and / or rechargeable.

[0030] In various examples, the processor 642 may control motor drivers to control the position, direction of rotation, and / or speed of the motors of assemblies 610, 620. In certain examples, the processor 642 may signal motor drivers to stop and / or disable the motors. The term “processor,” as used herein, should be understood to include any suitable microprocessor, microcontroller, or other basic computing device that integrates the functions of a computer’s central processing unit (CPU) on one or up to several integrated circuits. The processor 642 is a multipurpose programmable device that accepts digital data as input, processes that data according to instructions stored in memory, and provides the results as output. It is an example of sequential digital logic, as it has internal memory. The processor operates with numbers and symbols represented in binary.

[0031] In one example, processor 642 may be any single-core or multi-core processor, such as those known by the trade name ARM Cortex by Texas Instruments. In a particular example, microcontroller 620 may be, for example, the LM 4F230H5QR available from Texas Instruments. In at least one embodiment, Texas Instruments' LM4F230H5QR is an ARM Cortex-M4F processor core, which includes, among other features readily available in the product datasheet, 256KB of on-chip memory of single-cycle flash memory or other non-volatile memory up to 40MHz, a prefetch buffer to improve performance beyond 40MHz, 32KB of single-cycle SRAM, internal ROM with StellarisWare® software, 2KB of EEPROM, one or more PWM modules, one or more QEI analogs, and one or more 12-bit ADCs with 12 analog input channels. Other microcontrollers may be readily substituted for use with surgical instrument 600. Therefore, this disclosure should not be limited to this context.

[0032] In a particular example, memory 644 may contain program instructions for controlling each of the motors of the surgical instrument 600. For example, memory 644 may contain program instructions for controlling the closure motor and the joint movement motor. Such program instructions can cause the processor 642 to control the closure function and joint movement function according to input from the algorithm or control program of the surgical instrument 600.

[0033] In certain cases, one or more mechanisms and / or sensors, such as sensor 645, can be used to alert the processor 642 to program instructions that should be used in a particular setting. For example, sensor 645 can alert the processor 642 to use program instructions associated with closing the end effector and joint movement. In certain cases, sensor 645 may include a position sensor that can be used to sense the position of the closing actuator. Thus, if the processor 642 receives a signal from sensor 630 indicating the activation of the closing actuator, it may activate the motor of the closing drive assembly 620 using program instructions associated with closing the end effector.

[0034] In some examples, the motor may be a brushless DC electric motor, and each motor drive signal may consist of a PWM signal provided to one or more stator windings of the motor. Also, in some examples, the motor driver may be omitted, and the control circuit 601 may generate the motor drive signal directly.

[0035] It is a common practice in various laparoscopic surgical procedures to access the surgical site located within the patient's abdomen by inserting the surgical end-effector portion of a surgical instrument through a trocar placed in the patient's abdominal wall. In its simplest form, a trocar is a pen-shaped instrument with a sharp triangular dot at one end, typically used within a hollow tube known as a cannula or sleeve, to create an opening in the body into which a surgical end-effector can be introduced. Such an arrangement forms an access port into the body cavity into which the surgical end-effector can be inserted. The inner diameter of the trocar's cannula inevitably limits the size of the end-effector and drive support shaft of the surgical instrument that can be inserted through the trocar.

[0036] Regardless of the specific type of surgical procedure being performed, once a surgical end-effector is inserted into the patient through a trocar cannula, it is often necessary to move the surgical end-effector relative to the shaft assembly positioned within the trocar cannula in order to properly position it relative to the tissue or organ to be treated. This movement or positioning of the surgical end-effector relative to the portion of the shaft that remains within the trocar cannula is often referred to as the "articular movement" of the surgical end-effector. To facilitate such articular movement of the surgical end-effector, various articular joints have been developed for attaching the surgical end-effector to the associated shaft. In many surgical procedures, as expected, it is desirable to use a surgical end-effector with the largest possible range of articular movement.

[0037] Due to the size constraints imposed by the size of the trocar cannula, the components of the articular joint must be sized to be freely insertable through the trocar cannula. These size constraints also limit the size and composition of various drive members and components that operably interface with a motor and / or other control systems supported within a housing that may be handheld or part of a larger automated system. Often, these drive members must operably pass through the articular joint so as to operably couple with or interface with the surgical end effector. For example, one such drive member is commonly used to impart articular control movement to a surgical end effector. During use, the articular drive member can be deactivated to position the surgical end effector in a non-articular position in order to facilitate insertion of the surgical end effector through the trocar and then to act to articularize the surgical end effector to the desired position when the surgical end effector enters the patient.

[0038] Therefore, the aforementioned size constraints present numerous challenges in developing a joint motion system that can achieve the desired range of joint movement and accommodate the various different drive systems necessary to operate the various features of the surgical end effector. Furthermore, once the surgical end effector is positioned in the desired joint motion position, the joint motion system and joint joint must be able to hold the surgical end effector in that position upon operation of the end effector and completion of the surgical procedure. Such an arrangement of joint joints must also be able to withstand the external forces experienced by the end effector during use.

[0039] Various modes of one or more surgical devices are often used through specific surgical procedures. Communication paths extending between surgical devices and a centralized surgical hub can, for example, enhance the efficiency and success rate of surgical procedures. In various examples, each surgical device in a surgical system is equipped with a display that communicates the presence and / or operating status of other surgical devices in the surgical system. The surgical hub can use the information received via the communication paths to evaluate the suitability of surgical devices for use with each other, to evaluate the suitability of surgical devices for use during specific surgical procedures, and / or to optimize the operating parameters of surgical devices. As will be described in more detail herein, the operating parameters of one or more surgical devices can be optimized based on detected environmental conditions such as patient demographics, specific surgical procedures, and / or tissue thickness.

[0040] The split-display system is shown in Figures 4 to 9. The split display communicates various generator and / or surgical device parameters between the display 27010 of the handheld surgical instrument 27000 and the primary monitor display 27100. Figure 4 shows an example of the display 27010 of the handheld surgical instrument 27000. In various examples, the display 27010 includes a touch-sensitive graphic user interface that can receive user input. The display 27010 includes various settings and / or modes that allow the user to customize the information and / or images displayed on the display 27010 at any given time.

[0041] The surgical instrument 27000 communicates with the main display monitor 27100. The main display monitor 27100 has a larger screen than the display 27010 of the surgical instrument 27000. In various examples, the main display monitor 27100 displays the same information and / or images as the display 27010 of the surgical instrument 27000. In other examples, the main display monitor 27100 displays different information and / or images than the display 27010 of the surgical instrument 27000. In various examples, the main display monitor 27100 includes a touch-sensitive graphic user interface that can receive user input. Similar to the display 27010 of the surgical instrument 27000, the main display monitor 27100 includes various settings and / or modes that allow the user to customize the information and / or images displayed on the main display monitor 27100 at any given time. As will be described in more detail herein, the selected mode on the main display monitor 27100 can change the mode on the display 27010 on the surgical instrument 27000, and vice versa. In other words, the main display monitor 27100 and the surgical instrument display 27010 work together to most effectively communicate the selected operating parameters to the user.

[0042] The illustrated handheld surgical instrument 27000 has combined electrosurgical functions, and the surgical instrument 27000 includes an end effector having first jaws and second jaws. The first jaws and second jaws are equipped with electrodes disposed on them. The electrosurgical instrument 27000 includes one or more generators configured to power the electrodes in order to supply energy to the electrodes. More specifically, energy delivery to patient tissue supported between the first jaws and the second jaws is achieved by supplying energy to electrodes configured to deliver energy in unipolar mode, bipolar mode, and / or combined mode. The combined mode is configured to deliver alternating or fused bipolar and unipolar energy. In at least one embodiment, at least one generator comprises a battery, a rechargeable battery, a disposable battery, and / or a combination thereof. Various details relating to the operation of the first and second generators are described in more detail in U.S. Patent Application No. 16 / 562,123, filed September 5, 2019, titled "Method for Construction and Using a Modular Surgical Energy System with Multiple Devices," which is incorporated herein by reference in its entirety.

[0043] The display 27010 and main display monitor 27100 of the surgical instrument 27000 are equipped with a split display for communicating many operating parameters to the user. The split display is configured to be selectively segmentable. In other words, the user can choose which operating parameters to display and / or where to display the selected operating parameters. Such customization minimizes distractions by eliminating unnecessary and / or irrelevant information, while allowing the user to efficiently observe the information necessary and / or desired for controlling the surgical instrument 27000 and / or performing surgical procedures. The display 27010 of the surgical instrument 27000 is equipped with a first section 27012 which displays the power level of a particular mode. The display 27010 of the surgical instrument 27000 is further equipped with a second section 27014 which identifies, or otherwise communicates, the current mode of the surgical instrument 27000 and / or the type of energy being delivered by the surgical instrument 27000.

[0044] Similarly, the main display monitor 27100 has a segmented display; however, in various examples, the images displayed on the display monitor 27100 can be superimposed on each other. The central portion 27110 of the main display monitor 27100 streams live video and / or still images of the surgical site to the treatment room. The live video and / or images of the surgical site are captured through appropriately positioned cameras such as endoscopes. The menu selection portion 27130 of the main display monitor 27100 prompts the user to select which mode the main display monitor 27100 is in and / or the information the user wishes to see on the main display monitor 27100, and / or otherwise enables such user selection. The device status portion 27120 of the main 27100 communicates display monitor information, similar to the first portion 27012 of the surgical instrument display 27010. In various examples, the device status portion 27120 is further divided into multiple sections. For example, the first part 27122 is configured to communicate operating parameters that reflect the bipolar mode. Such operating parameters may be specific and / or general. Specific operating parameters may, for example, reflect the power level of the bipolar mode. General operating parameters may, for example, indicate whether the bipolar mode is active or inactive. The second part 27124 is configured to communicate operating parameters that reflect the unipolar mode. Such operating parameters may be specific and / or general. Specific operating parameters may, for example, reflect the power level of the unipolar mode. General operating parameters may, for example, indicate whether the unipolar mode is active or inactive. The third part 27126 is configured to communicate operating parameters that reflect the smoke exhaust system. Such operating parameters may be specific and / or general. Specific operating parameters may, for example, reflect the power level of the smoke exhaust system.Typical operating parameters can indicate, for example, whether the smoke exhaust system is active or inactive.

[0045] Referring here to Figures 5 to 9, the display 27010 of the surgical instrument 27000 is shown alongside the corresponding display on the main display monitor 27100. As will be described in more detail herein, when a user changes the power level on the handheld surgical instrument 27000, such changes in power levels are reflected on the main display monitor 27100. For example, as shown in Figure 5, a generator operating in bipolar mode is currently operating at a power level of 80 watts, as shown in the device status section 27120 of the main display monitor 27100 and the first section 27012 and second section 27014 of the surgical instrument display 27010. More specifically, the first section 27012 of the surgical instrument display 27010 represents the output of the generator, while the second section 27014 of the surgical instrument display 27010 represents the mode and / or type of energy. Similarly, the device status section 27120 of the main display monitor 27100 indicates that the generator is operating in bipolar energy mode at a power level of 80 watts and in unipolar energy mode at a power level of 0 watts. Upon receiving a command to increase the generator's power output to operate in bipolar mode at 100 watts, the surgical instrument display 27010 and the main display monitor 27100 change accordingly as shown in Figure 6. More specifically, the first section 27012 of the surgical instrument display 27010 represents a power level of 100 watts, and the device status section 27120 of the main display monitor 27100 indicates that the generator is currently operating in bipolar mode at a power level of 100 watts. The main display monitor 27100 continues to show that the unipolar energy mode is operating at a power level of 0 watts, but the main display monitor 27100 also shows that the smoke detection system in 27126 has been activated up to 20% due to smoke detection within the surgical site and / or increased power levels of surgical instruments.

[0046] Figures 7–9 show the display 27010 and corresponding main display monitor 27100 of the surgical instrument 27000 when both bipolar and unipolar energy combinations are being delivered to patient tissue. Figure 7 shows the first portion 27012' of the surgical instrument display 27010 in total power mode. As shown on the main display monitor 27100, the bipolar energy mode 27122 is operating at a power level of 60 watts, and the unipolar energy model 27124 is operating at a power level of 60 watts. However, a combined power level of 120 watts and / or total power level is shown on the first portion 27012' of the surgical instrument display 27010. The main display monitor 27100 also shows that the smoke detection system 27126 is activated to 50% due to smoke detection within the surgical site and / or the increased power level of the surgical instrument. As shown in Figure 8, the user may wish to view the individual power levels for bipolar and unipolar modes on the first section 27012'' of the surgical instrument display 27010, and the total power level on the instrument status section 27122' of the main display monitor 27100. In other words, the information shown on the display in Figure 8 is the reverse of the display shown in Figure 7. The main display monitor 27100 further indicates that the smoke detection system in 27126 is activated to 73% due to smoke detection within the surgical site and / or changes in the power levels for bipolar and / or unipolar modes. The pair of displays shown in Figure 9 are similar in many respects to the pair of displays shown in Figure 8, except that the user has chosen to remove the indicator of the operating level of the smoke detection system from the main display monitor 27100.

[0047] As will be discussed in more detail herein, the surgical instrument display 27010 and / or the main display monitor 27100 may have a touch-sensitive graphic user interface. In various examples, the surgical instrument display 27010 is used to control what is displayed on the surgical instrument display 27010 and what is displayed on the main display monitor 27100. In other examples, the main display monitor 27100 is used to control what is displayed on the surgical instrument display 27010 and what is displayed on the main display monitor 27100. In various examples, each display is configured to control what is displayed on its own display. In various examples, each display in the surgical system is configured to collaboratively control what is displayed on other displays in the surgical system.

[0048] In various examples, the surgical system comprises an electrosurgical device and a smoke extraction system. As will be discussed in more detail herein, the electrosurgical device is configured to deliver energy to patient tissue supported between the jaws of an end effector by supplying energy to electrodes. The electrodes are configured to deliver energy in unipolar mode, bipolar mode, and / or combined modes having alternating or fused bipolar and unipolar energies. In various examples, a first generator is configured to control a bipolar energy modality, a second generator is configured to control a unipolar energy modality, and a third generator is configured to control a smoke extraction system. Various details relating to the operation of the first and second generators are described in more detail in U.S. Patent Application No. 16 / 562,123, filed September 5, 2019, titled "Method for Construction and Using a Modular Surgical Energy System with Multiple Devices," which is incorporated herein by reference in its entirety.

[0049] Figure 10 is a graphical representation showing the proportional relationship between the duty cycle of the smoke exhaust system and the total effective energy delivered to patient tissue. Time is represented along the x-axis, and power (W) and the duty cycle (%) of the smoke exhaust system are represented along the y-axis. The total effective energy is represented in three phases: (1) bipolar therapy, (2) unipolar therapy, and (3) combined energy. The duty cycle percentage of the smoke exhaust system is represented in two phases: (1) in response to combined energy, and (2) in response to bipolar therapy only. For example, at time t0, no power is delivered to patient tissue, and the smoke exhaust system is inactive. At time t1, bipolar therapy is delivered at a first power level P1. At time t1, bipolar therapy 27230 is the only energy delivered to the patient tissue. When the power increases to P1 during the period t0-t1, the smoke exhaust system is activated. At time t1, the first percentage S1 of the smoke exhaust duty cycle is utilized.

[0050] At time t2, the power level of bipolar therapy 27230 increased, and monopolar therapy 27240 began to be delivered. At time t3, bipolar therapy 27230 decreased, while monopolar therapy 27240 increased. Overall, the combined energy 27250 remained substantially the same from t2 to t3. At time t3, the combined energy 27250 was delivered at a third power level P3, which is higher than the first power level P1 delivered at time t1. As the power increased to P3 during the period t1 to t3, the percentage of the flue gas system duty cycle also increased. At time t3, the third percentage S3 of the flue gas duty cycle was utilized. The third percentage S3 is greater than the first percentage S1. At time t4, delivery of bipolar therapy 27230 ceased, and the only energy delivered to the patient tissue was through monopolar therapy 27240. In particular, at time t4, the unipolar therapy 27240 delivers energy to the patient tissue at the highest level P4 of unipolar therapy delivered throughout the entire surgical procedure. Therefore, the energy P4 delivered at time t4 is greater than the energy P3 delivered at time t3, and thus the percentage of the flue gas duty cycle also increases. At time t4, the fourth percentage S4 of the flue gas duty cycle is utilized. The fourth percentage S4 is greater than the third percentage S3 and the first percentage S1.

[0051] The graphical representation in Figure 10 shows the bipolar energy 27230 being delivered at fluctuating levels throughout different points in time during a surgical procedure. Such points in time may correspond to a tissue sealing cycle in which the surgical hub instructs the smoke evacuation system to increase or decrease its operating level in response to the current bipolar power level. After the tissue sealing cycle is complete, unipolar energy can be applied over a defined period to cut the patient tissue. Once the patient tissue is cut, the surgical hub can instruct the smoke evacuation system to increase its operating level based on the increase in energy being applied to cut the tissue; therefore, for example, an increase in applied energy typically corresponds to an increase in smoke from the burning tissue. During a particular surgical procedure, the surgical hub is aware of predefined points in time when energy delivery and power levels are changed. These predefined points in time may vary, for example, based on the type of specific surgical procedure to be performed. These predefined points in time may also vary, for example, based on the patient demographics identified to the surgical hub. Any detected changes in the type of energy being applied and / or the level of energy being applied can trigger responses from different components of the surgical system.

[0052] Similar to the surgical system described with respect to Figure 10, the surgical system 27700 shown in Figure 11 comprises an electrosurgical instrument 27710 that communicates with a surgical hub. The electrosurgical instrument 27710 is configured to deliver energy to patient tissue supported between the jaws of an end effector by electrodes configured to deliver energy in unipolar, bipolar, and / or combined modes. When in combined mode, the electrosurgical instrument 27710 is configured to apply alternating or fused bipolar and unipolar energies to the patient tissue. The surgical system 27700 further comprises a first generator 27720 configured to control the unipolar energy modality and a second generator 27730 configured to control the bipolar energy modality. The display screen 27750 is positioned in a location within the treatment room within the user's field of view. In various examples, the electrosurgical instrument 27710 comprises a display positioned above it. When the second generator 27730 delivers bipolar energy to the patient tissue, the instrument display and / or display screen 27750 in the treatment room indicates the level of power being applied. In various examples, the level of smoke evacuation by the smoke evacuation system is shown on the display(s), and the smoke evacuation level is based on the level of power and / or type of energy being applied. As will be discussed in more detail herein, when the first generator 27720 delivers unipolar energy to the patient tissue and / or the second generator 27730 delivers a reduced amount of bipolar energy to the patient tissue, the display(s) are configured to update the displayed operating parameters, or otherwise communicated operating parameters. When the level of power changes during a surgical procedure, such change is communicated to the surgical hub. In response, the surgical hub is configured to automatically, or without external prompting, change the smoke evacuation level to compensate for the change in the level and / or type of energy being applied to the patient tissue.

[0053] At least one of the instrument displays and display screens 27750 includes a touch-sensitive graphic user interface configured to receive user input. The user can select what information to display, where on a particular display the selected information will appear, and / or which display in the surgical system will display the desired information. In various examples, the surgical system 27700 further includes one or more cameras positioned within the treatment room. One or more cameras are configured to monitor the movement of the user and / or the equipment of the surgical system. One or more cameras can communicate any detected movement to the surgical hub, which recognizes that the detected movement corresponds to a given command. For example, a camera can detect when the user shakes the arm. Memory in the surgical hub correlates the arm shake with the user's request to clear the display of all motion parameters, so that only live video and / or images of the surgical site remain on the display. Exemplary commands that may be associated with the movements of a specific user and / or instrument include adjusting the position of a display(s), adjusting the view(s) of a display(s), adjusting the information displayed on a display(s), adjusting the location of displayed information on a particular display, adjusting the size of displayed information, controlling the power level of a generator, and / or controlling the operating parameters of various surgical instruments in a surgical system.

[0054] As discussed with respect to surgical system 27700, the electrosurgical instrument 27710 comprises a combination of electrical modalities. The unipolar modality of the electrosurgical instrument is operated by the first generator 27720, while the bipolar modality is operated by the second generator 27730. Unipolar energy is delivered to patient tissue to make an incision or otherwise cut the treated tissue. Bipolar energy is delivered to the tissue to seal and / or cauterize the target tissue before cutting the patient tissue. Figure 12 shows a graphical representation of the power levels (watts) 27320a of the first and second generators against time (t) 27310. The power levels are represented in two phases: (1) of the first generator 27340 and (2) of the second generator 27330. Graph representation 27300 further shows the relationship between time (t) 27310 and tissue impedance (Ω) 27320b. Tissue impedance is represented in two phases: (1) in response to delivered unipolar energy 27345, and (2) in response to delivered bipolar energy 27335.

[0055] As the power level of the second generator 27330 increases from 0, bipolar energy is delivered to the patient tissue. The impedance of the patient tissue increases in response to the application of bipolar energy 27335. In particular, the impedance of the patient tissue continues to increase for a certain period of time, even after the power level of the second generator 27330 begins to decrease. In other words, the impedance of the tissue sealed by bipolar energy 27335 eventually decreases after the power level of the second generator 27330 is reduced, in the absence of delivery of unipolar energy to cut the patient tissue, although in such cases the impedance of the tissue does not necessarily decrease immediately. At time t1, the power level of the first generator 27340 increases, thereby cutting the tissue through the delivery of unipolar energy to the patient tissue. The impedance of the patient tissue also increases in response to the application of unipolar energy 27345. In particular, the patient's impedance increases exponentially as the tissue is cut and the power level of the first generator 27340 decreases.

[0056] Figure 13 shows algorithm 27400 for controlling various components of a surgical system. The surgical system comprises surgical instruments configured to perform intended surgical functions. In various examples, the surgical instruments are handheld and have handles. The user is configured to operate various modes of the surgical instruments via input elements on the handles. As described in more detail herein, the surgical instruments comprise a first generator configured to power a unipolar modality and a second generator configured to power a bipolar modality. The surgical system further comprises a fume extraction system configured to remove smoke and / or other unwanted particulate matter from the surgical site. The surgical instruments and / or the fume extraction system communicate with a surgical hub, which is configured to coordinate the appropriate response(s) of the components of the surgical system in response to user input to the surgical instruments, the fume extraction system, and / or other components within the surgical system.

[0057] As shown in Figure 13, the control algorithm 27400 begins when the user changes the mode 27410 of the surgical instrument. For example, the user may want to increase the power level of the first generator in order to cut patient tissue. In another example, the user may want the surgical instrument to seal and / or cut patient tissue. In either case, the surgical instrument then communicates the user input to the first and second generators, respectively, at 27412 and 27414. The surgical instrument further communicates the user input to the surgical hub at 27415. After the surgical hub is notified of the desired increase in unipolar energy at 27420, the surgical hub is configured to instruct the second generator at 27425 to supply and / or administer the appropriate power level. Upon receiving communication from the surgical instrument at 27412, the first generator increases its waveform at 27440 in preparation for cutting patient tissue. Upon receiving a communication from the surgical instrument at 27414 and a command from the surgical hub at 27425, the second generator increases the power level associated with the bipolar modality in preparation for sealing the patient tissue after the cutting has been performed at 27450. The second generator can then communicate to the first generator at 27455 that it is ready. The first generator can then begin cutting the patient tissue at 27442. In other words, the surgical hub prevents the unipolar electrode from being powered until the bipolar electrode is powered to prevent cutting unsealed tissue. The surgical hub is further configured at 27426 to instruct the fume exhaust system to increase the motor speed in response to the increase in the power levels of the first and second generators. In 27430, after the smoke exhaust system has increased its motor speed, the smoke exhaust system is configured to maintain communication lines with the surgical hub, surgical instruments, and / or the first and second generators throughout the duration of the surgical procedure. For example, in 27435, the smoke exhaust system is configured to continuously communicate the current motor speed to the surgical hub.In such an example, the smoke exhaust system transmits its current motor speed to the surgical hub every minute or every two minutes, although the smoke exhaust system can communicate its current motor speed at any preferred frequency. Once the surgical instrument completes the desired tissue cut, the user can again provide input on the instrument handle to reduce the power level of the first generator and / or terminate the control algorithm 27400. In various examples, the control algorithm 27400 is configured to automatically reduce the power level of the first generator after a predetermined period corresponding to the completion of the tissue cut. Using the control algorithm 27400, the surgical hub can adjust the operating parameters of the components of the surgical system, for example, to facilitate efficient and / or effective surgical procedures.

[0058] Many surgical instruments, tools, and / or interchangeable components are frequently used during specific surgical procedures. Disclosed herein are various systems that, in particular, play a role in streamlining instruments and / or components stockpiled in the operating room for use during specific procedures, minimizing operator error, and / or delays during surgical procedures. The systems described herein, among other things, enhance the efficiency of surgical procedures by using artificial intelligence and machine learning developed in the course of one or more surgical procedures.

[0059] Various components of an exemplary surgical system 27500 are shown in Figure 14. During a particular surgical procedure, the patient is on an operating table or any preferred treatment surface 27510. In various examples, the particular procedure is performed using a surgical robot at least partially. The surgical robot comprises one or more robotic arms 27520. Each robotic arm 27520 is configured to receive a tool component 27590. The tool components 27590 are configured to work together to assist the performer and / or clinician when performing a particular surgical procedure. The tool components may include, for example, surgical stapling and / or tissue cutting tool components, tissue gripping tool components, and / or electrosurgical tool components. The tool components may include other features such as size, manufacturer, manufacturing date, number of uses to date, and / or expiration date.

[0060] The surgical system 27500 further comprises a surgical hub 27530. Various surgical hubs are described in U.S. Patent Application No. 16 / 209,395, filed December 4, 2018, titled "METHOD OF HUB COMMUNICATION," which is incorporated herein by reference in its entirety. The surgical hub 27530 comprises a memory 27535 that stores various suitable or otherwise appropriate combinations of tool components 27590 to be used during a particular procedure. In other words, the memory 27535 of the surgical hub 27530 comprises a stored information bank that can be used to indicate which tool components 27590 are suitable for use during a selected procedure.

[0061] Prior to performing a desired surgical procedure, the clinician may notify or otherwise communicate details of the desired surgical procedure and / or the patient to the surgical hub 27530. Such details may include, for example, identification information for the surgical procedure, identification information for the clinician performing the surgical procedure, and / or the patient's biometric profile. The surgical hub 27530 is then configured to use one or more of the communicated details to evaluate and / or determine which tool components 27950 are necessary and / or appropriate for performing the desired surgical procedure. In various examples, the surgical hub 27530 is configured to evaluate which mode of each tool component 27950 is appropriate for performing the desired surgical procedure on a particular patient.

[0062] As shown in Figure 14, the four robotic arms 27250 surround or are otherwise mounted to the operating table 27510. Three tool components 27590 are connected to three corresponding robotic arms 27250, with one robotic arm free to receive additional tool components. Multiple unique tool components 27560, 27570, and 27580 are shown stored on a mobile stand 27550 within the treatment room. As discussed above, the types and / or functions of the tool components 27560, 27570, and 27580 may vary. In such an example, the surgical hub 27530 evaluates the available tool components 27560, 27570, and 27580 and identifies the appropriate tool components for mounting to the surgical robot. Appropriate tool components are identified based on one or more factors, such as which type of tool and / or function is still required by the surgical robot and / or which tool component requirements complete a predetermined pairing of tool components associated with the desired surgical procedure. In various examples, the surgical robot has a memory that stores predetermined tool component pairings based, for example, on a specific surgical procedure and / or the demographics of a specific patient. In such examples, the surgical robot can identify appropriate tool components for attachment to the surgical robot based on identification information of tool components already attached.

[0063] In another example, tool components 27560, 27570, and 27580 are of the same type and / or function, but each tool component includes at least one other feature, such as size, manufacturer, expiration date, and / or number of uses to date. The surgical hub 27530 evaluates the profile of each available tool component 27560, 27570, and 27580 and identifies the appropriate tool component based on whether its characteristics are compatible with the profiles of other selected and / or mounted tool components 27590.

[0064] As shown in Figure 14, each tool component 27560, 27570, and 27580 is provided with QR codes 27565, 27575, and 27585 positioned at any preferred location on them, and each QR code contains a profile of information representing the tool component to which the QR code is concatenated. The user scans and / or reads the QR codes 27565, 27575, and 27585 using any suitable scan tool 27540. The scan tool 27540 then communicates the QR codes and / or the information contained within them to the surgical hub 27530. In an example where the QR codes themselves are communicated to the surgical hub 27530 by the scan tool 27540, the processor of the surgical hub 27530 is configured to decode the profile of information contained by the received QR codes. While the illustrated embodiment provides QR codes, the tool components may provide any preferred memory device, such as barcodes, RFID tags, and / or memory chips.

[0065] The surgical hub 27530 is configured to alert the user when a tool component is unacceptable and / or undesirable to use during a surgical procedure. Such alerts can be communicated through various forms of feedback, including, for example, tactile, auditory, and / or visual feedback. In at least one example, the feedback includes auditory feedback, and the surgical system 27500 may include, for example, a speaker that emits a sound such as a beep when an error is detected. In a particular example, the feedback includes visual feedback, and the tool components may each include, for example, a light-emitting diode (LED) that flashes when an error is detected. In a particular example, the visual feedback can be communicated to the user by an alert presented on a display monitor within the clinician's field of view. In various examples, the feedback includes tactile feedback, and the components of the surgical system 27500 may include an electric motor with an eccentric element that vibrates when an error is detected. The alerts may be specific or general. For example, a warning may specifically state that it is unable to detect a QR code on a tool component, or a warning may specifically state that the QR code contains information that represents a non-compliant and / or non-functional tool component.

[0066] For example, a user attempts to attach a first tool component 27560 to an available robotic arm 27590 of a surgical robot. Before attaching the first tool component 27560 to the robotic arm 27590, a scan tool 27540 scans a QR code 27565 displayed on the first tool component 27560. The scan tool 27540 communicates the QR code 27565 and / or the information contained within the QR code 27565 to the surgical hub 27530. The surgical hub 27530 compares the information contained within the QR code 27565 to a stored list of acceptable tool components associated with a particular surgical procedure and / or a stored list of acceptable tool components compatible with the tool component currently attached to the surgical robot. In this case, the surgical hub 27530 cannot recognize and / or locate the first tool component 27560 in its memory 27535. Therefore, the first tool component 27560 is not recommended and / or suitable for use with the surgical robot. As discussed above, the surgical hub 27530 is configured to alert the clinician to the incompatibility between the first tool component 27560 and the surgical robot and / or certain surgical procedures. In various examples, the surgical system 27500 may prevent the first tool component 27560 from being attached to it, for example, by mechanical and / or electrical lockout. Such attachment lockout prevents the clinician from overlooking and / or simply ignoring warnings issued by the surgical system 27500. In other words, attachment lockout requires the clinician to take an active step when overriding errors communicated by the surgical system 27500. In such examples, the clinician may invoke an override to enable the use of the operational functions of the first tool component 27560 by overriding any system lockout. In various cases, overrides are unavailable to prevent clinicians from utilizing the functionality of the first tool component 27560 while it is recognized that the first tool component 27560 is unsuitable for use with a surgical robot.

[0067] Similarly, the user attempts to attach the second tool component 27570 to the available robotic arm 27590 of the surgical robot. Before attaching the second tool component 27570 to the robotic arm 27590, the scan tool 27540 scans the QR code 27575 displayed on the second tool component 27570. The scan tool 27540 communicates the QR code 27575 and / or the information contained within the QR code 27575 to the surgical hub 27530. The surgical hub 27530 compares the information contained within the QR code 27575 to a stored list of acceptable tool components associated with a particular surgical procedure and / or a stored list of acceptable tool components compatible with the tool component currently attached to the surgical robot. In this case, the surgical hub 27530 cannot recognize and / or locate the second tool component 27570 in its memory 27535. Therefore, the second tool component 27570 is not recommended and / or suitable for use with the surgical robot. As discussed above, the surgical hub 27530 is configured to alert the clinician to the incompatibility between the second tool component 27570 and the surgical robot and / or certain surgical procedures. In various examples, the surgical system 27500 may prevent the second tool component 27570 from being attached to it. Such an attachment lockout prevents the clinician from overlooking and / or simply ignoring a warning issued by the surgical system 27500. In other words, an attachment lockout requires the clinician to take an active step when overriding an error communicated by the surgical system 27500. In such examples, the clinician may invoke an override to enable the use of the operational functions of the second tool component 27570 by overriding any system lockout. In various cases, overrides are unavailable to prevent clinicians from utilizing the functionality of the second tool component 27570 while it is recognized that the second tool component 27570 is unsuitable for use with a surgical robot.

[0068] The user attempts to attach a third tool component 27580 to the available robotic arm 27590 of the surgical robot. Before attaching the third tool component 27580 to the robotic arm 27590, the scan tool 27540 scans the QR code 27585 displayed on the third tool component 27580. The scan tool 27540 communicates the QR code 27585 and / or the information contained within the QR code 27585 to the surgical hub 27530. The surgical hub 27530 compares the information contained within the QR code 27585 to a stored list of acceptable tool components associated with a particular surgical procedure and / or a stored list of acceptable tool components compatible with the tool component currently attached to the surgical robot. In this case, the surgical hub 27530 successfully recognizes and / or locates the third tool component 27580 in its memory 27535. The third tool component 27580 is then determined to be suitable for use with a surgical robot and / or other attached tool components during a particular surgical procedure. In various examples, the surgical hub 27530 is configured to alert the clinician to the compatibility of the third tool component 27580 with the surgical robot. In other examples, the surgical system 27500 does not simply prevent the attachment of the third tool component 27580 to an available robotic arm 27590.

[0069] In various examples, the memory 27535 of the surgical hub 27530 is configured to store QR codes associated with each tool component used during a particular surgical procedure. The surgical hub 27530 can then analyze the collected information to form observations and / or conclusions regarding factors such as the efficiency and / or effectiveness of a particular tool component and / or multiple tool components during a surgical procedure. These observations and / or conclusions can then be used by the surgical hub 27530 to select and / or recommend which tool components to utilize during future surgical procedures.

[0070] Figure 15 shows a surgical system 27600 comprising one or more cameras configured to assist clinicians in performing efficient and / or successful surgical procedures. Similar to the surgical system 27500, the surgical system 27600 comprises an operating table 27610 or any preferred treatment surface. The surgical system 27600 further comprises a surgical hub 27650 and an apparatus tower 27660. Various surgical hubs are described in U.S. Patent Application No. 16 / 209,395, filed December 4, 2018, titled "METHOD OF HUB COMMUNICATION," which is incorporated herein by reference in its entirety.

[0071] The surgical system 27600 further comprises a camera system including one or more cameras 27640 positioned at various locations throughout the treatment room. In the illustrated embodiment, two cameras 27640 are positioned at opposite corners of the treatment room, but the cameras 27640 can be positioned and / or oriented at any preferred location where the cameras 27640 can collaboratively capture the treatment room in an unobstructed manner. An artificial intelligence protocol detects and / or identifies various devices, equipment, and / or personnel, as well as their corresponding locations and / or orientations within the treatment room.

[0072] Camera 27640 of the camera system communicates with the surgical hub 27650. In other words, live video from camera 27640 can be transmitted to the surgical hub 27650 for processing and analysis. Through the analysis of the video collected by camera 27640, the surgical hub 27650 can maintain a real-time inventory of devices, equipment, and / or personnel in the treatment room, and / or monitor and / or control the interactions between detected devices, equipment, and / or personnel. Using the images and / or data collected by the camera system, the surgical hub 27650 is configured to be notified regarding the identification information of detected devices, to alert clinicians regarding the suitability of detected devices, and / or to control various components of the surgical system 27600 based on the presence and / or operation of detected devices. The surgical hub 27650 is configured to compare any detected devices to determine compatibility between devices and / or during a particular surgical procedure, to facilitate the collaboration of two devices intended to work together, and / or to facilitate the collaboration of two devices to construct sensed and / or controlled actions toward each other.

[0073] As shown in Figure 15, the anesthesia cart 27670 and the preparation table 27620 are located within the treatment room. The preparation table 27620 is configured to support a variety of surgical tools and / or surgical devices so that they are easily accessible for use during surgical procedures. Such surgical tools and / or surgical devices may include, for example, interchangeable staple cartridges of varying sizes, or shaft assemblies with end effectors of varying sizes and / or functions. In the illustrated embodiment, the preparation table 27620 supports a first device 27630a, a second device 27630b, and a third device 27630c.

[0074] Camera 27640 is configured to detect identification information relating to devices, equipment, and / or personnel located within the treatment room. For example, camera 27640 can capture serial numbers printed on visible parts of each device 27630a, 27630b, 27630c, such as on the device packaging. In various examples, the packaging may have a QR code printed on it, which contains information about the device contained therein. The QR code is captured by camera 27640 and communicated to the surgical hub 27650 for analysis and identification of the staple cartridge.

[0075] Such an identification system may be useful, for example, during a surgical procedure in which a surgical stapler has an end effector, and a 60 mm staple cartridge is configured to seat within the end effector. A camera 27640 in the treatment room is configured to capture the presence of the surgical stapler, for example, in the form of live video and / or still images. The camera 27640 then communicates the captured image(s) to the surgical hub 27650. The surgical hub 27650 is configured to identify the surgical stapler based on the image(s) received from the camera 27640. In cases where the surgical hub 27650 is aware of the surgical procedure to be performed, the surgical hub 27650 can alert the clinician regarding whether the identified surgical stapler is appropriate. For example, by knowing that a 45mm staple cartridge is associated with a particular surgical procedure, the surgical hub 27650 can alert the clinician that the detected surgical stapler is inappropriate because its end effector is configured to accept a 60mm staple cartridge.

[0076] The surgical hub 27650 includes a memory 27655 that stores technical requirements and / or specifications associated with various devices within it. For example, the memory 27655 of the surgical hub 27650 recognizes that the surgical stapling device described above is configured to accept a 60 mm staple cartridge. In various examples, the memory 27655 can also recognize a specific brand of 60 mm staple cartridge compatible with the surgical stapling device. In various examples, the camera 27640 can capture the presence of a replaceable staple cartridge, for example, in the form of live video and / or still images. The camera 27640 then communicates the captured image(s) to the surgical hub 27650. The surgical hub 27650 is configured to identify the characteristics of the replaceable staple cartridge based on the image(s) received from the camera 27640. Such characteristics include, for example, size, brand, and / or manufacturing lot. As will be discussed in more detail herein, the warning may be specific or general. In an example where camera 27640 captures the presence of a package containing a replaceable 45mm staple cartridge, surgical hub 27650 is configured to warn a clinician that an incompatible staple cartridge has been mistakenly stocked in the room. Such a warning can prevent, for example, malfunction of surgical instruments during a surgical procedure, injury to the patient, and / or loss of valuable time.

[0077] As discussed above, the camera system is configured to facilitate the surgical hub 27650 when adjusting devices detected in the treatment room. In various examples, combination energy devices and smoke exhaust systems are detected by the camera system. The combination energy device is configured to apply bipolar and unipolar energy to patient tissue. When the camera system and / or the surgical hub 27650 detect the activation of a combination energy device, the presence of a combination energy device located near the patient, and / or the presence of smoke in the treatment room, the surgical hub 27650 is configured to instruct the generator, for example, to activate a smoke exhaust system.

[0078] Surgical instruments can utilize measurable or otherwise detectable characteristics of their end effectors to confirm specific stages of a surgical procedure and / or control various operating parameters of the surgical instrument. Such characteristics may include, for example, the distance between the jaws of the end effector. The memory of the surgical instrument and / or surgical hub contains stored information that associates a specific jaw gap distance with a specific stage of a surgical procedure. For example, when a jaw-to-jaw distance of 0.030 inches to 0.500 inches is measured, the surgical instrument and / or surgical hub confirms that the end effector is delivering bipolar energy to patient tissue. In another example, when a jaw-to-jaw distance of 0.030 inches to 0.500 inches is measured, the surgical instrument and / or surgical hub activates a generator, thereby initiating the delivery of bipolar energy to patient tissue. In other words, the detection of characteristics of the surgical instrument and / or contact with patient tissue can be used by the surgical instrument and / or surgical hub to confirm and / or adapt the operation of the surgical instrument.

[0079] Figure 16 includes a chart showing various operating parameters and / or specifications of a surgical instrument corresponding to various stages of a surgical procedure. Similar to the surgical instruments described in more detail herein, the surgical instrument 27000 shown in Figures 17-19 has combined electrosurgical functions, and the surgical instrument includes an end effector comprising a first jaw 27810 and a second jaw 27820. At least one of the first jaw 27810 and the second jaw 27820 is movable relative to each other, and the end effector is configurable between an open configuration and a closed configuration. The first jaw 27810 has a first tissue support surface and / or tissue contact surface 27815, and the second jaw 27820 has a second tissue support surface and / or tissue contact surface 27825. The first jaw 27810 and the second jaw 27810 are equipped with electrodes disposed thereon. The electrosurgical instrument 27000 comprises one or more generators configured to power electrodes in order to supply energy to the electrodes. More specifically, energy delivery to patient tissue supported between a first jaw and a second jaw is achieved by electrodes configured to deliver energy in unipolar mode, bipolar mode, and / or combined mode. Alternating or fused bipolar and unipolar energies are configured to be delivered in combined mode. In at least one embodiment, at least one generator comprises a battery, a rechargeable battery, a disposable battery, and / or a combination thereof.

[0080] The end effector 27800 is used to perform various end effector functions during surgical procedures. At the original time t0, the end effector 27800 is used to treat patient tissue T t0 It is not in contact with the patient tissue T. Therefore, the electrodes of the end effector 27800 are not delivering any energy. At the original time t0, the patient tissue T t0is in a relaxed, uncompressed state. The end effector 27800 is shown in an open configuration. In the open configuration, the distance d0 ranges from 0.500 inches to 0.700 inches between the first tissue support surface 27815 and the second tissue support surface 27825. Said another way, the tissue support surfaces 27815, 27825 are separated by a maximum distance d0 of 0.500 inches to 0.700 inches from each other when the end effector 27800 is in the open configuration.

[0081] At a first time t1, the jaws 27810, 27820 of the end effector 27800 contact the patient tissue T t1 At least a portion of the patient tissue T t1 is positioned between the jaws 27810, 27820 of the end effector 27800 as the end effector 27800 moves from the open configuration toward the closed configuration. As the jaws 27810, 27820 are moved toward the closed configuration, the tissue T t1 is compressed therebetween. At time t1, the end effector 27800 is configured to deliver bipolar energy to the patient tissue T t1 Upon application of the bipolar energy, the end effector 27800 can, for example, feather through the parenchymal cells. The end effector 27800 is in a partially closed configuration at time T1. The first distance d1 ranges from 0.030 inches to 0.500 inches between the first tissue support surface 27815 and the second tissue support surface 27825 at time t1. Said another way, the tissue support surfaces 27815, 27825 are separated by a first maximum distance d1 of 0.030 inches to 0.500 inches when the end effector is delivering bipolar energy to the patient tissue T t1 At the first time t1, a detailed depiction of the jaws 27810, 27820 of the end effector 27800 delivering bipolar energy to the patient tissue T t1 is shown in FIG. 17.

[0082] At a second time t2, the jaws 27810, 27820 of the end effector 27800 contact the patient tissue Tt2 Maintain contact with the patient's tissue T. t2 At least a portion of it is positioned between the jaws 27810 and 27820 of the end effector 27800. At time t2, the end effector 27800 applies a combination of bipolar and unipolar energies to the patient tissue T t2 It is configured to deliver to the patient tissue T. By applying bipolar and unipolar energy, the end effector 27800 delivers to the patient tissue T. t2 It can warm the patient tissue. The end effector 27800 is in a partially closed configuration at time t2, but the end effector 27800 is closer to a fully closed configuration at time t2 than at time t1. More specifically, the second distance d2 at time t2 extends to either 0.010 inches to 0.030 inches between the first tissue support surface 27815 and the second tissue support surface 27825. In other words, the tissue support surfaces 27815, 27825 are such that the end effector is closer to a fully closed configuration at time t2 than at time t2. t2 When delivering bipolar and unipolar energy, a second maximum distance d2 of 0.010 inches to 0.030 inches is separated. At the second time t2, patient tissue T t2 A detailed depiction of the jaws 27810 and 27820 of the end effector 27800, which deliver bipolar and unipolar energy, is shown in Figure 18.

[0083] At the third time point t3, jaws 27810 and 27820 of end effector 27800 were in contact with patient tissue T t3 Maintain contact with the patient's tissue T. t3 At least a portion of it is positioned between the jaws 27810 and 27820 of the end effector 27800. At time t3, the end effector 27800 applies a combination of bipolar and unipolar energies to the patient tissue T t3 It is configured to continuously deliver to the patient tissue T. Through the continuous application of bipolar and unipolar energy, the end effector 27800 delivers to the patient tissue T. t3The end effector 27800 is in a partially closed configuration and / or a fully closed configuration at time t3. In other words, the end effector 27800 is in a fully closed configuration and / or is closer to a fully closed configuration at time t3 than at time t2. More specifically, the third distance d3 at time t3 extends from 0.003 inches to 0.010 inches between the first tissue support surface 27815 and the second tissue support surface 27825. In other words, the tissue support surfaces 27815, 27825 are in a configuration where the end effector is in a configuration where the patient tissue T at time t3 is t3 A third maximum distance d3 separation of 0.003 inches to 0.100 inches is maintained when delivering bipolar and unipolar energy to the patient tissue. A detailed depiction of the jaws 27810 and 27820 of the end effector 27800 delivering bipolar and unipolar energy to the patient tissue at a third time t3 is shown in Figure 18.

[0084] At the fourth time point t4, jaws 27810 and 27820 of end effector 27800 were in patient tissue T t4 Maintain contact with the patient's tissue T. t4 At least a portion of it is positioned as end effector 27800 between jaws 27810 and 27820 of end effector 27800. At time t4, end effector 27800 delivers unipolar energy to patient tissue T t4 It is configured to deliver to the patient tissue T. By applying unipolar energy, the end effector 27800 delivers to the patient tissue T. t4The end effector 27800 is in a partially closed configuration and / or a fully closed configuration at time t4. In other words, the end effector 27800 is in a fully closed configuration and / or is closer to a fully closed configuration at time t4 than at time t2. More specifically, the fourth distance d4 at time t4 extends from 0.003 inches to 0.010 inches between the first tissue support surface 27815 and the second tissue support surface 27825. In other words, the tissue support surfaces 27815, 27825 are such that the end effector is in a partially closed configuration and / or a fully closed configuration at time t4. t4 When delivering unipolar energy to the patient tissue, a fourth maximum distance d4 separation of 0.003 inches to 0.010 inches is observed. At the fourth time t4, the patient tissue T t4 A detailed depiction of the jaws 27810 and 27820 of the end effector 27800, which deliver unipolar energy, is shown in Figure 19.

[0085] Graph 27900, shown in Figure 20, illustrates the relationship between various operating parameters and / or specifications of the surgical instruments shown in Figures 16-19 over time. The surgical instruments and / or surgical hubs can utilize these illustrated relationships to verify the proper functioning of the surgical instruments during surgical procedures and / or to operate and / or adjust the various functions of the surgical instruments in response to one or more measured parameters. The graph shows (1) the change in power (W) 27920a of the generator controlling the bipolar modality of the surgical instrument over time 27910, (2) the change in power (W) 27920a of the generator controlling the unipolar modality of the surgical instrument over time 27910, (3) the change in the distance between the jaws of the end effector 27920b over time 27910, (4) the change in force (F) 27920c of the jaw motor over time 27910, and (5) the change in speed (V) 27920d of the jaw motor over time 27910.

[0086] At time t0, the electrodes of the end effector are not delivering energy to the patient tissue, and the end effector is not yet in contact with the patient tissue. The distance 27920b between the jaws of the end effector is maximum at time t0 because the end effector is in an open configuration. As the end effector moves from an open configuration to a closed configuration, it receives little to no resistance from the patient tissue, so the clamping force 27950 between the jaws is minimum from time t0 to time t1. The jaws of the end effector remain closed around the patient tissue from time t1 to time t2, and during that period the end effector begins to deliver bipolar energy 27930. The distance between the jaws of the end effector is smaller at time t1 than at time t0. From time t1 to time t2, the jaw motor speed 27960 begins to decelerate as the clamping force 27950 between the jaws of the end effector begins to increase.

[0087] As explained with respect to Figures 16 to 29, the combination of unipolar energy 27935 and bipolar energy 27930 is delivered to the patient tissue from time t2 to time t3. The jaws of the end effector continue to close around the patient tissue during this period. The distance between the jaws of the end effector is smaller at time t2 than at time t1. The specific distance between the jaws of the end effector at time t2 indicates to the surgical instrument and / or surgical hub that the tissue warming phase of the surgical procedure has been reached, and that the combination of unipolar and bipolar energy should and / or has been delivered to the patient tissue. From time t2 to time t3, the jaw motor speed continues to decrease and is lower than the jaw motor speed at time t1. The force required to clamp the jaws increases sharply between time t2 and time t3, thereby confirming to the surgical instrument and / or surgical hub that the combination of unipolar and bipolar energy is being delivered to the patient tissue.

[0088] Unipolar and bipolar energies continue to be delivered to the patient tissue, which is sealed between time t3 and time t4. The force clamping the jaws also reaches its maximum when the end effector reaches its fully closed configuration at time t3, but the jaw clamping force remains stable between time t3 and time t4. The power level of the generator delivering unipolar energy increases between time t3 and time t4, while the power level of the generator delivering bipolar energy decreases between time t3 and time t4. Finally, between time t4 and t5, unipolar energy is the only energy being delivered to cut the patient tissue. While the patient tissue is being cut, the force clamping the jaws of the end effector may fluctuate. In Example 27952, where the jaw clamping force decreases from its steady-state level maintained between time t3 and t4, efficient and / or effective tissue cutting is recognized by the surgical instrument and / or surgical hub. In example 27954, where the clamping force on the jaws increases from its steady-state level maintained between times t3 and t4, inefficient and / or ineffective tissue cutting is recognized by the surgical instrument and / or surgical hub. In such examples, the error can be communicated to the user.

[0089] In various examples, the clamping action of the end effector jaws can be adjusted based on detected characteristics of the contacted patient tissue. In various examples, detected characteristics include tissue thickness and / or tissue type. For example, actions such as the range of gap distance between jaws during the jaw closure stroke, load threshold, jaw closure speed, current limit applied during the jaw closure stroke, and / or waiting time between the jaw closure stroke and energy delivery can be adjusted based on the detected thickness of the patient tissue. In various examples, the detected characteristics of the contacted patient tissue can be used to adjust tissue welding parameters. More specifically, detected characteristics can be used to adjust, for example, multi-frequency sweep of impedance sensing, balance and / or sequence of energy modalities, energy delivery level, impedance cutoff level, and / or waiting time between energy level adjustments.

[0090] As will be discussed in more detail above, surgical instruments and / or surgical hubs can use measured tissue characteristics to control and / or adjust the operating parameters of the surgical instruments. For example, when patient tissue is positioned between the jaws of the end effector, tissue impedance can be detected. Detection of tissue impedance alerts the surgical instrument and / or surgical hub that the jaws of the end effector are in contact with and / or near patient tissue. Referring here to Figure 21, graph 28000 shows the tissue impedance 28020 calculated over time 28010. When the jaws of the end effector are not in contact with patient tissue, the tissue impedance 28030a is infinite. When the jaws of the end effector are clamped around patient tissue positioned between them, the patient tissue is in contact with both jaws. In such an example, the tissue impedance 28030b is measurable. The ability to measure tissue impedance indicates to the surgical instrument and / or surgical hub that patient tissue is properly positioned between the jaws of the end effector. The surgical instrument and / or surgical hub can then initiate an operation, such as applying bipolar and / or unipolar energy to the patient's tissue.

[0091] In various examples, surgical instruments and / or surgical hubs can use the magnitude of the detected tissue impedance to determine the stage of the surgical procedure. For example, as shown in Figure 21, the tissue impedance 28030b is measured at a first level during initial contact between the jaws of the end effector and the patient tissue. The surgical instrument can then begin delivering bipolar energy to the patient tissue. As the detected tissue impedance 28030b increases to and / or beyond a first predetermined level, the surgical instrument begins delivering a combination of bipolar and unipolar energy to the patient tissue to warm it and / or form a seal. As the detected tissue impedance 28030b continues to increase, the tissue impedance 28030b reaches and / or exceeds a second predetermined level, at which point the surgical instrument stops delivering bipolar energy to cut the patient tissue while continuing to deliver unipolar energy. Ultimately, tissue impedance reaches infinite levels because the patient tissue is no longer positioned between the jaws of the end effector upon completion of the cut. In such cases, the surgical instrument and / or surgical hub can cease delivering unipolar energy.

[0092] In various examples, strain can be a metric used to adjust the operating parameters of surgical instruments, such as clamping mechanisms. However, contact between the jaws of the end effector and patient tissue is desirable for accurate estimation of compressive strain. As will be considered in more detail with reference to Figure 21, the surgical instrument and / or surgical hub can determine the presence of contact between the jaws of the end effector and patient tissue by the detected tissue impedance. Figure 22 shows an end effector 28100 with a first jaw 28110 and a second jaw 28120, where the end effector is in an open configuration.

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[0096] Figure 23 shows the end effector 28100 of Figure 22 in an open configuration.

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[0100] As described above, calculating compressive strain by utilizing the defined gap between the first and second jaws of the end effector when the end effector is in an open configuration yields an accurate calculation only when the patient tissue is in contact with both jaws of the end effector at the initial time t0. Therefore, it is undesirable to use the standard defined gap between the first and second jaws of the end effector when the end effector is in an open configuration. Instead, the defined gap between the first and second jaws of the end effector when the patient tissue first makes contact with both jaws should be used when calculating compressive strain. The end effector is shown in the open configuration 28150 in Figure 24. In particular, the patient tissue is not in contact with both jaws 28110 and 28120 of the end effector. Therefore, the dimensions and / or specifications of the end effector in this configuration 28150 should not be used when calculating compressive strain. If at least one of the first jaw 28110 and the second jaw 28120 continues to move toward each other, the gap

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[0105] The motor control program for a combined electrosurgical instrument can utilize detected tissue stability as input. The surgical instrument can detect the compression rate and / or measure the creep of patient tissue compressed between the jaws of the end effector to determine tissue stability. The control program can be modified to adjust the waiting time between end effector functions, define when additional tissue stability determinations should be made, and / or adjust the jaw clamp speed based on the determined tissue stability.

[0106] As shown in Figure 25, the end effector 28250 comprises a first jaw 28254 and a second jaw 28256, at least one of the first jaw 28254 and the second jaw 28256 configured to move toward each other, and the patient tissue T is configured to be positioned between them. Figure 25 provides schematic diagrams of various positions of the first jaw 28254 and the second jaw 28256 relative to the patient tissue T during the jaw clamp stroke. The gap 28220a defined between the jaws of the end effector and the motor current 28220b required to clamp the jaws of the end effector vary over time 28210, at least in part, due to tissue stability measurements. The initial tilt S0 corresponds to the change in the gap 28230 between the jaws from when the jaws are fully open until initial contact is made between the jaws and the patient tissue T. The resulting motor current 28240 remains low while tissue contact is absent, until the end effector jaws make contact with patient tissue T. The surgical system is configured to monitor the current 28220b over time 28210 to identify when the current slope flattens, i.e., when the tissue stabilizes. When the current slope flattens, the surgical system is configured to take the difference between the peak current at the time of initial tissue contact by the end effector and the point at which the current flattens. In other words, the jaws can continue to clamp the tissue positioned between them when the waiting time ends, defined by the time it takes for tissue compression to stabilize. The creep of the motor current drives the next stage of motor current and speed to the desired jaw gap or level of tissue compression. The creep measurement is repeated to drive the next stage of motor current and speed until the final jaw capping or level of tissue compression is achieved.

[0107] In addition to sensing parameters associated with jaw clamp stroke, surgical systems can monitor additional functions for adjusting and / or improving the operating parameters of surgical instruments. For example, a surgical system can monitor the orientation of the surgical instrument relative to the user and / or patient, the impedance of tissue positioned between the jaws of the end effector to determine the location and / or composition of the tissue, the level of grounding to the patient, and / or leakage current. Monitoring leakage current can determine secondary leakage from other devices and / or create parasitic generated energy outputs through capacitive coupling.

[0108] In various examples, surgical instruments are configured to modify instrument and / or generator settings and / or control programs using local unsupervised machine learning. In such examples, the surgical instrument may update and / or adjust its local functional behavior based on summaries and / or aggregates of data from various surgical procedures performed using the same surgical instrument. Such functional behavior may be adjusted based on past use and / or the preferences of a particular user and / or hospital. In such examples, the control program of the surgical instrument recognizes the same user and automatically modifies the default program using the preferences of the identified user. The surgical instrument can be updated by receiving local and / or global updates and / or improvements to its digitally compatible control program and / or displayed information through interaction with a non-local server.

[0109] In various examples, surgical instruments are configured to modify instrument and / or generator settings and / or control programs using a global set of instrument operating parameters and / or surgical procedure outcomes. The global surgical system is configured to collect data on relevant and / or contributing instrument parameters, such as outcomes, complications, comorbidities, surgical instrument costs, instrument usage, procedure time, procedure data, and / or patient data. The global surgical system is further configured to collect data on generator operating data, such as impedance curves, power levels, energy modality, event annotations, and / or adverse events. The global surgical system is further configured to collect data on intelligent device operating parameters, such as clamp time, tissue pressure, standby time, number of uses, patient time on the operating table, battery level, motor current, and / or operating stroke. The global surgical system is configured to adapt default control programs and / or update existing control programs based on detected operating parameters. In this way, each surgical instrument within the global surgical system can perform the most effective and / or efficient surgical procedure possible.

[0110] Figure 26 shows a network 28300 of surgical instruments 28310 communicating with a cloud-based storage medium 28320. The cloud-based storage medium 28320 is configured to receive data on operating parameters from the surgical instruments 28310 collected over many surgical procedures. The data is used by the cloud-based storage medium 28320 to optimize the control program to achieve efficient and / or desired results. The cloud-based storage medium 28320 is further configured to analyze all the collected data in random batches 28340. The results of the analysis from the random batches 28340 can be further used in redefining the control program. For example, data collected within batch A may represent significantly different wear profiles. From this data, it can then be concluded that, for example, an instrument that adjusts power rather than clamp current will degrade faster. The cloud-based storage medium 28320 is configured to communicate this finding and / or conclusion to the surgical instruments. Subsequently, surgical instruments can maximize their lifespan by adjusting the clamping current instead of power, and / or the surgical system can alert the clinician to this discovery.

[0111] Figure 26 shows a network 28300 of surgical instruments 28310 communicating with a cloud-based storage medium 28320. The cloud-based storage medium 28320 is configured to receive data on operating parameters from the surgical instruments 28310 collected over many surgical procedures. The data is used by the cloud-based storage medium 28320 to optimize the control program to achieve efficient and / or desired results. The cloud-based storage medium 28320 is further configured to analyze all the collected data in random batches 28340. The results of the analysis from the random batches 28340 can be further used in redefining the control program. For example, data collected within batch A may represent significantly different wear profiles. From this data, it can then be concluded that, for example, an instrument that adjusts power rather than clamp current will degrade faster. The cloud-based storage medium 28320 is configured to communicate this finding and / or conclusion to the surgical instruments. Subsequently, surgical instruments can maximize their lifespan by adjusting the clamping current instead of power, and / or the surgical system can alert the clinician to this discovery.

[0112] Information collected from the network 28300 of surgical instruments 28310 by the cloud-based storage medium 28320 is presented in graphical form in Figures 27 and 28. More specifically, the relationship between the gap 28430 defined between the jaws of the end effector and the initial tissue contact point is shown in Figure 27 as a function of the jaw motor clamping current 28440, and thus changes over time during the surgical procedure. The number of times a particular end effector reaches a fully clamped state during the jaw clamping stroke affects the amount of force required to clamp tissue of the same thickness. For example, the jaws of the end effector can clamp to a greater extent with less current for an instrument 28430a that has been fully clamped 10 to 15 times than for an instrument 28430b that has been fully clamped 10 to 15 times. Furthermore, the jaws of the end effector can clamp to a greater extent with less current for an instrument 28430b that has been fully clamped 10 to 15 times than for an instrument 28430c that has been fully clamped 16 to 20 times. Ultimately, as surgical instruments continue to be used, more power, and therefore more current, is required to clamp tissue of the same thickness into the same perfectly clamped gap. The control program can be modified to perform more efficient and / or time-efficient jaw clamp strokes using information collected from the surgical instrument 28310 and the cloud-based storage medium 28320.

[0113] The current required to clamp tissue of the same thickness by achieving a similarly fully clamped gap between the jaws of the end effector is used to set the generator motor current threshold. As shown in Figure 28, the motor current threshold is lower for end effectors that have reached the fully clamped state fewer than 10 times because less current is required to achieve the fully clamped state. Therefore, the control program sets a lower threshold generator power for the new end effector than for the old end effector. If the same generator power is used in the old end effector than in the new end effector, the tissue may not be sufficiently clamped and / or compressed between the jaws of the end effector. If the same generator power is used in the new end effector than in the old end effector, the tissue and / or instrument may be damaged because the tissue may be overcompressed by the jaws of the end effector.

[0114] In various examples, surgical systems comprise modular components. For instance, a surgical system might include a surgical robot equipped with a robotic arm, configured to accept tools of different capabilities. The control program of the surgical system is modified based on the modular attachments, such as the type of tool connected to the surgical robotic arm. In another example, a surgical system might include a handheld surgical instrument configured to accept different and / or interchangeable end effectors. Before performing an intended surgical function, the handheld surgical instrument is configured to identify the attached end effector and modify its control program based on the determined identification information of the end effector.

[0115] The surgical system is configured to identify attached modular components using adaptive and / or intelligent calling techniques. In various examples, the surgical system uses a combination of electrical calling and mechanical calling to determine the capacity and / or capabilities of the attached component. The response to the calling can record and / or compare information stored in the surgical system's memory to establish baseline operating parameters associated with the identified modular attachment. In various examples, the established baseline parameters are stored in the surgical system's memory for use when the same or similar modular attachments are identified in the future.

[0116] In various examples, an electrical call signal is transmitted from the handle of a surgical instrument to an attached modular component, and the electrical call signal is sent in an attempt to determine the identification information, operating parameters, and / or status of the attached modular component. The attached modular component is configured to transmit a response signal using the identification information. In various examples, the response is not received in response to the call signal, and / or the response signal contains unidentifiable information. In such examples, the surgical instrument can perform a default function to evaluate the capabilities of the attached modular component. The default function is defined by the legacy operating parameters. In other words, the default operating parameters used during the performance of the default function are defined to a certain level to avoid injury to the surgical instrument and / or the attached modular component, to the patient, and / or to the user. The surgical instrument is configured to utilize the results of the default function to set an operating program specific to the attached modular component.

[0117] For example, a surgical instrument can perform a tissue cutting stroke, with the cutting member traversing from a proximal to a distal position through a mounted end effector. In cases where the surgical instrument cannot identify the mounted end effector, the instrument is configured to perform the tissue cutting stroke using default operating parameters. By utilizing the position of the cutting member within the end effector at the end of the tissue cutting stroke, the surgical instrument can determine the length of the tissue cutting stroke appropriate for and / or completion using the mounted end effector. The surgical instrument is configured to record the distal position of the cutting member in order to set additional operating parameters associated with the mounted end effector. Such additional operating parameters include, for example, the velocity of the cutting element during the tissue cutting stroke and / or the length of the end effector.

[0118] Additionally, a default function can be used to determine the current state and / or status of the installed modular components. For example, the default function can be used to determine whether and / or to what extent the installed end effector is articulating. The surgical instrument is then configured to adjust the control program accordingly. As the end effector articulates over a range of articulation angles, the length of the cutting stroke changes. In other words, the length of the cutting stroke is different when the end effector is articulating compared to when it is not. The surgical instrument is configured to update the control program to perform a cutting stroke that extends to the length associated with the last detected complete stroke. The surgical instrument is further configured to use the length of the last completed cutting stroke to determine whether and / or whether the total length of the cutting stroke can be achieved and / or completed using the current control program when the end effector is not articulating, compared to when the end effector is articulating.

[0119] In various applications, surgical systems can perform intelligent assessments of the characteristics of attached components. Such characteristics include, for example, tissue pad wear, attachment usage, and / or the operational state of attachments. In other words, surgical systems are configured to assess the function and / or condition of attached components. Upon detecting the characteristics of attached modular components, the control program used to operate the surgical system is adjusted accordingly.

[0120] A surgical instrument comprises one or more tissue pads positioned on the jaws of an end effector. It is generally well known that tissue pads tend to deteriorate and wear over time, for example, due to frictional engagement with the blade when no tissue is present between them. The surgical instrument is configured to determine the degree of tissue pad wear, for example, by analyzing the thickness and / or stiffness of the remaining tissue pads. Using the determined status of the tissue pads, the surgical instrument adjusts its control program accordingly. For example, the control program may change the applied pressure and / or power level of the surgical instrument based on the determined status of the tissue pads. In various examples, the power level of the surgical instrument may be automatically reduced by the instrument's processor in response to the detected thickness of the tissue pads that are below a threshold thickness.

[0121] The surgical instrument has combined electrosurgical functions and includes an end effector having first jaws and second jaws. At least one of the first jaws and the second jaws is configured to move toward each other to transition the end effector between an open configuration and a closed configuration. The first jaws and the second jaws are provided with electrodes disposed on them. The electrosurgical instrument includes one or more generators configured to power the electrodes to supply energy to them. The surgical instrument can assess the degree of charring and / or tissue contamination on one or more of the jaws of the end effector by measuring the impedance when the end effector is in a closed configuration in which patient tissue is not positioned between them. A predetermined impedance can be stored in the memory of the surgical instrument, and if the impedance exceeds a predetermined threshold, the jaws have an undesirable level of charring and / or tissue contamination on them. As will be discussed in more detail herein, a warning can be issued to the user when an undesirable level of charring is detected. In various examples, operating parameters can be automatically adjusted by the processor of the surgical instrument and / or surgical hub in response to the detected closed jaw impedance. Such operating parameters include, for example, power level, applied pressure level, and / or advanced tissue cutting parameters.

[0122] As shown in Figure 29, the graphical representation 28500 shows the relationship 28530 between the measured impedance 28250 and multiple activation cycles 28510. The baseline impedance is measured and recorded in memory before any energy activation (activation n=0). As discussed above, the impedance is measured when the end effectors of the surgical instrument are in a closed configuration and no patient tissue is positioned between them. The surgical instrument and / or surgical hub prompts the user to move the end effectors to a closed configuration in order to measure the closed jaw impedance. Such prompts can be delivered at predefined activation intervals, for example, n=5, 10, 15. As carbides and / or tissue contamination accumulate on the jaws of the end effectors, the impedance increases. At a first predetermined level 28540 and / or beyond, the surgical instrument and / or surgical hub is configured to warn the user of such carbide accumulation and advise the user to clean the end effectors. At a second predetermined level 28550 and / or beyond, surgical instruments and / or surgical hubs may prevent the user from using various operational functions of the surgical instruments until the end effector is cleaned. The operational lockout can be released when the end effector is cleaned, assuming that the measured impedance has decreased to an acceptable level.

[0123] As discussed above, surgical hubs and / or surgical instruments are configured to alert the user when a predetermined impedance is met and / or exceeded. Such alerts can be communicated through various forms of feedback, including, for example, tactile, auditory, and / or visual feedback. In at least one example, the feedback includes auditory feedback, and the surgical instrument may be equipped with a speaker that emits a sound, such as a beep, when an error is detected. In a particular example, the feedback includes visual feedback, and the surgical instrument may be equipped with, for example, a light-emitting diode (LED) that flashes when an error is detected. In a particular example, the visual feedback can be communicated to the user by an alert presented on a display monitor within the user's field of view. In various examples, the feedback includes tactile feedback, and the surgical instrument may be equipped with an electric motor having an eccentric element that vibrates when an error is detected. The alert may be specific or general. For example, the alert may specifically state that the closed jaw impedance has exceeded a predetermined level, or the alert may specifically state the measured impedance.

[0124] In various examples, surgical instruments and / or surgical hubs are configured to detect parameters such as stretching, damage, and / or tolerance buildup of integrated shafts to compensate for the functional parameter operation of electric actuators. The surgical instruments are configured to alert the user when the detected parameters of the attached end-effector and / or shaft are close to and / or outside the desired operating range specific to the attached component. In addition to alerting the user, in various examples, the operation of the surgical instrument is prevented when it is detected that the surgical instrument cannot operate within a predefined envelope of adjustment. The surgical instruments and / or surgical hubs include overrides that allow the user to disable lockout under certain predefined conditions. Such predefined conditions include emergencies, including a disposable override to allow for one additional use of the surgical instrument at the user's discretion during a surgical procedure where the inability to use the surgical instrument would harm the patient. In various examples, overrides are also available to allow the user to perform secondary end-effector functions that are independent of the primary end-effector function. For example, if a surgical instrument prevents the jaws of an end effector from articulating, the user can activate an override to allow the surgical instrument to articulate the end effector.

[0125] The surgical system can adapt a control program configured to operate the surgical instrument in response to detected instrument operating parameters, energy generator parameters, and / or user input. The determined status of the surgical instrument is used in conjunction with user input to adapt the control program. The determined status of the surgical instrument may include, for example, whether the end effector is in its open configuration, whether the end effector is in its closed configuration, and / or whether tissue impedance is detectable. The determined status of the surgical instrument may include two or more detected characteristics. For example, the determined status of the surgical instrument can be evaluated using a combination of two or more measures, a series of ordered operations, and / or a well-known interpretation of user input based on its contextual use. The control program is configured to adjust various functions of the surgical instrument, such as power levels, progressive step-up or step-down, and / or various motor control parameters.

[0126] The surgical system comprises a surgical instrument including a combined electrosurgical function, the surgical instrument including an end effector having first jaws and second jaws on which electrodes are disposed. The electrosurgical instrument comprises one or more generators configured to power the electrodes in order to supply energy to the electrodes. More specifically, energy delivery to the patient tissue supported between the first and second jaws is achieved by electrodes configured to deliver energy in unipolar mode, bipolar mode, and / or combined mode having alternating or fused bipolar and unipolar energies. As will be described in more detail herein, the surgical system may adapt the level of energy power activation of one or more generators based on various monitored parameters of the surgical instrument.

[0127] The surgical system is configured to adapt energy power activation based on monitored parameters of the instrument. In various examples, the surgical system can monitor the sequence in which various surgical instrument functions are activated. The surgical system can then automatically adjust various operating parameters based on the activation of the surgical instrument functions. For example, the surgical system can monitor the activation of rotation and / or joint movement control and prevent the surgical instrument from delivering energy to patient tissue while such secondary non-clamping control is in use.

[0128] In various examples, surgical systems can adapt the power level of instruments to compensate for detected operating parameters, such as insufficient battery and / or motor power levels. Detection of insufficient battery and / or motor power levels may indicate to the surgical system that, for example, the clamping strength of end effectors is affected and / or malfunctions, resulting in undesirable control over patient tissue positioned between them.

[0129] A surgical system can record the operating parameters of a surgical instrument during its period of use associated with a specific intended function. The surgical system can then use the recorded operating parameters to adapt the energy power level and / or the mode of the surgical instrument, for example, when the surgical system identifies that a specific intended function is being performed. In other words, when a desired function of the surgical instrument is identified, the surgical system can automatically adjust the energy power level and / or the mode of the surgical instrument, which has stored preferred operating parameters, and / or the surgical instrument can adjust the energy power level and / or the mode of the surgical instrument to support and complement the desired function. For example, a surgical system can supplement a detected lateral load on a shaft with the application of unipolar power, since the detected lateral load on the shaft is often due to polishing dissection at the end effector in its closed configuration. The surgical system has decided to apply unipolar power because, through previous procedures and / or through information stored in memory, unipolar power results in improved dissection. In various examples, surgical systems are configured to apply unipolar power in proportion to the detected increase in lateral load.

[0130] The surgical system can adapt a control program configured to operate the surgical instrument in response to detected end-effector parameters. As shown in Figure 30, the surgical instrument can automatically modify the gap clamp control program using the measured tissue conductance. Tissue conductance is measured at two frequencies, for example, 50 kHz and 5 MHz. Low-frequency conductance (GE) is driven by extracellular fluid, while high-frequency conductance (GI) is driven by intracellular fluid. Intracellular fluid levels change, for example, when cells are damaged. The end-effector can be configured in open and closed configurations. Therefore, when the end-effector is moved from its open configuration to its closed configuration, the jaws of the end-effector compress the tissue positioned between them. During tissue compression, changes in conductance between the two frequencies can be detected and / or recorded. The surgical system is configured to adapt a control program to control end-effector clamp compression based on the ratio of low-frequency conductance (GE) to high-frequency conductance (GI). The surgical system adapts the control program until it approaches a predetermined point and / or an inflection point, where the predetermined point and / or inflection point indicates that cell damage may be nearby.

[0131] More specifically, Figure 30 is a graphical representation of the relationship between the measured tissue conductance 29100, the ratio of low-frequency conductance to high-frequency conductance 29200, the jaw opening dimension 29300, and the jaw motor force 29400 over the duration 29010 of the jaw clamp stroke. At the start of the jaw clamp stroke, the measured tissue conductance is at its lowest because the jaws of the end effector are making initial contact with the patient tissue, and the jaw opening 29300 is at its maximum when the end effector is in its open configuration. The jaw motor force is low at the start of the jaw clamp stroke, at least in part due to the small resistance provided to the jaws by the tissue positioned between the jaws. Before compression, but after contact between the patient tissue and the jaws of the end effector, the low-frequency conductance 29110 increases to indicate the presence of extracellular fluid in the captured tissue. Similarly, before compression, but after contact between the patient tissue and the jaws of the end effector, the high-energy conductance 29120 increases, indicating the presence of intracellular fluid.

[0132] As the end effector begins to move toward its closed configuration, the jaws of the end effector begin to clamp the tissue positioned between them, and thus the jaw opening 29300 continues to decrease. The tissue begins to be compressed by the jaws, but patient tissue is not to be sealed by the surgical instrument until fluid begins to be discharged from the compressed tissue. The jaw motor force continues to increase during the jaw clamping stroke as the increased resistance is discharged against the end effector jaws by the trapped tissue.

[0133] After the initial drainage of extracellular fluid causes a decrease in low-frequency conductance (GE) 29110, the low-frequency conductance (GE) 29110 remains relatively constant during the jaw clamp stroke. The high-frequency conductance (GI) 29120 also remains relatively constant during the jaw clamp stroke until the patient tissue is sealed. If the tissue continues to be compressed after sealing is complete, intracellular tissue damage occurs and intracellular fluid is drained. At such a point, the high-frequency conductance 29120 decreases, causing a spike in the low-frequency to high-frequency conductance ratio 29210. The tissue damage threshold 29220 is predetermined to alert the user and / or automatically prompt the surgical system to correct the operating parameters when the spike in the low-frequency to high-frequency conductance ratio 29210 reaches and / or exceeds the tissue damage threshold 29220. At such a point, the surgical system is configured to modify its control program to stop moving the jaws of the end effector toward the closed configuration of the end effector and / or to start moving the jaws of the end effector toward the open configuration of the end effector. In various examples, the surgical system is configured to modify its control program to reduce the jaw clamping force. Such adaptations of the control program prevent additional tissue damage.

[0134] The surgical system is configured to modify its control program based on collaborative dual input. More specifically, the surgical system can vary the motor operating speed based on user input and predefined settings. For example, as the force applied by the user to the handle control increases, the motor to trigger the system is activated faster. In various examples, the handle control can be used to communicate different commands to the surgical system depending on its contextual use. More specifically, the surgical system can monitor and / or record specific user inputs. Specific user inputs can be analyzed for their length, duration, and / or any preferred characteristics that can be used to distinguish the input. For example, the handle of a surgical instrument may include a trigger, which is configured to control shaft rotation. In various examples, faster activation of the trigger corresponds to an increase in the speed at which the shaft rotates, while the motor's maximum force (current) threshold remains constant. In other examples, faster activation of the trigger corresponds to an increase in the force applied while the rotation speed threshold remains the same. Such control can be further differentiated by the fact that the shaft rotation speed increases based on the duration the user activates the trigger, while the force is based on the speed at which the trigger is activated.

[0135] In various examples, motor operation control is based on a combination of predefined settings and detection of instrument operation parameters and / or user control parameters. Figure 31 is a graphical representation of the relationship between the actual jaw closing speed 29520 and the trigger speed indicated by the user input 29510. The jaw closing speed 29520 resulting from the corresponding user input 29510 alone is represented by the first line 29530. As the user input trigger speed 29510 increases, the jaw closing speed 29520 also increases. Such a relationship 29530 is determined without considering any additional parameters. The jaw closing speed 29520 resulting from the determination of the thick tissue positioned between the jaws of the end effector and the corresponding user input 29510 is represented by the second line 29540. As the user input trigger speed 29510 increases, the jaw closing speed 29520 also increases, but the jaw closing speed 29520 is smaller than when only the user input trigger speed was considered. Additional considerations regarding tissue thickness include, for example, reducing the jaw closure speed to prevent damage to patient tissue and / or surgical instruments.

[0136] A surgical system comprises many components. For example, a surgical system may include many handheld surgical instruments, a surgical hub, and a surgical robot. In various examples, each component of a surgical system communicates with other components and can issue commands and / or modify control programs based on at least one monitored parameter and / or user input. A surgical system includes means for determining which system is responsible for which part of the operational decision-making process. This designation can be changed based on situational awareness, the occurrence of a predetermined event, and / or the exceeding of a threshold. In various examples, a command protocol may be established within the surgical system that indicates the types of commands that each component can issue and / or that a component issuing a command can instruct other components within the surgical system to issue.

[0137] The command protocol can use predefined thresholds to determine when control handoff is guaranteed. For example, a surgical system comprises a generator and a handheld surgical instrument containing various control units. At the start of a surgical procedure, the generator adjusts its power based on the impedance that is initially controlled and detected. The generator uses the detected impedance and / or current power level to instruct the pressure control unit in the handle of the surgical instrument to comply with specific pressure needs. At some point during the surgical procedure, the generator algorithm exceeds a lower impedance threshold, indicating that an electrical short circuit has been detected. The generator then hands control to the pressure control unit in the handle by instructing it to determine whether the tissue is still positioned between the jaws of the end effector. The pressure control unit can then determine appropriate tissue compression and communicate which power level and / or energy modality is most appropriate for the detected tissue.

[0138] The control protocol can be determined based on a consensus achieved by multiple components within the surgical system. For example, three components within the surgical system detect a first value for a monitored parameter, while two components within the surgical system detect a second value for the same monitored parameter, and the first value is different from the second value. The group of three components has more components than the group of two components, and therefore the first value of the monitored parameter is controlled. Each component within the surgical system can be assigned a position within a hierarchy. The hierarchy can be established based on the reliability and / or capabilities of a particular component. The first component detects a first value for a monitored parameter, and the second component detects a second value for the same monitored parameter, and the first value is different from the second value. The second component is "higher" than the first component within the hierarchy of the surgical system, and therefore the second value of the monitored parameter detected by the second component control is controlled.

[0139] Various aspects of the subject matter described herein will be illustrated in the following examples.

[0140] Example Set 1 Example 1 - A surgical system comprising a surgical instrument, a generator configured to supply power to an end effector, and a processor configured to execute a control program to operate the surgical system. The surgical instrument includes an end effector, which includes a first jaw and a second jaw. At least one of the first jaw and the second jaw is moved relative to each other between an open position and a closed position. Tissue is configured to be positioned between the first jaw and the second jaw. The processor is configured to detect a first parameter of the surgical system, to detect at least one user input, and to modify a control program in response to the detected first parameter and at least one user input.

[0141] Example 2 - The surgical system according to Example 1, wherein the control program is configured to control the power level of the generator.

[0142] Example 3 - The surgical system according to Example 1 or 2, wherein the control program is configured to control a motor, and the motor is configured to move an end effector between an open configuration and a closed configuration.

[0143] Example 4 - The surgical system according to Example 3, wherein the control program is configured to control the motor via motor control parameters, and the control program is configured to adjust the motor control parameters in response to detected first parameters and detected user input.

[0144] Example 5 - The surgical system according to Example 1, 2, 3, or 4, wherein the first parameter includes the instrument operating parameter.

[0145] Example 6 - A surgical system according to Example 1, 2, 3, 4, or 5, wherein the first parameter includes a generator operating parameter.

[0146] Example 7 - A surgical system according to Example 1, 2, 3, 4, 5, or 6, wherein the first parameter includes the status of the end effector.

[0147] Example 8 - A surgical system according to Example 1, 2, 3, 4, 5, 6, or 7, wherein the first parameter indicates whether the end effector is in an open configuration or a closed configuration.

[0148] Example 9 - The surgical system according to Example 1, 2, 3, 4, 5, 6, or 7, wherein the first parameter indicates whether the tissue is positioned between the first jaw and the second jaw.

[0149] Example 10 - The surgical system according to Example 1, 2, 3, 4, 5, 6, 7, 8, or 9, wherein the surgical instruments are motion-controlled and the generator is a slave control system by default.

[0150] Example 11 - The surgical system according to Example 1, 2, 3, 4, 5, 6, 7, 8, or 9, wherein the control program is configured to control the operation of a generator in response to a detected first parameter and detected user input, and to configure the surgical instrument as a slave control system.

[0151] Example 12 - A surgical system according to Example 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11, wherein the first parameter includes a combination of two scales.

[0152] Example 13 - The surgical system according to Example 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12, further comprising a trigger configured to receive user input, wherein a processor is configured to interpret a plurality of user inputs received by the trigger, each user input having a different purpose based on contextual use.

[0153] Example 14 - A surgical system comprising a surgical instrument, a generator configured to supply power to the surgical instrument, and a processor configured to execute a control program to operate the surgical system. The processor is configured to detect the status of the surgical instrument, to detect at least one user input, and to adapt the control program in response to the detected status of the surgical instrument and at least one user input.

[0154] Example 15 - The surgical system according to Example 14, wherein the surgical instrument includes an end effector, the end effector can be configured in an open configuration and a closed configuration, and the status of the surgical instrument corresponds to whether the end effector is in an open configuration or a closed configuration.

[0155] Example 16 - The surgical system according to Example 14 or 15, wherein the surgical instrument includes an end effector, the end effector can be configured in an open configuration and a closed configuration, and the status of the surgical instrument corresponds to whether the patient tissue is positioned between the first jaw and the second jaw.

[0156] Example 17 - The surgical system according to Example 14, 15, or 16, further comprising an input member configured to receive user inputs, wherein a processor is configured to interpret a plurality of user inputs received by the input member, and each received user input has a different purpose based on the contextual use of the surgical system.

[0157] Example 18 - A surgical system comprising a surgical instrument, a generator configured to supply power to an end effector, and a processor configured to execute a control program to operate the surgical system. The surgical instrument includes an end effector having a first jaw and a second jaw. At least one of the first jaw and the second jaw is moved relative to each other between an open position and a closed position. Tissue is configured to be positioned between the first jaw and the second jaw. The processor is configured to detect a first parameter of the surgical instrument, detect a second parameter of the generator, detect at least one user input, and modify a control program in response to the detected first parameter, the detected second parameter, and the at least one user input.

[0158] Example 19 - The surgical system according to Example 18, wherein the first parameter of the surgical instrument corresponds to whether the end effector is in an open configuration or a closed configuration, and whether the patient tissue is positioned between the first jaw and the second jaw.

[0159] Example 20 - The surgical system according to Example 18 or 19, wherein the surgical instrument further comprises an input member configured to receive user input, and a processor is configured to interpret a plurality of user inputs received by the input member, each received user input having a different purpose based on the contextual use of the surgical instrument in the surgical system.

[0160] Example Set 2 Example 1 - A surgical instrument comprising a housing, a shaft assembly, a processor, and memory. The shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions, and when a program instruction is executed from the memory, it causes the processor to: send an electrical calling signal to the mounted shaft assembly; receive a response signal from the mounted shaft assembly; perform a default function if no response signal is received by the mounted shaft assembly; determine the identification characteristics of the mounted shaft assembly as a result of performing the default function; and modify the control program based on the identification characteristics of the mounted shaft assembly.

[0161] Example 2 - The surgical instrument according to Example 1, wherein the identification feature includes the remaining capacity of the attached shaft assembly.

[0162] Example 3 - The surgical instrument according to Example 1 or 2, wherein the identification characteristics include the performance level of the attached shaft assembly.

[0163] Example 4 - The surgical instrument according to Example 1, 2, or 3, wherein the identification characteristics differ depending on the mounted shaft assembly of different capabilities.

[0164] Example 5 - The surgical instrument according to Example 1, 2, 3, or 4, wherein the memory includes a lookup table containing operating parameters corresponding to a specific shaft assembly, the processor uses an received response signal to identify the mounted shaft assembly in the lookup table, and the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.

[0165] Example 6 - The surgical instrument according to Example 1, 2, 3, 4, or 5, wherein the memory further includes program instructions, and when a program instruction is executed, the processor causes the modified control program to be stored in the memory.

[0166] Example 7 - A surgical instrument comprising a housing, a shaft assembly, a processor, and memory. The shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions, and when program instructions are executed from the memory, it causes the processor to transmit variable call communications to the mounted shaft assembly, determine the capabilities of the mounted shaft assembly based on the response to the variable call communications, and modify the control program based on the determined capabilities of the mounted shaft assembly.

[0167] Example 8 - The surgical instrument according to Example 7, wherein the variable calling communication includes an electrical calling signal and the physical operation of the surgical instrument.

[0168] Example 9 - The surgical instrument according to Example 7 or 8, wherein the physical operation of the surgical instrument is monitored to determine the functional capability of the attached shaft assembly.

[0169] Example 10 - A surgical instrument according to Example 7, 8, or 9, wherein the determined capacity relates to the remaining capacity of the shaft assembly.

[0170] Example 11 - A surgical instrument according to Example 7, 8, 9, or 10, wherein the determined capability relates to the performance level of the shaft assembly.

[0171] Example 12 - A surgical instrument according to Example 7, 8, 9, 10, or 11, wherein the determined capability differs based on the connected shaft assembly.

[0172] Example 13 - A surgical instrument according to Example 7, 8, 9, 10, 11, or 12, wherein the memory further includes program instructions, and when the program instructions are executed, the processor causes the modified control program and the determined capabilities of the shaft assembly to be stored in the memory.

[0173] Example 14 - A surgical instrument comprising a housing, a shaft assembly, a processor, and memory. The shaft assembly is interchangeably connected to the housing. The shaft assembly includes an end effector. The memory is configured to store program instructions, and when a program instruction is executed from the memory, it causes the processor to: send a call signal to the shaft assembly connected to the housing; receive a response signal from the shaft assembly connected to the housing; perform a default end effector function if no response signal is recognized; determine the identification characteristics of the shaft assembly connected to the housing as a result of performing the default end effector function; and modify the control program based on the identification characteristics of the shaft assembly connected to the housing.

[0174] Example 15 - The surgical instrument as in Example 14, wherein the response signal is not received by the processor and therefore not recognized by the processor.

[0175] Example 16 - The surgical instrument according to Example 14 or 15, wherein the identification feature includes the remaining capacity of the shaft assembly connected to the housing.

[0176] Example 17 - A surgical instrument according to Example 14, 15, or 16, wherein the identification characteristics include the performance level of a shaft assembly connected to a housing.

[0177] Example 18 - A surgical instrument according to Example 14, 15, 16, or 17, wherein the determined characteristics may differ based on a shaft assembly interchangeably connected to the housing.

[0178] Example 19 - A surgical instrument according to Example 14, 15, 16, 17, or 18, wherein the memory includes a lookup table containing operating parameters corresponding to a specific shaft assembly, the processor uses an received response signal to identify a shaft assembly coupled to a housing in the lookup table, and the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.

[0179] Example 20 - The surgical instrument according to Example 14, 15, 16, 17, 18, or 19, wherein the memory further includes program instructions, and when a program instruction is executed, the processor causes the modified control program to be stored in the memory.

[0180] Example Set 3 Example 1 - The surgical system comprises a surgical hub, surgical instruments, a generator configured to supply energy to an end effector, and a smoke extraction system configured to remove smoke from the surgical site. The surgical instruments include an end effector. Control commands are passed directly from the surgical hub to the surgical instruments. The surgical instruments are configured to pass control commands received from the surgical hub to the generator and smoke extraction system in a daisy-chain manner.

[0181] Example 2 - The surgical system according to Example 1, wherein the surgical instrument is configured to modify a control command using parameters detected by the surgical instrument.

[0182] Example 3 - The surgical system according to Example 2, wherein the surgical instrument is configured to pass modified control commands to a generator.

[0183] Example 4 - The surgical system according to Example 2 or 3, wherein the operating parameters of the generator are controlled by a modified control command.

[0184] Example 5 - The surgical system according to Example 2, 3, or 4, wherein the generator is configured to modify a modified control command using a second parameter detected by the generator.

[0185] Example 6 - The surgical system according to Example 2, 3, 4, or 5, wherein a surgical instrument is configured to pass modified control commands to a surgical hub, and the surgical hub is configured to pass modified control commands to a generator.

[0186] Example 7 - The surgical system according to Example 1, wherein a surgical instrument is configured to detect a first parameter of the surgical instrument, the surgical instrument is configured to communicate the detected first parameter to a generator, and the generator is configured to modify a control command using the first parameter.

[0187] Example 8 - The surgical system according to Example 1, wherein a surgical instrument is configured to detect a first parameter of the surgical instrument, the surgical instrument is configured to communicate the detected first parameter to a generator, the generator is configured to detect a second parameter, and the generator is configured to modify a control command using the first and second parameters.

[0188] Example 9 - The surgical system according to Example 1, 2, 3, 4, 5, 6, 7, or 8, further comprising a display screen configured to display live video of the surgical site and a first operating parameter of a surgical instrument.

[0189] Example 10 - The surgical system according to Example 9, further comprising an instrument display configured to display a second operating parameter of the surgical instrument, wherein the first operating parameter is the same as the second operating parameter.

[0190] Example 11 - The surgical system according to Example 9, further comprising an instrument display configured to display a second operating parameter of the surgical instrument, wherein the first operating parameter is different from the second operating parameter.

[0191] Example 12 - The surgical system according to Example 9, 10, or 11, wherein the display screen is further configured to display the operating parameters of the generator.

[0192] Example 13 - A surgical system comprising a surgical hub, surgical instruments, a generator configured to supply energy to an end effector, and a smoke extraction system configured to remove smoke from the surgical site. The surgical instruments include an end effector. Control commands are passed directly from the surgical hub to the surgical instruments. The surgical instruments are configured to pass control commands received from the surgical hub to the generator and the smoke extraction system.

[0193] Example 14 - The surgical system according to Example 13, wherein surgical instruments are configured to daisy-chain control commands received from a surgical hub to a generator and a smoke extraction system.

[0194] Example 15 - A surgical system comprising a surgical hub, a first surgical instrument, a first generator configured to supply energy to a first end effector, and a second surgical instrument. The first surgical instrument includes a first end effector. Control commands are passed directly from the surgical hub to the first surgical instrument. The first surgical instrument is configured to pass control commands received from the surgical hub to the first generator and the second surgical instrument in a daisy-chain manner.

[0195] Example 16 - The surgical system according to Example 15, wherein the first surgical instrument is configured to modify a control command using a first parameter detected by the first surgical instrument.

[0196] Example 17 - The surgical system according to Example 16, wherein the first surgical instrument is configured to pass a modified control command to the second surgical instrument.

[0197] Example 18 - The surgical system according to Example 17, wherein a second surgical instrument is configured to modify a modified control command using a second parameter detected by the second surgical instrument, and the second surgical instrument is configured to pass the modified control command to the first surgical instrument.

[0198] Example 19 - The surgical system according to Example 15, wherein a first surgical instrument is configured to detect a first parameter, a second surgical instrument is configured to detect a second parameter, the second surgical instrument is configured to communicate the detected second parameter to the first surgical instrument, and the first surgical instrument is configured to modify a control command using the first parameter detected by the first surgical instrument and the second parameter detected by the second surgical instrument.

[0199] Example 20 - The surgical system according to Example 15, 16, 17, 18, or 19, wherein the second surgical instrument includes a smoke extraction system configured to remove smoke from the surgical site.

[0200] While several forms have been shown and described, it is not the applicant's intention to limit or restrict the attached claims to such details. Many modifications, variations, alterations, substitutions, combinations, and equivalents of these forms can be implemented and will be conceived by those skilled in the art without departing from the scope of this disclosure. Furthermore, the structure of each element related to the described form can be alternatively described as a means for providing the function performed by that element. Also, while materials are disclosed with respect to specific components, other materials may be used. Therefore, it should be understood that the above description and the attached claims are intended to cover all such modifications, combinations, and variations as being included within the scope of the disclosed forms. The attached claims are intended to cover all such modifications, variations, alterations, substitutions, alterations, and equivalents.

[0201] The detailed descriptions above have used block diagrams, flowcharts, and / or examples to illustrate various forms of apparatus and / or processes. As far as such block diagrams, flowcharts, and / or examples include one or more functions and / or operations, it should be understood by those skilled in the art that each function and / or operation included in such block diagrams, flowcharts, and / or examples can be implemented individually and / or collectively by various hardware, software, firmware, or virtually any combination thereof. Those skilled in the art will recognize that all or part of some of the forms disclosed herein can be equivalently implemented on an integrated circuit as one or more computer programs running on one or more computers (e.g., one or more programs running on one or more computer systems), one or more programs running on one or more processors (e.g., one or more programs running on one or more microprocessors), firmware, or substantially any combination thereof, and that designing circuits and / or writing software and / or firmware code falls within the scope of the skills of those skilled in the art in light of this disclosure. In addition, as will be understood by those skilled in the art, mechanisms of the subject matter described herein can be distributed in various forms as one or more program products, and the specific forms of the subject matter described herein apply regardless of the particular type of signal carrier medium used to actually carry out the distribution.

[0202] Instructions used to program logic to implement various disclosed embodiments may be stored in system memory such as dynamic random access memory (DRAM), cache, flash memory, or other storage. Furthermore, instructions may be distributed over a network or by other computer-readable media. Therefore, machine-readable media can include any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), but are not limited to floppy diskettes, optical disks, compact disks, read-only memory (CD-ROMs), and magneto-optical disks, read-only memory (ROMs), random access memory (RAMs), erasable programmable read-only memory (EPROMs), electrically erasable programmable read-only memory (EEPROMs), magnetic or optical cards, flash memory, or tangible machine-readable storage used for transmitting information over the Internet via electrically, optically, acoustically, or other propagating signals (e.g., carrier waves, infrared signals, digital signals, etc.). Therefore, non-temporary computer-readable media can include any type of tangible machine-readable media suitable for storing or transmitting electronic instructions or information in a form readable by a machine (e.g., a computer).

[0203] When used in any aspect of this specification, the term “control circuit” can mean, for example, hardwired circuits, programmable circuits (e.g., computer processors, processing units, processors, microcontrollers, microcontroller units, controllers, digital signal processors (DSPs), programmable logic devices (PLDs), programmable logic arrays (PLAs), or field programmable gate arrays (FPGAs) including one or more individual instruction processing cores), state-machine circuits, firmware that stores instructions executed by programmable circuits, and any combination thereof. Control circuits can be embodied collectively or individually as circuits that form part of a larger system, such as an integrated circuit (IC), an application-specific integrated circuit (ASIC), a system on-chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, or a smartphone. Accordingly, as used herein, “control circuit” includes, but is not limited to, an electrical circuit having at least one separate electrical circuit, an electrical circuit having at least one integrated circuit, an electrical circuit having at least one application-specific integrated circuit, an electrical circuit forming a general-purpose computing device configured by a computer program (e.g., a general-purpose computer configured by a computer program that performs at least part of the processes and / or devices described herein, or a microprocessor configured by a computer program that performs at least part of the processes and / or devices described herein), an electrical circuit forming a memory device (e.g., in the form of random access memory), and / or an electrical circuit forming a communication device (e.g., a modem, a communication switch, or an optical-electric installation).Those skilled in the art will recognize that the subject matter described herein can be implemented in analog form, digital form, or a combination thereof.

[0204] When used in any aspect of this specification, the term “logic” may mean an application, software, firmware, and / or circuit configured to perform any of the operations described above. Software may be embodied as software packages, code, instructions, instruction sets, and / or data recorded on a non-temporary computer-readable storage medium. Firmware may be embodied as code, instructions, or instruction sets, and / or hardcoded (e.g., non-volatile) data in a memory device.

[0205] When used in any aspect of this specification, terms such as “component,” “system,” and “module” may refer to computer-related entities that are hardware, a combination of hardware and software, software, or running software.

[0206] Where used in any aspect of this specification, “algorithm” means a self-consistent sequence of steps leading to a desired result, and “step” means the manipulation of physical quantities and / or logical states that can take the form of electrical or magnetic signals, which are not necessarily required but can be stored, transferred, combined, compared, and otherwise manipulated. These signals are commonly referred to as bits, values, elements, symbols, characters, terms, numbers, etc. These and similar terms may be associated with appropriate physical quantities, or are simply convenient labels applied to these quantities and / or states.

[0207] A packet-switched network is one example of a network. Communication devices can communicate with each other using a selected packet-switched network communication protocol. One exemplary communication protocol is the Ethernet communication protocol, which can enable communication using the Transmission Control Protocol / Internet Protocol (TCP / IP). The Ethernet protocol may conform to or be compatible with the "IEEE 802.3 Standard" published in December 2008 by the Institute of Electrical and Electronics Engineers (IEEE), and / or later versions of the Ethernet standard. Alternatively or additionally, communication devices may communicate with each other using the X.25 communication protocol. The X.25 communication protocol may conform to or be compatible with standards published by the International Telecommunication Union - Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, communication devices may communicate with each other using the Frame Relay communication protocol. The Frame Relay communication protocol conforms to or may be compatible with standards published by the Consultative Committee for International Telegraph and Telephone (CCITT) and / or the American National Standards Institute (ANSI). Alternatively or additionally, transceivers may communicate with each other using the Asynchronous Transfer Mode (ATM) communication protocol. The ATM communication protocol conforms to or may be compatible with the ATM standard and / or later versions of this standard, published by the ATM Forum in August 2001 under the title "ATM-MPLS Network Interworking 2.0".Naturally, different and / or later developed connection-type network communication protocols are equally construed herein.

[0208] Unless otherwise explicitly stated, as is evident from the foregoing disclosures, any use of terms such as “processing,” “computing,” “calculating,” “determining,” and “displaying” throughout the foregoing disclosures should be understood to refer to the actions and processes of a computer system or similar electronic computing device that manipulate and convert data represented as physical (electronic) quantities in the registers and memory of a computer system into other data similarly represented as physical quantities in the memory or registers of a computer system or other such information storage, transmission, or display.

[0209] One or more components may be referred to herein as “configured to,” “configurable to,” “operable / operative to,” “adapted / adaptable,” “able to,” “conformable / conformed to,” and so on. Those skilled in the art will recognize that “configured to” generally encompasses active components and / or inactive components and / or standby components, unless the context should interpret it otherwise.

[0210] The terms “proximal” and “distal” are used herein in reference to the clinician operating the handle portion of a surgical instrument. “Proximal” refers to the part closest to the clinician, and “distal” refers to the part further away from the clinician. For convenience and clarity, spatial terms such as “vertical,” “horizontal,” “up,” and “down” may be used herein in reference to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be restrictive and / or absolute.

[0211] Those skilled in the art will generally understand that the terms used herein, and especially in the appended claims (e.g., the text of the appended claims), are intended to be generally "open" terms (for example, the term "including" should be interpreted as "including but not limited to," the term "having" should be interpreted as "having at least," and the term "includes" should be interpreted as "includes but is not limited to"). Furthermore, those skilled in the art will understand that if a particular number is intended in an introduced claim recitation, such intention is clearly stated in the claim, and if such statement is not made, such intention does not exist. For example, to aid understanding, subsequent appended claims may include the introductory phrases "at least one" and "one or more" to introduce the claim recitation. However, the use of such phrases should not be interpreted as suggesting that any particular claim containing such introduced claim description is limited to claims containing only one such description, even if the same claim contains an introductory phrase such as "one or more" or "at least one" and the indefinite article "a" or "an" when the claim description is introduced by the indefinite article "a" or "an" (for example, "a" and / or "an" should generally be interpreted as meaning "at least one" or "one or more"). The same applies when introducing a claim description using the definite article.

[0212] In addition, even if a specific number is explicitly stated in the introduced claim, it will be recognized by those skilled in the art that such a statement should typically be interpreted as meaning at least the number stated (for example, if there is a statement that is simply “two descriptions” without any other modifiers, it generally means at least two descriptions, or two or three or more descriptions). Furthermore, when a notation similar to “at least one of A, B, and C, etc.” is used, such a notation is generally intended to be understood in a way that those skilled in the art will understand (for example, “a system having at least one of A, B, and C” is not limited to systems having only A, only B, only C, both A and B, both A and C, both B and C and / or all of A, B and C, etc.). When expressions similar to "at least one of A, B, or C" are used, such expressions are generally intended to be understood in a way that a person skilled in the art would understand (for example, "a system having at least one of A, B, or C" includes, but is not limited to, systems having only A, only B, only C, both A and B, both A and C, both B and C, and / or all of A, B, and C). Furthermore, a person skilled in the art will understand that, typically, any disjunctive words and / or phrases representing two or more alternative terms should be understood, whether in the specification, claims, or drawings, to include the possibility of including one of those terms, any of those terms, or both of those terms, unless the context requires a different interpretation. For example, the phrase "A or B" will typically be understood to include the possibility of "A" or "B" or "A and B".

[0213] With respect to the attached claims, those skilled in the art will understand that the operations cited herein may generally be performed in any order. Furthermore, while flowcharts of various operations are shown in sequence(s), it should be understood that the operations may be performed in any order other than those shown, or simultaneously. Examples of such alternative orderings may include repetition, alternation, interruption, reordering, augmentation, preliminary, additional, simultaneous, reverse, or other different orderings, unless the context should interpret them otherwise. Moreover, terms such as “responding to,” “related to,” or other past tense adjectives are generally not intended to exclude such variations, unless the context should interpret them otherwise.

[0214] It is worth noting that any reference to “one aspect,” “aspect,” “example,” or “example” means that the specific mechanism, structure, or characteristic described in relation to that aspect is included in at least one aspect. Therefore, the phrases “in one aspect,” “in aspect,” “example,” and “example” found in various places throughout this specification do not necessarily all refer to the same aspect. Furthermore, specific features, structures, or characteristics can be combined in any preferred manner in one or more aspects.

[0215] In this specification, unless otherwise specified, the terms “about” or “approximately” as used in this disclosure mean a tolerance for a particular value as determined by a person skilled in the art, which depends in part on the method by which the value is measured or determined. In certain embodiments, the terms “about” or “approximately” mean one, two, three, or four standard deviations. In certain embodiments, the terms “about” or “approximately” mean 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.

[0216] In this specification, unless otherwise indicated, all numerical parameters should be understood in all cases as being preceded and modified by the word “approximately,” and such numerical parameters have variability characteristics inherent to the underlying measurement method used to determine the numerical value of the parameter. At the very least, no attempt should be made to limit the application of the doctrine of equivalents to the scope of the claims, and each numerical parameter described herein should be interpreted at least by taking into account the reported number of significant figures and applying the usual rounding method.

[0217] Any numerical range described herein includes all subranges contained within that range. For example, the range "1 to 10" includes all subranges between the listed minimum value of 1 and the listed maximum value of 10 (and including both the minimum and maximum values), i.e., all subranges having a minimum value of 1 or greater and a maximum value of 10 or less. Furthermore, all ranges listed herein include the endpoints of the listed ranges. For example, the range "1 to 10" includes the endpoints 1 and 10. Any maximum numerical limit described herein is intended to include all smaller numerical limits contained within it, and any minimum numerical limit described herein is intended to include all larger numerical limits contained within it. Accordingly, the applicant has the right to amend this specification, including the claims, to include any explicitly described subranges contained within the explicitly described range. All such ranges are essentially described herein.

[0218] Any patent application, patent, non-patent publication, or other disclosure material referenced herein and / or listed in any application data sheet is incorporated herein by reference to the extent that the incorporated material does not conflict with this Specified. Any disclosure expressly stated herein, either in itself or to the extent required, shall supersede any conflicting statement incorporated herein by reference. Any material, or any portion thereof, that is referred to as being incorporated herein by reference but conflicts with current definitions, views, or other disclosures contained herein, shall be incorporated only to the extent that it does not create a conflict between the incorporated material and the current disclosures.

[0219] In summary, the numerous benefits that can be obtained as a result of using the concepts described herein have been described. The above descriptions of one or more forms are presented for illustrative and explanatory purposes only. They are not intended to be comprehensive or to be limited to the exact forms disclosed. Modifications or variations are possible in light of the above teachings. One or more forms have been selected and described to illustrate the principle and practical applications, thereby enabling a person skilled in the art to utilize the various forms, along with various modifications, to be suitable for a particular conceivable use. The claims presented herein are intended to define the overall scope.

[0220] [Implementation Method] (1) Surgical instruments, Housing and A shaft assembly interchangeably connected to the housing, the shaft assembly including an end effector, Processor and A memory configured to store program instructions, wherein when a program instruction is executed from the memory, the processor... To transmit an electrical calling signal to the attached shaft assembly, Receiving a response signal from the attached shaft assembly, When a response signal is not received by the attached shaft assembly, the default function is to be performed. As a result of performing the default function described above, the identification characteristics of the attached shaft assembly are determined, Based on the identification characteristics of the attached shaft assembly, the control program is modified. To perform this, memory and A surgical instrument equipped with [a specific feature / feature]. (2) The surgical instrument according to Embodiment 1, wherein the identification characteristic includes the remaining capacity of the attached shaft assembly. (3) The surgical instrument according to Embodiment 1, wherein the identification characteristics include the performance level of the attached shaft assembly. (4) The surgical instrument according to Embodiment 1, wherein the identification characteristics differ depending on the attached shaft assemblies having different capabilities. (5) The surgical instrument according to Embodiment 1, wherein the memory includes a lookup table containing operating parameters corresponding to a specific shaft assembly, the processor uses the received response signal to identify the mounted shaft assembly in the lookup table, and the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.

[0221] (6) The surgical instrument according to Embodiment 1, wherein the memory further includes program instructions, and when the program instructions are executed, the processor causes the modified control program to be stored in the memory. (7) Surgical instruments, Housing and A shaft assembly interchangeably connected to the housing, the shaft assembly including an end effector, Processor and A memory configured to store program instructions, wherein when a program instruction is executed from the memory, the processor... To transmit variable call communication to the attached shaft assembly, Determining the capabilities of the attached shaft assembly based on the response to the variable call communication; Modifying a control program based on the determined capabilities of the attached shaft assembly; A memory for causing the above to be performed; A surgical instrument comprising the above. (8) The surgical instrument according to embodiment 7, wherein the variable call communication includes an electrical call signal and a physical actuation of the surgical instrument. (9) The surgical instrument according to embodiment 7, wherein the physical actuation of the surgical instrument is monitored to determine the functional capabilities of the attached shaft assembly. (10) The surgical instrument according to embodiment 7, wherein the determined capabilities are related to the remaining capacity of the shaft assembly.

[0222] (11) The surgical instrument according to embodiment 7, wherein the determined capabilities are related to the performance level of the shaft assembly. (12) The surgical instrument according to embodiment 7, wherein the capabilities to be determined are different based on the connected shaft assembly. (13) The surgical instrument according to embodiment 7, wherein the memory further includes program instructions, and when the program instructions are executed, the processor stores the modified control program and the determined capabilities of the shaft assembly in the memory. (14) A surgical instrument, A housing, A shaft assembly compatibly coupled to the housing, the shaft assembly including an end effector, A processor, A memory configured to store program instructions, and when the program instructions are executed from the memory, cause the processor to Transmit a call signal to the shaft assembly coupled to the housing; Receive a response signal from the shaft assembly coupled to the housing; When a response signal is not recognized, cause the default end effector function to be performed, and As a result of the performance of the default end effector function, determine the identification characteristics of the shaft assembly coupled to the housing, and Based on the identification characteristics of the shaft assembly coupled to the housing, modify a control program, and A memory that causes the above to be performed, and A surgical instrument comprising the above. (15) The surgical instrument according to embodiment 14, wherein the response signal is not recognized by the processor because the response signal is not received by the processor.

[0223] (16) The surgical instrument according to embodiment 14, wherein the identification characteristics include the remaining capacity of the shaft assembly coupled to the housing. (17) The surgical instrument according to embodiment 14, wherein the identification characteristics include the performance level of the shaft assembly coupled to the housing. (18) The surgical instrument according to embodiment 14, wherein the determined characteristics may be different based on the shaft assembly compatibly coupled to the housing. (19) The memory includes a look-up table containing operating parameters corresponding to a particular shaft assembly, the processor uses the received response signal to identify the shaft assembly coupled to the housing within the look-up table, and the control program is modified using the stored operating parameters corresponding to the identified shaft assembly. The surgical instrument according to embodiment 14. (20) The surgical instrument according to embodiment 14, wherein the memory further includes program instructions, and when the program instructions are executed, cause the processor to store the modified control program in the memory.

Claims

1. Surgical instruments, Housing and A shaft assembly interchangeably attached to the housing, the shaft assembly including an end effector, Processor and A memory configured to store program instructions, wherein when a program instruction is executed from the memory, the processor... To transmit an electrical calling signal to the attached shaft assembly, Receiving a response signal from the attached shaft assembly, The default function is to be executed only when the response signal is not received by the processor. As a result of performing the default function described above, the identification characteristics of the attached shaft assembly are determined, Based on the identification characteristics of the attached shaft assembly and data collected from multiple surgical procedures performed using the same surgical instrument, an unsupervised machine learning algorithm is used to modify the control program of the surgical instrument in order to adjust the functional behavior of the components of the surgical instrument. Based on the past use of the surgical instrument, the control program of the surgical instrument can be modified using an unsupervised machine learning algorithm to adjust the functional behavior of the components of the surgical instrument. Based on evaluations from specific users and hospitals, the control program of the surgical instrument can be modified using an unsupervised machine learning algorithm to adjust the functional behavior of the components of the surgical instrument. To perform this, memory and A surgical instrument equipped with [a specific feature / feature].

2. The surgical instrument according to claim 1, wherein the identification characteristic includes the remaining capacity of the battery of the attached shaft assembly.

3. The surgical instrument according to claim 1, wherein the identification characteristic includes the performance level of the attached shaft assembly.

4. The surgical instrument according to claim 1, wherein the identification characteristics vary depending on the attached shaft assemblies having different capabilities.

5. The surgical instrument according to claim 1, wherein the memory includes a lookup table containing operating parameters corresponding to a specific shaft assembly, the processor uses the received response signal to identify the mounted shaft assembly in the lookup table, and the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.

6. The surgical instrument according to claim 1, wherein the memory further includes program instructions, and when the program instructions are executed, the processor causes the modified control program to be stored in the memory.

7. Surgical instruments, Housing and A shaft assembly interchangeably connected to the aforementioned housing, the shaft assembly including an end effector, Processor and A memory configured to store program instructions, wherein when a program instruction is executed from the memory, the processor... To transmit a call signal to the shaft assembly connected to the housing, Receiving a response signal from the shaft assembly connected to the housing, The default end-effector function is to be executed only when the aforementioned response signal is not recognized. As a result of the implementation of the default end effector function, the identification characteristics of the shaft assembly connected to the housing are determined, Based on the identification characteristics of the shaft assembly connected to the housing and data collected from multiple surgical procedures performed using the same surgical instrument, an unsupervised machine learning algorithm is used to modify the control program of the surgical instrument in order to adjust the functional behavior of the components of the surgical instrument. Based on the past use of the surgical instrument, the control program of the surgical instrument can be modified using an unsupervised machine learning algorithm to adjust the functional behavior of the components of the surgical instrument. Based on evaluations from specific users and hospitals, the control program of the surgical instrument can be modified using an unsupervised machine learning algorithm to adjust the functional behavior of the components of the surgical instrument. To perform this, memory and A surgical instrument equipped with [a specific feature / feature].

8. The surgical instrument according to claim 7, wherein the response signal is not received by the processor when it is not recognized by the processor.

9. The surgical instrument according to claim 7, wherein the identification characteristic includes the remaining capacity of the battery of the shaft assembly connected to the housing.

10. The surgical instrument according to claim 7, wherein the identification characteristic includes the performance level of the shaft assembly connected to the housing.

11. The surgical instrument according to claim 7, wherein the determined characteristics may differ based on the shaft assembly interchangeably connected to the housing.

12. The surgical instrument according to claim 7, wherein the memory includes a lookup table containing operating parameters corresponding to a specific shaft assembly, the processor uses the received response signal to identify the shaft assembly connected to the housing in the lookup table, and the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.

13. The surgical instrument according to claim 7, wherein the memory further includes program instructions, and when the program instructions are executed, the processor causes the modified control program to be stored in the memory.

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